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Falandry C, Bacchetta J, Doret-Dion M, Ferraro-Peyret C, Confavreux CB, Douplat M, Feugier P, Friggeri A, Bolze PA, Dargaud Y, Messager A, Wallon M, Geffroy L, Matillon Y, Bradwejn J. Tailoring a specific medical leadership development program for faculty members: the Lyon-Ottawa experience. Med Educ Online 2024; 29:2308955. [PMID: 38290044 PMCID: PMC10829808 DOI: 10.1080/10872981.2024.2308955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
The development of leadership skills has been the topic of several position statements over recent decades, and the need of medical leaders for a specific training was emphasized during the COVID-19 crisis, to enable them to adequately collaborate with governments, populations, civic society, organizations, and universities. However, differences persist as to the way such skills are taught, at which step of training, and to whom. From these observations and building on previous experience at the University of Ottawa, a team of medical professors from Lyon (France), Ottawa, and Montreal (Canada) universities decided to develop a specific medical leadership training program dedicated to faculty members taking on leadership responsibilities. This pilot training program was based on a holistic vision of a transformation model for leadership development, the underlying principle of which is that leaders are trained by leaders. All contributors were eminent French and Canadian stakeholders. The model was adapted to French faculty members, following an inner and outer analysis of their specific needs, both contextual and related to their time constraints. This pilot program, which included 10 faculty members from Lyon, was selected to favor interactivity and confidence in older to favor long-term collaborations between them and contribute to institutional changes from the inner; it combined several educational methods mixing interactive plenary sessions and simulation exercises during onescholar year. All the participants completed the program and expressed global satisfaction with it, validating its acceptability by the target. Future work will aim to develop the program, integrate evaluation criteria, and transform it into a graduating training.
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Affiliation(s)
- Claire Falandry
- Service de Gériatrie, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Laboratoire CarMeN de l’Université de Lyon, INSERM U.1060/Université Lyon1/INRA U. 1397/INSA Lyon/Hospices Civils Lyon, Pierre-Bénite, France
| | - Justine Bacchetta
- Néphrologie Rhumatologie Dermatologie Pédiatrique, Hopital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
- UMR 1033, INSERM, Lyon, France
| | - Muriel Doret-Dion
- Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Faculté De Médecine Et De Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Oullins, France
| | - Carole Ferraro-Peyret
- Centre de biopathologie des tumeurs, Hôpitaux Est, Hospices Civils de Lyon, Bron, France
- ISPB Faculté de pharmacie, INSERM 1052, CNRS5286, Centre de Recherche sur le Cancer de Lyon, Université de Lyon, Lyon, France
| | - Cyrille B. Confavreux
- Service de Rhumatologie Sud, Hôpital Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Université Lyon 1, UFR médecine Lyon Est, INSERM UMR 1033, Lyon, France
| | - Marion Douplat
- Service des Urgences, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université de Lyon, Laboratoire RESHAPE - Research on Healthcare Performance, Université Lyon 1, Lyon, France
| | - Patrick Feugier
- Service de Chirurgie Vasculaire et Endovasculaire, Centre Hospitalier Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Université de Lyon, UFR médecine Lyon Est, Université Lyon1, Pierre-Bénite, France
| | - Arnaud Friggeri
- Service d’Anesthésie-Réanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
- Université de Lyon, Faculté De Médecine Et De Maïeutique Lyon Sud - Charles Mérieux, Université Lyon 1, Oullins, France
| | - Pierre-Adrien Bolze
- Service de Chirurgie Gynécologique et Oncologique, Obstétrique, Hôpital Lyon Sud, Hospices Civils de LyonPierre-Bénite, France
- Centre pour l’Innovation en Cancérologie de Lyon (CICLY EA3738), Université Lyon 1, Oullins, France
| | - Yesim Dargaud
- Centre d’Hémophilie de Lyon, Unité d’Hémostase clinique, Hôpital Louis Pradel, Bron, France
- Université de Lyon, Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
| | - Alexandre Messager
- Human Resources and Faculty/Clinical Leadership Development, Ottawa University, Ottawa, Canada
| | - Martine Wallon
- Service de Parasitologie et de Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Waking Team, Centre de Recherche en Neurosciences de Lyon, Bron, France
| | - Loïc Geffroy
- Stratégie et management des organisations, Université Lyon 1, Lyon, France
| | - Yves Matillon
- Laboratoire Parcours Santé Systémique, Université Lyon 1, Lyon, France
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George S, Regan J, Awan A, O’Connor M, Foster A, Raymond K, Gorfinkel I, McNeil SA. Attitudes, barriers, and facilitators to adherent completion of the recombinant zoster vaccine regimen in Canada: Qualitative interviews with healthcare providers and patients. Hum Vaccin Immunother 2024; 20:2317595. [PMID: 38502342 PMCID: PMC10956622 DOI: 10.1080/21645515.2024.2317595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
This qualitative, cross-sectional study aimed to understand the barriers and facilitators related to the adherence and completion of the recombinant zoster vaccine (RZV) two-dose series in Canada, as perceived by healthcare providers (HCPs) and patients. Data collection occurred via 60-minute concept elicitation interviews with 12 HCPs (4 physicians, 2 nurse practitioners, 6 pharmacists) who had prescribed and/or administered RZV in Canada, and 21 patients aged ≥50 years who had received ≥1 dose of RZV. Patients were categorized as adherent (received both doses within the recommended 2-to-6-month timeframe; n = 11) or non-adherent (received only one dose or second dose outside the recommended timeframe; n = 10). Interview transcripts were coded and analyzed using a two-part thematic analysis approach. HCP-identified barriers to RZV adherence included high out-of-pocket cost, inconsistent/lack of health plan coverage, inconvenient processes for accessing RZV, and patient forgetfulness. HCP-identified facilitators included desire for shingles protection, HCP encouragement, and reminders. Barriers to RZV adherence identified by patients included lack of HCP knowledge/experience with RZV, receiving unreliable/confusing information, having unpleasant/severe side effects following the first dose, high out-of-pocket cost, lack of insurance coverage, and forgetfulness. Patient-identified facilitators included self-motivation, financial support, convenient processes for obtaining RZV, and reminders. In conclusion, many factors can influence RZV series completion and adherence among adults in Canada, including cost, insurance coverage, HCP knowledge and encouragement, and reminders. Awareness of these factors may inform HCPs in helping patients overcome barriers and identify opportunities for future consideration, facilitating protection against herpes zoster.
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Affiliation(s)
| | | | | | | | | | | | | | - Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health and Nova Scotia Health, Dalhousie University, Halifax, NS, Canada
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Dubé E, Renaud MP, Lyonnais MC, Pelletier C, Fletcher C. "The needle is already ready to go": communities' and health care professionals' perceptions of routine vaccination in Nunavik, Canada. Int J Circumpolar Health 2024; 83:2295042. [PMID: 38105644 PMCID: PMC10732179 DOI: 10.1080/22423982.2023.2295042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population.
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Affiliation(s)
- Eve Dubé
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
- Département d’anthropologie, Université Laval, Québec, Canada
| | - Marie-Pierre Renaud
- École d’études autochtones, Université du Québec en Abitibi-Témiscamingue, Québec, Canada
| | | | - Catherine Pelletier
- Axe Maladies infectieuses et immunitaires, Centrre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Christopher Fletcher
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
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Kwegyir Tsiboe A, Raghuraman S, Marshall TC. Caught between two worlds: mental health literacy and stigma among bicultural youth. Int J Qual Stud Health Well-being 2024; 19:2321644. [PMID: 38431901 PMCID: PMC10911255 DOI: 10.1080/17482631.2024.2321644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. METHODS To fill this gap, the current study explored bicultural youths' mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. RESULTS Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor-celebrities' mental health journeys-may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. CONCLUSION The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.
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Affiliation(s)
| | - Shruthi Raghuraman
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | - Tara C. Marshall
- Department of Health, Aging & Society, McMaster University, Hamilton, Canada
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Hansson J, MacEachen E, Landstad BJ, Vinberg S, Tjulin Å. A comparative study of governmental financial support and resilience of self-employed people in Sweden and Canada during the COVID-19 pandemic. Int J Circumpolar Health 2024; 83:2298015. [PMID: 38157432 PMCID: PMC10763823 DOI: 10.1080/22423982.2023.2298015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024] Open
Abstract
Globally, self-employed people were among the hardest hit by the repercussions of the COVID-19 pandemic and faced hardships such as financial decline, restrictions, and business closures. A plethora of financial support measures were rolled out worldwide to support them, but there is a lack of research looking at the effect of the policy measures on self-employed people. To understand how different governmental financial support measures enhanced the resilience of the self-employed and improved their ability to manage the pandemic, we conducted a mixed-method study using policy analysis and semi-structured interviews. The documents described policies addressing governmental financial support in Sweden and Canada during the pandemic, and the interviews were conducted with Swedish and Canadian self-employed people to explore how they experienced the support measures in relation to their resilience. The key results were that self-employed people in both countries who were unable to telework were less resilient during the pandemic due to financial problems, restrictions, and lockdowns. The interviews revealed that many self-employed people in hard-hit industries were dissatisfied with the support measures and found them to be unfairly distributed. In addition, the self-employed people experiencing difficulties running their businesses reported reduced well-being, negatively affecting their business survival.
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Affiliation(s)
- Josefine Hansson
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Bodil J. Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Stig Vinberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Åsa Tjulin
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Pagaduan JE, Lazarescu C, Vallieres E, Skinner K, Zuckermann AM, Idzerda L. The impacts of the Nutrition North Canada program on the accessibility and affordability of perishable, nutritious foods among eligible communities: a scoping review. Int J Circumpolar Health 2024; 83:2313255. [PMID: 38346231 PMCID: PMC10863516 DOI: 10.1080/22423982.2024.2313255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
The Nutrition North Canada (NNC) program, introduced in April 2011 is a federal strategy to improve access to perishable, nutritious foods for remote and isolated communities in northern Canada by subsidising retailers to provide price reductions at the point of purchase. As of March 2023, 123 communities are eligible for the program. To evaluate existing evidence and research on the NNC program to inform policy decisions to improve the effectiveness of NNC. A scoping review of peer-reviewed articles was conducted in ten databases along with a supplemental grey literature search of government and non-government reports published between 2011 and 2022. The search yielded 172 publications for screening, of which 42 were included in the analysis. Narrative thematic evidence synthesis yielded 104 critiques and 341 recommendations of the NNC program across eight themes. The most-identified recommendations focus on transparency, communication, and support for harvesting, hunting, and community food initiatives. This review highlights recommendations informed by the literature to address critiques of the NNC program to improve food security, increase access to perishable and non-perishable items, and support community-based food initiatives among eligible communities. The review also identifies priority areas for future policy directions such as additional support for education initiatives, communication and transparency amidst program changes, and food price regulations.
