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1.
Artigo em Inglês | MEDLINE | ID: mdl-33916232

RESUMO

In this paper, we provide descriptive data that characterize the health, safety, and social care environment of migrant agricultural workers in British Columbia, Canada. Through the administration of surveys (n = 179), we gathered information in three domains: (1) living and working conditions; (2) barriers to rights, health, safety and advocacy/reporting; (3) accessibility of services. Our study confirms what predominantly qualitative studies and Ontario-based survey data indicate in terms of health, legal, and social barriers to care and protection for this population. Our findings also highlight the prevalence of communication barriers and the limited degree of confidence in government authorities and contact with support organizations this population faces. Notably, survey respondents expressed a strong intention to report concerns/issues to authorities while simultaneously reporting that they lacked the knowledge to initiate such complaints. These findings call into question government responses that task the agricultural industry with addressing access and service gaps that may be more effectively addressed by government agencies and service providers. In order to improve supports and protections for migrant agricultural workers, policies and practices should be implemented that: (1) empower workers to independently access health, social, and legal protections and limit workers' dependence on their employers when help-seeking; (2) provide avenues for increased proactive inspections, anonymous reporting, alternative housing/employment and meaningful 2-way communication with regulators so that the burden of reporting is lessened for this workforce; (3) systematically address breaches in privacy, translation, and adequate workplace injury assessments in the healthcare system. Ultimately, the COVID-19 context has put into sharper focus the complex gaps in health, social and legal services and protections for migrant agricultural workers. The close chronology of our data collection with this event can help us understand the factors that have resulted in so much tragedy among this workforce.


Assuntos
Migrantes , Colúmbia Britânica , Fazendeiros , Humanos , Ontário , Inquéritos e Questionários
2.
Artigo em Inglês | MEDLINE | ID: mdl-33922530

RESUMO

Children's independent mobility (CIM) is the freedom of children to move around their neighbourhood without adult supervision and is closely related to overall physical activity participation. The COVID-19 pandemic has impacted movement behaviours for children, with evidence indicating a decrease in physical activity. The aim of this study was to explore experiences of CIM and physical activity during the COVID-19 pandemic from the perspectives of children and their parents. We completed 21 family (at least one parent and one child aged 7-12) semi-structured interviews with 45 participants living in small urban and rural areas of British Columbia, Canada. Three themes were identified through a reflexive thematic analysis: (1) keeping everyone safe from COVID-19; (2) change in pattern and types of activity; (3) social impacts with family, friends, and community. Participants expressed a perceived increase in unstructured activity and a decrease in structured physical activity during the pandemic, which many parents viewed as a positive change. Parents and children indicated negative feelings due to spending less time with peers and reflected positively about spending more time with family. Parents and children expressed fear and anxiety in trying to keep their families safe from virus spread and creativity in adapting play behaviours. Findings highlight the impact of the pandemic on social friendship networks for families and a shift in activity patterns for children toward unstructured play.


Assuntos
Pandemias , Adulto , Colúmbia Britânica/epidemiologia , Criança , Exercício Físico , Humanos
3.
Artigo em Inglês | MEDLINE | ID: mdl-33808675

RESUMO

(1) Background: Condomless anal sex and substance use are associated with STI risk among gay, bisexual, and other men who have sex with men (gbMSM). Our first study objective was to describe event-level sexual risk and substance use trends among gbMSM. Our second study objective was to describe substances associated with event-level sexual risk. (2) Methods: Data come from the Momentum Health Study in Vancouver, British Columbia and participants were recruited from 2012-2015, with follow-up until 2018. Stratified by self-reported HIV status, we used generalized estimating equations to assess trends of sexual event-level substance use and assessed interactions between substance use and time period on event-level higher risk sex defined as condomless anal sex with an HIV serodifferent or unknown status partner. (3) Results: Event-level higher risk anal sex increased across the study period among HIV-negative/unknown (baseline prevalence: 13% vs. study end prevalence: 29%) and HIV-positive gbMSM (baseline prevalence: 16% vs. study end prevalence: 38%). Among HIV-negative/unknown gbMSM, event-level erectile drug use increased, while alcohol use decreased over the study period. Overall, interactions between substance use and time on higher risk anal sex were not statistically significant, regardless of serostatus. However, we found a number of time-specific significant interactions for erectile drugs, poppers, Gamma-hydroxybutyrate (GHB), crystal methamphetamine and ecstasy/MDMA use among HIV-negative/unknown gbMSM. (4) Conclusion: Significant differences in substance use trends and associated risks exist and are varied among gbMSM by serostatus. These findings provide a more comprehensive understanding of the effects of event-level substance use on sexual risk through longitudinal follow-up of nearly six years.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Bissexualidade , Colúmbia Britânica/epidemiologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
4.
J Environ Manage ; 289: 112366, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33848883

