Disposable flexible cystoscopes for removing double J catheter: A budget impact analysis.

Introduction: This study conducts a budget impact analysis to evaluate the cost of removing double J catheters using single-use flexible digital cystoscopes compared to reusable cystoscopes at the CHU de Québec.

Methods: The UETMIS of CHU de Québec estimated average costs per intervention for both reusable and single-use flexible cystoscopes in the endoscopy room. Costs included purchase, repair, reprocessing, and sterilization for reusable cystoscopes based on data from 2017-2019.

Cost-Effective Monitoring of Spruce Budworm Larvae.

The spruce budworm, Clem. (Lepidoptera: Tortricidae), is the most severe defoliator of balsam fir () in eastern Canada and northeast U.S.

Assessment of the economic relevance of the use of single-use digital flexible ureteroscopes A systematic review.

Introduction: Breakages and repairs related to flexible digital reusable ureteroscopes (flURS) are expensive. Thus, we aimed to assess the cost-effectiveness of single-use flexible digital ureteroscopes ureteroscopes (SUFDU).

Methods: We conducted a literature review on MEDLINE and EMBASE until September 19, 2018.

Mass Trapping Lepidopteran Pests with Light Traps, with Focus on Tortricid Forest Pests: What If?

The management of Lepidopteran pests with light traps () is often achieved by luring adults to death at light sources (light trap-based mass trapping, or ). Large-scale programs against agricultural pests initiated in the late 1920s in the United States were phased out in the 1970s, coinciding with the rise of pheromone-based management research. The interest in has surged in recent years with the advent of light emitting diodes, solar power sources, and intelligent design.

Derivation of Pheromone-Based Larval Thresholds in Spruce Budworm Accounting for Distance to Defoliated Forest Stands.

Spruce budworm, Choristoneura fumiferana Clem. (Lepidoptera: Tortricidae), is the most severe defoliator of Pinaceae in Nearctic boreal forests. Three tools widely used to guide large-scale management decisions (year-to-year defoliation maps; density of overwintering second instars [L2]; number of males at pheromone traps) were integrated to derive pheromone-based thresholds corresponding to specific intergenerational transitions in larval densities (L2i → L2i+1), taking into account the novel finding that threshold estimates decline with distance to defoliated forest stands (DIST).

Experiences of Using Cochrane Systematic Reviews by Local HTA Units.

This study evaluated the use of Cochrane systematic reviews (CSRs) by Quebec's local health technology assessment (HTA) units to promote efficiency in hospital decision-making. An online survey was conducted to examine: Characteristics of the HTA units; Knowledge about works and services from the Cochrane Collaboration; Level of satisfaction about the use of CSRs; Facilitating factors and barriers to the implementation of CSRs evidence in a local context; Suggestions to improve the use of CSRs. Data accuracy was checked by 2 independent evaluators.

Variation in Wing Load of Female Spruce Budworms (Lepidoptera: Tortricidae) During the Course of an Outbreak: Evidence for Phenotypic Response to Habitat Deterioration in Collapsing Populations.

Reproduction in female spruce budworms, Choristoneura fumiferana, entails sedentary oviposition early in life (gravid females with their heavy abdomen full of eggs are unable to sustain flight), followed by short- and long-range dispersal by females that have laid a portion of their eggs. Body size measurements (wing surface area and dry weight) of gravid females, spent females at death (after all eggs are laid), and inflight females captured at light traps were collected at one location (forest stands near Fredericton in New Brunswick) over multiple years, from the outbreak stage (1976-1979: peak budworm abundance) to late declining phase with collapsing populations (1988-1989, following near two-fold magnitude of decline in adult density after 1987). For both demographic phases, females rarely flew until having laid at least 40% of their eggs, in contradiction to the hypothesis that females in defoliated forest stands can fly upon emergence due to their light-weight abdomen.

The Introduction of New Non-Drug Health Technologies into Canadian Healthcare Institutions: Opportunities and Challenges.

Introduction: A recent pan-Canadian survey of 48 health organizations concluded that structures, processes, factors and information used to support funding decisions on new non-drug health technologies (NDTs) vary within and across jurisdictions in Canada.

Methods: A self-administered survey was used to determine demographic and financial characteristics of organizations, followed by in-depth interviews with senior leadership of consenting organizations to understand the processes for making funding decisions on NDTs.

