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1.
Environ Res ; 260: 119629, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39025349

ABSTRACT

From the beginning of May 2023 to the end of August 2023, the Northern Hemisphere experienced significant wildfire activity with the most widespread fires occurring in Canada. Forest fires in Canada destroyed more than 15.6 million hectares of forests. These wildfires worsened air quality across the region and other parts of the world. The smoke reached southern Europe by the end of June 2023. To better understand the consequences of such forest fires far from the site of origin, aerosol optical, microphysical and radiative properties were analyzed during this event for southern Europe using data from the Visible Infrared Imaging Radiometer Suite (VIIRS), TROPOspheric Monitoring Instrument (TROPOMI), and Aerosol Robotic Network (AERONET). TROPOMI aerosol index (AI) and the carbon monoxide (CO) product confirm that the smoke originated directly from these forest fires. AERONET data from the El Arenosillo site in southern Spain showed maximum aerosol optical depth (AOD) values on June 27 reached 2.36. Data on Angstrom Exponent (AE), aerosol volume size distribution (VSD), single scattering albedo (SSA), fine mode fraction (FMF), volume particle concentration, effective radius (REff), absorption AOD (AAOD), extinction AE (EAE) and absorption AE (AAE) showed that fine-mode particles with carbonaceous aerosols contribution predominated in the atmosphere above the El Arenosillo site. Direct aerosol radiative forcing (DARF) at the top (DARFTOA) and bottom of atmosphere (DARFBOA) were -103.1 and -198.93 Wm-2, respectively. The atmospheric aerosol radiative forcing (DARFATM) was found to be 95.83 Wm-2 and with a heating rate 2.69 K day-1, which indicates the resulting warming of the atmosphere.

3.
Headache ; 2024 Jul 09.
Article in English | MEDLINE | ID: mdl-38982656

ABSTRACT

OBJECTIVE: To evaluate preferences for key attributes of injected or infused preventive migraine treatments and assess heterogeneity in preferences among Canadian participants with migraine. BACKGROUND: Current treatment options for migraine prevention differ in their attributes, including mode of administration, efficacy, and dosing frequency; preferences for such attributes can vary among patients. With the advent of new therapies, evidence demonstrating patient preferences for injected or infused preventive migraine treatments is necessary. METHODS: Canadian adults self-reporting a diagnosis of migraine completed a cross-sectional, internet-based survey that included a discrete choice experiment. Participants were presented with attributes of preventive migraine treatments, including speed of onset, durability of efficacy, mode of administration, administration setting, and dosing frequency. Latent class analysis (LCA) was used to identify subgroups of patients who differed in their treatment preferences. RESULTS: In total, 200 participants completed the survey. Participants' treatment preferences were most sensitive to improvements in the durability of effectiveness from "wears off 2 weeks before next dose" to "does not wear off before the next dose" (absolute difference in weights = |-0.95 to 1.07| = 2.02) and improvements from "cranial injections" to "intravenous infusions" (|-1.04 to 0.58| = 1.62); participants equally preferred self-injection and intravenous infusion from a health-care provider (mean weight = 0.58 and 0.47, respectively) as a route of administration over cranial injections (mean weight = -1.04). Three subgroups were identified with LCA: group one (n = 103) prioritized fast-acting and durable therapies, group two (n = 54) expressed aversion to cranial injections, and group three (n = 43) favored treatments administered in a health-care provider setting. CONCLUSIONS: In this sample of Canadian adults with migraine, we showed that durability of effectiveness and mode of administration are key attributes influencing patient preferences for preventive migraine treatments; however, certain groups of patients may differ in their treatment priorities. Our results highlight the need for patient-provider discussions regarding treatment attributes and consideration of patients' preferences when selecting a preventive migraine treatment.

