Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 96.715
Filtrar
1.
Bull World Health Organ ; 99(9): 640-652E, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34475601

RESUMEN

Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences. Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations. Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.


Asunto(s)
Guías como Asunto , Accidente Cerebrovascular/terapia , Australia , Isquemia Encefálica , Canadá , Humanos , Accidente Cerebrovascular/prevención & control
2.
Sensors (Basel) ; 21(17)2021 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-34502600

RESUMEN

The use of global navigation satellite systems (GNSS) precise point positioning (PPP) to estimate zenith tropospheric delay (ZTD) profiles in kinematic vehicular mode in mountainous areas is investigated. Car-mounted multi-constellation GNSS receivers are employed. The Natural Resources Canada Canadian Spatial Reference System PPP (CSRS-PPP) online service that currently processes dual-frequency global positioning system (GPS) and Global'naya Navigatsionnaya Sputnikovaya Sistema (GLONASS) measurements and is now capable of GPS integer ambiguity resolution is used. An offline version that can process the above and Galileo measurements simultaneously, including Galileo integer ambiguity resolution is also tested to evaluate the advantage of three constellations. A multi-day static data set observed under open sky is first tested to determine performance under ideal conditions. Two long road profile tests conducted in kinematic mode are then analyzed to assess the capability of the approach. The challenges of ZTD kinematic profiling are numerous, namely shorter data sets, signal shading due to topography and forests of conifers along roads, and frequent losses of phase lock requiring numerous but not always successful integer ambiguity re-initialization. ZTD profiles are therefore often only available with float ambiguities, reducing system observability. Occasional total interruption of measurement availability results in profile discontinuities. CSRS-PPP outputs separately the zenith hydrostatic or dry delay (ZHD) and water vapour content or zenith wet delay (ZWD). The two delays are analyzed separately, with emphasis on the more unpredictable and highly variable ZWD, especially in mountainous areas. The estimated delays are compared with the Vienna Mapping Function 1 (VMF1), which proves to be highly effective to model the large-scale profile variations in the Canadian Rockies, the main contribution of GNSS PPP being the estimation of higher frequency ZWD components. Of the many conclusions drawn from the field experiments, it is estimated that kinematic profiles are generally determined with accuracy of 10 to 20 mm, depending on the signal harshness of the environment.


Asunto(s)
Sistemas de Información Geográfica , Vapor , Fenómenos Biomecánicos , Canadá , Lenguaje
3.
J Bus Contin Emer Plan ; 15(1): 17-29, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34465407

RESUMEN

Exercise GTA Unified was a functional, multi-agency, cross-jurisdictional, health-sector focused mass casualty preparedness exercise conducted in the Greater Toronto Area (GTA) on 28th November, 2019. With over 1,000 unique paper-based and electronic injects and 34 participating agencies, including 22 separate hospital sites, Exercise GTA Unified is likely the largest health-sector focused mass casualty preparedness exercise ever conducted in Canada. The exercise design approach supported a successful, objective-based functional exercise, with elements of marked realism for participants. The exercise offered a unique opportunity to collect data for future analysis and the insights gained will have a transformative impact on interagency engagement and cooperation for emergency response planning. Furthermore, the approach adopted for the exercise is affordable, reproducible, scalable and transferrable to sectors beyond the health system. This paper provides a detailed review of the key planning and design components adopted in the development and implementation of the exercise, as well as practical insights for the design and conduct of multi-agency, cross-jurisdictional functional exercises.


Asunto(s)
Planificación en Desastres , Incidentes con Víctimas en Masa , Canadá , Urgencias Médicas , Servicio de Urgencia en Hospital , Humanos
4.
BMC Med Educ ; 21(1): 476, 2021 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-34493276

RESUMEN

BACKGROUND: With increasing availability of point-of-care ultrasound (POCUS) education in medical schools, it is unclear whether or not learning needs of junior medical residents have evolved over time. METHODS: We invited all postgraduate year (PGY)-1 residents at three Canadian internal medicine residency training programs in 2019 to complete a survey previously completed by 47 Canadian Internal Medicine PGY-1 s in 2016. Using a five-point Likert scale, participants rated perceived applicability of POCUS to the practice of internal medicine and self-reported skills in 15 diagnostic POCUS applications and 9 procedures. RESULTS: Of the 97 invited residents, 58 (60 %) completed the survey in 2019. Participants reported high applicability but low skills across all POCUS applications and procedures. The 2019 cohort reported higher skills in assessing pulmonary B lines than the 2016 cohort (2.3 ± SD 1.0 vs. 1.5 ± SD 0.7, adjusted p-value = 0.01). No other differences were noted. CONCLUSIONS: POCUS educational needs continue to be high in Canadian internal medicine learners. The results of this needs assessment study support ongoing inclusion of basic POCUS elements in the current internal medicine residency curriculum.


