CHEO - Publications

Permanent URI for this collectionhttps://hdl.handle.net/10393/22953

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The Role of the Gut-Brain Axis in Mental Illness
(2019) Aldaqqaq, Zizo; Spettigue, Wendy; Norris, Mark; Isserlin, Leanna; Valois, Darcie; Obeid, Nicole
Influence of the timing of initiation of therapeutic hypothermia on brain injury on MRI and outcome in newborns with neonatal encephalopathy
(2017) Philippe, Marissa; Guillot, Mireille; Miller, Elka; Davila, Jorge; Barrowman, Nick; Harrison, Mary Ann; Ben Fadel, Nadia; Redpath, Stephanie; Lemyre, Brigitte
Uncovering cynicism in medical training: a qualitative analysis of medical online discussion forums
(2018) Doja, Asif; Peng, Jenny; Clarkin, Chantalle
Objective The development of cynicism in medicine, defined as a decline in empathy and emotional neutralisation during medical training, is a significant concern for medical educators. We sought to use online medical student discussion groups to provide insight into how cynicism in medicine is perceived, the consequences of cynicism on medical trainee development and potential links between the hidden curriculum and cynicism. Setting Online analysis of discussion topics in Premed101 (Canadian) and Student Doctor Network (American) forums. Participants 511 posts from seven discussion topics were analysed using NVivo 11. Participants in the forums included medical students, residents and practising physicians. Methods Inductive content analysis was used to develop a data-driven coding scheme that evolved throughout the analysis. Measures were taken to ensure the trustworthiness of findings, including duplicate independent coding of a sub-sample of posts and the maintenance of an audit trail. Results Medical students, residents and practising physicians participating in the discussion forums engaged in discourse about cynicism and highlighted themes of the hidden curriculum resulting in cynicism. These included the progression of cynicism over the course of medical training as a coping mechanism; the development of challenging work environments due to factors such as limited support, hierarchical demands and long work hours; and the challenge of initiating change due to the tolerance of unprofessionalism and the highly stressful nature of medicine. Conclusion Our unique study of North American medical discussion posts demonstrates that cynicism develops progressively and is compounded by conflicts between the hidden and formal curriculum. Online discussion groups are a novel resource to provide insight into the culture of medical training.
Neonatal Ethics Teaching Program - Scenario Oriented Learning in Ethics: Announcing the Diagnosis of Trisomy 21
(2018) Boggs, S; Daboval, T; Ben Fadel, N; Moore, G; Ferretti, E
Delivering news to patients and their families can lead to emotionally charged conversations that are difficult for trainees to feel comfortable or effective in. Trisomy 21 (T21), or Down syndrome, is the most common viable chromosomal anomaly. Although prenatal screening exists, over 80% of T21 diagnoses continue to be made postnatally to unsuspecting parents who report a desire for better communication from healthcare professionals when they first receive the news of their child’s diagnosis.16 To better equip trainees to thoughtfully and professionally deliver a diagnosis of T21, we have designed a workshop founded on the principles of Scenario Oriented Learning in Ethics (SOLE) which introduces a framework combining current evidence on communicating life altering news with stated parent preferences. During the workshop, trainees will have the opportunity to practice using the provided communication framework with a standardized patient trained as a new mother. By personally working through a clinical scenario as well as observing workshop colleagues doing the same, participants will gain insight into what is effective as well as ways to troubleshoot encountered pitfalls in a safe and supportive environment. By pre-emptively practicing evidence-based communication, we hope to increase trainee comfort with critical conversations and improve parents’ feelings regarding the quality of communication and support provided while receiving real life T21 diagnoses.
Neonatal Ethics Teaching Program - Scenario Oriented Learning in Ethics: Unexpected Birth Malformation
(2015) Ferretti, E; Moore, G; Rohde, K; Muirhead, P; Daboval, T
Neonatal Ethics Teaching Program – Scenario Oriented Learning in Ethics (SOLE): Unexpected Birth Malformation. SOLE uses standardized patients (SPs) as a teaching tool to impart knowledge on the principal and the 3 key competencies of the Neonatal Ethics Teaching Program that trainees are expected to acquire before completing their Neonatal-Perinatal Medicine (NPM) training at the University of Ottawa. Furthermore, this workshop provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. The goal of this workshop is to help trainees show improvement in their communication skills and demonstrate appropriate application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding their child. Trainees are encouraged to refer to a procedural form that outlines the steps they should follow during a one on one medical encounter and use the SP as a teaching tool. This SOLE is specific to the malformed child scenario where trainees are taught to recognize the typical emotional reactions of parents to an unexpected malformation at birth; describe ways to promote bonding between the parent and child; and learn at least three things parents want from physicians during disclosure of a birth malformation.
