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Accounting for vulnerability to illness and social disadvantage in pandemic critical care triage.

https://arctichealth.org/en/permalink/ahliterature96997
Source
J Clin Ethics. 2010;21(1):23-9
Publication Type
Article
Date
2010
Author
Chris Kaposy
Author Affiliation
Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. christopher.kaposy@med.mun.ca
Source
J Clin Ethics. 2010;21(1):23-9
Date
2010
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Critical Care
Cultural Characteristics
Disaster Planning - trends
Disease Outbreaks
Health Care Rationing - ethics
Health Policy - trends
Humans
Indians, North American - statistics & numerical data
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza, Human - ethnology - mortality - virology
Intensive Care Units - organization & administration - standards
Inuits - statistics & numerical data
Newfoundland and Labrador - epidemiology
Patient Selection - ethics
Prognosis
Risk assessment
Social Class
Triage - methods - organization & administration - standards - trends
Vulnerable Populations
Abstract
In a pandemic situation, resources in intensive care units may be stretched to the breaking point, and critical care triage may become necessary. In such a situation, I argue that a patient's combined vulnerability to illness and social disadvantage should be a justification for giving that patient some priority for critical care. In this article I present an example of a critical care triage protocol that recognizes the moral relevance of vulnerability to illness and social disadvantage, from the Canadian province of Newfoundland and Labrador.
PubMed ID
20465071 View in PubMed
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Source
Can Fam Physician. 2007 Nov;53(11):1961-2
Publication Type
Article
Date
Nov-2007
Author
Graham J Worrall
Author Affiliation
Dr William H. Newhook Memorial Health Centre, Whitbourne, NL. gworrall@mun.ca
Source
Can Fam Physician. 2007 Nov;53(11):1961-2
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Anti-Bacterial Agents - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Child
Child, Preschool
Family Practice - methods
Female
Humans
Incidence
Male
Newfoundland and Labrador - epidemiology
Pharyngitis - drug therapy - epidemiology - microbiology
Risk assessment
Sex Distribution
Streptococcal Infections - diagnosis - drug therapy - epidemiology
Streptococcus agalactiae - drug effects - isolation & purification
Treatment Outcome
Notes
Cites: Ann Intern Med. 2001 Mar 20;134(6):506-811255529
Cites: Cochrane Database Syst Rev. 2006;(4):CD00002317054126
Cites: CMAJ. 1998 Jan 13;158(1):75-839475915
Cites: Clin Infect Dis. 2002 Jul 15;35(2):113-2512087516
PubMed ID
18000276 View in PubMed
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Adapting the Hamilton Health Sciences critical care pandemic triage protocol.

https://arctichealth.org/en/permalink/ahliterature144550
Source
Healthc Q. 2010;13(2):60-3
Publication Type
Article
Date
2010
Author
Chris Kaposy
Natalie Bandrauk
Daryl Pullman
Rick Singleton
Fern Brunger
Author Affiliation
Faculty of Medicine, Division of Community Health and Humanities, at Memorial University of Newfoundland, St. John's, Newfoundland. christopher.kaposy@med.mun.ca
Source
Healthc Q. 2010;13(2):60-3
Date
2010
Language
English
Publication Type
Article
Keywords
Decision Making
Disease Outbreaks
Emergency Service, Hospital
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology - therapy
Newfoundland and Labrador - epidemiology
Organizational Case Studies
Triage - methods - organization & administration
PubMed ID
20357547 View in PubMed
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Adolescent and pre-adolescent suicide in Newfoundland and Labrador.

https://arctichealth.org/en/permalink/ahliterature225937
Source
Can J Psychiatry. 1991 Aug;36(6):432-6
Publication Type
Article
Date
Aug-1991
Author
D. Aldridge
K. St John
Author Affiliation
Lakehead Regional Family Centre, Thunder Bay, Ontario.
Source
Can J Psychiatry. 1991 Aug;36(6):432-6
Date
Aug-1991
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Cause of Death
Child
Cross-Sectional Studies
Female
Humans
Incidence
Indians, North American - psychology - statistics & numerical data
Male
Newfoundland and Labrador - epidemiology
Periodicity
Risk factors
Sex Factors
Suicide - prevention & control - psychology - statistics & numerical data
Abstract
This study investigated suicides by people aged ten to 19 in Newfoundland and Labrador from 1977 to 1988. It is the first study of suicide in the province to use the records of death from all eight hospital pathology departments in the province and from the office of the Chief Forensic Pathologist. Cases were selected for the study using standardized criteria, independent of the manner of death recorded on the death certificate. A suicide rate of 4.37 per 100,000 was found. This rate and the age- and sex-specific suicide rates are lower than the official figures for Canada but higher than those reported in earlier Newfoundland studies. The rate for males was nearly five times the female rate, and the rate for people aged 15 to 19 was nearly six times that of people aged ten to 14. Suicide rates for Labrador were higher than for the island portion of the province for both Native and for non Native adolescents. Extremely high rates of suicide were found only among the Native population living in Northern Labrador, while none were recorded for Native people elsewhere. Firearms accounted for 54% and hanging for 33% of all suicides. Thirty percent of suicides occurred on a Saturday. Only 36 of the 63 deaths included in this study were designated as suicide on death certificates. The higher rate of under-reporting of suicide than in other jurisdictions suggests that official rates may not be useful for comparisons. The reasons for the high rate of under-reporting are discussed.
PubMed ID
1933747 View in PubMed
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Adverse drug events in adult patients leading to emergency department visits.

