Retrospective review of atrial fibrillation in Standardbred racehorses at a tertiary care facility in Atlantic Canada.

Atrial fibrillation (AF) is the most clinically relevant cardiac arrhythmia identified in the Standardbred racehorse. However, there is limited literature regarding athletic ability in Standardbred racehorses following AF conversion. To investigate this issue, the objectives of this review were to: i) determine the success rate in using quinidine sulphate to treat AF in a population of hospitalized equine patients in Atlantic Canada between January 2008 and December 2019; and ii) measure return to athletic ability (using racetrack earnings and top-3 finishes) following cardioversion with quinidine sulphate in a population of Standardbred racehorses. Overall, 73% (16/22) of AF instances in this study were successfully treated with enteral quinidine sulphate. No significant difference was detected in racetrack earnings or number of top-3 finishes for each horse that raced at least 5 times pre- and post-conversion. Key clinical message: To the authors' knowledge, this is the first published review to assess the athletic ability of Standardbred racehorses following cardioversion with enteral quinidine sulphate. Based on the current information, it does not appear that treatment of AF with quinidine sulphate affects future athletic performance in horses that achieved cardioversion.

Examen rétrospectif de la fibrillation auriculaire chez des chevaux de course Standardbred dans un établissement de soins tertiaires au Canada Atlantique. La fibrillation auriculaire (FA) est l'arythmie cardiaque la plus cliniquement pertinente identifiée chez le cheval de course Standardbred. Cependant, il existe peu de littérature concernant la capacité athlétique des chevaux de course Standardbred après la conversion de l'FA. Pour étudier cette question, les objectifs de cette revue étaient de : i) déterminer le taux de réussite de l'utilisation du sulfate de quinidine pour traiter la FA dans une population de patients équins hospitalisés au Canada Atlantique entre janvier 2008 et décembre 2019; et ii) mesurer le retour à la capacité athlétique (en utilisant les gains en hippodrome et les trois premiers résultats) après une cardioversion avec du sulfate de quinidine dans une population de chevaux de course Standardbred. Dans l'ensemble, 73 % (16/22) des cas de FA dans cette étude ont été traités avec succès avec du sulfate de quinidine entérale. Aucune différence significative n'a été détectée dans les revenus de l'hippodrome ou le nombre de classements parmi les trois premiers pour chaque cheval ayant couru au moins cinq fois avant et après la conversion.Message clinique clé :À la connaissance des auteurs, il s'agit de la première revue publiée évaluant la capacité athlétique des chevaux de course Standardbred après une cardioversion avec sulfate de quinidine entérale. Sur la base des informations actuelles, il ne semble pas que le traitement de la FA avec du sulfate de quinidine affecte les performances sportives futures des chevaux ayant cardioversion réussie.(Traduit par Dr Serge Messier).

Musculoskeletal injuries in Standardbred racehorses on Prince Edward Island.

A study of musculoskeletal injuries in Standardbred racehorses on Prince Edward Island was conducted to determine the incidence and risk factors for injury. Monthly information was collected from 10 trainers and 153 Standardbred horses over a 12-month period. Seventeen new injuries were identified in pacers, representing a horse level incidence risk of 23% and an incidence rate of injury of 2.19 per horse-month at risk. Forty-one percent of the injuries occurred during a race, 53% during training and 6% during jogging. Fourteen horses had experienced a previous injury and 3 of these horses experienced a new injury during the study period. Potential risk factors for injury were the speed at which the horse was trained, previous injury, and the conformational fault of offset knees.

Blessures musculosquelettiques chez des chevaux de course Standardbred à l'Île-du-Prince-Édouard. Une étude des blessures musculosquelettiques chez des chevaux de course Standardbred à l'Île-du-Prince-Édouard a été menée pour déterminer l'incidence et les facteurs de risque de blessures. Des informations mensuelles ont été recueillies auprès de 10 entraîneurs et de 153 chevaux Standardbred sur une période de 12 mois. Dix-sept nouvelles blessures ont été identifiées chez les trotteurs, représentant un risque d'incidence au niveau du cheval de 23 % et un taux d'incidence de blessures de 2,19 par cheval-mois à risque. Quarante et un pour cent des blessures sont survenues pendant une course, 53 % pendant l'entraînement et 6 % pendant le jogging. Quatorze chevaux avaient déjà subi une blessure et trois de ces chevaux ont subi une nouvelle blessure au cours de la période d'étude. Les facteurs de risque potentiels de blessure étaient la vitesse à laquelle le cheval a été entraîné, les blessures antérieures et le défaut de conformation des genoux décalés.(Traduit par Dr Serge Messier).

