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Porter B, Orrell R, Graham A, Watt S, Lunt P, Norwood F, Roberts M, Willis T, Matthews E, Muni-Lofra R, Marini-Bettolo C. FSHD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Arnone R, Romano G, Skinner J, Watt S, Poenicke C, Hoestergard D, Chiaramonte G. Improving the operational skills of the health personnel working in the emergency departments. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In December 2013 the European Commission approved the project promoted by CEFPAS, The Centre for Training and Research in Public Health within the programme PROGRESS, “Improving the operational skills of health personnel working in the emergency departments. A useful tool to give concrete answers to EU policies on patients’ safety and to create new working opportunities”.
This project aimed to combine the need to find innovative solutions in the field of healthcare with the objective of increasing the safety of patients in emergency departments, while also covering the need to promote worker mobility within the European Union. The key tool for implementing this goal is the exchange of experience and best practices.
The project partners included: the Edinburgh University of Medicine, the Napier University (again in Edinburgh), the Dresden University of Technology, the Herlev Hospital (in Copenhagen) through the DIMS or the Danish Institute for Medical Simulation at the University of Copenhagen, as well as ISMETT and CREAM (the Research Centre of the University of Medicine) in Palermo.
Every partner, during the planning, has provided the know how developed in the area of emergency. Specifically it has been analyzed the possibility to compare and visit the simulation Centres of Edinburgh, Dresden and Palermo, and to study the use, in each country, of innovative methodology during the training of the health personnel.
The partner, during the planning of the project, studied also how to help people to find easier jobs opportunities in the health sector (so they thought to create a specific data base of the emergency departments operating in Italy, Scotland and Germany where to find a job or a chance for an internship).
The project has lasted for one year and has provided research activities and the exchange of experience and best practices.
Key messages
There is a huge difference regarding the way in which the emergency system is organized within single countries around Europe. Comparing high-level organisations we have benefited in terms of ideas, projects and potential objectives to be set in order to improve our work and to improve results for patients.
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Affiliation(s)
| | | | - J Skinner
- Edinburgh University of Medicine, Edinburgh, UK
| | - S Watt
- Napier University, Edinburgh, UK
| | - C Poenicke
- Dresden University of technology, Dresden, Germany
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Monmousseau F, Pradère B, Dubnitskiy-Robin S, Watt S, Le Fol T, Bruyère F, Rusch E, Faivre d’Arcier B, Brunet-Houdard S. Remplacer tous les urétéroscopes réutilisables par des dispositifs à usage unique ou adopter une stratégie mixte dans le traitement des lithiases urinaires ? Étude de la valeur-seuil reposant sur un modèle d’impact budgétaire. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dubnitskiy-Robin S, Pradère B, Faivre D’Arcier B, Watt S, Le Fol T, Bruyère F, Rusch E, Monmousseau F, Brunet-Houdard S. Analyse d’impact budgétaire du passage au « tout usage unique » pour la prise en charge des lithiases urinaires par urétéroscopie dans un établissement public de santé. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Vehling S, Tian Y, Malfitano C, Shnall J, Watt S, Mehnert A, Rydall A, Zimmermann C, Hales S, Lo C, Rodin G. Attachment security and existential distress among patients with advanced cancer. J Psychosom Res 2019; 116:93-99. [PMID: 30655000 DOI: 10.1016/j.jpsychores.2018.11.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Felt security in close relationships may affect individual adaptation responses to existential threat in severe illness. We examined the contribution of attachment security to demoralization, a state of existential distress involving perceived pointlessness and meaninglessness in advanced cancer. METHOD A mixed cross-sectional sample of 382 patients with advanced cancer (mean age 59, 60% female) was recruited from outpatient oncology clinics. Participants completed self-report measures of attachment security, demoralization, depression, and physical symptom burden. We used multiple linear regression to analyze the association between attachment security and demoralization, controlling for demographic factors and symptom burden and tested whether attachment security moderated the association of symptom burden with demoralization. Separate analyses compared the contribution of the dimensions of attachment anxiety and attachment avoidance. RESULTS The prevalence of clinically relevant demoralization was 35%. Demoralization was associated with lower attachment security (β = -0.54, 95%CI: -0.62 to 0.46). This effect was empirically stronger for attachment anxiety (β = 0.52, 95%CI: 0.44 to 0.60) compared to attachment avoidance (β = 0.36, 95%CI: 0.27 to 0.45). Attachment security also significantly moderated the association of physical symptom burden with demoralization, such that with less attachment security, there was a stronger association between symptom burden and demoralization. CONCLUSION Attachment security may protect from demoralization in advanced cancer. Its relative lack, particularly on the dimension of attachment anxiety, may limit adaptive capacities to deal with illness burden and to sustain morale and purpose in life. An understanding of individual differences in attachment needs can inform existential interventions for severely ill individuals.
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Affiliation(s)
- S Vehling
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Y Tian
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - C Malfitano
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - J Shnall
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - S Watt
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - A Mehnert
- Department of Medical Psychology and Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - A Rydall
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - C Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - S Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - C Lo
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Canada
| | - G Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Roach D, Jameson MG, Dowling JA, Ebert MA, Greer PB, Kennedy AM, Watt S, Holloway LC. Correlations between contouring similarity metrics and simulated treatment outcome for prostate radiotherapy. ACTA ACUST UNITED AC 2018; 63:035001. [DOI: 10.1088/1361-6560/aaa50c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hernandez D, Kronsteiner B, Tarunina M, Hua P, Partington L, Baboo J, Rologi E, Hassan E, Chan A, Watt S, Choo Y. Using CombiCult® screening platform to discover optimal protocols for ex vivo expansion of hematopoietic stem cells from cord blood and bone marrow. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roach D, Jameson M, Dowling J, Ebert M, Greer P, Watt S, Holloway L. EP-1728: Inter-observer contouring similarity metrics, correlation with treatment outcome for prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32260-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Asomaning K, Abramsky S, Liu Q, Zhou X, Sobel RE, Watt S. Re: Letter written in reaction to "Pregabalin prescriptions in the United Kingdom: a drug utilisation study of The Health Improvement Network (THIN) primary care database", by Pottegård et al. - The authors (Asomaning et al.) respond. Int J Clin Pract 2016; 70:697-8. [PMID: 27466016 DOI: 10.1111/ijcp.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- K Asomaning
- Department of Epidemiology, Pfizer Inc, New York, NY, USA.
