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Sample records for canadian heart health

  1. Heart Disease and Occupational Risk Factors in the Canadian Population: An Exploratory Study Using the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Behdin Nowrouzi-Kia

    2018-06-01

    Full Text Available Background: The objective of this study is to find temporal trends in the associations between cardiovascular disease and occupational risk factors in the context of the Canadian population. Methods: Population data were analyzed from the Canadian Community Health Survey (CCHS collected between 2001 and 2014 for trends over time between heart disease and various occupational risk factors: hours worked, physical exertion at work, and occupation type (management/arts/education, business/finance, sales/services, trades/transportations, and primary industry/processing. Results: We found no significant difference in the average number of hours worked/wk between individuals who report having heart disease in all years of data except in 2011 (F1,96 = 7.02, p = 0.009 and 2012 (F1,96 = 8.86, p = 0.004. We also found a significant difference in the degree of physical exertion at work in 2001 (F1,79 = 7.45, p = 0.008. There were statistically significant results of occupation type on self-reported heart disease from 2003 to 2014. Conclusion: Canadian data from the CCHS do not exhibit a trend toward an association between heart disease and the number of hours worked/wk. There is an association between heart disease and physical exertion at work, but the trend is inconsistent. The data indicate a trend toward an association between heart disease and occupation type, but further analysis is required to determine which occupation type may be associated with heart disease. Keywords: occupational health, occupation type, physical exertion, self-reported cardiovascular disease

  2. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  3. The Canadian Heart Health Strategy and Action Plan: Cardiac rehabilitation as an exemplar of chronic disease management.

    Science.gov (United States)

    Arthur, H M; Suskin, N; Bayley, M; Fortin, M; Howlett, J; Heckman, G; Lewanczuk, R

    2010-01-01

    In October 2006, federal funding was announced for the development of a national strategy to fight cardiovascular disease (CVD) in Canada. The comprehensive, independent, stakeholder-driven Canadian Heart Health Strategy and Action Plan (CHHS-AP) was delivered to the Minister of Health on February 24, 2009. The mandate of CHHS-AP Theme Working Group (TWG) 6 was to identify the optimal chronic disease management model that incorporated timely access to rehabilitation services and end-of-life planning and care. The purpose of the present paper was to provide an overview of worldwide approaches to CVD and cardiac rehabilitation (CR) strategies and recommendations for CR care in Canada, within the context of the well-known Chronic Care Model (CCM). A separate paper will address end-of-life issues in CVD. TWG 6 was composed of content representatives, primary care representatives and patients. Input in the area of Aboriginal and indigenous cardiovascular health was obtained through individual expert consultation. Information germane to the present paper was gathered from international literature and best practice guidelines. The CCM principles were discussed and agreed on by all. Prioritization of recommendations and overall messaging was discussed and decided on within the entire TWG. The full TWG report was presented to the CHHS-AP Steering Committee and was used to inform the recommendations of the CHHS-AP. Specific actionable recommendations for CR are made in accordance with the key principles of the CCM. The present CR blueprint, as part of the CHHS-AP, will be a first step toward reducing the health care burden of CVD in Canada.

  4. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    .... What contributes to this deterioration, and how can its effects be mitigated? Engendering Migrant Health brings together researchers from across Canada to address the intersections of gender, immigration, and health in the lives of new Canadians...

  5. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    ... these and other issues at the intersections of gender, immigration, and health in the lives of new Canadians. Situating their work within the context of Canadian policy and society, the contributors illuminate migrants' testimonies of struggle, resistance, and solidarity as they negotiate a place for themselves in a new country. Topics range fr...

  6. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  7. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    "Voluntary migrants to Canada are generally healthier than the average Canadian, but after ten years in the country they report poorer health and higher rates of chronic disease than those born here...

  8. Health practices of Canadian physicians.

    Science.gov (United States)

    Frank, Erica; Segura, Carolina

    2009-08-01

    To study the health and health practices of Canadian physicians, which can often influence patient health. Mailed survey. Canada. A random sample of 8100 Canadian physicians; 7934 were found to be eligible and 3213 responded (40.5% response rate). Factors that influence health, such as consumption of fruits and vegetables, amount of exercise and alcohol consumption, smoking status, body mass idex, and participation in preventive health screening measures, as well as work-life balance and emotional stability. Canadian physicians are healthy. More than 90% reported being in good to excellent health, and only 5% reported that poor physical or mental health made it difficult to handle their workload more than half the time in the previous month (although a quarter had reduced work activity because of long-term health conditions). Eight percent were obese, 3% currently smoked cigarettes, and 1% typically consumed 5 drinks or more on days when they drank alcohol. Physicians averaged 4.7 hours of exercise per week and ate fruits and vegetables 4.8 times a day. Their personal screening practices were largely compliant with Canadian Task Force on Preventive Health Care recommendations. They averaged 38 hours per week on patient care and 11 hours on other professional activities. Fifty-seven percent agreed that they had a good work-life balance, and 11% disagreed with the statement "If I can, I work when I am ill." Compared with self-reports from the general Canadian population, Canadian physicians, like American physicians, seem to be healthy and to have generally healthy behaviour. There is, however, room for improvement in physicians' personal and professional well-being, and improving their personal health practices could be an efficient and beneficent way to improve the health of all Canadians.

  9. Factors influencing the adoption of an innovation: An examination of the uptake of the Canadian Heart Health Kit (HHK

    Directory of Open Access Journals (Sweden)

    Plotnikoff Ronald C

    2008-10-01

    Full Text Available Abstract Background There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK is a risk management and patient education resource for the prevention of cardiovascular disease (CVD and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption. Objectives Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1 to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2, to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit. Methods A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability, confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour. Results 115 physicians (follow up rate of 75% completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of

  10. Factors influencing the adoption of an innovation: an examination of the uptake of the Canadian Heart Health Kit (HHK).

    Science.gov (United States)

    Scott, Shannon D; Plotnikoff, Ronald C; Karunamuni, Nandini; Bize, Raphaël; Rodgers, Wendy

    2008-10-02

    There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption. Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit. A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour. 115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the

  11. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    .... Focusing on the context of Canadian policy and society, the contributors illuminate migrants' testimonies of struggle, resistance, and solidarity as they negotiate a place for themselves in a new country. Topics range from the difficulties of Francophone refugees and the changing roles of fathers, to the experiences of queer newcomers and the importance of social unity to communal and individual health."--pub. desc.

  12. Social media for health promotion: What messages are women receiving about cardiovascular disease risk by the Canadian Heart and Stroke Foundation?

    Science.gov (United States)

    Gonsalves, Christine A; McGannon, Kerry R; Schinke, Robert J

    2017-11-01

    The aim of this study was to explore the meanings of women's cardiovascular disease constructed within the Canadian Heart and Stroke Foundation Facebook page. Posts from Heart and Stroke Foundation and public user comments surrounding the launch of the Heart and Stroke Foundation re-branding were of interest. Ethnographic content analysis was employed to analyse text ( n = 40), images ( n = 32), videos ( n = 6), user comments and replies ( n = 42) from November 2016 to March 2017. Constructions (re)presented on Facebook of 'typical' women at risk and risk reduction were problematic as women most at risk were excluded through the use of consumerist, medicalized identities which also excluded promotion of healthy behaviour changes.

  13. Heart-Health Screenings

    Science.gov (United States)

    ... Tools For Your Heart Health • Watch, Learn & Live Animations Library Subscribe to Heart Insight magazine and monthly ... in Spanish . Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  14. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  15. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  16. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) - a Pan Canadian cohort study.

    Science.gov (United States)

    Anand, Sonia S; Tu, Jack V; Awadalla, Philip; Black, Sandra; Boileau, Catherine; Busseuil, David; Desai, Dipika; Després, Jean-Pierre; de Souza, Russell J; Dummer, Trevor; Jacquemont, Sébastien; Knoppers, Bartha; Larose, Eric; Lear, Scott A; Marcotte, Francois; Moody, Alan R; Parker, Louise; Poirier, Paul; Robson, Paula J; Smith, Eric E; Spinelli, John J; Tardif, Jean-Claude; Teo, Koon K; Tusevljak, Natasa; Friedrich, Matthias G

    2016-07-27

    The Canadian Alliance for Healthy Hearts and Minds (CAHHM) is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services) with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity), cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI) of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  17. Social Workers' Role in the Canadian Mental Health Care System

    Science.gov (United States)

    Towns, Ashley M.; Schwartz, Karen

    2012-01-01

    Objective: Using Canadian survey data this research provides social workers in Canada with a better understanding of their role in the Canadian mental health care system. Methods: By analyzing data from the Canadian Community Health Survey, Cycle 1.2 Mental Health and Well-being, the role of social workers in the Canadian mental health system was…

  18. Stress and Heart Health

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Stress and Heart Health Updated:Jan 8,2018 When ... therapist in your community. Last reviewed 6/2014 Stress Management • Home • How Does Stress Affect You? Introduction ...

  19. Home care utilization and outcomes among Asian and other Canadian patients with heart failure

    Directory of Open Access Journals (Sweden)

    King Kathryn M

    2010-03-01

    Full Text Available Abstract Background Heart failure (HF is a major cause of hospitalization and death in the aging population around the world. Home care utilization is associated with improved survival for the patients with HF, and varies by ethno-culture. The purpose of this study was to investigate the difference in hospital readmission rate and mortality between Asian and other Canadian HF patients. Methods HF patients were identified using hospital discharge abstracts from March 31, 2000 to April 1, 2006 in Calgary Health Region. Readmission and one-year mortality for HF were determined by linking hospital discharge and vital statistics data. Stratified by home care services use, readmission and mortality rates were compared between the Asians and other Canadians while controlling for age, sex, comorbidities, and household income. Results Of 26,171 HF patients discharged from hospital, 56.6% of Asians and 58.0% of other Canadians used home care services [adjusted odds ratio (OR for Asian: 0.84, 95% confidence interval (CI: 0.74-0.89]. The hospital readmission rate was similar between Asians and other Canadians regardless of home care services use. Mortality was similar between those who used home care services (adjusted OR for Asian: 0.96, 95% CI: 0.81-1.13. For patients who did not use home care services, Asians had significantly lower mortality than other Canadians (adjusted OR for Asian: 0.76, 95% CI: 0.60-0.86. Conclusion Mortality was similar between Asian and other Canadian patients when home care services were utilized. However, among those without home care, Asian patients had a significantly lower mortality than other Canadian patients.

  20. Antioxidant health messages in Canadian women's magazines.

    Science.gov (United States)

    Steinberg, Alissa; Paisley, Judy; Bandayrel, Kristofer

    2011-01-01

    Recently, antioxidants have taken centre stage in media and advertising messages. While 80% of Canadians think they are well-informed about nutrition, many are confused about the health effects of specific nutrients. Forty-six percent of Canadians seek information from newspapers and books, and 67% of women rely on magazines. We examined the content and accuracy of antioxidant health messages in Canadian women's magazines. The top three Canadian magazines targeted at women readers were selected. A screening tool was developed, pilot tested, and used to identify eligible articles. A coding scheme was created to define variables, which were coded and analyzed. Seventy-seven percent of 36 magazine issues contained articles that mentioned antioxidants (n=56). Seventy-one percent (n=40) of articles reported positive health effects related to antioxidant consumption, and 36% and 40% of those articles framed those effects as definite and potential, respectively (p<0.01). The articles sampled conveyed messages about positive antioxidant health effects that are not supported by current evidence. Improved standards of health reporting are needed. Nutrition professionals may need to address this inaccuracy when they develop communications on antioxidants and health risk.

  1. 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology.

    Science.gov (United States)

    Green, Martin S; Guerra, Peter G; Krahn, Andrew D

    2011-01-01

    The last guidelines on training for adult cardiac electrophysiology (EP) were published by the Canadian Cardiovascular Society in 1996. Since then, substantial changes in the knowledge and practice of EP have mandated a review of the previous guidelines by the Canadian Heart Rhythm Society, an affiliate of the Canadian Cardiovascular Society. Novel tools and techniques also now allow electrophysiologists to map and ablate increasingly complex arrhythmias previously managed with pharmacologic or device therapy. Furthermore, no formal attempt had previously been made to standardize EP training across the country. The 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology represent a consensus arrived at by panel members from both societies, as well as EP program directors across Canada and other select contributors. In describing program requirements, the technical and cognitive skills that must be acquired to meet training standards, as well as the minimum number of procedures needed in order to acquire these skills, the new guidelines provide EP program directors and committee members with a template to develop an appropriate curriculum for EP training for cardiology fellows here in Canada. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  2. Alcohol and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  3. Protein and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  4. Dental Health and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  5. Mental Health and Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  6. The 2013 Canadian Forces Mental Health Survey

    Science.gov (United States)

    Bennett, Rachel E.; Boulos, David; Garber, Bryan G.; Jetly, Rakesh; Sareen, Jitender

    2016-01-01

    Objective: The 2013 Canadian Forces Mental Health Survey (CFMHS) collected detailed information on mental health problems, their impacts, occupational and nonoccupational determinants of mental health, and the use of mental health services from a random sample of 8200 serving personnel. The objective of this article is to provide a firm scientific foundation for understanding and interpreting the CFMHS findings. Methods: This narrative review first provides a snapshot of the Canadian Armed Forces (CAF), focusing on 2 key determinants of mental health: the deployment of more than 40,000 personnel in support of the mission in Afghanistan and the extensive renewal of the CAF mental health system. The findings of recent population-based CAF mental health research are reviewed, with a focus on findings from the very similar mental health survey done in 2002. Finally, key aspects of the methods of the 2013 CFMHS are presented. Results: The findings of 20 peer-reviewed publications using the 2002 mental health survey data are reviewed, along with those of 25 publications from other major CAF mental health research projects executed over the past decade. Conclusions: More than a decade of population-based mental health research in the CAF has provided a detailed picture of its mental health and use of mental health services. This knowledge base and the homology of the 2013 survey with the 2002 CAF survey and general population surveys in 2002 and 2012 will provide an unusual opportunity to use the CFMHS to situate mental health in the CAF in a historical and societal perspective. PMID:27270738

  7. A Canadian Indian Health Status Index.

    Science.gov (United States)

    Connop, P J

    1983-01-01

    Health care services for registered "band" Indians in Ontario are provided primarily by the Canadian Federal Government. Complex management methods preclude the direct involvement of Indian people in the decisions for their health resource allocation. Health indicators, need, and health status indexes are reviewed. The biostatistics of mortality and demography of the Indian and reference populations are aggregated with hospitalization/morbidity experience as the Chen G'1 Index, as an indicator of normative and comparative need. This is weighted by linear measurements of perceived need for preventive medicine programs, as ranked and scaled values of priorities, Zj. These were determined by community survey on 11 Indian reserves using a non-probabilistic psychometric method of "pair comparisons," based upon "Thurstone's Law of Comparative Judgement.," The calculation of the aggregate single unit Indian Health Status Index [Log.G'1].Zj and its potential application in a "zero-base" budget is described.

  8. Mental Health Disparities Among Canadian Transgender Youth.

    Science.gov (United States)

    Veale, Jaimie F; Watson, Ryan J; Peter, Tracey; Saewyc, Elizabeth M

    2017-01-01

    This study documented the prevalence of mental health problems among transgender youth in Canada and made comparisons with population-based studies. This study also compared gender identity subgroups and age subgroups (14-18 and 19-25). A nonprobability sample of 923 transgender youth from Canada completed an online survey. Participants were recruited through community organizations, health care settings, social media, and researchers' networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episodes, and suicide. For example, 65% of transgender 14- to 18-year olds seriously considered suicide in the past year compared with 13% in the British Columbia Adolescent Health Survey, and only a quarter of participants reported their mental health was good or excellent. Transgender boys/men and nonbinary youth were most likely to report self-harm and overall mental health remained stable across age subgroups. Although a notable minority of transgender youth did not report negative health outcomes, this study shows the mental health disparities faced by transgender youth in Canada are considerable. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM – a Pan Canadian cohort study

    Directory of Open Access Journals (Sweden)

    Sonia S. Anand

    2016-07-01

    Full Text Available Abstract Background The Canadian Alliance for Healthy Hearts and Minds (CAHHM is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Methods/Design Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity, cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. Discussion CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  10. Bridging Grant : Building Canadian Support for Global Health ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Canadian Coalition for Global Health Research (CCGHR) is a not-for-profit organization dedicated to supporting research for global health equity. The CCGHR provides a networking and action platform for the Canadian global health research community and partners in low- and middle-income countries. This grant will ...

  11. Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

    Science.gov (United States)

    Compton, Michael T; Frank, Erica

    2011-01-01

    In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Healthy Body, Happy Heart: Improve Your Heart Health

    Science.gov (United States)

    ... November 2017 Print this issue Healthy Body, Happy Heart Improve Your Heart Health En español Send us your comments Every moment of the day, your heart is pumping blood throughout your body. In silent ...

  13. Knowledge synthesis and the Canadian Institutes of Health Research

    Directory of Open Access Journals (Sweden)

    Graham Ian D

    2012-02-01

    Full Text Available Abstract The Canadian Institutes of Health Research (CIHR is Canada's premier health-research funding agency. We fund nearly 14,000 researchers and trainees in four theme areas: biomedical, clinical, health services, and population and public-health research. Our mandate is 'to excel according to international standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system'. Knowledge synthesis is a key element of the knowledge-translation objectives of CIHR, as outlined in our definition of knowledge-translation.

  14. Heart Health Tests: MedlinePlus Health Topic

    Science.gov (United States)

    ... Heart Institute) Also in Spanish Heart-Health Screenings (American Heart Association) Picturing the Heart (National Institute of Biomedical Imaging and Bioengineering) Related Issues EKGs and Exercise Stress Tests: When You Need Them for Heart Disease - ...

  15. Guidelines for Better Heart Health

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

  16. Integrating Ethnicity and Migration As Determinants of Canadian Women's Health

    OpenAIRE

    Vissandjee, Bilkis; Desmeules, Marie; Cao, Zheynuan; Abdool, Shelly; Kazanjian, Arminée

    2004-01-01

    Abstract Health Issue This chapter investigates (1) the association between ethnicity and migration, as measured by length of residence in Canada, and two specific self-reported outcomes: (a) self-perceived health and (b) self-reports of chronic conditions; and (2) the extent to which these selected determinants provide an adequate portrait of the differential outcomes on Canadian women's self-perceived health and self-reports of chronic conditions. The 2000 Canadian Community Health Survey w...

  17. Building Canadian Support for Global Health Research - Phase III ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    supported researcher is receiving international attention for his work to address maternal and child death rates in East Africa. View moreMaternal and child health research featured in Canadian Geographic ...

  18. Canadian Alliance for Healthy Hearts and Minds: First Nations Cohort Study Rationale and Design.

    Science.gov (United States)

    Anand, Sonia S; Abonyi, Sylvia; Arbour, Laura; Brook, Jeff; Bruce, Sharon; Castleden, Heather; Desai, Dipika; de Souza, Russell J; Harris, Stewart; Irvine, James; Lai, Christopher; Lewis, Diana; Oster, Richard T; Poirier, Paul; Toth, Ellen L; Bannon, Karen; Chrisjohn, Vicky; Davis, Albertha D; L'Hommecourt, Jean; Littlechild, Randy; McMullin, Kathleen; McIntosh, Sarah; Morrison, Julie; Picard, Manon; Landing First Nation, Pictou; M Thomas, Melissa; Tusevljak, Natasa; Friedrich, Matthias G; Tu, Jack V

    2018-01-01

    This is the first national indigenous cohort study in which a common, in-depth protocol with a common set of objectives has been adopted by several indigenous communities across Canada. The overarching objective of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to investigate how the community-level environment is associated with individual health behaviors and the presence and progression of chronic disease risk factors and chronic diseases such as cardiovascular disease (CVD) and cancer. CAHHM aims to recruit approximately 2,000 First Nations indigenous individuals from up to nine communities across Canada and have participants complete questionnaires, blood collection, physical measurements, cognitive assessments, and magnetic resonance imaging (MRI). Through individual- and community-level data collection, we will develop an understanding of the specific role of the socioenvironmental, biological, and contextual factors have on the development of chronic disease risk factors and chronic diseases. Information collected in the indigenous cohort will be used to assist communities to develop local management strategies for chronic disease, and can be used collectively to understand the contextual, environmental, socioeconomic, and biological determinants of differences in health status in harmony with First Nations beliefs and reality.

  19. Mental health literacy in secondary schools: a Canadian approach.

    Science.gov (United States)

    Kutcher, Stan; Bagnell, Alexa; Wei, Yifeng

    2015-04-01

    "Mental health literacy is an integral component of health literacy and has been gaining increasing attention as an important focus globally for mental health interventions. In Canada, youth mental health is increasingly recognized as a key national health concern and has received more focused attention than ever before within our health system. This article outlines 2 unique homegrown initiatives to address youth mental health literacy within Canadian secondary schools." Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Heart Health: Learn the Truth About Your Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

  1. Health psychology in autobiography: Three Canadian critical narratives.

    Science.gov (United States)

    Stam, Henderikus J; Murray, Michael; Lubek, Ian

    2018-03-01

    Three Canadian colleagues in health psychology recount their careers in a field of research and practice whose birth they witnessed and whose developments they have critiqued. By placing the development of health psychology in Canada in a context that is both institutional and personal, Stam, Murray, and Lubek raise a series of questions about health psychology and its propagation. While uniquely Canadian their professional careers were affected by international colleagues as well as others-patients and community members-whose views shaped their perspectives. This article is a plea for the continuing development of critical voices in health psychology.

  2. Worksite health and wellness programs: Canadian achievements & prospects.

    Science.gov (United States)

    Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

    2014-01-01

    Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    Science.gov (United States)

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  4. How to Prevent Heart Disease: MedlinePlus Health Topic

    Science.gov (United States)

    ... and your heart (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get How to Prevent ... your heart Stress and your heart Related Health Topics Blood Thinners Cholesterol Heart Diseases Heart Health Tests ...

  5. Public Health Adaptation to Climate Change in Canadian Jurisdictions

    Directory of Open Access Journals (Sweden)

    Stephanie E. Austin

    2015-01-01

    Full Text Available Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting autonomously.

  6. Public Health Adaptation to Climate Change in Canadian Jurisdictions

    Science.gov (United States)

    Austin, Stephanie E.; Ford, James D.; Berrang-Ford, Lea; Araos, Malcolm; Parker, Stephen; Fleury, Manon D.

    2015-01-01

    Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously. PMID:25588156

  7. Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers.

    Science.gov (United States)

    Arnold, J Malcom O; Howlett, Jonathan G; Dorian, Paul; Ducharme, Anique; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Ignaszewski, Andrew; Isaac, Debra; Jong, Philip; Liu, Peter; Mann, Elizabeth; McKelvie, Robert S; Moe, Gordon W; Parker, John D; Svendsen, Anna M; Tsuyuki, Ross T; O'Halloran, Kelly; Ross, Heather J; Rao, Vivek; Sequeira, Errol J; White, Michel

    2007-01-01

    Heart failure is common, yet it is difficult to treat. It presents in many different guises and circumstances in which therapy needs to be individualized. The Canadian Cardiovascular Society published a comprehensive set of recommendations in January 2006 on the diagnosis and management of heart failure, and the present update builds on those core recommendations. Based on feedback obtained through a national program of heart failure workshops during 2006, several topics were identified as priorities because of the challenges they pose to health care professionals. New evidence-based recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. Specific recommendations and practical tips were written for the prevention of heart failure, the management of heart failure during intercurrent illness, the treatment of acute heart failure, and the current and future roles of biomarkers in heart failure care. Specific clinical questions that are addressed include: which patients should be identified as being at high risk of developing heart failure and which interventions should be used? What complications can occur in heart failure patients during an intercurrent illness, how should these patients be monitored and which medications may require a dose adjustment or discontinuation? What are the best therapeutic, both drug and nondrug, strategies for patients with acute heart failure? How can new biomarkers help in the treatment of heart failure, and when and how should BNP be measured in heart failure patients? The goals of the present update are to translate best evidence into practice, to apply clinical wisdom where evidence for specific strategies is weaker, and to aid physicians and other health care providers to optimally treat heart failure patients to result in a measurable impact on patient health and clinical outcomes in Canada.

  8. Health care spending accounts: a flexible solution for Canadian employers.

    Science.gov (United States)

    Smithies, R; Steeves, L

    1996-01-01

    Flexible benefits plans have grown more slowly in Canada than in the United States, largely because of certain legal and regulatory considerations. Health care spending accounts (HCSAs) provide a cost-effective way for Canadian employers to address the health care benefit needs of a diverse workforce. A flexible health care spending account is a versatile and cost-effective instrument that can be used by Canadian employers that wish to provide a full range of health care benefits to employees. The health care alternatives available through an HCSA can provide employees with an opportunity to customize and optimize their benefits program. Regulatory requirements that an HCSA must meet in order to qualify for available tax advantages are discussed, as are the range of health care services that may be covered.

  9. Factors Affecting Canadian Teachers' Willingness to Teach Sexual Health Education

    Science.gov (United States)

    Cohen, Jacqueline N.; Byers, E. Sandra; Sears, Heather A.

    2012-01-01

    Non-specialist teachers in Canada are increasingly required to teach sexual health topics. However, research suggests that they do not always do so willingly. This study examined the associations between the characteristics of non-specialist elementary and middle school teachers (n = 294) in Canadian schools and their willingness to provide sexual…

  10. Air Quality and Heart Health: An Emerging Topic for Heart ...

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanisms are under investigation and are likely related to oxidative stress, inflammation and effects on autonomic control. Improvements in air pollution levels reduce health impacts and increase life expectancy. Reductions of short-term exposure in those at highest risk are predicted to mitigate adverse health effects. EPA regularly evaluates the standards, health risks and issues improved standards when needed. Public health action is needed along with EPA standards to reduce the public health burden of short- and long-term adverse health effects of air pollution. Health risks remain and need to be addressed through integrated efforts of public health, health care, environmental health, individuals and communities. Presented at Webinar for the National Association of Clean Air Agencies, February 2, 2017, Chapel Hill, NC- This webinar provided an update of environmental health information related to the effects of air pollution and heart and blood vessel disease. Such information is critically important for the Clean Air Agencies to understand as it provides the justification of their actions.

  11. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    OpenAIRE

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is l...

  12. The mental health of Canadian transgender youth compared with the Canadian population

    Science.gov (United States)

    Veale, Jaimie F.; Watson, Ryan J.; Peter, Tracey; Saewyc, Elizabeth M.

    2017-01-01

    Objectives This study documents the prevalence of mental health concerns among Canadian transgender youth and makes comparisons with cisgender or mostly-cisgender population-based studies. This study also compares gender identity subgroups (transgender girls/women, boys/men, and non-binary) and age subgroups (14–18 year olds and 19–25 year olds) on mental health outcomes. Methods A nonprobability sample of 923 transgender youth from across Canada completed a bilingual online survey. Participants were recruited through community organizations, healthcare settings, social media, and the researchers’ networks. Mental health measures were drawn from the British Columbia Adolescent Health Survey and the Canadian Community Health Survey. Results Transgender youth had a higher risk of reporting psychological distress, self-harm, major depressive episode, suicidal ideation, and suicide attempts. Risk ratios ranged from 3.8 to 16.1. Transgender boys/men and non-binary youth were most likely to report self-harm and non-binary youth also reported lower overall mental health. Rates of self-harm and suicide were lower in the 19–25 age group than the 14–18 age group, but reported overall mental health was the same across these age groups. Conclusions Although a notable minority of transgender youth reported good mental health, this study shows the mental health disparities faced by transgender youth in Canada are considerable. Policy Implications These findings underscore the need for policies and laws protecting transgender people from discrimination, training for transgender competency for mental healthcare providers, providers, and further development of transgender-specific interventions to promote positive mental health and reduce mental health problems among transgender youth. PMID:28007056

  13. Indigenous housing and health in the Canadian North

    DEFF Research Database (Denmark)

    Christensen, Julia

    2016-01-01

    In this article, I explore the relationship between housing, home and health amongst Indigenous homeless people living in the Canadian North. In particular, I examine the ways in which Indigenous homemaking practices conflict with housing policy, and exacerbate individual pathways to homelessness....... I argue that integral components in northern Indigenous conceptualizations of home and, in turn, health are not only unrecognized in housing policy, but actively discouraged. The potential for homemaking to inform health and housing policy speaks to the relevance of cultural safety not only...... to Indigenous health services, but also to a comprehensive framing of Indigenous health....

  14. Living in Two Cultures: Chinese Canadians' Perspectives on Health.

    Science.gov (United States)

    Lu, Chunlei; McGinn, Michelle K; Xu, Xiaojian; Sylvestre, John

    2017-04-01

    Chinese people have distinctive perspectives on health and illness that are largely unrecognized in Western society. The purpose of this descriptive study was to develop a profile of Chinese immigrants' beliefs and practices related to diet, mental and social health, and sexual health. A quantitative survey with descriptive and correlational analyses was employed to examine 100 first-generation Chinese immigrants living in four urban centres across Canada (Vancouver, Toronto, Halifax, and St. Catharines). Although most Chinese immigrants preferred a Chinese diet, where they resided affected the groceries they bought and the meals they ate. Almost all participants reported their mental health was important to them and most felt comfortable discussing mental health issues with others. However, only a third would see a psychiatrist if they believed they had a mental health problem. Most participants believed social relationships were important for their health. Only a small number of participants, however, preferred making friends with mainstream Caucasian Canadians. More men than women believed sexuality contributed to health and were comfortable talking about sexual health. Chinese immigrants should be encouraged to be more engaged in the larger community in order to fully integrate themselves into Canadian society while still being encouraged to retain their healthy practices. These findings may help educators and practitioners enhance their understandings of Chinese immigrants' perspectives on health and develop culturally competent education and services in health care and health promotion.

  15. Management of human resources in health care: the Canadian experience.

    Science.gov (United States)

    Adams, O

    1992-07-01

    Each of Canada's ten provinces has a publicly administered system of health insurance, funded by provincial and federal taxes, that is accessible to all citizens and covers all medically necessary services provided by physicians and hospitals. Canadians spend an estimated 9.2 percent of their gross national product on health care (about 2.8 percentage points below US spending), of which three quarters is public-sector spending. According to the Organization for Economic Cooperation and Development, Canada's health status is equal to or better than that of the United States, despite lower per capita health spending. About seven percent of the Canadian labour force works in health care, and attempts to introduce coordinated planning of human resources in health care have not as yet proceeded far. The predominant policy issue here is the supply and the role of physicians. It has been argued that entrenching within the system the fee-for-service method of paying physicians has created a disincentive to the delegation of responsibility to health personnel other than doctors. It is also argued that introduction of government-run health insurance provided the opportunity for human resource planning, but that the decision by governments to act only as the payer resulted in ad-hoc planning approaches. However, governments' concern over health care costs has led to a more direct role by them in the planning of the human resources in health. They are re-examining the autonomy and jurisdictional rights of the professions that deliver health care to Canadians.

  16. Canadian community pharmacists' use of digital health technologies in practice.

    Science.gov (United States)

    Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen

    2016-01-01

    In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx.

  17. Some health aspects of Canadian uranium mining

    International Nuclear Information System (INIS)

    Myers, D.K.; Stewart, C.G.

    1979-03-01

    The radiological health hazards associated with uranium mining in Canada are reviewed. Radiation hazards to individual members of the general population currently living in the vicinity of the mines appear to be extremely low. The major health hazards are those associated with underground mining. Hazards associated with the inhalation of radon daughters in the mines were estimated from analyses of available data from the U.S.A. and Czechoslovakia. These data can be fitted by various mathematical models including quasi-threshold models. On the reasonable assumption of a linear relationship between dose and effect, the risk would appear to be about 6.1 induced lung cancers per million WLM per year, which, averaged over a period of incidence of 15 years, would be equivalent to a total of about 100 induced cancers per million WLM. This value may be too high for estimation of the most probable risk of radon daughters to the general public. (author)

  18. Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.

    Science.gov (United States)

    Colley, Rachel C; Garriguet, Didier; Janssen, Ian; Craig, Cora L; Clarke, Janine; Tremblay, Mark S

    2011-03-01

    Physical activity is an important determinant of health and fitness. This study provides contemporary estimates of the physical activity levels of Canadians aged 6 to 19 years. Data are from the 2007 to 2009 Canadian Health Measures Survey. The physical activity of a nationally representative sample was measured using accelerometers. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement, and in steps accumulated per day. An estimated 9% of boys and 4% of girls accumulate 60 minutes of moderate-to-vigorous physical activity on at least 6 days a week. Regardless of age group, boys are more active than girls. Canadian children and youth spend 8.6 hours per day-62% of their waking hours-in sedentary pursuits. Daily step counts average 12,100 for boys and 10,300 for girls. Based on objective and robust measures, physical activity levels of Canadian children and youth are low.

  19. Canadian physicians' responses to cross border health care.

    Science.gov (United States)

    Runnels, Vivien; Labonté, Ronald; Packer, Corinne; Chaudhry, Sabrina; Adams, Owen; Blackmer, Jeff

    2014-04-03

    The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association's e-panel. The purpose of the survey was to gain an understanding of physicians' experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients' return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government-sanctioned and patient-initiated), and how they affect

  20. Canadian physicians’ responses to cross border health care

    Science.gov (United States)

    2014-01-01

    Background The idea for this survey emanated from desk research and two meetings for researchers that discussed medical tourism and out-of-country health care, which were convened by some of the authors of this article (VR, CP and RL). Methods A Cross Border Health Care Survey was drafted by a number of the authors and administered to Canadian physicians via the Canadian Medical Association’s e-panel. The purpose of the survey was to gain an understanding of physicians’ experiences with and views of their patients acquiring health care out of country, either as medical tourists (paying out-of-pocket for their care) or out-of-country care patients funded by provincial/territorial public health insurance plans. Quantitative and qualitative results of the survey were analyzed. Results 631 physicians responded to the survey. Diagnostic procedures were the top-ranked procedure for patients either as out-of-country care recipients or medical tourists. Respondents reported that the main reason why patients sought care abroad was because waiting times in Canada were too long. Some respondents were frustrated with a lack of information about out-of-country procedures upon their patients’ return to Canada. The majority of physician respondents agreed that it was their responsibility to provide follow-up care to medical travellers on return to Canada, although a substantial minority disagreed that they had such a responsibility. Conclusions Cross-border health care, whether government-sanctioned (out-of-country-care) or patient-initiated (medical tourism), is increasing in Canada. Such flows are thought likely to increase with aging populations. Government-sanctioned outbound flows are less problematic than patient-initiated flows but are constrained by low approval rates, which may increase patient initiation. Lack of information and post-return complications pose the greatest concern to Canadian physicians. Further research on both types of flows (government

  1. The promise of e-health--a Canadian perspective.

    Science.gov (United States)

    Alvarez, Richard C

    2004-01-01

    Canadians value their health care system above any other social programme. Canada's system of health care faces significant financial and population pressures, relating to cost, access, quality, accountability, and the intergration of information and communication technologies (ICTs). The health-system also faces certain unique challenges that include care delivery within a highly decentralised system of financing and accountability, and care delivery to a significant portion of the population sparsely distributed across a land mass of 10 million square kilometres, in areas of extreme climatic conditions. All of these challenges are significant catalysts in the development of technologies that aim to significantly mitigate or eliminate these selfsame challenges. The system is undergoing widespread review, nationally and within each province and territory, where the bulk of care provision is financed and managed. The challenges are being addressed by national, regional and provincial initiatives in the public, private and not-for-profit sectors. The promise of e-health lies in the manner and degree to which it can mitigate or resolve these challenges to the health system and build on advancements in ICTs supporting the development of a health infostructure. Canada is actively developing and implementing technological solutions to deliver health information and health care services across the country. These solutions, while exciting and promising, also present new challenges, particularly in regard to acceptable standards, choice of technologies, overcoming traditional jurisdictional boundaries, up-front investment, and privacy and confidentiality. Many organizations and governments are working to address these challenges. Canada Health Infoway, a not-for-profit corporation, was founded by the first ministers in 2001 to accelerate the establishment of an interoperable, pan-Canadian electronic health record. It works with partners in the federal, provincial and

  2. The impact of polypharmacy on the health of Canadian seniors.

    Science.gov (United States)

    Reason, Ben; Terner, Michael; Moses McKeag, Ali; Tipper, Brenda; Webster, Greg

    2012-08-01

    Prescription medication use increases with age. Seniors face an increased risk of adverse drug reactions from medications, partly because the kidneys and liver can lose functional ability with increasing age, resulting in the need for changes in dosage. To use population survey data to understand the extent and impact of multiple medication use and adverse drug events among Canadian seniors. This study consists of analysis of data from the Canadian Survey of Experiences with Primary Health Care, which was conducted through telephone by Statistics Canada in 2008. These analyses focussed on the 3132 respondents who were ≥ 65 years of age. Twenty-seven per cent of seniors reported taking five or more medications on a regular basis. Within the past year, 12% of seniors taking five or more medications experienced a side effect that required medical attention compared with 5% of seniors taking only one or two medications. Even when controlling for age and number of chronic conditions, the number of prescription medications was associated with the rate of emergency department use. Less than half of all seniors reported having received medication reviews and having the possible side effects of their prescription medications explained to them by their physician. Many Canadian seniors have an elevated risk of adverse events due to taking a high number of prescription medications and not having the potential side effects and drug interactions explained to them. There are interventions that can potentially reduce polypharmacy and adverse events, including routine medication reviews.

  3. Guidelines for Management Information Systems in Canadian Health Care Facilities

    Science.gov (United States)

    Thompson, Larry E.

    1987-01-01

    The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.

  4. The Canadian Natural Health Products (NHP) regulations: industry compliance motivations.

    Science.gov (United States)

    Laeeque, Hina; Boon, Heather; Kachan, Natasha; Cohen, Jillian Clare; D'Cruz, Joseph

    2007-06-01

    This qualitative study explores corporations' motivations to comply with new natural health products (NHP) Regulations in Canada. Interviews were conducted with representatives from 20 Canadian NHP companies. Findings show that the rationale for compliance differs for large compared to small and medium-sized enterprises (SMEs). Large firms are motivated to comply with the regulations because of the deterrent fear of negative media coverage, social motivations, ability to comply and maintaining a competitive market advantage. In contrast, SMEs are motivated to comply due to the deterrent fear of legal prosecution and a sense of duty.

  5. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    Science.gov (United States)

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks ofsurrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support. PMID:17296962

  6. Surrogate pregnancy: a guide for Canadian prenatal health care providers.

    Science.gov (United States)

    Reilly, Dan R

    2007-02-13

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks of surrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support.

  7. The psychology of the heart: Implications for health, physical activity ...

    African Journals Online (AJOL)

    ... for health, physical activity and sport of psychophysiological resonance, coherence and heart rate variability feedback applications involving respiration and facilitation of positive emotion. Keywords: Heart psychology, psychophysiology, resonance, coherence, transcultural context, heart rate variability, biofeedback.

  8. Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices.

    Science.gov (United States)

    Healey, Jeff S; Merchant, Richard; Simpson, Chris; Tang, Timothy; Beardsall, Marianne; Tung, Stanley; Fraser, Jennifer A; Long, Laurene; van Vlymen, Janet M; Manninen, Pirjo; Ralley, Fiona; Venkatraghavan, Lashmi; Yee, Raymond; Prasloski, Bruce; Sanatani, Shubhayan; Philippon, François

    2012-01-01

    There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists' Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients. The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual's type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference. The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  9. Health care: a community concern? : developments in the organization of Canadian health services

    National Research Council Canada - National Science Library

    Crichton, Anne

    1997-01-01

    ... Canadian Health Care Organizational Policies 1967-86 IV Service Delivery Systems and Their Response to the Need for Change to a Collective Care Organization 9. Care in the Doctor's Office 10. Support Services for Physicians in General Practice 11. Medical Practice Organization: Alternative Medical Care Delivery Models 12. Evolution of Public H...

  10. D-fence Against the Canadian Winter: Making Insufficient Vitamin D Levels a Higher Priority for Public Health

    Directory of Open Access Journals (Sweden)

    Jennifer D. Zwicker

    2015-04-01

    Full Text Available With most of the country situated above the latitude of the 42nd parallel north, there is a significant portion of the Canadian population that is not getting enough of the sunshine vitamin during the winter. Vitamin D is naturally produced when skin is exposed to sunlight, however during the winter months in Canada the sun is too low in the sky for this to occur. A full quarter of the Canadian population is estimated to have vitamin D levels so low as to be considered insufficient or deficient by Health Canada guidelines. Increasing vitamin D intake should be considered a public health priority. Vitamin D deficiency is known to be linked to rickets in children and osteomalacia in adults (bone softening and malformation as well as osteoporosis (loss of bone density, increasing susceptibility to fractures. However a growing body of evidence also suggests that vitamin D may have a role in the prevention of chronic diseases such as heart disease, high blood pressure, diabetes, cancer, cognitive decline, Parkinson’s disease, multiple sclerosis and arthritis. There is, of course, no way to change Canada’s proximity to the equator. But there are ways to help Canadians get more vitamin D through dietary intake. Improving the vitamin D status of the Canadian population through food fortification and dietary supplements represents an inexpensive intervention that can improve the health of the population, but debate remains over how much vitamin D the Canadian population needs and how to ensure the population adheres to whatever recommendations are made. Food fortification has already demonstrated its effectiveness in improving vitamin D levels (as it has for other public health priorities, such as with iodized salt. Decades ago, the prevalence of rickets in Canadian children led health professionals to lobby for, and win, legislation making vitamin D fortification mandatory for milk. Other foods, such as orange juice, milk of plant origin and

  11. Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

    Science.gov (United States)

    Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

    2011-01-01

    Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

  12. Racism and Oral Health Outcomes among Pregnant Canadian Aboriginal Women.

    Science.gov (United States)

    Lawrence, Herenia P; Cidro, Jaime; Isaac-Mann, Sonia; Peressini, Sabrina; Maar, Marion; Schroth, Robert J; Gordon, Janet N; Hoffman-Goetz, Laurie; Broughton, John R; Jamieson, Lisa

    2016-02-01

    This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes.

  13. Assessing perceived health risks of climate change : Canadian public opinion 2008

    International Nuclear Information System (INIS)

    2008-03-01

    This paper discussed a survey conducted to evaluate the awareness, knowledge, attitudes, and behaviours of Canadians in relation to climatic change. A total of 1600 telephone surveys were conducted with a broad range of age groups. The study showed that climate change is considered by many Canadians to pose a significant threat at both local and global levels. Evidence of climate change has been noted in many communities. However, relatively few Canadians understand how climate change may impact human health. While many Canadians associated climatic change with air pollution hazards and ozone depletion, most Canadians were not aware of the potential negative health impacts related to changes in disease vectors, extreme weather events, and coastal flooding. The strongest awareness and concern about health impacts were expressed by Canadians concerned about global warming. Individuals with chronic health conditions were more likely to be attuned to the potential health impacts of climatic change. Seniors viewed climate change as a longer term problem. Only 10 per cent of Canadians viewed global warming as a major health risk. Sixty-nine per cent of Canadians believed that global warming was happening, while 63 per cent attributed climate change to human activity. Nearly half of all respondents believed that an extreme weather disaster would affect their community during the course of their lifetime. The report suggested that marketing or communications campaigns should build public awareness of the health risks associated with direct or proximal environmental risks. Information about health risks should be specific, and communications should be tailored to age cohorts. Television and print media should be used to build awareness of the health risks of climate change. Provincial concerns related to climatic change were also outlined. tabs., figs

  14. Canadians' perceptions of food, diet, and health--a national survey.

    Directory of Open Access Journals (Sweden)

    Alyssa Schermel

    Full Text Available Poor nutrition is harmful to one's health as it can lead to overweight and obesity and a number of chronic diseases. Understanding consumer perceptions toward diet and nutrition is critical to advancing nutrition-related population health interventions to address such issues. The purpose of this paper was to examine Canadians' perceived health and diet status, compared to their actual health status, and general concern about their own diet and beliefs about health. Also analyzed were some of the perceived barriers to eating "healthy" foods, with a focus on the availability of "healthy" processed foods.Two surveys were administered online to a group of Canadian panelists from all ten provinces during May 2010 to January 2011. Thirty thousand were invited; 6,665 completed the baseline survey and 5,494 completed the second survey. Panelists were selected to be nationally representative of the Canadian adult population by age, sex, province and education level, according to 2006 census data.Approximately one third of Canadians perceived their health or diet to be very good while very few Canadians perceived their health or diet to be very poor. While the majority of Canadians believed food and nutrition to be very important for improving one's health, fewer Canadians were concerned about their own diets. The majority of Canadians reported difficulty finding "healthy" processed foods (low in salt and sugar and with sufficient vitamins and minerals. Many also reported difficulty finding healthy foods that are affordable.Although consumers believe that nutrition is one of the most important factors for maintaining health, there are still a number of attitudinal and perceived environmental barriers to healthy eating.

  15. Benchmarking participation of Canadian university health sciences librarians in systematic reviews

    Science.gov (United States)

    Murphy, Susan A.; Boden, Catherine

    2015-01-01

    This study describes the current state of Canadian university health sciences librarians' knowledge about, training needs for, and barriers to participating in systematic reviews (SRs). A convenience sample of Canadian librarians was surveyed. Over half of the librarians who had participated in SRs acknowledged participating in a traditional librarian role (e.g., search strategy developer); less than half indicated participating in any one nontraditional librarian role (e.g., data extractor). Lack of time and insufficient training were the most frequently reported barriers to participating in SRs. The findings provide a benchmark for tracking changes in Canadian university health sciences librarians' participation in SRs. PMID:25918485

  16. Benchmarking participation of Canadian university health sciences librarians in systematic reviews.

    Science.gov (United States)

    Murphy, Susan A; Boden, Catherine

    2015-04-01

    This study describes the current state of Canadian university health sciences librarians' knowledge about, training needs for, and barriers to participating in systematic reviews (SRs). A convenience sample of Canadian librarians was surveyed. Over half of the librarians who had participated in SRs acknowledged participating in a traditional librarian role (e.g., search strategy developer); less than half indicated participating in any one nontraditional librarian role (e.g., data extractor). Lack of time and insufficient training were the most frequently reported barriers to participating in SRs. The findings provide a benchmark for tracking changes in Canadian university health sciences librarians' participation in SRs.

  17. Best practices for online Canadian prenatal health promotion: A public health approach.

    Science.gov (United States)

    Chedid, Rebecca A; Terrell, Rowan M; Phillips, Karen P

    2017-11-04

    Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women. Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided. Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity. Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities. Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive

  18. Guideline-recommended therapy, including beta-blocker utilization, in patients with chronic heart failure: results from a Canadian community hospital heart function clinic

    Directory of Open Access Journals (Sweden)

    Heffernan M

    2016-06-01

    Full Text Available Michael Heffernan Division of Cardiology, Oakville Trafalgar Memorial Hospital, Oakville, ON, Canada Abstract: A comprehensive analysis of beta-blocker utilization and other guideline-recommended therapies for the treatment of chronic heart failure in a Canadian community hospital heart function clinic has not been undertaken and was, therefore, the focus of this study. The proportion of patients who would be potential candidates for ivabridine and sacubitril–valsartan therapy as a result of fulfilling the criteria for enrollment in either the Systolic Heart failure treatment with the If inhibitor ivabradine Trial (SHIFT study (left-ventricular ejection fraction [LVEF] >35%, sinus rhythm, New York Heart Association II–IV or the Prospective Comparison of angiotensin receptor-neprilysin inhibitor (ARNI with angiotensin-converting enzyme inhibitor (ACEI to determine impact on global Mortality and Morbidity in Heart Failure (PARADIGM-HF study (LVEF <40%, New York Heart Association II–IV, glomerular filtration rate >30 mL/min, was also assessed. A retrospective cross-sectional analysis was carried out in all 371 patients treated in this community heart function clinic for at least a 12-month period. The patients were elderly (mean age 74±13.3 years and predominately male (61.5% with symptomatic (82.5% moderate left-ventricular dysfunction (LVEF 45.4%±15.6%. A substantial proportion of the patients also had a diagnosis of atrial fibrillation (52.8%. The total use of beta blockers exceeded 87%, while 100% of patients without a documented contraindication or intolerance to a beta blocker received therapy. Adherence to other guideline-recommended pharmacotherapies specifically for heart failure with reduced left ventricular ejection was high: 86.1% of the eligible patients were treated with an ACEI/angiotensin receptor blocker and 61.9% received a mineralcorticoid receptor antagonist. We determined that 13.7% of the complement of this heart

  19. School Experiences Influence Personal Health and Interpersonal Relationships of Adolescents: The Canadian Case

    Science.gov (United States)

    Ma, Xin

    2007-01-01

    Canadian data from the 1998 Cross-National Survey on Health Behaviors in School-Aged Children were analyzed to examine the effects of school experiences on personal health (physical health, mental health, self-esteem, helplessness, and body image) and interpersonal relationships (number of close friends and making friends) among adolescents.…

  20. The health meanings and practices of older Greek-Canadian widows.

    Science.gov (United States)

    Rosenbaum, J N

    1991-11-01

    Folk health and illness beliefs and practices were abstracted from a large-scale study of older Greek-Canadian widows conceptualized within Leininger's theory of Cultural Care Diversity and Universality using ethnographic, ethnonursing, and life health-care history methods. Data were collected using observation-participation and interviews in three Greek-Canadian communities with 12 widowed key informants and 30 general informants. Interview inquiry guides, Leininger's Life History Health Care Protocol, and field journal recordings assisted data collection. Data were analysed using Leininger's phases of analysis for qualitative data. A major health theme which was abstracted from the raw data and patterns was: health for Greek-Canadian widows meant a state of well-being, ability to perform daily role activities, and avoidance of pain and illness. The findings, which also included folk health care and illness beliefs and practices, will stimulate future nursing research related to health and nursing care of people of diverse cultures.

  1. Canadian prediction equations of spirometric lung function for Caucasian adults 20 to 90 years of age: Results from the Canadian Obstructive Lung Disease (COLD) study and the Lung Health Canadian Environment (LHCE) study

    DEFF Research Database (Denmark)

    Tan, Wan C; Bourbeau, J; Hernandez, P

    2011-01-01

    BACKGROUND: Currently, no reference or normative values for spirometry based on a randomly selected Canadian population exist. OBJECTIVE: The aim of the present analysis was to construct spirometric reference values for Canadian adults 20 to 90 years of age by combining data collected from health...

