WorldWideScience

Sample records for health canada chopra

  1. Canada: Health system review.

    Science.gov (United States)

    Marchildon, Gregory

    2013-01-01

    Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and

  2. Building better health care leadership for Canada: implementing evidence

    National Research Council Canada - National Science Library

    Denis, Jean-Louis; Sullivan, Terrence James

    2011-01-01

    ... of the Government of Canada through the Canada Book Fund for our publishing activities. Library and Archives Canada Cataloguing in Publication Building better health care leadership for Canada: imple...

  3. Synchronicity - The Link Between Physics and Psyche, from Pauli and Jung to Chopra

    Science.gov (United States)

    Teodorani, M.

    2006-07-01

    This book, which is entirely dedicated to the mystery of "synchronicity", is divided into three parts: a) the joint research between analytic psychologist Carl Gustav Jung and quantum physicist Wolfgang Pauli; b) synchronicity mechanisms occurring in the microscopic (canonical quantum entanglement), mesoscopic and macroscopic scales; c) research and philosophy concerning synchronicity by MD Deepak Chopra.

  4. Lessons from Canada's health program.

    Science.gov (United States)

    Terris, M

    1990-01-01

    The Canadian health program is described and analyzed. Positive features include financing through progressive taxation; complete coverage of physician and hospital services; complete absence of deductibles, copayments, and extra charges by physicians and hospitals; lower administrative costs because private insurance companies are excluded from the program; and avoidance of the straitjacket of a single federal program by decentralization to the provinces. Negative features include ever-rising costs due to the almost complete dominance of fee-for-service payment to physicians; failure to monitor the quality of care; and neglect of serious support for preventive services and improved living standards--the two most important determinants of health status. Recommendations are made for a U.S. national health program that would incorporate the positive features of the Canadian program and avoid its deficiencies.

  5. Reforming health care in Canada: current issues

    Directory of Open Access Journals (Sweden)

    Baris Enis

    1998-01-01

    Full Text Available This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government's clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada's health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness.

  6. Regulation of natural health products in Canada.

    Science.gov (United States)

    Smith, Alysyn; Jogalekar, Sumedha; Gibson, Adam

    2014-12-02

    In Canada, all natural health products (NHPs) are regulated by Health Canada (HC) under the Food and Drugs Act and the Natural Health Product Regulations. All authorized products undergo pre-market assessment for safety, efficacy and quality and the degree of pre-market oversight varies depending on the risk of the product. In Canada, over 70,000 products have been authorized for sale and over 2000 sites have been licensed to produce NHPs. In the management of NHPs on the Canadian market, HC employs a number of active and collaborative methods to address the most common issues such as contamination, adulteration and deceptive or misleading advertising practices. HC is currently evolving its approaches to NHPs to recognize them as part of the larger group of health products available without a prescription. As such, the regulatory responsibility for all over-the-counter (OTC) drugs, including non-prescription drugs and NHPs, has been transferred to a single federal division. As a result of this transition a number of benefits are being realized with respect to government efficiency, clarity for industry, support for new innovations and consolidated government interactions with the Canadian market. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Health inequities in Canada: intersectional frameworks and practices

    National Research Council Canada - National Science Library

    Hankivsky, Olena; de Leeuw, Sarah; Lee, Jo-Anne; Vissandjée, Bilkis; Khanlou, Nazilla

    2011-01-01

    ... recycled) that is processed chlorineand acid-free. Library and Archives Canada Cataloguing in Publication Health inequities in Canada : intersectional frameworks and practices / edited by Olena Hankivsky. Includes bibliographical references and index. ISBN 978-0-7748-1975-6 (bound); ISBN 978-0-7748-1972-5 (pbk) 1. Health services accessibi...

  8. Health Canada unveils plan to distribute marijuana for medical use.

    Science.gov (United States)

    Thaczuk, Derek

    2003-08-01

    Under pressure from the courts, Health Canada reluctantly comes up with a distribution plan to provide dried cannabis and seeds to patients using medical marijuana. The plan has been greeted with considerable criticism

  9. Primary health care in Canada: systems in motion.

    Science.gov (United States)

    Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

    2011-06-01

    During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

  10. The core health science library in Canada.

    Science.gov (United States)

    Huntley, J L

    1974-04-01

    Core lists in Canada are characterized by regional differences. The lists of current importance are: (1) the British Columbia acquisitions guide for hospital libraries, (2) three Saskatchewan lists for hospitals of different sizes, (3) a core list recommended for Ontario hospitals, (4) Quebec core lists, including French language lists.

  11. Comparing population health in the United States and Canada

    Directory of Open Access Journals (Sweden)

    Huguet Nathalie

    2010-04-01

    Full Text Available Abstract Background The objective of the paper is to compare population health in the United States (US and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries. Methods Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3 was used to measure overall health-related quality of life (HRQL. Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE. Results Life expectancy in Canada is higher than in the US. For those Conclusions The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance and lower levels of social and economic inequality, especially among the elderly.

  12. Canada's health care system: A relevant approach for South Africa ...

    African Journals Online (AJOL)

    Background. While countries such as the USA, South Africa and China debate health reforms to improve access to care while rationalising costs, Canada's health care system has emerged as a notable option. In the USA, meaningful discussion of the advantages and disadvantages of the Canadian system has been ...

  13. Health social work in Canada: Five trends worth noting.

    Science.gov (United States)

    Bryson, Stephanie A; Bosma, Harvey

    2018-05-30

    Highlighting a strong human rights and social justice orientation underlying health social work in Canada, this paper describes recent contributions of Canadian health social work practitioners and scholars to five areas identified by Auslander (2001) in a delphi study of health social work in its first century. Five current 'trends' are discussed which correspond with Auslander's themes of professional legitimacy and scope, social causation, dissemination of knowledge, interventions, and cultural appropriateness. These trends are: 1) defining the scope of health social work practice; 2) addressing the social determinants of health; 3) promoting evidence-based practice in health social work; 4) delivering client and family-centered care; and 5) implementing cultural safety and trauma-informed practice. Suggestions are made to further strengthen the position of health social work in Canada.

  14. Ethnicity and Postmigration Health Trajectory in New Immigrants to Canada

    Science.gov (United States)

    Kim, Il-Ho; Carrasco, Christine; Muntaner, Carles; McKenzie, Kwame

    2013-01-01

    Objectives. In this prospective cohort study, we examined the trajectory of general health during the first 4 years after new immigrants’ arrival in Canada. We focused on the change in self-rated health trajectories and their gender and ethnic disparities. Methods. Data were derived from the Longitudinal Survey of Immigrants to Canada and were collected between April 2001 and November 2005 by Statistics Canada. We used weighted samples of 3309 men and 3351 women aged between 20 and 59 years. Results. At arrival, only 3.5% of new immigrants rated their general health as poor. Significant and steady increases in poor health were revealed during the following 4 years, especially among ethnic minorities and women. Specifically, we found a higher risk of poor health among West Asian and Chinese men and among South Asian and Chinese women than among their European counterparts. Conclusions. Newly arrived immigrants are extremely healthy, but the health advantage dissipates rapidly during the initial years of settlement in Canada. Women and minority ethnic groups may be more vulnerable to social changes and postmigration settlement. PMID:23409893

  15. Canada

    International Nuclear Information System (INIS)

    Thexton, H.E.

    1987-01-01

    The development of CANDU (Canada Deuterium Uranium) type reactors in Canada is traced. What is CANDU? and how does it differ from a pressurized water reactor? Whey did Canada adopt this design? What factors have led to its success? These questions are asked and answered. First the design itself is explained. Technical problems are considered and figures on operating reliability presented. The economic advantages of CANDU are shown by comparing electricity generating costs at CANDU stations with those at coal-fired stations. Future CANDU options are discussed and prospects for CANDU considered. (U.K.)

  16. Restricted access: aboriginal women and health care in Canada

    OpenAIRE

    Falcon-Borduas, Amelie

    2010-01-01

    “Restricted Access: Aboriginal Women and Health Care in Canada” addresses the barriers faced by indigenous women when accessing health care services in Canada. Using the distinction of practical (or needs-based) and strategic (or equity-based) barriers, it highlights the impact of physical isolation, cultural differences, and socio-economic disparities when using health services. However, the emphasis is placed on strategic challenges and more specifically on the impact of marginalization fro...

  17. ORIGINAL ARTICLES Canada's health care system: A relevant ...

    African Journals Online (AJOL)

    Canada's universal health care system, named Medicare, was fully in place. While this universal .... through lotteries and 'sin taxes' on alcohol and cigarettes. Since 2004, the federal portion of ..... Himmelstein DU, Thorne D, Warren E, Woolhandler S. Medical bankruptcy in the United. States, 2007: results of a national study.

  18. Adapting online learning for Canada's Northern public health workforce

    Directory of Open Access Journals (Sweden)

    Marnie Bell

    2013-08-01

    Full Text Available Background . Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. Methods . PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Results . Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and

  19. Adapting online learning for Canada's Northern public health workforce.

    Science.gov (United States)

    Bell, Marnie; MacDougall, Karen

    2013-01-01

    Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC) collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and Metis learners. Results demonstrate that

  20. 50 CFR 21.52 - Public health control order for resident Canada geese.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Public health control order for resident... and Otherwise Injurious Birds § 21.52 Public health control order for resident Canada geese. (a) Which... Canada geese, as defined in § 21.3. (b) What is the public health control order for resident Canada geese...

  1. Royal Society of Canada expert panel report : environmental and health impacts of Canada's oil sands industry

    International Nuclear Information System (INIS)

    Gosselin, P.; Hrudey, S.E.; Naeth, M.A.; Plourde, A.; Therrien, R.; Laval Univ., Quebec City, PQ; Van Der Kraak, G.; Guelph Univ., ON; Xu, Z.

    2010-12-01

    This expert panel report was commissioned by the Royal Society of Canada to provide a comprehensive evidence-based assessment of the environmental and health impacts of Canada's oil sands industry. The report evaluated the feasibility of land reclamation and the impacts of oil sands contaminants on downstream residents. Health impacts on residents living in the Regional Municipality of Wood Buffalo were assessed, and the impacts on regional water supplies were evaluated. Regional water and ground water quantities were examined, and issues related to tailing pond operations and reclamation were examined. Ambient air quality impacts were assessed, as well as potential impacts of the oil sands industry on greenhouse gas (GHG) emissions. The environmental regulatory performance of operators in the industry was also evaluated. A summary of economic and policy issues related to the industry was also provided. The study identified major gaps in the process of assessment, prevention, and mitigation of the health impacts of oil sands exploitation, as as major indirect health impacts linked to past exploitation activities. 672 refs., 11 tabs., 11 figs. 10 appendices.

  2. Canada

    International Nuclear Information System (INIS)

    Barrett, J.

    1991-01-01

    Canada, while professing a non-nuclear policy for its own armed forces, is, none the less, a member of a nuclear alliance. The security gained through participation in such arrangements does not come cost-free, despite the common view that countries such as Canada enjoy a free ride. Being under the nuclear umbrella, as this paper seeks to illustrate, does generate its own problems and costs. For example, does influence stem from the actual possession of nuclear weapons (albeit under US control), from support of the concept of nuclear deterrence and its infrastructure, or from possessing territory that is of strategic importance to a more powerful ally? Does the Canadian experience serve as a model for countries that are in close proximity to an existing or threshold nuclear power? Much depends on the willingness of a country to participate in the nuclear infrastructure associated with the acquisition of nuclear weapons for security purposes. It must accept the underlying rationale or logic of nuclear deterrence and the constraints on alternative security options that this imposes and it must also recognize that reliance on nuclear deterrence for military security seven if one seeks to emulate Canada and become a non-nuclear weapon state in a nuclear alliance can produce strains in its own right. The case of Canada shows that a country seeking security through such means should be aware of, and reflect upon, the fact that what appears to be a free ride does not come free of charge. However, a country may have other options in it, military security that have neither historically or geostrategically been available to Canada

  3. Integrating environment health and safety management at Petro-Canada

    International Nuclear Information System (INIS)

    Raymond, G.

    1993-01-01

    Petro-Canada has developed a tool to integrate, measure, and improve its management systems of environment, health, and safety (EH ampersand S). This tool, called the Total Loss Management System, is described in the areas of general management issues, policies and procedures, evaluations, organization, stewardship, issue management, and performance measures. Petro-Canada's policies on occupational health and safety are consistent with its environmental policy, being structured in the same way. An integrated audit system is used to cover health, safety, industrial hygiene, reliability, environment, and risk management. EH ampersand S matters are integrated at the corporate level in a separate department. Regional divisions review EH ampersand S performance every month, incidents are discussed, and preventive measures are taken as necessary. Regional performances are combined every quarter for ultimate presentation to the Petro-Canada board. New or emerging issues that may affect divisions are assigned an issue sponsor, a member of divisional management who makes sure the issue receives the resources necessary to study and define its impact. Examples of issues include soil contamination, process hazard management, and benzene exposure limits. Performance measures flow from the corporate environment and occupational health and safety policies, and come in two types: those that measure activities to improve performance and those that measure the outcome of the activities

  4. Putting Health Education on the Public Health Map in Canada--The Role of Higher Education

    Science.gov (United States)

    Vamos, Sandra; Hayos, Julia

    2010-01-01

    The health education profession has developed over recent years garnering national and international attention. Canada's evolving health education perspective emphasizing the concept of health literacy within the broader public health system reflects the need for trained, competent and skilled health educators designing, implementing and…

  5. Climate Change, Drought and Human Health in Canada.

    Science.gov (United States)

    Yusa, Anna; Berry, Peter; J Cheng, June; Ogden, Nicholas; Bonsal, Barrie; Stewart, Ronald; Waldick, Ruth

    2015-07-17

    Droughts have been recorded all across Canada and have had significant impacts on individuals and communities. With climate change, projections suggest an increasing risk of drought in Canada, particularly in the south and interior. However, there has been little research on the impacts of drought on human health and the implications of a changing climate. A review of the Canadian, U.S. and international literature relevant to the Canadian context was conducted to better define these impacts and adaptations available to protect health. Drought can impact respiratory health, mental health, illnesses related to exposure to toxins, food/water security, rates of injury and infectious diseases (including food-, water- and vector-borne diseases). A range of direct and indirect adaptation (e.g., agricultural adaptation) options exist to cope with drought. Many have already been employed by public health officials, such as communicable disease monitoring and surveillance and public education and outreach. However, gaps exist in our understanding of the impacts of short-term vs. prolonged drought on the health of Canadians, projections of drought and its characteristics at the regional level and the effectiveness of current adaptations. Further research will be critical to inform adaptation planning to reduce future drought-related risks to health.

  6. Climate Change, Drought and Human Health in Canada

    Science.gov (United States)

    Yusa, Anna; Berry, Peter; Cheng, June J.; Ogden, Nicholas; Bonsal, Barrie; Stewart, Ronald; Waldick, Ruth

    2015-01-01

    Droughts have been recorded all across Canada and have had significant impacts on individuals and communities. With climate change, projections suggest an increasing risk of drought in Canada, particularly in the south and interior. However, there has been little research on the impacts of drought on human health and the implications of a changing climate. A review of the Canadian, U.S. and international literature relevant to the Canadian context was conducted to better define these impacts and adaptations available to protect health. Drought can impact respiratory health, mental health, illnesses related to exposure to toxins, food/water security, rates of injury and infectious diseases (including food-, water- and vector-borne diseases). A range of direct and indirect adaptation (e.g., agricultural adaptation) options exist to cope with drought. Many have already been employed by public health officials, such as communicable disease monitoring and surveillance and public education and outreach. However, gaps exist in our understanding of the impacts of short-term vs. prolonged drought on the health of Canadians, projections of drought and its characteristics at the regional level and the effectiveness of current adaptations. Further research will be critical to inform adaptation planning to reduce future drought-related risks to health. PMID:26193300

  7. Administrative health data in Canada: lessons from history.

    Science.gov (United States)

    Lucyk, Kelsey; Lu, Mingshan; Sajobi, Tolulope; Quan, Hude

    2015-08-19

    Health decision-making requires evidence from high-quality data. As one example, the Discharge Abstract Database (DAD) compiles data from the majority of Canadian hospitals to form one of the most comprehensive and highly regarded administrative health databases available for health research, internationally. However, despite the success of this and other administrative health data resources, little is known about their history or the factors that have led to their success. The purpose of this paper is to provide an historical overview of Canadian administrative health data for health research to contribute to the institutional memory of this field. We conducted a qualitative content analysis of approximately 20 key sources to construct an historical narrative of administrative health data in Canada. Specifically, we searched for content related to key events, individuals, challenges, and successes in this field over time. In Canada, administrative health data for health research has developed in tangent with provincial research centres. Interestingly, the lessons learned from this history align with the original recommendations of the 1964 Royal Commission on Health Services: (1) standardization, and (2) centralization of data resources, that is (3) facilitated through governmental financial support. The overview history provided here illustrates the need for longstanding partnerships between government and academia, for classification, terminology and standardization are time-consuming and ever-evolving processes. This paper will be of interest to those who work with administrative health data, and also for countries that are looking to build or improve upon their use of administrative health data for decision-making.

  8. South Asian populations in Canada: migration and mental health

    Science.gov (United States)

    2014-01-01

    Background South Asian populations are the largest visible minority group in Canada; however, there is very little information on the mental health of these populations. The objective of this study was to determine the prevalence rates and characteristics of mental health outcomes for South Asian first-generation immigrant and second-generation Canadian-born populations. Methods The Canadian Community Health Survey (CCHS) 2011 was used to calculate the estimated prevalence rates of the following mental health outcomes: mood disorders, anxiety disorders, fair-poor self-perceived mental health status, and extremely stressful life stress. The characteristics associated with these four mental health outcomes were determined through multivariate logistic regression analysis of merged CCHS 2007–2011 data. Results South Asian Canadian-born (3.5%, 95% CI 3.4-3.6%) and South Asian immigrant populations (3.5%, 95% CI 3.5-3.5%) did not vary significantly in estimated prevalence rates of mood disorders. However, South Asian immigrants experienced higher estimated prevalence rates of diagnosed anxiety disorders (3.4%, 95% CI 3.4-3.5 vs. 1.1%, 95% CI 1.1-1.1%) and self-reported extremely stressful life stress (2.6%, 95% CI 2.6-2.7% vs. 2.4%, 95% CI 2.3-2.4%) compared to their Canadian-born counterparts. Lastly, South Asian Canadian-born populations had a higher estimated prevalence rate of poor-fair self-perceived mental health status (4.4%, 95% CI 4.3-4.5%) compared to their immigrant counterparts (3.4%, 95% CI 3.3-3.4%). Different profiles of mental health determinants emerged for South Asian Canadian-born and immigrant populations. Female gender, having no children under the age of 12 in the household, food insecurity, poor-fair self-rated health status, being a current smoker, immigrating to Canada before adulthood, and taking the CCHS survey in either English or French was associated with greater risk of negative mental health outcomes for South Asian immigrant

  9. The health of Inuit children under age 6 in Canada.

    Science.gov (United States)

    Findlay, Leanne C; Janz, Teresa A

    2012-01-01

    Previous research has suggested that Inuit children experience poor health as compared to their non-Aboriginal counterparts, although social determinants such as family and social conditions, lifestyle or behaviour, and cultural factors may be at play. The purpose of the current study was to examine the parent-reported health of Inuit children under 6 years of age living in Canada. Data from the 2006 Aboriginal Children's Survey were used to examine measures of Inuit child health as rated by parents including child health, limitations to physical activity, chronic conditions, ear infections, and dental problems. Associations between social determinants of health and parent-rated Inuit child health were also explored. Most Inuit children under age 6 were reported by their parents or guardians to be in excellent or very good health. The most common chronic conditions identified were asthma, speech and language difficulties, allergies, lactose intolerance, and hearing impairment. Several social determinants of health were associated with child health, including parental education, household income, breastfeeding, and perceived housing conditions. The findings show that social determinants of health, including both socio-economic and household characteristics, are associated with Inuit child health.

  10. The Atomic Energy of Canada Limited (AECL) employee health study

    International Nuclear Information System (INIS)

    Myers, D.K.; Werner, M.M.

    1985-01-01

    A preliminary examination of records relating to past Chalk River employees provides some reassurance that large numbers of cancer deaths that might be related to occupational radiation exposure do not exist in the groups of employees studied to the end of 1982. The lack of reliable information on deaths of ex-employees who left AECL for other employment prevented the inclusion of this group in this preliminary study. This information will presumably be obtained during the course of the more comprehensive Atomic Energy of Canada Ltd. employee health study. 6 refs

  11. Canada

    International Nuclear Information System (INIS)

    Maciej, H.

    1992-01-01

    This paper reports that the Canadian oil and natural gas sector is in for another grim year in 1992. Further streamlining to enhance operating efficiencies and control costs is the first order of the day. About $4 billion worth of producing properties remains on the market, as corporate focus continues to shift to core properties. New management structures put in place in the last two years will be severely tested to improve the sector's financial performance. Massive write-downs in 1990 and 1991 have put balance sheets in much better shape for improved financial performance in the future. Although new long-term debt exceeded redemptions in 1991, largely because of debt- financing of major capital projects, individually most companies are in better shape through significant debt repayment or restructuring. The substantial reductions in interest rates will also help to enhance discretionary cash flow. At this stage, everything appears to be in place to expect that 1992 will represent the bottom of the down-cycle for Canada

  12. Social determinants of self-reported health for Canada's indigenous peoples: a public health approach.

    Science.gov (United States)

    Bethune, R; Absher, N; Obiagwu, M; Qarmout, T; Steeves, M; Yaghoubi, M; Tikoo, R; Szafron, M; Dell, C; Farag, M

    2018-04-14

    In Canada, indigenous peoples suffer from a multitude of health disparities. To better understand these disparities, this study aims to examine the social determinants of self-reported health for indigenous peoples in Canada. This study uses data from Statistics Canada's Aboriginal Peoples Survey 2012. Multinomial logistic regression models were used to examine how selected social determinants of health are associated with self-reported health among off-reserve First Nations and Métis peoples in Canada. Our analysis shows that being older, female, and living in urban settings were significantly associated with negative ratings of self-reported health status among the indigenous respondents. Additionally, we found that higher income and levels of education were strongly and significantly associated with positive ratings of self-reported health status. Compared with indigenous peoples with an education level of grade 8 or lower, respondents with higher education were 10 times (5.35-22.48) more likely to report 'excellent' and 'very good' health. Respondents who earned more than $40,000 annually were three times (2.17-4.72) more likely to report 'excellent' and 'very good' health compared with those who earned less than $20,000 annually. When interacted with income, we also found that volunteering in the community is associated with better self-reported health. There are known protective determinants (income and education) and risk determinants (location of residence, gender, and age) which are associated with self-reported health status among off-reserve First Nations and Métis peoples. For indigenous-specific determinants, volunteering in the community appears to be associated with self-perceived health status. Thus, addressing these determinants will be necessary to achieve better health outcomes for indigenous peoples in Canada. Next steps include developing indigenous-specific social determinants of health indicators that adequately measure culture, connection

  13. A Bibliometric Analysis of Digestive Health Research in Canada

    Directory of Open Access Journals (Sweden)

    Désirée Tuitt

    2011-01-01

    Full Text Available Measurement of the impact and influence of medical/scientific journals, and of individual researchers has become more widely practiced in recent decades. This is driven, in part, by the increased availability of data regarding citations of research articles, and by increased competition for research funding. Digestive disease research has been identified as a particularly strong discipline in Canada. The authors collected quantitative data on the impact and influence of Canadian digestive health research. The present study involved an analysis of the research impact (Hirsch factor and research influence (Influence factor of 106 digestive health researchers in Canada. Rankings of the top 25 researchers on the basis of the two metrics were dominated by the larger research groups at the University of Toronto (Toronto, Ontario, McMaster University (Hamilton, Ontario, and the Universities of Calgary (Calgary, Alberta and Alberta (Edmonton, Alberta, but with representation by other research groups at the Universities of Manitoba (Winnipeg, Manitoba, Western Ontario (London, Ontario and McGill University (Montreal, Quebec. Female and male researchers had similar scores for the two metrics, as did basic scientists versus clinical investigators. Strategic recruitment, particularly of established investigators, can have a major impact on the ranking of research groups. Comparing these metrics over different time frames can provide insights into the vulnerabilities and strengths of research groups.

  14. Pharmaceutical health care and Inuit language communications in Nunavut, Canada.

    Science.gov (United States)

    Romain, Sandra J

    2013-01-01

    Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requiring that all public and private sector essential services offer verbal and written communication in Inuit languages (Inuktitut and Inuinnaqtun) by 2012. While the legislation mandates compliance, policy implementation for pharmaceutical services is problematic. Not a single pharmacist in Nunavut is fluent in either of the Inuit languages. Pharmacists have indicated challenges in formally translating written documentation into Inuit languages based on concerns for patient safety. These challenges of negotiating the joint requirements of language legislation and patient safety have resulted in pharmacies using verbal on-site translation as a tenuous solution regardless of its many limitations. The complex issues of pharmaceutical health care and communication among the Inuit of Nunavut are best examined through multimethod research to encompass a wide range of perspectives. This methodology combines the richness of ethnographic data, the targeted depth of interviews with key informants and the breadth of cross-Canada policy and financial analyses. The analysis of this information would provide valuable insights into the current relationships between health care providers, pharmacists and Inuit patients and suggest future directions for policy that will improve the efficacy of pharmaceuticals and health care spending for the Inuit in Canada.

  15. Pharmaceutical health care and Inuit language communications in Nunavut, Canada

    Directory of Open Access Journals (Sweden)

    Sandra J. Romain

    2013-08-01

    Full Text Available Background. Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requiring that all public and private sector essential services offer verbal and written communication in Inuit languages (Inuktitut and Inuinnaqtun by 2012. Methods. While the legislation mandates compliance, policy implementation for pharmaceutical services is problematic. Not a single pharmacist in Nunavut is fluent in either of the Inuit languages. Pharmacists have indicated challenges in formally translating written documentation into Inuit languages based on concerns for patient safety. These challenges of negotiating the joint requirements of language legislation and patient safety have resulted in pharmacies using verbal on-site translation as a tenuous solution regardless of its many limitations. Results. The complex issues of pharmaceutical health care and communication among the Inuit of Nunavut are best examined through multimethod research to encompass a wide range of perspectives. This methodology combines the richness of ethnographic data, the targeted depth of interviews with key informants and the breadth of cross-Canada policy and financial analyses. Conclusions. The analysis of this information would provide valuable insights into the current relationships between health care providers, pharmacists and Inuit patients and suggest future directions for policy that will improve the efficacy of pharmaceuticals and health care spending for the Inuit in Canada.

  16. Implementing Indigenous community control in health care: lessons from Canada.

    Science.gov (United States)

    Lavoie, Josée G; Dwyer, Judith

    2016-09-01

    Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions

  17. Canada.

    Science.gov (United States)

    2008-10-13

    Recruitment drive for nurse gradutates British Columbia (BC), the westernmost Canadian province, urgently needs 1,500 qualified nurses graduates to staff longterm care and assisted-living beds as well as home care clients. The provincial government has launched a $160,000 (£78,600) marketing campaign called BC Cares. Craig Hebert, dean of development and access training at Northern Lights College in BC, said: 'The industry needs to get the message out to students that there has never been a better time to start a career in senior health care. Graduates who study for about one year, sometimes less, will have their pick of jobs in a number of service environments and can advance relatively quickly to the nursing profession.'

  18. Health Consequences to Immigrant Family Caregivers in Canada

    Directory of Open Access Journals (Sweden)

    Suwal, Juhee Varacharya

    2010-01-01

    Full Text Available AbstractThis study revisited the “double jeopardy” hypothesis in terms of the health ofimmigrant family caregivers. It also investigated the effect of “reciprocity”(feeling of giving back something on the health of family caregivers. TheGeneral Social Survey 2002 Cycle 16 data were analyzed using χ2-test andLogistic regressions. About 16% of immigrants and 13.6% of non-immigrantssaid that their health was negatively affected as a result of caregiving.Immigrant family caregivers were three times more likely than non-immigrantsto report a health consequence. Reciprocity played a big role in this outcome.Given the fact that an increasing number of culturally diverse immigrants enterCanada every year and that the immigrant population is aging, more caregiverswill be in demand. Policy makers need to find ways to keep immigrantcaregivers healthy so that quality care can be given to immigrant older adultsand also for maintaining an overall healthy Canada.RésuméCette étude réexamine l'hypothèse de «non bis in idem» dans le contexte de lasanté des aidantes et aidants membres de familles immigrantes. Elle étudie aussil'effet de «réciprocité» (le sentiment de rendre quelque chose sur la santé desaidantes et aidants membres de la famille. Les données de l'Enquête socialegénérale 2002, cycle 16 ont été analysées à l'aide du test du χ² et de régressionslogistiques. À peu près 16% des immigrants et 13.6% des non-immigrantes ontreporté que leur santé avait été négativement affectée par leur dispensation desoins. Les aidantes et aidants membres de familles immigrantes avaient troisfois plus de chance de reporter une conséquence sur leur santé que ceux desfamilles non-immigrantes. La réciprocité jouait un rôle important dans cerésultat. Quand on considère qu'un nombre croissant d'immigrants issus decultures diverses entre au Canada chaque année et que la populationimmigrante vieillit, il est clair que plus en plus

  19. Brazilian immigrants? oral health literacy and participation in oral health care in Canada

    OpenAIRE

    Calvasina, Paola; Lawrence, Herenia P.; Hoffman-Goetz, Laurie; Norman, Cameron D.

    2016-01-01

    Background Inadequate functional health literacy is a common problem in immigrant populations. The aim of this study was to investigate the association between oral (dental) health literacy (OHL) and participation in oral health care among Brazilian immigrants in Toronto, Ontario, Canada. Methods The study used a cross-sectional design and a convenience sample of 101 Brazilian immigrants selected through the snowball sampling technique. Data were analyzed using descriptive statistics and logi...

  20. An innovative model for regulating supplement products: Natural health products in Canada

    International Nuclear Information System (INIS)

    Nestmann, Earle R.; Harwood, Melody; Martyres, Stephanie

    2006-01-01

    On 1 January 2004, Health Canada officially added a new term to the global list of synonyms for dietary supplements: natural health products (NHP). Developed with the intent of providing Canadian consumers with ready access to NHP that are safe, effective, and of high quality, the Natural Health Products Regulations (the NHP regulations) are applicable to the sale, manufacture, packaging, labelling, importation, distribution, and storage of NHP, and are administered by the recently formed Natural Health Products Directorate (NHPD) within Health Canada. This paper provides an overview of the process for regulating supplement products in Canada

  1. Forest health in Canada, Montane cordillera ecozone 2003

    Energy Technology Data Exchange (ETDEWEB)

    Allen, E.; Garbutt, R.; Hirvonen, H.; Pinnell, H.

    2004-07-01

    This paper describes the key forest health issues affecting the 6 main forest types in Canada's Montane Cordillera ecozone in the central interior of British Columbia and the Alberta Foothills. In order to protect and conserve biological diversity, the Canadian Council of Forest Ministers adopted national criteria to measure sustainable forest management. This report describes the Montane Cordillera landscape conditions, pre-industrial ecological influences, current ecological influences, and the impact of invasive alien insects and diseases on the diversity of tree species. Pine forests in the Montane Cordillera ecozone are threatened by the mountain pine beetle. Fire suppression has also resulted in ecological changes to forests in the Montane Cordillera, including an increase in Douglas-firs, gradual replacement of Lodgepole pine forests, and reduced health of Ponderosa pine ecosystems. Alien insects are being monitored by provincial forestry agencies through annual surveys. They are also being controlled through localized treatment programs. The impact of land use practices such as forest harvesting on forest structure and composition was also addressed. It was noted that the unrestricted movement of wood and forestry products also increases the threat of invasive alien diseases and insects. The trees in this ecozone have not been damaged by air pollution. refs., tabs., figs.

  2. Chopra, Prof. Virender Lal

    Indian Academy of Sciences (India)

    Ethical Guidelines and Procedures document. Posted on 17 January 2017. A revised version of the document 'Scientific Values: Ethical Guidelines and Procedures' has been produced by the Academy's Panel on Scientific Values. For more details, see the Academy Committee on Scientific Values page.

  3. Forest health in Canada, Atlantic Maritime ecozone 2003

    Energy Technology Data Exchange (ETDEWEB)

    Hurley, J.E.; Loo, J.; DesRochers, P.; Hirvonen, H.

    2004-07-01

    This paper describes the key forest health issues affecting Canada's Atlantic Maritime ecozone which includes 9 main forest types known collectively as the Acadian Forest. In order to protect and conserve biological diversity, the Canadian Council of Forest Ministers adopted national criteria to measure sustainable forest management. This report describes the Acadian Forest landscape conditions, pre-industrial ecological influences, current ecological influences, and the impact of invasive alien insects and diseases on the diversity of tree species. Spruce trees in the Atlantic Maritime ecozone are threatened by the brown spruce longhorn beetle and pine trees are threatened by a pine shoot beetle recently introduced to North America from Asia. Diseases are also attacking the butternut, beech and dutch trees. The impact of land use practices such as forest harvesting on forest structure and composition was also addressed along with the impact of air pollution and climate change. It was noted that there is a direct relationship between deteriorating air quality and decline in mountain paper birch. Some of the anticipated impacts from climate change include a greater incidence of vector borne diseases resulting from the migration of new insect species in a warmer Canadian climate. An increase in extreme weather events such as ice storms may also weaken trees. refs., tabs., figs.

  4. Dynamics of immigrants' health: Evidence from Canada, 1994-95 to 2002-03. Summary Report

    Directory of Open Access Journals (Sweden)

    Wilkins, Russell

    2005-01-01

    Full Text Available Summary of: Ng, Edward, Russell Wilkins, François Gendron, and Jean-Marie Berthelot.2005. "Dynamics of immigrants' health in Canada: evidence from the NationalPopulation Health Survey." Healthy today, healthy tomorrow? Findings fromthe National Population Health Survey. Ottawa: Statistics Canada catalogue 82-618; 2:1-11. Available free at: http://www.statcan.ca/english/research/82-618-MIE/82-618-MIE2005002.htm.

