[The Development Process of the New Quebec Digital Suicide Prevention Strategy: Suicide.ca]. / Processus d'élaboration de la nouvelle Stratégie québécoise numérique en prévention du suicide : Suicide.ca.

In Quebec, nearly 3 persons still take their own lives every day, even though this number has been declining since 2000. Several institutional and community actors are involved in suicide prevention and several initiatives have contributed to the reduction of suicide rates. Despite this hard work, additional efforts are needed to intensify service offers and resource access to better reach people at risk of suicide not reached by actual services. For many years, several countries have been implementing digital technologies to reach them. In Quebec, there were delays in adoption of digital technologies for suicide prevention. In this context, the Health and Social services Ministry mandated Association québécoise de prévention du suicide (AQPS) to develop a Digital Strategy for Suicide Prevention (DSPS). From the beginning, AQPS wanted to anchor DSPS's development in a decision-making process based on scientific, contextual and experiential evidence. A process, derived from implementation science, was therefore put in place to actualize this intent. Implementation science is defined as the science of implementing programs in real-world settings. It is recognized as contributing to the successful implementation of new programs while promoting a rigorous evaluation of their impacts and outcomes. Objectives This article aims to: 1) present the process that was put in place to facilitate DSPS design, implementation, and evaluation; and 2) describe the DSPS action model and the DSPS. Method The Knowledge to Action (KTA) framework is central to the design, implementation, and evaluation of DSPS. This framework proposes a cyclical process in 7 iterative phases, each with its own methodological aspects and data collections Results The results section illustrates the concrete actions taken at each phase of the KTA process and the highlights that emerge from the analysis of the data collected. This section also presents the DSPS. Conclusion Optimal conditions to promote the implementation of DSPS, its use and its sustainability have been put in place. The current implementation and evaluation of this implementation and its impacts will allow to assess the capacity of DSPS to achieve its main objectives: to provide information about suicide, to identify suicidal individuals, to increase the visibility of resources, and to offer help to suicidal individuals who respond less to traditional resources.

Intermittent bradyarrhythmia in a Hispaniolan Amazon parrot (Amazona ventralis).

A clinically normal 2-year-old Hispaniolan Amazon parrot (Amazona ventralis) was found to have periodic second-degree atrioventricular (AV) block with variable nodal conductions while anesthetized with isoflurane during a thermal-support research project. Arrhythmias were observed on 5 successive weekly electrocardiograms. A complete cardiac evaluation, including a diagnostic electrocardiogram, revealed intermittent bradyarrhythmias ranging from a 2:1 to a 7:1 second-degree AV block, with concurrent hypotensive episodes during the nodal blocks. Results of a complete blood cell count, plasma biochemical profile, blood gas analysis, and atropine-response test, as well as radiography and auscultation, revealed no obvious cause for the arrhythmias. Echocardiography demonstrated cardiac wall thickness, chamber size, and systolic function similar to other psittacine birds. On return to the colony, the parrot continued to be outwardly asymptomatic despite the dramatic conduction disturbances. Although cardiac arrhythmias, including second-degree AV block, have been widely reported in birds, the wide variation of nodal conductions, the intermittent nature, and an arrhythmia with a 7:1 second-degree AV block that spontaneously reverts to normal as seen in this case have not been well documented in parrots.