Suicide discourse in Canada : analysis and implications for prevention

According to the World Health Organization (WHO, 1999) someone in the world dies by suicide every forty seconds. The age group most likely to opt for suicide at this time is young adults, and among the 105 countries that provided data, suicide is now one of the three leading causes of death for young adults aged 15 to 35. This is a significant change, as it has historically been understood as a greater concern for the elderly population who, until the 1950s, died by suicide in greater numbers than any other age cohort. Among the industrialized countries that provide data to WHO, Canada has me of the highest rates of suicide in the world. The phenomenon of suicide has created controversy, debate, and interest that have resulted in copious amounts of literature being produced from a variety of disciplines. The phenomenon has been moralized, criminalized, and most recently medicalized in attempts to control a behaviour that is deemed unacceptable by ‘civilized countries.’ A Center for Suicide Prevention (SlEC), based in Calgary Alberta, has a database of over 100,000 documents on suicide that can be and are accessed at an average rate of 7,000 requests per month. The subject of suicide has been a personal and professional interest of mine for over two decades. 1 have experienced loss by suicide and was a coordinator for a suicide prevention program in Alberta during the implementation of the Alberta Model that was established by the Boldt Task Force in the early 1980s. Since that time 1 have continued to provide training to the professional community. Additionally, 1 have been a member of several community suicide prevention networks, and 1 have written a program for those bereaved by suicide. 1 have always been intrigued by the apparent reluctance of the political community to commit itself to the amelioration of this phenomenon. The issue in question that continued to present itself was the reluctance for pursuing a more affirmative approach. The analysis that I chose was based on a decision to focus on what these political forces and professional communities are being told vis-à-vis the discourse, in an effort to offer an understanding as to why they respond as they do. The construction of knowledge which is promoted in federal government documents will be analyzed in an effort to expose potential influences and consequences

Enhancing scholarly visibility using an institutional repository as a springboard for scholarly profiles in a multi-hospital health care system

In 2014 Aurora Health Care (AHC) Libraries licensed Digital Commons to act as our Institutional Repository (IR) including supporting am open‐source journal clinical journal. To optimize and integrate the repository’s full functionality AHC librarians explored ways use the Digital Commons to meet institution needs including increasing the visibility of the scholarly activities emerging from our medical education and research programs. In 2016 we licensed SelectedWorks ‐ a module that allows for creation of scholarly profiles and piggybacks off Digital Commons to integrate content with the strong education and research stakeholder support. These groups identified and have now implemented SelectedWorks features to: track scholarly output for education accreditation purposes (ACGME), make department scholarship more visible to internal and external stakeholders, and to track “reach” through mapping features. This presentation will describe the hurdles and benefits we encountered during our initial deployment and continued use of SelectedWorks. Attendees will gain: staffing and financial investment insights and strategies for creating participants’ research profiles. Dave Stout, from Bepress, will present two new services recently provided to our community: Expert Gallery, and Readership Dashboards. These new services present fresh, relevant approaches for our community to proactively look ahead to fill gaps in non‐traditional hospital/health care library services, while adding value to their local community

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

Using quotitive division problems to promote place-value understanding

Using quotitive division problems to promote A robust understanding of place value is essential. Using a problem-based approach set within meaningful contexts, students' attention may be drawn to the multiplicative structure of place value. By using quotitive division problems through a concrete-representational-abstract lesson structure, this study showed a powerful strengthening of Year 3 students' conceptual understanding of place value

Making GME scholarly activity visible on your residency program website using a cloud-based scholarly tool

Introduction/Background GME Programs at independent academic medical centers produce a broad array of scholarly activities consistent with Ernest Boyer’s categories of discovery, integration, application and teaching.[i] These activities reflect a scholarly approach[ii] to those curiosities and activities that occur in our medical centers and are now incorporated in the ACGME’s common program requirements effective July 2019. These new metrics include the traditional PMID publications and grants and now can include posters, workshops, QI presentations, non-peer-reviewed print/electronic resources, and contributions to professional committees and/or educational organizations. Yet residency applicants may worry that our programs do not engage in scholarly activities! Maintaining accurate, up-to-date lists of recent scholarly activity on residency websites can be time consuming and when out of date confirm applicants’ perceptions regarding our scholarly activity. Hypothesis/Aim Statement To utilize a dynamic, cloud-based technology publishing tool, linked to residency program websites, to showcase residency programs’ scholarly activity. Methods Librarians are now the information science experts! Our medical librarians use technology to “quickly conduct research, analyze data, tackle problems, and develop new solutions,”[iii] so we engaged them to help us solve this challenge. We outlined our criteria which included the need: (1) to create scholarly profiles to showcase our traditional and expanded forms of scholarly activities; (2) have flexibility in profiles allowing ones individuals (e.g., faculty with significant activity) or groups (e.g., residents, faculty); (3) link to residency program websites; and (4) export results to facilitate data entry into the ACGME’s accreditation data system (ADS). The librarians identified a dynamic cloud-based application they were already using that appeared to meet our needs.[iv] We piloted the application, beginning with one residency program to determine feasibility and then gradually expanding to our other programs. Results The Family Medicine Residency Program pilot resulted in the creation of individual faculty profiles hyperlinked to on the program’s website faculty listing and a single profile to showcase their residents’ scholarly activity. Profiles were then created for Ob/Gyn individual faculty and resident scholarship and the other programs. As other GME programs were rolled out, each program director had the option to create individual faculty profiles or a single faculty group profile. To date, 14 GME related group profiles have been created and \u3e75 faculty profiles. Program directors report that applicants now reference faculty/resident scholarship and specific profiles in during their interviews. Conclusions Partnering with your librarian to showcase your GME faculty and program scholarship can be a win-win. It brings visibility to your individual faculty, your program, and to your organization. Additional features of the cloud application are being piloted (e.g., faculty development resources) and explored (e.g., world map highlighting downloads) to highlight our GME scholarly activity