Results: Seventy-three and 48 organizations completed self-administered surveys and telephone interviews, respectively (with 45 participating in both ways).

Decision-Making on New Non-Drug Health Technologies by Hospitals and Health Authorities in Canada.

Introduction: Unlike those for publicly funded drugs in Canada, coverage decision-making processes for non-drug health technologies (NDTs) are not well understood.

Objectives: This paper aims to describe existing NDT decision-making processes in different healthcare organizations across Canada.

Methods: A self-administered survey was used to determine demographic and financial characteristics of organizations, followed by in-depth interviews with senior leadership of consenting organizations to understand the processes for making funding decisions on NDTs.

Bivariate Pheromone-based Monitoring of Spruce Budworm Larvae (Lepidoptera: Tortricidae).

A bivariate approach to pheromone-based monitoring is developed for the spruce budworm, Choristoneura fumiferana (Clem.) (Lepidoptera: Tortricidae). The approach uses captures of males at pheromone traps for generation t (♂t) as a transitive term between densities of overwintering larvae in consecutive generations (L2t, L2t+1), based on a large data set including >2,000 observations in the province of Quebec (QC) between the interval 1992 and 2010.

First Report of Mating Disruption With an Aggregation Pheromone: A Case Study With Tetropium fuscum (Coleoptera: Cerambycidae).

Tetropium fuscum (F.), native to Europe and established in Nova Scotia, Canada, since at least 1990, is considered a low-to-moderate threat to spruce (Picea spp.) forests in North America and regulated as a quarantine pest by the Canadian Food Inspection Agency.

EVALUATION OF THE SURGICAL TRAY OPENING PROCEDURE IN OPERATING SUITES: SYSTEMATIC REVIEW AND RECOMMENDATIONS.

Introduction: Optimizing the processes involved in managing operating suite activities is an essential element in obtaining gains in efficiency. The early opening of surgical trays could represent an innovative practice for reducing operating times and wait periods between surgeries as well as for increasing the number of daily surgeries. The purpose of this systematic review is to assess the risks and benefits of introducing this practice in the operating room.

LOCAL HEALTH TECHNOLOGY ASSESSMENT IN CANADA: CURRENT STATE AND NEXT STEPS.

Objectives: Canada has witnessed expansion of the health technology assessment (HTA) infrastructure in the last 25 years. Local HTA entities at the hospital or regional level are emerging to assist decision makers in the acquisition, implementation, maintenance, and disinvestment of healthcare technologies. There is a need to facilitate collaboration and exchange of expertise and knowledge between these entities regarding the role of local HTA in Canada.

Pheromone-Based Monitoring of Spruce Budworm (Lepidoptera: Tortricidae) Larvae in Relation to Trap Position.

The local abundance of male spruce budworm, Choristoneura fumiferana (Clemens) (Lepidoptera: Tortricidae), was evaluated in the province of Quebec at 112 locations between 2002–2012 using pheromone-baited traps deployed on lower branches near the ground level (GL) or in the tree canopy (TC; three traps at GL and TC for each location); in addition, the presence of second instars (L2) was assessed at each location on three balsam fir branches. Numbers of moths captured at GL and TC were highly correlated, and the regression parameters did not vary between years. Consequently, estimates of L2 based on pheromone trap catches are precise independent of trap location, and deploying traps at ground level (rather than in the tree canopy) does not come with a loss of accuracy in L2 assessments.

Size-Dependent Realized Fecundity in Two Lepidopteran Capital Breeders.

Body size is correlated with potential fecundity in capital breeders, but size-dependent functions of realized fecundity may be impacted by reproductive losses due to mating failure or oviposition time limitations (number of eggs remaining in the abdomen of females at death). Post-mortem assessment of adults collected in the field after natural death represents a sound approach to quantify how body size affects realized fecundity. This approach is used here for two Lepidoptera for which replicated field data are available, the spruce budworm Choristoneura fumiferana Clemens (Tortricidae) and bagworm Metisa plana Walker (Psychidae).

A population-based study on blood lead levels in blood donors.

Background: Recent studies suggested that blood transfusion may represent a significant source of lead exposure in premature infants. Objectives of this study were to determine blood lead levels (BLLs) in a representative sample of blood donors and to identify risk factors associated with BLLs of 0.15 µmol/L or more.