| | - S Abramsky
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - Q Liu
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - X Zhou
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - R E Sobel
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - S Watt
- Department of Medical Affairs, Pfizer Inc, New York, NY, USA
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Asomaning K, Abramsky S, Liu Q, Zhou X, Sobel RE, Watt S. Pregabalin prescriptions in the United Kingdom: a drug utilisation study of The Health Improvement Network (THIN) primary care database. Int J Clin Pract 2016; 70:380-8. [PMID: 27028939 DOI: 10.1111/ijcp.12791] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM In Europe, pregabalin is approved for treatment of neuropathic pain, general anxiety disorder (GAD) and as adjunctive therapy for epilepsy. The purpose of this study was to assess utilisation of pregabalin in the UK, including patients with a recorded history of substance abuse, from a large general practice database. METHODS This observational drug utilisation study (DUS) analysed pregabalin prescription data from the UK Health Improvement Network primary care database between September 2004 and July 2009. Patient demographics, diagnoses (by READ codes) and pregabalin dosing data were collected. Diagnosis codes were used as proxy for approved indication for pregabalin. RESULT A cohort of 18,951 patients was prescribed pregabalin; dosing information was available for 13,480 (71.1%). Median age of patients was 58 years, and majority were female (60.1%). Median (interquartile range) prescribed average daily dose (ADD) of pregabalin for all patients was 150.0 (162.5) mg/day; this was highest in patients with epilepsy (191.9 mg/day), followed by neuropathic pain (158.0 mg/day) and GAD (150.0 mg/day). Only 1.0% (136/13,480) of patients were prescribed an ADD of pregabalin over the maximum approved dose of 600 mg/day. Of these, 18.4% (25/136) of patients had a history of substance abuse compared with 14.0% (1884/13,480) in the full population. CONCLUSION Data from this DUS indicated that the majority of pregabalin prescribing in the UK was consistent with product labelling. The proportion of patients with prescribed ADD > 600 mg/day was small and with a similar proportion with a history of substance abuse as in the full population.
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Affiliation(s)
- K Asomaning
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - S Abramsky
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - Q Liu
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - X Zhou
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - R E Sobel
- Department of Epidemiology, Pfizer Inc, New York, NY, USA
| | - S Watt
- Department of Medical Affairs, Pfizer Inc, New York, NY, USA
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Priestly J, Simonsson P, Watt S, Campbell C. Changes to the World Anti-Doping Code and what that means for the Medical Professionals working with Australian athletes. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Affiliation(s)
- Liz Brodie
- Lecturer in mental health and substance misuse
| | | | - Susan Watt
- Senior lecturer in nursing at Edinburgh Napier University
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Raimbault M, Watt S, Bourgoin H, Brichart N, Bruyère F. Analyse comparative coût–efficacité de la photovaporisation prostatique par laser Greenlight et de l’adénomectomie pour hypertrophie de la prostate de gros volume. Prog Urol 2014; 24:470-6. [DOI: 10.1016/j.purol.2013.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/03/2013] [Accepted: 12/08/2013] [Indexed: 10/25/2022]
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Watt S. Water, Women & Health: The Dilemma of the Two Goats. Glob Bioeth 2014. [DOI: 10.1080/11287462.2011.10800691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S. Watt
- Professor, School of Social Work McMaster University 1280 Main Street West- KTH 309 Hamilton, ON L8S 4M4, Canada
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Holland A, Smith F, McCrossan G, Adamson E, Watt S, Penny K. Online video in clinical skills education of oral medication administration for undergraduate student nurses: a mixed methods, prospective cohort study. Nurse Educ Today 2013; 33:663-70. [PMID: 22341996 DOI: 10.1016/j.nedt.2012.01.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 01/16/2012] [Accepted: 01/20/2012] [Indexed: 05/13/2023]
Abstract
BACKGROUND Improvements in the safety of the prescribing, dispensing and administration of medicines are identified as a priority across international healthcare systems. It is therefore essential that higher education institutions play their part in helping to meet this patient safety objective. New developments in clinical skills education which are aligned to emerging educational theory are available, but evaluations and supportive evidence are limited. OBJECTIVES To evaluate the use of an online best practice exemplar as an adjunct to the clinical skills teaching of oral medication administration to undergraduate student nurses. DESIGN Mixed-methods prospective cohort design. SETTINGS AND PARTICIPANTS Two intakes of undergraduate nursing students (n=168, n=154) undertaking a first year clinical skills based module at a British university. METHODS The Control group received standard teaching using lectures and skills classes facilitated by experienced clinical skills lecturers. The Intervention group received the standard teaching and unlimited access to an online video clip of medication administration. Performance and satisfaction were measured using module assessment results and a satisfaction questionnaire. Qualitative data were gathered using focus groups (n=16, n=20). RESULTS The Intervention group was significantly (p=0.021) more likely to pass the assessment and rate their satisfaction with the teaching significantly higher (p<0.05) on more than half of the items from the Student Satisfaction Survey. Two Categories were identified from focus group data; Classroom Learning and Transfer to Practice. Classroom Learning included four themes of Peers, Self, Teaching and Time and when Classroom Learning was positive, the Transfer to Practice of the clinical skill was enhanced. CONCLUSIONS An online video of a best practice exemplar as an adjunct to taught clinical skills sessions improves student assessment results and satisfaction ratings. The video was also reported to positively influence all themes identified in Classroom Learning and was perceived to promote the Transfer to Practice of teaching input.
