32 results
Search Results
2. A national cohort study of community belonging and its influence on premature mortality.
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Michalski, Camilla, Hurst, Mack, Diemert, Lori, Mah, Sarah M., Helliwell, John, Kim, Eric S., and Rosella, Laura C.
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RISK assessment ,POISSON distribution ,SOCIAL determinants of health ,RESEARCH funding ,LIFE expectancy ,CAUSES of death ,DESCRIPTIVE statistics ,LONGITUDINAL method ,CONFIDENCE intervals ,WELL-being - Published
- 2024
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3. Differential impact of the Canadian point-of-sale tobacco display bans on quit attempts and smoking cessation outcomes by sex, income and education: longitudinal findings from the ITC Canada Survey.
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Usidame, Bukola, Yanmei Xie, Thrasher, James F., Lozano, Paula, Elliott, Michael R., Fong, Geoffrey T., and Fleischer, Nancy L.
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SMOKING prevention ,SMOKING cessation ,CONFIDENCE intervals ,ECONOMIC impact ,LEGAL status of sales personnel ,HEALTH outcome assessment ,MARKETING ,SOCIOECONOMIC factors ,SEX distribution ,SURVEYS ,DESCRIPTIVE statistics ,RESEARCH funding ,STATISTICAL models ,TOBACCO ,LONGITUDINAL method ,POISSON distribution ,EDUCATIONAL attainment - Published
- 2023
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4. Nicotine replacement therapy 'gift cards' for hospital inpatients who smoke: a prospective before-and-after controlled pilot evaluation.
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Mullen, Kerri A., Walker, Kathryn L., Noble, Shireen, Pritchard, Gillian, Garg, Aditi, Martin, Natalie, Pipe, Andrew L., and Reid, Robert D.
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PILOT projects ,HOSPITALS ,SMOKING cessation ,GIFT giving ,RESEARCH methodology ,PHARMACOLOGY ,MOTIVATION (Psychology) ,PATIENT satisfaction ,COMPARATIVE studies ,SURVEYS ,NICOTINE replacement therapy ,HOSPITAL care ,RESEARCH funding ,STATISTICAL sampling ,ODDS ratio ,LONGITUDINAL method - Published
- 2023
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5. Counting outcomes, coverage and quality for early child development programmes.
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Milner, Kate M., Bhopal, Sunil, Black, Maureen, Dua, Tarun, Gladstone, Melissa, Hamadani, Jena, Hughes, Rob, Kohli-Lynch, Maya, Manji, Karim, Hardy, Victoria Ponce, Radner, James, Sharma, Sonia, Tofail, Fahmida, Tann, Cally, Lawn, Joy E., and Ponce Hardy, Victoria
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CHILD development ,ECOLOGICAL houses ,MEASURING instruments ,LOW-income countries ,MIDDLE-income countries ,RESEARCH ,FERRANS & Powers Quality of Life Index ,KEY performance indicators (Management) ,EVALUATION of human services programs ,MATHEMATICAL models ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,HUMAN services programs ,COMPARATIVE studies ,CHILD health services ,CLINICAL medicine ,THEORY ,IMPACT of Event Scale ,RESEARCH funding ,DEVELOPING countries - Abstract
Improved measurement in early child development (ECD) is a strategic focus of the WHO, UNICEF and World Bank Nurturing Care Framework. However, evidence-based approaches to monitoring and evaluation (M&E) of ECD projects in low-income and middle-income countries (LMIC) are lacking. The Grand Challenges Canada®-funded Saving Brains® ECD portfolio provides a unique opportunity to explore approaches to M&E of ECD programmes across diverse settings. Focused literature review and participatory mixed-method evaluation of the Saving Brains portfolio was undertaken using an adapted impact framework. Findings related to measurement of quality, coverage and outcomes for scaling ECD were considered. Thirty-nine ECD projects implemented in 23 LMIC were evaluated. Projects used a 'theory of change' based M&E approach to measure a range of inputs, outputs and outcomes. Over 29 projects measured cognitive, language, motor and socioemotional outcomes. 18 projects used developmental screening tools to measure outcomes, with a trade-off between feasibility and preferred practice. Environmental inputs such as the home environment were measured in 15 projects. Qualitative data reflected the importance of measurement of project quality and coverage, despite challenges measuring these constructs across contexts. Improved measurement of intervention quality and measurement of coverage, which requires definition of the numerator (ie, intervention) and denominator (ie, population in need/at risk), are needed for scaling ECD programmes. Innovation in outcome measurement, including intermediary outcome measures that are feasible and practical to measure in routine services, is also required, with disaggregation to better target interventions to those most in need and ensure that no child is left behind. [ABSTRACT FROM AUTHOR]
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- 2019
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6. Cross-country comparison of smokers' reasons for thinking about quitting over time: findings from the International Tobacco Control Four Country Survey (ITC-4C), 2002-2015.
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Kasza, Karin A., Hyland, Andrew J., Borland, Ron, McNeill, Ann, Fong, Geoffrey T., Carpenter, Matthew J., Partos, Timea, and Cummings, K. Michael
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CONSUMER attitudes ,RESEARCH funding ,SMOKING cessation ,SURVEYS ,GOVERNMENT policy ,DATA analysis software ,DESCRIPTIVE statistics - Published
- 2017
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7. Smoking and vaping among Canadian youth and adults in 2017 and 2019.
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Reid, Katherine A. East Jessica L. and Hammond, David
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ELECTRONIC cigarettes ,CONFIDENCE intervals ,SMOKING cessation ,DISEASE prevalence ,RESEARCH funding ,SMOKING ,TOBACCO products ,PASSIVE smoking - Published
- 2023
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8. Return on investment of Canadian tobacco control policies implemented between 2001 and 2016.