4.
J Med Internet Res ; 26: e50483, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-39008348

ABSTRACT

BACKGROUND: In 2020, the Ministry of Health (MoH) in Ontario, Canada, introduced a virtual urgent care (VUC) pilot program to provide alternative access to urgent care services and reduce the need for in-person emergency department (ED) visits for patients with low acuity health concerns. OBJECTIVE: This study aims to compare the 30-day costs associated with VUC and in-person ED encounters from an MoH perspective. METHODS: Using administrative data from Ontario (the most populous province of Canada), a population-based, matched cohort study of Ontarians who used VUC services from December 2020 to September 2021 was conducted. As it was expected that VUC and in-person ED users would be different, two cohorts of VUC users were defined: (1) those who were promptly referred to an ED by a VUC provider and subsequently presented to an ED within 72 hours (these patients were matched to in-person ED users with any discharge disposition) and (2) those seen by a VUC provider with no referral to an in-person ED (these patients were matched to patients who presented in-person to the ED and were discharged home by the ED physician). Bootstrap techniques were used to compare the 30-day mean costs of VUC (operational costs to set up the VUC program plus health care expenditures) versus in-person ED care (health care expenditures) from an MoH perspective. All costs are expressed in Canadian dollars (a currency exchange rate of CAD $1=US $0.76 is applicable). RESULTS: We matched 2129 patients who presented to an ED within 72 hours of VUC referral and 14,179 patients seen by a VUC provider without a referral to an ED. Our matched populations represented 99% (2129/2150) of eligible VUC patients referred to the ED by their VUC provider and 98% (14,179/14,498) of eligible VUC patients not referred to the ED by their VUC provider. Compared to matched in-person ED patients, 30-day costs per patient were significantly higher for the cohort of VUC patients who presented to an ED within 72 hours of VUC referral ($2805 vs $2299; difference of $506, 95% CI $139-$885) and significantly lower for the VUC cohort of patients who did not require ED referral ($907 vs $1270; difference of $362, 95% CI 284-$446). Overall, the absolute 30-day costs associated with the 2 VUC cohorts were $18.9 million (ie, $6.0 million + $12.9 million) versus $22.9 million ($4.9 million + $18.0 million) for the 2 in-person ED cohorts. CONCLUSIONS: This costing evaluation supports the use of VUC as most complaints were addressed without referral to ED. Future research should evaluate targeted applications of VUC (eg, VUC models led by nurse practitioners or physician assistants with support from ED physicians) to inform future resource allocation and policy decisions.


Subject(s)
Emergency Service, Hospital , Ontario , Humans , Pilot Projects , Cohort Studies , Female , Male , Emergency Service, Hospital/economics , Emergency Service, Hospital/statistics & numerical data , Middle Aged , Adult , Ambulatory Care/economics , Aged , Telemedicine/economics , Health Care Costs/statistics & numerical data
6.
J Environ Manage ; 365: 121669, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38968887

ABSTRACT

The impacts of climate change and development present significant challenges and complexities that require new solutions, wise choices, and multi-disciplinary integration. In this context, emotional intelligence (EI) plays a crucial role. However, traditional engineering education and practice overlook the importance of understanding and managing emotions. This research aims to determine the impact of EI as a tool to enhance proactive decision-making and implement sustainable measures within the engineering profession.The study makes three main research contributions. First, it confirms a positive relationship between EI and proactive sustainable decision-making among engineers. This means that engineers with high EI are more likely to consider the impacts of their decisions on various stakeholders and dimensions of sustainability. Second, it suggests that EI can enhance creativity and innovative thinking in engineering, helping engineers to develop effective solutions for challenges related to climate change. Third, the study advocates for incorporating EI training and assessment into engineering curriculums to foster a sustainable and ethical engineering culture. By improving EI, engineers can enhance their interpersonal skills, self-awareness, and emotional management, which in turn can significantly improve teamwork in addressing challenges related to climate change.


Subject(s)
Climate Change , Decision Making , Emotional Intelligence , Engineering , Humans
7.
JMIR Form Res ; 8: e48434, 2024 Jul 17.
Article in English | MEDLINE | ID: mdl-39018551

