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1.
BMC Public Health ; 22(1): 2448, 2022 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-36577991

RESUMO

BACKGROUND: Income and housing are pervasive social determinants of health. Subsidized housing is a prominent affordability mechanism in Canada; however, waitlists are lengthy. Subsidized rents should provide greater access to residual income, which may theoretically improve health outcomes. However, little is known about the health of tenants who wait for and receive subsidized housing. This is especially problematic for New Brunswick, a Canadian province with low population density, whose inhabitants experience income inequality, social exclusion, and challenges with healthcare access.  METHODS: This study will use a longitudinal, prospective matched cohort design. All 4,750 households on New Brunswick's subsidized housing wait list will be approached to participate. The survey measures various demographic, social and health indicators at six-month intervals for up to 18 months as they wait for subsidized housing. Those who receive housing will join an intervention group and receive surveys for an additional 18 months post-move date. With consent, participants will have their data linked to a provincial administrative database of medical records.  DISCUSSION: Knowledge of housing and health is sparse in Canada. This study will provide stakeholders with a wealth of health information on a population that is historically under-researched and underserved.


Assuntos
Habitação , Habitação Popular , Humanos , Canadá , Saúde Mental , Novo Brunswick , Estudos Prospectivos , Acesso aos Serviços de Saúde
2.
J Prim Care Community Health ; 13: 21501319221138426, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36415141

RESUMO

PURPOSE: Effective communication is a key component to managing an event such as a global pandemic. In Canada, federal/provincial reports indicated that effective communication was a challenge in the early days of the COVID-19 pandemic. The purpose of this study was to examine the communication strategies used within long term care facilities in the Canadian province of New Brunswick. METHODS: Online surveys were used to collect data from administrators, staff, and individuals with family members living in long-term care facilities. RESULTS: The findings show an overall satisfaction with the information received by staff and families, however the frequency and format in which information was communicated were inconsistent. All participants indicated that too much information and poor quality information was a challenge. The importance of digital platforms to provide COVID-19 information was consistently identified as a successful communication strategy. CONCLUSION: The findings of this study reveal that the quantity and quality of information provided during the pandemic created challenges for administrators, staff, and families. This is in line with reports from Canadian provincial/federal reports on COVID-19 and long-term care. Recommendations have been made that would benefit the long-term care sector, not only for pandemics, but for communication in general.


Assuntos
COVID-19 , Pandemias , Humanos , Canadá/epidemiologia , Assistência de Longa Duração , Novo Brunswick , Comunicação
3.
PLoS One ; 17(11): e0277255, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36331954

RESUMO

INTRODUCTION: Immigrants from high tuberculosis-burdened countries have been shown to have an increased risk of latent tuberculosis infection (LTBI). To reduce the risk of increased tuberculosis cases in Canada, the country has a comprehensive immigration medical examination process that identifies individuals with active tuberculosis using chest X-ray; however, it fails to identify LTBI. The lack of LTBI identification is concerning because immigrants with LTBI are at an increased risk of developing active tuberculosis within their first few years of migration due to stressful experiences common to many immigrants. OBJECTIVES: The goal of this pilot study is to improve the current LTBI screening protocols among immigrants from high tuberculosis incidence countries and to better prevent and manage tuberculosis cases, by introducing an LTBI screening pilot program. The objectives are threefold: 1) to screen LTBI in immigrants from high tuberculosis incidence countries, including immigrants identified as being at risk of LTBI by the NB health care system, using the QuantiFERON-TB Gold Plus interferon-gamma release assay (IGRA); 2) to offer LTBI treatment and supports to those identified as having LTBI; and 3) to assess immigrant and health care providers (HCPs) satisfaction of the LTBI screening pilot program. METHODS: This cross-sectional study seeks to recruit 288 participants. Participants will be recruited via posters, social media platforms, invitations at immigrant wellness check-ups, presentations to local ethnocultural groups, and by snowball sampling. Consenting participants will be asked to submit a blood sample for LTBI screening; if positive, participants will be assessed and offered treatment for LTBI based on clinical assessment. Participants and HCPs' feedback will be gathered via short questionnaires. For the quantitative portion of the study, descriptive statistics will be used to summarize participant characteristics and feedback. Simultaneous logistic regression will be performed to identify variables associated with the IGRA test outcome and evidence of increased CD8 T-cell immune response among those found to be LTBI-positive. Qualitative results will be analyzed using inductive thematic analysis. DISCUSSION: The findings from this study will allow us to understand the role of the IGRA LTBI screening assay and its feasibility and acceptability by immigrants and HCPs in New Brunswick. The findings will additionally provide information on the enhancers and barriers of LTBI screening and management useful in determining how best to expand the LTBI screening program if deemed appropriate.