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Tarride, Jean-Eric, Blackhouse, Gord, Guindon, G. Emmanuel, Chaiton, Michael O., Planinac, Lynn, and Schwartz, Robert
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HEALTH policy ,INVESTMENTS ,TAXATION ,LIFE expectancy ,PUBLIC health ,MEDICAL care costs ,COST benefit analysis ,GOVERNMENT policy ,BUSINESS ,RESEARCH funding ,DESCRIPTIVE statistics ,PROFIT ,TOBACCO - Published
- 2023
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9. Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.
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Cryer, Colin, Miller, Ted R., Lyons, Ronan A., Macpherson, Alison K., Pérez, Katherine, Petridou, Eleni Th, Dessypris, Nick, Davie, Gabrielle S., Gulliver, Pauline J., Lauritsen, Jens, Boufous, Soufiane, Lawrence, Bruce, de Graaf, Brandon, and Steiner, Claudia A.
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TRAUMATOLOGY diagnosis ,PREVENTION of injury ,WOUND & injury classification ,COMPARATIVE studies ,CONFIDENCE intervals ,LENGTH of stay in hospitals ,HOSPITAL admission & discharge ,HOSPITAL emergency services ,NOSOLOGY ,PATIENTS ,PROBABILITY theory ,RESEARCH funding ,MATHEMATICAL variables ,DATA analysis software ,MEDICAL coding - Published
- 2017
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10. Trends in e- cigarette brands, devices and the nicotine profile of products used by youth in England, Canada and the USA: 2017-2019.
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Hammond, David, Reid, Jessica L., Burkhalter, Robin, O'Connor, Richard J., Goniewicz, Maciej L., Wackowski, Olivia A., Thrasher, James F., and Hitchman, Sara C.
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DRUG addiction risk factors ,COMPULSIVE behavior -- Risk factors ,ELECTRONIC cigarettes ,CONFIDENCE intervals ,CROSS-sectional method ,INTERNET ,SELF-evaluation ,NICOTINE ,REGRESSION analysis ,ADVERTISING ,SURVEYS ,DESCRIPTIVE statistics ,RESEARCH funding ,SMOKING ,ODDS ratio ,SOCIODEMOGRAPHIC factors ,EQUIPMENT & supplies - Published
- 2023
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11. Characterisation of vaping liquids used in vaping devices across four countries: results from an analysis of selected vaping liquids reported by users in the 2016 ITC Four Country Smoking and Vaping Survey.
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Fix, Brian Vincent, OConnor, Richard J., Goniewicz, Maciej Lukasz, Leigh, Noel L., Cummings, Michael, Hitchman, Sara C., Fong, Geoffrey T., Nahas, Georges el, Hammond, David, McNeill, Ann, Borland, Ron, King, Bill, and Palumbo, Mary N.
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FLAVORING essence analysis ,ACQUISITION of property ,ELECTRONIC cigarettes ,GOVERNMENT regulation ,NITROSOAMINES ,ALKALOIDS ,NICOTINE ,RESEARCH funding ,DESCRIPTIVE statistics ,SMOKING ,TOBACCO products ,STATISTICAL sampling - Published
- 2023
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12. Investigating the association between income inequality in youth and deaths of despair in Canada: a population-based cohort study from 2006 to 2019.
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Benny, Claire, Smith, Brendan T., Hyshka, Elaine, Senthilselvan, Ambikaipakan, Veugelers, Paul J., and Pabayo, Roman
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CAUSES of death ,SUICIDE ,CONFIDENCE intervals ,DRUG overdose ,ALCOHOLIC liver diseases ,INCOME ,SOCIOECONOMIC factors ,DESPAIR ,DESCRIPTIVE statistics ,RESEARCH funding ,LONGITUDINAL method ,CHILDREN ,ADOLESCENCE - Published
- 2023
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13. Consumer preferences for electronic cigarettes: results from a discrete choice experiment.
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Czoli, Christine D., Goniewicz, Maciej, Islam, Towhidul, Kotnowski, Kathy, and Hammond, David
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CONSUMER attitudes ,STATISTICAL correlation ,RESEARCH funding ,STATISTICAL sampling ,SEX distribution ,PILOT projects ,MULTIPLE regression analysis ,HARM reduction ,ELECTRONIC cigarettes ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Introduction E-cigarettes present a formidable challenge to regulators given their variety and the rapidly evolving nicotine market. The current study sought to examine the influence of e-cigarette product characteristics on consumer perceptions and trial intentions among Canadians. Methods An online discrete choice experiment was conducted with 915 Canadians aged 16 years and older in November 2013. An online commercial panel was used to sample 3 distinct subpopulations: (1) non-smoking youth and young adults (n=279); (2) smoking youth and young adults (n=264) and (3) smoking adults (n=372). Participants completed a series of stated-preference tasks, in which they viewed choice sets with e-cigarette product images that featured different combinations of attributes: flavour, nicotine content, health warnings and price. For each choice set, participants were asked to select one of the products or indicate 'none of the above' with respect to the following outcomes: interest in trying, less harm and usefulness in quitting smoking. The attributes' impact on consumer choice for each outcome was analysed using multinomial logit regression. Results Health warning was the most important attribute influencing participants' intentions to try e-cigarettes (42%) and perceived efficacy as a quit aid (39%). Both flavour (36%) and health warnings (35%) significantly predicted perceptions of product harm. Conclusions The findings indicate that consumers make trade-offs with respect to e-cigarette product characteristics, and that these trade-offs vary across different subpopulations. Given that health warnings and flavour were weighted most important by consumers in this study, these may represent good targets for e-cigarette regulatory frameworks. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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14. Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting.
