Administrative health care utilization databases have been promoted as resources for pharmacoepid... more Administrative health care utilization databases have been promoted as resources for pharmacoepidemiologic research for several years, but the validity of the diagnostic data in many systems has not been thoroughly investigated. This work outlines issues in assessing the validity of diagnostic information from a broad perspective, using results from the datafiles of the province of Saskatchewan to illustrate them and, where possible, contrasting them with findings from other databases. An evaluation of the validity of health care utilization data should be more than a simple check of coding and data entry errors. Comparisons of data records with information external to the computer system, an examination of the internal consistency of the data (especially in systems consisting of several data sources) and, where practicable, an assessment of the cohesiveness of the data within the context of current medical knowledge should be performed on a broad range of diagnoses and procedures. Careful consideration should also be given to the generalizability of results from the database. Summaries of such evaluations for all databases used for population-health research purposes should be widely disseminated. We caution researchers to continue to seek ways to validate their results in each use of these databases.
Standardized clinical interviews of 48 alcoholic patients consecutively admitted to an alcoholism... more Standardized clinical interviews of 48 alcoholic patients consecutively admitted to an alcoholism treatment program revealed that 22 (46%) had suffered major depressive episodes. However, only two had the typical depressed affect at the time of the interview. Cyclic mood swings, panic attacks and hypomania were common, indicating that this was a heterogeneous group of depressed patients. The alcoholism tended to precede the onset of depression, which was then followed by the seeking of help, but the whole sequence developed over a few years, when the patients were in their early 20s. The depressed patients had more psychiatric, marital and legal difficulties than the nondepressed patients. There is a need for better definitions of affective disorders in alcoholic patients.
The demographic characteristics and the trends in health care utilization of alcohol- and drug-de... more The demographic characteristics and the trends in health care utilization of alcohol- and drug-dependent residents of the Canadian province of Saskatchewan from 1969 to 1974 are examined.
For the purpose of examining patterns in the delivery of psychiatric services in the province of ... more For the purpose of examining patterns in the delivery of psychiatric services in the province of Saskatchewan during 1971 and 1972, a research data file was created containing data on all persons who had received medical treatment for explicitly psychiatric disorders: from PSB; from a physician paid on a fee-for-service basis under MCIC; and/or in a provincial general hospital. The resulting data file provides a history of the psychiatric care utilization behaviour of all patients who have been treated for a psychiatric illness in the province during the period January 1st, 1971 to December 31st, 1972, irrespective of the facilities in which this treatment was delivered. This data file, since it has keyed on explicitly psychiatric diagnoses and on diagnoses rather than type of service delivered, will give conservative estimates on the number of patients and patterns of contacts. During the two-year period a total of 123,099 received some form of psychiatric treatment. There were six...
Background.Little is understood about of the role of coping strategies in psychological well-bein... more Background.Little is understood about of the role of coping strategies in psychological well-being (PWB) and distress for the general population and different physical and psychiatric disease groups. A thorough examination of these relationships may provide evidence for the implementation of public mental health promotion and psychiatric disease prevention strategies aimed at improving the use of positive coping approaches or addressing the causes and maintainers of distress. The present study using a structural equation modelling (SEM) approach and nationally representative data on the Canadian population investigates the relationships among PWB, distress and coping strategies and identifies major factors related to PWB for both the general population and diverse-specific disease groups.Methods.Data examined were from the Canadian Community Health Survey of Mental Health and Well-being (CCHS 1.2), a large national survey (n= 36 984). We applied exploratory factor analysis (EFA), co...
Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially ... more Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially higher users of health services for psychiatric problems than are men. Women: 1) use up to twice as many services as men in the private sector, but use almost the same number of public sector services; 2) tend to be treated for psychosomatic and neurotic disorders on an outpatient basis; 3) have only a slightly greater chance than men of being hospitalized; and 4) are less likely than men to have organic or addictive diagnoses. These differentials in utilization cannot be explained by age, diagnoses and/or marital status. Sex is the best predictor of utilization. These results are largely consistent with utilization and epidemiological literature. It seems more likely that these sex differences in utilization result from the interaction of biology, sex roles, and the functioning and labelling processes of the health system rather than from any single factor. Combining Andersen's components of health behaviour with Freidson's lay-professional construction of illness continuum yields a possible framework for understanding sex differences in the utilization of psychiatric health services.
