A retrospective cohort study of liver toxicity in hepatitis B and C HIV co-infected patients in the HIV Ontario Observational Database

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Jejunal atresia, periodic fevers and psoriatic arthropathy in Baraitser-Winter malformation syndrome.

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Healthcare Utilization and Costs in Ventilator Dependent Children and Adults Receiving an eHealth Intervention During the COVID-19 Pandemic

Background: During the COVID-19 pandemic, we implemented The Long-term In Home Ventilator Engagement (LIVE) intervention to provide ‘virtual’ specialist care “Using a matched Home Mechanical Ventilation control group, we compare publicly funded health-service utilization and costs for ventilator dependent children and adults receiving the LIVE eHealth intervention. Methods: LIVE users were matched to controls on age, sex, ventilation type, years on ventilation and reason for ventilation. The Ventilator Equipment Pool database was linked to health administrative data which contains medically necessary healthcare service information on the entire population. We used analysis of covariance and generalized estimating equations to estimate the effect of the LIVE program on healthcare utilization and costs controlling for 12-month prior healthcare utilization. We used Kaplan Meier curves to compare survival rates. Results: Of the 250 LIVE users, we were able to 1:1 match 178 with home mechanical ventilation controls. Adjusted rate ratios for most outcomes resulted in elevated costs and utilization in the post period attributable to LIVE, however most did not reach statistical significance. All cause inpatient admissions (16%), outpatient pulmonology visits (41%) and General Practitioner costs (77%) were significantly elevated in LIVE participants in the post period. There was no statistically significant difference in survival between the groups. Conclusions: LIVE users had higher rates of outpatient respirology visits, inpatient admissions and GP visit costs, but no difference in overall costs or mortality. This study highlights the limitations of evaluating eHealth interventions through observational research and the need for a randomized controlled trial

Attending Nurse Practitioners in Long-Term Care Homes Evaluation

Introduction In 2014, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced funding for 75 nurse practitioners (NPs) over three years in long-term care (LTC) homes. This evaluation was approved by ICES’ Applied Health Research Question (AHRQ) team, a portfolio which answers questions from stakeholders having impact on healthcare policy. Objectives and Approach The purpose of this project is to evaluate the impact of the first thirty NPs hired. Changes will be evaluated using key outcome measures of resident care (e.g., early hospital discharge, emergency room bed days) identified through a literature review conducted by the MOHLTC. LTC home residents were identified using all individuals with claims in OHIP during the 2016-17 fiscal year with a location of a LTC home. LTC homes with a hired NP were considered to be cases and all other LTC homes were considered to be controls. Results For part one of this evaluation, case and control LTC homes were stratified by bed size, Case Mix Index, rurality and Local Health Integration Network. Hospitalization records and emergency visits (from Discharge Abstract Database and National Ambulatory Care Reporting System) were determined for LTCH residents 6 months before and after the NP hire date of October 1, 2016. Overall, the rate of hospital admissions (per 100 residents) increased by 3.44% (8.51% to 11.94%) following the NP hire date; whereas, the rate of hospital admissions increased by 2.29% (6.55% to 8.83%) among controls. Following the NP hire date, the rate of emergency department visits also increased by 3.15% among cases (16.62% to 19.77%) in comparison to a 2.31% increase among controls (12.55% to 14.86%). Conclusion/Implications The findings from this evaluation will inform further implementation strategies of the NP program and guide decision-making of future funding opportunities. In summary, the results will inform policies to strengthen care of LTC homes and improve the quality of care of residents

INNOVATION PROCESS MANAGEMENT OF INDUSTRIAL COMPLEX ENTERPRISES

The relevance of the research subject is defined by the fact that the industrial enterprise management is the main process of business activities. For the purpose of competitiveness improvement the top-management of industrial enterprises constantly improves the management techniques to increase profit, to reduce production costs, to minimize unprofitable parts of production activity. All this requires a research of methodological tools of business process management and a development of new forms of innovation business process management. The goal of the article is to consider the essence and classification of business processes of industrial enterprises carrying out innovative activities, and to develop a management model for innovation business processes of industrial enterprises and their development directions. The main part of the article is devoted to the research of methodological tools for business process management. The article presents the main management methods, the main management forms and the author’s contents of innovative business processes stages at industrial enterprises. Findings of the research are in presenting the structure of innovative business processes at industrial enterprises. The article proposes a model of innovative business processes management at industrial enterprises and a trend for their development. The article materials can be useful for managers of industrial enterprises, business economists and management specialists

