Select Practice Challenges for 2024
Notice bibliographique
Résumé
Facing a new year, the contributions of our authors reflect their current practice preoccupations. There is no doubt that for our physicians, the top of their list is the management of the opioid epidemic. This issue includes several attempts at answering these questions confronting our colleagues. Bakouni et al compare the effectiveness of buprenorphine/naloxone (BUP/NX) versus methadone for withdrawal symptoms using data from OPTIMA, a pan-Canadian randomized controlled trial. Methadone is associated with decreased withdrawal symptoms earlier during treatment compared to BUP/NX, particularly in cases involving fentanyl. Just like opioid overdoses often occur with combined opioids, Srivastava and Kahan report on the possible benefit of combining slow-release oral morphine with methadone maintenance treatment for long-term opioid agonist maintenance. Newborns exposed to opioids in utero experience withdrawal syndrome traditionally managed in a neonatal intensive care unit (NICU) for continuous cardio-respiratory monitoring. Patricelli et al, in a 5-year retrospective chart review at the BC Women’s Hospital, report that with the administration of a morphine oral solution, the monitoring in NICU may not be necessary, promoting instead a cost-effective rooming-in model of care. Digital health resources for substance use to support females according to gender and trauma-informed care principles are rated for conformity by Quilty et al. The rating process for 23 such digital resources available in Canada elicits that these resources identify some features of trauma-informed care and few features of gender-informed care. More features of social determinants to be included in these digital resources are recommended. A major recent public health initiative has been the promotion of the administration of naloxone by peers. From a literature review, Dlugos et al analyze 27 studies reporting on promising evidence for this strategy to reduce the risk of opioid overdoses. More prospective and controlled studies are warranted. This set of opioid-related articles has the common goal of expanding the range and specificity of opioid management options available to our practitioners. In the last article, addressing smoking as another major public health concern, Dahal et al report on data from a Canadian health survey, including a sample of 640 women who smoked regularly within 3 months before knowing of the pregnancy. The outcome variables are dichotomized as cessation or continuation of smoking during pregnancy, along with the availability of the regular care of a family physician. Overall, 26.5% of regular smokers before pregnancy quit smoking during pregnancy. This proportion was lower in the presence of second-hand smoke (14.3%) and higher in the presence of a regular family physician (29.9%). We hope that these articles facilitate decision-making during the course of our practices. Nady el-Guebaly CM, MD, FRCPC Editor-in-Chief, CJA
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».