Identifying policies, financial support and professional regulations for medically necessary hair removal

Hair removal is a necessary pre-surgical procedure prior to performing genital gender-affirming surgeries such as vaginoplasty and phalloplasty. For example, a recent literature review on the topic notes that the use of hairbearing skin in gender-affirming surgical procedures can result in post-operative intra-vaginal and intra-urethral hair growth, which can lead to complications and lower satisfaction with the surgery.

Identifying when, why and how to analyze and learn from deaths in healthcare settings

Each year more than 1,000 children and youth (0-19 years of age) die in Ontario.(1) The Office of the Chief Coroner has consistently investigated between 43-49% of these deaths each year,(1) and many of these investigations offer opportunities to learn from the circumstances of the death, although the extent to which these deaths are the result of modifiable factors (i.e. preventable) is currently unknown. The Office of the Chief Coroner of Ontario (OCC), which requested this rapid synthesis, has significant experience in undertaking death reviews ­ approximately 15% of the deaths of children and youth in Ontario are subject to review by an expert death committee of the OCC, in addition to adult deaths which are also reviewed in certain circumstances. The OCC is evaluating the current approach to reviewing the deaths of children and youth, with the objective of providing high quality death reviews to promote and advance death prevention. The OCC is interested in the experiences of the healthcare system, including hospitals, to inform an approach to analyzing and learning from these deaths. Specifically, the OCC was interested in the circumstances under which hospitals and other care providers conduct reviews of deaths, the criteria used for selection of occurrences, the objectives of reviews, the process undertaken, and the ways in which data, information and recommendations are collected and used.

Developing and refining the methods for a 'one-stop shop' for research evidence about health systems.

BACKGROUND: Policymakers, stakeholders and researchers have not been able to find research evidence about health systems using an easily understood taxonomy of topics, know when they have conducted a comprehensive search of the many types of research evidence relevant to them, or rapidly identify decision-relevant information in their search results. METHODS: To address these gaps, we developed an approach to building a 'one-stop shop' for research evidence about health systems. We developed a taxonomy of health system topics and iteratively refined it by drawing on existing categorization schemes and by using it to categorize progressively larger bundles of research evidence. We identified systematic reviews, systematic review protocols, and review-derived products through searches of Medline, hand searches of several databases indexing systematic reviews, hand searches of journals, and continuous scanning of listservs and websites. We developed an approach to providing 'added value' to existing content (e.g., coding systematic reviews according to the countries in which included studies were conducted) and to expanding the types of evidence eligible for inclusion (e.g., economic evaluations and health system descriptions). Lastly, we developed an approach to continuously updating the online one-stop shop in seven supported languages. RESULTS: The taxonomy is organized by governance, financial, and delivery arrangements and by implementation strategies. The 'one-stop shop', called Health Systems Evidence, contains a comprehensive inventory of evidence briefs, overviews of systematic reviews, systematic reviews, systematic review protocols, registered systematic review titles, economic evaluations and costing studies, health reform descriptions and health system descriptions, and many types of added-value coding. It is continuously updated and new content is regularly translated into Arabic, Chinese, English, French, Portuguese, Russian, and Spanish. CONCLUSIONS: Policymakers and stakeholders can now easily access and use a wide variety of types of research evidence about health systems to inform decision-making and advocacy. Researchers and research funding agencies can use Health Systems Evidence to identify gaps in the current stock of research evidence and domains that could benefit from primary research, systematic reviews, and review overviews.

Comparing multi-component chronic-disease programs to disease-specific programs

The provincial Chronic Disease Prevention and Management Strategy from 2008-12 (and then renewed until 2016) began with a focus on diabetes.(1) The strategy had a stated intention to expand beyond diabetes to a broader chronic-disease management approach. However, to determine whether it would be beneficial to evolve diabetes programs into more generalized chronic-disease prevention and management models, there is a need to review evidence that compares the effectiveness of general chronic-disease programs to disease-specific programs.