  5. ESL-speaking immigrant women's disillusions: voices of health care in Canada: an ethnodrama.

    Science.gov (United States)

    Nimmon, Laura E

    2007-04-01

    This article describes a research project that investigated whether language barriers play a part in immigrant women's health decreasing when they move to Canada. The findings are then represented in the form of an ethnodrama entitled "ESL-Speaking Immigrant Women's Disillusions: Voices of Health Care in Canada." I suggest that the play is catalytic because it encourages target audiences to empathize with the silenced voices of ESL-speaking immigrant women who live in Canada. I then conclude with a reflection about the potential that the genre of ethnodrama has for social change through its reflexive and critical nature.

  6. A critical public-health ethics analysis of Canada's international response to HIV.

    Science.gov (United States)

    Nixon, Stephanie A; Benatar, Solomon R

    2011-01-01

    As interconnections between health, ideology and politics become increasingly acknowledged, gaps in the literature also become visible in terms of analytic frameworks to engage these issues and empirical studies to understand the complexities. 'Critical public-health ethics' provides such an analytic lens. This article presents the results of a critical public-health ethics analysis of the government of Canada's international response to HIV. This qualitative study involved in-depth, semi-structured interviews with 23 experts on Canada's international response over time. Descriptive, thematic and theoretical analyses revealed an underlying dilemma between Canada's philanthropic desire to 'do the right thing' for the broader public good and Canada's commitment to its own economic growth and other forms of self-interest. Related to this tension were four conspicuous areas of silence in the data: (1) The relative absence of moral vocabulary for discussing Canada's duty to respond to the global HIV pandemic. (2) Scant reference to solutions based on poverty reduction. (3) Little awareness about the dominance of neoliberal economic rationality and its impact on HIV. (4) Limited understanding of Canada's function within the international economic order in terms of its role in poverty creation. Our study has implications for Canada and other rich nations through its empirical contribution to the chorus of calls challenging the legitimised, institutionalised and normative practice of considering the economic growth of wealthy countries as the primary objective of global economic policy.

  7. The mental health of Indigenous peoples in Canada: A critical review of research.

    Science.gov (United States)

    Nelson, Sarah E; Wilson, Kathi

    2017-03-01

    Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

    Science.gov (United States)

    Guyon, Ak'ingabe; Perreault, Robert

    2016-10-20

    Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

  9. Beyond Recovery: Colonization, Health and Healing for Indigenous People in Canada

    Science.gov (United States)

    Lavallee, Lynn F.; Poole, Jennifer M.

    2010-01-01

    How do we limit our focus to mental health when Indigenous teaching demands a much wider lens? How do we respond to mental health recovery when Indigenous experience speaks to a very different approach to healing, and how can we take up the health of Indigenous people in Canada without a discussion of identity and colonization? We cannot, for the…

  10. Major emerging vector-borne zoonotic diseases of public health importance in Canada.

    Science.gov (United States)

    Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

    2015-06-10

    In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

  11. Using a Delphi process to define priorities for prison health research in Canada.

    Science.gov (United States)

    Kouyoumdjian, Fiona G; Schuler, Andrée; McIsaac, Kathryn E; Pivnick, Lucie; Matheson, Flora I; Brown, Glenn; Kiefer, Lori; Silva, Diego; Hwang, Stephen W

    2016-01-14

    A large number of Canadians spend time in correctional facilities each year, and they are likely to have poor health compared to the general population. Relatively little health research has been conducted in Canada with a focus on people who experience detention or incarceration. We aimed to conduct a Delphi process with key stakeholders to define priorities for research in prison health in Canada for the next 10 years. We conducted a Delphi process using an online survey with two rounds in 2014 and 2015. We invited key stakeholders in prison health research in Canada to participate, which we defined as persons who had published research on prison health in Canada since 1994 and persons in the investigators' professional networks. We invited 143 persons to participate in the first round and 59 participated. We invited 137 persons to participate in the second round and 67 participated. Participants suggested topics in the first round, and these topics were collated by investigators. We measured the level of agreement among participants that each collated topic was a priority for prison health research in Canada for the next 10 years, and defined priorities based on the level of agreement. In the first round, participants suggested 71 topics. In the second round, consensus was achieved that a large number of suggested topics were research priorities. Top priorities were diversion and alternatives to incarceration, social and community re-integration, creating healthy environments in prisons, healthcare in custody, continuity of healthcare, substance use disorders and the health of Aboriginal persons in custody. Generated in an inclusive and systematic process, these findings should inform future research efforts to improve the health and healthcare of people who experience detention and incarceration in Canada. 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/

  12. Canada's global health role: supporting equity and global citizenship as a middle power.

    Science.gov (United States)

    Nixon, Stephanie A; Lee, Kelley; Bhutta, Zulfiqar A; Blanchard, James; Haddad, Slim; Hoffman, Steven J; Tugwell, Peter

    2018-02-22

    Canada's history of nation building, combined with its status as a so-called middle power in international affairs, has been translated into an approach to global health that is focused on equity and global citizenship. Canada has often aspired to be a socially progressive force abroad, using alliance building and collective action to exert influence beyond that expected from a country with moderate financial and military resources. Conversely, when Canada has primarily used economic self-interest to define its global role, the country's perceived leadership in global health has diminished. Current Prime Minister Justin Trudeau's Liberal federal government has signalled a return to progressive values, driven by appreciation for diversity, equality, and Canada's responsibility to be a good global citizen. However, poor coordination of efforts, limited funding, and the unaddressed legacy of Canada's colonisation of Indigenous peoples weaken the potential for Canadians to make meaningful contributions to improvement of global health equity. Amid increased nationalism and uncertainty towards multilateral commitments by some major powers in the world, the Canadian federal government has a clear opportunity to convert its commitments to equity and global citizenship into stronger leadership on the global stage. Such leadership will require the translation of aspirational messages about health equity and inclusion into concrete action at home and internationally. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy.

    Science.gov (United States)

    Lavoie, Josée G

    2013-12-27

    Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.

  14. Brazilian immigrants' oral health literacy and participation in oral health care in Canada.

    Science.gov (United States)

    Calvasina, Paola; Lawrence, Herenia P; Hoffman-Goetz, Laurie; Norman, Cameron D

    2016-02-15

    Inadequate functional health literacy is a common problem in immigrant populations. The aim of this study was to investigate the association between oral (dental) health literacy (OHL) and participation in oral health care among Brazilian immigrants in Toronto, Ontario, Canada. The study used a cross-sectional design and a convenience sample of 101 Brazilian immigrants selected through the snowball sampling technique. Data were analyzed using descriptive statistics and logistic regression modeling. Most of the sample had adequate OHL (83.1 %). Inadequate/marginal OHL was associated with not visiting a dentist in the preceding year (OR = 3.61; p = 0.04), not having a dentist as the primary source of dental information (OR = 5.55; p < 0.01), and not participating in shared dental treatment decision making (OR = 1.06; p = 0.05; OHL as a continuous variable) in multivariate logistic regressions controlling for covariates. A low average annual family income was associated with two indicators of poor participation in oral health care (i.e., not having visited a dentist in the previous year, and not having a dentist as regular source of dental information). Limited OHL was linked to lower participation in the oral health care system and with barriers to using dental services among a sample of Brazilian immigrants. More effective knowledge transfer will be required to help specific groups of immigrants to better navigate the Canadian dental care system.

  15. Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey.

    Science.gov (United States)

    Crann, Sara E; Cunningham, Shannon; Albert, Arianne; Money, Deborah M; O'Doherty, Kieran C

    2018-03-23

    The vaginal microbiome influences quality of life and health. The composition of vaginal microbiota can be affected by various health behaviors, such as vaginal douching. The purpose of this study was to examine the types and prevalence of diverse vaginal/genital health and hygiene behaviors among participants living in Canada and to examine associations between behavioral practices and adverse gynecological health conditions. An anonymous online survey, available in English and French, was distributed across Canada. The sample consisted of 1435 respondents, 18 years or older, living in Canada. Respondents reported engaging in diverse vaginal/genital health and hygiene behavioral practices, including the use of commercially manufactured products and homemade and naturopathic products and practices. Over 95% of respondents reported using at least one product in or around the vaginal area. Common products and practices included vaginal/genital moisturizers, anti-itch creams, feminine wipes, washes, suppositories, sprays, powders, and waxing and shaving pubic hair. The majority of the sample (80%) reported experiencing one or more adverse vaginal/genital symptom in their lifetime. Participants who had used any vaginal/genital product(s) had approximately three times higher odds of reporting an adverse health condition. Several notable associations between specific vaginal/genital health and hygiene products and adverse health conditions were identified. This study is the first of its kind to identify the range and prevalence of vaginal/genital health and hygiene behaviors in Canada. Despite a lack of credible information about the impact of these behaviors on women's health, the use of commercially manufactured and homemade products for vaginal/genital health and hygiene is common. Future research can extend the current exploratory study by identifying causal relationships between vaginal/genital health and hygiene behaviors and changes to the vaginal microbiome.

  16. Canada Selects African Health Organizations to Help Save the Lives ...

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

    IDRC-CRDI

    supported by the program and decision-makers in Africa. ... ensuring that high quality health care is delivered in clinics and hospitals. • working ... identifying how nurses, doctors, and other health professionals can better deliver the care that is.

  17. Multiple Roles and Women's Mental Health in Canada

    OpenAIRE

    Ansara Donna; Glynn Keva; Maclean Heather

    2004-01-01

    Abstract Health Issue Research on the relationship between women's social roles and mental health has been equivocal. Although a greater number of roles often protect mental health, certain combinations can lead to strain. Our study explored the moderating affects of different role combinations on women's mental health by examining associations with socioeconomic status and differences in women's distress (depressive symptoms, personal stress (role strain) and chronic stress (role strain plus...

  18. 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.

  19. Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts

    Directory of Open Access Journals (Sweden)

    Mohammad Hajizadeh

    2016-08-01

    Full Text Available Notwithstanding a century of prohibition, marijuana is the most widely used illicit substance in Canada. Due to the growing public acceptance of recreational marijuana use and ineffectiveness of the existing control system in Canada, the issue surrounding legalizing this illicit drug has received considerable public and political attentions in recent years. Consequently, the newly elected Liberal Government has formally announced that Canada will introduce legislation in the spring of 2017 to start legalizing and regulating marijuana. This editorial aims to provide a brief overview on potential economic, social, and public health impacts of legal marijuana in Canada. The legalization could increase tax revenue through the taxation levied on marijuana products and could also allow the Government to save citizens’ tax dollars currently being spent on prohibition enforcement. Moreover, legalization could also remove the criminal element from marijuana market and reduce the size of Canada’s black market and its consequences for the society. Nevertheless, it may also lead to some public health problems, including increasing in the uptake of the drug, accidents and injuries. The legalization should be accompanied with comprehensive strategies to keep the drug out of the hands of minors while increasing awareness and knowledge on harmful effects of the drug. In order to get better insights on how to develop an appropriate framework to legalize marijuana, Canada should closely watch the development in the neighboring country, the United States, where some of its states viz, Colorado, Oregon, Washington, and Alaska have already legalized recreational use of marijuana.

  20. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    NARCIS (Netherlands)

    Tawfik-Shukor, Ali R.; Klazinga, Niek S.; Arah, Onyebuchi A.

    2007-01-01

    BACKGROUND: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this

  1. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    NARCIS (Netherlands)

    A.R. Tawfik-Shukor (Ali); N.S. Klazinga (Niek); O.A. Arah (Onyebuchi)

    2007-01-01

    textabstractBackground: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support

  2. Call for proposals for the Joint Canada-Israel Health Research ...

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

    23 nov. 2017 ... Call for proposals for the Joint Canada-Israel Health Research Program 2018 competition ... developmental neurobiology; neuro-immunology; neuroendocrinology; regenerative medicine in brain disease; cellular and molecular basis of cognition; modeling brain function; imaging of neural processes ...

  3. Why equity in health and in access to health care are elusive: Insights from Canada and South Africa.

    Science.gov (United States)

    Benatar, Solomon; Sullivan, Terrence; Brown, Adalsteinn

    2017-12-04

    Health and access to health care vary strikingly across the globe, and debates about this have been pervasive and controversial. Some comparative data in Canada and South Africa illustrate the complexity of achieving greater equity anywhere, even in a wealthy country like Canada. Potential bi-directional lessons relevant both to local and global public health are identified. Both countries should consider the implications of lost opportunity costs associated with lack of explicit resource allocation policies. While National Health Insurance is attractive politically, Canada's example cannot be fully emulated in South Africa. Short- and medium-term attempts to improve equity in middle-income countries should focus on equitable access to insurance to cover primary health care and on making more use of nurse practitioners and community health workers. In the longer-term, attention is needed to the economic and political power structures that influence health and health care and that ignore the social and societal determinants of sustainable good health locally and globally. This long-term vision of health is needed globally to achieve improvements in individual and population health in a century characterised by limits to economic growth, widening disparities, continuing conflict and migration on a large scale and multiple adverse impacts of climate change.

  4. Bedford v. Canada: a paradigmatic case toward ensuring the human and health rights of sex workers.

    Science.gov (United States)

    Galldin, Karin; Robertson, Leslie; Wiseman, Charlene

    2011-10-01

    The Criminal Code of Canada prohibits certain aspects of sex work: the keeping of a common bawdy-house, living off the avails of prostitution and communicating for the purposes of prostitution in a public place. These legal constraints impede sex workers' ability to practise their profession safely and without risk to their bodily integrity; they also impair their personal autonomy and can lead to their stigmatization. Bedford v. Canada is a groundbreaking case, since the applicants and intervening organizations seek to overturn aspects of Canadian law that specifically put the health and human rights of sex workers at risk.

  5. A proposed benefits evaluation framework for health information systems in Canada.

    Science.gov (United States)

    Lau, Francis; Hagens, Simon; Muttitt, Sarah

    2007-01-01

    This article describes a benefits evaluation framework for the health information systems currently being implemented across Canada through Canada Health Infoway with its jurisdictional partners and investment programs. This framework is based on the information systems success model by DeLone and McLean, the empirical analysis by van der Meijden on the use of this model in the health setting and our own review of evaluation studies and systematic review articles in health information systems. The current framework includes three dimensions of quality (system, information and service), two dimensions of system usage (use and user satisfaction) and three dimensions of net benefits (quality, access and productivity). Measures have been developed and work is under way to establish detailed evaluation plans and instruments for the individual investment programs to launch a series of benefits evaluation field studies across jurisdictions later this year.

  6. 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.

  7. Hepatitis C, illicit drug use and public health: does Canada really have a viable plan?

    Science.gov (United States)

    Fischer, Benedikt; Kalousek, Kate; Rehm, Jürgen; Powis, Jeff; Krajden, Mel; Reimer, Jens

    2006-01-01

    Some 300,000 individuals are infected with the hepatitis C virus (HCV) in Canada. HCV infection is associated with major morbidity, mortality and health care costs; these indicators are projected to rise over the next decade. The vast majority of prevalent and incident HCV infections in Canada are illicit drug use-related; thus, the HCV disease burden can only be addressed through interventions targeting this primary risk factor. Both preventive (e.g., needle exchange, methadone treatment) and therapeutic (e.g., the accessibility of HCV treatment for illicit drug users) interventions aimed at HCV in illicit drug users have been broadly expanded in Canada in recent years. However, evidence suggests that existing preventive measures only offer limited effectiveness in reducing HCV risk exposure. Also, due to restricted resources, treatment for HCV currently only reaches an extremely small proportion (i.e., Canada is not achieving a net reduction in the prevalence of HCV-related to illicit drug use. In order to reduce the HCV disease burden, Canada needs to reconsider the scope, delivery and resourcing of both preventive and treatment interventions targeting the primary risk population of illicit drug users.

  8. Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts.

    Science.gov (United States)

    Hajizadeh, Mohammad

    2016-05-25

    Notwithstanding a century of prohibition, marijuana is the most widely used illicit substance in Canada. Due to the growing public acceptance of recreational marijuana use and ineffectiveness of the existing control system in Canada, the issue surrounding legalizing this illicit drug has received considerable public and political attentions in recent years. Consequently, the newly elected Liberal Government has formally announced that Canada will introduce legislation in the spring of 2017 to start legalizing and regulating marijuana. This editorial aims to provide a brief overview on potential economic, social, and public health impacts of legal marijuana in Canada. The legalization could increase tax revenue through the taxation levied on marijuana products and could also allow the Government to save citizens' tax dollars currently being spent on prohibition enforcement. Moreover, legalization could also remove the criminal element from marijuana market and reduce the size of Canada's black market and its consequences for the society. Nevertheless, it may also lead to some public health problems, including increasing in the uptake of the drug, accidents and injuries. The legalization should be accompanied with comprehensive strategies to keep the drug out of the hands of minors while increasing awareness and knowledge on harmful effects of the drug. In order to get better insights on how to develop an appropriate framework to legalize marijuana, Canada should closely watch the development in the neighboring country, the United States, where some of its states viz, Colorado, Oregon, Washington, and Alaska have already legalized recreational use of marijuana. © 2016 by Kerman University of Medical Sciences.

  9. Multiple Roles and Women's Mental Health in Canada.

    Science.gov (United States)

    Maclean, Heather; Glynn, Keva; Ansara, Donna

    2004-08-25

    HEALTH ISSUE: Research on the relationship between women's social roles and mental health has been equivocal. Although a greater number of roles often protect mental health, certain combinations can lead to strain. Our study explored the moderating affects of different role combinations on women's mental health by examining associations with socioeconomic status and differences in women's distress (depressive symptoms, personal stress (role strain) and chronic stress (role strain plus environmental stressors). KEY FINDINGS: Women with children, whether single or partnered, had a higher risk of personal stress. Distress, stress and chronic stress levels of mothers, regardless of employment, or marital status, are staggeringly high. Single, unemployed mothers were significantly more likely than all other groups to experience financial stress and food insecurity. For partnered mothers, rates of personal stress and chronic stress were significantly lower among unemployed partnered mothers. Married and partnered mothers reported better mental health than their single counterparts. Lone, unemployed mothers were twice as likely to report a high level of distress compared with other groups. Lone mothers, regardless of employment status, were more likely to report high personal and chronic stress. DATA GAPS AND RECOMMENDATIONS: National health surveys need to collect more data on the characteristics of women's work environment and their care giving responsibilities. Questions on household composition should include inter-generational households, same sex couples and multifamily arrangements. Data disaggregation by ethno-racial background would be helpful. Data should be collected on perceived quality of domestic and partnership roles and division of labours.

  10. Grand Challenges Canada: inappropriate emphasis and missed opportunities in global health research?

    Science.gov (United States)

    Larson, Charles P; Haddad, Slim; Birn, Anne-Emanuelle; Cole, Donald C; Labonte, Ronald; Roberts, Janet Hatcher; Schrecker, Ted; Sellen, Daniel; Zakus, David

    2011-01-01

    In May 2010, Grand Challenges Canada (GCC) was launched with the mandate to identify global challenges in health that could be supported through the Government of Canada's Development Innovations Fund (DIF: $225 million over five years). The GCC offers a potentially excellent mechanism for taking Canada's participation in global health challenges "to a higher level". Recent GCC announcements raise new questions about the emphasis being placed on technological discovery or "catalytic" research. Missing so far are opportunities that the Fund could offer in order to support innovative research addressing i) health systems strengthening, ii) more effective delivery of existing interventions, and iii) policies and programs that address broader social determinants of health. The Canadian Grand Challenges announced to date risk pushing to the sidelines good translational and implementation science and early career-stage scientists addressing important social, environmental and political conditions that affect disease prevalence, progress and treatment; and the many unresolved challenges faced in bringing to scale proven interventions within resource-constrained health systems. We wish to register our concern at the apparent prioritization of biotechnical innovation research and the subordination of the social, environmental, economic and political context in which human health is either protected or eroded.

  11. Partnership in employee health. A workplace health program for British Columbia Public Service Agency (Canada).

    Science.gov (United States)

    Tarride, J E; Harrington, K; Balfour, R; Simpson, P; Foord, L; Anderson, L; Lakey, W

    2011-01-01

    To evaluate the My Health Matters! (MHM) program, a multifaceted workplace intervention relying on education and awareness, early detection and disease management with a focus on risk factors for metabolic syndrome. The MHM program was offered to 2,000 public servants working in more than 30 worksites in British Columbia, Canada. The MHM program included a health risk assessment combined with an opportunity to attend an on-site screening and face-to-face call back visits and related on-site educational programs. Clinical and economic outcomes were collected over time in this one-year prospective study coupled with administrative and survey data. Forty three per cent of employees (N=857) completed the online HRA and 23 per cent (N=447) attended the initial clinical visit with the nurse. Risk factors for metabolic syndrome were identified in more than half of those attending the clinical visit. The number of risk factors significantly decreased by 15 per cent over six months (N=141). The cost per employee completing the HRA was $205 while the cost per employee attending the initial clinical visit was $394. Eighty-two per cent of employees would recommend the program to other employers. This study supports that workplace interventions are feasible, sustainable and valued by employees. As such, this study provides a new framework for implementing and evaluating workplace interventions focussing on metabolic disorders.

  12. Pharmaceutical health care and Inuit language communications in Nunavut, Canada

    OpenAIRE

    Romain, Sandra J.

    2013-01-01

    Background. Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requ...

  13. Incorporating Cognitive Behavioural Therapy into a Public Health Care System: Canada and England Compared

    Directory of Open Access Journals (Sweden)

    Noushon Farmanara

    2016-06-01

    Full Text Available Since the second half of the 2000s, Canada and England have instituted differing reforms to address the inadequate provision and quality of mental health services in both nations. With growing evidence demonstrating the success and cost-effectiveness of psychotherapy, the English reform sought to expand the delivery of psychological services through the Improving Access to Psychological Therapies program (IAPT focusing on cognitive behavioural therapy (CBT. In contrast, Canadian interventions at the federal level were centred on knowledge exchange and advocacy, primarily through the Mental Health Commission of Canada. While significant improvements were made during this period to increase CBT access in England, there continues to be an insufficient availability of psychological services to meet the growing need in Canada. While a national roll-out akin to the IAPT program in England is unlikely in Canada, similar reforms could be initiated at the provincial level of government. Indeed, several provincial governments have acknowledged the need for an expansion of CBT services and, over the last decade, some have tried to make CBT techniques more widely accessible. We review the case of the Bounce Back program developed in British Columbia (BC to illustrate this potential in the Canadian context. Best practices indicate that care is needed beyond the provision of psychiatric services and pharmacotherapy alone, and the initial results of both the IAPT program and BC’s Bounce Back program strongly suggest that it is possible to provide these cost-effective services in a public system.

  14. Impact of Diabetes Mellitus on Occupational Health Outcomes in Canada

    Directory of Open Access Journals (Sweden)

    Anson KC Li

    2017-04-01

    Full Text Available Background: Research suggests that diabetes mellitus (DM has a negative impact on employment and workplace injury, but there is little data within the Canadian context. Objective: To determine if DM has an impact on various occupational health outcomes using the Canadian Community Health Survey (CCHS. Methods: CCHS data between 2001 and 2014 were used to assess the relationships between DM and various occupational health outcomes. The final sample size for the 14-year study period was 505 606, which represented 159 432 239 employed Canadians aged 15–75 years during this period. Results: We found significant associations between people with diabetes and their type of occupation (business, finance, administration: 2009, p=0.002; 2010, p=0.002; trades, transportation, equipment: 2008, p=0.025; 2011, p=0.002; primary industry, processing, manufacturing, utility: 2013, p=0.018, reasons for missing work (looking for work: 2001, p=0.024; school or education: 2003, p=0.04; family responsibilities: 2014, p=0.015; other reasons: 2001, p<0.001; 2003, p<0.001; 2010, p=0.015, the number of work days missed (2010, 3 days, p=0.033; 4 days, p=0.038; 11 days, p<0.001; 24 days, p<0.001, and work-related injuries (traveling to and from work: 2014, p=0.003; working at a job or business: 2009, p=0.021; 2014, p=0.001. Conclusion: DM is associated with various occupational health outcomes, including work-related injury, work loss productivity, and occupation type. This allows stakeholders to assess the impact of DM on health outcomes in workplace.

  15. Drinking water quality in Indigenous communities in Canada and health outcomes: a scoping review.

    Science.gov (United States)

    Bradford, Lori E A; Okpalauwaekwe, Udoka; Waldner, Cheryl L; Bharadwaj, Lalita A

    2016-01-01

    Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar). Online searches for grey literature using relevant government websites were completed. Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature) met criteria for inclusion (contained keywords; publication year 2000-2015; peer-reviewed and from Canada). Studies were quantitative (8), qualitative (5) or mixed (3) and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of "health" was given (14/16), and the primary health issue described was gastrointestinal illness (12/16). Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a database to store and create access to research findings, increased

  16. Predictors of positive mental health among refugees: Results from Canada's General Social Survey.

    Science.gov (United States)

    Beiser, Morton; Hou, Feng

    2017-01-01

    Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

  17. A meeting of minds: interdisciplinary research in the health sciences in Canada

    Science.gov (United States)

    Hall, Judith G.; Bainbridge, Lesley; Buchan, Alison; Cribb, Alastair; Drummond, Jane; Gyles, Carlton; Hicks, T. Philip; McWilliam, Carol; Paterson, Barbara; Ratner, Pamela A.; Skarakis-Doyle, Elizabeth; Solomon, Patty

    2006-01-01

    Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in Canada. Based on first-hand knowledge and thoughtful reflection, the authors argue that although much progress has been made in support of IDHR in Canada, the practical experience of researchers does not always bear this out. This article examines government, industry and academia to identify the cultural and structural characteristics that demand, promote or prevent IDHR in each sector. At its heart is the question, How can universities best support and enhance IDHR, not only for the benefit of science, but also to meet the growing needs of industry and government for intellectual capital? Focusing on the predominant health sciences disciplines, the authors define IDHR as a team of researchers, solidly grounded in their respective disciplines, who come together around an important and challenging health issue, the research question for which is determined by a shared understanding in an interactive and iterative process. In addition, they suggest that IDHR is directly linked to translational research, which is the application of basic science to clinical practice and the generation of scientific questions through clinical observation. This analysis of academic, industry and government sectors is not intended to offer rigorous data on the current state of IDHR in Canada. Rather, the goal is to stimulate research-policy dialogue by suggesting a number of immediate measures that can help promote IDHR in Canada. Recommended measures to support IDHR are aimed at better resourcing and recognition (by universities and granting agencies), along with novel approaches to training, such as government- and industry-based studentships. In addition, we recommend that professional organizations reconsider their policies on publication and governance

  18. A meeting of minds: interdisciplinary research in the health sciences in Canada.

    Science.gov (United States)

    Hall, Judith G; Bainbridge, Lesley; Buchan, Alison; Cribb, Alastair; Drummond, Jane; Gyles, Carlton; Hicks, T Philip; McWilliam, Carol; Paterson, Barbara; Ratner, Pamela A; Skarakis-Doyle, Elizabeth; Solomon, Patty

    2006-09-26

    Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in Canada. Based on first-hand knowledge and thoughtful reflection, the authors argue that although much progress has been made in support of IDHR in Canada, the practical experience of researchers does not always bear this out. This article examines government, industry and academia to identify the cultural and structural characteristics that demand, promote or prevent IDHR in each sector. At its heart is the question, How can universities best support and enhance IDHR, not only for the benefit of science, but also to meet the growing needs of industry and government for intellectual capital? Focusing on the predominant health sciences disciplines, the authors define IDHR as a team of researchers, solidly grounded in their respective disciplines, who come together around an important and challenging health issue, the research question for which is determined by a shared understanding in an interactive and iterative process. In addition, they suggest that IDHR is directly linked to translational research, which is the application of basic science to clinical practice and the generation of scientific questions through clinical observation. This analysis of academic, industry and government sectors is not intended to offer rigorous data on the current state of IDHR in Canada. Rather, the goal is to stimulate research-policy dialogue by suggesting a number of immediate measures that can help promote IDHR in Canada. Recommended measures to support IDHR are aimed at better resourcing and recognition (by universities and granting agencies), along with novel approaches to training, such as government-and industry-based studentships. In addition, we recommend that professional organizations reconsider their policies on publication and governance

  19. Culture matters: a case of school health promotion in Canada.

    Science.gov (United States)

    McIsaac, Jessie-Lee D; Read, Kendra; Veugelers, Paul J; Kirk, Sara F L

    2017-04-01

    Rising concerns of poor health behaviours of children and youth have stimulated international support for a comprehensive approach to promoting the development of healthy behaviours in the early years. Health promoting schools (HPS) is increasingly adopted as an approach to guide supportive practices, but there is limited research that has reported how to effectively implement HPS at a population level. The purpose of this research was to qualitatively explore the factors preventing and facilitating implementation of HPS practices in the Canadian province of Nova Scotia. Interviews (n = 23) were conducted with school stakeholders (principals, teachers and parents) from a diverse sample of schools (n = 9) and data were analysed to develop an understanding of how school circumstances and experiences influenced HPS implementation. At a broad level, the reported barriers were structural and systemic, whereas the facilitating factors were related to organizational capacity and political leadership. It was evident that implementing and sustaining HPS required a shift in values and integration of supportive school health practices into school priorities. The results suggest that, without addressing the competing culture, which is persistently reinforced by strict academic mandates and unhealthy community norms, HPS will be vulnerable to circumstances that prevent implementation. Considering the emerging importance of mental wellbeing, it will also be important to provide schools with adequate and appropriate staff capacity and support to address this issue. Sustaining the positive effects of HPS will require continuous engagement and collaboration with multiple stakeholders to embed health promotion into school community norms. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Vigour Health: the ASC-Series launch in Canada

    OpenAIRE

    Danielsen, David M.; Fredriksen, Joakim; Nordli, Espen; Nøstberg, Bjørn R.

    2008-01-01

    This report is part of the authors’ bachelor degree in International Marketing and analyzes the Canadian vitamins and dietary supplements (VDS) industry. Based on this analysis, the authors will be proposing how Vigour can enter the market. Vigour Health was founded in 2006 by Omar Paulsen Bekheet and John Ivar Andre and the goal was to introduce a new lifestyle concept that should be inventive in its approach. Vigour utilizes raw materials from the northern parts of Norway, an...

  1. The Atomic Energy of Canada Limited (AECL) employee health study

    International Nuclear Information System (INIS)

    Weeks, J.L.

    1985-01-01

    The Atomic Energy Health Study formally began in April 1980. The purpose of the study is to determine the causes of death among a population of radiation workers and to compare this information with data available for the causes of death in the general population. The study population and the implementation are briefly discussed. The aim of the study is to determine the real occupational risk of being a radiation worker. 3 refs

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

    OpenAIRE

    Jessri, Mahsa; Nishi, Stephanie K.; L?Abbe, Mary R.

    2016-01-01

    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 pattern...

  3. Implementing Comprehensive School Health in Alberta, Canada: the principal's role.

    Science.gov (United States)

    Roberts, Erica; McLeod, Nicole; Montemurro, Genevieve; Veugelers, Paul J; Gleddie, Doug; Storey, Kate E

    2016-12-01

    Comprehensive School Health (CSH) is an internationally recognized framework that moves beyond the individual to holistically address school health, leading to the development of health-enhancing behaviors while also improving educational outcomes. Previous research has suggested that principal support for CSH implementation is essential, but this role has yet to be explored. Therefore, the purpose of this research was to examine the role of the principal in the implementation of a CSH project aimed at creating a healthy school culture. This research was guided by the grounded ethnography method. Semi-structured interviews were conducted with APPLE School principals (n = 29) to qualitatively explore their role in creating a healthy school culture. A model consisting of five major themes emerged, suggesting that the principal played a fluid role throughout the CSH implementation process. Principals (i) primed the cultural change; (ii) communicated the project's importance to others; (iii) negotiated concerns and collaboratively planned; (iv) held others accountable to the change, while enabling them to take ownership and (v) played an underlying supportive role, providing positive recognition and establishing ongoing commitment. This research provides recommendations to help establish effective leadership practices in schools, conducive to creating a healthy school culture. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Health-related quality of life for extremely low birth weight adolescents in Canada, Germany, and the Netherlands

    NARCIS (Netherlands)

    Verrips, E.; Vogels, T.; Saigal, S.; Wolke, D.; Meyer, R.; Hoult, L.; Verloove-Vanhorick, S.P.

    2008-01-01

    OBJECTIVE.The goal was to compare health-related quality of life of 12- to 16-year-old adolescents born at an extremely low birth weight in regional cohorts from Ontario (Canada), Bavaria (Germany), and the Netherlands. METHODS. Patients were extremely low birth weight survivors from Canada,

  5. Drinking water quality in Indigenous communities in Canada and health outcomes: a scoping review

    Directory of Open Access Journals (Sweden)

    Lori E. A. Bradford

    2016-07-01

    Full Text Available Background: Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. Objective: The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. Design: A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar. Online searches for grey literature using relevant government websites were completed. Results: Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature met criteria for inclusion (contained keywords; publication year 2000–2015; peer-reviewed and from Canada. Studies were quantitative (8, qualitative (5 or mixed (3 and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of “health” was given (14/16, and the primary health issue described was gastrointestinal illness (12/16. Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Conclusions: Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a

  6. Racialized identity and health in Canada: results from a nationally representative survey.

    Science.gov (United States)

    Veenstra, Gerry

    2009-08-01

    This article uses survey data to investigate health effects of racialization in Canada. The operative sample was comprised of 91,123 Canadians aged 25 and older who completed the 2003 Canadian Community Health Survey. A "racial and cultural background" survey question contributed a variable that differentiated respondents who identified with Aboriginal, Black, Chinese, Filipino, Latin American, South Asian, White, or jointly Aboriginal and White racial/cultural backgrounds. Indicators of diabetes, hypertension and self-rated health were used to assess health. The healthy immigrant effect suppressed some disparity in risk for diabetes by racial/cultural identification. In logistic regression models also containing gender, age, and immigrant status, no racial/cultural identifications corresponded with significantly better health outcomes than those reported by survey respondents identifying as White. Subsequent models indicated that residential locale did little to explain the associations between racial/cultural background and health and that socioeconomic status was only implicated in relatively poor health outcomes for respondents identifying as Aboriginal or Aboriginal/White. Sizable and statistically significant relative risks for poor health for respondents identifying as Aboriginal, Aboriginal/White, Black, Chinese, or South Asian remained unexplained by the models, suggesting that other explanations for health disparities by racialized identity in Canada - perhaps pertaining to experiences with institutional racism and/or the wear and tear of experiences of racism and discrimination in everyday life - also deserve empirical investigation in this context.

