Fraser Health

Introduction Bien que la prescription sociale constitue un courant de plus en plus important en faveur de la santé globale et de la société, aucune étude Delphi n’a déterminé quels résultats sont essentiels à évaluer. Notre objectif était de faire émerger un ensemble de résultats fondamentaux en fonction des commentaires de divers groupes d’utilisateurs susceptibles d’être concernés par la prescription sociale (aînés de 60 ans et plus) ou de personnes pouvant avoir une influence sur elle (comme les fournisseurs ou les chercheurs). Méthodologie Conformément aux lignes directrices normalisées pour les études Delphi, nous avons élaboré une enquête en ligne à deux cycles en ciblant les perspectives canadiennes. Nous avons demandé aux participants d’évaluer 21 résultats comme « cruciaux » (7 à 9 sur une échelle de 9 points), « importants mais non cruciaux » (4 à 6 points) ou « sans importance » (1 à 3 points). Nous présentons une description du sous-groupe de résultats obtenus du point de vue des aînés et de leurs familles et amis. Résultats Le premier cycle a été complété par 74 personnes relevant de 10 groupes d’utilisateurs et le second par 52 personnes relevant de 8 groupes d’utilisateurs (taux de rétention de 70 %). Les évaluations entre les cycles ont été généralement uniformes. Sept résultats ont atteint le seuil de résultat « crucial ». Aucun résultat n’a été exclu. Les résultats cruciaux portaient sur la santé mentale, le fonctionnement physique et social et le bien-être. Les participants ont formulé des commentaires sur les facteurs contextuels (ressources, prestation de soins, etc.) et les facteurs liés à l’équité Conclusion Cette étude a permis de faire émerger sept résultats cruciaux à prendre en compte dans les évaluations en matière de recherche et d’interventions portant sur la prescription sociale. Les recherches futures devraient porter sur la manière dont les facteurs contextuels et personnels ont une influence sur les résultats et elles devraient définir des outils précis (questionnaires, tests axés sur le rendement) pour évaluer chaque résultat. Définir quels résultats sont importants est un processus continu qui nécessite des mises à jour régulières dans la mesure où ces résultats sont susceptibles de changer en fonction de l’évolution de la prescription sociale et d’autres facteurs.

Plain Language Summary TitleCitalopram vs. Escitalopram for major depression: No Real Difference in Efficacy or Safety, Just Higher Cost.

Ethical conflicts (ECs) are an inseparable part of nursing care, particularly home care (HC). Nurses’ inability to effectively manage ECs may lead to occupational stress, job burnout, and low patient care quality. Despite various studies on ECs, there is limited research regarding the process of nurses’ confrontation with them in HC settings. This study aimed to explore the process of nurses’ confrontation with ECs in HC. This qualitative study was conducted from February 2023 to August 2025 using Corbin and Strauss’s approach to grounded theory. Twenty-two unstructured and semi-structured interviews were held with sixteen nurses recruited through purposeful and theoretical sampling from HC centers in Tehran, Iran. Data were analyzed using Corbin and Strauss’s approach to grounded theory. The main concern of participants was fear of harming patients, and their four strategies to manage it were expedient thinking, persuading, self-justifying, and disclosing. They used these strategies to balance the interests of all parties involved in the EC situation, including patients, families, colleagues, and HC center authorities. Therefore, the core category of the theory formulated in this study was “Balancing the interests”. Nurses’ confrontation with ECs in HC is a complex process influenced by a variety of contextual factors. Study findings can be used to develop purposeful educational and supportive programs for improving nurses’ ethical decision-making.

Abstract Background Laboratory tests are increasingly important for diagnosing multiple sclerosis (MS). Cerebrospinal fluid (CSF) laboratory testing, including detection of CSF oligoclonal bands (OCB), aids in the diagnosis of MS but significant variability in reporting practices across Canadian clinical laboratories has been shown. To address this issue, the Harmonized CSF Analysis for MS Investigation (hCAMI) subcommittee of the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group was formed. Methods The hCAMI subcommittee, comprised of clinical chemists and neurologists, identified key areas of CSF laboratory testing for MS investigation that require harmonization and formulated specific questions for targeted recommendations. The subcommittee comprehensively reviewed the literature, surveyed clinical chemists regarding current practices and neurologists on reporting preferences, and conducted studies to answer these questions. Recommendation statements were drafted and will undergo the Delphi process for refinement to ultimately generate evidence-based consensus statements. Results Six key areas for harmonization were identified: (1) quality control practices, (2) timing considerations for matched CSF and serum sample collection, (3) reporting protocols for band counts, (4) interpretation and follow-up for other patterns (i.e., monoclonal gammopathy, inflammatory response), (5) handling of matched band intensity variations, and (6) defining panel components and reference intervals/decision limits. Literature and data were reviewed for each key area. Draft recommendations were developed and will undergo iterative refinement via the Delphi process. Conclusion Harmonized laboratory reporting recommendations will lead to consistency and alignment of CSF laboratory testing for diagnosis of MS across Canada. This subcommittee’s efforts will promote evidence-based standardized reporting practices to improve diagnostic accuracy and patient care.

