Qui sommes-nous?
Knowledge Users
Julien Clément, MD, FRCSC
President of the Trauma Care Continuum Assessment Team (TCCAT) at the Institut national d’excellence en services de la santé et services sociaux (INESSS) and Trauma Program Director, CHU de Québec, Québec
The mandate of TCCAT is to strengthen the trauma network and promote best practices in Quebec’s trauma system. To accomplish this task, TCCAT develops up-to-date reminders (clinical protocols and best practice guidelines), produces clinical practice guidelines, and works with Quebec’s Ministry of Health and Social Services to disseminate and implement these guidelines. It operates a website for these purposes (http://fecst.inesss.qc.ca) that keeps clinicians up-to-date on scientifically recognized standards of practice.
A graduate of the University of Sherbrooke in 2002, Dr. Clement completed a Fellowship in Thoracic Surgery as well as a trauma fellowship at the University of British Columbia in Vancouver. Very committed, has was also deployed to Afghanistan as a military surgeon three times in recent years and was recently appointed Medical Director of the Trauma Program of the University Hospital of Quebec Hospital Child Jesus.
President Fondation NeuroTrauma Marie-Robert
Marie Robert (LL.B.) is head of an influential foundation that funds research in neurotrauma (http://goo.gl/PIrcw). She is an active patient advocate and is also the survivor of a severe car crash in 1991. This accident caused her multiple injuries, including a severe traumatic brain injury. She will be asked to present her views as a patient advocate and CEO of this important foundation. Her experience as a patient will be essential to our meeting and will help us focus on the needs of trauma victims in recovery. Her insights will help us explore how patients and their caregivers could be involved in the co-creation of knowledge tools that meet patients' needs.
Marie Robert, LL. B.
President of the Trauma Association of Canada, Professor of Surgery & Critical Care Medicine, University of Toronto Trauma Program Director, St Michael's Hospital, Ontario, Canada He will represent Canadian trauma centers and will be an essential partner to help us develop a community of Canadian trauma centers involved in co-creating and sharing best practice trauma protocols using a wiki-based reminder system. His leadership as president of the Trauma Association of Canada and expertise as a trauma surgeon will be a key factor in our success.
Sandro Rizoli, MD, FRCPC
Nathalie LarocheDirector of the Association des TCC des Deux Rives, Quebec, Canada Nathalie Laroche is the director of a local patient-support organization in the Quebec City area (http://goo.gl/BBVB2). This community-based organization offers support to patients recovering from traumatic brain injury. The participation of this organization will offer an important community perspective on the resources traumatic brain injury victims need and on how to involve patients as partners in the co-development and local adaptation of wiki-based reminders and knowledge tools (e.g. patient handouts and decision aids) that match their needs.
Guy Béland, MD, CCFPC, FCFPCDirector of the Department of Family Medicine and Emergency Medicine, Université Laval, Québec, Canada As director of the department of family medicine and emergency medicine, Guy Béland oversees the training programs in Family Medicine and Emergency Medicine. The training of future physicians in the use of new innovative communication technologies is part of his mandate. His department is interested in exploring how wikis could help support professional development and improve the quality of practice among members of his department and university network. Université Laval's network of primary care and emergency medicine clinicians spans across a large part of eastern part of Quebec and includes many centers in remote areas that would clearly benefit from easy access to a free and open evidence-based source. Primary care physicians provide much of the trauma care in these centers. These clinicians would greatly benefit using best practice protocols developed by a community of trauma experts across Canada.
Stéphane Panic, MD, FRCSC, FACS
Local trauma committee president, Hôpital Sacré-Cœur de Montréal; Service de Chirugie Générale & Traumatologie
Dr. Panic trained in General Surgery at the University of Montreal and trained as a trauma surgeon at the Hartford Hospital, University of Connecticut, Hartford, CT. He is a trauma surgeon since 1994 at Hôpital Sacré-Cœur de Montréal. He is also Assistant Clinical Professor of surgery at the University of Montreal. He is the local Trauma Committee President at the Hôpital Sacré-Cœur de Montréal and he oversees the quality of trauma care. Finally, he is a trauma surgeon for the Formula 1 Grand Prix of Canada.
