Browsing by Author "Sidhu, Davinder"

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    Difficulty in Transitioning from Medical Residency to Independent Practice in Pathology
    (2024-04-26) Ayala, Gabriel Eduardo; Naugler, Christopher; Sidhu, Davinder; Ismail, Zahinoor
    Transitioning from residency to medical independent medical practice may be a difficult experience for physicians. In this thesis, I explore this issue amongst Canadian Pathologists through an online survey of 118 practicing pathologists and 11 follow-up in-depth one-on-one interviews. Survey results revealed that only 40% of participants reported that they did not experience difficulty transitioning to independent practice. I used a mixed methods approach to determine themes associated with difficulty transitioning. I then developed a psychological traits profile for pathologists based on the Big 5 psychological traits and looked for differences in psychological profiles between individuals who reported difficulty and those who did not. Only minor differences were observed. The biggest predictor of difficulty transitioning was the Royal College specialty with Anatomic Pathologists experiencing significantly more difficulty than General Pathologists. This difference may relate to increased opportunity for graded responsibility in General Pathology residency training programs. Finally, I explored the way pathology residents perceive different forms of feedback and offered recommendations to residency training programs on ways that feedback could be optimized to best support the transition to independent practice.
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    Immunoglobulin utilization in Canada: a comparative analysis of provincial guidelines and a scoping review of the literature
    (2023-09-16) Harmon, Megan; Riazi, Kiarash; Callum, Jeannie; Arnold, Donald M.; Barty, Rebecca; Sidhu, Davinder; Heddle, Nancy M.; MacLeod, Laurie; Li, Na
    Abstract Background Canada has high immunoglobulin (IG) product utilization, raising concerns about appropriate utilization, cost and risk of shortages. Currently, there is no national set of standardized IG guidelines, and considerable variations exist among the existing provincial guidelines. The aims of this study were: (1) to compare the existing Canadian provincial guidelines on the use of IG products to identify their consistencies and differences and (2) to examine the existing research in Canada on IG supply and utilization following the establishment of IG guidelines to understand the scope of research and pinpoint the gaps. Methods A comparative analysis accounted for the differences across provincial IG guidelines. We highlighted similarities and differences in recommendations for medical conditions. A scoping review of citations from MEDLINE, PubMed, Scopus and Embase databases was conducted for studies published from January 01, 2014, to April 12, 2023. Results While provincial guidelines represented a considerable overlap in the medical conditions delineated and relatively uniform dose calculations, numerous differences were observed, including in recommendation categories, provision of pediatric dosing, and divergent recommendations for identical conditions based on patient demographics. The scoping review identified 29 studies that focused on the use of IG in Canada. The themes of the studies included: IVIG utilization and audits, the switch from IVIG to SCIG, patient satisfaction with IVIG and/or SCIG, the economic impact of self-administered SCIG versus clinically administered IVIG therapy, and the efficacy and cost-effectiveness of alternative medications to IG treatment. Conclusion The differences in guidelines across provinces and the factors influencing IVIG/SCIG use, patient satisfaction, and cost savings are highlighted. Future research may focus on clarifying costs and comparative effectiveness, exploring factors influencing guideline adherence, and evaluating the impact of updated guidelines on IG use and patient outcomes.
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    Incidence and Risk Factors for Hyponatremia in Patients Newly Prescribed Citalopram
    (2019-04-26) Shysh, Andrea Christine; Naugler, Christopher T.; Sidhu, Davinder; Ismail, Zahinoor
    Hyponatremia is a common and under-recognized adverse drug reaction of citalopram. This study aims to determine the incidence of hyponatremia and to identify risk factors in a large, population-based cohort initiating new prescriptions for citalopram. Following approval from the ethics review board, data were obtained from Alberta Information Network databases to identify patients with new citalopram prescriptions from 2010-2017, inclusive. Hyponatremia was defined as serum sodium level <135 mmol/L. Associations were determined by performing Cox regression with time-varying covariate analysis, with the development of hyponatremia as the dependent variable. This is the first large-scale, population-based study to explore risk factors, based solely on laboratory serum data, for the development of hyponatremia in patients initiating citalopram therapy. We report a 16.7% incidence of hyponatremia after starting citalopram treatment and significant risk factors include lower baseline sodium, concurrent thiazide diuretic use, older age, and male sex.