RESUMO

Pro-environmental behaviours (PEBs) are important for mitigation and restoration efforts in the Anthropocene. As recreationists are motivated to engage in leisure activities to increase their own personal wellbeing, we submit that threats to wellbeing (an egocentric motivator) predict engagement in PEBs amongst recreationists. We also predict that differences in experiences across groups of recreationists leads to differences in PEB engagement. Using an online survey, we test our two hypotheses (if recreationists perceive there is a threat to their wellbeing and that their behaviours can yield environmental successes, then they will be more likely to engage in PEBs, and if recreationists differ in recreational experiences then they will demonstrate differences in PEB engagement) amongst outdoor recreationists, specifically Canadian rainbow trout and steelhead anglers in British Columbia (n = 894 respondents). We define 'threat to wellbeing' as the interaction of environmental threat-perceptions of used environments for fishing, and level of centrality fishing has to one's lifestyle. To test our first hypothesis, we conducted three linear regressions corresponding to three different PEBs related to catch-and-release (C&R) fishing. Our egocentric predictor 'threat to wellbeing' was only significant for one out of the three PEBs tested, showing mixed support for our first hypothesis. It is of note that 'environmental threat perceptions' and one's belief in successes resulting from PEB engagement were found to be significant predictors for all three PEBs tested. These results suggest that predictors of PEB may not always be transferable across PEBs relating to recreational activities, and environmental threat perception and one's belief in successes resulting from PEB engagement are strong predictors of PEBs amongst recreationists. To test our second hypothesis, we conducted a Kruskal Wallis test to determine if there were significant differences across angler groups in PEB predictor scores and PEB engagement and conducted pairwise population Z-tests to determine proportional participation rates across angler groups for the three PEBs and PEB predictors investigated. Experiences were found to shape predictors of PEBs, as well as likelihood to engage in PEBs, as different angler groups targeting different fish (i.e., rainbow trout vs steelhead) and using different aquatic habitats (i.e., rivers vs. lakes) demonstrated significantly different scores for PEB predictors, as well as significantly different likelihood to engage in two of the three PEBs tested. These findings support the notion that recreationists are not a homogenous group, and that their beliefs and resulting behaviours during recreational activities are determined by their experiences in nature and can be influenced by the species with which they interact, and the habitats they use for recreation.


Assuntos
Pesqueiros , Recreação , Animais , Colúmbia Britânica , Conservação dos Recursos Naturais , Ecossistema , Lagos
5.
PLoS One ; 16(4): e0249186, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886570

RESUMO

BACKGROUND: The first wave of COVID-19 infections caused disturbances in all aspects of personal and professional lives. The aim of this study was to explore the ways in which that first wave of novel coronavirus infections resulted in uncertainties, as experienced by members of the oral health care workforce in British Columbia, Canada. METHODS: This qualitative inquiry purposefully recruited frontline oral health care workers, including dentists, dental hygienists, certified dental assistants, and administrative staff, via remote semi-structured interviews between April 20 and May 4, 2020. Coding, categories, and themes were inductively assigned. RESULTS: A total of 45 interviews, lasting between 39 and 74 minutes each, were conducted involving 18 dentists (6 females), 12 dental hygienists (11 females), 6 certified dental assistants (all females), and 9 administrators/front-desk staff (7 females). Fifty-one hours of audio recordings and more than 650 single-spaced pages of transcripts were produced. Five main themes emerged pertaining to uncertainties surrounding COVID-19, patient care, personal lives and infectiousness, concern for the future, and variations among different pandemics. Certitudes were less evident, but surfaced mostly when considering a potential new normal resulting from the pandemic. CONCLUSION: Participants indicated that the uncertainties they felt were dependent upon what is known, and unknown, about the pandemic and the provision of oral health care during the first wave of infections. Future studies are needed to include the viewpoints of oral health care workers from other provinces, as well the perceptions of patients who received oral health care during the height of the first wave of the pandemic.