This paper reports on the results of a large scale mail questionnaire survey of the prevalence, a... more This paper reports on the results of a large scale mail questionnaire survey of the prevalence, as well as some social/psychological correlates, of nonpsychotic psychiatric symptoms in the general population of the Province of Saskatchewan. The level of nonpsychotic psychiatric symptoms was measured using the 30-item General Health Questionnaire (GHQ) developed by Goldberg. The respondent group (2000+, 53% of the available sample) was reasonably representative of the provincial population and forms a good basis for generalization. Data analysis shows that women report a higher level of symptoms than men. There were also significant age variations:for women there was a general decline in mean scores from younger to older age categories with the possible exception of the oldest age group, over 70, in which we see a slight increase; for men, there was a pronounced U-shaped distribution with both younger and older age groups exhibiting high levels of symptomatology. In addition to age a...
BackgroundLiterature supports a strong relationship between childhood maltreatment and mental ill... more BackgroundLiterature supports a strong relationship between childhood maltreatment and mental illness but most studies reviewed are cross-sectional and/or use recall to assess maltreatment and are thus prone to temporality and recall bias. Research on the potential prospective impact of maltreatment reduction on the incidence of psychiatric disorders is scarce.MethodElectronic databases and grey literature from 1990 to 2014 were searched for English-language cohort studies with criteria for depression and/or anxiety and non-recall measurement of childhood maltreatment. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Initial screening of titles and abstracts resulted in 199 papers being reviewed. Eight high-quality articles met eligibility criteria. Population attributable fractions (PAFs) estimated potential preventive impact.ResultsThe pooled odds ratio (OR) between any type of maltreatment and depressi...
Introduction Excessive use of emergency departments (EDs) for the treatment of mental health comp... more Introduction Excessive use of emergency departments (EDs) for the treatment of mental health complaints (MHCs) suggests alternate interventions are required. Objectives To understand attributes of patients who are high frequent users (HFUs) of EDs for the treatment for MHCs. Aims Suggest realistic changes that would make the health care system more effectively respond to HFUs needs. Methods Administrative data were used to analyze the use of all three emergency departments in Saskatoon Health Region by patients presenting with primary MHCs in 2012. A chart review of HFUs for the years 2011 to 2013 was also undertaken. Results In 2012 approximately 1.2% (3,824) of the Region’s population made the 6,235 visits for a primary MHC. ED visits exhibit a Pareto distribution with most patients (72.8%) making a single visit however < 0.1 % (34) made 10+ visits. HFUs (10+ visits) used EDs in multiple years, over 3 years making an average of 59 ED visits (R=19 to 194). They were generally, young, male, unemployed, transient or homeless with many unmet social and economic needs. They could be categorized into: 1) suffering from severe alcohol abuse/withdrawal or illicit drug use; 2) chronic mood and anxiety disorders; 3) significant personal and social stressors; and 4) a complex combination of psychiatric disease(s) and cognitive impairment. Conclusions Action should be taken to identify ‘High Frequency Users’ early in their patient career and develop appropriate interventions taking into account their unique and diverse needs.
Clinical and investigative medicine. Médecine clinique et experimentale, 2003
The computer telephony system (CTS) combines computer and telephone to automate the collection, p... more The computer telephony system (CTS) combines computer and telephone to automate the collection, processing and dissemination of information. Many innovative applications of the CTS have emerged. In this article we summarize the evidence for CTS-based medical interventions based on randomized controlled trials. We searched for trials in MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, and bibliographies of retrieved articles, review articles and textbooks. We excluded non-English articles and those pertaining to psychology, addiction, psychiatry, research and education. In health care delivery, 3 of 4 trials of CTS-based interventions improved clinic show rates. In preventive health care, 4 of 5 showed higher childhood immunization rates. For nutrition, 2 small trials showed no clear benefit in cholesterol lowering or in weight reduction, but 1 trial showed a benefit in fibre intake. For increasing physical activity, 1 smaller trial showed no benefit but a larger ...