  2. Air Quality and Heart Health: An Emerging Topic for Heart Month

    Science.gov (United States)

    Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanism...

  3. Healthy Hearts (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for one in three deaths. Improving heart health could save millions of lives each year. In this podcast, Dr. Barbara Bowman discusses ways to prevent heart problems.

  4. Healthy Hearts (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-10-02

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for one in three deaths. Improving heart health could save millions of lives each year. In this podcast, Dr. Barbara Bowman discusses ways to prevent heart problems.  Created: 10/2/2014 by MMWR.   Date Released: 10/2/2014.

  5. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian Community Health Survey

    Science.gov (United States)

    Ng, Alena Praneet; L’Abbé, Mary R.

    2017-01-01

    The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada’s Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach’s α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17–1.71). Closer adherence to Canada’s Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada’s Food

  6. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Mahsa Jessri

    2017-08-01

    Full Text Available The Healthy Eating Index (HEI is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010 has been made. The aims of this study were: (a to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010 by adapting the recommendations of the HEI-2010 to Canada’s Food Guide (CFG 2007; (b to evaluate the validity and reliability of the HEI-C 2010; and (c to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach’s α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001. Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17–1.71. Closer adherence to Canada’s Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada

  7. Impact of the 2008 global financial crisis on the health of Canadians: repeated cross-sectional analysis of the Canadian Community Health Survey, 2007-2013.

    Science.gov (United States)

    Nour, Sabrina; Labonté, Ronald; Bancej, Christina

    2017-04-01

    Despite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 global financial crisis (GFC) in this country. This study fills this gap in knowledge by conducting a repeated cross-sectional analysis of the Canadian Community Health Survey (CCHS). Data from 7 cycles (2007-2013) of the CCHS were combined to form a large data set representative of the Canadian working-age population (15-64 years) residing in 1 of 10 provinces. A logistic regression model was used to determine whether exposure to various periods of the GFC resulted in increased odds of reporting poor mental health. Exposure was categorised into 4 periods based on political and economic indicators, as follows: precrisis period (baseline), initial crisis period, stimulus period and austerity period. Other outcomes investigated included: anxiety disorders (AD), mood disorders (MD), poor physical health and health-related behaviours (heavy alcohol drinking (HAD) and decreased fruit/vegetable consumption (FVC)). A significant increased odds of reporting poor mental health was observed during the austerity period compared with the precrisis period (OR=1.26 (1.16 to 1.32)); findings remain significant when adjusted for sex, marital status and education. Exposure to the austerity period was also significantly associated with increased odds of reporting AD, MD, HAD and decreased odds of FVC. No significant associations were observed for the poor self-perceived physical health variable. Statistically significant associations were observed between several negative health outcomes and the austerity period when compared with the precrisis period. Austerity has been linked to worsening health in other studies and represents an example of how the policy response can have greater detrimental impact on health than the financial crisis itself. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  8. Does Mental Health Status Influence Susceptibility to the Physiologic Effects of Air Pollution? A Population Based Study of Canadian Children.

    Science.gov (United States)

    Dales, Robert E; Cakmak, Sabit

    2016-01-01

    Both air pollution exposure and the presence of mental illness are associated with an increased risk of physical illness. To determine whether or not children with less favourable mental health are more susceptible to pulmonary and cardiovascular effects of ambient air pollution, compared to those who are mentally healthy. We carried out a cross-sectional study of 1,883 children between the ages of 6 and 17 years of age who participated in the Canadian Health Measures population survey between 2007 and 2009. Subjects were assigned the air pollution values obtained from the National Air Pollution monitor closest to their neighborhood. Lung function, heart rate and blood pressure were stratified by indicators of mental health. The latter were ascertained by questions about feelings of happiness, a diagnosed mood disorder, and the emotional symptom subscale of the Strengths and Difficulties Questionnaire. Among those who reported a mood disorder, an interquartile increase in ozone was associated with increases in systolic and diastolic pressures of 3.8 mmHg (95% CI 1.6, 5.9) and 3.0mmHg (95%CI 0.9, 5.2) respectively, and a decreases in FVC of 7.6% (95% CI 2.9, 12.3). No significant changes in these variables were observed in those who did not report a mood disorder. Among those with unfavourable emotional symptoms, ozone was associated with a 6.4% (95% CI 1.7, 11.3) increase in heart rate, a 4.1% (95%CI 1.2, 7.1) increase in systolic blood pressure, and a 6.0% (95% CI 1.4, 10.6) decrease in FEVl. No significant effect was seen in these variables among those with no emotional symptoms. In the Canadian population, children who report mood disorders or unfavourable emotional symptoms appear to be more vulnerable to the adverse physiologic effects of air pollution.

  9. When Does an Immigrant with HIV Represent an Excessive Demand on Canadian Health or Social Services?

    Directory of Open Access Journals (Sweden)

    KEDNAPA THAVORN

    2010-01-01

    Full Text Available The Canadian Immigration and Refugee Protection Act of 2001 outlines conditions under which individuals may be granted or denied admission to Canada. The Act stipulates that applications for residence will be rejected if their health is expected to generate excessive demand on Canadian health or social services. The purpose of this paper is to derive a statistical definition of excessive demand and to apply that threshold to persons with HIV who are seeking admission to Canada. The paper demonstrates that the current threshold used by Citizenship and Immigration Canada is much lower than the thresholds that may be derived statistically.

  10. Heart Disease Prevention: Does Oral Health Matter?

    Science.gov (United States)

    ... Will taking care of my teeth help prevent heart disease? Answers from Thomas J. Salinas, D.D.S. Taking ... teeth isn't a proven way to prevent heart disease. While there appears to be some connection between ...

  11. Canadian federalism and the Canadian health care program: a comparison of Ontario and Quebec.

    Science.gov (United States)

    Palley, H A

    1987-01-01

    The Quebec and Ontario health insurance and health service delivery systems, developed within the parameters of federal regulations and national financial subsidies, provide generally universal and comprehensive basic hospital and medical benefits and increasingly provide for the delivery of long-term care services. Within a framework of cooperative federalism, the health care systems of Ontario and Quebec have developed uniquely. In terms of vital statistics, the health of Ontario and Quebec residents generally is comparable. In viewing expenditures, Quebec has a more clearly articulated plan for providing accessible services to low-income persons and for integrating health and social services, although it has faced some difficulties in seeking to achieve the latter goal. Its plans for decentralized services are counter-balanced by a strong provincial role in health policy decision-making. Quebec's political culture also allows the province to play a stronger role in hospital planning and in the regulation of physician income than one finds in Ontario. These political dynamics allow Quebec an advantage in control of costs. In Ontario, in spite of some recent setbacks, physician interests and hospital sector interests play a more active role in health system bargaining and are usually able to influence remuneration and resource allocation decisions more than physician interests and hospital sector interests in Quebec.

  12. THE 'FROZEN' HEART OF THE CONTINENT: PLACE-BRANDING WINNIPEG IN CANADIAN CRIME FILMS

    Directory of Open Access Journals (Sweden)

    James Gacek

    2016-08-01

    Full Text Available Brands play an imperative role when representing places, as culture and the people who live and create it are at the core of the brand. Aside from promoting experiences and destinations, place brands enhance culture and identity, and orchestrate space and atmosphere to create a particular ambiance in which societies are immersed. Over the past century, the representation of Canada in fictional film has generally emphasized its northerly location, its imagined wilderness landscape, and inevitably, its harsh winter climate. For films that focus on crime, justice is frequently imagined along the lines of the cinematic western, with frontier lawmen bringing order and the reach of the state to remote frontier outposts. For much of the twentieth century, this cultural depiction of Winnipeg justice remained frozen and unchallenged. However, beginning in the latter decades of the twentieth century, a growing number of independent Canadian crime films have taken up these familiar Hollywood tropes in ways that reflect, refract, and sometimes challenge the dominant construction of crime and justice. I examine how these films construct crime and the places that foster crime by emphasizing aspects of racialized identity, class, and the branding dynamics of the city of Winnipeg. Far from the rugged northwest of mid-century Hollywood cinema, crime is relocated to the contemporary city, and while still shaped by the endless Canadian winter, justice is frequently fraught, and the power of law and order distant and unable to extend the civilizing effects of the state to these new urban frontiers.

  13. Inequalities in the spiritual health of young Canadians: a national, cross-sectional study.

    Science.gov (United States)

    Michaelson, Valerie; Freeman, John; King, Nathan; Ascough, Hannah; Davison, Colleen; Trothen, Tracy; Phillips, Sian; Pickett, William

    2016-11-28

    Spiritual health, along with physical, emotional, and social aspects, is one of four domains of health. Assessment in this field of research is challenging methodologically. No contemporary population-based studies have profiled the spiritual health of adolescent Canadians with a focus on health inequalities. In a 2014 nationally representative sample of Canadians aged 11-15 years we therefore: (1) psychometrically evaluated a series of items used to assess the perceived importance of spiritual health and its four potential sub-domains (connections with: self, others, nature and the natural environment, and the transcendent) to adolescents; (2) described potential inequalities in spiritual health within adolescent populations, overall and by spiritual health sub-domain, by key socio-demographic factors. Cross-sectional analysis of survey reports from the 2014 (Cycle 7) of the Canadian Health Behaviour in School-aged Children study (weighted n = 25,036). Principal components analysis followed by confirmatory factor analysis were used to explore the psychometric properties of the spiritual health items and the associated composite scale describing perceived importance of spiritual health. Associations among this composite scale, its individual sub-domains, and key socio-demographic factors were then explored. The principal components analysis best supported a four-factor structure where the eight scale items loaded highly according to the original four domains. This was also supported in confirmatory factor analyses. We then combined the eight items into composite spiritual health score as supported by theory, principal components analysis findings, and acceptable tests of reliability. Further confirmatory factor analysis suggested the need for additional refinements to this scale. Based upon exploratory cross-sectional analyses, strong socio-demographic inequalities were observed in the spiritual health measures by age, gender, relative material wealth

  14. Current trends in Canadian health care: myths and misconceptions in health economics.

    Science.gov (United States)

    Coyte, P C

    1990-01-01

    This paper is concerned with the economic aspects of the trends in Canadian health care. Various myths and misconceptions abound regarding the applicability of economics to behaviour in the health care industry as well as to the interpretation of recent trends. Both issues are examined in this paper. While most discussions regarding health care trends begin with the share of health expenditures in Gross National Product, I propose an alternative share that adjusts for cyclical variations in both unemployment and labour force participation. Using this measure, I show that the "real" growth of resources devoted to the health care industry is much larger than that obtained with conventional measures, and that the difference in growth rates between Canada and the U.S. is narrowed considerably. The paper outlines and disputes the validity of three public health policy propositions. First, it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. Second, it is not correct to argue that the change in the federal funding for hospital and medical care in 1977 was a "fiscal non-event". And finally, the proposed "equity" funding formula for Ontario hospitals is unlikely to contain costs and will potentially skew hospitals towards the provision of complex forms of care instead of cost-effective community-based alternatives.

  15. Ecosystem and population health: the role of Canadian physicians at home and abroad.

    OpenAIRE

    Woollard, R F

    1995-01-01

    Seemingly intractable problems of overpopulation, ecologic degradation, diminishing resources and regional warfare are having a profound effect on global population health. Canadian physicians can assist in ameliorating these problems by helping to modify the overconsumption of natural resources at home and by participating in international health projects focused at the community level, where the health of individuals and that of their environment intersect. The author describes the work of ...

  16. Fall-related injuries among Canadian seniors, 2005–2013: an analysis of the Canadian Community Health Survey

    Science.gov (United States)

    Do, M. T.; Chang, V. C.; Kuran, N.; Thompson, W.

    2015-01-01

    Abstract Introduction: We describe the epidemiology and trends of fall-related injuries among Canadian seniors aged 65 years and older by sex and age, as well as the circumstances and consequences of their injuries. Methods: We analyzed nationally representative data from the 2005, 2009/2010 and 2013 samples of the Canadian Community Health Survey to calculate the number and rates of fall-related injuries for each survey year. Where possible, we combined data from two or more samples to estimate the proportion of fall-related injuries by type of injury, part of body injured, type of activity and type of treatment. Results: The rate of fall-related injuries among seniors increased from 49.4 to 58.8 per 1000 population between 2005 and 2013, during which the number of fall-related injuries increased by 54% overall. Women had consistently higher rates than men across all survey years, while rates increased with advancing age. The upward trend in fall-related injury rates was more prominent among women and younger age groups. The most common type of injury was broken or fractured bones (37%), and the shoulder or upper arm (16%) was the most commonly injured body part. Many fall-related injuries occurred while walking on a surface other than snow or ice (45%). Over 70% of seniors seeking treatment for their injuries visited a hospital emergency department. Conclusion: Given the increase in both the number and rates of fall-related injuries over time, there is a need to continue monitoring trends and injury patterns associated with falls. PMID:26378768

  17. Fall-related injuries among Canadian seniors, 2005-2013: an analysis of the Canadian Community Health Survey.

    Science.gov (United States)

    Do, M T; Chang, V C; Kuran, N; Thompson, W

    2015-09-01

    We describe the epidemiology and trends of fall-related injuries among Canadian seniors aged 65 years and older by sex and age, as well as the circumstances and consequences of their injuries. We analyzed nationally representative data from the 2005, 2009/2010 and 2013 samples of the Canadian Community Health Survey to calculate the number and rates of fall-related injuries for each survey year. Where possible, we combined data from two or more samples to estimate the proportion of fall-related injuries by type of injury, part of body injured, type of activity and type of treatment. The rate of fall-related injuries among seniors increased from 49.4 to 58.8 per 1000 population between 2005 and 2013, during which the number of fall-related injuries increased by 54% overall. Women had consistently higher rates than men across all survey years, while rates increased with advancing age. The upward trend in fall-related injury rates was more prominent among women and younger age groups. The most common type of injury was broken or fractured bones (37%), and the shoulder or upper arm (16%) was the most commonly injured body part. Many fall-related injuries occurred while walking on a surface other than snow or ice (45%). Over 70% of seniors seeking treatment for their injuries visited a hospital emergency department. Given the increase in both the number and rates of fall-related injuries over time, there is a need to continue monitoring trends and injury patterns associated with falls.

  18. Future human health research directions for the Canadian Northern Contaminants Program

    Science.gov (United States)

    Donaldson, Shawn G.; Curren, Meredith S.; Adlard, Bryan; Provost, Jonathan; Leech, Tara; Tikhonov, Constantine; Feeley, Mark; Tomlinson, Scott; Shearer, Russel

    2013-01-01

    Studies conducted in the mid-1980s and early 1990s demonstrated that persistent organic pollutants (POPs) and metals were reaching the Arctic ecosystem at unexpectedly high levels, many of which had no Arctic or Canadian sources. Epidemiological and toxicological studies in Canada and in other countries have found that these contaminants may pose a risk to human health. The objective of this paper is to provide the foundation for the discussion on future northern human health research under the Northern Contaminants Program (NCP) in Canada. This short discussion of human health priorities will help guide a path forward for future northern human health research in Canada to address on-going and new health concerns related to contaminants exposure in the Canadian Arctic. PMID:24282784

  19. Formation of a national network for rapid response to device and lead advisories: The Canadian Heart Rhythm Society Device Advisory Committee

    Science.gov (United States)

    Krahn, Andrew D; Simpson, Christopher S; Parkash, Ratika; Yee, Raymond; Champagne, Jean; Healey, Jeffrey S; Cameron, Doug; Thibault, Bernard; Mangat, Iqwal; Tung, Stanley; Sterns, Laurence; Birnie, David H; Exner, Derek V; Sivakumaran, Soori; Davies, Ted; Coutu, Benoit; Crystal, Eugene; Wolfe, Kevin; Verma, Atul; Stephenson, Elizabeth A; Sanatani, Shubhayan; Gow, Robert; Connors, Sean; Paredes, Felix Ayala; Turabian, Mike; Kus, Teresa; Essebag, Vidal; Gardner, Martin

    2009-01-01

    The Canadian Heart Rhythm Society (CHRS) Device Advisory Committee was commissioned to respond to advisories regarding cardiac rhythm device and lead performance on behalf of the CHRS. In the event of an advisory, the Chair uses an e-mail network to disseminate advisory information to Committee members broadly representative of the Canadian device community. A consensus recommendation is prepared by the Committee and made available to all Canadian centres on the CHRS Web site after approval by the CHRS executive. This collaborative approach using an e-mail network has proven very efficient in providing a rapid national response to device advisories. The network is an ideal tool to collect specific data on implanted device system performance and allows for prompt reporting of clinically relevant data to front-line clinicians and patients. PMID:19584969

  20. Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study.

    Science.gov (United States)

    Léon, Grégory; Ouimet, Mathieu; Lavis, John N; Grimshaw, Jeremy; Gagnon, Marie-Pierre

    2013-03-21

    Evidence-informed health policymaking logically depends on timely access to research evidence. To our knowledge, despite the substantial political and societal pressure to enhance the use of the best available research evidence in public health policy and program decision making, there is no study addressing availability of peer-reviewed research in Canadian health ministries. To assess availability of (1) a purposive sample of high-ranking scientific journals, (2) bibliographic databases, and (3) health library services in the fourteen Canadian health ministries. From May to October 2011, we conducted a cross-sectional survey among librarians employed by Canadian health ministries to collect information relative to availability of scientific journals, bibliographic databases, and health library services. Availability of scientific journals in each ministry was determined using a sample of 48 journals selected from the 2009 Journal Citation Reports (Sciences and Social Sciences Editions). Selection criteria were: relevance for health policy based on scope note information about subject categories and journal popularity based on impact factors. We found that the majority of Canadian health ministries did not have subscription access to key journals and relied heavily on interlibrary loans. Overall, based on a sample of high-ranking scientific journals, availability of journals through interlibrary loans, online and print-only subscriptions was estimated at 63%, 28% and 3%, respectively. Health Canada had a 2.3-fold higher number of journal subscriptions than that of the provincial ministries' average. Most of the organisations provided access to numerous discipline-specific and multidisciplinary databases. Many organisations provided access to the library resources described through library partnerships or consortia. No professionally led health library environment was found in four out of fourteen Canadian health ministries (i.e. Manitoba Health, Northwest

  1. Tracing the social gradient in the health of Canadians: primary and secondary determinants.

    Science.gov (United States)

    Kosteniuk, Julie G; Dickinson, Harley D

    2003-07-01

    The social gradient in heath refers to the fact that inequalities in population health status are related to inequalities in social status. This study advances and tests a model of the relationships between what we term primary and secondary determinants of the social gradient in health. The primary determinants of health include socioeconomic and demographic indicators. Secondary determinants include stressors, control, self-esteem, social support, and social involvement. Health status is indicated by measures of physical health, self-reported health status, and mental distress. Data are taken from the Canadian National Population Health (NPH) Survey (1994-1995). The study sample consists of 7720 men and 9269 women 15 to over 80 years of age. Using path analysis, we found that higher household income, being retired and growing older are significantly associated with lower stressor levels. Higher stressor levels are associated with lower levels of control, self-esteem, and social support. Higher income Canadians experience greater levels of control and social support, while older Canadians experience lower rates of social support but higher rates of social involvement. Being employed and caring for one's family are positively associated with better physical and self-reported health status. Higher household income, being retired, and aging are associated with better physical health and lower mental distress when accounting for their role in lowering stressor levels and bolstering control, self-esteem, social support, and social involvement. Replicating this study with future samples of the NPH Survey should be of benefit in ascertaining whether the social gradient in Canadians' health status shows signs of declining.

  2. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Science.gov (United States)

    2011-01-01

    Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad

  3. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Directory of Open Access Journals (Sweden)

    Snyder Jeremy

    2011-05-01

    Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients

  4. An industry perspective on Canadian patients' involvement in medical tourism: implications for public health.

    Science.gov (United States)

    Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul

    2011-05-31

    The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public

  5. Capturing pan-Canadian Primary Health Care indicator data using multiple approaches for data collection.

    Science.gov (United States)

    Walker, Vicky; Sullivan-Taylor, Patricia; Webster, Greg; Macphail, Judith

    2009-01-01

    The Canadian Institute for Health Information (CIHI), in collaboration with diverse stakeholders, led the development of pan-Canadian indicators to measure primary health care. In 2006, CIHI released a set of 105 pan-Canadian Primary Health Care (PHC) indicators that were developed with the assistance of national, provincial and territorial representatives, clinicians and researchers. Additionally, data gaps were identified in a series of reports. In 2006 and 2007, CIHI assessed options for closing the data gaps so that the indicators could be measured and reported. CIHI then began a program to build the data infrastructure needed for the PHC indicators. The program included the development of content standards for electronic medical records, a prototype of a voluntary reporting system, enhancements to surveys, and the development of reports. In 2006, fewer than 10% of the 105 indicators could be calculated with existing data sources. Now, four projects have begun and over 50% of the indicators are being captured. Important relationships have been established with key collaborators. These relationships will lead to the development of a reporting system prototype and to the refinement of PHC indicators and electronic medical record (EMR) content standards. The project for pan-Canadian PHC indicators has encouraged consultation and synergy. It has motivated CIHI to establish an information program to fill data gaps and to make PHC indicators available.

  6. Health in adults with congenital heart disease

    NARCIS (Netherlands)

    Cuypers, Judith A. A. E.; Utens, Elisabeth M. W. J.; Roos-Hesselink, Jolien W.

    2016-01-01

    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many

  7. Health in adults with congenital heart disease.

    Science.gov (United States)

    Cuypers, Judith A A E; Utens, Elisabeth M W J; Roos-Hesselink, Jolien W

    2016-09-01

    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many adults with congenital heart disease encounter late complications. Late morbidity can be related to the congenital heart defect itself, but may also be the consequence of the surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. This narrative review describes the cardiac and non-cardiac long-term morbidity in the adult population with congenital heart disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Nuts and Your Heart: Eating Nuts for Heart Health

    Science.gov (United States)

    ... benefits of nuts if they're covered with chocolate, sugar or salt. Here's some nutrition information on ... disease. Clinical Cardiology. 2015;38:570. Ros E. Health benefits of nut consumption. Nutrients. 2010;2:652. Suggested ...

  9. The Canadian Natural Health Products (NHP regulations: industry perceptions and compliance factors

    Directory of Open Access Journals (Sweden)

    Boon Heather

    2006-05-01

    Full Text Available Abstract Background The use of natural health products, such as vitamins, minerals, and herbs, by Canadians has been increasing with time. As a result of consumer concern about the quality of these products, the Canadian Department of Health created the Natural Health Products (NHP Regulations. The new Canadian regulations raise questions about whether and how the NHP industry will be able to comply and what impact they will have on market structure. The objectives of this study were to explore who in the interview sample is complying with Canada's new NHP Regulations (i.e., submitted product licensing applications on time; and explore the factors that affect regulatory compliance. Methods Twenty key informant interviews were conducted with employees of the NHP industry. The structured interviews focused on the level of satisfaction with the Regulations and perceptions of compliance and non-compliance. Interviews were tape recorded and then transcribed verbatim. Data were independently coded, using qualitative content analysis. Team meetings were held after every three to four interviews to discuss emerging themes. Results The major finding of this study is that most (17 out of 20 companies interviewed were beginning to comply with the new regulatory regime. The factors that contribute to likelihood of regulatory compliance were: perceptions and knowledge of the regulations and business size. Conclusion The Canadian case can be instructive for other countries seeking to implement regulatory standards for natural health products. An unintended consequence of the Canadian NHP regulations may be the exit of smaller firms, leading to industry consolidation.

  10. An Industry Perspective on Canadian Patients' Involvement in Medical Tourism: Implications for Public Health

    OpenAIRE

    Johnston, Rory; Crooks, Valorie A.; Adams, Krystyna; Kingsbury, Paul; Snyder, Jeremy

    2011-01-01

    Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian med...

  11. Indigenous community based participatory research and health impact assessment: A Canadian example

    International Nuclear Information System (INIS)

    Kwiatkowski, Roy E.

    2011-01-01

    The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples.

  12. United States and Canadian approaches to justice in health care: a comparative analysis of health care systems and values.

    Science.gov (United States)

    Jecker, N S; Meslin, E M

    1994-06-01

    The purpose of this study is to compare and contrast the basic ethical values underpinning national health care policies in the United States and Canada. We use the framework of ethical theory to name and elaborate ethical values and to facilitate moral reflection about health care reform. Section one describes historical and contemporary social contract theories and clarifies the ethical values associated with them. Sections two and three show that health care debates and health care systems in both countries reflect the values of this tradition; however, each nation interprets the tradition differently. In the U.S., standards of justice for health care are conceived as a voluntary agreement reached by self-interested parties. Canadians, by contrast, interpret the same justice tradition as placing greater emphasis on concern for others and for the community. The final section draws out the implications of these differences for future U.S. and Canadian health care reforms.

  13. Health service interventions targeting relatives of heart patients

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe

    2008-01-01

    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...

  14. Heart Check (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-09-24

    Heart disease is the leading cause of death worldwide. In the U.S., it’s related to one in four deaths. This podcast discusses heart health.  Created: 9/24/2015 by MMWR.   Date Released: 9/24/2015.

  15. Healthy Hearts (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-10-02

    Heart disease is among the leading causes of death worldwide. Combined with stroke, it accounts for nearly one in three deaths. This podcast discusses the importance of improving heart health.  Created: 10/2/2014 by MMWR.   Date Released: 10/2/2014.

  16. Canadian initiative leading the way for equitable health systems and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-27

    Apr 27, 2016 ... Home · Resources · Publications ... The field of health systems research has grown into a vibrant community. IDRC grantees are actively involved in Health Systems Global, a newinternational agency that gathers researchers, ...

  17. The Canadian Geospatial Data Infrastructure and health mapping

    DEFF Research Database (Denmark)

    Gao, Sheng; Mioc, Darka; Yi, Xiaolun

    2008-01-01

    such as emergency management, public health, disaster relief, environmental impact assessment, transportation, and land information systems. In this paper, our aims are to use the CGDI and to identify its usability in supporting online health mapping. To identify the usability of the CGDI for health mapping, we...

  18. Heart Health Tests for Diabetes Patients

    Science.gov (United States)

    ... or fluids in the body. They include: Electrocardiogram ("EKG" or "ECG") This test measures the electrical activity ... Tools & Resources Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  19. Tax-Assisted Approaches for Helping Canadians Meet Out-of-Pocket Health-Care Costs

    Directory of Open Access Journals (Sweden)

    J.C. Herbert Emery

    2016-06-01

    Full Text Available Canadians are not saving for the inevitable costs of drugs and long-term care which they will have to pay for out of pocket in their old age, and these costs could potentially be financially devastating for them. Later in life, when out-of-pocket health-care costs mount, those who previously enjoyed the security of a workplace insurance plan to cover such expenses will face a grim financial reality. Many aspects of care for older Canadians aren’t covered by this country’s single-payer health-care system. Besides prescription drugs, these include management of chronic conditions by ancillary health professionals, home care, long-term care, and dental and vision care. Statistics show that in 2012, Canadians’ private spending on health care totaled $60 billion, with private health insurance covering $24.5 billion of that amount. Coverage of health-care costs that don’t fall under Medicare’s purview is at present rather piecemeal. The non-refundable federal Medical Expense Tax Credit covers expenses only after the three-per-cent minimum, or first $2,171, of out-of-pocket costs have been paid by the individual. The Disability Tax Credit is available to those with a certified chronic disability, and these individuals are eligible for further support via the Registered Disability Savings Plan. A Caregiver Tax Credit is also available. The federal government has a golden opportunity to provide an incentive for Canadians to set aside money to pay not only for the often catastrophic medical and drug costs that can come with aging, but also to save so they can afford long-term care, or purchase private health insurance. Too many Canadians, unfortunately, believe that the federal government picks up the tab for long-term care. In fact, provincial subsidies are provided on a means-testing basis, thus leaving many better-off Canadians in the lurch when they can no longer live alone and must make the transition to long-term care. Providing more

  20. Experience with the SynCardia total artificial heart in a Canadian centre.

    Science.gov (United States)

    Nguyen, Anthony; Pellerin, Michel; Perrault, Louis P; White, Michel; Ducharme, Anique; Racine, Normand; Carrier, Michel

    2017-12-01

    The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke ( n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation ( n = 5, 38%) and acute renal failure requiring temporary dialysis ( n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH.

  1. Practical guide on home health in heart failure patients

    DEFF Research Database (Denmark)

    Jaarsma, T.; Larsen, Torben; Stromberg, A.

    2013-01-01

    in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method: We developed a guide on Home Health in Heart Failure patients...... from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results: In integrated home care for heart failure patients, it is advised to consider the following...... components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. Discussion: We summarised the state of the art of home-based care for heart failure patients...

  2. Computerized health physics record system at a Canadian fabrication facility

    International Nuclear Information System (INIS)

    Thind, K.S.

    1984-01-01

    This poster session will describe the types of Health Physics data input into a Hewlett-Packard 3000 computer. The Health Physics data base at this facility includes the following: employee hours data, airborne uranium concentrations, external dosemetry (badge readings), internal dosemetry (bioassay) and environmental health physics (stack sample results) data. It will describe the types of outputs achievable in the form of various reports, such as: individual employee health physics report for a given period, a general health physics summary report for a given period, individual urinalysis report, local air concentration report and graphs. The use of this computerized health physics record system in the overall radiation protection program at this facility is discussed

  3. Fasting Diet: Can It Improve My Heart Health?

    Science.gov (United States)

    ... health? Is it true that occasionally following a fasting diet can reduce my risk of heart disease? ... t sure why, but it seems that regularly fasting — severely restricting food and drink for a 24- ...

  4. Screening for congenital heart malformation in child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard); J. Hess (Jakob); C.W.N. Looman (Caspar); G.J. van Oortmarssen (Gerrit); P.J. van der Maas (Paul)

    1998-01-01

    textabstractBACKGROUND: Although screening for congenital heart malformations is part of the child health care programme in several countries, there are very few published evaluations of these activities. This report is concerned with the evaluation of this screening at

  5. The perceptions of caregivers toward physical activity and health in youth with congenital heart disease.

    Science.gov (United States)

    Moola, Fiona; Fusco, Caroline; Kirsh, Joel A

    2011-02-01

    Medical advances have reduced mortality in youth with congenital heart disease (CHD). Although physical activity is associated with enhanced quality of life, most patients are inactive. By addressing medical and psychological barriers, previous literature has reproduced discourses of individualism which position cardiac youth as personally responsible for physical inactivity. Few sociological investigations have sought to address the influence of social barriers to physical activity, and the insights of caregivers are absent from the literature. In this study, caregiver perceptions toward physical activity for youth with CHD were investigated at a Canadian hospital. Media representations, school liability, and parental overprotection construct cardiac youth as "at risk" during physical activity, and position their health precariously. Indeed, from the perspective of hospital staff, the findings indicate the centrality of sociological factors to the physical activity experiences of youth with CHD, and the importance of attending to the contextual barriers that constrain their health and physical activity.

  6. Immigrant Youth in Canadian Health Promoting Schools: A Literature Review

    Science.gov (United States)

    Nyika, Lawrence; McPherson, Charmaine; Murray-Orr, Anne

    2017-01-01

    In this essay, we review empirical, theoretical, and substantial grey literature in relation to immigrant youth and health promoting schools (HPS). We examine the health promotion concept to consider how it may inform the HPS model. Using Canada as an example, we examine current immigrant youth demographics and define several key terms including…

  7. Screening for congenital heart malformations in child health centres

    OpenAIRE

    Juttmann, Rikard

    1999-01-01

    textabstractThe objective of this thesis is to clarify the effectiveness and the efficiency of screening for congenital heart malformations in Dutch child health centres and the possibilities to optimise this prevention programme. To this end the following main questions will be addressed. 1. Does screening for congenital heart malformations, as actually performed in Dutch child health centres, prevent adverse outcomes of these disorders in the short and long run? What would be the answer to ...

  8. National evaluation of policies on individual financial conflicts of interest in Canadian academic health science centers.

    Science.gov (United States)

    Lexchin, Joel; Sekeres, Melanie; Gold, Jennifer; Ferris, Lorraine E; Kalkar, Sunila R; Wu, Wei; Van Laethem, Marleen; Chan, An-Wen; Moher, David; Maskalyk, M James; Taback, Nathan; Rochon, Paula A

    2008-11-01

    Conflicts of interest (COI) in research are an important emerging topic of investigation and are frequently cited as a serious threat to the integrity of human participant research. To study financial conflicts of interest (FCOI) policies for individual investigators working in Canadian academic health centers. Survey instrument containing 61 items related to FCOI. All Canadian academic health science centers (universities with faculties of medicine, faculties of medicine and teaching hospitals) were requested to provide their three primary FCOI policies. Number of all centers and teaching hospitals with policies addressing each of the 61 items related to FCOI. Only one item was addressed by all 74 centers. Thirteen items were present in fewer than 25% of centers. Fewer than one-quarter of hospitals required researchers to disclose FCOI to research participants. The role of research ethics boards (REBs) in hospitals was marginal. Asking centers to identify only three policies may not have inclusively identified all FCOI policies in use. Additionally, policies at other levels might apply. For instance, all institutions receiving federal grant money must comply with the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. Canadian centers within the same level (for instance, teaching hospitals) differ significantly in the areas that their policies address and these policies differ widely in their coverage. Presently, no single policy in any Canadian center informs researchers about the broad range of individual FCOI issues. Canadian investigators need to understand the environment surrounding FCOI, be able to access and follow the relevant policies and be confident that they can avoid entering into a FCOI.

  9. Canadian medical students' perceptions of public health education in the undergraduate medical curriculum.

    Science.gov (United States)

    Tyler, Ingrid V; Hau, Monica; Buxton, Jane A; Elliott, Lawrence J; Harvey, Bart J; Hockin, James C; Mowat, David L

    2009-09-01

    To understand the perceptions and attitudes of Canadian medical students toward their undergraduate medical public health curriculum and to identify student suggestions and priorities for curriculum change. Five focus groups of 11 or 12 medical students from all years of medical school were recruited at McMaster University Faculty of Health Sciences, Université de Sherbrooke Faculty of Medicine and Health Sciences, University of Toronto Faculty of Medicine, University of Manitoba Faculty of Medicine, and University of British Columbia Faculty of Medicine between February and April 2006. A professional facilitator was hired to conduct the focus groups using a unique, computer-based facilitation system. Questions in both the focus group and an accompanying survey sought to determine medical students' understanding and exposure to public health and how this impacted their attitudes and choices toward careers in the public health medical specialty of community medicine. The transcripts were independently reviewed and analyzed by each of the authors to identify themes. Four major themes related to students' desired curriculum change were identified: (1) poor educational experiences in public health courses, (2) lack of positive role models, especially exposure to community medicine specialists, (3) emphasis on statistics and epidemiology, and (4) negative attitudes toward public health topics. Students are disillusioned, disengaged, and disappointed with the public health curriculum currently being provided at the Canadian medical schools studied. Many medical students would prefer a public health curriculum that is more challenging and has more applied field experience and exposure to public health physician role models.

  10. Dyslipidemia prevalence, treatment, control, and awareness in the Canadian Health Measures Survey.

    Science.gov (United States)

    Joffres, Michel; Shields, Margot; Tremblay, Mark S; Connor Gorber, Sarah

    2013-04-24

    The most recent Canadian population-level data on lipid levels are from 1992. This study presents current estimates of Canadians with dyslipidemia, the proportion aware of their condition, and the proportion being treated and below target values. The Canadian Health Measures Survey (2007-2009) assessed the prevalence, awareness and treatment of dyslipidemia. Dyslipidemia was defined as TC/HDL-C ratio ≥5; measured LDL-C ≥3.5 mmol/L; or taking lipid-modifying medications. The 2009 guidelines for the diagnosis and treatment of dyslipidemia were used to define low, moderate or high cardiovascular disease (CVD) risk and treatment initiation and targets. Forty-five percent of Canadians aged 18-79 years have dyslipidemia. Fifty-seven percent of respondents were not aware of their condition. Lipid-modifying therapy was initiated in individuals where treatment would be recommended in 49%, 20% and 54% of those at high, moderate, and low risk levels, respectively. The majority (81%) of those taking medication had their lipid levels under desirable levels, however, only 24% of those with dyslipidemia reported medication use. Overall, only 19% of those with dyslipidemia had their lipids under recommended levels. Only 41% of those taking lipid-modifying medication reached a recommended target of LDL-C dyslipidemia, who are not being treated to recommended levels. These data need to be integrated into CVD reduction recommendations and represent an important baseline for assessing progress.

  11. Linkage of the Canadian Study of Health and Aging to provincial administrative health care databases in Nova Scotia.

    Science.gov (United States)

    Yip, A M; Kephart, G; Rockwood, K

    2001-01-01

    The Canadian Study of Health and Aging (CSHA) was a cohort study that included 528 Nova Scotian community-dwelling participants. Linkage of CSHA and provincial Medical Services Insurance (MSI) data enabled examination of health care utilization in this subsample. This article discusses methodological and ethical issues of database linkage and explores variation in the use of health services by demographic variables and health status. Utilization over 24 months following baseline was extracted from MSI's physician claims, hospital discharge abstracts, and Pharmacare claims databases. Twenty-nine subjects refused consent for access to their MSI file; health card numbers for three others could not be retrieved. A significant difference in healthcare use by age and self-rated health was revealed. Linkage of population-based data with provincial administrative health care databases has the potential to guide health care planning and resource allocation. This process must include steps to ensure protection of confidentiality. Standard practices for linkage consent and routine follow-up should be adopted. The Canadian Study of Health and Aging (CSHA) began in 1991-92 to explore dementia, frailty, and adverse health outcomes (Canadian Study of Health and Aging Working Group, 1994). The original CSHA proposal included linkage to provincial administrative health care databases by the individual CSHA study centers to enhance information on health care utilization and outcomes of study participants. In Nova Scotia, the Medical Services Insurance (MSI) administration, which drew the sampling frame for the original CSHA, did not retain the list of corresponding health card numbers. Furthermore, consent for this access was not asked of participants at the time of the first interview. The objectives of this study reported here were to examine the feasibility and ethical considerations of linking data from the CSHA to MSI utilization data, and to explore variation in health

  12. Heart Health (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. This podcast discusses the importance of controlling the risk factors that can lead to heart disease.

  13. Mental Illness-Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data.

    Science.gov (United States)

    Weeks, Murray; Zamorski, Mark A; Rusu, Corneliu; Colman, Ian

    2017-07-01

    This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians. Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care. Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25). Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.

  14. Heart Health (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. One in 10 U.S. adults have been diagnosed with some form of heart disease. In this podcast, Dr. Matthew Ritchey discusses the four simple steps to prevent heart disease.

  15. An Analysis of Canadian Institute for Health Research Funding for Research on Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    R. Deonandan

    2016-01-01

    Full Text Available We examined patterns of Canadian Institute for Health Research (CIHR funding on autism spectrum disorder (ASD research. From 1999 to 2013, CIHR funded 190 ASD grants worth $48 million. Biomedical research received 43% of grants (46% of dollars, clinical research 27% (41%, health services 10% (7%, and population health research 8% (3%. The greatest number of grants was given in 2009, but 2003 saw the greatest amount. Funding is clustered in a handful of provinces and institutions, favouring biomedical research and disfavouring behavioural interventions, adaptation, and institutional response. Preference for biomedical research may be due to the detriment of clinical research.

  16. Health behavior of patients with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Paweł Węgorowski

    2017-06-01

    Full Text Available Admission By analyzing the available scientific literature, it is possible to define ischemic heart disease as a set of disease symptoms that are a consequence of a chronic state of imbalance between the ability to supply nutrients and oxygen and the real need of myocardial cells for these substances. Adapting life-style behaviors to healthy living is a priority to prevent the onset and development of cardiovascular disease, especially ischemic heart disease, Purpose of research The aim of the study is to determine the health behavior of patients with ischemic heart disease. Materials and methods The study was conducted from 01.08.2015 to 28.12.2015 in a group of 35 people (15 women and 20 men. The research method used in the work is a diagnostic survey, the research technique used was a survey of its own author. Conclusions By analyzing the data collected, it is important to note that patients with coronary heart disease are often associated with health problems such as hypertension, diabetes and abnormal weight. The nutritional habits of the subjects studied can be described as abnormal, particularly the excessive intake of oily meat and too little fish intake. It has also been observed that most of the patients studied have familial predisposition to ischemic heart disease. Discussion Heart attacks occur mostly in people with obesity, diabetes and atherosclerosis. It is also closely related to ischemic heart disease. The health behaviors of patients suffering from Ischemic Heart Disease are moderately satisfactory and therefore the role of a nurse practitioner as a health educator is very difficult but essential in the prevention of ischemic heart disease.

  17. Genital warts: Canadians' perception, health-related behaviors, and treatment preferences.

    Science.gov (United States)

    Steben, Marc; LaBelle, Deborah

    2012-10-01

    The study aimed to gauge the perceptions of Canadians toward genital warts, related health behaviors, and treatment preferences. An online survey supported by an unrestricted grant from Graceway Canada was conducted in February 2011 by Leger Marketing. It included 9 demographic questions and 17 questions relating to genital wart perception (2 multiple-choice, 15 four-point rating from strongly agree to strongly disagree). The survey was completed by 1520 Canadian adults aged 18 to older than 75 years, of whom 52% (786/1520) were female. Fifty-two percent of respondents stated that they would monitor an unrecognized spot on their genitals, and only seek medical assistance if it did not go away. Only 43% (652/1520) said that they would stop having sex until the spots were gone. Although only 10% (158/1520) of respondents stated that they would not inform their partner, this was much higher among men (14%, 103/734) than women (7%, 55/786), with p ≤ .01. Concerns of being judged by friends/family were high (44%, 669/1520), especially among younger (18-34 y) Canadians (60%), with p ≤ .05. Regarding prevention, 32% (493/1520) of respondents believed that monogamy would protect against genital warts and 25% (373/1520) believed they are not at risk if they use a condom. Treatment preference was in favor of a cream rather than an "invasive" treatment (58%, 886/1520), particularly among younger (67%, 283/425, p ≤ .05) and male respondents (63%, 464/734, p ≤ .01). Sixty percent (921/1520) would worry that genital warts could not be resolved; and 44% (668/1520), that they would recur. Among Canadians, genital warts were associated with a fair degree of social stigma and potential negative impact on their psyche, especially for younger Canadians.

  18. Quality and Health Literacy Demand of Online Heart Failure Information.

    Science.gov (United States)

    Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi; Hladek, Melissa; Han, Hae-Ra

    The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials. A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%. The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.

  19. Paid health and family leave: the Canadian experience in the global context.

    Science.gov (United States)

    Heymann, S Jody; Gerecke, Megan; Chaussard, Martine

    2010-01-01

    Two thirds of Canadian adults participate in the workforce. Their health and that of their families can be markedly affected by the availability of paid sick leave, paid leave to care for family members' health and paid parental leave. We gathered data from all Canadian provinces and territories on these essential leave policies and compared Canadian policies with data collected on 186 United Nations (UN) countries. While Canada pays sickness benefits for 15 weeks for serious illnesses, globally at least 90 countries provide benefits for at least 26 weeks or until recovery. Moreover, within Canada only Saskatchewan and Quebec guarantee job protection if sick leave lasts over 12 days. The federal government guarantees Canadian workers six weeks of paid leave to provide care or support to gravely ill family members. Only 39 countries guarantee such leave with pay. Most, but not all, provinces guarantee workers' job protection during compassionate care leave. Eligibility for job protection during parental leave varies across the country from having no restrictions to requiring at least one year of service. Compared with Canada, many countries offer a longer duration of paid sick leave for employees and replace a higher percentage of wages lost. Internationally, Canada performs well in having policies that guarantee paid leave to care for dependants with serious illnesses, but it lags behind in the provision of paid leave to address the health needs of children or family members' with non-life-threatening conditions. Finally, while paid parental leave is of adequate duration, the wage replacement rate lowers its accessibility to families with limited means.

  20. Heart check: the development and evolution of an organizational heart health assessment.

    Science.gov (United States)

    Golaszewski, Thomas; Fisher, Brian

    2002-01-01

    The purpose of this article is to document the development, testing, and application of an organizational assessment tool used to measure employer support for heart health. Additional information is presented on its future research and applications plan. This article represents the pooling of results from multiple studies using a variety of designs, including pilot tests, cross-sectional analyses, and quasi-experiments. Worksites covering the spectrum of employers across industry types and size, and throughout all of New York State. Over 10,000 New York employees and 1000 New York employers are represented in the multiple phases of this research. Heart Check is a 226-item inventory designed to measure such features in the worksite as organizational foundations, administrative supports, tobacco control, nutrition support, physical activity support, stress management, screening services, and company demographics. Additional side studies used professional judgments and behavioral surveys. As an assessment tool Heart Check shows evidence for reliability and validity. Applications of the instrument show characteristics that define high-scoring companies, quasi standards for New York employers, and, when applied during interventions, positive changes in organizational support levels. A relatively inexpensive, easy-to-use, and metrically tested instrument exists for measuring the construct of organizational support for employee heart health. The instrument shows promise as part of a system to enhance heart health through public health-based interventions in the workplace.

  1. Leadership skills are associated with health behaviours among Canadian children.

    Science.gov (United States)

    Ferland, Adam; Chu, Yen Li; Gleddie, Doug; Storey, Kate; Veugelers, Paul

    2015-03-01

    Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Human health considerations in the assessment of Canadian concept for the disposal of nuclear fuel wastes

    International Nuclear Information System (INIS)

    Baweja, A.S.; Tracy, B.L.; Ahier, B.; Bartlett, S.

    1996-01-01

    In 1978, AECL was mandated by the government of Ontario and the federal government to find a permanent disposal solution for spent nuclear fuels. Canada opted for disposal in plutonic rocks of the Canadian shield. The Canadian concept calls for disposal in crystalline rocks at a depth of 500 to 1000 m below the surface. The spent fuel would be contained in a canister, the canister would be emplaced in a vault containing clay-based buffer materials, and the cavity would be backfilled and sealed with natural materials. A Federal Environmental Assessment Review Panel was formed in 1992 to assess the concept for disposal of the spent fuel. In this paper a brief discussion of the human health impacts of the proposed concept is presented. Our assessment is based on the information provided by AECL, namely, the main EIS document, a summary and nine other supporting documents

  3. Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey.

    Science.gov (United States)

    Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

    2011-01-01

    Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994-2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89-1.94, females OR: 1.14, 95% C.I.: 0.78-1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73-2.23, females OR: 1.23, 95% C.I.: 0.64-2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17-0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00-1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population. © 2010 Blackwell Publishing Ltd.

  4. Health Activities Project (HAP): Heart Fitness and Action Module.

    Science.gov (United States)

    Buller, Dave; And Others

    Contained within this Health Activities Project (HAP) learning packet are activities for children in grades 5-8. Design of the activities centers around the idea that students can control their own health and safety. Within the Heart Fitness and Action Module are teacher and student folios describing five activities which involve students in…

  5. Heart Health (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-02-27

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. One in 10 U.S. adults have been diagnosed with some form of heart disease. In this podcast, Dr. Matthew Ritchey discusses the four simple steps to prevent heart disease.  Created: 2/27/2014 by MMWR.   Date Released: 2/27/2014.

  6. Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

    Science.gov (United States)

    Hanusaik, Nancy; O'Loughlin, Jennifer L; Kishchuk, Natalie; Paradis, Gilles; Cameron, Roy

    2010-04-01

    There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

  7. The 2015 National Canadian Homeless Youth Survey: Mental Health and Addiction Findings.

    Science.gov (United States)

    Kidd, Sean A; Gaetz, Stephen; O'Grady, Bill

    2017-07-01

    This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population. This study reports mental health-related data from the 2015 "Leaving Home" national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators. Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]). This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.

  8. Introduction to the Special Issue: Precarious Solidarity-Preferential Access in Canadian Health Care.

    Science.gov (United States)

    Reid, Lynette

    2017-06-01

    Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration (conceptual, practical, and ethical) call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries (the concept of medical need) and on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries.

  9. Canadian and the United States' health care systems performance and governance: elements of convergence.

    Science.gov (United States)

    Globerman, Steven; Hodges, Hart; Vining, Aidan

    2002-01-01

    International comparisons of the organisation and performance of health care sectors are increasingly informing policy makers about potential policies relating to health care. Politicians, academics and critics in both the United States and Canada have compared and contrasted the health care systems in the two countries. Public debate tends to emphasise the differences between the US and Canadian health care systems. But, dramatic differences between the organisation and performances of health care systems of the two countries would be surprising given that most elements of divergence have only emerged in the last fifty years, and that health systems tend to be driven by the same basic economic problems. This paper provides an overview of the main economic efficiency issues that must be addressed by health care delivery systems, as well as statistical and related evidence on both input usage and output performance of the two health care systems. While Canada clearly spends less on health care, it is difficult to conclude that Canada has a more efficient health care system than the United States. In particular, the US population puts greater demands on its national health care system owing to a combination of behavioural patterns and socio-economic disparities that contribute to much higher rates of violent accidents, as well as specific diseases and other health problems. Also, the stylized representation of the US system as being 'market-driven' and the Canadian system as being 'centrally controlled' is, increasingly, inept. Both systems are evolving toward bureaucratic models that rely more on internal competition than market competition for governance. In this respect, economic forces are nudging both systems towards a convergence of structure and performance.

  10. Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools.

    Science.gov (United States)

    Mcluckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia

    2014-12-31

    Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.

  11. Promoting equitable global health research: a policy analysis of the Canadian funding landscape.

    Science.gov (United States)

    Plamondon, Katrina; Walters, Dylan; Campbell, Sandy; Hatfield, Jennifer

    2017-08-29

    Recognising radical shifts in the global health research (GHR) environment, participants in a 2013 deliberative dialogue called for careful consideration of equity-centred principles that should inform Canadian funding polices. This study examined the existing funding structures and policies of Canadian and international funders to inform the future design of a responsive GHR funding landscape. We used a three-pronged analytical framework to review the ideas, interests and institutions implicated in publically accessible documents relevant to GHR funding. These data included published literature and organisational documents (e.g. strategic plans, progress reports, granting policies) from Canadian and other comparator funders. We then used a deliberative approach to develop recommendations with the research team, advisors, industry informants and low- and middle-income country (LMIC) partners. In Canada, major GHR funders invest an estimated CA$90 M per annum; however, the post-2008 re-organization of funding structures and policies resulted in an uncoordinated and inefficient Canadian strategy. Australia, Denmark, the European Union, Norway, Sweden, the United Kingdom and the United States of America invest proportionately more in GHR than Canada. Each of these countries has a national strategic plan for global health, some of which have dedicated benchmarks for GHR funding and policy to allow funds to be held by partners outside of Canada. Key constraints to equitable GHR funding included (1) funding policies that restrict financial and cost burden aspects of partnering for GHR in LMICs; and (2) challenges associated with the development of effective governance mechanisms. There were, however, some Canadian innovations in funding research that demonstrated both unconventional and equitable approaches to supporting GHR in Canada and abroad. Among the most promising were found in the International Development Research Centre and the (no longer active) Global Health

  12. At the heart of soil health

    Science.gov (United States)

    Soil health is receiving resurgent attention with a number of recent national soil health initiatives which are sponsored by cooperators from diverse sectors including agribusiness, commodity groups, governmental organizations, and non-profits. The health of the soil is dependent on its biology. A...