Inequitable Impacts of Climate Change on Our Patients | Getting Climate Smart

Introduction/Background: Climate change is impacting our patients’ health now— heatwaves, flooding and storms, wildfires all have adverse effects on patients’ health. For our most vulnerable communities it is a threat multiplier, worsening already prevalent disease states. “Clinicians have a powerful megaphone - and a profound responsibility - to effectively communicate” to their patients the relationship between climate and its effects on their health.[1] The messages need to be consistent and clear across and within professions. Yet, while most clinicians are “concerned” that climate is changing, only a few have knowledge and skills about its specific impacts on health and how to discuss the implications with their patients.[2],[3] Confounding this challenge is that often these knowledgeable individuals are siloed within their own profession with limited time and resources to educate their faculty, peers, and learners. Hypothesis/Aim Statement: To design a core curriculum on climate change impacts on patient health and realistic patient communications strategies to discuss these impacts, accessible by learners across the continuum of health professions with a goal for clinicians to get “climate smart”. Methods: Two graduate medical education (GME) faculty met with continuing education leaders to discuss the need for interprofessional climate change education. The result was the creation of an interprofessional climate change education planning committee. Knowledgeable individuals from medicine, nursing, pharmacy, behavioral science/social work, and system sustainability were invited to explore options for designing CE accredited, clinically actionable climate education that could be accessed by students, residents and practicing clinicians. Competencies from various organizations were shared[4] and committee perspectives were discussed. Between meetings, a core group met to take the committee’s ideas and generate potential session outlines, interactivity options, and presenters for review/discussion at subsequent planning meetings. Results:­ A six-session curriculum was designed, framed by an APHA model on health impacts of climate change.[5] The first session lays the groundwork for why climate change is “in my lane’ as a health care professional. The next four sessions focus on different public and population health implications of climate change (rising temperatures, extreme weather, air quality impacts, vector borne disease) and how these affect and interface with medications, chronic conditions (CV, respiratory, allergies), mental health, and infectious diseases (eg, Lyme, zika, malaria). The final session emphasizes communication strategies with patients. Conclusions: ­Innovation within GME is common yet outreach to continuing education leaders in other professions creates a synergy of expertise and resources to design comprehensive, system wide education that enhances climate-smart expertise and skills among the various clinician groups in health systems. [1] Peters E, Salas RN. Communicating Statistics on the Health Effects of Climate Change. NEJM. 2022;387(3):193-6. [2] Luong KT, et al. Prescription for healing the climate crisis: Insights on how to activate health professionals to advocate for climate and health solutions. J Clim Chang Health. 2021;4 doi: 10.1016/j.joclim.2021.100082. 7 [3] den Boer AC, et al. Discussing climate change and other forms of global environmental change during the clinical encounter: Exploring US physicians’ perspectives. J Clim Chang Health. 2021;4:100058. [4] Global Consortium on Climate and Health Education (GCCHE). Core Climate & Health Competencies for Health Professionals. https://www.publichealth.columbia.edu/sites/default/files/pdf/gcche_competencies.pdf [5] American Public Health Association (APHA). How Climate Change Affects Your Health. Infographic available at: https://www.apha.org/news-and-media/multimedia/infographics/how-climate-change-affects-your-healt

Analysis of microsatellite markers in the genome of the plant pathogen Ceratocystis fimbriata

Ceratocystis fimbriata sensu lato represents a complex of cryptic and commonly plant pathogenic species that are morphologically similar. Species in this complex have been described using morphological characteristics, intersterility tests and phylogenetics. Microsatellite markers have been useful to study the population structure and origin of some species in the complex. In this study we sequenced the genome of C. fimbriata. This provided an opportunity to mine the genome for microsatellites, to develop new microsatellite markers, and map previously developed markers onto the genome. Over 6000 microsatellites were identified in the genome and their abundance and distribution was determined. Ceratocystis fimbriata has a medium level of microsatellite density and slightly smaller genome when compared with other fungi for which similar microsatellite analyses have been performed. This is the first report of a microsatellite analysis conducted on a genome sequence of a fungal species in the order Microascales. Forty-seven microsatellite markers have been published for population genetic studies, of which 35 could be mapped onto the C. fimbriata genome sequence. We developed an additional ten microsatellite markers within putative genes to differentiate between species in the C. fimbriata s.l. complex. These markers were used to distinguish between 12 species in the complex.The National Research Foundation (NRF), the South African Biosystematics Initiative (SABI), members of the Tree Protection Co-Operative Programme (TPCP), and the Department of Science and Technology (DST)/ NRF Centre of Excellence in Tree Health Biotechnology (CTHB), South Africa.http://www.elsevier.com/locate/funbiohj201