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Affiliation(s)
- Jason Edward Pagaduan
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Calin Lazarescu
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Eric Vallieres
- Health Security and Regional Operations Branch, Public Health Agency of Canada, Montreal, Quebec, Canada
| | - Kelly Skinner
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Alexandra M.E. Zuckermann
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Leanne Idzerda
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Khawer MS, Goulet T, Brothwell D, Da Silva K. Practice Trends and Job Satisfaction of Dental Therapists in Canada: Results from a National Survey. Int J Circumpolar Health 2024; 83:2294568. [PMID: 38096367 PMCID: PMC10732177 DOI: 10.1080/22423982.2023.2294568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023] Open
Abstract
The objective of this research was to evaluate the practice trends, clinical services and job satisfaction of dental therapists in Canada. Licenced Canadian dental therapists were recruited to participate in this cross-sectional study. A total of 124 dental therapists completed the survey (~68% response rate), with 57.3% of respondents being over the age of 50. Most respondents were actively engaged in full-time clinical practice in private dental offices. Indigenous dental therapists were significantly more likely to work outside of private dental offices providing care for Indigenous communities. Just over half of respondents were compensated by an annual salary, with the highest proportion of full-time practitioners earning between $75,000 and $99,000 per year. Dental therapists who were active in clinical practice performed a wide range of preventive, diagnostic, and treatment services consistent with their scope of practice. This research demonstrates that Canadian dental therapists are highly engaged and satisfied with their profession. Dental therapists can facilitate improved access to oral health care in less accessible areas of Canada; however, compensation packages and incentives to work in these less accessible areas must be addressed, as well as legal and regulatory requirements to ensure that dental therapists are licenced providers throughout Canada.
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Affiliation(s)
| | - Trish Goulet
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Doug Brothwell
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
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Suissa S. Guidelines for the Pharmacologic Treatment of COPD 2023: Canada versus GOLD. COPD 2024; 21:2292613. [PMID: 38329461 DOI: 10.1080/15412555.2023.2292613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/01/2023] [Indexed: 02/09/2024]
Affiliation(s)
- Samy Suissa
- Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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Ngo MH, Pankrac J, Ho RCY, Ndashimye E, Pawa R, Ceccacci R, Biru T, Olabode AS, Klein K, Li Y, Kovacs C, Assad R, Jacobson JM, Canaday DH, Tomusange S, Jamiru S, Anok A, Kityamuweesi T, Buule P, Galiwango RM, Reynolds SJ, Quinn TC, Redd AD, Prodger JL, Mann JFS, Arts EJ. Effective and targeted latency reversal in CD4 + T cells from individuals on long term combined antiretroviral therapy initiated during chronic HIV-1 infection. Emerg Microbes Infect 2024; 13:2327371. [PMID: 38444369 DOI: 10.1080/22221751.2024.2327371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/01/2024] [Indexed: 03/07/2024]
Abstract
To date, an affordable, effective treatment for an HIV-1 cure remains only a concept with most "latency reversal" agents (LRAs) lacking specificity for the latent HIV-1 reservoir and failing in early clinical trials. We assessed HIV-1 latency reversal using a multivalent HIV-1-derived virus-like particle (HLP) to treat samples from 32 people living with HIV-1 (PLWH) in Uganda, US and Canada who initiated combined antiretroviral therapy (cART) during chronic infection. Even after 5-20 years on stable cART, HLP could target CD4+ T cells harbouring latent HIV-1 reservoir resulting in 100-fold more HIV-1 release into culture supernatant than by common recall antigens, and 1000-fold more than by chemotherapeutic LRAs. HLP induced release of a divergent and replication-competent HIV-1 population from PLWH on cART. These findings suggest HLP provides a targeted approach to reactivate the majority of latent HIV-1 proviruses among individuals infected with HIV-1.
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Affiliation(s)
- Minh Ha Ngo
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
- College of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi, Vietnam
| | - Joshua Pankrac
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Ryan C Y Ho
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Emmanuel Ndashimye
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Rahul Pawa
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Renata Ceccacci
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Tsigereda Biru
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
- Special Immunology Unit and Division of Infectious Diseases, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Abayomi S Olabode
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Katja Klein
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Yue Li
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Colin Kovacs
- Maple Leaf Medical Clinic and Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Canada
| | - Robert Assad
- Special Immunology Unit and Division of Infectious Diseases, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Jeffrey M Jacobson
- Special Immunology Unit and Division of Infectious Diseases, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - David H Canaday
- Special Immunology Unit and Division of Infectious Diseases, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Aggrey Anok
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | - Paul Buule
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | - Steven J Reynolds
- Rakai Health Sciences Program, Kalisizo, Uganda
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thomas C Quinn
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Andrew D Redd
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jessica L Prodger
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
| | - Jamie F S Mann
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Eric J Arts
- Department of Microbiology and Immunology, University of Western Ontario, London, Canada
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Sengupta N. Factors affecting Family Physician follow-up 30 days post-discharge from a Canadian Academic Emergency Department. Ann Fam Med 2024; 21. [PMID: 38271161 DOI: 10.1370/afm.22.s1.5551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Close outpatient follow-up of patients discharged from the emergency department (ED) has been associated with improved antimicrobial stewardship, medication compliance, and decreased mortality. Despite these clear benefits, studies have shown most patients do not receive follow-up from specialists or Family Physicians (FP). While age, race and insurance status may be factors in Australia and the United States, there remains a paucity of Canadian studies investigating potential factors that influence follow-up. This retrospective cohort study aimed to elucidate factors associated with Family Physician follow up within 30 days at two urban, academic Family Medicine clinics. Our study included patients aged 18 or older who have an academic Family Physician and visited a London Health Sciences Centre ED between January 1, 2021 and June 1, 2021. A binary logistic regression was used to determine if a specific patient or provider factor was associated with follow-up. Of the 367 cases that met criteria, 220 (60%) patients received Family Physician follow-up within 30 days. Additionally, 51 patients (23%) received specialist follow-up within 30 days. A higher number of medications (OR 1.12 p=0.003) and a Family Physician appointment within the 90 days preceding the ED visit (OR 2.51, p<0.001) were significantly predictive of Family Physician follow-up. The use of a Family Physician referral form, documented discharge instructions, and increasing comorbidity (as documented by the Charlson Comorbidity Index) were not associated with a higher odds of follow-up. These data suggest that patients on numerous medications may require close follow-up for monitoring, dose adjustments, and reassessment. Additionally, those patients with recent Family Physician visits may have stronger relationships with their provider, increasing their likelihood of follow-up. Based on this study, there is insufficient evidence to suggest that documented discharge instructions nor the use of a FP referral form impact the rate of follow-up. Future work should focus on an optimal mechanism to ensure Family Physician follow-up, when required, in urban centres. The impact of mental health and substance use disorders on the rate of follow-up should also be evaluated.
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Sondekoppam RV, Dexter F, Vithani S, Wong CA. Survey of anesthesia department chairs about the environmental sustainability initiatives of their programs. J Clin Anesth 2024; 94:111378. [PMID: 38237442 DOI: 10.1016/j.jclinane.2024.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/05/2023] [Accepted: 01/04/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Anesthesia departments can reduce their environmental impact. Barriers exist to the promotion of individual anesthesiologists' roles in environmentally sustainable practices. We hypothesized that accountability of departmental leadership is associated with reports of practices that can encourage and sustain environmentally favorable practices. METHODS Invitations to complete a six-question survey were sent to academic anesthesia department chairs in the United States and Canada. Questions were presented in random sequence. We assessed the association between the sum of the answers to five questions about department- and hospital-related sustainability activities (e.g., more than one "educational session dedicated to environmental sustainability … for anesthesiology residents or other trainees?") and the sixth question ("In the past 12 months, did review of the anesthesia department chair or review of your department include" more than one "item related to promotion of environmental sustainability?"). RESULTS Of the 138 departments receiving invitation and reminder emails, 63 departments (46%) responded to our requests. The median (interquartile range) was 1 (0,3) sustainability activity for "No" items evaluating the department chair or department (N = 43) versus 4 (2, 4.5) activities for "Yes" evaluation of department chair or department (N = 20) (Wilcoxon-Mann-Whitney test, P = 0.0021; median regression, P = 0.0002). Results were similar for sensitivity analyses (excluding one question about hospital leadership, excluding the four responding Canadian departments, controlling for time to complete the survey, and controlling for the date of completion of the survey). CONCLUSIONS Anesthesia department chairs and departments with annual performance evaluations that included items related to environmental sustainability reported more activities to promote sustainability. The result suggests that leadership-sponsored initiatives directed toward environmental sustainability are associated with environmental sustainability activities in anesthesia departments.
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Affiliation(s)
| | - Franklin Dexter
- University of Iowa, Iowa City, IA, United States of America.
| | - Samira Vithani
- University of Iowa, Iowa City, IA, United States of America.
| | - Cynthia A Wong
- University of Iowa, Iowa City, IA, United States of America.
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12
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Noël C, Scharf D, Koné A, Armiento C, Dylan D. Cannabis advertising impacts on youth cannabis use intentions following recreational legalization in Canada: An Ecological Momentary Assessment (EMA) study. Addict Behav 2024; 153:107981. [PMID: 38367505 DOI: 10.1016/j.addbeh.2024.107981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE In 2018, Canada's Cannabis Act legalized adult recreational cannabis use and limited cannabis product advertising to adults. Cannabis product advertising to youth remains illegal. The extent to which adult-targeted, or illicit youth-targeted cannabis advertisements is reaching and impacting Canadian youth is unknown. We used Ecological Momentary Assessment (EMA) to describe how often and how much exposures to cannabis advertising influence Canadian youths' real-world, real-time intentions to use cannabis. METHODS 120 Ontario, Canada youths ages 14-18, took photos of cannabis advertising that they encountered in their natural environments over a period of nine consecutive days. Following each exposure and twice daily device-issued random prompts, they also rated their intentions to use cannabis. RESULTS Many participating youth (n = 85; 70.83 %) reported at least one cannabis advertising exposure during the study (range 1-30, M = 4.02). Exposures occurred through a range of advertising channels (e.g., internet ads, billboards). Multilevel modeling showed that youth advertising exposure increased cannabis use intentions in vivo (β = 0.06,SE = 0.03;t = 1.98;p =.04;n = 1,348). CONCLUSION Data from this study shows that cannabis advertisements are regularly reaching Canadian youth and increasing their intentions to use cannabis. This suggests that current Canadian prohibitions on cannabis advertising to youth are ineffective and/or ineffectively enforced, and that the Canadian government needs additional or enhanced prohibitions on cannabis promotion to protect youth from harms associated with increased advertisement exposure, such as increased cannabis use.
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Affiliation(s)
- Chelsea Noël
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Deborah Scharf
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada; Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada.
| | - Anna Koné
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - Daniel Dylan
- Bora Laskin Faculty of Law, Lakehead University, Thunder Bay, Ontario, Canada
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13
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Canadian Radiation Protection Association (CPRA) 2023 Annual Conference Abstracts. Health Phys 2024; 126:346-58. [PMID: 38526253 DOI: 10.1097/HP.0000000000001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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14
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Capello K, Moffat R, Schiebelbein A. Optimizing the Positioning of Detectors for Improved Counting Efficiencies Using Monte Carlo Simulations. Health Phys 2024; 126:309-314. [PMID: 38526249 DOI: 10.1097/hp.0000000000001794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT The Human Monitoring Laboratory (HML) at Health Canada updated its whole-body counter with four new electrically cooled HPGe detectors. To optimize the counting efficiency of the new system, Monte Carlo simulation was used to model the whole-body counter using a reference BOMAB male phantom. The resulting modeled counting efficiencies showed that the best position to install the four new detectors could be obtained without performing laborious real measurements, thereby reducing the cost of preparing the BOMAB phantoms and reconfiguring the detector arrays in multiple geometries, saving time and energy.
