scholarly journals Development of a primary care pandemic plan informed by in-depth policy analysis and interviews with family physicians across Canada during COVID-19: a qualitative case study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048209
Author(s):  
Maria Mathews ◽  
Sarah Spencer ◽  
Lindsay Hedden ◽  
Emily Gard Marshall ◽  
Julia Lukewich ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
British Columbia ◽  
Policy Analysis ◽  
Research Ethics ◽  
Newfoundland And Labrador ◽  
Family Physicians ◽  
Pandemic Response ◽  
Research Ethics Board

IntroductionGiven the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians’ roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario.Methods and analysisWe will employ a multiple-case study of regions in four provinces. Each case consists of a mixed methods design which comprises: (1) a chronology of family physician roles in the COVID-19 pandemic response; (2) a provincial policy analysis; and (3) qualitative interviews with family physicians. Relevant policy and guidance documents will be identified through targeted, snowball and general search strategies. Additionally, these policy documents will be analysed to identify gaps and/or emphases in existing policies and policy responses. Interviews will explore family physicians’ proposed, actual and potential roles during the pandemic, the facilitators and barriers they have encountered throughout and the influence of gender on their professional roles. Data will be thematically analysed using a content analysis framework, first at the regional level and then through cross-case analyses.Ethics and disseminationApproval for this study has been granted by the Research Ethics of British Columbia, the Health Research Ethics Board of Newfoundland and Labrador, the Nova Scotia Health Authority Research Ethics Board and the Western University Research Ethics Board. Findings will be disseminated via conferences and peer-reviewed publications. Evidence and lessons learnt will be used to develop tools for government ministries, public health units and family physicians for improved pandemic response plans for primary care.

scholarly journals Evaluating the efficacy of intranasal oxytocin on pain and function among individuals who experience chronic pain: a protocol for a multisite, placebo-controlled, blinded, sequential, within-subjects crossover trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e055039
Author(s):  
Joshua A. Rash ◽  
Tavis S. Campbell ◽  
Lynn Cooper ◽  
David Flusk ◽  
Aaron MacInnes ◽  
...  
Keyword(s):  
Chronic Pain ◽  
British Columbia ◽  
Side Effects ◽  
Research Ethics ◽  
Health Research ◽  
Newfoundland And Labrador ◽  
Crossover Trial ◽  
Adverse Side Effects ◽  
Research Ethics Board ◽  
And Function

IntroductionCurrent treatments for chronic pain (eg, opioids) can have adverse side effects and rarely result in resolution of pain. As such, there is a need for adjuvant analgesics that are non-addictive, have few adverse side effects and are effective for pain management across several chronic pain conditions. Oxytocin is a naturally occurring hormone that has gained attention for its potential analgesic properties. The objective of this trial is to evaluate the efficacy of intranasal oxytocin on pain and function among adults with chronic pain.Methods and analysisThis is a placebo-controlled, triple-blind, sequential, within-subject crossover trial. Adults with chronic neuropathic, pelvic and musculoskeletal pain will be recruited from three Canadian provinces (British Columbia, Alberta and Newfoundland and Labrador, respectively). Enrolled patients will provide one saliva sample pretreatment to evaluate basal oxytocin levels and polymorphisms of the oxytocin receptor gene before being randomised to one of two trial arms. Patients will self-administer three different oxytocin nasal sprays twice daily for a period of 2 weeks (ie, 24 IU, 48 IU and placebo). Patients will complete daily diaries, including standardised measures on day 1, day 7 and day 14. Primary outcomes include pain and pain-related interference. Secondary outcomes include emotional function, sleep disturbance and global impression of change. Intention-to-treat analyses will be performed to evaluate whether improvement in pain and physical function will be observed posttreatment.Ethics and disseminationTrial protocols were approved by the Newfoundland and Labrador Health Research Ethics Board (HREB #20227), University of British Columbia Clinical Research Ethics Board (CREB #H20-00729), University of Calgary Conjoint Health Research Ethics Board (REB20 #0359) and Health Canada (Control # 252780). Results will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences.Trial registration numberNCT04903002; Pre-results.

scholarly journals A reflection on research ethics and citizen science

2019 ◽  
Vol 15 (3-4) ◽  
pp. 1-10 ◽  
Author(s):  
Kathleen M Oberle ◽  
Stacey A Page ◽  
Fintan KT Stanley ◽  
Aaron A Goodarzi
Keyword(s):  
Medical Research ◽  
Research Ethics ◽  
Citizen Science ◽  
Low Risk ◽  
Community Based ◽  
Research Methodologies ◽  
Ethics Review ◽  
Research Ethics Board ◽  
The One