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 6, 1999
Violence during pregnancy is a health and social problem that poses particular risks to the woman... more Violence during pregnancy is a health and social problem that poses particular risks to the woman and her fetus. To address the lack of Canadian information on this issue, the authors studied the prevalence and predictors of physical abuse in a sample of pregnant women in Saskatoon. Of 728 women receiving prenatal services through the Saskatoon District public health system between Apr. 1, 1993, and Mar. 31, 1994, 605 gave informed consent to participate in the study and were interviewed in the second trimester. Of these, 543 were interviewed again late in the third trimester. During the initial interview, information was collected on the women's sociodemographic characteristics, the current pregnancy, health practices and psychosocial variables. The second interview focused on the women's experience of physical abuse during the pregnancy and during the preceding year, the demographic characteristics and the use of alcohol or illicit drugs by their male partner. In all, 31 (...
Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been... more Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been no national study of the use of these drugs. We have attempted to correct this deficit in our knowledge by using data from an international survey of health care utilization performed in 1968-9 and from the Canada Health Survey (1978-9), the Health Promotion Survey (1985) and the National Alcohol and Other Drugs Survey (1989) to examine sedative-hypnotic use among individuals aged 15 or more. The results suggest that the use of these drugs in Canada is about average for an industrialized society. Several socioeconomic and health care correlates of sedative-hypnotic use were found. The rate of use of these drugs was higher among women, the elderly, separated, divorced or widowed individuals, those who had a secondary school education or less, individuals with a low family income, the retired, and the unemployed. Among women, higher rates of use were reported by those whose main activity ...
Trace amines are possibly involved in some psychiatric disorders (Boulton, 1980). β-Phenylethylam... more Trace amines are possibly involved in some psychiatric disorders (Boulton, 1980). β-Phenylethylamine, for example, is chemically similar to amphetamine, and can induce behavioural effects in laboratory animals resembling those of amphetamine (Mantegazza and Riva, 1963). Amphetamine abuse in large doses is often associated with homicidal violence (Ellinwood, 19071; Allen et al., 1975). Paradoxically amphetamine can suppress aggressive behaviour (Miczek, 1974) and hyperactivity in children (Arnold et al., 1978). It has been argued that the hyperactive child syndrome and adult psychopathy are related in that a common pathophysiological condition of low CNS arousal states may underlie both conditions (Satterfield, 1978). β-Phenylethylamine has, therefore, become a center of interest in research on mental disorders. Trace amines are metabolized rapidly (Wu and Boulton 1975; Philips and Boulton, 1979; Durden and Philips, 1980). Enzymes involved in the catabolism of the trace amines, monoamine oxidase (MAO) and phenolsulfotransferase (PST), as well as the trace acid metabolites themselves have been analyzed.
The Journal of Continuing Education in Nursing, 2007
This article examines the barriers to participation in continuing education activities that are p... more This article examines the barriers to participation in continuing education activities that are perceived by rural and remote registered nurses in Canada. The data are drawn from a national survey that was part of a larger national project, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;The Nature of Nursing Practice in Rural and Remote Canada.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; Perceived barriers to participation in continuing education activities include the isolation of rural nurses and time and financial constraints. Nurses who perceived barriers to participation were more likely to be middle-aged, unmarried, and working full-time than nurses who did not perceive barriers. They were also more likely to possess higher levels of nursing education and have children or dependents. The perception of barriers to participation was also associated with lower job and scheduling satisfaction. Rural and remote registered nurses have moderately high levels of participation in continuing education; however, participation and job satisfaction can be improved if some of the barriers identified are addressed.
This study examines predictors of job satisfaction among rural acute care registered nurses. The ... more This study examines predictors of job satisfaction among rural acute care registered nurses. The data are from a cross-sectional national survey, which was part of a larger project, The Nature of Nursing Practice in Rural and Remote Canada. This analysis suggests that a combination of individual, workplace, and community characteristics are interrelated predictors of job satisfaction for rural acute care nurses. There were nine variables that accounted for 38% of the total variance in job satisfaction. Four variables alone (available and up-to-date equipment and supplies, satisfaction with scheduling and shifts, lower psychological job demands, and home community satisfaction) explained 33% of the variance. Recruitment and retention strategies in rural areas must acknowledge that rural nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; work lives and community lives are inextricably intertwined. Attention to these issues will help ensure high-quality working environments and a continued commitment to quality nursing care in the rural hospital settings in Canada.