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Affiliation(s)
- Kevin Capello
- Human Monitoring Laboratory, Radiation Protection Bureau, 775 Brookfield Road, Ottawa, Ontario K1A 1C1, Canada
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15
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Niven D. Canadian Radiation Protection: Papers and Conference Abstracts. Health Phys 2024; 126:267. [PMID: 38526243 DOI: 10.1097/hp.0000000000001820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Affiliation(s)
- Dave Niven
- McMaster University, Hamilton, Ontario, Canada
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16
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Fasakin I, von Massow M. Consumer's preferences and willingness to pay for immune enhanced dairy products in Canada. Appetite 2024; 196:107156. [PMID: 38103791 DOI: 10.1016/j.appet.2023.107156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
This study examined consumer preferences for, willingness to pay for, and the most preferred mode of delivery for immune enhanced dairy products across Canada. Two sets of choice experiments were designed to evaluate preferences for functional foods and nutraceuticals as the modes of delivery for immune enhanced dairy products. Data (N = 1001) was collected through an online stated preference survey and analyzed using conditional logit model. Results revealed that there is a general consumer interest in immune enhanced dairy products, and consumers place a premium on them. Also, the presence of children below the age of fifteen in a household was a major factor that increased consumer receptivity towards the products. Further results revealed that individuals who usually consume functional foods are less likely to be interested in nutraceuticals, and vice versa, implying that the preferred mode of delivery depended on consumer preferences for either functional foods or nutraceuticals.
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Affiliation(s)
- Ifeoluwa Fasakin
- Department of Food, Agricultural and Resource Economics, University of Guelph, ON, N1G 2W1, Canada
| | - Michael von Massow
- Department of Food, Agricultural and Resource Economics, University of Guelph, ON, N1G 2W1, Canada.
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17
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Capello K, Tremblay M, Schiebelbein A, Janzen N. 3D Printed Lung Phantom for Individual Monitoring. Health Phys 2024; 126:292-295. [PMID: 38526247 DOI: 10.1097/hp.0000000000001777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT The Human Monitoring Laboratory, Health Canada (HML), has used a 3D printer to re-engineer its Lawrence Livermore National Laboratory (LLNL) foam lung sets (manufactured by Radiology Support Devices, Inc., Long Beach, CA). The foam sets are currently the HML standard for calibrating and performance testing lung-counting systems in Canada. This paper describes the process of creating and validating new 3D-printed lung sets modeled from one of the HML's existing RSD foam sets. The existing sets were custom made, making them costly and difficult to obtain or replace. Also, after many years of use, the HML has found that they are prone to wear and tear. When used with planar inserts containing various isotopes, the blank sets can become contaminated and are difficult to clean. Using 3D printing, the HML has created new blank lung sets that are nearly identical copies of the originals and are inexpensive and easily manufactured. Measurements using natural uranium (Nat U), 241Am, and 152Eu planar lung inserts were performed to compare obtained efficiencies at a wide range of energies using the original RSD foam sets and the 3D-printed ones. Both the foam and the 3D-printed lung sets were counted using the LLNL chest phantom positioned in the same counting geometry in the lung counting system. Biases, all below 15%, were obtained between the foam and the 3D-printed sets for energies above 40 KeV. Based on these results, as well as cost benefits and ease of use, the HML has decided to replace its original RSD foam lung set with the 3D-printed version for its lung performance testing program.
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Affiliation(s)
- Kevin Capello
- Radiation Protection Bureau, Health Canada, 775 Brookfield Rd, Ottawa, Canada K1A 1C1
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18
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Simpson AK, Drysdale M, Gamberg M, Froese K, Brammer J, Dumas P, Ratelle M, Skinner K, Laird BD. Human biomonitoring of dioxins, furans, and non-ortho dioxin-like polychlorinated biphenyls (PCBs) in blood plasma from Old Crow, Yukon, Canada (2019). Sci Total Environ 2024; 923:171222. [PMID: 38408666 DOI: 10.1016/j.scitotenv.2024.171222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
Dioxins, furans, and dioxin-like polychlorinated biphenyls (PCBs) are a group of persistent and toxic chemicals that are known to have human health effects at low levels. These chemicals have been produced for commercial use (PCBs) or unintentionally as by-products of industry or natural processes (PCBs, dioxins, and furans). Additionally, dioxin-like PCBs were formerly used in electrical applications before being banned internationally (2004). These chemicals are widely dispersed in the environment as they can contaminate air and travel hundreds to thousands of kilometers before depositing on land or water, thereafter, potentially entering food chains. Community concerns surrounding the safety of traditional foods prompted a human biomonitoring project in Old Crow, Yukon Territory (YT), Canada (2019). Through collaborative community engagement, dioxins and like compounds were identified as a priority for exposure assessment from biobanked samples. In 2022, biobanked plasma samples (n = 54) collected in Old Crow were used to measure exposures to seven dioxins, ten furans, and four dioxin-like PCBs. 1,2,3,6,7,8-HxCDD, 1,2,3,7,8,9-HxCDD, 1,2,3,4,6,7,8-HpCDD, OCDD, 2,3,4,7,8-PeCDF, 1,2,3,6,7,8-HxCDF, PCB 126, and PCB 169 were detected in at least 50 % of samples. Among these analytes, the only congener at elevated levels was PCB 169, which was approximately ∼2-fold higher than the general population of Canada. No significant sex-based or body mass index (BMI) differences in biomarker concentrations were observed. Generally, the concentrations of the detected congeners increased with age, except for 1,2,3,4,6,7,8-HpCDD. For the first time, this research measures dioxin and like-compound exposures in Old Crow, advancing the information available on chemical exposures in the Arctic. Further research could be directed towards the investigation of PCB 169 exposure sources and temporal monitoring of exposures and determinants.
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Affiliation(s)
- Ashlyn K Simpson
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Mallory Drysdale
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Mary Gamberg
- Gamberg Consulting, Whitehorse, Yukon Y1A 6N5, Canada
| | - Ken Froese
- GatePost Risk Analysis, Red Deer, Alberta T4R 0A9, Canada.
| | - Jeremy Brammer
- Vuntut Gwitchin Government, Old Crow, Yukon Y0B 1N0, Canada.
| | - Pierre Dumas
- Centre de Toxicologie du Québec (CTQ), Institut National de Santé Publique du Québec (INSPQ), Québec G1V 5B3, Canada.
| | - Mylène Ratelle
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec H3N 1X9, Canada.
| | - Kelly Skinner
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Brian D Laird
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Hounkpatin H, Simpson G, Santer M, Farmer A, Dambha-Miller H. Multiple long-term conditions, loneliness and social isolation: A scoping review of recent quantitative studies. Arch Gerontol Geriatr 2024; 120:105347. [PMID: 38309103 DOI: 10.1016/j.archger.2024.105347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Multiple long-term conditions (MLTC), loneliness and social isolation are common in older adults. Recent studies have explored the association of MLTC with loneliness and social isolation. This scoping review aimed to map this current evidence and identify gaps in the literature. METHODS A scoping review was conducted following the PRISMA guidelines for scoping reviews. Ovid Medline, Embase, CINAHL, The Cochrane Library, PsycInfo, and Bielefeld Academic Search Engine were searched for studies published between January 2020-April 2023. Quantitative studies, published in any language, that assessed the association of MLTC with loneliness and/or social isolation were included. RESULTS 1827 records were identified and screened. Of these, 17 met inclusion criteria. Most studies were cross-sectional and based on older adults. Studies were conducted in Europe, the US, Canada, and low- and middle-income countries. Ten studies focused on the association between MLTC and loneliness, six assessed the association between MLTC and social isolation and one examined associations with both loneliness and social isolation. Most studies reported a significant cross-sectional association of MLTC with loneliness, but there was weaker evidence for a longitudinal association between MLTC and loneliness and an association between MLTC and social isolation. Studies were heterogenous in terms of measures and definitions of loneliness/social isolation and MLTC, confounders adjusted for, and analytical models used, making comparisons difficult. CONCLUSIONS Further population-based longitudinal studies using consistent measures and methodological approaches are needed to improve understanding of the association of MLTC with both loneliness and social isolation.
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Affiliation(s)
- Hilda Hounkpatin
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK.
| | - Glenn Simpson
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Hajira Dambha-Miller
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
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20
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Marjan P, Martyniuk CJ, Arlos MJ, Servos MR, Ruecker NJ, Munkittrick KR. Identifying transcriptomic indicators of tertiary treated municipal effluent in longnose dace (Rhinichthys cataractae) caged under semi-controlled conditions in experimental raceways. Sci Total Environ 2024; 923:171257. [PMID: 38417510 DOI: 10.1016/j.scitotenv.2024.171257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
To evaluate effects of tertiary treated wastewater treatment plant effluent (MWWE) on transcriptomic responses in longnose dace (Rhinichthys cataractae; LND) we conducted a semi-controlled study in experimental raceways (Advancing Canadian Water Assets facility) imbedded in the Pine Creek treatment plant (Calgary, AB). LND collected from a reference site in the Bow River (REF) were caged in raceways containing either 5 % Pine Creek effluent (PC) or Bow River water (BR; control) over 28 d. Liver transcriptomes were analyzed in males and females sampled on days 7, 14 and 28 from BR and PC, and compared to REF fish on day 0. Concurrent with the caging, selected environmental substances of concern were analyzed in the BR and PC. Significantly different unigenes (SDUs) in females (vs males) within both BR and PC raceways increased over time and compared to REF fish. Moreover, SDUs in females and males within the same treatment (i.e., BR, PC) showed a temporal increase as well as compared to REF fish. Time was the dominant factor affecting SDUs, whereas sex and treatment had less of an impact on the transcriptome profiling. Gene Set Enrichment Analysis of BR vs PC over time revealed effects on genes involved in growth, metabolism of carbohydrates and lipids, and immune system on day 7; however, by day 28, 80-100 % of the transcripts localized to enriched biomarkers were associated with tissue immune responses in both sexes. Exposure to 5 % effluent had significant effects on female liver somatic index but no effects were observed on other phenotypic health indices in either sex. BR was used as the source of reference water, but analyses showed trace amounts of ESOCs. Analyses did not point towards definitive response patterns that could be used in field-based ecotoxicogenomic studies on the impacts of well-treated MWWE but suggested compromised adaptive immune responses.
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Affiliation(s)
- Patricija Marjan
- University of Calgary, Department of Biological Sciences, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
| | - Christopher J Martyniuk
- University of Florida, Department of Physiological Sciences, College of Veterinary Medicine, 2187 Mowry Rd., Gainesville, FL 32611, USA
| | - Maricor J Arlos
- University of Alberta, Civil and Environmental Engineering, 9211-116 Street NW, Edmonton, AB T6G 1H9, Canada
| | - Mark R Servos
- University of Waterloo, Department of Biology, 200 University Ave. W, Waterloo, ON N2L 3G1, Canada
| | - Norma J Ruecker
- The City of Calgary, Water Services, UEP-Water Resources, 2100, Station M, #35B, Calgary, AB T2P 2M5, Canada
| | - Kelly R Munkittrick
- University of Calgary, Department of Biological Sciences, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
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21
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Alghazali W, Van Geel PJ, Kenny S. A comprehensive study of settlement during the filling and post-closure phases at a landfill in Québec, Canada: Field data and TMB modelling. Waste Manag 2024; 178:85-96. [PMID: 38382350 DOI: 10.1016/j.wasman.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
In Northern climates, waste placed curbside the evening before waste collection can lead to partially frozen waste at placement, which delays biodegradation and biodegradation-induced settlement. A 12-year settlement dataset collected during the filling and post-closure phases at a landfill in Québec, Canada was analyzed. The dataset showed a delay in biodegradation-induced settlement due to the first three waste lifts being placed in the winter months and exhibited an increase in the settlement rate at later times when the waste temperatures increased to values that support biodegradation. The field data also demonstrated that the stiffness of MSW increased in response to confined stress as subsequent waste lifts were added. A thermal-mechanical-biological (TMB) model was developed, in COMSOL Multiphysics, to simulate the settlement dataset. TMB integrates a Generalized Kelvin-Voigt (GKV) model, simulating instantaneous and mechanical creep settlements, with a biodegradation-induced settlement model that relates heat/gas generation with time to biodegradation-induced settlement. The thermal model simulates heat transfer through conduction and includes a biodegradation heat generation source term. The GKV stiffness parameters are expressed as a function of the applied stress to account for waste compressibility effects on mechanical response, which is consistent with field data and the research literature. The paper focuses solely on the MSW settlement field data and model predictions, with thermal response analysis presented in a separate publication. The TMB model effectively predicted waste behaviour, including resistance to compressibility under higher stress and the delay in waste settlement for waste placed in winter. The temperature and settlement data provide a valuable dataset to validate different models that can be used to predict waste settlement in cold regions.
