Search

The role of the occupational health nurse is broad and includes health care provider, manager/coordinator, educator/advisor, and case manager and consultant, depending on the type of industry and the country in which the nurse practices. Regardless of the type of role, the occupational health nurse must participate in continuing nursing education (CNE) activities. This study describes the roles, credentials, and number of CNE activities undertaken by occupational health nurses working in Ontario, Canada. Using a nonexperimental descriptive design, a questionnaire was mailed to all practicing occupational health nurses who are members (n=900) of a local nursing association. Three hundred fifty-four questionnaires were returned. Nurses reported a variety of roles in the following categories: case management, health promotion, policy development, infection control/travel health, ergonomics, education, research, health and safety, direct care, consultation, disaster preparedness, and industrial hygiene. Sixty-five percent of nurses held an occupational health nurse credential, and 19% of nurses attended more than 100 hours of CNE annually. Occupational health nurses have multiple workplace roles. Many attend CNE activities and they often prepare for credentialing. [ABSTRACT FROM AUTHOR]

This study sought to provide insights into the personal experiences of individuals with sickle cell disorder and nurses involved in the management of painful sickle cell crisis. The sample consisted of 10 patients who experienced hospitalization for the management of pain during sickle cell crisis and 10 nurses who have cared for patients during such crises. The method of data collection used a combination of group and individual interviews, utilizing a 'guided conversation approach.' Data analysis consisted of content analysis of transcribed interviews which resulted in the identification of the following categories of problems: poor pain management, anxieties about pethidine, loss of control, lack of individuality and playing up. The results revealed that pain control during sickle cell crisis is often inadequate, with nurses admitting that they often have to resort to 'trial and error' strategy to manage pain. The findings are discussed in terms of attitudinal and knowledge factors and an individualized approach to pain management. [ABSTRACT FROM AUTHOR]

Musculoskeletal (MSK) conditions are the leading cause of disability, resulting in up to 40% of visits to family physicians. Current primary care workforce shortages in Canada require other providers to maximize scopes of practice. Few MSK providers have been trained in team-based primary care settings. Study objectives included: (1) educating participating primary care teams through synchronous education, (2) educating Canadian primary care providers through asynchronous education, and (3) integrating chiropractors into primary care teams, whilst evaluating team MSK care knowledge/attitudes and integration experience. Results indicated improvements in collaborative competency, improved understanding and attitudes to chiropractic, and the importance of providing MSK care within funded primary care. Teams employed unique approaches to integrating chiropractors and indicated high demand for their services by patients and providers. Provision of MSK care without economic barrier is desirable and highly valued by teams. Chiropractors are well suited to participate in funded primary care teams in Canada., Competing Interests: Declaration of conflicting interestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Competency-based medical education has been introduced into many health professional curricula. Based on CanMEDs, a framework has recently been developed for podiatric medicine education in Canada. This study aimed to validate the framework through a consensus of various podiatric medicine experts across Canada., Methods: An adapted Delphi method was used for content validation. Two structured online questionnaires were used to gather expert opinions and agreement on the roles and core competencies described in the framework previously developed. The validation consensus threshold was set at a minimum of 80% agreement. The summary of comments and suggestions was used to reformulate certain items after the research team reached a consensus., Results: Out of the 51 experts invited from the Canadian Podiatric Medicine Association, 19 completed the first-round questionnaire (mean podiatric experience = 24.5 years; standard deviation 17.6). After the first round, "Podiatric Expert", "Communicator" and "Scholar" roles have been modified. After these modifications, a consensus was obtained at the second round completed by 13 experts. Overall, 95% of the experts agreed that the competency framework was relevant even if some indicators would need to be adapted to suit the requirements of each province and territory., Conclusion: This validated framework supports the excellence and the quality of our podiatric educational program. It also promotes the adoption of a uniform education of podiatrists in Canada and worldwide., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Alcohol misuse has deleterious effects on personal health, family, societal units, and global economies. Moreover, alcohol misuse usually leads to several diseases and conditions, including alcoholism, which is a chronic condition and a form of addiction. Alcohol misuse, whether as acute intoxication or alcoholism, adversely affects skeletal, cardiac and/or smooth muscle contraction. Ethanol (ethyl alcohol) is the main effector of alcohol-induced dysregulation of muscle contractility, regardless of alcoholic beverage type or the ethanol metabolite (with acetaldehyde being a notable exception). Ethanol, however, is a simple and "promiscuous" ligand that affects many targets to mediate a single biological effect. In this review, we firstly summarize the processes of excitation-contraction coupling and calcium homeostasis which are critical for the regulation of contractility in all muscle types. Secondly, we present the effects of acute and chronic alcohol exposure on the contractility of skeletal, cardiac, and vascular/ nonvascular smooth muscles. Distinctions are made between in vivo and in vitro experiments, intoxicating vs. sub-intoxicating ethanol levels, and human subjects vs. animal models. The differential effects of alcohol on biological sexes are also examined. Lastly, we show that alcohol-mediated disruption of muscle contractility, involves a wide variety of molecular players, including contractile proteins, their regulatory factors, membrane ion channels and pumps, and several signaling molecules. Clear identification of these molecular players constitutes a first step for a rationale design of pharmacotherapeutics to prevent, ameliorate and/or reverse the negative effects of alcohol on muscle contractility., Competing Interests: CONFLICT OF INTEREST The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Background: Studies have evaluated the concomitant use of hyaluronan (HA) with steroids, anti-inflammatory drugs and analgesic agents in an attempt to magnify the extent and duration of pain relief due to knee osteoarthritis. To date there has not been an intra-articular combination therapy available for relief of knee osteoarthritis symptoms--one that combines the fast acting onset of symptom relief provided by a corticosteroid with the long-lasting symptom relief provided by HA in a single injection. The objective of this study was to evaluate the safety and preliminary performance of two new HA formulations, Hydros (hyaluronan-based hydrogel suspended in hyaluronan solution) and Hydros-TA (HA plus 10 mg of triamcinolone acetonide [TA]) in subjects with knee osteoarthritis., Methods: We conducted a Phase 2 prospective, multicenter, randomized, double-blind feasibility trial. Participants (n = 98; mean age 60 years) with knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) were randomized to three treatment groups: Hydros, Hydros-TA, and Synvisc-One® (hylan G-F 20). Participants received one 6 ml intra-articular injection in the treatment knee and were evaluated at 2, 6, 13, and 26 weeks post-treatment. Safety was assessed from adverse events at all study visits. The primary efficacy outcome was the change from baseline on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) A (Pain) score for the treatment knee., Results: Adverse events were similar across treatment groups with the most common being arthralgia, joint swelling, back pain, and joint stiffness. Arthralgia was reported 5 times with Synvisc-One, 4 with Hydros, and 1 with Hydros-TA. Each group demonstrated a reduction in the WOMAC A (Pain) score over 26 weeks: [least-square mean (standard error)] 30.5 (5.1) mm for Hydros; 34.4 (4.7) mm for Hydros-TA; 28.0 (5.4) mm for Synvisc-One and an observed improvement of 2.5 mm (p = 0.64) and 6.4 mm (p = 0.24) over Synvisc-One for Hydros and Hydros-TA, respectively., Conclusions: A single injection of Hydros or Hydros-TA was well-tolerated and relieved pain associated with knee osteoarthritis over 26 weeks. Data indicate that Hydros-TA had a more rapid pain relief compared to Hydros alone. A Phase 3 trial is underway to confirm these preliminary results., Trial Registration Number: NCT01134406.