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Prakash, Varuna, Koczmara, Christine, Savage, Pamela, Trip, Katherine, Stewart, Janice, McCurdie, Tara, Cafazzo, Joseph A., and Trbovich, Patricia
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MEDICATION error prevention ,ACTION research ,CANCER chemotherapy ,CHI-squared test ,CLINICS ,FOCUS groups ,HUMAN anatomical models ,MEDICAL protocols ,NURSES' attitudes ,NURSING ,RESEARCH funding ,QUALITATIVE research ,DATA analysis ,DATA analysis software - Abstract
Background Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. Objective The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. Methods The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Results Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Conclusions Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. [ABSTRACT FROM AUTHOR]
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- 2014
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15. 'Whatever you cut, I can fix it': clinical supervisors' interview accounts of allowing trainee failure while guarding patient safety.
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Klasen, Jennifer M., Driessen, Erik, Teunissen, Pim W., and Lingard, Lorelei A.
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PREVENTION of medical errors ,CLINICAL competence ,CONTENT analysis ,EXPERIENCE ,GROUNDED theory ,HOSPITAL medical staff ,INTERVIEWING ,RESEARCH methodology ,MEDICAL errors ,PATIENT safety ,RESEARCH funding ,STATISTICAL sampling ,SUPERVISION of employees ,QUALITATIVE research ,JUDGMENT sampling ,THEMATIC analysis ,CLINICAL supervision ,COLLEGE teacher attitudes ,DATA analysis software - Abstract
Background Learning is in delicate balance with safety, as faculty supervisors try to foster trainee development while safeguarding patients. This balance is particularly challenging if trainees are allowed to experience the educational benefits of failure, acknowledged as a critical resource for developing competence and resilience. While other educational domains allow failure in service of learning, however, we do not know whether or not this strategy applies to clinical training. Methods We conducted individual interviews of clinical supervisors, asking them whether they allowed failure for educational purposes in clinical training and eliciting their experiences of this phenomenon. Participants' accounts were descriptively analysed for recurring themes. Results Twelve women and seven men reported 48 specific examples of allowing trainee failure based on their judgement that educational value outweighed patient risk. Various kinds of failures were allowed: both during operations and technical procedures, in medication dosing, communication events, diagnostic procedures and patient management. Most participants perceived minimal consequences for patients, and many described their rescue strategies to prevent an allowed failure. Allowing failure under supervision was perceived to be important for supporting trainee development. Conclusion Clinical supervisors allow trainees to fail for educational benefit. In doing so, they attempt to balance patient safety and trainee learning. The educational strategy of allowing failure may appear alarming in the zero-error tolerant culture of healthcare with its commitment to patient safety. However, supervisors perceived this strategy to be invaluable. Viewing failure as inevitable, they wanted trainees to experience it in protected situations and to develop effective technical and emotional responses. More empirical research is required to excavate this tacit supervisory practice and support its appropriate use in workplace learning to ensure both learning and safety. [ABSTRACT FROM AUTHOR]
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- 2020
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16. Ventilation inhomogeneity in infants with recurrent wheezing.
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Zihang Lu, Foong, Rachel E., Kowalik, Krzysztof, Moraes, Theo J., Boyce, Ayanna, Dubeau, Aimee, Balkovec, Susan, Gustafsson, Per Magnus, Becker, Allan B., Mandhane, Piush J., Turvey, Stuart E., Lou, Wendy, Ratjen, Felix, Sears, Malcolm, Subbarao, Padmaja, and Lu, Zihang
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NITRIC oxide analysis ,ASTHMA ,COMPARATIVE studies ,LONGITUDINAL method ,LUNGS ,RESEARCH methodology ,MEDICAL cooperation ,PLETHYSMOGRAPHY ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,PULMONARY function tests ,RESPIRATORY organ sounds ,EVALUATION research ,CASE-control method - Abstract
Background: The care of infants with recurrent wheezing relies largely on clinical assessment. The lung clearance index (LCI), a measure of ventilation inhomogeneity, is a sensitive marker of early airway disease in children with cystic fibrosis, but its utility has not been explored in infants with recurrent wheezing.Objective: To assess ventilation inhomogeneity using LCI among infants with a history of recurrent wheezing compared with healthy controls.Methods: This is a case-control study, including 37 infants with recurrent wheezing recruited from outpatient clinics, and 113 healthy infants from a longitudinal birth cohort, the Canadian Healthy Infant Longitudinal Development study. All infants, at a time of clinical stability, underwent functional assessment including multiple breath washout, forced expiratory flows and body plethysmography.Results: LCI z-score values among infants with recurrent wheeze were 0.84 units (95% CI 0.41 to 1.26) higher than healthy infants (mean (95% CI): 0.26 (-0.11 to 0.63) vs -0.58 (-0.79 to 0.36), p<0.001)). Nineteen percent of recurrently wheezing infants had LCI values that were above the upper limit of normal (>1.64 z-scores). Elevated exhaled nitric oxide, but not symptoms, was associated with abnormal LCI values in infants with recurrent wheeze (p=0.05).Conclusions: Ventilation inhomogeneity is present in clinically stable infants with recurrent wheezing. [ABSTRACT FROM AUTHOR]- Published
- 2018
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17. Banning tobacco price promotions, smoking-related beliefs and behaviour: findings from the International Tobacco Control Four Country (ITC 4C) Survey.