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Affiliation(s)
- Agi Holland
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, United Kingdom.
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Stewart M, Letourneau N, Masuda JR, Anderson S, Cicutto L, McGhan S, Watt S. Support needs and preferences of young adolescents with asthma and allergies: "just no one really seems to understand". J Pediatr Nurs 2012; 27:479-90. [PMID: 22920659 DOI: 10.1016/j.pedn.2011.06.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Revised: 06/13/2011] [Accepted: 06/21/2011] [Indexed: 10/17/2022]
Abstract
The objectives of this study were to identify support needs, support resources, and support barriers for young adolescents with asthma and allergies and to describe preferences for an accessible support intervention. Adolescents (N = 57) completed a survey questionnaire. Eight young adolescents, 10 parents, and 5 older adolescents participated in separate group interviews. Young adolescents' challenges included transition to self-care, balancing restrictions with safety, social isolation, and loneliness. Young teens recommended supportive networks facilitated by older adolescent peers and wanted to meet with other young adolescents living with asthma and allergies online and share information, advice, and encouragement with them.
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Affiliation(s)
- Susan Watt
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University
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McIntosh B, Watt S. Snakes and ladders: human resources in nursing. Br J Nurs 2012; 21:849. [PMID: 23252166 DOI: 10.12968/bjon.2012.21.14.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Watt S, Sword W, Sheehan D, Foster G, Thabane L, Krueger P, Landy CK. The effect of delivery method on breastfeeding initiation from the The Ontario Mother and Infant Study (TOMIS) III. J Obstet Gynecol Neonatal Nurs 2012; 41:728-37. [PMID: 22823063 DOI: 10.1111/j.1552-6909.2012.01394.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To report on the relationship between delivery method (cesarean vs. vaginal) and type (planned vs. unplanned) and breastfeeding initiation in hospital and continuation to 6 weeks postpartum as self-reported by study participants. DESIGN Quantitative sequential mixed methods design. SETTING Women were recruited from 11 hospital sites in Ontario, Canada. PARTICIPANTS Participants included 2,560 women age 16 years or older who delivered live, full-term, singleton infants. METHODS Data were collected from an in-hospital questionnaire, hospital records, and a 6-week postpartum interview. RESULTS Ninety-two percent of women reported initiating breastfeeding, and 74% continued to 6 weeks. The method of delivery, when defined as cesarean versus vaginal, was not a determining factor in breastfeeding initiation in hospital or in the early postdischarge period. An unexpected delivery method (i.e., unplanned cesarean or instrument-assisted vaginal deliveries) was associated, at a statistically significant level, with an increased likelihood of initiating breastfeeding and continuation to 6 weeks postdischarge. CONCLUSION Breastfeeding can be considered a coping strategy that serves to normalize an abnormal experience and allows the individual to once again assume control. These unexpected results warrant further investigation to understand why women make the decision to initiate breastfeeding, why they choose to continue breastfeeding, and how they can be supported to achieve exclusive breastfeeding as recommended for infants in the first 6 months.
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Affiliation(s)
- Susan Watt
- School of Social Work, McMaster University, Hamilton, ON, Canada.
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Cheng JJ, Schuster-Wallace CJ, Watt S, Newbold BK, Mente A. An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environ Health 2012; 11:4. [PMID: 22280473 PMCID: PMC3293047 DOI: 10.1186/1476-069x-11-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 01/27/2012] [Indexed: 05/25/2023]
Abstract
BACKGROUND Water and sanitation access are known to be related to newborn, child, and maternal health. Our study attempts to quantify these relationships globally using country-level data: How much does improving access to water and sanitation influence infant, child, and maternal mortality? METHODS Data for 193 countries were abstracted from global databases (World Bank, WHO, and UNICEF). Linear regression was used for the outcomes of under-five mortality rate and infant mortality rate (IMR). These results are presented as events per 1000 live births. Ordinal logistic regression was used to compute odds ratios for the outcome of maternal mortality ratio (MMR). RESULTS Under-five mortality rate decreased by 1.17 (95%CI 1.08-1.26) deaths per 1000, p < 0.001, for every quartile increase in population water access after adjustments for confounders. There was a similar relationship between quartile increase of sanitation access and under-five mortality rate, with a decrease of 1.66 (95%CI 1.11-1.32) deaths per 1000, p < 0.001. Improved water access was also related to IMR, with the IMR decreasing by 1.14 (95%CI 1.05-1.23) deaths per 1000, p < 0.001, with increasing quartile of access to improved water source. The significance of this relationship was retained with quartile improvement in sanitation access, where the decrease in IMR was 1.66 (95%CI 1.11-1.32) deaths per 1000, p < 0.001. The estimated odds ratio that increased quartile of water access was significantly associated with increased quartile of MMR was 0.58 (95%CI 0.39-0.86), p = 0.008. The corresponding odds ratio for sanitation was 0.52 (95%CI 0.32-0.85), p = 0.009, both suggesting that better water and sanitation were associated with decreased MMR. CONCLUSIONS Our analyses suggest that access to water and sanitation independently contribute to child and maternal mortality outcomes. If the world is to seriously address the Millennium Development Goals of reducing child and maternal mortality, then improved water and sanitation accesses are key strategies.
