Knowledge and Attitudes Towards Breastfeeding Among Medical Students at Memorial University

Breastfeeding has many short term and long term health benefits to mothers and children, yet not all mothers in Canada initiate breastfeeding. Physicians’ support has been shown to improve breastfeeding rates, yet many physicians have poor knowledge and skills about breastfeeding. Improving breastfeeding education at an undergraduate level in medical school may lead to improved breastfeeding knowledge amongst physicians. This thesis explores medical students’ knowledge and attitudes towards breastfeeding at Memorial University. A previously validated questionaire was administered to first and second year medical students at Memorial University to examine their knowledge and attitudes towards breastfeeding. A descriptive qualitative study was conducted with breastfeeding educators at Memorial University to examine knowledge gaps within the breastfeeding curriculum. Medical students were found to have positive attitudes towards breastfeeding, yet limited knowledge. Students from rural areas had the highest attitude scores, whereas second year students had the highest knowledge scores. Breastfeeding educators noted many curriculum gaps in breastfeeding education, and provided suggestions to improve the curriculum. This study was the first to examine medical students’ knowledge and attitudes towards breastfeeding in Canada. The study was conducted in the Province of Newfoundland and Labrador, which has the lowest breastfeeding initiation rate in Canada. During the time of this study, undergraduate curriculum refinement was occurring at the medical school of Memorial University. Thus the findings of this study may lead to potential curricular improvements at Memorial University

Engaging a community for youth mental health and wellness: Reflections and lessons learned

As clinicians at a university-affiliated health centre faced with youth mental health and substance use concerns, we reached out to the local community for guidance. We partnered with community leaders to explore how to best understand the issues and engage with the community. Using a community-engaged research (CEnR) approach, we conducted a needs assessment to explore the issues and inform change. We formalised a partnership with the local school and community board, which led to the creation of a Community Alliance. Our engagement efforts allowed us to understand the community more deeply and establish more effective change. Our most successful outcome was the development of a youth mental health and wellness Action Plan which helped direct our strategies moving forward. This article highlights our community engagement activities, processes and lessons learned, which may be of benefit to other academic researchers and clinicians who are interested in CEnR

Involvement of social partners in policymaking during the COVID-19 outbreak

Aquesta publicació s'elabora a partir de les contribucions de cadascú dels membres nacionals que integren la Network of Eufound Correspondent. Pel cas d'Espanya la contribució ha estat realitzada per l'Oscar Molina GodinoSince 2016, Eurofound has closely monitored the involvement of national social partners in policymaking as part of the European Semester cycle. In 2020, the focus was on their involvement during the first months of the COVID-19 outbreak. While the pandemic has presented a huge challenge to social dialogue, the results of the analysis highlight how social dialogue can be an effective tool in shaping policy initiatives and finding solutions to emergency situations affecting businesses, workers, the economy and society. It is clear that the participation of social partners in the design and implementation of national recovery and resilience plans in 2021 will be key in the recovery process and for strengthening social dialogue going forward

Randomized trial of physician alerts for thromboprophylaxis after discharge

BACKGROUND: Many hospitalized Medical Service patients are at risk for venous thromboembolism in the months after discharge. We conducted a multicenter randomized controlled trial to test whether a hospital staff member\u27s thromboprophylaxis alert to an Attending Physician before discharge will increase the rate of extended out-of-hospital prophylaxis and, in turn, reduce the incidence of symptomatic venous thromboembolism at 90 days. METHODS: From April 2009 to January 2010, we enrolled hospitalized Medical Service patients using the point score system developed by Kucher et al to identify those at high risk for venous thromboembolism who were not ordered to receive thromboprophylaxis after discharge. There were 2513 eligible patients from 18 study sites randomized by computer in a 1:1 ratio to the alert group or the control group. RESULTS: Patients in the alert group were more than twice as likely to receive thromboprophylaxis at discharge as controls (22.0% vs 9.7%, P \u3c.0001). Based on an intention-to-treat analysis, symptomatic venous thromboembolism at 90 days (99.9% follow-up) occurred in 4.5% of patients in the alert group, compared with 4.0% of controls (hazard ratio 1.12; 95% confidence interval, 0.74-1.69). The rate of major bleeding at 30 days in the alert group was similar to that of the control group (1.2% vs 1.2%, hazard ratio 0.94; 95% confidence interval, 0.44-2.01). CONCLUSIONS: Alerting providers to extend thromboprophylaxis after hospital discharge in Medical Service patients increased the rate of prophylaxis but did not decrease the rate of symptomatic venous thromboembolism

Urbanization, climate and species traits shape mammal communities from local to continental scales

Human-driven environmental changes shape ecological communities from local to global scales. Within cities, landscape-scale patterns and processes and species characteristics generally drive local-scale wildlife diversity. However, cities differ in their structure, species pools, geographies and histories, calling into question the extent to which these drivers of wildlife diversity are predictive at continental scales. In partnership with the Urban Wildlife Information Network, we used occurrence data from 725 sites located across 20 North American cities and a multi-city, multi-species occupancy modelling approach to evaluate the effects of ecoregional characteristics and mammal species traits on the urbanization-diversity relationship. Among 37 native terrestrial mammal species, regional environmental characteristics and species traits influenced within-city effects of urbanization on species occupancy and community composition. Species occupancy and diversity were most negatively related to urbanization in the warmer, less vegetated cities. Additionally, larger-bodied species were most negatively impacted by urbanization across North America. Our results suggest that shifting climate conditions could worsen the effects of urbanization on native wildlife communities, such that conservation strategies should seek to mitigate the combined effects of a warming and urbanizing world