Objectives Earlier longitudinal reviews on environmental and occupational toxins and Parkinson’s disease (PD) risk have limitations. This study aimed to determine the strength of association between three types of toxic occupational exposures and the occurrence of PD by diagnostic methods. Methods A search was conducted of EMBASE, PubMed/Medline, Toxnet, LILACS, and Cochrane Library databases for longitudinal studies that assessed toxic occupational exposure, Parkinsonian, or related disorders, diagnosed by International Classification of Diseases (ICD) codes, medical records, or confirmation by a neurologist/nurse, and published in the English language from January 1990 to July 2021. Pooled risk ratios (RR) estimates were produced using random-effects models. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. High-quality articles that met the inclusion criteria were analyzed. Results Twenty-four articles were used in the analyses. The pooled RR for electromagnetic exposure and PD were (RR=1.03, 95% confidence interval [CI] 0.91–1.16) while the pooled RR between PD and metal and pesticide exposure were (RR=1.07, 95% CI 0.92–1.24) and (RR=1.41, 95% CI 1.20–1.65), respectively. Pooled RR for methods of diagnosis and their associations with PD were: confirmation by a neurologist or nurse (RR=2.17, 95% CI 1.32–3.54); ICD codes (RR=1.14, 95% CI 1.03–1.26), and medical records (RR=1.06, 95% CI 0.92–1.21). Conclusions Our systematic review provides robust evidence that toxic occupational exposures are significant risk factors for PD especially those diagnosed by neurologists or nurses using standardized methods.
Background: Alzheimer’s disease/dementia (AD) prevalence is of concern globally and in Canada owing to the rapidly aging population and increase in life expectancy. This study explored: (1) trends in the overall prevalence of self-reported AD/dementia by sex, age groups, educational levels, and geographic areas in Canada from 1994 to 2014, and (2) assessed what the observed trends mean in the context of the aging Canadian population and the health care system. Design and methods: This cross-sectional study used Canadian national survey data. Data for this study were from two Canadian national health surveys (National Population Health Survey and the Canadian Community Health Survey), between 1994 and 2014. After age-sex standardization, trends in the prevalence of self-reported Alzheimer’s disease/dementia were tracked over time. The two cross-sectional surveys used similar diagnostic criteria over the years. Results: The overall prevalence of Alzheimer’s disease/dementia increased from 0.14 in 1994 to 0.80 in 2014 representing a 0.66-point increase over the 20 years. Alzheimer’s disease/dementia prevalence increased with age across all years but was more pronounced after age 80. Men 65+ years, those with lower education, and Canadians living in Central Canada had an increased prevalence. Conclusions: The overall prevalence of Alzheimer’s disease/dementia in the community increased over time. This study highlights the importance of establishing effective community-based prevention strategies that focus on minimizing risk and optimizing protection as well as health system capacity strengthening and preparation for long-term care including increased demand for neurologists’ services, increased associated disability, psychosocial difficulties, rising costs, and caregiver burden.
Background Neurological conditions (NCs) can lead to long-term challenges including functional impairments and limitations to activities of daily living. People with neurological conditions often report unmet health care needs and experience barriers to care. This study aimed to (1) explore the factors predicting patient satisfaction with general health care, hospital, and physician services among Canadians with NCs, (2) examine the association between unmet health care needs and satisfaction with health care services among neurological patients in Canada, and (3) contrast patient satisfaction between physician care and hospital care among Canadians with NCs. Methods We conducted a secondary analysis on a subsample of the 2010 Canadian Community Health Survey - Annual Component data (N = 6335) of respondents with neurological conditions, who received general health care services, hospital services, and physician services within twelve months. Multivariate logistic regression fitted the models and odds ratios and 95% confidence intervals were reported using STATA version 14. Results Excellent quality care predicts higher odds of patient satisfaction with general health care services (OR, 95%CI–237.6, 70.4–801.5), hospital services (OR, 95%CI–166.9, 67.9–410.6), and physician services (OR, 95%CI–176.5, 63.89–487.3). In contrast, self-perceived unmet health care needs negatively predict patient satisfaction across all health care services: general health care services (OR, 95%CI–0.59, 0.37–0.93), hospital services (OR, 95%CI–0.41, 0.21–0.77), and physician services (OR, 95%CI–0.29, 0.13–0.69). Other negative predictors of patient satisfaction include some post-secondary education (OR, 95%CI–0.36, 0.18–0.72) for general health services and (OR, 95%CI–0.26, 0.09–0.80) for physician services. Those with secondary (OR, 95% CI–0.32, 0.13–0.76) and post-secondary graduation (OR, 95%CI– 0.28, 0.11–0.67) negatively predicted patient satisfaction among users of physician services while being an emergency room patient most recently (OR, 95%CI– 0.39, 0.20–0.77) was also negatively associated with patients satisfaction among hospital services users. Conclusion This study found self-perceived unmet health care needs as a significant negative predictor of neurological patients’ satisfaction across health care services and emphasizes the importance of ensuring coordinated efforts to provide appropriate and accessible care of the highest quality for Canadians with neurological conditions.
The benefits of mentorship to individuals in post-secondary relate to wellbeing, satisfaction, and perceived success which translates to organizational commitment. Mentorship improves skills in academic roles and leadership, yet a disconnect remains on what mentees and mentors expect and what institutions provide. Supports are required for mentorship to be effective in empowering employees and creating a culture that espouses competence and autonomy through collaboration and creativity. The aim of this research was to replicate and advance an earlier study assessing nursing and health sciences in a polytechnic to describe the perceived mentorship culture for faculty, professional services, and leadership, across a provincial organization. This was accomplished through a sequential descriptive mixed methods study assessing the building blocks and hallmarks of a Mentorship Culture Audit. This paper reports on both the comparative assessment from 2013 and this new quantitative survey, along with a qualitative component enhancing the understanding of the mentorship culture within a polytechnic providing a variety of programming for vocational students. The audit revealed the employee perception of a mentorship culture to a mean of 4.52 on a seven-point Likert scale and noted areas of strength or infrastructure to be developed. Qualitative data portrayed further understanding where hallmarks of mentorship promoted or were lacking for informal or formal structures. Organizations benefit from mentorship. Tailoring mentorship to a framework ensures mentorship is anchored for success. This study is unique in its replication, the mixed methods approach, and its originality as an organizational level mentorship assessment.
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