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Affiliation(s)
- June J Cheng
- Public Health and Preventive Medicine Residency Program, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, ON, Canada
| | - Corinne J Schuster-Wallace
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, ON, Canada
- School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Institute of Environment and Health, McMaster University, Hamilton, ON, Canada
| | - Susan Watt
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, ON, Canada
- School of Social Work, McMaster University, Hamilton, ON, Canada
| | - Bruce K Newbold
- School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
- McMaster Institute of Environment and Health, McMaster University, Hamilton, ON, Canada
| | - Andrew Mente
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, David Braley Cardiac, Vascular, and Stroke Research Institute, Hamilton General Hospital, Hamilton, ON, Canada
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Abstract
The global picture of maternal mortality and morbidity has changed very little over the past 20 years despite isolated (and often medically based) efforts to improve the situation. A multidisciplinary approach to this very complicated social and cultural problem has been recommended. This article describes the approach taken by the Save the Mothers program in Uganda (Master of Public Health Leadership) and its focus on training national, primarily nonmedical, advocates to bring about the political and cultural change needed to improve maternal health. Emphasis is placed on attracting the right students (through targeted advertising and interviews of candidates), delivering the appropriate package of information to these multidisciplinary students (through problem-based learning and experiential opportunities in the community), and fostering networks among students and graduates to keep the issue of maternal mortality high on their personal and political agendas. Students benefit from a flexible program that allows them to continue to work and study simultaneously while ensuring a high-quality program with faculty who are experts in their area of teaching. Students require practical assistance in their research endeavors and are encouraged to focus their topic on a field related to their place of employment.
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Watt S, Mullaly D, Harcourt P. The anti-doping landscape now and beyond—A practical guide to assist athlete support personnel in the prevention of doping. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sword W, Kurtz Landy C, Thabane L, Watt S, Krueger P, Farine D, Foster G. Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study. BJOG 2011; 118:966-77. [DOI: 10.1111/j.1471-0528.2011.02950.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Stewart M, Masuda JR, Letourneau N, Anderson S, Cicutto L, McGhan S, Watt S. Online Support Intervention for Adolescents With Asthma and Allergies. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/2150129711402686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives. To determine appropriate components and contents of an online peer support intervention for young adolescents and to evaluate intervention processes, perceived benefits, and satisfaction with the intervention. Methods. Three months of support were provided through synchronous chat, e-mail exchange, instant messaging, and bulletin boards. Online support group sessions were facilitated by trained peer mentors (older youth/young adults with asthma and allergies) and health professionals. Participant use of online options was tracked (eg, log-ons, e-mails, chat minutes). Qualitative data were elicited from peer mentor reports, online support group chat transcripts, project coordinators’ field notes, peer mentor exit interviews, and adolescent telephone interviews. Results. Almost all adolescents were satisfied with this online support intervention. Topics discussed in the support groups were pertinent to their educational and support needs. Peer mentors provided emotional, affirmation, and information support. Participants appreciated opportunities for social comparison and reciprocal exchange of support with peers. Conclusion and implications. A major contribution was documentation of the complex intervention ingredients and processes through qualitative and quantitative methods that elicited diverse stakeholders’ perspectives. This strategy enables adaptation and integration into practice. Adolescents who benefited most felt isolated, suggesting the importance of targeting vulnerable youth for support programs.
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Affiliation(s)
- Miriam Stewart
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Jeffrey R. Masuda
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Nicole Letourneau
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Sharon Anderson
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Lisa Cicutto
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Shawna McGhan
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
| | - Susan Watt
- University of Alberta, Edmonton, Alberta (MS, SA)
- University of Manitoba, Winnipeg, Manitoba (JRM)
- University of New Brunswick, Fredericton, New Brunswick (NL)
- University of Toronto, Toronto, Ontario (LC)
- Alberta Asthma Centre, Edmonton, Alberta (SM)
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Stewart M, McGhan S, Watt S, Anderson S, Masuda JR, Letourneau N, Sharpe HM. Health Professionals’ Preparation for Supporting Children and Parents Affected by Asthma and Allergies. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/2150129710388032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although social support originates from sources both informal (eg, family, peers) and formal (eg, health professionals), most reported research focuses on informal support providers. The perspectives and learning needs of health professionals as potential support providers for children and families affected by asthma and allergies form a gap in the reported research. The objective of this study was to assess health professionals’ learning needs and preferences pertinent to the support and education of children with asthma and allergies. A 26-item online survey and qualitative interviews (n, 10) elicited information from health professionals about the perceived support and educational needs of children with asthma and allergies, experience and challenges working with children, health professionals’ educational needs regarding support of children, and continuing education needs and barriers. Health professionals believed that children needed professional education, support, and strategies to reduce the effects of asthma and allergies on their lifestyle. Time (66.0%) and cost (80.9%) were significant barriers to non-Web-based education, but only 14.6% rated time and cost a barrier to Web-based education. Family or work commitments were slightly greater obstacles for non-Web-based education (63.8%) than for Web-based education (51.2%). Although these health professionals were interested in learning from and connecting with their peers, promoting peer support for children with asthma and allergies received a lower rating on their list of educational needs. This needs assessment study confirms that health professionals have limited time, funds, and options for asthma- and allergy-related professional development activities. It validates the need and value of Web-based education with access to an instructor, experts, and group discussions, and it supports the inclusion of asthma-specific information and practical skills for teaching children and for addressing challenges when teaching. Exposure to and understanding of the value of incorporating peer support and social support into existing health programs may be limited.
