Newfoundland and Labrador doctors seek double-digit pay hikes.
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ABSTRACT:
SUBMITTER: Casey Q
PROVIDER: S-EPMC2871235 | biostudies-literature | 2010 May
REPOSITORIES: biostudies-literature
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Newfoundland and Labrador doctors seek double-digit pay hikes.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20100412 8
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Project description: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.
| S-EPMC5070906 | biostudies-literature
Project description:Freshwater fish populations are rapidly declining globally due to the impacts of rapid climate change and existing non-climatic anthropogenic stressors. In response to these drivers, freshwater fishes are responding by shifting their distribution range, altering the timing of migration and spawning and through demographic processes. By 2050, the mean daily air temperature is predicted to increase by 2 to 3 degrees C in insular Newfoundland and by 3 to 4 degrees C in Labrador. Mean daily precipitation is also projected to increase in all locations, with increased intensity projected for several regions. To mitigate negative consequences of these changes, managers require analytical approaches that describe the vulnerability of fish to climate change. To address this need, the current study adopts the National Marine Fisheries Service vulnerability assessment framework to characterize the vulnerability of freshwater fishes in Newfoundland and Labrador. Twelve vulnerability indicators were developed from an extensive literature review and applied to the assessment. Experts were solicited using an online questionnaire survey and scores for exposure, sensitivity and adaptive capacity were collated and analyzed to derive a final vulnerability score and rank for each species. The analysis showed one species to be of high-very high vulnerability, two species were highly vulnerable while four species were moderately vulnerable to climate change. The result provides insight into the factors that drive vulnerability of freshwater fishes in the region, this information is significant to decision-makers and other stakeholders engaged in managing freshwater fish resources in Newfoundland and Labrador.
| S-EPMC6277096 | biostudies-literature
Project description:Globally, fisheries have been the site of multiple documented outbreaks of COVID-19. Existing studies point to the threat posed by the pandemic to livelihoods and health among migrant industrial fishery workers, small-scale fish harvesters, and fishing communities. They show the pandemic enhanced safety, economic, social and political layers of vulnerability in fisheries, while also showcasing examples of resilience. Case studies of COVID-19 response provide an opportunity to explore how existing organizational structures, leadership and networks in fisheries can enable the rapid co-development of customized strategies for fishing safely during large-scale global disruptions such as pandemics. This article contributes to our understanding of governance and fishing safety in small-scale fisheries during the early pandemic, examining the response of small-scale fisheries in the Canadian province of Newfoundland and Labrador. These seasonal fisheries successfully opened with regulator approval after a short delay and operated without documented COVID-19 outbreaks during 2020. Findings draw from key informant interviews with a safety sector association and union leader, complemented with insights from an anonymous online survey of small-scale harvesters. Interviews capture the organizational processes and resources mobilized to rapidly co-develop the COVID-19 Safe Work Practice Guideline. Online survey findings indicate that fifty-nine percent of respondents (crew and skippers) had no COVID-19-related concerns while fishing in 2020; older harvesters and owner-operators were significantly more likely to indicate concerns. When asked about the relative practicality of listed COVID-19 precautions, respondents commonly identified sanitization, reduced interactions with shore workers, social distancing, protection equipment, modifications to eating/rest areas, and reduced crew as impractical. These assessments are generally consistent with those of the interviewed leaders and the Guideline approach. This suggests the co-developed Guideline provided tailored and practical COVID-19 prevention strategies. Pre-existing governance structures and networks can help address small-scale fisheries vulnerabilities to pandemics by supporting co-development of organizational resources and evidence-informed prevention strategies.