Assuntos
Emigrantes e Imigrantes , Tuberculose Latente , Tuberculose , Humanos , Teste Tuberculínico/métodos , Projetos Piloto , Estudos Transversais , Novo Brunswick , Testes de Liberação de Interferon-gama/métodos , Tuberculose Latente/diagnóstico , Tuberculose Latente/epidemiologia , Tuberculose Latente/tratamento farmacológico , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Programas de Rastreamento
4.
Can Fam Physician ; 68(9): e270-e278, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36100380

RESUMO

OBJECTIVE: To develop a framework of population-based primary care quality indicators adapted to patients with dementia and to identify a subset of stakeholder-driven priority indicators. DESIGN: Framework development was carried out through the selection of an initial framework based on a rapid review and identification of relevant indicators and enrichment based on existing dementia indicators and guidelines. Prioritization of indicators was carried out through a stakeholder survey. SETTING: Ontario, Quebec, New Brunswick, and Saskatchewan. PARTICIPANTS: Stakeholders in community dementia care (N=109) including clinicians, patients, caregivers, decision makers, and managers. MAIN OUTCOME MEASURES: Primary care quality indicators. RESULTS: The framework comprised 34 indicators across 8 domains of quality (access, integration, effective care, efficient care, equity, safety, population health, and patient-centred care). Access to a regular primary care provider, continuity of care, early-stage diagnosis, and access to home care were consistently rated as priorities. Equitable care was a specific priority among patients and caregivers; clinicians reported avoidable hospitalizations as among their priorities. CONCLUSION: A framework of indicators was established for persons with dementia that adds an important dimension to existing primary care and dementia quality indicators by providing primary care and population-based perspectives. This framework could set a foundation for the ongoing monitoring of primary care practices and policies for persons with dementia at a population level.


Assuntos
Demência , Serviços de Assistência Domiciliar , Demência/diagnóstico , Demência/terapia , Humanos , Novo Brunswick , Atenção Primária à Saúde , Indicadores de Qualidade em Assistência à Saúde
5.
Artigo em Inglês | MEDLINE | ID: mdl-35742507

RESUMO

In the early 2000s, the Province of New Brunswick, Canada, undertook health system restructuring, including closing some rural hospitals. We examined whether changes in geographic access to hospitals and primary care were associated with changes in patterns of hospital use. We described three measures of hospital use for ambulatory care sensitive conditions (ACSCs) among adults 75 years and younger annually during the period 2004-2013 overall, and at the community scale. We described spatial and temporal patterns in: age-standardized hospitalization rates, age-standardized incidence of hospital admissions, and rates of admissions via ambulance. Overall, rates and incidence of hospitalizations for ACSCs declined while admissions via ambulance remained largely unchanged. We observed considerable regional variation in rates between communities in 2004. This regional variation decreased over time, with rural areas demonstrating the sharpest declines. Changes in hospital service provision within individual communities had little impact on rates of ACSC admissions. Results were consistent across urban and rural communities and were robust to analyses that included older patients and those admitted for reasons other than ACSCs. Our results suggest that the restructuring and hospital closures did not result in substantial changes to regional patterns or rates of service use.


