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Background and Aims: In-person yoga interventions have shown feasibility and effectiveness in improving the outcomes of patients with irritable bowel syndrome (IBS), but experiences in virtual yoga interventions have not been examined. This study aimed to explore patients' experiences of a virtually delivered yoga intervention for IBS. Methods: An embedded qualitative substudy was included in a randomized controlled trial examining the feasibility and effectiveness of a virtual yoga program among adult patients with IBS. Semi-structured interviews captured participants' past and current experiences, program satisfaction, perceived impact on IBS symptoms and overall physical and mental health, facilitators and barriers to participation, perceptions of social support and supervised learning, and input on improving future programming. Data were coded and analyzed in duplicate using NVivo 12. An analytic template based on the interview guide was developed and thematic analysis identified themes, as well as the relationship between themes and subthemes. Results: Among the 14 participants (all female, mean age 47.7 years), three major themes were identified: (1) positive experience in the yoga program, (2) incorporating yoga into IBS management post-study, and (3) recommendations for program improvement. Conclusion: Patients with IBS experience in a virtual yoga program was positive with improvements in physical and mental health outcomes. Considering the barriers and facilitators to participating in an online yoga program along with participant recommendations may improve future intervention design and delivery to increase self-efficacy and confidence among patients with IBS. [ABSTRACT FROM AUTHOR]

INTRODUCTION It is estimated that half of the emergency care in Canada is managed in rural, remote or isolated health centres. (1) However, only 20% of the Canadian population is [...], Introduction: Although the interfacility transport (IFT) of critically ill pediatric patients from rural to tertiary health centres may improve outcomes, the impact of IFTs on the rural referring centre is not known. The purpose of this study was to investigate how the IFT of critically ill children affects staffing and functionality of rural emergency departments (EDs) in Manitoba. Methods: In 2015, surveys were emailed to the medical directors of all 15 regional EDs within 2 hours' travel time from a tertiary pediatric hospital. The survey consisted of 9 questions that addressed baseline characteristics of the regional EDs and duration of ED staffing changes or closures due to IFT of critically ill pediatric patients. Results: Ten surveys were received (67% response rate); a regional ED catchment population of about 130 000 people was represented. Interfacility transport caused most EDs (60%, with an average catchment population of 15 000) to close or to alter their staffing to a registered nurse only. These temporary changes lasted a cumulative total of 115 hours. Conclusion: Interfacility transport of critically ill pediatric patients resulted in ED closures and staffing changes in rural Manitoba. These findings suggest that long-term sustainable solutions are required to improve access to emergency care. Introduction : Meme si le transfert entre etablissements (TEE) des patients pediatriques gravement malades des centres de sante ruraux vers des centres tertiaires peut ameliorer les resultats, l'impact du TEE sur les centres ruraux d'origine est inconnu. Le but de cette etude etait d'evaluer dans quelle mesure le TEE des enfants gravement malades affecte la dotation en personnel et la fonctionnalite des services d'urgence ruraux au Manitoba. Methodes : En 2015, des sondages ont ete envoyes par courriel aux directeurs medicaux des 15 services d'urgence regionaux se trouvant a 2 heures de distance ou moins d'un hopital pediatrique de soins tertiaires. Le sondage comportait 9 questions qui portaient sur les caracteristiques de base des services d'urgence regionaux et la duree des changements de leur dotation en personnel ou leur fermeture en raison du TEE des patients pediatriques gravement malades. Resultats : Dix sondages ont ete recus (taux de reponse : 67%); une population d'environ 130 000 personnes desservies par les services d'urgence regionaux se trouvait representee. Le transfert entre etablissements a entraine la fermeture ou la modification de la dotation en personnel ramene a une seule infirmiere dans la plupart des services d'urgence (60%, desservant en moyenne une population de 15 000 personnes). Ces changements temporaires ont eu une duree cumulative de 115 heures. Conclusion : Le transfert entre etablissements des patients pediatriques gravement malades a entraine la fermeture des services d'urgence et des modifications de leur dotation en personnel dans les regions manitobaines rurales. Ces observations donnent a penser que des solutions viables a long terme sont necessaires pour ameliorer l'acces aux soins d'urgence.

