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Attitudes and perceptions of registered nurses during and shortly after acute care restructuring in Newfoundland and Labrador.

https://arctichealth.org/en/permalink/ahliterature172218
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:22-30
Publication Type
Article
Date
Oct-2005
Author
Christine Way
Deborah Gregory
Norma Baker
Sandra Lefort
Brendan Barrett
Patrick Parfrey
Author Affiliation
Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. cway@mun.ca
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:22-30
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Health Care Reform
Hospital Planning
Hospital Restructuring
Humans
Newfoundland and Labrador
Nursing Staff, Hospital - psychology
Quality of Health Care
Questionnaires
Regional Health Planning - organization & administration
Utilization Review
Workplace
Abstract
To monitor changes in registered nurses' perceptions of the impact of seven years of health care restructuring in Newfoundland and Labrador (NL) and to measure the attitudinal and behavioural reactions over four years comparing the St John's region, where hospital aggregation occurred, to other regions of the province.
Data were collected on acute care nurses' personal characteristics and perceptions of the importance of reform and its impact on workplace conditions and health care quality in 1995, 1999, 2000 and 2002. Nurses' attitudes and intentions were monitored across three time periods (i.e. 1999, 2000 and 2002).
Perceived workplace conditions and health care quality, as well as attitudes and behaviours were generally negative. However, there was some improvement over time. The temporal sequence of scores suggests that restructuring had an adverse impact on nurses' attitudes. Few significant regional differences were observed.
Although health services restructuring had an adverse impact on nurses' attitudes, aggregation of hospitals in St John's region was achieved without further deterioration. Provincial wide initiatives are needed to promote more positive work environments and increase the organizational effectiveness.
PubMed ID
16259698 View in PubMed
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Combined carrier status of prothrombin 20210A and factor XIII-A Leu34 alleles as a strong risk factor for myocardial infarction: evidence of a gene-gene interaction.

https://arctichealth.org/en/permalink/ahliterature187366
Source
Blood. 2003 Apr 15;101(8):3037-41
Publication Type
Article
Date
Apr-15-2003
Author
Christopher Butt
Hong Zheng
Edward Randell
Desmond Robb
Patrick Parfrey
Ya-Gang Xie
Author Affiliation
Discipline of Laboratory Medicine, Memorial University of Newfoundland, St John's, NF, Canada.
Source
Blood. 2003 Apr 15;101(8):3037-41
Date
Apr-15-2003
Language
English
Publication Type
Article
Keywords
5' Untranslated Regions - genetics
Activated Protein C Resistance - complications - genetics
Adult
Age of Onset
Aged
Alleles
Amino Acid Substitution
DNA Mutational Analysis
Epistasis, Genetic
Factor V - genetics
Factor XIII - genetics
Female
Founder Effect
Gene Frequency
Genetic Predisposition to Disease
Genotype
Heterozygote
Humans
Linkage Disequilibrium
Male
Middle Aged
Mutation, Missense
Myocardial Infarction - epidemiology - etiology - genetics
Newfoundland and Labrador - epidemiology
Point Mutation
Prevalence
Prospective Studies
Prothrombin - genetics
Risk factors
Sex Factors
Thrombophilia - complications - genetics
Abstract
Studies associating the prothrombin 20210G>A (FII 20210A), factor V Leiden (FVL), and factor XIII Leu34 (FXIII-A Leu34) alleles with myocardial infarction (MI) have yielded conflicting results. Complicated gene-gene interactions, small sample sizes, and heterogeneous genetic and environmental backgrounds may contribute to opposing findings. Simultaneous analysis of multiple gene variants in a large sample size from a genetically isolated population may overcome these weaknesses. Genotyping was performed in 500 MI patients and 500 control subjects from the genetically isolated Newfoundland population to determine the prevalence of the FII 20210A, FVL, and FXIII-A Leu34 variants and their association with MI. Gene-gene interactions were also analyzed. The prevalence of the FII 20210A allele was higher in MI patients (3.2%) than in control subjects (1.0%; P =.015). The FII 20210A allele was also 5.6-fold higher in MI patients younger than 51 years than in age-matched control subjects (P =.04). FVL showed 3.9-fold higher prevalence in young patients than in patients older than 50 years (P =.004) and 2.7-fold higher than in age-matched control subjects (P =.007). Furthermore, the prevalence of combined carriers of the FXIII-A L34 and FII 20210A alleles was 12-fold higher in MI patients than in control subjects (P =.002) and with 92% penetrance. There was disequilibrium of the FXIII-A Leu34 allele to MI patients carrying the FII 20210A allele as a genetic background. Based on our data, we determined that (1) the FII 20210A allele is a risk factor for MI, possibly important for early onset; (2) FVL may predispose for early-onset MI; (3) the FXIII-A Leu34 allele predisposes for MI in males only; however, (4) interaction between the FII 20210A and FXIII-A Leu34 alleles forms a synergistic coeffect that strongly predisposes for MI, placing combined carriers at high risk for MI.