Assuntos
Recursos Humanos em Odontologia , Odontólogos , Atitude do Pessoal de Saúde , Colúmbia Britânica/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Saúde Bucal , Incerteza
6.
BMC Ecol Evol ; 21(1): 63, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888062

RESUMO

BACKGROUND: Identifying ecologically significant phenotypic traits and the genomic mechanisms that underly them are crucial steps in understanding traits associated with population divergence. We used genome-wide data to identify genomic regions associated with key traits that distinguish two ecomorphs of rainbow trout (Oncorhynchus mykiss)-insectivores and piscivores-that coexist for the non-breeding portion of the year in Kootenay Lake, southeastern British Columbia. "Gerrards" are large-bodied, rapidly growing piscivores with high metabolic rates that spawn north of Kootenay Lake in the Lardeau River, in contrast to the insectivorous populations that are on average smaller in body size, with lower growth and metabolic rates, mainly forage on aquatic insects, and spawn in tributaries immediately surrounding Kootenay Lake. We used pool-seq data representing ~ 60% of the genome and 80 fish per population to assess the level of genomic divergence between ecomorphs and to identify and interrogate loci that may play functional or selective roles in their divergence. RESULTS: Genomic divergence was high between sympatric insectivores and piscivores ([Formula: see text] = 0.188), and in fact higher than between insectivorous populations from Kootenay Lake and the Blackwater River ([Formula: see text] = 0.159) that are > 500 km apart. A window-based [Formula: see text] analysis did not reveal "islands" of genomic differentiation; however, the window with highest [Formula: see text] estimate did include a gene associated with insulin secretion. Although we explored the use of the "Local score" approach to identify genomic outlier regions, this method was ultimately not used because simulations revealed a high false discovery rate (~ 20%). Gene ontology (GO) analysis identified several growth processes as enriched in genes occurring in the ~ 200 most divergent genomic windows, indicating many loci of small effect involved in growth and growth-related metabolic processes are associated with the divergence of these ecomorphs. CONCLUSION: Our results reveal a high degree of genomic differentiation between piscivorous and insectivorous populations and indicate that the large body piscivorous phenotype is likely not due to one or a few loci of large effect. Rather, the piscivore phenotype may be controlled by several loci of small effect, thus highlighting the power of whole-genome resequencing in identifying genomic regions underlying population-level phenotypic divergences.


Assuntos
Oncorhynchus mykiss , Animais , Evolução Biológica , Colúmbia Britânica , Oncorhynchus mykiss/genética , Fenótipo , Simpatria
8.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33656310

RESUMO

PURPOSE: Currently, people leaving prisons face concurrent risks from the COVID-19 pandemic and the overdose public health emergency. The closure or reduction of community services people rely on after release such as treatment centres and shelters has exacerbated the risks of poor health outcomes and harms. This paper aims to learn from peer health mentors (PHM) about changes to their work during overlapping health emergencies, as well as barriers and opportunities to support people leaving prison in this context. DESIGN/METHODOLOGY/APPROACH: The Unlocking the Gates (UTG) Peer Health Mentoring Program supports people leaving prison in British Columbia during the first three days after release. The authors conducted two focus groups with PHM over video conference in May 2020. Focus groups were recorded and transcribed, and themes were iteratively developed using narrative thematic analysis. FINDINGS: The findings highlighted the importance of peer health mentorship for people leaving prisons. PHM discussed increased opportunities for collaboration, ways the pandemic has changed how they are able to provide support, and how PHM are able to remain responsive and flexible to meet client needs. Additionally, PHM illuminated ways that COVID-19 has exacerbated existing barriers and identified specific actions needed to support client health, including increased housing and recovery beds, and tools for social and emotional well-being. ORIGINALITY/VALUE: This study contributes to our understanding of peer health mentorship during the COVID-19 pandemic from the perspective of mentors. PHM expertise can support release planning, improved health and well-being of people leaving prison and facilitate policy-supported pandemic responses.