In September, the international sports medicine community lost one of its rising stars. Editorial board member Alexandra Kirkley, MD, (more commonly known as Sandy), 40, and her husband, Michael, 42, died when their small plane crashed en route to their home in London, Ontario, Canada, from a presentation she was giving at the West Point Academy in New Jersey. Their sons, Colin (age 8) and Connor (age 5), miraculously survived the crash through the heroic efforts of rescuers and others.

This article provides practical advice on healthy exercise prescription for children. There is growing scientific evidence about the abilities and limits of child athletes in both recreational and competitive environments. As exercise becomes essential for the prevention of illness and maintenance of health, the counselling for an exercise prescription requires enhanced knowledge. The latest recommendations on safe strength, resistance and weight training are presented in a concise format for office use.

The article reviews some of the more influential literature of the past decade on the health needs of ethnic groups, in an effort to identify what is being done by nursing and midwifery education to address the health care needs of these groups and to prepare practitioners who are able to respond to these needs. The article suggests that despite the relative lack of progress in this field of health care and education, there still exists much confusion, disagreement and lack of clarity around many issues, such as the identification of relevant content, the integration of this content into the curriculum and more importantly the delivery of this content. The literature seems to point to a lack of cultural knowledge, particularly for certain ethnic groups, which needs to be rectified. But even when knowledge is available, the evidence clearly indicates that both educators and practitioners are failing to translate this into effective and culturally sensitive care. The article suggests that nursing and midwifery education could and should play an important role in the development and dissemination of culturally sensitive care.

Much can be learned about transcultural care from nursing colleagues who belong to minority ethnic groups. If they are willing and adequately empowered these nurses can become effective role models for their colleagues.

This article describes the steps taken by the North London College of Health Studies to facilitate the development and delivery of culturally sensitive courses. It suggests that transcultural education for transcultural care can only truly be achieved if the organisational ethos, the epistemology which underpins the curriculum and the way that this is structured and taught, articulate together into a cohesive framework to enable the rhetoric to become reality.

This article examines the problems of the multicultural approach in our multiracial society. It describes a need for nurses to be aware of the contribution of racism to inequalities in health care and to have insight into cultural and ethnic issues.

This is the first of a series of articles that will discuss some of the concepts associated with transcultural nursing. It suggests that nurse education fails in any significant way to deliver culturally sensitive care.

This trial took 22 volunteer family physicians and randomly exposed some to training intervention and some to no training to study the effect on frequency and quality of exercise prescription to ambulatory adults. During the 6 weeks after training, the trained physicians addressed the issue of exercise with 35.3% of patients. The untrained physicians discussed exercise with only 8.6% of their patients.

It is important to recognize the process of implementing systems as a process of change. The hospital, through its steering committee, must manage this process, initiating change instead of responding to it. Only then will the implementation of information systems be an orderly process and the impact of these changes on the hospital's organization clearly controlled. The probability of success in implementing new systems would likely be increased if attention centers on gaining commitment to the project, gaining commitment to any changes necessitated by the new system, and assuring that the project is well defined and plans clearly specified. These issues, if monitored throughout the systems implementation, will lead to early identification of potential problems and probable failures. This highly increases the chance of success. A probably failure, once identified, can be given specific attention to assure that associated problems are successfully resolved. The cost of this special attention, monitoring and managing systems implementation, is almost always much less than the cost of the eventual implementation failure.