Asunto(s)
Internado y Residencia , Sistemas de Atención de Punto , Canadá , Competencia Clínica , Curriculum , Humanos , Autoinforme
5.
J Wound Ostomy Continence Nurs ; 48(5): 435-439, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34495935

RESUMEN

PURPOSE: The aims of this study were to determine if there was a change in medical unit nursing staffs' knowledge about lower urinary tract symptoms following an education presentation and whether the education session met their learning needs. DESIGN: Single-group, before-after study. SUBJECTS AND SETTING: The study sample comprised 21 licensed nurses and 16 health care aides from 3 medical units in a tertiary care hospital in western Canada. METHODS: Participants completed pre- and post-true/false questionnaires developed for the project to assess lower urinary tract symptom knowledge, and a questionnaire to determine whether the education session met staff learning needs. RESULTS: Knowledge was moderate on the pretest in both groups, with licensed nurses showing a significant improvement after the education intervention. Health care aides did not have a significant change in knowledge; they persisted in their belief that incontinence is a normal change of aging. CONCLUSIONS: Health care aides need targeted education and enhanced care processes to shift their knowledge and thinking about continence.


Asunto(s)
Personal de Enfermería , Incontinencia Urinaria , Anciano , Actitud del Personal de Salud , Canadá , Humanos , Encuestas y Cuestionarios
6.
Trials ; 22(1): 600, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488853

RESUMEN

BACKGROUND: Canadians of South Asian (SA) origin comprise the largest racialized group in Canada, representing 25.6% of what Statistics Canada terms "visible minority populations". South Asian Canadians are disproportionately impacted by the social determinants of health, and this can result in high rates of mood and anxiety disorders. These factors can negatively impact mental health and decrease access to care, thereby increasing mental health inequities. Cognitive Behavioural Therapy (CBT) in its current form is not suitable for persons from the non-western cultural backgrounds. Culturally adapted Cognitive Behavioural Therapy (CaCBT) is an evidence-based practice. CaCBT is more effective than standard CBT and can reduce dropouts from therapy compared with standard CBT. Thus, CaCBT can increase access to mental health services and improve outcomes for immigrant, refugee and ethno-cultural and racialized populations. Adapting CBT for growing SA populations in Canada will ensure equitable access to effective and culturally appropriate interventions. METHODS: The primary aim of the study is to develop and evaluate CaCBT for Canadian South Asian persons with depression and anxiety and to gather data from stakeholders to develop guidelines to culturally adapt CBT. This mixed methods study will use three phases: (1) cultural adaptation of CBT, (2) pilot feasibility of CaCBT and (3) implementation and evaluation of CaCBT. Phase 1 will use purposive sampling to recruit individuals from four different groups: (1) SA patients with depression and anxiety, (b) caregivers and family members of individuals affected by anxiety and depression, (c) mental health professionals and (d) SA community opinion leaders. Semi-structured interviews will be conducted virtually and analysis of interviews will be informed by an ethnographic approach. Phase 2 will pilot test the newly developed CaCBT for feasibility, acceptability and effectiveness via quantitative methodology and a randomized controlled trial, including an economic analysis. Phase 3 will recruit therapists to train and evaluate them in the new CaCBT. DISCUSSION: The outcome of this trial will benefit health services in Canada, in terms of helping to reduce the burden of depression and anxiety and provide better care for South Asians. We expect the results to help guide the development of better services and tailor existing services to the needs of other vulnerable groups. TRIAL REGISTRATION: ClinicalTrials.gov NCT04010890. Registered on July 8, 2019.