Assuntos
Assistência Ambulatorial , Hospitais Rurais , Adulto , Fechamento de Instituições de Saúde , Hospitalização , Humanos , Novo Brunswick/epidemiologia , População Rural
6.
Environ Monit Assess ; 194(7): 470, 2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35650315

RESUMO

Culverts are very important hydraulic structures for stream crossing, and they come in various shapes and materials. There are generally two different types of culverts, i.e., closed bottom and open bottom structures. In the present study, two closed bottom culverts have been replaced by open bottom structures (arch culverts) during the summer of 2018. The objective of the present study was to analyze water temperature variability along the impacted sites, one year after the replacement, i.e., 2019 to assess potential impacts of the streamside vegetation removal on the thermal conditions of these streams. Results showed a significant (p < 0.05) change in mean summer temperatures at both sites. Changes in stream temperatures at Barnet Brook were attributed to the removal of an old sediment pond, whereas changes in stream temperatures at the tributary of the Nerepis River were likely due to the removal of the streamside vegetation. Increases in water temperatures (> 4 °C) were more pronounced during low flow periods compared to high flow conditions at both sites.


Assuntos
Rios , Água , Canadá , Monitoramento Ambiental , Novo Brunswick , Lagoas , Temperatura
7.
J Community Health ; 47(4): 674-679, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35567712

RESUMO

Vaccine refusal by even a small subset of the population can undermine the success of the vaccination campaigns which are currently underway worldwide. The goal of this study was to identify determinants of intention to receive COVID-19 vaccine. More precisely, it aimed at examining whether socioeconomic factors, levels of mistrust toward authorities, perceived scientific consensus, and perceived severity of COVID-19 can predict vaccination intentions against COVID-19. Vaccination intentions included being ready to get vaccinated, contemplating vaccination, and not considering vaccination. A sample of 399 individuals from New Brunswick, Canada, completed an online survey in March and April 2021. Results revealed that participants who declared they would probably get vaccinated were more likely to report lower levels of mistrust toward authorities, as well as higher perceived scientific consensus and perceived severity of COVID-19, compared to those who did not intend to get vaccinated or remained unsure. Strategies to guide healthcare professionals in assisting their patients in making the best healthcare decision for their family and themselves are discussed.


Assuntos
COVID-19 , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Canadá/epidemiologia , Humanos , Intenção , Novo Brunswick , Vacinação
8.
Can J Public Health ; 113(4): 504-518, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35488147

RESUMO

OBJECTIVES: To describe the extent to which New Brunswick residents reported having drug insurance coverage supplementary to Canadian Medicare; to examine associations between socioeconomic and demographic characteristics, health status, language identity, and having reported such coverage; and to document any changes in coverage associated with the introduction of the New Brunswick Drug Plan in 2014. METHODS: We used repeated cross-sectional data for New Brunswick from eight cycles of the Canadian Community Health Survey from 2007 to 2017 and undertook logistic regression analysis. RESULTS: We found statistically significant, substantial and policy-relevant socioeconomic differences in the reporting of prescription drug insurance coverage among those 25-64 years and those ≥ 65 years of age, and an increasing reliance on private drug insurance over time. We found that individuals in the second decile of household income were particularly vulnerable to reporting neither public nor private drug coverage. The introduction of the New Brunswick Drug Plan in 2014 does not appear to have led to increased public drug coverage; however, from 2014, the decreasing trend in public drug coverage appears to have ceased. Those who reported lower health status usually had lower odds of reporting private drug coverage but higher odds of reporting public drug coverage. Driven by differences in private coverage, we found that relative to anglophones, francophones were less likely to report any drug coverage. CONCLUSION: Our findings emphasize the shortcomings of drug insurance systems such as that introduced in New Brunswick and substantiate calls for a universal drug program. New Brunswick's increasing reliance on private drug insurance is of concern and warrants additional research.