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El-Toukhy, Sherine, Choi, Kelvin, Hitchman, Sara C., Bansal-Travers, Maansi, Thrasher, James F., Hua-Hie Yong, O'Connor, Richard J., and Ce Shang
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TOBACCO products ,HEALTH behavior ,RESEARCH funding ,SURVEYS ,COST analysis ,DATA analysis software ,DESCRIPTIVE statistics ,ECONOMICS - Published
- 2018
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18. International comparison of emergency hospital use for infants: data linkage cohort study in Canada and England.
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Harron, Katie, Gilbert, Ruth, Cromwell, David, Oddie, Sam, Guttmann, Astrid, and van der Meulen, Jan
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BIRTH weight ,CONFIDENCE intervals ,GESTATIONAL age ,HOSPITAL admission & discharge ,HOSPITAL emergency services ,INFANT mortality ,INFORMATION retrieval ,LONGITUDINAL method ,PATIENTS ,RESEARCH funding ,LOGISTIC regression analysis ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Objectives To compare emergency hospital use for infants in Ontario (Canada) and England. Methods We conducted a population-based data linkage study in infants born ≥34 weeks' gestation between 2010 and 2013 in Ontario (n=253 930) and England (n=1 361 128). Outcomes within 12 months of postnatal discharge were captured in hospital records. The primary outcome was all-cause unplanned admissions. Secondary outcomes included emergency department (ED) visits, any unplanned hospital contact (either ED or admission) and mortality. Multivariable regression was used to evaluate risk factors for infant admission. Results The percentage of infants with >1 unplanned admission was substantially lower in Ontario (7.9% vs 19.6% in England) while the percentage attending ED but not admitted was higher (39.8% vs 29.9% in England). The percentage of infants with any unplanned hospital contact was similar between countries (42.9% in Ontario, 41.6% in England) as was mortality (0.05% in Ontario, 0.06% in England). Infants attending ED were less likely to be admitted in Ontario (7.3% vs 26.2%), but those who were admitted were more likely to stay for ≥ 1 night (94.0% vs 55.2%). The strongest risk factors for admission were completed weeks of gestation (adjusted OR for 34-36 weeks vs 39+ weeks: 2.44; 95% CI 2.29 to 2.61 in Ontario and 1.66; 95% CI 1.62 to 1.70 in England) and young maternal age. Conclusions Children attending ED in England were much more likely to be admitted than those in Ontario. The tendency towards more frequent, shorter admissions in England could be due to more pressure to admit within waiting time targets, or less availability of paediatric expertise in ED. Further evaluations should consider where best to focus resources, including in-hospital, primary care and paediatric care in the community. [ABSTRACT FROM AUTHOR]
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- 2018
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19. The prevalence of medical error related to end-of-life communication in Canadian hospitals: results of a multicentre observational study.
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Heyland, Daren K., Ilan, Roy, Xuran Jiang, You, John J., and Dodek, Peter
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PREVENTION of medical errors ,AUDITING ,COMMUNICATION ,CARDIOPULMONARY resuscitation ,DEMOGRAPHY ,FAMILIES ,HOSPITALS ,INTENSIVE care units ,MEDICAL care ,MEDICAL quality control ,MEDICAL cooperation ,PATIENTS ,PHYSICIAN-patient relations ,RESEARCH ,RESEARCH funding ,RESUSCITATION ,TERMINALLY ill ,ACQUISITION of data ,HUMAN research subjects ,PATIENT selection - Published
- 2016
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20. How important are determinants of obesity measured at the individual level for explaining geographic variation in body mass index distributions? Observational evidence from Canada using Quantile Regression and Blinder-Oaxaca Decomposition.
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Dutton, Daniel J. and McLaren, Lindsay
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OBESITY ,REGRESSION analysis ,RESEARCH funding ,SURVEYS ,BODY mass index - Abstract
Background Obesity prevalence varies between geographic regions in Canada. The reasons for this variation are unclear but most likely implicate both individual-level and population-level factors. The objective of this study was to examine whether equalising correlates of body mass index (BMI) across these geographic regions could be reasonably expected to reduce differences in BMI distributions between regions. Methods Using data from three cycles of the Canadian Community Health Survey (CCHS) 2001, 2003 and 2007 for males and females, we modelled between-region BMI cross-sectionally using quantile regression and Blinder-Oaxaca decomposition of the quantile regression results. Results We show that while individual-level variables (ie, age, income, education, physical activity level, fruit and vegetable consumption, smoking status, drinking status, family doctor status, rural status, employment in the past 12 months and marital status) may be Caucasian important correlates of BMI within geographic regions, those variables are not capable of explaining variation in BMI between regions. Discussion Equalisation of common correlates of BMI between regions cannot be reasonably expected to reduce differences in the BMI distributions between regions. [ABSTRACT FROM AUTHOR]
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- 2016
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21. A validation study of a clinical prediction rule for screening asymptomatic chlamydia and gonorrhoea infections among heterosexuals in British Columbia.