Asunto(s)
Terapia Cognitivo-Conductual , Servicios Comunitarios de Salud Mental , Ansiedad/diagnóstico , Ansiedad/terapia , Grupo de Ascendencia Continental Asiática , Canadá , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
7.
BMC Res Notes ; 14(1): 347, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488867

RESUMEN

OBJECTIVES: Existing information on Arctic marine food web structure is fragmented. Integrating data across research programs is an important strategy for building a baseline understanding of food web structure and function in many Arctic regions. Naturally-occurring stable isotope ratios of nitrogen (δ15N) and carbon (δ13C) measured directly in the tissues of organisms are a commonly-employed method for estimating food web structure. The objective of the current dataset was to synthesize disparate δ15N, and secondarily δ13C, data in the Canadian Beaufort continental shelf region relevant to trophic and ecological studies at the local and pan-Arctic scales. DATA DESCRIPTION: The dataset presented here contains nitrogen and carbon stable isotope ratios (δ15N, δ13C) measured in marine organisms from the Canadian Beaufort continental shelf region between 1983 and 2013, gathered from 27 published and unpublished sources with associated sampling metadata. A total of 1077 entries were collected, summarizing 8859 individual organisms/samples representing 333 taxa across the Arctic food web, from top marine mammal predators to primary producers.


Asunto(s)
Organismos Acuáticos , Nitrógeno , Animales , Regiones Árticas , Canadá , Ecosistema , Cadena Alimentaria , Isótopos de Nitrógeno/análisis
8.
Health Res Policy Syst ; 19(1): 123, 2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496875

RESUMEN

BACKGROUND: Quality improvement (QI) casebooks, compilations of QI experiences, are one way to share experiential knowledge that healthcare policy-makers, managers and professionals can adapt to their own contexts. However, QI casebook use, characteristics and impact are unknown. We aimed to synthesize published research on QI prevalence, development, characteristics and impact. METHODS: We conducted a scoping review by searching MEDLINE, EMBASE, CINAHL and SCOPUS from inception to 4 February 2021. We extracted data on study characteristics and casebook definitions, development, characteristics (based on the WIDER [Workgroup for Intervention Development and Evaluation Research] framework) and impact. We reported findings using summary statistics, text and tables. RESULTS: We screened 2999 unique items and included five articles published in Canada from 2011 to 2020 describing three studies. Casebooks focused on promoting positive weight-related conversations with children and parents, coordinating primary care-specialist cancer management, and showcasing QI strategies for cancer management. All defined casebooks similarly described real-world experiences of developing and implementing QI strategies that others could learn from, emulate or adapt. In all studies, casebook development was a multistep, iterative, interdisciplinary process that engages stakeholders in identifying, creating and reviewing content. While casebooks differed in QI topic, level of application and scope, cases featured common elements: setting or context, QI strategy details, impacts achieved, and additional tips for implementing strategies. Cases were described with a blend of text, graphics and tools. One study evaluated casebook impact, and found that it enhanced self-efficacy and use of techniques to improve clinical care. Although details about casebook development and characteristics were sparse, we created a template of casebook characteristics, which others can use as the basis for developing or evaluating casebooks. CONCLUSION: Future research is needed to optimize methods for developing casebooks and to evaluate their impact. One approach is to assess how the many QI casebooks available online were developed. Casebooks should be evaluated alone or in combination with other interventions that support QI on a range of outcomes.


Asunto(s)
Atención a la Salud , Mejoramiento de la Calidad , Canadá , Niño , Comunicación , Humanos
9.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48303

RESUMEN

“Proteger a Amamentação: Uma Responsabilidade de Todos” é o tema da Semana Mundial de Aleitamento Materno 2021 e foi o responsável por reunir, pela primeira vez, especialistas do Canadá e da Rede Brasileira de Bancos de Leite Humano (rBLH-BR), em encontro virtual promovido pela Fundação Canadense de Bebês Prematuros (Canadian Premature Babies Foundation).


