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Manneh B, Andrew MK, Okechukwu CE. Life Satisfaction and Influenza Vaccination Among Older Adults in Canada. Can J Aging 2022; 41:514-22. [PMID: 35899995 DOI: 10.1017/S0714980822000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Older adults have an increased risk of complications or death from influenza. Despite the benefits of vaccination for older adults, vaccination coverage among older adults ages 65 years and over is still below Canada's national target of 80 per cent. As health-care-seeking behaviours are influenced by several factors, including life satisfaction, we investigated the relationship between life satisfaction and influenza vaccination among older adults. A sample (n = 22,424) from the 2015-2016 Canadian Community Health Survey data was analysed using descriptive and multinomial logistic regression analyses. Higher life satisfaction was associated with a more recent influenza vaccination history. Vaccination differed by gender, age, and self-reported health status, as women, much older adults, and those with the poorest health status were more likely to be vaccinated. The study suggests an association between life satisfaction and influenza vaccination. More research into the factors that impact influenza vaccination in older adults is needed to increase vaccination coverage in the older adult population.
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Lin J, Pol SJ, Korczak DJ, Coelho S, Segovia A, Matava CT, Parekh RS, Science M, Caldeira-Kulbakas M, Crosbie J, Carroll S, Greenwood JL, Panzera G, Imgrund R, Anthony SJ. Impact of COVID-19 Public Health Protocols on Teachers Instructing Children and Adolescents During an In-Person Simulation. J Can Acad Child Adolesc Psychiatry 2022; 31:52-63. [PMID: 35614958 PMCID: PMC9084371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/09/2021] [Indexed: 06/15/2023]
Abstract
Objective As a result of the COVID-19 pandemic, public health agencies and school boards across Canada enacted new protocols, including face masks, physical distancing and enhanced hygiene, to support the safe reopening of in-person school. This study explored the experiences and perceptions of teachers instructing children and adolescents in person during a two-day school simulation. Method This study was part of a large school simulation exercise conducted in Toronto, Ontario. Kindergarten to grade 12 teachers taught in classrooms with either masked students, or students who were un-masked or only masked when physical distancing was not possible. A qualitative descriptive phenomenology approach was utilized, and data were collected via virtual focus groups. Qualitative data analysis involved multiple rounds of inductive coding to generate themes. Results The sample included 14 teachers (92.9% female; 85.7% White), with a median of 9.5 years teaching experience. Three primary themes emerged: 1) learning to navigate public health measures, 2) needing to adapt teaching strategies and 3) striving to manage conflicting priorities. The majority of teachers reported that mask-wearing and physical distancing impacted their classroom teaching, communication and connection with students. Conclusions As schools transition to in-person instruction, teachers will be required to play dual roles in education and public health, with implications on safety, teaching and professional identity. Public health agencies and school boards are encouraged to engage teachers in ongoing conversations regarding in-person school planning and operations. Furthermore, evidence-based interventions, including increased teaching development programs, are recommended to support teachers during the COVID-19 pandemic.