Life participation has been identified as a critically important core outcome to be reported in all trials in people receiving peritoneal dialysis (PD). Life participation is defined as the ability to participate in meaningful activities such as work (e.g. employment, housework, study), family, social (e.g. time with friends) and leisure (travel, hobbies, exercise) activities. However, life participation is rarely and inconsistently reported in trials in PD. The standardised outcomes in nephrology-life participation (SONG-LP) instrument was validated in adult kidney transplant recipients and demonstrated internal consistency and test-retest reliability. In this article, we outline the rationale and process for validating the SONG-LP instrument in people receiving PD.

Background/Objectives: In 2017, the Canadian Government updated labeling requirements for prepackaged products to include potassium as a mandatory nutrient. Higher potassium intakes are beneficial in the general population, but for those with hyperkalemia, a lower potassium intake is recommended. Methods: The Canadian Food Inspection Agency (CFIA) collects food products and analyzes them to determine their potassium content. The authors requested data collected by the CFIA between January 2005 and November 2023 through an Access to Information request (A-2023-00410). Paired-sample two-sided t-tests were used to compare the difference between the labeled and analyzed potassium contents. Cohen’s Kappa was also used to assess agreement between values. Results: Data were available for 406 food items, with 376 having a labeled and analyzed potassium value. The number of samples within each product type was not equally spread; 60% of samples (243/405) were considered dairy analogs—comprising either plant-based milk or cheese products. The mean difference between analyzed and labeled potassium content was statistically significant at 15 mg per serving (SD, 68 mg; 95% CI, 8–22 mg; p < 0.001). Cohen’s Kappa suggested moderate agreement between labeled and analyzed values (κ = 0.376; 95% CI, 0.305–0.447; p < 0.001). A total of 271 (69.7%) products exceeded a ±10% difference, with 90 (23.9%) over-reporting potassium and 181 (48.1%) under-reporting potassium. Conclusions: The total number of products that were compliance-tested for potassium in Canada was relatively low and skewed disproportionately toward plant-based dairy analogs. Most products had labeled potassium values that differed from the lab-analyzed values, with a greater tendency to under-report vs. over-report potassium content. This suggests that at least some labels may not be accurate enough to correctly identify high-potassium foods for those who are following a low-potassium diet.

<h3>Background</h3> The ACP-international society is in the process of conducting a global ACP consensus driven definition and the structural elements necessary for advance care planning through a Delphi process. Prior to this, two international ACP definitions were published for adults (2017), one for persons with dementia (2023) and one for Asia societies (2024). Those contributed significantly to our understanding of ACP however lacked global inclusion, various population group (e.g. minors) and required structural elements for ACP programs. <h3>Aim/Purpose</h3> Building upon the global Delphi process results, this focus group workshop will further contribute to the global understanding of an ACP and required design elements. <h3>Objectives</h3> Participants will be asked to identify, articulate and discuss what regional specifics, population groups and structural elements are not included in the current ACP definitions. Participants will contribute to a global, inclusive and comprehensive ACP definition and required structural elements. <h3>Audience</h3> This workshop is intended for consumers and ACP experts (practitioners, research and science, policy making) with heterogeneous professional, local and cultural backgrounds. There should be a willingness for the discussions to be audio-recorded and transcribed. Consent will be asked for in the workshop. No min./max. number of attendees. <h3>Structure/Format</h3> Through storytelling and case studies, participants will be provided the opportunity to learn about unintended excluded populations and overlooked structural elements of current ACP. Participants will actively collaborate in small group discussions with an aim to include diversity, culture and inclusion throughout ACP definitions and structural elements. Standardize questions will be posed, followed by facilitated discussion with a goal to be curious and learn from the diversity of participants lived experiences and expertise. <h3>Uniqueness</h3> Participants in this workshop will have a unique opportunity to contribute to a global consensus driven definition of ACP and required design elements through in-person dialogue. Following the evaluation of the on-line Dephi process, this qualitative focus group method provides further exploration into how ACP has expanded and evolved at a micro, meso and macro levels. <h3>Implications</h3> The previous ACP Delphi studies provided us a step towards unifying select countries consensus definition and practice recommendations. A globally shared consensus-based definition will support consistent application within multidisciplinary clinical practice, organizational policies, research, and the law. This work will significantly impact how ACP is understood, practiced and conveyed to persons and those important to them as they go through their health journey within the broader health systems.

IntroductionWe previously presented a paper on new processes and documents implemented for our library's systematic review service at the annual CHLA conference in 2023. A task force of health sciences librarians had aimed to formalize our systematic review service to make it more standard, transparent, and to cut down on zombie (uncompleted) reviews. Now that we are two years into using the new procedures and forms, we have decided to assess the model.Methods/Description/Discussion:We will share feedback on use of the new intake form, MOU document, and protocol template that were developed and we'll discuss the edits to the forms and procedures we are considering based on this feedback. We will also review our positive and negative experiences using a project management software program to store and share data from our knowledge synthesis projects. Future plans for analyzing quantitative data and obtaining patron feedback will also be discussed.