Assuntos
Integração Comunitária/psicologia , Criminosos , Acesso aos Serviços de Saúde , Mentores/psicologia , Ajustamento Social , Colúmbia Britânica , Grupos Focais , Humanos , Grupo Associado , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
9.
Artigo em Inglês | MEDLINE | ID: mdl-33672804

RESUMO

A total of 475,214 COVID-19 cases, including 13,659 deaths, had been recorded in Canada as of 15 December 2020. The daily reports of confirmed cases and deaths in Canada prior to 15 December 2020 were obtained from publicly available sources and used to examine regional variations in case fatality rate (CFR). Based on a factor of underestimation and the duration of time from symptom onset to death, the time-delay adjusted CFR for COVID-19 was estimated in the four most affected provinces (Quebec, Ontario, Alberta, and British Columbia) and nationwide. The model-based adjusted CFR was higher than the crude CFR throughout the pandemic, primarily owing to the incorporation in our estimation of the delay between case reports and deaths. The adjusted CFR in Canada was estimated to be 3.36% nationwide. At the provincial level, the adjusted CFR was the highest in Quebec (5.13%)-where the proportion of deaths among older individuals was also the highest among the four provinces-followed by Ontario (3.17%), British Columbia (1.97%), and Alberta (1.13%). Provincial-level variations in CFR were considerable, suggesting that public health interventions focused on densely populated areas and elderly individuals can ameliorate the mortality burden of the COVID-19 pandemic.


Assuntos
/mortalidade , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alberta/epidemiologia , Colúmbia Britânica/epidemiologia , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Ontário/epidemiologia , Quebeque/epidemiologia , Adulto Jovem
10.
Lancet Public Health ; 6(4): e249-e259, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33773635

RESUMO

BACKGROUND: Being recently released from prison or discharged from hospital, or being dispensed opioids, benzodiazepines, or antipsychotics have been associated with an increased risk of fatal drug overdose. This study aimed to examine the association between these periods and non-fatal drug overdose using a within-person design. METHODS: In this self-controlled case series, we used data from the provincial health insurance client roster to identify a 20% random sample of residents (aged ≥10 years) in British Columbia, Canada between Jan 1, 2015, and Dec 31, 2017 (n=921 346). Individuals aged younger than 10 years as of Jan 1, 2015, or who did not have their sex recorded in the client roster were excluded. We used linked provincial health and correctional records to identify a cohort of individuals who had a non-fatal overdose resulting in medical care during this time period, and key exposures, including periods of incarceration, admission to hospital, emergency department care, and supply of medications for opioid use disorder (MOUD), opioids for pain (unrelated to MOUD), benzodiazepines, and antipsychotics. Using a self-controlled case series, we examined the association between the time periods during and after each of these exposures and the incidence of non-fatal overdose with case-only, conditional Poisson regression analysis. Sensitivity analyses included recurrent overdoses and pre-exposure risk periods. FINDINGS: We identified 4149 individuals who had a non-fatal overdose in 2015-17. Compared with unexposed periods (ie, all follow-up time that was not part of a designated risk period for each exposure), the incidence of non-fatal overdose was higher on the day of admission to prison (adjusted incidence rate ratio [aIRR] 2·76 [95% CI 1·51-5·04]), at 1-2 weeks (2·92 [2·37-3·61]), and 3-4 weeks (1·34 [1·01-1·78]) after release from prison, 1-2 weeks after discharge from hospital (1·35 [1·11-1·63]), when being dispensed opioids for pain (after ≥4 weeks) or benzodiazepines (entire use period), and from 3 weeks after discontinuing antipsychotics. The incidence of non-fatal overdose was reduced during use of MOUD (aIRRs ranging from 0·33 [0·26-0·42] to 0·41 [0·25-0·67]) and when in prison (0·12 [0·08-0·19]). INTERPRETATION: Expanding access to and increasing support for stable and long-term medication for the management of opioid use disorder, improving continuity of care when transitioning between service systems, and ensuring safe prescribing and medication monitoring processes for medications that reduce respiratory function (eg, benzodiazepines) could decrease the incidence of non-fatal overdose. FUNDING: Murdoch Children's Research Institute and National Health and Medical Research Council.


