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Menstrual health inequities and "period poverty" in Canada. 加拿大的经期健康不平等和 "经期贫困"。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-21 DOI: 10.17269/s41997-024-00853-1
Ann C Lee, Leisha Toory, Megan E Harrison

Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.

经期贫困是指无法获得月经用品、性健康和生殖健康教育、安全的废物管理和适当的设施。尽管经期贫困是一个公共卫生问题,也是众多加拿大人关心的一个重要问题,但在加拿大却缺乏关于经期贫困的同行评审研究。加拿大现有的研究主要由非营利组织/慈善机构或月经产品行业领导者进行,导致数据不完整。需要进行更多的研究,以探讨加拿大经期不平等现象及其对加拿大人福祉的影响。这是确保加拿大人的月经需求得到适当满足的关键一步。
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引用次数: 0
Alimentation infantile et changements climatiques : une opportunité prometteuse. 儿童营养与气候变化:大有可为的机遇。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-03-25 DOI: 10.17269/s41997-024-00869-7
Micheline Beaudry, Ray Bustinza, Isabelle Michaud-Létourneau

The method of infant feeding has consequences for the production of greenhouse gases (GHG) as well as for the risks to infants posed by climate change. Breastfeeding can reduce the carbon footprint associated with the use of commercial infant formula by nearly 50% while reducing its water footprint and waste. It is also an excellent way of coping with emergencies associated with climate change, such as water shortages, since breastfed children are better protected than those fed with formula. To ensure that the protection offered by breastfeeding can be realized, we present elements that can help decision-makers seize a promising opportunity: improve infant feeding support for women and families.

婴儿喂养方式对温室气体(GHG)的产生以及气候变化给婴儿带来的风险都有影响。与使用商业婴儿配方奶粉相比,母乳喂养可减少近 50%的碳足迹,同时减少水足迹和废物。母乳喂养也是应对与气候变化有关的紧急情况(如缺水)的绝佳方式,因为母乳喂养的婴儿比用配方奶粉喂养的婴儿得到更好的保护。为了确保母乳喂养所提供的保护得以实现,我们提出了可以帮助决策者抓住大好机会的要素:改善对妇女和家庭的婴儿喂养支持。
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引用次数: 0
The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime. 加拿大监督注射点对公共健康的影响:超越社会接受度和对犯罪的影响。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-04-11 DOI: 10.17269/s41997-024-00874-w
Carolyn Côté-Lussier, Paul Rodrigues

Canada has been a pioneer in adopting a harm reduction approach to address risks associated with drug use for people who inject drugs. Today, Canada is home to 39 supervised injection sites spread throughout the country. The scientific literature demonstrates, unequivocally, that these sites have numerous health benefits for people who inject drugs, namely by decreasing risks of blood-borne diseases, overdose, and mortality. Yet, a lack of clear guidelines on optimal locations for the implementation of such sites and NIMBYISM ("Not In My Back Yard") have been stumbling blocks for planned and operating sites. Various Canadian governments have introduced their own policies to overcome the lack of national public health guidelines on community planning. Namely, policies aim to limit the exposure to sites and drug use for vulnerable populations, such as children. However, there is a veritable lack of research on the public health impacts of supervised injection sites for local communities, who tend to be disadvantaged. The existing literature fails to address the broader and differential impacts of such sites for local vulnerable and disadvantaged populations, including use of active transportation, psychological distress, perceived safety, and social cohesion. Moreover, existing research, largely focusing on assessing pre-implementation social acceptability and post-implementation impacts on crime, faces important methodological limitations. The following commentary reviews the existing literature and makes recommendations for future public health research on the impacts of supervised injection sites.