Mélanie Bérubé, APN, MScN
Advanced Practice Nurse, Trauma and Orthopaedics, Hôpital du Sacré-Coeur PhD Student, Ingram School of Nursing, McGill University
Melanie Berube is an advanced practice nurse in trauma and orthopaedics since 2011 at the Hopital du Sacré-Coeur, Montréal, Canada. She has been a clinical nurse specialist in trauma and critical care fields for 10 years before occupying this position. Miss Berube completed a post-masters acute care nurse practitioner diploma at the University of Toronto in 2009 and a master’s degree at the University of Montreal in 2001. She is currently pursuing doctoral studies at the Ingram School of Nursing - McGill University. Her research interests are to develop and evaluate nursing interventions in acute care settings and in the trauma to rapidly address symptoms, such as pain, for the prevention of adverse events and optimization of patients’ recovery.
Principal investigator
Chief, Division of Trauma Surgery, McGill University Health Centre, Assistant Professor of Surgery, Associate, Critical Care Medicine, Co-director: MUHC Centre for Global Surgery
Dr. Tarek Razek is trauma/general surgeon and intensivist who is the current Director of the Adult Trauma Program at the McGill University Health Centre (MUHC). He is a co-director of the Centre for Global Surgery at the MUHC. He actively participates in the surgical development programs in Dar es Salaam, Tanzania and Kigali, Rwanda. Dr. Razek is the current Chair of the Canadian Network for International Surgery (CNIS) board of directors. His work with this organization involves developing surgical capacity (trauma, emergency surgery and obstetric skills) with comprehensive educational programs, developing injury control centres and injury databases. This work involves teaching courses such as the Trauma Team Training (TTT™), the Essential Surgical Skills (ESS™) and the Structured Operative Obstetrics (SOO™) courses. He has been involved in these programs in Ethiopia, Tanzania, Rwanda and Haiti. He is also assistant physician for the Montreal Canadiens Hockey Club.
Dr. Tarek Razek, MD, CM, FRCSC, FACS
FRQS Clinical Research Scholar Junior 1, Assistant professor, Département de médecine familiale et médecine d'urgence, Université Laval
Dr. Archambault obtained his medical degree from the Université Laval in 2000 and completed his post-graduate training to become a member of the Royal College of Physicians and Surgeons of Canada as an emergency medicine specialist at Université Laval in 2005. He was awarded a McLaughlin Fellowship bursary by the Dean of the Faculty of Medicine at Université Laval and, in 2007, completed a Royal College subspecialization in Critical Care Medicine at the University of Ottawa. Dr. Archambault graduated with honours from the master’s program in clinical research at Université Laval in 2007 and the Royal College awarded him a certificate of completion of the clinician investigator program. During his master's studies, Dr. Archambault studied the negative impact of etomidate on the production of cortisol in traumatic brain injuries. In October 2008, Dr. Archambault was awarded a Canadian Health Services Research Foundation (CHSRF) CADRE postdoctoral fellowship scholarship within André Lavoie’s REISS program, "Performance of a Continuum of Services in Trauma". He completed training in Knowledge Translation under the direction of France Légaré, André Lavoie and Jean Lapointe.
Patrick Archambault, MD, MSc, FRCPC
Co-investigators
Dr. France Légaré is a Full Professor at the department of Family medicine and Emergency medicine at Université Laval, clinical investigator interested in public health and practice changing research, and a knowledge translation researcher. Her interest lies in the implementation processes of shared decision making in primary care. She received funding from the Canada Foundation of Innovation to implement a large network of primary care practices in the Quebec City area. Dr. Légaré has conducted a number of research project assessing implementation barriers to behaviour change among health care professionals. Her expertise will inform the KT methodology for all phases of this research project.
France Légaré, MD, PhD, CCMFCanada Research Chair in Implementation of Shared Decision Making in Primary Care, Quebec, Canada
Dr. François Lauzier's research program focuses on pituitary disorders in traumatic brain injury victims. He has a FRQS junior 1 clinician-scientist career award and is an active critical care physician at the CHU de Québec. He has many research interests and clinical expertise. In particular, he has led many research projects in relation with the use of platelets and use of fresh frozen plasma in trauma patients. We have invited him to talk about his needs as a clinical and research expert in using a wiki-based reminder system.