Notes
Comment In: Blood. 2003 Aug 15;102(4):1558-9; author reply 1559-6012900358
PubMed ID
12480694 View in PubMed
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Community engagement with genetics: public perceptions and expectations about genetics research.

https://arctichealth.org/en/permalink/ahliterature274526
Source
Health Expect. 2015 Oct;18(5):1413-25
Publication Type
Article
Date
Oct-2015
Author
Holly Etchegary
Jane Green
Patrick Parfrey
Catherine Street
Daryl Pullman
Source
Health Expect. 2015 Oct;18(5):1413-25
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Attitude to Health
Consumer Participation
Genetic Research - ethics
Humans
Information Dissemination
Newfoundland and Labrador
Public Opinion
Public Policy
Surveys and Questionnaires
Abstract
Knowledge of molecular biology and genomics continues to expand rapidly, promising numerous opportunities for improving health. However, a key aspect of the success of genomic medicine is related to public understanding and acceptance.
Using community consultations and an online survey, we explored public attitudes and expectations about genomics research.
Thirty-three members of the general public in Newfoundland, Canada, took part in the community sessions, while 1024 Atlantic Canadians completed the online survey. Overall, many participants noted they lacked knowledge about genetics and associated research and took the opportunity to ask numerous questions throughout sessions. Participants were largely hopeful about genomics research in its capacity to improve health, not only for current residents, but also for future generations. However, they did not accept such research uncritically, and a variety of complex issues and questions arose during the community consultations and were reflected in survey responses.
With the proliferation of biobanks and the rapid pace of discoveries in genomics research, public support will be crucial to realize health improvements. If researchers can engage the public in regular, transparent dialogue, this two-way communication could allow greater understanding of the research process and the design of efficient and effective genetic health services, informed by the public that will use them.
PubMed ID
23968492 View in PubMed
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Consulting the community: public expectations and attitudes about genetics research.

https://arctichealth.org/en/permalink/ahliterature114686
Source
Eur J Hum Genet. 2013 Dec;21(12):1338-43
Publication Type
Article
Date
Dec-2013
Author
Holly Etchegary
Jane Green
Elizabeth Dicks
Daryl Pullman
Catherine Street
Patrick Parfrey
Author Affiliation
1] Clinical Epidemiology, Faculty of Medicine, Memorial University, St John's, Newfoundland and Labrador, Canada [2] Eastern Health, St John's, Newfoundland and Labrador, Canada.
Source
Eur J Hum Genet. 2013 Dec;21(12):1338-43
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Attitude
Canada
Delivery of Health Care
Female
Genetic Services
Genetics
Humans
Male
Middle Aged
Primary Health Care
Referral and Consultation
Research Personnel
Young Adult
Abstract
Genomic discoveries and technologies promise numerous opportunities for improving health. Key to these potential health improvements, however, are health-care consumers' understanding and acceptance of these new developments. We identified community groups and invited them to a public information-consultation session in order to explore public awareness, perception and expectations about genetics and genomics research. One hundred and four members of seven community groups in Newfoundland, Canada took part in the community sessions. Content analysis of participant comments revealed they were largely hopeful about genetics research in its capacity to improve health; however, they did not accept such research uncritically. Complex issues arose during the community consultations, including the place of genetics in primary care, the value of genetics for personal health, and concerns about access to and uses of genetic information. Participants unequivocally endorsed the value of public engagement with these issues. The rapid pace of discoveries in genomics research offers exciting opportunities to improve population health. However, public support will be crucial to realize health improvements. Our findings suggest that regular, transparent dialog between researchers and the public could allow a greater understanding of the research process, as well as assist in the design of efficient and effective genetic health services, informed by the public that will use them.
PubMed ID
23591403 View in PubMed
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Estimating successive cancer risks in Lynch Syndrome families using a progressive three-state model.