加拿大一直率先采用减少伤害的方法来应对注射毒品者使用毒品的相关风险。如今,加拿大全国共有 39 个受监督的注射点。科学文献明确表明,这些场所对注射吸毒者的健康有诸多益处,如降低血液传播疾病、用药过量和死亡率的风险。然而,由于缺乏明确的指导方针来确定这些场所的最佳实施地点,以及 "不在我家后院"("NIMBYISM")的存在,这些一直是规划和运营这些场所的绊脚石。加拿大多国政府都出台了自己的政策,以克服社区规划方面缺乏国家公共卫生指导方针的问题。也就是说,这些政策旨在限制儿童等弱势人群接触毒品和吸毒。然而,有关监督注射点对当地社区公共卫生影响的研究却非常缺乏,而这些社区往往是弱势群体。现有文献没有涉及此类场所对当地弱势和贫困人群的更广泛和不同的影响,包括积极交通的使用、心理困扰、安全感和社会凝聚力。此外,现有研究主要侧重于评估实施前的社会可接受性和实施后对犯罪的影响,在方法上存在很大的局限性。以下评论回顾了现有文献,并对未来有关监督注射点影响的公共卫生研究提出了建议。
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引用次数: 0
Preconception health disparities among reproductive-aged women with and without disabilities in Canada. 加拿大残疾和非残疾育龄妇女在孕前健康方面的差异。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-04-04 DOI: 10.17269/s41997-024-00873-x
Samantha M Forbes, Lesley A Tarasoff, Meredith Evans, Hilary K Brown

Objectives: Preconception health (PCH), which describes the health status of reproductive-aged individuals, can influence reproductive, maternal, and fetal/neonatal outcomes. PCH disparities have been observed in certain populations, prompting the development of tailored resources. Our objective was to compare the PCH characteristics of women with and without disabilities.

Methods: We undertook a secondary analysis of the 2003-2014 cycles of the Canadian Community Health Survey (CCHS), which included n = 115,295 women aged 15-49 years. Among these, we also examined a sub-sample of n = 12,495 women with a subsequent obstetrical delivery identified in a linkage of the CCHS with the Discharge Abstract Database (DAD, 2003-2017). The outcomes were 8 PCH indicators. We used modified Poisson regression to estimate adjusted prevalence ratios (aPRs) for each PCH indicator, comparing women with and without disabilities, and multinomial logistic regression to calculate adjusted odds ratios for 1, 2, and ≥ 3 PCH indicators (vs. 0). Analyses were adjusted for baseline demographics.

Results: Reproductive-aged women with disabilities had significantly increased aPRs of smoking (1.42 [95% CI:1.37-1.48]), obesity (1.57 [1.48-1.65]), and self-reported fair/poor physical (5.56 [5.09-6.07]) and mental health (4.07 [3.71-4.47]), compared to those without disabilities. They were also more likely to have ≥ 3, 2, and 1 PCH indicators (vs. 0). Findings were similar in the sub-sample with a subsequent obstetrical delivery.

Conclusion: Canadian reproductive-aged women with disabilities experience important PCH disparities. Further research is needed to inform tailored education and resources to support PCH in individuals with disabilities, in combination with policies to address structural barriers to PCH.

