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1.
Rural Remote Health ; 22(4): 7559, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36419216

RESUMO

INTRODUCTION: The perspectives of rural communities, specifically people with lived experience of suicidality and suicide loss in rural places, are often neglected in suicide research. It is critical that rural and remote health researchers acquire a deeper understanding of suicidality in rural Canadian communities for generation of relevant knowledge to better inform the development of suicide prevention, intervention and postvention solutions. This article presents research findings of how rural residents understand their community values, what information gaps they identify in relation to current suicide research, and how research can be mobilized to reach rural communities. METHOD: Researchers conducted six virtual focus groups with 47 participants from the Canadian provinces of British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, and Newfoundland and Labrador between March and May 2021. All focus groups were transcribed verbatim and analyzed using thematic analysis. RESULTS: Focus group findings revealed the need for research that recognizes the significance of rural culture, the sense of community experienced and the ways in which they shape rural suicide experiences with associated impacts of suicide. Participatory, community-based action research methods are required to examine the interplay between rural residence, community, and suicide. In addition, the voices of rural people with lived experience of suicide are absent in the research literature. The need exists for qualitative research conducted for the purpose of investigating the lived experience of rural suicidality. CONCLUSION: Research participants asked that a lived experience agenda be prioritized to include the voices and stories of rural people, with consideration of rural culture, an aspect of rural suicidality currently not evident in Canadian research literature.


Assuntos
Suicídio , Humanos , Suicídio/prevenção & controle , População Rural , Ideação Suicida , Terra Nova e Labrador , Alberta
2.
Can J Rural Med ; 27(4): 143-147, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36254937

RESUMO

Introduction: Wait times to see an orthopaedic consultant can be lengthy. Remote communities such as Labrador City and Goose Bay, located in Labrador in the province of Newfoundland and Labrador, often do not have an orthopaedic specialist locally and patients are required to travel great distances to attend clinic appointments. The objectives of this report are to describe our Orthopaedic Outreach Programme where patients receive fracture assessments and care for musculoskeletal concerns at two local clinics by a visiting orthopaedic surgeon. We also describe the justification for the Orthopaedic Outreach Programme and list the benefits; financial and otherwise. Methods: A review of the programme, operating out of Happy Valley-Goose Bay and Labrador City, using electronic medical records, was undertaken from 1st January 2015 to 31st December 2019 including demographics and procedures completed. Travel and hotel costs were estimated. Results: Over the last 5 years, the Orthopaedic Outreach Programme treated 1,698 patients at the 2 clinics. Cost savings were estimated at $366,768 per annum. The cost savings over the last 5 years were estimated at a total of $1,833,840. This does not account for patient's time off work and lost revenue that would occur when they make the trip to St John's for a clinic appointment. Conclusions: Our Orthopaedic Outreach Programme was implemented to improve access to orthopaedic services in the remote areas of Labrador. This report aims to describe the result of a programme focused on providing orthopaedic care to individuals who would otherwise be required to travel great distances for their care.


Résumé Introduction: Les temps d'attente pour voir un orthopédiste peuvent être longs. Les communautés éloignées telles que Labrador City et Goose Bay, situées au Labrador dans la province de Terre-Neuve-et-Labrador, n'ont souvent pas de spécialistes en orthopédie sur place et les patients doivent parcourir de grandes distances pour se rendre à leurs rendez-vous en clinique. Les objectifs de ce rapport sont de décrire notre Programme de sensibilisation à l'orthopédie dans le cadre duquel les patients reçoivent des évaluations de fractures et des soins pour des problèmes musculosquelettiques dans deux cliniques locales par un orthopédiste en visite. Nous décrivons également la justification du programme et énumérons les avantages, financiers et autres. Méthodes: Un examen du programme, opérant à partir de Happy Valley-Goose Bay et Labrador City, à l'aide de dossiers médicaux électroniques, a été entrepris du 1er janvier 2015 au 31 décembre 2019, y compris les données démographiques et les procédures effectuées. Les frais de déplacement et d'hôtel ont été estimés. Résultats: Au cours des 5 dernières années, le programme de sensibilisation à l'orthopédie a traité 1 698 patients dans les deux cliniques. Les économies de coûts ont été estimées à 366 768 $ par an. Les économies réalisées au cours des 5 dernières années ont été estimées à un total de 1 833 840 $. Ce montant ne tient pas compte du temps d'arrêt de travail des patients et des pertes de revenus qui se produiraient lorsqu'ils se rendent à St John's pour un rendez-vous à la clinique. Conclusion: Notre Programme de sensibilisation à l'orthopédie a été mis en œuvre pour améliorer l'accès aux services orthopédiques dans les régions éloignées du Labrador. Ce rapport vise à décrire le résultat d'un programme axé sur la fourniture de soins orthopédiques à des personnes qui, autrement, seraient obligées de parcourir de grandes distances pour recevoir leurs soins. Mots-clés: Rural; orthopédie; orthopédistes.