https://arctichealth.org/en/permalink/ahliterature108023
Source
Stat Med. 2014 Feb 20;33(4):618-38
Publication Type
Article
Date
Feb-20-2014
Author
Yun-Hee Choi
Laurent Briollais
Jane Green
Patrick Parfrey
Karen Kopciuk
Author Affiliation
The Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON N6A 5C1, Canada.
Source
Stat Med. 2014 Feb 20;33(4):618-38
Date
Feb-20-2014
Language
English
Publication Type
Article
Keywords
Age Factors
Algorithms
Colorectal Neoplasms, Hereditary Nonpolyposis - genetics
Computer simulation
Female
Genetic Predisposition to Disease - genetics
Genotype
Heterozygote
Humans
Male
Models, Genetic
Mutation - genetics
Newfoundland and Labrador
Penetrance
Proportional Hazards Models
Risk Assessment - methods
Abstract
Lynch Syndrome (LS) families harbor mutated mismatch repair genes,which predispose them to specific types of cancer. Because individuals within LS families can experience multiple cancers over their lifetime, we developed a progressive three-state model to estimate the disease risk from a healthy (state 0) to a first cancer (state 1) and then to a second cancer (state 2). Ascertainment correction of the likelihood was made to adjust for complex sampling designs with carrier probabilities for family members with missing genotype information estimated using their family's observed genotype and phenotype information in a one-step expectation-maximization algorithm. A sandwich variance estimator was employed to overcome possible model misspecification. The main objective of this paper is to estimate the disease risk (penetrance) for age at a second cancer after someone has experienced a first cancer that is also associated with a mutated gene. Simulation study results indicate that our approach generally provides unbiased risk estimates and low root mean squared errors across different family study designs, proportions of missing genotypes, and risk heterogeneities. An application to 12 large LS families from Newfoundland demonstrates that the risk for a second cancer was substantial and that the age at a first colorectal cancer significantly impacted the age at any LS subsequent cancer. This study provides new insights for developing more effective management of mutation carriers in LS families by providing more accurate multiple cancer risk estimates.
PubMed ID
23946183 View in PubMed
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Excess body weight and colorectal cancer risk in Canada: associations in subgroups of clinically defined familial risk of cancer.

https://arctichealth.org/en/permalink/ahliterature161372
Source
Cancer Epidemiol Biomarkers Prev. 2007 Sep;16(9):1735-44
Publication Type
Article
Date
Sep-2007
Author
Peter T Campbell
Michelle Cotterchio
Elizabeth Dicks
Patrick Parfrey
Steven Gallinger
John R McLaughlin
Author Affiliation
Cancer Prevention, Fred Hutchinson Cancer Research Center, M4-B402, Seattle, WA 98109, USA. ptcampbe@fhcrc.org
Source
Cancer Epidemiol Biomarkers Prev. 2007 Sep;16(9):1735-44
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Body Height
Body mass index
Body Weight
Canada - epidemiology
Colorectal Neoplasms - epidemiology - etiology
Colorectal Neoplasms, Hereditary Nonpolyposis - epidemiology - etiology
Female
Humans
Male
Middle Aged
Nutritional Status
Risk
Risk factors
Sex Factors
Abstract
Overweight and obesity are linked with several chronic diseases, including colorectal cancer, among men, but results among women are equivocal. Previous evidence suggests that menopausal status, postmenopausal hormone use, and family history of cancer may modify the link between adiposity and colorectal cancer. In data from two population-based case-control studies (cases: 1,292 males and 1,404 females; controls: 1,465 males and 1,203 females) in Ontario and Newfoundland, Canada, we examined the link between colorectal cancer and body mass index (BMI) at two reference periods (BMI 2 years prior and BMI at age 20 years), weight gain since age 20 years, and height. Based on recent BMI indices among men, obesity (BMI >/=30 kg/m(2)) was associated with an 80% [95% confidence interval (95% CI), 1.43-2.27] increased risk of colorectal cancer relative to a normal BMI (18.5-24.9 kg/m(2)). The same comparison for BMI at age 20 years suggested a 94% increased risk of colorectal cancer (95% CI, 1.19-3.16). Odds ratios were similar among subgroups of men with and without a clinically defined familial risk of cancer (according to the Amsterdam or revised Bethesda criteria for Lynch syndrome). Associations were moderately stronger for cancer of the colon than cancer of the rectum. Among women, BMI and weight gain were not linked with colorectal cancer; the null associations were persistent in subgroups of familial risk of cancer, menopausal status, estrogenic status, and subsite. Tall height (>1.75 m), however, was linked with increased risk of colorectal cancer among women (odds ratio, 2.27; 95% CI, 1.46-3.59) but not among men. This study suggests that obesity is associated with increased risk of sporadic and Lynch syndrome-related colon and rectal cancers among men but not among women, whereas height is directly linked with all such cancers among women but not among men.