RéSUMé: OBJECTIFS: Décrire la mesure dans laquelle les résidents du Nouveau-Brunswick ont déclaré avoir une couverture d'assurance médicaments supplémentaire au régime public d'assurance maladie canadien; examiner les associations entre les caractéristiques socioéconomiques et démographiques, l'état de santé, l'identité linguistique et avoir déclaré une telle couverture; et documenter tout changement de couverture associé à l'introduction du Régime médicaments du Nouveau-Brunswick en 2014. MéTHODES: Nous avons utilisé des données transversales répétées du Nouveau-Brunswick de huit cycles de l'Enquête sur la santé dans les collectivités canadiennes de 2007 à 2017 et avons entrepris une analyse de régression logistique. RéSULTATS: Nous avons constaté des différences socioéconomiques statistiquement significatives, substantielles et pertinentes en matière de politiques dans la déclaration de la couverture d'assurance médicaments chez les 25 à 64 ans et les 65 ans et plus, et une dépendance croissante à l'égard de l'assurance médicaments privée au fil du temps. Nous avons constaté que les personnes appartenant au deuxième décile du revenu du ménage étaient particulièrement vulnérables au fait de ne pas avoir déclaré d'assurance médicaments publique ou privée. La mise en place du Régime médicaments du Nouveau-Brunswick en 2014 ne semble pas avoir entraîné une augmentation de la couverture publique des médicaments; cependant, à partir de 2014, la tendance à la baisse de la couverture publique des médicaments semble avoir cessé. Ceux qui ont déclaré un état de santé inférieur avaient généralement une cote exprimant la probabilité plus faible de déclarer une assurance médicaments privée, mais plus élevée de déclarer une couverture publique des médicaments. En raison des différences de couverture privée, nous avons trouvé que, par rapport aux anglophones, les francophones étaient moins susceptibles de déclarer une couverture pour les médicaments. CONCLUSION: Nos résultats mettent en évidence les lacunes des systèmes d'assurance médicaments comme celui mis en place au Nouveau-Brunswick et justifient les appels en faveur d'un programme universel de médicaments. La dépendance croissante du Nouveau-Brunswick à l'égard de l'assurance médicaments privée est préoccupante et justifie des recherches supplémentaires.


Assuntos
Medicamentos sob Prescrição , Idoso , Canadá , Estudos Transversais , Humanos , Cobertura do Seguro , Seguro de Serviços Farmacêuticos , Programas Nacionais de Saúde , Novo Brunswick , Prescrições
9.
BMC Med Genomics ; 15(1): 98, 2022 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-35488281

RESUMO

BACKGROUND: Founder populations that have recently undergone important genetic bottlenecks such as French-Canadians and Ashkenazi Jews can harbor some pathogenic variants at a higher carrier rate than the general population, putting them at a higher risk for certain genetic diseases. In these populations, there can be considerable benefit to performing ethnic-based or expanded preconception carrier screening, which can help in the prevention or early diagnosis and management of some genetic diseases. Acadians are descendants of French immigrants who settled in the Atlantic Coast of Canada in the seventeenth century. Yet, the Acadian population has never been investigated for the prevalence/frequency of disease-causing genetic variants. METHODS: An exome sequencing panel for 312 autosomal recessive and 30 X-linked diseases was designed and specimens from 60 healthy participants were sequenced to assess carrier frequency for the targeted diseases. RESULTS: In this study, we show that a sample population of Acadians in South-East New Brunswick harbor variants for 28 autosomal recessive and 1 X-linked diseases, some of which are significantly more frequent in comparison to reference populations. CONCLUSION: Results from this pilot study suggests a need for further investigation of genomic variation in this population and possibly implementation of targeted carrier and neonatal screening programs.


Assuntos
Etnicidade , Canadá , Humanos , Recém-Nascido , Novo Brunswick , Projetos Piloto
11.
Int J Drug Policy ; 103: 103629, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35228057

RESUMO

INTRODUCTION: Since recreational legalization of cannabis in Canada in 2018, self-reported use in New Brunswick (NB) has increased from 15.1% to 20.3%, the largest increase of any province. Current literature on the impact of recreational cannabis legislation in other jurisdictions is conflicting, though retail availability has often been delayed on enactment. Given the immediate availability of cannabis in NB after legalization, we sought to establish the effect this had on post-mortem cannabinoid detection. Furthermore, we wanted to investigate the impact that age, sex, and manner of death had on cannabis use. We also established if there were any increases in commonly detected drugs over the study period. METHODS: A retrospective chart review was conducted on all adult Coroner's cases with toxicology analysis in NB between January 2014 and May 2020 (n = 3060). Differences in the proportion of cannabinoid-positive samples pre- versus post-legalization in the overall cohort as well as within each demographic parameter were assessed using chi-square tests. The effects of demographic parameters on cannabis presence were further assessed by logistic regression. Lastly, chi-square tests for trend were performed to identify increasing trends in cannabis detection, as well as cocaine, ethanol, opiates/opioids, benzodiazepines, and amphetamines over the study period. RESULTS: After controlling for age, sex, and manner of death, participants that died after recreational legalization had higher odds of having cannabis present post-mortem than those that died pre-legalization. In addition, demographic sub-analysis identified a greater proportion of cannabinoid-positive samples post-legalization in 25- to 44-year-olds and in deaths classified as either suicide or accidental compared to pre-legalization. We also observed a significant increase in the presence of cocaine and amphetamines in post-mortem samples over the study period. CONCLUSION: This study demonstrates that cannabis use has increased post-legalization in NB, particularly within young adults and those dying by suicide or accidental means. It also highlights the need for future research into the impact that legalization has on cannabis use in other jurisdictions.