Assuntos
Ortopedia , Humanos , Terra Nova e Labrador , Especialização , Viagem
3.
Proc Natl Acad Sci U S A ; 119(44): e2203468119, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36279448

RESUMO

Sea ice decline in the North Atlantic and Nordic Seas has been proposed to contribute to the repeated abrupt atmospheric warmings recorded in Greenland ice cores during the last glacial period, known as Dansgaard-Oeschger (D-O) events. However, the understanding of how sea ice changes were coupled with abrupt climate changes during D-O events has remained incomplete due to a lack of suitable high-resolution sea ice proxy records from northwestern North Atlantic regions. Here, we present a subdecadal-scale bromine enrichment (Brenr) record from the NEEM ice core (Northwest Greenland) and sediment core biomarker records to reconstruct the variability of seasonal sea ice in the Baffin Bay and Labrador Sea over a suite of D-O events between 34 and 42 ka. Our results reveal repeated shifts between stable, multiyear sea ice (MYSI) conditions during cold stadials and unstable, seasonal sea ice conditions during warmer interstadials. The shift from stadial to interstadial sea ice conditions occurred rapidly and synchronously with the atmospheric warming over Greenland, while the amplitude of high-frequency sea ice fluctuations increased through interstadials. Our findings suggest that the rapid replacement of widespread MYSI with seasonal sea ice amplified the abrupt climate warming over the course of D-O events and highlight the role of feedbacks associated with late-interstadial seasonal sea ice expansion in driving the North Atlantic ocean-climate system back to stadial conditions.


Assuntos
Mudança Climática , Camada de Gelo , Movimentos da Água , Bromo , Baías , Terra Nova e Labrador , Oceanos e Mares
4.
J Cutan Med Surg ; 26(5): 494-501, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938546

RESUMO

BACKGROUND: Psoriasis is a chronic, immune-mediated inflammatory disease with an implied connection to psychiatric disorders. OBJECTIVE: This study aims to illustrate an association between psoriasis and psychiatric disorders using real world data gathered from the Newfoundland and Labrador population. METHODS: Data on 15,100 patients with psoriasis and 75,500 controls (1:5) was collected from the Newfoundland and Labrador Centre for Health Information's Electronic Health Records. The cases and controls were matched for age, sex, and geography. Indicators for psychiatric disorders include diagnosis of mental illnesses from physician's visits and hospitalization records (all coded for mental health using ICD-9 and ICD-10 codes). RESULTS: 9,991 (66.2%) cases were identified to have at least one visit with a diagnostic code for mental illness compared to 42,276 (56.0%), P < .0001 in the control group. The percentage of people coded for anxiety was 36.50% compared to 28.95%, P < .0001; depression was 37.04% compared to 30.19%, P < .0001; and adjustment disorder was 6.89% versus 5.48%, P < .0001, among those with and without psoriasis, respectively. The greatest risk for anxiety [OR 1.4 (1.20, 1.67)] and depression [OR 1.65 (1.36, 2.00)] among psoriasis patients was between the 0 to 20 age group. Women with psoriasis are more likely to have anxiety [OR 1.08 (1.03, 1.13)], depression [OR 1.04 (1.01, 1.09)] and adjustment disorder [OR 1.07 (0.98, 1.17)] compared to female controls. CONCLUSION: Our result shows that patients with psoriasis have an increased prevalence of mental illness. Using real world data to carry out further investigations will better elucidate this association and provide an increased understanding of the association between psoriasis and mental disorders.