Asunto(s)
Lactancia Materna , Bancos de Leche , Leche Humana , Promoción de la Salud , Brasil , Canadá
10.
JAMA Netw Open ; 4(8): e2121867, 2021 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-34448866

RESUMEN

Importance: Postoperative atrial fibrillation (POAF) occurring after cardiac surgery is associated with adverse outcomes. Whether POAF persists beyond discharge is not well defined. Objective: To determine whether continuous cardiac rhythm monitoring enhances detection of POAF among cardiac surgical patients during the first 30 days after hospital discharge compared with usual care. Design, Setting, and Participants: This study is an investigator-initiated, open-label, multicenter, randomized clinical trial conducted at 10 Canadian centers. Enrollment spanned from March 2017 to March 2020, with follow-up through September 11, 2020. As a result of the COVID-19 pandemic, enrollment stopped on July 17, 2020, at which point 85% of the proposed sample size was enrolled. Cardiac surgical patients with CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, prior stroke or transient ischemic attack, vascular disease, age 65-74 years, female sex) score greater than or equal to 4 or greater than or equal to 2 with risk factors for POAF, no history of preoperative AF, and POAF lasting less than 24 hours during hospitalization were enrolled. Interventions: The intervention group underwent continuous cardiac rhythm monitoring with wearable, patch-based monitors for 30 days after randomization. Monitoring was not mandated in the usual care group within 30 days after randomization. Main Outcomes and Measures: The primary outcome was cumulative AF and/or atrial flutter lasting 6 minutes or longer detected by continuous cardiac rhythm monitoring or by a 12-lead electrocardiogram within 30 days of randomization. Prespecified secondary outcomes included cumulative AF lasting 6 hours or longer and 24 hours or longer within 30 days of randomization, death, myocardial infarction, ischemic stroke, non-central nervous system thromboembolism, major bleeding, and oral anticoagulation prescription. Results: Of the 336 patients randomized (163 patients in the intervention group and 173 patients in the usual care group; mean [SD] age, 67.4 [8.1] years; 73 women [21.7%]; median [interquartile range] CHA2DS2-VASc score, 4.0 [3.0-4.0] points), 307 (91.4%) completed the trial. In the intent-to-treat analysis, the primary end point occurred in 32 patients (19.6%) in the intervention group vs 3 patients (1.7%) in the usual care group (absolute difference, 17.9%; 95% CI, 11.5%-24.3%; P < .001). AF lasting 6 hours or longer was detected in 14 patients (8.6%) in the intervention group vs 0 patients in the usual care group (absolute difference, 8.6%; 95% CI, 4.3%-12.9%; P < .001). Conclusions and Relevance: In post-cardiac surgical patients at high risk of stroke, no preoperative AF history, and AF lasting less than 24 hours during hospitalization, continuous monitoring revealed a significant increase in the rate of POAF after discharge that would otherwise not be detected by usual care. Studies are needed to examine whether these patients will benefit from oral anticoagulation therapy. Trial Registration: ClinicalTrials.gov Identifier: NCT02793895.


Asunto(s)
Fibrilación Atrial/diagnóstico , Aleteo Atrial/diagnóstico , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Electrocardiografía Ambulatoria/métodos , Tamizaje Masivo/métodos , Alta del Paciente , Complicaciones Posoperatorias/diagnóstico , Anciano , Fibrilación Atrial/etiología , Aleteo Atrial/etiología , COVID-19 , Canadá , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/cirugía , Electrocardiografía , Femenino , Hemorragia , Hospitalización , Humanos , Análisis de Intención de Tratar , Ataque Isquémico Transitorio , Masculino , Pandemias , Factores de Riesgo , Accidente Cerebrovascular , Tromboembolia
11.
Pharmaceut Med ; 35(4): 203-213, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34453703

RESUMEN

The Emergency Use Authorization (EUA) originated in 2004 because of the need for emergency medical countermeasures (MCMs) against potential bioterrorist attacks. The EUA also proved useful in dealing with subsequent pandemics and has emerged as a critical regulatory pathway for therapeutics and vaccines throughout the Coronavirus Disease 2019 (COVID-19) pandemic. With the EUA process in the USA, we witnessed emergency authorizations, their expansions, as well as withdrawal of previously authorized products, which exemplifies the dynamic nature of scientific review of EUA products. EUAs proved vital for the first group of COVID-19 vaccines, including the temporary pause of one vaccine while emergency safety issues were evaluated. Although this review on the EUA is primarily focused on the USA, distinctions were made with other jurisdictions such as Europe and Canada with respect to the emergency authorizations of the vaccines. Finally, we discuss some important differences following EUA and formal new drug/vaccine application (NDA/BLA) approvals.


