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Access to syringes for HIV prevention for injection drug users in St. Petersburg, Russia: syringe purchase test study.

https://arctichealth.org/en/permalink/ahliterature115926
Source
BMC Public Health. 2013;13:183
Publication Type
Article
Date
2013
Author
Ekaterina V Fedorova
Roman V Skochilov
Robert Heimer
Patricia Case
Leo Beletsky
Lauretta E Grau
Andrey P Kozlov
Alla V Shaboltas
Author Affiliation
The Biomedical Center, 8, Viborgskaya Street, St. Petersburg 194044, Russia. ekaterina_fedorova@yahoo.com
Source
BMC Public Health. 2013;13:183
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Commerce - methods
Female
HIV Infections - etiology - prevention & control
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Male
Pharmacies - classification - legislation & jurisprudence - statistics & numerical data
Pharmacists - psychology - statistics & numerical data
Professional Practice Location - statistics & numerical data
Qualitative Research
Questionnaires
Russia
Substance Abuse, Intravenous - complications - epidemiology
Syringes - economics - supply & distribution
Abstract
The HIV epidemic in Russia is concentrated among injection drug users (IDUs). This is especially true for St. Petersburg where high HIV incidence persists among the city's estimated 80,000 IDUs. Although sterile syringes are legally available, access for IDUs may be hampered. To explore the feasibility of using pharmacies to expand syringe access and provide other prevention services to IDUs, we investigated the current access to sterile syringes at the pharmacies and the correlation between pharmacy density and HIV prevalence in St. Petersburg.
965 pharmacies citywide were mapped, classified by ownership type, and the association between pharmacy density and HIV prevalence at the district level was tested. We selected two districts among the 18 districts--one central and one peripheral--that represented two major types of city districts and contacted all operating pharmacies by phone to inquire if they stocked syringes and obtained details about their stock. Qualitative interviews with 26 IDUs provided data regarding syringe access in pharmacies and were used to formulate hypotheses for the pharmacy syringe purchase test wherein research staff attempted to purchase syringes in all pharmacies in the two districts.
No correlation was found between the density of pharmacies and HIV prevalence at the district level. Of 108 operating pharmacies, 38 (35%) did not sell syringes of the types used by IDUs; of these, half stocked but refused to sell syringes to research staff, and the other half did not stock syringes at all. Overall 70 (65%) of the pharmacies did sell syringes; of these, 49 pharmacies sold single syringes without any restrictions and 21 offered packages of ten.
Trainings for pharmacists need to be conducted to reduce negative attitudes towards IDUs and increase pharmacists' willingness to sell syringes. At a structural level, access to safe injection supplies for IDUs could be increased by including syringes in the federal list of mandatory medical products sold by pharmacies.
Notes
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PubMed ID
23452390 View in PubMed
Less detail

The acute care nurse practitioner in Ontario: a workforce study.

https://arctichealth.org/en/permalink/ahliterature154071
Source
Nurs Leadersh (Tor Ont). 2008;21(4):100-16
Publication Type
Article
Date
2008
Author
Christina Hurlock-Chorostecki
Mary van Soeren
Sharon Goodwin
Author Affiliation
Parkwood Hospital of St. Joseph's Health Care, London, Ontario, Canada. tina.hurlock-chorostecki@sjhc.london.on.ca
Source
Nurs Leadersh (Tor Ont). 2008;21(4):100-16
Date
2008
Language
English
Publication Type
Article
Keywords
Acute Disease - nursing
Health Care Surveys
Humans
Job Satisfaction
Nurse Practitioners - statistics & numerical data
Nurse's Role
Nursing Staff, Hospital - statistics & numerical data
Ontario
Professional Autonomy
Professional Practice Location
Salaries and Fringe Benefits
Task Performance and Analysis
Abstract
In spite of the long history of nurse practitioner practice in primary healthcare, less is known about nurse practitioners in hospital-based environments because until very recently, they have not been included in the extended class registration (nurse practitioner equivalent) with the College of Nurses of Ontario. Recent changes in the regulation of nurse practitioners in Ontario to include adult, paediatric and anaesthesia, indicates that a workforce review of practice profiles is needed to fully understand the depth and breadth of the role within hospital settings. Here, we present information obtained through a descriptive, self-reported survey of all nurse practitioners working in acute care settings who are not currently regulated in the extended class in Ontario. Results suggest wide acceptance of the role is concentrated around academic teaching hospitals. Continued barriers exist related to legislation and regulation as well as understanding and support for the multiple aspects of this role beyond clinical practice. This information may be used by nurse practitioners, nursing leaders and other administrators to position the role in hospital settings for greater impact on patient care. As well, understanding the need for regulatory and legislative changes to support the hospital-based Nurse Practitioner role will enable greater impact on health human resources and healthcare transformation.
PubMed ID
19029848 View in PubMed
Less detail