Assuntos
Transtornos Mentais , Psoríase , Ansiedade , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Terra Nova e Labrador/epidemiologia , Prevalência , Psoríase/complicações , Psoríase/epidemiologia , Psoríase/psicologia
5.
Health Rep ; 33(8): 31-38, 2022 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-35984952

RESUMO

Background: Globally, the suicide rate is two times higher for males than for females. Previous studies in Newfoundland and Labrador did not examine age-specific rates by sex. The objectives of this study were to determine suicide rates by sex and age group and to compare the demographic and clinical characteristics of males and females who died by suicide. Data and methods: This observational study analyzed a routinely collected dataset based on all medical examiner-determined suicide deaths among people aged 10 years and older in Newfoundland and Labrador, Canada, between 1997 and 2016. Age-standardized and age-specific suicide rates and rate ratios were calculated based on the number of deaths during the period, and descriptive statistics were used to compare demographic and clinical characteristics between males and females. Results: The age-standardized suicide rate was 4.6 times higher among males than females and was higher for males in most age groups. Rates were highest in the young adult age groups for males (20 to 24 years) and females (35 to 39 years). Males who died by suicide were more likely to be from a rural community and to have died by firearm; females were more likely to die by self-poisoning and to have had a mental illness or substance use history. Interpretation: The results are broadly consistent with previous research, though this is the first study to report age-specific suicide rates among females across the life course in Newfoundland and Labrador. The results underscore the need to design public health and clinical interventions that account for sex differences in suicide risks.


Assuntos
Médicos Legistas , Suicídio , Distribuição por Idade , Canadá , Feminino , Humanos , Masculino , Terra Nova e Labrador , Caracteres Sexuais , Distribuição por Sexo , Adulto Jovem
6.
Sci Rep ; 12(1): 13078, 2022 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-35906469

RESUMO

The planktonic diversity throughout the oceans is vital to ecosystem functioning and linked to environmental change. Plankton monitoring tools have advanced considerably with high-throughput in-situ digital cameras and genomic sequencing, opening new challenges for high-frequency observations of community composition, structure, and species discovery. Here, we combine multi-marker metabarcoding based on nuclear 18S (V4) and plastidial 16S (V4-V5) rRNA gene amplicons with a digital in-line holographic microscope to provide a synoptic diversity survey of eukaryotic plankton along the Newfoundland Shelf (Canada) during the winter transition phase of the North Atlantic bloom phenomenon. Metabarcoding revealed a rich eukaryotic diversity unidentifiable in the imaging samples, confirming the presence of ecologically important saprophytic protists which were unclassifiable in matching images, and detecting important groups unobserved or taxonomically unresolved during similar sequencing campaigns in the Northwest Atlantic Ocean. In turn, imaging analysis provided quantitative observations of widely prevalent plankton from every trophic level. Despite contrasting plankton compositions portrayed by each sampling method, both capture broad spatial differences between the northern and southern sectors of the Newfoundland Shelf and suggest complementary estimations of important features in eukaryotic assemblages. Future tasks will involve standardizing digital imaging and metabarcoding for wider use and consistent, comparable ocean observations.


Assuntos
Holografia , Plâncton , Biodiversidade , Ecossistema , Eucariotos/genética , Terra Nova e Labrador , Plâncton/genética
7.
Transbound Emerg Dis ; 69(5): e2694-e2705, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35689408

RESUMO

Some parvoviruses of carnivorans can infect multiple host species. Since many canine parvoviruses were only discovered recently, their host-range is still unexplored. We examined the host distribution and diversity of five dog parvoviruses in four canine populations from Newfoundland and Labrador, Canada, and investigated the potential for these viruses to cross the species barriers. Canine bocavirus 2 (CBoV-2) and the minute virus of canines were detected in stool from free-roaming dogs from Labrador (5/48 [10.4%] and 3/48 [6.3%], respectively) and two different CBoV-2 variants were identified. Canine bufavirus was identified in stool from free-roaming dogs (1/48, 2.1%) and foxes (3/80, 3.8%) from Labrador, but two different variants were observed in the two host species. The variant found in foxes was highly divergent from previously identified strains. Two cachavirus 1 variants, genetically similar to those circulating in other Canadian wildlife, were found in spleens from Newfoundland coyotes (3/87, 3.5%). Canine parvovirus type 2 (CPV-2) was found in stool from free-roaming dogs from Labrador (2/48, 4.2%) and in spleens from Newfoundland coyotes (3/87, 3.5%). Comparing CPV-2 sequences from these hosts to those retrieved from local symptomatic domestic dogs revealed the presence of a highly heterogeneous viral population as detected strains belonged to five different clades. The close relationship between CPV-2a strains from a dog and a coyote suggests the occurrence of viral transfer between wild and domestic canids. The identification of highly related strains with a similar molecular signature characteristic of older CPV-2 strains in free-roaming and domestic dogs suggests a probable common ancestry and that older CPV-2 strains, which have not been identified in dogs since the 1990s, persist in this part of Canada. Follow-up studies should evaluate samples from a larger number of animals and host species to extensively investigate the possible occurrence of cross-species transmission for recently discovered parvoviruses.