Administrative health care utilization databases have been promoted as resources for pharmacoepid... more Administrative health care utilization databases have been promoted as resources for pharmacoepidemiologic research for several years, but the validity of the diagnostic data in many systems has not been thoroughly investigated. This work outlines issues in assessing the validity of diagnostic information from a broad perspective, using results from the datafiles of the province of Saskatchewan to illustrate them and, where possible, contrasting them with findings from other databases. An evaluation of the validity of health care utilization data should be more than a simple check of coding and data entry errors. Comparisons of data records with information external to the computer system, an examination of the internal consistency of the data (especially in systems consisting of several data sources) and, where practicable, an assessment of the cohesiveness of the data within the context of current medical knowledge should be performed on a broad range of diagnoses and procedures. Careful consideration should also be given to the generalizability of results from the database. Summaries of such evaluations for all databases used for population-health research purposes should be widely disseminated. We caution researchers to continue to seek ways to validate their results in each use of these databases.
Standardized clinical interviews of 48 alcoholic patients consecutively admitted to an alcoholism... more Standardized clinical interviews of 48 alcoholic patients consecutively admitted to an alcoholism treatment program revealed that 22 (46%) had suffered major depressive episodes. However, only two had the typical depressed affect at the time of the interview. Cyclic mood swings, panic attacks and hypomania were common, indicating that this was a heterogeneous group of depressed patients. The alcoholism tended to precede the onset of depression, which was then followed by the seeking of help, but the whole sequence developed over a few years, when the patients were in their early 20s. The depressed patients had more psychiatric, marital and legal difficulties than the nondepressed patients. There is a need for better definitions of affective disorders in alcoholic patients.
The demographic characteristics and the trends in health care utilization of alcohol- and drug-de... more The demographic characteristics and the trends in health care utilization of alcohol- and drug-dependent residents of the Canadian province of Saskatchewan from 1969 to 1974 are examined.
For the purpose of examining patterns in the delivery of psychiatric services in the province of ... more For the purpose of examining patterns in the delivery of psychiatric services in the province of Saskatchewan during 1971 and 1972, a research data file was created containing data on all persons who had received medical treatment for explicitly psychiatric disorders: from PSB; from a physician paid on a fee-for-service basis under MCIC; and/or in a provincial general hospital. The resulting data file provides a history of the psychiatric care utilization behaviour of all patients who have been treated for a psychiatric illness in the province during the period January 1st, 1971 to December 31st, 1972, irrespective of the facilities in which this treatment was delivered. This data file, since it has keyed on explicitly psychiatric diagnoses and on diagnoses rather than type of service delivered, will give conservative estimates on the number of patients and patterns of contacts. During the two-year period a total of 123,099 received some form of psychiatric treatment. There were six...
Background.Little is understood about of the role of coping strategies in psychological well-bein... more Background.Little is understood about of the role of coping strategies in psychological well-being (PWB) and distress for the general population and different physical and psychiatric disease groups. A thorough examination of these relationships may provide evidence for the implementation of public mental health promotion and psychiatric disease prevention strategies aimed at improving the use of positive coping approaches or addressing the causes and maintainers of distress. The present study using a structural equation modelling (SEM) approach and nationally representative data on the Canadian population investigates the relationships among PWB, distress and coping strategies and identifies major factors related to PWB for both the general population and diverse-specific disease groups.Methods.Data examined were from the Canadian Community Health Survey of Mental Health and Well-being (CCHS 1.2), a large national survey (n= 36 984). We applied exploratory factor analysis (EFA), co...
Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially ... more Comprehensive data on all pscyhiatric patients in Saskatchewan show that women are substantially higher users of health services for psychiatric problems than are men. Women: 1) use up to twice as many services as men in the private sector, but use almost the same number of public sector services; 2) tend to be treated for psychosomatic and neurotic disorders on an outpatient basis; 3) have only a slightly greater chance than men of being hospitalized; and 4) are less likely than men to have organic or addictive diagnoses. These differentials in utilization cannot be explained by age, diagnoses and/or marital status. Sex is the best predictor of utilization. These results are largely consistent with utilization and epidemiological literature. It seems more likely that these sex differences in utilization result from the interaction of biology, sex roles, and the functioning and labelling processes of the health system rather than from any single factor. Combining Andersen&amp;amp;#39;s components of health behaviour with Freidson&amp;amp;#39;s lay-professional construction of illness continuum yields a possible framework for understanding sex differences in the utilization of psychiatric health services.
