[Psychoeducational Group Intervention for Parents of Adolescents with an Eating Disorders: Feasibility and Satisfaction]. / Intervention psychoéducative de groupe pour les parents d'adolescents avec un trouble des conduites alimentaires : faisabilité et satisfaction.

Parental involvement is recommended and essential in the treatment of eating disorders in adolescence. This role is certainly difficult to accomplish and requires guidance.Objective This article aims to describe the implementation of a psychoeducational group intervention for parents of teenagers consulting for eating disorders in a regional hospital in the province of Quebec, and the results of a satisfaction survey.Method The intervention is mainly based on the principles of the Maudsley approach. Additional information on physical activity and the disorder maintenance cycle was added. It consisted of 2 meetings of 2 hours, and was offered to 36 parents divided in 5 cohorts. Their level of satisfaction was then assessed.Results The intervention was feasible and parents have expressed overall high satisfaction with the services they received.Conclusion This type of intervention has proven to be feasible, acceptable and valued.

Strategies to promote smoking cessation among adolescents.

In recent years, youth have been exposed to a broader spectrum of tobacco products including smokeless tobacco, hookah (water pipe) and e-cigarettes. Despite active local, provincial/territorial and national prevention strategies and legislated controls, thousands of teenagers develop an addiction to tobacco products each year. Current and available smoking cessation interventions for youth have the potential to help teens stop smoking and, as a result, greatly reduce Canada's health burden in the future. Paediatricians and health care professionals can play a key role in helping teens make informed decisions related to tobacco consumption and cessation. This practice point presents the evidence and rationales for smoking cessation interventions which have been studied in youth specifically, such as individual counselling, psychological support, nicotine replacement therapy, bupropion and varenicline. Interventions for which limited or conflicting data exist are also discussed.

Ces dernières années, les jeunes ont été exposés à un plus large spectre de produits du tabac, y compris le tabac sans fumée, la shisha (pipe à eau) et la vapoteuse (cigarette électronique). Malgré les stratégies actives de prévention et les mesures législatives locales, provinciales, territoriales et fédérales, des milliers d'adolescents développent une dépendance aux produits du tabac chaque année. Les interventions d'abandon du tabac destinées aux adolescents peuvent les aider à arrêter de fumer et, par conséquent, réduire considérablement le fardeau du tabagisme sur la santé au Canada. Les pédiatres et les autres professionnels de la santé peuvent jouer un rôle important pour aider les adolescents à prendre des décisions éclairées sur le tabagisme et l'abandon du tabac. Le présent point de pratique expose les données et les principes relatifs aux interventions d'abandon du tabac qui ont fait l'objet d'études expressément chez les jeunes, telles que les conseils individuels, le soutien psychologique, les substituts nicotiniques, le bupropion et la varénicline. Il traite également d'interventions pour lesquelles les données sont limitées ou contradictoires.

Preventing smoking in children and adolescents: Recommendations for practice and policy.

Canada has witnessed a general decrease in smoking prevalence among all age groups in recent years. However, despite large numbers of campaigns and interventions, thousands of young Canadians continue to initiate cigarette smoking every year. The increasing popularity of alternative tobacco products and e-cigarettes is also creating new health challenges. Research has shown that the deleterious effects of nicotine and cigarette smoke are significant and long lasting. Health care professionals have key responsibilities in preventing tobacco use among youth and their families, and need to know more about effective smoking prevention and cessation strategies. Clinicians need to integrate tobacco counselling into health assessments of teenagers and be aware of the roles that families, communities and governments can play in promoting tobacco-free environments. Information, effective strategies and opportunities for health care professionals to intervene and advocate for Canadian adolescents are discussed.