FRAMEWORK FOR USER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT THE LOCAL LEVEL: VIEWS OF HEALTH MANAGERS, USER REPRESENTATIVES, AND CLINICIANS.

Objectives: The aim of this study was to explore stakeholders' points of views regarding the applicability and relevance of a framework for user involvement in health technology assessment (HTA) at the local level. We tested this framework in the context of the assessment of alternative measures to restraint and seclusion among hospitalized adults and those living in long-term-care facilities.

Methods: Twenty stakeholders (health managers, user representatives, and clinicians) from seven regions of Quebec participated in a semi-structured interview.

Use of nonsteroidal anti-inflammatory drugs in colorectal surgery: do the risks cast a shadow on the benefits?

Nonsteroidal anti-inflammatory drug (NSAID) use is recognized as a key component of the Enhanced Recovery After Surgery protocols and is systematically recommended in colorectal surgery to optimize perioperative care. However, a red flag about this practice has been raised because clinical studies have recently pointed out an increased risk of anastomotic leak after colorectal surgery following NSAID administration. Therefore, we used the Bradford Hill criteria to examine this potential relationship and concluded that use of perioperative NSAIDs in colorectal surgery should be evaluated carefully and on an individual basis considering the potentially increased risk of anastomotic leak and its consequences.

Specimen plastic containers used to store expressed breast milk in neonatal care units: a case of precautionary principle.

Breast milk is the only milk that meets both the nutritional and immunitary needs of infants. Since breastfeeding is widely promoted, public health measures to preserve the nutritional qualities of expressed breast milk (EBM) should be applied in hospital care settings. The Health Technology Assessment Unit (HTAU) of the Centre hospitalier universitaire de Québec was requested by the Neonatal Care Unit to assess the acceptability of a plastic specimen container, designed to harvest tissues and body fluids, for storing collected EBM.

[Patient participation in the assessment of alternatives to restraint and seclusion].

Aim: To explore the perceptions of members of a working group of caregivers, health technology assessment (HTA) units members, healthcare facilities managers and patients representatives regarding the participation of the latter in the assessment of alternatives to restraint and seclusion among adults in short-term psychiatric wards and in long-term care facilities for the elderly, in Quebec.

Methods: A descriptive design was used for this research based on fifteen semi-structured interviews with caregivers, healthcare managers, patient representatives and HTA unit members. The direct observation of two meetings of the working group and informal discussions with participants at these meetings was also performed.

Involving patient in the early stages of health technology assessment (HTA): a study protocol.

Background: Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them.

Omega-3 long-chain polyunsaturated fatty acids for extremely preterm infants: a systematic review.

Background And Objective: Omega-3 long chain polyunsaturated fatty acid (LCPUFA) exposure can be associated with reduced neonatal morbidities. We systematically review the evidence for the benefits of omega-3 LCPUFAs for reducing neonatal morbidities in extremely preterm infants.

Methods: Data sources were PubMed, Embase, Center for Reviews and Dissemination, and the Cochrane Register of Controlled Trials.

Introducing the patient's perspective in hospital health technology assessment (HTA): the views of HTA producers, hospital managers and patients.

Background: The recent establishment of health technology assessment (HTA) units in University hospitals in the Province of Quebec (Canada) provides a unique opportunity to foster increased participation of patients in decisions regarding health technologies and interventions at the local level. However, little is known about factors that influence whether the patient's perspective is taken into consideration when such decisions are made.

Objective: To explore the practices, perceptions and views of the various HTA stakeholders concerning patient involvement in HTA at the local level.

Evidence for limited spatial spread in an exotic longhorn beetle, Tetropium fuscum (Coleoptera: Cerambycidae).

The longhorn beetle Tetropium fuscum F. (Coleoptera: Cerambycidae) has become established in Nova Scotia, Canada, where it coexists with Tetropium cinnamopterum Kirby. The two Tetropium species share a similar ecological niche and use the same volatile cues for mate attraction.

Involving patients in HTA activities at local level: a study protocol based on the collaboration between researchers and knowledge users.

Background: The literature recognizes a need for greater patient involvement in health technology assessment (HTA), but few studies have been reported, especially at the local level. Following the decentralisation of HTA in Quebec, Canada, the last few years have seen the creation of HTA units in many Quebec university hospital centres. These units represent a unique opportunity for increased patient involvement in HTA at the local level.