  7. Status of men’s health in Canada

    OpenAIRE

    Goldenberg, S. Larry

    2014-01-01

    Men are more likely to die of cancer, heart disease, or diabetes at younger ages than women – a reality that is compounded by the reluctance of men to use healthcare services. In addition to reduced life expectancy, men can also expect to live fewer healthy years than their female counterparts. As gynecologists and obstetricians have led the women’s health movement in addressing gender-specific gaps in care, urologists are well-poised to take on a leadership role to advocate for, and address,...

  8. Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

    Directory of Open Access Journals (Sweden)

    H. Orpana

    2016-01-01

    Full Text Available Introduction: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. Methods: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada’s definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. Results: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada’s strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course.

  9. A study on the health of the employees of Atomic Energy of Canada Limited. III

    International Nuclear Information System (INIS)

    Johnston, L.H.; Werner, M.M.

    1987-01-01

    The Atomic Energy of Canada Ltd (AECL) Employee Health Study commenced in 1980 July following the issue of a Company-Wide General Notice of 1980 April by the President of Atomic Energy of Canada Limited, Mr. James Donnelly. The study was set up to determine the causes of death of the AECL study population as compared to a similar group in the general population and to determine if there is a relationship between cause of death and occupational exposure to ionising radiation. Previous AECL reports have outlined how the study has been set up and implemented. The purpose of this report is to describe the reasons for and the methods of upgrading the data base for the AECL Employee Health Study. Some description of procedures used during the first linkage and recommendations for future linkages are included

  10. Health Promotion in Canada: perspectives & future prospects - doi:10.5020/18061230.2007.p3

    Directory of Open Access Journals (Sweden)

    Blake Poland

    2012-01-01

    Full Text Available Thank-you for the opportunity to be with you today in this fascinating panel on the state of health promotion in Brazil, Canada and around the world. It is a great pleasure to be here, and to share my thoughts and reflections with you, not as na expert here to tell you how it ‘should’ be, but as a colleague interested in dialogue around points of mutual concern. I feel we have much to learn from what has been happening here in Brazil, and the work of Paolo Freire and many contemporary colleagues who continue this tradition of critical pedagogy for health (like my colleague and friend here at UNIFOR, Dr. Francisco Cavalcante Jr.. So in this spirit of friendship, dialogue and mutual learning, I will be very frank with you about the lessons learned in Canada, including some of our failures and mistakes which I hope you can successfully avoid. Also, I offer my apologies for not being able to speak with you in your own language. I wish to thank my friends Nicolas Ayres and Francisco Cavalcante Jr. For their assistance with translation. In addition to a brief overview of the development of health promotion in Canada, I would like to share some reflections on the social, political and economic context in which the field has evolved, both in Canada and internationally. I Will address three (3 key tensions I see in the field at the moment (from a Canadian perspective, and reflect on our successes and our failures. I will close with a few thoughts on future prospects and some of the challenges that I see that lie ahead. I would like to emphasize that any brief history of health promotion in Canada, and any assessment of its strengths, contributions and failures is inherently ‘subjective’ and idiosyncratic. Rather than repeat the work of other analysts and commentators (see for example – cite PHAC/HC docs, I offer my observations based on over a decade of involvement in the field (including involvement in the Critical Social Science and Health

  11. Walking to work in Canada: health benefits, socio-economic characteristics and urban-regional variations.

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Chowhan, James

    2011-04-04

    There is mounting concern over increasing rates of physical inactivity and overweight/obesity among children and adult in Canada. There is a clear link between the amount of walking a person does and his or her health. The purpose of this paper is to assess the health factors, socio-economic characteristics and urban-regional variations of walking to work among adults in Canada. Data is drawn from two cycles of the Canadian Community Health Survey: 2001 and 2005. The study population is divided into three groups: non-walkers, lower-duration walkers and high-duration walkers. Logistic regression modeling tests the association between levels of walking and health related outcomes (diabetes, high blood pressure, stress, BMI, physical activity), socio-economic characteristics (sex, age, income, education) and place of residence (selected Census Metropolitan Areas). In 2005, the presence of diabetes and high blood pressure was not associated with any form of walking. Adults within the normal weight range were more likely to be high-duration walkers. Females and younger people were more likely to be lower-duration walkers but less likely to be high-duration walkers. There was a strong association between SES (particularly relative disadvantage) and walking to work. In both 2001 and 2005, the conditions influencing walking to work were especially prevalent in Canada's largest city, Toronto, as well as in several small to medium sized urban areas including Halifax, Kingston, Hamilton, Regina, Calgary and Victoria. A number of strategies can be followed to increase levels of walking in Canada. It is clear that for many people walking to work is not possible. However, strategies can be developed to encourage adults to incorporate walking into their daily work and commuting routines. These include mass transit walking and workplace walking programs.

  12. Walking to work in Canada: health benefits, socio-economic characteristics and urban-regional variations

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    Williams Allison

    2011-04-01

    Full Text Available Abstract Background There is mounting concern over increasing rates of physical inactivity and overweight/obesity among children and adult in Canada. There is a clear link between the amount of walking a person does and his or her health. The purpose of this paper is to assess the health factors, socio-economic characteristics and urban-regional variations of walking to work among adults in Canada. Methods Data is drawn from two cycles of the Canadian Community Health Survey: 2001 and 2005. The study population is divided into three groups: non-walkers, lower-duration walkers and high-duration walkers. Logistic regression modeling tests the association between levels of walking and health related outcomes (diabetes, high blood pressure, stress, BMI, physical activity, socio-economic characteristics (sex, age, income, education and place of residence (selected Census Metropolitan Areas. Results In 2005, the presence of diabetes and high blood pressure was not associated with any form of walking. Adults within the normal weight range were more likely to be high-duration walkers. Females and younger people were more likely to be lower-duration walkers but less likely to be high-duration walkers. There was a strong association between SES (particularly relative disadvantage and walking to work. In both 2001 and 2005, the conditions influencing walking to work were especially prevalent in Canada's largest city, Toronto, as well as in several small to medium sized urban areas including Halifax, Kingston, Hamilton, Regina, Calgary and Victoria. Conclusion A number of strategies can be followed to increase levels of walking in Canada. It is clear that for many people walking to work is not possible. However, strategies can be developed to encourage adults to incorporate walking into their daily work and commuting routines. These include mass transit walking and workplace walking programs.

  13. Understanding sexual orientation and health in Canada: Who are we capturing and who are we missing using the Statistics Canada sexual orientation question?

    Science.gov (United States)

    Dharma, Christoffer; Bauer, Greta R

    2017-04-20

    Public health research on inequalities in Canada depends heavily on population data sets such as the Canadian Community Health Survey. While sexual orientation has three dimensions - identity, behaviour and attraction - Statistics Canada and public health agencies assess sexual orientation with a single questionnaire item on identity, defined behaviourally. This study aims to evaluate this item, to allow for clearer interpretation of sexual orientation frequencies and inequalities. Through an online convenience sampling of Canadians ≥14 years of age, participants (n = 311) completed the Statistics Canada question and a second set of sexual orientation questions. The single-item question had an 85.8% sensitivity in capturing sexual minorities, broadly defined by their sexual identity, lifetime behaviour and attraction. Kappa statistic for agreement between the single item and sexual identity was 0.89; with past year, lifetime behaviour and attraction were 0.39, 0.48 and 0.57 respectively. The item captured 99.3% of those with a sexual minority identity, 84.2% of those with any lifetime same-sex partners, 98.4% with a past-year same-sex partner, and 97.8% who indicated at least equal attraction to same-sex persons. Findings from Statistics Canada surveys can be best interpreted as applying to those who identify as sexual minorities. Analyses using this measure will underidentify those with same-sex partners or attractions who do not identify as a sexual minority, and should be interpreted accordingly. To understand patterns of sexual minority health in Canada, there is a need to incorporate other dimensions of sexual orientation.

  14. Examining fiscal federalism, regionalization and community-based initiatives in Canada's health care delivery system.

    Science.gov (United States)

    Forest, Pierre-Gerlier; Palley, Howard A

    2008-01-01

    This study focuses on the ability of Canadian provinces to shape in different ways the development of various provincial health delivery systems within the constraints of the mandates of the federal Canada Health Act of 1984 and the fiscal revenues that the provinces receive if they comply with these mandates. In so doing, it will examine the operation of Canadian federalism with respect to various provincial health systems. This study applies a comparative analysis framework developed by Heisler and Peters to facilitate an understanding of the dimensionality of provincial health delivery systems as applied to the case of provincial regionalization and community-based initiatives. The three sets of relationships touched upon are: first, the levels of government and the nature of their involvement in public policy concerning the provincial health care delivery systems; and secondly, understanding of the factors influencing provincial governments' political dispositions to act in various directions. A third dimension that is taken are the factors influencing the "timing" of particular decisions. A fourth area noted by Heisler and Peters and other comparative analysts is the nature and characteristics of public and private sector activities in health care and other social policy areas. While the evolving nature of public and private sector health care delivery activities within Canada's provincial and territorial systems is a significant policy matter in the Canadian context, due to the space limitations of this article, they are not discussed herein.

  15. Book Review: Greenwood, M. et al. (Eds.. (2015. Determinants of Indigenous Peoples' Health in Canada: Beyond the Social

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    Javier Mignone

    2017-03-01

    Full Text Available This article provides a review of the book Determinants of Indigenous Peoples’ Health in Canada: Beyond the Social edited by Margo Greenwood, Sarah de Leeuw, Nicole Marie Lindsay, and Charlotte Reading.

  16. Eating well with Canada's food guide? Authoritative knowledge about food and health among newcomer mothers.

    Science.gov (United States)

    Anderson, L C; Mah, C L; Sellen, D W

    2015-08-01

    Current versions of Canada's Food Guide (CFG) aim to inform a culturally diverse population, but it is not known how intended audiences from different cultural and linguistic groups within Canada's diverse population understand and apply its messages. We analyzed data from qualitative interviews conducted with 32 newcomer mothers of children aged 1-5 years to explore how conceptions of food and health change with migration to Canada among Spanish-speaking Latin American and Tamil Speaking Sri Lankan newcomers and may influence the appropriateness and applicability of Canada's Food Guide (CFG) as a nutrition education tool. We applied Jordan's model of authoritative knowledge to identify different forms of newcomer maternal nutrition knowledge, how they influence child feeding practices, and shifts causing some forms of knowledge to be devalued in favor of others. Awareness of CFG differed between groups, with all Latin American and only half of Tamil participants familiar with it. Three distinct, overlapping ways of knowing about the relationship between food and health are identified within both groups of mothers: "natural" foods as healthy; influence of foods on illness susceptibility, and the nutritional components of food. CFG was found to be limited in its representations of recommended foods and its exclusive utilization of biomedical concepts of nutrition. Development of new, culturally competent versions of CFG that depict a variety of ethno-culturally meaningful diets and encompass both non-biomedical conceptualizations of food and health has the potential to enhance effective knowledge translation of CFG's key messages to an increasingly cosmopolitan Canadian population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Culturally Safe Health Initiatives for Indigenous Peoples in Canada: A Scoping Review.

    Science.gov (United States)

    Brooks-Cleator, Lauren; Phillipps, Breanna; Giles, Audrey

    2018-01-01

    Background Cultural safety has the potential to improve the health disparities between Indigenous and non-Indigenous Canadians, yet practical applications of the concept are lacking in the literature. Purpose This study aims to identify the key components of culturally safe health initiatives for the Indigenous population of Canada to refine its application in health-care settings. Methods We conducted a scoping review of the literature pertaining to culturally safe health promotion programs, initiatives, services, or care for the Indigenous population in Canada. Our initial search yielded 501 publications, but after full review of 44 publications, 30 were included in the review. After charting the data, we used thematic analysis to identify themes in the data. Results We identified six themes: collaboration/partnerships, power sharing, address the broader context of the patient's life, safe environment, organizational and individual level self-reflection, and training for health-care providers. Conclusion While it is important to recognize that the provision of culturally safe initiatives depend on the specific interaction between the health-care provider and the patient, having a common understanding of the components of cultural safety, such as those that we identified through this research, will help in the transition of cultural safety from theory into practice.

  18. Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

    Energy Technology Data Exchange (ETDEWEB)

    McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: collson@intrinsik.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: fenvdean@sfu.ca [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)

    2015-11-15

    Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

  19. A study of the health of the employees of Atomic Energy of Canada Limited

    International Nuclear Information System (INIS)

    Weeks, J.L.; Johnston, L.H.

    1984-09-01

    The Atomic Energy of Canada Limited Employee Health Study is a program that was established in 1980 to determine, over the long term, the causes of death in a population consisting of some 14 000 AECL employees and past employees. In a previous report (AECL-6813) the steps taken to set up the study were described. The present report is a description of the way in which the study was implemented, and includes discussion of some recent developments that have had a bearing on epidemiological studies of the health of radiation workers

  20. Health Care and Aboriginal Seniors in Urban Canada: Helping a Neglected Class

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    Loleen Berdahl

    2011-05-01

    Full Text Available Canadian researchers and policymakers have paid limited attention to the health care needs of Aboriginal seniors. This lack of attention is problematic, as the situation of Aboriginal seniors – including both status and non-status First Nations, Métis and Inuit – is particularly bleak. Using Winnipeg, Regina and Saskatoon as examples, this paper analyses the health care challenges facing Aboriginal seniors in urban Canada. We ask, what policy approaches are needed to improve the health and wellbeing of urban Aboriginal seniors so that they can have good quality living reflective of their needs and culture? We suggest that, in thinking throughpresent and future health services for urban Aboriginal seniors, policymakers should consider four key factors: socioeconomic conditions; underutilization of urban health services; jurisdiction; and elder abuse.

  1. Public awareness of income-related health inequalities in Ontario, Canada

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    Shankardass Ketan

    2012-05-01

    Full Text Available Abstract Introduction Continued action is needed to tackle health inequalities in Canada, as those of lower income continue to be at higher risk for a range of negative health outcomes. There is arguably a lack of political will to implement policy change in this respect. As a result, we investigated public awareness of income-related health inequalities in a generally representative sample of Ontarians in late 2010. Methods Data were collected from 2,006 Ontario adults using a telephone survey. The survey asked participants to agree or disagree with various statements asserting that there are or are not health inequalities in general and by income in Ontario, including questions pertaining to nine specific conditions for which inequalities have been described in Ontario. A multi-stage process using binary logistic regression determined whether awareness of health inequalities differed between participant subgroups. Results Almost 73% of this sample of Ontarians agreed with the general premise that not all people are equally healthy in Ontario, but fewer participants were aware of health inequalities between the rich and the poor (53%–64%, depending on the framing of the question. Awareness of income-related inequalities in specific outcomes was considerably lower, ranging from 18% for accidents to 35% for obesity. Conclusions This is the first province-wide study in Canada, and the first in Ontario, to explore public awareness on health inequalities. Given that political will is shaped by public awareness and opinion, these results suggest that greater awareness may be required to move the health equity agenda forward in Ontario. There is a need for health equity advocates, physicians and researchers to increase the effectiveness of knowledge translation activities for studies that identify and explore health inequalities.

  2. Numeracy and Health Numeracy Among Chinese and Kenyan Immigrants to Canada

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    S. Gatobu

    2014-02-01

    Full Text Available Mathematics self-efficacy plays an important role in the performance of quantitative tasks. The objective of this study was to examine the role of mathematics self-efficacy in numeracy and health numeracy among immigrants (60 Mandarin-speaking and 60 Kikuyu-speaking immigrants to Canada for whom English was a second language (ESL. Two French Kit numeracy tasks (the addition, and the addition and subtraction correction tasks constituted objective measures of numeracy, and the numeracy component of a health literacy instrument (The Short Test of Functional Health Literacy for Adults [S-TOFHLA] constituted the health numeracy measure. We measured math self-efficacy using the Mathematics Self-Efficacy Scale (MSES and the Subjective Numeracy Scale (SNS. All measures were presented in English. Kikuyu speakers had lower math self-efficacy (p < .05 compared with Mandarin speakers (p < .05. Mandarin speakers outperformed Kikuyu speakers in numeracy (p < .001 and health numeracy (p < .023 skills. In multiple regression analyses, 32% to 57 % of the variance in objective numeracy was explained by language, residency in Canada, and self-efficacy, adjusting for the other predictor variables; self-efficacy and format of numeric health information (numbers only vs. numbers with detailed text consistently predicted health numeracy. Mathematics self-efficacy may be an important factor in numeracy, but not as important in health numeracy for Kikuyu- and Mandarin-speaking immigrants for whom English is a second language. Factors contributing to low numeracy may differ from those explaining low health numeracy in ESL immigrants.

  3. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders

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    Marie-Pierre Gagnon

    2016-07-01

    Full Text Available Background: Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Methods: Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers. A detailed summary of each interview was created and thematic analysis was conducted. Results: We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness, system design (usability and relevance, user capacities and attitudes (patient health literacy, education and interest, support for professionals, environmental factors (government commitment, targeted populations and legal and ethical issues (information control and custody, confidentiality, privacy and security. Conclusion: ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem wellprepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs. Better guidance on these issues would provide a greater awareness of ePHRs and inform

  4. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Payne-Gagnon, Julie; Breton, Erik; Fortin, Jean-Paul; Khoury, Lara; Dolovich, Lisa; Price, David; Wiljer, David; Bartlett, Gillian; Archer, Norman

    2016-04-06

    Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted. We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security). ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders including clinicians, decision-makers, patients

  5. How Bell Canada Capitalises on the Millennial: Affective Labour, Intersectional Identity, and Mental Health

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    Peters Meg

    2018-01-01

    Full Text Available Since 2010, the large telecommunications company, Bell Canada, has invited Canadians to “break the stigma” around mental illness through a campaign called #BellLetsTalk. The campaign claims to donate millions to mental health initiatives, aiming to also “start a conversation” about mental health online. In large part, the Bell Let’s Talk campaign depends on the position of the millennial as a social media user with a real stake in conversations revolving around mental health. I highlight how the term “mental health” is often correlated to normative affect and behaviour, pointing to the importance of an intersectional understanding of mental health. Colonialism is also at play here, as the Bell campaign donates to Indigenous communities, but fails to address how psychiatric intervention is often a colonial process in itself. Through a feminist and critical disability studies lens, I critique Bell for its seemingly apolitical ad campaign, arguing that it bolsters normative narratives around psychological distress and its place in neoliberal corporations and colonial Canada.

  6. Social dimensions of health across the life course: Narratives of Arab immigrant women ageing in Canada.

    Science.gov (United States)

    Salma, Jordana; Keating, Norah; Ogilvie, Linda; Hunter, Kathleen F

    2018-04-01

    The increase in ethnically and linguistically diverse older adults in Canada necessitates attention to their experiences and needs for healthy ageing. Arab immigrant women often report challenges in maintaining health, but little is known about their ageing experiences. This interpretive descriptive study uses a transnational life course framework to understand Arab Muslim immigrant women's experiences of engaging in health-promoting practices as they age in Canada. Women's stories highlight social dimensions of health such social connectedness, social roles and social support that are constructed and maintained within different migration contexts across the life course. Barriers and facilitators to healthy ageing in this population centred around five themes: (i) the necessity of staying strong, (ii) caring for self while caring for others, (iii) double jeopardy of chronic illnesses and loneliness, (iv) inadequate support within large social networks and (v) navigating access to health-supporting resources. The findings point to transnational connections and post-migration social support as major influencers in creating facilitators and barriers to healthy ageing for Arab Muslim immigrant women. © 2017 John Wiley & Sons Ltd.

  7. Between education and memory: health and childhood in English-Canada, 1900-1950.

    Science.gov (United States)

    Gleason, Mona

    2006-01-01

    Despite contemporary concerns regarding the state of Canadian children's health, historians in Canada have yet to fully explore how conventional medical experts and educators thought about, and safeguarded, children's health. This paper explores the interplay between two sources of information regarding the provision of healthy children between 1900 and the end of the Second World War in the English Canadian context: curricular messages regarding health and illness aimed at public school children and the oral histories and autobiographies of adults who grew up in this period. Rather than simply juxtapose official health curriculum and lived memory, I argue that the two co-mingled to produce differing kinds of embodied knowledge aimed at the production and reproduction of hegemonic social values in the English Canadian setting. These values co-existed both harmoniously and uncomfortably, depending very much upon the priorities of, and socially constructed limitations placed upon, particular families in particular contexts.

  8. Filipino women living in Canada: constructing meanings of body, food, and health.

    Science.gov (United States)

    Farrales, L L; Chapman, G E

    1999-01-01

    This qualitative study explored the understandings of body size, food and eating, and health held by Filipino women living in Canada. Women (n = 11) aged 19 to 30 years old who were born in the Philippines and living in British Columbia participated in individual interviews where they discussed their beliefs and practices relating to their body, food, and health. Informants' comments reflected contrasting "Canadian" and "Filipino" meanings. Canadian beliefs emphasized the desirability of thinness, "watching" intake of fat, rice, and junk food, and minimizing disease risk. Filipino beliefs valued fatness, "just eating" fat and rice, and maximizing disease resistance. While most informants appeared to have adopted the Canadian values, Filipino beliefs continued to be of some significance in their lives. These findings demonstrate the socially constructed nature of health beliefs and illustrate how members of a minority ethnic group negotiate among conflicting cultural beliefs about body size, food and health.

  9. Alternative health care consultations in Ontario, Canada: A geographic and socio-demographic analysis

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    Eby Jeanette

    2011-06-01

    Full Text Available Abstract Background An important but understudied component of Canada's health system is alternative care. The objective of this paper is to examine the geographic and socio-demographic characteristics of alternative care consultation in Ontario, Canada's largest province. Methods Data is drawn from the Canadian Community Health Survey (CCHS Cycle 3.1, 2005 for people aged 18 or over (n = 32,598 who had a consultation with an alternative health care provider. Four groups of consultations are examined: (1 all consultations (2 massage therapy (3 acupuncture, and (4 homeopath/naturopath. Descriptive statistics, mapping and logistic regression modeling are employed to analyze the data and to compare modalities of alternative health care use. Results In 2005, more than 1.2 million adults aged 18 or over consulted an alternative health care provider, representing about 13% of the total population of Ontario. The analysis revealed a varied geographic pattern of consultations across the province. Consultations were fairly even across the urban to rural continuum and rural residents were just as likely to consult a provider as their urban counterparts. From a health perspective, people with a chronic condition, lower health status and self-perceived unmet health care needs were more likely to see an alternative health provider. Women with chronic conditions such as fibromyalgia, high blood pressure, chronic fatigue syndrome and chemical sensitivities were more likely to see an alternative provider if they felt their health care needs were not being met. Conclusions The analysis revealed that geography is not a factor in determining alternative health care consultations in Ontario. By contrast, there is a strong association between these consultations and socio-demographic characteristics particularly age, sex, education, health and self-perceived unmet health care needs. The results underscore the importance of women's health needs as related to

  10. Moral regulation and the presumption of guilt in Health Canada's medical cannabis policy and practice.

    Science.gov (United States)

    Lucas, Philippe

    2009-07-01

    This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating

  11. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    Noble, B.F.; Bronson, J.E.

    2005-01-01

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  12. Barriers to health-care and psychological distress among mothers living with HIV in Quebec (Canada).

    Science.gov (United States)

    Blais, Martin; Fernet, Mylène; Proulx-Boucher, Karène; Lebouché, Bertrand; Rodrigue, Carl; Lapointe, Normand; Otis, Joanne; Samson, Johanne

    2015-01-01

    Health-care providers play a major role in providing good quality care and in preventing psychological distress among mothers living with HIV (MLHIV). The objectives of this study are to explore the impact of health-care services and satisfaction with care providers on psychological distress in MLHIV. One hundred MLHIV were recruited from community and clinical settings in the province of Quebec (Canada). Prevalence estimation of clinical psychological distress and univariate and multivariable logistic regression models were performed to predict clinical psychological distress. Forty-five percent of the participants reported clinical psychological distress. In the multivariable regression, the following variables were significantly associated with psychological distress while controlling for sociodemographic variables: resilience, quality of communication with the care providers, resources, and HIV disclosure concerns. The multivariate results support the key role of personal, structural, and medical resources in understanding psychological distress among MLHIV. Interventions that can support the psychological health of MLHIV are discussed.

  13. Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada.

    Science.gov (United States)

    Beiser, Morton; Hou, Feng

    2016-06-01

    This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.

  14. Analysing contractual environments: lessons from Indigenous health in Canada, Australia and New Zealand.

    Science.gov (United States)

    Lavoie, Josée; Boulton, Amohia; Dwyer, Judith

    2010-01-01

    Contracting in health care is a mechanism used by the governments of Canada, Australia and New Zealand to improve the participation of marginalized populations in primary health care and improve responsiveness to local needs. As a result, complex contractual environments have emerged. The literature on contracting in health has tended to focus on the pros and cons of classical versus relational contracts from the funder's perspective. This article proposes an analytical framework to explore the strengths and weaknesses of contractual environments that depend on a number of classical contracts, a single relational contract or a mix of the two. Examples from indigenous contracting environments are used to inform the elaboration of the framework. Results show that contractual environments that rely on a multiplicity of specific contracts are administratively onerous, while constraining opportunities for local responsiveness. Contractual environments dominated by a single relational contract produce a more flexible and administratively streamlined system.

  15. "I feel like I am surviving the health care system": understanding LGBTQ health in Nova Scotia, Canada.

    Science.gov (United States)

    Colpitts, Emily; Gahagan, Jacqueline

    2016-09-22

    Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations in the province of Nova Scotia, Canada. Historically, LGBTQ health research has tended to focus on individual-level health risks associated with poor health outcomes among these populations, which has served to obscure the ways in which they maintain their own health and wellness across the life course. As such, there is an urgent need to shift the focus of LGBTQ health research towards strengths-based perspectives that explore the complex and resilient ways in which LGBTQ populations promote their health. This paper discusses the findings of our recent scoping review as well as the qualitative data to emerge from community consultations aimed at developing strengths-based approaches to understanding and advancing LGBTQ pathways to health across Nova Scotia. Our scoping review findings demonstrated the lack of strengths-based research on LGBTQ health in Nova Scotia. Specifically, the studies examined in our scoping review identified a number of health-promoting factors and a wide variety of measurement tools, some of which may prove useful for future strengths-based health research with LGBTQ populations. In addition, our community consultations revealed that many participants had negative experiences with health care systems and services in Nova Scotia. However, participants also shared a number of factors that contribute to LGBTQ health and suggestions for how LGBTQ pathways to health in Nova Scotia can be improved. There is an urgent need to conduct research on the health needs, lived experiences, and outcomes of LGBTQ populations in Nova Scotia to address gaps in our knowledge of their unique health needs. In moving forward, it is important that future health research take an intersectional, strengths-based perspective in an effort to highlight the factors that promote LGBTQ health and wellness across the life course, while taking

  16. “I feel like I am surviving the health care system”: understanding LGBTQ health in Nova Scotia, Canada

    Directory of Open Access Journals (Sweden)

    Emily Colpitts

    2016-09-01

    Full Text Available Abstract Background Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ populations in the province of Nova Scotia, Canada. Historically, LGBTQ health research has tended to focus on individual-level health risks associated with poor health outcomes among these populations, which has served to obscure the ways in which they maintain their own health and wellness across the life course. As such, there is an urgent need to shift the focus of LGBTQ health research towards strengths-based perspectives that explore the complex and resilient ways in which LGBTQ populations promote their health. Methods This paper discusses the findings of our recent scoping review as well as the qualitative data to emerge from community consultations aimed at developing strengths-based approaches to understanding and advancing LGBTQ pathways to health across Nova Scotia. Results Our scoping review findings demonstrated the lack of strengths-based research on LGBTQ health in Nova Scotia. Specifically, the studies examined in our scoping review identified a number of health-promoting factors and a wide variety of measurement tools, some of which may prove useful for future strengths-based health research with LGBTQ populations. In addition, our community consultations revealed that many participants had negative experiences with health care systems and services in Nova Scotia. However, participants also shared a number of factors that contribute to LGBTQ health and suggestions for how LGBTQ pathways to health in Nova Scotia can be improved. Conclusions There is an urgent need to conduct research on the health needs, lived experiences, and outcomes of LGBTQ populations in Nova Scotia to address gaps in our knowledge of their unique health needs. In moving forward, it is important that future health research take an intersectional, strengths-based perspective in an effort to highlight the factors that

  17. Bariatric surgery tourism hidden costs? How Canada is not doing its part in covering bariatric surgery under the Canada Health Act.

    Science.gov (United States)

    Gagner, Michel

    2017-08-01

    Many Canadians seek medical treatment outside our borders. Waiting times, rather than lack of expertise, are the number one culprit, and with globalization of health care, the number of patients who travel to obtain medical care will continue to rise. Though the provinces have covered the costs of complications from surgeries performed abroad for many years, complications from bariatric surgery performed abroad have been receiving negative attention. This commentary discusses associated costs and questions how the Canada Health Act should be covering bariatric procedures.

  18. The global financial crisis and health equity: early experiences from Canada.

    Science.gov (United States)

    Ruckert, Arne; Labonté, Ronald

    2014-01-06

    It is widely acknowledged that austerity measures in the wake of the global financial crisis are starting to undermine population health results. Yet, few research studies have focused on the ways in which the financial crisis and the ensuing 'Great Recession' have affected health equity, especially through their impact on social determinants of health; neither has much attention been given to the health consequences of the fiscal austerity regime that quickly followed a brief period of counter-cyclical government spending for bank bailouts and economic stimulus. Canada has not remained insulated from these developments, despite its relative success in maneuvering the global financial crisis. The study draws on three sources of evidence: A series of semi-structured interviews in Ottawa and Toronto, with key informants selected on the basis of their expertise (n = 12); an analysis of recent (2012) Canadian and Ontario budgetary impacts on social determinants of health; and documentation of trend data on key social health determinants pre- and post the financial crisis. The findings suggest that health equity is primarily impacted through two main pathways related to the global financial crisis: austerity budgets and associated program cutbacks in areas crucial to addressing the inequitable distribution of social determinants of health, including social assistance, housing, and education; and the qualitative transformation of labor markets, with precarious forms of employment expanding rapidly in the aftermath of the global financial crisis. Preliminary evidence suggests that these tendencies will lead to a further deepening of existing health inequities, unless counter-acted through a change in policy direction. This article documents some of the effects of financial crisis and severe economic decline on health equity in Canada. However, more research is necessary to study policy choices that could mitigate this effect. Since the policy response to a similar set of

  19. Echinococcosis: An Economic Evaluation of a Veterinary Public Health Intervention in Rural Canada

    Science.gov (United States)

    Farag, Marwa; Zeng, Wu; Jenkins, Emily J.

    2015-01-01

    Echinococcosis is a rare but endemic condition in people in Canada, caused by a zoonotic cestode for which the source of human infection is ingestion of parasite eggs shed by canids. The objectives of this study were to identify risk factors associated with infection and to measure the cost-utility of introducing an echinococcosis prevention program in a rural area. We analyzed human case reports submitted to the Canadian Institutes for Health Information between 2002 and 2011. Over this 10 year period, there were 48 cases associated with E. granulosus/E. canadensis, 16 with E. multilocularis, and 251 cases of echinococcosis for which species was not identified (total 315 cases). Nationally, annual incidence of echinococcosis was 0.14 cases per 100 000 people, which is likely an underestimate due to under-diagnosis and under-reporting. Risk factors for echinococcosis included female gender, age (>65 years), and residing in one of the northern territories (Nunavut, Yukon, or Northwest Territories). The average cost of treating a case of cystic echinococcosis in Canada was $8,842 CAD. Cost-utility analysis revealed that dosing dogs with praziquantel (a cestocide) at six week intervals to control cystic echinococcosis is not currently cost-effective at a threshold of $20,000-100,000 per Quality Adjusted Life Year (QALY) gained, even in a health region with the highest incidence rate in Canada ($666,978 -755,051 per QALY gained). However, threshold analysis demonstrated that the program may become cost-saving at an echinococcosis incidence of 13-85 cases per 100,000 people and therefore, even one additional CE case in a community of 9000 people could result in the monetary benefits of the program outweighing costs. PMID:26135476

  20. Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

    Science.gov (United States)

    Sunderland, Naomi; Harris, Paul; Johnstone, Kylie; Del Fabbro, Letitia; Kendall, Elizabeth

    2015-03-01

    This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research. © The Author(s) 2014.

  1. Comparing Strategies for Providing Child and Youth Mental Health Care Services in Canada, the United States, and The Netherlands.

    Science.gov (United States)

    Ronis, Scott T; Slaunwhite, Amanda K; Malcom, Kathryn E

    2017-11-01

    This paper reviews how child and youth mental health care services in Canada, the United States, and the Netherlands are organized and financed in order to identify systems and individual-level factors that may inhibit or discourage access to treatment for youth with mental health problems, such as public or private health insurance coverage, out-of-pocket expenses, and referral requirements for specialized mental health care services. Pathways to care for treatment of mental health problems among children and youth are conceptualized and discussed in reference to health insurance coverage and access to specialty services. We outline reforms to the organization of health care that have been introduced in recent years, and the basket of services covered by public and private insurance schemes. We conclude with a discussion of country-level opportunities to enhance access to child and youth mental health services using existing health policy levers in Canada, the United States and the Netherlands.

