Search

Background: The association between elbow fractures and outdoor playgrounds has always been anecdotal. We sought to determine the impact of closing outdoor playgrounds and other play areas during the COVID-19 lockdown on elbow fractures in a pediatric population. Methods: We conducted a retrospective cohort study of all elbow fractures from a single pediatric referral hospital between 2016 and 2020 for the months of April and May. The months chosen corresponded to the COVID-19 lockdown during which outdoor playgrounds were closed. Inclusion criteria were elbow fracture diagnosis based on radiography and age younger than 18 years. Fracture type, where the injury occurred and the mechanism of injury were recorded. Results: A total of 370 fractures were reported, with an average of 83 (95% confidence interval [CI] 83-84) per year for 2016-19 and only 36 recorded in 2020. The average annual number of fractures before 2020 was 17 (95% CI 16-17) for schools, and 33 (95% CI 31-34) for outdoor playgrounds, including 22 (95% CI 21-24) falls from playground structures. No fracture was reported in schools in 2020, and only 3 were reported from outdoor playgrounds (including 1 associated with falling from playground structures). Conclusion: We found an association between elbow fractures in a pediatric population and outdoor playground accessibility, but also with indoor public locations. Our findings emphasize the importance of safety measures in those facilities. Contexte: Le lien entre les fractures du coude et la fréquentation des terrains de jeux extérieurs a toujours été anecdotique. Nous avons voulu mesurer l'impact de la fermeture des terrains de jeux extérieurs et autres aires de jeux durant le confinement dû à la COVID-19 sur les fractures du coude dans une population pédiatrique. Méthodes : Nous avons procédé à une étude de cohorte rétrospective regroupant tous les cas de fracture du coude dans 1 seul centre pédiatrique de référence entre 2016 et 2020 pour les mois d'avril et de mai. Les mois choisis correspondent au confinement dû à la COVID-19 durant lesquels les terrains de jeux extérieurs étaient fermés. Les critères d'inclusion étaient un diagnostic de fracture du coude, radiographie à l'appui et un âge inférieur à 18 ans. On a également noté le type de fracture, le lieu de sa survenue et son mécanisme. Résultats: En tout, 370 fractures ont été signalées, à raison d'une moyenne de 83 (intervalle de confiance [IC] de 95% 83-84) par année pour 2016-2019, et de seulement 36 en 2020. Le nombre annuel moyen de fractures avant 2020 était de 17 (IC de 95% 16-17) pour les écoles, et de 33 (IC de 95% 31-34) pour les terrains de jeux extérieurs, incluant 22 (IC de 95% 21-24) chutes des structures de terrains de jeu. Aucune fracture n'a été signalée dans les écoles en 2020, et seulement 3 ont été signalées dans des terrains de jeux extérieurs (dont 1 associée à une chute d'une structure de jeu). Conclusion : Nous avons établi un lien entre les fractures du coude dans une population pédiatrique et l'accessibilité aux terrains de jeux extérieurs, mais aussi avec les aires de jeux intérieures publiques. Nos observations confirment l'importance des mesures de sécurité dans ces lieux., Elbow fractures have a bimodal distribution, being more prevalent in the pediatric and elderly populations. (1) Among younger patients, elbow fractures represent approximately 20% of all fractures (2) and supracondylar [...]

PURPOSE The effective integration of primary care into public health responses to the COVID-19 pandemic, particularly through data sharing, has received some attention in the literature. However, the specific policies and structures that facilitate this integration are understudied. This paper describes the experiences of clinicians and administrators in Alberta, Canada as they built a data bridge between primary care and public health to improve the province's community-based response to the pandemic. METHODS Fifty-seven semistructured qualitative interviews were conducted with a range of primary care and public health stakeholders working inside the Calgary Health Zone. Interpretive description was used to analyze the interviews. RESULTS SARS-CoV-2 test results produced by the local public laboratory were, initially, only available to central public health clinicians and not independent primary care physicians. This enabled centrally managed contact tracing but meant primary care physicians were unaware of their patients' COVID-19 status and unable to offer in-community follow-up care. Stakeholders from both central public health and independent primary care were able to leverage a policy commitment to the Patient Medical Home (PMH) care model, and a range of existing organizational structures, and governance arrangements to create a data bridge that would span the gap. CONCLUSIONS Primary care systems looking to draw lessons from the data bridge's construction may consider ways to: leverage care model commitments to integration and adjust or create organization and governance structures which actively draw together primary care and non-primary care stakeholders to work on common projects. Such policies and structures develop trusting relationships, open the possibility for champions to emerge, and create the spaces in which integrative improvisation can take place. Key words: primary care; integration; public health response; data sharing; COVID-19; qualitative; primary care network, INTRODUCTION The vast majority of COVID-19 cases and their 'long COVID' sequalae (1,2) have been managed in the community by primary care teams. (3,4) As much as those primary care [...]