PubMed ID
17855691 View in PubMed
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Family history of renal disease severity predicts the mutated gene in ADPKD.

https://arctichealth.org/en/permalink/ahliterature150958
Source
J Am Soc Nephrol. 2009 Aug;20(8):1833-8
Publication Type
Article
Date
Aug-2009
Author
Moumita Barua
Onur Cil
Andrew D Paterson
Kairon Wang
Ning He
Elizabeth Dicks
Patrick Parfrey
York Pei
Author Affiliation
Division of Nephrology and Genomic Medicine, Department of Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada.
Source
J Am Soc Nephrol. 2009 Aug;20(8):1833-8
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Aged, 80 and over
Child
Child, Preschool
DNA Mutational Analysis
Humans
Kidney Failure, Chronic - epidemiology - etiology
Middle Aged
Ontario - epidemiology
Polycystic Kidney, Autosomal Dominant - complications - genetics
TRPP Cation Channels - genetics
Young Adult
Abstract
Mutations of PKD1 and PKD2 account for 85 and 15% of cases of autosomal dominant polycystic kidney disease (ADPKD), respectively. Clinically, PKD1 is more severe than PKD2, with a median age at ESRD of 53.4 versus 72.7 yr. In this study, we explored whether a family history of renal disease severity predicts the mutated gene in ADPKD. We examined the renal function (estimated GFR and age at ESRD) of 484 affected members from 90 families who had ADPKD and whose underlying genotype was known. We found that the presence of at least one affected family member who developed ESRD at age 70 was highly predictive of a PKD2 mutation (positive predictive value 100%; sensitivity 74%). These data suggest that close attention to the family history of renal disease severity in ADPKD may provide a simple means of predicting the mutated gene, which has prognostic implications.
Notes
Cites: Q J Med. 1991 Jun;79(290):477-851946928
Cites: Am J Kidney Dis. 1983 May;2(6):630-96846334
Cites: Genet Epidemiol. 1993;10(3):189-2008349100
Cites: Lancet. 1994 Apr 2;343(8901):824-77908078
Cites: Lancet. 1999 Jan 9;353(9147):103-710023895
Cites: Ann Intern Med. 1999 Mar 16;130(6):461-7010075613
Cites: J Am Soc Nephrol. 2005 Mar;16(3):755-6215677307
Cites: Kidney Int. 2005 Apr;67(4):1234-4715780076
Cites: J Am Soc Nephrol. 2006 Nov;17(11):3013-917035604
Cites: J Am Soc Nephrol. 2007 Jul;18(7):2143-6017582161
Cites: Clin J Am Soc Nephrol. 2006 Jul;1(4):710-717699277
Cites: Clin J Am Soc Nephrol. 2006 Sep;1(5):1108-1417699332
Cites: Mol Genet Metab. 2007 Sep-Oct;92(1-2):160-717574468
Cites: Clin J Am Soc Nephrol. 2008 Jan;3(1):146-5218077784
Cites: J Am Soc Nephrol. 2009 Jan;20(1):205-1218945943
Cites: Annu Rev Med. 2009;60:321-3718947299
Cites: Am J Hum Genet. 2001 Feb;68(2):355-6311156533
Cites: J Am Soc Nephrol. 2002 May;13(5):1230-711961010
Cites: J Am Soc Nephrol. 2003 May;14(5):1164-7412707387
Cites: Contrib Nephrol. 1992;97:128-391633713
PubMed ID
19443633 View in PubMed
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Family physician referral rates for lumbar spine computed tomography in Newfoundland and Labrador: a cross-sectional analysis using routinely collected data.

https://arctichealth.org/en/permalink/ahliterature307145
Source
CMAJ Open. 2020 Jan-Mar; 8(1):E56-E59
Publication Type
Journal Article
Author
Gabrielle S Logan
Bethan Copsey
Holly Etchegary
Patrick Parfrey
Krista Mahoney
Amanda Hall
Author Affiliation
Faculty of Medicine (Logan, Etchegary, Parfrey, Mahoney, Hall), Memorial University of Newfoundland, St. John's, Nfld.; Centre for Statistics in Medicine (Copsey), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Primary Health Research Unit (Hall), Memorial University of Newfoundland, St. John's, Nfld. glogan@mun.ca.
