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  • 1
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Social inequalities in complications associated with diabetes mellitus persist. As a primary care sensitive condition (PCSC), this association could be related to differential access to primary care. Our objectives are to establish a typology of care trajectories following a new diagnosis, and to explore social determinants of trajectories. Methods We used the TorSaDe (The Care Trajectories-Enriched Data) cohort, which links Canadian Community Health Survey respondents to health administrative data. Care trajectories were mapped over a two-year period following a new diagnosis and analysed using state sequence and clustering methods. Associations between individual and geographic characteristics with trajectory types were assessed with multinomial logistic regression. Results Three trajectories were identified: Regular Family Physician (FP) Predominant, Specialist Physician Predominant, and Few Services. With Regular FP as the reference, males had higher odds of experiencing the Few Services trajectory, higher education was associated with higher odds of both the Few Services and the Specialist trajectories, and immigrants had higher odds of the Specialist trajectory. Diagnoses in a physician’s office, as opposed to in hospital, were associated with higher odds of the Regular FP trajectory. Conclusions The Regular FP trajectory most closely aligns with the management principles of the PCSC approach. We did not find strong evidence of social status privileging access to this trajectory. However, the association with location of diagnosis suggests that efforts to ensure patients diagnosed in hospital are well linked to a regular family physician for follow up may help to reduce unnecessary specialist use and meet PCSC goals.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2050434-2
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  • 2
    In: SSM - Mental Health, Elsevier BV, Vol. 2 ( 2022-12), p. 100124-
    Type of Medium: Online Resource
    ISSN: 2666-5603
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 3099923-6
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  • 3
    In: European Journal of Immunology, Wiley, Vol. 48, No. 2 ( 2018-02), p. 250-257
    Abstract: Viruses, particularly the Epstein‐Barr virus (EBV) has long been suspected to exacerbate acute arthritic symptoms. However, the cell populations that contribute to import viruses into the inflamed tissues remain to be identified. In the present study, we have investigated the role of monocytes in the transport of Murid herpesvirus 68 (MHV‐68), a mouse virus closely related to EBV, using the serum transfer‐induced arthritis (STIA) model. We found compelling evidence that MHV‐68 infection markedly increased disease severity in NR4A1 −/− mice, which are deficient for Ly6C low monocytes. In contrast, the MHV‐68‐induced enhancement of joint inflammation was lessened in CCR2 −/− mice, suggesting the involvement of inflammatory Ly6C high monocytes in viral transport. We also observed that following selective depletion of monocyte subsets by administration of clodronate, MHV‐68 transport into the synovium occurs only in the presence of Ly6C high monocytes. Tracking of adoptively transferred Ly6C high GFP infected monocytes into arthritic CCR2 −/− mice by two‐photon intravital microscopy showed that this monocyte subset has the capacity to deliver viruses to inflamed AR joints, as confirmed by the detection of viral DNA in inflamed tissues of recipient mice. We thus conclude that Ly6C high monocytes import MHV‐68 when they are mobilized to the inflamed arthritic joint.
    Type of Medium: Online Resource
    ISSN: 0014-2980 , 1521-4141
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1491907-2
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  • 4
    In: Experimental Neurology, Elsevier BV, Vol. 301 ( 2018-03), p. 39-49
    Type of Medium: Online Resource
    ISSN: 0014-4886
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 1466932-8
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  • 5
    In: Biological Psychiatry, Elsevier BV, Vol. 91, No. 9 ( 2022-05), p. S173-
    Type of Medium: Online Resource
    ISSN: 0006-3223
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1499907-9
    SSG: 12
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  • 6
    In: The Canadian Journal of Hospital Pharmacy, Canadian Society of Hospital Pharmacists (CSHP), Vol. 72, No. 1 ( 2019-02-26)