ABSTRACT

BACKGROUND: Multiple chemical sensitivity (MCS) develops in response to repeated small-level chemical exposures or a major exposure in a subset of people, who then experience symptoms that can range from mild to debilitating when exposed to chemicals. The arrival of the COVID-19 pandemic and the stringent health measures put in place may have increased the burden for those living with MCS, as it became more challenging to avoid chemicals that trigger their condition. OBJECTIVE: This study aimed to better understand the lived experience of Canadians living with MCS during the first year of the COVID-19 pandemic. METHODS: An online questionnaire was created to ask participants to compare daily living during the pandemic to before March 11, 2020. Data were collected in January and February 2021. Three areas were investigated: (1) environmental exposures to chemical triggers from ambient air (pollution from industry, farming, and traffic) and indoor air (the smell of cleaning products, cooking odors, and smoke); (2) access to, and satisfaction with, health care visits; and (3) how people experiencing MCS rated contact with their social network. RESULTS: In all, 119 Canadians who had lived with MCS for more than a year completed the questionnaire. The participant sample was mostly female (86.6%, n=103) and highly educated, with 57.1% (n=68) having a university degree. Slightly more than half (57.1%, n=68) were older than 55 years. McNemar chi-square and Wilcoxon signed rank tests were used to evaluate if there were statistically significant changes before ("prepandemic period") and after ("postpandemic period") March 11, 2020. Perceived exposure to pollution from a highway or a road was significantly decreased from the prepandemic to postpandemic period (z=-3.347; P<.001). Analysis of industry or power plants also suggested a significant decrease in the perceived exposure from the prepandemic to postpandemic period (z=-2.152; P=.04). Participants reported an increase in exposure to odors from disinfectants or sanitizers that entered their living environment (P<.001). There was a significant decrease between prepandemic and postpandemic levels of satisfaction when attending in-person meetings with a physician (z=-2.048; P=.04), yet there were no significant differences between prepandemic and postpandemic levels of satisfaction for online or telephone meetings with a physician. Although people with MCS experienced increased social isolation (P<.001), they also reported an increase in understanding from family (P=.03) and a decrease in stigma for wearing personal protective equipment (P<.001). CONCLUSIONS: During the first year of the COVID-19 pandemic, people with MCS were impacted by inaccessibility, loss of social support, and barriers to accessing health care. This study highlights unique challenges and possible benefits associated with the COVID-19 pandemic public health measures for individuals living with MCS. These findings can guide decision makers to improve policies on accessibility through appropriate accommodation measures.

8.
Can Commun Dis Rep ; 50(6): 197-210, 2024 Jun 28.
Article in English | MEDLINE | ID: mdl-39021379

ABSTRACT

Background: Healthcare-associated infections (HAIs) are a significant healthcare burden in Canada. National surveillance of HAIs at sentinel acute care hospitals is conducted by the Canadian Nosocomial Infection Surveillance Program. Objective: This article describes device and surgical procedure-related HAI epidemiology in Canada from 2018 to 2022. Methods: Data were collected from over 60 Canadian sentinel acute care hospitals between January 1, 2018, and December 31, 2022, for central line-associated bloodstream infections (CLABSIs), hip and knee surgical site infections (SSIs), cerebrospinal fluid shunt (CSF) SSIs and paediatric cardiac SSIs. Case counts, rates, patient and hospital characteristics, pathogen distributions and antimicrobial resistance data are presented. Results: Between 2018 and 2022, 2,258 device-related infections and 987 surgical procedure-related infections were reported. A significant rate increase was observed in adult mixed intensive care unit CLABSIs (1.07-1.93 infections per 1,000 line days, p=0.05) and a non-significant rate increase was observed in SSIs following knee arthroplasty (0.31-0.42 infections per 100 surgeries, p=0.45). A fluctuating rate trend was observed in CSF shunt SSIs over the time period and a significant rate decrease in paediatric cardiac SSIs was observed (68%, from 7.5-2.4 infections per 100 surgeries, p=0.01). The most commonly identified pathogens were coagulase-negative staphylococci (22.8%) among CLABSIs and Staphylococcus aureus (42%) among SSIs. Conclusion: Epidemiological and microbiological trends among selected device and surgical procedure-related HAIs are essential for benchmarking infection rates nationally and internationally, identifying any changes in infection rates or antimicrobial resistance patterns and helping inform hospital infection prevention and control and antimicrobial stewardship policies and programs.

9.
JMIR Res Protoc ; 13: e54365, 2024 Jul 18.
Article in English | MEDLINE | ID: mdl-39024011

ABSTRACT

BACKGROUND: Primary care physicians are at the forefront of the clinical process that can lead to diagnosis, referral, and treatment. With electronic medical records (EMRs) being introduced and, over time, gaining acceptance by primary care users, they have now become a standard part of care. EMRs have the potential to be further optimized with the introduction of artificial intelligence (AI). There has yet to be a widespread exploration of the use of AI in primary health care and how clinicians envision AI use to encourage further uptake. OBJECTIVE: The primary objective of this research is to understand if the user-centered design approach, rooted in contextual design, can lead to an increased likelihood of adoption of an AI-enabled encounter module embedded in a primary care EMR. In this study, we use human factor models and the technology acceptance model to understand the results. METHODS: To accomplish this, a partnership has been established with an industry partner, TELUS Health, to use their EMR, the collaborative health record. The overall intention is to understand how to improve the user experience by using user-centered design to inform how AI should be embedded in an EMR encounter. Given this intention, a user-centered approach will be used to accomplish it. The approach of user-centered design requires qualitative interviewing to gain a clear understanding of users' approaches, intentions, and other key insights to inform the design process. A total of 5 phases have been designed for this study. RESULTS: As of March 2024, a total of 14 primary care clinician participants have been recruited and interviewed. First-cycle coding of all qualitative data results is being conducted to inform redesign considerations. CONCLUSIONS: Some limitations need to be acknowledged related to the approach of this study. There is a lack of market maturity of AI-enabled EMR encounters in primary care, requiring research to take place through scenario-based interviews. However, this participant group will still help inform design considerations for this tool. This study is targeted for completion in the late fall of 2024. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54365.