目标:孕前健康(PCH)描述了育龄个体的健康状况,可影响生殖、孕产和胎儿/新生儿的结局。在某些人群中已发现孕前保健存在差异,这促使人们开发有针对性的资源。我们的目标是比较残疾妇女和非残疾妇女的 PCH 特征:我们对 2003-2014 年周期的加拿大社区健康调查(CCHS)进行了二次分析,其中包括 n = 115,295 名 15-49 岁的女性。在这些妇女中,我们还研究了一个子样本,该子样本包括在加拿大社区健康调查(CCHS)与出院摘要数据库(DAD,2003-2017 年)的连接中确定的 n = 12,495 名随后进行了产科分娩的妇女。结果为 8 项 PCH 指标。我们使用改良泊松回归来估算每个 PCH 指标的调整患病率(aPRs),并对有残疾和无残疾的产妇进行比较;我们还使用多项式逻辑回归来计算 1、2 和 ≥ 3 个 PCH 指标(与 0 相比)的调整几率比。分析对基线人口统计学进行了调整:与非残疾女性相比,育龄残疾女性的吸烟(1.42 [95% CI:1.37-1.48])、肥胖(1.57 [1.48-1.65])、自我报告的身体健康(5.56 [5.09-6.07])和心理健康(4.07 [3.71-4.47])的调整赔率均显著增加。他们也更有可能拥有≥ 3、2 和 1 个 PCH 指标(相对于 0)。在随后进行顺产的子样本中,研究结果与此类似:结论:加拿大的育龄残疾妇女在 PCH 方面存在很大差异。需要进一步开展研究,以提供有针对性的教育和资源,为残疾人士的 PCH 提供支持,并结合相关政策解决 PCH 面临的结构性障碍。
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引用次数: 0
Racial and sociodemographic distribution of colorectal cancer screening in Canada: A cross-sectional study. 加拿大大肠癌筛查的种族和社会人口分布:横断面研究。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.17269/s41997-024-00859-9
Kazeem Adefemi, John C Knight, Yun Zhu, Peter Peizhong Wang

Objectives: To assess the racial and sociodemographic distribution of colorectal cancer (CRC) screening uptake in Canada, identify disparities, and evaluate the potential predictors and barriers to CRC screening.

Methods: Data from the 2017 cycle of the Canadian Community Health Survey (CCHS) were analyzed, focusing on individuals aged 50-74 years. CRC screening participation rates were evaluated at both national and provincial levels and across various sociodemographic characteristics. Multivariable logistic regression models were employed to identify predictors and barriers to CRC screening.

Results: Of the 56,950 respondents to the 2017 CCHS, 41.7% (n = 23,727) were between 50 and 74 years of age. The overall CRC screening participation rate was 59.8%, with provinces like Alberta and Manitoba achieving rates of 65.7% and 66.5%, respectively. Significant disparities were observed across socioeconomic, geographical, and racial or ethnic groups. Notably, older adults [AOR 2.41, 95% CI 2.06‒2.83], higher income earners [AOR 1.99, 95% CI 1.77‒2.24], and non-smokers [AOR 1.76, 95% CI 1.55‒2.0] had higher odds of screening, while immigrants and minority ethnic groups, especially South-East Asians [AOR 0.48, 95% CI 0.29‒0.78] and South Asians [AOR 0.65, 95% CI 0.44‒0.95], had lower odds of being up to date with CRC screening. A significant portion of unscreened individuals cited their healthcare provider's perception of the test as unnecessary.

Conclusion: While there is promising progress in CRC screening participation rates across Canada, significant disparities persist. Addressing these disparities is crucial for public health. Efforts should focus on enhancing public awareness, facilitating accessibility, and ensuring cultural appropriateness of CRC screening initiatives.

目的:评估加拿大接受大肠癌筛查的种族和社会人口分布情况:评估加拿大接受结直肠癌(CRC)筛查的种族和社会人口分布情况,确定差异,并评估CRC筛查的潜在预测因素和障碍:分析了加拿大社区健康调查(CCHS)2017 年周期的数据,重点关注 50-74 岁的人群。对全国和各省的 CRC 筛查参与率以及各种社会人口特征进行了评估。研究采用了多变量逻辑回归模型来确定CRC筛查的预测因素和障碍:在2017年CCHS的56950名受访者中,41.7%(n=23727)的年龄在50至74岁之间。CRC筛查的总体参与率为59.8%,艾伯塔省和马尼托巴省的参与率分别为65.7%和66.5%。不同的社会经济、地域、种族或民族群体之间存在显著差异。值得注意的是,老年人[AOR 2.41,95% CI 2.06-2.83]、高收入者[AOR 1.99,95% CI 1.77-2.24]和非吸烟者[AOR 1.76,95% CI 1.55-2.0]接受筛查的几率更高。而移民和少数民族群体,尤其是东南亚人[AOR 0.48,95% CI 0.29-0.78]和南亚人[AOR 0.65,95% CI 0.44-0.95],接受最新的 CRC 筛查的几率较低。很大一部分未接受筛查的人认为他们的医疗服务提供者认为这种检查是不必要的:尽管加拿大各地的 CRC 筛查参与率取得了可喜的进步,但仍存在显著差异。解决这些差距对公共卫生至关重要。工作重点应放在提高公众意识、促进可及性和确保 CRC 筛查措施的文化适宜性上。
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引用次数: 0
Grief is a public health issue. 悲伤是一个公共卫生问题。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 DOI: 10.17269/s41997-024-00898-2
Mary Ellen Macdonald
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引用次数: 0
Determinants of non-vaccination against seasonal influenza during pregnancy. 孕期不接种季节性流感疫苗的决定因素。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.17269/s41997-024-00871-z
David Guan, Nicolas L Gilbert, Mireille Guay, Aubrey Maquiling, Jackie Kokaua, Isabelle Lévesque, Vanessa Poliquin