Assuntos
Canabinoides , Cannabis , Cocaína , Alucinógenos , Analgésicos , Analgésicos Opioides , Agonistas de Receptores de Canabinoides , Humanos , Legislação de Medicamentos , Novo Brunswick , Estudos Retrospectivos , Adulto Jovem
12.
BMC Res Notes ; 15(1): 79, 2022 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-35197119

RESUMO

OBJECTIVE: It has been postulated that social and economic inequalities may shape the distributions of comorbid diabetes and mental illness. This observational cohort study using linked population-based administrative and geospatial datasets aimed to describe associations between neighbourhood socioenvironments and disorder-specific mental health service use among adults with diabetes in the province of New Brunswick, Canada. RESULTS: A baseline cohort of 66,275 persons aged 19 and over living with diabetes was identified. One-quarter (26.3%) had used healthcare services for mood and anxiety disorders at least once during the six-year follow-up period 2012/2013-2017/2018. Based on Cox proportional hazards models, the risk of mental health service contacts was significantly higher among those residing in the most materially deprived neighbourhoods [HR: 1.07 (95% CI: 1.01-1.14)] compared to those in the least so, and those in areas characterized with the highest residential instability [HR: 1.13 (95% CI: 1.05-1.22)] compared to those in areas with the lowest instability. Among adults with incident diabetes (N = 4410), age and sex but not neighbourhood factors were related to differential help-seeking behaviours for mental health problems. These findings underscored the gap between theoretical postulations and population-based observations in delineating the syndemics of neighbourhood socioenvironments and mental health outcomes in populations with high diabetes prevalence.


Assuntos
Diabetes Mellitus , Serviços de Saúde Mental , Adulto , Canadá/epidemiologia , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos , Características da Vizinhança , Novo Brunswick/epidemiologia , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
13.
PLoS One ; 17(1): e0263156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35081174

RESUMO

BACKGROUND: Addiction treatment and harm reduction services reduce risks of death and re-infection among patients with injection drug use-associated infective endocarditis (IDU-IE), but these are not offered at many hospitals. Among hospitalized patients with IDU-IE at the two tertiary-care hospitals in the Canadian Maritimes, we aimed to identify (1) the availability of opioid agonist treatment (OAT) and sterile drug injecting equipment, and (2) indicators of potential unmet addiction care needs. METHODS: Retrospective review of IDU-IE hospitalizations at Queen Elizabeth II Health Sciences Centre (Halifax, Nova Scotia) and the Saint John Regional Hospital (Saint John, New Brunswick), October 2015 -March 2017. In Halifax, there are no addiction medicine providers on staff; in Saint John, infectious diseases physicians also practice addiction medicine. Inclusion criteria were: (1) probable or definite IE as defined by the modified Duke criteria; and (2) injection drug use within the prior 3 months. RESULTS: We identified 38 hospitalizations (21 in Halifax and 17 in Saint John), for 30 unique patients. Among patients with IDU-IE and untreated opioid use disorder, OAT was offered to 36% (5/14) of patients in Halifax and 100% (6/6) of patients in Saint John. Once it was offered, most patients at both sites initiated OAT and planned to continue it after discharge. In Halifax, no patients were offered sterile injecting equipment, and during five hospitalizations staff confiscated patients' own equipment. In Saint John, four patients were offered (and one was provided) injecting equipment in hospital, and during two hospitalizations staff confiscated patients' own equipment. Concerns regarding undertreated pain or opioid withdrawal were documented during 66% (25/38) of hospitalizations, and in-hospital illicit or non-medical drug use during 32% (12/38). Two patients at each site (11%; 4/38) had self-directed discharges against medical advice. CONCLUSIONS: Patients with IDU-IE in the Canadian Maritimes have unequal access to evidence-based addiction care depending on where they are hospitalized, which differs from the community-based standard of care. Indicators of potential unmet addiction care needs in hospital were common.