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Affiliation(s)
- Jia Lin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
| | - Sarah J Pol
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
| | - Daphne J Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Sophie Coelho
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
| | - Alicia Segovia
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario
| | - Clyde T Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Rulan S Parekh
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Michelle Science
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario
| | | | - Jennifer Crosbie
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario
- Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario
| | - Stacie Carroll
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario
| | - Jodi L Greenwood
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Toronto District School Board, Toronto, Ontario
| | - Giovanna Panzera
- Child and Family Centred Care, The Hospital for Sick Children, Toronto, Ontario
- Education and Community Partnership Program, Toronto District School Board, Toronto, Ontario
| | - Ryan Imgrund
- York Catholic District School Board, Aurora, Ontario
| | - Samantha J Anthony
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario
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Sivarajahkumar S, So M, Morris AM, Lok C, Bell CM, Battistella M. Patterns of Antimicrobial Use in an Outpatient Hemodialysis Unit. Can J Hosp Pharm 2022; 75:15-20. [PMID: 34987258 PMCID: PMC8677003 DOI: 10.4212/cjhp.v75i1.3250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Patients receiving hemodialysis (HD) are at high risk of infections, including those caused by multidrug-resistant organisms. Given that antimicrobial exposure is a major risk factor for the emergence of these resistant organisms, minimizing inappropriate use is imperative. To optimize use, it is important to understand patterns of antimicrobial prescribing in this setting. OBJECTIVES To measure antimicrobial use and to describe prescribing patterns among patients receiving outpatient HD. METHODS A retrospective observational case series study was performed in an outpatient HD unit from February to April 2017. Adults for whom at least 1 antimicrobial was prescribed were included. The primary outcome was total antimicrobial days of therapy (DOT) per 1000 patient-days. Secondary outcomes were the characteristics of the antimicrobial prescriptions, in terms of antimicrobial class, indication, purpose, route, and prescriber group. RESULTS Antimicrobials were prescribed for 53 (16%) of the 330 patients treated in the HD unit during the study period; the total number of prescriptions was 75. Antimicrobial use was 27.5 DOTs/1000 patient-days. Fluoroquinolones were the most frequently prescribed type of antimicrobial (n = 17, 23%), whereas the second most frequently prescribed were first-generation cephalosporins (n = 16, 21%). The most common indication was skin or soft-tissue infection (n = 14, 19%), followed by bloodstream infection (n = 13, 17%). Of the 75 antimicrobials, 48 (64%) were prescribed for empiric therapy, 19 (25%) for targeted therapy, and 8 (11%) for prophylaxis. Two-thirds of the antimicrobials prescribed (n = 50, 67%) were oral medications, and most (n = 72, 96%) were ordered by hospital prescribers. CONCLUSIONS Antimicrobial use was common in this study setting, with 1 in 6 HD patients receiving this type of medication. The findings of this study create opportunities to standardize antimicrobial prescribing at the local level for common infections that occur in patients receiving outpatient HD.
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Affiliation(s)
- Sylvia Sivarajahkumar
- , HBSc, BScPhm, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Miranda So
- , BScPhm, PharmD, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | - Andrew M Morris
- , MD, FRCPC, SM(Epi), is with the University Health Network, the Sinai Health System, and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Charmaine Lok
- , MD, FRCPC, MSc, is with the University Health Network and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Chaim M Bell
- , MD, FRCPC, PhD, is with the University Health Network, the Sinai Health System, and the Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Marisa Battistella
- , BScPhm, PharmD, is with the University Health Network and the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
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Valéria Dias Ferreira M, Gabryelle Nunes Cardoso Mello A, Sena LWP, Regina Matos Lopes T, Luiz Fernandes Vieira J. The extent of chloroquine underdosing in adult patients with malaria by Plasmodium vivax from an endemic area of the Brazilian Amazon basin. Trop Med Int Health 2020; 25:1093-1097. [PMID: 32633099 DOI: 10.1111/tmi.13459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the extent of chloroquine underdosing and to measure the concentrations of chloroquine and desethylchloroquine in adult patients with P. vivax malaria in the Brazilian Amazon basin. METHODS Prospective study of cases in male adult patients with malaria by Plasmodium vivax treated with a total dose of 1500 mg chloroquine over three days and a short course of primaquine. Patients were weighed at admission, and the dose per mg/kg was determined. Blood samples were collected at 24 and 168 h after enrolment, and the concentrations of chloroquine and desethylchloroquine were measured in plasma by high-performance liquid chromatography with fluorescence detection. RESULTS Of 61 patients were included in the study, and 60% received a total dose of chloroquine below 25 mg/kg. Plasma chloroquine concentrations ranged from 90 to 184 ng/ml and from 175 to 827 ng/ml at 24 and 168 hours. For desethylchloroquine, the values ranged from 32 to 144 ng/ml and from 90 to 440 ng/ml at 24 and 168 h. There were no significant correlations between the plasma levels of chloroquine and the doses administered (mg/kg) at 24 and 196 h. Similar results were found for desethylchloroquine. CONCLUSION There is widespread suboptimal dosing of chloroquine that is probably due to the dosing regimen based on patient age, which reduces the drug exposure with a possible influence on parasite clearance.
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