Assuntos
Coiotes , Doenças do Cão , Infecções por Parvoviridae , Parvovirus Canino , Parvovirus , Animais , Canadá , Doenças do Cão/epidemiologia , Cães , Raposas , Terra Nova e Labrador/epidemiologia , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/veterinária , Parvovirus Canino/genética , Filogenia
8.
BMC Prim Care ; 23(1): 143, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35659251

RESUMO

BACKGROUND: Low back pain (LBP) is a leading cause of disability and is among the top five reasons that patients visit their family doctors. Over-imaging for non-specific low back pain remains a problem in primary care. To inform a larger study to develop and evaluate a theory-based intervention to reduce inappropriate imaging, we completed an assessment of the barriers and facilitators to reducing unnecessary imaging for NSLBP among family doctors in Newfoundland and Labrador (NL). METHODS: This was an exploratory, qualitative study describing family doctors' experiences and practices related to diagnostic imaging for non-specific LBP in NL, guided by the Theoretical Domains Framework (TDF). Data were collected using in-depth, semi-structured interviews. Transcripts were analyzed deductively (assigning text to one or more domains) and inductively (generating themes at each of the domains) before the results were examined to determine which domains should be targeted to reduce imaging. RESULTS: Nine family doctors (four males; five females) working in community (n = 4) and academic (n = 5) clinics in both rural (n = 6) and urban (n = 3) settings participated in this study. We found five barriers to reducing imaging for patients with NSLBP: 1) negative consequences, 2) patient demand 3) health system organization, 4) time, and 5) access to resources. These were related to the following domains: 1) beliefs about consequences, 2) beliefs about capabilities, 3) emotion, 4) reinforcement, 5) environmental context and resources, 6) social influences, and 7) behavioural regulation. CONCLUSIONS: Family physicians a) fear that if they do not image they may miss something serious, b) face significant patient demand for imaging, c) are working in a system that encourages unnecessary imaging, d) don't have enough time to counsel patients about why they don't need imaging, and e) lack access to appropriate practitioners, community programs, and treatment modalities to prescribe to their patients. These barriers were related to seven TDF domains. Successfully reducing inappropriate imaging requires a comprehensive intervention that addresses these barriers using established behaviour change techniques. These techniques should be matched directly to relevant TDF domains. The results of our study represent the important first step of this process - identifying the contextual barriers and the domains to which they are related.


Assuntos
Dor Lombar , Terapia Comportamental , Diagnóstico por Imagem , Feminino , Humanos , Dor Lombar/diagnóstico , Masculino , Terra Nova e Labrador , Atenção Primária à Saúde
9.
Curr Biol ; 32(12): R666-R671, 2022 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-35728550

RESUMO

Every spring a 600 lb Atlantic bluefin tuna travels over 3000 miles from Newfoundland to its spawning grounds in the Gulf of Mexico. That it does so on a meal of a couple of bluefish is nothing short of remarkable. Humans will likely never engineer such an efficient swimming machine. Of course, that has not stopped us from trying. We have achieved remarkable progress by following a strategy of inspiration by nature. At the same time, our fish-like robots often fall short of matching fish performance by a considerable margin. Despite our advances, we are still left asking the question: How do fish swim so well?


Assuntos
Natação , Atum , Animais , Terra Nova e Labrador , Reprodução , Estações do Ano
10.
Healthc Q ; 25(1): 36-42, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35596763

RESUMO

Eastern Health (EH) is the most populous of four Regional Health Authorities in Newfoundland and Labrador. In 2017, EH realized the potential impact that healthcare innovation could have on improving patient care, its outcomes as well as provincial economic development. This paper describes EH's innovation journey with "vested contracting," a relatively rare approach in Canada, for its procurement of management services for support activities, such as housekeeping, laundry, patient/resident food services, retail food services and portering. Through individual interviews with EH executives, directors and the successful vendor, this paper describes the system changes needed to accommodate "vested contracting," the burden associated with learning and changing the procurement process and lessons learned.