This study examines worker voice in the development and implementation of safety plans or protocols for COVID-19 prevention among hospital workers, long-term care workers, and education workers in the Canadian province of Ontario. Although Ontario occupational health and safety law and official public health policy appear to recognize the need for active consultation with workers and labour unions, there were limited--and in some cases no--efforts by employers to meaningfully involve workers, worker representatives (reps), or union officials in assessing COVID-19 risks and planning protection and prevention measures. The political and legal efforts of workers and unions to assert their right to participate and the outcomes of those efforts are also documented through archival evidence and interviews with worker reps and union officials. The article concludes with an assessment of weaknesses in the government promotion and protection of worker health and safety rights and calls for greater labour attention to the critical importance of worker health and safety representation. Keywords: COVID-19, worker voice, worker representation, occupational health and safety, joint committees, labour unions, public health, long-term care, health care, public schools Cette etude examine la voix des travailleurs dans l'elaboration et la mise en oeuvre de plans ou de protocoles de securite pour la prevention du COVID-19 chez les travailleurs hospitaliers, les travailleurs de soins de longue duree et les travailleurs de l'education dans la province canadienne de l'Ontario. Bien que la loi ontarienne sur la sante et la securite au travail et la politique officielle de la sante publique semblent reconnaitre la necessite d'une consultation active avec les travailleurs et les syndicats, il y a eu des efforts limites--et dans certains cas aucuns efforts--deployes par les employeurs pour impliquer de maniere significative les travailleurs, les representants des travailleurs (delegues), ou des responsables syndicaux pour evaluer les risques lies au COVID-19 et planifier les mesures de protection et de prevention. Les efforts politiques et juridiques des travailleurs et des syndicats pour affirmer leur droit de participer et les resultats de ces efforts sont egalement documentes par des preuves d'archives et des entretiens avec des delegues et des responsables syndicaux. L'article se termine par une evaluation des faiblesses de la promotion et de la protection par le gouvernement des droits des travailleurs en matiere de sante et de securite et appelle a une plus grande attention des travailleurs a l'importance cruciale de la representation en matiere de sante et de securite des travailleurs. Mots clefs : COVID-19, voix des travailleurs et travailleuses, representation des travailleurs et travailleuses, sante et securite du travail, comites paritaires, syndicats, sante publique, soins de longue duree, soins de sante, ecoles publiques, THE COVID-19 PANDEMIC IMPOSED an unwelcome stress test on our institutions and social arrangements, often revealing their underlying weaknesses and flaws. Regimes of occupational health and safety (OHS) regulation are [...]

Cell-free synthetic biology is a rapidly developing biotechnology with the potential to solve the world's biggest problems; however, this promise also has implications for global biosecurity and biosafety. Given the current situation of COVID-19 and its economic impact, capitalizing on the potential of cell-free synthetic biology from an economic, biosafety, and biosecurity perspective contributes to our preparedness for the next pandemic, and urges the development of appropriate policies and regulations, together with the necessary mitigation technologies. Proactive involvement from scientists is necessary to avoid misconceptions and assist in the policymaking process. Key words: next-generation synthetic biology, biotechnology policy and regulation, cell-free systems, life-similar systems. La biologie de synthèse acellulaire est une biotechnologie qui se développe rapidement et qui a le potentiel de résoudre les plus grands problèmes du monde ; toutefois, cette promesse a également des implications pour la biosécurité et la biosûreté mondiales. Compte tenu de la situation actuelle avec la COVID-19 et de son impact économique, exploiter le potentiel de la biologie de synthèse acellulaire d'un point de vue économique, de la biosécurité et de la biosûreté contribue à notre préparation à la prochaine pandémie, et exhorte au développement de politiques et de réglementations appropriées, associé aux technologies d'atténuation nécessaires. La participation proactive des scientifiques est nécessaire pour éviter les idées fausses et contribuer au processus d'élaboration des politiques. [Traduit par la Rédaction] Mots-clés : biologie de synthèse de nouvelle génération, politique et réglementation en matière de biotechnologie, systèmes acellulaires, systèmes similaires au vivant., Introduction Synthetic biology (synbio) has emerged as a scientific field with tremendous transformative potential, providing critical tools for achieving the sustainable development goals identified by the United Nations (2015). Through [...]

The COVID-19 pandemic has caused unprecedented challenges in health care, threatening access and delivery of medical services across all sectors. Patients with breast cancer desiring breast reconstruction require timely interdisciplinary care; resource limitations threaten access to this elective reconstructive element of cancer care. An expert panel was convened to identify challenges, recommend preliminary solutions, and identify important future directions in anticipation of prolonged restrictions. This paper presents consensus recommendations for care of breast cancer reconstruction patients during the pandemic based on expert opinion from the BC Breast Reconstruction Network., Cancer management has been hindered by the COVID-19 pandemic, with imposed requirements for physical distancing, closure of ambulatory care programs and cancellation of elective surgeries. (1) In response to these [...]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease (COVID-19) in humans; symptoms can range from asymptomatic to mild or severe, including severe respiratory distress and sometimes death (1). [...]

Coronavirus disease 2019 (COVID-19) is already the third coronavirus outbreak in the past two decades. SARS-CoV-2, the strain of coronavirus that causes COVID-19, may continue to spread worldwide for years [...]