Adherence to guidelines on antibiotic treatment for respiratory tract infections in various categories of physicians: a retrospective cross-sectional study of data from electronic patient records.

https://arctichealth.org/en/permalink/ahliterature271494
Source
BMJ Open. 2015;5(7):e008096
Publication Type
Article
Date
2015
Author
David Tell
Sven Engström
Sigvard Mölstad
Source
BMJ Open. 2015;5(7):e008096
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Anti-Bacterial Agents - therapeutic use
Child
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Electronic Health Records
Female
General Practice - statistics & numerical data
Guideline Adherence - statistics & numerical data
Humans
Internship and Residency - statistics & numerical data
Male
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Professional Practice Location
Respiratory Tract Infections - drug therapy
Retrospective Studies
Sex Factors
Sweden
Young Adult
Abstract
To study how prescription patterns concerning respiratory tract infections differ between interns, residents, younger general practitioners (GPs), older GPs and locums.
Retrospective study of structured data from electronic patient records.
Data were obtained from 53 health centres and 3 out-of-hours units in Jönköping County, Sweden, through their common electronic medical record database.
All physicians working in primary care during the 2-year study period (1 November 2010 to 31 October 2012).
Physicians' adherence to current guidelines for respiratory tract infections regarding the use of antibiotics.
We found considerable differences in prescribing patterns between physician categories. The recommended antibiotic, phenoxymethylpenicillin, was more often prescribed by interns, residents and younger GPs, while older GPs and locums to a higher degree prescribed broad-spectrum antibiotics. The greatest differences were seen when the recommendation in guidelines was to refrain from antibiotics, as for acute bronchitis. Interns and residents most often followed guidelines, while compliance in descending order was: young GPs, older GPs and locums. We also noticed that male doctors were somewhat overall more restrictive with antibiotics than female doctors.
In general, primary care doctors followed national guidelines on choice of antibiotics when treating respiratory tract infections in children but to a lesser degree when treating adults. Refraining from antibiotics seems harder. Adherence to national guidelines could be improved, especially for acute bronchitis and pneumonia. This was especially true for older GPs and locums whose prescription patterns were distant from the prevailing guidelines.
Notes
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Cites: Lakartidningen. 2013 Apr 3-16;110(27-28):1282-423951882
PubMed ID
26179648 View in PubMed
Less detail

Advocate or abdicate: the responsible choice for today's emergency medicine resident.

https://arctichealth.org/en/permalink/ahliterature152110
Source
CJEM. 2009 Mar;11(2):123
Publication Type
Article
Date
Mar-2009
Author
Alan Drummond
Source
CJEM. 2009 Mar;11(2):123
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Canada
Career Choice
Emergency Medicine - manpower
Humans
Internship and Residency
Professional Practice Location - statistics & numerical data
Questionnaires
Notes
Comment On: CJEM. 2009 Jan;11(1):99-10019166648
PubMed ID
19280721 View in PubMed
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An alumni study of a Master's in international health.