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Affiliation(s)
- Wameed Alghazali
- Department of Civil and Environmental Engineering, Carleton University, 1125 Colonel By Drive, Ottawa K1S 5B6, Canada
| | - Paul J Van Geel
- Department of Civil and Environmental Engineering, Carleton University, 1125 Colonel By Drive, Ottawa K1S 5B6, Canada.
| | - Shawn Kenny
- Department of Civil and Environmental Engineering, Carleton University, 1125 Colonel By Drive, Ottawa K1S 5B6, Canada
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22
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Nogovitsyn N, Ballester P, Lasby M, Dunlop K, Ceniti AK, Squires S, Rowe J, Ho K, Suh J, Hassel S, Souza R, Casseb RF, Harris JK, Zamyadi M, Arnott SR, Strother SC, Hall G, Lam RW, Poppenk J, Lebel C, Bray S, Metzak P, MacIntosh BJ, Goldstein BI, Wang J, Rizvi SJ, MacQueen G, Addington J, Harkness KL, Rotzinger S, Kennedy SH, Frey BN. An empirical analysis of structural neuroimaging profiles in a staging model of depression. J Affect Disord 2024; 351:631-640. [PMID: 38290583 DOI: 10.1016/j.jad.2024.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
We examine structural brain characteristics across three diagnostic categories: at risk for serious mental illness; first-presenting episode and recurrent major depressive disorder (MDD). We investigate whether the three diagnostic groups display a stepwise pattern of brain changes in the cortico-limbic regions. Integrated clinical and neuroimaging data from three large Canadian studies were pooled (total n = 622 participants, aged 12-66 years). Four clinical profiles were used in the classification of a clinical staging model: healthy comparison individuals with no history of depression (HC, n = 240), individuals at high risk for serious mental illness due to the presence of subclinical symptoms (SC, n = 80), first-episode depression (FD, n = 82), and participants with recurrent MDD in a current major depressive episode (RD, n = 220). Whole-brain volumetric measurements were extracted with FreeSurfer 7.1 and examined using three different types of analyses. Hippocampal volume decrease and cortico-limbic thinning were the most informative features for the RD vs HC comparisons. FD vs HC revealed that FD participants were characterized by a focal decrease in cortical thickness and global enlargement in amygdala volumes. Greater total amygdala volumes were significantly associated with earlier onset of illness in the FD but not the RD group. We did not confirm the construct validity of a tested clinical staging model, as a differential pattern of brain alterations was identified across the three diagnostic groups that did not parallel a stepwise clinical staging approach. The pathological processes during early stages of the illness may fundamentally differ from those that occur at later stages with clinical progression.
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Affiliation(s)
- Nikita Nogovitsyn
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Pedro Ballester
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mike Lasby
- Electrical and Software Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Katharine Dunlop
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Amanda K Ceniti
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada
| | - Scott Squires
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Jessie Rowe
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Keith Ho
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - JeeSu Suh
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Roberto Souza
- Electrical and Software Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Raphael F Casseb
- Neuroimaging Laboratory, University of Campinas, Campinas, SP, Brazil
| | | | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | | | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, ON, Canada
| | - Geoffrey Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jordan Poppenk
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, AB, Canada
| | - Signe Bray
- Department of Radiology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada; Child & Adolescent Imaging Research (CAIR) Program, Calgary, AB, Canada
| | - Paul Metzak
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Bradley J MacIntosh
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Hurvitz Brain Sciences Program, Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada; Computational Radiology & Artificial Intelligence (CRAI) Unit, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sakina J Rizvi
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Susan Rotzinger
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Krembil Research Centre, University Health Network, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Sidney H Kennedy
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Suicide & Depression Studies Program, St. Michael's Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Krembil Research Centre, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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23
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Lie JJ, Huynh C, Li J, Mak N, Wiseman SM. Psychological Impact of the COVID-19 Pandemic on Canadian Surgical Residents: A Province-Wide Study. J Surg Educ 2024; 81:486-494. [PMID: 38388311 DOI: 10.1016/j.jsurg.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/22/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the psychological impact of the COVID-19 pandemic on surgical residents. DESIGN An online survey was distributed evaluating multiple domains: demographics, health and socioeconomic factors, clinical experience, educational experience, and psychological outcomes. The Mayo Clinic Resident Well-Being Index (RWBI) was used as a validated measure of resident mental health. SETTING AND PARTICIPANTS Surgical residents from University of British Columbia's surgical residency programs. RESULTS A total of 31/86 surgical residents responded to the survey. Of which, 57% and 46% reported feeling burned out or depressed, respectively. Residents who were concerned about personal protective equipment supply and who lived with family members with comorbidities had a higher risk of depression (p = 0.03, p = 0.04). The median Mayo Clinic Resident Well-Being Index was 2.5, higher than the median of 2 observed in the United States national survey of residents. CONCLUSIONS The pandemic had a considerable negative impact on the psychological well-being of surgical residents.
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Affiliation(s)
- Jessica J Lie
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Huynh
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Li
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Mak
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.
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24
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Awad S, Turnnidge J, Cheung JJH, Taylor D, Dalgarno N, Schwartz A. Exploring perspectives of personal learning plans in a residency programme. Clin Teach 2024; 21:e13677. [PMID: 37969042 DOI: 10.1111/tct.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Personal learning plans (PLPs) have gained traction in postgraduate medical education as an avenue for enhancing resident learning. However, implementing PLPs in real-world education settings presents unique challenges. To realise the potential of PLPs, we must understand the factors that influence the quality of PLP implementation. The purpose of this study was to explore the use and implementation of PLPs during residency training from the residents' and academic advisors' perspectives within a competency-based residency programme. METHODS We conducted semi-structured interviews with residents (n = 18) and academic advisors (n = 9) in an Internal Medicine residency programme at a Canadian academic centre. Interviews were audio recorded, transcribed verbatim and analysed using open coding. FINDINGS Three higher order themes were developed to represent the participants' perceptions of implementing PLPs in a competency-based residency programme: (a) setting the stage for learning, (b) fostering meaningful engagement and (c) learning through reflection. Results indicated that implementing PLPs requires collaboration between residents and academic advisors and supports from the broader programme and institution. PLP implementation is an iterative process that can provide a salient avenue for reflection and the development of self-regulation skills. DISCUSSION AND CONCLUSION PLPs can be a useful tool to foster self-regulated learning skills in residency education. It is imperative to consider how social and environmental supports can be enacted to facilitate engagement with, and implementation of, PLPs.
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Affiliation(s)
- Sara Awad
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Jennifer Turnnidge
- Office of Professional Development and Educational Scholarship, Queen's University, Kingston, Ontario, Canada
| | - Jeffrey J H Cheung
- Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois, USA
| | - David Taylor
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nancy Dalgarno
- Office of Professional Development and Educational Scholarship, Queen's University, Kingston, Ontario, Canada
| | - Alan Schwartz
- Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois, USA
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25
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Lusty A, Alexanian J, Kitto S, Wood T, Lavallée LT, Morash C, Cagiannos I, Breau RH, Raîche I. How Surgeons Think to Avoid Error: A Case Study of the Neurovascular Bundle Sparing During a Robotic Prostatectomy. J Surg Educ 2024; 81:570-577. [PMID: 38490802 DOI: 10.1016/j.jsurg.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/06/2024] [Accepted: 01/15/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To illustrate how experts efficiently navigate a "slowing down moment" to obtain optimal surgical outcomes using the neurovascular bundle sparing during a robotic prostatectomy as a case study. DESIGN A series of semistructured interviews with four expert uro-oncologists were completed using a cognitive task analysis methodology. Cognitive task analysis, CTA, refers to the interview and extraction of a general body of knowledge. Each interview participant completed four 1 to 2-hour semistructured CTA interviews. The interview data were then deconstructed, coded, and analyzed using a grounded theory analysis to produce a CTA-grid for a robotic prostatectomy for each surgeon, with headings of: surgical steps, simplification maneuvers, visual cues, error/complication recognition, and error/complication management and avoidance. SETTING The study took place at an academic teaching hospital located in an urban center in Canada. PARTICIPANTS Four expert uro-oncologists participated in the study. RESULTS Visual cues, landmarks, common pitfalls, and technique were identified as the 4 key components of the decision-making happening during a slowing down moment in the neurovascular bundle sparing during a robotic prostatectomy. CONCLUSION The data obtained from the CTA is novel information identifying patterns and cues that expert surgeons use to inform their surgical decision-making and avoid errors. This decision-making knowledge of visual cues, landmarks, common pitfalls and techniques is also generalizable for other surgical subspecialties. Surgeon educators, surgical teaching programs and trainees looking to improve their decision-making skills could use these components to guide their educational strategies.
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Affiliation(s)
- Avril Lusty
- University of Ottawa, Queen's University, Ottawa, Ontario, Canada.
| | - Janet Alexanian
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Simon Kitto
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Tim Wood
- Department of Medical Education, Director, Assessment and Evaluation, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Luke T Lavallée
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Chris Morash
- Division of Urology, Department of Surgery, University of Ottawa, Ontario, Canada
| | - Ilias Cagiannos
- Division of Urology, Department of Surgery, University of Ottawa, Ontario, Canada
| | - Rodney H Breau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute/University of Ottawa, Ontario, Canada
| | - Isabelle Raîche
- Department of Surgery, University of Ottawa, Ontario, Canada
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26
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Samuels H. Reflections on Medical Assistance in Dying (MAID). Acad Psychiatry 2024; 48:199-200. [PMID: 37919540 DOI: 10.1007/s40596-023-01893-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Hannah Samuels
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Kinitz DJ, Ross LE, MacEachen E, Fehr C, Gesink D. "…full of opportunities, but not for everyone": A narrative inquiry into mechanisms of labor market inequity among precariously employed gay, bisexual, and queer men. Am J Ind Med 2024; 67:350-363. [PMID: 38374777 DOI: 10.1002/ajim.23574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/24/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle. METHODS Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis. RESULTS Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment. CONCLUSIONS These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.