Assuntos
Analgésicos Opioides/uso terapêutico , Endocardite Bacteriana/epidemiologia , Disparidades em Assistência à Saúde , Programas de Troca de Agulhas , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Comorbidade , Feminino , Redução do Dano , Humanos , Masculino , Pessoa de Meia-Idade , Novo Brunswick/epidemiologia , Nova Escócia/epidemiologia , Alta do Paciente , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
14.
J Relig Health ; 61(5): 4119-4138, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35099652

RESUMO

This study assessed the association between religion and spirituality on general life satisfaction among a sample of community-dwelling Canadians with neurological conditions. The data represented responses from two provinces that participated in the national Canadian Community Health Survey-Annual Component (CCHS-2011). A weighted subsample (n = 4562) of respondents with neurological conditions from the provinces of New Brunswick and Manitoba was used. Multivariate logistic regression fitted the models using STATA version 14. Spiritual coping, self-perceived general, and mental health were found to be predictors of greater life satisfaction and quality of life. It may be beneficial to incorporate spiritual and religious needs in the circle of care for those living in the community with neurological conditions.


Assuntos
Qualidade de Vida , Espiritualidade , Canadá , Humanos , Manitoba , Novo Brunswick , Satisfação Pessoal , Religião
15.
Health Place ; 73: 102726, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34883408

RESUMO

Most home care for people living with chronic illness or disability is provided by informal, or unpaid, family members. Family caregivers in rural New Brunswick engage in essential work to maintain the home as a site of care. Renovations, property maintenance, and the administrative work involved in accessing medical equipment and managing staff are examples of the types of invisible labour involved in interacting with a complex care environment. Conversations with 13 family caregivers across a small rural Canadian province suggest that even when resources are 'available', place-based factors involved in caring at home in a rural setting make it difficult for carers to use these resources and accessing them becomes another form of work itself. Similar to Wiles et al.'s (2018) findings in their study of end-of-life family care in Aotearoa, New Zealand, carers in rural New Brunswick spoke of their activities as part of an ongoing process of interaction with the care recipient and care environment. Carers with fewer financial and material resources experienced higher burdens of invisible work. The paper sheds light on the types of labour involved in 'knowing, doing, and negotiating' care at home and re-categorizes these activities as 'health work' as a means of informing home care policy. The paper finds that family caregivers are aware of their invisible work, characterize it as essential health work, and seek recognition for their complex contribution to the formal health system.


Assuntos
Cuidadores , Família , Canadá , Humanos , Novo Brunswick , População Rural
16.
Midwifery ; 105: 103227, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34954470

RESUMO

OBJECTIVE: This study contextualizes client experiences of midwifery in New Brunswick within the broader literature on midwifery in Canada and contributes to understandings of how midwifery care fits into the landscape of reproductive healthcare in the province. DESIGN: Semi structured interviews with 32 clients and supportive others of the New Brunswick midwifery program were carried out in 2019 and 2020, and transcripts were analysed using general thematic analysis. SETTING: N New Brunswick, Canada PARTICIPANTS: Clients of midwifery care provided by the Fredericton Midwifery Centre, as well as their supportive others (partners and spouses, family members, friends) FINDINGS: Participants in this study reported a high degree of satisfaction with midwifery services and identified several approaches to practice that they felt contributed to high quality midwifery care. These include competence and expertise, time and access as abundance rather than scarcity, attention to the familial context, trauma informed care and attention to mental and emotional health, postpartum care, and supporting agency and autonomy. In short, participants' responses indicate that midwifery care in New Brunswick meets the criteria for respectful maternity care, as outlined by Shakibazadeh et al. (Shakibazadeh et al., 2018) and Butler et al. (Butler et al., 2020). Our findings are in line with research on midwifery care in other settings, although there is a significant emphasis on the medical expertise and training of midwives amongst our participants which is less evident in the scholarly literature. KEY CONCLUSIONS: In a province where reproductive health care has been systematically underfunded, clients celebrate the expertise and competence of midwives, challenging the narrative which constructs midwifery as 'traditional' care, and hospital-based obstetrics as expert care. Instead, midwives are recognized as highly specialized evidence-based practitioners, and this is particularly prized by clients in relation to processes of information sharing.