  2. High Purity Germanium Detector as part of Health Canada's Mobile Nuclear Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Stocki, Trevor J.; Bouchard, Claude; Rollings, John; Boudreau, Marc-Oliver; McCutcheon- Wickham, Rory; Bergman, Lauren [Radiation Protection Bureau, Health Canada, AL6302D, 775 Brookfield Road, Ottawa, K1A 0K9 (Canada)

    2014-07-01

    In the event of a nuclear emergency on Canadian soil, Health Canada has designed and equipped two Mobile Nuclear Labs (MNLs) which can be deployed near a radiological accident site to provide radiological measurement capabilities. These measurements would help public authorities to make informed decisions for radiation protection recommendations. One of the MNLs has been outfitted with a High Purity Germanium (HPGe) detector within a lead castle, which can be used for identification as well as quantification of gamma emitting radioisotopes in contaminated soil, water, and other samples. By spring 2014, Health Canada's second MNL will be equipped with a similar detector to increase sample analysis capacity and also provide redundancy if one of the detectors requires maintenance. The Mobile Nuclear Lab (MNL) with the HPGe detector has been successfully deployed in the field for various exercises. One of these field exercises was a dirty bomb scenario where an unknown radioisotope required identification. A second exercise was an inter-comparison between the measurements of spiked soil and water samples, by two field teams and a certified laboratory. A third exercise was the deployment of the MNL as part of a full scale nuclear exercise simulating an emergency at a Canadian nuclear power plant. The lessons learned from these experiences will be discussed. (authors)

  3. ASA24-Canada

    Science.gov (United States)

    A Canadian adaptation of the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24-Canada), developed by the Food Directorate at Health Canada in collaboration with NCI, has been freely available since April 2014.

  4. Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

    Science.gov (United States)

    Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

    2017-10-02

    Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the

  5. Mental health help-seeking attitudes, utilization, and intentions among older Chinese immigrants in Canada.

    Science.gov (United States)

    Tieu, Yvonne; Konnert, Candace A

    2014-03-01

    This study had three objectives. First, to determine the extent to which demographic factors, perceived social support, and Chinese cultural beliefs predict attitudes toward mental health help seeking; second, to assess mental health utilization; and third, to assess intentions to utilize mental health services among older Chinese immigrants in Canada aged 55 and above. A total of 149 older Chinese adults (M = 73.92 years, SD = 9.99, range = 55-95 years) completed a semi-structured interview protocol in Cantonese or Mandarin. Demographic and health information were collected, and questionnaires assessing perceived social support, mental health help-seeking attitudes, and belief in Chinese culture and values were administered. Demographic and health information, perceived social support, Chinese cultural beliefs and values accounted for 21.8% of the variance in help-seeking attitudes. Descriptive data related to mental health utilization and intentions are provided. Older Chinese participants exhibited less positive attitudes that were significantly associated with Chinese cultural beliefs and values. Implications for practice with older Chinese adults are also discussed.

  6. Why do we need an oral health care policy in Canada?

    Science.gov (United States)

    Leake, James L

    2006-05-01

    Although health care is a right of citizenship, severe inequities in oral health and access to care persist. This paper provides information on the financing, organization and delivery of oral health services in Canada. It concludes that dental care has largely fallen out of consideration as health care. The increasing costs of dental insurance and disparities in oral health and access to care threaten the system"s sustainability. The legislation that allows the insured to receive tax-free care and requires all taxpayers to subsidize that expenditure is socially unjust. Unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research. However, never before have we had the opportunity presented by high levels of oral health, the extensive resources already allocated to oral health care, plus the support of other organizations to allow us to consider what else we might do. One of the first steps would be to establish new models for the delivery of preventive measures and care that reach out to those who do not now enjoy access.

  7. 78 FR 9701 - Draft Joint Food and Drug Administration/Health Canada Quantitative Assessment of the Risk of...

    Science.gov (United States)

    2013-02-11

    ... on the sources of L. monocytogenes contamination, the effects of individual manufacturing and/or... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-1182] Draft Joint Food and Drug Administration/Health Canada Quantitative Assessment of the Risk of...

  8. Race and Culture in the Secondary School Health and Physical Education Curriculum in Ontario, Canada: A Critical Reading

    Science.gov (United States)

    Petherick, LeAnne

    2018-01-01

    Purpose: The purpose of this paper is to explore issues of race and culture in health education in the secondary school health and physical education (HPE) curriculum in Ontario, Canada. Design/methodology/approach: Using Ontario's secondary school curriculum as a point of analysis, this paper draws from critical race theory and a whiteness lens…

  9. Article Commentary: Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework

    Directory of Open Access Journals (Sweden)

    Colleen Anne Dell

    2012-01-01

    Full Text Available The intentional misuse of psychotropic drugs is recognized as a significant public health concern in Canada, although there is a lack of empirical research detailing this. Even less research has been documented on the misuse of prescription drugs among First Nations in Canada. In the past, Western biomedical and individual-based approaches to researching Indigenous health have been applied, whereas First Nations’ understandings of health are founded on a holistic view of wellbeing. Recognition of this disjuncture, alongside the protective influence of First Nations traditional culture, is foundational to establishing an empirical understanding of and comprehensive response to prescription drug misuse. We propose health promotion as a framework from which to begin to explore this. Our work with a health promotion framework has conveyed its potential to support the consideration of Western and Indigenous worldviews together in an ‘ethical space’, with illustrations provided. Health promotion also allots for the consideration of Canada's colonial history of knowledge production in public health and supports First Nations’ self-determination. Based on this, we recommend three immediate ways in which a health promotion framework can advance research on prescription drug misuse among First Nations in Canada.

  10. 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.

  11. An examination of the health information seeking experiences of women in rural Ontario, Canada

    Directory of Open Access Journals (Sweden)

    C.N. Wathen

    2006-01-01

    Full Text Available Introduction. Women are active information seekers, particularly in the context of managing health for themselves and their families. Rural living may present particular challenges and opportunities for women in their health information seeking. Method. Forty women living in a rural part of Ontario, Canada were interviewed using a semi-structured interview guide. They were asked about their health information seeking for both chronic and acute concerns. Analysis. Interview transcripts were organized using NVivo software (version 6 and analysed using a coding scheme iteratively developed by both authors. Results. Emerging themes included: the context of rural living, information and health literacy, the role of unanticipated information intermediaries in the search process, and the mis-match between assumptions made by 'the system' about sources of information, and women's lived realities. Conclusion. . There are unique challenges and enablers to health information seeking for women living in rural areas, including the role of formal, informal and ICT-based information intermediaries, the availability to women of required literacies for health information seeking and uptake. Research findings such as those presented in this paper can assist in better understanding both the contexts of information seeking, as well as the preferences and behaviour of those with information needs.

  12. Is health a labour, citizenship or human right? Mexican seasonal agricultural workers in Leamington, Canada.

    Science.gov (United States)

    Barnes, Nielan

    2013-07-01

    Post-North American Free Trade Agreement (NAFTA) trade liberalisation combined with post-9/11 border securitisation means North America increasingly relies on pools of temporary foreign labour, particularly in the agricultural and service sectors. Despite being temporary, these workers often spend most of their years on foreign soil, living and working in isolated rural communities, far from their own families and communities. Migrants' mental and physical health suffers due to hazardous and stressful working conditions, sub-standard housing, lack of social support and limited access to health and social welfare services. Assuming access to health is a basic human right, who is responsible for the health of temporary foreign migrant workers? Is it the nation-state? or the Employers and/or unions? or Civil society? Research and practice show that a combined multisector approach is best; however, such initiatives are often uneven due to questions of sovereignty and citizenship rights. Community-based organisations (CBOs) have emerged to advocate for and serve migrants' social and welfare needs; analysis of CBO projects reveals an uneven application of rights to migrants. Using a comparative case study from Canada, this project contributes to understanding how civil-society helps to activate different types of health care rights for migrants, and to create an informed policy that provides migrant workers with access to a wider range of human and health rights.

  13. Engaging patients as partners in health research: Lessons from BC, Canada.

    Science.gov (United States)

    Holmes, Bev J; Bryan, Stirling; Ho, Kendall; McGavin, Colleen

    2018-03-01

    Canada is seeing increased interest in engaging patients in health research, recognizing the potential to improve its relevance and quality. The momentum is promising, but there may be a tendency to ignore the challenges inherent when lay people and professionals collaborate. We address some of these challenges as they relate to recruitment, training, and support for patients at the British Columbia (BC) Support for People and Patient-Oriented Research Unit, part of Canada's Strategy for Patient-Oriented Research. A retrospective review of a telehealth project demonstrates that, as well as the practical elements of recruitment, training, and support, attention must be paid to issues of credibility, legitimacy, and power when engaging patients. We propose that all patient-oriented research projects would benefit from using a similar framework to guide patient engagement planning and implementation, helping to anticipate and mitigate challenges from the outset. Projects would ideally also include the study of patient engagement methods, to add to this important body of knowledge.

  14. The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada; Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”

    OpenAIRE

    Stephanie Lake; Thomas Kerr

    2017-01-01

    A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited ...

  15. Legislated changes to federal pension income in Canada will adversely affect low income seniors' health.

    Science.gov (United States)

    Emery, J C Herbert; Fleisch, Valerie C; McIntyre, Lynn

    2013-12-01

    This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator. Food insecurity prevalence and income source were assessed for unattached low income (seniors aged 65-69 years (population weighted n=151,485) using public use data from the Canadian Community Health Survey Cycle 4.1 (2007-2008). Seniors' benefits through federal public pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65-69 years, in contrast to low income seniors aged 60-64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥65 years versus 22.8% for seniors seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship. © 2013.

  16. Health Canada Warning on Citalopram and Escitalopram--Its Effects on Prescribing in Consultation-Liaison Psychiatry.

    Science.gov (United States)

    Do, André; Noohi, Saeid; Elie, Dominique; Mahdanian, Artin A; Yu, Ching; Segal, Marilyn; Looper, Karl J; Rej, Soham

    2016-01-01

    Reports have suggested that citalopram and escitalopram may prolong the QTc interval, leading Health Canada to issue a warning to limit their dosages in 2012. Little is known about the effects of this warning and similar ones (e.g., by the Food and Drug Administration) on antidepressant prescribing in inpatients with acute medical illness, who are theoretically at high risk of QTc prolongation. The main objective of our study is to examine the effect of the Health Canada warning on citalopram/escitalopram prescribing patterns in the consultation-liaison (C-L) psychiatry setting. We performed a retrospective cohort study including 275 randomly selected inpatients with medical illness assessed by the psychiatric C-L team of a large Canadian academic hospital between 2008 and 2014. We grouped patients based on whether they were assessed by the C-L team before or after the citalopram Health Canada warning. Our primary outcome was change in citalopram/escitalopram prescribing patterns. We found that of patients seen before the Health Canada warning, a significantly higher number were prescribed citalopram/escitalopram (44.1% vs. 22.3%, χ(2) = 14.835, p Canada warning was similar in both groups (8.9% vs. 12.1%, χ(2) = 0.233, p = 0.63). Overall, C-L psychiatrists were less likely to prescribe citalopram/escitalopram following the Health Canada warning, which did not translate into safer dosing. Clinicians should not avoid prescribing citalopram/escitalopram appropriately in medically vulnerable inpatients when benefits outweigh disadvantages. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  17. Alcohol use and self-perceived mental health status among pregnant and breastfeeding women in Canada: a secondary data analysis.

    Science.gov (United States)

    Lange, S; Quere, M; Shield, K; Rehm, J; Popova, S

    2016-05-01

    To estimate the prevalence of alcohol consumption during pregnancy and while breastfeeding in Canada from 2003 to 2010, and to test the relation between self-perceived mental health status and alcohol consumption during pregnancy and while breastfeeding. Secondary analysis of four cycles of the Canadian Community Health Survey, a population-based cross-sectional survey. Canada. A total of 18 612 pregnant and 15 836 breastfeeding women. The prevalence of alcohol consumption during pregnancy and while breastfeeding and 95% confidence intervals (CI) were calculated by province and territory, and cycle. The relation between self-perceived mental health status and alcohol consumption during pregnancy and while breastfeeding was explored using quasi-Poisson regression models. Alcohol consumption during pregnancy and while breastfeeding, and self-perceived mental health status. In Canada, between 2003 and 2010, approximately one in every ten pregnant women (9.9%; 95%CI 9.2-10.5%) and two in every ten breastfeeding women (20.3%; 95%CI 19.4-21.2%) women consumed alcohol. Women with a lower self-perceived mental health status (i.e. 'good') were 1.40 (95%CI 1.18-1.67, P women with an 'excellent' self-perceived mental health. There were no notable differences between the categories of mental health status in regard to alcohol consumption while breastfeeding. Despite public health efforts in Canada, a significant proportion of pregnant and breastfeeding women consume alcohol. It is imperative that a standard screening protocol be initiated among pregnant and breastfeeding women, especially in high-risk populations (e.g. women utilising substance abuse treatment programs). In Canada in 2003-2010, approximately 10% of pregnant and 20% of breastfeeding women consumed alcohol. © 2015 Royal College of Obstetricians and Gynaecologists.

  18. A study of the health of the employees of Atomic Energy of Canada Limited. 1

    International Nuclear Information System (INIS)

    Weeks, J.L.

    1981-09-01

    This report summarizes the status of Atomic Energy of Canada Ltd.'s health study of its present and past employees, and is a description of the steps which have been taken up to the time of writing. During the design phase there was a shift in the emphasis of the study. What was originally proposed as a study of mortality in a population of radiation workers, related spacifically to radiation exposure, has become a study of mortality data for all AECL employees. The interest in mortality as a function of occupational radiation expksure remains, but it is recognized that the data available to the study will probably be inadequate for the definition of a dose-effect relationship, although it will be useful in conjuction with other similar studies. The importance of cancer incidence is recognized, and the possibility of linking the AECL data to that contained in the National Cancer Incidence Reporting System is being pursued

  19. A descriptive qualitative examination of knowledge translation practice among health researchers in Manitoba, Canada.

    Science.gov (United States)

    Sibley, Kathryn M; Roche, Patricia L; Bell, Courtney P; Temple, Beverley; Wittmeier, Kristy D M

    2017-09-06

    The importance of effective translation of health research findings into action has been well recognized, but there is evidence to suggest that the practice of knowledge translation (KT) among health researchers is still evolving. Compared to research user stakeholders, researchers (knowledge producers) have been under-studied in this context. The goals of this study were to understand the experiences of health researchers in practicing KT in Manitoba, Canada, and identify their support needs to sustain and increase their participation in KT. Qualitative semi-structured interviews were conducted with 26 researchers studying in biomedical; clinical; health systems and services; and social, cultural, environmental and population health research. Interview questions were open-ended and probed participants' understanding of KT, their experiences in practicing KT, barriers and facilitators to practicing KT, and their needs for KT practice support. KT was broadly conceptualized across participants. Participants described a range of KT practice experiences, most of which related to dissemination. Participants also expressed a number of negative emotions associated with the practice of KT. Many individual, logistical, and systemic or organizational barriers to practicing KT were identified, which included a lack of institutional support for KT in both academic and non-academic systems. Participants described the presence of good relationships with stakeholders as a critical facilitator for practicing KT. The most commonly identified needs for supporting KT practice were access to education and training, and access to resources to increase awareness and promotion of KT. While there were few major variations in response trends across most areas of health research, the responses of biomedical researchers suggested a unique KT context, reflected by distinct conceptualizations of KT (such as commercialization as a core component), experiences (including frustration and lack of

  20. Health outcomes in low-income children with current asthma in Canada.

    Science.gov (United States)

    To, T; Dell, S; Tassoudji, M; Wang, C

    2009-01-01

    Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

  1. Social determinants of health and retention in HIV care in a clinical cohort in Ontario, Canada.

    Science.gov (United States)

    Rachlis, Beth; Burchell, Ann N; Gardner, Sandra; Light, Lucia; Raboud, Janet; Antoniou, Tony; Bacon, Jean; Benoit, Anita; Cooper, Curtis; Kendall, Claire; Loutfy, Mona; Wobeser, Wendy; McGee, Frank; Rachlis, Anita; Rourke, Sean B

    2017-07-01

    Continuous HIV care supports antiretroviral therapy initiation and adherence, and prolongs survival. We investigated the association of social determinants of health (SDH) and subsequent retention in HIV care in a clinical cohort in Ontario, Canada. The Ontario HIV Treatment Network Cohort Study is a multi-site cohort of patients at 10 HIV clinics. Data were collected from medical charts, interviews, and via record linkage with the provincial public health laboratory for viral load tests. For participants interviewed in 2009, we used three-category multinomial logistic regression to identify predictors of retention in 2010-2012, defined as (1) continuous care (≥2 viral loads ≥90 days in all years; reference category); (2) discontinuous care (only 1 viral load/year in ≥1 year); and (3) a gap in care (≥1 year in 2010-2012 with no viral load). In total, 1838 participants were included. In 2010-2012, 71.7% had continuous care, 20.9% had discontinuous care, and 7.5% had a gap in care. Discontinuous care in 2009 was predictive (p Health Ontario Laboratories; REB: Research Ethics Board; SDH: social determinants of health; US: United States.

  2. Pathogen Loading From Canada Geese Faeces in Freshwater: Potential Risks to Human Health Through Recreational Water Exposure.

    Science.gov (United States)

    Gorham, T J; Lee, J

    2016-05-01

    Canada geese (Branta canadensis) faeces have been shown to contain pathogenic protozoa and bacteria in numerous studies over the past 15 years. Further, increases in both the Canada geese populations and their ideal habitat requirements in the United States (US) translate to a greater presence of these human pathogens in public areas, such as recreational freshwater beaches. Combining these factors, the potential health risk posed by Canada geese faeces at freshwater beaches presents an emerging public health issue that warrants further study. Here, literature concerning human pathogens in Canada geese faeces is reviewed and the potential impacts these pathogens may have on human health are discussed. Pathogens of potential concern include Campylobacter jejuni, Salmonella Typhimurium, Listeria monocytogenes, Helicobacter canadensis, Arcobacter spp., Enterohemorragic Escherichia coli pathogenic strains, Chlamydia psitacci, Cryptosporidium parvum and Giardia lamblia. Scenarios presenting potential exposure to pathogens eluted from faeces include bathers swimming in lakes, children playing with wet and dry sand impacted by geese droppings and other common recreational activities associated with public beaches. Recent recreational water-associated disease outbreaks in the US support the plausibility for some of these pathogens, including Cryptosporidium spp. and C. jejuni, to cause human illness in this setting. In view of these findings and the uncertainties associated with the real health risk posed by Canada geese faecal pathogens to users of freshwater lakes, it is recommended that beach managers use microbial source tracking and conduct a quantitative microbial risk assessment to analyse the local impact of Canada geese on microbial water quality during their decision-making process in beach and watershed management. © 2015 Blackwell Verlag GmbH.

  3. Exploring the role of the dental hygienist in reducing oral health disparities in Canada: A qualitative study.

    Science.gov (United States)

    Farmer, J; Peressini, S; Lawrence, H P

    2018-05-01

    Reducing oral health disparities has been an ongoing challenge in Canada with the largest burden of oral disease exhibited in vulnerable populations, including Aboriginal people, the elderly, rural and remote residents, and newcomers. Dental hygienists are a unique set of professionals who work with and within communities, who have the potential to act as key change agents for improving the oral health of these populations. The purpose of this qualitative study was to explore, from the dental hygiene perspective, the role of dental hygienists in reducing oral health disparities in Canada. Dental hygienists and key informants in dental hygiene were recruited, using purposeful and theoretical sampling, to participate in a non-directed, semi-structured one-on-one in-depth telephone interview using Skype and Call Recorder software. Corbin and Strauss's grounded theory methodology was employed with open, axial, and selective coding analysed on N-Vivo Qualitative software. The resulting theoretical framework outlines strategies proposed by participants to address oral health disparities; these included alternate delivery models, interprofessional collaboration, and increased scope of practice. Participants identified variation in dental care across Canada, public perceptions of oral health and dental hygiene practice, and lack of applied research on effective oral health interventions as challenges to implementing these strategies. The research confirmed the important role played by dental hygienists in reducing oral health disparities in Canada. However, due to the fragmentation of dental hygiene practice across Canada, a unified voice and cohesive action plan is needed in order for the profession to fully embrace their role. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. International migration to Canada: the post-birth health of mothers and infants by immigration class.

    Science.gov (United States)

    Gagnon, Anita J; Dougherty, Geoffrey; Wahoush, Olive; Saucier, Jean-François; Dennis, Cindy-Lee; Stanger, Elizabeth; Palmer, Becky; Merry, Lisa; Stewart, Donna E

    2013-01-01

    There are over 214 million international migrants worldwide, half of whom are women, and all of them assigned by the receiving country to an immigration class. Immigration classes are associated with certain health risks and regulatory restrictions related to eligibility for health care. Prior to this study, reports of international migrant post-birth health had not been compared between immigration classes, with the exception of our earlier, smaller study in which we found asylum-seekers to be at greatest risk for health concerns. In order to determine whether refugee or asylum-seeking women or their infants experience a greater number or a different distribution of professionally-identified health concerns after birth than immigrant or Canadian-born women, we recruited 1127 migrant (and in Canada immigration class (refugee, asylum-seeker, immigrant, or Canadian-born). Between February 2006 and May 2009, we followed them from childbirth (in one of eleven birthing centres in Montreal or Toronto) to four months and found that at one week postpartum, asylum-seeking and immigrant women had greater rates of professionally-identified health concerns than Canadian-born women; and at four months, all three migrant groups had greater rates of professionally-identified concerns. Further, international migrants were at greater risk of not having these concerns addressed by the Canadian health care system. The current study supports our earlier findings and highlights the need for case-finding and services for international migrant women, particularly for psychosocial difficulties. Policy and program mechanisms to address migrants' needs would best be developed within the various immigration classes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Cost-effectiveness of cognitive-behavioural therapy for mental disorders: implications for public health care funding policy in Canada.

    Science.gov (United States)

    Myhr, Gail; Payne, Krista

    2006-09-01

    Publicly funded cognitive-behavioural therapy (CBT) for mental disorders is scarce in Canada, despite proven efficacy and guidelines recommending its use. This paper reviews published data on the economic impact of CBT to inform recommendations for current Canadian mental health care funding policy. We searched the literature for economic analyses of CBT in the treatment of mental disorders. We identified 22 health economic studies involving CBT for mood, anxiety, psychotic, and somatoform disorders. Across health care settings and patient populations, CBT alone or in combination with pharmacotherapy represented acceptable value for health dollars spent, with CBT costs offset by reduced health care use. International evidence suggests CBT is cost-effective. Greater access to CBT would likely improve outcomes and result in cost savings. Future research is warranted to evaluate the economic impact of CBT in Canada.

  6. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    Directory of Open Access Journals (Sweden)

    Gore Dana

    2012-08-01

    Full Text Available Abstract Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered, blueprints (or frameworks to tailor developed programs, and building blocks (resources to develop programs. Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the

  7. Mental health and substance use among bisexual youth and non-youth in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Lori E Ross

    Full Text Available Research has shown that bisexuals have poorer health outcomes than heterosexuals, gays, or lesbians, particularly with regard to mental health and substance use. However, research on bisexuals is often hampered by issues in defining bisexuality, small sample sizes, and by the failure to address age differences between bisexuals and other groups or age gradients in mental health. The Risk & Resilience Survey of Bisexual Mental Health collected data on 405 bisexuals from Ontario, Canada, using respondent-driven sampling, a network-based sampling method for hidden populations. The weighted prevalence of severe depression (PHQ-9 ≥ 20 was 4.7%, possible anxiety disorder (OASIS ≥ 8 was 30.9%, possible post-traumatic stress disorder (PCL-C ≥ 50 was 10.8%, and past year suicide attempt was 1.9%. With respect to substance use, the weighted prevalence of problem drinking (AUDIT ≥ 5 was 31.2%, and the weighted prevalence of illicit polydrug use was 30.5%. Daily smoking was low in this sample, with a weighted prevalence of 7.9%. Youth (aged 16-24 reported significantly higher weighted mean scores on depression and post-traumatic stress disorder, and higher rates of past year suicidal ideation (29.7% vs. 15.2% compared with those aged 25 and older. The burden of mental health and substance use among bisexuals in Ontario is high relative to population-based studies of other sexual orientation groups. Bisexual youth appear to be at risk for poor mental health. Additional research is needed to understand if and how minority stress explains this burden.

  8. A grounded theory model for reducing stigma in health professionals in Canada.

    Science.gov (United States)

    Knaak, S; Patten, S

    2016-08-01

    The Mental Health Commission of Canada was formed as a national catalyst for improving the mental health system. One of its initiatives is Opening Minds (OM), whose mandate is to reduce mental health-related stigma. This article reports findings from a qualitative study on antistigma interventions for healthcare providers, which includes a process model articulating key stages and strategies for implementing successful antistigma programmes. The study employed a grounded theory methodology. Data collection involved in-depth interviews with programme stakeholders, direct observation of programmes, a review of programme documents, and qualitative feedback from programme participants. Analysis proceeded via the constant comparison method. A model was generated to visually present key findings. Twenty-three in-depth interviews were conducted representing 18 different programmes. Eight programmes were observed directly, 48 programme documents were reviewed, and data from 1812 programme participants were reviewed. The analysis led to a four-stage process model for implementing successful antistigma programmes targeting healthcare providers, informed by the basic social process 'targeting the roots of healthcare provider stigma'. The process model developed through this research may function as a tool to help guide the development and implementation of antistigma programmes in healthcare contexts. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Religious involvement and health-related behaviors among Black Seventh-Day Adventists in Canada.

    Science.gov (United States)

    McKenzie, Monica M; Modeste, Naomi N; Marshak, Helen Hopp; Wilson, Colwick

    2015-03-01

    Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in the United States. We sought to examine the association between religious involvement and lifestyle practices among Black SDAs in Canada. A convenience sample of 509 Black SDA church members 18 years and older completed a self-administered questionnaire, assessing religious involvement and seven lifestyle practices promoted by the SDA church: diet, physical activity, water intake, exposure to sunlight, alcohol use, caffeine and tobacco use, and rest. Compliance with lifestyle practices ranged from a low of 10% meeting fitness guidelines to a high of 99% abstaining from tobacco products. Religious involvement and lifestyle were positively related (rs = .11, p < .05). Multivariate analyses indicated that private religious practice (β = .16, p =.003), importance of the health principles (β = .17, p = .003), and acceptance of health principles (β = .65, p = .00001) significantly predicted the number of behaviors practiced. Greater religious involvement is associated with positive lifestyle practices but is not an independent predictor of lifestyle practices for Black Canadian SDAs. © 2014 Society for Public Health Education.

  10. Concurrent Disorders and Health Care Utilization Among Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Zhang, Linda; Norena, Monica; Gadermann, Anne; Hubley, Anita; Russell, Lara; Aubry, Tim; To, Matthew J; Farrell, Susan; Hwang, Stephen; Palepu, Anita

    2018-03-01

    Individuals who are homeless or vulnerably housed have a higher prevalence of concurrent disorders, defined as having a mental health diagnosis and problematic substance use, compared to the general housed population. The study objective was to investigate the effect of having concurrent disorders on health care utilization among homeless or vulnerably housed individuals, using longitudinal data from the Health and Housing in Transition Study. In 2009, 1190 homeless or vulnerably housed adults were recruited in Ottawa, Toronto, and Vancouver, Canada. Participants completed baseline interviews and four annual follow-up interviews, providing data on sociodemographics, housing history, mental health diagnoses, problematic drug use with the Drug Abuse Screening Test (DAST-10), problematic alcohol use with the Alcohol Use Disorders Identification Test (AUDIT), chronic health conditions, and utilization of the following health care services: emergency department (ED), hospitalization, and primary care. Concurrent disorders were defined as the participant having ever received a mental health diagnosis at baseline and having problematic substance use (i.e., DAST-10 ≥ 6 and/or AUDIT ≥ 20) at any time during the study period. Three generalized mixed effects logistic regression models were used to examine the independent association of having concurrent disorders and reporting ED use, hospitalization, or primary care visits in the past 12 months. Among our sample of adults who were homeless or vulnerably housed, 22.6% (n = 261) reported having concurrent disorders at baseline. Individuals with concurrent disorders had significantly higher odds of ED use (adjusted odds ratio [AOR] = 1.71; 95% confidence interval [CI], 1.4-2.11), hospitalization (AOR = 1.45; 95% CI, 1.16-1.81), and primary care visits (AOR = 1.34; 95% CI, 1.05-1.71) in the past 12 months over the four-year follow-up period, after adjusting for potential confounders. Concurrent disorders were associated with

  11. The mental health needs of incarcerated youth in British Columbia, Canada.

    Science.gov (United States)

    Gretton, Heather M; Clift, Robert J W

    2011-01-01

    The purpose of the study was to identify the current prevalence of mental disorders and mental health needs among incarcerated male and female youths in Canada, and to present these data in the context of rates found in other jurisdictions. One hundred forty male and 65 female incarcerated young offenders in British Columbia were screened with the Massachusetts Youth Screening Instrument Version 2 (MAYSI-2); provisional psychiatric diagnoses were assessed with the Diagnostic Interview Schedule for Children Version IV (DISC-IV); abuse history and aggressive symptoms of Conduct Disorder (CD) were coded from file information. Nearly all youths (91.9% of males and 100% of females) met the criteria for at least one mental disorder. Substance abuse and dependence disorders were highly prevalent (85.5% of males and 100% of females). Aggressive forms of CD were common (72.9% of males and 84.3% of females), as were exposure to physical abuse (60.8% of males and 54.3% of females) and sexual abuse (21.2% of males and 42.4% of females). Female youths had significantly higher odds of presenting with: (1) substance abuse/dependence disorders; (2) current suicide ideation; (3) sexual abuse; (4) PTSD; (5) symptoms of depression and anxiety; (6) Oppositional Defiant Disorder; and (7) multiple mental disorder diagnoses. Male youths had significantly higher odds of presenting with aggressive symptoms of CD. Overall, rates of mental disorder among this sample of serious and violent young offenders were higher than rates previously reported for incarcerated youths - both in Canada and in other jurisdictions. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  12. Quality and quantity of information in summary basis of decision documents issued by health Canada.

    Science.gov (United States)

    Habibi, Roojin; Lexchin, Joel

    2014-01-01

    Health Canada's Summary Basis of Decision (SBD) documents outline the clinical trial information that was considered in approving a new drug. We examined the ability of SBDs to inform clinician decision-making. We asked if SBDs answered three questions that clinicians might have prior to prescribing a new drug: 1) Do the characteristics of patients enrolled in trials match those of patients in their practice? 2) What are the details concerning the drug's risks and benefits? 3) What are the basic characteristics of trials? 14 items of clinical trial information were identified from all SBDs published on or before April 2012. Each item received a score of 2 (present), 1 (unclear) or 0 (absent). The unit of analysis was the individual SBD, and an overall SBD score was derived based on the sum of points for each item. Scores were expressed as a percentage of the maximum possible points, and then classified into five descriptive categories based on that score. Additionally, three overall 'component' scores were tallied for each SBD: "patient characteristics", "benefit/risk information" and "basic trial characteristics". 161 documents, spanning 456 trials, were analyzed. The majority (126/161) were rated as having information sometimes present (score of >33 to 66%). No SBDs had either no information on any item, or 100% of the information. Items in the patient characteristics component scored poorest (mean component score of 40.4%), while items corresponding to basic trial information were most frequently provided (mean component score of 71%). The significant omissions in the level of clinical trial information in SBDs provide little to aid clinicians in their decision-making. Clinicians' preferred source of information is scientific knowledge, but in Canada, access to such information is limited. Consequently, we believe that clinicians are being denied crucial tools for decision-making.

  13. Unregulated health care workers in the care of aging populations: Similarities and differences between Brazil and Canada

    Directory of Open Access Journals (Sweden)

    Mirella Veras

    2016-02-01

    Full Text Available Introduction: The world’s population is rapidly aging. Unregulated health care workers (UHCWs are emerging as a potentially important workforce in the care of older adults. Objective: A review was conducted to identify the activities of UHCWs with respect to contributions and limitations. Methods: A systematic integrative literature review was conducted using online databases (LILACS, PubMed, EMBASE, CINAHL, and grey literature. The inclusion criteria were as follows: (i description of UHCW activities related to older adults; and (ii description of UHCW activities performed in Brazil or Canada. Results: Eleven papers were included in this review. In both countries, UHCW activities included health promotion, mental health care, and rehabilitation. In Brazil, UHCWs performed integrated care, while in Canada UHCWs performed personal care and housekeeping. Conclusion: These results highlight the potential and limits of UHCWs who provide care for the aging population. Such information is important to health and social policy making and household decision making.

  14. A registry for the study of the health of radiation workers employed by Atomic Energy of Canada Limited

    International Nuclear Information System (INIS)

    Weeks, J.L.

    1979-05-01

    Factors to be considered in formulating a study of the health of radiation workers are discussed, and a proposal is made for the establishment of such a study in relation to the employees of Atomic Energy of Canada Limited. By setting up a registry of AECL radiation workers, data could be accumulated suitable for the long-term followup of their health, and for preparing periodic interim reports on mortality and morbidity. (author)

  15. A comparison of health access between permanent residents, undocumented immigrants and refugee claimants in Toronto, Canada.