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Affiliation(s)
- David J Kinitz
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Charles Fehr
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Yang Y, Bachour K, Tong M, Khair D, Gaffar J, Robert MC, Thompson P, Racine L, Segal L, Harissi-Dagher M. Incidence of ocular surface squamous neoplasia in pterygium specimens. Can J Ophthalmol 2024; 59:79-82. [PMID: 36610703 DOI: 10.1016/j.jcjo.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Pterygium and ocular surface squamous neoplasia (OSSN) have been recognized as likely related conditions and share similar risk factors such as ultraviolet radiation and chronic inflammation. The purpose of this study is to review the incidence of OSSN in pathology specimens sent as pterygium at a single tertiary centre between 2010 and 2022. METHODS This is a retrospective chart review of patients operated on for pterygium between 2010 and 2022 at the University of Montreal Health Centre. Data collected include baseline demographics, results of pathology specimen, and clinical information for cases diagnosed as OSSN on pathology. RESULTS A total of 1559 patients were operated on for a clinical diagnosis of pterygium between 2010 and 2022, of which 854 patients (55%) were male. A total of 1142 specimens had available pathology reports, and most of the specimens were consistent with pterygium on pathology (1105 of 1142; 97%). There was an unexpected finding of 3 cases of OSSN (3 of 1142; 0.3%). Other diagnosis besides pterygium were seen in 3% of specimens (34 of 1142), including nevus (n = 12), spheroidal degeneration (n = 3), pyogenic granuloma (n = 3), and lymphangiectasia (n = 2). The 3 cases of OSSN included an 81-year-old male of French-Canadian background, a 52-year-old male of South Asian background, and a 59-year-old female of French-Canadian background. The pathology was diagnosed as conjunctival intraepithelial neoplasia (CIN) grade 3, CIN grade 2, and CIN grade 2, respectively. CONCLUSION The finding of OSSN in pterygium is rare in our population but can be clinically difficult to distinguish. It is important to send all pterygium specimens for pathology.
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Affiliation(s)
- Yelin Yang
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Kenan Bachour
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Maya Tong
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Diana Khair
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Judy Gaffar
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Marie-Claude Robert
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Paul Thompson
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Louis Racine
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Laura Segal
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC
| | - Mona Harissi-Dagher
- Department of Ophthalmology, University of Montreal Health Centre (CHUM), Montreal, QC..
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29
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Chan WS, Funk L, Krawczyk M, Cohen SR, Cherba M, Dujela C, Stajduhar K. Community perspectives on structural barriers to dying well at home in Canada. Palliat Support Care 2024; 22:347-353. [PMID: 37503570 DOI: 10.1017/s1478951523001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVES To analyze how structural determinants and barriers within social systems shape options for dying well at home in Canada, while also shaping preferences for dying at home. METHODS To inform a descriptive thematic analysis, 24 Canadian stakeholders were interviewed about their views, experiences, and preferences about dying at home. Participants included compassionate community advocates, palliative care professionals, volunteers, bereaved family caregivers, residents of rural and remote regions, service providers working with structurally vulnerable populations, and members of francophone, immigrant, and 2SLGBTQ+ communities. RESULTS Analysis of stakeholders' insights and experiences led to the conceptualization of several structural barriers to dying well at home: inaccessible public and community infrastructure and services, a structural gap in death literacy, social stigma and discrimination, and limited access to relational social capital. SIGNIFICANCE OF RESULTS Aging in Canada, as elsewhere across the globe, has increased demand for palliative care and support, especially in the home. Support for people wishing to die at home is a key public health issue. However, while Canadian policy documents normalize dying in place as ideal, it is uncertain whether these fit with the real possibilities for people nearing the end of life. Our analysis extends existing research on health equity in palliative and end-of-life care beyond a focus on service provision. Results of this analysis identify the need to expand policymakers' structural imaginations about what it means to die well at home in Canada.
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Affiliation(s)
- Wing-Sun Chan
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
| | - Laura Funk
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
| | - Marian Krawczyk
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK
| | | | - Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, ON, Canada
| | - Carren Dujela
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Kelli Stajduhar
- School of Nursing, University of Victoria, Victoria, BC, Canada
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30
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Premranjith P, King W, Ashley-Martin J, Borghese MM, Bouchard M, Foster W, Arbuckle TE, Velez MP. Maternal exposure to metals and time-to-pregnancy: The MIREC cohort study. BJOG 2024; 131:589-597. [PMID: 38239019 DOI: 10.1111/1471-0528.17759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To study the association between maternal exposure to arsenic, cadmium, lead, manganese and mercury, time-to-pregnancy (TTP) and infertility. DESIGN Pregnancy-based retrospective TTP cohort study. SETTING Hospitals and clinics from ten cities across Canada. POPULATION A total of 1784 pregnant women. METHODS Concentrations of arsenic, cadmium, lead, manganese and mercury were measured in maternal whole blood during the first trimester of pregnancy as a proxy of preconception exposure. Discrete-time Cox proportional hazards models generated fecundability odds ratios (FOR) for the association between metals and TTP. Logistic regression generated odds ratios (OR) for the association between metals and infertility. Models were adjusted for maternal age, pre-pregnancy body mass index, education, income, recruitment site and plasma lipids. MAIN OUTCOME MEASURES TTP was self-reported as the number of months of unprotected intercourse to become pregnant. Infertility was defined as TTP longer than 12 months. RESULTS A total of 1784 women were eligible for the analysis. Mean ± SD maternal age and gestational age at interview were 32.2 ± 5.0 years, and 11.6 ± 1.6 weeks, respectively. Exposure to arsenic, cadmium, manganese or mercury was not associated with TTP or infertility. Increments of one standard deviation of lead concentrations resulted in a shorter TTP (adjusted FOR 1.09, 95% CI 1.02-1.16); however, the association was not linear when exposure was modelled in tertiles. CONCLUSION Blood concentrations of metals at typical levels of exposure among Canadian pregnant women were not associated with TTP or infertility. Further studies are needed to assess the role of lead, if any, on TTP.
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Affiliation(s)
- Priya Premranjith
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Will King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jillian Ashley-Martin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Michael M Borghese
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Maryse Bouchard
- Department of Environmental and Occupational Health, Université de Montréal, Montreal, Quebec, Canada
| | - Warren Foster
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, Ontario, Canada
| | - Tye E Arbuckle
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Maria P Velez
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
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31
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Racine M, Jensen MP, Cane D, Moulin DE, Vlaeyen JWS, Nielson WR. The Activity Management Inventory for Pain (AMI-P): Initial Development and Validation of a Questionnaire Based on Operant Learning and Energy Conservation Models of Activity Management. Clin J Pain 2024; 40:200-211. [PMID: 38258309 DOI: 10.1097/ajp.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVES Activity management is an important treatment component in chronic pain programs. However, there are shortcomings in measures of this construct, leading to inconsistencies in research findings. Here, we describe the development of the Activity Management Inventory for Pain (AMI-P). MATERIALS AND METHODS The AMI-P was developed by a group of international researchers with extensive expertise in both chronic pain and activity management. The initial evaluation of the AMI-P items included 2 studies that were both conducted in Canadian tertiary pain care centers. RESULTS The resulting 20-item measure has 3 behavior scales (Rest, Alternating Activity, and Planned Activity), and 4 goal scales (Feel Less Pain, Get More Done, Complete the Task, and Save Energy). The behavior scales evidenced marginal to good internal consistency and test-retest reliability, and a moderate positive association with an existing pacing measure. The Rest and Alternating Activity scales were associated with greater pain interference, the Alternating Activity and Planned Activity scales were associated with less satisfaction with social roles, and the Planned Activity scale was associated with fewer depressive symptoms. The Alternating Activity scale increased significantly from pretreatment to posttreatment. All goal scales were positively associated with all behavior scales. The Feel Less Pain goal scale was positively associated with measures of avoidance and pain interference, while the Get More Done goal scale was negatively associated with measures of depressive symptoms and overdoing. DISCUSSION The findings support the reliability and validity of the AMI-P scales, while also highlighting the complexity and multidimensional aspects of activity management.
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Affiliation(s)
- Mélanie Racine
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Douglas Cane
- Pain Management Unit, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Dwight E Moulin
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University
| | - Johan W S Vlaeyen
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven
- Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Warren R Nielson
- Department of Psychology, Western University and Lawson Health Research Institute, London, ON
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Ribeiro Paula R, Cusson M, Bertrand N, Bouchard S, Chantigny MH, Lemieux J, Marouani E, Villeneuve C, Faubert P. Correction factors for large-scale greenhouse gas assessment from pulp and paper mill sludge landfill sites. Waste Manag 2024; 177:177-181. [PMID: 38330513 DOI: 10.1016/j.wasman.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 02/10/2024]
Abstract
Assessments of greenhouse gas (GHG) emissions in managed areas are facing various challenges. A non-flow-through, non-steady-state (NFT-NSS) chamber coupled to a frame permanently inserted into the landfilled substrates is a standard method for quantifying GHG emissions in managed areas, such as pulp and paper mill sludge (PPMS) landfill sites. Frequent measurements are needed to minimize uncertainties on GHG emission factors at the landfill site scale. However, maintaining a frame inserted into the substrates for a long time period is often impossible due to landfilling management operations. Therefore, GHG measurements using NFT-NSS chambers placed directly on substrates' surface could be an interesting option. Our objectives were to determine the relationships between CO2, CH4, and N2O fluxes measured with (F + ) and without (F-) a frame inserted in the substrates' surface and to develop correction factors for fluxes measured without a frame. Measurements were made at different PPMS landfill sites in the province of Québec, Canada. Stronger GHG flux relationships were observed at the provincial (across sites) than the specific site scale: the variance in GHG fluxes from F- chambers explained up to 80 % of variance in fluxes from F + chambers. The measured CO2, CH4, and N2O fluxes in F- chambers were on average 53, 78, and 63 % lower, respectively, than those estimated by the models at provincial scale. The correction factors developed with this approach could greatly extend the number of sites where in situ GHG measurements can be done and would help refining GHG inventories at the provincial and national levels.
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Affiliation(s)
- Ranieri Ribeiro Paula
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Mathieu Cusson
- Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Normand Bertrand
- Research and Development Centre, Agriculture and Agri-Food Canada, 2560 Hochelaga Blvd, Québec, QC, G1V 2J3, Canada.
| | - Sylvie Bouchard
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Martin H Chantigny
- Research and Development Centre, Agriculture and Agri-Food Canada, 2560 Hochelaga Blvd, Québec, QC, G1V 2J3, Canada.
| | - Julie Lemieux
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Emna Marouani
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Claude Villeneuve
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada.
| | - Patrick Faubert
- Carbone boréal, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada; Laboratoire sur les écosystèmes terrestres boréaux, Département des sciences fondamentales, Université du Québec à Chicoutimi, 555 boulevard de l'Université, Chicoutimi, QC G7H 2B1, Canada.