  13. Reports on boys', youth's and men's health in Canadian newspapers: Now what?

    Science.gov (United States)

    Zanchetta, Margareth Santos; Byam, Aaron Andrew; Solomon, Donna; Jalili, Katayoon; Haag, Carlos; Tallarico, Silvia

    2017-01-01

    Background: This media content analysis explored the Canadian newspapers reporting on men's health, and their contribution to public understanding of the social determinants of men's health and lifestyles. Methods: A media content analysis of 44 news articles on boys', youth's and men's health,published from 2010 to 2014 by three national newspapers (The Globe and Mail, National Post,and Metro News). Results: Data indicated that the predominant discourse consists of informative and awareness messages, mostly about men's prostate and sexual health. Very little health news content referred to working conditions, education and income, all of which are significant social determinants of health (SDH). This may reflect the current state of health research, which does not adequately incorporate the effects of these determinants. It may also indicate a reproduction of dominant health knowledge and understanding of masculinity. Little content was found on policy solutions to other publicized health issues, such as limited access to health services or inter-sectoral collaborations; this reflects a lack of government action and a lack of citizen engagement toward the creation of a concerted men's health policy. Conclusion: Despite the acknowledged importance of the media in promoting access to health information and indirectly contributing to improve the general public's level of health literacy, it is also necessary to remember that there must be a greater attention to the structural constraints imposed by socioeconomic inequalities. Future studies should explore media discourses about men's unequal access to health care services and citizens' awareness of ways to overcome those inequalities shortcomings.

  14. Heart Health (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-02-27

    Cardiovascular disease, which includes heart disease, stroke, and high blood pressure, is the leading cause of death in the U.S. This podcast discusses the importance of controlling the risk factors that can lead to heart disease.  Created: 2/27/2014 by MMWR.   Date Released: 2/27/2014.

  15. Infectious respiratory disease outbreaks and pregnancy: occupational health and safety concerns of Canadian nurses.

    Science.gov (United States)

    Phillips, Karen P; O'Sullivan, Tracey L; Dow, Darcie; Amaratunga, Carol A

    2011-04-01

    This paper is a report of a qualitative study of emergency and critical care nurses' perceptions of occupational response and preparedness during infectious respiratory disease outbreaks including severe acute respiratory syndrome (SARS) and influenza. Healthcare workers, predominantly female, face occupational and personal challenges in their roles as first responders/first receivers. Exposure to SARS or other respiratory pathogens during pregnancy represents additional occupational risk for healthcare workers. Perceptions of occupational reproductive risk during response to infectious respiratory disease outbreaks were assessed qualitatively by five focus groups comprised of 100 Canadian nurses conducted between 2005 and 2006. Occupational health and safety issues anticipated by Canadian nurses for future infectious respiratory disease outbreaks were grouped into four major themes: (1) apprehension about occupational risks to pregnant nurses; (2) unknown pregnancy risks of anti-infective therapy/prophylaxis; (3) occupational risk communication for pregnant nurses; and (4) human resource strategies required for pregnant nurses during outbreaks. The reproductive risk perceptions voiced by Canadian nurses generally were consistent with reported case reports of pregnant women infected with SARS or emerging influenza strains. Nurses' fears of fertility risks posed by exposure to infectious agents or anti-infective therapy and prophylaxis are not well supported by the literature, with the former not biologically plausible and the latter lacking sufficient data. Reproductive risk assessments should be performed for each infectious respiratory disease outbreak to provide female healthcare workers and in particular pregnant women with guidelines regarding infection control and use of anti-infective therapy and prophylaxis.

  16. Exclusive breastfeeding among Canadian Inuit: results from the Nunavut Inuit Child Health Survey.

    Science.gov (United States)

    McIsaac, Kathryn E; Lou, Wendy; Sellen, Daniel; Young, T Kue

    2014-05-01

    Very little population-based research has been conducted around the exclusive breastfeeding practices of Inuit Canadians. This research aims to assess the distribution of exclusive breastfeeding among Inuit Canadians and to identify factors associated with exclusive breastfeeding as recommended. We use data from 188 infant-mother dyads who completed the Nunavut Inuit Child Health Survey, a cross-sectional, population-based survey of Inuit children aged 3 to 5 years. A series of multinomial logistic regression models were run to identify factors associated with 4 exclusive breastfeeding durations (≤ 1 month, > 1- 6.5 months). Of infants, 23% were exclusively breastfed as recommended (ie, between 5.5 and 6.5 months; 95% CI, 16.2-29.3). Many infants (61%) were exclusively breastfed for less than 5.5 months and 16% (95% CI, 10.9-22.0) were exclusively breastfed for more than 6.5 months. Families receiving income support were less likely to discontinue exclusive breastfeeding before 5.5 months (pOR1- Inuit Canadian infants receive suboptimal exclusive breastfeeding. National, provincial, and community-specific interventions to protect, promote, and support exclusive breastfeeding should emphasize not only the benefits of exclusively breastfeeding to 6 months but also the importance of timely introduction of complementary foods into the infant's diet.

  17. Comprehensive School Mental Health: An Integrated "School-Based Pathway to Care" Model for Canadian Secondary Schools

    Science.gov (United States)

    Wei, Yifeng; Kutcher, Stan; Szumilas, Magdalena

    2011-01-01

    Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, "School-Based Pathway to Care," for Canadian secondary schools that links schools with primary care providers and…

  18. Serum 25-Hydroxyvitamin D Concentrations and Indicators of Mental Health: An Analysis of the Canadian Health Measures Survey.

    Science.gov (United States)

    Chu, Filmer; Ohinmaa, Arto; Klarenbach, Scott; Wong, Zing-Wae; Veugelers, Paul

    2017-10-13

    The main function of vitamin D is calcium homeostasis. However, emerging evidence has correlated adequate serum 25-hydroxyvitamin D (25(OH)D) concentrations with better mental health. The objective of this study is to investigate the association of serum 25(OH)D concentrations with indicators of mental health such as depression, anxiety, and stress. Associations of serum 25(OH)D concentrations with four indicators of mental health were examined using ordered logistic regression models with increasing specificity that account for demographics, socio-economic status, and health. Margin effects are used to determine the probability of the average adult Canadian being in the best mental health state by groupings of serum 25(OH)D concentrations. A robust association between serum 25(OH)D concentrations and the indicators of mental health were observed. In the fully adjusted ordered logistic model, an average Canadian appeared more likely to experience better mental health when serum 25(OH)D concentrations were higher. This study adds to the weight of the existence of an association between vitamin D status and mental health, but, as this study is cross sectional, it does not establish causality. Due to the low risk of harm from toxicity and the relative modest costs of vitamin D supplements, more research to establish the effectiveness and causality of this relationship is recommended.

  19. Research-based-decision-making in Canadian health organizations: a behavioural approach.

    Science.gov (United States)

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

    Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build

  20. The Canadian health care system: a model for American to emulate?

    Science.gov (United States)

    Naylor, C D

    1992-04-01

    The American health care system has the world's highest per capita costs and over 30 million citizens uninsured. The neighbouring Canadian system provides coverage for all basic medical and hospital services, at costs per capita that are about US$700 lower. Single-agency public funding allows tighter control of Canadian expenditures, and reduces administrative overheads. Hospitals are run as non-profit private corporations, funded primarily by a fixed annual allocation for operating costs. Most physicians are in private fee-for-service practice, but cannot charge more than the insured tariff negotiated between their provincial government and medical association. This approach, while attractive in its decentralization, tends to separate the funding and management of clinical services. Thus, hospital information systems lag a decade behind the USA, managed care initiatives are few, health maintenance organisations do not exist, and experimentation with alternative funding or delivery systems has been sporadic. Strengths of the system compared to the USA include: higher patient satisfaction, universal coverage, slightly better cost containment, higher hospital occupancy rates, and reduction in income-related rationing with more equitable distribution of services. Weaknesses in common with the United States are: cost escalation consistently outstripping the consumer price index with costs per capita second highest in the world, ever rising consumption of services per capita, inadequate manpower planning and physician maldistribution, poor regional co-ordination of services, inadequate quality assurance and provider frustration. Additional weaknesses include: an emerging funding crisis caused by the massive federal deficit, less innovation in management and delivery of care as compared to the USA, implicit rationing with long waiting lists for some services, and recurrent provider-government conflicts that have reduced goodwill among stakeholders. Thus, while the

  1. The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study

    OpenAIRE

    Effoe, Valery S.; Carnethon, Mercedes R.; Echouffo‐Tcheugui, Justin B.; Chen, Haiying; Joseph, Joshua J.; Norwood, Arnita F.; Bertoni, Alain G.

    2017-01-01

    Background: The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Methods and Results: Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes me...

  2. Dominant Health Discourses in Action: Constructing People with Disabilities as the "Inadmissible Other" in Canadian Immigration

    Directory of Open Access Journals (Sweden)

    Yahya El-Lahib

    2016-08-01

    Full Text Available This paper reports on a Critical Discourse Analysis study situated within a postcolonial theoretical framework and informed by Foucauldian analysis and the lens of governmentality.  The study examined official Canadian immigration documents and guidelines.  Findings suggest that discourses of risk and protection are used to mask dominant health discourses that construct immigration applicants with disabilities as the "inadmissible Other".  Implications for social work and other helping professions involved in facilitating immigration and settlement for newcomers with disabilities are discussed, and suggestions for future directions in research are offered.

  3. Beyond nutrition: hunger and its impact on the health of young Canadians.

    Science.gov (United States)

    Pickett, William; Michaelson, Valerie; Davison, Colleen

    2015-07-01

    In a large Canadian study, we examined: (1) the prevalence of hunger due to an inadequate food supply at home; (2) relations between this hunger and a range of health outcomes, and; (3) contextual explanations for any observed associations. A cross-sectional survey was conducted of 25,912 students aged 11-15 years from 436 Canadian schools. Analyses were descriptive and also involved hierarchical logistic regression models. Hunger was reported by 25 % of participants, with 4 % reporting this experience "often" or "always". Its prevalence was associated with socio-economic disadvantage and family-related factors, but not with whether or not a student had access to school-based food and nutrition programs. The consistency of hunger's associations with the health outcomes was remarkable. Relations between hunger and health were partially explained when models controlled for family practices, but not the socio-economic or school measures. Societal responses to hunger certainly require the provision of food, but may also consider family contexts and basic essential elements of care that children need to thrive.

  4. Sex and sexual health: A survey of Canadian youth and mothers

    Science.gov (United States)

    Frappier, Jean-Yves; Kaufman, Miriam; Baltzer, Franziska; Elliott, April; Lane, Margo; Pinzon, Jorge; McDuff, Pierre

    2008-01-01

    INTRODUCTION Apparent changes in adolescent sexual behaviours have led to debate in recent years. A survey on adolescent sexuality was designed to determine mainstream Canadian adolescents’ current knowledge and sources of sexual health information, to identify their needs, and to understand the perceptions and the role of parents in sexual health education. METHODOLOGY In October 2005, on-line interviews were conducted by Ipsos Reid (Ipsos Canada) with 1171 Canadian teenagers (14 to 17 years of age) and 1139 mothers of teenagers. RESULTS Twenty-seven per cent of teens were sexually active at a mean age of 15 years, with an average of 2.5 lifetime partners, and had been in their current relationship for longer than eight months. The last time that they had had sex, 76% had used a condom. Teens and mothers overestimated the percentages of teens sexually active at any age. Most valuable sources of information were school, parents, friends and doctors. Sixty-nine per cent of teens could not find the information that they were looking for, and 62% reported obstacles in getting information. Teens lacked knowledge about sexually transmitted infections and their consequences. Seventy-five per cent of mothers believed that their teenagers’ friends were significant role models when it came to sexuality, and 50% mentioned entertainment celebrities at par with them. However, 45% of teenagers regarded their parents as their role models, far ahead of friends (32%) and entertainment celebrities (15%). Despite saying that they had positive relationships with their mothers, 38% of teens had not discussed sexuality with them. Most teens trusted the information given by health professionals (94%) and believed that it was their role to provide sexual health information. CONCLUSIONS Most adolescents are responsible when it comes to sexuality, but there are still areas of concern. Adolescents identify barriers to getting information and lack knowledge about sexually transmitted

  5. Marketers don't wear plaid: marketing and health care administration in the Canadian context.

    Science.gov (United States)

    Rigby, J M; Backman, A M

    1997-01-01

    Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

  6. Screening for congenital heart malformations in child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard)

    1999-01-01

    textabstractThe objective of this thesis is to clarify the effectiveness and the efficiency of screening for congenital heart malformations in Dutch child health centres and the possibilities to optimise this prevention programme. To this end the following main questions will be addressed. 1. Does

  7. Health actions and disease patterns related to coronary heart ...

    African Journals Online (AJOL)

    The health-related behaviour of the Cape Peninsula coloured population, which has been shown to have an adverse coronary heart disease (CHO) risk factor profile, is reported. Private medical services were used most often by participants: 54,1% and 51,6% of males and females respectively had made use of these ...

  8. Health behaviours in a Canadian community college sample: prevalence of drug use and interrelationships among behaviours.

    Science.gov (United States)

    Mathieson, C M; Faris, P D; Stam, H J; Egger, L A

    1992-01-01

    This study investigated the prevalence of drug use among a Canadian college sample and the covariation of drug taking and other health-related behaviours. A representative sample of students at a community college in Alberta were interviewed using telephone surveys, mail-in questionnaires and face-to-face interviews. Data was collected on drug, alcohol and caffeine use, cigarette smoking, eating habits, sleep habits and exercise. While use of illicit drugs did not appear to be widespread, alcohol appeared to be a primary substance abuse problem for a minority of subjects. Factor analysis indicated that the various health habits did not form one dimension of health-related behaviours. Four separate factors emerged: abusive drinking, eating habits, a drug use factor (caffeine intake, smoking, cannabis and hallucinogen use), and exercise levels. Findings are discussed in terms of their implications for future research, treatment and intervention.

  9. Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

    Science.gov (United States)

    Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

    2014-02-24

    Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

  10. Public health human resources: a comparative analysis of policy documents in two Canadian provinces

    Science.gov (United States)

    2014-01-01

    Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

  11. Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

    Science.gov (United States)

    Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

    2005-01-01

    Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

  12. Wheelchair cleaning and disinfection in Canadian health care facilities: "That's wheelie gross!".

    Science.gov (United States)

    Gardner, Paula; Muller, Matthew P; Prior, Betty; So, Ken; Tooze, Jane; Eum, Linda; Kachur, Oksana

    2014-11-01

    Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Pan-Canadian Respiratory Standards Initiative for Electronic Health Records (PRESTINE: 2011 National Forum Proceedings

    Directory of Open Access Journals (Sweden)

    M Diane Lougheed

    2012-01-01

    Full Text Available In a novel knowledge translation initiative, the Government of Ontario’s Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS. Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen’s University (Kingston, Ontario are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to

  14. A survey of Canadian public health personnel regarding knowledge, practice and education of zoonotic diseases.

    Science.gov (United States)

    Snedeker, K G; Anderson, M E C; Sargeant, J M; Weese, J S

    2013-11-01

    Zoonoses, diseases that can spread under natural conditions between humans and other animals, are become a major public health concern in many countries including Canada. In Canada, investigations of zoonotic disease incidents are often conducted by public health inspectors (PHIs). However, little is known about PHIs' knowledge of transmission of zoonotic pathogens, their perceptions of zoonotic disease importance or their education regarding zoonotic diseases. The objective of this study was therefore to assess the knowledge, perceptions and education of Canadian PHIs regarding zoonotic diseases. Data were collected from December 2008-January 2009 using an internet-based survey distributed to members of the Canadian Institute of Public Health Inspectors national listserv. Responses were received from 229 PHIs in four provinces, with a response rate of approximately 20%. The majority of respondents reported at least 10 years of experience in the public health sector, 80% (181/225) were in frontline positions, and 62% (137/222) were routinely involved in investigations of infectious diseases. Two-thirds believed that the importance of zoonotic diseases with regards to public health would increase in the next 5 years. Whilst most respondents were able to correctly identify animals capable of directly transmitting common zoonotic pathogens, there were gaps in knowledge, particularly with regard to rabies and transmission of gastrointestinal pathogens by companion animals. PHIs tended to feel that their training on zoonotic diseases prior to working as PHIs was deficient in some areas, or left some room for improvement. Their responses also suggested that there is a need for improvement in both the quantity and the quality of continuing education on zoonotic diseases. In particular, less than one-third of PHIs received ongoing continuing education regarding zoonotic diseases, and of those that did, nearly two-thirds rated the quantity and quality as only fair.

  15. Massage therapy and canadians' health care needs 2020: proceedings of a national research priority setting summit.

    Science.gov (United States)

    Dryden, Trish; Sumpton, Bryn; Shipwright, Stacey; Kahn, Janet; Reece, Barbara Findlay

    2014-03-01

    The health care landscape in Canada is changing rapidly as forces, such as an aging population, increasingly complex health issues and treatments, and economic pressure to reduce health care costs, bear down on the system. A cohesive national research agenda for massage therapy (MT) is needed in order to ensure maximum benefit is derived from research on treatment, health care policy, and cost effectiveness. A one-day invitational summit was held in Toronto, Ontario to build strategic alliances among Canadian and international researchers, policy makers, and other stakeholders to help shape a national research agenda for MT. Using a modified Delphi method, the summit organizers conducted two pre-summit surveys to ensure that time spent during the summit was relevant and productive. The summit was facilitated using the principles of Appreciative Inquiry which included a "4D" strategic planning approach (defining, discovery, dreaming, designing) and application of a SOAR framework (strengths, opportunities, aspirations, and results). Twenty-six researchers, policymakers, and other stakeholders actively participated in the events. Priority topics that massage therapists believe are important to the Canadian public, other health care providers, and policy makers and massage therapists themselves were identified. A framework for a national massage therapy (MT) research agenda, a grand vision of the future for MT research, and a 12-month action plan were developed. The summit provided an excellent opportunity for key stakeholders to come together and use their experience and knowledge of MT to develop a much-needed plan for moving the MT research and professionalization agenda forward.

  16. Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

    Science.gov (United States)

    McGrath, Jennifer J.

    2015-01-01

    Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533

  17. Province-level income inequality and health outcomes in Canadian adolescents.

    Science.gov (United States)

    Quon, Elizabeth C; McGrath, Jennifer J

    2015-03-01

    To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Participants (aged 12-17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues.

    Science.gov (United States)

    Poulton, Alexander; Rose, Heather

    2015-01-01

    Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada's CanMEDS competency framework. A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

  19. The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

    Directory of Open Access Journals (Sweden)

    Alexander Poulton

    2015-12-01

    Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

  20. Reports on boys’, youth’s and men’s health in Canadian newspapers: Now what?

    Directory of Open Access Journals (Sweden)

    Margareth Santos Zanchetta

    2017-06-01

    Full Text Available Background: This media content analysis explored the Canadian newspapers reporting on men's health, and their contribution to public understanding of the social determinants of men’s health and lifestyles. Methods: A media content analysis of 44 news articles on boys’, youth’s and men’s health,published from 2010 to 2014 by three national newspapers (The Globe and Mail, National Post,and Metro News. Results: Data indicated that the predominant discourse consists of informative and awareness messages, mostly about men’s prostate and sexual health. Very little health news content referred to working conditions, education and income, all of which are significant social determinants of health (SDH. This may reflect the current state of health research, which does not adequately incorporate the effects of these determinants. It may also indicate a reproduction of dominant health knowledge and understanding of masculinity. Little content was found on policy solutions to other publicized health issues, such as limited access to health services or inter-sectoral collaborations; this reflects a lack of government action and a lack of citizen engagement toward the creation of a concerted men’s health policy. Conclusion: Despite the acknowledged importance of the media in promoting access to health information and indirectly contributing to improve the general public’s level of health literacy, it is also necessary to remember that there must be a greater attention to the structural constraints imposed by socioeconomic inequalities. Future studies should explore media discourses about men’s unequal access to health care services and citizens’ awareness of ways to overcome those inequalities shortcomings.

  1. Society position statement : Canadian Cardiovascular Society/Canadian Anesthesiologists' Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices.

    Science.gov (United States)

    Healey, Jeff S; Merchant, Richard; Simpson, Chris; Tang, Timothy; Beardsall, Marianne; Tung, Stanley; Fraser, Jennifer A; Long, Laurene; van Vlymen, Janet M; Manninen, Pirjo; Ralley, Fiona; Venkatraghavan, Lashmi; Yee, Raymond; Prasloski, Bruce; Sanatani, Shubhayan; Philippon, François

    2012-04-01

    There are more than 200,000 Canadians living with permanent pacemakers or implantable defibrillators, many of whom will require surgery or invasive procedures each year. They face potential hazards when undergoing surgery; however, with appropriate planning and education of operating room personnel, adverse device-related outcomes should be rare. This joint position statement from the Canadian Cardiovascular Society (CCS) and the Canadian Anesthesiologists' Society (CAS) has been developed as an accessible reference for physicians and surgeons, providing an overview of the key issues for the preoperative, intraoperative, and postoperative care of these patients. The document summarizes the limited published literature in this field, but for most issues, relies heavily on the experience of the cardiologists and anesthesiologists who contributed to this work. This position statement outlines how to obtain information about an individual's type of pacemaker or implantable defibrillator and its programming. It also stresses the importance of determining if a patient is highly pacemaker-dependent and proposes a simple approach for nonelective evaluation of dependency. Although the document provides a comprehensive list of the intraoperative issues facing these patients, there is a focus on electromagnetic interference resulting from electrocautery and practical guidance is given regarding the characteristics of surgery, electrocautery, pacemakers, and defibrillators which are most likely to lead to interference. The document stresses the importance of preoperative consultation and planning to minimize complications. It reviews the relative merits of intraoperative magnet use vs reprogramming of devices and gives examples of situations where one or the other approach is preferable.

  2. Evolution of health technology assessment: best practices of the pan-Canadian Oncology Drug Review

    Directory of Open Access Journals (Sweden)

    Rocchi A

    2015-06-01

    Full Text Available Angela Rocchi,1 Isabelle Chabot,2 Judith Glennie3 1Athena Research Inc., Burlington, ON, 2EvAccess Inc., Vaudreuil-Dorion, QC, 3JL Glennie Consulting Inc., Aurora, ON, Canada Background: In 2007, Canada chose to develop a separate and distinct path for oncology drug health technology assessment (HTA. In 2013, the decision was made to transfer the pan-Canadian Oncology Drug Review (pCODR to the Canadian Agency for Drugs and Technologies in Health (CADTH, to align the pCODR and CADTH Common Drug Review processes while building on the best practices of both. The objective of this research was to conduct an examination of the best practices established by the pCODR. Methods: A qualitative research approach was taken to assess the policies, processes, and practices of the pCODR, based on internationally accepted best practice “principles” in HTA, with a particular focus on stakeholder engagement. Publicly available information regarding the approach of the pCODR was used to gauge the agency's performance against these principles. In addition, stakeholder observations and real-world experiences were gathered through key informant interviews to be inclusive of perspectives from patient advocacy groups, provincial and/or cancer agency decision-makers, community and academic oncologists, industry, expert committee members, and health economists. Results: This analysis indicated that, through the pCODR, oncology stakeholders have had a voice in and have come to trust the quality and relevance of oncology HTA as a vital tool to ensure the best decisions for Canadians with cancer and their health care system. It could be expected that adoption of the principles and processes of the pCODR would bring a similar level of engagement and trust to other HTA organizations in Canada and elsewhere. Conclusion: The results of this research led to recommendations for improvement and potential extrapolation of these best practices to other HTA organizations

  3. Canadian governance of health research involving human subjects: is anybody minding the store?

    Science.gov (United States)

    McDonald, M

    2001-01-01

    From an ethical perspective, good governance involves the translation of collective moral intentions into effective and accountable institutional actions. With respect to the use of human subjects in Canadian health research, I contend that there have been many good intentions but very little in the way of appropriate governance arrangements. Hence, the question, "who minds the store?" is especially acute with respect to the protection of vulnerable individuals and groups that are typically recruited as subjects for health research in Canada. Beyond diagnosing failures in governance and their causes, I offer suggestions for significant reforms, including evidence-based ethics assessment, independent oversight, and greater participation of research subjects in governance. I will close with some more general reflections on ethics, law, and governance.

  4. The costs of uncertainty: regulating health and safety in the Canadian uranium industry

    International Nuclear Information System (INIS)

    Robinson, I.

    1982-04-01

    Federalism, and particularly federal/provincial jurisdictional relationships, have led to considerable uncertainty in the regulation of occupational health and safety and of environmental protection in the Canadian uranium mining industry. The two principal uranium producing provinces in Canada are Saskatchewan and Ontario. Since 1978, in an attempt to avoid constitutional issues, both these provinces and the federal government as well have proceeded unilaterally with health and safety reforms for the industry. In Saskatchewan this has resulted in areas of overlapping jurisdiction, which have led to uncertainty over the legal enforceability of the provincial regulations. In Ontario, the province has left significant gaps in the protection of both workers and the environment. Little progress can be expected in eliminating these gaps and overlaps until the current administrative and jurisdictional arrangements are understood

  5. Brighter Smiles Africa--translation of a Canadian community-based health-promoting school program to Uganda.

    Science.gov (United States)

    Macnab, A J; Radziminski, N; Budden, H; Kasangaki, A; Zavuga, R; Gagnon, F A; Mbabali, M

    2010-08-01

    PROJECT GOAL: To adapt a successful Canadian health-promoting school initiative to a Ugandan context through international partnership. Rural children face many health challenges worldwide; health professionals in training understand these better through community-based learning. Aboriginal leaders in a Canadian First-Nations community identified poor oral health as a child health issue with major long-term societal impact and intervened successfully with university partners through a school-based program called "Brighter Smiles". Makerere University, Kampala, Uganda (MUK) sought to implement this delivery model for both the benefit of communities and the dental students. MUK identified rural communities where hospitals could provide dental students with community-based learning and recruited four local schools. A joint Ugandan and Canadian team of both trainees and faculty planned the program, obtained ethics consent and baseline data, initiated the Brighter Smiles intervention model (daily at-school tooth-brushing; in-class education), and recruited a cohort to receive additional bi-annual topical fluoride. Hurdles included: challenging international communication and planning due to inconsistent internet connections; discrepancies between Canadian and developing world concepts of research ethics and informed consent; complex dynamics for community engagement and steep learning curve for accurate data collection; an itinerant population at one school; and difficulties coordinating Canadian and Ugandan university schedules. Four health-promoting schools were established; teachers, children, and families were engaged in the initiative; community-based learning was adopted for the university students; quarterly team education/evaluation/service delivery visits to schools were initiated; oral health improved, and new knowledge and practices were evident; an effective international partnership was formed providing global health education, research and health care

  6. Investigating relationships between ancestry, lifestyle behaviors and perceptions of heart disease and breast cancer among Canadian women with British and with South Asian ancestry.

    Science.gov (United States)

    Curtin, Kimberley D; Berry, Tanya R; Courneya, Kerry S; McGannon, Kerry R; Norris, Colleen M; Rodgers, Wendy M; Spence, John C

    2018-04-01

    Ethnic minority groups including Asians in Canada have different knowledge and perceptions of heart disease and breast cancer compared with the ethnic majority group. Examine relationships between perceptions of heart disease and breast cancer, and lifestyle behaviors for Canadian women with British and with South Asian ancestry. Women with South Asian ( n = 170) and with British ( n = 373) ancestry ( M age = 33.01, SD = 12.86) reported leisure time physical activity, intended fruit and vegetable consumption, disease perceptions (ability to reduce risk, control over getting the diseases, and influence of family history), and demographic information. Mann-Whitney tests and multiple hierarchical linear regressions were used to examine the relationships between lifestyle behaviors and disease perceptions, with ancestry explored as a possible moderator. Participants with South Asian ancestry believed they had greater ability to reduce their risk and have control over getting breast cancer than participants with British ancestry. Family history influences on getting either disease was perceived as higher for women with British ancestry. Age was positively related to all three perceptions in both diseases. Intended fruit and vegetable consumption was positively related to perceptions of ability to reduce risk and control of both diseases, but was stronger for women with South Asian ancestry regarding perceptions of breast cancer. Leisure time physical activity was positively related to perceptions of control over getting heart disease for women with British ancestry. Women's disease perceptions can vary by ancestry and lifestyle behaviors. Accurate representation of diseases is essential in promoting effective preventative behaviors.

  7. Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Chaput

    2017-11-01

    Full Text Available Abstract Background New Canadian 24-Hour Movement Guidelines for the Early Years have been released in 2017. According to the guidelines, within a 24-h period, preschoolers should accumulate at least 180 min of physical activity (of which at least 60 min is moderate-to-vigorous physical activity, engage in no more than 1 h of screen time, and obtain between 10 and 13 h of sleep. This study examined the proportions of preschool-aged (3 to 4 years Canadian children who met these new guidelines and different recommendations within the guidelines, and the associations with adiposity indicators. Methods Participants were 803 children (mean age: 3.5 years from cycles 2–4 of the Canadian Health Measures Survey (CHMS, a nationally representative cross-sectional sample of Canadians. Physical activity was accelerometer-derived, and screen time and sleep duration were parent-reported. Participants were classified as meeting the overall 24-Hour Movement Guidelines if they met all three specific time recommendations for physical activity, screen time, and sleep. The adiposity indicators in this study were body mass index (BMI z-scores and BMI status (World Health Organization Growth Standards. Results A total of 12.7% of preschool-aged children met the overall 24-Hour Movement Guidelines, and 3.3% met none of the three recommendations. A high proportion of children met the sleep duration (83.9% and physical activity (61.8% recommendations, while 24.4% met the screen time recommendation. No associations were found between meeting individual or combined recommendations and adiposity. Conclusions Very few preschool-aged children in Canada (~13% met all three recommendations contained within the 24-Hour Movement Guidelines. None of the combinations of recommendations were associated with adiposity in this sample. Future work should focus on identifying innovative ways to reduce screen time in this population, and should examine the associations of

  8. "It is about being outside": Canadian youth's perspectives of good health and the environment.

    Science.gov (United States)

    Woodgate, Roberta L; Skarlato, Olga

    2015-01-01

    Drawing on qualitative data generated from an ethnographic study exploring Canadian youth's understanding of health, this paper examines youth's perspectives of the relationships between health and environment. Seventy-one youth (12 to 19 years of age) took part in individual and focus group interviews, as well as in photovoice interviews. Although initial discourse about health mainly focused on healthy eating and exercise, youth were more enthused and able to share their thoughts and feelings about the relationships between health and environment during the photovoice interviews. For these youth, good health was defined and visualized as "being outside" in a safe, clean, green, and livable space. Youth talked about conditions contributing to healthy environments and how healthy environments contributed to a strong sense of place. Overall, the conversations about the environment evoked many feelings in the youth. Results are discussed in the context of current research and in relation to youth, but also more broadly in relation to research on health and environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience.

    Science.gov (United States)

    Bergeron, Sherry; Senn, Charlene Y

    2003-01-01

    This study was designed to test an exploratory path model predicting health care utilization by lesbian women. Using structural equation modeling we examined the joint influence of internalized homophobia, feminism, comfort with health care providers (HCPs), education, and disclosure of sexual identity both in one's life and to one's HCP on health care utilization. Surveys were completed by 254 Canadian lesbian women (54% participation rate) recruited through snowball sampling and specialized media. The majority (95%) of women were White, 3% (n = 7) were women of colour, and the remaining six women did not indicate ethnicity. Participants ranged in age from 18 to 67 with a mean age of 38.85 years (SD = 9.12). In the final path model, higher education predicted greater feminism, more disclosure to HCPs, and better utilization of health services. Feminism predicted both decreased levels of internalized homophobia and increased disclosure across relationships. Being more open about one's sexual identity was related to increased disclosure to HCPs, which in turn, led to better health care utilization. Finally, the more comfortable women were with their HCP the more likely they were to seek preventive care. All paths were significant at p < .01. The path model offers insight into potential target areas for intervention with the goal of improving health care utilization in lesbian women.

  10. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: executive summary

    NARCIS (Netherlands)

    Silversides, Candice K.; Marelli, Ariane; Beauchesne, Luc; Dore, Annie; Kiess, Marla; Salehian, Omid; Bradley, Timothy; Colman, Jack; Connelly, Michael; Harris, Louise; Khairy, Paul; Mital, Seema; Niwa, Koichiro; Oechslin, Erwin; Poirier, Nancy; Schwerzmann, Markus; Taylor, Dylan; Vonder Muhll, Isabelle; Baumgartner, Helmut; Benson, Lee; Celermajer, David; Greutmann, Matthias; Horlick, Eric; Landzberg, Mike; Meijboom, Folkert; Mulder, Barbara; Warnes, Carole; Webb, Gary; Therrien, Judith

    2010-01-01

    With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. They have distinctive forms of heart failure, and

  11. Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations.

    Science.gov (United States)

    Sareen, Jitender; Belik, Shay-Lee; Afifi, Tracie O; Asmundson, Gordon J G; Cox, Brian J; Stein, Murray B

    2008-12-01

    We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5). A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.

  12. Past Fame, Present Frames and Future Flagship? An Exploration of How Health is Positioned in Canadian Foreign Policy

    Science.gov (United States)

    Labonté, Ronald; Runnels, Vivien; Gagnon, Michelle

    2014-01-01

    Canada has been regarded as a model global citizen with firm commitments to multilateralism. It has also played important roles in several international health treaties and conventions in recent years. There are now concerns that its interests in health as a foreign policy goal may be diminishing. This article reports on a thematic analysis of key Canadian foreign policy statements issued over the past decade, and interviews with key informants knowledgeable of, or experienced in the interstices of Canadian health and foreign policy. It finds that health is primarily and increasingly framed in relation to national security and economic interests. Little attention has been given to human rights obligations relevant to health as a foreign policy issue, and global health is not seen as a priority of the present government. Global health is nonetheless regarded as something with which Canadian foreign policy must engage, if only because of Canada’s membership in many United Nations and other multilateral fora. Development of a single global health strategy or framework is seen as important to improve intersectoral cooperation on health issues, and foreign policy coherence. There remains a cautious optimism that health could become the base from which Canada reasserts its internationalist status. PMID:24977037

  13. Past Fame, Present Frames and Future Flagship? An Exploration of How Health is Positioned in Canadian Foreign Policy.

    Science.gov (United States)

    Labonté, Ronald; Runnels, Vivien; Gagnon, Michelle

    2012-06-01

    Canada has been regarded as a model global citizen with firm commitments to multilateralism. It has also played important roles in several international health treaties and conventions in recent years. There are now concerns that its interests in health as a foreign policy goal may be diminishing. This article reports on a thematic analysis of key Canadian foreign policy statements issued over the past decade, and interviews with key informants knowledgeable of, or experienced in the interstices of Canadian health and foreign policy. It finds that health is primarily and increasingly framed in relation to national security and economic interests. Little attention has been given to human rights obligations relevant to health as a foreign policy issue, and global health is not seen as a priority of the present government. Global health is nonetheless regarded as something with which Canadian foreign policy must engage, if only because of Canada's membership in many United Nations and other multilateral fora. Development of a single global health strategy or framework is seen as important to improve intersectoral cooperation on health issues, and foreign policy coherence. There remains a cautious optimism that health could become the base from which Canada reasserts its internationalist status.

  14. Globalization and the health of Canadians: 'Having a job is the most important thing'.

    Science.gov (United States)

    Labonté, Ronald; Cobbett, Elizabeth; Orsini, Michael; Spitzer, Denise; Schrecker, Ted; Ruckert, Arne

    2015-05-12

    Globalization describes processes of greater integration of the world economy through increased flows of goods, services, capital and people. Globalization has undergone significant transformation since the 1970s, entrenching neoliberal economics as the dominant model of global market integration. Although this transformation has generated some health gains, since the 1990s it has also increased health disparities. As part of a larger project examining how contemporary globalization was affecting the health of Canadians, we undertook semi-structured interviews with 147 families living in low-income neighbourhoods in Canada's three largest cities (Montreal, Toronto and Vancouver). Many of the families were recent immigrants, which was another focus of the study. Drawing on research syntheses undertaken by the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health, we examined respondents' experiences of three globalization-related pathways known to influence health: labour markets (and the rise of precarious employment), housing markets (speculative investments and affordability) and social protection measures (changes in scope and redistributive aspects of social spending and taxation). Interviews took place between April 2009 and November 2011. Families experienced an erosion of labour markets (employment) attributed to outsourcing, discrimination in employment experienced by new immigrants, increased precarious employment, and high levels of stress and poor mental health; costly and poor quality housing, especially for new immigrants; and, despite evidence of declining social protection spending, appreciation for state-provided benefits, notably for new immigrants arriving as refugees. Job insecurity was the greatest worry for respondents and their families. Questions concerning the impact of these experiences on health and living standards produced mixed results, with a majority expressing greater

  15. Understanding the structure of community collaboration: the case of one Canadian health promotion network.

    Science.gov (United States)

    Barnes, Martha; Maclean, Joanne; Cousens, Laura

    2010-06-01

    In 2004, over 6.8 million Canadians were considered overweight, with an additional 2.4 million labeled clinically obese. Due to these escalating levels of obesity in Canada, physical activity is being championed by politicians, physicians, educators and community members as a means to address this health crisis. In doing so, many organizations are being called upon to provide essential physical activity services and programs to combat rising obesity rates. Yet, strategies for achieving these organizations' mandates, which invariably involve stretching already scarce resources, are difficult to implement and sustain. One strategy for improving the health and physical activity levels of people in communities has been the creation of inter-organizational networks of service providers. Yet, little is known about whether networks are effective in addressing policy issues in non-clinical health settings. The purpose of this investigation was 2-fold; to use whole network analysis to determine the structure of one health promotion network in Canada, and to identify the types of ties shared by actors in the health network. Findings revealed a network wherein information sharing constituted the basis for collaboration, whereas efforts related to sharing resources, marketing and/or fundraising endeavors were less evident.

  16. Servant leadership: a case study of a Canadian health care innovator

    Directory of Open Access Journals (Sweden)

    Vanderpyl TH

    2012-02-01

    Full Text Available Tim H VanderpylSchool of Global Leadership, Regent University, Virginia Beach, VA, USAAbstract: Both servant leadership and innovation are easier to theorize than to actually implement in practice. This article presents a case study of a Canadian health care executive who led a remarkable turnaround of St Michael's Health Centre, a floundering and almost bankrupt nursing home. In less than 7 years, Kevin Cowan turned around the finances and changed numerous broken relationships into strategic alliances. Under his leadership, St Michael's Health Centre went from being one of the most underperforming health care organizations in Canada, to one of the most innovative. This article describes some of Cowan's strategies and argues that a servant leadership approach has a direct impact on an organization's ability to innovate. As far as the author is aware, this is the first published article on this specific change effort, which presents a unique perspective on the topics of servant leadership and innovation.Keywords: servant leadership, innovation, Canada, health care, case study

  17. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    Directory of Open Access Journals (Sweden)

    Dastjerdi Mahdieh

    2012-09-01

    Full Text Available Abstract Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men who were adults (at least 18 years old and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP, becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains

  18. Building Collaborative Health Promotion Partnerships: The Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Clifton C. Addison

    2015-12-01

    Full Text Available Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS Community Outreach Center (CORC to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD. This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.

  19. [Health valuations for patients with chronic ischemic heart disease].

    Science.gov (United States)

    Meder, M; Farin, E

    2011-08-01

    The study deals with the question of how patients with chronic ischemic heart disease assess different health situations that can be achieved by rehabilitation. Furthermore it examines which factors influence these health valuations and whether the predictors vary depending on the level of education. The health valuations of n = 331 patients with chronic ischemic heart disease are compiled using visual analogue scales (VAS). In addition to sociodemographic questions, generic and illness-specific scales (SF-12, MacNew) for the health-related quality of life (HRQOL) are used as potential predictors of the health valuations. Additional basic medical data were provided by the physician. Hierarchical regression analyses are conducted; the sociodemographic, medical and HRQOL variables are included stepwise. Since many variables are observed for the regression models, an imputation of missing values is made. The health dimensions "Self-care and domestic life" and "Mobility" are assigned the highest values on the VAS. The lowest preference is assigned to the dimensions "Reduction of symptoms" and "Information about the disease". The differences between the health dimensions are statistically significant. Sociodemographic variables explain up to 3.6% of the variance of health valuations, with level of education and living with a partner being the most important predictors. The medical variables included in the second step explain between 2.1 and 6.8% incremental variance; the most important predictor is the operation performed prior to rehabilitation (bypass, heart valve). The HRQOL variables in the third block provide 7.1-24.9% incremental explanation of variance, by far the highest percentage. This is mainly achieved using the 3 MacNew scales (emotional, social and physical functioning). The overall explanation of variance for the health valuations is 17.1-28.8%. For patients with a higher level of education, the total explanation of variance is about 9.2% higher on

  20. [Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

    Science.gov (United States)

    Ulrich, Lisa-R; Pham, Thuy-Nga Tia; Gerlach, Ferdinand M; Erler, Antje

    2017-07-11

    The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners. In 2014, the German Advisory Council on the Assessment of Developments in the Health Care System highlighted the importance of regional, integrated care with community-based primary care centres at its core, providing comprehensive, population-based, patient-centred primary care with adequate access to general practitioners for a given geographical area. Such centres exist already in Ontario, Canada; within Family Health Teams (FHT), family physicians work hand-in-hand with pharmacists, nurses, nurse practitioners, social workers, and other allied health professionals. In this article, the Canadian model of FHT will be introduced and we will discuss which components could be adapted to suit the German primary care system. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Methods to stimulate national and sub-national benchmarking through international health system performance comparisons: a Canadian approach.

    Science.gov (United States)

    Veillard, Jeremy; Moses McKeag, Alexandra; Tipper, Brenda; Krylova, Olga; Reason, Ben

    2013-09-01

    This paper presents, discusses and evaluates methods used by the Canadian Institute for Health Information to present health system performance international comparisons in ways that facilitate their understanding by the public and health system policy-makers and can stimulate performance benchmarking. We used statistical techniques to normalize the results and present them on a standardized scale facilitating understanding of results. We compared results to the OECD average, and to benchmarks. We also applied various data quality rules to ensure the validity of results. In order to evaluate the impact of the public release of these results, we used quantitative and qualitative methods and documented other types of impact. We were able to present results for performance indicators and dimensions at national and sub-national levels; develop performance profiles for each Canadian province; and show pan-Canadian performance patterns for specific performance indicators. The results attracted significant media attention at national level and reactions from various stakeholders. Other impacts such as requests for additional analysis and improvement in data timeliness were observed. The methods used seemed attractive to various audiences in the Canadian context and achieved the objectives originally defined. These methods could be refined and applied in different contexts. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  2. 77 FR 9842 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2012-02-21

    ... (formerly 2006P-0316)] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug... concerning the use of the health claim for phytosterols and risk of coronary heart disease (CHD), in a manner... risk of coronary heart disease (CHD) for phytosterol-containing conventional food and dietary...

  3. What can the Canadians and Americans learn from each other's health care systems?

    Science.gov (United States)

    Weil, Thomas P

    2016-07-01

    Numerous papers have been written comparing the Canadian and US healthcare systems, and a number of health policy experts have recommended that the Americans implement their single-payer system to save 12-20% of its healthcare expenditures. This paper is different in that it assumes that neither country will undertake a significant philosophic or structural change in their healthcare system, but there are lessons to be learned that are inherent in one that could be a major breakthrough for the other. Following the model in Canada and in Western Europe, the USA could implement universal health insurance so that the 32.0 million (2015) Americans still uninsured would have at least minimal coverage when incurring medical expenditures. Also, the USA could use smart cards to evaluate eligibility and to process health insurance claims; these changes resulting in an estimated 15% reduction in US health expenditures without adversely effecting access or quality of care. Such a strategy would result in the eventual loss of 2.5 million white-collar jobs at hospitals, physician offices and insurance companies, a long-term economic gain. Only a few would agree with the statement that Canada already functions with a multi-payer reimbursement system as evidenced by (1) a federal-provincial, tax-supported plan, administered by each of the provinces, providing universal coverage for hospital and physician services and (2) roughly 60% of its residents receiving employer-paid health insurance benefits, underwritten primarily by investor-owned plans, that are less than effective to reimburse for pharmaceuticals, dental and other healthcare services. What could be learned from the USA and particularly from Western European countries is possibly implementing an approach, whereby at least upper-income Canadians could opt out of their federal-provincial plan and purchase private insurance coverage - being eligible for far more comprehensive "private" benefits for hospital, physician

  4. Reminiscence functions and the health of Israeli Holocaust survivors as compared to other older Israelis and older Canadians.

    Science.gov (United States)

    O'Rourke, Norm; Bachner, Yaacov G; Cappeliez, Philippe; Chaudhury, Habib; Carmel, Sara

    2015-01-01

    Existing research with English-speaking samples indicates that various ways in which older adults recall their past affect both their physical and mental health. Self-positive reminiscence functions (i.e. identity, problem-solving, death preparation) correlate and predict mental health in later life whereas self-negative functions (i.e. bitterness revival, boredom reduction, intimacy maintenance) correlate and predict the physical health of older adults. For this study, we recruited 295 Israeli Holocaust survivors to ascertain if early life trauma affects these associations between reminiscence and health. In order to distinguish cross-national differences from survivor-specific effects, we also recruited two comparative samples of other older Israelis (not Holocaust survivors; n = 205) and a second comparative sample of 335 older Canadians. Three separate structural equation models were computed to replicate this tripartite reminiscence and health model. Coefficients for self-negative functions significantly differed between survivors and both Canadians and other older Israelis, and between Canadians and both Israeli samples. However, no differences were found between prosocial and self-positive functions. Moreover, the higher order structure of reminiscence and health appears largely indistinguishable across these three groups. Early life trauma does not appear to fundamentally affect associations between reminiscence and health. These findings underscore the resilience of Holocaust survivors.

  5. I want to move, but cannot: characteristics of involuntary stayers and associations with health among Canadian seniors.

    Science.gov (United States)

    Strohschein, Lisa

    2012-08-01

    The purpose of this study was to investigate characteristics of seniors in the Canadian population who are involuntary stayers and to assess associations with health. Data come from the 1994 Canadian National Population Health Survey, with the sample restricted to those 65 and older (N = 2,551). Nearly 1 in 10 seniors identified as an involuntary stayer. Seniors with few socioeconomic resources, poor health, greater need for assistance, and low social involvement were more likely to identify as an involuntary stayer. Furthermore, seniors who were involuntary stayers report significantly more distress and greater odds of low self-rated health than other seniors. This study brings into visibility an understudied segment of the elderly population: seniors who are unable to move from their present location despite their desire to do so. Further research and policy responses assisting seniors to age in a setting of their own choosing are needed.

  6. "Judging a body by its cover": young Lebanese-Canadian women's discursive constructions of the "healthy" body and "health" practices.

    Science.gov (United States)

    Abou-Rizk, Zeina; Rail, Geneviève

    2014-02-01

    Our interest stems from the dramatic increase in the number of obesity studies, which expose Canadian women to a huge amount of information that links health to weight. Using feminist poststructuralist and postcolonial lenses, this paper investigates young Lebanese-Canadian women's constructions of the body and "health" practices within the context of the dominant obesity discourse. Participant-centered conversations were held with 20 young Christian Lebanese-Canadian women. A thematic analysis was first conducted and was followed by a poststructuralist discourse analysis to further our understanding of how the participants construct themselves as subjects within various discourses surrounding health, obesity, and the body. Our findings reveal that most participants conflate the "healthy" body and the "ideal" body, both of which they ultimately portray as thin. The young women construct the "healthy"/"ideal" body as a solely individual responsibility, thus reinforcing the idea of "docile bodies." The majority of participants report their frequent involvement in disciplinary practices such as rigorous physical activity and dietary restrictions, and a few young women mention the use of other extreme forms of bodily monitoring such as detoxes, dieting pills, and compulsive exercise. We discuss the language employed by participants to construct their multiple and shifting subjectivities. For instance, many of these Lebanese-Canadian women use the term "us" to dissociate themselves from Lebanese women ("them"), whom they portray as overly focused on thinness and beauty and engaged in physical activity and other bodily practices for "superficial" purposes. The participants also use the "us/them" trope to distance themselves from "Canadian" women (read: white Euro-Canadian women), whom they portray as very physically active for purposes beyond the improvement of the physical appearance of the body. We discuss the impacts of the young Christian Lebanese-Canadian women

  7. Urinary bisphenol A and obesity in adults: results from the Canadian Health Measures Survey

    Directory of Open Access Journals (Sweden)

    Minh T. Do

    2017-12-01

    Full Text Available Introduction: Exposure to bisphenol A (BPA has been shown to affect lipid metabolism and promote weight gain in animal studies. Recent epidemiological studies also support a link between BPA and obesity in human populations, although many were limited to a single adiposity measure or have not considered potential confounding by dietary factors. The purpose of this study is to examine associations between urinary BPA and adiposity measures in a nationally representative sample of Canadian adults. Methods: We performed analyses using biomonitoring and directly measured anthropometric data from 4733 adults aged 18 to 79 years in the Canadian Health Measures Survey (2007–2011. We used multinomial and binary logistic regression models to estimate associations of urinary BPA with body mass index (BMI categories (overweight vs. under/normal weight; obesity vs. under/normal weight and elevated waist circumference (males: ≥ 102 cm; females: ≥ 88 cm, respectively, while controlling for potential confounders. Linear regression analyses were also performed to assess associations between urinary BPA and continuous BMI and waist circumference measures. Results: Urinary BPA was positively associated with BMI-defined obesity, with an odds ratio of 1.54 (95% confidence interval [CI]: 1.002–2.37 in the highest (vs. lowest BPA quartile (test for trend, p = .041. Urinary BPA was not associated with elevated waist circumference defined using standard cut-offs. Additionally, each natural-log unit increase in urinary BPA concentration was associated with a 0.33 kg/m2 (95% CI: 0.10–0.57 increase in BMI and a 1.00 cm (95% CI: 0.34–1.65 increase in waist circumference. Conclusion: Our study contributes to the growing body of evidence that BPA is positively associated with obesity. Prospective studies with repeated measures are needed to address temporality and improve exposure classification.