This paper reports on the results of a large scale mail questionnaire survey of the prevalence, a... more This paper reports on the results of a large scale mail questionnaire survey of the prevalence, as well as some social/psychological correlates, of nonpsychotic psychiatric symptoms in the general population of the Province of Saskatchewan. The level of nonpsychotic psychiatric symptoms was measured using the 30-item General Health Questionnaire (GHQ) developed by Goldberg. The respondent group (2000+, 53% of the available sample) was reasonably representative of the provincial population and forms a good basis for generalization. Data analysis shows that women report a higher level of symptoms than men. There were also significant age variations:for women there was a general decline in mean scores from younger to older age categories with the possible exception of the oldest age group, over 70, in which we see a slight increase; for men, there was a pronounced U-shaped distribution with both younger and older age groups exhibiting high levels of symptomatology. In addition to age a...
BackgroundLiterature supports a strong relationship between childhood maltreatment and mental ill... more BackgroundLiterature supports a strong relationship between childhood maltreatment and mental illness but most studies reviewed are cross-sectional and/or use recall to assess maltreatment and are thus prone to temporality and recall bias. Research on the potential prospective impact of maltreatment reduction on the incidence of psychiatric disorders is scarce.MethodElectronic databases and grey literature from 1990 to 2014 were searched for English-language cohort studies with criteria for depression and/or anxiety and non-recall measurement of childhood maltreatment. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Initial screening of titles and abstracts resulted in 199 papers being reviewed. Eight high-quality articles met eligibility criteria. Population attributable fractions (PAFs) estimated potential preventive impact.ResultsThe pooled odds ratio (OR) between any type of maltreatment and depressi...
Introduction Excessive use of emergency departments (EDs) for the treatment of mental health comp... more Introduction Excessive use of emergency departments (EDs) for the treatment of mental health complaints (MHCs) suggests alternate interventions are required. Objectives To understand attributes of patients who are high frequent users (HFUs) of EDs for the treatment for MHCs. Aims Suggest realistic changes that would make the health care system more effectively respond to HFUs needs. Methods Administrative data were used to analyze the use of all three emergency departments in Saskatoon Health Region by patients presenting with primary MHCs in 2012. A chart review of HFUs for the years 2011 to 2013 was also undertaken. Results In 2012 approximately 1.2% (3,824) of the Region’s population made the 6,235 visits for a primary MHC. ED visits exhibit a Pareto distribution with most patients (72.8%) making a single visit however < 0.1 % (34) made 10+ visits. HFUs (10+ visits) used EDs in multiple years, over 3 years making an average of 59 ED visits (R=19 to 194). They were generally, young, male, unemployed, transient or homeless with many unmet social and economic needs. They could be categorized into: 1) suffering from severe alcohol abuse/withdrawal or illicit drug use; 2) chronic mood and anxiety disorders; 3) significant personal and social stressors; and 4) a complex combination of psychiatric disease(s) and cognitive impairment. Conclusions Action should be taken to identify ‘High Frequency Users’ early in their patient career and develop appropriate interventions taking into account their unique and diverse needs.
Clinical and investigative medicine. Médecine clinique et experimentale, 2003
The computer telephony system (CTS) combines computer and telephone to automate the collection, p... more The computer telephony system (CTS) combines computer and telephone to automate the collection, processing and dissemination of information. Many innovative applications of the CTS have emerged. In this article we summarize the evidence for CTS-based medical interventions based on randomized controlled trials. We searched for trials in MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials, and bibliographies of retrieved articles, review articles and textbooks. We excluded non-English articles and those pertaining to psychology, addiction, psychiatry, research and education. In health care delivery, 3 of 4 trials of CTS-based interventions improved clinic show rates. In preventive health care, 4 of 5 showed higher childhood immunization rates. For nutrition, 2 small trials showed no clear benefit in cholesterol lowering or in weight reduction, but 1 trial showed a benefit in fibre intake. For increasing physical activity, 1 smaller trial showed no benefit but a larger ...