| S-EPMC9483834 | biostudies-literature
Project description:Mothers have a significant influence on family dynamics, child development, and access to family services. There is a lack of literature on the typical Canadian maternal experience and its influence on access to services for mothers despite recognizing the importance of mothers. A cross-sectional study was conducted to address this research gap that employed Andersen's Behavioral Model of Health Service Use in conjunction with a feminist lens. A total of 1,082 mothers who resided in Newfoundland and Labrador (NL) participated in a province-wide survey in 2017 and reported on their wellbeing, family life, and healthcare utilization. Stepwise binomial logistic regressions and linear regressions were used to predict initiation and continued service utilization within the preceding 12 months, respectively. Mothers who participated in this survey were older, and were more likely to be in a relationship than those in the Canadian census, while no difference was observed in annual income. Approximately half of mothers accessed services for themselves over the previous 12-months, with the overwhelming majority accessing services for their children. Medical services were the most likely to be utilized, and mental health and behavioural services were the most likely services to be needed, but not available. Sociodemographic (e.g., age, education attainment), familial relationships and role satisfaction, health need, and health practices predicted maternal initiation and continued use of services, with a larger number of variables influencing maternal service initiation as compared to continuous use of services. Sociodemographic (e.g., maternal age, community population), maternal social support, health need, and maternal health practices predicted maternal access of at least one child service while family relationships, health need, and maternal health practices predicted maternal use of a range of child services conditional on initial access. These results can support the provincial health system to better support access to care by acknowledging the interdependent nature of maternal and child health care utilization. They also highlight the importance of equitable healthcare access in rural locations. Results are discussed in terms of their clinical relevance to health policy.
| S-EPMC11233017 | biostudies-literature
Project description:BackgroundData that have been reported on antimicrobial use in Newfoundland and Labrador (NL) do not appear to be representative of use at the population level. We sought to use pharmacy network data on prescriptions to describe outpatient antimicrobial use in NL.MethodsWe analyzed all outpatient antimicrobial prescriptions dispensed between June 1, 2017, and June 8, 2021, from the provincial pharmacy network database and translated deidentified data into SPSS. We excluded prescriptions for parenteral and topical antimicrobials, antivirals and antifungals. We described antimicrobial use using the prescription rate and defined daily dose (DDD) rate.ResultsOverall, we analyzed 1 586 534 prescriptions dispensed to 394 708 people by 3431 prescribers. The rate of antimicrobial use was 741 prescriptions per 1000 population per year (7161 DDD/1000 population/yr). The median duration of prescriptions was 7 (interquartile range 7-10) days. The prescription rate decreased from 867 to 546 per 1000 population per year (-37%) over the study period, and the mean DDD rate decreased from 8387 to 5356 DDD per 1000 population per year (-36.1%). Antimicrobials with the highest DDD rate were amoxicillin (1568 DDD/1000/yr), doxycycline (864 DDD/1000/yr) and ciprofloxacin (633 DDD/1000/yr). Prescribers wrote a mean of 102 (standard deviation 248) prescriptions per year; 3 prescribers wrote more than 2500 prescriptions per year. Overall, 9203 (2.3%) of the 394 708 people in the study population received 4 or more prescriptions per year.InterpretationThe rate of antimicrobial use in NL is lower than previously described in national surveillance data. Potential targets for stewardship intervention include prolonged duration of prescriptions, high-rate prescribers and high-rate patients, but further research is needed to assess the appropriateness of prescriptions according to diagnosis.
| S-EPMC10699289 | biostudies-literature
Project description:IntroductionResidents of rural regions may have higher and unique suicide risks. Newfoundland and Labrador (NL) is a Canadian province replete with rural regions. Despite an abundance of rural suicide research, heterogeneity in rural regions may preclude amalgamating findings to inform prevention efforts. Thus, exploring the unique needs of NL is needed. Importantly, health care providers (HCP) may afford unique perspectives on the suicide-related needs or concerns of rural life. We asked HCPs of residents of rural NL their perceived suicide risk factors, concerns, and needs for rural NL.MethodTwelve HCPs of rural residents of NL completed virtual semi-structured interviews. Interviews were analysed using reflexive thematic analysis [13,14].ResultsHCPs noted individual, psychological, social, and practical factors linked to rural-suicide risk and subsequent needs. Findings highlight the unique challenges of residing and providing health care in rural NL and inform prevention and intervention efforts.