Background: Few studies have examined depression after a cancer diagnosis and before initiating adjuvant or neoadjuvant systemic treatments. In this study, we present baseline data on device‐measured physical activity, sedentary behaviour, depression, happiness, and satisfaction with life in newly diagnosed breast cancer survivors. Purpose: To examine associations of accelerometer‐assessed physical activity and sedentary time with depression symptoms and prevalence, happiness, and satisfaction with life. Methods: Shortly after diagnosis, 1425 participants completed depression, happiness, and satisfaction with life measures and wore an ActiGraph® device on their hip to measure physical activity and the activPALTM inclinometer on their thigh for 7 days to measure sedentary time (sitting/lying) and steps (1384 completed both device measures). ActiGraph® data were analysed using a hybrid machine learning method (R Sojourn package, Soj3x), and activPALTM data using activPALTM algorithms (PAL Software version 8). We used linear and logistic regression to examine associations of physical activity and sedentary time with depression symptom severity (0–27) and depression prevalence, happiness (0–100), and satisfaction with life (0–35). For the logistic regression analysis, we compared participants with none‐minimal depression (n = 895) to participants with some depression (that is, mild, moderate, moderately‐severe, or severe depression [n = 530]). Results: Participants reported a mean depression symptom severity score of 4.3 (SD = 4.1), a satisfaction with life score of 25.7 (SD = 7.2), and a happiness score of 70 (SD = 21.8). Higher moderate‐to‐vigorous physical activity (MVPA) was associated with reduced depression symptom severity scores (β = −0.51, 95% CI: −0.87 to −0.14, p = 0.007). A 1 hour increase in MVPA was associated with a reduced odds of at least mild or worse depression by 24% (Odds Ratio [OR] = 0.76, 95% CI: 0.62–0.94, p = 0.012). Higher daily step counts were associated with lower depression symptom severity scores (β = −0.16, 95% CI: −0.24 to −0.10, p < 0.001). Perceptions of happiness was associated with higher MVPA (β = 2.17, 95% CI: 0.17–4.17, p = 0.033). Sedentary time was not associated with depression severity, but higher sedentary time was associated with lower perceptions of happiness (β = −0.80, 95% CI: −1.48 to −0.11, p = 0.023). Conclusions: Higher physical activity was associated with fewer depression symptom severity scores and reduced odds of mild or worse depression in women newly diagnosed with breast cancer. Higher physical activity and daily step counts were also associated with stronger perceptions of happiness and satisfaction with life, respectively. Sedentary time was not associated with depression symptom severity or odds of having depression, but was associated with stronger perceptions of happiness. [ABSTRACT FROM AUTHOR]

Background: Decisions to participate in cancer trials are associated with uncertainty, distress, wanting to help find a cure, the hope for benefit, and altruism. There is a gap in the literature regarding research examining participation in prospective cohort studies. The aim of this study was to examine the experiences of newly diagnosed women with breast cancer participating in the AMBER Study to identify potential strategies to support patients' recruitment, retention, and motivation. Methods: Newly diagnosed breast cancer patients were recruited from the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. Data were collected using semi-structured conversational interviews with 21 participants from February to May 2020. Transcripts were imported into NVivo software for management, organization, and coding. Inductive content analysis was undertaken. Results: Five main concepts associated with recruitment, retention, and motivation to participate were identified. These main concepts included: (1) personal interest in exercise and nutrition; (2) investment in individual results; (3) personal and professional interest in research; (4) burden of assessments; (5) importance of research staff. Conclusions: Breast cancer survivors participating in this prospective cohort study had numerous reasons for participating and these reasons could be considered in future studies to enhance participant recruitment and retention. Improving recruitment and retention in prospective cancer cohort studies could result in more valid and generalizable study findings that could improve the care of cancer survivors. [ABSTRACT FROM AUTHOR]

The article reports that the paradoxical embolism through a patent foramen ovale or other shunts in the heart may be responsible for several percentage of all ischemic strokes, and PFO are more common stroke mechanism than was previously thought.