Asunto(s)
Antivirales/normas , Vacunas contra la COVID-19/normas , COVID-19/prevención & control , Aprobación de Drogas/legislación & jurisprudencia , Urgencias Médicas/historia , Antivirales/administración & dosificación , Antivirales/efectos adversos , Bioterrorismo/historia , Bioterrorismo/prevención & control , COVID-19/tratamiento farmacológico , COVID-19/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Vacunas contra la COVID-19/efectos adversos , Canadá/epidemiología , Defensa Civil/historia , Aprobación de Drogas/historia , Urgencias Médicas/epidemiología , Europa (Continente)/epidemiología , Historia del Siglo XXI , Humanos , Pandemias/prevención & control , Estados Unidos/epidemiología
12.
Sci Total Environ ; 790: 148142, 2021 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-34380267

RESUMEN

The effects of chlorination on 16 humic and fulvic acids (HAs and FAs, respectively) extracted from six different soil samples from Korea and two purchased soil samples (Canadian peat moss, Elliott Silt Loam Soil) were investigated to identify the changes in their structural characteristics and their effects on trihalomethane formation potential (THMFP) and haloacetic acid formation potential. The effect of chlorination was also investigated in fractionated samples (Aldrich HA, F1-F5) based on molecular weight (MW). Total organic carbon (TOC), specific UV absorbance (SUVA), fulvic-like fluorescence (%FLF), terrestrial humic-like fluorescence (%THLF), weight-average molecular weight (MWw), and carbon structures (13C NMR) were measured for each sample before and after chlorination, and factors relating to the chlorination mechanism were examined using principal component analysis (PCA). The results showed that the changes in the structural characteristics and the disinfection by-product formation of chlorinated HA and FA differed critically. For chlorinated HA, TOC and %FLF decreased due to oxidation, whereas %THLF was reduced via incorporation; MW also affected the structural changes and THMFP generation. In the PCA results, high SUVA, low MW, low N/C, and low O groups of aromatic C were associated with high THMFP production in HA, whereas low O groups of aliphatic C in FA were associated with both oxidation and incorporation in terms of THMFP. These results elucidate the mechanisms associated with the effects of chlorination in HA and FA and will support the prediction of THMFP generation in HA and FA based on their specific structural characteristics.


Asunto(s)
Trihalometanos , Purificación del Agua , Canadá , Desinfección , Halogenación , Sustancias Húmicas/análisis , Suelo , Trihalometanos/análisis
13.
BMJ Open ; 11(8): e046831, 2021 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-34389566

RESUMEN

INTRODUCTION: Preschool aged children with cerebral palsy (CP) and like conditions are at risk of performing below their peers in key skill areas of school readiness. Kindy Moves was developed to support school readiness in preschool aged children with CP and like conditions that are dependent on physical assistance and equipment throughout the day. The primary aims are to determine the feasibility of motor-based interventions that are functional and goal directed, adequately dosed and embedded into a play environment with interdisciplinary support to optimise goal-driven outcomes. METHODS AND ANALYSIS: Forty children with CP and like conditions aged between 2 and 5 years with a Gross Motor Function Classification System (GMFCS) level of III-V or equivalent, that is, dependent on physical assistance and equipment will be recruited in Western Australia. Participants will undertake a 4-week programme, comprised three, 2-hour sessions a week consisting of floor time, gross motor movement and play (30 min), locomotor treadmill training (30 min), overground walking in gait trainers (30 min) and table-top activities (30 min). The programme is group based with 3-4 children of similar GMFCS levels in each group. However, each child will be supported by their own therapist providing an interdisciplinary and goal directed approach. Primary outcomes of this feasibility study will be goal attainment (Goal Attainment Scale) and secondary outcomes will include Canadian Occupational Performance Measure, 10 metre walk test, Children's Functional Independence Measure, Sleep Disturbance Scale, Infant and Toddler Quality of Life Questionnaire, Peabody Developmental Motor Scale and Gross Motor Function Measure. Outcomes will be assessed at baseline, post intervention (4 weeks) and retention at the 4-week follow-up. ETHICS AND DISSEMINATION: Ethical approval was obtained from Curtin University Human Ethics Committee (HRE2019-0073). Results will be disseminated through published manuscripts in peer-reviewed journals, conference presentations and public seminars for stakeholder groups. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12619000064101p).