| S-EPMC11318929 | biostudies-literature
Project description:BackgroundAlthough the province of Newfoundland and Labrador has the highest rates of chronic disease in Canada, the current state of many chronic diseases in the province, including diabetes mellitus, has not been well explored. We profiled the demographic characteristics associated with, and the management of, diabetes in Newfoundland and Labrador, including any rural-urban differences.MethodsWe performed a population-based, cross-sectional analysis using data from the provincial Chronic Disease Registry for fiscal year 2015/16. Patients in the study sample were 20 years of age or older, with documented identifiers for age, sex and geographic location. We examined demographic characteristics, results of screening and diabetes clinical tests (glycated hemoglobin [HbA1c], low-density lipoprotein [LDL] cholesterol and urine albumin-to-creatinine ratio) and hospitalization rates. We described and compared demographic, clinical and hospitalization variables across urban and rural residents of the province.ResultsThe study sample consisted of 66 325 individuals with diabetes in Newfoundland and Labrador (mean age 64.1 yr; 56.3% rural residents). Larger proportions of rural than urban residents with diabetes were aged 65 to 79 years (41.2% v. 37.5%), were female (50.2% v. 48.7%) and were identified as having the disease by laboratory tests only (19.6% v. 13.1%). Rural residents had worse clinical test outcomes than their urban counterparts, specifically with respect to HbA1c (mean and standard deviation [SD], 7.41% [SD 1.49] v. 7.26% [SD 1.50]) and LDL cholesterol (mean 2.46 [SD 0.95] v. mean 2.36 [SD 0.94] mmol/L). A total of 13.7% of individuals were admitted to hospital during the cohort year, with slightly more rural residents admitted for renal disease (standardized difference 0.021, 95% confidence interval 0.005 to 0.036).InterpretationFor many individuals with diabetes in Newfoundland and Labrador, recommended targets for diabetes management are not being met, and residents in rural areas have poorer clinical outcomes. To inform the development and implementation of targeted provincial strategies for chronic disease management, further research is needed to determine how outcomes relate to the availability of primary health care services.
| S-EPMC7759100 | biostudies-literature
Project description:In many jurisdictions, public health authorities have implemented travel restrictions to reduce coronavirus disease 2019 (COVID-19) spread. Policies that restrict travel within countries have been implemented, but the impact of these restrictions is not well known. On 4 May 2020, Newfoundland and Labrador (NL) implemented travel restrictions such that non-residents required exemptions to enter the province. We fit a stochastic epidemic model to data describing the number of active COVID-19 cases in NL from 14 March to 26 June. We predicted possible outbreaks over nine weeks, with and without the travel restrictions, and for contact rates 40-70% of pre-pandemic levels. Our results suggest that the travel restrictions reduced the mean number of clinical COVID-19 cases in NL by 92%. Furthermore, without the travel restrictions there is a substantial risk of very large outbreaks. Using epidemic modelling, we show how the NL COVID-19 outbreak could have unfolded had the travel restrictions not been implemented. Both physical distancing and travel restrictions affect the local dynamics of the epidemic. Our modelling shows that the travel restrictions are a plausible reason for the few reported COVID-19 cases in NL after 4 May.
| S-EPMC8206704 | biostudies-literature
Project description:BackgroundThe suicide rate in Canada decreased by 24% during the past four decades. However, rates vary between provinces and territories, and not all jurisdictions experienced the same changes. This study examined suicide rates over time in the province of Newfoundland and Labrador.MethodsWe used cross-sectional surveillance data from the Canadian Vital Statistics Death Database to examine suicide rates in Newfoundland and Labrador from 1981 to 2018. We calculated annual age-standardized suicide mortality rates and used joinpoint regression to estimate the average annual percent change (AAPC) in suicide rates overall and by sex, age group, and means of suicide.ResultsFrom 1981 to 2018, 1759 deaths by suicide were recorded among people in Newfoundland and Labrador. The age-standardized suicide mortality rate increased more than threefold over the study period, from 4.6 to 15.4 deaths per 100,000. The suicide rate was higher among males than females, and accounted for 83.1% of suicide deaths (n = 1462); the male-to-female ratio of suicide deaths was 4.9 to 1. The average annual percent change in suicide rates was higher among females than males (6.3% versus 2.0%). Age-specific suicide rates increased significantly for all age groups, except seniors (aged 65 or older); the largest increase was among youth aged 10 to 24 years old (AAPC 3.5; 95% CI, 1.6 to 5.5). The predominant means of suicide was hanging/strangulation/suffocation, which accounted for 43.8% of all deaths by suicide.ConclusionsThe suicide rate in Newfoundland and Labrador increased steadily between 1981 and 2018, which was in contrast to the national rate decline. The disparity between the provincial and national suicide rates and the variations by sex and age underscore the need for a public health approach to prevention that accounts for geographic and demographic differences in the epidemiology of suicide.
| S-EPMC8252247 | biostudies-literature
Project description: Not available
| S-EPMC1309674 | biostudies-literature