https://arctichealth.org/en/permalink/ahliterature144829
Source
Ann Pharmacother. 2010 Apr;44(4):641-9
Publication Type
Article
Date
Apr-2010
Author
Khokan C Sikdar
Reza Alaghehbandan
Don MacDonald
Brendan Barrett
Kayla D Collins
Jennifer Donnan
Veeresh Gadag
Author Affiliation
Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NL, Canada. khokan.sikdar@nlchi.nl.ca
Source
Ann Pharmacother. 2010 Apr;44(4):641-9
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Data Collection
Drug-Related Side Effects and Adverse Reactions
Emergency Medical Services - statistics & numerical data
Female
Hospitals - statistics & numerical data
Humans
Male
Middle Aged
Newfoundland and Labrador - epidemiology
Retrospective Studies
Sex Factors
Socioeconomic Factors
Terminology as Topic
Treatment Outcome
Young Adult
Abstract
Adverse drug events (ADEs) occurring in the community and treated in emergency departments (EDs) have not been well studied.
To determine the prevalence, severity, and preventability of ADEs in patients presenting at EDs in 2 university-affiliated tertiary care hospitals in the Canadian province of Newfoundland and Labrador.
A retrospective chart review was conducted on a stratified random sample (n = 1458) of adults (> or =18 y) who presented to EDs from January 1 to December 31, 2005. Prior to the chart review, the sample frame was developed by first eliminating visits that were clearly not the result of an ADE. The ED summary of each patient was initially reviewed by 2 trained reviewers in order to identify probable ADEs. All eligible charts were subsequently reviewed by a clinical team, consisting of 2 pharmacists and 2 ED physicians, to identify ADEs and determine their severity and preventability.
Of the 1458 patients presenting to the 2 EDs, 55 were determined to have an ADE or a possible ADE (PADE). After a sample-weight adjustment, the prevalence of ADEs/PADEs was found to be 2.4%. Prevalence increased with age (0.7%, 18-44 y; 1.9%, 45-64 y; 7.8%, > or =65 y) and the mean age for patients with ADEs was higher than for those with no ADEs (69.9 vs 63.8 y; p
PubMed ID
20233911 View in PubMed
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An investigation of cancer rates in the Argentia region, Newfoundland and Labrador: an ecological study.

https://arctichealth.org/en/permalink/ahliterature274996
Source
J Environ Public Health. 2015;2015:421562
Publication Type
Article
Date
2015
Author
Pauline Duke
Marshall Godwin
Mandy Peach
Jacqueline Fortier
Stephen Bornstein
Sharon Buehler
Farah McCrate
Andrea Pike
Peizhong Peter Wang
Richard M Cullen
Source
J Environ Public Health. 2015;2015:421562
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Canada - epidemiology
Child
Child, Preschool
Environmental Pollutants - analysis
Humans
Incidence
Infant
Infant, Newborn
Middle Aged
Neoplasms - epidemiology - etiology
Newfoundland and Labrador - epidemiology
Young Adult
Abstract
The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region.
Cases of cancer diagnosed between 1985 and 2011 were obtained for the Argentia region, two comparison communities, and the province of Newfoundland and Labrador. Crude and age-standardized incidence rates of cancer diagnosis were calculated and compared. The crude incidence rate was adjusted for differences in age demographics using census data, and age-standardized incidence rates were compared.
Although the Argentia region had a higher crude rate of cancer diagnosis, the age-standardized incidence rate did not differ significantly from the comparison communities or the provincial average. Argentia has an aging population, which may have influenced the perception of increased cancer diagnosis in the community.
We did not detect an increased burden of cancer in the Argentia region.
Notes
Cites: Am J Public Health. 2000 Aug;90(8):1300-210937014
Cites: Am J Epidemiol. 1990 Jul;132(1 Suppl):S48-522356835
Cites: Occup Environ Med. 1996 Nov;53(11):782-69038804
Cites: J Hazard Mater. 2006 Aug 25;136(3):406-1716386833
Cites: Occup Environ Med. 2007 Jun;64(6):402-817259164
Cites: JAMA. 2007 Jun 6;297(21):2360-7217545690
Cites: Int J Circumpolar Health. 2013;72. doi: 10.3402/ijch.v72i0.2118723984298
Cites: Am J Public Health. 2014 Jul;104(7):1204-824832152
Cites: J Pediatr. 2014 Dec;165(6):1216-2125241182
PubMed ID
26633979 View in PubMed
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An Investigation of Comorbid Disease and Health Service Utilization Among Patients With Moderate to Severe Psoriasis in Newfoundland and Labrador.