Ethics review of research involving humans has become something of an institution in recent years. It is intended to protect participants from harm and, to that end, follows rigorous standards. Given recent changes in research methodologies utilized in medical research, it may be that ethics review for some kinds of studies needs to be reexamined. The purpose of this paper is to stimulate dialogue regarding the kind of review required for citizen science-based research. We describe a case study of a proposal submitted to our research ethics board and propose different approaches to proportionate review in research involving citizen scientists. In particular, we describe how problems with the term “participant” led to confusion in review of this study and examine the study in light of current Canadian guidelines. We suggest that the term participant and indeed the general approach to low-risk community-based studies such as the one described warrant reexamination.

scholarly journals Is untargeted iron supplementation harmful when iron deficiency is not the major cause of anaemia? Study protocol for a double-blind, randomised controlled trial among non-pregnant Cambodian women

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037232
Author(s):  
Jordie AJ Fischer ◽  
Lulu X Pei ◽  
David M Goldfarb ◽  
Arianne Albert ◽  
Rajavel Elango ◽  
...  
Keyword(s):  
British Columbia ◽  
Iron Deficiency ◽  
Research Ethics ◽  
Iron Supplementation ◽  
Double Blind ◽  
Ferritin Concentration ◽  
Potential Harm ◽  
Research Ethics Board ◽  
Randomised Controlled ◽  
Forms Of Iron

IntroductionThe WHO recommends daily oral iron supplementation for 12 weeks in women and adolescents where anaemia prevalence is greater than 40%. However, if iron deficiency is not a major cause of anaemia, then, at best, untargeted iron supplementation is a waste of resources; at worst, it could cause harm. Further, different forms of iron with varying bioavailability may present greater risks of harm.Methods and analysisA 12-week three-arm, double-blind, randomised controlled supplementation trial was conducted in Cambodia to determine if there is potential harm associated with untargeted iron supplementation. We will recruit and randomise 480 non-pregnant women (ages 18–45 years) to receive one of three interventions: 60 mg elemental iron as ferrous sulfate (the standard, commonly used form), 18 mg ferrous bisglycinate (a highly bioavailable iron amino acid chelate) or placebo. We will measure ferritin concentrations (to evaluate non-inferiority between the two forms of iron), as well as markers of potential harm in blood and stool (faecal calprotectin, gut pathogen abundance and DNA damage) at baseline and 12 weeks. Mixed-effects generalised linear models will be used to assess the effect of iron on ferritin concentration and markers of potential harm at 12 weeks.Ethics and disseminationEthical approval was obtained from the University of British Columbia Clinical Research Ethics Board (H18-02610), the Children's and Women's Health Centre of British Columbia Research Ethics Board (H18-02610) and the National Ethics Committee for Health Research in Cambodia (273-NECHR). Findings will be published in peer-reviewed journals, presented to stakeholders and policymakers globally and shared within participants’ communities.Trial registration numberClinicalTrials.gov Registry (NCT04017598).

scholarly journals Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year (the PUPPY Study): Protocol for a Longitudinal Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Emily Gard Marshall ◽  
Mylaine Breton ◽  
Benoit Cossette ◽  
Jennifer Isenor ◽  
Maria Mathews ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Nova Scotia ◽  
Research Ethics ◽  
Health Research ◽  
Health Sciences ◽  
Mixed Methods Study ◽  
Care Practice ◽  
Research Ethics Board ◽  
Unattached Patients

BACKGROUND The COVID-19 pandemic has significantly disrupted primary care in Canada, with many walk-in clinics and family practices initially closing or being perceived as inaccessible; pharmacies remaining open with restrictions on patient interactions; rapid uptake of virtual care; and reduced referrals for lab tests, diagnostics, and specialist care. OBJECTIVE The PUPPY Study (Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year) seeks to understand the impact of the COVID-19 pandemic across the quadruple aims of primary care, with particular focus on the effects on patients without attachment to a regular provider and those with chronic health conditions. METHODS The PUPPY study builds on an existing research program exploring patients’ access and attachment to a primary care practice, pivoted to adapt to the emerging COVID-19 context. We intend to undertake a longitudinal mixed methods study to understand critical gaps in primary care access and coordination, as well as compare prepandemic and postpandemic data across 3 Canadian provinces (Quebec, Ontario, and Nova Scotia). Multiple data sources will be used such as a policy review; qualitative interviews with primary care policymakers, providers (ie, family physicians, nurse practitioners, and pharmacists), and patients (N=120); and medication prescriptions and health care billing data. RESULTS This study has received funding by the Canadian Institutes of Health Research COVID-19 Rapid Funding Opportunity Grant. Ethical approval to conduct this study was granted in Ontario (Queens Health Sciences & Affiliated Teaching Hospitals Research Ethics Board, file 6028052; Western University Health Sciences Research Ethics Board, project 116591; University of Toronto Health Sciences Research Ethics Board, protocol 40335) in November 2020, Québec (Centre intégré universitaire de santé et de services sociaux de l'Estrie, project 2020-3446) in December 2020, and Nova Scotia (Nova Scotia Health Research Ethics Board, file 1024979) in August 2020. CONCLUSIONS To our knowledge, this is the first study of its kind to explore the effects of the COVID-19 pandemic on primary care systems, with particular focus on the issues of patient’s attachment and access to primary care. Through a multistakeholder, cross-jurisdictional approach, the findings of the PUPPY study will inform the strengthening of primary care during and beyond the COVID-19 pandemic, as well as have implications for future policy and practice. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/29984