Source
CMAJ Open. 2020 Jan-Mar; 8(1):E56-E59
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Factors
Aged
Cross-Sectional Studies
Female
Health Care Surveys
Humans
Lumbar Vertebrae - diagnostic imaging
Male
Middle Aged
Newfoundland and Labrador - epidemiology
Physicians, Family
Primary Health Care - statistics & numerical data
Referral and Consultation - statistics & numerical data
Sex Factors
Tomography, X-Ray Computed
Young Adult
Abstract
Reducing computed tomography (CT) examinations of the lumbar spine is one of Choosing Wisely Canada's initial top 10 recommendations. This study's objective was to report the age- and-sex standardized rates of lumbar spine CT ordered by family physicians in 1 health region in Newfoundland and Labrador.
We conducted a retrospective study using local health data from Meditech, an electronic health record system, from 2013 to 2016 for the Eastern Health Region of Newfoundland and Labrador, the largest health region in the province. Records were included if the referral was for an adult aged 20 years or more, and CT was ordered by a family physician. Lumbar spine CT rates were contextualized with age- and sex-stratified estimates. Population estimates were provided by the Newfoundland and Labrador Centre for Health Information to calculate age- and sex-standardized rates per 100 000 people. We calculated rate ratios to test for statistical significance in differences in rates between years.
A total of 14 370 records were examined. The age- and sex-standardized rates of lumbar spine CT per 100 000 were 1225 in 2013, 1393 in 2014, 1556 in 2015 and 1395 in 2016. The rate ratio was 1.137 (95% confidence interval [CI] 1.084-1.194) for the comparison between 2014 and 2013, 1.117 (95% CI 1.067-1.169) between 2015 and 2014, and 0.896 (95% CI 0.857-0.938) between 2016 and 2015.
The age- and sex-standardized rates suggest that there was a steady rate of lumbar spine CT examinations being ordered by family physicians in Newfoundland and Labrador in 2013-2016. Although all rate ratios were statistically significant, the magnitude of the difference between years is likely not clinically relevant. These rates are important because they serve as a benchmark for future initiatives to reduce unnecessary referrals for lumbar spine CT.
PubMed ID
31992560 View in PubMed
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Genetic structure of the Newfoundland and Labrador population: founder effects modulate variability.

https://arctichealth.org/en/permalink/ahliterature284662
Source
Eur J Hum Genet. 2016 Jul;24(7):1063-70
Publication Type
Article
Date
Jul-2016
Author
Guangju Zhai
Jiayi Zhou
Michael O Woods
Jane S Green
Patrick Parfrey
Proton Rahman
Roger C Green
Source
Eur J Hum Genet. 2016 Jul;24(7):1063-70
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Consanguinity
Founder Effect
Genome, Human
Genotype
Humans
Newfoundland and Labrador
Polymorphism, Single Nucleotide
Population - genetics
Abstract
The population of the province of Newfoundland and Labrador (NL) has been a resource for genetic studies because of its historical isolation and increased prevalence of several monogenic disorders. Controversy remains regarding the genetic substructure and the extent of genetic homogeneity, which have implications for disease gene mapping. Population substructure has been reported from other isolated populations such as Iceland, Finland and Sardinia. We undertook this study to further our understanding of the genetic architecture of the NL population. We enrolled 494 individuals randomly selected from NL. Genome-wide SNP data were analyzed together with that from 14 other populations including HapMap3, Ireland, Britain and Native American samples from the Human Genome Diversity Project. Using multidimensional scaling and admixture analysis, we observed that the genetic structure of the NL population resembles that of the British population but can be divided into three clusters that correspond to religious/ethnic origins: Protestant English, Roman Catholic Irish and North American aboriginals. We observed reduced heterozygosity and an increased inbreeding coefficient (mean=0.005), which corresponds to that expected in the offspring of third-cousin marriages. We also found that the NL population has a significantly higher number of runs of homozygosity (ROH) and longer lengths of ROH segments. These results are consistent with our understanding of the population history and indicate that the NL population may be ideal for identifying recessive variants for complex diseases that affect populations of European origin.