https://arctichealth.org/en/permalink/ahliterature301343
Source
J Cutan Med Surg. 2019 Jan/Feb; 23(1):29-34
Publication Type
Journal Article
Author
Wayne P Gulliver
Shane Randell
Susanne Gulliver
Don Macdonald
Valerie Gregory
Sean Nagle
Olivier Chambenoit
Author Affiliation
1 Newlab Clinical Research, St. John's, NL, Canada.
Source
J Cutan Med Surg. 2019 Jan/Feb; 23(1):29-34
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Cardiovascular Diseases - epidemiology
Comorbidity
Cross-Sectional Studies
Depression - epidemiology
Female
Humans
Inflammatory Bowel Diseases - epidemiology
Male
Middle Aged
Newfoundland and Labrador - epidemiology
Patient Acceptance of Health Care - statistics & numerical data
Psoriasis - epidemiology
Retrospective Studies
Abstract
Psoriasis is an inflammatory skin condition affecting 2% to 3% of the population and is associated with several comorbidities, including cardiovascular disease, depression, inflammatory bowel disease, metabolic syndrome, mood disorder, psoriatic arthritis, and weight gain. Psoriasis is treated with a number of topical and systemic therapies, including biologic drugs that directly target proinflammatory cytokines. This cross-sectional retrospective study investigated comorbid conditions reported in the Newfoundland and Labrador psoriasis population, outcomes associated with therapeutic treatment, and use of health care resources. Of the psoriasis comorbidities investigated, psoriatic arthritis was significantly associated with the use of biologic therapy while a failure to respond to biologics was associated with a higher incidence of cardiovascular disease. Patients responsive to biologic treatment had fewer hospital stays than patients treated with other therapies. Our results suggest that biologic therapies have a cardioprotective effect and reduce the number of hospital visits in patients whose symptoms are responsive to treatment.
PubMed ID
30041544 View in PubMed
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Association of RBP4 gene variants and serum HDL cholesterol levels in the Newfoundland population.

https://arctichealth.org/en/permalink/ahliterature147534
Source
Obesity (Silver Spring). 2010 Jul;18(7):1393-7
Publication Type
Article
Date
Jul-2010
Author
Jennifer L Shea
J Concepción Loredo-Osti
Guang Sun
Author Affiliation
Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
Source
Obesity (Silver Spring). 2010 Jul;18(7):1393-7
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adult
Cholesterol, HDL - blood
Female
Gene Frequency
Genetic Predisposition to Disease - epidemiology
Genetic Variation
Genotype
Glucose Intolerance - epidemiology - genetics
Homeostasis - genetics
Humans
Hyperlipidemias - epidemiology - genetics
Insulin Resistance - genetics
Lipid Metabolism - genetics
Male
Middle Aged
Newfoundland and Labrador - epidemiology
Obesity - epidemiology - genetics
Polymorphism, Single Nucleotide
Retinol-Binding Proteins, Plasma - genetics
Risk factors
Abstract
Retinol-binding protein 4 (RBP4) is a novel adipokine that likely contributes to systemic insulin resistance and dyslipidemia. The role of genetic variations in RBP4 on phenotypes of glucose and lipid metabolism is not clear in humans. The purpose of this study was to examine five single-nucleotide polymorphisms (SNPs) in the RBP4 gene to determine their relationship with markers of insulin resistance and serum lipids in the CODING Study. The CODING Study consists of 1,836 subjects recruited from the genetically homogeneous population of Newfoundland and Labrador (NL), Canada. Serum glucose, insulin, homeostasis model assessment of insulin resistance (HOMA(IR)), HOMA for beta cell function (HOMA(beta)), total cholesterol (Chol), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were determined after a 12-h fast. Five SNPs within RBP4 (rs3758539, G/A 5' flanking region; rs61461737, A/G intron; rs10882280, C/A intron; rs11187545, A/G intron; and rs12265684, C/G intron) were genotyped using TaqMan validated or functionally tested SNP genotyping assays. After correcting for multiple testing, we observed a significant association between the minor allele of two noncoding SNPs (rs10882280 and rs11187545) and higher serum HDL-C (P = 0.043 and 0.042, respectively). No significant associations were observed with any other parameter related to lipid metabolism. We also found no significant association between any variant sites and markers of insulin resistance. Our results suggest that genetic variations in RBP4 may play a role in the differences in serum HDL-C levels in the NL population.
PubMed ID
19893506 View in PubMed
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189 records – page 1 of 19.