Institutional and policy analysis of wastewater (re)use for agriculture: case study Hyderabad, India

2015 ◽  
Vol 72 (2) ◽  
pp. 322-331 ◽  
Author(s):  
C. Saldías ◽  
S. Speelman ◽  
P. Amerasinghe ◽  
G. van Huylenbroeck
Keyword(s):  
Public Health ◽  
Adverse Effects ◽  
Policy Analysis ◽  
Institutional Analysis ◽  
Water Source ◽  
Agricultural Use ◽  
Alternative Water ◽  
The City

Wastewater constitutes an alternative water source for the irrigation sector. To fully benefit from it, and reduce possible adverse effects on public health and the environment, we need to look at the regulation of the practice. A prerequisite for this is an institutional analysis, and the points to consider are the institutional mandates. We used the city of Hyderabad, India, as a case study. There, irrigation with wastewater is not supported or recognized, but it happens in practice. It takes place in an indirect and unplanned way. Institutions fail at enforcing regulations, and little attention is given to formalization of the practice. With this article, we aim to untangle the institutional setup, and by doing so, identify the constraints surrounding development of a formal practice. Ultimately, we aim at contributing to the discussion on the agricultural use of wastewater.

scholarly journals How do Canadian public health agencies respond to the COVID-19 emergency using social media: a protocol for a case study using content and sentiment analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041818
Author(s):  
Anita Kothari ◽  
Lyndsay Foisey ◽  
Lorie Donelle ◽  
Michael Bauer
Keyword(s):  
Public Health ◽  
Social Media ◽  
Research Ethics ◽  
Sentiment Analysis ◽  
Health Agency ◽  
Message Content ◽  
Public Health Agencies ◽  
The Public ◽  
Board Review

IntroductionKeeping Canadians safe requires a robust public health (PH) system. This is especially true when there is a PH emergency, like the COVID-19 pandemic. Social media, like Twitter and Facebook, is an important information channel because most people use the internet for their health information. The PH sector can use social media during emergency events for (1) PH messaging, (2) monitoring misinformation, and (3) responding to questions and concerns raised by the public. In this study, we ask: what is the Canadian PH risk communication response to the COVID-19 pandemic in the context of social media?Methods and analysisWe will conduct a case study using content and sentiment analysis to examine how provinces and provincial PH leaders, and the Public Health Agency of Canada and national public heath leaders, engage with the public using social media during the first wave of the pandemic (1 January–3 September 2020). We will focus specifically on Twitter and Facebook. We will compare findings to a gold standard during the emergency with respect to message content.Ethics and disseminationWestern University’s research ethics boards confirmed that this study does not require research ethics board review as we are using social media data in the public domain. Using our study findings, we will work with PH stakeholders to collaboratively develop Canadian social media emergency response guideline recommendations for PH and other health system organisations. Findings will also be disseminated through peer-reviewed journal articles and conference presentations.

scholarly journals Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?

2021 ◽  
Vol 7 ◽  
pp. 237796082110534
Author(s):  
Maria Mathews ◽  
Dana Ryan ◽  
Richard Buote ◽  
Sandra Parsons ◽  
Julia Lukewich
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Family Practice ◽  
Newfoundland And Labrador ◽  
Secondary Analysis ◽  
Family Physicians ◽  
Scope Of Practice ◽  
Professional Competencies ◽  
Structured Interviews ◽  
Practice Nurses

Background Family practice nurses are Registered Nurses who work collaboratively in primary care and deliver a range of services. Professional competency statements have been developed to describe the skills and knowledge of family practice nurses as a distinct field. Purpose We conducted a secondary analysis of qualitative interview data to examine how family practice nurse roles/activities relate to recently developed professional competencies. Methods Family physicians and family practice nurses in Newfoundland and Labrador (NL) participated in semi-structured interviews, during which they discussed roles/activities and scope of practice surrounding family practice nursing. For this secondary analysis, we used competency statements to inform thematic coding of the transcribed interviews. Results For the initial study, a total of 8 participants (5 family practice nurses; 3 family physicians) were interviewed from diverse practices. All transcripts from the original study (n = 8) were included in the secondary analysis and analysed across 47 competencies encompassing 6 domains (Professionalism; Clinical Practice; Communication; Collaboration and Partnership; Quality Assurance, Evaluation and Research; Leadership). Roles/activities reported by participants were reflective of the competencies, but with substantial variation in expression. Conclusions Family practice nursing competency statements reflect the actual activities of family practice nurses in NL. The professional competencies can serve as a framework to examine contributions of family practice nurses and identify areas warranting further training. The use of competencies to explore family practice nurses’ roles and activities can assist with optimizing scope of practice.

Sign in / Sign up

Export Citation Format

Share Document