Subject(s)
Artificial Intelligence , Electronic Health Records , Primary Health Care , User-Centered Design , Humans , Primary Health Care/organization & administration , Canada
10.
J Can Acad Child Adolesc Psychiatry ; 33(2): 93-130, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38952787

ABSTRACT

Background: There is an urgent need for culturally and contextually relevant mental health support for First Nations, Inuit and Métis youth. Objective: Our aim was to identify mental health and wellness services that are currently available to Indigenous youth across Canada. Methodology: As a first step, we conducted a web-based environmental scan of services tailored to Indigenous youth. Specific factors were examined for each program, including organization type and mission, types of services, and who provides services. Results: One hundred and seventeen programs were found, with 54% being non-profits and 34% being on-reserve. Four core features were identified. The first was a strengths-based focus, rather than a pathology/deficit-focus, in programs' vision and mission statements, reflected in words like wellness and resilience. The second (87% of included programs) was the integration of mental health services with a range of other services and supports (e.g., health, employment, housing). The third was the provision of land-based programming (in 34% of programs) such as camps or hunting. Such programs were framed as promoting wellness and healing and strengthening identity. The fourth was the role of community members without formal mental health professional training (in 42% of programs), for example, as youth workers or knowledge keepers. This stems not only from the dearth of specialists in many Indigenous settings, but also a valuing of Indigenous knowledge. Conclusion: These core features in mental health services for Indigenous youth may be promising avenues for communities seeking to strengthen the services they offer to First Nations, Inuit and Métis youth.


Contexte: Il y a un besoin urgent de soutien en santé mentale adapté à la culture et au contexte pour les jeunes des Premières Nations, Inuits et Métis. Objectif: Nous cherchions à identifier les services de santé mentale et de bien-être actuellement disponibles pour les jeunes autochtones du Canada. Méthodologie: Dans un premier temps, nous avons mené une analyse environnementale en ligne des services adaptés aux jeunes autochtones. Des facteurs spécifiques ont été examinés pour chaque programme, notamment le type et la mission de l'organisation, les types de services offerts, et les prestataires de ces services. Résultats: Cent dix-sept programmes ont été recensés, dont 54 % étaient sans but lucratif et 34 % situés dans une réserve. Quatre caractéristiques principales ont été identifiées. La première était l'accent mis sur les forces plutôt que sur la pathologie ou le déficit, reflété dans les énoncés de vision et de mission des programmes, où des termes comme bien-être et résilience étaient utilisés. La deuxième caractéristique (présente dans 87 % des programmes) était l'intégration des services de santé mentale avec une gamme d'autres services et soutiens (p.ex., santé, emploi, logement). La troisième était l'offre de programmes liés au territoire (dans 34 % des programmes) comme des camps ou des activités de chasse, conçus pour promouvoir le bien-être, la guérison et le renforcement de l'identité. La quatrième caractéristique était le rôle des membres de la communauté sans formation professionnelle officielle en santé mentale (dans 42 % des programmes), par exemple en tant que travailleurs auprès des jeunes ou gardiens du savoir. Cela découle non seulement du manque de spécialistes dans de nombreux contextes autochtones, mais aussi de la valorisation des connaissances autochtones. Conclusion: Ces principales caractéristiques des services de santé mentale pour les jeunes autochtones peuvent constituer des avenues prometteuses pour les communautés cherchant à consolider les services qu'elles offrent aux jeunes des Premières Nations, Inuits et Métis.