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Falasinnu, Titilola, Gilbert, Mark, Gustafson, Paul, and Shoveller, Jean
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CHLAMYDIA infections ,GONORRHEA ,PREVENTION of sexually transmitted diseases ,HETEROSEXUALS ,SEXUAL health ,DISEASES ,DISEASE risk factors ,CHLAMYDIA infection diagnosis ,CHLAMYDIA infection prevention ,GONORRHEA diagnosis ,GONORRHEA prevention ,ALGORITHMS ,CLINICS ,COMPARATIVE studies ,DECISION making ,HEALTH planning ,HEALTH services accessibility ,HETEROSEXUALITY ,RESEARCH methodology ,MEDICAL cooperation ,MEDICAL screening ,PUBLIC health ,RESEARCH ,RESEARCH funding ,RISK assessment ,EVALUATION research ,DISEASE prevalence ,INFECTIOUS disease transmission - Abstract
Background: One component of effective sexually transmitted infections (STIs) control is ensuring those at highest risk of STIs have access to clinical services because terminating transmission in this group will prevent most future cases. Here, we describe the results of a validation study of a clinical prediction rule for identifying individuals at increased risk for chlamydia and gonorrhoea infection derived in Vancouver, British Columbia (BC), against a population of asymptomatic patients attending sexual health clinics in other geographical settings in BC.Methods: We examined electronic records (2000-2012) from clinic visits at seven sexual health clinics in geographical locations outside Vancouver. The model's calibration and discrimination were examined by the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow (H-L) statistic, respectively. We also examined the sensitivity and proportion of patients that would need to be screened at different cut-offs of the risk score.Results: The prevalence of infection was 5.3% (n=10 425) in the geographical validation population. The prediction rule showed good performance in this population (AUC, 0.69; H-L p=0.26). Possible risk scores ranged from -2 to 27. We identified a risk score cut-off point of ≥8 that detected cases with a sensitivity of 86% by screening 63% of the geographical validation population.Conclusions: The prediction rule showed good generalisability in STI clinics outside of Vancouver with improved discriminative performance compared with temporal validation. The prediction rule has the potential for augmenting triaging services in STI clinics and enhancing targeted testing in population-based screening programmes. [ABSTRACT FROM AUTHOR]- Published
- 2016
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22. Associations between fruit and vegetable consumption and depressive symptoms: evidence from a national Canadian longitudinal survey.
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Kingsbury, Mila, Dupuis, Gabrielle, Jacka, Felice, Roy-Gagnon, Marie-Hélène, McMartin, Seanna E., and Colman, Ian
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MENTAL depression ,FRUIT ,LONGITUDINAL method ,RESEARCH funding ,SURVEYS ,TIME ,VEGETABLES ,SOCIOECONOMIC factors ,LIFESTYLES ,CROSS-sectional method ,DATA analysis software - Abstract
Background Several cross-sectional studies have demonstrated associations between diet quality, including fruit and vegetable consumption, and mental health. However, research examining these associations longitudinally, while accounting for related lifestyle factors (eg, smoking, physical activity) is scarce. Methods This study used data from the National Population Health Survey (NPHS), a large, national longitudinal survey of Canadians. The sample included 8353 participants aged 18 and older. Every 2 years from 2002/2003 to 2010/2011, participants completed self-reports of daily fruit and vegetable consumption, physical activity, smoking and symptoms of depression and psychological distress. Using generalised estimating equations, we modelled the associations between fruit and vegetable consumption at each timepoint and depression at the next timepoint, adjusting for relevant covariates. Results Fruit and vegetable consumption at each cycle was inversely associated with next-cycle depression (β= -0.03, 95% CI -0.05 to -0.01, p<0.01) and psychological distress (β=-0.03, 95% CI -0.05 to -0.02, p<0.0001). However, once models were adjusted for other health-related factors, these associations were attenuated (β=-0.01, 95% CI -0.04 to 0.02, p=0.55; β=-0.00, 95% CI -0.03 to 0.02, p=0.78 for models predicting depression and distress, respectively). Conclusions These findings suggest that relations between fruit and vegetable intake, other health-related behaviours and depression are complex. Behaviours such as smoking and physical activity may have a more important impact on depression than fruit and vegetable intake. Randomised control trials of diet are necessary to disentangle the effects of multiple health behaviours on mental health. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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23. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia and Ontario, Canada.
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Davies, Hilary, Gilbert, Ruth, Johnson, Kathryn, Petersen, Irene, Nazareth, Irwin, O'Donnell, Melissa, Guttmann, Astrid, and Gonzalez-Izquierdo, Arturo
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NEONATAL abstinence syndrome ,DISEASE prevalence ,NARCOTICS ,BIRTH weight ,PUBLIC health ,HOSPITAL care ,LENGTH of stay in hospitals ,LONGITUDINAL method ,MATERNAL age ,EVALUATION of medical care ,PREGNANCY ,RESEARCH funding ,RETROSPECTIVE studies - Abstract
Objectives: We determined trends over time in the prevalence of neonatal drug withdrawal syndrome (NWS) in England compared with that reported in the USA, Western (W) Australia and Ontario, Canada. We also examined variation in prevalence of NWS according to maternal age, birth weight and across the English NHS by hospital trusts.Design and Setting: Retrospective study using national hospital administrative data (Hospital Episode Statistics) for the NHS in England between 1997 and 2011. NWS was identified using international classification of disease codes in hospital admission records. We searched the research literature and contacted researchers to identify studies reporting trends in the prevalence of NWS.Main Outcome Measures: Prevalence of NWS by calendar year per 1000 live births for each country/state. For births in England, prevalence by maternal age group and birth weight group. Prevalence by NHS trust and region at birth, and funnel plot to show outlying English NHS hospital trusts (>3 SD of mean prevalence).Main Results: Mean prevalence rates of recorded NWS increased in all four countries. Rates stabilised in England and W. Australia from the early 2000s and rose steeply in the USA and Ontario during the late 2000s. The most recent prevalence rates were 2.7/1000 live births in England (2011; 1544 cases); 2.7/1000 in W. Australia (2009); 3.6/1000 in the USA (2009) and 5.1/1000 in Ontario (2011). The highest prevalence in England was among babies born to mothers aged 25-34 years at delivery and among babies born with low birth weight (1500-2500 g). In England in 2011, 8.6% of hospital trusts had a recorded prevalence outside 3 SD of the overall average (7% above, 1% below). The North East region of England had the highest recorded prevalence of NWS.Conclusions: Although recorded NWS is stable in England and W. Australia, rising rates in the USA and Ontario may reflect better recognition and/or increased use of prescribed opiate analgesics and highlight the need for surveillance. The extent to which different prevalence rates by hospital trust reflect variation in occurrence, recognition or recording requires further investigation. [ABSTRACT FROM AUTHOR]- Published
- 2016
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24. Relationships between community social capital and injury in Canadian adolescents: a multilevel analysis.