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Affiliation(s)
- Miriam Stewart
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Shawna McGhan
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Susan Watt
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Sharon Anderson
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Jeffrey R. Masuda
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Nicole Letourneau
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
| | - Heather M. Sharpe
- Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (MS)
- Alberta Asthma Centre, Department of Medicine, University of Alberta (SM)
- School of Social Work, McMaster University, Hamilton, Ontario, Canada (SW)
- Social Support Research Program, University of Alberta (SA)
- Department of Environment and Geography, University of Manitoba, Winnipeg, Manitoba, Canada (JRM)
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Watt S, Owens C. ASADA: Australia's driving force for pure performance in sport. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2010.10.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Stewart M, Reid G, Brown JB, Burge F, Dicenso A, Watt S, McWilliam C, Beaulieu MD, Meredith L. Development and implementation of training for interdisciplinary research in primary health care. Acad Med 2010; 85:974-979. [PMID: 20505396 DOI: 10.1097/acm.0b013e3181dbe31f] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The authors describe a national training program in Canada focusing on research in primary health care (PHC). The program, sponsored by the Canadian Institutes of Health Research's Strategic Training in Health Research Program, is called Transdisciplinary Understanding and Training on Research-Primary Health Care (TUTOR-PHC); it began in 2002 and is funded to continue until 2015. The purpose-built curriculum has two main goals: (1) to build a cadre of skilled, independent researchers to enhance the evidence base for PHC practice and policy and (2) to increase the interdisciplinary focus in PHC research. The program consists of three elements: (1) a three-day on-site symposium, (2) four online workshops (three weeks each), and (3) two online interdisciplinary discussion groups (seven weeks each). Participants develop PHC research skills during in-person and online workshops. They gain knowledge of and experience in interdisciplinary PHC research through participation in interdisciplinary discussion groups and by observing mentor interactions. Both the symposium and the online components involve a variety of interactive education approaches. The 77 graduates from across Canada represent 14 disciplines, most commonly family medicine, nursing, epidemiology, psychology, social work, and sociology. Graduates of the program publish at a high rate and are building their careers in PHC research. The structure of TUTOR-PHC encourages not only skill development and content uptake but also the exchange of tacit knowledge. The complete program leads to a synthesis of skills, knowledge, personal communication abilities, and cross-discipline curiosity, creating a well-rounded collaborative PHC researcher.
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Affiliation(s)
- Moira Stewart
- Department of Family Medicine, The University of Western Ontario, London, Ontario, Canada.
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Keefe B, Elsby M, Watt S. Visually guided grasping: Using a small stimulus set can lead to overestimation of the effectiveness of depth cues. J Vis 2010. [DOI: 10.1167/8.6.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Watt S, Keefe B, Hibbard P. Visual uncertainty predicts grasping when monocular cues are removed but not when binocular cues are removed. J Vis 2010. [DOI: 10.1167/8.6.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Takahashi C, Diedrichsen J, Watt S. The brain integrates visual and haptic information from different spatial locations when using a tool. J Vis 2010. [DOI: 10.1167/8.6.1060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mellanby RJ, Broadhurst C, Wondafrash M, Ewnetu M, Watt S, Critchlow R, Dadesa A, Deas T, Enawgaw C, Gebremedhin B, Graham E, Maclean S, Ross B. Perceptions of habitat changes in the Yabelo Sanctuary and surrounding areas. Afr J Ecol 2010. [DOI: 10.1111/j.1365-2028.2009.01087.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sword W, Watt S, Krueger P, Thabane L, Landy CK, Farine D, Swinton M. The Ontario Mother and Infant Study (TOMIS) III: a multi-site cohort study of the impact of delivery method on health, service use, and costs of care in the first postpartum year. BMC Pregnancy Childbirth 2009; 9:16. [PMID: 19397827 PMCID: PMC2688481 DOI: 10.1186/1471-2393-9-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 04/28/2009] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The caesarean section rate continues to rise globally. A caesarean section is inarguably the preferred method of delivery when there is good evidence that a vaginal delivery may unduly risk the health of a woman or her infant. Any decisions about delivery method in the absence of clear medical indication should be based on knowledge of outcomes associated with different childbirth methods. However, there is lack of sold evidence of the short-term and long-term risks and benefits of a planned caesarean delivery compared to a planned vaginal delivery. It also is important to consider the economic aspects of caesarean sections, but very little attention has been given to health care system costs that take into account services used by women for themselves and their infants following hospital discharge. METHODS AND DESIGN The Ontario Mother and Infant Study III is a prospective cohort study to examine relationships between method of delivery and maternal and infant health, service utilization, and cost of care at three time points during the year following postpartum hospital discharge. Over 2500 women were recruited from 11 hospitals across the province of Ontario, Canada, with data collection occurring between April 2006 and October 2008. Participants completed a self-report questionnaire in hospital and structured telephone interviews at 6 weeks, 6 months, and 12 months after discharge. Data will be analyzed using generalized estimating equation, a special generalized linear models technique. A qualitative descriptive component supplements the survey approach, with the goal of assisting in interpretation of data and providing explanations for trends in the findings. DISCUSSION The findings can be incorporated into patient counselling and discussions about the advantages and disadvantages of different delivery methods, potentially leading to changes in preferences and practices. In addition, the findings will be useful to hospital- and community-based postpartum care providers, managers, and administrators in guiding risk assessment and early intervention strategies. Finally, the research findings can provide the basis for policy modification and implementation strategies to improve outcomes and reduce costs of care.