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Janke N, Gohar B, Blokland K, Coe JB. Workplace psychosocial factors are associated with veterinary employees' organizational commitment to their current veterinary hospital. J Am Vet Med Assoc 2024; 262:1-10. [PMID: 38183765 DOI: 10.2460/javma.23.10.0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/06/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE To classify a sample of veterinary professionals into distinct organizational-commitment profiles and to identify associations between psychosocial aspects of the workplace and organizational-commitment profile membership. SAMPLE 487 veterinary employees who worked for a corporate veterinary organization in Canada. METHODS Survey components measured for this study included the Three-Component Model (TCM) Employee Commitment Survey-Revised, the Copenhagen Psychosocial Questionnaire, and participant demographics. First, latent profile analysis was used to identify distinct organizational-commitment profiles based on 3 components of commitment (affective, continuance, and normative). Next, the Mann-Whitney U test was used to compare participants' intention to leave their hospital on the basis of organizational-commitment profile. Finally, logistic regression was performed to assess the association between perceived psychosocial workplace characteristics and organizational-commitment profile membership. RESULTS 2 organizational-commitment profiles were identified: Affective/Normative (AC/NC) Dominant (n = 388) and Mid-Low Commitment (99). Participants in the Mid-Low Commitment Profile had a significantly higher intention-to-leave score (median, 3.0) than participants in the AC/NC Dominant Profile (median, 2.0; P < .001). Psychosocial factors found to predict membership in the AC/NC Dominant Profile included the following: influence at work (OR, 2.08; P < .001), meaning of work (OR, 1.38; P = .067), rewards/recognition (OR, 1.63; P = .007), and quality of leadership (OR, 1.85; P = .0003). Members of the AC/NC Dominant Profile also experienced greater work-life conflict (OR, 1.65; P = .003) compared to the Mid-Low Commitment Profile. CLINICAL RELEVANCE Findings identified potential psychosocial aspects of the workplace that can be considered to support more desirable organizational-commitment profiles that are likely to lead to favorable outcomes for veterinary practices and their employees.
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Affiliation(s)
- Natasha Janke
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Basem Gohar
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- 2Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - Kirsten Blokland
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jason B Coe
- 1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Grzybowski M, Singh M, Shah PS, Lee S, Toye J, Kanungo J, Khurshid F. Determining the Effect of Birth Weight on Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy. Am J Perinatol 2024; 41:554-560. [PMID: 35158385 DOI: 10.1055/s-0042-1742454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE We examine the effect of birth weight (BW) for gestational age (GA) on the temperatures reached during the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) with therapeutic hypothermia (TH). STUDY DESIGN Retrospective data of 1,736 neonates with HIE who received TH were extracted from the Canadian Neonatal Network database for neonates admitted from 2010 to 2017. Neonates were stratified into three BW groups: small for GA < 10th centile, large for GA > 90th centile, and according to GA 10th to 89th centile at a given gestation using Canadian population data norms. RESULTS There was no significant difference in the lowest temperature reached, the likelihood of overshooting temperatures < 32.5°C during TH, or the change of encephalopathy stages among the three groups. CONCLUSION BW for GA did not appear to influence the temperatures neonates reached during hypothermia or encephalopathy stage following TH. KEY POINT · Therapeutic hypothermia is well tolerated irrespective of weight for age. · SGA infants achieved and maintained target temperature similar to AGA and LGA babies. · Change in the Sarnat stage after hypothermia was similar across all birth weight groups.
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Affiliation(s)
| | - Megan Singh
- Queen's School of Medicine, Kingston, Ontario, Canada
| | - Prakesh S Shah
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Shoo Lee
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Toye
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jaideep Kanungo
- Department of Pediatrics, Victoria General Hospital, Victoria, Canada
| | - Faiza Khurshid
- Department of Pediatrics, Kingston Health Science Center, Kingston, Ontario, Canada
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Vishnyakova O, Song X, Rockwood K, Elliott LT, Brooks-Wilson A. Physiological phenotypes have optimal values relevant to healthy aging: sweet spots deduced from the Canadian Longitudinal Study on Aging. GeroScience 2024; 46:1589-1605. [PMID: 37688655 PMCID: PMC10828371 DOI: 10.1007/s11357-023-00895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 07/27/2023] [Indexed: 09/11/2023] Open
Abstract
Previous observations on a group of exceptionally healthy "Super-Seniors" showed a lower variance of multiple physiological measures relevant for health than did a less healthy group of the same age. The finding was interpreted as the healthier individuals having physiological measurement values closer to an optimal level, or "sweet spot." Here, we tested the generalizability of the sweet-spot hypothesis in a larger community sample, comparing differences in the variance between healthier and less healthy groups. We apply this method to the Canadian Longitudinal Study on Aging (CLSA) comprehensive cohort of 30,097 participants aged 45 to 85 years with deep phenotype data. Data from both sexes and four age ranges were analyzed. Five instruments were used to represent different aspects of health, physical, and cognitive functioning. We tested 231 phenotypic measures for lower variance in the most healthy vs. least healthy quartile of each sex and age group, as classified by the five instruments. Segmented regression was used to determine sex-specific optimal values. One hundred forty-two physiological measures (61%) showed lower variance in the healthiest than in the least healthy group, in at least one sex and age group. The difference in variance was most significant for hemoglobin A1c and was also significant for many body composition measurements, but not for bone mineral density. Ninety-four phenotypes showed a nonmonotonic relationship with health, consistent with the idea of a sweet spot; for these, we determined optimal values and 95% confidence intervals that were generally narrower than the ranges of current clinical reference intervals. These findings for sweet spot discovery validate the proposed approach for identifying traits important for healthy aging.
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Affiliation(s)
- Olga Vishnyakova
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Department of Statistics & Actuarial Science, Simon Fraser University, Room SC K10545, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Xiaowei Song
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- Surrey Memorial Hospital, Fraser Health Authority, Surrey, BC, Canada
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Lloyd T Elliott
- Department of Statistics & Actuarial Science, Simon Fraser University, Room SC K10545, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada.
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
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Tremblay-Cantin JC, Martin L, Proulx M, Priest ND, Larivière D. Levels of naturally occurring radioisotopes in local and imported bottled drinking water available in Québec City, Canada. J Environ Radioact 2024; 274:107411. [PMID: 38471302 DOI: 10.1016/j.jenvrad.2024.107411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Consumption of local and imported bottled water in Canada has greatly increased during the past three decades. While the presence of natural radioactivity is often overlooked when dealing with the water quality of these bottled products, it could contribute substantially to the uptake of radionuclides especially when sourced from regions with higher radioactivity levels compared to where it is consumed. In this study, the activity of several naturally occurring radionuclides (i.e., 210Po, 226,228Ra, 230,232Th, 234,235,238U) were measured in bottled water available in Québec, Canada after sample pretreatment and analysis by either radiometric or mass spectrometry approaches. 230,232Th and 228Ra concentrations were below minimum detectable activity levels in all samples tested. Analytical results for 234U, 235U, 238U, and 226Ra showed concentrations that ranged from 0.38 to 115 mBq/L, (2.2-313) x 10-2 mBq/L, 0.48-58.4 mBq/L, and 1.1-550 mBq/L, respectively. 210Po was detected in only 5 samples and its activity ranged from 2 to 26 mBq/L. To determine variability in activity within brands, the same brands of bottled water were purchased during two consecutive years and analyzed. The possible radiological impact of the consumption of these types of water was assessed based on different drinking habit scenarios. Some of the imported water brands showed higher activity concentrations than local sources or tap water, suggesting that individuals drinking predominantly imported bottled water would receive a higher radiation dose than those who drink mainly local water.
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Affiliation(s)
| | - Laurie Martin
- Radioecology Laboratory, Chemistry Department, Laval University, 1045 Avenue de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Myriame Proulx
- Radioecology Laboratory, Chemistry Department, Laval University, 1045 Avenue de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Nicholas D Priest
- Radioecology Laboratory, Chemistry Department, Laval University, 1045 Avenue de la Médecine, Québec, QC, Canada, G1V 0A6
| | - Dominic Larivière
- Radioecology Laboratory, Chemistry Department, Laval University, 1045 Avenue de la Médecine, Québec, QC, Canada, G1V 0A6.
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Istanboulian L, Dale C, Terblanche E, Rose L. Clinician-perceived barriers and facilitators for the provision of actionable processes of care important for persistent or chronic critical illness. J Adv Nurs 2024; 80:1619-1629. [PMID: 37902117 DOI: 10.1111/jan.15924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/06/2023] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
AIM To explore clinician-perceived barriers to and facilitators for the provision of actionable processes of care important for patients with persistent or chronic critical illness. DESIGN Qualitative descriptive interview study. METHODS Secondary analysis of semi-structured telephone interviews (December 2018 - February 2019) with professionally diverse clinicians working with adults experiencing persistent or chronic critical illness in Canadian intensive care units. We used deductive content analysis informed by the Social-Ecological Model. RESULTS We recruited 31 participants from intensive care units across nine Canadian provinces. Reported intrapersonal level barriers to the provision of actionable processes of care included lack of training, negative emotions and challenges prioritizing these patients. Facilitators included establishment of positive relations and trust with patients and family. Interpersonal barriers included communication difficulties, limited access to physicians and conflict. Facilitators included communication support, time spent with the patient/family and conflict management. Institutional barriers comprised inappropriate care processes, inadequate resources and disruptive environmental conditions. Facilitators were regular team rounds, appropriate staffing and employment of a primary care (nurse and/or physician) model. Community-level barriers included inappropriate care location and insufficient transition support. Facilitators were accessed to alternate care sites/teams and to formalized transition support. Public policy-level barriers included inadequacy of formal education programs for the care of these patients; knowledge implementation for patient management was identified as a facilitator. CONCLUSION Our results highlighted multilevel barriers and facilitators to the delivery of actionable processes important for quality care for patient/family experiencing persistent or chronic critical illness. IMPACT Using the Social-Ecological Model, the results of this study provide intra and interpersonal, institutional, community and policy-level barriers to address and facilitators to harness to improve the care of patients/family experiencing persistent or chronic critical illness. REPORTING METHOD Consolidated criteria for reporting qualitative studies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Laura Istanboulian
- Michael Garron Hospital, Toronto, Canada
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada
| | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing and Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Ella Terblanche
- Department of Critical Care, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Department of Critical Care and Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK
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Reed MJ, Karuranga S, Kearns D, Alawiye S, Clarke B, Möckel M, Karamercan M, Janssens K, Riesgo LGC, Torrecilla FM, Golea A, Fernández Cejas JA, Lupan-Muresan EM, Zaimi E, Nuernberger A, Rennét O, Skjaerbaek C, Polyzogopoulou E, Imecz J, Groff P, Camilleri R, Cimpoesu D, Jovic M, Miró Ò, Anderson R, Laribi S. Management of syncope in the Emergency Department: a European prospective cohort study (SEED). Eur J Emerg Med 2024; 31:136-146. [PMID: 38015745 DOI: 10.1097/mej.0000000000001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND AND IMPORTANCE In 2018, the European Society of Cardiology (ESC) produced syncope guidelines that for the first-time incorporated Emergency Department (ED) management. However, very little is known about the characteristics and management of this patient group across Europe. OBJECTIVES To examine the prevalence, clinical presentation, assessment, investigation (ECG and laboratory testing), management and ESC and Canadian Syncope Risk Score (CSRS) categories of adult European ED patients presenting with transient loss of consciousness (TLOC, undifferentiated or suspected syncope). DESIGN Prospective, multicentre, observational cohort study. SETTINGS AND PARTICIPANTS Adults (≥18 years) presenting to European EDs with TLOC, either undifferentiated or thought to be of syncopal origin. MAIN RESULTS Between 00:01 Monday, September 12th to 23:59 Sunday 25 September 2022, 952 patients presenting to 41 EDs in 14 European countries were enrolled from 98 301 ED presentations (n = 40 sites). Mean age (SD) was 60.7 (21.7) years and 487 participants were male (51.2%). In total, 379 (39.8%) were admitted to hospital and 573 (60.2%) were discharged. 271 (28.5%) were admitted to an observation unit first with 143 (52.8%) of these being admitted from this. 717 (75.3%) participants were high-risk according to ESC guidelines (and not suitable for discharge from ED) and 235 (24.7%) were low risk. Admission rate increased with increasing ESC high-risk factors; 1 ESC high-risk factor; n = 259 (27.2%, admission rate=34.7%), 2; 189 (19.9%; 38.6%), 3; 106 (11.1%, 54.7%, 4; 62 (6.5%, 60.4%), 5; 48 (5.0%, 67.9%, 6+; 53 (5.6%, 67.9%). Furthermore, 660 (69.3%), 250 (26.3%), 34 (3.5%) and 8 (0.8%) participants had a low, medium, high, and very high CSRS respectively with respective admission rates of 31.4%, 56.0%, 76.5% and 75.0%. Admission rates (19.3-88.9%), use of an observation/decision unit (0-100%), and percentage high-risk (64.8-88.9%) varies widely between countries. CONCLUSION This European prospective cohort study reported a 1% prevalence of syncope in the ED. 4 in 10 patients are admitted to hospital although there is wide variation between country in syncope management. Three-quarters of patients have ESC high-risk characteristics with admission percentage rising with increasing ESC high-risk factors.