https://arctichealth.org/en/permalink/ahliterature306909
Source
Public Health. 2020 Apr; 181:168-170
Publication Type
Journal Article
Date
Apr-2020
Author
H Kismul
W Hasha
S G Hinderaker
B E Moen
Author Affiliation
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5009, Bergen, Norway. Electronic address: hallgeir.kismul@uib.no.
Source
Public Health. 2020 Apr; 181:168-170
Date
Apr-2020
Language
English
Publication Type
Journal Article
Keywords
Education, Graduate
Education, Public Health Professional
Employment
Global Health - education
Goals
Humans
Norway
Professional Practice Location
Program Evaluation
Students - psychology
Surveys and Questionnaires
Universities
Abstract
The objective of the study was to clarify the reasons why students who graduated from a Master's programme in international health were joining the programme. Another objective was to document how the Master's degree had influenced the careers of the graduates.
An online survey of students who graduated from a Master's programme in international health, including oral science, between 2010 and 2015.
The study used an anonymous questionnaire that contained 28 items. Topics included information such as demographics, questions about the reasons for joining the Master's programme and the benefits and influence of the programme on the career of the students.
Of the 102 alumni who were invited to participate, 70 responded. The response rate was 69%, and we have no information about the non-responders. The results showed that the main reasons for students enrolling in the programme were to improve their competence and develop their career. Around 63% of the respondents reported that the programme had increased their competencies in the jobs they had, whereas 24% answered that their increased qualifications had enabled them to acquire new positions. Thus successfully completing the programme had a positive influence on the graduates' careers in international health. Most of the graduates, who were working, were typically employed at hospitals and universities. Several graduates had proceeded to gain further qualifications by now being enrolled in a PhD programme.
Among the 70% of responders in this survey, the master's programme had benefitted the alumni and the programme had fulfilled their expectations. The programme had a positive influence on the alumni in areas such as increased competency, development of their careers, new positions and better salaries.
PubMed ID
32062171 View in PubMed
Less detail

Are Canadian General Internal Medicine training program graduates well prepared for their future careers?

https://arctichealth.org/en/permalink/ahliterature166469
Source
BMC Med Educ. 2006;6:56
Publication Type
Article
Date
2006
Author
Sharon E Card
Linda Snell
Brian O'Brien
Author Affiliation
Department of Medicine, University of Saskatchewan, Saskatoon, Canada. sharon.card@saskatoonhealthregion.ca
Source
BMC Med Educ. 2006;6:56
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Clinical Competence
Competency-Based Education
Curriculum
Education, Medical, Graduate - standards
Female
Humans
Institutional Practice - classification - statistics & numerical data
Internal Medicine - education
Male
Needs Assessment
Professional Practice Location - statistics & numerical data
Program Evaluation
Questionnaires
Abstract
At a time of increased need and demand for general internists in Canada, the attractiveness of generalist careers (including general internal medicine, GIM) has been falling as evidenced by the low number of residents choosing this specialty. One hypothesis for the lack of interest in a generalist career is lack of comfort with the skills needed to practice after training, and the mismatch between the tertiary care, inpatient training environment and "real life". This project was designed to determine perceived effectiveness of training for 10 years of graduates of Canadian GIM programs to assist in the development of curriculum and objectives for general internists that will meet the needs of graduates and ultimately society.
Mailed survey designed to explore perceived importance of training for and preparation for various aspects of Canadian GIM practice. After extensive piloting of the survey, including a pilot survey of two universities to improve the questionnaire, all graduates of the 16 universities over the previous ten years were surveyed.
Gaps (difference between importance and preparation) were demonstrated in many of the CanMEDS 2000/2005 competencies. Medical problems of pregnancy, perioperative care, pain management, chronic care, ambulatory care and community GIM rotations were the medical expert areas with the largest gaps. Exposure to procedural skills was perceived to be lacking. Some procedural skills valued as important for current GIM trainees and performed frequently (example ambulatory ECG interpretation) had low preparation ratings by trainees. Other areas of perceived discrepancy between training and practice included: manager role (set up of an office), health advocate (counseling for prevention, for example smoking cessation), and professional (end of life issues, ethics).
Graduates of Canadian GIM training programs over the last ten years have identified perceived gaps between training and important areas for practice. They have identified competencies that should be emphasized in Canadian GIM programs. Ongoing review of graduate's perceptions of training programs as it applies to their current practice is important to ensure ongoing appropriateness of training programs. This information will be used to strengthen GIM training programs in Canada.
Notes
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PubMed ID
17112385 View in PubMed
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Assessing the suitability of host communities for secondary palliative care hubs: a location analysis model.