Assuntos
Atenção à Saúde , Assistência ao Paciente , Canadá , Comércio , Humanos , Terra Nova e Labrador
11.
Ecohealth ; 19(1): 99-113, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35471683

RESUMO

Presence of PBDEs tested in 127 liver samples from Atlantic Cod (Gadus morhua) and Turbot (Scophthalmus Maximus) and 80 adult participants from two rural Newfoundland communities. Seafood consumption was measured through a validated seafood consumption questionnaire. PBDEs (-28, -47, -99, -156, and -209) were found in all fish liver samples, and PBB-153 and PBDEs-28, -47, -99, -100, -153 were identified as the most prominent congeners from the participants' serum samples. Cod was the most frequently consumed species in the seafood consumption survey. PBB-153 was higher amongst older (> 50 years age) participants (p < 0.0001), however, no PBDE congeners were significantly different by age. PBB-153 (p = 0.001), PBDE-153 (p = 0.006), and 5PBDE (p = 0.008) levels were significantly higher in males. The study shows that the marine ecosystem around Newfoundland has been contaminated by PBDEs, and that rural coastal residents are potentially exposed to these contaminants through local seafood consumption.


Assuntos
Éteres Difenil Halogenados , Poluentes Químicos da Água , Animais , Exposição Dietética , Ecossistema , Peixes , Éteres Difenil Halogenados/análise , Humanos , Terra Nova e Labrador , Alimentos Marinhos/análise
12.
J Fish Dis ; 45(6): 919-930, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35397120

RESUMO

An incursion of infectious salmon anaemia virus (ISAV) was detected in 2020 in southern Newfoundland, Canada. This resulted in an outbreak affecting four marine farms stocking Atlantic salmon (Salmo salar L.) vaccinated against ISAV. This study provides the first description of epidemiologic characteristics of an ISAV outbreak in 2020 and 2021, and detected ISAV variants at the population level. Fish kidneys were screened for ISAV by real-time RT-PCR and non-negative samples were submitted for genotyping and further diagnostic testing. Nine distinct ISAV variants were identified: five European and three North American (NA) HPRΔ ISAV, and one NA-HPR0 ISAV variant. A notable finding was the concurrent detection of both an HPR0 and an HPRΔ ISAV variant in one individual fish. In two farms, both European and NA variants were simultaneously detected, while in the other two farms either NA or European variants were identified, but not both together. Generally, mortality increases followed rises in ISAV prevalence and cycle threshold values on RT-PCR decreased with time. Epidemiologic descriptions of ISAV outbreaks in Atlantic Canada contributes to the understanding of local disease dynamics and identification of changes thereof. Such insights are essential for the strengthening of disease management plans.


Assuntos
Doenças dos Peixes , Isavirus , Infecções por Orthomyxoviridae , Salmo salar , Animais , Canadá , Doenças dos Peixes/epidemiologia , Isavirus/genética , Terra Nova e Labrador , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Filogenia
13.
CMAJ ; 194(10): E371-E377, 2022 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-35288408

RESUMO

BACKGROUND: Diverse health care leadership teams may improve health care experiences and outcomes for patients. We sought to explore the race and gender of hospital and health ministry executives in Canada and compare their diversity with that of the populations they serve. METHODS: This cross-sectional study included leaders of Canada's largest hospitals and all provincial and territorial health ministries. We included individuals listed on institutional websites as part of the leadership team if a name and photo were available. Six reviewers coded and analyzed the perceived race and gender of leaders, in duplicate. We compared the proportion of racialized health care leaders with the race demographics of the general population from the 2016 Canadian Census. RESULTS: We included 3056 leaders from 135 institutions, with reviewer concordance on gender for 3022 leaders and on race for 2946 leaders. Reviewers perceived 37 (47.4%) of 78 health ministry leaders as women, and fewer than 5 (< 7%) of 80 as racialized. In Alberta, Saskatchewan, Prince Edward Island and Nova Scotia, provinces with a centralized hospital executive team, reviewers coded 36 (50.0%) of 72 leaders as women and 5 (7.1%) of 70 as racialized. In British Columbia, New Brunswick and Newfoundland and Labrador, provinces with hospital leadership by region, reviewers perceived 120 (56.1%) of 214 leaders as women and 24 (11.5%) of 209 as racialized. In Manitoba, Ontario and Quebec, where leadership teams exist at each hospital, reviewers perceived 1326 (49.9%) of 2658 leaders as women and 243 (9.2%) of 2633 as racialized. We calculated the representation gap between racialized executives and the racialized population as 14.5% for British Columbia, 27.5% for Manitoba, 20.7% for Ontario, 12.4% for Quebec, 7.6% for New Brunswick, 7.3% for Prince Edward Island and 11.6% for Newfoundland and Labrador. INTERPRETATION: In a study of more than 3000 health care leaders in Canada, gender parity was present, but racialized executives were substantially under-represented. This work should prompt health care institutions to increase racial diversity in leadership.