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Vafaei, Afshin, Pickett, William, and Alvarado, Beatriz E.
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PREVENTION of injury ,INJURY risk factors ,AGE distribution ,ANALYSIS of variance ,CHI-squared test ,CONFIDENCE intervals ,FACTOR analysis ,HEALTH behavior in adolescence ,QUESTIONNAIRES ,RESEARCH funding ,RISK-taking behavior ,SCALE analysis (Psychology) ,SELF-evaluation ,SEX distribution ,SOCIAL networks ,SURVEYS ,MATHEMATICAL variables ,WOUNDS & injuries ,LOGISTIC regression analysis ,SOCIAL capital ,SOCIOECONOMIC factors ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,ADOLESCENCE - Abstract
Background Characteristics of social environments are potential risk factors for adolescent injury. Impacts of social capital on the occurrence of such injuries have rarely been explored. Methods General health questionnaires were completed by 8910 youth aged 14 years and older as part of the 2010 Canadian Health Behaviour in School- Aged Children study. These were supplemented with community-level data from the 2006 Canada Census of Population. Multilevel logistic regression models with random intercepts were fit to examine associations of interest. The reliability and validity of variables used in this analysis had been established in past studies, or in new analyses that employed factor analysis. Results Between school differences explained 2% of the variance in the occurrence of injuries. After adjustment for all confounders, community social capital did not have any impact on the occurrence of injuries in boys: OR: 1.01, 95% CI 0.80 to 1.29. However, living in areas with low social capital was associated with lower occurrence of injuries in girls (OR 0.78, 95% CI 0.63 to 0.96). Other factors that were significantly related to injuries in both genders were younger age, engagement in more risky behaviours, and negative behavioural influences from peers. Conclusions After simultaneously taking into account the influence of community-level and individual-level factors, community levels of social capital remained a relatively strong predictor of injury among girls but not boys. Such gender effects provide important clues into the social aetiology of youth injury. [ABSTRACT FROM AUTHOR]
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- 2015
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25. The implementation of a municipal indoor ice skating helmet policy: effects on helmet use, participation and attitudes.
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O'Mahony-Menton, Colleen, Willmore, Jacqueline, and Russell, Katherine
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HEAD injury prevention ,CHI-squared test ,STATISTICAL correlation ,HOSPITAL emergency services ,RESEARCH funding ,ICE skating ,SAFETY hats ,SURVEYS ,GOVERNMENT policy ,HEAD injuries ,HUMAN services programs ,EVALUATION of human services programs ,DATA analysis software ,LAW - Abstract
Relevant local injury epidemiology In Ottawa, between 2005 and 2009 there was an annual average of 47.2 head injuries due to ice skating in children and youth (1-19 years of age) requiring a visit to the emergency department, with the highest rates among those aged 5-14 years. Between 2002 and 2007, only 6% of children were wearing a helmet during ice skating when the head injury occurred. During indoor public skating sessions, 93% of children (<10 years)-57% aged 10-12 years, 20% aged 13-17 years and 9% adults-wore helmets in the absence of a policy. Support for a helmet policy was high from public health, medical, political and community perspectives. Best practice Helmet policies in relation to cycling have demonstrated increases in helmet use and reduction of head injuries without decreasing physical activity. However, no known studies have examined the effect of indoor ice skating helmet policy coupled with education and promotional activities on helmet use, participation and attitudes towards helmet use. Implementation An ice skating helmet policy for children (<11 years of age) and those with limited skating experience at indoor rinks during public skating sessions was developed, implemented and evaluated. Supportive activities such as discount coupons, promotional materials, a media launch, social marketing and staff training are described. Discussion The helmet policy was associated with increased helmet use for young children and for older children, youth and adults not included in the policy, without decreasing attendance to public skating sessions. [ABSTRACT FROM AUTHOR]
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- 2015
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26. Welfare generosity and population health among Canadian provinces: a time-series cross-sectional analysis, 1989-2009.