    Abstract: ABSTRACTBackground: Drug shortages represent a complex global problem affect-ing patients and health care professionals on a daily basis. Objectives: To identify, describe, and compare drug shortages in health care facilities in Canada and 4 European countries in early 2018.Methods: A descriptive cross-sectional study was conducted in 1 hospital in each of 5 countries: Canada, France, Belgium, Spain, and Switzerland. Over a 4-week period, shortage data were collected daily by each hospital using a standardized grid and a standard process. Results: From January 8 to February 2, 2018, there were a total of 84 shortages (median duration 32 days) in the Canadian hospital, 62 shortages (median duration 9 days) in the French hospital, 46 shortages (median duration 37 days) in the Belgian hospital, 28 shortages (median duration 25 days) in the Spanish hospital, and 98 shortages (median duration 68 days) in the Swiss hospital. The number of manufacturers implicated in the shortages was 28 for the Canadian hospital, 30 for the French hospital, 19 for the Belgian hospital, 16 for the Spanish hospital, and 42 for the Swiss hospital. Most of the shortages involved parenteral drugs, with both innovative and generic manufacturers being affected. Most therapeutic classes were affected by shortages to some extent, with the top 3 classes being anti-infective agents (accounting for 21.1% of shortages overall), central nervous system drugs (11.3%), and cardio-vascular drugs (8.2%).Conclusions: Drug shortages occurred almost daily in all of the study hospitals. Across the 5 hospitals, the frequency of shortages varied by a factor of 3, which may imply similar variability at the national level. All stakeholders should work more diligently to prevent and manage drug shortages.RÉSUMÉContexte : Les pénuries de médicaments représentent un problème mondial complexe qui touche quotidiennement les patients et les professionnels de la santé.Objectifs : Recenser, décrire et comparer les pénuries de médicaments ayant eu lieu au début de 2018 dans des établissements de soins de santé du Canada et de quatre pays d’Europe.Méthodes : Une étude descriptive et transversale a été menée dans un hôpital de chacun des cinq pays suivants : le Canada, la France, la Belgique, l’Espagne et la Suisse. Sur une période de quatre semaines, chaque hôpital a recueilli quotidiennement les données sur les pénuries à l’aide d’une grille et d’un processus normalisés. Résultats : Pour la période allant du 8 janvier au 2 février 2018, on a recensé 84 pénuries (durée médiane de 32 jours) dans l’hôpital canadien, 62 pénuries (durée médiane de 9 jours) dans l’hôpital français, 46 pénuries (durée médiane de 37 jours) dans l’hôpital belge, 28 pénuries (durée médiane de 25 jours) dans l’hôpital espagnol et 98 pénuries (durée médiane de 68 jours) dans l’hôpital suisse. Vingt-huit (28) fabricants étaient impliqués dans les cas de pénuries dans l’hôpital canadien, 30 dans l’hôpital français, 19 dans l’hôpital belge, 16 dans l’hôpital espagnol et 42 dans l’hôpital suisse. La plupart des pénuries touchaient les médicaments parentéraux et mettaient en cause tant les fabricants de médicaments novateurs que ceux de médicaments génériques. Les pénuries ont affecté d’une manière ou d’une autre la plupart des classes de médicaments , mais les trois classes les plus touchées étaient les agents anti-infectieux (21,1 %) les médicaments agissant sur le système nerveux central (11,3 %) et les agents cardiovasculaires (8,2 %).Conclusions : Des pénuries survenaient presque quotidiennement dans chaque hôpital de l’étude. Dans l’ensemble des hôpitaux, la fréquence des pénuries variait selon un facteur de trois, ce qui pourrait se traduire par une variabilité semblable à l’échelle nationale. Toutes les parties prenantes doivent travailler avec plus d’ardeur à la prévention et à la gestion des pénuries de médicaments. 
    Type of Medium: Online Resource
    ISSN: 1920-2903 , 0008-4123
    Language: Unknown
    Publisher: Canadian Society of Hospital Pharmacists (CSHP)
    Publication Date: 2019
    detail.hit.zdb_id: 2107012-X
    SSG: 15,3
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  • 7
    Online Resource
    Online Resource
    Canadian Society of Hospital Pharmacists (CSHP) ; 2019
    In:  The Canadian Journal of Hospital Pharmacy Vol. 72, No. 3 ( 2019-06-25)
    In: The Canadian Journal of Hospital Pharmacy, Canadian Society of Hospital Pharmacists (CSHP), Vol. 72, No. 3 ( 2019-06-25)
    Abstract: ABSTRACTBackground: Pharmacists are required to maintain a secure inventory of medications and to ensure proper, safe, and diversion-free dispensing practices. Objectives: The primary objectives of this study were to determine compliance with recommended practices for the management of controlled substances in a mother–child teaching hospital and to identify actions to improve compliance. The secondary objective was to identify steps in the drug pathway for controlled substances and associated failure modes in the study hospital.Methods: This descriptive cross-sectional study used a framework devel-oped by the California Hospital Association (CHA) to assess compliance with recommended practices for the management of controlled substances in hospitals. For each criterion, a research assistant observed practices within the pharmacy, on patient care units, at outpatient care clinics, and in operating and delivery rooms. The level of compliance was recorded as compliant, partially compliant, or noncompliant. An Ishikawa diagram was developed to illustrate steps in the drug pathway