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Affiliation(s)
- Wendy Sword
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
| | - Susan Watt
- School of Social Work, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8N 4M4, Canada
| | - Paul Krueger
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada
- St. Joseph's Health System Research Network, 99 Wayne Gretzky Parkway, Suite 105, Brantford, Ontario, N3S 6T6, Canada
| | - Lehana Thabane
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada
- Biostatistics Unit, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada
| | - Christine Kurtz Landy
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
| | - Dan Farine
- Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada
| | - Marilyn Swinton
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
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Ross J, Macdiarmid J, Osman L, Watt S, Lawson A. Health-related quality of life in former North Sea divers. Occup Med (Lond) 2007; 57:611-2; author reply 612. [DOI: 10.1093/occmed/kqm119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chamberlain J, Watt S, Mohide P, Muggah H, Trim K, Bantebya Kyomuhendo G. Women's perception of self-worth and access to health care. Int J Gynaecol Obstet 2007; 98:75-9. [PMID: 17459386 DOI: 10.1016/j.ijgo.2007.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Revised: 03/13/2007] [Accepted: 03/13/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVE : Research has shown differences in health status and health care utilization related to culture, economic status, and health care development. This paper reports on a study comparing attitudes of women in three countries, at various stages of development, about their own health and self-worth and asks if these differences account for differences in health care utilization and inequities in health status. METHOD : A questionnaire, administered to 100 women in each of Yemen, Uganda and Canada, explored women's perception of their own health and health care seeking behavior. RESULT : Women's perception of themselves as worthy of care was positively related to utilization. The ability to make one's own health care decisions varied with her country's development level. Implementation strategies must consider women's decision-making capacity. CONCLUSION : To achieve improved health status, policies and programs must commit to encouraging appropriate social and cultural changes, using a 'cross-sectoral approach', involving both gender and development issues.
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Affiliation(s)
- J Chamberlain
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Martin-Rendon E, Brunskill S, Doree C, Hyde C, Watt S, Mathur A. Stem cell treatment for acute myocardial infarction. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2007. [DOI: 10.1002/14651858.cd006536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Affiliation(s)
| | - Pat Dudgeon
- Centre for Aboriginal Studies, Curtin University of Technology, Bentley
| | - Susan Watt
- School of Psychology, University of New England
| | - Brian Griffiths
- School of Psychology, Curtin University of Technology, Bentley, Western Australia, Australia
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Abstract
OBJECTIVE To describe immigrant women's postpartum health, service needs, access to services, and service use during the first 4 weeks following hospital discharge compared to women born in Canada. DESIGN Data were collected as part of a larger cross-sectional study. SETTING Women were recruited from 5 hospitals purposefully selected to provide a diverse sample. PARTICIPANTS A sample of 1,250 women following vaginal delivery of a healthy infant; approximately 31% were born outside of Canada. MAIN OUTCOME MEASURES Self-reported health status, postpartum depression, postpartum needs, access to services, service use. RESULTS Immigrant women were significantly more likely than Canadian-born women to have low family incomes, low social support, poorer health, possible postpartum depression, learning needs that were unmet in hospital, and a need for financial assistance. However, they were less likely to be able to get financial aid, household help, and reassurance/support. There were no differences between groups in ability to get care for health concerns. CONCLUSIONS Health care professionals should attend not only to the basic postpartum health needs of immigrant women but also to their income and support needs by ensuring effective interventions and referral mechanisms.
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Affiliation(s)
- Wendy Sword
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.
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Abstract
The Ontario Mother and Infant Study II examined changes in postpartum health outcomes, including breastfeeding initiation and discontinuation, for mothers and their infants and compared these results to data collected prior to the initiation of the Universal Hospital Stay and Postpartum Home Visiting Program policy change in 1998. Data were collected using cross-sectional surveys before discharge and at 4 weeks postdischarge. Ninety percent of the women surveyed at 4 weeks postpartum initiated breastfeeding. Of these, 84% were still breastfeeding at 4 weeks postpartum. None of the 3 major program components-extended length of stay, a postpartum phone call from a public health worker, or a postpartum in-home visit-were associated with breastfeeding continuation to 4 weeks. Discontinuation before 4 weeks postdischarge was associated with maternal attitudes toward breastfeeding, formula feeding or supplementation in hospital, infant readmission, and use of walk-in clinics for infant care.
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Affiliation(s)
- Debbie Sheehan
- Family Health Division, City of Hamilton Public Health Services, Dundas, ON, Canada
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Rosemond A, Lanotte P, Watt S, Sauget AS, Guerif F, Royère D, Goudeau A, Mereghetti L. Existe-t-il un bénéfice au dépistage systématique de Chlamydia trachomatis, Mycoplasma hominis et Ureaplasma urealyticum dans les prélèvements génito-urinaires réalisés au cours d'un bilan d'infertilité ? ACTA ACUST UNITED AC 2006; 54:125-9. [PMID: 16298086 DOI: 10.1016/j.patbio.2005.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2004] [Accepted: 09/27/2005] [Indexed: 10/25/2022]
Abstract
We conducted a prospective study on 100 couples consulting for infertility at the teaching Hospital of Tours, with the scope to determine if there is a benefit for systematic screening of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum among genito-urinary specimen when exploring couples infertility. C. trachomatis was detected by PCR on sperm, endocervix and urine specimen. M. hominis and U. urealyticum were detected by culture on A7 agar medium and with minigaleries on sperm and endocervix specimen. Standard cultures were also performed on sperm, endocervix, vaginal and urine specimen. Only one specimen (sperm) was positive for C. trachomatis. Three percent of the specimen were positive for U. urealyticum (from which 2,5% of the sperm specimen). No specimen was positive for M. hominis. Our results show that screening of C. trachomatis, M. hominis and U. urealyticum is not systematically required for among check up of infertile couples, given the prevalence of chlamydiosis among the population studied. However, it would be interesting to perform it on a targeted population, according to anamnestic or clinical criteria. In addition, an important modification of vaginal flora was observed in 12% of cases, and 2 vaginosis were diagnosed; the putative consequences of this disequilibrium has to be further investigated.