  8. Support infrastructure available to Canadian residents completing post-graduate global health electives: current state and future directions

    Directory of Open Access Journals (Sweden)

    Lojan Sivakumaran

    2016-12-01

    Conclusion: Canadian universities are encouraged to continue to send their trainees on global health electives. To address the gaps in infrastructure reported in this study, the authors suggest the development of comprehensive standardized guidelines by post-graduate regulatory/advocacy bodies to better ensure patient and participant safety. We also encourage the centralization of infrastructure management to the universities’ global health departments to aid in resource management.

  9. Engaging Canadian youth in conversations: Using knowledge exchange in school-based health promotion

    Directory of Open Access Journals (Sweden)

    Donna Murnaghan

    2014-06-01

    Full Text Available The voice of youth is crucial to advancing solutions that contribute to effective strategies to improve youth health outcomes. The problem, however, is that youth/student voices are often overlooked, and stakeholders typically engage in decision-making without involving youth. The burden of chronic disease is increasing worldwide, and in Canada chronic disease accounts for 89 per cent of deaths. However, currently, youth spend less time being physically active while engaging in more unhealthy eating behaviours than ever before. High rates of unhealthy behaviours such as physical inactivity, unhealthy eating and tobacco use are putting Canadian youth at risk of health problems such as increased levels of overweight and obesity, cardiovascular disease and type 2 diabetes. Focus group methodology was utilised to conduct 7 focus groups with 50 students in grades 7–12 from schools in Prince Edward Island, Canada. The key themes that emerged included: (1 youth health issues such as lack of opportunities to be physically active, cost and quality of healthy food options, and bullying; (2 facilitators and barriers to health promotion, including positive peer and adult role models, positive relationships with adults and competitiveness of school sports; and (3 lack of student voice. Our findings suggest that actively engaging youth provides opportunities to understand youth perspectives on how to encourage them to make healthy choices and engage in healthy behaviours. Attention needs to be paid to inclusive knowledge exchange practices that value and integrate youth perspectives and ideas as a basis for building health promotion actions and interventions. Keywords: knowledge exchange, youth health, youth engagement

  10. An Analysis of Canadian Psychiatric Mental Health Nursing through the Junctures of History, Gender, Nursing Education, and Quality of Work Life in Ontario, Manitoba, Alberta, and Saskatchewan

    Science.gov (United States)

    2013-01-01

    A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. PMID:23710367

  11. Occupational Health Services Plans to Make February a Healthy, Heart-y Month | Poster

    Science.gov (United States)

    In celebration of American Heart Month this February, Occupational Health Services is hosting multiple events to promote heart health and raise awareness about heart disease and its associated risks. American Heart Month kicks off on Monday, January 29, when staff will be sponsoring a table outside of the 15th Annual Protective Services Chili Cookoff and holding a raffle for free gym bags to encourage employees to stay active.

  12. Stages of Biological Development across Age: An Analysis of Canadian Health Measure Survey 2007-2011.

    Science.gov (United States)

    Chao, Yi-Sheng; Wu, Hsing-Chien; Wu, Chao-Jung; Chen, Wei-Chih

    2017-01-01

    The stages of biological development are not clearly defined despite the fact that they have been used to refer to concepts such as adolescence and aging. This study aimed to (1) propose and test a framework to search for stages of representative components and determine stages of stability and transition, (2) identify stages of biological development based on health questionnaire and biomarker data, and (3) interpret the major trajectories in a health and biomarker database. This study analyzed the data on the Canadian Health Measures Survey (CHMS) interviewees from cycle 1 to 3 (2007-2013) in Canada. We selected 282 variables containing information from questionnaire and on biomarkers after removing redundant variables based on high correlation. Fifty-nine nominal variables were replaced by 122 binominal variables, leaving 345 variables for analysis. Principal component (PC) analysis was conducted to summarize the data and the loadings were used to interpret the PCs. A stable stage was assumed to be the age groups without significantly different values of PCs. The CHMS interviewed 16,340 Canadians. Of all, 51.25% were female. The age ranged from 6 to 79 years (mean = 34.41 years, 95% CI = 34.74-34.08). The proportions of total variance explained by the first three PCs were 12.14, 4.03, and 3.19%, respectively. The differences of the first PC were not significant, especially between age 22 and 33, 34 and 40, 41 and 45, 46 and 71, and 72 and 79 years (adjusted p  > 0.05 for all). The leading variable, in terms of the variance contributed to PC1, was time spent in physical activities, followed by variables related to alcohol consumption, and smoking. The 13 leading contributors to PC2 variances were all lung function measures. There are stages of stability and transition across all age groups based on the first PCs. The first and second PCs are related to physical development and lung function. The identification of stable stages is the first step

  13. Prevalence of Pregnancy Involvement Among Canadian Transgender Youth and its Relation to Mental Health, Sexual Health, and Gender Identity.

    Science.gov (United States)

    Veale, Jaimie; Watson, Ryan J; Adjei, Jones; Saewyc, Elizabeth

    2016-01-01

    While little research has been conducted into the reproductive experiences of transgender people, available evidence suggests that like cisgender people, most transgender people endorse a desire for these experiences. This study explores the pregnancy experiences and related health factors among transgender and gender-diverse 14-25 year olds using a national Canadian sample ( N = 923). Results indicated that 26 (5%) transgender youth reported a pregnancy experience in the past and the prevalence among 14-18 year olds was comparable to population-based estimates using the same question in the British Columbia Adolescent Health Survey. Transgender youth with a history of pregnancy involvement reported a diverse range of gender identities, and this group did not differ from the remainder of the sample on general mental health, social supports, and living in felt gender. This group did report over six times greater likelihood of having been diagnosed with a sexually transmitted infection by a doctor (19%), but did they not differ in reported contraception use during last sexual intercourse. These findings suggest that pregnancy involvement is an issue that should not be overlooked by health professionals working with transgender youth and that this group has particular sexual health needs.

  14. The Global Public Health Intelligence Network and early warning outbreak detection: a Canadian contribution to global public health.

    Science.gov (United States)

    Mykhalovskiy, Eric; Weir, Lorna

    2006-01-01

    The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.

  15. Health Care "as Usual": The Insertion of Positive Psychology in Canadian Mental Health Discourse

    Science.gov (United States)

    Jhangiani, Surita Jassal; Vadeboncoeur, Jennifer A.

    2010-01-01

    The recent shift to a "positive psychological" approach that emphasizes a "health model," rather than a "disease model," in mental health discourses is intended both to reduce the stigma around mental health issues and to enable people to play a role in monitoring their own mental health. As a component of a larger…

  16. True North: Building Imaginary Worlds with the Revised Canadian (CADTH Guidelines for Health Technology Assessment

    Directory of Open Access Journals (Sweden)

    Paul C Langley

    2017-05-01

    Full Text Available In March 2017 the Canadian Agency for Drugs and Technologies in Health (CADTH released the 4th edition of their Guidelines for the Economic Evaluation of Health Technologies: Canada. These guidelines, which were first published and revised for a 3rd edition in 2006 are intended to help decision makers, health systems leaders and policy makers make well-informed decisions. They are designed, apparently, to support best practice in conducting health technology assessments in Canada. The purpose of this commentary is to consider whether or not the evidence standards proposed and the consequent modeled claims for economic effectiveness meet the standards of normal science: are the CADTH standards capable of generating claims for competing products that are credible, evaluable and replicable? The review argues that the standards proposed by CADTH do not meet the standards expected in normal science. Technical sophistication in building reference case imaginary worlds is not a substitute for claims that are experimentally evaluable or capable of assessment through systematic observation. There is no way of judging whether imaginary claims are right or even if they are wrong. CADTH is not alone in setting standards that fail to meet the standards of normal science. Recent commentaries on formulary submission guidelines in a number of other countries, to include Ireland, the Netherlands, France, Australia, the UK and New Zealand conclude that they are subject to the same criticism. If the CADTH guidelines were never intended to support feedback to health system decision makers, then this should be made clear. If not, then consideration should be given to withdrawing the guidelines to ensure they conform to these standards. Hopefully, future versions of the CADTH guidelines will address this issue and focus on a rigorous research program of claims assessment and feedback and not the building of imaginary worlds.   Type:  Commentary

  17. Congenital Heart Disease: Guidelines of Care for Children with Special Health Care Needs.

    Science.gov (United States)

    Minnesota State Dept. of Health, Minneapolis. Services for Children with Handicaps.

    These guidelines were written to help families coordinate the health care that may be needed by a child with congenital heart disease. The booklet begins with general information about congenital heart disease. It then discusses the goals of health care, the health care team, the importance of periodic health care, and record keeping procedures.…

  18. Physical Activity, Physical Fitness, and Body Composition of Canadian Shift Workers: Data From the Canadian Health Measures Survey Cycles 1 and 2.

    Science.gov (United States)

    Neil-Sztramko, Sarah E; Gotay, Carolyn C; Demers, Paul A; Campbell, Kristin L

    2016-01-01

    The aim of the study was to compare objectively measured physical activity, sedentary time, physical fitness, and body composition in shift workers (SWs) with those who work regular days. Population-based, cross-sectional data from the Canadian Health Measures Survey (n = 4323) were used. Univariate and multivariate linear and logistic regression models were used to compare outcomes between SWs and day workers. In unweighted analyses, SWs were more likely to have poor body composition, although had fewer minutes per week of sedentary time. Despite no differences in physical activity, SWs had a lower aerobic capacity. In weighted analyses, only differences in aerobic capacity were observed. This analysis confirms previous findings that SWs have poorer body composition than day workers, and suggest that SWs may need to engage in more physical activity to achieve the same aerobic capacity as day workers.

  19. Single-Parent and Working-Parent Heart Health

    Science.gov (United States)

    ... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

  20. Evaluating health inequity interventions: applying a contextual (external) validity framework to programs funded by the Canadian Health Services Research Foundation.

    Science.gov (United States)

    Phillips, Kaye; Müller-Clemm, Werner; Ysselstein, Margaretha; Sachs, Jonathan

    2013-02-01

    Including context in the measurement and evaluation of health in equity interventions is critical to understanding how events that occur in an intervention's environment might contribute to or impede its success. This study adapted and piloted a contextual validity assessment framework on a selection of health inequity-related programs funded by the Canadian Health Services Research Foundation (CHSRF) between 1998 and 2006. The two overarching objectives of this study were (1) to determine the relative amount and quality of attention given to conceptualizing, measuring and validating context within CHSRF funded research final reports related to health-inequity; and (2) to contribute evaluative evidence towards the incorporation of context into the assessment and measurement of health inequity interventions. The study found that of the 42/146 CHSRF programs and projects, judged to be related to health inequity 20 adequately reported on the conceptualization, measurement and validation of context. Amongst these health-inequity related project reports, greatest emphasis was placed on describing the socio-political and economical context over actually measuring and validating contextual evidence. Applying a contextual validity assessment framework was useful for distinguishing between the descriptive (conceptual) versus empirical (measurement and validation) inclusion of documented contextual evidence. Although contextual validity measurement frameworks needs further development, this study contributes insight into identifying funded research related to health inequities and preliminary criteria for assessing interventions targeted at specific populations and jurisdictions. This study also feeds a larger critical dialogue (albeit beyond the scope of this study) regarding the relevance and utility of using evaluative techniques for understanding how specific external conditions support or impede the successful implementation of health inequity interventions. Copyright

  1. The effects of outdoor air pollution on the respiratory health of Canadian children: A systematic review of epidemiological studies.

    Science.gov (United States)

    Rodriguez-Villamizar, Laura Andrea; Magico, Adam; Osornio-Vargas, Alvaro; Rowe, Brian H

    2015-01-01

    Outdoor air pollution is a global problem with serious effects on human health, and children are considered to be highly susceptible to the effects of air pollution. To conduct a comprehensive and updated systematic review of the literature reporting the effects of outdoor air pollution on the respiratory health of children in Canada. Searches of four electronic databases between January 2004 and November 2014 were conducted to identify epidemiological studies evaluating the effect of exposure to outdoor air pollutants on respiratory symptoms, lung function measurements and the use of health services due to respiratory conditions in Canadian children. The selection process and quality assessment, using the Newcastle-Ottawa Scale, were conducted independently by two reviewers. Twenty-seven studies that were heterogeneous with regard to study design, population, respiratory outcome and air pollution exposure were identified. Overall, the included studies reported adverse effects of outdoor air pollution at concentrations that were below Canadian and United States standards. Heterogeneous effects of air pollutants were reported according to city, sex, socioeconomic status and seasonality. The present review also describes trends in research related to the effect of air pollution on Canadian children over the past 25 years. The present study reconfirms the adverse effects of outdoor air pollution on the respiratory health of children in Canada. It will help researchers, clinicians and environmental health authorities identify the available evidence of the adverse effect of outdoor air pollution, research gaps and the limitations for further research.

  2. Diet quality and mental health in subsequent years among Canadian youth.

    Science.gov (United States)

    McMartin, Seanna E; Kuhle, Stefan; Colman, Ian; Kirk, Sara F L; Veugelers, Paul J

    2012-12-01

    To examine the association between diet quality and the diagnosis of an internalizing disorder in children and adolescents. A prospective study examining the relationship between diet quality and mental health. FFQ responses of 3757 children were used to calculate a composite score for diet quality and its four components: variety, adequacy, moderation and balance. Physicians' diagnoses on internalizing disorders were obtained by linking the children's dietary information to administrative health data. Negative binomial regression models were used to examine the association between diet quality and diagnosis of an internalizing disorder. The Canadian province of Nova Scotia. A provincially representative sample of grade 5 students (age 10-11 years). Diet quality was not found to be associated with internalizing disorder in a statistically significant manner (incidence rate ratio = 1.09; 95 % CI 0.73, 1.63). However, relative to children with little variety in their diets, children with greater variety in their diet had statistically significant lower rates of internalizing disorder in subsequent years (incidence rate ratio = 0.45; 95 % CI 0.25, 0.82). These findings suggest the importance of variety in children's diet and opportunities in the prevention of adolescent depression and anxiety.

  3. An Environmental Scan of Health and Social System Navigation Services in an Urban Canadian Community

    Directory of Open Access Journals (Sweden)

    Nancy Carter RN, PhD

    2017-01-01

    Full Text Available Systems navigation services provided by a designated provider or team have the potential to address health and social disparities. We conducted an environmental scan of navigation activities in a large urban Canadian community to identify and describe: service providers who engage in systems navigation; the clients who require systems navigation support and the issues they face; activities involved; and barriers and facilitators in providing systems navigation support to clients. Using an online survey and convenience sampling, we recruited individuals who self-identified as community navigators or practiced systems navigation activities as part of their role. The majority of respondents ( n  = 145 were social workers, social services workers, or nurses. Clients of navigators struggled with mental health or addictions issues, disabilities, chronic diseases, and history of trauma or abuse. The most frequently reported activities of navigators were building professional relationships, managing paperwork, and communicating with relevant agencies or organizations. Barriers to navigation were time available in the work day, difficulty partnering due to bureaucratic structures, differing philosophies and ways of working, and a lack of central information repository in the community. Facilitators were a client-centered organization, the availability of multiple community resources in the region, and organizational support. Participants struggled with client waitlists, system issues such as lack of resources and interagency collaboration, and role clarity.

  4. Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.

    Science.gov (United States)

    Smith, Neale; Mitton, Craig; Bryan, Stirling; Davidson, Alan; Urquhart, Bonnie; Gibson, Jennifer L; Peacock, Stuart; Donaldson, Cam

    2013-07-02

    Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Between January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating. About one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as 'good' or 'very good'. This paper explores these findings in greater detail and assesses them in context of the larger literature. Data from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada's health system leadership teams.

  5. A qualitative study of health information technology in the Canadian public health system

    OpenAIRE

    Zinszer, Kate; Tamblyn, Robyn; Bates, David W; Buckeridge, David L

    2013-01-01

    Background: Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technol...

  6. Intersections of Stigma, Mental Health, and Sex Work: How Canadian Men Engaged in Sex Work Navigate and Resist Stigma to Protect Their Mental Health.

    Science.gov (United States)

    Jiao, Sunny; Bungay, Vicky

    2018-05-01

    Men engaged in sex work experience significant stigma that can have devastating effects for their mental health. Little is known about how male sex workers experience stigma and its effects on mental health or their strategies to prevent its effects in the Canadian context. This study examined the interrelationships between stigma and mental health among 33 Canadian indoor, male sex workers with a specific goal of understanding how stigma affected men's mental health and their protective strategies to mitigate against its effects. Men experienced significant enacted stigma that negatively affected their social supports and ability to develop and maintain noncommercial, romantic relationships. Men navigated stigma by avoidance and resisting internalization. Strategy effectiveness to promote mental health varied based on men's perspectives of sex work as a career versus a forced source of income. Programming to promote men's mental health must take into consideration men's diverse strategies and serve to build social supports.

  7. Air Quality and Heart Health: Managing an Emerging ...

    Science.gov (United States)

    Dr. Cascio will share with a broad range of federal agencies current understanding of the links between air quality and cardiovascular health. The key facts include that air pollution contributes a high attributable health burden. That certain well-defined vulnerable subpopulations are at higher risk. At-risk populations include those with heart disease, lung disease and diabetes, older adults, children and individuals living in low socioeconomic neighborhoods. There is no established threshold level for safe long-term exposure to air particle pollution, and some of the basic biological mechanisms that account for adverse health effects are now known. This knowledge is giving us insight into how we might mitigate the effects apart from the regulatory efforts to improve overall air quality. Moreover, the work that each State has done to improve air quality has resulted in improved health outcomes including cardiovascular outcomes, and longer lives. The presentation will address: 1) What do we know? 2) Who are the at-risk populations? 3) What can communities do to reduce risk? 4) What can healthcare professionals do to reduce risk of the at-risk population? And 5) What tools are available to help healthcare professionals and their patients reduce exposure and risk from air pollutants? The talk will feature a description of the Air Quality Index and associated EPA tools and health information that can be used by health care providers to educate their at-ris

  8. Heart health = urologic health and heart unhealthy = urologic unhealthy: rapid review of lifestyle changes and dietary supplements.

    Science.gov (United States)

    Moyad, Mark A

    2011-08-01

    Almost all aspects of urology are affected positively and negatively by certain lifestyle changes and dietary supplements. Some of these interventions have potential profound impacts independently or in combination with conventional therapy, others have no impact, and some could negatively impact treatment and overall health. The heart-healthiest recommendations have consistently served as the safest and most potentially effective options in urology from benign prostatic hyperplasia, chronic nonbacterial prostatitis, interstitial cystitis, multiple urologic cancers, male infertility, male and female sexual dysfunction, kidney stones, and Peyronie disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Fatigue, General Health, and Ischemic Heart Disease in Older Adults

    DEFF Research Database (Denmark)

    Ekmann, Anette; Petersen, Inge; Mänty, Minna Regina

    2013-01-01

    Backgrounds.Fatigue has been shown to predict ischemic heart disease (IHD) and mortality in nonsmoking middle-aged men free of cardiovascular disease. The aim of this study was to investigate the predictive value of fatigue for IHD and general health in nondisabled individuals free...... of cardiovascular disease and older than 70 years. METHODS: The study population was drawn from The Longitudinal Study of Aging Danish Twins. In total, 1,696 participants were followed up for 2-10 years by questionnaires and 10-16 years through registries. Kaplan Meier, Cox Proportional Hazard and logistic.......08-2.00) compared with participants without fatigue. CONCLUSION: We concluded that fatigue in nondisabled older adults free of cardiovascular disease is an early predictor for development of subsequent poor general health and IHD....

  10. Canadians leaving the Canadian health care system to seek bariatric surgery abroad: Examining patient experience with international bariatric tourism

    OpenAIRE

    Hohm, Carly Desiree

    2017-01-01

    Globally, bariatric surgery, commonly known as weight loss surgery, has grown in popularity among obese individuals as a means to addressing their weight-related negative health when more traditional weight loss programs, such as diet and exercise, fail to elicit long term sustained weight loss. In Canada, however, complex barriers related to social, administrative, and other structural factors restrict access to care domestically, leaving some patients turning to surgical options abroad thro...

  11. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    Directory of Open Access Journals (Sweden)

    Tayyab Ikram Shah

    Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood

  12. Assessing the Dietary Habits of Canadians by Eating Location and Occasion: Findings from the Canadian Community Health Survey, Cycle 2.2

    Directory of Open Access Journals (Sweden)

    Stephanie K. Nishi

    2018-05-01

    Full Text Available Occasion and location of food environment has an influence on dietary habits, nutritional quality and overall health and nutrition-related chronic disease risk. Eating occasion and location was assessed in 20,402 Canadians aged ≥ 2 years, with a focus on energy, saturated fat, added sugars, and sodium intake by age group. Data showed >80% of children, compared to ~60% of adolescents and adults, consumed three meals (breakfast, lunch, dinner plus snacks in a day. Dinner contributed the most calories [ranging from 395 ± 11 kcal (2–3 year olds to 952 ± 27 kcal (men 19–30 years], saturated fat [7.4 ± 0.2% energy (2–3 year olds to 9.1 ± 0.3% energy (women 31–50 years], and sodium [851 ± 24 mg (2–3 year olds to 1299 ± 69 mg (men 19–30 years], while snacks contributed the most added sugars [22 ± 1 kcal (men >70 years to 45 ± 1 kcal (2–3 year olds]. By eating location, most Canadians (>90% reported consuming food from home. Subsequently, home was associated with the majority of energy [1383 ± 23 kcal (women >70 years to 2090 ± 35 kcal (boys 9–13 years], saturated fat [20.4 ± 0.4%E (men 51–70 years to 24.2 ± 0.4%E (2–3 year olds], added sugars [77 ± 3 kcal (men 19–30 years to 117 ± 2 kcal (2–3 year olds], and sodium [2137 ± 59 mg (women 19–30 years to 2638 ± 45 mg (men 51–70 years] intakes. Reported eating behaviours suggest action is needed at individual and population levels to alter food purchasing and consumption habits, specifically with regards to snacking habits and foods prepared at home.

  13. Community Health Status Indicators (CHSI) to Combat Obesity, Heart Disease and Cancer

    Data.gov (United States)

    U.S. Department of Health & Human Services — Community Health Status Indicators (CHSI) to combat obesity, heart disease, and cancer are major components of the Community Health Data Initiative. This dataset...

  14. The Effect of Leisure-Time Physical Activity on Obesity, Diabetes, High BP and Heart Disease Among Canadians: Evidence from 2000/2001 to 2005/2006.

    Science.gov (United States)

    Sarma, Sisira; Devlin, Rose Anne; Gilliland, Jason; Campbell, M Karen; Zaric, Gregory S

    2015-12-01

    Although studies have looked at the effect of physical activity on obesity and other health outcomes, the causal nature of this relationship remains unclear. We fill this gap by investigating the impact of leisure-time physical activity (LTPA) and work-related physical activity (WRPA) on obesity and chronic conditions in Canadians aged 18-75 using instrumental variable and recursive bivariate probit approaches. Average local temperatures surrounding the respondents' interview month are used as a novel instrument to help identify the causal relationship between LTPA and health outcomes. We find that an active level of LTPA (i.e., walking ≥1 h/day) reduces the probability of obesity by five percentage points, which increases to 11 percentage points if also combined with some WRPA. WRPA exhibits a negative effect on the probability of obesity and chronic conditions. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Occupational Health Services Shows Its Support for American Heart Month | Poster

    Science.gov (United States)

    The American Heart Association (AHA) has recognized February as American Heart Month since President Lyndon B. Johnson’s 1964 proclamation made it an annual occurrence. Throughout the month, Occupational Health Services did its part to help educate NCI and Frederick National Lab employees about the dangers of heart disease.

  16. How does culture affect experiential training feedback in exported Canadian health professional curricula?

    Science.gov (United States)

    Wilbur, Kerry; Mousa Bacha, Rasha; Abdelaziz, Somaia

    2017-03-17

    To explore feedback processes of Western-based health professional student training curricula conducted in an Arab clinical teaching setting. This qualitative study employed document analysis of in-training evaluation reports (ITERs) used by Canadian nursing, pharmacy, respiratory therapy, paramedic, dental hygiene, and pharmacy technician programs established in Qatar. Six experiential training program coordinators were interviewed between February and May 2016 to explore how national cultural differences are perceived to affect feedback processes between students and clinical supervisors. Interviews were recorded, transcribed, and coded according to a priori cultural themes. Document analysis found all programs' ITERs outlined competency items for students to achieve. Clinical supervisors choose a response option corresponding to their judgment of student performance and may provide additional written feedback in spaces provided. Only one program required formal face-to-face feedback exchange between students and clinical supervisors. Experiential training program coordinators identified that no ITER was expressly culturally adapted, although in some instances, modifications were made for differences in scopes of practice between Canada and Qatar.  Power distance was recognized by all coordinators who also identified both student and supervisor reluctance to document potentially negative feedback in ITERs. Instances of collectivism were described as more lenient student assessment by clinical supervisors of the same cultural background. Uncertainty avoidance did not appear to impact feedback processes. Our findings suggest that differences in specific cultural dimensions between Qatar and Canada have implications on the feedback process in experiential training which may be addressed through simple measures to accommodate communication preferences.

  17. The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

    Science.gov (United States)

    Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

    2017-01-01

    Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

  18. Unpacking the financial costs of "bariatric tourism" gone wrong: Who holds responsibility for costs to the Canadian health care system?

    Science.gov (United States)

    Snyder, Jeremy C; Silva, Diego S; Crooks, Valorie A

    2016-12-01

    Canadians are motivated to travel abroad for bariatric surgery owing to wait times for care and restrictions on access at home for various reasons. While such surgery abroad is typically paid for privately, if "bariatric tourists" experience complications or have other essential medical needs upon their return to Canada, these costs are borne by the publicly funded health system. In this commentary, we discuss why assigning responsibility for the costs of complications stemming from bariatric tourism is complicated and contextual.

  19. Health-related quality of life in Canadian adolescents and young adults: normative data using the SF-36.

    Science.gov (United States)

    Hopman, Wilma M; Berger, Claudie; Joseph, Lawrence; Towheed, Tanveer; Prior, Jerilynn C; Anastassiades, Tassos; Poliquin, Suzette; Zhou, Wei; Adachi, Jonathan D; Hanley, David A; Papadimitropoulos, Emmanuel A; Tenenhouse, Alan

    2009-01-01

    Normative data for the SF-36 measure of health-related quality of life (HRQOL) exist for those over 25 years of age, based on data from the population-based Canadian Multicentre Osteoporosis Study (CaMos). CaMos recently recruited a sample of young Canadians aged between 16 and 24 years. The purpose of this study was to develop normative SF-36 data for this age group. After direct standardization to the Canadian population, means, standard deviations (SD), 95% confidence intervals and percentage at floor and ceiling were produced for the eight domain and two summary scores of the SF-36. Domains are scored from 0 (poor) to 100 (excellent). Summary scores are standardized to a mean of 50, with scores over 50 representing better than average and below 50 poorer than average function. Separate analyses were completed for men and women, and for those 16-19 years and 20-24 years. The 1,001 community-based participants consisted of 474 men and 527 women from nine CaMos centres across Canada. Mean Physical Component Summary scores were 53.9 (SD = 6.9) and 53.3 (SD = 5.7) for young men and women, respectively. The equivalent Mental Component Summary scores were 49.3 (SD = 9.7) and 48.8 (SD = 8.9). In general, men scored somewhat higher than women, and younger (16-19 years) women scored higher than older (20-24 years) women, although the differences were small. HRQOL is good in this cohort of young Canadians. Both men and women scored somewhat better on physically than mentally oriented domains. In general, Canadian scores were similar to those of the US, while a comparable Swedish sample scored higher than both countries on most domains. Results underscore the importance of taking country, age and gender into consideration when using normative data.

  20. Heart health risk factors in Punjabi early teens

    Directory of Open Access Journals (Sweden)

    Elizabeth Mary John

    2014-01-01

    Full Text Available Context: India is experiencing an epidemiological health transition characterized by rapid decline in nutritional and parasitic diseases (pre-transitional diseases with an alarming rise in cardiovascular diseases, mainly coronary heart disease and stroke (post-transitional diseases. Many of these risk factors manifesting themselves as diseases in adults can be found during adolescence. Aims: To determine the prevalence of risk factors of heart disease among urban high-school students aged 13-15 yrs in Ludhiana city. Materials and Methods: This cross-sectional study included 330 high school-going early teens aged 13-15 years using a pretested questionnaire. Details regarding food habits, physical activity, and family history were collected along with anthropometric measures and blood pressure recordings. Statistical Analysis Used: Data was analysed using frequencies and proportion. Chi-square was the test of significance. Results: The prevalence of at least one risk factor in the population was 48.5%. Family history with prevalence of at least one coronary artery disease risk factor was of 27.4%, diabetic parents 12.2%, hypertension 17.6%, and heart disease was 1.8%. Physical inactivity as a risk factor showed an overall prevalence of 73%. Nearly 50% of the students consumed some junk food every day. Only 18.2% consume 3-5 servings of fruits per day, 11.2% do not take any fruits at all. Prevalence of overweight was 11.2% and 4.6% of them were obese. Hypertension was seen in 20.1% of subjects. Conclusions: The present generation of early teens are at high risk of future cardiovascular disease and schools and society need to address these issues urgently.

  1. Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

    Science.gov (United States)

    Nguyen, Minh Nguyet; Otis, Joanne

    2003-06-01

    As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.

  2. An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities.

    Science.gov (United States)

    Rahaman, Zaida; Holmes, Dave; Chartrand, Larry

    2016-05-22

    The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Within this research study, three significant findings emerged from the data. First, the Aboriginal person's identity was constructed in relation to the health care provider's role of delivering essential health services. Second, health care providers were not treating the "ill" patient, but rather treating the patient for being "ill." Third, health care providers were treating the Aboriginal person for being "Aboriginal" by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being "Aboriginal." © The Author(s) 2016.

  3. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten

    2010-01-01

    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  4. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten

    2012-02-01

    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  5. Have a Healthy Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease continues to be the leading cause of death for both men and women in the U.S. This podcast discusses the importance of decreasing the chances of developing heart disease via a healthy lifestyle.

  6. Body Mass Index Trajectories among Middle-Aged and Elderly Canadians and Associated Health Outcomes

    Directory of Open Access Journals (Sweden)

    Meng Wang

    2016-01-01

    Full Text Available Background. Whether there is heterogeneity in the development of BMI from middle-age onward is still unknown. The primary aim of this study is to analyze long-term obesity and how BMI trajectories are associated with health outcomes in midlife. Methods. Latent Class Growth Modelling was used to capture the changes in BMI over time. In this study, 3070 individuals from the National Population Health Survey (NPHS, aged 40–55 years at baseline, were included. Results. Four BMI trajectory groups, “Normal-Stable” (N-S, “Overweight-Stable” (OV-S, “Obese I-Stable” (OB I-S, and “Obese II-Stable” (OB II-S, were identified. Men, persons of White ancestry, and individuals who had no postsecondary education had higher odds of being in the latter three groups. Moreover, members of the OV-S, OB I-S, and OB II-S groups experienced more asthma, arthritis, hypertension, diabetes, heart disease, cognitive impairment, and reduced self-rated overall health. Individuals in the OB II-S group were at greater risk for back problems, chronic bronchitis or emphysema, and emotional issues when compared to the N-S group. Conclusion. Understanding different BMI trajectories is important in order to identify people who are at the highest risk of developing comorbidities due to obesity and to establish programs to intervene appropriately.

  7. Mobile health in adults with congenital heart disease: Current use and future needs

    NARCIS (Netherlands)

    Schuuring, M.J.; A. Backx (Ad); Zwart, R.; Veelenturf, A.H.; D. Robbers-Visser (Daniëlle); M. Groenink (Maarten); A. Abu-Hanna (Ameen); N. Bruining (Nico); M.P. Schijven; B.J.M. Mulder (Barbara); B.J. Bouma (Berto)

    2016-01-01

    textabstractObjective Many adults with congenital heart disease (CHD) are affected lifelong by cardiac events, particularly arrhythmias and heart failure. Despite the care provided, the cardiac event rate remains high. Mobile health (mHealth) brings opportunities to enhance daily monitoring and

  8. The relationship between child protection contact and mental health outcomes among Canadian adults with a child abuse history.

    Science.gov (United States)

    Afifi, Tracie O; McTavish, Jill; Turner, Sarah; MacMillan, Harriet L; Wathen, C Nadine

    2018-05-01

    Despite being a primary response to child abuse, it is currently unknown whether contact with child protection services (CPS) does more good than harm. The aim of the current study was to examine whether contact with CPS is associated with improved mental health outcomes among adult respondents who reported experiencing child abuse, after adjusting for sociodemographic factors and abuse severity. The data were drawn from the 2012 Canadian Community Health Survey-Mental Health (CCHS-2012), which used a multistage stratified cluster design (household-level response rate = 79.8%). Included in this study were individuals aged 18 years and older living in the 10 Canadian provinces (N = 23,395). Child abuse included physical abuse, sexual abuse, and exposure to intimate partner violence (IPV). Mental health outcomes included lifetime mental disorders, lifetime and past year suicidal ideation, plans, and attempts, and current psychological well-being and functioning and distress. All models were adjusted for sociodemographic factors and severity of child abuse. For the majority of outcomes, there were no statistically significant differences between adults with a child abuse history who had CPS contact compared to those without CPS contact. However, those with CPS contact were more likely to report lifetime suicide attempts. These findings suggest that CPS contact is not associated with improved mental health outcomes. Implications are discussed. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  9. Factors Facilitating the Implementation of Church-Based Heart Health Promotion Programs for Older Adults: A Qualitative Study Guided by the Precede-Proceed Model.

    Science.gov (United States)

    Banerjee, Ananya Tina; Kin, R; Strachan, Patricia H; Boyle, Michael H; Anand, Sonia S; Oremus, Mark

    2015-01-01

    To describe the factors facilitating the implementation of heart health promotion programs for older adults in Anglican, United, and Catholic churches. The study used qualitative methods comprising semistructured interviews and focus groups. The interviews and focus groups were conducted in Anglican, Catholic, and United churches located in the Canadian cities of Toronto and Hamilton, Ontario. Twelve ordained pastors and 21 older parishioners who attended church regularly and who had no health conditions were recruited to best explain how churches could be suitable locations for health promotion activities targeting older adults. Twelve semistructured interviews with the pastors and three focus groups with the 21 parishioners were undertaken. A component of the Precede-Proceed model (a model for planning health education and health promotion programs and policies) was applied to the findings after direct content analysis of the data. Participants identified pastor leadership, funding for a parish nurse, community-focused interventions, secured infrastructure, and social support from congregation members as pertinent factors required for implementing health promotion programs in Anglican, United, and Catholic churches. The findings have particular relevance for health promotion and public health because they suggest factors that would be necessary to design church-based heart health promotion programs for older adults at risk of chronic diseases.

  10. Occupational Stress, Mental Health and Satisfaction in the Canadian Multicultural Workplace

    Science.gov (United States)

    Pasca, Romana; Wagner, Shannon L.

    2012-01-01

    Workplaces are becoming increasingly multicultural and therefore, include a large variety of employees from more than one ethnicity, nationality, religious and/or cultural background. In the context of this new global economy, Canadian workplace structure and composition has also permanently changed. Consequently, the primary purpose of this…

  11. The household food insecurity gradient and potential reductions in adverse population mental health outcomes in Canadian adults.

    Science.gov (United States)

    Jessiman-Perreault, Geneviève; McIntyre, Lynn

    2017-12-01

    Household food insecurity is related to poor mental health. This study examines whether the level of household food insecurity is associated with a gradient in the risk of reporting six adverse mental health outcomes. This study further quantifies the mental health impact if severe food insecurity, the extreme of the risk continuum, were eliminated in Canada. Using a pooled sample of the Canadian Community Health Survey (N = 302,683), we examined the relationship between level of food insecurity, in adults 18-64 years, and reporting six adverse mental health outcomes. We conducted a probit analysis adjusted for multi-variable models, to calculate the reduction in the odds of reporting mental health outcomes that might accrue from the elimination of severe food insecurity. Controlling for various demographic and socioeconomic covariates, a food insecurity gradient was found in six mental health outcomes. We calculated that a decrease between 8.1% and 16.0% in the reporting of these mental health outcomes would accrue if those who are currently severely food insecure became food secure, after controlling for covariates. Household food insecurity has a pervasive graded negative effect on a variety of mental health outcomes, in which significantly higher levels of food insecurity are associated with a higher risk of adverse mental health outcomes. Reduction of food insecurity, particularly at the severe level, is a public health concern and a modifiable structural determinant of health worthy of macro-level policy intervention.

  12. Development of a Canadian deceased donation education program for health professionals: a needs assessment survey.

    Science.gov (United States)

    Hancock, Jennifer; Shemie, Sam D; Lotherington, Ken; Appleby, Amber; Hall, Richard

    2017-10-01

    The purpose of this survey was to determine how Canadian healthcare professionals perceive their deficiencies and educational requirements related to organ and tissue donation. We surveyed 641 intensive care unit (ICU) physicians, 1,349 ICU nurses, 1,561 emergency room (ER) physicians, and 1,873 ER nurses. The survey was distributed by the national organization for each profession (the Canadian Association of Emergency Physicians, the Canadian Association of Critical Care Nurses, and the National Emergency Nurses Association). Canadian Blood Services developed the critical care physician list in collaboration with the Canadian Critical Care Society. Survey development included questions related to comfort with, and knowledge of, key competencies in organ and tissue donation. Eight hundred thirty-one (15.3%) of a possible 5,424 respondents participated in the survey. Over 50% of respondents rated the following topics as highly important: knowledge of general organ and tissue donation, neurological determination of death, donation after cardiac death, and medical-legal donation issues. High competency comfort levels ranged from 14.7-50.9% for ICU nurses and 8.0-34.6% for ER nurses. Competency comfort levels were higher for ICU physicians (67.5-85.6%) than for ER physicians who rated all competencies lower. Respondents identified a need for a curriculum on national organ donation and preferred e-learning as the method of education. Both ICU nurses and ER practitioners expressed low comfort levels with their competencies regarding organ donation. Intensive care unit physicians had a much higher level of comfort; however, the majority of these respondents were specialty trained and working in academic centres with active donation and transplant programs. A national organ donation curriculum is needed.

  13. Canadian Health Libraries’ Responses to the Truth and Reconciliation Commission’s Calls to Action: A Literature Review and Content Analysis

    Directory of Open Access Journals (Sweden)

    Lara Maestro

    2017-12-01

      Introduction: As part of the Truth and Reconciliation Commission of Canada’s (TRC Final Report on the history and legacy of residential schools in Canada, ninety-four (94 Calls to Action were identified. Of those, seven are health-specific. The objective of this research paper is to determine how Canadian health library websites are responding to these calls to action.   Methods: The authors conducted an initial literature review to gain an understanding of the context of Indigenous health in Canada. A content analysis of Canadian health library websites was conducted to track mentions of the TRC and their responses to the need for Indigenous-focused resources.   Results: The results of content analysis indicated few online responses to the TRC’s Calls to Action from Canadian health libraries. Only thirty-three per cent of Canadian health libraries had content that was Indigenous-focused, and only about fifteen per cent of health libraries had visible content related to the TRC’s Calls to Action. Academic and consumer health libraries were more likely to have both TRC- and Indigenous-focused content.   Discussion: Nuances related to the research question resulted in some challenges to research design. For example, website content analysis is an imperfect indicator of real-world action. Limitations in research design notwithstanding, visibility is an important part of conveying commitment to the TRC, and the information available indicates the Canadian medical community is not living up to that commitment.   Conclusion: Canadian health libraries need to do more to show a visible commitment to the TRC’s Calls to Action.

  14. Rehab for the Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-24

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. This podcast discusses the importance of getting cardiac rehab after a heart attack.  Created: 8/24/2017 by MMWR.   Date Released: 8/24/2017.

  15. Rehab for the Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. For a third of these, it's not their first. Cardiac rehabilitation could have prevented many of these. In this podcast, Dr. Fleetwood Loustalot discusses the importance of getting cardiac rehab after a heart attack.

  16. Have a Healthy Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-02-05

    Heart disease continues to be the leading cause of death in the U.S. In this podcast, Dr. Derrick Gervin discusses ways to keep our hearts healthy.  Created: 2/5/2015 by MMWR.   Date Released: 2/5/2015.

  17. Heart Check (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-09-24

    Heart disease is the leading cause of death worldwide. It’s related to one in four deaths in the U.S. In this podcast, Jacquie Dozier discusses the importance of maintaining a healthy heart.  Created: 9/24/2015 by MMWR.   Date Released: 9/24/2015.

  18. Have a Healthy Heart (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-02-05

    Heart disease continues to be the leading cause of death for both men and women in the U.S. This podcast discusses the importance of decreasing the chances of developing heart disease via a healthy lifestyle.  Created: 2/5/2015 by MMWR.   Date Released: 2/5/2015.

  19. Cost-Effectiveness Analysis of Systemic Therapies in Advanced Pancreatic Cancer in the Canadian Health Care System.

    Science.gov (United States)

    Coyle, Doug; Ko, Yoo-Joung; Coyle, Kathryn; Saluja, Ronak; Shah, Keya; Lien, Kelly; Lam, Henry; Chan, Kelvin K W

    2017-04-01

    To assess the cost-effectiveness of gemcitabine (G), G + 5-fluorouracil, G + capecitabine, G + cisplatin, G + oxaliplatin, G + erlotinib, G + nab-paclitaxel (GnP), and FOLFIRINOX in the treatment of advanced pancreatic cancer from a Canadian public health payer's perspective, using data from a recently published Bayesian network meta-analysis. Analysis was conducted through a three-state Markov model and used data on the progression of disease with treatment from the gemcitabine arms of randomized controlled trials combined with estimates from the network meta-analysis for the newer regimens. Estimates of health care costs were obtained from local providers, and utilities were derived from the literature. The model estimates the effect of treatment regimens on costs and quality-adjusted life-years (QALYs) discounted at 5% per annum. At a willingness-to-pay (WTP) threshold of greater than $30,666 per QALY, FOLFIRINOX would be the most optimal regimen. For a WTP threshold of $50,000 per QALY, the probability that FOLFIRINOX would be optimal was 57.8%. There was no price reduction for nab-paclitaxel when GnP was optimal. From a Canadian public health payer's perspective at the present time and drug prices, FOLFIRINOX is the optimal regimen on the basis of the cost-effectiveness criterion. GnP is not cost-effective regardless of the WTP threshold. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  20. Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC).

    Science.gov (United States)

    Sritharan, Jeavana; MacLeod, Jill; Harris, Shelley; Cole, Donald C; Harris, Anne; Tjepkema, Michael; Peters, Paul A; Demers, Paul A

    2018-04-01

    As there are no well-established modifiable risk factors for prostate cancer, further evidence is needed on possible factors such as occupation. Our study uses one of the largest Canadian worker cohorts to examine occupation, industry, and prostate cancer and to assess patterns of prostate cancer rates. The Canadian Census Health and Environment Cohort (CanCHEC) was established by linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). A total of 37,695 prostate cancer cases were identified in men aged 25-74 based on age at diagnosis. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals. In men aged 25-74 years, elevated risks were observed in the following occupations: senior management (HR = 1.12, 95% CI: 1.04-1.20); office and administration (HR = 1.19, 95% CI: 1.11-1.27); finance services (HR = 1.09, 95% CI: 1.04-1.14); education (HR = 1.05, 95% CI: 1.00-1.11); agriculture and farm management (HR = 1.12, 95% CI: 1.06-1.17); farm work (HR = 1.11, 95% CI: 1.01-1.21); construction managers (HR = 1.07, 95% CI: 1.01-1.14); firefighting (HR = 1.17, 95% CI: 1.01-1.36); and police work (HR = 1.22, 95% CI: 1.09-1.36). Decreased risks were observed across other construction and transportation occupations. Results by industry were consistent with occupation results. Associations were identified for white-collar, agriculture, protective services, construction, and transportation occupations. These findings emphasize the need for further study of job-related exposures and the potential influence of nonoccupational factors such as screening practices. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  1. Assessing the nutritional quality of diets of Canadian children and adolescents using the 2014 Health Canada Surveillance Tool Tier System

    Directory of Open Access Journals (Sweden)

    Mahsa Jessri

    2016-05-01

    Full Text Available Abstract Background Health Canada’s Surveillance Tool (HCST Tier System was developed in 2014 with the aim of assessing the adherence of dietary intakes with Eating Well with Canada’s Food Guide (EWCFG. HCST uses a Tier system to categorize all foods into one of four Tiers based on thresholds for total fat, saturated fat, sodium, and sugar, with Tier 4 reflecting the unhealthiest and Tier 1 the healthiest foods. This study presents the first application of the HCST to examine (i the dietary patterns of Canadian children, and (ii the applicability and relevance of HCST as a measure of diet quality. Methods Data were from the nationally-representative, cross-sectional Canadian Community Health Survey 2.2. A total of 13,749 participants aged 2–18 years who had complete lifestyle and 24-hour dietary recall data were examined. Results Dietary patterns of Canadian children and adolescents demonstrated a high prevalence of Tier 4 foods within the sub-groups of processed meats and potatoes. On average, 23–31 % of daily calories were derived from “other” foods and beverages not recommended in EWCFG. However, the majority of food choices fell within the Tier 2 and 3 classifications due to lenient criteria used by the HCST for classifying foods. Adherence to the recommendations presented in the HCST was associated with closer compliance to meeting nutrient Dietary Reference Intake recommendations, however it did not relate to reduced obesity as assessed by body mass index (p > 0.05. Conclusions EWCFG recommendations are currently not being met by most children and adolescents. Future nutrient profiling systems need to incorporate both positive and negative nutrients and an overall score. In addition, a wider range of nutrient thresholds should be considered for HCST to better capture product differences, prevent categorization of most foods as Tiers 2–3 and provide incentives for product reformulation.

  2. Assessing the nutritional quality of diets of Canadian children and adolescents using the 2014 Health Canada Surveillance Tool Tier System.

    Science.gov (United States)

    Jessri, Mahsa; Nishi, Stephanie K; L'Abbe, Mary R

    2016-05-10

    Health Canada's Surveillance Tool (HCST) Tier System was developed in 2014 with the aim of assessing the adherence of dietary intakes with Eating Well with Canada's Food Guide (EWCFG). HCST uses a Tier system to categorize all foods into one of four Tiers based on thresholds for total fat, saturated fat, sodium, and sugar, with Tier 4 reflecting the unhealthiest and Tier 1 the healthiest foods. This study presents the first application of the HCST to examine (i) the dietary patterns of Canadian children, and (ii) the applicability and relevance of HCST as a measure of diet quality. Data were from the nationally-representative, cross-sectional Canadian Community Health Survey 2.2. A total of 13,749 participants aged 2-18 years who had complete lifestyle and 24-hour dietary recall data were examined. Dietary patterns of Canadian children and adolescents demonstrated a high prevalence of Tier 4 foods within the sub-groups of processed meats and potatoes. On average, 23-31 % of daily calories were derived from "other" foods and beverages not recommended in EWCFG. However, the majority of food choices fell within the Tier 2 and 3 classifications due to lenient criteria used by the HCST for classifying foods. Adherence to the recommendations presented in the HCST was associated with closer compliance to meeting nutrient Dietary Reference Intake recommendations, however it did not relate to reduced obesity as assessed by body mass index (p > 0.05). EWCFG recommendations are currently not being met by most children and adolescents. Future nutrient profiling systems need to incorporate both positive and negative nutrients and an overall score. In addition, a wider range of nutrient thresholds should be considered for HCST to better capture product differences, prevent categorization of most foods as Tiers 2-3 and provide incentives for product reformulation.

  3. Mental disorders and their association with perceived work stress: an investigation of the 2010 Canadian Community Health Survey.

    Science.gov (United States)

    Szeto, Andrew C H; Dobson, Keith S

    2013-04-01

    The economic repercussions of mental disorders in the workplace are vast. Research has found that individuals in high-stress jobs tend to have higher prevalence of mental disorders. The current cross-sectional study examined the relationships between work-related stress and mental disorders in a recent representative population-based sample-the 2010 Canadian Community Health Survey by Statistics Canada (CCHS; 2010a; Retrieved from http://www23.statcan.gc.ca/imdb-bmdi/instrument/3226_Q1_V7-eng.pdf). Respondents in the highest level of perceived work stress had higher odds of ever being treated for an emotional or mental-health problem and for being treated in the past 12 months. These high-stress respondents also had higher odds of being diagnosed for mood and anxiety disorders than their nonstressed counterparts. These associations highlight the continued need to examine and promote mental health and well-being in the workplace.

  4. Canadian soil quality guidelines for the protection of environmental and human health : benzene

    Energy Technology Data Exchange (ETDEWEB)

    Potter, K.

    2005-07-01

    This report presented soil quality guidelines for benzene to protect humans and ecological receptors in 4 types of land uses: agricultural; residential and parklands; commercial and industrial. The chemical and physical properties of benzene were reviewed, as well as the sources and emissions of benzene in Canada. The distribution and behaviour of benzene in the environment was examined, and the toxicological effects of benzene on microbial processes, plants, animals and humans were reviewed. It was noted that the background information and rationale for the derivation of Canadian Soil Quality Guidelines for this substance were originally published in 1999 by the Canadian Council of Ministers of the Environment (CCME) in Canadian Environmental Quality Guidelines. These guidelines have since been revised to reflect new data and lessons learned during the development of the Canada-wide Standard for Petroleum Hydrocarbons in Soil (CCME 2000). Modifications in this report included the derivation of guidelines for different soil textures and depths. Behaviour and effects in biota were reviewed, including soil microbial processes; terrestrial plants; terrestrial invertebrates; livestock and wildlife; and bioaccumulation. Behaviour and effects in humans and mammalian species were examined. The derivation of environmental soil quality guidelines was outlined. Recommendations for Canadian soil quality guidelines were presented. It was concluded that there is a lack of studies on the toxic effects of benzene on livestock, mammalian wildlife and birds and that studies on the metabolism of benzene in mammals and birds as well as invertebrates are needed. In addition, research is needed on the effects of benzene on nitrogen fixation, nitrification, nitrogen mineralization, decomposition and respiration. 118 refs., 3 tabs., 2 figs.