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Affiliation(s)
- Matthew J Reed
- Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Suvi Karuranga
- European Society for Emergency Medicine, Antwerp, Belgium
| | - David Kearns
- University of Edinburgh Medical School, Edinburgh, UK
| | - Salma Alawiye
- Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh
| | - Ben Clarke
- Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh
| | - Martin Möckel
- Department of Emergency and Acute Medicine, Campus Mitte and Virchow, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Mehmet Karamercan
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Kelly Janssens
- St Vincents University Healthcare Group, Dublin, Ireland
| | | | | | - Adela Golea
- Emergency Unit, University of Medicine and Pharmacy Cluj, University Emergency County Hospital, Cluj Napoca, Romania
| | | | - Eugenia Maria Lupan-Muresan
- Emergency Medicine Discipline, 'Iuliu Hatieganu' University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Edmond Zaimi
- University Hospital Centre, Mother Teresa of Tirana, Tirana, Albania
| | | | | | | | | | | | - Paolo Groff
- Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Diana Cimpoesu
- University of Medicine and Pharmacy Grigore T Popa, Iasi, Romania
| | - Miljan Jovic
- General Hospital, Health Centre, Zaječar, Serbia
| | - Òscar Miró
- Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | | | - Said Laribi
- Emergency Medicine Department, CHU Tours, Tours University, Tours, France
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Bodenstein K, Diep D, Gruber J, Varga P, Mehta G, Memarpour M, Klil-Drori S, Bukari S, Launay C, Rej S, Sekhon H. myHealthHub for older adult inpatients to reduce loneliness, and improve patient engagement and mental health: protocol of a pilot randomized controlled trial. Aging Ment Health 2024; 28:646-651. [PMID: 37830771 DOI: 10.1080/13607863.2023.2265841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/27/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Older Canadian adults make up 85% of hospital stays which are associated with increased loneliness, stress, anxiety, and/or depression. There is a need for novel approaches to reduce loneliness and mental health outcomes in older adult hospital inpatients to prevent further strain on an already overwhelmed healthcare system. METHODS This is a pilot randomized controlled trial (RCT) exploring the efficacy of a bedside multimodal interaction system, myHealthHub, on loneliness, quality of life (QOL), patient engagement, and other mental health outcomes compared to an active control group in older adult inpatients (n = 60) from baseline to 5-days. Qualitative analyses will be conducted through semi-structured interviews with older adults (n = 8-10) and hospital staff, nurses, and clinicians (n = 4-5) facilitating the service to evaluate patient engagement and experience with myHealthHub. RESULTS Not applicable. CONCLUSION This novel pilot clinical trial will obtain preliminary data on the efficacy of myHealthHub in reducing loneliness, QOL, patient engagement, and mental health outcomes in older adult inpatients. If successful, this could provide a potential means to improve patient experience in hospitals and reduce the burden and additional expense on the healthcare system.
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Affiliation(s)
- Katie Bodenstein
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Danny Diep
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Johanna Gruber
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Peter Varga
- Healthhub Patient Engagement Solutions, ON, Canada
| | | | | | - Sivan Klil-Drori
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Syeda Bukari
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Cyrille Launay
- Division of Geriatric Medicine, Jewish General Hospital, Montreal, QC, Canada
| | - Soham Rej
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
| | - Harmehr Sekhon
- Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada
- Division of Geriatric Psychiatry, McLean Hospital, Boston, MA, USA
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Lebrault H, Martini R, Manolov R, Chavanne C, Krasny-Pacini A, Chevignard M. Cognitive Orientation to daily Occupational Performance to improve occupational performance goals for children with executive function deficits after acquired brain injury. Dev Med Child Neurol 2024; 66:501-513. [PMID: 37792283 DOI: 10.1111/dmcn.15759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 10/05/2023]
Abstract
AIM To determine the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in improving the occupational performance goals of children and young people with executive function deficits after acquired brain injury (ABI) (e.g. etiologies such as stroke, encephalitis, brain tumor, and traumatic brain injury). METHOD A replicated single-case experimental study using a randomized multiple baseline design across participants and goals was used. Three clusters of four participants (12 participants, nine males and three females, aged 8-16 years) were included. The intervention consisted of 14 individual CO-OP sessions. Each participant chose four goals; three goals were trained during the intervention sessions and a fourth goal served as the control. The Goal Attainment Scale (GAS) was used as a repeated measure to determine goal achievement while the Canadian Occupational Performance Measure (COPM) was used to identify the perceived goal achievement of children, young people, and their parents. RESULTS For 26 of the 35 trained goals, the intervention led to statistically significant improvements in the GAS. Perceived occupational performance and satisfaction improved significantly for the trained goals (30 out of 35 goals for the COPM performance and satisfaction of participants; 26 out 31 goals for the COPM performance of parents; 24 out of 31 goals for the COPM satisfaction of parents) and were maintained at the follow-up. Almost all COPM control goal results were significant, but these changes were not supported by the GAS measures or the statistical analysis. INTERPRETATION The generally positive results of this study provide evidence of the benefits of using the CO-OP approach with this population.
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Affiliation(s)
- Hélène Lebrault
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Rose Martini
- Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Rumen Manolov
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Céline Chavanne
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
| | - Agata Krasny-Pacini
- Pôle de Médecine Physique et de Réadaptation, Institut Universitaire de Réadaptation Clemenceau (IURC), Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Unité INSERM 1114 Neuropsychologie Cognitive et Physiopathologie De La Schizophrenie, Département De Psychiatrie, University of Strasbourg, Strasbourg, France
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint-Maurice Hospitals, Saint-Maurice, France
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
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Nath S, Thomson WM, Baker SR, Jamieson LM. A bibliometric analysis of Community Dentistry and Oral Epidemiology: Fifty years of publications. Community Dent Oral Epidemiol 2024; 52:171-180. [PMID: 37798876 DOI: 10.1111/cdoe.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/18/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. METHODS The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. RESULTS The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. CONCLUSION This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Sarah R Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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Rindi LV, Zaçe D, Braccialarghe N, Massa B, Barchi V, Iannazzo R, Fato I, De Maria F, Kontogiannis D, Malagnino V, Sarmati L, Iannetta M. Drug-Induced Progressive Multifocal Leukoencephalopathy (PML): A Systematic Review and Meta-Analysis. Drug Saf 2024; 47:333-354. [PMID: 38321317 DOI: 10.1007/s40264-023-01383-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Progressive multifocal leukoencephalopathy (PML) was first described among patients affected by hematological or solid tumors. Following the human immunodeficiency virus (HIV) epidemic, people living with HIV have represented most cases for more than a decade. With the diffusion of highly active antiretroviral therapy, this group progressively decreased in favor of patients undergoing treatment with targeted therapy/immunomodulators. In this systematic review and meta-analysis, the objective was to assess which drugs are most frequently related to PML development, and report the incidence of drug-induced PML through a meta-analytic approach. METHODS The electronic databases MEDLINE, EMBASE, ClinicalTrials.gov, Web of Science and the Canadian Agency for Drugs and Technologies in Health Database (CADTH) were searched up to May 10, 2022. Articles that reported the risk of PML development after treatment with immunomodulatory drugs, including patients of both sexes under the age of 80 years, affected by any pathology except HIV, primary immunodeficiencies or malignancies, were included in the review. The incidence of drug-induced PML was calculated based on PML cases and total number of patients observed per 100 persons and the observation time. Random-effect metanalyses were conducted for each drug reporting pooled incidence with 95% confidence intervals (CI) and median (interquartile range [IQR]) of the observation time. Heterogeneity was measured by I2 statistics. Publication bias was examined through funnel plots and Egger's test. RESULTS A total of 103 studies were included in the systematic review. In our analysis, we found no includible study reporting cases of PML during the course of treatment with ocrelizumab, vedolizumab, abrilumab, ontamalimab, teriflunomide, daclizumab, inebilizumab, basiliximab, tacrolimus, belimumab, infliximab, firategrast, disulone, azathioprine or danazole. Dalfampridine, glatiramer acetate, dimethyl fumarate and fingolimod show a relatively safe profile, although some cases of PML have been reported. The meta-analysis showed an incidence of PML cases among patients undergoing rituximab treatment for multiple sclerosis (MS) of 0.01 cases/100 persons (95% CI - 0.08 to 0.09; I2 = 20.4%; p = 0.25) for a median observation period of 23.5 months (IQR 22.1-42.1). Treatment of MS with natalizumab carried a PML risk of 0.33 cases/100 persons (95% CI 0.29-0.37; I2 = 50%; p = 0.003) for a median observation period of 44.1 months (IQR 28.4-60) and a mean number of doses of 36.3 (standard deviation [SD] ± 20.7). When comparing data about patients treated with standard interval dosing (SID) and extended interval dosing (EID), the latter appears to carry a smaller risk of PML, that is, 0.08 cases/100 persons (95% CI 0.0-0.15) for EID versus 0.3 cases/100 persons (95% CI 0.25-0.34) for SID. CONCLUSIONS A higher risk of drug-related PML in patients whose immune system is not additionally depressed by means of neoplasms, HIV or concomitant medications is found in the neurological field. This risk is higher in MS treatment, and specifically during long-term natalizumab therapy. While this drug is still routinely prescribed in this field, considering the efficacy in reducing MS relapses, in other areas it could play a smaller role, and be gradually replaced by other safer and more recently approved agents.
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Affiliation(s)
- Lorenzo Vittorio Rindi
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Drieda Zaçe
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Neva Braccialarghe
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Barbara Massa
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Virginia Barchi
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Roberta Iannazzo
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Ilenia Fato
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Francesco De Maria
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Dimitra Kontogiannis
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
| | - Vincenzo Malagnino
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | - Marco Iannetta
- Department of Systems Medicine, Tor Vergata University, Via Montpellier, 1, 00133, Rome, Italy.
- Infectious Disease Clinic, Policlinico Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy.