11.
CEN Case Rep ; 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38954395

ABSTRACT

Cronkhite-Canada syndrome (CCS) is a non-hereditary disorder characterized by non-neoplastic hamartomatous gastrointestinal polyposis, hair loss, nail atrophy, hyperpigmentation, and diarrhea. While the relationship between CCS and nephritis remains unclear, seven cases of nephritis complicated by CCS have been reported to date, all of which were membranous nephropathy (MN). A 57-year-old man presented with taste disturbance, hair loss, nail plate atrophy, skin pigmentation, and frequent diarrhea. Endoscopic findings showed multiple polyposis of the stomach and large intestine. Given the above, he was diagnosed with CCS. The symptoms gradually improved with prednisolone treatment, although urinary protein and hypoproteinemia appeared during the tapering of prednisolone. He was diagnosed with MN using a renal biopsy, and immunofluorescence microscopy with IgG subclass staining showed predominantly diffuse granular capillary wall staining of IgG4. The cause of secondary MN was not found, including malignant tumors. Nephrotic-range proteinuria persisted despite treatment with prednisolone and cyclosporine. Additional treatment with mizoribine resulted in incomplete remission type 1 of nephrotic syndrome, suggesting that mizoribine may be a treatment option for patients with CCS with steroid-resistant MN. Considering a high prevalence of hypoproteinemia due to chronic diarrhea and protein-losing enteropathy in patients with CCS, proteinuria might be overlooked; thus, follow-up urinalysis would be recommended in patients with CCS.

12.
J Occup Environ Hyg ; : 1-13, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38954746

ABSTRACT

Food retail businesses experienced a pronounced increase in sales when food hospitality outlets closed in the early stages of the COVID-19 pandemic in Canada. This study investigates how pandemic-related modifications to food retail businesses in Ontario, Canada affected the well-being of workers. Semi-structured interviews were conducted with 17 food retail employees between June 2020 and May 2021 as part of the Food Retail Environment Study for Health and Economic Resiliency (FRESHER). Transcripts were analyzed inductively, and themes were refined using the Effort Reward Imbalance Model. Themes were connected to the main components of this model: extrinsic effort, intrinsic effort, money, esteem, status control, and burnout. Results indicate that, for food retail employees, the presence of an imbalance between efforts and rewards threatens well-being via symptoms of burnout. Further study is needed to examine how this inequality and burnout among this population might be measured and addressed.

13.
Front Public Health ; 12: 1426152, 2024.
Article in English | MEDLINE | ID: mdl-39035175

ABSTRACT

Introduction: Patients with major mental illness (MMI) and substance use disorders (SUD) face barriers in accessing healthcare. In this population-based retrospective cohort study, we investigated the uptake of COVID-19 vaccination in Ontario, Canada among community-dwelling individuals receiving healthcare for major mental illness (MMI) and/or substance use disorders (SUD), comparing them to matched general population controls. Methods: Using linked health administrative data, we identified 337,290 individuals receiving healthcare for MMI and/or SUD as of 14 December 2020, matched by age, sex, and residential geography to controls without such healthcare. Follow-up extended until 31 December 2022 to document vaccination events. Results: Overall, individuals receiving healthcare for MMI and/or SUD (N = 337,290) had a slightly lower uptake of first (cumulative incidence 82.45% vs. 86.44%; hazard ratio [HR] 0.83 [95% CI 0.82-0.83]) and second dose (78.82% vs. 84.93%; HR 0.77 [95% CI 0.77-0.78]) compared to matched controls. Individuals receiving healthcare for MMI only (n = 146,399) had a similar uptake of first (87.96% vs. 87.59%; HR 0.97 [95% CI 0.96-0.98]) and second dose (86.09% vs. 86.05%, HR 0.94 [95% CI 0.93-0.95]). By contrast, individuals receiving healthcare for SUD only (n = 156,785) or MMI and SUD (n = 34,106) had significantly lower uptake of the first (SUD 78.14% vs. 85.74%; HR 0.73 [95% CI 0.72-0.73]; MMI & SUD 78.43% vs. 84.74%; HR 0.76 [95% CI 0.75-0.77]) and second doses (SUD 73.12% vs. 84.17%; HR 0.66 [95% CI 0.65-0.66]; MMI & SUD 73.48% vs. 82.93%; HR 0.68 [95% CI 0.67-0.69]). Discussion: These findings suggest that effective strategies to increase vaccination uptake for future COVID-19 and other emerging infectious diseases among community-dwelling people with SUD are needed.