  5. Disease-specific health status as a predictor of mortality in patients with heart failure

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Zijlstra, Wobbe P

    2014-01-01

    AIMS: Some, but not all, studies have shown that patient-reported health status, including symptoms, functioning, and health-related quality of life, provides additional information to traditional clinical factors in predicting prognosis in heart failure patients. To evaluate the overall evidence......, the association of disease-specific health status on mortality in heart failure was examined through a systematic review and meta-analysis. METHODS AND RESULTS: Prospective cohort studies that assessed the independent association of disease-specific health status with mortality in heart failure were selected....... Searching PubMed (until March 2013) resulted in 17 articles in the systematic review and 17 studies in the meta-analysis. About half of the studies reported a significant relationship between disease-specific health status and mortality in heart failure, while the remainder found no association. A larger...

  6. Canadian valuation of EQ-5D health states: preliminary value set and considerations for future valuation studies.

    Directory of Open Access Journals (Sweden)

    Nick Bansback

    Full Text Available The EQ-5D is a preference based instrument which provides a description of a respondent's health status, and an empirically derived value for that health state often from a representative sample of the general population. It is commonly used to derive Quality Adjusted Life Year calculations (QALY in economic evaluations. However, values for health states have been found to differ between countries. The objective of this study was to develop a set of values for the EQ-5D health states for use in Canada.Values for 48 different EQ-5D health states were elicited using the Time Trade Off (TTO via a web survey in English. A random effect model was fitted to the data to estimate values for all 243 health states of the EQ-5D. Various model specifications were explored. Comparisons with EQ-5D values from the UK and US were made. Sensitivity analysis explored different transformations of values worse than dead, and exclusion criteria of subjects.The final model was estimated from the values of 1145 subjects with socio-demographics broadly representative of Canadian general population with the exception of Quebec. This yielded a good fit with observed TTO values, with an overall R2 of 0.403 and a mean absolute error of 0.044.A preference-weight algorithm for Canadian studies that include the EQ-5D is developed. The primary limitations regarded the representativeness of the final sample, given the language used (English only, the method of recruitment, and the difficulty in the task. Insights into potential issues for conducting valuation studies in countries as large and diverse as Canada are gained.

  7. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

    Science.gov (United States)

    Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

    2014-01-01

    Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

  8. 76 FR 9525 - Health Claim; Phytosterols and Risk of Coronary Heart Disease

    Science.gov (United States)

    2011-02-18

    ... coronary heart disease (CHD), in a manner that is consistent with FDA's February 14, 2003, letter of.... FDA-2000-P-0102, FDA-2000-P-0133, and FDA-2006-P-0033] Health Claim; Phytosterols and Risk of Coronary Heart Disease AGENCY: Food and Drug Administration, HHS. ACTION: Extension of enforcement discretion...

  9. Assessing the Nutritional Quality of Diets of Canadian Adults Using the 2014 Health Canada Surveillance Tool Tier System

    Directory of Open Access Journals (Sweden)

    Mahsa Jessri

    2015-12-01

    Full Text Available The 2014 Health Canada Surveillance Tool (HCST was developed to assess adherence of dietary intakes with Canada’s Food Guide. HCST classifies foods into one of four Tiers based on thresholds for sodium, total fat, saturated fat and sugar, with Tier 1 representing the healthiest and Tier 4 foods being the unhealthiest. This study presents the first application of HCST to assess (a dietary patterns of Canadians; and (b applicability of this tool as a measure of diet quality among 19,912 adult participants of Canadian Community Health Survey 2.2. Findings indicated that even though most of processed meats and potatoes were Tier 4, the majority of reported foods in general were categorized as Tiers 2 and 3 due to the adjustable lenient criteria used in HCST. Moving from the 1st to the 4th quartile of Tier 4 and “other” foods/beverages, there was a significant trend towards increased calories (1876 kcal vs. 2290 kcal and “harmful” nutrients (e.g., sodium as well as decreased “beneficial” nutrients. Compliance with the HCST was not associated with lower body mass index. Future nutrient profiling systems need to incorporate both “positive” and “negative” nutrients, an overall score and a wider range of nutrient thresholds to better capture food product differences.

  10. Rehab for the Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-24

    Each year, nearly 790,000 adults in the U.S. suffer a heart attack. For a third of these, it’s not their first. Cardiac rehabilitation could have prevented many of these. In this podcast, Dr. Fleetwood Loustalot discusses the importance of getting cardiac rehab after a heart attack.  Created: 8/24/2017 by MMWR.   Date Released: 8/24/2017.

  11. Health behavior of patients with ischemic heart disease

    OpenAIRE

    Paweł Węgorowski; Joanna Michalik; Rafał Zarzeczny; Renata Domżał-Drzewiecka; Grzegorz Nowicki

    2017-01-01

    Admission By analyzing the available scientific literature, it is possible to define ischemic heart disease as a set of disease symptoms that are a consequence of a chronic state of imbalance between the ability to supply nutrients and oxygen and the real need of myocardial cells for these substances. Adapting life-style behaviors to healthy living is a priority to prevent the onset and development of cardiovascular disease, especially ischemic heart disease, Purpose of research T...

  12. Factors that determine the effectiveness of screening for congenital heart malformations at child health centres

    NARCIS (Netherlands)

    R.E. Juttmann (Rikard); J. Hess (Jakob); C.W.N. Looman (Caspar); P.J. van der Maas (Paul)

    2000-01-01

    textabstractBACKGROUND: The actual yield from current screening for clinically significant congenital heart malformations in Dutch child health care is far from optimal. In this study factors that determine the effectiveness of this screening are identified and

  13. Keep Baby’s Heart Healthy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby.

  14. Take the Pressure off Your Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Heart disease and stroke are leading causes of death in the U.S. High blood pressure, or hypertension, can lead to both. In this podcast, Dr. Fleetwood Loustalot discusses the health consequences of hypertension.

  15. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2018-01-01

    disease-specific health-related quality of life questionnaire, in implantable cardioverter defibrillator recipients. Design This study involved cross-sectional and test-retest study designs. Method Implantable cardioverter defibrillator recipients in the cross-sectional study completed the Heart......QoL, the Short-Form 36 Health Survey, and the Hospital Anxiety and Depression Scale. The HeartQoL structure, construct-related validity (convergent and discriminative) and reliability (internal consistency) were assessed. HeartQoL reproducibility (test-retest) was assessed in an independent sample of implantable...... psychometric attributes of validity and reliability in this implantable cardioverter defibrillator population. This study adds support for the HeartQoL as a core heart-specific health-related quality of life questionnaire in a broad group of patients with heart disease including implantable cardioverter...

  16. Early life environment and social determinants of cardiac health in children with congenital heart disease.

    Science.gov (United States)

    Wong, Peter; Denburg, Avram; Dave, Malini; Levin, Leo; Morinis, Julia Orkin; Suleman, Shazeen; Wong, Jonathan; Ford-Jones, Elizabeth; Moore, Aideen M

    2018-04-01

    Congenital heart disease is a significant cause of infant mortality. Epidemiology and social context play a crucial role in conditioning disease burden and modulating outcomes, while diagnosis and treatment remain resource intensive. This review will address the role of social demographics, environmental exposure, epigenetics and nutrition in the aetiology of congenital heart disease. We then discuss the determinant effect of social factors on the provision and outcomes of care for congenital heart disease and implications for practice. It is our hope that enhanced knowledge of the intersection of social determinants of health and congenital heart disease will facilitate effective preventative strategies at the individual and population levels to optimize heart health outcomes across the life course.

  17. "With human health it's a global thing": Canadian perspectives on ethics in the global governance of an influenza pandemic.

    Science.gov (United States)

    Thompson, Alison K; Smith, Maxwell J; McDougall, Christopher W; Bensimon, Cécile; Perez, Daniel Felipe

    2015-03-01

    We live in an era where our health is linked to that of others across the globe, and nothing brings this home better than the specter of a pandemic. This paper explores the findings of town hall meetings associated with the Canadian Program of Research on Ethics in a Pandemic (CanPREP), in which focus groups met to discuss issues related to the global governance of an influenza pandemic. Two competing discourses were found to be at work: the first was based upon an economic rationality and the second upon a humanitarian rationality. The implications for public support and the long-term sustainability of new global norms, networks, and regulations in global public health are discussed.

  18. How do medical device manufacturers' websites frame the value of health innovation? An empirical ethics analysis of five Canadian innovations.

    Science.gov (United States)

    Lehoux, P; Hivon, M; Williams-Jones, B; Miller, F A; Urbach, D R

    2012-02-01

    While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology's promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate "value proposition" of their innovation and seek to respond to what they consider the key expectations of their customers. Our analysis shows that the manufacturers' framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians' and patients' expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others.

  19. Advancing Strategies for Agenda Setting by Health Policy Coalitions: A Network Analysis of the Canadian Chronic Disease Prevention Survey.

    Science.gov (United States)

    McGetrick, Jennifer Ann; Raine, Kim D; Wild, T Cameron; Nykiforuk, Candace I J

    2018-06-11

    Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers' contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents' jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.

  20. Prevalence and Characteristics Associated with Breastfeeding Initiation Among Canadian Inuit from the 2007-2008 Nunavut Inuit Child Health Survey.

    Science.gov (United States)

    McIsaac, Kathryn E; Sellen, Daniel W; Lou, Wendy; Young, Kue

    2015-09-01

    We aimed to determine the prevalence of, and factors associated with, breastfeeding initiation in Canadian Inuit. We used data from the Nunavut Inuit Child Health Survey, a population-based, cross-sectional survey conducted in the Canadian territory of Nunavut. Inuit children aged 3-5 years in 2007 or 2008 were randomly selected for the survey. Select household, maternal, infant and community characteristics were collected from the child's primary caregiver and entered into logistic regression models as potential predictors of breastfeeding initiation. Analyses were repeated in a subgroup of caregiver reports from biological mothers. The reported prevalence of breastfeeding initiation was 67.6% (95% CI 62.4-72.8) overall and 85.1% (95% CI 80.2-90.1) in a subgroup of caregiver reports from biological mothers. Adjusted prevalence odds ratios (pOR) indicate the primary caregiver was an important determinant of breastfeeding (adopted parent vs. biological mother: pOR = 0.03, 95% CI 0.01-0.07; other vs. biological mother: pOR = 0.33, 95% CI 0.14-0.74). Maternal smoking during pregnancy and having access to a community birthing facility were also potentially important, but not statistically significant (p > 0.05). In conclusion, data from the Nunavut Inuit Child Health Survey indicate breastfeeding is initiated for more than two-thirds of children, but rates are below the national average and this may be one of several pathways to poor health outcomes documented in many Inuit communities. Considered in the particular context of birthing facilities utilization and postnatal care arrangements in Inuit communities, these results suggest that increasing breastfeeding initiation will require health interventions that effectively engage all types of primary caregivers.

  1. Management of risk to human health posed by dioxins under the Canadian Environmental Protection Act (CEPA)

    Energy Technology Data Exchange (ETDEWEB)

    Seed, L. [Health Canada, Ottawa, ON (Canada)

    2004-09-15

    The Canadian federal Toxic Substances Management Policy requires that for substances which: - are toxic - persist in the environment - bioaccumulate - result predominantly from human activity the ultimate goal is virtual elimination. Because dioxins and furans satisfy these criteria, the management objective is virtual elimination of measurable releases of these substances into the environment. Measurable releases are defined as releases above the Level of Quantification (LoQ), which is the lowest concentration that can be accurately measured using sensitive but routine sampling and analytical methods. For dioxins and furans released to air, that level is 32 picograms of toxic equivalents (TEQ) per cubic metre.

  2. Convergence of body mass index of immigrants to the Canadian-born population: evidence from the National Population Health Survey (1994-2006).

    Science.gov (United States)

    Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

    2009-01-01

    Recent immigrants typically have better physical health than the native born population. However, this 'healthy immigrant effect' tends to gradually wane over time, with increasing length of residence in the host country. To assess whether the body mass index (BMI) of different immigrant groups converged to the Canadian population's levels, we estimated 12-year trajectories of changes in BMI (accounting for socio-demographic changes). Using data from seven longitudinal waves of the National Population Health Survey (1994 through 2006), we compared the changes in BMI (kg/m(2)) among three groups: white immigrants, non-white immigrants and Canadian born, aged 18-54 at baseline. We applied linear random effects models to evaluate these BMI separately in 2,504 males and 2,960 females. BMI increased in Canadian born, white immigrants, and non-white immigrants over the 12-year period. However, non-white immigrants (males and females) had a lower mean BMI than Canadian born individuals during this period [Males: -2.27, 95% Confidence interval (CI) -3.02 to -1.53; Females: -1.84, 95% CI -2.79 to -0.90]. In contrast, the mean BMI in white male immigrants and Canadian born individuals were similar (-0.32, 95% CI -0.91 to 0.27). Even after adjusting for time since immigration, non-white immigrants had lower BMI than white immigrants. White male immigrants were the only sub-group to converge to the BMI of the Canadian born population. These results indicate that the loss of 'healthy immigrant effect' with regard to convergence of BMI to Canadian levels may not be experienced equally by all immigrants in Canada.

  3. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Outflow tract obstruction, coarctation of the aorta, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome

    Science.gov (United States)

    Silversides, Candice K; Beauchesne, Luc; Bradley, Timothy; Connelly, Michael; Niwa, Koichiro; Mulder, Barbara; Webb, Gary; Colman, Jack; Therrien, Judith

    2010-01-01

    With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. Part II of the guidelines includes recommendations for the care of patients with left ventricular outflow tract obstruction and bicuspid aortic valve disease, coarctation of the aorta, right ventricular outflow tract obstruction, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome. Topics addressed include genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy risk and follow-up requirements. The complete document consists of four manuscripts that are published online in the present issue of The Canadian Journal of Cardiology. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. PMID:20352138

  4. Addressing Health Inequities: Coronary Heart Disease Training within Learning Disabilities Services

    Science.gov (United States)

    Holly, Deirdre; Sharp, John

    2014-01-01

    People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…

  5. Linking evidence to action on social determinants of health using Urban HEART in the Americas.

    Science.gov (United States)

    Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi

    2013-12-01

    To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  6. Linking evidence to action on social determinants of health using Urban HEART in the Americas

    Directory of Open Access Journals (Sweden)

    Amit Prasad

    2013-12-01

    Full Text Available OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil, Toronto (Canada, and Bogotá and Medellín (Colombia. Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto, academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights CONCLUSIONS: Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  7. Capturing how age-friendly communities foster positive health, social participation and health equity: a study protocol of key components and processes that promote population health in aging Canadians.

    Science.gov (United States)

    Levasseur, Mélanie; Dubois, Marie-France; Généreux, Mélissa; Menec, Verena; Raina, Parminder; Roy, Mathieu; Gabaude, Catherine; Couturier, Yves; St-Pierre, Catherine

    2017-05-25

    To address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities' physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms. This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to: 1) Describe and compare age-friendly key components of communities across Canada 2) Identify key components best associated with positive health, social participation and health equity of aging adults 3) Explore how these key components foster positive health, social participation and health equity METHODS: A mixed-method sequential explanatory design will be used. The quantitative part will involve a survey of Canadian communities and secondary analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The survey will include an age-friendly questionnaire targeting key components in seven domains: physical environment, housing options, social environment, opportunities for participation, community supports and healthcare services, transportation options, communication and information. The CLSA is a large, national prospective study representative of the Canadian aging population designed to examine health transitions and trajectories of adults as they age. In the qualitative part, a multiple

  8. Employers' perceptions and attitudes toward the Canadian national standard on psychological health and safety in the workplace: A qualitative study.

    Science.gov (United States)

    Kunyk, Diane; Craig-Broadwith, Morgan; Morris, Heather; Diaz, Ruth; Reisdorfer, Emilene; Wang, JianLi

    2016-01-01

    The estimated societal and economic costs of mental illness and psychological injury in the workplace is staggering. Governments, employers and other stakeholders have been searching for policy solutions. This qualitative, exploratory study sought to uncover organizational receptivity to a voluntary comprehensive standard for dealing with psychological health and safety in the workplace. A series of five focus groups were conducted in a large Western Canadian city in November 2013. The seventeen participants were from the fields of healthcare, construction/utilities, manufacturing industries, business services, and finance. They worked in positions of management, consulting, human resources, health promotion, health and safety, mediation, and occupational health and represented organizations ranging in size from 20 to 100,000 employees. The findings confirm and illustrate the critical role that psychological health and safety plays across workplaces and occupations. This standard resonated across the represented organizations and fit with their values. This alignment posed challenges with articulating its added value. There appears to be a need for simplified engagement and implementation strategies of the standard that can be tailored to the nuanced differences between types and sizes of industries. It appears that organizations in the most need of improving psychological health and safety may be the least receptive. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Patient Perceptions of Prejudice and Discrimination by Health Care Providers and its Relationship with Mental Disorders: Results from the 2012 Canadian Community Health-Mental Health Survey Data.

    Science.gov (United States)

    Marchand, Kirsten; Palis, Heather; Oviedo-Joekes, Eugenia

    2016-04-01

    Using data from a nationally representative survey, the Canadian Community Health Survey-Mental Health, this secondary analysis aimed to determine the prevalence of perceived prejudice by health care providers (HCPs) and its relationship with mental disorders. Respondents accessing HCPs in the prior year were asked if they experienced HCP prejudice. A hypothesis driven multivariable logistic regression analysis was conducted to determine the relationship between type of mental disorders and HCP prejudice. Among the 3006 respondents, 10.9 % perceived HCP prejudice, 62.4 % of whom reported a mental disorder. The adjusted odds of prejudice was highest for respondents with anxiety (OR 3.12; 95 % CI 1.60, 6.07), concurrent mood or anxiety and substance disorders (OR 3.08; 95 % CI 1.59, 5.95) and co-occurring mood and anxiety disorders (OR 2.89; 95 % CI 1.68, 4.97) compared to respondents without any mental disorders. These findings are timely for informing discussions regarding policies to address HCP prejudice towards people with mental disorders.

  10. Technology assessment and resource allocation for predictive genetic testing: A study of the perspectives of Canadian genetic health care providers

    Directory of Open Access Journals (Sweden)

    Einsiedel Edna

    2009-06-01

    Full Text Available Abstract Background With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. Methods The authors conducted semi-structured interviews with 16 senior lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Results Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Conclusion Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate.

  11. An overview of human biomonitoring of environmental chemicals in the Canadian Health Measures Survey: 2007-2019.

    Science.gov (United States)

    Haines, Douglas A; Saravanabhavan, Gurusankar; Werry, Kate; Khoury, Cheryl

    2017-03-01

    Human biomonitoring (HBM) is used to indicate and quantify exposure by measuring environmental chemicals, their metabolites or reaction products in biological specimens. The biomonitoring component of the Canadian Health Measures Survey (CHMS) is the most comprehensive initiative providing general population HBM data in Canada. The CHMS is an ongoing cross-sectional direct measures survey implemented in 2-year cycles. It provides nationally-representative data on health, nutritional status, environmental exposures, and related risks and protective characteristics. The survey follows a robust planning, design and sampling protocol as well as a comprehensive quality assurance and quality control regime implemented for all aspect of the survey to ensure the validity of the HBM results. HBM blood and urine data are available for CHMS cycles 1 (2007-2009), 2 (2009-2011) and 3 (2012-2013). Field collection has been completed for cycle 4 (2014-2015), with cycle 5 (2016-2017) in progress and cycle 6 planning (2018-2019) being finalized. Biomonitoring results for 279 chemicals are expected over the six cycles of the CHMS (220 in individual blood, urine or hair samples, and 59 in pooled serum samples). The chemicals include metals and trace elements, polychlorinated biphenyls (PCBs), organochlorines, flame retardants, perfluoroalkyl substances, volatile organic compounds (VOCs) and metabolites, environmental phenols, triclocarban, acrylamide, pesticides (e.g., triazines, carbamates, organophosphates, phenoxy, pyrethroids) and/or their metabolites, chlorophenols, polycyclic aromatic hydrocarbon (PAH) metabolites, phthalates and alternate plasticizer metabolites, and tobacco biomarkers. Approximately one half of the chemicals measured in individual blood and urine samples over the first three cycles were detected in more than 60% of samples. CHMS biomonitoring data have been used to establish baseline HBM concentrations in Canadians; inform public health, regulatory risk

  12. The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study.

    Science.gov (United States)

    Effoe, Valery S; Carnethon, Mercedes R; Echouffo-Tcheugui, Justin B; Chen, Haiying; Joseph, Joshua J; Norwood, Arnita F; Bertoni, Alain G

    2017-06-21

    The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person-years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high-sensitivity C-reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74-0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79-1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  13. On the Move to Better Heart Health for African Americans

    Science.gov (United States)

    ... low-fat (1%) milk. ❑ Prepare a heart healthy lunch the night before. Include fruits, vegetables, and small portions of leftovers. ❑ Take a piece of fruit ... broil, or grill instead of frying. • Use a small amount of vegetable oil instead of lard or ... to your lunch. • Add vegetables and beans to soups and casseroles. ■ ...

  14. Omega-3 Index of Canadian adults.

    Science.gov (United States)

    Langlois, Kellie; Ratnayake, Walisundera M N

    2015-11-01

    Cardioprotective properties have been associated with two fatty acids-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The Omega-3 Index indicates the percentage of EPA+DHA in red blood cell fatty acids. Omega-3 Index levels of the Canadian population have not been directly measured. Data for respondents aged 20 to 79 from cycle 3 (2012/2013) of the Canadian Health Measures Survey were used to calculate means and the prevalence of Omega-3 Index coronary heart disease (CHD) risk cut-offs-high (4% or less), moderate (more than 4% to less than 8%), and low (8% or more)-by sociodemographic and lifestyle characteristics, including fish consumption and use of omega-3 supplements. Associations between the Omega-3 Index and CHD-related factors including biomarkers, risk factors, and previous CHD events, were examined in multivariate regression models. The mean Omega-3 Index level of Canadians aged 20 to 79 was 4.5%. Levels were higher for women, older adults, Asians and other non-white Canadians, omega-3 supplement users, and fish consumers; levels were lower for smokers and people who were obese. Fewer than 3% of adults had levels associated with low CHD risk; 43% had levels associated with high risk. No CHD-related factor was associated with the Omega-3 Index when control variables were taken into account. Omega-3 Index levels among Canadian adults were strongly related to age, race, supplement use, fish consumption, smoking status and obesity. Fewer than 3% of adults had Omega-3 Index levels associated with low risk for CHD.

  15. Evaluating the integration of cultural competence skills into health and physical assessment tools: a survey of Canadian schools of nursing.

    Science.gov (United States)

    Chircop, Andrea; Edgecombe, Nancy; Hayward, Kathryn; Ducey-Gilbert, Cherie; Sheppard-Lemoine, Debbie

    2013-04-01

    Currently used audiovisual (AV) teaching tools to teach health and physical assessment reflect a Eurocentric bias using the biomedical model. The purpose of our study was to (a) identify commonly used AV teaching tools of Canadian schools of nursing and (b) evaluate the identified tools. A two-part descriptive quantitative method design was used. First, we surveyed schools of nursing across Canada. Second, the identified AV teaching tools were evaluated for content and modeling of cultural competence. The majority of the schools (67%) used publisher-produced videos associated with a physical assessment textbook. Major findings included minimal demonstration of negotiation with a client around cultural aspects of the interview including the need for an interpreter, modesty, and inclusion of support persons. Identification of culturally specific examples given during the videos was superficial and did not provide students with a comprehensive understanding of necessary culturally competent skills.

  16. A 10-Year Follow-Up of Urinary and Fecal Incontinence among the Oldest Old in the Community: The Canadian Study of Health and Aging

    Science.gov (United States)

    Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar

    2004-01-01

    Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…

  17. Comorbidity between lifetime eating problems and mood and anxiety disorders: results from the Canadian Community Health Survey of Mental Health and Well-being.

    Science.gov (United States)

    Meng, Xiangfei; D'Arcy, Carl

    2015-03-01

    This study was to examine profiles of eating problems (EPs), mood and anxiety disorders and their comorbidities; explore risk patterns for these disorders; and document differences in health service utilization in a national population. Data were from the Canadian Community Health Survey of Mental Health and Well-being. The lifetime prevalence of EPs was 1.70% among Canadians, compared with 13.25% for mood disorder, 11.27% for anxiety disorder and 20.16% for any mood or anxiety disorder. Almost half of those with EPs also suffered with mood or anxiety disorders. A similar pattern in depressive symptoms was found among individuals with major depression and EPs, but individuals with EPs reported fewer symptoms. Factors associated with the comorbidity of EPs and mood and anxiety disorders were identified. Individuals with EPs reported more unmet needs. Patients with EPs should be concomitantly investigated for mood and anxiety disorders, as similar interventions may be effective for both. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  18. Association between lung function in adults and plasma DDT and DDE levels: results from the Canadian Health Measures Survey.

    Science.gov (United States)

    Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

    2015-05-01

    Although DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] has been banned in many countries since the 1970s, it may still pose a risk to human respiratory health. In agriculture, DDT exposures have been associated with asthma and chronic bronchitis. However, little is known about the effect of DDT on lung function. We used data on 1,696 participants 20-79 years of age from the Canadian Health Measures Survey (CHMS) and conducted multiple regression analysis to estimate associations between plasma p,p´-DDT/DDE and lung function. Almost all participants (> 99.0%) had detectable concentrations of plasma p,p´-DDE, but only 10.0% had detectable p,p´-DDT. Participants with detectable p,p´-DDT had significantly lower mean FVC (difference = 311 mL; 95% CI: -492, -130; p = 0.003) and FEV1 (difference = 232 mL; 95% CI: -408, -55; p = 0.015) than those without. A 100-ng/g lipid increase in plasma p,p´-DDE was associated with an 18.8-mL decrease in mean FVC (95% CI: -29, -9) and an 11.8-mL decrease in mean FEV1 (95% CI: -21, -3). Neither exposure was associated with FEV1/FVC ratio or FEF25%-75%. DDT exposures, which may have occurred decades ago, were still detectable among Canadians. Plasma DDT and DDE were negatively associated with lung function parameters. Additional research on the potential effects of DDT use on lung function is warranted.

  19. Canadian Punjabi Sikh men's experiences of lifestyle changes following myocardial infarction: cultural connections.

    Science.gov (United States)

    Galdas, Paul M; Oliffe, John L; Wong, Sabrina T; Ratner, Pamela A; Johnson, Joy L; Kelly, Mary T

    2012-01-01

    To describe how culture underlies Canadian Punjabi Sikh men's experiences of adopting lifestyle changes following myocardial infarction (MI). Qualitative, interpretive design. In-depth, individual interviews were conducted with 27 Canadian Punjabi Sikh men post-MI. Data were analysed using constant comparative methods. Cultural influences were identified in Punjabi Sikh men's descriptions of their experience of adopting lifestyle changes. Actions related to self-care, rehabilitation and lifestyle change post-MI were embedded in collectivist family and community contexts. Three themes, derived from the data, were found to intertwine with these contexts; they related to food consumption, physical exercise and faith and religion. These findings highlight how collectivist ideals influence Canadian Punjabi Sikh men's adoption of lifestyle changes post-MI. The content and processes by which healthcare providers deliver heart health and rehabilitation to Canadian Punjabi Sikh men might be guided, at least in part, by the collectivist cultural practices underpinning our findings.

  20. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    Background Patient-reported health-related quality of life is increasingly used as an outcome measure in clinical trials and as a performance measure to evaluate quality of care. The objective of this study was to assess the psychometric properties of the Danish HeartQoL questionnaire, a core heart...... disease-specific health-related quality of life questionnaire, in implantable cardioverter defibrillator recipients. Design This study involved cross-sectional and test-retest study designs. Method Implantable cardioverter defibrillator recipients in the cross-sectional study completed the Heart......QoL, the Short-Form 36 Health Survey, and the Hospital Anxiety and Depression Scale. The HeartQoL structure, construct-related validity (convergent and discriminative) and reliability (internal consistency) were assessed. HeartQoL reproducibility (test-retest) was assessed in an independent sample of implantable...

  1. Predictors of health-related quality of life in children with chronic heart disease.

    Science.gov (United States)

    Niemitz, Mandy; Gunst, Diana C M; Hövels-Gürich, Hedwig H; Hofbeck, Michael; Kaulitz, Renate; Galm, Christoph; Berger, Felix; Nagdyman, Nicole; Stiller, Brigitte; Borth-Bruhns, Thomas; Konzag, Ines; Balmer, Christian; Goldbeck, Lutz

    2017-10-01

    Chronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease. Patients and methods The Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers. Greater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart-lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R2=0.41; proxy-report: R2=0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child's health-related quality of life. Beyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs.

  2. Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure.

    Science.gov (United States)

    McNaughton, Candace D; Cawthon, Courtney; Kripalani, Sunil; Liu, Dandan; Storrow, Alan B; Roumie, Christianne L

    2015-04-29

    More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 566 (41.0%) were female, and 324 (23.5%) had low health literacy. Median follow-up was 20.7 months (interquartile range 12.8 to 29.6 months), and 403 (29.2%) patients died. Adjusted hazard ratio [aHR] for death among patients with LHL was 1.32 (95%confidence interval [CI] 1.05, 1.66, P=0.02) compared to BHLS>9 [corrected].Within 90 days of discharge, there were 415 (30.1%) rehospitalizations and 201 (14.6%) emergency department visits, with no evident association with health literacy. Lower health literacy was associated with increased risk of death after hospitalization for acute heart failure. There was no evident relationship between health literacy and 90-day rehospitalization or emergency department visits. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  3. [Health literacy in patients with heart failure treated in primary care].

    Science.gov (United States)

    Santesmases-Masana, Rosalia; González-de Paz, Luis; Real, Jordi; Borràs-Santos, Alicia; Sisó-Almirall, Antoni; Navarro-Rubio, Maria Dolors

    2017-01-01

    The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. A multicentre cross-sectional study. 10 Primary care centres from the metropolitan area of Barcelona. Patients diagnosed with heart failure. to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  4. Identification and Progression of Heart Disease Risk Factors in Diabetic Patients from Longitudinal Electronic Health Records

    Directory of Open Access Journals (Sweden)

    Jitendra Jonnagaddala

    2015-01-01

    Full Text Available Heart disease is the leading cause of death worldwide. Therefore, assessing the risk of its occurrence is a crucial step in predicting serious cardiac events. Identifying heart disease risk factors and tracking their progression is a preliminary step in heart disease risk assessment. A large number of studies have reported the use of risk factor data collected prospectively. Electronic health record systems are a great resource of the required risk factor data. Unfortunately, most of the valuable information on risk factor data is buried in the form of unstructured clinical notes in electronic health records. In this study, we present an information extraction system to extract related information on heart disease risk factors from unstructured clinical notes using a hybrid approach. The hybrid approach employs both machine learning and rule-based clinical text mining techniques. The developed system achieved an overall microaveraged F-score of 0.8302.

  5. Promoting heart health: an HBCU collaboration with the Living Heart Foundation and the National Football League Retired Players Association.

    Science.gov (United States)

    Valentine, Peggy; Duren-Winfield, Vanessa; Onsomu, Elijah O; Hoover, Eddie L; Cammock, Cheryl E; Roberts, Arthur

    2012-01-01

    Cardiovascular disease continues to be the leading cause of death in the United States and African Americans are disproportionately affected. Cardiovascular disease risk factors such as obesity, hypertension, family history of heart disease, and physical inactivity are often higher in African American young adults. The aim of the current study was to assess cardiovascular disease risk factors at a historically black college and university (HBCU) in North Carolina. A collaborative partnership was established that included Living Heart Foundation, the NFL Retired Players Association and a HBCU. Ninety-one students (77 females and 14 males) aged 18 to 55 years (mean, 24 y, SD = 9 y) were recruited via dissemination of flyers, brochures, mass e-mailing, and announcements. Demographic and medical history data were collected. Stata version 10.1 was used for all analyses. Fifty-three percent of the participants reported having experienced a chronic health condition, 32% were overweight (body mass index [BMI], 25-29.9 kg/m2) and 31% obese (BMI > or = 30 kg/m2). Five percent of females and 23% of males had high-density lipoprotein cholesterol of 40 mg/dL or less, indicative of a risk for developing heart disease. There is an urgent need to intervene among African American college students and address behavioral risk factors for cardiovascular disease. Such interventions may have a major impact on their overall and future health outcomes. Strategies to be employed need to focus on the integration of culturally appropriate healthy lifestyle programs into the curriculum and university health centers. Consultations with stakeholders for ideas and resources should be encouraged.

  6. Relationship of Health Literacy of Heart Failure Patients and Their Family Members on Heart Failure Knowledge and Self-Care.

    Science.gov (United States)

    Wu, Jia-Rong; Reilly, Carolyn M; Holland, James; Higgins, Melinda; Clark, Patricia C; Dunbar, Sandra B

    2017-02-01

    We explored the relationships among patients' and family members' (FMs) health literacy, heart failure (HF) knowledge, and self-care behaviors using baseline data from HF patients and their FMs ( N = 113 pairs) in a trial of a self-care intervention. Measures included Rapid Estimate of Adult Literacy in Medicine, Atlanta HF Knowledge Test, a heart failure Medication Adherence Scale, and sodium intake (24-hr urine and 3-day food record). Patients with low health literacy (LHL) were more likely to have lower HF knowledge ( p < .001) and trended to poorer medication adherence ( p = .077) and higher sodium intake ( p = .072). When FMs had LHL, FMs were more likely to have lower HF knowledge ( p = .001) and patients trended toward higher sodium intake ( p = .067). When both patients and FMs had LHL, lowest HF knowledge and poorest medication adherence were observed ( p < .027). The health literacy of both patient and FM needs to be considered when designing interventions to foster self-care.

  7. The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

    Science.gov (United States)

    Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

    2000-01-01

    This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

  8. Pregnancy-related Health Behavior of Women with Congenital Heart Disease : Room for Behavioral Change Interventions

    NARCIS (Netherlands)

    Moons, Philip; Budts, Werner; Costermans, Els; Huyghe, Els; Pieper, Petronella G.; Drenthen, Wim

    2009-01-01

    Background. Pregnancy in women with congenital heart disease is associated with maternal and neonatal complications. In order to reduce risks for unfavorable outcomes, pregnant women need to adopt specific health behaviors. We investigated the pregnancy-related health behavior of women with

  9. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California

  10. Thoughts about death and perceived health status in elderly patients with heart failure

    NARCIS (Netherlands)

    Stroemberg, Anna; Jaarsma, Tiny

    Aim: To explore thoughts about death and perceived health status in elderly patients with heart failure during a 6 month period after a deterioration needing hospitalisation. Methods: A descriptive, mixed methods design was used. Health was measured with EuroQol-5D, thoughts about death with

  11. Effects of eHealth physical activity encouragement in adolescents with complex congenital heart disease

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Andersen, Lars L; Søndergaard, Lars

    2016-01-01

    OBJECTIVE: To assess benefit and harms of adding an eHealth intervention to health education and individual counseling in adolescents with congenital heart disease. DESIGN: Randomized clinical trial. SETTING: Denmark. PATIENTS: A total of 158 adolescents aged 13-16years with no physical activity...... restrictions after repaired complex congenital heart disease. INTERVENTIONS: PReVaiL consisted of individually tailored eHealth encouragement physical activity for 52weeks. All patients received 45min of group-based health education and 15min of individual counseling involving patients' parents. OUTCOMES......·kg(-1)·min(-1) (95% CI -2.66 to 1.36). Between-group differences at 1year in physical activity, generic health-related quality of life, and disease-specific quality of life were not statistically significant. CONCLUSIONS: Adding a tailored eHealth intervention to health education and individual...

  12. The fundamental association between mental health and life satisfaction: results from successive waves of a Canadian national survey.

    Science.gov (United States)

    Lombardo, Patrick; Jones, Wayne; Wang, Liangliang; Shen, Xin; Goldner, Elliot M

    2018-03-12

    A self-reported life satisfaction question is routinely used as an indicator of societal well-being. Several studies support that mental illness is an important determinant for life satisfaction and improvement of mental healthcare access therefore could have beneficial effects on a population's life satisfaction. However, only a few studies report the relationship between subjective mental health and life satisfaction. Subjective mental health is a broader concept than the presence or absence of psychopathology. In this study, we examine the strength of the association between a self-reported mental health question and self-reported life satisfaction, taking into account other relevant factors. We conducted this analysis using successive waves of the Canadian Community Health Survey (CCHS) collected between 2003 and 2012. Respondents included more than 400,000 participants aged 12 and over. We extracted information on self-reported mental health, socio-demographic and other factors and examined correlation with self-reported life satisfaction using a proportional ordered logistic regression. Life satisfaction was strongly associated with self-reported mental health, even after simultaneously considering factors such as income, general health, and gender. The poor-self-reported mental health group had a particularly low life satisfaction. In the fair-self-reported mental health category, the odds of having a higher life satisfaction were 2.35 (95% CI 2.21 to 2.50) times higher than the odds in the poor category. In contrast, for the "between 60,000 CAD and 79,999 CAD" household income category, the odds of having a higher life satisfaction were only 1.96 (95% CI 1.90 to 2.01) times higher than the odds in the "less than 19,999 CAD" category. Subjective mental health contributes highly to life satisfaction, being more strongly associated than other selected previously known factors. Future studies could be useful to deepen our understanding of the interplay between

  13. Swimming against the tide: A Canadian qualitative study examining the implementation of a province-wide public health initiative to address health equity.

    Science.gov (United States)

    McPherson, Charmaine; Ndumbe-Eyoh, Sume; Betker, Claire; Oickle, Dianne; Peroff-Johnston, Nancy

    2016-08-19

    Effectively addressing the social determinants of health and health equity are critical yet still-emerging areas of public health practice. This is significant for contemporary practice as the egregious impacts of health inequities on health outcomes continue to be revealed. More public health organizations seek to augment internal organizational capacity to address health equity while the evidence base to inform such leadership is in its infancy. The purpose of this paper is to report on findings of a study examining key factors influencing the development and implementation of the social determinants of health public health nurse (SDH-PHN) role in Ontario, Canada. A descriptive qualitative case study approach examined the first Canadian province-wide initiative to add SDH-PHNs to each public health unit. Data sources were documents and staff from public health units (i.e., SDH-PHNs, Managers, Directors, Chief Nursing Officers, Medical Officers of Health) as well as external stakeholders. Data were collected through 42 individual interviews and 226 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to the SDH-PHN role implementation were identified: (1) 'Swimming against the tide' to lead change as staff navigated ideological tensions, competency development, and novel collaborations; (2) Shifting organizational practice environments impacted by initial role placement and action to structurally embed health equity priorities; and (3) Bridging policy implementation gaps related to local-provincial implementation and reporting expectations. This study extends our understanding of the dynamic interplay among leadership, change management, ideological tensions, and local-provincial public health policy impacting health equity agendas. Given that the social determinants of health lie outside public health, collaboration with communities, health partners and non-health partners is

  14. 76 FR 49707 - Food Labeling; Health Claim; Phytosterols and Risk of Coronary Heart Disease; Reopening of the...

    Science.gov (United States)

    2011-08-11

    ... Risk of Coronary Heart Disease; Reopening of the Comment Period AGENCY: Food and Drug Administration... reconsider its proposed amendments to the phytosterols and risk of coronary heart disease health [[Page 49708... December 8, 2010, proposing to amend regulations on plant sterol/ stanol esters and risk of coronary heart...

  15. Disability in two health care systems: access, quality, satisfaction, and physician contacts among working-age Canadians and Americans with disabilities.

    Science.gov (United States)

    Gulley, Stephen P; Altman, Barbara M

    2008-10-01

    An overarching question in health policy concerns whether the current mix of public and private health coverage in the United States can be, in one way or another, expanded to include all persons as it does in Canada. As typically high-end consumers of health care services, people with disabilities are key stakeholders to consider in this debate. The risk is that ways to cover more persons may be found only by sacrificing the quantity or quality of care on which people with disabilities so frequently depend. Yet, despite the many comparisons made of Canadian and U.S. health care, few focus directly on the needs of people with disabilities or the uninsured among them in the United States. This research is intended to address these gaps. Given this background, we compare the health care experiences of working-age uninsured and insured Americans with Canadian individuals (all of whom, insured) with a special focus on disability. Two questions for research guide our inquiry: (1) On the basis of disability severity level and health insurance status, are there differences in self-reported measures of access, utilization, satisfaction with, or quality of health care services within or between the United States and Canada? (2) After controlling covariates, when examining each level of disability severity, are there any significant differences in these measures of access, utilization, satisfaction, or quality between U.S. insured and Canadian persons? Cross-sectional data from the Joint Canada/United States Survey of Health (JCUSH) are analyzed with particular attention to disability severity level (none, nonsevere, or severe) among three analytic groups of working age residents (insured Americans, uninsured Americans, and Canadians). Differences in three measures of access, one measure of satisfaction with care, one quality of care measure, and two varieties of physician contacts are compared. Multivariate methods are then used to compare the healthcare experiences of

  16. Survey on allied health personnel in Canadian ophthalmology: the scalpel for change.

    Science.gov (United States)

    Astle, William F; El-Defrawy, Sherif; LaRoche, G Robert; Lafontaine, Marc D; Anderson, Lynn D; Dukes, Margaret; Anderson, Inika; Weirens, Nicholas

    2011-02-01

    To determine the recruiting and training needs for ophthalmic medical personnel (OMP), assess the value of their certification, and compare the ophthalmic practice productivity and performance of non-certified and certified OMP, as rated by both ophthalmologists and OMP. Comparative analysis. One hundred and sixteen Canadian ophthalmologists and 98 OMP. An invitation to complete an online survey on OMP recruitment, training, certification, and productivity performance in a clinical setting was sent to 1081 ophthalmologists and OMP. Fifteen percent of ophthalmologists and 31% of OMP completed the survey. Ophthalmologists (61%) reported difficulty hiring OMP; employee referrals was the best method (40%). Awareness of formal OMP training programs was high and 50% of respondents supported developing additional training programs; 55% of OMP were encouraged by their employers to obtain certification. Personal challenge and achievement (79%) and improved skills (71%) were the main reasons for OMP to obtain certification. The majority of OMP and ophthalmologists felt that certified OMP enhanced most practice productivity measures. Higher wages associated with certification were reported by 73% of respondents. Training of qualified OMP was identified as a need by ophthalmologists. Ophthalmic practices can increase their overall productivity by adding certified OMP to their staff.

  17. Tests That Can Help Protect Your Heart Health

    Science.gov (United States)

    ... Red Dress ® , and Red Dress ® are registered trademarks of U.S. Department of Health and Human Services. National Wear Red Day ® is a registered trademark of the U.S. Department of Health and Human ...

  18. Financial outlook for the Canadian gas industry

    International Nuclear Information System (INIS)

    Friedenberg, B.

    1995-01-01

    The financial outlook for the Canadian gas industry depends on the outlook for gas prices at Canadian producing basins, the cost of producing in Canada and the volume of production of Canadian natural gas. Price, cost and volume determine the health of the Canadian industry. Industry's costs are the basis of the supply (volume) offered on the market and price is determined by the interaction of supply and demand. (author)

  19. Positive Affect and Health Behaviors Across 5 Years in Patients With Coronary Heart Disease: The Heart and Soul Study.

    Science.gov (United States)

    Sin, Nancy L; Moskowitz, Judith Tedlie; Whooley, Mary A

    2015-01-01

    Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD). Outpatients with CHD reported positive affect, physical activity, sleep quality, medication adherence, cigarette smoking, and alcohol use at baseline (n = 1022) and 5 years later (n = 662). Covariates in regression analyses included demographics, cardiac disease severity, and depressive symptoms. At baseline, higher positive affect (per 1 standard deviation) was associated with better health behaviors: physical activity (odds ratio [OR] = 1.52, 95% 95% confidence interval [CI] = 1.30-1.77, p positive affect did not predict health behaviors at follow-up, accounting for baseline behaviors. However, increases in positive affect across 5 years co-occurred with improvements in physical activity (B = 0.023, standard error [SE] = 0.008, p = .002), sleep quality (B = 0.011, SE = 0.005, p = .039), and medication adherence (B = 0.014, SE = 0.004, p Positive affect was associated with health behaviors among patients with CHD. Efforts to sustain or enhance positive affect may be promising for promoting better health behaviors.

  20. Not on the radar: the impact of rural health realities on Canadian public policy and HHR migration from Sub-Saharan Africa.

    Science.gov (United States)

    Kazanjian, Arminée; Apland, Lars E; Labonté, Ronald

    2007-01-01

    The policy environment of Health Human Resource (HHR) demands in rural and remote areas of Canada seems to compel health system planners either to ignore or only pay lip service to memoranda of understanding and other non-binding international agreements on ethical principles of recruitment. Despite common acknowledgement that the migration of health professionals from Sub-Saharan Africa (SSA) and the resultant loss of capacity to deliver health services are devastating for populations in that region, Canadian public policy consideration of the "brain drain" of health human resources from SSA seems cursory, at best. As a result, broadly based domestic HHR policies and international development policy objectives invariably seem to conflict and produce unsatisfactory results that continue to be detrimental to populations of source countries in the developing world, while doing little to alleviate the continued reliance of Canada's rural and remote "'gateways" on foreign-trained health professionals. A key challenge for Canadian public policy, at all levels of government, is to coordinate and find common ground, whereby brain drain issues and specific domestic Canadian HHR needs can be simultaneously and effectively addressed. This research explored the congruity between rural HHR policy principles and international development objectives in the context of federal, provincial, and territorial government relations in Canada.

  1. Comorbid Mental Health Symptoms and Heart Diseases: Can Health Care and Mental Health Care Professionals Collaboratively Improve the Assessment and Management?

    Science.gov (United States)

    Ai, Amy L.; Rollman, Bruce L.; Berger, Candyce S.

    2010-01-01

    On the basis of current epidemiological and clinical research, this article describes how mental health symptoms are associated with heart disease, a major chronic condition that occurs primarily in middle and late life. The article describes the culturally and historically important link between heart and mind. It then describes depression and…

  2. Development of key indicators to quantify the health impacts of climate change on Canadians

    OpenAIRE

    Cheng, June J.; Berry, Peter

    2013-01-01

    Objectives This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. Methods A literature review was conducted in OVID Medline to identify health morbidity and mortality indicators currently used to quantify climate change impacts. Public health frameworks and other studies of climate change indicators were reviewed to identify criteria with which to evaluate the list of proposed key indicators and a rating scale was d...

  3. The Availability of MeSH in Vendor-Supplied Cataloguing Records, as Seen Through the Catalogue of a Canadian Academic Health Library

    Directory of Open Access Journals (Sweden)

    Pamela S. Morgan

    2007-09-01

    Full Text Available This study examines the prevalence of medical subject headings in vendor-supplied cataloguing records for publications contained within aggregated databases or publisher collections. In the first phase, the catalogue of one Canadian academic medical library was examined to determine the extent to which medical subject headings (MeSH are available in the vendor-supplied records. In the second phase, these results were compared to the catalogues of other Canadian academic medical libraries in order to reach a generalization regarding the availability of MeSH headings for electronic resources. MeSH was more widespread in records for electronic journals but was noticeably lacking in records for electronic monographs, and for Canadian publications. There is no standard for ensuring MeSH are assigned to monograph records for health titles and there is no library in Canada with responsibility for ensuring that Canadian health publications receive Medical Subject Headings. It is incumbent upon libraries using MeSH to ensure that vendors are aware of this need when purchasing record sets.

  4. A Comprehensive Profile of Health Risk Behaviors Among Students at a Small Canadian University

    Science.gov (United States)

    Taylor, Jennifer P.; McCarthy, Mary Jean; Herbert, Rosemary J.; Smith, Philip B.

    2009-01-01

    Despite recent attention to health promotion and illness prevention, young people continue to engage in a variety of risk behaviors, which may negatively influence current and future health status. The purpose of this study was to create a comprehensive profile of health risk behaviors among undergraduate students at the University of Prince…

  5. Urinary Dialkyl Phosphate Concentrations and Lung Function Parameters in Adolescents and Adults: Results from the Canadian Health Measures Survey.

    Science.gov (United States)

    Ye, Ming; Beach, Jeremy; Martin, Jonathan W; Senthilselvan, Ambikaipakan

    2016-04-01

    Epidemiological studies have reported associations between lung function parameters and organophosphate (OP) pesticide exposures in agricultural occupations, but to our knowledge associations have not been evaluated in general populations. We examined associations between OP metabolite dialkyl phosphates (DAPs) and lung function using data from the Canadian Health Measures Survey (CHMS) Cycle 1. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1/FVC ratio, and forced expiratory flow between 25% and 75% of FVC (FEF25%-75%) were measured for 4,446 CHMS participants. Urinary concentrations of six DAP metabolites (DMP, DMTP, DMDTP, DEP, DETP, and DEDTP), smoking status, and other predictors of lung function were also measured in the CHMS-Cycle 1. Multiple linear regression analyses were used to examine the relationship between total DAP concentrations (ΣDAPs) and lung function in adolescents (12-19 years) and adults (20-79 years). In adults, estimates from multiple regression analyses suggested that a 1-unit increase on natural logarithmic scale (171% increase on the original scale) in the creatinine-corrected urinary concentration (nanomoles per gram creatinine) of ΣDAP was associated with a 32.6-mL (95% CI: -57.2, -8.1) reduction in FVC, 32.6-mL (95% CI: -59.0, -6.3) reduction in FEV1, 0.2% (95% CI: -0.6, 0.2) reduction in FEV1/FVC ratio, and 53.1-mL/sec (95% CI: -113.9, 7.7) reduction in FEF25%-75%. In adolescents, associations between ΣDAP and FEV1 were closer to the null and positive for FVC, whereas associations with FEV1/FVC and FEF25%-75% were negative, as in adults. However, none of the associations were significant in adolescents. The negative association between ΣDAP and lung function in adult participants suggests a detrimental effect of OP pesticides on lung function in the adult general population. Further studies using prospective designs are warranted to confirm the findings reported in this study. Ye M, Beach J, Martin JW

  6. Application of HEART technique in health care system and accuracy of its results

    Directory of Open Access Journals (Sweden)

    Mohammad Beiruti

    2016-12-01

    Full Text Available Introduction: Human error is considered as a crucial challenge in occupational settings. Health care system is amongst occupational environments with high rate of human errors. Numerous preceding studies noted that more than 2/3 of medical errors are preventable. Accordingly, different methods are suggested to evaluate human errors, especially in nuclear industries. The aim of this study was to evaluate the application and accuracy of HEART technique in medical health system. Material and Method:  This qualitative study was conducted in surgical intensive care units of a hospital in Shiraz city. All nurses recorded errors were categorized regarding the given tasks and then all tasks were ranked based on the number of errors. The probability of nurses’ tasks error was estimated through AHP-HEART method and the resultant ranking was compared with the recorded errors. Additionally, the prioritization of contributing factors to errors, determined by AHP and AHP-HEART methods, was compared employing Pearson statistical test. Results: Based on the results, there was a concordance in the rate of nurses’ error determined by HEART method and the recorded errors. However, no significant correlation was between errors contributing factors determined by AHP and AHP-HEART methods. Conclusion: This study suggested that although HEART technique was successful to rank the tasks considering the magnitude of error probability, but the coefficients of error producing conditions should be customized for nurses’ tasks in order to provide appropriate control measures.