    Science.gov (United States)

    Campbell, Ruth M; Klei, A G; Hodges, Brian D; Fisman, David; Kitto, Simon

    2014-02-01

    Understanding the immigrant experience accessing healthcare is essential to improving their health. This qualitative study reports on experiences seeking healthcare for three groups of immigrants in Toronto, Canada: permanent residents, refugee claimants and undocumented immigrants. Undocumented immigrants who are on the Canadian Border Services Agency deportation list are understudied in Canada due to their precarious status. This study will examine the vulnerabilities of this particular subcategory of immigrant and contrast their experiences seeking healthcare with refugee claimants and permanent residents. Twenty-one semi-structured, one-on-one qualitative interviews were conducted with immigrants to identify barriers and facilitators to accessing healthcare. The open structure of the interviews enabled the participants to share their experiences seeking healthcare and other factors that were an integral part of their health. This study utilized a community-based participatory research framework. The study identifies seven sections of results. Among them, immigration status was the single most important factor affecting both an individual's ability to seek out healthcare and her experiences when trying to access healthcare. The healthcare seeking behaviour of undocumented immigrants was radically distinct from refugee claimants or immigrants with permanent resident status, with undocumented immigrants being at a greater disadvantage than permanent residents and refugee claimants. Language barriers are also noted as an impediment to healthcare access. An individual's immigration status further complicates their ability to establish relationships with family doctors, access prescriptions and medications and seek out emergency room care. Fear of authorities and the complications caused by the above factors can lead to the most disadvantaged to seek out informal or black market sources of healthcare. This study reaffirmed previous findings that fear of deportation

  16. Mandatory universal drug plan, access to health care and health: Evidence from Canada.

    Science.gov (United States)

    Wang, Chao; Li, Qing; Sweetman, Arthur; Hurley, Jeremiah

    2015-12-01

    This paper examines the impacts of a mandatory, universal prescription drug insurance program on health care utilization and health outcomes in a public health care system with free physician and hospital services. Using the Canadian National Population Health Survey from 1994 to 2003 and implementing a difference-in-differences estimation strategy, we find that the mandatory program substantially increased drug coverage among the general population. The program also increased medication use and general practitioner visits but had little effect on specialist visits and hospitalization. Findings from quantile regressions suggest that there was a large improvement in the health status of less healthy individuals. Further analysis by pre-policy drug insurance status and the presence of chronic conditions reveals a marked increase in the probability of taking medication and visiting a general practitioner among the previously uninsured and those with a chronic condition. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. A systematic review of asthma and health literacy: a cultural-ethnic perspective in Canada.

    Science.gov (United States)

    Poureslami, Iraj M; Rootman, Irving; Balka, Ellen; Devarakonda, Rajashree; Hatch, James; Fitzgerald, J Mark

    2007-08-21

    ethnocultural communities and minority groups in many Western countries. In this systematic review, several themes were identified, including: approaches to language limitation and cultural barriers; the recognition of healthcare system bias (in terms of culturally competent care); and relationship-building to facilitate participatory decision-making by both provider and patient. This review provides further understanding and considerations regarding the beliefs and perspectives of care providers and populations in relation to health and illness, literacy and health literacy, and their association with asthma among ethnocultural communities. There is an urgent need to better define the impact of cultural and ethnic issues in the management of asthma in Canada. Appropriately designed studies should better define the barriers in the optimal delivery of asthma care influenced by these parameters.

  18. Mental health and hospital chaplaincy: strategies of self-protection (case study: toronto, Canada).

    Science.gov (United States)

    Kianpour, Masoud

    2013-01-01

    This is a study about emotion management among a category of healthcare professional - hospital chaplains - who have hardly been the subject of sociological research about emotions. The aim of the study was to understand how chaplains manage their work-related emotions in order to protect their mental health, whilst also providing spiritual care. Using in-depth, semi structured interviews, the author spoke with 21 chaplains from five faith traditions (Christianity, Islam, Judaism, Buddhism and modern paganism) in different Toronto (Canada) Hospitals to see how they manage their emotion, and what resources they rely on in order to protect their mental health. Data analysis was perfumed according to Sandelowski's method of qualitative description. The average age and work experience of the subjects interviewed in this study are 52 and 9.6 respectively. 11 chaplains worked part-time and 10 chaplains worked full-time. 18 respondents were women and the sample incudes 3 male chaplains only. The findings are discussed, among others, according to the following themes: work-life balance, self-reflexivity, methods of self-care, and chaplains' emotional make-up. Emotion management per se is not a problem. However, if chaplains fail to maintain a proper work-life balance, job pressure can be harmful. As a strategy, many chaplains work part-time. As a supportive means, an overwhelming number of chaplains regularly benefit from psychotherapy and/or spiritual guidance. None.

  19. Contextual determinants of health behaviours in an aboriginal community in Canada: pilot project

    Directory of Open Access Journals (Sweden)

    Joseph Pamela

    2012-11-01

    Full Text Available Abstract Background Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized. Methods To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco. In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS, questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH tool. Results The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access. Conclusions The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.

  20. Restructuring health services in Canada: challenges for policy makers, planners and managers in the eighties.

    Science.gov (United States)

    Crichton, A

    1985-11-01

    Is downsizing the latest jargon word applied to rationalization, a new concept or a different manifestation of a long term trend in health services management? At present, Canada is struggling to implement feasible reductions of expansionary pressures in the health care system. While provincial governments tend to see the issue as one of controlling chronic excess demand, federal government is still concerned to ensure free access to care on an equitable basis. Thus the problems of downsizing can be expressed by the provinces in terms of an ideological struggle with an unfeeling central government which does not understand their problems; although all know they are really about the feasibility of continuing to provide a service to meet demand. The present economic recession enables provincial governments to appeal to their voters for supporting a new way. Earlier, the appeal was to consumers to become involved in health service organization management and this policy succeeded, to a degree, where there were fluorishing grass roots communities; albeit that the service continued to be driven by professionals. Now the appeal is to taxpayers for their strong support in cost cutting. This has been more successful. Provincial governments are now permitted to 'touch the untouchables', that is to downsize the medical profession and previously sacrosanct health care institutions. They also are exploring the feasibility of introducing a two-tier system which would provide basic care for everyone and extra care for those able to pay, thus side-stepping federal conditions. By reorganizing support in this way, provincial governments have extended the range of policy choices, and two types of planning, the rational and the political, have now become combined into strategic management activity.

  1. AECL'S (Atomic Energy Canada Limited) R and D program in health and environmental sciences

    International Nuclear Information System (INIS)

    Osborne, R.V.

    1996-01-01

    Radiological protection is a fundamental requirement in any nuclear technology endeavour. It is also an area where public concerns are often expressed. If protection is inadequate, or is believed to be so, or if concerns are not addressed, the beneficial application of nuclear technologies is inhibited. Historically. AECL, as the driver of nuclear technology in Canada, has ensured that the growing Canadian nuclear industry and other users of the technology have a sound technical base to support, explain and confirm all aspects of radiological protection. Meeting this need has meant developing and maintaining R%D programs in environmental sciences, health physics, radiation biology, and radiological health matters in general. The programs undertaken encompass the links from sources of radiation exposure and radionuclides to potential impact on biota and on human health. The behaviours of radionuclides released to the atmosphere, surface waters, or ground waters are examined and described quantitatively to enable predictions to be made of the radiation doses received in different parts of the biosphere and by people. Radiation properties and human physiological and biokinetic processes are studied to provide quantitative links from exposure to radiation dose in tissues and organs. Biological processes involved in determining whether there are any consequences to health from small absorbed doses are identified at levels ranging from molecular level, to cells in tissue culture, and animals. Throughout the programs, required measurement technologies are developed. The results of the R%D have contributed to radiological protection programs being soundly based and, equally important, are being seen to be soundly based. (author)

  2. Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal

    Directory of Open Access Journals (Sweden)

    Vidhi Thakkar

    2017-11-01

    Full Text Available Health services and policy research (HSPR represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publiclyfunded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending.

  3. Socio-geographic mobility and health status: a longitudinal analysis using the National Population Health Survey of Canada.

    Science.gov (United States)

    Curtis, Sarah; Setia, Maninder S; Quesnel-Vallee, Amelie

    2009-12-01

    The paper reviews arguments that associations between small area socio-economic conditions and individual health are likely to vary according to the type of health condition considered. We comment on the importance of longitudinal research to examine how far area conditions predict later health outcomes, and also how far area variations in health may result from selective migration processes predicted by health status. Using data for 1996 and 2002, from the National Population Health Survey of Canada, linked to small area data on social and on material deprivation in the area of residence for 6950 survey respondents at the two time points, we report on analyses to address these questions. The area measures of material and social deprivation were previously developed by Pampalon and colleagues at the Institut National de Santé Publique de Québec and related to the dissemination area matching the informant's postal code. The health outcomes considered were restriction of activity due to chronic conditions and psychological distress. Our findings suggest that individuals living in materially deprived areas in 2002 were more likely to be affected by health conditions resulting in restriction of activity. Prevalence of psychological distress was higher in areas with greater social deprivation in 2002. Most of these area differences were attenuated when adjustment was made for individual socio-demographic characteristics. Measures recorded in 1996 of individual characteristics and measures of deprivation for area of residence were used to predict change in health outcomes by 2002. Several individual factors (sex, age group, income, household composition) in 1996 were predictive of later health outcomes. After controlling for these individual characteristics the only significant association between health change and area deprivation was with development of restricted activity, which was more common among people who, in 1996, had lived in areas that ranked moderately

  4. A Decade Lost: Primary Healthcare Performance Reporting across Canada under the Action Plan for Health System Renewal.

    Science.gov (United States)

    Johnston, Sharon; Hogel, Matthew

    2016-05-01

    In 2004, Canada's First Ministers committed to reforms that would shape the future of the Canadian healthcare landscape. These agreements included commitments to improved performance reporting within the primary healthcare system. The aim of this paper was to review the state of primary healthcare performance reporting after the public reporting mandate agreed to a decade ago in the Action Plan for Health System Renewal of 2003 expired. A grey literature search was performed to identify reports released by the governmental and independent reporting bodies across Canada. No province, or the federal government, met their performance reporting obligations from the 2004 accords. Although the indicators required to report on in the 2004 Accord no longer reflect the priorities of patients, policy makers and physicians, provinces are also failing to report on these priorities. Canada needs better primary healthcare performance reporting to enable accountability and improvement within and across provinces. Despite the national mandate to improve public health system reporting, an opportunity to learn from the diverse primary healthcare reforms, underway across Canada for the past decade, has already been lost. Copyright © 2016 Longwoods Publishing.

  5. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review

    Science.gov (United States)

    Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-01-01

    Introduction The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. PMID:29662521

  6. Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

    Science.gov (United States)

    Gotovac, Sandra; Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

    2018-04-01

    The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.

  7. Incorporating public priorities in the Ocean Health Index: Canada as a case study.

    Directory of Open Access Journals (Sweden)

    Rémi M Daigle

    Full Text Available The Ocean Health Index (OHI is a framework to assess ocean health by considering many benefits (called 'goals' provided by the ocean provides to humans, such as food provision, tourism opportunities, and coastal protection. The OHI framework can be used to assess marine areas at global or regional scales, but how various OHI goals should be weighted to reflect priorities at those scales remains unclear. In this study, we adapted the framework in two ways for application to Canada as a case study. First, we customized the OHI goals to create a national Canadian Ocean Health Index (COHI. In particular, we altered the list of iconic species assessed, added methane clathrates and subsea permafrost as carbon storage habitats, and developed a new goal, 'Aboriginal Needs', to measure access of Aboriginal people to traditional marine hunting and fishing grounds. Second, we evaluated various goal weighting schemes based on preferences elicited from the general public in online surveys. We quantified these public preferences in three ways: using Likert scores, simple ranks from a best-worst choice experiment, and model coefficients from the analysis of elicited choice experiment. The latter provided the clearest statistical discrimination among goals, and we recommend their use because they can more accurately reflect both public opinion and the trade-offs faced by policy-makers. This initial iteration of the COHI can be used as a baseline against which future COHI scores can be compared, and could potentially be used as a management tool to prioritise actions on a national scale and predict public support for these actions given that the goal weights are based on public priorities.

  8. Measuring electromagnetic fields (EMF) around wind turbines in Canada: is there a human health concern?

    Science.gov (United States)

    McCallum, Lindsay C; Whitfield Aslund, Melissa L; Knopper, Loren D; Ferguson, Glenn M; Ollson, Christopher A

    2014-02-15

    The past five years has seen considerable expansion of wind power generation in Ontario, Canada. Most recently worries about exposure to electromagnetic fields (EMF) from wind turbines, and associated electrical transmission, has been raised at public meetings and legal proceedings. These fears have not been based on any actual measurements of EMF exposure surrounding existing projects but appear to follow from worries from internet sources and misunderstanding of the science. The study was carried out at the Kingsbridge 1 Wind Farm located near Goderich, Ontario, Canada. Magnetic field measurements were collected in the proximity of 15 Vestas 1.8 MW wind turbines, two substations, various buried and overhead collector and transmission lines, and nearby homes. Data were collected during three operational scenarios to characterize potential EMF exposure: 'high wind' (generating power), 'low wind' (drawing power from the grid, but not generating power) and 'shut off' (neither drawing, nor generating power). Background levels of EMF (0.2 to 0.3 mG) were established by measuring magnetic fields around the wind turbines under the 'shut off' scenario. Magnetic field levels detected at the base of the turbines under both the 'high wind' and 'low wind' conditions were low (mean = 0.9 mG; n = 11) and rapidly diminished with distance, becoming indistinguishable from background within 2 m of the base. Magnetic fields measured 1 m above buried collector lines were also within background (≤ 0.3 mG). Beneath overhead 27.5 kV and 500 kV transmission lines, magnetic field levels of up to 16.5 and 46 mG, respectively, were recorded. These levels also diminished rapidly with distance. None of these sources appeared to influence magnetic field levels at nearby homes located as close as just over 500 m from turbines, where measurements immediately outside of the homes were ≤ 0.4 mG. The results suggest that there is nothing unique to wind farms with respect to EMF exposure; in

  9. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Directory of Open Access Journals (Sweden)

    Diane McClymont Peace

    2012-05-01

    Full Text Available Objectives: Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design: The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods: Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results: Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions: Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies.

  10. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Science.gov (United States)

    Peace, Diane McClymont; Myers, Erin

    2012-01-01

    Objectives Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies. PMID:22584509

  11. Public perceptions of climate change as a human health risk: surveys of the United States, Canada and Malta.

    Science.gov (United States)

    Akerlof, Karen; Debono, Roberto; Berry, Peter; Leiserowitz, Anthony; Roser-Renouf, Connie; Clarke, Kaila-Lea; Rogaeva, Anastasia; Nisbet, Matthew C; Weathers, Melinda R; Maibach, Edward W

    2010-06-01

    We used data from nationally representative surveys conducted in the United States, Canada and Malta between 2008 and 2009 to answer three questions: Does the public believe that climate change poses human health risks, and if so, are they seen as current or future risks? Whose health does the public think will be harmed? In what specific ways does the public believe climate change will harm human health? When asked directly about the potential impacts of climate change on health and well-being, a majority of people in all three nations said that it poses significant risks; moreover, about one third of Americans, one half of Canadians, and two-thirds of Maltese said that people are already being harmed. About a third or more of people in the United States and Canada saw themselves (United States, 32%; Canada, 67%), their family (United States, 35%; Canada, 46%), and people in their community (United States, 39%; Canada, 76%) as being vulnerable to at least moderate harm from climate change. About one third of Maltese (31%) said they were most concerned about the risk to themselves and their families. Many Canadians said that the elderly (45%) and children (33%) are at heightened risk of harm, while Americans were more likely to see people in developing countries as being at risk than people in their own nation. When prompted, large numbers of Canadians and Maltese said that climate change can cause respiratory problems (78-91%), heat-related problems (75-84%), cancer (61-90%), and infectious diseases (49-62%). Canadians also named sunburn (79%) and injuries from extreme weather events (73%), and Maltese cited allergies (84%). However, climate change appears to lack salience as a health issue in all three countries: relatively few people answered open-ended questions in a manner that indicated clear top-of-mind associations between climate change and human health risks. We recommend mounting public health communication initiatives that increase the salience of the

  12. Public Perceptions of Climate Change as a Human Health Risk: Surveys of the United States, Canada and Malta

    Directory of Open Access Journals (Sweden)

    Karen Akerlof

    2010-06-01

    Full Text Available We used data from nationally representative surveys conducted in the United States, Canada and Malta between 2008 and 2009 to answer three questions: Does the public believe that climate change poses human health risks, and if so, are they seen as current or future risks? Whose health does the public think will be harmed? In what specific ways does the public believe climate change will harm human health? When asked directly about the potential impacts of climate change on health and well-being, a majority of people in all three nations said that it poses significant risks; moreover, about one third of Americans, one half of Canadians, and two-thirds of Maltese said that people are already being harmed. About a third or more of people in the United States and Canada saw themselves (United States, 32%; Canada, 67%, their family (United States, 35%; Canada, 46%, and people in their community (United States, 39%; Canada, 76% as being vulnerable to at least moderate harm from climate change. About one third of Maltese (31% said they were most concerned about the risk to themselves and their families. Many Canadians said that the elderly (45% and children (33% are at heightened risk of harm, while Americans were more likely to see people in developing countries as being at risk than people in their own nation. When prompted, large numbers of Canadians and Maltese said that climate change can cause respiratory problems (78–91%, heat-related problems (75–84%, cancer (61–90%, and infectious diseases (49–62%. Canadians also named sunburn (79% and injuries from extreme weather events (73%, and Maltese cited allergies (84%. However, climate change appears to lack salience as a health issue in all three countries: relatively few people answered open-ended questions in a manner that indicated clear top-of-mind associations between climate change and human health risks. We recommend mounting public health communication initiatives that increase the

  13. Effect of air quality alerts on human health: a regression discontinuity analysis in Toronto, Canada.

    Science.gov (United States)

    Chen, Hong; Li, Qiongsi; Kaufman, Jay S; Wang, Jun; Copes, Ray; Su, Yushan; Benmarhnia, Tarik

    2018-01-01

    Ambient air pollution is a major health risk globally. To reduce adverse health effects on days when air pollution is high, government agencies worldwide have implemented air quality alert programmes. Despite their widespread use, little is known about whether these programmes produce any observable public-health benefits. We assessed the effectiveness of such programmes using a quasi-experimental approach. We assembled a population-based cohort comprising all individuals who resided in the city of Toronto (Ontario, Canada) from 2003 to 2012 (about 2·6 million people). We ascertained seven health outcomes known to be affected by short-term elevation of air pollution, using provincial health administrative databases. These health outcomes were cardiovascular-related mortality, respiratory-related mortality, and hospital admissions or emergency-department visits for acute myocardial infarction, heart failure, stroke, asthma, and chronic obstructive pulmonary disease (COPD). We applied a regression discontinuity design to assess the effectiveness of an intervention (ie, the air quality alert programme). To quantify the effect of the air quality alert programme, we estimated for each outcome both the absolute rate difference and the rate ratio attributable to programme eligibility (by intention-to-treat analysis) and the alerts themselves (by two-stage regression approach), respectively. Between Jan 1, 2003, and Dec 31, 2012, on average between three and 27 daily cardiovascular or respiratory events were reported in Toronto (depending on the outcome). Alert announcements reduced asthma-related emergency-department visits by 4·73 cases per 1 000 000 people per day (95% CI 0·55-9·38), or in relative terms by 25% (95% CI 1-47). Programme eligibility also led to 2·05 (95% CI 0·07-4·00) fewer daily emergency-department visits for asthma. We did not detect a significant reduction in any other health outcome as a result of alert announcements or programme

  14. Vitamin D status of refugees arriving in Canada: findings from the Calgary Refugee Health Program.

    Science.gov (United States)

    Aucoin, Michael; Weaver, Rob; Thomas, Roger; Jones, Lanice

    2013-04-01

    To determine the 25-hydroxyvitamin D (25[OH]D) serum levels in refugee women of childbearing age and in refugee children; to compare their 25(OH)D levels with the recommended levels in order to determine the prevalence of deficiency; to compare their 25(OH)D levels with those in the general Canadian population in the appropriate age and sex groups; and to investigate the association of vitamin D deficiency with potential risk factors. Cross-sectional chart review. The Calgary Refugee Health Program, an urban family practice that serves newly arrived refugees in Calgary, Alta. A total of 1217 refugee women and children screened between June 2005 and January 2010. Serum 25(OH)D values that were measured during initial screening visits. Overall, 1217 of the 1768 eligible participants (69%) had 25(OH)D laboratory values recorded. The mean concentration of 25(OH)D was 52.0 nmol/L (95% CI 50.6 to 53.3 nmol/L). Using the Institute of Medicine guideline for adequate serum vitamin D levels (>50 nmol/L), 61% of women and 42% of children had lower-than-desirable 25(OH)D levels. Considering the Osteoporosis Canada guidelines, 88% of women and 81% of children had lower-than-desirable 25(OH)D levels (refugees between the ages of 12 and 19 years old had lower mean values of 25(OH)D than male refugees in the same age group did (P=.01). Most refugees had lower-than-desirable vitamin D levels. All age groups studied had lower mean 25(OH)D levels compared with the general Canadian population. Health care providers should be aware of this concern and consider vitamin D supplementation among refugees.

  15. Antipsychotics and dementia in Canada: a retrospective cross-sectional study of four health sectors.

    Science.gov (United States)

    Rios, Sebastian; Perlman, Christopher M; Costa, Andrew; Heckman, George; Hirdes, John P; Mitchell, Lori

    2017-10-23

    Antipsychotic medications are not recommended for the management of symptoms of dementia, particularly among persons with no behavioral or psychological symptoms. We examine patterns of antipsychotic medication use among persons with dementia across health sectors in Canada, with a focus on factors related to use among those without behavioral or psychotic symptoms. Using a retrospective cross-sectional design, this study examines antipsychotic use among adults aged 65 or older with dementia in home care (HC), complex continuing care (CCC), long-term care (LTC), and among alternate level care patients in acute hospitals (ALC). Using clinical data from January 1, 2009 to December 31, 2014, the prevalence of antipsychotic medication use was estimated by the presence of behavioral and psychotic symptoms. Logistic regression was used to identify sector specific factors associated with antipsychotic use in the absence of behavioral and psychotic symptoms. The total prevalence of antipsychotic use among older adults with dementia was 26% in HC, 54% in ALC, 41% in CCC, and 48% in LTC. This prevalence ranged from 38% (HC) to 73% (ALC) for those with both behavioral and psychotic symptoms and from 15% (HC) to 31% (ALC) among those with no symptoms. The regression models identified a number of variables were related to antipsychotic use in the absence of behavior or psychotic symptoms, such as bipolar disorder (OR = 6.63 in CCC; OR = 5.52 in LTC), anxious complaints (OR = 1.54 in LTC to 2.01 in CCC), and wandering (OR = 1.83 in ALC). Potentially inappropriate use of antipsychotic medications is prevalent among older adults with dementia across health sectors. The variations in prevalence observed from community to facility based care suggests that system issues may exist in appropriately managing persons with dementia.

  16. Advancing team-based primary health care: a comparative analysis of policies in western Canada.

    Science.gov (United States)

    Suter, Esther; Mallinson, Sara; Misfeldt, Renee; Boakye, Omenaa; Nasmith, Louise; Wong, Sabrina T

    2017-07-17

    We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.

  17. A Population-Based Study of Postpartum Mental Health Service Use by Immigrant Women in Ontario, Canada.

    Science.gov (United States)

    Vigod, Simone; Sultana, Anjum; Fung, Kinwah; Hussain-Shamsy, Neesha; Dennis, Cindy-Lee

    2016-11-01

    Postpartum mental disorders are twice as common among immigrant women compared to nonimmigrant women in developed countries. Immigrant women may experience barriers to access and use of postpartum mental health services, but little is known about their service use on a population level. We described postpartum mental health service use of immigrant mothers living in Ontario, Canada, comparing to a referent group of mothers who were either born in Canada or had lived in Ontario or another Canadian province since 1985. Among all women in Ontario, Canada, delivering a live infant from 2008 to 2012 (n = 450,622), we described mental health service use within 1 year postpartum, including mental health physician visits, psychiatric emergency department visits, and psychiatric hospitalization. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) comparing immigrant women to the referent group were adjusted for maternal age, parity, income, rurality, mental health services in prior 2 years, and maternal and newborn health. Immigrant women (n = 123,231; 27%) were less likely to use mental health services than women in the referent group (14.1% vs. 21.4%; aOR, 0.59; 95% CI, 0.58 to 0.61), including for physician-based (13.9% vs. 21.1%; aOR, 0.59; 95% CI, 0.58 to 0.61) and emergency department (0.6% vs. 1.3%; aOR, 0.63; 95% CI, 0.57 to 0.68) services. Hospitalization risk was lower among immigrants (0.20% vs. 0.33%) but became similar after covariate adjustment (aOR, 0.92; 95% CI, 0.79 to 1.06). Underuse of postpartum mental health services may be contributing to the high burden of postpartum mental disorders among immigrant women. © The Author(s) 2016.

  18. Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

    Science.gov (United States)

    Shakya, Yogendra; Gagnon, Anita J; Cole, Donald C; Rashid, Meb; Blake, Jennifer; Dastoori, Parisa; Moineddin, Rahim; Ray, Joel G; Urquia, Marcelo L

    2018-01-01

    Objectives Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes. Design This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data. Setting and participants Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014. Primary outcomes Numerous adverse maternal and perinatal health outcomes. Results Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers. Conclusions Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration

  19. Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada

    Directory of Open Access Journals (Sweden)

    C. Steensma

    2016-10-01

    Full Text Available Introduction: Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL on the overall population. Health-adjusted life expectancy (HALE is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. Methods: We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS participants 20 years and older (n = 12 373 were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007-2009. The Canadian Community Health Survey (2009/10 provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. Results: For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2-43.8 compared to 57.0 years (95% CI: 56.8-57.2 for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5-41.5 for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6-54.0 for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The 14.8 fewer

  20. The Devil Is in the Details! On Regulating Cannabis Use in Canada Based on Public Health Criteria; Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”

    Directory of Open Access Journals (Sweden)

    Jürgen Rehm

    2017-03-01

    Full Text Available This commentary to the editorial of Hajizadeh argues that the economic, social and health consequences of legalizing cannabis in Canada will depend in large part on the exact stipulations (mainly from the federal government and on the implementation, regulation and practice of the legalization act (on provincial and municipal levels. A strict regulatory framework is necessary to minimize the health burden attributable to cannabis use. This includes prominently control of production and sale of the legal cannabis including control of price and content with ban of marketing and advertisement. Regulation of medical marijuana should be part of such a framework as well

  1. Development of a health effects based priority ranking system for air emissions reductions from oil refineries in Canada

    International Nuclear Information System (INIS)

    McColl, S.; Gower, S.; Hicks, J.; Shortreed, J.; Craig, L.

    2004-01-01

    This paper presents the concept and methodologies behind the development of a health effects priority ranking tool for the reduction of air emissions from oil refineries. The Health Effects Indicators Decision Index- Versions 2 (Heidi II) was designed to assist policy makers in prioritizing air emissions reductions on the basis of estimated risk to human health. Inputs include facility level rankings of potential health impacts associated with carcinogenic air toxics, non-carcinogenic air toxics and criteria air contaminants for each of the 20 refineries in Canada. Rankings of estimated health impacts are presented on predicted incidence of health effects. Heidi II considers site-specific annual pollutant emission data, ambient air concentrations associated with releases and concentration response functions for various types of health effects. Additional data includes location specific background air concentrations, site-specific population densities, and the baseline incidence of different health effects endpoints, such as cancer, non-cancer illnesses and cardiorespiratory illnesses and death. Air pollutants include the 29 air toxics reported annually in Environment Canada's National Pollutant Release Inventory. Three health impact ranking outputs are provided for each facility: ranking of pollutants based on predicted number of annual cases of health effects; ranking of pollutants based on simplified Disability Adjusted Life Years (DALYs); and ranking of pollutants based on more complex DALYs that consider types of cancer, systemic disease or types of cardiopulmonary health effects. Rankings rely on rough statistical estimates of predicted incidence rates for health endpoints. The models used to calculate rankings can provide useful guidance by comparing estimated health impacts. Heidi II has demonstrated that it is possible to develop a consistent and objective approach for ranking priority reductions of air emissions. Heidi II requires numerous types and

  2. Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

    Science.gov (United States)

    Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

    2009-12-01

    Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

  3. Diffusion of the Digital Health Self-Tracking Movement in Canada: Results of a National Survey

    Science.gov (United States)

    Leaver, Chad; Bourget, Claire

    2018-01-01

    Background With the ever-increasing availability of mobile apps, consumer wearables, and smart medical devices, more and more individuals are self-tracking and managing their personal health data. Objective The aim of this study was to investigate the diffusion of the digital self-tracking movement in Canada. It provides a comprehensive, yet detailed account of this phenomenon. It examines the profile of digital self-trackers, traditional self-trackers, and nontrackers, further investigating the primary motivations for self-tracking and reasons for nontracking; barriers to adoption of connected care technologies; users’ appreciation of their self-tracking devices, including what they perceive to be the main benefits; factors that influence people’s intention to continue using connected care technologies in the future; and the reasons for usage discontinuance. Methods We conducted an online survey with a sample of 4109 Canadian adults, one of the largest ever. To ensure a representative sample, quota method was used (gender, age), following stratification by region. The maximum margin of error is estimated at 1.6%, 19 times out of 20. Results Our findings reveal that 66.20% (2720/4109) of our respondents regularly self-track one or more aspects of their health. About one in 4 respondents (1014/4109, 24.68%) currently owns a wearable or smart medical device, and 57.20% (580/1014) use their devices on a regular basis for self-tracking purposes. Digital self-trackers are typically young or mature adults, healthy, employed, university educated, with an annual family income of over $80,000 CAD. The most popular reported device is the fitness tracker or smartwatch that can capture a range of parameters. Currently, mobile apps and digital self-tracking devices are mainly used to monitor physical activity (856/1669, 51.13%), nutrition (545/1669, 32.65%), sleep patterns (482/1669, 28.88%) and, to a much lesser extent, cardiovascular and pulmonary biomarkers (215/1669, 12

  4. Diffusion of the Digital Health Self-Tracking Movement in Canada: Results of a National Survey.

    Science.gov (United States)

    Paré, Guy; Leaver, Chad; Bourget, Claire

    2018-05-02

    With the ever-increasing availability of mobile apps, consumer wearables, and smart medical devices, more and more individuals are self-tracking and managing their personal health data. The aim of this study was to investigate the diffusion of the digital self-tracking movement in Canada. It provides a comprehensive, yet detailed account of this phenomenon. It examines the profile of digital self-trackers, traditional self-trackers, and nontrackers, further investigating the primary motivations for self-tracking and reasons for nontracking; barriers to adoption of connected care technologies; users' appreciation of their self-tracking devices, including what they perceive to be the main benefits; factors that influence people's intention to continue using connected care technologies in the future; and the reasons for usage discontinuance. We conducted an online survey with a sample of 4109 Canadian adults, one of the largest ever. To ensure a representative sample, quota method was used (gender, age), following stratification by region. The maximum margin of error is estimated at 1.6%, 19 times out of 20. Our findings reveal that 66.20% (2720/4109) of our respondents regularly self-track one or more aspects of their health. About one in 4 respondents (1014/4109, 24.68%) currently owns a wearable or smart medical device, and 57.20% (580/1014) use their devices on a regular basis for self-tracking purposes. Digital self-trackers are typically young or mature adults, healthy, employed, university educated, with an annual family income of over $80,000 CAD. The most popular reported device is the fitness tracker or smartwatch that can capture a range of parameters. Currently, mobile apps and digital self-tracking devices are mainly used to monitor physical activity (856/1669, 51.13%), nutrition (545/1669, 32.65%), sleep patterns (482/1669, 28.88%) and, to a much lesser extent, cardiovascular and pulmonary biomarkers (215/1669, 12.88%), medication intake (126/1669, 7

  5. A qualitative study on the ethics of transforming care: examining the development and implementation of Canada's first mental health strategy.

    Science.gov (United States)

    Park, Melissa M; Lencucha, Raphael; Mattingly, Cheryl; Zafran, Hiba; Kirmayer, Laurence J

    2015-08-19

    The Mental Health Commission of Canada worked collaboratively with stakeholders to create a new framework for a federal mental health strategy, which is now mandated for implementation by 2017. The proposed strategies have been written into provincial health plans, hospital accreditation standards, and the annual objectives of psychiatric departments and community organizations. This project will explore the decision-making process among those who contributed to Canada's first federal mental health policy and those implementing this policy in the clinical setting. Despite the centrality of ethical reasoning to the successful uptake of the recent national guidelines for recovery-oriented care, to date, there are no studies focused exclusively on the ethical tensions that emerged and continue to emerge during the creation and implementation of the new standards for recovery-oriented practice. This two-year Canadian Institute of Health Research Catalyst Grant in Ethics (2015-2017) consists of three components. C-I, a retrospective, qualitative study consisting of document analysis and interviews with key policy-makers of the ethical tensions that arose during the development of Canada's Mental Health Strategy will be conducted in parallel to C-II, a theory-based, focused ethnography of how mental health practitioners in a psychiatric setting reason about and act upon new standards in everyday practice. Case-based scenarios of ethical tensions will be developed from C-I/II and fed-forward to C-III: participatory forums with policy-makers, mental health practitioners, and other stakeholders in recovery-oriented services to collectively identify and prioritize key ethical concerns and generate action steps to close the gap between the policy-making process and its implementation at the local level. Policy-makers and clinicians make important everyday decisions that effect the creation and implementation of new practice standards. Particularly, there is a need to

  6. Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada.

    Science.gov (United States)

    Chiu, Maria; Amartey, Abigail; Wang, Xuesong; Kurdyak, Paul

    2018-01-01

    The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. We found that self-reported physician-diagnosed mood and anxiety disorders and mental health service use were generally lower among South Asian, Chinese, and black respondents compared to white respondents. Chinese individuals reported the weakest sense of belonging to their local community and the poorest self-rated mental health and were nearly as likely to report suicidal thoughts in the past year as white respondents. Among those self-reporting fair or poor mental health, less than half sought help from a mental health professional, ranging from only 19.8% in the Chinese group to 50.8% in the white group. The prevalence of mental health factors and mental health service use varied widely across ethnic groups. Efforts are needed to better understand and address cultural and system-level barriers surrounding high unmet needs and to identify ethnically tailored and culturally appropriate clinical supports and practices to ensure equitable and timely mental health care.

  7. Water quality and Inuit health: an examination of drinking water consumption, perceptions, and contamination in Rigolet, Canada.