https://arctichealth.org/en/permalink/ahliterature152185
Source
Health Place. 2009 Sep;15(3):792-800
Publication Type
Article
Date
Sep-2009
Author
Jonathan Cinnamon
Nadine Schuurman
Valorie A Crooks
Author Affiliation
Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada V5A 1S6. jca80@sfu.ca
Source
Health Place. 2009 Sep;15(3):792-800
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
British Columbia
Geographic Information Systems
Health Services Accessibility
Health services needs and demand
Humans
Models, Theoretical
Palliative Care
Professional Practice Location
Rural Population
Terminally ill
Abstract
An increased need for palliative care has been acknowledged world-wide. However, recent Canadian end-of-life care frameworks have largely failed to consider the unique challenges of delivery in rural and remote regions. In the Canadian province of British Columbia (BC), urban areas are well-served for specialized palliative care; however, rural and remote regions are not. This study presents a location analysis model designed to determine appropriate locations to allocate palliative care services. Secondary palliative care hubs (PCH) are introduced as an option for delivering these services in rural and remote regions. Results suggest that several BC communities may be appropriate locations for secondary PCHs. This model could be applied to the allocation of palliative care resources in other jurisdictions with similar rural and remote regions.
PubMed ID
19269241 View in PubMed
Less detail

Association between proximity to the attending nephrologist and mortality among patients receiving hemodialysis.

https://arctichealth.org/en/permalink/ahliterature160680
Source
CMAJ. 2007 Oct 23;177(9):1039-44
Publication Type
Article
Date
Oct-23-2007
Author
Marcello Tonelli
Braden Manns
Bruce Culleton
Scott Klarenbach
Brenda Hemmelgarn
Natasha Wiebe
John S Gill
Author Affiliation
Division of Nephrology and Transplant Immunology, Department of Medicine, University of Alberta, Edmonton, Alta. mtonelli-admin@med.ualberta.ca
Source
CMAJ. 2007 Oct 23;177(9):1039-44
Date
Oct-23-2007
Language
English
Publication Type
Article
Keywords
Aged
Canada - epidemiology
Female
Health Services Accessibility
Humans
Male
Middle Aged
Professional Practice Location
Proportional Hazards Models
Prospective Studies
Registries
Renal Dialysis - mortality
Renal Insufficiency - epidemiology - therapy
Risk factors
Survival Rate
Travel
Abstract
Many Canadian patients who receive hemodialysis live far from their attending nephrologist, which may affect clinical outcomes. We investigated whether patients receiving hemodialysis who live farther from their attending nephrologist are more likely to die than those who live closer.
We studied a random sample of 18,722 patients who began hemodialysis between 1990 and 2000 in Canada. We calculated the distance between each patient's residence location at the start of dialysis and the practice location of their attending nephrologist. We used Cox proportional hazards models to examine the adjusted relation between distance and clinical outcomes (death from all causes, infectious causes and cardiovascular causes) over a follow-up period of up to 14 years.
During the follow-up period (median 2.5 yr, interquartile range 1.0-4.7 yr), 11,582 (62%) patients died. Compared with patients who lived within 50 km of their nephrologist, the adjusted hazard ratio of death among those who lived 50.1-150 km away was 1.06 (95% confidence interval [CI] 1.01-1.12), 1.13 (95% CI 1.04-1.22) for those who lived 150.1-300 km away and 1.13 (95% CI 1.03-1.24) for those who lived more than 300 km from their nephrologist (p for trend
Notes
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Comment In: CMAJ. 2007 Oct 23;177(9):1055-617954895
PubMed ID
17954893 View in PubMed
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Attracting dental graduates to rural locations: evaluation of the Saskatchewan initiative.

https://arctichealth.org/en/permalink/ahliterature233863
Source
Can J Community Dent. 1988;3(2):24-8
Publication Type
Article
Date
1988

204 records – page 1 of 21.