Neonatal Ethics Teaching Program - Scenario Oriented Learning in Ethics: Critically Ill Newborn in the NICU
(2015) Moore, G; Ferretti, E; Rohde, K; Muirhead, P; Daboval, T
Neonatal Ethics Teaching Program – Scenario Oriented Learning in Ethics (SOLE): Critically Ill Newborn in the NICU. SOLE uses standardized patients (SPs) as a teaching tool to impart knowledge on the principal and the 3 key competencies of the Neonatal Ethics Teaching Program that trainees are expected to acquire before completing their Neonatal-Perinatal Medicine (NPM) training at the University of Ottawa. Furthermore, this workshop provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. The goal of this workshop is to help trainees show improvement in their communication skills and demonstrate appropriate application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding their child. Trainees are encouraged to refer to a procedural form that outlines the steps they should follow during a one on one medical encounter and use the SP as a teaching tool. This SOLE is specific to the critically ill newborn in the NICU where trainees learn to distinguish the three parent rationales behind the question: “If my baby was yours, what would you do?” and explain the appropriate response to the parent question: “Have you done everything you can for my baby?”
Neonatal Ethics Teaching Program - Scenario Oriented Learning in Ethics: Antenatal Consultation at the Limit of Viability
(2015) Daboval, T; Ferretti, E; Rohde, K; Muirhead, P; Moore, G
Neonatal Ethics Teaching Program – Scenario Oriented Learning in Ethics (SOLE): Antenatal Consultation at the Limit of Viability. SOLE uses standardized patients (SPs) as a teaching tool to impart knowledge on the principal and the 3 key competencies of the Neonatal Ethics Teaching Program that trainees are expected to acquire before completing their Neonatal-Perinatal Medicine (NPM) training at the University of Ottawa. Furthermore, this workshop provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. The goal of this workshop is to help trainees show improvement in their communication skills and demonstrate appropriate application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding their child. Trainees are encouraged to refer to a procedural form that suggests steps to follow during a one on one medical encounter and use the SP as a teaching tool. This SOLE is specific to an antenatal consultation at the limit of viability scenario where trainees are taught to identify areas of potential conflict, explain ways to resolve conflict at the limit of viability, and learn how to facilitate a shared decision making process.
eLearning among Canadian anesthesia residents: a survey of podcast use and content needs
(2013-04-25) Matava, Clyde T; Rosen, Derek; Siu, Eric; Bould, Dylan M
Podcasts are increasingly being used in medical education. In this study, we conducted a survey of Canadian anesthesia residents to better delineate the content needs, format preferences, and usage patterns among anesthesia residents.
Neonatal Ethics Teaching Program - Problem Based Learning in Ethics (PBLE): Antenatal Consultation at the Limit of Viability
(2013-05-02) Daboval, Thierry; Ferretti, Emanuela; Moore, Gregory
A PBLE is a teaching tool that imparts knowledge on some of the competencies of the Neonatal Ethics Teaching Program that the NICU fellows are expected to acquire before completing their Neonatal-Perinatal Medicine training at the University of Ottawa. Furthermore, a PBLE provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. This helps trainees improve their communication skills and application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding either their unborn or born child. Trainees are encouraged to refer to a procedural form that outlines the steps they should follow during a one on one medical encounter and use the standardized patient as a teaching tool. This PBLE is specific to an antenatal consultation at the limit of viability scenario where trainees are taught to identify areas of potential conflict and explain the major ways to resolve conflict at the limit of viability.
Neonatal Ethics Teaching Program - Problem Based Learning in Ethics (PBLE): Critically Ill Newborn in the NICU
(2013-01-07) Moore, Gregory; Ferretti, Emanuela; Daboval, Thierry
A PBLE is a teaching tool that imparts knowledge on some of the competencies of the Neonatal Ethics Teaching Program that the NICU fellows are expected to acquire before completing their Neonatal-Perinatal Medicine training at the University of Ottawa. Furthermore, a PBLE provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. This helps trainees improve their communication skills and application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding either their unborn or born child. Trainees are encouraged to refer to a procedural form that outlines the steps they should follow during a one on one medical encounter and use the standardized patient as a teaching tool. This PBLE is specific to the critically ill newborn in the NICU scenario where trainees are taught to distinguish the three parent rationales behind the question: “If my baby was yours, what would you do?” and explain the appropriate response to the parent question: “Have you done everything you can for my baby?”