  7. 'Race' matters: racialization and egalitarian discourses involving Aboriginal people in the Canadian health care context.

    Science.gov (United States)

    Tang, Sannie Y; Browne, Annette J

    2008-04-01

    The major purpose of this paper is to examine how 'race' and racialization operate in health care. To do so, we draw upon data from an ethnographic study that examines the complex issues surrounding health care access for Aboriginal people in an urban center in Canada. In our analysis, we strategically locate our critical examination of racialization in the 'tension of difference' between two emerging themes, namely the health care rhetoric of 'treating everyone the same,' and the perception among many Aboriginal patients that they were 'being treated differently' by health care providers because of their identity as Aboriginal people, and because of their low socio-economic status. Contrary to the prevailing discourse of egalitarianism that paints health care and other major institutions as discrimination-free, we argue that 'race' matters in health care as it intersects with other social categories including class, substance use, and history to organize inequitable access to health and health care for marginalized populations. Specifically, we illustrate how the ideological process of racialization can shape the ways that health care providers 'read' and interact with Aboriginal patients, and how some Aboriginal patients avoid seeking health care based on their expectation of being treated differently. We conclude by urging those of us in positions of influence in health care, including doctors and nurses, to critically reflect upon our own positionality and how we might be complicit in perpetuating social inequities by avoiding a critical discussion of racialization.

  8. The vascular health status of a population of adult Canadian Indigenous peoples from British Columbia.

    Science.gov (United States)

    Foulds, H J A; Bredin, S S D; Warburton, D E R

    2016-04-01

    Indigenous populations currently experience greater cardiovascular disease burdens. However, subclinical vascular structure and function among these populations is not well known. This investigation evaluated vascular structure and function among Canadian Indigenous populations. Blood pressure, body composition, pulse-wave velocity (PWV), baroreceptor sensitivity (BRS), arterial compliance and intima-media thickness (IMT) were measured. Vascular measures were evaluated across sexes and age groups. Vascular assessments were conducted among 55 Indigenous adults (38±18 years, 29 Female), including both First Nations (N=36) and Métis (N=19) individuals. Some differences in vascular measures were found between males and females, respectively (spectral BRS: 9.6±6.8 ms mm Hg(-1) vs 16.9±10.0 ms mm Hg(-1), P=0.01; small arterial compliance: 8.9±3.7 ml mm Hg(-1) × 100 vs 6.4±2.3 ml mm Hg(-1) × 100, P=0.004), with similar measures of overall IMT (0.61±0.14 mm vs 0.57±0.08 mm, P=0.19) and central PWV (5.7±2.5 m s(-1) vs 5.1±2.3 m s(-1), P=0.58). Greater IMT, and lower BRS and arterial compliance were identified among older adults. This relatively healthy population demonstrated healthy vascular measures, with poorer measures among older individuals.

  9. A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

    Science.gov (United States)

    Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

    2012-07-01

    To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

  10. Effect of multidisciplinary disease management for hospitalized heart failure under a national health insurance programme.

    Science.gov (United States)

    Mao, Chun-Tai; Liu, Min-Hui; Hsu, Kuang-Hung; Fu, Tieh-Cheng; Wang, Jong-Shyan; Huang, Yu-Yen; Yang, Ning-I; Wang, Chao-Hung

    2015-09-01

    Multidisciplinary disease management programmes (MDPs) for heart failure have been shown to be effective in Western countries. However, it is not known whether they improve outcomes in a high population density country with a national health insurance programme. In total, 349 patients hospitalized because of heart failure were randomized into control and MDP groups. All-cause death and re-hospitalization related to heart failure were analyzed. The median follow-up period was approximately 2 years. Mean patient age was 60 years; 31% were women; and 50% of patients had coronary artery disease. MDP was associated with fewer all-cause deaths [hazard ratio (HR) = 0.49, 95% confidence interval (CI) = 0.27-0.91, P = 0.02] and heart failure-related re-hospitalizations (HR = 0.44, 95% CI = 0.25-0.77, P = 0.004). MDP was still associated with better outcomes for all-cause death (HR = 0.53, 95% CI = 0.29-0.98, P = 0.04) and heart failure-related re-hospitalization (HR = 0.46, 95% CI = 0.26-0.81, P = 0.007), after adjusting for age, diuretics, diabetes mellitus, chronic kidney disease, hypertension, sodium, and albumin. However, MDPs' effect on all-cause mortality and heart failure-related re-hospitalization was significantly attenuated after adjusting for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers or β-blockers. A stratified analysis showed that MDP combined with guideline-based medication had synergistic effects. MDP is effective in lowering all-cause mortality and re-hospitalization rates related to heart failure under a national health insurance programme. MDP synergistically improves the effectiveness of guidelines-based medications for heart failure.

  11. Health Literacy and Health Outcomes in Very Old Patients With Heart Failure.

    Science.gov (United States)

    León-González, Rocío; García-Esquinas, Esther; Paredes-Galán, Emilio; Ferrero-Martínez, Ana Isabel; González-Guerrero, José Luis; Hornillos-Calvo, Mercedes; Menéndez-Colino, Rocío; Torres-Torres, Ivett; Galán, María Concepción; Torrente-Carballido, Marta; Olcoz-Chiva, Mayte; Rodríguez-Pascual, Carlos; Rodríguez-Artalejo, Fernando

    2018-03-01

    Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level. This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain. About 74% of patients had less than primary education and 71% had preserved systolic function. Health literacy was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults questionnaire, knowledge of HF with the DeWalt questionnaire, and HF self-care with the European Heart Failure Self-Care Behaviour Scale. Disease knowledge progressively increased with HL; compared with being in the lowest (worse) tertile of HL, the multivariable beta coefficient (95%CI) of the HF knowledge score was 0.60 (0.01-1.19) in the second tertile and 0.87 (0.24-1.50) in the highest tertile, P-trend = .008. However, no association was found between HL and HF self-care. During the 12 months of follow-up, there were 189 deaths. Compared with being in the lowest tertile of HL, the multivariable HR (95%CI) of mortality was 0.84 (0.56-1.27) in the second tertile and 0.99 (0.65-1.51) in the highest tertile, P-trend = .969. No association was found between HL and 12-month mortality. This could be partly due to the lack of a link between HL and self-care. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Healthy hearts--and the universal benefits of being physically active: physical activity and health.

    Science.gov (United States)

    Blair, Steven N; Morris, Jeremy N

    2009-04-01

    Although ancient thinkers suggested that physical activity is good for health, systematic research on the topic did not begin until the middle of the 20th century. Early reports showed that individuals in active occupations had lower rates of heart disease than individuals in sedentary occupations. Investigators then began to evaluate leisure-time physical activity and health and found similar results. Later research used objective measures of cardiorespiratory fitness as the exposure, and found even stronger associations with health outcomes. Recent research has extended the earlier findings on activity or fitness and heart disease to a wide variety of health outcomes. We now know that regular physical activity of 150 minutes/week of moderate intensity physical activity reduces the risk of numerous chronic diseases, preserves health and function (both physical and mental) into old age, and extends longevity. The current challenge is to develop programs and interventions to promote physical activity for all in our increasingly sedentary societies.

  13. Association between Organizational Capacity and Involvement in Chronic Disease Prevention Programming among Canadian Public Health Organizations

    Science.gov (United States)

    Hanusaik, Nancy; Sabiston, Catherine M.; Kishchuk, Natalie; Maximova, Katerina; O'Loughlin, Jennifer

    2015-01-01

    In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement…

  14. Relation of Perceived Health Competence to Physical Activity in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bachmann, Justin M; Mayberry, Lindsay S; Wallston, Kenneth A; Huang, Shi; Roumie, Christianne L; Muñoz, Daniel; Patel, Niral J; Kripalani, Sunil

    2018-05-01

    Physical inactivity is highly associated with mortality, especially in patients with coronary heart disease. We evaluated the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on cumulative physical activity levels in the Mid-South Coronary Heart Disease Cohort Study. The Mid-South Coronary Heart Disease Cohort Study consists of 2,587 outpatients (32% were female) with coronary heart disease at an academic medical center network in the United States. Cumulative physical activity was quantified in metabolic equivalent (MET)-minutes per week with the International Physical Activity Questionnaire. We investigated associations between the 2-item Perceived Health Competence Scale (PHCS-2) and MET-minutes/week after adjusting for co-morbidities and psychosocial factors with linear regression. Nearly half of participants (47%) exhibited low physical activity levels (Perceived health competence was highly associated with physical activity after multivariable adjustment. A nonlinear relation was observed, with the strongest effect on physical activity occurring at lower levels of perceived health competence. There was effect modification by gender (p = 0.03 for interaction). The relation between perceived health competence and physical activity was stronger in women compared with men; an increase in the PHCS-2 from 3 to 4 was associated with a 73% increase in MET-minutes/week in women (95% confidence interval 43% to 109%, p perceived health competence was strongly associated with less physical activity in patients with coronary heart disease and may represent a potential target for behavioral interventions. Published by Elsevier Inc.

  15. Social support, social conflict, and immigrant women's mental health in a Canadian context: a scoping review.

    Science.gov (United States)

    Guruge, S; Thomson, M S; George, U; Chaze, F

    2015-11-01

    Social support has positive and negative dimensions, each of which has been associated with mental health outcomes. Social networks can also serve as sources of distress and conflict. This paper reviews journal articles published during the last 24 years to provide a consolidated summary of the role of social support and social conflict on immigrant women's mental health. The review reveals that social support can help immigrant women adjust to the new country, prevent depression and psychological distress, and access care and services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health. It is crucial that interventions, programmes, and services incorporate strategies to both enhance social support as well as reduce social conflict, in order to improve mental health and well-being of immigrant women. Researchers have documented the protective role of social support and the harmful consequences of social conflict on physical and mental health. However, consolidated information about social support, social conflict, and mental health of immigrant women in Canada is not available. This scoping review examined literature from the last 24 years to understand how social support and social conflict affect the mental health of immigrant women in Canada. We searched MEDLINE, PsycINFO, CINAHL, Healthstar, and EMBASE for peer-reviewed publications focusing on mental health among immigrant women in Canada. Thirty-four articles that met our inclusion criteria were reviewed, and are summarized under the following four headings: settlement challenges and the need for social support; social support and mental health outcomes; social conflict and reciprocity; and social support, social conflict, and mental health service use. The results revealed that social support can have a positive effect on immigrant women's mental health and well-being, and facilitate social inclusion and the use of

  16. The Canadian Urban Environmental Health Research Consortium - a protocol for building a national environmental exposure data platform for integrated analyses of urban form and health.

    Science.gov (United States)

    Brook, Jeffrey R; Setton, Eleanor M; Seed, Evan; Shooshtari, Mahdi; Doiron, Dany

    2018-01-08

    Multiple external environmental exposures related to residential location and urban form including, air pollutants, noise, greenness, and walkability have been linked to health impacts or benefits. The Canadian Urban Environmental Health Research Consortium (CANUE) was established to facilitate the linkage of extensive geospatial exposure data to existing Canadian cohorts and administrative health data holdings. We hypothesize that this linkage will enable investigators to test a variety of their own hypotheses related to the interdependent associations of built environment features with diverse health outcomes encompassed by the cohorts and administrative data. We developed a protocol for compiling measures of built environment features that quantify exposure; vary spatially on the urban and suburban scale; and can be modified through changes in policy or individual behaviour to benefit health. These measures fall into six domains: air quality, noise, greenness, weather/climate, and transportation and neighbourhood factors; and will be indexed to six-digit postal codes to facilitate merging with health databases. Initial efforts focus on existing data and include estimates of air pollutants, greenness, temperature extremes, and neighbourhood walkability and socioeconomic characteristics. Key gaps will be addressed for noise exposure, with a new national model being developed, and for transportation-related exposures, with detailed estimates of truck volumes and diesel emissions now underway in selected cities. Improvements to existing exposure estimates are planned, primarily by increasing temporal and/or spatial resolution given new satellite-based sensors and more detailed national air quality modelling. Novel metrics are also planned for walkability and food environments, green space access and function and life-long climate-related exposures based on local climate zones. Critical challenges exist, for example, the quantity and quality of input data to many of

  17. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  18. The Canadian minimum dataset for chronic low back pain research: a cross-cultural adaptation of the National Institutes of Health Task Force Research Standards.

    Science.gov (United States)

    Lacasse, Anaïs; Roy, Jean-Sébastien; Parent, Alexandre J; Noushi, Nioushah; Odenigbo, Chúk; Pagé, Gabrielle; Beaudet, Nicolas; Choinière, Manon; Stone, Laura S; Ware, Mark A

    2017-01-01

    To better standardize clinical and epidemiological studies about the prevalence, risk factors, prognosis, impact and treatment of chronic low back pain, a minimum data set was developed by the National Institutes of Health (NIH) Task Force on Research Standards for Chronic Low Back Pain. The aim of the present study was to develop a culturally adapted questionnaire that could be used for chronic low back pain research among French-speaking populations in Canada. The adaptation of the French Canadian version of the minimum data set was achieved according to guidelines for the cross-cultural adaptation of self-reported measures (double forward-backward translation, expert committee, pretest among 35 patients with pain in the low back region). Minor cultural adaptations were also incorporated into the English version by the expert committee (e.g., items about race/ethnicity, education level). This cross-cultural adaptation provides an equivalent French-Canadian version of the minimal data set questionnaire and a culturally adapted English-Canadian version. Modifications made to the original NIH minimum data set were minimized to facilitate comparison between the Canadian and American versions. The present study is a first step toward the use of a culturally adapted instrument for phenotyping French- and English-speaking low back pain patients in Canada. Clinicians and researchers will recognize the importance of this standardized tool and are encouraged to incorporate it into future research studies on chronic low back pain.

  19. Canadian Medicare: prognosis guarded.

    Science.gov (United States)

    Naylor, C D; Fooks, C; Williams, J I

    1995-08-01

    Beset by unprecedented fiscal pressures, Canadian medicare has reached a crossroads. The authors review the impact of recent cuts in federal transfer payments on provincial health care programs and offer seven suggestions to policymakers trying to accommodate these reductions. (1) Go slowly: public health care spending is no longer rising and few provinces have the necessary systems in place to manage major reductions. (2) Target reductions, rewarding quality and efficiency instead of making across-the-board cuts. (3) Replace blame with praise:give health care professionals and institutions credit for their contributions. (4) Learn from the successful programs and policies already in place across the country. (5) Foster horizontal and vertical integration of services. (6) Promote physician leadership by rewarding efforts to promote the efficient use of resources. (7) Monitor the effects of cutbacks: physician groups should cooperate with government in maintaining a national "report card" on services, costs and the health status of Canadians.

  20. Shock from heart device often triggers further health care needs

    Science.gov (United States)

    ... Branding Guidelines Copyright Permissions Embargo/Recording Policies Linking Policy Public Service Announcements Resources About Us Consumer Health Care AHA/ASA Watch and Learn Medical Illustration Library (copyrighted materials for viewing only - may be licensed ...

  1. Are Indigenous Determinants of Health Associated with Self-Reported Health Professional-Diagnosed Anxiety Disorders Among Canadian First Nations Adults?: Findings from the 2012 Aboriginal Peoples Survey.

    Science.gov (United States)

    Nasreen, Sharifa; Brar, Ramanpreet; Brar, Samanpreet; Maltby, Alana; Wilk, Piotr

    2018-05-01

    We estimated the prevalence of self-reported health professional-diagnosed anxiety disorders among Canadian First Nations adults living off-reserve, and assessed the relationship between anxiety disorders and Indigenous determinants of health (Status Indian, residential school attendance, knowledge of Indigenous language, and participation in traditional activities) using the 2012 Aboriginal Peoples Survey. Multivariable logistic regression models were performed using bootstrap weights. The prevalence of anxiety disorders was 14.5% among off-reserve First Nations adults. There was an increased odds of anxiety disorders among those participating in traditional activities compared to their counterparts (aOR 1.46, 95% CI 1.12-1.90). No association was found between anxiety disorders and other Indigenous determinants of health. There is a high prevalence of self-reported anxiety among First Nations adults living off-reserve. However, further studies are warranted to identify and assess the role of Indigenous determinants of health for anxiety disorders and other prevalent mental health conditions in this population.

  2. Newspaper portrayals of health and illness among Canadian seniors : Who ages healthily and at what cost?

    Directory of Open Access Journals (Sweden)

    Julia Rozanova

    2006-12-01

    Full Text Available While media representations of health and illness receive growing atten-tion from researchers, few studies have considered the newspaper por-trayals of health and illness among the elderly. Yet, print media are one vehicle through which governments, in a climate of concern about population aging and the sustainability of the social safety net, empha-size individual responsibility for health and well-being in later life. By praising healthy aging, the media may, perhaps inadvertently, perpetu-ate new ageist stereotypes that marginalize vulnerable adults who fail to age healthily, and downplay the role of social institutions and structural inequalities (particularly gender and socio-economic status in influenc-ing individuals’ personal resources and lifestyle choices. This paper explores whether, and if so, how the media represent interrelations between health and aging, through thematic analysis of a pool of articles about seniors published in The Globe and Mail in 2005.

  3. Self-rated health in Canadian immigrants: analysis of the Longitudinal Survey of Immigrants to Canada.

    Science.gov (United States)

    Setia, Maninder Singh; Lynch, John; Abrahamowicz, Michal; Tousignant, Pierre; Quesnel-Vallee, Amelie

    2011-03-01

    Using a multi-level random effects logistic model, we examine the contribution of source country, individual characteristics and post-migration experiences to the self-rated health (SRH) of 2468 male and 2614 female immigrants from the Longitudinal Survey of Immigrants to Canada (2001-2005). Sex/gender differences were found for all categories of health determinants. Source country characteristics explained away some ethnic differentials in health and had independent negative effects, particularly among women. Thus, women from countries lower on the development index appear at greater risk of poor SRH, and should be at the forefront of public health programmes aimed at new immigrants in Canada. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Canadian Medicare: prognosis guarded.

    OpenAIRE

    Naylor, C D; Fooks, C; Williams, J I

    1995-01-01

    Beset by unprecedented fiscal pressures, Canadian medicare has reached a crossroads. The authors review the impact of recent cuts in federal transfer payments on provincial health care programs and offer seven suggestions to policymakers trying to accommodate these reductions. (1) Go slowly: public health care spending is no longer rising and few provinces have the necessary systems in place to manage major reductions. (2) Target reductions, rewarding quality and efficiency instead of making ...

  5. Development of key indicators to quantify the health impacts of climate change on Canadians.

    Science.gov (United States)

    Cheng, June J; Berry, Peter

    2013-10-01

    This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. A literature review was conducted in OVID Medline to identify health morbidity and mortality indicators currently used to quantify climate change impacts. Public health frameworks and other studies of climate change indicators were reviewed to identify criteria with which to evaluate the list of proposed key indicators and a rating scale was developed. Total scores for each indicator were calculated based on the rating scale. A total of 77 health indicators were identified from the literature. After evaluation using the chosen criteria, 8 indicators were identified as the best for use. They include excess daily all-cause mortality due to heat, premature deaths due to air pollution (ozone and particulate matter 2.5), preventable deaths from climate change, disability-adjusted life years lost from climate change, daily all-cause mortality, daily non-accidental mortality, West Nile Disease incidence, and Lyme borreliosis incidence. There is need for further data and research related to health effect quantification in the area of climate change.

  6. Feasibility and utility of mapping disease risk at the neighbourhood level within a Canadian public health unit: an ecological study

    Directory of Open Access Journals (Sweden)

    Wanigaratne Susitha

    2010-05-01

    Full Text Available Abstract Background We conducted spatial analyses to determine the geographic variation of cancer at the neighbourhood level (dissemination areas or DAs within the area of a single Ontario public health unit, Wellington-Dufferin-Guelph, covering a population of 238,326 inhabitants. Cancer incidence data between 1999 and 2003 were obtained from the Ontario Cancer Registry and were geocoded down to the level of DA using the enhanced Postal Code Conversion File. The 2001 Census of Canada provided information on the size and age-sex structure of the population at the DA level, in addition to information about selected census covariates, such as average neighbourhood income. Results Age standardized incidence ratios for cancer and the prevalence of census covariates were calculated for each of 331 dissemination areas in Wellington-Dufferin-Guelph. The standardized incidence ratios (SIR for cancer varied dramatically across the dissemination areas. However, application of the Moran's I statistic, a popular index of spatial autocorrelation, suggested significant spatial patterns for only two cancers, lung and prostate, both in males (p Conclusion This paper demonstrates the feasibility and utility of a systematic approach to identifying neighbourhoods, within the area served by a public health unit, that have significantly higher risks of cancer. This exploratory, ecologic study suggests several hypotheses for these spatial patterns that warrant further investigations. To the best of our knowledge, this is the first Canadian study published in the peer-reviewed literature estimating the risk of relatively rare public health outcomes at a very small areal level, namely dissemination areas.

  7. Patterns of Alcohol Use Among Canadian Military Personnel and Their Associations With Health and Well-Being.

    Science.gov (United States)

    Richer, Isabelle; Lee, Jennifer E C; Born, Jennifer

    2016-04-07

    Heavy drinking increases the risk of injury, adverse physical and mental health outcomes, and loss of productivity. Nonetheless, patterns of alcohol use and related symptomatology among military personnel remain poorly understood. A latent class analysis (LCA) was used to explore the presence of subgroups of alcohol users among Canadian Armed Forces (CAF) Regular Forces members. Correlates of empirically derived subgroups were further explored. Analyses were performed on a subsample of alcohol users who participated in a 2008/09 cross-sectional survey of a stratified random sample of currently serving CAF Regular Force members (N = 1980). Multinomial logistic regression models were conducted to verify physical and mental health differences across subgroups of alcohol users. All analyses were adjusted for complex survey design. A 4-class solution was considered the best fit for the data. Subgroups were labeled as follows: Class 1 - Infrequent drinkers (27.2%); Class 2 - Moderate drinkers (41.5%); Class 3 - Regular binge drinkers with minimal problems (14.8%); and Class 4 - Problem drinkers (16.6%). Significant differences by age, sex, marital status, element, rank, recent serious injuries, chronic conditions, psychological distress, posttraumatic stress disorder, and depression symptoms were found across the subgroups. Problem drinkers demonstrated the most degraded physical and mental health. Findings highlight the heterogeneity of alcohol users and heavy drinkers among CAF members and the need for tailored interventions addressing high-risk alcohol use. Results have the potential to inform prevention strategies and screening efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Keep Baby’s Heart Healthy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-02-04

    Congenital heart defects are the most common type of birth defect in the U.S. This podcast discusses the importance of pregnant women talking with their health care providers about ways to increase chances of having a healthy baby.  Created: 2/4/2016 by MMWR.   Date Released: 2/4/2016.

  9. Health-related quality of life and anemia in hospitalized patients with heart failure

    NARCIS (Netherlands)

    Kraai, I. H.; Luttik, M. L. A.; Johansson, P.; De Jong, R. M.; Van Veldhuisen, D. J.; Hillege, H. L.; Jaarsma, T.

    2012-01-01

    Background: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. Methods: Baseline data from

  10. Foundations for Health Promotion with Youth: A Review of Observations from the Bogalusa Heart Study.

    Science.gov (United States)

    Nicklas, Theresa; And Others

    1995-01-01

    Presents findings from the Bogalusa Heart Study that describe the early natural history of coronary artery disease and hypertensive cardiovascular disease, noting the benefits of early, regular, comprehensive school health education. A discussion of cholesterol, hypertension, diabetes, obesity, smoking, oral contraception, drinking, and diet…

  11. Health-related quality of life and anemia in hospitalized patients with heart failure

    NARCIS (Netherlands)

    Kraai, Imke H.; Luttik, Marie Louise; Johansson, P.; van Veldhuisen, Dirk J.; Hillege, Hans L.; de Jong, Remco; Jaarsma, Tiny

    2012-01-01

    BACKGROUND: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. METHODS: Baseline data from

  12. Take the Pressure off Your Heart (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-06-02

    Heart disease and stroke are leading causes of death in the U.S. High blood pressure, or hypertension, can lead to both. In this podcast, Dr. Fleetwood Loustalot discusses the health consequences of hypertension.  Created: 6/2/2016 by MMWR.   Date Released: 6/2/2016.

  13. Mental Health Problems in Parents of Children with Congenital Heart Disease

    NARCIS (Netherlands)

    Kolaitis, Gerasimos A.; Meentken, Maya G.; Utens, Elisabeth M. W. J.

    2017-01-01

    This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with

  14. The Canadian health system and its financing El sistema de salud del Canadá y su financiamiento

    Directory of Open Access Journals (Sweden)

    Francisco Xavier Solórzano

    1997-07-01

    Full Text Available This work stems from a brief visit in 1993 to the Canadian health services as part of the PAHO International Health Training Program and the subsequent research, discussion, and analysis relating to that experience. By no means is this paper an exhaustive account of the system, but rather a close look at one of its aspects: financing. The main objective is to identify some of the virtues and limitations of a health system that is considered one of the most efficient, effective, and equitable in the world. Although the Canadian health system is financed by the federal government and the provincial governments, cost containment is a constant concern, since factors such as the growing use of highly complex technologies, hospital care, and long-term treatment of chronic and degenerative illnesses tend to increase costs. The progressive reduction in the federal budget has led to more efficient use of resources and the rationalization of installed capacity. At the same time, the relative simplicity of the system’s operation has permitted administrative costs to be kept low. In addition, alternative forms of care, such as local centers for community-based care, care at home and in special institutions to promote the maximum level of self-sufficiency, and the use of volunteers, have been devised in order to partially control cost increases. The people’s participation in planning and decision-making permit them to guide the development of the health services. Nevertheless, given the current situation, it is essential that the system be modified to prepare it for the challenges the twenty-first century will bring.El presente trabajo es el fruto de una breve visita realizada en 1993 a los servicios de salud de Canadá como parte del Programa de Formación en Salud Internacional de la OPS, y de un subsiguiente ejercicio de investigación, discusión y análisis. No pretende en modo alguno ser exhaustivo, sino más bien aproximarse a uno de los aspectos

  15. El sistema de salud del Canadá y su financiamiento The Canadian health system and its financing

    Directory of Open Access Journals (Sweden)

    Francisco Xavier Solórzano

    1997-03-01

    Full Text Available El presente trabajo es el fruto de una breve visita realizada en 1993 a los servicios de salud de Canadá como parte del Programa de Formación en Salud Internacional de la OPS, y de un subsiguiente ejercicio de investigación, discusión y análisis. No pretende en modo alguno ser exhaustivo, sino más bien aproximarse a uno de los aspectos relevantes del sistema: su financiamiento. El objetivo central es identificar algunas de las virtudes y limitaciones de un sistema de salud que se considera de los más eficientes, efectivos y equitativos del mundo. A pesar de que el gobierno federal y los gobiernos provinciales financian el sistema de salud canadiense, la contención de costos es una preocupación constante, ya que factores como el uso creciente de tecnologías de alta complejidad, la atención hospitalaria y el tratamiento prolongado de las enfermedades crónicas y degenerativas contribuyen a aumentar los costos. La progresiva reducción del presupuesto federal ha llevado a un uso más eficiente de los recursos y a la racionalización de la capacidad instalada. Asimismo, la relativa sencillez con que funciona el sistema ha permitido mantener bajos los costos administrativos. Además, se han ideado otras formas de atención, como los centros locales de atención comunitaria, la atención domiciliaria y en asilos para promover la autosuficiencia en la medida de lo posible, y el uso de personal voluntario, para controlar parcialmente el incremento de los costos. La participación de la población en la planificación de los servicios de salud y en la toma de decisiones le permite orientar su desarrollo. Dada la situación actual, resulta imprescindible, sin embargo, modificar el sistema para adecuarlo a los desafíos planteados por el siglo XXI.This work stems from a brief visit in 1993 to the Canadian health services as part of the PAHO International Health Training Program and the subsequent research, discussion, and analysis relating to

  16. Association Between Internet Use and Body Dissatisfaction Among Young Females: Cross-Sectional Analysis of the Canadian Community Health Survey.

    Science.gov (United States)

    Carter, Allison; Forrest, Jamie I; Kaida, Angela

    2017-02-09

    Recent research suggests Internet exposure, including Facebook use, is positively correlated with body dissatisfaction, especially among girls and young women. Canada has one of the highest Internet access rates in the world, yet no previous study has examined this relationship using nationally representative data. Our objective was to evaluate the relationship between Internet use and body dissatisfaction among a national, population-based sample of Canadian females 12-29 years of age. We used cross-sectional data from the Canadian Community Health Survey 2011-2012. Body dissatisfaction was measured using a 5-point Likert scale and defined as "very dissatisfied/dissatisfied" with one's body. The explanatory variable was time spent using the Internet per week in the past 3 months, ranging from none/20 hours. We used multinomial logistic regression to investigate whether greater Internet use was associated with increasing odds of being very dissatisfied/dissatisfied, neutral, or satisfied with one's body, using very satisfied as the referent. Probability survey sampling weights were applied to all analyses. Of 2983 included participants, sampled to represent 940,786 young Canadian females, most were 20-29 years old (61.98%) and living in households with an annual income Can $80,000 or more (44.61%). The prevalence of body dissatisfaction was 14.70%, and 25- to 29-year-olds were more likely than 12- to 14-year-olds to be very dissatisfied or dissatisfied with their body (20.76% vs 6.34%). Few (5.01%) reported none/Internet use, over half (56.93%) reported 1-10 hours, and one-fifth (19.52%) reported spending >20 hours online per week. Adjusting for age and income, the odds of being very dissatisfied/dissatisfied, relative to very satisfied, were greater in the highest versus lowest Internet use group (adjusted odds ratio [AOR] 3.03, 95% CI 1.19-7.70). The AORs for this level of body dissatisfaction increased across increasing levels of Internet use, ranging from 0

  17. Tapping into the Power of Twitter: A Look at Its Potential in Canadian Health Libraries

    Directory of Open Access Journals (Sweden)

    David C. Waddell

    2012-12-01

    Full Text Available In health libraries, it is becoming increasingly important to recognize and understand user interactions and expectations. Research suggests that more and more patients will begin to rely on online resources to receive health information. In response, many health organizations have turned to social media and micro-blogging services to try and meet those needs. The ease of posting and sharing information on Twiter makes it an essential tool for health libraries use to reach their users. However, libraries that lack systematic metrics for measuring success can find themselves pouring precious resources into social media upkeep without knowing if they are promoting their strategic vision. This paper first uses a literature review to summarize the best practices among Twitter researchers. The authors then measure the success of these practices among several health libraries using simple metrics for evaluation. By advocating accountable Twitter use, the authors hope to promote a goal-oriented social media strategy that ensures health libraries are maximizing their efficiency. Administrators and libraries can engage communities through active Twitter use by going well beyond just promoting their services. Through better Twitter use, libraries can show users that they listen to other organizations in the community, hear and respond to the questions and concerns of individual users, and send people links to information that go beyond the reach of their own website. Administrators can subsequently report accurate metrics to demonstrate what is working well and which strategies have not been successful. It is then possible to make immediate changes to maximize the impact that social media can have on that organization’s strategic goals. The objective of this paper is to provide every reader with the ability to head into a meeting about social media and confidently develop a strategy that will plan for success, with the metrics to prove it.

  18. Health actions and disease patterns related to coronary heart ...

    African Journals Online (AJOL)

    1990-07-21

    Jul 21, 1990 ... The health-related behaviour of the Cape Peninsula coloured population, which ... cholesterolaemia, yet their knowledge of the prudent diet was poor and ..... and socio-economic standing, the number of people per habit- able room .... facilities to motivate and assist smokers in their attempts to stop smoking ...

  19. Effects of Psychoeducation on Mental Health in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Bashiri, Zahra; Aghajani, Mohammad; Masoudi Alavi, Negin

    2016-05-01

    Patients with coronary heart disease are at high risk for mental health disorders, such as depression and anxiety. Psychoeducation is a well-known intervention for psychiatric patients, but its use has been limited in other health conditions, such as coronary heart disease. The aim of this study was to evaluate the effect of psychoeducation on mental health in coronary heart disease patients. This randomized clinical trial included 70 patients with coronary heart disease at Shahid Beheshti hospital, in Kashan, Iran, in 2014. The patients were randomly assigned into two groups: the experimental group, which received eight sessions of psychoeducation, and the control group, which received routine care. Data were collected with the Goldberg mental health questionnaire (GHQ) and were analyzed using independent and paired t-tests performed with SPSS version 16. The means of overall GHQ scores were significantly decreased post-test in the intervention group, and the differences between the two groups were statistically significant in the overall GHQ scores (P = 0.0001). A significant difference was observed between the mean GHQ scores of the intervention group prior to and after the psychoeducational program (PEP) intervention (30 ± 4.66 vs. 20.50 ± 3.30) (P = 0.0001). No significant changes were observed in the control group pre- and post-test (P = 0.07). Psychoeducation resulted in improved mental health in patients with coronary heart disease. Therefore, it is recommended that this approach be performed as a complementary, effective, non-invasive, low-cost nursing intervention to reduce psychological problems in these patients.

  20. Intake patterns and dietary associations of soya protein consumption in adults and children in the Canadian Community Health Survey, Cycle 2.2.

    Science.gov (United States)

    Mudryj, Adriana N; Aukema, Harold M; Yu, Nancy

    2015-01-28

    Soya foods are one of the recommended alternatives to meat in many dietary guidelines. While this is expected to increase the intake of some nutrients, potential concerns regarding others have been raised. The purpose of the present study was to examine the prevalence and the association of soya food consumption with nutrient intakes and dietary patterns of Canadians (age ≥ 2 years). Cross-sectional data from the 2004 Canadian Community Health Survey (Cycle 2.2; n 33,218) were used to classify soya consumers and non-consumers. Soya consumers were further divided into two groups based on their soya protein intake. Sample weights were applied and logistic regression analysis was used to explore the association between nutrient intakes and soya consumption, with cultural background, sex, age and economic status being included as covariates. On any given day, 3.3% (n 1085) of Canadians consume soya foods, with females, Asian Canadians and adults with post-secondary education being more likely to be soya consumers. As a whole, adolescent and adult respondents who had consumed at least one soya food during their 24 h dietary recall had higher energy intakes, as well as increased intakes of nutrients such as protein, fibre, vitamin C, vitamin B6, naturally occurring folate, thiamin, Ca, P, Mg, PUFA, Fe and K and lowered intakes of saturated fat. These data indicate that soya food consumption is associated with improved diet quality of Canadians. However, future research is necessary to investigate the association between increased energy intake and soya consumption.

  1. Where theory and practice of global health intersect: the developmental history of a Canadian global health initiative.

    Science.gov (United States)

    Daibes, Ibrahim; Sridharan, Sanjeev

    2014-01-01

    This paper examines the scope of practice of global health, drawing on the practical experience of a global health initiative of the Government of Canada--the Teasdale-Corti Global Health Research Partnership Program. A number of challenges in the practical application of theoretical definitions and understandings of global health are addressed. These challenges are grouped under five areas that form essential characteristics of global health: equity and egalitarian North-South partnerships, interdisciplinary scope, focus on upstream determinants of health, global conceptualization, and global health as an area of both research and practice. Information in this paper is based on the results of an external evaluation of the program, which involved analysis of project proposals and technical reports, surveys with grantees and interviews with grantees and program designers, as well as case studies of three projects and a review of relevant literature. The philosophy and recent definitions of global health represent a significant and important departure from the international health paradigm. However, the practical applicability of this maturing area of research and practice still faces significant systemic and structural impediments that, if not acknowledged and addressed, will continue to undermine the development of global health as an effective means to addressing health inequities globally and to better understanding, and acting upon, upstream determinants of health toward health for all. While it strives to redress global inequities, global health continues to be a construct that is promoted, studied, and dictated mostly by Northern institutions and scholars. Until practical mechanisms are put in place for truly egalitarian partnerships between North and South for both the study and practice of global health, the emerging philosophy of global health cannot be effectively put into practice.

  2. Examining occupational health and safety vulnerability among Canadian workers with disabilities.

    Science.gov (United States)

    Breslin, F Curtis; Lay, A Morgan; Jetha, Arif; Smith, Peter

    2017-05-26

    To compare workers with and without disabilities on their reported workplace hazard exposure and the presence of occupational health and safety vulnerability factors. Working-aged adults in Ontario or British Columbia were recruited to participate in a cross-sectional survey (n = 1988). Self-reported measures included demographic factors, work-related variables, perceived level of activity limitation at work, and presence of work safety vulnerability factors utilizing a novel framework. Reporting a disability at work was significantly associated with greater hazard exposure than those without a disability. In addition, those reporting a disability at work were more likely to be employed in conditions where hazard exposure was combined with inadequate policies and procedures, or hazard exposures were combined with inadequate empowerment. Work safety vulnerability is one way that health inequalities can be perpetuated even among those with disabilities who have found work. Our results suggest that employers and policy makers need to focus on assessing and addressing hazard exposures and targeting occupational health and safety resources in the workplace in a way that includes workers with disabilities. Implications for Rehabilitation Workers with disabilities experience greater hazard exposure than those without a disability. Those with moderate and severe disabilities reported occupational health and safety vulnerability, suggesting that workplace accommodations should be available to a broader range of disability levels. It appears that, above and beyond standard safety procedures, providing workplace accommodations for people with disabilities may further reduce their hazard exposure and improve their safety.

  3. Changes in smoking during pregnancy in Ontario, 1995 to 2010: results from the Canadian community health survey.

    Science.gov (United States)

    Brown, Hilary K; Wilk, Piotr

    2014-10-01

    The objectives of this study were (1) to examine changes in smoking behaviour across time in pregnant women in Ontario (relative to non-pregnant women and men) and (2) to assess whether, among pregnant women, changes across time vary as a function of sociodemographic characteristics. This study used data from the Canadian Community Health Survey. The study sample included 15- to 49-year-old residents of Ontario. Multivariable logistic regression, with interactions between time period and the characteristic of interest, was used to examine whether changes varied across time according to (1) group (pregnant women, non-pregnant women, men; two-year intervals, 2001 to 2010) and (2) pregnant subgroup (maternal age, maternal marital status, maternal education; 1995 to 2000 [n = 3745], 2001 to 2005 [n = 5084], and 2006 to 2010 [n = 2900]). A decrease in the prevalence of smoking across time was seen in all groups but was smaller in pregnant women than in non-pregnant women (23.5% vs. 30.8%). Among pregnant women, interactions between time period and maternal age, maternal marital status, and maternal education were statistically significant. The prevalence of smoking during pregnancy decreased in older, married, and more highly educated women, but increased in younger women (by 8.2%) and less educated women (by 12.8%). Although the prevalence of smoking during pregnancy decreased in unmarried women, the change was smaller than in married women. Although the prevalence of smoking in pregnant women is decreasing over time, the decrease is smaller than that in non-pregnant women. Pregnant subgroups particularly resistant to change include younger, unmarried, and less educated mothers. These findings suggest there are subgroups that should be targeted more deliberately by public health interventions.

  4. Outdoor time, physical activity, sedentary time, and health indicators at ages 7 to 14: 2012/2013 Canadian Health Measures Survey.

    Science.gov (United States)

    Larouche, Richard; Garriguet, Didier; Gunnell, Katie E; Goldfield, Gary S; Tremblay, Mark S

    2016-09-21

    International data show that the majority of children and youth are not sufficiently active. According to recent research, children who spend more time outdoors accumulate more daily moderate-to-vigorous physical activity and engage in less sedentary behaviour. However, the generalizability of these findings is uncertain, and few studies investigated whether outdoor time is associated with other physical and psychosocial health indicators. This study examined associations between outdoor time and measures of physical activity, sedentary time, and physical and psychosocial health in a nationally representative sample of 7-to-14-year-olds (n = 1,159) who participated in the 2012/2013 Canadian Health Measures Survey. Physical activity and sedentary time were measured with Actical accelerometers. Direct measures of height, weight, waist circumference, grip strength, blood pressure, cholesterol, and glycohemoglobin were obtained. The Strengths and Difficulties Questionnaire was used to assess psychosocial health. Relationships between outdoor time and physical health measures were examined with multi-variable linear regression models adjusted for age, sex, parental education, and household income. Logistic regression models controlling for the same variables were used for psychosocial health. Each additional hour spent outdoors per day was associated with 7.0 more minutes of moderate-to-vigorous physical activity, 762 more steps, and 13 fewer minutes of sedentary time. As well, each hour outdoors was associated with lower odds of negative psychosocial outcomes (specifically, peer relationship problems and total difficulties score). Outdoor time was not associated with any of the measures of physical health. Children reporting more time outdoors are more active, less sedentary, and less likely to have peer relationship problems, compared with those who spend less time outdoors.

  5. Resettling refugees and safeguarding their mental health: lessons learned from the Canadian Refugee Resettlement Project.

    Science.gov (United States)

    Beiser, Morton

    2009-12-01

    The Ryerson University Refugee Resettlement Project (RRP), a decade-long study of 1348 Southeast Asian refugees who came to Canada between 1979 and 1981, is one of the largest, most comprehensive and longest-lived investigations of refugee resettlement ever carried out. Knowledge gleaned from the RRP about research methodology, about the resettlement experience, about the social costs of resettling refugees, about factors that promote or hinder integration, about risk and protective factors for refugee mental health, and about the refugees' consumption of mental health and social services is summarized in the form of 18 "Lessons." The lessons are offered in order to encourage and stimulate further research, as well to suggest policy and practice innovations that could help make resettlement easier, less costly, more effective, and more humane.

  6. Income and the mental health of Canadian mothers: Evidence from the Universal Child Care Benefit

    Directory of Open Access Journals (Sweden)

    Angela Daley

    2017-12-01

    I find the income transfer improved mental health and life satisfaction regardless of family structure, albeit not necessarily for a given individual. Rather, average scores were higher for mothers with young children after implementation of the Universal Child Care Benefit. For example, they were more likely to report ‘excellent’ mental health and less likely to be in each of the other categories. The transfer also reduced stress among lone mothers with young children. Specifically, they were less likely to be ‘quite a bit’ or ‘extremely’ stressed on a daily basis, and more likely to be ‘not at all’ or ‘not very’ stressed. I argue that assumptions of the model are plausible and show that results are consistent across several robustness checks.

  7. Canadian Consensus on Medically Acceptable Wait Times for Digestive Health Care

    Directory of Open Access Journals (Sweden)

    William G Paterson

    2006-01-01

    Full Text Available BACKGROUND: Delays in access to health care in Canada have been reported, but standardized systems to manage and monitor wait lists and wait times, and benchmarks for appropriate wait times, are lacking. The objective of the present consensus was to develop evidence- and expertise-based recommendations for medically appropriate maximal wait times for consultation and procedures by a digestive disease specialist.

  8. Development of radio dramas for health communication pilot intervention in Canadian Inuit communities.

    Science.gov (United States)

    Racicot-Matta, Cassandra; Wilcke, Markus; Egeland, Grace M

    2016-03-01

    A mixed-methods approach was used to develop a culturally appropriate health intervention over radio within the Inuit community of Pangnirtung, Nunavut (NU), Canada. The radio dramas were developed, recorded and tested pre-intervention through the use of Participatory Process and informed by the extended elaboration likelihood model (EELM) for education-communication. The radio messages were tested in two focus groups (n = 4 and n = 5) to determine fidelity of the radio dramas to the EELM theory. Focus group feedback identified that revisions needed to be made to two characteristics required of educational programmes by the EELM theorem: first, the quality of the production was improved by adding Inuit youth recorded music and second, the homophily (relatability of characters) of radio dramas was improved by re-recording the dramas with voices of local youth who had been trained in media communication studies. These adjustments would not have been implemented had pre-intervention testing of the radio dramas not taken place and could have reduced effectiveness of the overall intervention. Therefore, it is highly recommended that media tools for health communication/education be tested with the intended target audience before commencement of programmes. Participatory Process was identified to be a powerful tool in the development and sustainability of culturally appropriate community health programming. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Cocoa and heart health: a historical review of the science.

    Science.gov (United States)

    Pucciarelli, Deanna L

    2013-09-26

    The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés's first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America--ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa's bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health.

  10. Cocoa and Heart Health: A Historical Review of the Science

    Science.gov (United States)

    Pucciarelli, Deanna L.

    2013-01-01

    The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America―ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa’s bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health. PMID:24077240

  11. Cocoa and Heart Health: A Historical Review of the Science

    Directory of Open Access Journals (Sweden)

    Deanna L. Pucciarelli

    2013-09-01

    Full Text Available The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America—ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa’s bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health.

  12. Mental Health and Stressful Life Events in Coronary Heart Disease Patients and Non- Patients

    Directory of Open Access Journals (Sweden)

    Samaneh Nateghian

    2008-07-01

    Full Text Available "nObjective: "n The main goal of this study is to compare stressful life events and mental health in coronary heart disease (CHD patients and non-patients. "nMethod: In this research, 120 participants (n=68 male, n= 52 female were divided into two groups of patients (n=60 and non-patients (n=60. They were selected from Vali Asr Hospital of Meshginshahr (Iran and completed the  General Health Questionnaire (GHQ and Stressful Life Events Inventory . "nResults: Data was analyzed using independent t-test. The results showed significant differences between CHD patients and non-patients in mental health and stressful life events. CHD patients showed high rates of physical symptoms and anxiety of GHQ . "nConclusion: CHD patients reported more stressful life events. Therefore, it can be inferred that psychological factors are important in coronary heart disease.

  13. Knowledge and Oral Health Attitudes among Parents of Children with Congenital Heart Disease.

    Science.gov (United States)

    Suvarna, Reshma; Rai, Kavita; Hegde, Amitha M

    2011-01-01

    Congenital heart disease (CHD) is a devastating complex of diseases resulting from defects of development. It affects more than 1 of every 100 live births. Early preventive dental care should be adjusted to the special needs of these children in their first years of life. Knowledge of parental attitudes and experiences of dental care are therefore important. Aim : This study was done to assess the knowledge and attitudes among parents of children with congenital heart disease towards oral health and dental care. Materials and methods : Parents (n = 105) of children with congenital heart disease of an age ranging from 0 to 16 years were included in the study. A questionnaire was used to assess the knowledge and oral health attitudes. Results : The parents' knowledge was fair but the oral health attitudes were not very satisfactory. The parents in this study also recognized the importance of oral health for the well-being of rest of the body. Conclusion : The results of this study indicate that parents' and children's attitudes toward oral health and dental care need to be improved.

  14. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease.

    Science.gov (United States)

    Langrish, Jeremy P; Li, Xi; Wang, Shengfeng; Lee, Matthew M Y; Barnes, Gareth D; Miller, Mark R; Cassee, Flemming R; Boon, Nicholas A; Donaldson, Ken; Li, Jing; Li, Liming; Mills, Nicholas L; Newby, David E; Jiang, Lixin

    2012-03-01

    Air pollution exposure increases cardiovascular morbidity and mortality and is a major global public health concern. We investigated the benefits of reducing personal exposure to urban air pollution in patients with coronary heart disease. In an open randomized crossover trial, 98 patients with coronary heart disease walked on a predefined route in central Beijing, China, under different conditions: once while using a highly efficient face mask, and once while not using the mask. Symptoms, exercise, personal air pollution exposure, blood pressure, heart rate, and 12-lead electrocardiography were monitored throughout the 24-hr study period. Ambient air pollutants were dominated by fine and ultrafine particulate matter (PM) that was present at high levels [74 μg/m³ for PM(2.5) (PM with aerodynamic diamater reduced maximal ST segment depression (-142 vs. -156 μV, p = 0.046) over the 24-hr period. When the face mask was used during the prescribed walk, mean arterial pressure was lower (93 ± 10 vs. 96 ± 10 mmHg, p = 0.025) and heart rate variability increased (high-frequency power: 54 vs. 40 msec², p = 0.005; high-frequency normalized power: 23.5 vs. 20.5 msec, p = 0.001; root mean square successive differences: 16.7 vs. 14.8 msec, p = 0.007). However, mask use did not appear to influence heart rate or energy expenditure. Reducing personal exposure to air pollution using a highly efficient face mask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to PM air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population.

  15. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey

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    Koren L. Fisher

    2015-01-01

    Full Text Available Purpose. To examine relationships between leisure time physical activity (LTPA and health services utilization (H in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50–65-year-old individuals were 27% less likely to report any GP consultations ORadj=0.73; P<0.001 and had 8% fewer GP consultations annually (IRRadj=0.92; P<0.01 than their inactive peers. Active persons aged 65–79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj=0.82, P<0.05. Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.

  16. Point of care hand hygiene-where's the rub? A survey of US and Canadian health care workers' knowledge, attitudes, and practices.

