Paed Child Healt Can
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Most Canadian parents make sure that their children are immunized on time, but health care providers often encounter parents who are hesitant about vaccination or refuse recommended vaccines. This practice point offers evidence-based guidance to clinicians on how to work with vaccine-hesitant parents. ⋯ Immunization is one of the most important preventive health measures in existence and responsible for saving millions of lives. Addressing the concerns of vaccine-hesitant parents is a priority for health care providers.
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The Supreme Court decision in Carter v. Canada (2015) has led to changes to the Canadian Criminal Code, such that physician-assisted death is now a legal option for consenting adult patients who have a 'grievous and irremediable medical condition' that causes 'enduring' and 'intolerable' suffering. In June 2016, Bill C-14 was enacted, allowing medical assistance in dying (MAID) for an eligible adult whose death is 'reasonably foreseeable'. ⋯ Results from a Canadian Paediatric Surveillance Program (CPSP) survey, discussed below, indicate that parents raise such questions with paediatricians more often than do minors. The discussion of MAID policy in Canada has been framed as much by the issue and context of suffering as by considerations of autonomy. While current legislation clearly prohibits MAID for incapable persons at the request of any other person, it is possible that parents may request MAID on behalf of their dying child.
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Firearm injuries are a significant and preventable cause of death in Canadian youth. Adolescent and young adult males are disproportionately affected; however, firearm-related deaths occur in youth of all ages. Canada's rate of firearm ownership is lower than that of the USA, but high compared with other upper-income countries. ⋯ Guns should not be kept in homes or environments where children and adolescents live or play. Screening for the presence of a firearm in the home is an essential part of the safety assessment of a depressed or suicidal youth, and removal of the firearm from the home must be recommended in this situation. Legislative measures to strictly control the acquisition, transport, ownership and storage of firearms, and to reduce smuggling of firearms, are also recommended.
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Paed Child Healt Can · Jul 2017
Wellness in Canadian paediatric residents and their program directors.
This study aimed to explore the prevalence of and identify risk factors for depression and burnout in paediatric residents and paediatric program directors (PDs) in Canada. ⋯ Paediatric PDs in Canada have relatively low rates of burnout and depression. In contrast, a large number of Canadian paediatric residents met criteria for burnout. Residents in programs with wellness curricula described as helpful are at lowest risk of burnout. Future research should include identifying features that define helpful wellness curricula and exploring interventions to help residents at risk of burnout and depression.
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Paed Child Healt Can · Jul 2017
Canada's eight-component vaccine safety system: A primer for health care workers.
Concerns about vaccine safety make some parents hesitant about immunization. Health care providers are pivotal in helping parents understand that Canada is a leader in vaccine safety. The present practice point provides an update on the eight components of Canada's vaccine safety system: (1) an evidence-based pre-license review and approval process; (2) strong regulations for manufacturers; (3) independent evidence-based vaccine use recommendations; (4) immunization competency training and standards for health care providers; (5) pharmacovigilance programs to detect and (6) determine causality of adverse events following immunization (AEFIs); (7) a program for vaccine safety and efficacy signal detection; and (8) the Canadian Immunization Research Network's special immunization clinics for children who have experienced serious AEFIs.