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 6, 1999
Violence during pregnancy is a health and social problem that poses particular risks to the woman... more Violence during pregnancy is a health and social problem that poses particular risks to the woman and her fetus. To address the lack of Canadian information on this issue, the authors studied the prevalence and predictors of physical abuse in a sample of pregnant women in Saskatoon. Of 728 women receiving prenatal services through the Saskatoon District public health system between Apr. 1, 1993, and Mar. 31, 1994, 605 gave informed consent to participate in the study and were interviewed in the second trimester. Of these, 543 were interviewed again late in the third trimester. During the initial interview, information was collected on the women's sociodemographic characteristics, the current pregnancy, health practices and psychosocial variables. The second interview focused on the women's experience of physical abuse during the pregnancy and during the preceding year, the demographic characteristics and the use of alcohol or illicit drugs by their male partner. In all, 31 (...
Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been... more Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been no national study of the use of these drugs. We have attempted to correct this deficit in our knowledge by using data from an international survey of health care utilization performed in 1968-9 and from the Canada Health Survey (1978-9), the Health Promotion Survey (1985) and the National Alcohol and Other Drugs Survey (1989) to examine sedative-hypnotic use among individuals aged 15 or more. The results suggest that the use of these drugs in Canada is about average for an industrialized society. Several socioeconomic and health care correlates of sedative-hypnotic use were found. The rate of use of these drugs was higher among women, the elderly, separated, divorced or widowed individuals, those who had a secondary school education or less, individuals with a low family income, the retired, and the unemployed. Among women, higher rates of use were reported by those whose main activity ...
Trace amines are possibly involved in some psychiatric disorders (Boulton, 1980). β-Phenylethylam... more Trace amines are possibly involved in some psychiatric disorders (Boulton, 1980). β-Phenylethylamine, for example, is chemically similar to amphetamine, and can induce behavioural effects in laboratory animals resembling those of amphetamine (Mantegazza and Riva, 1963). Amphetamine abuse in large doses is often associated with homicidal violence (Ellinwood, 19071; Allen et al., 1975). Paradoxically amphetamine can suppress aggressive behaviour (Miczek, 1974) and hyperactivity in children (Arnold et al., 1978). It has been argued that the hyperactive child syndrome and adult psychopathy are related in that a common pathophysiological condition of low CNS arousal states may underlie both conditions (Satterfield, 1978). β-Phenylethylamine has, therefore, become a center of interest in research on mental disorders. Trace amines are metabolized rapidly (Wu and Boulton 1975; Philips and Boulton, 1979; Durden and Philips, 1980). Enzymes involved in the catabolism of the trace amines, monoamine oxidase (MAO) and phenolsulfotransferase (PST), as well as the trace acid metabolites themselves have been analyzed.
The Journal of Continuing Education in Nursing, 2007
This article examines the barriers to participation in continuing education activities that are p... more This article examines the barriers to participation in continuing education activities that are perceived by rural and remote registered nurses in Canada. The data are drawn from a national survey that was part of a larger national project, &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;The Nature of Nursing Practice in Rural and Remote Canada.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; Perceived barriers to participation in continuing education activities include the isolation of rural nurses and time and financial constraints. Nurses who perceived barriers to participation were more likely to be middle-aged, unmarried, and working full-time than nurses who did not perceive barriers. They were also more likely to possess higher levels of nursing education and have children or dependents. The perception of barriers to participation was also associated with lower job and scheduling satisfaction. Rural and remote registered nurses have moderately high levels of participation in continuing education; however, participation and job satisfaction can be improved if some of the barriers identified are addressed.
This study examines predictors of job satisfaction among rural acute care registered nurses. The ... more This study examines predictors of job satisfaction among rural acute care registered nurses. The data are from a cross-sectional national survey, which was part of a larger project, The Nature of Nursing Practice in Rural and Remote Canada. This analysis suggests that a combination of individual, workplace, and community characteristics are interrelated predictors of job satisfaction for rural acute care nurses. There were nine variables that accounted for 38% of the total variance in job satisfaction. Four variables alone (available and up-to-date equipment and supplies, satisfaction with scheduling and shifts, lower psychological job demands, and home community satisfaction) explained 33% of the variance. Recruitment and retention strategies in rural areas must acknowledge that rural nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; work lives and community lives are inextricably intertwined. Attention to these issues will help ensure high-quality working environments and a continued commitment to quality nursing care in the rural hospital settings in Canada.
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