Subject(s)
COVID-19 Vaccines , COVID-19 , Independent Living , Mental Disorders , Substance-Related Disorders , Humans , Retrospective Studies , Male , Female , COVID-19/prevention & control , Ontario , Middle Aged , Adult , Independent Living/statistics & numerical data , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/therapeutic use , Aged , Vaccination/statistics & numerical data , SARS-CoV-2 , Young Adult
14.
Prev Med Rep ; 44: 102805, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39035360

ABSTRACT

Objectives: We characterized trends in medical cannabis use; examined characteristics associated with medical cannabis use without medical authorization; and examined the association between recreational cannabis legalization and medical cannabis use in Ontario, Canada. Methods: Data were from a repeated, population-based, cross-sectional survey of adults (N = 19,543; 2014-2019). Cannabis use was categorized as either medical cannabis use, recreational cannabis use or no cannabis use. The analytical strategy included jointpoint regression, logistic regression and multinomial logistic regression. Results: Medical cannabis use increased from 4 % to 11 % (Annual Percentage Change [APC]: 25 %, 95 % Confidence Interval [CI]: 17 %-33 %) and recreational cannabis use increased from 9 % to 15 % (APC: 9 %, 95 % CI: 3 %-15 %) between 2014 and 2019. Being 18 to 29 years old compared with being 65+ years old was associated with an increased likelihood of medical cannabis use without medical authorization (Odds Ratio [OR]: 4.05, 95 % CI: 2.12-7.72), while being of fair or poor self-perceived health compared with excellent, very good or good self-perceived health (OR: 0.61, 95 % CI: 0.40-0.95) was associated with a decreased likelihood of medical cannabis use without medical authorization. Recreational cannabis legalization was associated with an increased likelihood of medical cannabis use compared with no cannabis use (OR: 1.48, 95 % CI: 1.19-1.85) and of recreational cannabis use compared with no cannabis use (OR: 1.35, 95 % CI: 1.11-1.65). Conclusions: Although medical cannabis use increased, it was largely used without medical authorization. Guidance and education that encourages medical usage under clinical supervision is recommended, and mitigation of known barriers to medical cannabis authorization.

15.
Int J Circumpolar Health ; 83(1): 2376799, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38988226

ABSTRACT

Inuit youth face challenges in maintaining their wellbeing, stemming from continued impacts of colonisation. Recent work documented that urban centres, such as Winnipeg Canada, have large Inuit populations comprised of a high proportion of youth. However, youth lack culturally appropriate health and wellbeing services. This review aimed to scan peer-reviewed and grey literature on Inuit youth health and wellbeing programming in Canada. This review is to serve as an initial phase in the development of Inuit-centric youth programming for the Qanuinngitsiarutiksait program of research. Findings will support further work of this program of research, including the development of culturally congruent Inuit-youth centric programming in Winnipeg. We conducted an environmental scan and used an assessment criteria to assess the effectiveness of the identified programs. Results showed that identified programs had Inuit involvement in creation framing programming through Inuit knowledge and mostly informed by the culture as treatment approach. Evaluation of programs was diffcult to locate, and it was hard to discren between programming, pilots or explorative studies. Despite the growing urban population, more non-urban programming was found. Overall, research contributes to the development of effective strategies to enhance the health and wellbeing of Inuit youth living in Canada.


Subject(s)
Inuit , Humans , Canada , Adolescent , Child , Female , Arctic Regions , Male , Health Promotion/organization & administration , Young Adult , Adolescent Health/ethnology , Health Status
16.
Vet Med Sci ; 10(4): e1530, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38979670

ABSTRACT

AIM: This study aimed to summarize the frequency and the antimicrobial susceptibility profiles of the Salmonella serotypes identified from the specimens of companion animals, livestock, avian, wildlife and exotic species within Atlantic Canada. MATERIALS AND METHODS: The retrospective electronic laboratory data of microbiological analyses of a selected subset of samples from 03 January 2012 to 29 December 2021 submitted from various animal species were retrieved. The frequency of Salmonella serotypes identified, and their antimicrobial susceptibility results obtained using the disk diffusion or broth method were analysed. The test results were interpreted according to the Clinical and Laboratory Standards Institute standard. The Salmonella serotypes were identified by slide agglutination (Kauffman-White-Le-Minor Scheme) and/or the Whole Genome Sequencing for the Salmonella in silico Serovar Typing Resource-based identification. RESULTS: Of the cases included in this study, 4.6% (n = 154) had at least one Salmonella isolate, corresponding to 55 different serovars. Salmonella isolation was highest from exotic animal species (n = 40, 1.20%), followed by porcine (n = 26, 0.78%), and canine (n = 23, 0.69%). Salmonella subsp. enterica serovar Typhimurium was predominant among exotic mammals, porcine and caprine samples, whereas S. Enteritidis was mostly identified in bovine and canine samples. S. Typhimurium of porcine origin was frequently resistant (>70.0%) to ampicillin. In contrast, S. Typhimurium isolates from porcine and caprine samples were susceptible (>70.0%) to florfenicol. S. Oranienburg from equine samples was susceptible to chloramphenicol, but frequently resistant (>90.0%) to azithromycin. In avian samples, S. Copenhagen was susceptible (>90.0%) to florfenicol, whereas Muenchen was frequently resistant (>90.0%) to florfenicol. S. subsp. diarizonae serovar IIIb:61:k:1,5 of ovine origin was resistant (50.0% isolates) to sulfadimethoxine. No significant changes were observed in the antibiotic resistance profiles across the study years. CONCLUSIONS: This report provides data for surveillance studies, distribution of Salmonella serotypes and their antimicrobial resistance among veterinary specimens of Atlantic Canada.