FRQS Clinical Research Scholar Junior 1; Assistant Professor in the Division of Critical Care Medicine and the Department of Internal Medicine at Université Laval, Critical Care physician, Quebec, Canada
Alexis Turgeon, MD, MSc, FRCPC
FRQS Clinical Research Scholar Junior 2; Assistant Professor in the Division of Critical Care Medicine and the Department of Anesthesiology, Université Laval; Director of Research for the Division of Critical Care Medicine and for the Department of Anesthesiology
Dr. Alexis Turgeon’s research program focuses on the evaluation of the neurological prognosis in critically ill patients with severe traumatic brain injury and on the comprehension of level of care decisions in neurocritically ill patients. As part of his research program and with colleagues from across Canada, he recently showed a variation in mortality in patients with severe traumatic brain injury across centers in Canada, and a variation in the incidence of withdrawal of life-sustaining therapies. He currently leads the CIHR-funded TBI-Prognosis Multicenter Prospective Study, a pan-canadian study aiming to develop a prognostic model of long-term prognosis following severe traumatic brain injury.
François Lauzier, MD, MSc, FRCPC
FRQS Clinical Research Scholar Junior 1; Assistant Professor in the Division of Critical Care Medicine and the Department of Internal Medicine at Université de Sherbrooke
Dr. Lamontagne is an assistant professor at Université de Sherbrooke in the Department of Medicine, a critical care physician and a clinician scientist who obtained a Canadian Institutes of Health Research (CIHR) RCT mentorship award. His research focuses on patient-centered therapies in the ICU and is leading a CIHR-funded RCT on the titration of vasopressors. He will provide methodological expertise in conducting this RCT.
François Lamontagne, MD, MSc, FRCPC
Marie-Pierre Gagnon, PhD.
Canada Research Chair in Technologies and Practices in Health; Assistant Professor at the Faculty of Nursing, Université Laval; expert in IT implementation adoption factors, Quebec, Canada
Marie-Pierre Gagnon is an expert in theoretical models associated with health care professionals’ implementation of information and communication technology (ICT). She has conducted a number of systematic reviews, including a mixed-methods review on barriers and facilitators to the implementation of ICT. She will be invited to present two conferences during our meeting as an expert in behaviour change and ICT adoption. She will be asked to present the different theory-based intervention methods and practical strategies to change, as well as the rationale for adopting a theory-based approach.
Associate Professor, Department of Health Policy, Management and Evaluation at the University of Toronto; Senior Scientist at the Centre for Global eHealth Innovation at the University Health Network, Ontario, Canada Gunther Eysenbach researches open access publishing, health policy, eHealth, and consumer health informatics. Eysenbach is also the founder and editor-in-chief of the Journal of Medical Internet Research. Dr. Eysenbach is also the initiator, organizer, and chair of the annual international Medicine 2.0 Congress. His content expertise and knowledge of social media will be essential to this meeting.
Gunther Eysenbach, MD, MPH
Associate Professor - Senior Researcher at University of Calgary, Alberta, Canada Dr. Lang is Senior Researcher in the Division of Emergency Medicine at the University of Calgary. His specific areas of interest include knowledge translation, evidence-based medicine and faculty development. Dr. Lang and Dr. Archambault are collaborating within Knowledge Translation Canada to translate and adapt the survey developed by Dr. Archambault for English-speaking trauma centers. Dr. Lang's knowledge of evidence-based medicine and clinical emergency medicine will inform his presentation on the wiki-based reminder system. His recognized international leadership in evidence-based emergency medicine and his active role within the Canadian Association of Emergency Physicians will also be key factors in creating a community of experts and researchers involved in implementing the wiki-based reminder system across Canada and abroad.
Eddy Lang, MD, CCFM
Assistant Professor of Critical Care Medicine, Medicine and Community Health Sciences at the University of Calgary, Alberta, Canada Dr. Tom Stelfox received his MD at the University of Alberta, Internal Medicine Residency at the University of Toronto, PhD in Health Care Policy at Harvard University and Critical Care Fellowship at the Massachusetts General Hospital. Dr. Stelfox’s research program focuses on the application of health services research methods to evaluate and improve the quality of health care delivery to critically ill patients. His research activities include developing quality indicators in trauma care; evaluating the structure and transfer of knowledge in hospitalized patients; and evaluating new health care technologies, risk stratification tools and methods of health service delivery. He is an active leader and expert in trauma performance indicators and has published extensively on this topic (http://goo.gl/Xf2o6).