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Affiliation(s)
- A Rosemond
- Service de Bactériologie-Virologie, Hôpital Bretonneau, CHRU de Tours, 37044 Tours cedex, France
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Watt S, Sword W, Krueger P. Longer postpartum hospitalization options--who stays, who leaves, what changes? BMC Pregnancy Childbirth 2005; 5:13. [PMID: 16225678 PMCID: PMC1266374 DOI: 10.1186/1471-2393-5-13] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2005] [Accepted: 10/14/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper examines the practice implications of a policy initiative, namely, offering women in Ontario Canada up to a 60-hour postpartum in-hospital stay following an uncomplicated vaginal delivery. This change was initiated out of concern for the effects of 'early' discharge on the health of mothers and their infants. We examined who was offered and who accepted extended stays, to determine what factors were associated with the offer and acceptance of this option, and the impact that these decisions had on post-discharge health status and service utilization of mothers and infants. METHODS The data reported here came from two related studies of health outcomes and service utilization of mothers and infants. Data were collected from newly delivered mothers who had uncomplicated vaginal deliveries. Questionnaires prior to discharge and structured telephone interviews at 4-weeks post discharge were used to collect data before and after policy implementation. Qualitative data were collected using focus groups with hospital and community-based health care managers and providers at each site. For both studies, samples were drawn from the same five purposefully selected hospitals. Further analysis compared postpartum health outcomes and post discharge service utilization of women and infants before and after the practice change. RESULTS Average length of stay (LOS) increased marginally. There was a significant reduction in stays of <24 hours. The offer of up to a 60-hour LOS was dependent upon the hospital site, having a family physician, and maternal ethnicity. Acceptance of a 60-hour LOS was more likely if the baby had a post-delivery medical problem, it was the woman's first live birth, the mother identified two or more unmet learning needs in hospital, or the mother was unsure about her own readiness for discharge. Mother and infant health status in the first 4 weeks after discharge were unchanged following introduction of the extended stay option. Infant service use also was unchanged but rate of maternal readmission to hospital increased and mothers' use of community physicians and emergency rooms decreased. CONCLUSION This research demonstrates that this policy change was selectively implemented depending upon both institutional and maternal factors. LOS marginally increased overall with a significant decrease in <24-hour stays. Neither health outcomes nor service utilization changed for infants. Women's health outcomes remained unchanged but service utilization patterns changed.
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Affiliation(s)
- Susan Watt
- School of Social Work, McMaster University, Hamilton, Ontario, Canada
| | - Wendy Sword
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Paul Krueger
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton and Senior Research Associate, St. Joseph's Health System Research Network, Brantford, Ontario, Canada
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Watt S, Sword W, Krueger P. Implementation of a health care policy: an analysis of barriers and facilitators to practice change. BMC Health Serv Res 2005; 5:53. [PMID: 16102173 PMCID: PMC1201138 DOI: 10.1186/1472-6963-5-53] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Accepted: 08/15/2005] [Indexed: 11/29/2022] Open
Abstract
Background Governments often create policies that rely on implementation by arms length organizations and require practice changes on the part of different segments of the health care system without understanding the differences in and complexities of these agencies. In 2000, in response to publicity about the shortening length of postpartum hospital stay, the Ontario government created a universal program offering up to a 60-hour postpartum stay and a public health follow-up to mothers and newborn infants. The purpose of this paper is to examine how a health policy initiative was implemented in two different parts of a health care system and to analyze the barriers and facilitators to achieving practice change. Methods The data reported came from two studies of postpartum health and service use in Ontario Canada. Data were collected from newly delivered mothers who had uncomplicated vaginal deliveries. The study samples were drawn from the same five purposefully selected hospitals for both studies. Questionnaires prior to discharge and structured telephone interviews at 4-weeks post discharge were used to collect data before and after policy implementation. Qualitative data were collected using focus groups with hospital and community-based health care practitioners and administrators at each site. Results In both studies, the respondents reflected a population of women who experienced an "average" or non-eventful hospital-based, singleton vaginal delivery. The findings of the second study demonstrated wide variance in implementation of the offer of a 60-hour stay among the sites and focus groups revealed that none of the hospitals acknowledged the 60-hour stay as an official policy. The uptake of the offer of a 60-hour stay was unrelated to the rate of offer. The percentage of women with a hospital stay of less than 25 hours and the number with the guideline that the call be within 48 hours of hospital discharge. Public health telephone contact was high although variable in relation to compliance the guideline that the call be within 48 hours of hospital discharge. Home visits were offered at consistently high rates. Conclusion Policy enactment is sometimes inadequate to stimulate practice changes in health care. Policy as a tool for practice change must thoughtfully address the organizational, professional, and social contexts within which the policy is to be implemented. These contexts can either facilitate or block implementation. Our examination of Ontario's universal postpartum program provides an example of differential implementation of a common policy intended to change post-natal care practices that reflects the differential influence of context on implementation.
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Affiliation(s)
- Susan Watt
- School of Social Work, McMaster University, Hamilton, Ontario, Canada
| | - Wendy Sword
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Paul Krueger
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton and Senior Research Associate, St. Joseph's Health System Research Network, Brantford, Ontario, Canada
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Abstract
BACKGROUND Little is known about how information needs change over time in the early postpartum period or about how these needs might differ given socioeconomic circumstances. This study's aim was to examine women's concerns at the time of hospital discharge and unmet learning needs as self-identified at 4 weeks after discharge. METHODS Data were collected as part of a cross-sectional survey of postpartum health outcomes, service use, and costs of care in the first 4 weeks after postpartum hospital discharge. Recruitment of 250 women was conducted from each of 5 hospitals in Ontario, Canada (n = 1,250). Women who had given vaginal birth to a single live infant, and who were being discharged at the same time as their infant, assuming care of their infant, competent to give consent, and able to communicate in one of the study languages were eligible. Participants completed a self-report questionnaire in hospital; 890 (71.2%) took part in a structured telephone interview 4 weeks after hospital discharge. RESULTS Approximately 17 percent of participants were of low socioeconomic status. Breastfeeding and signs of infant illness were the most frequently identified concerns by women, regardless of their socioeconomic status. Signs of infant illness and infant care/behavior were the main unmet learning needs. Although few differences in identified concerns were evident, women of low socioeconomic status were significantly more likely to report unmet learning needs related to 9 of 10 topics compared with women of higher socioeconomic status. For most topics, significantly more women of both groups identified learning needs 4 weeks after discharge compared with the number who identified corresponding concerns while in hospital. CONCLUSIONS It is important to ensure that new mothers are adequately informed about topics important to them while in hospital. The findings highlight the need for accessible and appropriate community-based information resources for women in the postpartum period, especially for those of low socioeconomic status.