Neonatal Ethics Teaching Program - Problem Based Learning in Ethics (PBLE): Unexpected Birth Malformation
(2013) Ferretti, Emanuela; Daboval, Thierry; Moore, Gregory
A PBLE is a teaching tool that imparts knowledge on some of the competencies of the Neonatal Ethics Teaching Program that the NICU fellows are expected to acquire before completing their Neonatal-Perinatal Medicine training at the University of Ottawa. Furthermore, a PBLE provides trainees the opportunity to practice and learn how they would interact with a true patient in a given clinical scenario. This helps trainees improve their communication skills and application of ethical principles when they have to interact with parents in delicate, difficult, and ethically charged situations regarding either their unborn or born child. Trainees are encouraged to refer to a procedural form that outlines the steps they should follow during a one on one medical encounter and use the standardized patient as a teaching tool. This PBLE is specific to the malformed child scenario where trainees are taught to recognize the typical emotional reactions of parents to an unexpected birth malformation; describe ways to promote bonding between the parent and child; and list at least three things parents want from physicians during disclosure of a birth malformation.
Acute exercise increases adiponectin levels in abdominally obese men
(2012-06-28) Saunders, Travis J.; Palombella, Andrew; McGuire, K. Ashlee; Janiszewski, Peter M.; Després, Jean-Pierre; Ross, Robert
Objective. To examine the effect of acute and short-term (~1 week) aerobic exercise training on plasma adiponectin levels in inactive, abdominally obese men. Materials and Methods. Inactive and abdominally obese men (n = 38, waist circumference =102 cm) recruited from Kingston, Canada were randomly allocated to perform three bouts of aerobic treadmill exercise at either low (50% VO2 peak) or high (75% VO2 peak) intensity during a 1-week period. Blood samples were taken before and after the first exercise session and 24–72 hours following the completion of the final exercise session. Results. Adiponectin levels were elevated immediately following an acute bout of exercise at both high and low intensities (High: 5.79±0.42 versus 5.05±0.41 ug/mL; Low: 5.24 ± 0.44 versus 4.37 ± 0.44 ug/mL, P < 0.05) and remained elevated following 30 minutes of rest. In comparison to baseline, adiponectin levels were also elevated 24–72 hours following the final exercise session (High: 5.47 ± 0.48 versus 4.88 ± 0.48 ug/mL; Low: 5.18±0.49 versus 4.47±0.49 ug/mL,P < 0.05). Conclusion. Both acute and short-term aerobic exercise result in a significant increase in plasma adiponectin levels in inactive, abdominally obese men independent of intensity.
Influence of sleeping habits on adaptive thermogenesis during weight loss in adults
(2012-06-28) Chaput, Jean-Philippe; Doyon, Caroline Y.; McNeil, Jessica; Doucet, Éric; Tremblay, Angelo
Objective: To verify whether sleeping habits affect adaptive thermogenesis (i.e. greater than predicted decrease in resting energy expenditure, REE) in overweight and obese adults subjected to caloric restriction. // Methods: A total of 123 overweight and obese men and women (mean ± SD age, 41.1 ± 6.0 years; mean ± SD body mass index, 33.2 ± 3.6 kg/m2) were tested before and 17.2 ± 3.7 weeks after dietary treatment (-300 kcal/day on average). Body fat mass (dual-energy X-ray absorptiometry), REE (indirect calorimetry) and sleep duration and quality (Pittsburgh Sleep Quality Index, PSQI) were assessed at both baseline and at the end of the weight loss program. Two sets of formula were used to predict changes in REE and the difference between the changes in the predicted REE from the reference equations and the changes in the measured REE were compared between sleep duration groups. // Results: The mean weight loss of all participants over the dietary intervention was 5.9 ± 4.6 kg, 73% of which came from fat losses. The small dietary restriction led to a 57 kcal/day reduction in REE at the end of the weight-loss program (P<0.01). Using multivariable linear regression models, none of sleep duration or quality was associated with a greater than predicted decrease in REE. Similarly, adaptive thermogenesis was not significantly different between short- (<6 h/night) and average-duration (7-9 h/night) sleepers and between poor (PSQI score >5) and good (PSQI score = 5) sleepers. // Conclusion: This study provides evidence that sleeping habits are not associated with a greater than predicted decrease in REE during weight loss in adults exposed to small caloric restriction.

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