Tom Stelfox, MD, PhD, FRCPC
Derek Roberts, BSc (Pharm), MD, PhD (Cand)
General Surgery/Clinician Investigator Program Resident and Surgeon Scientist Program Member, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada
Derek Roberts received a Bachelor of Science in Pharmacy and a Doctor of Medicine with Distinction from Dalhousie University in 2005 and 2009, respectively. He subsequently completed two years of residency training in the Division of General Surgery at the University of Calgary before joining the Clinician Investigator and Surgeon Scientist Programs at the same institution. Currently, Derek is a PhD (Epidemiology) Candidate in the Department of Community Health Sciences and the past Chief Resident of the Clinician Investigator Program. He is also enrolled in a Knowledge Translation (KT) Canada Strategic Training in Health Research Graduate Training Program. Derek's interests include trauma and acute care surgery, epidemiology and biostatistics, and the science and practice of KT and KT research relating to trauma and emergency surgery.
CIHR New Investigator; Epidemiologist and Biostatistician, Assistant Professor and CIHR New Investigator,
FRQS-Research Centre, Centre Hospitalier Universitaire de Quebec, Université Laval, Quebec, Canada
Lynne Moore's research program is based on the development and validation of quality of care indicators for trauma systems and she has expertise in predictive modelling, techniques for dealing with missing data, and risk adjustment. Lynne Moore, Alexis Turgeon, François Lauzier and Tom Stelfox have collaborated in the past on a number of research projects. Lynne Moore is also actively involved with Jean Lapointe and the TCCAT in the development of a system-wide report card to help trauma centers in the province of Quebec improve the quality of care delivered to trauma patients.
Lynne Moore, PhD.
John Muscedere, MD, FRCPC
Associate Professor, Department of Medicine & Critical Care Program
Research Director, Critical Care Program, Queen's University, Kingston, Canada
Dr. Muscedere is the principal investigator for the CIHR-funded Canadian Critical Care Knowledge Translation Network (AK3CTION Net). Dr. Muscedere is also an accomplished critical care researcher, whose interests include ventilator-associated pneumonia, clinical practice guidelines, quality improvement, knowledge translation, venous thromboembolism and Acute Respiratory Distress Syndrome. He will help develop knowledge tools within WikiTrauma.
Engineer, Human Factors specialist, Assistant Professor, Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada Holly Witteman is developing information and communication technologies (ICT) that will help clinicians and
patients make appropriate decisions. She is particularly interested in the way risks and tradeoffs are
presented to patients when making decisions about their health care. She will be invited to present the human
design principles that we will need to consider in the design of the wiki-based reminder system and
implementation intervention.
Holly Witteman, PhD
Tanya Horsley, MD, PhD
Associate Director, Research Unit & Principal Scientist, Royal College of Physicians and Surgeons, Ottawa, Canada
Dr. Horsley obtained her PhD in 2002 from the University of Western Ontario with a thesis entitled “The use of autogenous hamstring tendons for anterior cruciate ligament reconstruction”. She completed a two-year postdoctoral Fellowship at the National Centers for Chronic Disease Prevention and Health Promotion, in the Division of Diabetes Translation with the Centers for Disease Control (CDC) specifically focused on systematic reviews and meta-analysis. She also gained valuable methodological expertise of critically appraising and summarizing randomized and non-randomized designs, having worked previously at both the Ottawa and McMaster Agency for Healthcare Research and Quality Evidence-based Practice Centers (AHRQ EPC).
Assistant professor, Molecular Biology Department, Université Laval, Québec
Arnaud is working on Next Generation Sequencing, proteomics and semantic web. He hosts the bio2rdf website. The Bio2RDF project uses a data integration approach based on semantic web rules to answer a broad question about the mouse and human genomes. His expertise about semantic web technology and ontology will be essential to our development and use of semantic wiki technology for WikiTrauma.ca. His primary focus of research is about proteomics software tools, the application and computations for automated high-throughput, quantitative proteomics and extraction of knowledge from databases. He manages and integrates public databases (IPI, UniProt, HPRD, DIP, STRING, GO). He is also the instructor for bioinformatics course and teaches Unix, databases, Perl and algorithms for proteins identifications.