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Affiliation(s)
- Wendy Sword
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
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46
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Grodet C, Dequin PF, Watt S, Lanotte P, de Gialluly C, Taha MK, Alonso JM, Quentin R, Goudeau A, Mereghetti L. Outbreak in France of Neisseria meningitidis B:15:P1.12 belonging to sequence type 1403. Clin Microbiol Infect 2004; 10:845-8. [PMID: 15355418 DOI: 10.1111/j.1469-0691.2004.00935.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This report describes a meningococcal outbreak in France caused by Neisseria meningitidis B:15:P1.12 of sequence type 1403, which affected eight young patients, between November 2000 and February 2002. Epidemiological typing confirmed that a single strain was responsible. Favourable outcome, sequelae or death resulted in similar proportions as in other cases of meningococcal disease in France during the same period, but purpura was observed in all eight cases. The patients were aged between 14 and 28 years, whereas the median age of patients affected by other meningococcal strains during this period in the same area was 60.4 years.
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Affiliation(s)
- C Grodet
- Service de Bactériologie et Hygiène Hospitalière, Hôpital Trousseau, Tours, France
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47
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Sword W, Watt S, Krueger P. Implementation, uptake, and impact of a provincial postpartum program. Can J Nurs Res 2004; 36:60-82. [PMID: 15369165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
This paper examines implementation and uptake of the Hospital Stay and Postpartum Home Visiting Program at 5 sites in the Canadian province of Ontario using a cross-sectional survey. It also examines concomitant changes in satisfaction with services and maternal and infant health indicators by comparing the findings of this survey, administered after policy implementation, with those of a previous survey. In both surveys, data were collected via a self-administered in-hospital questionnaire and a structured telephone interview at 4 weeks post-discharge. There were statistically significant differences in implementation of the 60-hour hospital-stay option across sites, with between 11.7% and 81.2% of women having been offered an extended stay. However, there were no significant differences in acceptance rates (21.1-39.4%) among those women given this option. There were no statistically significant differences in the offer of a home visit by a public health nurse (91.5-96.6%), but there were significant differences in uptake of a visit. Between 21.1% and 39.4% of those women who were offered a home visit accepted. When compared to the previous survey findings, there were few changes in client satisfaction with services and health indicators following program implementation.This study raises questions about the utility of the postpartum program as currently implemented and highlights the need for further research.
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Affiliation(s)
- Wendy Sword
- School of Nursing, McMaster University, Ontario, Canada
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48
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Lanotte P, Bastides F, Watt S, Mereghetti L, Vidal C, Dabernat H, Goudeau A. [Spheroplasts and apparent resistance of Haemophilus influenzae to betalactamin antibiotics]. Ann Biol Clin (Paris) 2003; 61:458-62. [PMID: 12915356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- P Lanotte
- Laboratoire de bactériologie-virologie, CHU Bretonneau, 2, Boulevard Tonnellé, 37044 Tours.
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49
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Abstract
Atherosclerosis is a major health problem in industrialised countries. Several studies have suggested an association exists between certain microorganisms and the development of atherosclerosis. The aim of the study presented here was to assess the presence of viral or bacterial DNA in carotid atherosclerotic lesions. Nucleic acids were extracted from 18 carotid atherosclerotic lesions that had been collected surgically. Polymerase chain reaction was used to screen for specific genomic DNA from Chlamydia pneumoniae, cytomegalovirus and herpes simplex virus types 1 and 2. An original approach, based on the amplification by PCR of conserved bacterial 16S rDNA nucleotide sequences was also used to detect any bacterial species. The amplification product was identified by sequencing. Chlamydia pneumoniae, cytomegalovirus and herpes simplex 2 DNA were not detected in any of the samples. Herpes simplex 1 DNA was detected in 3 of the 18 samples. Genes encoding bacterial 16S rRNA were amplified and sequenced in eight atherosclerotic lesions. DNA sequences were identified by comparison with sequences registered in the GenBank database. These eight carotid atherosclerotic lesions were shown to contain several bacterial species belonging to human flora or the environment. The exact role of these microorganisms in the genesis or development of the atherosclerotic lesions remains unclear, but they may increase the inflammatory process or be an epiphenomenon.
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Affiliation(s)
- S Watt
- Département de Microbiologie Médicale et Moléculaire EA 3250, CHU Bretonneau, 2 Boulevard Tonnellé, 37044, Tours Cedex 01, France.
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50
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Quentin R, Morange-Saussier V, Watt S. [Obstetrical management of Streptococcus agalactiae]. J Gynecol Obstet Biol Reprod (Paris) 2002; 31:4S65-4S73. [PMID: 12451360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
S. agalactiae is the main cause of maternal and neonatal infections. Correct bacteriological explorations of pregnant women and neonates with risk factors may allow early and effective antibiotherapy. The screening of S. agalactiae vaginal carriage at 34-38 weeks of amenorrhea and the administration of penicillin at delivery is considered as the best strategy for preventing S. agalactiae infections for asymptomatic patients.
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Affiliation(s)
- R Quentin
- Département de Gynécologie, Obstétrique et Pathologie de la Reproduction, CHU Bretonneau, 37044 Tours Cedex 1, France
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