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Ng, Edwin and Muntaner, Carles
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ECONOMICS ,PUBLIC health ,PUBLIC welfare ,CONFIDENCE intervals ,RESEARCH funding ,TIME series analysis ,GOVERNMENT aid ,SOCIOECONOMIC factors ,DEMOGRAPHIC characteristics ,HEALTH equity ,DATA analysis software ,HEALTH & social status ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background Recent work in comparative social epidemiology uses an expenditures approach to examine the link between welfare states and population health. More work is needed that examines the impact of disaggregated expenditures within nations. This study takes advantage of provincial differences within Canada to examine the effects of subnational expenditures and a provincial welfare generosity index on population health. Methods Time-series cross-sectional data are retrieved from the Canadian Socio-Economic Information Management System II Tables for 1989-2009 (10 provinces and 21 years=210 cases). Expenditures are measured using 20 disaggregated indicators, total expenditures and a provincial welfare generosity index, a ombined measure of significant predictors. Health is measured as total, male and female age-standardised mortality rates per 1000 deaths. Estimation techniques include the Prais-Winsten regressions with panel-corrected SEs, a first-order autocorrelation correction model, and fixed-unit effects, adjusted for alternative factors. Results Analyses reveal that four expenditures effectively reduce mortality rates: medical care, preventive care, other social services and postsecondary education. The provincial welfare generosity index has even larger effects. For an SD increase in the provincial welfare generosity index, total mortality rates are expected to decline by 0.44 SDs. Standardised effects are larger for women (β=-0.57, z(19)=-5.70, p<0.01) than for men (β=-0.38, z(19)=-5.59, p<0.01). Conclusions Findings show that the expenditures approach can be effectively applied within the context of Canadian provinces, and that targeted spending on health, social services and education has salutary effects. [ABSTRACT FROM AUTHOR]
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- 2015
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27. Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study.
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Perry, Jeffrey J., Alyahya, Bader, Sivilotti, Marco L. A., Bullard, Michael J., Émond, Marcel, Sutherland, Jane, Worster, Andrew, Hohl, Corinne, Lee, Jacques S., Eisenhauer, Mary A., Pauls, Merril, Lesiuk, Howard, Wells, George A., and Stiell, Ian G.
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CEREBROSPINAL fluid examination ,CONFIDENCE intervals ,HEADACHE ,LONGITUDINAL method ,RESEARCH funding ,LUMBAR puncture ,SUBARACHNOID hemorrhage ,DESCRIPTIVE statistics ,DISEASE complications - Abstract
The article presents a study on the differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage (SAH) from a traumatic lumbar puncture. Topics covered include acute non-traumatic headache, the diagnosis of SAH with a sensitivity of 100 percent, and the relatively wide confidence interval around the sensitivity.
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- 2015
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28. Tobacco on the web: surveillance and characterisation of online tobacco and e-cigarette advertising.
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Richardson, Amanda, Ganz, Ollie, and Vallone, Donna
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ADVERTISING ,MARKETING ,RESEARCH funding ,ELECTRONIC commerce ,THEMATIC analysis ,TOBACCO products ,ELECTRONIC cigarettes ,DATA analysis software - Abstract
Background Despite the internet's broad reach and potential to influence consumer behaviour, there has been little examination of the volume, characteristics, and target audience of online tobacco and e-cigarette advertisements. Methods A full-service advertising firm was used to collect all online banner/video advertisements occurring in the USA and Canada between 1 April 2012 and 1 April 2013. The advertisement and associated meta-data on brand, date range observed, first market, and spend were downloaded and summarised. Characteristics and themes of advertisements, as well as topic area and target demographics of websites on which advertisements appeared, were also examined. Results Over a 1-year period, almost $2 million were spent by the e-cigarette and tobacco industries on the placement of their online product advertisements in the USA and Canada. Most was spent promoting two brands: NJOY e-cigarettes and Swedish Snus. There was almost no advertising of cigarettes. About 30% of all advertisements mentioned a price promotion, discount coupon or price break. e-Cigarette advertisements were most likely to feature messages of harm reduction (38%) or use for cessation (21%). Certain brands advertised on websites that contained up to 35% of youth (<18 years) as their audience. Conclusions Online banner/video advertising is a tactic used mainly to advertise e-cigarettes and cigars rather than cigarettes, some with unproven claims about benefits to health. Given the reach and accessibility of online advertising to vulnerable populations such as youth and the potential for health claims to be misinterpreted, online advertisements need to be closely monitored. [ABSTRACT FROM AUTHOR]
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- 2015
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29. 'Herbal' but potentially hazardous: an analysis of the constituents and smoke emissions of tobacco-free waterpipe products and the air quality in the cafés where they are served.
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Hammal, Fadi, Chappell, Alyssa, Wild, T. Cameron, Kindzierski, Warren, Shihadeh, Alan, Vanderhoek, Amanda, Cong Khanh Huynh, Plateel, Gregory, and Finegan, Barry A.
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PLANT chemical analysis ,INDOOR air pollution ,TOXIN analysis ,PASSIVE smoking ,RESEARCH funding ,RESTAURANTS ,SMOKE ,SMOKING ,TOBACCO ,WATER ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Background There are limited data on the composition and smoke emissions of 'herbal' shisha products and the air quality of establishments where they are smoked. Methods Three studies of 'herbal' shisha were conducted: (1) samples of 'herbal' shisha products were chemically analysed; (2) 'herbal' and tobacco shisha were burned in a waterpipe smoking machine and main and sidestream smoke analysed by standard methods and (3) the air quality of six waterpipe cafés was assessed by measurement of CO, particulate and nicotine vapour content. Results We found considerable variation in heavy metal content between the three products sampled, one being particularly high in lead, chromium, nickel and arsenic. A similar pattern emerged for polycyclic aromatic hydrocarbons. Smoke emission analyses indicated that toxic byproducts produced by the combustion of 'herbal' shisha were equivalent or greater than those produced by tobacco shisha. The results of our air quality assessment demonstrated that mean PM2.5 levels and CO content were significantly higher in waterpipe establishments compared to a casino where cigarette smoking was permitted. Nicotine vapour was detected in one of the waterpipe cafés. Conclusions 'Herbal' shisha products tested contained toxic trace metals and PAHs levels equivalent to, or in excess of, that found in cigarettes. Their mainstream and sidestream smoke emissions contained carcinogens equivalent to, or in excess of, those of tobacco products. The content of the air in the waterpipe cafés tested was potentially hazardous. These data, in aggregate, suggest that smoking 'herbal' shisha may well be dangerous to health. [ABSTRACT FROM AUTHOR]
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- 2015
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30. Fix and forget or fix and report: a qualitative study of tensions at the front line of incident reporting.