Subject(s)
Salmonella Infections, Animal , Salmonella , Serogroup , Animals , Retrospective Studies , Salmonella/drug effects , Salmonella/isolation & purification , Salmonella/genetics , Salmonella/classification , Salmonella Infections, Animal/microbiology , Salmonella Infections, Animal/epidemiology , Animals, Wild/microbiology , Canada/epidemiology , Livestock/microbiology , Anti-Bacterial Agents/pharmacology , Pets/microbiology , Birds/microbiology , Microbial Sensitivity Tests/veterinary
17.
Yale J Biol Med ; 97(2): 125-139, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38947110

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a significant respiratory disease and is globally ranked as the third leading cause of death. In Canada, the direct healthcare costs associated with COPD are estimated to be $1.5 billion annually. This study utilized quantitative analyses to examine the impact of specific dimensions of social support, namely, guidance, reliable alliance, reassurance of worth, attachment, and social integration within a clinically identified population of individuals with COPD who exhibit symptoms of depression and anxiety. The study was based on the Social Provisions Theory and stress-buffering hypothesis, utilizing large-scale population data from Statistics Canada's 2012 Canadian Community Health Survey (CCHS) Mental Health component. On a national scale, individuals were more likely to report a decreased sense of belonging to a group of friends (social integration) and struggle to depend on others in stressful times (reliable alliance) while experiencing symptoms of anxiety and depression. These findings underscore the potential benefits of integrating peer support, socialization initiatives, and caregiver training into clinical programs designed for individuals with COPD.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Social Support , Humans , Pulmonary Disease, Chronic Obstructive/psychology , Pulmonary Disease, Chronic Obstructive/epidemiology , Canada/epidemiology , Male , Female , Middle Aged , Mental Health/statistics & numerical data , Depression/epidemiology , Depression/psychology , Aged , Anxiety/epidemiology , Anxiety/psychology , Adult , Psychological Well-Being
18.
J Psychoactive Drugs ; : 1-10, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38946663

ABSTRACT

Canada legalized the use of non-medical cannabis in 2018. This study examines youth and young adults' knowledge and perceptions of harms, benefits, and education around cannabis use since legalization. An online survey was completed by a convenience sample of 1,759 individuals aged 12-25 years living in Manitoba, Canada. Most participants (n = 1,525, 86.7%) reported receiving education on the potential effects/harms related to cannabis; the most common topics included driving and cannabis use (79.9%), the mental harms of cannabis (67.4%), and addiction and dependency (66.3%). Youth who reported using cannabis more than once (n = 1,203) were more knowledgeable about the effects of cannabis than youth who never used cannabis or used cannabis once (n = 580; mean score: 6.6 versus 5.7 out of 8, respectively; p < .001). Vaping cannabis oil was perceived as the most harmful cannabis product among all participants. Among participants with experience using cannabis, the most frequently reported benefits were relaxation, improved sleep, and enhanced enjoyment of food/music. Half of the participants reported ever being in a car with someone driving high, of which, 40% of these participants reported doing so in the last 30 days. Future tailored education is needed to address knowledge related to cannabis use among youth and young adults who use and do not use cannabis.

19.
Can J Public Health ; 2024 Jul 24.
Article in English | MEDLINE | ID: mdl-39048848

ABSTRACT

Cannabis control policies are increasingly being liberalized, including the legalization of non-medical cannabis use and supply in multiple settings, for example in Canada, with main policy objectives focusing on improved public health. An important while contested matter has been the appropriate design of legal cannabis supply structures and sources. These, in most Americas-based legalization settings, have included provisions for (limited) 'home cultivation'. Recent data suggest that about 8% of active consumers engage in cannabis home cultivation for their own supply, while approximately 14% are exposed to it in/around their home. Home cultivation commonly exceeds legal limits and/or occurs where not allowed, and is disproportionately associated with high-frequency and/or other risk patterns of cannabis use. In addition, home cultivation may facilitate exposure or diversion of cannabis to minors, as well as pose possible environmental exposure risks especially when occurring indoors. Given its placement in private spaces, related regulations are largely shielded from enforcement. Home cultivation, therefore, bears substantive potential to circumvent or work counter to public health‒oriented legalization policy objectives. Recent assessments of health outcomes from cannabis legalization show mixed-including multiple adverse-results, implying the need for regulatory revisions towards protecting public health outcomes. Especially in settings where extensive (e.g. commercial) retail systems were established to provide regulated, legal cannabis products to consumers, it is questionable whether home cultivation overall serves primary public health‒oriented objectives; relevant data should be expanded and used to review related provisions.