Asunto(s)
Parálisis Cerebral , Australia , Canadá , Preescolar , Estudios de Factibilidad , Objetivos , Humanos , Lactante , Destreza Motora , Calidad de Vida
14.
Health Rep ; 32(8): 18-26, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34405972

RESUMEN

BACKGROUND: Public health measures related to the COVID-19 pandemic have upended the way Canadians eat and shop for food. Since the pandemic began, many Canadians have reported consuming food away from home (FAFH) less often. FAFH tends to be less healthful than food prepared at home. Little is known about patterns of Canadians' FAFH consumption before the pandemic. This study used 2015 national-level nutrition data, the most recent available, to characterize patterns of FAFH consumption and selected markers of dietary intake. DATA AND METHODS: National-level food intake data came from the first 24-hour dietary recall provided by 20,475 respondents aged 1 or older to the 2015 Canadian Community Health Survey-Nutrition. Mean daily intakes of selected food subgroups and nutrients, adjusted for total energy intake, were compared between those who had consumed any food in a restaurant on the previous day and those who had not. Estimates were generated overall and for eight age and sex groups. RESULTS: In 2015, overall, 21.8% of Canadians had consumed FAFH in a restaurant on the previous day. Eating out was most common among males aged 19 to 54 (27.7%) and least common among young children aged 1 to 5 (8.4%). Compared with Canadians who had not eaten out on the previous day, those who had eaten out had consumed, on that day, fewer servings of whole fruit; whole grains; dark green and orange vegetables; other vegetables (excluding potatoes); milk and fortified soy-based beverages; and legumes, nuts and seeds, on average. Those who had eaten out had consumed, on average, less fibre and total sugar, and more total fat, saturated fat and sodium on that day. There were few differences for meat and poultry, fish and seafood, and protein intake. DISCUSSION: On the day that Canadians ate out in a restaurant, their dietary intake was generally less favourable than that of Canadians who did not eat out. If Canadians continue to eat at home more and to consume less FAFH, as early pandemic-period reports suggest, then results can be used to gauge the potential dietary implications of these shifts.


Asunto(s)
COVID-19 , Dieta , Conducta Alimentaria , Valor Nutritivo , Pandemias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Canadá , Niño , Preescolar , Encuestas sobre Dietas , Ingestión de Alimentos , Ingestión de Energía , Femenino , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Adulto Joven
15.
Nutrients ; 13(8)2021 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-34445006

RESUMEN

Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.


Asunto(s)
Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Bebidas Alcohólicas/legislación & jurisprudencia , Política de Salud , Salud Pública , Consumo de Bebidas Alcohólicas/efectos adversos , Bebidas Alcohólicas/economía , COVID-19/epidemiología , Canadá , Comercio/economía , Comercio/normas , Costos y Análisis de Costo , Programas de Gobierno , Regulación Gubernamental , Humanos , Pandemias , Etiquetado de Productos/legislación & jurisprudencia , Política Pública , SARS-CoV-2/aislamiento & purificación
16.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-34455733

RESUMEN

PURPOSE: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS: The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS: Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE: Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.


Asunto(s)
Agotamiento Profesional/psicología , COVID-19/enfermería , Personal de Enfermería en Hospital/psicología , Servicios de Salud del Trabajador , Estrés Psicológico/psicología , Adulto , Agotamiento Profesional/prevención & control , Canadá , Comunicación , Femenino , Humanos , Entrevistas como Asunto , Liderazgo , Masculino , Evaluación de Necesidades , Política Organizacional , Pandemias , Equipo de Protección Personal , SARS-CoV-2 , Ausencia por Enfermedad , Estrés Psicológico/prevención & control , Estados Unidos , Carga de Trabajo
17.
Emerg Infect Dis ; 27(9): 2434-2444, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34424161

RESUMEN

Antimicrobial use contributes to the global rise of antimicrobial resistance (AMR). In 2014, the poultry industry in Canada initiated its Antimicrobial Use Reduction Strategy to mitigate AMR in the poultry sector. We monitored trends in antimicrobial use and AMR of foodborne bacteria (Salmonella, Escherichia coli, and Campylobacter) in broiler chickens during 2013 and 2019. We quantified the effect of antimicrobial use and management factors on AMR by using LASSO regression and generalized mixed-effect models. AMR in broiler chickens declined by 6%-38% after the decrease in prophylactic antimicrobial use. However, the withdrawal of individual compounds, such as cephalosporins and fluoroquinolones, prompted an increase in use of and resistance levels for other drug classes, such as aminoglycosides. Canada's experience with antimicrobial use reduction illustrates the potential for progressive transitions from conventional antimicrobial-dependent broiler production to more sustainable production with respect to antimicrobial use.