    Science.gov (United States)

    Wright, Carlee

    2017-01-01

    Canadian Inuit have often reported concerns about the quality of their municipal drinking water; research has also shown that some Inuit communities experience some of the highest incidence rates of self-reported acute gastrointestinal illness (AGI) in Canada and globally. The goal of this thesis research was to investigate drinking water perceptions and consumption patterns, as well as water contamination and potential associations with AGI in the Inuit community of Rigolet, Canada. Three census cross-sectional surveys captured data on AGI, drinking water, and water storage (2012-2014); additionally, bacterial contamination of household drinking water was assessed alongside the 2014 survey. Concerns regarding the taste, smell, and colour of tap water were associated with lower odds of consuming tap water. The use of transfer devices (i.e. small bowls or measuring cups) was associated with household water contamination; while no water-related risk factors for AGI were identified, incidence of AGI was high compared with southern Canada. This thesis research provides a valuable contribution to the limited literature assessing drinking water and health in the Arctic. Ultimately, this work is intended to inform safe water management practices, as well as contextually appropriate drinking water interventions, risk assessments, and public health messaging in the Canadian Arctic.

  8. Emerging arboviruses in Quebec, Canada: assessing public health risk by serology in humans, horses and pet dogs.

    Science.gov (United States)

    Rocheleau, J P; Michel, P; Lindsay, L R; Drebot, M; Dibernardo, A; Ogden, N H; Fortin, A; Arsenault, J

    2017-10-01

    Periodic outbreaks of West Nile virus (WNV), Eastern equine encephalitis virus (EEEV) and to a lesser extent, California serogroup viruses (CSGV), have been reported in parts of Canada in the last decade. This study was designed to provide a broad assessment of arboviral activity in Quebec, Canada, by conducting serological surveys for these arboviruses in 196 horses, 1442 dogs and 485 humans. Sera were screened by a competitive enzyme linked immunosorbent assay and positive samples confirmed by plaque reduction neutralisation tests. The percentage of seropositive samples was 83·7%, 16·5%, 7·1% in horses, 18·8%, 0·6%, 0% in humans, 11·7%, 3·1%, 0% in adult dogs and 2·9%, 0·3%, 0% in juvenile dogs for CSGV, WNV and EEEV, respectively. Serological results in horses and dogs appeared to provide a meaningful assessment of risk to public health posed by multiple arboviruses.

  9. Emerging issues in paediatric health research consent forms in Canada: working towards best practices.

    Science.gov (United States)

    Dove, Edward S; Avard, Denise; Black, Lee; Knoppers, Bartha M

    2013-01-30

    Obtaining a research participant's voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008-2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child's assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child's psychological and social perspective; (3) whether a child's ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child's perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed. The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study. The analysis provides valuable insight and evidence into

  10. Emerging issues in paediatric health research consent forms in Canada: working towards best practices

    Directory of Open Access Journals (Sweden)

    Dove Edward S

    2013-01-01

    Full Text Available Abstract Background Obtaining a research participant’s voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Methods Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008–2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1 whether the scope of parental consent allows for a child’s assent, dissent, or future consent; (2 whether the concepts of risk and benefit incorporate the child’s psychological and social perspective; (3 whether a child’s ability to withdraw is respected and to what extent withdrawal is permitted; (4 whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5 whether privacy and confidentiality concerns adequately address the child’s perspective and whether standard data and/or sample identifiability nomenclature is used; and (6 whether retention of and access to paediatric biological samples and associated medical data are addressed. Results The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad, and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the

  11. Development of a health-based air quality index for Canada : public opinion research 2004-05 : final report

    International Nuclear Information System (INIS)

    2005-05-01

    Canadians rely on an air quality indexes (AQIs) to inform them about air pollution conditions in their communities. However, there is no AQI common to all of Canada, and there is a lack of consistency in the way in which air quality is calculated and reported, as well as in the use of health-based messages. This paper reported findings of a public opinion research survey conducted to gauge Canadians' awareness, perceptions and behavioural responses to air quality, air pollution and AQIs. The aim of the study was to guide the development of health messages to more effectively communicate the AQI to Canadians with respect to the health risks associated with poor air quality. Telephone surveys were conducted immediately following a poor air quality episode to measure the public's awareness and response to these events, as well as residents' general awareness and use of AQIs. A separate research project was then conducted which consisted of in-depth qualitative interviews with 28 individuals recruited from the general population. A comprehensive national telephone survey was then conducted following the summer 2004 'smog season', which focused on the public's awareness of air pollution and AQIs. Results from the first 2 phases of the research were then presented at a workshop comprised of health and environmental communities specializing in air issues in Canada. Focus groups were then held to test public reaction to new AQI communications concepts derived from the research. Results indicated that Canadians widely identify air pollution as a significant environmental problem. However, the information from AQIs had a limited impact in terms of prompting actions to reduce personal exposure. A new type of national AQI for Canada was developed that conveyed information on air quality conditions and their significance. Key features include a 0 to 10 point unbounded scale showing current air quality conditions; a forecast of future conditions; standardized information

  12. The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada; Comment on “Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts”

    Directory of Open Access Journals (Sweden)

    Stephanie Lake

    2017-05-01

    Full Text Available A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization – adolescent usage and impaired driving – and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization – specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use – that have to date not received adequate attention.

  13. Does Social Context Matter? Income Inequality, Racialized Identity, and Health Among Canada's Aboriginal Peoples Using a Multilevel Approach.

    Science.gov (United States)

    Spence, Nicholas D

    2016-03-01

    Debates surrounding the importance of social context versus individual level processes have a long history in public health. Aboriginal peoples in Canada are very diverse, and the reserve communities in which they reside are complex mixes of various cultural and socioeconomic circumstances. The social forces of these communities are believed to affect health, in addition to individual level determinants, but no large scale work has ever probed their relative effects. One aspect of social context, relative deprivation, as indicated by income inequality, has greatly influenced the social determinants of health landscape. An investigation of relative deprivation in Canada's Aboriginal population has never been conducted. This paper proposes a new model of Aboriginal health, using a multidisciplinary theoretical approach that is multilevel. This study explored the self-rated health of respondents using two levels of determinants, contextual and individual. Data were from the 2001 Aboriginal Peoples Survey. There were 18,890 Registered First Nations (subgroup of Aboriginal peoples) on reserve nested within 134 communities. The model was assessed using a hierarchical generalized linear model. There was no significant variation at the contextual level. Subsequently, a sequential logistic regression analysis was run. With the sole exception culture, demographics, lifestyle factors, formal health services, and social support were significant in explaining self-rated health. The non-significant effect of social context, and by extension relative deprivation, as indicated by income inequality, is noteworthy, and the primary role of individual level processes, including the material conditions, social support, and lifestyle behaviors, on health outcomes is illustrated. It is proposed that social structure is best conceptualized as a dynamic determinant of health inequality and more multilevel theoretical models of Aboriginal health should be developed and tested.

  14. Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

    Science.gov (United States)

    Auger, Monique; Howell, Teresa; Gomes, Tonya

    2016-12-27

    This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

  15. Health and economic impact of PHiD-CV in Canada and the UK: a Markov modelling exercise.

    Science.gov (United States)

    Knerer, Gerhart; Ismaila, Afisi; Pearce, David

    2012-01-01

    The spectrum of diseases caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) represents a large burden on healthcare systems around the world. Meningitis, bacteraemia, community-acquired pneumonia (CAP), and acute otitis media (AOM) are vaccine-preventable infectious diseases that can have severe consequences. The health economic model presented here is intended to estimate the clinical and economic impact of vaccinating birth cohorts in Canada and the UK with the 10-valent, pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) compared with the newly licensed 13-valent pneumococcal conjugate vaccine (PCV-13). The model described herein is a Markov cohort model built to simulate the epidemiological burden of pneumococcal- and NTHi-related diseases within birth cohorts in the UK and Canada. Base-case assumptions include estimates of vaccine efficacy and NTHi infection rates that are based on published literature. The model predicts that the two vaccines will provide a broadly similar impact on all-cause invasive disease and CAP under base-case assumptions. However, PHiD-CV is expected to provide a substantially greater reduction in AOM compared with PCV-13, offering additional savings of Canadian $9.0 million and £4.9 million in discounted direct medical costs in Canada and the UK, respectively. The main limitations of the study are the difficulties in modelling indirect vaccine effects (herd effect and serotype replacement), the absence of PHiD-CV- and PCV-13-specific efficacy data and a lack of comprehensive NTHi surveillance data. Additional limitations relate to the fact that the transmission dynamics of pneumococcal serotypes have not been modelled, nor has antibiotic resistance been accounted for in this paper. This cost-effectiveness analysis suggests that, in Canada and the UK, PHiD-CV's potential to protect against NTHi infections could provide a greater impact on overall disease burden than

  16. Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

    Science.gov (United States)

    Cohen, Benita E; Gregory, David

    2009-01-01

    Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

  17. The intersection of health and wealth: association between personal bankruptcy and myocardial infarction rates in Canada.

    Science.gov (United States)

    Savu, Anamaria; Schopflocher, Donald; Scholnick, Barry; Kaul, Padma

    2016-01-13

    We examined the association between personal bankruptcy filing and acute myocardial infarction (AMI) rates in Canada. Between 2002 and 2009, aggregate and yearly bankruptcy and AMI rates were estimated for 1,155 forward sortation areas of Canada. Scatter plot and correlations were used to assess the association of the aggregate rates. Cross-lagged structural equation models were used to explore the longitudinal relationship between bankruptcy and AMI after adjustment for socio-economic factors. A cross-lagged structural equation model estimated that on average, an increase of 100 in bankruptcy filing count is associated with an increase of 1.5 (p = 0.02) in AMI count in the following year, and an increase of 100 in AMI count is associated with an increase of 7 (p stress, as indicated by personal bankruptcy rate, and vice-versa.

  18. Measuring electromagnetic fields (EMF) around wind turbines in Canada: is there a human health concern?

    OpenAIRE

    McCallum, Lindsay C; Whitfield Aslund, Melissa L; Knopper, Loren D; Ferguson, Glenn M; Ollson, Christopher A

    2014-01-01

    Background The past five years has seen considerable expansion of wind power generation in Ontario, Canada. Most recently worries about exposure to electromagnetic fields (EMF) from wind turbines, and associated electrical transmission, has been raised at public meetings and legal proceedings. These fears have not been based on any actual measurements of EMF exposure surrounding existing projects but appear to follow from worries from internet sources and misunderstanding of the science. Meth...

  19. Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada.

    Science.gov (United States)

    Vahabi, Mandana; Wong, Josephine Pui-Hing

    2017-05-23

    Canada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services. In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis. A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants' narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women. A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant

  20. Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada

    Directory of Open Access Journals (Sweden)

    Mandana Vahabi

    2017-05-01

    Full Text Available Abstract Background Canada depends on Temporary Foreign Workers (TFWs, also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC, constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services. Method In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis. Results A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants’ narratives: (1 precarious migration-employment status (reproduces exploitation; (2 deskilling and downward social mobility reinforce alienation; (3 endurance of hardship for family back home; (4 double lives of public cheerfulness and private anguish; and (4 unrecognized mental health needs. The study results reflected gross injustices experienced by these women. Conclusion A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living

  1. Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

    Directory of Open Access Journals (Sweden)

    Graham Douglas

    2009-12-01

    Full Text Available Abstract Background Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care. Methods A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers. Results The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes. Conclusions This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.

  2. Social Media and Men's Health: A Content Analysis of Twitter Conversations During the 2013 Movember Campaigns in the United States, Canada, and the United Kingdom.

    Science.gov (United States)

    Bravo, Caroline A; Hoffman-Goetz, Laurie

    2017-11-01

    The Movember Foundation raises awareness and funds for men's health issues such as prostate and testicular cancers in conjunction with a moustache contest. The 2013 Movember campaigns in the United States, Canada, and the United Kingdom shared the same goal of creating conversations about men's health that lead to increased awareness and understanding of the health risks men face. Our objective was to explore Twitter conversations to identify whether the 2013 Movember campaigns sparked global conversations about prostate cancer, testicular cancer, and other men's health issues. We conducted a content analysis of 12,666 tweets posted during the 2013 Movember campaigns in the United States, Canada, and the United Kingdom (4,222 tweets from each country) to investigate whether tweets were health-related or non-health-related and to determine what topics dominated conversations. Few tweets ( n = 84, 0.7% of 12,666 tweets) provided content-rich or actionable health information that would lead to awareness and understanding of men's health risks. While moustache growing and grooming was the most popular topic in U.S. tweets, conversations about community engagement were most common in Canadian and U.K. tweets. Significantly more tweets co-opted the Movember campaign to market products or contests in the United States than Canada and the United Kingdom ( p campaigns in the United States, Canada, and the United Kingdom sparked few conversations about prostate and testicular cancers that could potentially lead to greater awareness and understanding of important men's health issues.

  3. The Devil Is in the Details! On Regulating Cannabis Use in Canada Based on Public Health Criteria Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

    Science.gov (United States)

    Rehm, Jürgen; Crépault, Jean-François; Fischer, Benedikt

    2016-08-20

    This commentary to the editorial of Hajizadeh argues that the economic, social and health consequences of legalizing cannabis in Canada will depend in large part on the exact stipulations (mainly from the federal government) and on the implementation, regulation and practice of the legalization act (on provincial and municipal levels). A strict regulatory framework is necessary to minimize the health burden attributable to cannabis use. This includes prominently control of production and sale of the legal cannabis including control of price and content with ban of marketing and advertisement. Regulation of medical marijuana should be part of such a framework as well. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  4. Patient safety culture and leadership within Canada's Academic Health Science Centres: towards the development of a collaborative position paper.

    Science.gov (United States)

    Nicklin, Wendy; Mass, Heather; Affonso, Dyanne D; O'Connor, Patricia; Ferguson-Paré, Mary; Jeffs, Lianne; Tregunno, Deborah; White, Peggy

    2004-03-01

    Currently, the Academy of Canadian Executive Nurses (ACEN) is working with the Association of Canadian Academic Healthcare Organizations (ACAHO) to develop a joint position paper on patient safety cultures and leadership within Academic Health Science Centres (AHSCs). Pressures to improve patient safety within our healthcare system are gaining momentum daily. Because AHSCs in Canada are the key organizations that are positioned regionally and nationally, where service delivery is the platform for the education of future healthcare providers, and where the development of new knowledge and innovation through research occurs, leadership for patient safety logically must emanate from them. As a primer, ACEN provides an overview of current patient safety initiatives in AHSCs to date. In addition, the following six key areas for action are identified to ensure that AHSCs continue to be leaders in delivering quality, safe healthcare in Canada. These include: (1) strategic orientation to safety culture and quality improvement, (2) open and transparent disclosure policies, (3) health human resources integral to ensuring patient safety practices, (4) effective linkages between AHSCs and academic institutions, (5) national patient safety accountability initiatives and (6) collaborative team practice.

  5. Drinking water management: health risk perceptions and choices in First Nations and non-First Nations communities in Canada.

    Science.gov (United States)

    Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

    2014-05-30

    The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000-2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009-2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience.

  6. Drinking Water Management: Health Risk Perceptions and Choices in First Nations and Non-First Nations Communities in Canada

    Science.gov (United States)

    Dupont, Diane; Waldner, Cheryl; Bharadwaj, Lalita; Plummer, Ryan; Carter, Blair; Cave, Kate; Zagozewski, Rebecca

    2014-01-01

    The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000–2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009–2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience. PMID:24886757

  7. Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada

    Directory of Open Access Journals (Sweden)

    Laliberté Marie-Claude

    2012-03-01

    Full Text Available Abstract Background An increased interest is observed in broadening community pharmacists' role in public health. To date, little information has been gathered in Canada on community pharmacists' perceptions of their role in health promotion and prevention; however, such data are essential to the development of public-health programs in community pharmacy. A cross-sectional study was therefore conducted to explore the perceptions of community pharmacists in urban and semi-urban areas regarding their ideal and actual levels of involvement in providing health-promotion and prevention services and the barriers to such involvement. Methods Using a five-step modified Dillman's tailored design method, a questionnaire with 28 multiple-choice or open-ended questions (11 pages plus a cover letter was mailed to a random sample of 1,250 pharmacists out of 1,887 community pharmacists practicing in Montreal (Quebec, Canada and surrounding areas. It included questions on pharmacists' ideal level of involvement in providing health-promotion and preventive services; which services were actually offered in their pharmacy, the employees involved, the frequency, and duration of the services; the barriers to the provision of these services in community pharmacy; their opinion regarding the most appropriate health professionals to provide them; and the characteristics of pharmacists, pharmacies and their clientele. Results In all, 571 out of 1,234 (46.3% eligible community pharmacists completed and returned the questionnaire. Most believed they should be very involved in health promotion and prevention, particularly in smoking cessation (84.3%; screening for hypertension (81.8%, diabetes (76.0% and dyslipidemia (56.9%; and sexual health (61.7% to 89.1%; however, fewer respondents reported actually being very involved in providing such services (5.7% [lifestyle, including smoking cessation], 44.5%, 34.8%, 6.5% and 19.3%, respectively. The main barriers to the

  8. Tackling health literacy: adaptation of public hypertension educational materials for an Indo-Asian population in Canada.

    Science.gov (United States)

    Jones, Charlotte A; Mawani, Shefina; King, Kathryn M; Allu, Selina Omar; Smith, Megan; Mohan, Sailesh; Campbell, Norman R C

    2011-01-11

    Indo-Asians in Canada are at increased risk for cardiovascular diseases. There is a need for cultural and language specific educational materials relating to this risk. During this project we developed and field tested the acceptability of a hypertension public education pamphlet tailored to fit the needs of an at risk local Indo-Asian population, in Calgary, Alberta, Canada. A community health board representing Calgary's Indo-Asian communities identified the culturally specific educational needs and language preferences of the local population. An adaptation of an existing English language Canadian Public Hypertension Recommendations pamphlet was created considering the literacy and translation challenges. The adapted pamphlet was translated into four Indo-Asian languages. The adapted pamphlets were disseminated as part of the initial educational component of a community-based culturally and language-sensitive cardiovascular risk factor screening and management program. Field testing of the materials was undertaken when participants returned for program follow-up seven to 12 months later. Fifty-nine English-speaking participants evaluated and confirmed the concept validity of the English adapted version. 28 non-English speaking participants evaluated the Gujarati (N = 13) and Punjabi (N = 15) translated versions of the adapted pamphlets. All participants found the pamphlets acceptable and felt they had improved their understanding of hypertension. Involving the target community to identify health issues as well as help to create culturally, language and literacy sensitive health education materials ensures resources are highly acceptable to that community. Minor changes to the materials will be needed prior to formal testing of hypertension knowledge and health decision-making on a larger scale within this at risk community.

  9. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Directory of Open Access Journals (Sweden)

    M Eugenia Socías

    Full Text Available Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC, sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC.Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access. Multivariable logistic regression analyses, using generalized estimating equations (GEE, were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013.In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4% women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%, limited hours of operation (36.5%, and perceived disrespect by health care providers (26.1%. In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94, workplace- (AOR = 1.31, 95% CI 1.05-1.63, and community-level violence (AOR = 1.41, 95% CI 1.04-1.92, as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69, a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06, and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57 emerged as independent correlates of institutional barriers to health services.Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex

  10. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada.

    Science.gov (United States)

    Socías, M Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10-1.94), workplace- (AOR = 1.31, 95% CI 1.05-1.63), and community-level violence (AOR = 1.41, 95% CI 1.04-1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03-1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34-2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59-7.57) emerged as independent correlates of institutional barriers to health services. Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care, alongside broader policy changes to fulfill sex workers

  11. It can't hurt to ask; a patient-centered quality of service assessment of health canada's medical cannabis policy and program

    Science.gov (United States)

    2012-01-01

    Background In 2001 Health Canada responded to a series of Ontario court decisions by creating the Marihuana Medical Access Division (MMAD) and the Marihuana Medical Access Regulations (MMAR). Although Health Canada has conducted a small number of stakeholder consultations, the federal government has never polled federally authorized cannabis patients. This study is an attempt to learn more about patient needs, challenges and experiences with the MMAD. Methods Launched in the spring of 2007, Quality of Service Assessment of Health Canada's Medical Cannabis Policy and Program pairs a 50 question online survey addressing the personal experiences of patients in the federal cannabis program with 25 semi-guided interviews. Data gathering for this study took place from April 2007 to Jan. 2008, eventually garnering survey responses from 100 federally-authorized users, which at the time represented about 5% of the patients enrolled in Health Canada's program. This paper presents the results of the survey portion of the study. Results 8% of respondents report getting their cannabis from Health Canada, while 66% grow it for themselves. >50% report that they frequent compassion clubs or dispensaries, which remain illegal and unregulated in Canada. 81% of patients would chose certified organic methods of cultivation; >90% state that not all strains are equally effective at relieving symptoms, and 97% would prefer to obtain cannabis from a source where multiple strains are available. Of the 48 patients polled that had tried the Health Canada cannabis supply, >75% rank it as either "1" or "2" on a scale of 1-10 (with "1" being "very poor", and 10 being "excellent"). Discussion 72% of respondents report they are either "somewhat" or "totally unsatisfied" with Canada's medical cannabis program. These survey results and relevant court decisions suggest that the MMAR are not meeting the needs of most of the nation's medical cannabis patient community. It is hoped this research will

  12. It can't hurt to ask; a patient-centered quality of service assessment of health canada's medical cannabis policy and program

    Directory of Open Access Journals (Sweden)

    Lucas Philippe

    2012-01-01

    Full Text Available Abstract Background In 2001 Health Canada responded to a series of Ontario court decisions by creating the Marihuana Medical Access Division (MMAD and the Marihuana Medical Access Regulations (MMAR. Although Health Canada has conducted a small number of stakeholder consultations, the federal government has never polled federally authorized cannabis patients. This study is an attempt to learn more about patient needs, challenges and experiences with the MMAD. Methods Launched in the spring of 2007, Quality of Service Assessment of Health Canada's Medical Cannabis Policy and Program pairs a 50 question online survey addressing the personal experiences of patients in the federal cannabis program with 25 semi-guided interviews. Data gathering for this study took place from April 2007 to Jan. 2008, eventually garnering survey responses from 100 federally-authorized users, which at the time represented about 5% of the patients enrolled in Health Canada's program. This paper presents the results of the survey portion of the study. Results 8% of respondents report getting their cannabis from Health Canada, while 66% grow it for themselves. >50% report that they frequent compassion clubs or dispensaries, which remain illegal and unregulated in Canada. 81% of patients would chose certified organic methods of cultivation; >90% state that not all strains are equally effective at relieving symptoms, and 97% would prefer to obtain cannabis from a source where multiple strains are available. Of the 48 patients polled that had tried the Health Canada cannabis supply, >75% rank it as either "1" or "2" on a scale of 1-10 (with "1" being "very poor", and 10 being "excellent". Discussion 72% of respondents report they are either "somewhat" or "totally unsatisfied" with Canada's medical cannabis program. These survey results and relevant court decisions suggest that the MMAR are not meeting the needs of most of the nation's medical cannabis patient community. It is

  13. Practitioner survey of the state of health integration in environmental assessment: The case of northern Canada

    International Nuclear Information System (INIS)

    Noble, Bram; Bronson, Jackie

    2006-01-01

    Based on a case study of health integration in Canadian northern EA, this paper further demonstrates the lack of consistent integration of health in EA practice. A survey was administered to northern EA and health practitioners, administrators and special interest groups to assess current northern health assessment practices, the scope of health in EA, EA performance with regard to health assessment and the perceived barriers to health integration. Results suggest that health is currently recognized as an important component of northern EA and is addressed in the majority of cases; however, health is addressed primarily during the pre-decision stages of EA and less often during post-decision follow-up and monitoring. Moreover, when health is addressed, attention is limited to the physical components of health and health impacts due to physical environmental change, with considerably less attention given to the social aspects of health. Results also suggest dissent between EA practitioners, health practitioners and other interests concerning the overall state of health in EA; however, there is consensus on the key challenges to improved integration, namely differences in understanding of the scope of health and expectations of EA to assess health impacts; limited coordination between EA and health practitioners; limited scope and requirements of current EA legislation for health assessment; and the lack of supporting EA methods and frameworks

  14. Race, gender, class, and sexual orientation: intersecting axes of inequality and self-rated health in Canada

    Science.gov (United States)

    2011-01-01

    Background Intersectionality theory, a way of understanding social inequalities by race, gender, class, and sexuality that emphasizes their mutually constitutive natures, possesses potential to uncover and explicate previously unknown health inequalities. In this paper, the intersectionality principles of "directionality," "simultaneity," "multiplicativity," and "multiple jeopardy" are applied to inequalities in self-rated health by race, gender, class, and sexual orientation in a Canadian sample. Methods The Canadian Community Health Survey 2.1 (N = 90,310) provided nationally representative data that enabled binary logistic regression modeling on fair/poor self-rated health in two analytical stages. The additive stage involved regressing self-rated health on race, gender, class, and sexual orientation singly and then as a set. The intersectional stage involved consideration of two-way and three-way interaction terms between the inequality variables added to the full additive model created in the previous stage. Results From an additive perspective, poor self-rated health outcomes were reported by respondents claiming Aboriginal, Asian, or South Asian affiliations, lower class respondents, and bisexual respondents. However, each axis of inequality interacted significantly with at least one other: multiple jeopardy pertained to poor homosexuals and to South Asian women who were at unexpectedly high risks of fair/poor self-rated health and mitigating effects were experienced by poor women and by poor Asian Canadians who were less likely than expected to report fair/poor health. Conclusions Although a variety of intersections between race, gender, class, and sexual orientation were associated with especially high risks of fair/poor self-rated health, they were not all consistent with the predictions of intersectionality theory. I conclude that an intersectionality theory well suited for explicating health inequalities in Canada should be capable of accommodating axis

  15. Race, gender, class, and sexual orientation: intersecting axes of inequality and self-rated health in Canada

    Directory of Open Access Journals (Sweden)

    Veenstra Gerry

    2011-01-01

    Full Text Available Abstract Background Intersectionality theory, a way of understanding social inequalities by race, gender, class, and sexuality that emphasizes their mutually constitutive natures, possesses potential to uncover and explicate previously unknown health inequalities. In this paper, the intersectionality principles of "directionality," "simultaneity," "multiplicativity," and "multiple jeopardy" are applied to inequalities in self-rated health by race, gender, class, and sexual orientation in a Canadian sample. Methods The Canadian Community Health Survey 2.1 (N = 90,310 provided nationally representative data that enabled binary logistic regression modeling on fair/poor self-rated health in two analytical stages. The additive stage involved regressing self-rated health on race, gender, class, and sexual orientation singly and then as a set. The intersectional stage involved consideration of two-way and three-way interaction terms between the inequality variables added to the full additive model created in the previous stage. Results From an additive perspective, poor self-rated health outcomes were reported by respondents claiming Aboriginal, Asian, or South Asian affiliations, lower class respondents, and bisexual respondents. However, each axis of inequality interacted significantly with at least one other: multiple jeopardy pertained to poor homosexuals and to South Asian women who were at unexpectedly high risks of fair/poor self-rated health and mitigating effects were experienced by poor women and by poor Asian Canadians who were less likely than expected to report fair/poor health. Conclusions Although a variety of intersections between race, gender, class, and sexual orientation were associated with especially high risks of fair/poor self-rated health, they were not all consistent with the predictions of intersectionality theory. I conclude that an intersectionality theory well suited for explicating health inequalities in Canada should be

  16. Sperm donation: implications of Canada's Assisted Human Reproduction Act 2004 for recipients, donors, health professionals, and institutions.

    Science.gov (United States)

    Daniels, K; Feyles, V; Nisker, J; Perez-Y-Perez, M; Newton, C; Parker, J A; Tekpetey, F; Haase, J

    2006-07-01

    On April 22, 2004, the Assisted Human Reproduction Act came into force, prohibiting the purchase of sperm or eggs from donors in Canada. In response to the concerns of medical professionals and some consumers that prohibiting payment would lead to a decline in the number of gamete donors, Health Canada commissioned research on altruistic donor recruitment and recruitment strategies. Twenty-two studies of sperm donors were located and their findings reviewed. The studies spanned 23 years (1980-2003), were undertaken in a range of countries, and were chosen on the merit of their relevance to the development of recruitment strategies within a policy of altruistic sperm donation. Observations were derived from assessing and comparing the purposes, findings, and implications of the 22 studies. Payment for providing sperm was made in all but three studies, although participants in 15 studies indicated clearly that their motivations were primarily altruistic. Observations indicate that men who are more willing to be identified to offspring in the future share demographic characteristics, such as age and parental status, with those who are prepared to donate altruistically. These characteristics appear to be a factor in motivation to donate altruistically. The studies show that there are men who are prepared to donate sperm without financial payment. The findings suggest that a change is required in the culture of sperm donation, specifically the adoption of a new approach to donor recruitment.

  17. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Directory of Open Access Journals (Sweden)

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  18. How do people attribute income-related inequalities in health? A cross-sectional study in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Aisha Lofters

    Full Text Available CONTEXT: Substantive equity-focused policy changes in Ontario, Canada have yet to be realized and may be limited by a lack of widespread public support. An understanding of how the public attributes inequalities can be informative for developing widespread support. Therefore, the objectives of this study were to examine how Ontarians attribute income-related health inequalities. METHODS: We conducted a telephone survey of 2,006 Ontarians using random digit dialing. The survey included thirteen questions relevant to the theme of attributions of income-related health inequalities, with each statement linked to a known social determinant of health. The statements were further categorized depending on whether the statement was framed around blaming the poor for health inequalities, the plight of the poor as a cause of health inequalities, or the privilege of the rich as a cause of health inequalities. RESULTS: There was high agreement for statements that attributed inequalities to differences between the rich and the poor in terms of employment, social status, income and food security, and conversely, the least agreement for statements that attributed inequalities to differences in terms of early childhood development, social exclusion, the social gradient and personal health practices and coping skills. Mean agreement was lower for the two statements that suggested blame for income-related health inequalities lies with the poor (43.1% than for the three statements that attributed inequalities to the plight of the poor (58.3% or the eight statements that attributed inequalities to the privilege of the rich (58.7%. DISCUSSION: A majority of this sample of Ontarians were willing to attribute inequalities to the social determinants of health, and were willing to accept messages that framed inequalities around the privilege of the rich or the plight of the poor. These findings will inform education campaigns, campaigns aimed at increasing public support

  19. Education as a Social Determinant of Health: Issues Facing Indigenous and Visible Minority Students in Postsecondary Education in Western Canada

    Directory of Open Access Journals (Sweden)

    Gavin Lam

    2013-08-01

    Full Text Available The level of educational attainment is increasingly being recognized as an important social determinant of health. While higher educational attainment can play a significant role in shaping employment opportunities, it can also increase the capacity for better decision making regarding one’s health, and provide scope for increasing social and personal resources that are vital for physical and mental health. In today’s highly globalized knowledge based society postsecondary education (PSE is fast becoming a minimum requirement for securing employment that can afford young adults the economic, social and personal resources needed for better health. Canada ranks high among OECD countries in terms of advanced education, with 66% of Canadians having completed some form of postsecondary education. Yet youth from low income indigenous and visible minority (LIIVM backgrounds continue to be poorly represented at PSE levels. The current study aimed to understand the reasons for this poor representation by examining the experiences of LIIVM students enrolled in a postsecondary program. Findings show that the challenges they faced during the course of their study had an adverse impact on their health and that improving representation of these students in PSE will require changes at many levels.

  20. Education as a Social Determinant of Health: Issues Facing Indigenous and Visible Minority Students in Postsecondary Education in Western Canada

    Science.gov (United States)

    Shankar, Janki; Ip, Eugene; Khalema, Ernest; Couture, Jennifer; Tan, Shawn; Zulla, Rosslynn T.; Lam, Gavin

    2013-01-01

    The level of educational attainment is increasingly being recognized as an important social determinant of health. While higher educational attainment can play a significant role in shaping employment opportunities, it can also increase the capacity for better decision making regarding one’s health, and provide scope for increasing social and personal resources that are vital for physical and mental health. In today’s highly globalized knowledge based society postsecondary education (PSE) is fast becoming a minimum requirement for securing employment that can afford young adults the economic, social and personal resources needed for better health. Canada ranks high among OECD countries in terms of advanced education, with 66% of Canadians having completed some form of postsecondary education. Yet youth from low income indigenous and visible minority (LIIVM) backgrounds continue to be poorly represented at PSE levels. The current study aimed to understand the reasons for this poor representation by examining the experiences of LIIVM students enrolled in a postsecondary program. Findings show that the challenges they faced during the course of their study had an adverse impact on their health and that improving representation of these students in PSE will require changes at many levels. PMID:23989527

  1. The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

    Science.gov (United States)

    Lake, Stephanie; Kerr, Thomas

    2016-09-10

    A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization - adolescent usage and impaired driving - and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization - specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use - that have to date not received adequate attention. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. Health care in Canada: a citizen's guide to policy and politics

    National Research Council Canada - National Science Library

    Fierlbeck, Katherine

    2011-01-01

    ... outlines the basic framework of the health care system with reference to speci fi c areas such as administration and governance, public health, human resources, drugs and drug policy, and mental health. She also discusses alternative models in other countries such as Britain, the United States, and France. As health care becomes increasingly complex...

  3. Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

    Science.gov (United States)

    Shain, Martin

    2011-01-01

    While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

  4. INCREASING THE REPRESENTATION OF THE BLACK POPULATION IN THE HEALTH PROFESSIONS IN CANADA.

    Science.gov (United States)

    Vukic, Adele; Steenbeek, Audrey; Muxlow, Josephine

    2016-01-01

    Increased representation of the Black population in the health care system is central to decrease health disparities, enhance access to services, and improve health outcomes and quality of care. Current strategies for recruitment and retention of the Black population in higher education in the health fields are explored. The added value of mentorship programs are presented as a promising approach for addressing the high rates of attrition of the Black population in health professional education institutions.

  5. A study of the health of the employees of Atomic Energy of Canada Limited. IV

    International Nuclear Information System (INIS)

    Howe, G.R.; Chiarelli, A.M.; Etezadi-Amoli, J.; Miller, A.B.; Weeks, J.L.