Notes
Cites: Ann Med. 2009;41(3):234-4019160088
Cites: Clin Genet. 2002 Apr;61(4):233-4712030885
Cites: Clin Genet. 2013 Dec;84(6):522-3023278430
Cites: Nat Genet. 2000 Jul;25(3):320-310888882
Cites: Nat Genet. 2000 Jul;25(3):324-810888883
Cites: Hum Mol Genet. 2003 Oct 15;12 Spec No 2:R167-7212915452
Cites: Nat Genet. 2006 May;38(5):556-6016582909
Cites: Nat Genet. 1999 Dec;23(4):397-40410581024
Cites: Am J Med Genet. 1988 Mar;29(3):649-603377008
Cites: Am J Hum Genet. 1999 Dec;65(6):1680-710577922
Cites: Kidney Int. 2005 Apr;67(4):1638-4815780130
Cites: Eur J Hum Genet. 2013 Nov;21(11):1277-8523531865
Cites: Am J Hum Genet. 2008 Apr;82(4):809-2118313022
Cites: Fam Cancer. 2007;6(1):53-6217039269
Cites: Genetics. 2012 Nov;192(3):1065-9322960212
Cites: Science. 2015 Aug 21;349(6250):aab388426198033
Cites: N Engl J Med. 2009 Jun 4;360(23):2426-3719494218
Cites: Nat Rev Genet. 2000 Dec;1(3):182-9011252747
Cites: Bioinformatics. 2005 Jan 15;21(2):263-515297300
Cites: Nature. 2010 Sep 2;467(7311):52-820811451
Cites: Am J Med Genet. 1987 Aug;27(4):807-303425597
Cites: Hum Biol. 2000 Dec;72(6):997-101611236869
Cites: Hum Mol Genet. 2008 Mar 1;17(5):768-7418057069
Cites: PLoS Genet. 2012 Jan;8(1):e100245322291602
Cites: Am J Hum Genet. 2008 Dec;83(6):787-9419061986
Cites: Am J Health Behav. 2009 Sep-Oct;33(5):513-2019296741
Cites: Eur J Hum Genet. 2012 Sep;20(9):956-6422378280
Cites: Genetics. 2013 Apr;193(4):1233-5423410830
Cites: Am J Med Genet A. 2005 Feb 1;132A(4):352-6015637713
Cites: Am J Hum Genet. 2007 Sep;81(3):559-7517701901
Cites: Clin Genet. 2008 Sep;74(3):213-2218684116
Cites: Nature. 2010 Apr 1;464(7289):713-2020360734
Cites: Genome Res. 2009 Sep;19(9):1655-6419648217
Cites: Eur J Hum Genet. 2010 Nov;18(11):1248-5420571510
Cites: Science. 2008 Feb 22;319(5866):1100-418292342
Cites: Nature. 2003 Dec 18;426(6968):789-9614685227
PubMed ID
26669659 View in PubMed
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Health care provider outcomes during and shortly after acute care restructuring in Newfoundland and Labrador.

https://arctichealth.org/en/permalink/ahliterature172214
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:58-67
Publication Type
Article
Date
Oct-2005
Author
Christine Way
Deborah Gregory
Michael Doyle
Laurie Twells
Brendan Barrett
Patrick Parfrey
Author Affiliation
School of Nursing, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada. cway@mun.ca
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:58-67
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Data Collection
Female
Health Care Reform
Hospital Restructuring
Humans
Male
Middle Aged
Newfoundland and Labrador
Organizational Culture
Personnel Administration, Hospital
Personnel, Hospital - psychology
Regional Health Planning
Workplace
Abstract
To monitor changes in human resource indicators during six years of restructuring in Newfoundland and Labrador, and to measure providers' perceptions of reform impact and attitudinal and behavioural reactions comparing changes in the St John's region, where hospital aggregation occurred, to other regions.
Data on human resource indicators from 1995/96 to 2001/02 were obtained and analysed. The Employee Attitude Survey was sent to acute care staff (n = 5353) to assess perceptions of reform impact on workplace conditions, work-related attitudes, turnover intentions and personal characteristics. The response rate for 2000 and 2002 was approximately 42% (n = 1222 and 1034, respectively). Only respondents to both surveys (n = 589) were used in the analysis.
Increases in average employee and full-time equivalent numbers occurred in the St John's region, despite hospital closure and aggregation. Increases in staff dislocation and turnover were observed, but paid sick hours decreased. Sick leave and overtime costs increased. Although perceived workplace conditions, and attitudes and behaviours were generally negative, there was evidence of improvement over time, especially in St John's. Few significant regional or provider group differences were observed on most study variables.
Aggregation of hospitals in St John's did not lead to a decrease in employee counts, or deterioration in human resource indicators or attitudes. However, province-wide initiatives are needed to promote more positive work environments and increase organizational effectiveness.
PubMed ID
16259702 View in PubMed
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22 records – page 1 of 3.