Assuntos
Overdose de Drogas/epidemiologia , Alta do Paciente/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Adulto , Colúmbia Britânica/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Tempo
11.
Vaccine ; 39(15): 2020-2023, 2021 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-33736921

RESUMO

IMPORTANCE: An effective vaccine against SARS-CoV-2 will reduce morbidity and mortality and allow substantial relaxation of physical distancing policies. However, the ability of a vaccine to prevent infection or disease depends critically on protecting older individuals, who are at highest risk of severe disease. OBJECTIVE: We quantitatively estimated the relative benefits of COVID-19 vaccines, in terms of preventing infection and death, with a particular focus on effectiveness in elderly people. DESIGN: We applied compartmental mathematical modelling to determine the relative effects of vaccines that block infection and onward transmission, and those that prevent severe disease. We assumed that vaccines showing high efficacy in adults would be deployed, and examined the effects of lower vaccine efficacy among the elderly population. SETTING AND PARTICIPANTS: Our mathematical model was calibrated to simulate the course of an epidemic among the entire population of British Columbia, Canada. Within our model, the population was structured by age and levels of contact. MAIN OUTCOME(S) AND MEASURE(S): We assessed the effectiveness of possible vaccines in terms of the predicted number of infections within the entire population, and deaths among people aged 65 years and over. RESULTS: In order to reduce the overall rate of infections in the population, high rates of deployment to all age groups will be critical. However, to substantially reduce mortality among people aged 65 years and over, a vaccine must directly protect a high proportion of people in that group. CONCLUSIONS AND RELEVANCE: Effective vaccines deployed to a large fraction of the population are projected to substantially reduce infection in an otherwise susceptible population. However, even if transmission were blocked highly effectively by vaccination of children and younger adults, overall mortality would not be substantially reduced unless the vaccine is also directly protective in elderly people. We strongly recommend: (i) the inclusion of people aged 65 years and over in future trials of COVID-19 vaccine candidates; (ii) careful monitoring of vaccine efficacy in older age groups following vaccination.


Assuntos
Fatores Etários , /prevenção & controle , Idoso , Colúmbia Britânica , Humanos , Pandemias
12.
CJEM ; 23(2): 237-241, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33709367

RESUMO

OBJECTIVE: To date in the COVID-19 pandemic, there has been a decrease in patients accessing emergency health services, (EHS) but research has been conducted in areas with a very high incidence of COVID-19. In an area with a low COVID-19 incidence, we estimate changes in EHS use. METHODS: We compared EHS encounters in British Columbia from March 15 (the date of school and business closures) to May 15, 2020, when compared to the same period in 2019. We categorized EHS encounters into 18 presenting complaints and prespecified critical care complaints including major trauma, cardiac arrest, stroke, and ST-elevation myocardial infarction. We analyzed by descriptive methods. RESULTS: Comparing 2019 to 2020, total EHS encounters decreased from 83,925 (incidence rate 834 per 100,000 person-months) to 71,611 (incidence rate 701 per 100,000 person-months) for a decrease of 133 per 100,000 person-months (95% CI 126-141). The top 18 codes had a significant decrease in every category except respiratory and anxiety. Encounters for critically ill patients decreased significantly overall from 3019 to 2753 (incidence rate difference 3.1 per 100,000 person-months, 95% CI 1.6-4.5), including stroke, trauma, and STEMI, but the incidence of OHCA appeared stable. CONCLUSION: In a single province with a low incidence of COVID-19, there was a 15% reduction in overall EHS use and a 9% reduction in critical illness. EHS planners will need to match patient need with available resources.


Assuntos
/epidemiologia , Emergências , Pandemias , Sistema de Registros , Colúmbia Britânica/epidemiologia , Serviço Hospitalar de Emergência , Humanos , Incidência , Estudos Retrospectivos
13.
Environ Monit Assess ; 193(4): 216, 2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33759034