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Critical Care Canada Forum 2023 Abstracts. Can J Anaesth 2024; 71:1-224. [PMID: 38453796 DOI: 10.1007/s12630-024-02727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
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Wong TKY, Hamza CA. Longitudinal Associations among Identity Processes and Mental Health in Young Adulthood: The Mediating Role of Social Support. J Youth Adolesc 2024; 53:814-832. [PMID: 37864731 DOI: 10.1007/s10964-023-01883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Abstract
Emerging adulthood (ages 18-25) is a period of identity exploration, particularly for young adults navigating the transition to post-secondary school. Little is known about how changes in identity exploration may be related to emerging adults' mental health, or the role of social support plays in identity-related processes. In the present study, associations among identity exploration, internalizing symptoms, and perceived social support were examined. Participants included a diverse group of emerging adults (N = 1,125, Mage = 17.96 years) studying at a Canadian university. Random-intercept cross-lagged modeling demonstrated that within-person increases in exploration in breadth predicted fewer depressive symptoms over time, whereas within-person increases in exploration in depth predicted more depressive and anxious symptoms over time. A mediation effect from perceived support from significant other to depressive symptoms via exploration in breadth was also evident. Findings suggest that identity exploratory processes may be developmentally relevant in emerging adulthood, but their implications for mental health may differ. Perceived social support is also meaningfully related to identity exploration and mental health.
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Affiliation(s)
- Tracy K Y Wong
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada.
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Chloe A Hamza
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
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Patel A, Wilson CA, Davidson J, Lam JY, Graham ME, Seemann NM. The Intersection of Family Planning and Perception of Career Advancement in General Surgery. J Surg Res 2024; 296:481-488. [PMID: 38325010 DOI: 10.1016/j.jss.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Women in surgery face unique challenges, particularly as it relates to family planning, parental leave, infant feeding, and career advancement. This study highlights disparities in present day general surgery training to tackle longstanding gender inequities. METHODS An open, anonymous online survey was distributed to Canadian residents, fellows, and practicing general surgeons through the Canadian Association of General Surgeons e-mail list from November 2021-March 2022. Data were analyzed descriptively and chi-square tests were performed to examine categorical outcomes across gender. RESULTS A total of 89 general surgery respondents (13.8% response rate) completed the survey (22 cisgender men; 65 cisgender women). Twenty six percent of participants had accessed fertility services or used assistive reproductive technologies. Of the participants with children, 36.4% of men and 100.0% of women took at least one parental leave during residency or clinical practice. A greater proportion of women compared to men agreed that their training/practice influenced their decision to have children (P = 0.002) and when to have children (P < 0.001). Similarly, a greater proportion of women indicated they had concerns about future family planning (P = 0.008), future fertility (P = 0.002), and future parental leave (P = 0.026). Fifty nine percent of women and zero men agreed that taking parental leave impacted their career advancement (P = 0.04). CONCLUSIONS Women surgeons and surgical trainees continue to face challenges with respect to family planning, parental leave, infant feeding, and career advancement. Further research is needed to explore the experiences of women surgeons. By providing surgeons with the support required to achieve their family planning goals, surgeons can accomplish their family and career goals with less conflict.
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Affiliation(s)
- Ashaka Patel
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Claire A Wilson
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada
| | - Jacob Davidson
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada
| | - Jennifer Y Lam
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada
| | - M Elise Graham
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada
| | - Natashia M Seemann
- Division of Paediatric Surgery, London Health Sciences Centre, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada.
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Hassanabadi N, Berger C, Papaioannou A, Cheung AM, Rahme E, Leslie WD, Goltzman D, Morin SN. Geographic variation in bone mineral density and prevalent fractures in the Canadian longitudinal study on aging. Osteoporos Int 2024; 35:599-611. [PMID: 38040857 DOI: 10.1007/s00198-023-06975-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
Awareness of the prevalence of osteoporosis and fractures across jurisdictions can guide the development of local preventive programs and healthcare policies. We observed geographical variations in total hip bone mineral density and in the prevalence of major osteoporotic fractures across Canadian provinces, which persisted after adjusting for important covariates. PURPOSE We aimed to describe sex-specific total hip bone mineral density (aBMD) and prevalent major osteoporotic fractures (MOF) variation between Canadian provinces. METHODS We used baseline data from 21,227 Canadians (10,716 women, 10,511 men) aged 50-85 years in the Canadian Longitudinal Study on Aging (CLSA; baseline: 2012-2015). Linear and logistic regression models were used to examine associations between province of residence and total hip aBMD and self-reported MOF, stratified by sex. CLSA sampling weights were used to generate the prevalence and regression estimates. RESULTS The mean (SD) age of participants was 63.9 (9.1) years. The mean body mass index (kg/m2) was lowest in British Columbia (27.4 [5.0]) and highest in Newfoundland and Labrador (28.8 [5.3]). Women and men from British Columbia had the lowest mean total hip aBMD and the lowest prevalence of MOF. Alberta had the highest proportion of participants reporting recent falls (12.0%), and Manitoba (8.4%) the fewest (p-value=0.002). Linear regression analyses demonstrated significant differences in total hip aBMD: women and men from British Columbia and Alberta, and women from Manitoba and Nova Scotia had lower adjusted total hip aBMD than Ontario (p-values<0.02). Adjusted odds ratios (95% confidence intervals, CI) for prevalent MOF were significantly lower in women from British Columbia (0.47 [95% CI: 0.32; 0.69]) and Quebec (0.68 [95% CI: 0.48; 0.97]) and in men from British Columbia (0.40 [95% CI:0.22; 0.71]) compared to Ontario (p-values<0.03). Results were similar when adjusting for physical performance measures and when restricting the analyses to participants who reported White race/ethnicity. CONCLUSION Geographical variations in total hip aBMD and in the prevalence of MOF between provinces persisted after adjusting for important covariates which suggests an association with unmeasured individual and environmental factors.
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Affiliation(s)
- N Hassanabadi
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - C Berger
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - A Papaioannou
- Department of Medicine, McMaster University, Hamilton, Canada
| | - A M Cheung
- Department of Medicine, University of Toronto, Toronto, Canada
| | - E Rahme
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - W D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Canada
| | - D Goltzman
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - S N Morin
- Department of Medicine, McGill University, Montreal, Canada.
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada.
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News Brief: The FDA grants Florida approval to import drugs from Canada. Am J Nurs 2024; 124:15. [PMID: 38511698 DOI: 10.1097/01.NAJ.0001010536.57932.d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
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Tian EJ, Nguyen C, Chung L, Morris C, Kumar S. The Effectiveness of Public Awareness Initiatives Aimed at Encouraging the Use of Evidence-Based Recommendations by Health Professionals: A Systematic Review. J Patient Saf 2024; 20:147-163. [PMID: 38372511 DOI: 10.1097/pts.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Public awareness initiatives have attracted growing attention globally, as a strategy to reduce low-value care and disinformation. However, knowledge gap remains in determining their effects. The aim of this systematic review was to summarize existing evidence to date on global effectiveness of public awareness initiatives. METHODS Primary quantitative studies focusing on passive delivery of public awareness initiatives that targeted health professionals were included. Eligible studies were identified through search of MEDLINE, Embase, Emcare, the Cochrane Library, PsycINFO, Business Source Complete, Emerald Insight, and Google (initially on December 19, 2018, followed by updated search between July 8-10, 2019, and then between March 8-9, 2022) and the reference list of relevant studies. Methodological quality of included studies was assessed using modified McMaster critical appraisal tool. A narrative synthesis of the study outcomes was conducted. RESULTS Twenty studies from United States, United Kingdom, Canada, Australia, and multicountry were included. Nineteen studies focused on Choosing Wisely initiative and one focused on National Institute of Clinical Excellence reminders. Most studies investigated one recommendation of a specialty. The findings showed conflicting evidence on the effectiveness of public awareness initiatives, suggesting passive delivery has limited success in reducing low-value care among health professionals. CONCLUSIONS This review highlights the complexity of change in an established practice pattern in health care. As passive delivery of public awareness initiatives has limited potential to initiate and sustain change, wide-ranging intervention components need to be integrated for a successful implementation.
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Affiliation(s)
| | - Cathy Nguyen
- UniSA Business, University of South Australia, University of South Australia, Adelaide, Australia
| | - Lilian Chung
- From the UniSA Allied Health and Human Performance
| | - Chloe Morris
- From the UniSA Allied Health and Human Performance
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Salimi A, Saed Aldien A, ElHawary H, Ambikkumar A, Kapusta MA. Canadian legal cases in ophthalmology: a closer look at 40 years' worth of data. Can J Ophthalmol 2024; 59:83-88. [PMID: 36931321 DOI: 10.1016/j.jcjo.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023]
Abstract
OBJECTIVE To assess the characteristics of malpractice lawsuits against Canadian ophthalmologists and the predisposing factors leading to claims. DESIGN Retrospective case series. METHODS A systematic search of the 2 largest Canadian online legal databases, LexisNexis Canada and Westlaw Canada, was performed to collect cases against ophthalmologists in Canadian courts from 1977 to 2021. RESULTS This study comprised 68 legal cases, including 52 lawsuits, 14 cases appealed once, and 2 cases appealed twice. Most cases concerned surgical procedures (46.2%), followed by misdiagnoses or lack thereof (32.7%) and nonsurgical procedures (21.2%). Half the cases (n = 26) were immediately dismissed by the judge in favour of the ophthalmologist, though among the remaining half that proceeded to trial the majority (88.5%) were won by the patients. All appeals by patients were dismissed by the judge. The median monetary value of damages awarded was $308,202. CONCLUSIONS This study is the first to report on ophthalmology-involved medical litigation cases in Canada. Most cases were ruled in favour of the ophthalmologist, but most of those that were not immediately dismissed by the judge were ruled in favour of the plaintiff. Notably, a plurality of these cases argued for a lack of informed consent, and every case in which a lack was successfully pleaded was ruled in favour of the plaintiff, highlighting the importance of appropriate informed consent. The findings of this study give Canadian ophthalmologists insight into areas of practice that commonly lead to litigation and can aid in improving clinical practice and risk management.
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Affiliation(s)
- Ali Salimi
- Department of Ophthalmology, McGill University, Montreal, QC.
| | - Ammar Saed Aldien
- School of Law, New York University, New York, NY; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC
| | - Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, QC
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Carl J, Abu-Omar K, Bernard P, Lohmann J, White P, Peters J, Sahlqvist S, Ma J, Duncan M, Barnett LM. Physical Literacy in the Context of Climate Change: Is There a Need for Further Refinement of the Concept? J Phys Act Health 2024; 21:316-319. [PMID: 38176406 DOI: 10.1123/jpah.2023-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
The concept of physical literacy (PL) has witnessed enormous popularity in recent years and has undergone substantial theoretical evolvement during the last 2 decades. However, the research field pertaining to PL has not yet initiated discussions around the challenges of climate change and the alignment with conceptualizations of planetary health. Therefore, we argue that the consideration of an "ecological domain" for individual physical activity, in the form of ecological awareness, would further evolve the concept. We illustrate how to potentially integrate adjustments within the most frequent PL definitions of the field (eg, those in Australia, Canada, England, Ireland, the United States, or by the International Physical Literacy Association) without questioning the entire integrity of these elaborate conceptualizations. An ecological domain of PL would not only interact with the postulated physical, cognitive, psychological/affective, and social domains of PL but also have important implications for the (re)design of interventions and practices in physical activity contexts. We call the scientific community, both on national and international scales, to intensify the discussions and initiate a research agenda involving an "ecological domain" of PL.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, University Institute of Mental Health at Montreal, Montreal, QC, Canada
| | - Julia Lohmann
- Institute of Sports Science, Augsburg University, Augsburg, Germany
| | - Peta White
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Jacqui Peters
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Shannon Sahlqvist
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds,VIC, Australia
| | - Jiani Ma
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Michael Duncan
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Lisa M Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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