Arnaud Droit, PhD
Collaborators
Tom H van de Belt, PhD
Postdoctoral Researcher, Radboud REshape Center, Radboud University Medical Center Nijmegen, the Netherlands.
Tom is one of the first researchers who obtained a PhD on Social Media in healthcare, and probably the first one with a # (hashtag) in the title of his PhD-Thesis. He was co-investigator in our CHIR-funded Scoping Review. He also published about the definition of Health 2.0 and Medicine 2.0, the use of Social Media by hospitals and consumers’ preferences regarding the use of Social Media in Healthcare. More recently, he studied the relation between information on social media and the quality and safety of healthcare, of which the first paper is available here. Tom also studied wikis in the field of infertility. He used two different wikis to generate dynamic patient information with participation from patients and healthcare professionals. It appeared that wikis are promising tools for this purpose, but that many barriers for using the wikis exist. As a result, he has developed a deep understanding of the technical issues facing the implementation of wikis in health care. Tom currently works at the Radboud REshape Center, a program set up by the Radboud University Medical Center to stimulate participatory healthcare and eventually to embrace patients into the healthcare team, and to study new technology as a potential solution with nowadays’ challenges in healthcare, such as increasing demands, decreasing budgets and shortage of skilled personnel.
Wikipedia editor and administrator, Wikimedia Foundation Grantee, and the Coordinator of the WikiProject Medicine FoundationJacob has been involved in many different projects associated with the Wikipedia movement. He designed Wikipedia Adventure, a learning game funded by the Wikimedia Foundation. He helped raise more than 500 000$ in donations for the WikiMedia Foundation and initiated many different partnerships with different organizations (eg, HighBeam Research, Questia Online Library and the Cochrane Collaboration). He initiated a collaboration with Turnitin to improve copyright violation detection on Wikipedia and was an advisor to different corporations and governments (eg, Monitor Group, Occidental Petroleum, Eli Lilly, and the U.S. Government). He has been very active within the wiki movement and participated in multiple conferences such as Wikimania 2012, GLAM Bootcamp 2013, GSummit 2013, Mediawiki Hackathon 2013, Open Help Conference 2013, Wikimania 2013, and the Cochrane Colloqium 2013. He has presented many times at different occasions about Wikipedia to different organizations: the Public Relations Society of America, the Association of American Medical Colleges Medical Education Conference; and the UCSF Medical School.
Jacob Orlowitz, BS
Head of Informatics and Knowledge Management at The Cochrane CollaborationChris is head of Informatics and Knowledge Management for The Cochrane Collaboration (www.cochrane.org), a large, global non-profit healthcare knowledge organisation. His background is in information science, information architecture and knowledge management with an emphasis on web and application development. More recently, his focus has been on semantic web and linked data technologies as well as making people, process and technology coalesce to meet organisational goals.
Chris Mavergames, BA, MLIS
Cisco Grajales III, MSc.
Analyst, Mobile Wallet, Emerging Products, Scotia Bank
Cisco is a Knowledge Management professional with international experience in the strategic implementation of disruptive innovation projects in the financial and healthcare sectors. Cisco is multilingual and is currently reading for a Doctorate of Philosophy on the use of Big Data at the University of British Columbia. He is a graduate of Google's Singularity University, holds an interdisciplinary MS in Knowledge Management, and a Bachelors with a specialization on risk assessment and algorithm scoring performance. He also collaborates and co-directs a number of ongoing international research projects on e-Health Services Research. Notably, he has co-authored a scoping review on wikis and collaborative writing applications in health care.
Patient representative, Advisory Board, Quebec Tertiary Cardiology Network; Director major accounts (health sector), Telus, Canada
Mr. Chabot represents patients on the Quebec Tertiary Cardiology Network (RQCT). He is an active patient advocate
having himself benefited from the services of tertiary cardiology care. This network is a permanent organization with a
mission to advise Quebec's health minister of the measures required to ensure that all patients have access to safe, high-quality services within recommended timeframes. The RQCT assures that all patients have a timely access to high quality services according to the seriousness and urgency of their condition. It monitors the development of tertiary cardiology, and makes recommendations with respect to the organization of services and the allocation of resources. It promotes networking among all of Quebec’s tertiary cardiology centres. Mr. Chabot has also been working for the advancement of IT in Quebec since 1985 and accumulating to date, more than 25 years of relevant experience with a global perspective in many different IT companies (MultiHexa, Cognicase, Nurun, Siemens, IBM and Telus). He has vast experience in marketing eHealth solutions such as Electronic Medical Records (EMRs) for hospitals. His insight and active role in the current eHealth industry will support the development of our Creative Commons WikiTrauma.ca and help us link this collaboratively created content with the eHealth EMR industry.
