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"Sadler, Marilyn"
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P.J. Funnybunny's bag of tricks
P.J. studies and practices to perform a magic show for his family and friends but afterwards no one seems to be interested in his tricks, so he shows them the best trick of all.
Book
Let them get on with their lives
Well I know the other side of the coin: Two years of sleepless nights, pacing floors, throwing up, unsure of the future, curfews, non-association with acquaintances, court appearances, huge legal fees and family stress.
Newspaper Article
It's not easy being a bunny
Unhappy being a bunny, P.J. Funnybunny tries living with bears, birds, beavers, pigs, moose, possums, and skunks.
Book
Alistair & the alien invasion
The plant quest part of the disc has the most potential for enjoyment: every new start brings on four different plants to hunt for, and some of the plants are truly beautiful. However, the fun could turn to frustration because of two oversights. The instruction in the CD-ROM fails to tell the player that many of the plants are hidden--that information appears in the guide book only. And Alistair gives no clues along the way, except for making unhelpful statements like \"I would not look there if I were you,\" or \"You are getting frosty.\"
Magazine Article
Honey Bunny's honey bear
Honey Bunny Funnybear wants very much to be friends with the cute bear who sits next to her in school, but he never seems to notice her.
Book
PR095/#215 HPV-associated and HPV-independent vulvar squamous cell carcinoma: is there an impact of resection margins on local recurrence?
IntroductionVulvar Squamous Cell Carcinoma (VSCC) is classified as Human Papilloma Virus Associated (HPV-A) or HPV Independent (HPV-I), with HPV-I VSCC having greater risk of recurrence and poorer survival. Surgical guidelines do not distinguish between the aetiologies and all previous surgical margins publications report the aetiologies together, traditionally recommending a 8 mm pathological margin. This study investigates the impact of resection margins on VSCC first local recurrence stratified by HPV-A and HPV-I subtypes.MethodsA retrospective single centre clinico-pathological case note review of 314 patients treated with primary surgery for VSCC between January 1990 to December 2018. The impact of resection margins on first local recurrence was assessed for HPV-A and HPV-I tumours separately in both univariable and multivariable analyses.ResultsLocal recurrences occurred in 9/143 HPV-A VSCC (6.3%) compared to 45/171 HPV-I VSCC (26.3%). In HPV-A VSCC, resection margins <8 mm compared to >=8 mm were not associated with local recurrence in univariable analysis (HR 0.63, 95% CI 0.17–2.39, p=0.50). Low case numbers prevented multivariable analysis. In HPV-I VSCC, resection margins <8 mm were associated with increased local recurrence compared to >=8 mm in univariable analysis (HR 1.90, 95% CI 1.05–3.44, p=0.03), but this finding was attenuated in the multivariable analysis (HR 1.55, 95% CI 0.79–3.05, p=0.20).Conclusion/ImplicationsIn HPV-I VSCC, there is some evidence that resection margins may impact local recurrence, but further prospective study is needed. Analysis for HPV-A VSCC was limited by the low recurrence rate. HPV testing may be utilised in VSCC management protocols to individualise treatment.
Journal Article
P.J. Funnybunny camps out
Although P.J. and his friends refuse to let Donna and Honey Bunny go camping with them because \"camping is not for girls,\" the girls follow and get proof that camping is hard work even for boys.
Book
The cirrhosis care Alberta (CCAB) protocol: implementing an evidence-based best practice order set for the management of liver cirrhosis - a hybrid type I effectiveness-implementation trial
Liver cirrhosis is a leading cause of morbidity, premature mortality and acute care utilization in patients with digestive disease. In the province of Alberta, hospital readmission rates for patients with cirrhosis are estimated at 44% at 90 days. For hospitalized patients, multiple care gaps exist, the most notable stemming from i) the lack of a structured approach to best practice care for cirrhosis complications, ii) the lack of a structured approach to broader health needs and iii) suboptimal preparation for transition of care into the community. Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial which aims to address these gaps. The proposed intervention is initiated at the time of hospitalization through implementation of a clinical information system embedded electronic order set for delivering evidence-based best practices under real-world conditions. The overarching objective of the CCAB trial is to demonstrate effectiveness and implementation feasibility for use of the order set in routine patient care within eight hospital sites in Alberta.
A mixed methods hybrid type I effectiveness-implementation design will be used to evaluate the effectiveness of the order set intervention. The primary outcome is a reduction in 90-day cumulative length of stay. Implementation outcomes such as reach, adoption, fidelity and maintenance will also be evaluated alongside other patient and service outcomes such as readmission rates, quality of care and cost-effectiveness. This theory-based trial will be guided by Normalization Process Theory, Consolidated Framework on Implementation Research (CFIR) and the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) Framework.
The CCAB project is unique in its breadth, both in the comprehensiveness of the multi-component order set and also for the breadth of its roll-out. Lessons learned will ultimately inform the feasibility and effectiveness of this approach in \"real-world\" conditions as well as adoption and adaptation of these best practices within the rest of Alberta, other provinces in Canada, and beyond.
ClinicalTrials.gov: NCT04149223, November 4, 2019.
Journal Article
Charlie Piechart and the case of the missing dog
\"Watson has to be at Dirty Dog Groomers by 4:15 p.m., but no one can find him! Where could Watson be? Charlie and Lewis search high and low to uncover the mystery of the missing dog. With just 45 minutes left, they find a trail of cookie crumbs and drips of pink nail polish. They even set a pepperoni trap. Will they find Watson in time for his appointment at the groomer's? Only time will tell!\"--Jacket.
Book