The COVID-19 crisis silver lining: interprofessional education to guide future innovation.

Globally, the advent and rapid spread of the COVID-19 virus has created significant disruption to health professions education and practice, and consequently interprofessional education, leading to a model of learning and practicing where much is unknown. Key questions for this ongoing evolution emerge for the global context leading to reflections on future directions for the interprofessional education field and its role in shaping future practice models. Health professions programs around the world have made a dramatic shift to virtual learning platforms in response to closures of academic institutions and restrictions imposed on learners accessing practice settings. Telemedicine, slow to become established in many countries to date, has also revolutionized practice in the current environment. Within the state of disruption and rapid change is the awareness of a silver lining that provides an opportunity for future growth. Key topics explored in this commentary include reflection on the application of existing competency frameworks, consideration of typology of team structures, reconsideration of theoretical underpinnings, revisiting of core dimensions of education, adaptation of interprofessional education activities, and the role in the future pandemic planning. As an international community of educators and researchers, the authors consider current observations relevant to interprofessional education and practice contexts and suggest a response from scholarship voices across the globe. The current pandemic offers a unique opportunity for educators, practitioners, and researchers to retain what has served interprofessional education and practice well in the past, break from what has not worked as well, and begin to imagine the new.

Compliance with the Code of Practice for the Care and Handling of Equines on 50 horse farms in Prince Edward Island.

The objective of this study was to determine the proportion of horse farms on Prince Edward Island, Canada that comply with the requirements of the Code of Practice for the Care and Handling of Equines (Code). An investigator performed on-farm assessments while administering a questionnaire to owners of 50 horse farms. The percentage of farms in compliance with specific requirements in the Code ranged from 20% to 100% per requirement. The largest areas of non-compliance regarding facilities and housing were the lack of the ability to segregate sick or injured animals and the lack of an emergency action plan. It was determined that 72% of farms were in compliance with body condition scores and 54% reported to have taken corrective action when required. Farm owners who were aware of the Code were more likely to have good quality air in their barns as well as an emergency action plan in place.

L'objectif de la présente étude était de déterminer la proportion de fermes équines sur l'Île-du-Prince-Édouard, Canada qui se conforme aux exigences du Code de pratiques pour les soins et la manipulation des chevaux (Code). Un enquêteur effectua des évaluations à la ferme tout en procédant à un questionnaire auprès des propriétaires de 50 fermes équines. Le pourcentage de fermes en conformité avec des exigences spécifiques du Code variait de 20 % à 100 % selon l'exigence. Les secteurs les plus importants de nonconformité en regard des facilités et de logement étaient l'absence de la capacité à isoler les animaux malades ou blessés et l'absence d'un plan d'action d'urgence. Il fut déterminé que 72 % des fermes étaient en conformité pour les pointages d'état de chair et 54 % rapportèrent d'avoir pris les actions correctives lorsque requises. Les propriétaires de ferme qui étaient au courant du Code étaient plus susceptibles d'avoir un air de bonne qualité dans leurs fermes ainsi qu'un plan d'action d'urgence en place.(Traduit par Dr Serge Messier).

Bedside nurses' roles in discharge collaboration in general internal medicine: Disconnected, disempowered and devalued?

Collaboration among nurses and other healthcare professionals is needed for effective hospital discharge planning. However, interprofessional interactions and practices related to discharge vary within and across hospitals. These interactions are influenced by the ways in which healthcare professionals' roles are being shaped by hospital discharge priorities. This study explored the experience of bedside nurses' interprofessional collaboration in relation to discharge in a general medicine unit. An ethnographic approach was employed to obtain an in-depth insight into the perceptions and practices of nurses and other healthcare professionals regarding collaborative practices around discharge. Sixty-five hours of observations was undertaken, and 23 interviews were conducted with nurses and other healthcare professionals. According to our results, bedside nurses had limited engagement in interprofessional collaboration and discharge planning. This was apparent by bedside nurses' absence from morning rounds, one-way flow of information from rounds to the bedside nurses following rounds, and limited opportunities for interaction with other healthcare professionals and decision-making during the day. The disconnection, disempowerment and devaluing of bedside nurses in patient discharge planning has implications for quality of care and nursing work. Study findings are positioned within previous work on nurse-physician interactions and the current context of nursing care.