Assuntos
Atenção à Saúde , Colúmbia Britânica , Canadá , Estudos Transversais , Feminino , Humanos , Terra Nova e Labrador , Ontário
14.
Healthc Q ; 24(4): 16-21, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35216644

RESUMO

Eastern Health (EH), the most populous region of the four Newfoundland and Labrador (NL) Regional Health Authorities, has been advancing innovation to improve patient care, health outcomes and provincial economic development. This paper describes how EH engaged with the provincial Department of Finance to estimate the direct, indirect and induced economic impacts on provincial gross domestic product, employment and employment income from innovation-related activities. The modelling demonstrated significant economic benefits in both 2019 and 2020. There was a large increase in 2020 due to pandemic-related personal protective equipment manufacturing opportunities. The number of well-paying jobs created also increased. Local healthcare innovation was stimulated by EH's Living Lab, Health Innovation Team and increased coordination between vendor partners, Memorial University, the NL Centre for Health Information and government funding agencies.


Assuntos
Atenção à Saúde , Renda , Humanos , Terra Nova e Labrador
15.
Healthc Manage Forum ; 35(2): 71-79, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35112917

RESUMO

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Newfoundland and Labrador (NL). Faced with the destabilization of its traditional supply chain, NL leveraged an existing centralized healthcare supply chain structure to organize its supply chain response to the pandemic. To overcome product shortages, health leaders collaborated with their local business community and industries to source and procure personal protective equipment and create domestic manufacturing capacity for critical supplies. The healthcare supply chain response in NL demonstrates the value of a highly integrated and centralized healthcare supply chain management strategy. It also makes clear the value of a diversified healthcare supply chain, one which draws on local manufacturing capacity to create a domestic source of critical supplies and overcome shortages from global suppliers.


Assuntos
COVID-19 , Humanos , Liderança , Terra Nova e Labrador , Equipamento de Proteção Individual , SARS-CoV-2
16.
J Forensic Sci ; 67(4): 1557-1564, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35122244

RESUMO

A comprehensive review of medical examiner data was undertaken of all hanging deaths in the Canadian Maritime province of Newfoundland and Labrador from 1982 to 2021. A total of 811 cases were identified representing suicidal, accidental, and undetermined manners of death. Variables examined included age; sex; seasonality; ligature type; location; time since death; prior attempts/suicidal ideation; presence/absence of a suicide note; and presence/absence of alcohol and drugs. Data subsets were generated, and additional analysis was conducted for hangings involving females; suicidal hangings occurring in the region of Labrador; and those who hanged themselves outdoors. Results indicate that females are choosing to kill themselves by hanging in rapidly increasing numbers. Outdoor suicides by hanging were more common in Newfoundland and Labrador (22.1%) than previously reported in Alberta (11.5%), Texas (5%), and Turkey (12-13%). Unique trends in seasonality were revealed, as were repeated incidents of suicidal clusters. The age distribution was skewed strongly toward youths (10 to 22 years of age), particularly in Labrador. Although Labrador represents only 5% of the total provincial population, it produced 20.1% of the total suicidal hangings in the study. The suicide rate in Canada has decreased by 24% over the past 40 years, yet the rates of suicidal hangings nationally and in Newfoundland and Labrador have increased during the same time period. With a better understanding of the circumstances under which people commit suicide by hanging within the province, it may be possible to target at-risk groups to prevent future cases.