    Science.gov (United States)

    Kirk, Jane; Kendall, Anson; Marx, James F; Pincock, Ted; Young, Elizabeth; Hughes, Jillian M; Landers, Timothy

    2016-10-01

    Hand hygiene at the point of care is recognized as a best practice for promoting compliance at the moments when hand hygiene is most critical. The objective of this study was to compare knowledge, attitudes, and practices of US and Canadian frontline health care personnel regarding hand hygiene at the point of care. Physicians and nurses in US and Canadian hospitals were invited to complete a 32-question online survey based on evidence supporting point of care hand hygiene. Eligible health care personnel were in direct clinical practice at least 50% of the time. Three hundred fifty frontline caregivers completed the survey. Among respondents, 57.1% were from the United States and 42.9% were from Canada. Respondents were evenly distributed between physician and nurses. The US and Canadian respondents gave identical ranking to their perceived barriers to hand hygiene compliance. More than half of the respondents from both the United States and Canada agreed or strongly agreed that they would be more likely to clean their hands when recommended if alcohol-based handrub was closer to the patient. This survey demonstrates that similarities between Canada and the United States were more common than not, and the survey raises, or suggests, potential knowledge gaps that require further illumination. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Sex workers as peer health advocates: community empowerment and transformative learning through a Canadian pilot program.

    Science.gov (United States)

    Benoit, Cecilia; Belle-Isle, Lynne; Smith, Michaela; Phillips, Rachel; Shumka, Leah; Atchison, Chris; Jansson, Mikael; Loppie, Charlotte; Flagg, Jackson

    2017-08-30

    Social marginalization and criminalization create health and safety risks for sex workers and reduce their access to health promotion and prevention services compared to the general population. Community empowerment-based interventions that prioritize the engagement of sex workers show promising results. Peer-to-peer interventions, wherein sex workers act as educators of their colleagues, managers, clients and romantic partners, foster community mobilization and critical consciousness among sex workers and equip them to exercise agency in their work and personal lives. A pilot peer health education program was developed and implemented, with and for sex workers in one urban centre in Canada. To explore how the training program contributed to community empowerment and transformative learning among participants, the authors conducted qualitative interviews, asked participants to keep personal journals and to fill out feedback forms after each session. Thematic analysis was conducted on these three data sources, with emerging themes identified, organized and presented in the findings. Five themes emerged from the analysis. Our findings show that the pilot program led to reduced internalized stigma and increased self-esteem in participants. Participants' critical consciousness increased concerning issues of diversity in cultural background, sexual orientation, work experiences and gender identity. Participants gained knowledge about how sex work stigma is enacted and perpetuated. They also became increasingly comfortable challenging negative judgments from others, including frontline service providers. Participants were encouraged to actively shape the training program, which fostered positive relationships and solidarity among them, as well as with colleagues in their social network and with the local sex worker organization housing the program. Resources were also mobilized within the sex worker community through skills building and knowledge acquisition. The peer

  18. Periodic health examination, 1995 update: 1. Screening for human papillomavirus infection in asymptomatic women. Canadian Task Force on the Periodic Health Examination.

    Science.gov (United States)

    Johnson, K

    1995-02-15

    To develop recommendations for practising physicians on the advisability of screening for human papillomavirus (HPV) infection in asymptomatic women. Visual inspection, Papanicolaou testing, colposcopy or cervicography, use of HPV group-specific antigen, DNA hybridization, dot blot technique, Southern blot technique or polymerase chain reaction followed by physical or chemical therapeutic intervention. Evidence for a link between HPV infection and cervical cancer, sensitivity and specificity of HPV screening techniques, effectiveness of treatments for HPV infection, and the social and economic costs incurred by screening. MEDLINE was searched for articles published between January 1966 to June 1993 with the use of the key words "papillomavirus," "cervix neoplasms," "mass screening," "prospective studies," "prevalence," "sensitivity," "specificity," "human" and "female." Proven cost-effective screening techniques that could lead to decreased morbidity or mortality were given a high value. The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. Potential benefits are to prevent cervical cancer and eliminate HPV infection. Potential harmful effects include the creation of an unnecessary burden on the health care system and the labelling of otherwise healthy people as patients with a sexually transmitted disease for which therapy is generally ineffective. Potential costs would include expense of testing, increased use of colposcopy and treatment. There is fair evidence to exclude HPV screening (beyond Papanicolaou testing for cervical cancer) in asymptomatic women (grade D recommendation). The report was reviewed by members of the task force and three external reviewers who were selected to represent different areas of expertise. These guidelines were developed and endorsed by the task force, which is funded by Health Canada and the National Health Research and Development Program. The principal author (K.J.) was

  19. Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims.

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    Bernstein, Jodi T; Franco-Arellano, Beatriz; Schermel, Alyssa; Labonté, Marie-Ève; L'Abbé, Mary R

    2017-11-01

    The objective of this study was to evaluate differences in calories, nutrient content, overall healthfulness, and use of sweetener ingredients between products with and without sugar claims. Consumers assume products with sugar claims are healthier and lower in calories. It is therefore important claims be found on comparatively healthier items. This study is a cross-sectional analysis of the University of Toronto's 2013 Food Label Database. Subcategories where at least 5% of products (and n ≥ 5) carried a sugar claim were included (n = 3048). Differences in median calorie content, nutrient content, and overall healthfulness, using the Food Standards Australia/New Zealand Nutrient Profiling Scoring criterion, between products with and without sugar claims, were determined. Proportion of products with and without claims that had excess free sugar levels (≥10% of calories from free sugar) and that contained sweeteners was also determined. Almost half (48%) of products with sugar claims contained excess free sugar, and a greater proportion contained sweeteners than products without such claims (30% vs 5%, χ 2 = 338.6, p contents than products without claims. At the subcategory level, reductions in free sugar contents were not always met with similar reductions in calorie contents. This study highlights concerns with regards to the nutritional composition of products bearing sugar claims. Findings can support educational messaging to assist consumer interpretation of sugar claims and can inform changes in nutrition policies, for example, permitting sugar claims only on products with calorie reductions and without excess free sugar.

  20. Barriers to implementing the World Health Organization's Trauma Care Checklist: A Canadian single-center experience.

    Science.gov (United States)

    Nolan, Brodie; Zakirova, Rimma; Bridge, Jennifer; Nathens, Avery B

    2014-11-01

    Management of trauma patients is difficult because of their complexity and acuity. In an effort to improve patient care and reduce morbidity and mortality, the World Health Organization developed a trauma care checklist. Local stakeholder input led to a modified 16-item version that was subsequently piloted. Our study highlights the barriers and challenges associated with implementing this checklist at our hospital. The checklist was piloted over a 6-month period at St. Michael's Hospital, a Level 1 trauma center in Toronto, Canada. At the end of the pilot phase, individual, semistructured interviews were held with trauma team leaders and nursing staff regarding their experiences with the checklist. Axial coding was used to create a typology of attitudes and barriers toward the checklist, and then, vertical coding was used to further explore each identified barrier. Checklist compliance was assessed for the first 7 months. Checklist compliance throughout the pilot phase was 78%. Eight key barriers to implementing the checklist were identified as follows: perceived lack of time for the use of the checklist in critically ill patients, unclear roles, no memory trigger, no one to enforce completion, not understanding its importance or purpose, difficulty finding physicians at the end of resuscitation, staff/trainee changes, and professional hierarchy. The World Health Organization Trauma Care Checklist was a well-received tool; however, consideration of barriers to the implementation and staff adoption must be done for successful integration, with special attention to its use in critically ill patients. Therapeutic/care management, level V.

  1. Lifetime intimate partner violence exposure, attitudes and comfort among Canadian health professions students

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    Gerber Megan R

    2009-09-01

    Full Text Available Abstract Background Intimate partner violence (IPV is a widespread public health problem and training of health professions students has become common. Understanding students' prior knowledge, attitudes and personal exposure to IPV will aid educators in designing more effective curriculum. As interprofessional educational efforts proliferate, understanding differences across disciplines will be critical. Findings Students in the schools of Medicine, Nursing and Rehabilitation at a university in Ontario attend an annual daylong interprofessional IPV training. To measure perceived role and comfort with IPV and prior personal exposure, we administered a brief Likert scale survey to a convenience sample of students over three years. 552 students completed the survey; the overall response rate was 73%. The majority (82% agreed that it was their role to intervene in cases of IPV; however Rehabilitation students expressed lower overall comfort levels than did their peers in other schools (p Conclusion While the majority of professional students believe it is their role to address IPV in clinical practice, comfort level varied significantly by field of study. More than one fifth of the students reported some personal exposure to IPV. However this did not impact their level of comfort in addressing this issue. Educators need to take students' preexisting attitudes and personal exposure into account when planning curriculum initiatives in this area.

  2. The deterioration of Canadian immigrants' oral health: analysis of the Longitudinal Survey of Immigrants to Canada.

    Science.gov (United States)

    Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos

    2015-10-01

    To examine the effect of immigration on the self-reported oral health of immigrants to Canada over a 4-year period. The study used Statistics Canada's Longitudinal Survey of Immigrants to Canada (LSIC 2001-2005). The target population comprised 3976 non-refugee immigrants to Canada. The dependent variable was self-reported dental problems. The independent variables were as follows: age, sex, ethnicity, income, education, perceived discrimination, history of social assistance, social support, and official language proficiency. A generalized estimation equation approach was used to assess the association between dependent and independent variables. After 2 years, the proportion of immigrants reporting dental problems more than tripled (32.6%) and remained approximately the same at 4 years after immigrating (33.3%). Over time, immigrants were more likely to report dental problems (OR = 2.77; 95% CI 2.55-3.02). An increase in self-reported dental problems over time was associated with sex, history of social assistance, total household income, and self-perceived discrimination. An increased likelihood of reporting dental problems occurred over time. Immigrants should arguably constitute an important focus of public policy and programmes aimed at improving their oral health and access to dental care in Canada. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A Systematic Review of mHealth-Based Heart Failure Interventions.

    Science.gov (United States)

    Cajita, Maan Isabella; Gleason, Kelly T; Han, Hae-Ra

    2016-01-01

    The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. PubMed, CINAHL Plus, EMBASE, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Ten articles, representing 9 studies, were included in this review. The majority of the studies utilized mobile health technology as part of an HF monitoring system, which typically included a blood pressure-measuring device, weighing scale, and an electrocardiogram recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, New York Heart Association functional class, left ventricular ejection fraction, quality of life, and self-care were inconsistent at best. Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (eg, inadequate sample size, quasi-experimental design, use of older mobile phone models, etc) should be taken into account when designing future studies.

  4. Adapting heart failure guidelines for nursing care in home health settings: challenges and solutions.

    Science.gov (United States)

    Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth

    2014-07-01

    Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.

  5. Blue-collar workplaces: a setting for reducing heart health inequalities in New Zealand?

    Science.gov (United States)

    Novak, Brad; Bullen, Chris; Howden-Chapman, Philippa; Thornley, Simon

    2007-09-07

    To review the evidence for the effectiveness of workplaces as settings for cardiovascular health promotion and reduction of heart health inequalities in New Zealand. Literature review and structured appraisal of 154 articles meeting inclusion criteria, of which one review and three trials addressed cardiovascular interventions specifically, and four systematic reviews addressed the effectiveness of workplace health promotion programmes generally. The reviewed studies showed that workplaces have good potential as settings for health promotion. We found mixed but largely supportive evidence that workplace interventions can lead to improvements in health outcomes, workplace environments, lifestyles, and productivity. Workplace programmes that ranked highest in both clinical and cost-effectiveness targeted industries employing large numbers of blue-collar workers, tackled multiple risk factors, intervened at both individual and environmental levels and incorporated occupational safety components. Such programmes appear to offer a substantial return on investment for employers in other countries, but local evidence is lacking. Employers and workers in blue-collar industries should be encouraged to participate in comprehensive heart health promotion programmes as a strategy for reducing existing socioeconomic and ethnic disparities in health. However, high-quality evidence of improved employee health and productivity is needed from well-designed New Zealand-based research to ensure that these programmes are optimally configured for effectiveness and attractive to employers and employees alike.

  6. Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

    Science.gov (United States)

    Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

    2015-09-01

    Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

  7. The Ecology of Gahu : Participatory Music and Health Benefits of Ewe P erformanc e in a Canadian Drum and Dance Ensemble

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    Kathy Armstrong

    2016-12-01

    Full Text Available Ghanaian music and dance provide a rich environment for social interaction, which is a significant contributory factor to health and well-being, both for individuals and the communities in which they live. The vibrant and energetic drumming and dance of the popular Ewe piece Gahu offer numerous opportunities for participatory music-making, not only in Ghana but throughout the world, in performance, educational and community settings. Through video analysis and discussion of cross-disciplinary research, this article identifies the ecological factors present in a Canadian university performance of Gahu that play a positive role in the health of the students involved.

  8. Heart Health Risk Assessment System: A Nonintrusive Proposal Using Ontologies and Expert Rules

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    Teresa Garcia-Valverde

    2014-01-01

    Full Text Available According to the World Health Organization, the world’s leading cause of death is heart disease, with nearly two million deaths per year. Although some factors are not possible to change, there are some keys that help to prevent heart diseases. One of the most important keys is to keep an active daily life, with moderate exercise. However, deciding what a moderate exercise is or when a slightly abnormal heart rate value is a risk depends on the person and the activity. In this paper we propose a context-aware system that is able to determine the activity the person is performing in an unobtrusive way. Then, we have defined ontology to represent the available knowledge about the person (biometric data, fitness status, medical information, etc. and her current activity (level of intensity, heart rate recommended for that activity, etc.. With such knowledge, a set of expert rules based on this ontology are involved in a reasoning process to infer levels of alerts or suggestions for the users when the intensity of the activity is detected as dangerous for her health. We show how this approach can be accomplished by using only everyday devices such as a smartphone and a smartwatch.

  9. USING THE HEALTH TECHNOLOGY ASSESSMENT TOOLBOX TO FACILITATE PROCUREMENT: THE CASE OF SMART PUMPS IN A CANADIAN HOSPITAL.

    Science.gov (United States)

    Poder, Thomas G

    2017-01-01

    The aim of this study was to present the experience of a Canadian hospital-based health technology assessment (HTA) unit that performed the traditional functions of the HTA process along with many other activities to facilitate the choice of smart pumps. A rapid literature review was initiated, but little evidence was found. Moreover, the evidence provided was too far from our hospital context. To help our decision makers, we offered them a list of various services based on the skills of our HTA unit staff. To involve our HTA unit in the choice of the new smart pumps led to a strong collaboration between hospital services. After a rapid review on smart pumps, we proceeded to establish the clinical needs, followed by an evaluation of technical features. To ascertain clinical needs, we participated in the establishment of a conformity list for the tender, a failure and mode-effect analysis, an audit on the use of actual smart pumps, and simulation exercises with nurses and doctors to evaluate the ease of use and ergonomics. With regard to technical tests, these were mainly conducted to identify potential dysfunction and to assess the efficiency of the pump. This experience with smart pumps was useful for evidence-based procurement and led to the formulation of a nine-step process to guide future work. HTA units and agencies are faced with rapid development of new technologies that may not be supported by sufficient amount of pertinent published evidence. Under these circumstances, approaches other than evidence-based selection might provide useful information. Because these activities may be different from those related to classic HTA, this widens the scope of what can be done in HTA to support decision making.

  10. Outdoor time, physical activity and sedentary time among young children: The 2012-2013 Canadian Health Measures Survey.

    Science.gov (United States)

    Larouche, Richard; Garriguet, Didier; Tremblay, Mark S

    2017-03-01

    Previous studies have shown that children who spend more time outdoors are more active and spend less time sedentary, but these studies were limited by the use of small convenience samples. We examined the relationship between outdoor time and measures of physical activity (PA), screen time and sedentary time in a nationally-representative sample of young children. Parental reports of outdoor time were obtained for 594 children aged 3-6 years (47.8% girls) who participated in the 2012-2013 Canadian Health Measures Survey. Participants were asked to wear an Actical accelerometer for seven consecutive days. Outdoor time and screen time were assessed by parent reports. The relationships between outdoor time and measures of PA, screen time and sedentary time were examined with linear regression models. Adherence to PA guidelines was estimated based on a betabinomial distribution, and adherence with the screen time guidelines was assessed through logistic regression models. All analyses were stratified by age group (3-4 and 5-6 year olds) and adjusted for sex, parental education and household income. Among 5-6 year olds, each additional hour spent outdoors was associated with an additional 10 minutes of moderate-to-vigorous PA (95% CI: 6-14), 27,455 more accelerometer counts/day (95% CI: 11,929-42,980) and an increased likelihood of meeting the PA guidelines (OR = 2.53; 95% CI: 1.68-3.82). No significant relationships were observed among 3-4 year olds. Outdoor time has a large effect on PA among 5-6 year olds at a population level. Future studies should examine the correlates of outdoor time to inform novel PA promotion interventions.

  11. Lung health and heart rate variability changes in salt workers.

    Science.gov (United States)

    Glad Mohesh, M I; Sundaramurthy, A

    2016-04-01

    India is the third largest salt producing country in the World, with a global annual production of 230 million tonnes. Large number of salt workers get employed in these salt milling plants risking their life from the effects of salt. Recent foreign evidences reported that these salt workers are exposed to aerosol salt particles that disturb their lung and cardiovascular autonomic control. To compare the status of lung health, cardiovascular autonomic control and biochemical changes in a group of salt industry workers with that of the age-matched normal subjects. Volunteers of both sexes (25-35 years) were divided into Group I (n=10) controls and Group II (n=10) non-brine salt workers in salt milling plants. From fasting blood sample, complete blood count, plasma electrolyte and lipid profile estimation were done. After resting for 15min, blood pressure and lead II ECG were recorded. Spirometry was done using RMS Helios spirometer. Data collected were later analysed using GraphPad Prism 5.0 with statistical significance set at p4.0, 112.8±1.7, pindustry has shown a little or no impact on the respiratory system, however there are changes in the blood and cardiovascular system, which need to be further studied to understand the long-term influences of salt in this population. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  12. The MacNew Heart Disease health-related quality of life instrument: A summary

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    Guyatt Gordon

    2004-01-01

    Full Text Available Abstract Background The measurement of health, the effects of disease, and the impact of health care include not only an indication of changes in disease frequency and severity but also an estimate of patients' perception of health status before and after treatment. One of the more important developments in health care in the past decade may be the recognition that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. This has lead to the development of instruments to quantify the patients' perception of their health status before and after treatment. Methods We review evidence supporting the measurement properties of the MacNew Heart Disease Health-related Quality of Life [MacNew] Questionnaire which was designed to evaluate how daily activities and physical, emotional, and social functioning are affected by coronary heart disease and its treatment. Results Reliability was demonstrated by using internal consistency and the intraclass correlation coefficients for the three domains in the Dutch, English, Farsi, German, and Spanish versions of the MacNew. With internal consistency and intraclass correlation coefficients =>0.73, reliability is high. Validity of the MacNew was examined with factor analysis and three core underlying factors, physical, emotional, and social, were identified, explaining 63.0 – 66.5% of the observed variance and replicated in the translations with psychometric data. Construct validity of the MacNew was further demonstrated by extensive substantiation of the logical relationships, defined a priori, between items and other comparison tools. The MacNew is responsive and sensitive to changes in HRQL following various interventions for patients with heart disease with 11 of 13 effect size statistics >0.80. Taking an average of 10 minutes or less to complete, the respondent-burden for the MacNew is low and its acceptability is demonstrated by response rates of over 90

  13. A Health at Every Size intervention improves intuitive eating and diet quality in Canadian women.

    Science.gov (United States)

    Carbonneau, Elise; Bégin, Catherine; Lemieux, Simone; Mongeau, Lyne; Paquette, Marie-Claude; Turcotte, Mylène; Labonté, Marie-Ève; Provencher, Véronique

    2017-06-01

    Health at Every Size ® (HAES ® ) interventions focus on healthy lifestyle by promoting behavioral changes related to diet and physical activity while emphasizing self-acceptance and well-being through an empowerment and intuitive approach. The purpose of this study was to investigate the effects of a HAES ® program on intuitive eating and diet quality in women. The HAES ® intervention, offered by professionals from Health and Social Services Centers in Quebec (Canada), was composed of thirteen 3-h weekly meetings and a 6-h intensive day. For this study, 216 women (1.9% normal-weight, 21.1% overweight, 77.0% obese) who took part to the HAES program were compared to 110 women (3.9% normal-weight, 23.3% overweight, 72.8% obese) from a control group (waiting list). Intuitive eating was assessed using the Intuitive Eating Scale and diet quality was evaluated through the calculation of the Healthy Eating Index (HEI) from a validated web-based self-administrated food frequency questionnaire. Measurements were performed at baseline, post-intervention, and at one-year follow-up. Women who participated in the HAES ® program significantly increased their intuitive eating score compared to women in the control group at post-intervention and at follow-up (group by time interaction, p = 0.0002). A significant improvement in diet quality was also observed in the HAES ® group in comparison with the control group at post-intervention (group by time interaction, p = 0.0139). The intuitive eating score and the HEI score were positively associated in the HAES ® group at post-intervention (r = 0.20, p = 0.0237) and one-year follow-up (r = 0.22, p = 0.0359), but no such associations were noted in the control group (post-intervention, r = 0.04, p = 0.70; one-year follow-up, r = -0.15, p = 0.30). The HAES ® program seems effective in improving intuitive eating and also favours improvements in diet quality. However, the association between intuitive eating and

  14. Costs of the 'Hartslag Limburg' community heart health intervention

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    Ruland Erik

    2006-03-01

    Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very

  15. Decreasing medication turnaround time with digital scanning technology in a canadian health region.

    Science.gov (United States)

    Neville, Heather; Nodwell, Lisa; Alsharif, Sahar

    2014-11-01

    Reducing medication turnaround time can improve efficiency, patient safety, and quality of care in the hospital setting. Digital scanning technology (DST) can be used to electronically transmit scanned prescriber orders to a pharmacy computer queue for verification and processing, which may help to improve medication turnaround time. To evaluate medication turnaround time before and after implementation of DST for all medications and for antibiotics only. Medication turnaround times were evaluated retrospectively for periods before (June 6-10, 2011) and after (September 26-30, 2011) implementation of DST at 2 hospital sites in 1 health region. Medication turnaround time was defined as the time from composition of a medication order by the prescriber to its verification by the pharmacy (phase 1) and the time from prescriber composition to administration to the patient by a nurse (total). Median turnaround times were analyzed with SPSS software using the Mann-Whitney U test. In total, 304 and 244 medication orders were audited before and after DST implementation, respectively. Median phase 1 turnaround time for all medications declined significantly, from 2 h 23 min before DST implementation to 1 h 33 min after DST implementation (p < 0.001). Antibiotics were also processed significantly faster (1 h 51 min versus 1 h 9 min, p = 0.015). However, total turnaround time for all medications did not differ significantly (5 h 15 min versus 5 h 0 min, p = 0.42). Implementation of DST was associated with a 50-min decrease in medication turnaround time for the period from when an order was prescribed to the time it was processed by the pharmacy. Regular evaluation of medication turnaround times is recommended to compare with benchmarks, to ensure that hospital standards are being met, and to measure the effects of policy changes and implementation of new technology on medication-use processes.

  16. Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

    Science.gov (United States)

    Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

    2013-05-01

    Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

  17. [Anxiety, depression, health-related control beliefs, and their association with health behavior in patients with ischemic heart disease].

    Science.gov (United States)

    Rafael, Beatrix; Konkolÿ Thege, Barna; Kovács, Péter; Balog, Piroska

    2015-05-17

    Psychological and lifestyle factors affect the development and outcome of heart disease considerably. The aims of the authors were to examine health control, level of anxiety and depression and to analyse their relationship with health behaviour in patients with ischemic heart disease. The present cross-sectional study involved 116 patients who took part in residential cardiac rehabilitation (56.9% men, mean age: 57.65±8.22 years). 30.9% of the patients reported elevated anxiety and 21.9% increased depressive symptomatology. Social-external control belief was the strongest among respondents. Further, anxiety and depression were negatively associated with healthy diet and the frequency of exercise. Patients with stronger social-external control beliefs were more likely to seek medical attention if they suspected a disease. It is important to assess psychological risk factors linked to cardiovascular diseases in cardiac rehabilitation departments and to initiate psychological interventions if indicated.

  18. Men's and Women's Health Beliefs Differentially Predict Coronary Heart Disease Incidence in a Population-Based Sample

    Science.gov (United States)

    Korin, Maya Rom; Chaplin, William F.; Shaffer, Jonathan A.; Butler, Mark J.; Ojie, Mary-Jane; Davidson, Karina W.

    2013-01-01

    Objective: To examine gender differences in the association between beliefs in heart disease preventability and 10-year incidence of coronary heart disease (CHD) in a population-based sample. Methods: A total of 2,688 Noninstitutionalized Nova Scotians without prior CHD enrolled in the Nova Scotia Health Study (NSHS95) and were followed for 10…

  19. The Canadian systemic sclerosis oral health study II: the relationship between oral and global health-related quality of life in systemic sclerosis.

    Science.gov (United States)

    Baron, Murray; Hudson, Marie; Tatibouet, Solène; Steele, Russell; Lo, Ernest; Gravel, Sabrina; Gyger, Geneviève; El Sayegh, Tarek; Pope, Janet; Fontaine, Audrey; Masetto, Ariel; Matthews, Debora; Sutton, Evelyn; Thie, Norman; Jones, Niall; Copete, Maria; Kolbinson, Dean; Markland, Janet; Nogueira-Filho, Getulio; Robinson, David; Gornitsky, Mervyn

    2015-04-01

    Both oral and global health-related quality of life (HRQoL) are markedly impaired in SSc. In this study we aimed to determine the degree of association between oral HRQoL and global HRQoL in SSc. Subjects were recruited from the Canadian Scleroderma Research Group registry. Global HRQoL was measured using the Medical Outcomes Trust 36-item Short Form Health Survey (SF-36) and oral HRQoL with the Oral Health Impact Profile (OHIP). The Medsger Disease Severity Score was used to determine organ involvement. Multivariate regression models determined the independent association of the OHIP with the SF-36 after adjusting for confounders. This study included 156 SSc subjects. The majority (90%) were women, with a mean age of 56 years, mean disease duration 13.8 years (s.d. 8.5) and 29% of the subjects had dcSSc. Mean total OHIP score was 40.8 (s.d. 32.4). Mean SF-36 mental component summary (MCS) score was 49.7 (s.d. 11.1) and physical component summary (PCS) score was 37.0 (s.d. 10.7). In adjusted analyses, the total OHIP score was significantly associated with the SF-36 MCS and PCS, accounting for 9.7% and 5.6% of their respective variances. Measures of disease severity were not related to OHIP score. Oral HRQoL in SSc is independently associated with global HRQoL. Oral HRQoL, however, is not related to physician-assessed disease severity. This suggests that physicians may be disregarding issues related to oral health. HRQoL is an additional dimension of HRQoL not captured by generic instruments such as the SF-36. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. ABCC-JNIH Adult Health Study Hiroshima, 1958 to 1959. Hypertension and ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Switzer, S

    1963-11-12

    The interrelations of hypertension, ischemic heart disease, blood lipid levels and ionizing irradiation were investigated among 1051 male and 1872 female members of the ABCC-JNIH Adult Health Study. No significant effect of ionizing irradiation upon the cardiovascular system were detected. No major difference in age-sex specific mean blood pressures between Adult Health Study subjects and a suitable American comparison group was found. An accelerated course with fulminating vascular deterioration was suspected in only 1% of the hypertensive subjects. As a result, advanced retinopathy and renal failure were rarely seen. Electrocardiographic evidence of left ventricular hypertrophy occurred in 7.2% of the hypertensive subjects in this study, and was readily correlated with ambient systolic blood pressure. Evidences of ischemic heart disease and congestive failure were rare and distinctly less common than in American males unselected as to blood pressure levels. In contrast, mortality statistics indicate cerebrovascular disease to be at least as common in Japan as in the United States. Adult Health Study data exhibit low serum cholesterol concentrations by Western standards and elevated levels are predominantly limited to the obese. Both factors appear of importance in the occasional hypertensive subject with ischemic heart disease. The therapeutic implication of this observation is briefly discussed. 57 references, 10 tables.

  1. Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study.

    Science.gov (United States)

    Belton, Suzanne; Kruske, Sue; Jackson Pulver, Lisa; Sherwood, Juanita; Tune, Kylie; Carapetis, Jonathan; Vaughan, Geraldine; Peek, Michael; McLintock, Claire; Sullivan, Elizabeth

    2017-11-06

    To study rheumatic heart disease health literacy and its impact on pregnancy, and to identify how health services could more effectively meet the needs of pregnant women with rheumatic heart disease. Researchers observed and interviewed a small number of Aboriginal women and their families during pregnancy, childbirth and postpartum as they interacted with the health system. An Aboriginal Yarning method of relationship building over time, participant observations and interviews with Aboriginal women were used in the study. The settings were urban, island and remote communities across the Northern Territory. Women were followed interstate if they were transferred during pregnancy. The participants were pregnant women and their families. We relied on participants' abilities to tell their own experiences so that researchers could interpret their understanding and perspective of rheumatic heart disease. Aboriginal women and their families rarely had rheumatic heart disease explained appropriately by health staff and therefore lacked understanding of the severity of their illness and its implications for childbearing. Health directives in written and spoken English with assumed biomedical knowledge were confusing and of limited use when delivered without interpreters or culturally appropriate health supports. Despite previous studies documenting poor communication and culturally inadequate care, health systems did not meet the needs of pregnant Aboriginal women with rheumatic heart disease. Language-appropriate health education that promotes a shared understanding should be relevant to the gender, life-stage and social context of women with rheumatic heart disease. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

    Science.gov (United States)

    Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

    2016-11-01

    Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

  3. Canadian gas supply : an update

    International Nuclear Information System (INIS)

    Rochefort, T.

    1998-01-01

    An overview of the daily production from the Western Canada Sedimentary Basin (WCSB) from 1986 to 1997 was presented. This presentation also outlined Canadian production trends, Canadian reserves and resources, and supply challenges. Ultimate conventional marketable gas from the WCSB, the Scotian Shelf, the Beaufort Sea and Canada's Arctic region was estimated at 591 TCF. Issues regarding supply and demand of natural gas such as the impact of electricity restructuring on pricing, generation fuel mix, the capacity of the U.S. market to absorb Canadian heavy oil production, and the influence of the rate of technological advances on supply and demand were outlined. The overall conclusion confirmed the health and competitiveness of the Canadian upstream sector and expressed confidence that the WCSB can support rising levels of production to meet the expected continued market growth. tabs., figs

  4. Protect your heart: a culture-specific multimedia cardiovascular health education program.

    Science.gov (United States)

    Shah, Amy; Clayman, Marla L; Glass, Sara; Kandula, Namratha R

    2015-04-01

    South Asians, the second fastest growing racial/ethnic minority in the United States, have high rates of coronary heart disease. Few coronary heart disease prevention efforts target this population. The authors developed and tested a culture-specific, multimedia coronary heart disease prevention education program in English and Hindi for South Asians. Participants were recruited from community organizations in Chicago, Illinois, between June and October of 2011. Bilingual interviewers used questionnaires to assess participants' knowledge and perceptions before and after the patient education program. The change from pretest score to posttest score was calculated using a paired t test. Linear regression was used to determine the association between posttest scores and education and language. Participants' (N = 112) average age was 41 years, 67% had more than a high school education, and 50% spoke Hindi. Participants' mean pretest score was 15 (SD = 4). After the patient education program, posttest scores increased significantly among all participants (posttest score = 24, SD = 4), including those with limited English proficiency. Lower education was associated with a lower posttest score (β = -2.2, 95% CI [-0.68, -3.83]) in adjusted regression. A culture-specific, multimedia patient education program significantly improved knowledge and perceptions about coronary heart disease prevention among South Asian immigrants. Culturally salient multimedia education may be an effective and engaging way to deliver health information to diverse patient populations.

  5. Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.

    Science.gov (United States)

    Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry

    2018-05-29

    Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and their carers, as well as support from hospital management.

  6. Differential Item Functioning in the SF-36 Physical Functioning and Mental Health Sub-Scales: A Population-Based Investigation in the Canadian Multicentre Osteoporosis Study.

    Science.gov (United States)

    Lix, Lisa M; Wu, Xiuyun; Hopman, Wilma; Mayo, Nancy; Sajobi, Tolulope T; Liu, Juxin; Prior, Jerilynn C; Papaioannou, Alexandra; Josse, Robert G; Towheed, Tanveer E; Davison, K Shawn; Sawatzky, Richard

    2016-01-01

    Self-reported health status measures, like the Short Form 36-item Health Survey (SF-36), can provide rich information about the overall health of a population and its components, such as physical, mental, and social health. However, differential item functioning (DIF), which arises when population sub-groups with the same underlying (i.e., latent) level of health have different measured item response probabilities, may compromise the comparability of these measures. The purpose of this study was to test for DIF on the SF-36 physical functioning (PF) and mental health (MH) sub-scale items in a Canadian population-based sample. Study data were from the prospective Canadian Multicentre Osteoporosis Study (CaMos), which collected baseline data in 1996-1997. DIF was tested using a multiple indicators multiple causes (MIMIC) method. Confirmatory factor analysis defined the latent variable measurement model for the item responses and latent variable regression with demographic and health status covariates (i.e., sex, age group, body weight, self-perceived general health) produced estimates of the magnitude of DIF effects. The CaMos cohort consisted of 9423 respondents; 69.4% were female and 51.7% were less than 65 years. Eight of 10 items on the PF sub-scale and four of five items on the MH sub-scale exhibited DIF. Large DIF effects were observed on PF sub-scale items about vigorous and moderate activities, lifting and carrying groceries, walking one block, and bathing or dressing. On the MH sub-scale items, all DIF effects were small or moderate in size. SF-36 PF and MH sub-scale scores were not comparable across population sub-groups defined by demographic and health status variables due to the effects of DIF, although the magnitude of this bias was not large for most items. We recommend testing and adjusting for DIF to ensure comparability of the SF-36 in population-based investigations.

  7. Sharing Health Information and Influencing Behavioral Intentions: The Role of Health Literacy, Information Overload, and the Internet in the Diffusion of Healthy Heart Information.

    Science.gov (United States)

    Crook, Brittani; Stephens, Keri K; Pastorek, Angie E; Mackert, Michael; Donovan, Erin E

    2016-01-01

    Low health literacy remains an extremely common and problematic issue, given that individuals with lower health literacy are more likely to experience health challenges and negative health outcomes. In this study, we use the first three stages of the innovation-decision process found in the theory of diffusion of innovations (Rogers, 2003). We incorporate health literacy into a model explaining how perceived health knowledge, information sharing, attitudes, and behavior are related. Results show that health information sharing explains 33% of the variance in behavioral intentions, indicating that the communicative practice of sharing information can positively impact health outcomes. Further, individuals with high health literacy tend to share less information about heart health than those with lower health literacy. Findings also reveal that perceived heart-health knowledge operates differently than health literacy to predict health outcomes.

  8. Social Capital and Health Among Older Chinese Immigrants: a Cross-Sectional Analysis of a Sample in a Canadian Prairie City.

    Science.gov (United States)

    Luo, Hai; Menec, Verena

    2018-03-01

    The objective of this study was to examine the relationship between social capital and health among Chinese immigrants. The sample included 101 older Chinese immigrants aged 60 to 96 who were recruited in 2013 in a city on the Canadian prairies. Participant completed a questionnaire assessing their structural and cognitive social capital (views on community, trust and reciprocity, civic participation, social networks and support, and social participation), physical and mental health status (SF-36), and sociodemographic characteristics. Findings indicate that Chinese seniors overall obtained low levels of social capital on all social capital dimensions. Social networks and support (a structural social capital indicator) was significantly positively associated with mental health (β = .31, p social capital is potentially more promising than ensuring cognitive social capital in terms of providing physical and mental health benefits to older adults from Chinese background.

  9. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

    Science.gov (United States)

    Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

    2017-11-01

    In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  10. The Complexities of Intimate Partner Violence: Mental Health, Disabilities, and Child Abuse History for White, Indigenous, and Other Visible Minority Canadian Women.

    Science.gov (United States)

    Tutty, Leslie M; Radtke, H L; Ateah, Christine A; Ursel, E Jane; Thurston, Wilfreda E Billie; Hampton, Mary; Nixon, Kendra

    2017-11-01

    This research examines how mental health issues associated with intimate partner violence (IPV) relate to women's intersecting identities of race/ethnicity, disability status, and child abuse history. Data ( N = 595) from a Canadian triprovincial study included women who were White ( n = 263, 44.8%), Indigenous ( n = 292, 49.7%), or visible minority ( n = 32, 5.5%). Few demographic differences were found. None of the mental health measures (Symptom Checklist-Short Form [SCL-10], Centre for Epidemiological Studies-Depression [CES-D-10], Posttraumatic Stress Disorder [PTSD] Checklist) were in the clinical ranges. In a MANCOVA on the mental health scales, with IPV severity, racial group, disability status, and child abuse history as variables, only disability was significantly associated with more mental health symptoms.

  11. Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study.

    Science.gov (United States)

    Khan, Sarah; Khoory, Ayesha; Al Zaffin, Dhabia; Al Suwaidi, Meera

    2016-11-07

    Cardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region. Social constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings. Emirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment. This study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to

  12. Long term health care consumption and cost expenditure in systolic heart failure.

    Science.gov (United States)

    Mejhert, Märit; Lindgren, Peter; Schill, Owe; Edner, Magnus; Persson, Hans; Kahan, Thomas

    2013-04-01

    The prevalence, health care consumption, and mortality increase in elderly patients with heart failure. This study aimed to analyse long term cost expenditure and predictors of health care consumption in these patients. We included 208 patients aged 60 years or older and hospitalised with heart failure (NYHA class II-IV and left ventricular systolic dysfunction); 58% were men, mean age 76 years, and mean ejection fraction 0.34. Data on all hospital admissions, discharge diagnoses, lengths of stay, and outpatient visits were collected from the National Board of Health and Welfare. We obtained data of all health care consumption for each individual. After 8-12 years of prospective follow up 72% were dead (median survival 4.6 years). Main drivers of health care expenditure were non-cardiac (40%) and cardiac (29%) hospitalizations, and visits to primary care centres (16%), and hospital outpatient clinics (15%). On average, health care expenditures were € 36,447 per patient during follow up. The average yearly cost per patient was about 5,700€, in contrast to the estimated consumption of primary and hospital care in the general population: € 1,956 in 65-74 year olds and € 2,701 in 75-84 year olds. Poor quality of life (Nottingham Health Profile) was the strongest independent predictor of total health care consumption and costs (pheart failure are at least two-fold higher than in the general population. Quality of life is a strong independent predictor of health care consumption. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. Understanding the performance and impact of public knowledge translation funding interventions: protocol for an evaluation of Canadian Institutes of Health Research knowledge translation funding programs.

    Science.gov (United States)

    McLean, Robert K D; Graham, Ian D; Bosompra, Kwadwo; Choudhry, Yumna; Coen, Stephanie E; Macleod, Martha; Manuel, Christopher; McCarthy, Ryan; Mota, Adrian; Peckham, David; Tetroe, Jacqueline M; Tucker, Joanne

    2012-06-22

    The Canadian Institutes of Health Research (CIHR) has defined knowledge translation (KT) as a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products, and strengthen the healthcare system. CIHR, the national health research funding agency in Canada, has undertaken to advance this concept through direct research funding opportunities in KT. Because CIHR is recognized within Canada and internationally for leading and funding the advancement of KT science and practice, it is essential and timely to evaluate this intervention, and specifically, these funding opportunities. The study will employ a novel method of participatory, utilization-focused evaluation inspired by the principles of integrated KT. It will use a mixed methods approach, drawing on both quantitative and qualitative data, and will elicit participation from CIHR funded researchers, knowledge users, KT experts, as well as other health research funding agencies. Lines of inquiry will include an international environmental scan, document/data reviews, in-depth interviews, targeted surveys, case studies, and an expert review panel. The study will investigate how efficiently and effectively the CIHR model of KT funding programs operates, what immediate outcomes these funding mechanisms have produced, and what impact these programs have had on the broader state of health research, health research uptake, and health improvement. The protocol and results of this evaluation will be of interest to those engaged in the theory, practice, and evaluation of KT. The dissemination of the study protocol and results to both practitioners and theorists will help to fill a gap in knowledge in three areas: the role of a public research funding agency in facilitating KT, the outcomes and impacts KT funding interventions, and how KT can best be evaluated.

  14. Unpacking the financial costs of “bariatric tourism” gone wrong: Who holds responsibility for costs to the Canadian health care system?

    Science.gov (United States)

    Snyder, Jeremy C.; Silva, Diego S.; Crooks, Valorie A.

    2016-01-01

    Summary Canadians are motivated to travel abroad for bariatric surgery owing to wait times for care and restrictions on access at home for various reasons. While such surgery abroad is typically paid for privately, if “bariatric tourists” experience complications or have other essential medical needs upon their return to Canada, these costs are borne by the publicly funded health system. In this commentary, we discuss why assigning responsibility for the costs of complications stemming from bariatric tourism is complicated and contextual. PMID:28234613

  15. Portable Heart Rate Detector Based on Photoplethysmography with Android Programmable Devices for Ubiquitous Health Monitoring System

    Directory of Open Access Journals (Sweden)

    Chi Kin Lao

    2013-01-01

    Full Text Available In this paper, a miniature portable heart rate detector system is implemented by modern hardware ICs and simple sensor circuit with software executable on both PC and Android platform. The biosignal is first extracted via photoplethysmography (PPG principle into electric signal. Then a microprocessor is used to covert biosignal from analog to digital format, suitably for feeding into an RF module (nRF24L01 for RF transmission. On the receiver end, the computer and/or smart phone can analyze the data using a robust algorithm that can detect peaks of the PPG waveform, hence to calculating the heart rate. Some application software running on Windows and Android phone have been developed to display heart rate information and time domain waveform to users for health care monitoring. In the future, pure Bluetooth technology will be used for wireless personal communications instead of RF modules. At the same time, the data can be sent to computer console using existing available networks (3G, 4G, WiFi, etc. for health database logging purpose.

  16. Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Carnethon, Mercedes R; Pu, Jia; Howard, George; Albert, Michelle A; Anderson, Cheryl A M; Bertoni, Alain G; Mujahid, Mahasin S; Palaniappan, Latha; Taylor, Herman A; Willis, Monte; Yancy, Clyde W

    2017-11-21

    Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines. © 2017 American Heart Association, Inc.

  17. The impact of smoking status on the health status of heart failure patients.

    LENUS (Irish Health Repository)

    Conard, Mark W

    2012-02-01

    Smoking is a major risk factor for the development of heart failure (HF). Yet, little is known about smoking\\'s effects on the health status of established HF patients. HF patients were recruited from outpatient clinics across North America. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess disease-specific health status. Smoking behaviors were classified as never having smoked, prior smoker, and as having smoked within the past 30 days. Risk-adjusted multivariable regression was used to evaluate the association of smoking status with baseline and 1-year KCCQ overall summary scores. Smoking was not associated with baseline health status. However, a significant effect was observed on 1-year health status among outpatients with HF with current smokers reporting significantly lower KCCQ scores than never smokers or ex-smokers. These findings highlight an additional adverse consequence of smoking in HF patients not previously discussed.

  18. Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program.

    Science.gov (United States)

    Todorova, Irina L G; Tejada, Shirley; Castaneda-Sceppa, Carmen

    Puerto Ricans are the second largest Hispanic group in the U.S. and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being developed. To develop it as a participatory program, the community members were asked about their perspectives. Five focus groups with 28 participants, aged 45-60, were conducted, transcribed and analyzed using Thematic Analysis. In-depth analysis of meanings of health promoting behaviors, in the context of cultural beliefs and values was carried out. The following themes were identified: Health as balance and integration; Health as connection of self, connection with others; Cultural meanings of lifestyle choices; Stresses and struggles. Participants suggested that the program should have significant variety and a holistic perspective, be sensitive to different needs and motivations, stimulate mutual understanding and shared cultural meanings. The program needs to support lifestyle changes which maximally preserve traditions and to introduce multi-level changes. The identified cultural meanings of diet, physical activity and relationships were taken into account to develop the educational curriculum.

  19. Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

    Science.gov (United States)

    Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

    2017-08-01

    Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend hypertension risk. © 2017 American Heart Association, Inc.

  20. A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education.

    Science.gov (United States)

    Toupin April, Karine; Gaboury, Isabelle

    2013-12-28

    While some effort has been made to integrate complementary and alternative medicine (CAM) information in conventional biomedical training, it is unclear whether regulated Canadian CAM schools' students are exposed to research activities and continuing education, or whether topics such as evidence-based health care and interprofessional collaboration (IPC) are covered during their training. Since these areas are valued by the biomedical training field, this may help to bridge the attitudinal and communication gaps between these different practices. The aim of this study was to describe the training offered in these areas and gather the perceptions of curriculum/program directors in regulated Canadian CAM schools. A two-phase study consisting of an electronic survey and subsequent semi-structured telephone interviews was conducted with curriculum/program (C/P) directors in regulated Canadian CAM schools. Questions assessed the extent of the research, evidence-based health care, IPC training and continuing education, as well as the C/P directors' perceptions about the training. Descriptive statistics were used to describe the schools', curriculum's and the C/P directors' characteristics. Content analysis was conducted on the interview material. Twenty-eight C/P directors replied to the electronic survey and 11 participated in the interviews, representing chiropractic, naturopathy, acupuncture and massage therapy schools. Canadian regulated CAM schools offered research and evidence-based health care training as well as opportunities for collaboration with biomedical peers and continuing education to a various extent (58% to 91%). Although directors were generally satisfied with the training offered at their school, they expressed a desire for improvements. They felt future CAM providers should understand research findings and be able to rely on high quality research and to communicate with conventional care providers as well as to engage in continuing education

  1. The reporting of theoretical health risks by the media: Canadian newspaper reporting of potential blood transmission of Creutzfeldt-Jakob disease

    Directory of Open Access Journals (Sweden)

    Ahmad Nadya

    2004-01-01

    Full Text Available Abstract Background The media play an important role at the interface of science and policy by communicating scientific information to the public and policy makers. In issues of theoretical risk, in which there is scientific uncertainty, the media's role as disseminators of information is particularly important due to the potential to influence public perception of the severity of the risk. In this article we describe how the Canadian print media reported the theoretical risk of blood transmission of Creutzfeldt-Jakob disease (CJD. Methods We searched 3 newspaper databases for articles published by 6 major Canadian daily newspapers between January 1990 and December 1999. We identified all articles relating to blood transmission of CJD. In duplicate we extracted information from the articles and entered the information into a qualitative software program. We compared the observations obtained from this content analysis with information obtained from a previous policy analysis examining the Canadian blood system's decision-making concerning the potential transfusion transmission of CJD. Results Our search identified 245 relevant articles. We observed that newspapers in one instance accelerated a policy decision, which had important resource and health implication, by communicating information on risk to the public. We also observed that newspapers primarily relied upon expert opinion (47 articles as opposed to published medical evidence (28 articles when communicating risk information. Journalists we interviewed described the challenges of balancing their responsibility to raise awareness of potential health threats with not unnecessarily arousing fear amongst the public. Conclusions Based on our findings we recommend that journalists report information from both expert opinion sources and from published studies when communicating information on risk. We also recommend researchers work more closely with journalists to assist them in identifying

  2. Report on the activities carried out by 'Sonrisas' to promote oral health: the experience of a Canadian dental hygienist in the Dominican Republic.

    Science.gov (United States)

    Katsman, Elina

    2007-08-01

    Smiles Foundation is a non-profitable organization established in Canada as a sister foundation to the Dominican Fundacion para la Prevencion y la Salud Bucal de los Ninos "Sonrisas" the Dominican Republic, which provides free dental treatment and oral health education to underprivileged children. Its founder Elina Katsman, a Canadian dental hygienist embarked on this project in 1986, and started giving lectures in the small community of Samana along with two local nurses that she trained in the principles of oral hygiene and related primary health care. Today, the foundation runs eight dental clinics and five mobile units that serve remote areas and has benefited 1,723,119 people in total. The aim of this article was to report on the growth that Smiles Foundation has experienced to promote oral health among children and adults in the Dominican Republic including its activities and the results it has achieved up until 2005.

  3. Sources of social support associated with health and quality of life: a cross-sectional study among Canadian and Latin American older adults

    Science.gov (United States)

    Bélanger, Emmanuelle; Ahmed, Tamer; Vafaei, Afshin; Curcio, Carmen Lucia; Phillips, Susan P; Zunzunegui, Maria Victoria

    2016-01-01

    Objectives To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults. Design Cross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living. Setting Kingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil. Participants 1600 community-dwelling adults aged 65–74 years, n=400 at each site. Outcome measures Likert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale. Results Relationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67). Conclusions Among older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and

  4. Attitudes of heart failure patients and health care providers towards mobile phone-based remote monitoring.

    Science.gov (United States)

    Seto, Emily; Leonard, Kevin J; Masino, Caterina; Cafazzo, Joseph A; Barnsley, Jan; Ross, Heather J

    2010-11-29

    Mobile phone-based remote patient monitoring systems have been proposed for heart failure management because they are relatively inexpensive and enable patients to be monitored anywhere. However, little is known about whether patients and their health care providers are willing and able to use this technology. The objective of our study was to assess the attitudes of heart failure patients and their health care providers from a heart function clinic in a large urban teaching hospital toward the use of mobile phone-based remote monitoring. A questionnaire regarding attitudes toward home monitoring and technology was administered to 100 heart failure patients (94/100 returned a completed questionnaire). Semi-structured interviews were also conducted with 20 heart failure patients and 16 clinicians to determine the perceived benefits and barriers to using mobile phone-based remote monitoring, as well as their willingness and ability to use the technology. The survey results indicated that the patients were very comfortable using mobile phones (mean rating 4.5, SD 0.6, on a five-point Likert scale), even more so than with using computers (mean 4.1, SD 1.1). The difference in comfort level between mobile phones and computers was statistically significant (Pmobile phones to view health information (mean 4.4, SD 0.9). Patients and clinicians were willing to use the system as long as several conditions were met, including providing a system that was easy to use with clear tangible benefits, maintaining good patient-provider communication, and not increasing clinical workload. Clinicians cited several barriers to implementation of such a system, including lack of remuneration for telephone interactions with patients and medicolegal implications. Patients and clinicians want to use mobile phone-based remote monitoring and believe that they would be able to use the technology. However, they have several reservations, such as potential increased clinical workload, medicolegal

  5. The direct health-care burden of valvular heart disease: evidence from US national survey data

    Directory of Open Access Journals (Sweden)

    Moore M

    2016-10-01

    Full Text Available Matt Moore,1 Jie Chen,2 Peter J Mallow,3 John A Rizzo4 1Global Health Economic Strategy, Edwards Lifesciences Inc, Irvine, CA, 2Department of Health Services and Administration, University of Maryland, College Park, MD, 3Health Economics and Outcomes Research, CTI Clinical Trial & Consulting Services Inc, Cincinnati, OH, 4Department of Preventive Medicine and Economics, Stony Brook University, Stony Brook, NY, USA Purpose: This study quantified the overall effects of aortic valve disease (AVD and mitral valve disease (MVD by disease severity on direct health-care costs to insurers and patients.Materials and methods: Based on 1996–2011 data from the Medical Expenditure Panel Survey (MEPS, a large, nationally representative US database, multivariate analyses were performed to assess the relationship between AVD and MVD and direct annual health-care costs to insurers and patients, at individual and US-aggregate levels. Adults aged 18 years and over with diagnosis codes for AVD or MVD based on International Classification of Diseases (ninth revision diagnosis codes were identified. Subjects were further classified as symptomatic AVD, asymptomatic AVD, symptomatic MVD, and asymptomatic MVD. These classifications were determined with clinical assistance and based in part on data availability in the MEPS.Results: The MEPS database included 148 patients with AVD: 53 patients with symptomatic AVD, 95 patients with asymptomatic AVD, and 1,051 with MVD, including 315 patients with symptomatic MVD and 736 patients with asymptomatic MVD. Symptomatic AVD had the largest incremental effect on annual per patient health-care expenditure: $12,789 for symptomatic AVD, $10,816 for asymptomatic AVD, $5,163 for symptomatic MVD, and $1,755 for asymptomatic MVD. When aggregated to the US population, heart-valve disease accounted for an incremental annual cost of $23.4 billion. The largest aggregate annual costs were incurred by patients with symptomatic MVD ($7

  6. Evaluation of HeartSmarts, a Faith-Based Cardiovascular Health Education Program.

    Science.gov (United States)

    Tettey, Naa-Solo; Duran, Pedro A; Andersen, Holly S; Boutin-Foster, Carla

    2017-02-01

    In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p health assessment scores had an average increase of 12.74 correct responses (p health messages and reducing cardiovascular risk among African Americans.