    1987-01-01

    A follow-up study of 13,570 individuals employed by Atomic Energy of Canada Limited has been conducted by linking the records for the cohort to Canadian mortality data for the period between 1950 and 1981. Approximately 60 percent of the individuals in this cohort had some radiation exposure recorded during their employment. A total of 150 deaths from cancer were observed in those males with some radiation exposure, compared to 166 expected, giving a standardized mortality ratio of 0.90. No individual cancer shows a significantly increased death rate compared to the population rate. In general, these results provide useful evidence that the currently accepted risk estimates for radiation-induced cancer are reasonable for low dose rate experience

  6. The political economy of decentralization of health and social services in Canada.

    Science.gov (United States)

    Tsalikis, G

    1989-01-01

    A trend to decentralization in Canada's 'welfare state' has received support from the Left and from the Right. Some social critics of the Left expect decentralization to result in holistic services adjusted to local needs. Others, moreover, feel we are in the dawn of a new epoch in which major economic transformations are to bring about, through new class alliances and conflict, decentralization of power and a better quality of life in communities. These assumptions and their theoretical pitfalls are discussed here following an historical overview of the centralization/decentralization issue in Canadian social policy. It is argued that recent proposals of decentralization are a continuation of reactionary tendencies to constrain social expenditures, but not a path to better quality of life.

  7. Mental Health and Service Issues Faced by Older Immigrants in Canada: A Scoping Review.

    Science.gov (United States)

    Guruge, Sepali; Thomson, Mary Susan; Seifi, Sadaf Grace

    2015-12-01

    RÉSUMÉ Une population vieillissante et la croissance de la population sur la base de l'immigration nécessitent que la recherche, la pratique et la politique doivent se concentrer sur la santé mentale des immigrants âgés, surtout parce que leur santé mentale semble se détériorer au fil du temps. Cette revue se concentre sur: Qu'est-ce que l'on sait sur les déterminants sociaux de la santé mentale chez les immigrants âgés, et quels sont les obstacles à l'accès aux services de santé mentale confrontés par les immigrants âgés? Les résultats révèlent que (1) les déterminants sociaux décisifs de la santé mentale sont la culture, le sexe et les services de santé; (2) que les immigrants plus âgés utilisent les services de santé mentale de moins que leurs homologues nés au Canada à cause des obstacles tels que, par exemple, les croyances et les valeurs culturelles, un manque de services culturellement et linguistiquement appropriées, des difficultés financières, et l'âgisme; et (3) quelles que soient les sous-catégories dans cette population, les immigrants âgés éprouvent des inégalités en matière de la santé mentale. La preuve des recherches disponibles indique que de combler les lacunes des service de santé mentale devrait devenir une priorité pour la politique et la pratique du système de soins de santé au Canada.

  8. Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada.

    Science.gov (United States)

    Moubarac, Jean-Claude; Martins, Ana Paula Bortoletto; Claro, Rafael Moreira; Levy, Renata Bertazzi; Cannon, Geoffrey; Monteiro, Carlos Augusto

    2013-12-01

    To investigate consumption of ultra-processed products in Canada and to assess their association with dietary quality. Application of a classification of foodstuffs based on the nature, extent and purpose of food processing to data from a national household food budget survey. Foods are classified as unprocessed/minimally processed foods (Group 1), processed culinary ingredients (Group 2) or ultra-processed products (Group 3). All provinces and territories of Canada, 2001. Households (n 5643). Food purchases provided a mean per capita energy availability of 8908 (se 81) kJ/d (2129 (se 19) kcal/d). Over 61·7 % of dietary energy came from ultra-processed products (Group 3), 25·6 % from Group 1 and 12·7 % from Group 2. The overall diet exceeded WHO upper limits for fat, saturated fat, free sugars and Na density, with less fibre than recommended. It also exceeded the average energy density target of the World Cancer Research Fund/American Institute for Cancer Research. Group 3 products taken together are more fatty, sugary, salty and energy-dense than a combination of Group 1 and Group 2 items. Only the 20 % lowest consumers of ultra-processed products (who consumed 33·2 % of energy from these products) were anywhere near reaching all nutrient goals for the prevention of obesity and chronic non-communicable diseases. The 2001 Canadian diet was dominated by ultra-processed products. As a group, these products are unhealthy. The present analysis indicates that any substantial improvement of the diet would involve much lower consumption of ultra-processed products and much higher consumption of meals and dishes prepared from minimally processed foods and processed culinary ingredients.

  9. "From this place and of this place:" climate change, sense of place, and health in Nunatsiavut, Canada.

    Science.gov (United States)

    Cunsolo Willox, Ashlee; Harper, Sherilee L; Ford, James D; Landman, Karen; Houle, Karen; Edge, Victoria L

    2012-08-01

    As climate change impacts are felt around the globe, people are increasingly exposed to changes in weather patterns, wildlife and vegetation, and water and food quality, access and availability in their local regions. These changes can impact human health and well-being in a variety of ways: increased risk of foodborne and waterborne diseases; increased frequency and distribution of vector-borne disease; increased mortality and injury due to extreme weather events and heat waves; increased respiratory and cardiovascular disease due to changes in air quality and increased allergens in the air; and increased susceptibility to mental and emotional health challenges. While climate change is a global phenomenon, the impacts are experienced most acutely in place; as such, a sense of place, place-attachment, and place-based identities are important indicators for climate-related health and adaptation. Representing one of the first qualitative case studies to examine the connections among climate change, a changing sense of place, and health in an Inuit context, this research draws data from a multi-year community-driven case study situated in the Inuit community of Rigolet, Nunatsiavut, Canada. Data informing this paper were drawn from the narrative analysis of 72 in-depth interviews conducted from November 2009 to October 2010, as well as from the descriptive analysis of 112 questionnaires from a survey in October 2010 (95% response rate). The findings illustrated that climate change is negatively affecting feelings of place attachment by disrupting hunting, fishing, foraging, trapping, and traveling, and changing local landscapes-changes which subsequently impact physical, mental, and emotional health and well-being. These results also highlight the need to develop context-specific climate-health planning and adaptation programs, and call for an understanding of place-attachment as a vital indicator of health and well-being and for climate change to be framed as an

  10. Housing Characteristics and their Influence on Health-Related Quality of Life in Persons Living with HIV in Ontario, Canada: Results from the Positive Spaces, Healthy Places Study

    OpenAIRE

    Rourke, Sean B.; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W.; Dunn, James; Hambly, Keith

    2012-01-01

    Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and...

  11. SHEAR Kit case study : ConocoPhillips Canada leverages technology for health, safety and environmental operations to improve program effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Hayter, J. [Pangaea Systems Inc., Calgary, AB (Canada)

    2003-07-01

    This PowerPoint presentation outlined the elements of an automated safety program that Pangaea Systems Inc. has provided to ConocoPhillips Canada Ltd. SHEAR is a web-based computer application that centralizes health, safety and environment documentation to enable better reporting and improved business analysis of management involvement; hazard identification and risk control; rules and work procedures; training; communication; and, incident and accident reporting and investigation. SHEAR collects findings from audits, site inspections, safety meetings, hazards and risks, and accidents. Its purpose is to identify, classify and better understand events and to develop a process for remedial action. This presentation described SHEAR's incident severity potential index, the incident reporting process, and the elements of the management system. 8 figs.

  12. The precarious supply of physical therapists across Canada: exploring national trends in health human resources (1991 to 2005

    Directory of Open Access Journals (Sweden)

    Ricketts Thomas C

    2007-09-01

    Full Text Available Abstract Background Health Human Resource (HHR ratios are one measure of workforce supply, and are often expressed as a ratio in the number of health professionals to a sub-set of the population. In this study, we explore national trends in HHR among physical therapists (PTs across Canada. Methods National population data were combined with provincial databases of registered physical therapists in order to estimate the HHR ratio in 2005, and to establish trends between 1991 and 2005. Results The national HHR ratio was 4.3 PTs per 10,000 population in 1991, which increased to 5.0 by 2000. In 2005, the HHR ratios varied widely across jurisdictions; however, we estimate that the national average dropped to 4.8 PTs per 10,000. Although the trend in HHR between 1991 and 2005 suggests positive growth of 11.6%, we have found negative growth of 4.0% in the latter 5-years of this study period. Conclusion Demand for rehabilitation services is projected to escalate in the next decade. Identifying benchmarks or targets regarding the optimal number of PTs, along with other health professionals working within inter professional teams, is necessary to establish a stable supply of health providers to meet the emerging rehabilitation and mobility needs of an aging and increasingly complex Canadian population.

  13. Second opinion: what's wrong with Canada's health care system and how to fix it

    National Research Council Canada - National Science Library

    Kushner, Carol; Rachlis, Michael L

    1989-01-01

    .... Authors call for a reduction in public spending on hospital beds and doctors and a redirection of public funds towards cheaper forms of health care such as home-care, community-based health clinics...

  14. 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.

  15. Evaluation of the ability of standardized supports to improve public health response to syndromic surveillance for respiratory diseases in Canada

    Directory of Open Access Journals (Sweden)

    Laura A. Rivera

    2017-02-01

    Full Text Available Abstract Background Despite widespread implementation of syndromic surveillance systems within public health agencies, previous studies of the implementation and use of these systems have indicated that the functions and responses taken in response to syndromic surveillance data vary widely according to local context and preferences. The objective of the Syndromic Surveillance Evaluation Study was to develop and implement standardized supports in local public health agencies in Ontario, Canada, and evaluate the ability of these supports to affect actions taken as part of public health communicable disease control programs. Methods Local public health agencies (LPHA in Ontario, which used syndromic surveillance based on emergency department visits for respiratory disease, were recruited and randomly allocated to the study intervention or control group. The intervention group health agencies received standardized supports in terms of a standardized aberrant event detection algorithm and a response protocol dictating steps to investigate and assess the public health significance of syndromic surveillance alerts. The control group continued with their pre-existing syndromic surveillance infrastructure and processes. Outcomes were assessed using logbooks, which collected quantitative and qualitative information about alerts received, investigation steps taken, and public health responses. The study was conducted prospectively for 15 months (October 2013 to February 2015. Results Fifteen LPHAs participated in the study (n = 9 intervention group, n = 6 control group. A total of 1,969 syndromic surveillance alerts were received by all LPHAs. Variations in the types and amount of responses varied by LPHA, in particularly differences were noted by the size of the health unit. Smaller health units had more challenges to both detect and mount a response to any alerts. LPHAs in the control group were more likely to declare alerts to have public

  16. Trends and structural shifts in health tourism: evidence from seasonal time-series data on health-related travel spending by Canada during 1970-2010.

    Science.gov (United States)

    Loh, Chung-Ping A

    2015-05-01

    There has been a growing interest in better understanding the trends and determinants of health tourism activities. While much of the expanding literature on health tourism offers theoretical or qualitative discussion, empirical evidences has been lacking. This study employs Canada's outbound health tourism activities as an example to examine the trends in health tourism and its association with changing domestic health care market characteristics. A time-series model that accounts for potential structural changes in the trend is employed to analyze the quarterly health-related travel spending series reported in the Balance of Payments Statistics (BOPS) during 1970-2010 (n = 156). We identified a structural shift point which marks the start of an accelerated growth of health tourism and a flattened seasonality in such activities. We found that the health tourism activities of Canadian consumers increase when the private investment in medical facilities declines or when the private MPI increases during the years following the structural-change. We discussed the possible linkage of the structural shift to the General Agreement on Trade in Services (GATS), which went into effect in January, 1995. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Does Adding Information on Toxic Constituents to Cigarette Pack Warnings Increase Smokers' Perceptions about the Health Risks of Smoking? A Longitudinal Study in Australia, Canada, Mexico, and the United States

    Science.gov (United States)

    Cho, Yoo Jin; Thrasher, James F.; Swayampakala, Kamala; Lipkus, Isaac; Hammond, David; Cummings, Kenneth Michael; Borland, Ron; Yong, Hua-Hie; Hardin, James W.

    2018-01-01

    Background: Health warning labels (HWLs) on cigarette packs in Australia, Canada, Mexico, and the United States include varying information about toxic cigarette smoke constituents and smoking-related health risks. HWL information changed more recently in Australia, Canada, and Mexico than in the United States. Aims: To investigate whether…

  18. Predictors of immigrant children's mental health in Canada: selection, settlement contingencies, culture, or all of the above?

    Science.gov (United States)

    Beiser, Morton; Goodwill, Alasdair M; Albanese, Patrizia; McShane, Kelly; Nowakowski, Matilda

    2014-05-01

    A previous publication from the New Canadian Children and Youth Study, a national study of immigrant children and youth in Canada, showed a gradient of levels of emotional distress with children from Hong Kong (HK) at the most severe end, Filipino children at the least severe, and children from the People's Republic of China (PRC) in between. Based on the premise that country of origin can be regarded as an index for differing immigration trajectories, the current study examines the extent to which arrival characteristics, resettlement contingencies and cultural factors account for country of origin variations in immigrant children's mental health. Arrival characteristics included child's age at arrival, parental education, parental fluency in English or French, and assistance from family at arrival. Resettlement contingencies included parental mental health, intra-familial conflict, settlement stress, separations from parents and child's age when mother started working outside the home. Cultural factors included one-child family composition and parenting styles. A national survey of 2,031 families with at least one child between the ages of 4 and 6 or 11 and 13 from HK, the PRC and the Philippines was conducted with the Person Most Knowledgeable (PMK) in snowball-generated samples in 6 different cities across Canada. Predictors of the dependent variable, emotional problems (EP), were examined in a hierarchical block regression analysis. EP was regressed on ethnic and country of origin group in model 1; arrival characteristics were added in model 2; resettlement contingencies in model 3 and cultural factors in model 4. The final set of predictor variables accounted for 19.3 % of the variance in EP scores among the younger cohort and 23.2 % in the older. Parental human and social capital variables accounted for only a small amount of the overall variance in EP, but there were statistically significant inverse relationships between EP and PMK fluency in English or

  19. Unikkaartuit: meanings of well-being, unhappiness, health, and community change among Inuit in Nunavut, Canada.

    Science.gov (United States)

    Kral, Michael J; Idlout, Lori; Minore, J Bruce; Dyck, Ronald J; Kirmayer, Laurence J

    2011-12-01

    Suicide among young Inuit in the Canadian Arctic is at an epidemic level. In order to understand the distress and well-being experienced in Inuit communities, a first step in understanding collective suicide, this qualitative study was designed. Fifty Inuit were interviewed in two Inuit communities in Nunavut, Canada, and questionnaires asking the same questions were given to 66 high school and college students. The areas of life investigated here were happiness and wellbeing, unhappiness, healing, and community and personal change. Three themes emerged as central to well-being: the family, talking/communication, and traditional Inuit cultural values and practices. The absence of these factors were most closely associated with unhappiness. Narratives about community and personal change were primarily about family, intergenerational segregation, an increasing population, more trouble in romantic relationships among youth, drug use, and poverty. Change over time was viewed primarily as negative. Discontinuity of kinship structure and function appears to be the most harmful effect of the internal colonialism imposed by the Canadian government in the 1950s and 1960s. Directions toward community control and action are encouraging, and are highlighted. Inuit community action toward suicide prevention and community wellness is part of a larger movement of Indigenous self-determination.

  20. Canadian Public Health Laboratory Network laboratory Guidelines for the Diagnosis of Neurosyphilis in Canada

    Directory of Open Access Journals (Sweden)

    Tom Wong

    2015-01-01

    Full Text Available Neurosyphilis refers to infection of the central nervous system by Treponema pallidum, which may occur at any stage. Neurosyphilis has been categorized in many ways including early and late, asymptomatic versus symptomatic and infectious versus non-infectious. Late neurosyphilis primarily affects the central nervous system parenchyma, and occurs beyond early latent syphilis, years to decades after the initial infection. Associated clinical syndromes include general paresis, tabes dorsalis, vision loss, hearing loss and psychiatric manifestations. Unique algorithms are recommended for HIV-infected and HIV-uninfected patients, as immunocompromised patients may present with serologic and cerebrospinal fluid findings that are different from immunocompetent hosts. Antibody assays include a VDRL assay and the FTA-Abs, while polymerase chain reaction for T. pallidum can be used as direct detection assays for some specimens. This chapter reviews guidelines for specimen types and sample collection, and identifies two possible algorithms for use with immunocompromised and immunocompetent hosts using currently available tests in Canada, along with a review of treatment response and laboratory testing follow-up.

  1. Positioning pharmacists' roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada.

    Science.gov (United States)

    Hughes, Christine A; Breault, Rene R; Hicks, Deborah; Schindel, Theresa J

    2017-11-23

    A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists' roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists' Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists' roles were constructed in communications about the Compensation Plan. In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists' changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists' roles as: (1) expanding to include services such as medication management for chronic diseases, (2) contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3) collaborating with other health care team members. Pharmacists' changing roles were positioned in alignment with the

  2. Positioning pharmacists’ roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada

    Directory of Open Access Journals (Sweden)

    Christine A. Hughes

    2017-11-01

    Full Text Available Abstract Background A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists’ roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Methods Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists’ Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists’ roles were constructed in communications about the Compensation Plan. Results In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists’ changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists’ roles as: (1 expanding to include services such as medication management for chronic diseases, (2 contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3 collaborating with other health care team members

  3. Making the links: do we connect climate change with health? A qualitative case study from Canada.

    Science.gov (United States)

    Cardwell, Francesca S; Elliott, Susan J

    2013-03-08

    Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public's views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change. Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change. Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours. The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the

  4. Fusion Canada

    International Nuclear Information System (INIS)

    1987-07-01

    This first issue of a quarterly newsletter announces the startup of the Tokamak de Varennes, describes Canada's national fusion program, and outlines the Canadian Fusion Fuels Technology Program. A map gives the location of the eleven principal fusion centres in Canada. (L.L.)

  5. Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for indigenous populations in Canada.

    Science.gov (United States)

    Smylie, Janet; Firestone, Michelle

    Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations.

  6. The influence of perceived discrimination, sense of control, self-esteem and multiple discrepancies on the mental health and subjective well-being in Serbian immigrants in Canada

    Directory of Open Access Journals (Sweden)

    Vukojević Vesna

    2016-01-01

    Full Text Available The study focuses on the mental health and subjective well-being (SWB of Serbian immigrants of the first generation in Canada. We wanted to examine if perceived discrimination, sense of control, self-esteem and perceived multiple discrepancy affect their mental health and SWB. Our results indicate that self-esteem and sense of control have a positive effect on mental health and all aspects of the SWB, while the perceived discrimination and perceived multiple discrepancy negatively affect SWB and mental health. Self-esteem was the most salient predictor of mental health, while the perceived multiple discrepancy was the most salient predictor of life satisfaction of Serbian immigrants.

  7. Chronic fatigue syndrome and fibromyalgia in Canada: prevalence and associations with six health status indicators

    Directory of Open Access Journals (Sweden)

    C. Rusu

    2015-03-01

    Full Text Available Introduction: Few studies have considered the factors independently associated with chronic fatigue syndrome (CFS and/or fibromyalgia (FM or considered the impact of these conditions on health status using population-based data. Methods: We used data from the nationally representative 2010 Canadian Community Health Survey (n= 59 101 to describe self-reported health professional-diagnosed CFS and/or FM, and their associations with 6 health status indicators. Results: In 2010, diagnosed CFS and FM are reported by 1.4% (95% confidence interval [CI]: 1.3%–1.6% and 1.5% (1.4%–1.7%, respectively, of the Canadian household population aged 12 years and over, with comorbid CFS and FM affecting 0.3% (0.3%–0.4% of that population. Prevalent CFS and/or FM were more common among women, adults aged 40 years and over, those with lowest income, and those with certain risk factors for chronic disease (i.e. obesity, physical inactivity and smoking. After controlling for differences between the groups, people with CFS and/or FM reported poorer health status than those with neither condition on 5 indicators of health status, but not on the measure of fair/poor mental health. Having both CFS and FM and having multiple comorbid conditions was associated with poorer health status. Conclusion: Co-occurrence of CFS and FM and having other chronic conditions were strongly related to poorer health status and accounted for much of the differences in health status. Understanding factors contributing to improved quality of life in people with CFS and/or FM, particularly in those with both conditions and other comorbidities, may be an important area for future research.

  8. Do "Virtual" and "Outpatient" Public Health Tuberculosis Clinics Perform Equally Well? A Program-Wide Evaluation in Alberta, Canada.

    Directory of Open Access Journals (Sweden)

    Richard Long

    Full Text Available Meeting the challenge of tuberculosis (TB elimination will require adopting new models of delivering patient-centered care customized to diverse settings and contexts. In areas of low incidence with cases spread out across jurisdictions and large geographic areas, a "virtual" model is attractive. However, whether "virtual" clinics and telemedicine deliver the same outcomes as face-to-face encounters in general and within the sphere of public health in particular, is unknown. This evidence is generated here by analyzing outcomes between the "virtual" and "outpatient" public health TB clinics in Alberta, a province of Western Canada with a large geographic area and relatively small population.In response to the challenge of delivering equitable TB services over long distances and to hard to reach communities, Alberta established three public health clinics for the delivery of its program: two outpatient serving major metropolitan areas, and one virtual serving mainly rural areas. The virtual clinic receives paper-based or electronic referrals and generates directives which are acted upon by local providers. Clinics are staffed by dedicated public health nurses and university-based TB physicians. Performance of the two types of clinics is compared between the years 2008 and 2012 using 16 case management and treatment outcome indicators and 12 contact management indicators.In the outpatient and virtual clinics, respectively, 691 and 150 cases and their contacts were managed. Individually and together both types of clinics met most performance targets. Compared to outpatient clinics, virtual clinic performance was comparable, superior and inferior in 22, 3, and 3 indicators, respectively.Outpatient and virtual public health TB clinics perform equally well. In low incidence settings a combination of the two clinic types has the potential to address issues around equitable service delivery and declining expertise.

  9. Risk - a symposium on the assessment and perception of risk to human health in Canada. Proceedings

    International Nuclear Information System (INIS)

    Rogers, J.T.; Bates, D.V.

    1983-04-01

    The central concern in this Symposium is with risk to human health and life. Health risk includes the possibility of deaths (mortality), either immediate or delayed, and less severe health effects due to injury and illness (morbidity). Risk is defined as the product of the magnitude and the probability so that where it may be expressed quantitatively it is stated in units of harm per unit time (e.g. deaths per year or deaths per year per million of population). The 15 papers presented at this conference discuss the measurement, analysis perception, and management of risk. Six papers judged to be in scope were indexed for INIS

  10. Social space, social class and Bourdieu: health inequalities in British Columbia, Canada.

    Science.gov (United States)

    Veenstra, Gerry

    2007-03-01

    This article adopts Pierre Bourdieu's cultural-structuralist approach to conceptualizing and identifying social classes in social space and seeks to identify health effects of class in one Canadian province. Utilizing data from an original questionnaire survey of randomly selected adults from 25 communities in British Columbia, social (class) groupings defined by cultural tastes and dispositions, lifestyle practices, social background, educational capital, economic capital, social capital and occupational categories are presented in visual mappings of social space constructed by use of exploratory multiple correspondence analysis techniques. Indicators of physical and mental health are then situated within this social space, enabling speculations pertaining to health effects of social class in British Columbia.

  11. Reforming health care in Canada: current issues La reforma del sistema de atención a la salud en Canadá: situación actual

    OpenAIRE

    Enis Baris

    1998-01-01

    This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government’s clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among sta...

  12. The perceived impact of location privacy: A web-based survey of public health perspectives and requirements in the UK and Canada

    Directory of Open Access Journals (Sweden)

    Boulos Maged

    2008-05-01

    Full Text Available Abstract Background The "place-consciousness" of public health professionals is on the rise as spatial analyses and Geographic Information Systems (GIS are rapidly becoming key components of their toolbox. However, "place" is most useful at its most precise, granular scale – which increases identification risks, thereby clashing with privacy issues. This paper describes the views and requirements of public health professionals in Canada and the UK on privacy issues and spatial data, as collected through a web-based survey. Methods Perceptions on the impact of privacy were collected through a web-based survey administered between November 2006 and January 2007. The survey targeted government, non-government and academic GIS labs and research groups involved in public health, as well as public health units (Canada, ministries, and observatories (UK. Potential participants were invited to participate through personally addressed, standardised emails. Results Of 112 invitees in Canada and 75 in the UK, 66 and 28 participated in the survey, respectively. The completion proportion for Canada was 91%, and 86% for the UK. No response differences were observed between the two countries. Ninety three percent of participants indicated a requirement for personally identifiable data (PID in their public health activities, including geographic information. Privacy was identified as an obstacle to public health practice by 71% of respondents. The overall self-rated median score for knowledge of privacy legislation and policies was 7 out of 10. Those who rated their knowledge of privacy as high (at the median or above also rated it significantly more severe as an obstacle to research (P Conclusion The clash between PID requirements – including granular geography – and limitations imposed by privacy and its associated bureaucracy require immediate attention and solutions, particularly given the increasing utilisation of GIS in public health. Solutions

  13. Lifetime Doctor-Diagnosed Mental Health Conditions and Current Substance Use Among Gay and Bisexual Men Living in Vancouver, Canada.

    Science.gov (United States)

    Lachowsky, Nathan J; Dulai, Joshun J S; Cui, Zishan; Sereda, Paul; Rich, Ashleigh; Patterson, Thomas L; Corneil, Trevor T; Montaner, Julio S G; Roth, Eric A; Hogg, Robert S; Moore, David M

    2017-05-12

    Studies have found that gay, bisexual, and other men who have sex with men (GBM) have higher rates of mental health conditions and substance use than heterosexual men, but are limited by issues of representativeness. To determine the prevalence and correlates of mental health disorders among GBM in Metro Vancouver, Canada. From 2012 to 2014, the Momentum Health Study recruited GBM (≥16 years) via respondent-driven sampling (RDS) to estimate population parameters. Computer-assisted self-interviews (CASI) collected demographic, psychosocial, and behavioral information, while nurse-administered structured interviews asked about mental health diagnoses and treatment. Multivariate logistic regression using manual backward selection was used to identify covariates for any lifetime doctor diagnosed: (1) alcohol/substance use disorder and (2) any other mental health disorder. Of 719 participants, 17.4% reported a substance use disorder and 35.2% reported any other mental health disorder; 24.0% of all GBM were currently receiving treatment. A lifetime substance use disorder diagnosis was negatively associated with being a student (AOR = 0.52, 95% CI [confidence interval]: 0.27-0.99) and an annual income ≥$30,000 CAD (AOR = 0.38, 95% CI: 0.21-0.67) and positively associated with HIV-positive serostatus (AOR = 2.54, 95% CI: 1.63-3.96), recent crystal methamphetamine use (AOR = 2.73, 95% CI: 1.69-4.40) and recent heroin use (AOR = 5.59, 95% CI: 2.39-13.12). Any other lifetime mental health disorder diagnosis was negatively associated with self-identifying as Latin American (AOR = 0.25, 95% CI: 0.08-0.81), being a refugee or visa holder (AOR = 0.18, 95% CI: 0.05-0.65), and living outside Vancouver (AOR = 0.52, 95% CI: 0.33-0.82), and positively associated with abnormal anxiety symptomology scores (AOR = 3.05, 95% CI: 2.06-4.51). Mental health conditions and substance use, which have important implications for clinical and public health practice, were highly prevalent and co-occurring.

  14. Call for proposals for the Joint Canada-Israel Health Research ...

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

    2017-11-23

    Nov 23, 2017 ... ... cellular and molecular basis of cognition; modeling brain function; imaging ... a range of activities supporting the research and training objectives of the ... Innovation Fund—managed by the Department of Health and Social ...

  15. Nurse leaders' experiences of implementing regulatory changes in sexual health nursing practice in British Columbia, Canada.

    Science.gov (United States)

    Bungay, Vicky; Stevenson, Janine

    2013-05-01

    Most research about regulatory policy change concerning expanded nursing activities has emphasized advanced practice roles and acute care settings. This study is a contribution to the small pool of research concerned with regulatory policy implementation for nurses undertaking expanded nursing practice activities in a public health context. Using the regulatory changes in certified nursing practice in one Canadian province as our starting point, we investigated the experiences of nurse leaders in implementing this change. Using a qualitative interpretive descriptive approach informed by tenets of complexity theory, we examined the experiences of 16 nurse leaders as situated within the larger public health care system in which nurses practice. Two interrelated themes, (a) preparing for certification and (b) the certification process, were identified to illustrate how competing and contrasting demands between health care and regulatory organizations created substantial barriers to policy change. Implications for health service delivery and future research are discussed.

  16. The emergence of precision therapeutics: New challenges and opportunities for Canada's health leaders.

    Science.gov (United States)

    Slater, Jim; Shields, Laura; Racette, Ray J; Juzwishin, Donald; Coppes, Max

    2015-11-01

    In the era of personalized and precision medicine, the approach to healthcare is quickly changing. Genetic and other molecular information are being increasingly demanded by clinicians and expected by patients for prevention, screening, diagnosis, prognosis, health promotion, and treatment of an increasing number of conditions. As a result of these developments, Canadian health leaders must understand and be prepared to lead the necessary changes associated with these disruptive technologies. This article focuses on precision therapeutics but also provides background on the concepts and terminology related to personalized and precision medicine and explores Canadian health leadership and system issues that may pose barriers to their implementation. The article is intended to inspire, educate, and mobilize Canadian health leaders to initiate dialogue around the transformative changes necessary to ready the healthcare system to realize the benefits of precision therapeutics. © 2015 Collège canadien des leaders en santé

  17. Internal Variations in Health-care Federalism in Canada and the United States

    Directory of Open Access Journals (Sweden)

    Vandna Bhatia

    2014-12-01

    Full Text Available Federal systems are prone to dividing health benefits inconsistently across subnational jurisdictions. In this article, we examine how federalism intersects with economic and social factors, particularly gender and immigration status, to create structural barriers to accessing and receiving necessary healthcare. Drawing on insights from the historical institutionalist literature and the experiences of immigrant women in the Canadian and American health systems, we find significant subnational variations in access to health services and insurance coverage. Gaps in service – which are filled (if at all by costly, inaccessible private provision – are the product of piecemeal policymaking, as new programs and services are layered onto existing systems which are themselves outdated and anachronistic. Our analysis demonstrates the need to move beyond analyses of federal state architectures to an intersectional approach to better understand the differential negative impact of subnational variations on equity between social groups and their ability to access to basic health services.

  18. Teenage pregnancy and long-term mental health outcomes among Indigenous women in Canada.

    Science.gov (United States)

    Xavier, Chloé G; Brown, Hilary K; Benoit, Anita C

    2017-11-22

    Our objectives were to (1) compare the risks for poor long-term mental health outcomes among indigenous women with and without a teenage pregnancy and (2) determine if community and cultural factors modify this risk. We conducted a secondary analysis of the 2012 Aboriginal Peoples Survey. Respondents were women aged 25 to 49 years who had given birth to at least one child. Teenage mothers (age at first birth 13 to 19 years; n = 1330) were compared to adult mothers (age at first birth 20 years or older; n = 2630). Mental health outcomes were psychological distress, mental health status, suicide ideation/attempt, and alcohol consumption. To address objective 1, we used binary logistic regression analyses before and after controlling for covariates. To address objective 2, we tested the significance of interaction terms between teenage pregnancy status and effect measure modifiers. In unadjusted analyses, teenage pregnancy was associated with increased risk for poor/fair mental health [odds ratio (OR) 1.77, 95% confidence interval (CI) 1.24-2.53] and suicide attempt/ideation (OR 1.95, 95% CI 1.07-3.54). However, the associations were not statistically significant after adjusting for demographic, socioeconomic, environmental, and health covariates. Teenage pregnancy was not associated with increased risk for high psychological distress or heavy alcohol consumption in unadjusted or adjusted analyses. The interaction term for involvement in cultural activities was statistically significant for poor/fair mental health; however, after stratification, ORs were non-significant. Among indigenous mothers, teenage pregnancy was less important than broader social and health circumstances in predicting long-term mental health.

  19. Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

    Science.gov (United States)

    Veale, Jaimie F.; Peter, Tracey; Travers, Robb; Saewyc, Elizabeth M.

    2017-01-01

    Abstract Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual online survey. Logistic regression models were conducted to analyze the relationship between these risk and protective factors and dichotomous mental health outcomes among two separate age groups, 14- to 18-year-old and 19- to 25-year-old participants. Results: Experiences of discrimination, harassment, and violence (enacted stigma) were positively related to mental health problems and social support was negatively associated with mental health problems in all models among both age groups. Among 14–18 year olds, we examined school connectedness, family connectedness, and perception of friends caring separately, and family connectedness was always the strongest protective predictor in multivariate models. In all the mental health outcomes we examined, transgender youth reporting low levels of enacted stigma experiences and high levels of protective factors tended to report favorable mental health outcomes. Conversely, the majority of participants reporting high levels of enacted stigma and low levels of protective factors reported adverse mental health outcomes. Conclusion: While these findings are limited by nonprobability sampling procedures and potential additional unmeasured risk and protective factors, the results provide positive evidence for the Minority Stress Model in this population and affirm the need for policies and programs to support schools and families to support transgender youth. PMID:29279875

  20. Enacted Stigma, Mental Health, and Protective Factors Among Transgender Youth in Canada

    OpenAIRE

    Veale, Jaimie F.; Peter, Tracey; Travers, Robb; Saewyc, Elizabeth M.

    2017-01-01

    Abstract Purpose: We aimed to assess the Minority Stress Model which proposes that the stress of experiencing stigma leads to adverse mental health outcomes, but social supports (e.g., school and family connectedness) will reduce this negative effect. Methods: We measured stigma-related experiences, social supports, and mental health (self-injury, suicide, depression, and anxiety) among a sample of 923 Canadian transgender 14- to 25-year-old adolescents and young adults using a bilingual onli...