and associated failure modes related to the use of controlled substances in the study hospital. Results: The pathway for controlled substances at the study hospital was compliant for 56 (49.6%) of the 113 CHA criteria, partially compliant for 27 (23.9%) of the criteria, and noncompliant for 24 (21.2%) of the criteria; the remaining 6 (5.3%) criteria were not applicable. This practice evaluation highlighted 22 corrective actions, 12 (55%) that could be implemented in the short term, 8 (36%) suitable for implementation in the medium term, and 2 (9%) suitable for both the short and medium term. A total of 57 potential failure modes related to the use of controlled substances were identified.Conclusions: The pathway for controlled substances at the study hospital was compliant with almost half of the CHA criteria, and 22 corrective actions were identified. Pharmacists, physicians, and nurses should be mobilized to optimize the use of controlled substances throughout the drug-use process.RÉSUMÉContexte: Les pharmaciens sont responsables de maintenir à jour les réserves de médicaments et doivent faire en sorte que les pratiques de distribution soient adéquates, sûres et exemptes de détournement. Objectifs : Les objectifs principaux de la présente étude consistaient à déterminer le degré de conformité aux pratiques de gestion des substances contrôlées, recommandées dans un hôpital universitaire mère-enfant, et de trouver des mesures pour améliorer leur degré de conformité. L’objectif secondaire visait à recenser les étapes que suivent les substances contrôlées dans le circuit des médicaments et les modes de défaillance qui y sont associés dans l’hôpital à l’étude.Méthodes : La présente étude descriptive et transversale s’appuyait sur un cadre mis au point par la California Hospital Association (CHA), qui sert à évaluer le degré de conformité aux recommandations relatives aux pratiques de gestion des substances contrôlées dans les hôpitaux. Pour chaque critère, un assistant de recherche observait les pratiques dans le service de pharmacie, les unités de soins, les cliniques de consultation ex-terne et les salles d’opération ou les salles d’accouchement. Il évaluait le degré de conformité à l’aide d’un des qualificatifs suivants : conforme, partiellement conforme ou non conforme. Un diagramme d’Ishikawa a été conçu pour illustrer les étapes du circuit des médicaments et les modes de défaillance associés à l’utilisation de substances contrôlées dans l’hôpital à l’étude. Résultats : Le circuit des substances contrôlées à l’hôpital où se déroulait l’étude était conforme à 56 (49,6 %) des 113 critères de la CHA, partiellement conforme à 27 (23,9 %) critères et non conforme à 24 (21,2 %) critères; les 6 (5,3 %) critères restants n’étaient pas applicables. Cette évaluation des pratiques a mis en évidence 22 actions correctives, dont 12 (55 %) pouvaient être mises en place à court terme, 8 (36 %) à moyen terme et 2 (9 %) à court ou à moyen terme. Les investigateurs ont repéré 57 modes de défaillance potentiels liés à l’utilisation de substances contrôlées.Conclusions : L’analyse du circuit des substances contrôlées à l’hôpital où se déroulait l’étude a révélé que près de la moitié des critères de la CHA étaient conformes, et 22 actions correctives ont été proposées. Les pharmaciens, médecins et infirmières devraient participer à l’optimisation de l’utilisation des substances contrôlées dans l’ensemble du processus de distribution des médicaments.
    Type of Medium: Online Resource
    ISSN: 1920-2903 , 0008-4123
    Language: Unknown
    Publisher: Canadian Society of Hospital Pharmacists (CSHP)
    Publication Date: 2019
    detail.hit.zdb_id: 2107012-X
    SSG: 15,3
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  • 8
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2007
    In:  Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Vol. 34, No. 1 ( 2007-02), p. 18-29
    In: Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, Cambridge University Press (CUP), Vol. 34, No. 1 ( 2007-02), p. 18-29
    Abstract: Les récepteurs dopaminergiques, exprimés notamment dans les noyaux caudé et putamen du cerveau, sont la cible pharmacologique de plusieurs médicaments employés dans le traitement de maladies neurologiques telle que la maladie de Parkinson. Bien que ces médicaments soient efficaces pour renverser les symptômes cliniques de la maladie, ils sont associés au développement d'effets secondaires incommodants majeurs lorsque utilisés à long terme. L'avancement de la recherche sur la fonction des récepteurs dopaminergiques a mis en lumière plusieurs nouvelles voies de signalisation, dont certaines sont reconnues pour initier la neurodégénérescence. Ainsi, des études récentes ont démontré l'implication des récepteurs dopaminergiques D1 dans la toxicité induite par des niveaux synaptiques élevés de dopamine. Cet article a pour but d'exposer le rôle potentiel d'un dérèglement de la signalisation des récepteurs dopaminergiques dans l'apparition de dysfonctions neuronales, voire même la neurodégénérescence.