A sociological exploration of the tensions related to interprofessional collaboration in acute-care discharge planning.

Patient discharge is a key concern in hospitals, particularly in acute care, given the multifaceted and challenging nature of patients' healthcare needs. Policies on discharge have identified the importance of interprofessional collaboration, yet research has described its limitations in this clinical context. This study aimed to extend our understanding of interprofessional interactions related to discharge in a general internal medicine setting by using sociological theories to illuminate the existence of, and interplay between, structural factors and microlevel practices. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions regarding discharge. Data collection involved observations, interviews, and document analysis. Approximately 65 hours of observations were undertaken, 23 interviews were conducted with healthcare providers, and government and hospital discharge documents were collected. Data were analysed using a directed content approach. The findings indicate the existence of a medically dominated division of healthcare labour in patient discharge with opportunities for some interprofessional negotiations; the role of organizational routines in facilitating and challenging interprofessional negotiations in patient discharge; and tensions in organizational priorities that impact an interprofessional approach to discharge. The findings provide insight into the various levels at which interventions can be targeted to improve interprofessional collaboration in discharge while recognizing the organizational tensions that challenge an interprofessional approach.

A scoping review of interprofessional education within Canadian nursing literature.

The purpose of this scoping review is to examine the nature of the interprofessional education (IPE) discussion that the Canadian nursing profession is having within the Canadian peer-reviewed nursing literature. An electronic database search of CINAHL was conducted using a modified Arksey & O'Malley scoping review framework. Peer-reviewed, English-language articles published in Canadian nursing journals from January 1981 to February 2016 were retrieved. Articles were included if they discussed IPE, or described an educational activity that met our conceptual definition of IPE. A total of 88 articles were screened, and 11 articles were eligible for analysis. Analysis revealed that this body of literature does not seem to be purposefully engaging Canadian nurses in a critical discourse about the role of IPE. The majority of articles located were reflective or commentaries. At the time of this review, there was a paucity of theoretically informed empirical research articles on IPE in the nursing literature. While IPE may be viewed by some critical scholars as a means of shifting the control of healthcare delivery traditionally held by medicine to other professions, our results suggest that this may not be the case in the Canadian nursing profession.

Medical Residents and Interprofessional Interactions in Discharge: An Ethnographic Exploration of Factors That Affect Negotiation.

BACKGROUND: Interprofessional collaboration is an important aspect of patient discharge from a general internal medicine (GIM) unit. However, there has been minimal empirical or theoretical research that has examined interactions that occur between medical residents and other healthcare professionals in the discharge process. This study provides insight into the social processes that shape and characterize such interactions. OBJECTIVE: To explore factors that shape interactions between medical residents and other healthcare professionals in relation to patient discharge, and to examine the opportunities for negotiations about discharge between these professional groups. DESIGN: A qualitative ethnographic approach using observations, interviews and documentary analysis. PARTICIPANTS AND SETTING: Healthcare professionals working in a GIM unit in Canada. APPROACH: Sixty-five hours of observations were undertaken in a range of settings (e.g. interprofessional rounds, medical and nursing rounds, nursing station) in the unit over a 17-month period. A maximum variation sampling approach was used to identify healthcare professionals working in the unit. Twenty-three interviews were completed, recorded and transcribed verbatim. A directed content approach using theories of medical dominance and negotiated order was used to analyze the data. KEY RESULTS: The organization of clinical work in combination with clinical teaching influenced interprofessional interactions and the quality of discharge in this GIM unit. While organizational activities (orientation and rounds) and individual activities (e.g. role modeling, teaching) supported negotiations between medical residents and other healthcare professionals around discharge, participants had varied perspectives about their effectiveness. CONCLUSIONS: This study illuminates social factors and processes that require attention in order to address challenges with interprofessional collaboration and discharge in GIM. These findings have implications for medical education, workplace learning, patient safety and quality improvement.