RESUMO

With amphibian populations facing a multitude of threats, including habitat loss, climate change, invasive species and infectious diseases, it is important to identify valuable amphibian habitat and the imminent pressures these environments face. Between 2004 and 2019, 6 years of amphibian surveys were conducted at Greenburn, Roe and McLean lakes in the Southern Gulf Islands of British Columbia, Canada. We assessed (1) species composition and trends of native amphibians, including at-risk northern red-legged frog (Rana aurora); (2) observations of invasive American bullfrog (Lithobates catesbeianus); and (3) the efficacy of visual encounter and trapping survey methods in determining multi-species amphibian occupancy. The shallow, semi-ephemeral McLean Lake hosted more amphibian species and more breeding activity than the larger, deeper waters of Greenburn and Roe lakes. Despite multiple observations, bullfrogs have thus far not established a detectable population within these lakes, with the presence of native and introduced predators as potential contributing factors. Declining trends in occupancy of native populations of R. aurora, Pacific chorus frog (Pseudacris regilla) and rough-skinned newt (Taricha granulosa) were observed at all three lakes. Results varied within years by species and survey method, highlighting the importance of effective replication and employing complementary survey methods to optimize studies of amphibian occupancy. These observations also emphasize the value of shallow, small- to medium-sized waterbodies to native amphibian populations in the Southern Gulf Islands. As these waterbodies become increasingly threatened by global climate change and habitat degradation, the potential impacts of declining freshwater ecosystem health on amphibian populations should be considered.


Assuntos
Ecossistema , Monitoramento Ambiental , Anfíbios , Animais , Colúmbia Britânica , Espécies Introduzidas , Dinâmica Populacional
14.
Can J Public Health ; 112(3): 376-390, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33650060

RESUMO

INTERVENTION: Street reallocation interventions in three Canadian mid-sized cities: Victoria (British Columbia), Kelowna (British Columbia), and Halifax (Nova Scotia) related to the COVID-19 pandemic. RESEARCH QUESTION: What street reallocation interventions were implemented, and what were the socio-spatial equity patterns? METHODS: We collected data on street reallocations (interventions that expand street space for active transportation or physical distancing) from April 1 to August 15, 2020 from websites and media. For each city, we summarized length of street reallocations (km) and described implementation strategies and communications. We assessed socio-spatial patterning of interventions by comparing differences in where interventions were implemented by area-level mobility, accessibility, and socio-demographic characteristics. RESULTS: Two themes motivated street reallocations: supporting mobility, recreation, and physical distancing in populous areas, and bolstering COVID-19 recovery for businesses. The scale of responses ranged across cities, from Halifax adding an additional 20% distance to their bicycle network to Kelowna closing only one main street section. Interventions were located in downtown cores, areas with high population density, higher use of active transportation, and close proximity to essential destinations. With respect to socio-demographics, interventions tended to be implemented in areas with fewer children and areas with fewer visible minority populations. In Victoria, the interventions were in areas with lower income populations and higher proportions of Indigenous people. CONCLUSION: In this early response phase, some cities acted swiftly even in the context of massive uncertainties. As cities move toward recovery and resilience, they should leverage early learnings as they act to create more permanent solutions that support safe and equitable mobility.


Assuntos
Ambiente Construído/estatística & dados numéricos , /prevenção & controle , Colúmbia Britânica/epidemiologia , Cidades/epidemiologia , Humanos , Nova Escócia/epidemiologia , Fatores Socioeconômicos , Análise Espacial
15.
JCI Insight ; 6(8)2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33720905

RESUMO

Preexisting cross-reactivity to SARS-CoV-2 occurs in the absence of prior viral exposure. However, this has been difficult to quantify at the population level due to a lack of reliably defined seroreactivity thresholds. Using an orthogonal antibody testing approach, we estimated that about 0.6% of nontriaged adults from the greater Vancouver, Canada, area between May 17 and June 19, 2020, showed clear evidence of a prior SARS-CoV-2 infection, after adjusting for false-positive and false-negative test results. Using a highly sensitive multiplex assay and positive/negative thresholds established in infants in whom maternal antibodies have waned, we determined that more than 90% of uninfected adults showed antibody reactivity against the spike protein, receptor-binding domain (RBD), N-terminal domain (NTD), or the nucleocapsid (N) protein from SARS-CoV-2. This seroreactivity was evenly distributed across age and sex, correlated with circulating coronaviruses' reactivity, and was partially outcompeted by soluble circulating coronaviruses' spike. Using a custom SARS-CoV-2 peptide mapping array, we found that this antibody reactivity broadly mapped to spike and to conserved nonstructural viral proteins. We conclude that most adults display preexisting antibody cross-reactivity against SARS-CoV-2, which further supports investigation of how this may impact the clinical severity of COVID-19 or SARS-CoV-2 vaccine responses.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Antígenos Virais/imunologia , /imunologia , Adulto , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Colúmbia Britânica/epidemiologia , /diagnóstico , /estatística & dados numéricos , Reações Cruzadas/imunologia , Estudos Transversais , Feminino , Geografia , Voluntários Saudáveis , Humanos , Imunidade Humoral , Imunoensaio/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença
16.
Harm Reduct J ; 18(1): 21, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33596901