Objective: The objective of this study was to identify the determinants of influenza non-vaccination during pregnancy in Canada.

Methods: Biological mothers of children born between December 2018 and March 2019 were surveyed about vaccinations they had received during pregnancy, reasons for non-vaccination, obstetrical history, and demographics. Simple and multiple logistic regression models were used to measure associations between various sociodemographic factors as well as obstetrical history, and non-vaccination against influenza. We analyzed data from 2361 mothers.

Results: Factors associated with non-vaccination included being followed during pregnancy by a midwife compared to by an obstetrician-gynecologist (OR 2.02; 95% CI, 1.17‒3.50); having two or more past live births compared to none (OR 1.58; 95% CI, 1.01‒2.49); having an education level below high school diploma compared to a bachelor's degree or above (OR 2.50; 95% CI, 1.06‒5.90); and having a household income below $60,000 (OR 2.46; 95% CI, 1.42‒4.24) or between $60,000 and $99,999 (OR 2.77; 95% CI, 1.70‒4.52) compared to a household income of $140,000 or more. The province or territory of prenatal care proved to be an important factor in non-vaccination, with statistically significant odds ratios for certain provinces: OR 7.50 (95% CI, 1.40‒40.26) for Ontario, 8.23 (95% CI, 1.53‒44.23) for Newfoundland and Labrador, and 11.39 (95% CI, 2.14‒60.60) for Quebec, as compared to the territories.

Conclusion: Despite universal access to influenza vaccines in Canada during pregnancy, regional variations and socioeconomic disparities in non-vaccination are still observable.

研究目的本研究旨在确定加拿大怀孕期间未接种流感疫苗的决定因素:对 2018 年 12 月至 2019 年 3 月间出生儿童的生母进行了调查,了解她们在怀孕期间接种疫苗的情况、不接种疫苗的原因、产科病史和人口统计学特征。我们使用简单和多元逻辑回归模型来衡量各种社会人口因素以及产科病史与未接种流感疫苗之间的关联。我们分析了 2361 名母亲的数据:与不接种疫苗相关的因素包括:在怀孕期间由助产士跟踪而不是由妇产科医生跟踪(OR 2.02;95% CI,1.17-3.50);过去有过两次或两次以上活产而不是没有(OR 1.58;95% CI,1.01-2.49);教育水平低于高中或高中以上(OR 1.58;95% CI,1.01-2.49)。49);教育水平低于高中文凭与本科或以上学历相比(OR 2.50;95% CI,1.06-5.90);家庭收入低于 60,000 美元(OR 2.46;95% CI,1.42-4.24)或介于 60,000 美元与 99,999 美元之间(OR 2.77;95% CI,1.70-4.52)与家庭收入 140,000 美元或以上相比。事实证明,产前护理所在的省份或地区是导致不接种疫苗的一个重要因素,某些省份的几率比有统计学意义:与各地区相比,安大略省的概率为 7.50(95% CI,1.40-40.26),纽芬兰和拉布拉多省为 8.23(95% CI,1.53-44.23),魁北克省为 11.39(95% CI,2.14-60.60):尽管加拿大普及了孕期流感疫苗接种,但在未接种疫苗方面仍存在地区差异和社会经济差异。
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引用次数: 0
Community perspectives on COVID-19 outbreak and public health: Inuit positive protective pathways and lessons for Indigenous public health theory. 社区对 COVID-19 爆发和公共卫生的看法:因纽特人的积极保护途径和对土著公共卫生理论的启示。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-04-23 DOI: 10.17269/s41997-024-00863-z
Gwen K Healey Akearok, Zoha Rana