Assuntos
Médicos Legistas , Suicídio , Adolescente , Adulto , Canadá , Criança , Feminino , Humanos , Terra Nova e Labrador/epidemiologia , Estudos Retrospectivos , Adulto Jovem
18.
BMC Health Serv Res ; 22(1): 82, 2022 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-35034657

RESUMO

BACKGROUND: A single-entry model in healthcare consolidates waiting lists through a central intake and allows patients to see the next available health care provider based on the prioritization. This study aimed to examine whether and to what extent the prioritization reduced wait times for hip and knee replacement surgeries. METHOD: The survival regression method was used to estimate the effects of priority levels on wait times for consultation and surgery for hip and knee replacements. The sample data included patients who were referred to the Orthopedic Central Intake clinic at the Eastern Health region of Newfoundland and Labrador and had surgery of hip and knee replacements between 2011 and 2019. RESULT: After adjusting for covariates, the hazard of having consultation booked was greater in patients with priority 1 and 2 than those in priority 3 when and at 90 days after the referral was made for both hip and knee replacements. Regarding wait time for surgery after the decision for surgery was made, while the hazard of having surgery was lower in priority 2 than in priority 3 when and indifferent at 182 days after the decision was made, it was not significantly different between priority 1 and priority 3 among hip replacement patients. Priority levels were not significantly related to the hazard of having surgery for a knee replacement after the decision for surgery was made. Overall, the hazard of having surgery after the referral was made by a primary care physician was greater for patients in high priority than those in low priority. Preferring a specific surgeon indicated at referral was found to delay consultation and it was not significantly related to the total wait time for surgery. Incomplete referral forms prolonged wait time for consultation and patients under age 65 had a longer total wait time than those aged 65 or above. CONCLUSION: Patients with high priority could have a consultation booked earlier than those with low priority and prioritization in a single entrance model shortens the total wait time for surgery. However, the association between priority levels and wait for surgery after the decision for surgery was made has not well-established.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Idoso , Humanos , Terra Nova e Labrador , Encaminhamento e Consulta , Listas de Espera
19.
PLoS One ; 17(1): e0262957, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35089949

RESUMO

OBJECTIVE: To assess the incidence of COVID-19 infection in the absence of a confirmatory test in persons suspecting they contracted COVID-19 and elucidate reasons for their belief. METHODS: We recruited persons with a confirmed COVID-19 diagnosis and persons who believed they may have contracted COVID-19 between December, 2019 and April, 2021 into a study of immunity against SARS-CoV-2. An intake questionnaire captured their perceived risk factors for exposure and symptoms experienced, including symptom duration and severity. ELISA testing against multiple SARS-CoV-2 antigens was done to detect antibodies against SARS-CoV-2. No participant had received COVID-19 vaccination prior to the time of testing. RESULTS: The vast majority of study subjects without Public Health confirmation of infection had no detectable antibodies against SARS-CoV-2. Suspected infection with SARS-CoV-2 generally involved experiencing symptoms common to many other respiratory infections. Unusually severe or persistent symptoms often supported suspicion of infection with SARS-CoV-2 as did travel or contact with travelers from outside Newfoundland and Labrador. Rare cases in which antibodies against SARS-CoV-2 were detected despite negative results of Public Health testing for SARS-CoV-2 RNA involved persons in close contact with confirmed cases. CONCLUSIONS: Broad public awareness and declaration of pandemic status in March, 2020 contributed to the perceived risk of contracting COVID-19 in Newfoundland and Labrador from late 2019 to April 2021 and raised expectation of its severity. Serological testing is useful to diagnose past infection with SARS-CoV-2 to accurately estimate population exposure rates.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Adulto , COVID-19/diagnóstico , COVID-19/imunologia , Teste para COVID-19 , Feminino , Humanos , Incidência , Masculino , Terra Nova e Labrador/epidemiologia , Percepção
20.
J Aging Soc Policy ; 34(1): 1-19, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34139958

RESUMO

There has been a growing focus on healthy aging in the political agenda. Discourses contained within policy documents have the potential to shape our notions of healthy aging and well-being. This comprehensive critical document analysis of provincial aging policies in Newfoundland and Labrador (2006-2015) contributes to a larger research study exploring aging women's notions of health and the body in relation to the aging process. The findings highlight how healthy aging discourses focus on the concept of productivity and how a certain type of health is required for ongoing contribution. The paper concludes by arguing that if healthy aging is framed around one's ability to remain productive, notions of health will remain limited to an externalized measure of output versus subjective experience of well-being.


Assuntos
Envelhecimento , Políticas , Canadá , Feminino , Humanos , Terra Nova e Labrador
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