RESUMO

Since the start of the opioid epidemic in 2016, the Downtown Eastside community of Vancouver, Canada, has lost many pioneering leaders, activists and visionaries to the war on drugs. The Vancouver Area Network of Drug Users (VANDU), the Western Aboriginal Harm Reduction Society (WAHRS), and the British Columbia Association People on Opiate Maintenance (BCAPOM) are truly concerned about the increasing overdose deaths that have continued since 2016 and have been exacerbated by the novel coronavirus (SARS-COVID-19) despite many unique and timely harm reduction announcements by the British Columbia (B.C.) government. Some of these unique interventions in B.C., although in many cases only mere announcements with limited scope, are based on the philosophy of safe supply to illegal street drugs. Despite all the efforts during the pandemic, overdose deaths have spiked by over 100% compared to the previous year. Therefore, we urge the Canadian federal government, specifically the Honorable Patty Hajdu, the federal Minister of Health, to decriminalize simple possession immediately by granting exemption under the Controlled Drugs and Substances Act. The Canadian federal government has a moral obligation under Sect. 7 of the Canadian Charter of Rights and Freedoms to protect the basic human rights of marginalized Canadians.


Assuntos
Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Redução do Dano , Direitos Humanos/legislação & jurisprudência , /mortalidade , Analgésicos Opioides , Colúmbia Britânica/epidemiologia , Canadá , Overdose de Drogas/mortalidade , Governo Federal , Liberdade , Humanos , Governo Local , Epidemia de Opioides/mortalidade , Transtornos Relacionados ao Uso de Opioides
17.
Mar Environ Res ; 166: 105268, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33626460

RESUMO

Incidental mortality of marine birds in fisheries is an international conservation concern, including in Canada where globally significant populations of vulnerable diving species overlap with coastal gillnet fisheries. In British Columbia (BC), commercial salmon gillnet fishing effort was historically very high (>200,000 days fished annually in the early 1950's), and although this fishery has declined, over 6,400 days were fished annually in the 2006-2016 decade. Observations of seabird bycatch within the commercial fishery, however, are limited in both scope (comprising <2% of cumulative effort 2001-2016) and in time (being available only from 1995 onwards and only for a small number of areas). Using onboard fishery observer data from commercial, test and experimental fisheries (1995-2016), we developed two models to estimate the number of marine birds captured per set in sockeye (Oncorhynchus nerka) and chum (O. keta) salmon gillnet fisheries employing a Generalized Linear Mixed Modeling (GLMM) approach in a hierarchical Bayesian framework, with observer data post-stratified by fisheries management area and year. Using estimates of total commercial fishing effort (estimated number of sets, 2001-2016) we applied the models to extrapolate annual take for the main bird species (or groups) of interest. Multinomial probability estimates of species composition were calculated based upon a sample of 852 birds identified to species that were associated with sockeye or chum fisheries, enabling estimates (with CIs) of potential numbers of the mostly commonly observed species (common murres (Uria aalge), rhinoceros auklets (Cerorhinca monocerata), and marbled murrelets (Brachyramphus marmoratus)) entangled annually in commercial sockeye and chum salmon gillnet fisheries throughout BC. Conservative estimates of annual losses to entanglement were greatest for common murres (2,846, 95% CI: 2,628-3,047), followed by rhinoceros auklets (641, CI: 549-770) and marbled murrelets (228 CI: 156-346). Populations of all three of these alcids species are currently in decline in BC and entanglement mortality is a conservation concern. Gillnet mortality has been identified as a longstanding threat to marbled murrelet populations, which are recognized as Threatened in the Canada and the United States of America (USA). In addition, 622 (CI: 458-827) birds from 12 other species were estimated to be entangled annually. We conclude that cumulative mortality from incidental take in salmon gillnet fisheries is one of the largest sources of human-induced mortality for marine birds in BC waters, a conservation concern impacting both breeders and visiting migrants.