    Type of Medium: Online Resource
    ISSN: 0317-1671 , 2057-0155
    RVK:
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2007
    detail.hit.zdb_id: 2577275-2
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2022
    In:  European Journal of Neuroscience Vol. 55, No. 9-10 ( 2022-05), p. 2851-2894
    In: European Journal of Neuroscience, Wiley, Vol. 55, No. 9-10 ( 2022-05), p. 2851-2894
    Abstract: Regulation of emotions is generally associated exclusively with the brain. However, there is evidence that peripheral systems are also involved in mood, stress vulnerability vs. resilience, and emotion‐related memory encoding. Prevalence of stress and mood disorders such as major depression, bipolar disorder, and post‐traumatic stress disorder is increasing in our modern societies. Unfortunately, 30%–50% of individuals respond poorly to currently available treatments highlighting the need to further investigate emotion‐related biology to gain mechanistic insights that could lead to innovative therapies. Here, we provide an overview of inflammation‐related mechanisms involved in mood regulation and stress responses discovered using animal models. If clinical studies are available, we discuss translational value of these findings including limitations. Neuroimmune mechanisms of depression and maladaptive stress responses have been receiving increasing attention, and thus, the first part is centered on inflammation and dysregulation of brain and circulating cytokines in stress and mood disorders. Next, recent studies supporting a role for inflammation‐driven leakiness of the blood–brain and gut barriers in emotion regulation and mood are highlighted. Stress‐induced exacerbated inflammation fragilizes these barriers which become hyperpermeable through loss of integrity and altered biology. At the gut level, this could be associated with dysbiosis, an imbalance in microbial communities, and alteration of the gut–brain axis which is central to production of mood‐related neurotransmitter serotonin. Novel therapeutic approaches such as anti‐inflammatory drugs, the fast‐acting antidepressant ketamine, and probiotics could directly act on the mechanisms described here improving mood disorder‐associated symptomatology. Discovery of biomarkers has been a challenging quest in psychiatry, and we end by listing promising targets worth further investigation.
    Type of Medium: Online Resource
    ISSN: 0953-816X , 1460-9568
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2005178-5
    SSG: 12
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  • 10
    Online Resource
    Online Resource
    Wiley ; 2011
    In:  Synapse Vol. 65, No. 1 ( 2011-01), p. 69-76
    In: Synapse, Wiley, Vol. 65, No. 1 ( 2011-01), p. 69-76
    Abstract: Microtubules are involved in the formation of axons and dendrites, maintenance of neuronal morphology, and cellular trafficking. Recent studies suggest that drugs affecting dopamine activity in the brain can induce cytoskeletal modifications. For instance, we have demonstrated in acute rat brain slices a molecular chain of events connecting dopamine D1 receptor to aberrant phosphorylation of the microtubule‐associated protein tau. However, the molecular and cellular effects of tau phosphorylated by means of the activation of dopamine receptors were unexplored. Here we used SK‐N‐MC cells, which express endogenously functional D1 receptors, to demonstrate that levels of phosphorylated tau at serines 199–202 or 214 are increased by a calcium‐dependent pathway subsequent to D1 receptor stimulation. Using selective pharmacological tools, we showed that enhanced intracellular calcium lead to cyclin‐dependent kinase 5 (cdk5) activation, by calpain proteolysis of p35 to p25, as well as glycogen synthase kinase 3β (GSK3β) activation, by its phosphorylation at tyrosine 216. Interestingly, while the activation of protein kinase A (PKA) led directly to the phosphorylation of tau at serine 214, tau phosphorylation at serines 199–202 was independent of PKA. In addition, inhibition of cdk5 or GSK3β prevented the decrease in cell viability induced by D1 receptor stimulation whereas PKA inhibition had no influence. Our data demonstrate that activation of cdk5 and GSK3β following D1 receptor stimulation could have profound influence on both the neuronal cytoskeletal constituent tau and cell survival in SK‐N‐MC cells. Synapse 65:69–76, 2011. © 2010 Wiley‐Liss, Inc.
    Type of Medium: Online Resource
    ISSN: 0887-4476 , 1098-2396
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 1474927-0
    SSG: 12
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