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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 24 | Issue 3
Page Nos. 71-96

Online since Wednesday, June 26, 2019

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EDITORIALS / ÉDITORIAUX  

We don't want to think about it p. 71
Peter Hutten-Czapski
DOI:10.4103/CJRM.CJRM_32_19  PMID:31249151
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Nous ne voulons pas y penser p. 72
Peter Hutten-Czapski
DOI:10.4103/1203-7796.261318  PMID:31249152
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President's Message. A rural lens p. 73
Margaret Tromp
DOI:10.4103/CJRM.CJRM_33_19  PMID:31249153
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Message du Président. Une lentille rurale p. 74
Margaret Tromp
DOI:10.4103/1203-7796.261320  PMID:31249154
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ORIGINAL ARTICLES / ARTICLES ORIGINAUX Top

Telepsychiatry and patient–provider concordance p. 75
Nicholas James Schubert, Paul J Backman, Rajiv Bhatla, Kimberly M Corace
DOI:10.4103/CJRM.CJRM_9_18  PMID:31249155
Context: Telepsychiatry has become a common modality for the provision of psychiatric consultations to patients in rural regions. Aims: The aims of this study were to assess and compare patient and provider satisfaction and perceptions of access to care with telepsychiatry. Methods: Telepsychiatric consultations were given by providers based on an urban tertiary academic health centre to patients located in rural primary care clinics. Results: Patients (n = 110) and providers (n = 10) were both highly satisfied with telepsychiatry and both believed that telepsychiatry provided patients with better access to care. Paired patient and provider survey results demonstrated a high level of concordance between patients and provider responses. Conclusions: Concordance between patient and provider satisfaction may contribute to adherence and positive treatment outcomes. These results provide support for the use of telepsychiatry consultations to improve patient access to psychiatric care in rural regions.
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Standardised early warning scores in rural interfacility transfers: A pilot study into their potential as a decision-making aid p. 83
Andrew Stanley, Holly Buhler, Brent Hobbs, Jude Kornelsen, Scott Lamont, Rebecca Kaus, Kari Grant, Stefan Grzybowski
DOI:10.4103/CJRM.CJRM_17_18  PMID:31249156
Introduction: While 12.4% of British Columbians live rurally, only 2.0% of specialists practise rurally, making interfacility transport of high-acuity patients vital. Decision-making aids have been identified as a way to improve the interfacility transfer process. We conducted a pilot study to explore the potential of the Standardised Early Warning Score (SEWS) as a decision-making aid for staff at sending facilities. Methods: SEWSs were calculated from a database of 418 transfers from sending facilities in rural, small and medium population centres to larger receiving facilities. The SEWSs were compared against one another over time using McNemar's and the Wilcoxon signed-ranks tests. The SEWSs were then tested for their association with six outcomes using Pearson's or Fisher's Chi-squared test and the Mann–Whitney U-test. Results: While at the sending facility, both the number of SEWSs that was four or greater and the average SEWS decreased over time (P < 0.001 for both). A first SEWS of four or greater was predictive of more intervention categories during transport (P = 0.047), an adverse event during transport (P = 0.004), an adverse event within 30 min of arrival at the receiving facility (P = 0.004) and death before discharge from the receiving facility (P = 0.043) but not deterioration during transport, or the length of stay at the receiving facility. Conclusion: Overall, the performance of the SEWS in the context of rural interfacility transport suggests that the tool will have utility in supporting decision-making.
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PROCEDURE Top

The occasional allergy skin test p. 92
Peter Hutten-Czapski
DOI:10.4103/CJRM.CJRM_10_19  PMID:31249157
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PODIUM Top

Beyond an admission - Support for an ageing population p. 95
Christopher Patey
DOI:10.4103/CJRM.CJRM_23_18  PMID:31249158
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