Christian Chabot
François Belleau, BSc.
Bioinformatician, Université Laval; Information Technology Analyst at the Ministry of Education, Recreation and Sports, Quebec, Canada
Mr. Belleau is a bioinformatician who has developed an expertise in data integration by applying the semantic web model to a dozen of existing public databases. He manages the bio2rdf database and he has extensive experience with semantic wiki technology. He has experience working for different ministries in the province of Quebec as an IT Analyst (eg, Ministère du Développement économique du Québec, Ministère du Développement économique, de l'Innovation et de l'Exportation (MDEIE), Commission de la santé et de la sécurité du travail (CSST)).
Simon Berthelot, MD, MSc, FRCPC, CCFP(EM)Emergency physician and clinical scientist, Department of emergency medicine, CHU de Québec.
Dr. Simon Berthelot graduated from the Université Laval medical school in 1998. He completed post-graduate training in family medicine with special competence in emergency medicine (2001) and in emergency medicine (2007). He obtained his master's degree from the Department of Community Health Sciences of the University of Calgary in 2014. His main research interests are on ED performance assessment and quality-of-care indicators. He is currently working on developing an in-hospital standardized mortality ratio for ED patients admitted with emergency-sensitive conditions.
Richard Boisvert, MD, FRCP, CSPQ, MSc
Emergency Physician, Departement of Emergency Medicine, CHU de Sherbrooke
Dr. Richard Boisvert is a full-time ED physician with special interests in evaluation of health care organisation and trauma. He graduated from Université de Montréal in 1983 and then completed a master in Health Care Administration. He has worked as a clinician in different settings ranging from tertiary trauma center (Hopital Sacré-Cœur de Montréal), secondary center (CHUS) and local centers. He has been involved in pre-hospital care, development of regional trauma system and evaluation of health care systems. He his in charge of Quality of care in the Emergency Department of the CHUS.
Coordonnatrice de recherche
Audrey Dupuis, MA, PhD(c)Coordonnatrice de recherche, Centre de recherche CISSS de Chaudière-Appalaches (CHAU-Hôtel-Dieu de Lévis) et Doctorante en communication publique, Université Laval
Audrey Dupuis est membre-étudiante du Groupe de recherche en communication politique depuis septembre 2011. Elle est actuellement coordonnatrice de recherche au CISSS Chaudière-Appalaches (Hôtel-Dieu de Lévis) et doctorante en communication publique à l’Université Laval. Elle détient un baccalauréat et une maîtrise avec mémoire en communication sociale de l'Université du Québec à Trois-Rivières. Ses intérêts de recherche portent sur la psychophysiologie des médias, le traitement de l’information, la publicité sociale et électorale, la communication en santé publique et le transfert de connaissances. Alors que son mémoire portait sur le traitement de l'information des publicités sociales chocs de sécurité routière par les webacteurs, sa thèse cible plutôt les réponses psychophysiologiques à l'égard du ton émotionnel des publicités électorales canadiennes. Elle a obtenu plusieurs bourses de recherche et distinctions durant son parcours, dont la Bourse d'études supérieures du Canada Vanier.
CSSS Alphonse-Desjardins
The CSSS Alphonse-Desjardins is a result of the merger of the University Affiliated Hospital (Hôtel-Dieu de Lévis) and CSSS du Grand Littoral formally established on January 29 2011.
The CSSS Alphonse- Desjardins serves a population of 237,863 citizens residing in the city of Lévis and the regional municipalities of Bellechasse, Lotbinière and Nouvelle-Beauce. The CSSS AD has approximately 4,330 employees, 550 physicians and pharmacists and 600 volunteers. Its annual budget is nearly $ 300 million and it has 25 installations including: 1 Level II regional trauma center that is affiliated to Université Laval (CHAU de Lévis) that also houses the largest hyperbaric chamber in Canada, 5 local community health service centers (CLSC); 13 nursing homes and one long-term care hospital (CHSLD); and a family medicine teaching unit among other services.