Objectives: Indigenous public health theory and the voices of Canadian Indigenous communities remain under-represented in the literature despite the Canadian Truth and Reconciliation Calls to Action, and the perspectives of Inuit are further under-represented in this literature. The goal of this paper is to explore the perspectives of Iqalungmiut (people of Iqaluit), frontline staff, and decision-makers on the management of the COVID-19 outbreak in Iqaluit in April to June 2021 and to identify lessons learned and contributions to public health policy and practice specific to Inuit populations in Canada.

Methods: This study used the Piliriqatigiinniq Community Health Research Model which was developed by Nunavummiut to guide community-based health and well-being research. Interviews were conducted with 44 individuals: 22 community members and shelter users; 17 frontline workers; and 5 decision-makers representing municipal and territorial government. Participants were asked about their experiences during the outbreak, sources of information, and strengths and challenges during outbreak management.

Results: Challenges included overcrowding, physical disconnection from family members, and mental health and trauma. Community-identified strengths included strong interagency cooperation, food hamper and COVID-19 care kit deliveries, and travel restrictions. Several Inuit positive health-protective pathways were identified including Ilaginniq; Silativut; Inuuqatigiittiarniq; Piliriqatigiinniq; Ikajurniq; and Pijitsirniq.

Conclusion: Outbreaks of infectious illness are not new to Nunavut communities and Inuit protective pathways have and continue to be critical avenues to adapt to and mitigate such challenges. This exploratory study provides clear direction for Inuit public health policy and practice in Canada, while contributing to the body of literature on Indigenous public health theory.

目标:尽管加拿大发出了 "真相与和解行动呼吁",但原住民公共卫生理论和加拿大原住民社区的声音在文献中的代表性仍然不足,因纽特人的观点在这些文献中的代表性进一步不足。本文旨在探讨伊魁特人(Iqalungmiut)、一线工作人员和决策者对 2021 年 4 月至 6 月伊魁特 COVID-19 疫情管理的看法,并总结经验,为加拿大因纽特人特有的公共卫生政策和实践做出贡献:本研究采用了 Piliriqatigiinniq 社区健康研究模型,该模型由努纳武米人开发,用于指导基于社区的健康和福祉研究。研究人员对 44 人进行了访谈,其中包括 22 名社区成员和庇护所使用者、17 名一线工作人员以及 5 名代表市政和地区政府的决策者。访谈内容包括疫情爆发期间的经历、信息来源以及疫情管理过程中的优势和挑战:挑战包括过度拥挤、与家人失去联系、心理健康和创伤。社区认可的优势包括机构间的紧密合作、食品篮和 COVID-19 护理包的运送以及旅行限制。还发现了一些因纽特人积极的健康保护途径,包括 Ilaginniq、Silativut、Inuuqatigiittiarniq、Piliriqatigiinniq、Ikajurniq 和 Pijitsirniq:传染病的爆发对努勒维特社区来说并不陌生,因纽特人的保护途径已经并将继续成为适应和减轻此类挑战的重要途径。这项探索性研究为加拿大因纽特人的公共卫生政策和实践提供了明确的方向,同时也为有关土著公共卫生理论的文献做出了贡献。
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引用次数: 0
Responding to and managing multijurisdictional outbreaks of COVID-19 in Canadian industrial worksite/work camp settings. 应对和管理在加拿大工业工地/营地环境中爆发的 COVID-19 多辖区疫情。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-04-29 DOI: 10.17269/s41997-024-00887-5
Erin McGill, Anna Bellos, Andrea Nwosu, Adrian Zetner, Andrea Tyler, Natalie Knox, Kristyn Franklin, Kaitlin Patterson