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Hewitt, Tanya Anne and Chreim, Samia
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CLINICAL competence ,MEDICAL care ,MEDICAL personnel ,PATIENT safety ,QUESTIONNAIRES ,RESEARCH funding ,QUALITATIVE research ,TERTIARY care - Abstract
Introduction Practitioners frequently encounter safety problems that they themselves can resolve on the spot. We ask: when faced with such a problem, do practitioners fix it in the moment and forget about it, or do they fix it in the moment and report it? We consider factors underlying these two approaches. Methods We used a qualitative case study design employing in-depth interviews with 40 healthcare practitioners in a tertiary care hospital in Ontario, Canada. We conducted a thematic analysis, and compared the findings with the literature. Results 'Fixing and forgetting' was the main choice that most practitioners made in situations where they faced problems that they themselves could resolve. These situations included (A) handling near misses, which were seen as unworthy of reporting since they did not result in actual harm to the patient, (B) prioritising solving individual patients' safety problems, which were viewed as unique or one-time events and (C) encountering re-occurring safety problems, which were framed as inevitable, routine events. In only a few instances was 'fixing and reporting' mentioned as a way that the providers dealt with problems that they could resolve. Conclusions We found that generally healthcare providers do not prioritise reporting if a safety problem is fixed. We argue that fixing and forgetting patient safety problems encountered may not serve patient safety as well as fixing and reporting. The latter approach aligns with recent calls for patient safety to be more preventive. We consider implications for practice. [ABSTRACT FROM AUTHOR]
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- 2015
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31. Unintentional drowning mortality, by age and body of water: an analysis of 60 countries.
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Ching-Yih Lin, Yi-Fong Wang, Tsung-Hsueh Lu, and Ichiro Kawach
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AGE distribution ,CONFIDENCE intervals ,DROWNING ,NOSOLOGY ,RESEARCH funding ,PSYCHOLOGY - Abstract
Background To examine unintentional drowning mortality by age and body of water across 60 countries, to provide a starting point for further in-depth investigations within individual countries. Methods The latest available three years of mortality data for each country were extracted from WHO Health Statistics and Information Services (updated at 13 November 2013). We calculated mortality rate of unintentional drowning by age group for each country. For countries using International Classification of Disease 10 (ICD-10) detailed 3 or 4 Character List, we further examined the body of water involved. Results A huge variation in age-standardised mortality rate (deaths per 100 000 population) was noted, from 0.12 in Turkey to 9.19 in Guyana. Of the ten countries with the highest age-standardised mortality rate, six (Belarus, Lithuania, Latvia, Russia, Ukraine and Moldova) were in Eastern Europe and two (Kazakhstan and Kyrgyzstan) were in Central Asia. Some countries ( Japan, Finland and Greece) had a relatively low rank in mortality rate among children aged 0-4 years, but had a high rank in mortality rate among older adults. On the contrary, South Africa and Colombia had a relatively high rank among children aged 0-4 years, but had a relatively low rank in mortality rate among older adults. With regard to body of water involved, the proportion involving a bathtub was extremely high in Japan (65%) followed by Canada (11%) and the USA (11%). Of the 13 634 drowning deaths involving bathtubs in Japan between 2009 and 2011, 12 038 (88%) were older adults aged 65 years or above. The percentage involving a swimming pool was high in the USA (18%), Australia (13%), and New Zealand (7%). The proportion involving natural water was high in Finland (93%), Panama (87%), and Lithuania (85%). Conclusions After considering the completeness of reporting and quality of classifying drowning deaths across countries, we conclude that drowning is a highpriority public health problem in Eastern Europe, Central Asia, Japan (older adults involving bathtubs), and the USA (involving swimming pools). [ABSTRACT FROM AUTHOR]
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- 2015
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32. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma.
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Subbarao, Padmaja, Anand, Sonia S., Becker, Allan B., Befus, A. Dean, Brauer, Michael, Brook, Jeffrey R., Denburg, Judah A., HayGlass, Kent T., Kobor, Michael S., Kollmann, Tobias R., Kozyrskyj, Anita L., Lou, W. Y. Wendy, Mandhane, Piushkumar J., Miller, Gregory E., Moraes, Theo J., Pare, Peter D., Scott, James A., Takaro, Tim K., Turvey, Stuart E., and Duncan, Joanne M.
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ASTHMA diagnosis ,ALLERGIES ,ASTHMA ,CHILD development ,CHRONIC diseases ,LONGITUDINAL method ,RESEARCH funding ,PHENOTYPES ,SOCIOECONOMIC factors ,DIAGNOSIS - Abstract
The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study recruited 3624 pregnant women, most partners and 3542 eligible offspring. We hypothesise that early life physical and psychosocial environments, immunological, physiological, nutritional, hormonal and metabolic influences interact with genetics influencing allergic diseases, including asthma. Environmental and biological sampling, innate and adaptive immune responses, gene expression, DNA methylation, gut microbiome and nutrition studies complement repeated environmental and clinical assessments to age 5. This rich data set, linking prenatal and postnatal environments, diverse biological samples and rigorous phenotyping, will inform early developmental pathways to allergy, asthma and other chronic inflammatory diseases. [ABSTRACT FROM AUTHOR]
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- 2015
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