The Essence and Contents of Methodological Approaches to Business Processes of Industrial Enterprises Complex Management

The relevance of the problem is determined by the fact that industrial enterprise management is the basic process of its activities. In order to improve its competitiveness top-management of industrial processes, enterprises constantly upgrade management techniques to increase profit, reduce production costs, minimize unprofitable parts of production activity. All this demands research of methodological tools of business processes management. The basic management methods are presented in this article. The goal of this article is to consider the essence and contents of methodological approaches to business processes for industrial enterprises management and to present their classification. This classification depends on their functions. The main part of the article is given to research of methodological tools for business processes management, basic methods are presented. This article reveals the benefits of process management as a factor of quality improvement and creating product value for customers, the benefits of excluding unnecessary procedures in industrial enterprise activity. This article can be useful for industrial enterprise’s SEO, economy and management specialists

A population-based study of the extent of colorectal cancer screening in men with HIV

BACKGROUND: Because of the increased life-expectancy of persons with HIV, the need for age-appropriate colorectal cancer screening among these patients will increase. We examined rates of colorectal cancer screening among HIV-infected men aged 50 to 65 years. METHODS: We used Ontario’s administrative databases to identify all men between the ages of 50 and 65 years who were alive on April 1, 2007, and identified HIV-infected men using a validated case-finding algorithm. We excluded men with a history of colorectal cancer, anal cancer, inflammatory bowel disease and any colorectal investigation in the preceding five-years, and used multivariable regression to compare rates of colorectal cancer screening between men with and without HIV during five years of follow-up. RESULTS: We identified 743,801 men between the ages of 50 and 65 years, of whom 1,432 (0.19%) were HIV-infected. The proportions of men with and without HIV who underwent any screening during the 5-year follow up period were 49.1% (95% CI 46.5% to 51.7%) and 41.4% (95% CI 41.3% to 41.5%), respectively. Compared with HIV-negative men, men with HIV had lower rates of fecal occult blood testing [adjusted rate ratio (aRR) 0.74; 95% confidence interval (CI) 0.63 to 0.87] and barium-enema radiography (aRR 0.66; 95% CI 0.39 to 1.12), but higher rates of colonoscopy (aRR 1.24; 95% CI 1.13 to 1.37), flexible sigmoidoscopy (aRR 1.72; 95% CI 1.28 to 2.30) and rigid sigmoidoscopy (aRR 2.98; 95% CI 2.26 to 3.93). CONCLUSION: As with the general population of men aged 50 to 65 years, less than half of the population of men with HIV received colorectal cancer screening. Strategies are required to improve uptake of this intervention. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0711-9) contains supplementary material, which is available to authorized users

The effect of sodium nitroprusside on the vegetative development of Aronia melanocarpa [Michx.] Elliot under in vitro conditions

Aronia is a berry fruit that has a significant amount of antioxidants. Both sexual and vegetative methods of propagation are available for aronia. Genetic diversity is present in the process of seed propagation. Therefore, clonal propagation techniques such as cuttings, basal shoots, and tissue culture are preferred. Plant tissue culture is a process that offers a high multiplication rate and the ability to produce clean plant material. This study aimed to stimulate the growth of plantlets by introducing several growth-promoting agents into the culture media. Specifically, the effects of a nitric oxide donor SNP (sodium nitroprusside) on the vegetative development of the plants were examined under in vitro conditions. Four distinct concentrations of SNP (0, 100, 200, and 300 µM) were administered to promote vegetative development. The survival rate (%), rooting rate (%), root number (per plantlet), root length (cm), leaf number (per plantlet), shoot length (cm), plant fresh weight (g), and plant dry weight (g) of the plantlets were estimated on the 60th day of growth in the nutrient medium under in vitro conditions. The survival rate was 100% for the applications of SNP at concentrations of 100 µM and 200 µM. The 0 µM treatment had the highest root number, the 100 µM treatment had the longest root, and the 200 µM treatment had the highest values for shoot length. The 0 µM treatment provided the highest values for plant fresh weight, while the 0 and 100 µM applications resulted in the highest plant dry weight values. The study suggested that an increased concentration of SNP causes a toxic effect