RéSUMé: Les politiques de contrôle du cannabis sont de plus en plus libéralisées, y compris la légalisation de la consommation et de l'accès au cannabis à des fins non médicales dans de nombreux contextes, par exemple au Canada, dont les principaux objectifs politiques sont axés sur l'amélioration de la santé publique. Une question importante, bien que controversée, a été la conception appropriée des structures et sources d'approvisionnement légal en cannabis. Celles-ci, dans la plupart des contextes de légalisation basés en Amériques, ont inclus des dispositions pour la 'culture à domicile' (limitée). Des données récentes suggèrent qu'environ 8 % des consommateurs actifs pratiquent la culture à domicile de cannabis pour leur propre approvisionnement, tandis qu'environ 14 % y sont exposés dans/autour de leur maison. La culture à domicile dépasse généralement les limites légales et/ou a lieu là où elle n'est pas autorisée, et est associée de manière disproportionnée à une consommation de cannabis à fréquence élevée et/ou à d'autres risques. En outre, la culture à domicile peut faciliter l'exposition ou le détournement du cannabis pour les mineurs, ainsi que présenter des risques d'exposition environnementale, en particulier lorsqu'elle se produit à l'intérieur. Étant donné qu'elles touchent à des espaces privés, les réglementations connexes sont largement à l'abri de toute application. La culture à domicile présente donc un potentiel important de contournement ou d'obstacles aux objectifs politiques axés sur la santé publique. Des évaluations récentes des conséquences sur la santé de la légalisation du cannabis montrent des résultats mitigés, y compris de multiples effets négatifs, ce qui implique la nécessité de révisions réglementaires en vue d'améliorer les résultats en matière de santé publique. En particulier dans les contextes où de vastes systèmes de vente au détail (par exemple commerciaux) ont été établis pour fournir aux consommateurs des produits à base de cannabis légaux et réglementés, on peut se demander si la culture à domicile sert globalement les principaux objectifs de santé publique; les données pertinentes devraient être élargies et utilisées pour réexaminer les dispositions y étant reliées.

20.
Hum Vaccin Immunother ; 20(1): 2379090, 2024 Dec 31.
Article in English | MEDLINE | ID: mdl-39051527

ABSTRACT

Human papillomavirus (HPV) infections, the most common sexually transmitted infections, are associated with various health outcomes including anogenital warts and cancers. Despite significant investments in HPV vaccination programs, ensuring adequate vaccination coverage for adolescents remains a challenge in Canada. This analysis used data collected through the 2019 Childhood National Immunization Coverage Survey (CNICS) to determine national estimates of HPV non-vaccination and investigate determinants of HPV non-vaccination for adolescents aged 14-years old in Canada, both overall and stratified by gender. The primary outcome of interest was HPV vaccination status, categorized as vaccinated with at least one dose or unvaccinated. Simple and multiple logistic regression models were used to investigate determinants of HPV non-vaccination. In 2019, an estimated 19.8% of the 14-year-olds in Canada were unvaccinated for the HPV vaccine, with males having higher non-vaccination rates than females (27.0% compared to 12.9%). In the unstratified analysis, factors associated with HPV non-vaccination for 14-year-olds were gender and region of residence. These factors differed by gender - for males, region of residence and respondent's age were significant factors, whereas for females, total household income was a significant factor. These results could help public health officials and policymakers develop and implement tailored interventions to enhance the delivery of HPV vaccination programs for male and female adolescents. By targeting populations that are under-vaccinated, vaccine uptake could be better facilitated to help reduce inequalities in access to the HPV vaccine, which could also potentially reduce disparities in HPV-related health outcomes.


Subject(s)
Papillomavirus Infections , Papillomavirus Vaccines , Vaccination Coverage , Humans , Adolescent , Male , Female , Canada/epidemiology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/administration & dosage , Vaccination Coverage/statistics & numerical data , Immunization Programs/statistics & numerical data , Vaccination/statistics & numerical data , Surveys and Questionnaires , North American People
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