Ces dernières années, le Canada a connu une diminution générale de la prévalence de tabagisme dans tous les groupes d'âge. Cependant, malgré les multiples campagnes et interventions, des milliers de jeunes Canadiens commencent encore à fumer chaque année. La popularité croissante d'autres produits du tabac et de la cigarette électronique (vapoteuse) engendre d'ailleurs de nouveaux enjeux en matière de santé. D'après les recherches, les effets délétères de la nicotine et de la fumée du tabac sont prononcés et persistants. Les professionnels de la santé ont un rôle essentiel à jouer pour prévenir le tabagisme chez les enfants, les adolescents et leur famille, et ils doivent mieux connaître les stratégies efficaces de prévention du tabagisme et d'abandon du tabac. Les cliniciens doivent intégrer les conseils sur le tabagisme à leur évaluation de santé des jeunes et être conscients du rôle des familles, des communautés et des gouvernements dans la promotion de milieux sans tabac. L'information que les professionnels de la santé doivent connaître, les stratégies efficaces qu'ils peuvent utiliser et les occasions d'intervenir et de défendre les intérêts des adolescents canadiens qu'ils peuvent saisir sont présentées.

Clinician perspectives on protocols designed to minimize sedation.

PURPOSE: Within a multicenter randomized trial comparing protocolized sedation with protocolized sedation plus daily interruption (DI), we sought perspectives of intensive care unit (ICU) clinicians regarding each strategy. METHODS: At 5 ICUs, we administered a questionnaire daily to nurses and physicians, asking whether they liked using the assigned strategy, reasons for their responses, and concerns regarding DI. RESULTS: A total of 301 questionnaires were completed, for 31 patients (15 protocol only and 16 DI); 117 (59 physicians and 58 nurses) were the first questionnaire completed by that health care provider for that patient and were included in analyses. Most respondents liked using the assigned strategy (81% protocol only and 81% DI); more physicians than nurses liked DI (100% vs 61%; P < .001). Most common reasons for liking the assigned sedation strategy were better neurologic assessment (70% DI), ease of use (58% protocol only), and improved patient outcomes (51% protocol only and 44% DI). Only 19% of clinicians disliked the assigned sedation strategy (equal numbers for protocol only and DI). Respondents' concerns during DI were respiratory compromise (61%), pain (48%), agitation (45%), and device removal (26%). More questionnaires from nurses than physicians expressed concerns about DI. CONCLUSIONS: Most respondents liked both sedation strategies. Nurses and physicians had different preferences and rationales for liking or disliking each strategy.

Research ethics board approval for an international thromboprophylaxis trial.

BACKGROUND: Research ethics board (REB) review of scientific protocols is essential, ensuring participants' dignity, safety, and rights. The objectives of this study were to examine the time from submission to approval, to analyze predictors of approval time, and to describe the scope of conditions from REBs evaluating an international thromboprophylaxis trial. METHODS: We generated survey items through literature review and investigators' discussions, creating 4 domains: respondent and institutional demographics, the REB application process, and alternate consent models. We conducted a document analysis that involved duplicate assessment of themes from REB critique of the protocol and informed consent forms (ICF). RESULTS: Approval was granted from 65 REB institutions, requiring 58 unique applications. We analyzed 44 (75.9%) of 58 documents and surveys. Survey respondents completing the applications had 8 (5-12) years of experience; 77% completed 4 or more REB applications in previous 5 years. Critical care personnel were represented on 54% of REBs. The time to approval was a median (interquartile range) of 75 (42, 150) days, taking longer for sites with national research consortium membership (89.1 vs 31.0 days, P = .03). Document analysis of the application process and ICF yielded 5 themes: methodology, data management, consent procedures, cataloguing, and miscellaneous. Protocol-specific themes focused on trial implementation, external critiques, and budget. The only theme specific to the ICF was risks and benefits. The most frequent comments on the protocol and ICF were about methodology and miscellaneous issues; ICF comments also addressed study risks and benefits. CONCLUSIONS: More studies on methods to enhance efficiency and consistency of the REB approval processes for clinical trials are needed while still maintaining high ethical standards.