Assuntos
Pesqueiros , Salmão , Animais , Teorema de Bayes , Aves , Colúmbia Britânica , Conservação dos Recursos Naturais
18.
Addict Sci Clin Pract ; 16(1): 13, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627183

RESUMO

BACKGROUND: We describe addiction consult services (ACS) adaptations implemented during the Novel Coronavirus Disease 2019 (COVID-19) pandemic across four different North American sites: St. Paul's Hospital in Vancouver, British Columbia; Oregon Health & Sciences University in Portland, Oregon; Boston Medical Center in Boston, Massachusetts; and Yale New Haven Hospital in New Haven, Connecticut. EXPERIENCES: ACS made system, treatment, harm reduction, and discharge planning adaptations. System changes included patient visits shifting to primarily telephone-based consultations and ACS leading regional COVID-19 emergency response efforts such as substance use treatment care coordination for people experiencing homelessness in COVID-19 isolation units and regional substance use treatment initiatives. Treatment adaptations included providing longer buprenorphine bridge prescriptions at discharge with telemedicine follow-up appointments and completing benzodiazepine tapers or benzodiazepine alternatives for people with alcohol use disorder who could safely detoxify in outpatient settings. We believe that regulatory changes to buprenorphine, and in Vancouver other medications for opioid use disorder, helped increase engagement for hospitalized patients, as many of the barriers preventing them from accessing care on an ongoing basis were reduced. COVID-19 specific harm reductions recommendations were adopted and disseminated to inpatients. Discharge planning changes included peer mentors and social workers increasing hospital in-reach and discharge outreach for high-risk patients, in some cases providing prepaid cell phones for patients without phones. RECOMMENDATIONS FOR THE FUTURE: We believe that ACS were essential to hospitals' readiness to support patients that have been systematically marginilized during the pandemic. We suggest that hospitals invest in telehealth infrastructure within the hospital, and consider cellphone donations for people without cellphones, to help maintain access to care for vulnerable patients. In addition, we recommend hospital systems evaluate the impact of such interventions. As the economic strain on the healthcare system from COVID-19 threatens the very existence of ACS, overdose deaths continue rising across North America, highlighting the essential nature of these services. We believe it is imperative that health care systems continue investing in hospital-based ACS during public health crises.


Assuntos
/epidemiologia , Assistência à Saúde/tendências , Admissão do Paciente/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Telemedicina/tendências , Colúmbia Britânica , Buprenorfina/uso terapêutico , Connecticut , Comparação Transcultural , Previsões , Implementação de Plano de Saúde/tendências , Acesso aos Serviços de Saúde/tendências , Humanos , Massachusetts , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/reabilitação , Oregon , Equipe de Assistência ao Paciente/tendências , Alta do Paciente/tendências , Consulta Remota/tendências
19.
J Alzheimers Dis ; 80(2): 865-875, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33554905

RESUMO

BACKGROUND: The COVID-19 pandemic is impacting the physical and emotional health of older adults living with dementia and their care partners. OBJECTIVE: Using a patient-centered approach, we explored the experiences and needs of people living with dementia and their care partners during the COVID-19 pandemic as part of an ongoing evaluation of dementia support services in British Columbia, Canada. METHODS: A survey instrument was developed around the priorities identified in the context of the COVID-19 and Dementia Task Force convened by the Alzheimer Society of Canada. RESULTS: A total of 417 surveys were analyzed. Overall, respondents were able to access information that was helpful for maintaining their own health and managing a period of social distancing. Care partners reported a number of serious concerns, including the inability to visit the person that they care for in long-term or palliative care. Participants also reported that the pandemic increased their levels of stress overall and that they felt lonelier and more isolated than they did before the pandemic. The use of technology was reported as a way to connect socially with their loved ones, with the majority of participants connecting with others at least twice per week. CONCLUSION: Looking at the complex effects of a global pandemic through the experiences of people living with dementia and their care partners is vital to inform healthcare priorities to restore their quality of life and health and better prepare for the future.


Assuntos
Adaptação Psicológica , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Pessoas com Deficiência/psicologia , Idoso , Colúmbia Britânica , Feminino , Humanos , Solidão/psicologia , Masculino , Determinação de Necessidades de Cuidados de Saúde , Sistemas de Apoio Psicossocial , Isolamento Social/psicologia , Apoio Social , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Inquéritos e Questionários
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