Assuntos
Serviços de Saúde Materna , Tocologia , Obstetrícia , Canadá , Feminino , Humanos , Novo Brunswick , Gravidez , Pesquisa Qualitativa
17.
PLoS One ; 16(11): e0258839, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34813618

RESUMO

BACKGROUND: During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. METHODS: This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. RESULTS: The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. INTERPRETATION: The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.


Assuntos
COVID-19/epidemiologia , Médicos de Atenção Primária/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , SARS-CoV-2/isolamento & purificação , Telemedicina/estatística & dados numéricos , COVID-19/virologia , Humanos , Novo Brunswick/epidemiologia , Inquéritos e Questionários , Telemedicina/tendências
18.
J Fish Dis ; 44(12): 1971-1984, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34411315

RESUMO

The objective of this study was to estimate the impact of infestation pressures on the abundance of the parasitic sea louse, Lepeophtheirus salmonis, in the Bay of Fundy, New Brunswick (NB), Canada, using the Fish-iTrends database for the years 2009-2018. Infestation pressures were calculated as time-lagged weighted averages of the abundance of adult female (AF) sea lice within a site (internal infestation pressure: IIP) and among sites (external infestation pressure: EIP). The EIP weights were calculated from seaway distances among sites and a Gaussian kernel density for bandwidths of 5 to 60 km. The EIP with a bandwidth of 10 km had the best fit, as determined with Akaike's information criterion, and historical AF sea lice abundance. This estimated dispersal distance of 10 km was similar to previous studies in Norway, Scotland and in New Brunswick. The infestation pressures estimated from empirical AF sea lice abundance within and among sites significantly increased the abundance of AF sea lice (p < .001). This study concludes that sea lice burdens within Atlantic salmon farms in the Bay of Fundy, NB, are affected by within site management and could be improved by synchronizing treatments between sites.


Assuntos
Copépodes , Doenças dos Peixes/parasitologia , Salmo salar , Animais , Aquicultura , Feminino , Doenças dos Peixes/epidemiologia , Novo Brunswick/epidemiologia , Análise Espacial
19.
Front Public Health ; 9: 660041, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249835

RESUMO

Objectives: The aim of this paper is to assess the odds of suffering from anxiety or depression symptoms based on the presence of certain determinants of health for youth living in the province of New Brunswick, Canada, and in two linguistically different Official Language Minority Communities (OLMCs) in the same province. Methods: With a sample of 22,329 students from grades 7 to 12 in the province of New Brunswick, Canada, logistic regressions were performed to assess each determinant of health's effect on symptoms of anxiety and depression. Results: Some social determinants, like family support, social support and food insecurity, were identified as important determinants of mental health status regardless of linguistic group membership or community membership, while other determinants, such as alcohol use, cannabis use and natural environment, were more prominent in one OLMC than the other. Discussion: Social psychology and public health theories are used in an attempt to explain the results. Limitations and recommendations are also brought forward.


Assuntos
Depressão , Idioma , Adolescente , Ansiedade/epidemiologia , Canadá/epidemiologia , Criança , Depressão/epidemiologia , Humanos , Novo Brunswick , Instituições Acadêmicas
20.
Nurs Leadersh (Tor Ont) ; 34(2): 21-25, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34197289

RESUMO

Loch Lomond Villa is one of the largest long-term care communities within the province of New Brunswick. Our organization supports caring living environments for over 450 clients and their family members along with 354 employees.


Assuntos
COVID-19/prevenção & controle , Diretores de Hospitais/psicologia , Assistência de Longa Duração/métodos , Enfermeiras Administradoras/psicologia , COVID-19/enfermagem , Humanos , Assistência de Longa Duração/psicologia , Novo Brunswick , Papel do Profissional de Enfermagem/psicologia
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