  7. Factors associated with health-related quality of life in stable ambulatory congestive heart failure patients: Systematic review.

    Science.gov (United States)

    Baert, Anneleen; De Smedt, Delphine; De Sutter, Johan; De Bacquer, Dirk; Puddu, Paolo Emilio; Clays, Els; Pardaens, Sofie

    2018-03-01

    Background Since improved treatment of congestive heart failure has resulted in decreased mortality and hospitalisation rates, increasing self-perceived health-related quality of life (HRQoL) has become a major goal of congestive heart failure treatment. However, an overview on predictieve factors of HRQoL is currently lacking in literature. Purpose The aim of this study was to identify key factors associated with HRQoL in stable ambulatory patients with congestive heart failure. Methods A systematic review was performed. MEDLINE, Web of Science and Embase were searched for the following combination of terms: heart failure, quality of life, health perception or functional status between the period 2000 and February 2017. Literature screening was done by two independent reviewers. Results Thirty-five studies out of 8374 titles were included for quality appraisal, of which 29 were selected for further data extraction. Four distinct categories grouping different types of variables were identified: socio-demographic characteristics, clinical characteristics, health and health behaviour, and care provider characteristics. Within the above-mentioned categories the presence of depressive symptoms was most consistently related to a worse HRQoL, followed by a higher New York Heart Association functional class, younger age and female gender. Conclusion Through a systematic literature search, factors associated with HRQoL among congestive heart failure patients were investigated. Age, gender, New York Heart Association functional class and depressive symptoms are the most consistent variables explaining the variance in HRQoL in patients with congestive heart failure. These findings are partly in line with previous research on predictors for hard endpoints in patients with congestive heart failure.

  8. A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease.

    Science.gov (United States)

    Huang, Hui-Ru; Chen, Chi-Wen; Chen, Chin-Mi; Yang, Hsiao-Ling; Su, Wen-Jen; Wang, Jou-Kou; Tsai, Pei-Kwei

    2018-03-01

    Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. A total of 320 adolescents with congenital heart disease who were aged 12-18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.

  9. Disclosing Genetic Risk for Coronary Heart Disease: Attitudes Toward Personal Information in Health Records.

    Science.gov (United States)

    Brown, Sherry-Ann; Jouni, Hayan; Marroush, Tariq S; Kullo, Iftikhar J

    2017-04-01

    Incorporating genetic risk information in electronic health records (EHRs) will facilitate implementation of genomic medicine in clinical practice. However, little is known about patients' attitudes toward incorporation of genetic risk information as a component of personal health information in EHRs. This study investigated whether disclosure of a genetic risk score (GRS) for coronary heart disease influences attitudes toward incorporation of personal health information including genetic risk in EHRs. Participants aged 45-65 years with intermediate 10-year coronary heart disease risk were randomized to receive a conventional risk score (CRS) alone or with a GRS from a genetic counselor, followed by shared decision making with a physician using the same standard presentation and information templates for all study participants. The CRS and GRS were then incorporated into the EHR and made accessible to both patients and physicians. Baseline and post-disclosure surveys were completed to assess whether attitudes differed by GRS disclosure. Data were collected from 2013 to 2015 and analyzed in 2015-2016. GRS and CRS participants reported similar positive attitudes toward incorporation of genetic risk information in the EHR. Compared with CRS participants, participants with high GRS were more concerned about the confidentiality of genetic risk information (OR=3.67, 95% CI=1.29, 12.32, p=0.01). Post-disclosure, frequency of patient portal access was associated with positive attitudes. Participants in this study of coronary heart disease risk disclosure overall had positive attitudes toward incorporation of genetic risk information in EHRs, although those who received genetic risk information had concerns about confidentiality. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Knowledge of parents about oral health in children with heart diseases

    Directory of Open Access Journals (Sweden)

    Homa Noorollahian

    2010-09-01

    Full Text Available Background: Transient bacteremia in dentistry is discussed as an important causative factor in bacterial endocarditis. The aim of this study was evaluate the knowledge of importance of dental caries prevention in parents whose children had heart disease. Materials and Method: In this descriptive cross sectional study a simple consecutive sampling was used and 320 parents (125 fathers, 195 mothers referred to the heart clinics of Zahedan were evaluated by a questionnaire. Questions were about the demographic information and their knowledge about oral health and it's relation to heart diseases. Data were analyzed using Mann-Whitney U and Kruskal-Wallis tests.Results: The results showed that the mean of their knowledge was 21.3±10.1 of 100. The father's knowledge (24.4±8.7 was higher compared to the mothers (19.23±10.3. The knowledge rural families were more than the urban families (22.5±9.8 and 14.51±9.1 respectively. Conclusion: Our findings showed limited knowledge of the parents about the interactions between oral hygiene and the risk bacterial endocarditis

  11. Periodic health examination, 1996 update: 1. Prenatal screening for and diagnosis of Down syndrome. Canadian Task Force on the Periodic Health Examination.

    Science.gov (United States)

    Dick, P T

    1996-02-15

    To make recommendations to physicians providing prenatal care on (1) whether prenatal screening for and diagnosis of Down syndrome (DS) is advisable and (2) alternative screening and diagnosis manoeuvres. "Triple-marker" screening of maternal serum levels of alpha-fetoprotein, human chorionic gonadotropin and unconjugated estriol; fetal ultrasonographic examination; amniocentesis; and chorionic villus sampling (CVS). Accuracy of detection of DS in fetuses, and risks to the mother, including psychologic distress, and to the fetus from the screening and diagnostic interventions. A MEDLINE search for relevant articles published from Jan. 1, 1966, to Mar. 31, 1994, with the use of MeSH terms "Down syndrome," "prenatal diagnosis," "screening," "prevention," "amniocentesis," "chorionic villus sampling," "ultrasonography," "anxiety," "depression" and "psychological stress" and a manual search of bibliographies, recent issues of key journals and Current Contents. The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. A high value was placed on providing pregnant women with the opportunity to determine whether they are carrying a fetus with DS and to make choices concerning the termination of the pregnancy. The economic issues involved are complex and were not considered. Triple-marker screening identifies an estimated 58% of fetuses with DS, but it has an estimated rate of true-positive results of 0.1% and of false-positive results of 3.7% (given a risk cut-off of one chance in 190 of DS). These rates vary with maternal age and the risk cut-off chosen. Women with a known risk of having a fetus with DS (e.g., those who have had a previous child with DS) may benefit from a reduction in anxiety after confirmation that their fetus does not have DS. Screening allows women at low risk of having a child with DS to detect fetuses with the syndrome, but may cause psychologic distress if there is a false-positive screening test

  12. Health-related fitness profiles in adolescents with complex congenital heart disease

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Wetterslev, Jørn; Søndergaard, Lars

    2015-01-01

    PURPOSE: This study investigates whether subgroups of different health-related fitness (HrF) profiles exist among girls and boys with complex congenital heart disease (ConHD) and how these are associated with lifestyle behaviors. METHODS: We measured the cardiorespiratory fitness, muscle strength...... in the Robust clusters reported leading a physically active lifestyle and participants in the Less robust cluster reported leading a sedentary lifestyle. Diagnoses were evenly distributed between clusters. CONCLUSIONS: The cluster analysis attributed some of the variability in cardiorespiratory fitness among...

  13. Assessing responsiveness of generic and specific health related quality of life measures in heart failure

    Directory of Open Access Journals (Sweden)

    Johnson Jeffrey A

    2006-11-01

    Full Text Available Abstract Background Responsiveness, or sensitivity to clinical change, is an important consideration in selection of a health-related quality of life (HRQL measure for trials or clinical applications. Many approaches can be used to assess responsiveness, which may affect the interpretation of study results. We compared the relative responsiveness of generic and heart failure specific HRQL instruments, as measured both by common psychometric indices and by external clinical criteria. Methods We analyzed data collected at baseline and 6-weeks in 298 subjects with heart failure on the following HRQL measures: EQ-5D (US, UK, and VAS Scoring, Kansas City Cardiomyopathy Questionnaire (KCCQ (Clinical and Overall Summary Score, and RAND12 (Physical and Mental Component Summaries. Three external indicators of clinical change were used to classify subjects as improved, deteriorated, or unchanged: 6-minute walk test, New York Heart Association (NYHA class, and physician global rating of change. Four responsiveness statistics (T-test, effect size, Guyatt's responsiveness statistic, and standardized response mean were used to evaluate the responsiveness of the select measures. The median rank of each HRQL measure across responsiveness indices and clinical criteria was then determined. Results Average age of subjects was 60 years, 75 percent were male, and had moderate to severe heart failure symptoms. Overall, the KCCQ Summary Scores had the highest relative ranking, irrespective of the responsiveness index or external criterion used. Importantly, we observed that the relative ranking of responsiveness of the generic measures (i.e. EQ-5D, RAND12 was influenced by both the responsive indices and external criterion used. Conclusion The disease specific KCCQ was the most responsive HRQL measure assessing change over a 6-week period, although generic measures provide information for which the KCCQ is not suitable. The responsiveness of generic HRQL measures may

  14. Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure.

    Science.gov (United States)

    Cajita, Maan Isabella; Hodgson, Nancy A; Lam, Katherine Wai; Yoo, Sera; Han, Hae-Ra

    2018-05-04

    The purpose of this descriptive, exploratory study was to assess the perceptions of older adults with heart failure regarding the use of mobile technology and to identify potential facilitators of and barriers to mHealth adoption. Semistructured interviews were used to collect data. Transcripts were analyzed using qualitative content analysis. The findings indicated that older adults do not base their intention to use mHealth solely on perceived ease of use and perceived usefulness, as outlined in the Technology Acceptance Model. The following themes emerged from the content analysis: facilitators included previous experience with mobile technology, willingness to learn mHealth, ease of use, presence of useful features, adequate training, free equipment, and doctor's recommendation; barriers included lack of knowledge regarding how to use mHealth, decreased sensory perception, lack of need for technology, poorly designed interface, cost of technology, and limited/fixed income. Overall, the findings suggest that older adults are willing to use mobile health technology, albeit with reservations. Future researchers who seek to implement mHealth-based interventions should address person-related, technology-related, and contextual barriers, and simultaneously capitalize on the influence of potential facilitators, such as a physician's recommendation, to promote mHealth adoption.

  15. Metabolic Modulators in Heart Disease: Past, Present, and Future.

    Science.gov (United States)

    Lopaschuk, Gary D

    2017-07-01

    Ischemic heart disease and heart failure are leading causes of mortality and morbidity worldwide. They continue to be major burden on health care systems throughout the world, despite major advances made over the past 40 years in developing new therapeutic approaches to treat these debilitating diseases. A potential therapeutic approach that has been underutilized in treating ischemic heart disease and heart failure is "metabolic modulation." Major alterations in myocardial energy substrate metabolism occur in ischemic heart disease and heart failure, and are associated with an energy deficit in the heart. A metabolic shift from mitochondrial oxidative metabolism to glycolysis, as well as an uncoupling between glycolysis and glucose oxidation, plays a crucial role in the development of cardiac inefficiency (oxygen consumed per work performed) and functional impairment in ischemic heart disease as well as in heart failure. This has led to the concept that optimizing energy substrate use with metabolic modulators can be a potentially promising approach to decrease the severity of ischemic heart disease and heart failure, primarily by improving cardiac efficiency. Two approaches for metabolic modulator therapy are to stimulate myocardial glucose oxidation and/or inhibit fatty acid oxidation. In this review, the past, present, and future of metabolic modulators as an approach to optimizing myocardial energy substrate metabolism and treating ischemic heart disease and heart failure are discussed. This includes a discussion of pharmacological interventions that target enzymes involved in fatty acid uptake, fatty acid oxidation, and glucose oxidation in the heart, as well as enzymes involved in ketone and branched chain amino acid catabolism in the heart. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  16. Atoms for Power, Health and the Environment. 31st annual conference of the Canadian Nuclear Society and 34th annual conference of the Canadian Nuclear Society and Canadian Nuclear Association

    International Nuclear Information System (INIS)

    2010-01-01

    The 31st Annual Conference of the CNS and 34th Annual Student Conference of the CNS and CNA was held in Montreal, Quebec, Canada on May 24-27, 2010. The theme of the conference, 'Atoms for Power, Health, and the Environment', brought together scientists, engineers, technologists and students interested in all aspects and applications of energy from the atom. The central objective of this conference was to provide a forum for exchange of views on how this technical enterprise can best serve the needs of humanity, now and in the future. There were over 400 attendees and more than 100 technical papers, as well as plenary sessions that addressed broad industrial and commercial developments in the field.

  17. Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhu, Li-Xia; Ho, Shuk-Ching; Wong, Thomas K S

    2013-11-01

    Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants' physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients. Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta-analysis was done using the random-effect model. Thirty-seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty-eight studies were included in the meta-analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior. Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  18. Intervention Mapping Approach in the Design of an Interactive Mobile Health Application to Improve Self-care in Heart Failure.

    Science.gov (United States)

    Athilingam, Ponrathi; Clochesy, John M; Labrador, Miguel A

    2018-02-01

    Heart failure is a complex syndrome among older adults who may experience and interpret symptoms differently. These differences in symptom interpretation may influence decision-making in symptom management. A well-informed and motivated person may develop the knowledge and skills needed to successfully manage symptoms. Therefore, the patient-centered mobile health application HeartMapp was designed to engage patients with heart failure in self-care management by offering tailored alerts and feedback using mobile phones. The main objective of this article is to describe the six-step intervention mapping approach including (1) the initial needs assessment, (2) proximal program objective, (3) selection of theory-based methods, (4) the translation of objectives into an actual program plan for mobile health intervention, (5) adaptation and implementation plan, and (6) evaluation plan that assisted the team in the development of a conceptual framework and intervention program matrix during the development of HeartMapp. The HeartMapp intervention takes the information, motivation, and behavioral skills model as the theoretical underpinning, with "patient engagement" as the key mediator in achieving targeted and persistent self-care behavioral changes in patients with heart failure. The HeartMapp intervention is proposed to improve self-care management and long-term outcomes.

  19. Heart Disease and Stroke Statistics

    Science.gov (United States)

    ... Media for Heart.org Heart and Stroke Association Statistics Each year, the American Heart Association, in conjunction ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

  20. Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development.

    Science.gov (United States)

    Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob

    2016-04-29

    Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Canada-wide EDI records from 2004 to 2014 (representing over 700,000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood development action and policies, using the database as a tool

  1. Cardiometabolic risks, lifestyle health behaviors and heart disease in Filipino Americans.

    Science.gov (United States)

    Bayog, Maria Lg; Waters, Catherine M

    2017-08-01

    Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations. The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population. Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey. The metropolitan sample of Filipino American adults included 57.3% women and had a mean age of 47.9 ± 18.3 years ( n = 555). Among the sample, 7.4% had heart disease, 38.9% had hypertension, 16.6% had diabetes, 12.4% smoked cigarettes, 83.2% were insufficiently active, 54.2% were overweight/obese, 21.8% routinely ate fast food, 13.2% routinely drank soda and 90.3% did not meet the fruit/vegetable consumption recommendation. Age (unadjusted odds ratio [OR] = 1.0, p Filipino American population. A multidisciplinary, chronic care model that is population-specific, emphasizes integrated, comprehensive care and provides linkages between primary healthcare and community resources is recommended for practice.

  2. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pelle, Aline J; Smith, Otto R F

    2009-01-01

    Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF....

  3. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Widdershoven, Jos W

    2005-01-01

    Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether T...

  4. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    Science.gov (United States)

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-04-03

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

  5. [Medical and surgical health care for congenital heart disease: a panoramic vision of the reality in Mexico. Inquiry 2009].

    Science.gov (United States)

    Calderón-Colmenero, Juan; De-la-Llata, Manuel; Vizcaíno, Alfredo; Ramírez, Samuel; Bolio, Alejandro

    2011-01-01

    The only way to characterize the Mexican problem related to congenital heart disease care is promoting the creation of a national database for registering the organization, resources, and related activities. The Health Secretary of Mexico adopted a Spanish registration model to design a survey for obtaining a national Mexican reference in congenital heart disease. This survey was distributed to all directors of medical and/or surgical health care centers for congenital heart disease in Mexico. This communication presents the results obtained in relation to organization, resources and activities performed during the last year 2009. From the 22 health care centers which answered the survey 10 were reference centers (45%) and 12 were assistant centers (55%). All of them are provided with cardiologic auxiliary diagnostic methods. Except one, all centers have at least one bidimentional echocardiography apparatus. There is a general deficit between material and human resources detected in our study. Therapeutic actions for congenital heart disease (70% surgical and 30% therapeutical interventionism) show a clear centralization tendency for this kind of health care in Mexico City, Monterrey and finally Guadalajara. Due to the participation of almost all cardiac health centers in Mexico, our study provides an important information related to organization, resources, and medical and/or surgical activities for congenital heart disease. The data presented not only show Mexican reality, but allows us to identify better the national problematic for establishing priorities and propose solution alternatives.

  6. The impact of taxation reduction on smoking in youth between 1990 and 1999: results from a reconstructed cohort analysis of the Canadian Community Health Surveys.

    Science.gov (United States)

    Birkett, Nicholas J

    2014-01-01

    Increases in taxation can contribute to smoking control. In the early 1990's, tobacco smuggling rates in Canada increased dramatically. Governments responded with a substantial reduction in taxes on tobacco products. This study examines the impact of these tax changes on smoking in youth in Canada. Data on smoking from three consecutive cycles of the Canadian Community Health Surveys were combined and analyzed using a reconstructed cohort approach. Age, sex and calendar year specific rates of smoking experimentation and the onset of daily smoking were estimated for youth. Estimates apply to the entire Canadian population. There was a strong increase in smoking in youth in the years following the reduction in tobacco taxes. The increase was stronger in women. The rates returned to pre-1990 rates by about 2002. The number of excess daily smokers for people born between 1977 and 1985 that can be linked to the taxation reduction is about 190,000. There is strong evidence that reduction of tobacco taxes to combat smuggling had an adverse impact on smoking rates in youth.

  7. A booming economy means a bursting trauma system: association between hospital admission for major injury and indicators of economic activity in a large Canadian health region.

    Science.gov (United States)

    Roberts, Derek J; Das, Debanjana; Mercado, Michelle; Vis, Christine; Kortbeek, John B; Kirkpatrick, Andrew W; Ball, Chad G

    2014-05-01

    Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression. An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged. Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. CADIOVASCULAR HEALTH AND INCIDENT HYPERTENSION IN AFRICAN AMERICANS: THE JACKSON HEART STUDY

    Science.gov (United States)

    Booth, John N.; Abdalla, Marwah; Tanner, Rikki M.; Diaz, Keith M.; Bromfield, Samantha G.; Tajeu, Gabriel S.; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P.; Spruill, Tanya M.; Shimbo, Daichi; Muntner, Paul

    2018-01-01

    Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trendhypertension risk. PMID:28652461

  9. Differential Item Functioning in the SF-36 Physical Functioning and Mental Health Sub-Scales: A Population-Based Investigation in the Canadian Multicentre Osteoporosis Study.

    Directory of Open Access Journals (Sweden)

    Lisa M Lix

    Full Text Available Self-reported health status measures, like the Short Form 36-item Health Survey (SF-36, can provide rich information about the overall health of a population and its components, such as physical, mental, and social health. However, differential item functioning (DIF, which arises when population sub-groups with the same underlying (i.e., latent level of health have different measured item response probabilities, may compromise the comparability of these measures. The purpose of this study was to test for DIF on the SF-36 physical functioning (PF and mental health (MH sub-scale items in a Canadian population-based sample.Study data were from the prospective Canadian Multicentre Osteoporosis Study (CaMos, which collected baseline data in 1996-1997. DIF was tested using a multiple indicators multiple causes (MIMIC method. Confirmatory factor analysis defined the latent variable measurement model for the item responses and latent variable regression with demographic and health status covariates (i.e., sex, age group, body weight, self-perceived general health produced estimates of the magnitude of DIF effects.The CaMos cohort consisted of 9423 respondents; 69.4% were female and 51.7% were less than 65 years. Eight of 10 items on the PF sub-scale and four of five items on the MH sub-scale exhibited DIF. Large DIF effects were observed on PF sub-scale items about vigorous and moderate activities, lifting and carrying groceries, walking one block, and bathing or dressing. On the MH sub-scale items, all DIF effects were small or moderate in size.SF-36 PF and MH sub-scale scores were not comparable across population sub-groups defined by demographic and health status variables due to the effects of DIF, although the magnitude of this bias was not large for most items. We recommend testing and adjusting for DIF to ensure comparability of the SF-36 in population-based investigations.

  10. Socioeconomic and Cultural Correlates of Diet Quality in the Canadian Arctic: Results from the 2007-2008 Inuit Health Survey.

    Science.gov (United States)

    Galloway, Tracey; Johnson-Down, Louise; Egeland, Grace M

    2015-09-01

    We examined the impact of socioeconomic and cultural factors on dietary quality in adult Inuit living in the Canadian Arctic. Interviews and a 24-h dietary recall were administered to 805 men and 1292 women from Inuit regions in the Canadian Arctic. We examined the effect of age, sex, education, income, employment, and cultural variables on respondents' energy, macronutrient intake, sodium/potassium ratio, and healthy eating index. Logistic regression was used to assess the impact of socioeconomic status (SES) on diet quality indicators. Age was positively associated with traditional food (TF) consumption and greater energy from protein but negatively associated with total energy and fibre intake. Associations between SES and diet quality differed considerably between men and women and there was considerable regional variability in diet quality measures. Age and cultural variables were significant predictors of diet quality in logistic regression. Increased age and use of the Inuit language in the home were the most significant predictors of TF consumption. Our findings are consistent with studies reporting a nutrition transition in circumpolar Inuit. We found considerable variability in diet quality and complex interaction between SES and cultural variables producing mixed effects that differ by age and gender.

  11. Financial burdens and mental health needs in families of children with congenital heart disease.

    Science.gov (United States)

    McClung, Nancy; Glidewell, Jill; Farr, Sherry L

    2018-04-06

    To examine the financial burdens and mental health needs of families of children with special healthcare needs (CSHCN) with congenital heart disease (CHD). Data from the 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used to examine parent-reported financial burdens (out-of-pocket expenses, financial problems, employment impact, caregiving hours) and family members' need for mental health services in families of CSHCN with CHD. Multivariable logistic regression was used to compare financial burdens and family members' need for mental health services among CSHCN with and without CHD. Among CSHCN with CHD, multivariable logistic regression, stratified by age (0-5 and 6-17 years), was used to assess characteristics associated with the outcomes. Overall, families of 89.1% of CSHCN with CHD experienced at least one financial burden and 14.9% needed mental health services due to the child's condition. Compared with CSHCN without CHD, those with CHD had families with a higher prevalence of all financial burdens (adjusted prevalence ratio [aPR] range: 1.4-1.8) and similar family member need for mental health services (aPR = 1.3, 95% CI [1.0, 1.6]). Across both age groups, insurance type, activity limitations, and comorbidities were significantly associated with financial burdens and/or family members' need for mental health services. CSHCN with CHD, compared with those without CHD, lived in families with more financial burdens. Interventions that reduce financial burdens and improve mental health of family members are needed, especially among CSHCN with CHD who are uninsured and have comorbidities or activity limitations. © 2018 Wiley Periodicals, Inc.

  12. Canadian perspectives in evaluating transparency

    International Nuclear Information System (INIS)

    Herwig, L.

    2007-01-01

    The Canadian Nuclear Safety Commission's mission is to regulate the use of nuclear energy and materials to protect the health, safety, and security of Canadians and the environment, as well as to respect Canada's international commitments on the peaceful use of nuclear energy. In 2001, the CNSC established a vision to be one of the best nuclear regulators in the world and established four strategic priorities of effectiveness, transparency, excellence in staff, and efficiency. While fulfilling a very comprehensive mandate, the CNSC operates with a. very clear vision of its clientele - the Canadian people. That commitment guides every employee and every action of the CNSC and ensures a firm commitment to transparency. The presentation will begin with a brief overview of the worldwide context of transparency and transparency measurement, with a look at what lessons can be learned from other organizations and initiatives. It will look broadly at the Canadian context and the government framework that establishes transparency, including the keystone legislation of the Access to Information Act. The presentation will then focus on the Canadian Nuclear Safety Commission. The CNSC is firmly committed to putting additional measures in place to ensure transparency, which is being done concurrently with an overall organisational performance measurement system. It is within this framework that the presentation will address the transparency efforts at the CNSC as well transparency measurement activities. And, finally, the presentation will look at future directions for transparency and its measurement at the CNSC. (author)

  13. Exploratory study into awareness of heart disease and health care seeking behavior among Emirati women (UAE) - Cross sectional descriptive study.

    Science.gov (United States)

    Khan, Sarah; Ali, Syed Adnan

    2017-09-26

    Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually happen in older women thus symptoms of heart disease may be masked by symptoms of chronic diseases, which could explain the delay in seeking health care and higher mortality following an ischaemic episode among women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women's health care seeking behaviour in UAE. A cross sectional, descriptive study was conducted using a survey instrument adapted from the American Heart Association National survey. A convenience sample of 676 Emirati women between the ages of 18-55 years completed the questionnaire. The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p < 0.05) among all the other emirates and in the 18-45 years age group (OR 2.74, p < 0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking health care. Interestingly, just 49.1% Emirati women believed that good quality and affordable health care was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries. Emirati women clearly lack the knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific awareness on heart disease risks and symptoms. The study has also highlighted potential modifiable barriers in seeking health care that should be overcome to reduce morbidity and mortality due to heart

  14. Coping Styles Mediate the Relationship Between Self-esteem, Health Locus of Control, and Health-Promoting Behavior in Chinese Patients With Coronary Heart Disease.

    Science.gov (United States)

    Zou, Huijing; Tian, Qian; Chen, Yuxia; Cheng, Cheng; Fan, Xiuzhen

    Health-promoting behavior plays an important role in reducing the burden of coronary heart disease. Self-esteem and health locus of control may contribute to health-promoting behavior, and coping styles may mediate these associations. The aims of our study were to examine whether self-esteem and health locus of control are associated with health-promoting behavior and examine the possible mediating effect of coping styles in patients with coronary heart disease. Health-promoting behavior, self-esteem, health locus of control, and coping styles were assessed in 272 hospitalized patients (60 ± 12 years, 61% male) with coronary heart disease. Hierarchical regression analysis was conducted to analyze the relationships between health-promoting behavior and other variables. Mediation effect was examined according to the methods of Baron and Kenny. The mean score for health-promoting behavior was 2.57 ± 0.51; 38.2% of patients (n = 104) scored lower than 2.5. Self-esteem (β = .139, P locus of control and health-promoting behavior. Confrontation plays a mediating role in the association among self-esteem, internal health locus of control, and health-promoting behavior. Strategies should be undertaken to encourage the use of confrontation coping style, which will facilitate health-promoting behavior.

  15. Monitoring and Follow-up of Chronic Heart Failure: a Literature Review of eHealth Applications and Systems.

    Science.gov (United States)

    de la Torre Díez, Isabel; Garcia-Zapirain, Begoña; Méndez-Zorrilla, Amaia; López-Coronado, Miguel

    2016-07-01

    In developed countries heart failure is one of the most important causes of death, followed closely by strokes and other cerebrovascular diseases. It is one of the major healthcare issues in terms of increasing number of patients, rate of hospitalizations and costs. The main aim of this paper is to present telemedicine applications for monitoring and follow-up of heart failure and to show how these systems can help reduce costs of administering heart failure. The search for e-health applications and systems in the field of telemonitoring of heart failure was pursued in IEEE Xplore, Science Direct, PubMed and Scopus systems between 2005 and the present time. This search was conducted between May and June 2015, and the articles deemed to be of most interest about treatment, prevention, self-empowerment and stabilization of patients were selected. Over 100 articles about telemonitoring of heart failure have been found in the literature reviewed since 2005, although the most interesting ones have been selected from the scientific standpoint. Many of them show that telemonitoring of patients with a high risk of heart failure is a measure that might help to reduce the risk of suffering from the disease. Following the review conducted, in can be stated that via the research articles analysed that telemonitoring systems can help to reduce the costs of administering heart failure and result in less re-hospitalization of patients.

  16. Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

    Science.gov (United States)

    McCraty, Rollin; Shaffer, Fred

    2015-01-01

    Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

  17. Vitamin C and Heart Health: A Review Based on Findings from Epidemiologic Studies

    Directory of Open Access Journals (Sweden)

    Melissa A. Moser

    2016-08-01

    Full Text Available Vitamin C is a powerful dietary antioxidant that has received considerable attention in the literature related to its possible role in heart health. Although classical vitamin C deficiency, marked by scurvy, is rare in most parts of the world, some research has shown variable heart disease risks depending on plasma vitamin C concentration, even within the normal range. Furthermore, other studies have suggested possible heart-related benefits to vitamin C taken in doses beyond the minimal amounts required to prevent classically defined deficiency. The objective of this review is to systematically review the findings of existing epidemiologic research on vitamin C and its potential role in cardiovascular disease (CVD. It is well established that vitamin C inhibits oxidation of LDL-protein, thereby reducing atherosclerosis, but the cardiovascular outcomes related to this action and other actions of vitamin C are not fully understood. Randomized controlled trials as well as observational cohort studies have investigated this topic with varying results. Vitamin C has been linked in some work to improvements in lipid profiles, arterial stiffness, and endothelial function. However, other studies have failed to confirm these results, and observational cohort studies are varied in their findings on the vitamin’s effect on CVD risk and mortality. Overall, current research suggests that vitamin C deficiency is associated with a higher risk of mortality from CVD and that vitamin C may slightly improve endothelial function and lipid profiles in some groups, especially those with low plasma vitamin C levels. However, the current literature provides little support for the widespread use of vitamin C supplementation to reduce CVD risk or mortality.

  18. [Quality of service provided to heart surgery patients of the Unified Health System-SUS].

    Science.gov (United States)

    Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

    2010-01-01

    To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (Pquality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

  19. Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study.

    Science.gov (United States)

    Sims, Mario; Diez-Roux, Ana V; Gebreab, Samson Y; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-02-01

    Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES). Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, pwomen, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, pdiscrimination: -0.08, pdiscrimination was associated with more smoking and fewer hours of sleep in women only. Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Factors Affecting Health Related Quality of Life in Hospitalized Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Georgia Audi

    2017-01-01

    Full Text Available This study identified factors affecting health related quality of life (HRQOL in 300 hospitalized patients with heart failure (HF. Data were collected by the completion of a questionnaire which included patients’ characteristics and the Minnesota Living with Heart Failure Questionnaire (MLHFQ. Analysis of data showed that the median of the total score of MLHFQ was 46 and the median of the physical and mental state was 22 and 6, respectively. Also, participants who were householders or had “other” professions had lower score of 17 points and therefore better quality of life compared to patients who were civil/private employees (p<0.001 and p<0.001, resp.. Patients not receiving anxiolytics and antidepressants had lower quality of life scores of 6 and 15.5 points, respectively, compared to patients who received (p=0.003 and p<0.001, resp.. Patients with no prior hospitalization had lower score of 7 points compared to those with prior hospitalization (p=0.002, whereas patients not retired due to the disease had higher score of 7 points (p=0.034. Similar results were observed for the physical and mental state. Improvement of HF patients’ quality of life should come to the forefront of clinical practice.

  1. Big heart data: advancing health informatics through data sharing in cardiovascular imaging.

    Science.gov (United States)

    Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R; Young, Alistair A

    2015-07-01

    The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases.

  2. Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L.; Berg, Selina K.; Rasmussen, Trine B.

    2016-01-01

    Objective: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart......-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. Results: 76% were men, mean age 62 years......, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0...

  3. Chocolate consumption and risk of heart failure in the Physicians' Health Study.

    Science.gov (United States)

    Petrone, Andrew B; Gaziano, J Michael; Djoussé, Luc

    2014-12-01

    To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure (HF). We prospectively studied 20 278 men from the Physicians' Health Study. Chocolate consumption was assessed between 1999 and 2002 via a self-administered food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of HF. During a mean follow-up of 9.3 years there were 876 new cases of HF. The mean age at baseline was 66.4 ± 9.2 years. Hazard ratios [95% confidence intervals (CI)] for HF were 1.0 (ref), 0.86 (0.72-1.03), 0.80 (0.66-0.98), 0.92 (0.74-1.13), and 0.82 (0.63-1.07), for chocolate consumption of less than 1/month, 1-3/week, 2-4/week, and 5+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol, exercise, energy intake, and history of atrial fibrillation (P for quadratic trend = 0.62). In a secondary analysis, chocolate consumption was inversely associated with risk of HF in men whose BMI was chocolate might be associated with a lower risk of HF in male physicians. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  4. The "Canadian" in Canadian Children's Literature.

    Science.gov (United States)

    Bainbridge, Joyce; Wolodko, Brenda

    2001-01-01

    Notes that a rich body of Canadian children's literature exists that reflects the country's literary and socio-cultural values, beliefs, themes and images, including those of geography, history, language and identity. Discusses how Canadians tend to identify themselves first by region or province and then by nation. (SG)

  5. Understanding Campus Culture and Student Coping Strategies for Mental Health Issues in Five Canadian Colleges and Universities

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    Giamos, Dimitris; Lee, Alex Young Soo; Suleiman, Amanda; Stuart, Heather; Chen, Shu-Ping

    2017-01-01

    This study aimed to better understand campus mental health culture and student mental health coping strategies, and to identify the mental health needs of students as well as gaps in mental health services within postsecondary education. A videovoice method was used to identify and document health-related issues and advocate for change. Forty-one…

  6. Protest: The Canadian pulse

    International Nuclear Information System (INIS)

    Lott, J.E.

    1979-01-01

    This popularly written article compares Canadian attitudes to protests against nuclear power to those in the United States. Canadian protesters are more peaceful, expressing their opinions within the law. The article describes the main anti-nuclear groups in Canada and presents the results of public opinion surveys of Canadians on the use of nuclear power for generating electricity. (TI)

  7. Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal

    Directory of Open Access Journals (Sweden)

    Nadia Fazal

    2017-11-01

    Full Text Available Introduction: In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. Methods: The promising practices criteria were developed using the Public Health Agency of Canada’s (PHAC’s existing best practices criteria as the foundation. They were modified and pilot tested (three rounds using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. Results: The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. Conclusion: While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal’s screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

  8. Sense of coherence does not moderate the relationship between the perceived impact of stress on health and self-rated health in adults with congenital heart disease.

    Science.gov (United States)

    Apers, Silke; Sevenants, Lien; Budts, Werner; Luyckx, Koen; Moons, Philip

    2016-12-01

    Adults with congenital heart disease seem to be more distressed than their healthy counterparts, which might render them even more susceptible to developing detrimental health outcomes. Previous research has confirmed the relationship between the perceived impact of stress on health and self-rated health. However, it remains unknown whether sense of coherence, a person's capacity to cope with stressors, moderates this relationship. This cross-sectional study aims to explore: the relationship between demographic and clinical characteristics, sense of coherence, and the perceived impact of stress on health; the relationship between the perceived impact of stress on health and self-rated health; and the moderating effect of sense of coherence in a sample of adults with congenital heart disease. Patients were recruited from the database of congenital and structural cardiology of a university hospital. The analytic sample included 255 patients (median age 35 years; 50% men). Data were obtained using self-report questionnaires and through medical record view. Univariate analyses and multiple regression analysis were conducted. The perceived impact of stress on health was negatively associated with sense of coherence (Pstress on health and self-rated health were negatively associated (Prelationship. Our findings support the need for further research on the perceived impact of stress on health. Such insights can be valuable for developing interventions aimed at reducing the negative health consequences of stress in patients with congenital heart disease. © The European Society of Cardiology 2015.

  9. Health Literacy and Global Cognitive Function Predict E-Mail but Not Internet Use in Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Jared P. Schprechman

    2013-01-01

    Full Text Available Background. The internet offers a potential for improving patient knowledge, and e-mail may be used in patient communication with providers. However, barriers to internet and e-mail use, such as low health literacy and cognitive impairment, may prevent patients from using technological resources. Purpose. We investigated whether health literacy, heart failure knowledge, and cognitive function were related to internet and e-mail use in older adults with heart failure (HF. Methods. Older adults (N=119 with heart failure (69.84±9.09 years completed measures of health literacy, heart failure knowledge, cognitive functioning, and internet use in a cross-sectional study. Results. Internet and e-mail use were reported in 78.2% and 71.4% of this sample of patients with HF, respectively. Controlling for age and education, logistic regression analyses indicated that higher health literacy predicted e-mail (P<.05 but not internet use. Global cognitive function predicted e-mail (P<.05 but not internet use. Only 45% used the Internet to obtain information on HF and internet use was not associated with greater HF knowledge. Conclusions. The majority of HF patients use the internet and e-mail, but poor health literacy and cognitive impairment may prevent some patients from accessing these resources. Future studies that examine specific internet and email interventions to increase HF knowledge are needed.

  10. Towards a Broader Conceptualization of Need, Stigma, and Barriers to Mental Health Care in Military Organizations: Recent Research Findings from the Canadian Forces

    Science.gov (United States)

    2011-04-01

    disorder for which help is availablethese individuals acknowledge symptoms but dont recognize unmet need. And among those who do identify unmet need...Canadian general population. 2006. Poster presented at the Canadian Psychiatric Association Annual Meeting, Toronto, ON. [10] Fikretoglu D, Guay...occupational risk factors. Poster presented at the American Psychiatric Association Meeting, Toronto, ON, 24 May 2006 . 5-24-2006. [41] Canadian

  11. [Healthy heart: Results of a community education program on cardiovascular health].

    Science.gov (United States)

    Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

    2014-11-01

    To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), pcardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

  12. An exploratory, descriptive study of consumer opinions and behaviors regarding health products sales at 4 chiropractic practices in a large, western Canadian urban center.

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    Page, Stacey A; Mbadiwe, Chinyere; McMorland, D Gordon; Grod, Jaroslaw P

    2015-01-01

    This study describes the opinions and behaviors of chiropractic patients in a large, western Canadian urban center regarding the sale of health products by doctors of chiropractic. A brief, descriptive survey consisting of both fixed-choice and open-ended questions was distributed by clinic reception staff at 4 chiropractic offices in Calgary, Alberta, Canada. Each practice sold a range of health products, including those relating to musculoskeletal care and nutrition, and served between 275 and 320 clients per week. After a 10-week recruitment interval between January and March 2013, a convenience sample of 103 chiropractic patients was obtained. Most patients supported the sale of health products by doctors of chiropractic (n = 101; 98.1%), and most had made health product purchases from a doctor of chiropractic at some point (n = 73; 70.9%). Products relating to muscular care, exercise/rehabilitation products, and pillows were purchased most often (>40%). Consumers were most supportive of doctors of chiropractic selling products they perceived to be directly related to musculoskeletal care. Some participants believed that there should be limits placed on the range of products sold including the products had to be consistent with the practitioner's area of expertise and had to have some demonstrated level of effectiveness. Primary reasons for health product purchase included the doctor's recommendations, convenience, and perception that the product would improve well-being (>50%). This study found that chiropractic patients were supportive of health product sales by doctors of chiropractic, assuming certain conditions were met. Consumers believed that product sales should be undertaken with integrity and should be consistent with the doctor's area of expertise. Consumer beliefs appeared to impact their purchasing behaviors. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  13. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives’ perspectives

    Science.gov (United States)

    Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca

    2013-01-01

    Objectives Medical tourism involves patients’ intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. Design We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Participants Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Results Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Conclusions Concern was expressed that medical tourism might have unintended and undesired effects upon patients’ home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose

  14. A pilot study of expenditures on, and utilization of resources in, health care in adults with congenital heart disease.

    Science.gov (United States)

    Moons, P; Siebens, K; De Geest, S; Abraham, I; Budts, W; Gewillig, M

    2001-05-01

    Congenital cardiac disease may be a chronic condition, necessitating life-long follow-up for a substantial proportion of the patients. Such patients, therefore, are often presumed to be high users of resources for health care. Information on utilization of resources in adults with congenital heart disease, however, is scarce. This retrospective pilot study, performed in Belgium, investigated 192 adults with congenital heart disease to measure the annual expenditures and utilization of health care and compared the findings with data from the general population. We also sought to explore demographic and clinical parameters as predictors for the expenditures. Hospitalization was documented in 20.3% of the patients, with a median length of stay of 5 days. The overall payment by health insurance associations in 1997 was 1794.5 ECU per patient, while patients paid on average 189.5 ECU out-of-pocket. For medication, the average reimbursement and out-of-pocket expenses were estimated at 78 ECU and 20 ECU, respectively. Expenditures for patients with congenital heart disease were considerably higher than the age and gender-corrected expenditures for the general population (411.7 ECU), though this difference was accounted for by only one-eighth of the cohort of those with congenital heart disease. In general, higher expenditures were associated with abnormal left ventricular end-diastolic diameter, female gender, functional impairment and higher age, although the explained variance was limited. Our study has provided pilot data on the economic outcomes for patients with congenital heart diseases. We have identified parameters that could predict expenditure, but which will have to be examined in future research. This is needed to develop guidelines for health insurance for those with congenital heart diseases.

  15. Signs for early diagnosis of heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Devroey D

    2011-09-01

    Full Text Available Dirk Devroey1,2, Viviane Van Casteren11Scientific Institute of Public Health, Unit of Epidemiology, Brussels, Belgium; 2Vrije Universiteit Brussel (VUB, Department of Family Medicine, Brussels, BelgiumObjective: The current guidelines for the diagnosis of heart failure (HF are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.Materials/subjects and methods: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.Results: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018. From a logistic regression, breathlessness on exercise (P < 0.001, limitations of physical activity (P = 0.003, and orthopnea (P = 0.040 were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001, peripheral edema (P < 0.001, and raised jugular venous pressure (P = 0.039. An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.Conclusion: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.Keywords: heart failure, primary health care, diagnostic clinical signs

  16. Women's knowledge about heart disease: Differences among ethnic and cultural groups in the Israeli Women's Health in Midlife Study.

    Science.gov (United States)

    Blumstein, Tzvia; Benyamini, Yael; Boyko, Valentina; Lerner-Geva, Liat

    2016-01-01

    The current investigation aimed to assess levels of knowledge about risk factors for heart disease among midlife Israeli women, and to evaluate the relationship of knowledge to personal risk factors and vulnerability to heart disease. Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTR), immigrants from the former Soviet Union, and Arab women. The survey instrument included six knowledge statements relating to: the risk after menopause, family history, elevated cholesterol level, diabetes, obesity, and warning signs of a heart attack. The findings showed wide disparities in knowledge by educational level and between immigrants and LTR, after taking into account personal risk factors and education. Personal risk factors were not significantly related to the knowledge items, except for personal history of cardiovascular disease, which was associated with knowledge about "warning signs of a heart attack" and "family history." Women who perceived themselves as more vulnerable to heart disease were more likely to identify several risk factors correctly. These findings stress the need to increase knowledge about heart disease, especially among less educated and minority women, and to emphasize the risk of patients' personal status by health providers.

  17. The FORCE Fitness Profile--Adding a Measure of Health-Related Fitness to the Canadian Armed Forces Operational Fitness Evaluation.

    Science.gov (United States)

    Gagnon, Patrick; Spivock, Michael; Reilly, Tara; Mattie, Paige; Stockbrugger, Barry

    2015-11-01

    In 2013, the Canadian Armed Forces (CAF) implemented the Fitness for Operational Requirements of Canadian Armed Forces Employment (FORCE), a field expedient fitness test designed to predict the physical requirements of completing common military tasks. Given that attaining this minimal physical fitness standard may not represent a challenge to some personnel, a fitness incentive program was requested by the chain of command to recognize and reward fitness over and above the minimal standard. At the same time, it was determined that the CAF would benefit from a measure of general health-related fitness, in addition to this measure of operational fitness. The resulting incentive program structure is based on gender and 8 age categories. The results on the 4 elements of the FORCE evaluation were converted to a point scale from which normative scores were derived, where the median score corresponds to the bronze level, and silver, gold, and platinum correspond to a score which is 1, 2, and 3 SDs above this median, respectively. A suite of rewards including merit board point toward promotions and recognition on the uniform and material rewards was developed. A separate group rewards program was also tabled, to recognize achievements in fitness at the unit level. For general fitness, oxygen capacity was derived from FORCE evaluation results and combined with a measure of abdominal circumference. Fitness categories were determined based on relative risks of mortality and morbidity for each age and gender group. Pilot testing of this entire program was performed with 624 participants to assess participants' reactions to the enhanced test, and also to verify logistical aspects of the electronic data capture, calculation, and transfer system. The newly dubbed fitness profile program was subsequently approved by the senior leadership of the CAF and is scheduled to begin a phased implementation in June 2015.

  18. Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit: the International Polar Year Inuit Health Survey for Adults 2007-2008.

    Science.gov (United States)

    Egeland, Grace M; Cao, Zhirong; Young, T Kue

    2011-06-14

    Inuit have not experienced an epidemic in type 2 diabetes mellitus, and it has been speculated that they may be protected from obesity's metabolic consequences. We conducted a population-based screening for diabetes among Inuit in the Canadian Arctic and evaluated the association of visceral adiposity with diabetes. A total of 36 communities participated in the International Polar Year Inuit Health Survey. Of the 2796 Inuit households approached, 1901 (68%) participated, with 2595 participants. Households were randomly selected, and adult residents were invited to participate. Assessments included anthropometry and fasting plasma lipids and glucose, and, because of survey logistics, only 32% of participants underwent a 75 g oral glucose tolerance test. We calculated weighted prevalence estimates of metabolic risk factors for all participants. Participants' mean age was 43.3 years; 35% were obese, 43.8% had an at-risk waist, and 25% had an elevated triglyceride level. Diabetes was identified in 12.2% of participants aged 50 years and older and in 1.9% of those younger than 50 years. A hypertriglyceridemic-waist phenotype was a strong predictor of diabetes (odds ratio [OR] 8.6, 95% confidence interval [CI] 2.1-34.6) in analyses adjusted for age, sex, region, family history of diabetes, education and use of lipid-lowering medications. Metabolic risk factors were prevalent among Inuit. Our results suggest that Inuit are not protected from the metabolic consequences of obesity, and that their rate of diabetes prevalence is now comparable to that observed in the general Canadian population. Assessment of waist circumference and fasting triglyceride levels could represent an efficient means for identifying Inuit at high risk for diabetes.

  19. Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning.

    Science.gov (United States)

    Armour, Cherie; Contractor, Ateka; Elhai, Jon D; Stringer, Maurice; Lyle, Gary; Forbes, David; Richardson, J Don

    2015-07-30

    Posttraumatic stress disorder (PTSD) has been consistently reported as being highly comorbid with major depressive disorder (MDD) and as being associated with health related functional impairment (HRF). We used archival data from 283 previously war-zone deployed Canadian veterans. Latent profile analysis (LPA) was used to uncover patterns of PTSD and MDD comorbidity as measured via the PTSD Checklist-Military version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Individual membership of latent classes was used in a series of one-way ANOVAs to ascertain group differences related to HRF as measured via the Short-Form-36 Health Survey (SF-36). LPA resulted in three discrete patterns of PTSD and MDD comorbidity which were characterized by high symptoms of PTSD and MDD, moderate symptoms, and low symptoms. All ANOVAs comparing class membership on the SF-36 subscales were statistically significant demonstrating group differences across levels of HRF. The group with the highest symptoms reported the worst HRF followed by the medium and low symptom groups. These findings are clinically relevant as they demonstrate the need for continual assessment and targeted treatment of co-occurring PTSD and MDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Use of a knowledge synthesis by decision makers and planners to facilitate system level integration in a large Canadian provincial health authority

    Directory of Open Access Journals (Sweden)

    Esther Suter

    2011-03-01

    Full Text Available Purpose: The study is an examination of how a knowledge synthesis, conducted to fill an information gap identified by decision makers and planners responsible for integrating health systems in a western Canadian health authority, is being used within that organisation. Methods: Purposive sampling and snowball technique were used to identify 13 participants who were interviewed about how they are using the knowledge synthesis for health services planning and decision-making. Results: The knowledge synthesis is used by those involved in the strategic direction of the provincial healthcare organisation and those tasked with the operationalization of integration at the provincial or local level. Both groups most frequently use the ten key principles for integration, followed by the sections on integration processes, strategies and models. The key principles facilitate discussion on priority areas to be considered and provide a reference point for a desired future state. Perceived information gaps relate to a lack of detail on "how to" strategies, tools and processes that wo