Setting: Early in the COVID-19 pandemic, the Public Health Agency of Canada (PHAC) and provincial/territorial (P/T) public health identified the need for a coordinated response to complex multijurisdictional COVID-19 outbreaks. The first large multijurisdictional industrial worksite COVID-19 outbreak highlighted the risk of transmission within these congregate work settings, the risk of transmission to the broader community(ies), and the need to develop setting-specific outbreak response frameworks.

Intervention: PHAC assembled a team to provide national outbreak support for multijurisdictional COVID-19 outbreaks in May 2020. The COVID-19 Outbreak Response Unit (ORU) worked with P/T partners to develop guiding principles for outbreak response and outbreak investigation processes, guidance documents, and investigation tools (e.g., minimum data elements and questionnaires).

Outcomes: The ORU, P/T partners, and onsite industrial worksite health and safety staff leveraged outbreak investigation guidelines, industrial worksite outbreak process documents (including minimum data elements), and enhanced case questionnaires to respond to multiple COVID-19 outbreak investigations in industrial worksites. Clear roles/responsibilities and processes, along with standardized data, allowed for more efficient outbreak investigations and earlier implementation of mitigation measures.

Implications: Multijurisdictional COVID-19 outbreaks highlighted the importance of public health collaboration with industry partners onsite. The assembly of a national outbreak response team was important to facilitate information sharing and provide technical support. Lessons learned and recommendations on outbreak preparation, detection, management, and communication are included to enhance a response framework applicable to future emerging or re-emerging pathogens with epidemic and/or pandemic potential.

背景:在 COVID-19 大流行的早期,加拿大公共卫生署 (PHAC) 和省/地区 (P/T) 公共卫生部门确定有必要协调应对复杂的多辖区 COVID-19 爆发。首次大规模多辖区工业工作场所 COVID-19 疫情爆发凸显了这些聚集工作场所的传播风险、向更广泛社区传播的风险,以及制定特定环境疫情应对框架的必要性:PHAC 组建了一个团队,为 2020 年 5 月爆发的多辖区 COVID-19 疫情提供国家疫情支持。COVID-19疫情应对小组(ORU)与P/T合作伙伴合作,制定疫情应对和疫情调查流程的指导原则、指导文件和调查工具(如最低数据元素和调查问卷):ORU、P/T 合作伙伴和现场工业工地健康与安全人员利用疫情调查指导原则、工业工地疫情调查流程文件(包括最低数据要素)和增强型病例调查问卷来应对工业工地的多起 COVID-19 疫情调查。明确的角色/职责和流程以及标准化的数据使疫情调查更有效率,并能更早地实施缓解措施:多辖区 COVID-19 疫情突显了公共卫生与现场行业合作伙伴合作的重要性。组建国家疫情应对小组对于促进信息共享和提供技术支持非常重要。汲取的经验教训和有关疫情准备、检测、管理和沟通的建议被纳入其中,以加强适用于未来新出现或再次出现的具有流行和/或大流行潜力的病原体的响应框架。
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引用次数: 0
Correction: The public health impacts of supervised injection sites in Canada: Moving beyond social acceptability and impacts on crime. 更正:加拿大监督注射点对公共健康的影响:超越社会接受度和对犯罪的影响。
IF 4.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 DOI: 10.17269/s41997-024-00892-8
Carolyn Côté-Lussier, Paul Rodrigues
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引用次数: 0
期刊
Canadian Journal of Public Health-Revue Canadienne De Sante Publique
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