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Department of Pediatrics
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Neonatal Intensive Care Unit (NICU)
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  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the impact of a health system-wide fetal fibronectin (fFN) testing programme on the rates of hospital admission for preterm labour (PTL). Multiple baseline time-series design. Canadian province of Ontario. A retrospective population-based cohort of antepartum and delivered obstetrical admissions in all Ontario hospitals between 1 April 2002 and 31 March 2010. International Classification of Diseases codes in a health system-wide hospital administrative database were used to identify the study population and define the outcome measure. An aggregate time series of monthly rates of hospital admissions for PTL was analysed using segmented regression models after aligning the fFN test implementation date for each institution. Rate of obstetrical hospital admission for PTL. Estimated rates of hospital admission for PTL following fFN implementation were lower than predicted had pre-implementation trends prevailed. The reduction in the rate was modest, but statistically significant, when estimated at 12 months following fFN implementation (-0.96 hospital admissions for PTL per 100 preterm births; 95% confidence interval [CI], -1.02 to -0.90, P = 0.04). The statistically significant reduction was sustained at 24 and 36 months following implementation. Using a robust quasi-experimental study design to overcome confounding as a result of underlying secular trends or concurrent interventions, we found evidence of a small but statistically significant reduction in the health system-level rate of hospital admissions for PTL following implementation of fFN testing in a large Canadian province.
    BJOG An International Journal of Obstetrics & Gynaecology 12/2013;
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    ABSTRACT: As pregnant women are considered a high-risk group for severe influenza illness, current recommendations advise vaccination of all pregnant women with inactivated influenza vaccine. Nevertheless, rates of maternal influenza vaccination have historically been low, possibly reflecting ongoing concerns about vaccine safety. Until recently, the majority of evidence concerning safety of influenza vaccination during pregnancy was limited to post-marketing pharmacovigilance studies; however, in the past 5 years, one randomized clinical trial and a number of observational studies reflecting seasonal trivalent inactivated influenza vaccines and monovalent H1N1 influenza vaccines have been published. This review summarizes the evidence pertaining to fetal and neonatal outcomes following influenza vaccination during pregnancy for comparative analytic studies published between 2008 and August 2013. Since the majority of these studies are observational in nature, issues related to study quality are also addressed.
    Expert Review of Vaccines 12/2013; 12(12):1417-30.
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    ABSTRACT: Muscle function can be assessed through jumping mechanography, where portable ground reaction force plates collect dynamic information as a subject jumps. The aim of this study was to assess both intra- and inter- rater reliability of jumping mechanography. Ten healthy adults underwent 3 sets of testing (collected by 3 different raters) at two separate sessions, one week apart. They performed a number of tests in each session: multiple one-legged hopping (M1LH; on right and left legs) and single two-legged jumps (S2LJ; with or without arm swing). The S2LJ assessed variables of power per body mass, jump height, velocity and efficiency; whereas, M1LH assessed maximum force per body mass and stiffness. Inter-rater coefficients of variation (CV) were less than 0.6% and 2.6% for the S2LJ and M1LH, respectively, for the primary outcome variables of power/body mass and force/body mass. Analyzing intra-rater results also produced CVs less than 5.3% for all variables. The present study reports that the Leonardo ground reaction force plate system yields reproducible results between sessions, without significant contribution of variability from the test operator. Jumping mechanography is an easy, safe and reliable method for the assessment of lower limb musculoskeletal function.
    Journal of musculoskeletal & neuronal interactions 12/2013; 13(4):480-6.


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Autoimmunity reviews 03/2012; 11(12):863-72.
Canadian Psychology 01/2008; 49:250-256.

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