Asunto(s)
Antiinfecciosos , Campylobacter , Animales , Canadá/epidemiología , Pollos , Farmacorresistencia Bacteriana , Escherichia coli , Salmonella
18.
Emerg Infect Dis ; 27(9): 2489-2491, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34424169

RESUMEN

We report a case of human infection with a Brucella canis isolate in an adult in Canada who was receiving a biologic immunomodulating medication. We detail subsequent investigations, which showed that 17 clinical microbiology staff had high-risk exposures to the isolate, 1 of whom had a positive result for B. canis.


Asunto(s)
Brucella canis , Brucelosis , Adulto , Brucella canis/genética , Brucelosis/diagnóstico , Brucelosis/tratamiento farmacológico , Canadá , Humanos , Laboratorios
19.
PLoS One ; 16(8): e0256204, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34424933

RESUMEN

Online charitable crowdfunding has become an increasingly prevalent way for Canadians to deal with costs that they would otherwise not be able to shoulder on their own. With the onset of COVID-19 and related lockdown measures, there is evidence of a surge in crowdfunding use relating to the pandemic. This study gathered, classified, and analysed Canadian crowdfunding campaigns created in response to COVID-19 from GoFundMe.com, a popular crowdfunding platform. Spatio-temporal analysis of classified campaigns allowed for observation of emergent trends in the distribution of pandemic-related need incidence and financial support throughout the pandemic. Campaigns raising money on behalf of established charities were the most common in the sample, and accounted for the greatest portion of funding raised, while campaigns for businesses made up a small proportion. Dense metropolitan areas accounted for the vast majority of campaign locations, and total sample funding was disproportionately raised by campaigners in Ontario and British Columbia.


Asunto(s)
COVID-19/economía , Organizaciones de Beneficencia/tendencias , Obtención de Fondos/tendencias , COVID-19/epidemiología , Canadá , Humanos , Análisis Espacio-Temporal
20.
Artículo en Inglés | MEDLINE | ID: mdl-34444112

RESUMEN

BACKGROUND: Extreme temperatures have negative consequences on the environment, ecosystem, and human health. With recent increases in global temperatures, there has been a rise in the burden of heat-related illnesses, with a disproportionate impact on low- and middle-income countries. Effective population-level interventions are critical to a successful public health response. OBJECTIVE: This scoping review aims to summarize the evidence on the effectiveness of population-level heat-related interventions and serve as a potential guide to the implementation of these interventions. METHODS: Studies that evaluated the effectiveness of community-based interventions to mitigate or reduce the impact of extreme heat on heat-related mortality and morbidity were sought by searching four electronic databases. Studies published in the English language and those that had quantifiable, measurable mortality, morbidity or knowledge score outcomes were included. RESULTS: The initial electronic search yielded 2324 articles, and 17 studies were included. Fourteen studies were based in high-income countries (HICs) (Europe, US, Canada) and discussed multiple versions of (1) heat action plans, which included but were not limited to establishing a heat monitoring system, informative campaigns, the mobilization of health care professionals, volunteers, social workers and trained caregivers in the surveillance and management of individuals with known vulnerabilities, or stand-alone (2) education and awareness campaigns. Multi-pronged heat action plans were highly effective in reducing heat-related mortality and morbidity, especially among vulnerable populations such as the elderly and those with chronic conditions. CONCLUSIONS: The heat action plans covered in these studies have shown promising results in reducing heat-related mortality and morbidity and have included instituting early warning systems, building local capacity to identify, prevent or treat and manage heat-related illnesses, and disseminating information. Nevertheless, they need to be cost-effective, easy to maintain, ideally should not rely on a mass effort from people and should be specifically structured to meet the local needs and resources of the community.


Asunto(s)
Ecosistema , Calor , Anciano , Canadá , Cuidadores , Europa (Continente) , Humanos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...