  1. Making the links: do we connect climate change with health? A qualitative case study from Canada

    OpenAIRE

    Cardwell, Francesca S; Elliott, Susan J

    2013-01-01

    Background Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an ...

  2. 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.

  3. Effect of incentive payments on chronic disease management and health services use in British Columbia, Canada: Interrupted time series analysis.

    Science.gov (United States)

    Lavergne, M Ruth; Law, Michael R; Peterson, Sandra; Garrison, Scott; Hurley, Jeremiah; Cheng, Lucy; McGrail, Kimberlyn

    2018-02-01

    We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods. We observed no increases in primary care visits or continuity of care after incentives were introduced. Rates of ACR testing and antihypertensive dispensing increased among patients with hypertension, but none of the other modest increases in laboratory testing or prescriptions dispensed reached statistical significance. Rates of hospitalizations for stroke and heart failure among patients with hypertension fell relative to pre-intervention patterns, while hospitalizations for COPD increased. Total hospitalizations and hospitalizations via the emergency department did not change. Health care spending increased for patients with hypertension. This large-scale incentive scheme for primary care physicians showed some positive effects for patients with hypertension, but we observe no similar changes in patient management, reductions in hospitalizations, or changes in spending for patients with diabetes and COPD. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  4. The use of 'arms-length' organizations for health system change in Ontario, Canada: some observations by insiders.

    Science.gov (United States)

    Pink, George H; Leatt, Peggy

    2003-01-01

    During the past decade, there has been substantial health system reform in the United States, United Kingdom, New Zealand, and many other countries. For the most part, Canada has not pursued 'big bang' health system change but rather a variety of strategies to achieve incremental change. In this paper, we present the ways in which three arms-length organizations have been used by government to effect incremental system change in Ontario during the past several years. We observe that, (1) the influence of politics and political interference can be reduced through an arms-length organization; (2) an arms-length organization with the power to make decisions entails more political risk for government and encounters more scrutiny and criticism by providers and the media than an organization with the power to recommend only; (3) an arms-length organization with a limited lifespan faces more delaying tactics by adversely affected parties than an organization without a limited lifespan; (4) an arms-length organization with perceived influence may attract causes that are not related to its mandate; (5) the importance and difficulty of communicating complex information about system change to a wide variety of audiences cannot be overstated; (6) system change informed by the use of expert opinion encounters less provider resistance and may result in better decisions; and (7) the reputation of the Chair and the perceived competence and experience of the CEO are critical success factors in the success of an arms-length organization.

  5. Learning reflexively from a health promotion professional development program in Canada.

    Science.gov (United States)

    Tremblay, Marie-Claude; Richard, Lucie; Brousselle, Astrid; Beaudet, Nicole

    2014-09-01

    In recent decades, reflexivity has received much attention in the professional education and training literature, especially in the public health and health promotion fields. Despite general agreement on the importance of reflexivity, there appears to be no consensus on how to assess reflexivity or to conceptualize the different forms developed among professionals and participants of training programs. This paper presents an analysis of the reflexivity outcomes of the Health Promotion Laboratory, an innovative professional development program aimed at supporting practice changes among health professionals by fostering competency development and reflexivity. More specifically, this paper explores the difference between two levels of reflexivity (formative and critical) and highlights some implications of each for practice. Data were collected through qualitative interviews with participants from two intervention sites. Results showed that involvement in the Health Promotion Laboratory prompted many participants to modify their vision of their practice and professional role, indicating an impact on reflexivity. In many cases, new understandings seem to have played a formative function in enabling participants to improve their practice and their role as health promoters. The reflective process also served a critical function culminating in a social and moral understanding of the impacts on society of the professionals' practices and roles. This type of outcome is greatly desired in health promotion, given the social justice and equity concerns of this field of practice. By redefining the theoretical concept of reflexivity on two levels and discussing their impacts on practice, this study supports the usefulness of both levels of reflexivity. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Taking ad-Vantage of lax advertising regulation in the USA and Canada: reassuring and distracting health-concerned smokers.

    Science.gov (United States)

    Anderson, Stacey J; Pollay, Richard W; Ling, Pamela M

    2006-10-01

    We explored the evolution from cigarette product attributes to psychosocial needs in advertising campaigns for low-tar cigarettes. Analysis of previously secret tobacco industry documents and print advertising images indicated that low-tar brands targeted smokers who were concerned about their health with advertising images intended to distract them from the health hazards of smoking. Advertising first emphasized product characteristics (filtration, low tar) that implied health benefits. Over time, advertising emphasis shifted to salient psychosocial needs of the target markets. A case study of Vantage cigarettes in the USA and Canada showed that advertising presented images of intelligent, upward-striving people who had achieved personal success and intentionally excluded the act of smoking from the imagery, while minimal product information was provided. This illustrates one strategy to appeal to concerned smokers by not describing the product itself (which may remind smokers of the problems associated with smoking), but instead using evocative imagery to distract smokers from these problems. Current advertising for potential reduced-exposure products (PREPs) emphasizes product characteristics, but these products have not delivered on the promise of a healthier alternative cigarette. Our results suggest that the tobacco control community should be on the alert for a shift in advertising focus for PREPs to the image of the user rather than the cigarette. Global Framework Convention on Tobacco Control-style advertising bans that prohibit all user imagery in tobacco advertising could preempt a psychosocial needs-based advertising strategy for PREPs and maintain public attention on the health hazards of smoking.

  7. Health impacts of the July 2010 heat wave in Québec, Canada.

    Science.gov (United States)

    Bustinza, Ray; Lebel, Germain; Gosselin, Pierre; Bélanger, Diane; Chebana, Fateh

    2013-01-21

    One of the consequences of climate change is the increased frequency and intensity of heat waves which can cause serious health impacts. In Québec, July 2010 was marked by an unprecedented heat wave in recent history. The purpose of this study is to estimate certain health impacts of this heat wave. The crude daily death and emergency department admission rates during the heat wave were analyzed in relation to comparison periods using 95% confidence intervals. During the heat wave, the crude daily rates showed a significant increase of 33% for deaths and 4% for emergency department admissions in relation to comparison periods. No displacement of mortality was observed over a 60-day horizon. The all-cause death indicator seems to be sufficiently sensitive and specific for surveillance of exceedences of critical temperature thresholds, which makes it useful for a heat health-watch system. Many public health actions combined with the increased use of air conditioning in recent decades have contributed to a marked reduction in mortality during heat waves. However, an important residual risk remains, which needs to be more vigorously addressed by public health authorities in light of the expected increase in the frequency and severity of heat waves and the aging of the population.

  8. Health impacts of the July 2010 heat wave in Québec, Canada

    Directory of Open Access Journals (Sweden)

    Bustinza Ray

    2013-01-01

    Full Text Available Abstract Background One of the consequences of climate change is the increased frequency and intensity of heat waves which can cause serious health impacts. In Québec, July 2010 was marked by an unprecedented heat wave in recent history. The purpose of this study is to estimate certain health impacts of this heat wave. Methods The crude daily death and emergency department admission rates during the heat wave were analyzed in relation to comparison periods using 95% confidence intervals. Results During the heat wave, the crude daily rates showed a significant increase of 33% for deaths and 4% for emergency department admissions in relation to comparison periods. No displacement of mortality was observed over a 60-day horizon. Conclusions The all-cause death indicator seems to be sufficiently sensitive and specific for surveillance of exceedences of critical temperature thresholds, which makes it useful for a heat health-watch system. Many public health actions combined with the increased use of air conditioning in recent decades have contributed to a marked reduction in mortality during heat waves. However, an important residual risk remains, which needs to be more vigorously addressed by public health authorities in light of the expected increase in the frequency and severity of heat waves and the aging of the population.

  9. Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

    2015-01-01

    Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

  10. Participatory methods for Inuit public health promotion and programme evaluation in Nunatsiavut, Canada.

    Science.gov (United States)

    Saini, Manpreet

    2017-01-01

    Engaging stakeholders is crucial for health promotion and programme evaluations; understanding how to best engage stakeholders is less clear, especially within Indigenous communities. The objectives of this thesis research were to use participatory methods to: (1) co-develop and evaluate a whiteboard video for use as a public health promotion tool in Rigolet, Nunatsiavut, and (2) develop and validate a framework for participatory evaluation of Inuit public health initiatives in Nunatsiavut, Labrador. Data collection tools included interactive workshops, community events, interviews, focus-group discussions and surveys. Results indicated the whiteboard video was an engaging and suitable medium for sharing public health messaging due to its contextually relevant elements. Participants identified 4 foundational evaluation framework components necessary to conduct appropriate evaluations, including: (1) community engagement, (2) collaborative evaluation development, (3) tailored evaluation data collection and (4) evaluation scope. This research illustrates stakeholder participation is critical to develop and evaluate contextually relevant public health initiatives in Nunatsiavut, Labrador and should be considered in other Indigenous communities.

  11. Acculturation, gender, and mental health of Southeast Asian immigrant youth in Canada.

    Science.gov (United States)

    Hilario, Carla T; Vo, Dzung X; Johnson, Joy L; Saewyc, Elizabeth M

    2014-12-01

    The relationships between mental health, protective factors and acculturation among Southeast Asian youth were examined in this study using a gender-based analysis. Population-based data from the 2008 British Columbia Adolescent Health Survey were used to examine differences in extreme stress and despair by acculturation. Associations between emotional distress and hypothesized protective factors were examined using logistic regression. Stratified analyses were performed to assess gender-related differences. Recent immigrant youth reported higher odds of emotional distress. Family connectedness and school connectedness were linked to lower odds of extreme stress and despair among girls. Family connectedness was associated with lower odds of extreme stress and despair among boys. Higher cultural connectedness was associated with lower odds of despair among boys but with higher odds of extreme stress among girls. Findings are discussed in relation to acculturation and gender-based patterns in protective factors for mental health among Southeast Asian immigrant youth.

  12. Meanings of Food, Eating and Health in Punjabi Families Living in Vancouver, Canada

    Science.gov (United States)

    Chapman, Gwen E; Ristovski-Slijepcevic, Svetlana; Beagan, Brenda L

    2011-01-01

    Objective: South Asians living in western countries have increased risk for developing diet-related chronic disease compared to Caucasians of European heritage. To increase understanding of social and cultural factors associated with their food habits, this study examined the meanings of food, health and well-being embedded in the food practices…

  13. Continuing education for primary health care nurse practitioners in Ontario, Canada.

    Science.gov (United States)

    Baxter, Pamela; DiCenso, Alba; Donald, Faith; Martin-Misener, Ruth; Opsteen, Joanne; Chambers, Tracey

    2013-04-01

    The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Canada's residential school system: measuring the intergenerational impact of familial attendance on health and mental health outcomes.

    Science.gov (United States)

    Hackett, Christina; Feeny, David; Tompa, Emile

    2016-11-01

    We estimate the intergenerational relationship between the residential school (RS) attendance of an older generation family member and the physical and mental health of a younger generation. Data from the 2012 Aboriginal Peoples Survey (APS) is used to examine the relationship between previous generational family RS attendance and the current physical and mental health of off-reserve First Nations, Métis and Inuit Canadians. Five outcomes are considered (self-perceived health, mental health, distress, suicidal ideation and suicide attempt). Direct (univariate) and indirect (multivariate) effects of family RS attendance are examined for each dependent variable. We draw from the general and indigenous-specific social determinants of health literature to inform the construction of our models. Familial RS attendance is shown to affect directly all five health and mental health outcomes, and is associated with lower self-perceived health and mental health, and a higher risk for distress and suicidal behaviours. Background, mediating and structural-level variables influence the strength of association. Odds of being in lower self-perceived health remain statistically significantly higher with the presence of familial attendance of RS when controlling for all covariates. The odds of having had a suicide attempt within the past 12 months remain twice as high for those with familial attendance of RS. Health disparities exist between indigenous and non-indigenous Canadians, an important source of which is a family history of RS attendance. This has implications for clinical practice and Canadian public health, as well as countries with similar historical legacies. 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/.

  15. Health behaviours, body weight and self-esteem among grade five students in Canada.

    Science.gov (United States)

    Wu, Xiuyun; Kirk, Sara F L; Ohinmaa, Arto; Veugelers, Paul

    2016-01-01

    This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students. We analysed data from a population-based survey among 4918 grade five students, who are primarily 10 and 11 years of age, and their parents in the Canadian province of Nova Scotia. The survey comprised the Harvard Youth and Adolescent Questionnaire, parental reporting of students' physical activity (PA) and time spent watching television or using computer/video games. Students heights and weights were objectively measured. We applied principal component analysis (PCA) to derive the components of self-esteem, and multilevel, multivariable logistic regression to quantify associations of diet quality, PA, sedentary behaviour and body weight with these components of self-esteem. PCA identified four components for self-esteem: self-perception, externalizing problems, internalizing problems, social-perception. Influences of health behaviours and body weight on self-esteem varied across the components. Better diet quality was associated with higher self-perception and fewer externalizing problems. Less PA and more use of computer/video games were related to lower self-perception and social-perception. Excessive TV watching was associated with more internalizing problems. Students classified as obese were more likely to report low self- and social-perception, and to experience fewer externalizing problems relative to students classified as normal weight. This study demonstrates independent influences of diet quality, physical activity, sedentary behaviour and body weight on four aspects of self-esteem among children. These findings suggest that school programs and health promotion strategies that target health behaviours may benefit self-esteem in childhood, and mental health and quality of life later in life.

  16. Mental health of South Asian youth in Peel Region, Toronto, Canada: a qualitative study of determinants, coping strategies and service access

    Science.gov (United States)

    Multani, Amanpreet; Hynie, Michaela; Shakya, Yogendra; McKenzie, Kwame

    2017-01-01

    Objectives This qualitative study set out to understand the mental health challenges and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada. Setting In-depth semistructured interviews were carried out with South Asian youth living in Peel Region (Mississauga, Brampton and Caledon), a suburb of Toronto, Canada, home to over 50% of Ontario’s South Asian population. Participants South Asian youth (n=10) engaged in thoughtful, candid dialogue about their mental health and service access barriers. Primary and secondary outcome measures Qualitative interview themes related to mental health stressors and mental health service access barriers experienced by youth living in Peel Region were assessed using thematic analysis. Results South Asian youth face many mental health stressors, from intergenerational and cultural conflict, academic pressure, relationship stress, financial stress and family difficulties. These stressors can contribute to mental health challenges, such as depression and anxiety and drug use, with marijuana, alcohol and cigarettes cited as the most popular substances. South Asian youth were only able to identify about a third (36%) of the mental health resources presented to them and did not feel well informed about mental health resources available in their neighbourhood. Conclusions They offered recommendations for improved youth support directed at parents, education system, South Asian community and mental health system. Institutions and bodies at all levels of the society have a role to play in ensuring the mental health of South Asian youth. PMID:29101148

  17. Antecedents of open source software adoption in health care organizations: a qualitative survey of experts in Canada.

    Science.gov (United States)

    Marsan, Josianne; Paré, Guy

    2013-08-01

    Open source software (OSS) adoption and use in health care organizations (HCOs) is relatively low in developed countries, but several contextual factors have recently encouraged the consideration of the possible role of OSS in information technology (IT) application portfolios. This article aims at developing a research model for investigating the antecedents of OSS adoption decisions in HCOs. Based on a conceptual framework derived from a synthesis of the literature on IT adoption in organizations, we conducted 18 semi-structured interviews with IT experts from all levels of the Province of Quebec's health and social services sector in Canada. We also interviewed 10 IT suppliers in the province. A qualitative data analysis of the interviews was performed to identify major antecedents of OSS adoption decisions in HCOs. Eight factors associated with three distinct theoretical perspectives influence OSS adoption. More specifically, they are associated with the classical diffusion of innovations theory, the theory of resources, as well as institutional theory and its spin-off, the organizing vision theory. The factors fall under three categories: the characteristics of OSS as an innovation, the characteristics of the HCO with respect to its ability to absorb OSS, and the characteristics of the external environment with respect to institutional pressures and public discourse surrounding OSS. We shed light on two novel factors that closely interact with each other: (1) interest of the health care community in the public discourse surrounding OSS, and (2) clarity, consistency and richness of this discourse, whether found in magazines or other media. OSS still raises many questions and presents several challenges for HCOs. It is crucial that the different factors that explain an HCO's decision on OSS adoption be considered simultaneously. Doing so allows a better understanding of HCOs' rationale when deciding to adopt, or not to adopt, OSS. Copyright © 2013 Elsevier

  18. Collaborating to embrace evidence-informed management practices within Canada's health system.

    Science.gov (United States)

    Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

    2007-01-01

    In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

  19. Mental Health and Hospital Chaplaincy: Strategies of Self-Protection (Case Study: Toronto, Canada)

    OpenAIRE

    Kianpour, Masoud

    2013-01-01

    Objective: This is a study about emotion management among a category of healthcare professional – hospital chaplains – who have hardly been the subject of sociological research about emotions. The aim of the study was to understand how chaplains manage their work-related emotions in order to protect their mental health, whilst also providing spiritual care. Methods: Using in-depth, semi structured interviews, the author spoke with 21 chaplains from five faith traditions (Christianity, Islam, ...

  20. Enabling the participation of marginalized populations: case studies from a health service organization in Ontario, Canada.

    Science.gov (United States)

    Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R

    2017-08-01

    We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Mentoring Relationships and the Mental Health of Aboriginal Youth in Canada.

    Science.gov (United States)

    DeWit, David J; Wells, Samantha; Elton-Marshall, Tara; George, Julie

    2017-04-01

    We compared the mentoring experiences and mental health and behavioral outcomes associated with program-supported mentoring for 125 Aboriginal (AB) and 734 non-Aboriginal (non-AB) youth ages 6-17 participating in a national survey of Big Brothers Big Sisters community mentoring relationships. Parents or guardians reported on youth mental health and other outcomes at baseline (before youth were paired to a mentor) and at 18 months follow-up. We found that AB youth were significantly less likely than non-AB youth to be in a long-term continuous mentoring relationship. However, AB youth were more likely than non-AB youth to be in a long-term relationship ending in dissolution. AB youth were also more likely than non-AB youth to have been mentored by a female adult. AB youth were significantly more likely than non-AB youth to report a high quality mentoring relationship, regular weekly contact with their mentor, and monthly mentoring activities. Structural equation model results revealed that, relative to non-mentored AB youth, AB youth with mentors experienced significantly fewer emotional problems and symptoms of social anxiety. These relationships were not found for non-AB youth. Our findings suggest that mentoring programs may be an effective intervention for improving the health and well-being of AB youth.

  2. Dissemination of health technology assessments: identifying the visions guiding an evolving policy innovation in Canada.

    Science.gov (United States)

    Lehoux, Pascale; Denis, Jean-Louis; Tailliez, Stéphanie; Hivon, Myriam

    2005-08-01

    Health technology assessment (HTA) has received increasing support over the past twenty years in both North America and Europe. The justification for this field of policy-oriented research is that evidence about the efficacy, safety, and cost-effectiveness of technology should contribute to decision and policy making. However, concerns about the ability of HTA producers to increase the use of their findings by decision makers have been expressed. Although HTA practitioners have recognized that dissemination activities need to be intensified, why and how particular approaches should be adopted is still under debate. Using an institutional theory perspective, this article examines HTA as a means of implementing knowledge-based change within health care systems. It presents the results of a case study on the dissemination strategies of six Canadian HTA agencies. Chief executive officers and executives (n = 11), evaluators (n = 19), and communications staff (n = 10) from these agencies were interviewed. Our results indicate that the target audience of HTA is frequently limited to policy makers, that three conflicting visions of HTA dissemination coexist, that active dissemination strategies have only occasionally been applied, and that little attention has been paid to the management of diverging views about the value of health technology. Our discussion explores the strengths, limitations, and trade-offs associated with the three visions. Further efforts should be deployed within agencies to better articulate a shared vision and to devise dissemination strategies that are consistent with this vision.

  3. Poverty, Family Process, and the Mental Health of Immigrant Children in Canada

    Science.gov (United States)

    Beiser, Morton; Hou, Feng; Hyman, Ilene; Tousignant, Michel

    2002-01-01

    Objectives. This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of nonimmigrant parents. Methods. Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted. Results. Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer. Conclusions. Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage. PMID:11818295

  4. Neighbourhood immigration, health care utilization and outcomes in patients with diabetes living in the Montreal metropolitan area (Canada): a population health perspective.

    Science.gov (United States)

    Vanasse, Alain; Courteau, Josiane; Orzanco, Maria Gabriela; Bergeron, Patrick; Cohen, Alan A; Niyonsenga, Théophile

    2015-04-09

    Understanding health care utilization by neighbourhood is essential for optimal allocation of resources, but links between neighbourhood immigration and health have rarely been explored. Our objective was to understand how immigrant composition of neighbourhoods relates to health outcomes and health care utilization of individuals living with diabetes. This is a secondary analysis of administrative data using a retrospective cohort of 111,556 patients living with diabetes without previous cardiovascular diseases (CVD) and living in the metropolitan region of Montreal (Canada). A score for immigration was calculated at the neighbourhood level using a principal component analysis with six neighbourhood-level variables (% of people with maternal language other than French or English, % of people who do not speak French or English, % of immigrants with different times since immigration (immigration scores, those living in neighbourhoods with high immigration scores were less likely to die, to suffer a CVD event, to frequently visit general practitioners, but more likely to visit emergency departments or a specialist and to use an antidiabetic drug. These differences remained after controlling for patient-level variables such as age, sex, and comorbidities, as well as for neighbourhood attributes like material and social deprivation or living in the urban core. In this study, patients with diabetes living in neighbourhoods with high immigration scores had different health outcomes and health care utilizations compared to those living in neighbourhoods with low immigration scores. Although we cannot disentangle the individual versus the area-based effect of immigration, these results may have an important impact for health care planning.

  5. Western Canada study of animal health effects associated with exposure to emissions from oil and gas field facilities : technical summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    The impact of exposure to emissions from oil and gas field facilities on animal and human health has been a long-standing concern in western Canada. This technical summary presented highlights of the 17 major research appendices of a study examining associations between emissions and important reproductive parameters in beef cattle, including pregnancy rates, frequencies of abortions and stillbirths, and the risk of death among young calves. The effect of exposure to emissions on the respiratory, immune and nervous systems of calves and yearlings was also evaluated. The study was an epidemiological investigation that drew on large blocks of data collected from privately owned cow-calf operations, laboratory analyses of biological samples and samplers from air monitors. Mixed effect regression models were used to investigate whether measures of reproductive, immunological, and pathology outcomes were associated with emissions from the petroleum industry. Appropriate statistical adjustments were made to correct for multiple comparisons following standard statistical practice. An overview of the methods used to analyze the data was presented, as well as an examination of the methods of epidemiology in determining a causal effect, and the limitations of a single study in determining causation with certainty. Information on water quality testing and feeding management and forage testing was provided. 15 tabs., 26 figs.

  6. Western Canada study of animal health effects associated with exposure to emissions from oil and gas field facilities : technical summary

    International Nuclear Information System (INIS)

    2006-01-01

    The impact of exposure to emissions from oil and gas field facilities on animal and human health has been a long-standing concern in western Canada. This technical summary presented highlights of the 17 major research appendices of a study examining associations between emissions and important reproductive parameters in beef cattle, including pregnancy rates, frequencies of abortions and stillbirths, and the risk of death among young calves. The effect of exposure to emissions on the respiratory, immune and nervous systems of calves and yearlings was also evaluated. The study was an epidemiological investigation that drew on large blocks of data collected from privately owned cow-calf operations, laboratory analyses of biological samples and samplers from air monitors. Mixed effect regression models were used to investigate whether measures of reproductive, immunological, and pathology outcomes were associated with emissions from the petroleum industry. Appropriate statistical adjustments were made to correct for multiple comparisons following standard statistical practice. An overview of the methods used to analyze the data was presented, as well as an examination of the methods of epidemiology in determining a causal effect, and the limitations of a single study in determining causation with certainty. Information on water quality testing and feeding management and forage testing was provided. 15 tabs., 26 figs

  7. Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada.

    Science.gov (United States)

    Joffres, Michel R; Campbell, Norm R C; Manns, Braden; Tu, Karen

    2007-05-01

    Hypertension is the leading risk factor for mortality worldwide. One-quarter of the adult Canadian population has hypertension, and more than 90% of the population is estimated to develop hypertension if they live an average lifespan. Reductions in dietary sodium additives significantly lower systolic and diastolic blood pressure, and population reductions in dietary sodium are recommended by major scientific and public health organizations. To estimate the reduction in hypertension prevalence and specific hypertension management cost savings associated with a population-wide reduction in dietary sodium additives. Based on data from clinical trials, reducing dietary sodium additives by 1840 mg/day would result in a decrease of 5.06 mmHg (systolic) and 2.7 mmHg (diastolic) blood pressures. Using Canadian Heart Health Survey data, the resulting reduction in hypertension was estimated. Costs of laboratory testing and physician visits were based on 2001 to 2003 Ontario Health Insurance Plan data, and the number of physician visits and costs of medications for patients with hypertension were taken from 2003 IMS Canada. To estimate the reduction in total physician visits and laboratory costs, current estimates of aware hypertensive patients in Canada were used from the Canadian Community Health Survey. Reducing dietary sodium additives may decrease hypertension prevalence by 30%, resulting in one million fewer hypertensive patients in Canada, and almost double the treatment and control rate. Direct cost savings related to fewer physician visits, laboratory tests and lower medication use are estimated to be approximately $430 million per year. Physician visits and laboratory costs would decrease by 6.5%, and 23% fewer treated hypertensive patients would require medications for control of blood pressure. Based on these estimates, lowering dietary sodium additives would lead to a large reduction in hypertension prevalence and result in health care cost savings in Canada.

  8. End of life discussion in an academic family health team in Kingston, Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Reta French

    2013-01-01

    Full Text Available Background: End-of-life (EOL discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been discussed. Objectives and Methods: The objective of this study was to explore the prevalence of EOL discussions in non-terminal adult patients, the perceived barriers to such discussions and suggested methods for improvement. A study mixed-methods study was performed by a group of PGY1 family medicine residents in an academic health team in Kingston, Ontario. Results: EOL discussion was performed in a very small proportion of non-terminal patient encounters. Compared with attending physicians, residents were less likely to discuss EOL issues and reported more perceived barriers. Conclusion: Our findings reflect the need for an early and open approach in conducting EOL discussion for non-terminal healthy patients.

  9. The cost and impact of the interim federal health program cuts on child refugees in Canada.

    Directory of Open Access Journals (Sweden)

    Andrea Evans

    Full Text Available INTRODUCTION: On June 30, 2012, Interim Federal Health Program (IFHP funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. METHODS: We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. RESULTS: There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (p<0.001. INTERPRETATION: After the cuts to the IFHP, The Hospital for Sick Children was unable to obtain federal health coverage for the vast majority of refugee claimant children registered under the IFHP. This preliminary analysis showed that post-IFHP cuts healthcare costs at the largest tertiary pediatric institution in the country increased.

  10. Help Received for Perceived Needs Related to Mental Health in a Montreal (Canada Epidemiological Catchment Area

    Directory of Open Access Journals (Sweden)

    Marie-Josée Fleury

    2015-10-01

    Full Text Available This study sought to identify variables associated with help received in terms of information, medication, counselling and total help received (including other needs among 571 individuals needing health care services for mental health problems. Study participants were randomly selected from an epidemiological survey. Data on help received were collected using the Canadian version of the Perceived Need for Care Questionnaire (PNCQ, and were analyzed using a multinomial logistic regression model. Most help received was in the form of counselling, followed by medication and information. Compared with individuals who received no help, those who reported receiving help for all their needs were more likely to have psychological distress, to be non-verbally aggressive, to consult more healthcare professionals, to be men and to be somewhat older. Compared with individuals who received no help, those who received partial help were more likely to be not addicted to drugs or alcohol, to consult more healthcare professionals, and to be older. Healthcare services should prioritize strategies (e.g., early detection, outreach, public education on mental and addiction disorders that address barriers to help seeking among youth, as well as individuals addicted to drugs and alcohol or those presenting with aggressive behavior.

  11. Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada.

    Science.gov (United States)

    Townsend, Anne; Cox, Susan M

    2013-10-12

    Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. A predominant theme to emerge was 'participation in health research to access health services.' Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a "trial and error" process akin to research, which further blurred the boundaries between research and treatment. Our findings have implications for recruitment, informed consent, and the dichotomizing of medical/health procedures as either research or

  12. Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada

    Science.gov (United States)

    2013-01-01

    Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. Methods This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. Results A predominant theme to emerge was 'participation in health research to access health services.’ Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a “trial and error” process akin to research, which further blurred the boundaries between research and treatment. Conclusions Our findings have implications for recruitment, informed consent, and the dichotomizing of medical/health

  13. Learning together: a Canada-Cuba research collaboration to improve the sustainable management of environmental health risks.

    Science.gov (United States)

    Spiegel, Jerry; Garcia, Maricel; Bonet, Mariano; Yassi, Annalee

    2006-01-01

    To build a national Cuban capacity for training environmental health professionals directly linked to the needs of policy-makers and communities. The University of Manitoba and University of British Columbia collaborated with an established training centre in Cuba (the Instituto Nacional de Higiene y Epidemiologia--INHEM) and new centres in the Central (Santa Clara) and Eastern (Santiago) regions of the country. Cuba. In the mid-1990s, a comprehensive curriculum (masters and diploma programs) was collaboratively developed, applying interactive teaching methods, and was delivered through a series of workshops and other interactions in Cuba, and short-term visits to Canada by Cuban PhD students. The collaboration was successful in fulfilling capacity-building targets (over 50 Masters graduates, 467 Diploma graduates, over 30 trained core faculty in all regional centres as well as new curriculum and new accredited regional programs). Alongside this, a number of collaborative community-based research projects were undertaken in all three regions (drinking water in Santiago; housing and urban renewal, and dengue control in Havana; and tourism-related effects, and effective intersectoral management of population health determinants in Santa Clara). The collaboration led to adopting new strategies for challenges such as a dengue epidemic in 2002, and new research on the effectiveness of intersectoral management of risks of particular interest to both Cuban and Canadian policy-makers. It triggered an ambitious collaboration between the Canadian-Cuban team and colleagues in Ecuador in order to build a similar national network there, built on South-South and North-South links.

  14. (222)Rn activity in groundwater of the St. Lawrence Lowlands, Quebec, eastern Canada: relation with local geology and health hazard.

    Science.gov (United States)

    Pinti, Daniele L; Retailleau, Sophie; Barnetche, Diogo; Moreira, Floriane; Moritz, Anja M; Larocque, Marie; Gélinas, Yves; Lefebvre, René; Hélie, Jean-François; Valadez, Arisai

    2014-10-01

    One hundred ninety-eight groundwater wells were sampled to measure the (222)Rn activity in the region between Montreal and Quebec City, eastern Canada. The aim of this study was to relate the spatial distribution of (222)Rn activity to the geology and the hydrogeology of the study area and to estimate the potential health risks associated with (222)Rn in the most populated area of the Province of Quebec. Most of the groundwater samples show low (222)Rn activities with a median value of 8.6 Bq/L. Ninety percent of samples show (222)Rn activity lower than 100 Bq/L, the exposure limit in groundwater recommended by the World Health Organization. A few higher (222)Rn activities (up to 310 Bq/L) have been measured in wells from the Appalachian Mountains and from the magmatic intrusion of Mont-Saint-Hilaire, known for its high level of indoor radon. The spatial distribution of (222)Rn activity seems to be related mainly to lithology differences between U-richer metasediments of the Appalachian Mountains and magmatic intrusions and the carbonaceous silty shales of the St. Lawrence Platform. Radon is slightly enriched in sodium-chlorine waters that evolved at contact with clay-rich formations. (226)Ra, the parent element of (222)Rn could be easily adsorbed on clays, creating a favorable environment for the production and release of (222)Rn into groundwater. The contribution of groundwater radon to indoor radon or by ingestion is minimal except for specific areas near Mont-Saint-Hilaire or in the Appalachian Mountains where this contribution could reach 45% of the total radioactive annual dose. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. The cost and impact of the interim federal health program cuts on child refugees in Canada.

    Science.gov (United States)

    Evans, Andrea; Caudarella, Alexander; Ratnapalan, Savithiri; Chan, Kevin

    2014-01-01

    On June 30, 2012, Interim Federal Health Program (IFHP) funding was cut for refugee claimant healthcare. The potential financial and healthcare impacts of these cuts on refugee claimants are unknown. We conducted a one-year retrospective chart review spanning 6 months before and after IFHP funding cuts at The Hospital for Sick Children, a tertiary care children's hospital in Toronto. We analyzed emergency room visits characteristics, admission rates, reasons for admission, and financial records including billing from Medavie Blue Cross. There were 173 refugee children visits to the emergency room in the six months before and 142 visits in the six months after funding cuts. The total amount billed to the IFHP program during the one-year of this study was $131,615. Prior to the IFHP cuts, 46% of the total emergency room bills were paid by IFHP compared to 7% after the cuts (pinstitution in the country increased.

  16. Structural analysis of health-relevant policy-making information exchange networks in Canada.

    Science.gov (United States)

    Contandriopoulos, Damien; Benoît, François; Bryant-Lukosius, Denise; Carrier, Annie; Carter, Nancy; Deber, Raisa; Duhoux, Arnaud; Greenhalgh, Trisha; Larouche, Catherine; Leclerc, Bernard-Simon; Levy, Adrian; Martin-Misener, Ruth; Maximova, Katerina; McGrail, Kimberlyn; Nykiforuk, Candace; Roos, Noralou; Schwartz, Robert; Valente, Thomas W; Wong, Sabrina; Lindquist, Evert; Pullen, Carolyn; Lardeux, Anne; Perroux, Melanie

    2017-09-20

    Health systems worldwide struggle to identify, adopt, and implement in a timely and system-wide manner the best-evidence-informed-policy-level practices. Yet, there is still only limited evidence about individual and institutional best practices for fostering the use of scientific evidence in policy-making processes The present project is the first national-level attempt to (1) map and structurally analyze-quantitatively-health-relevant policy-making networks that connect evidence production, synthesis, interpretation, and use; (2) qualitatively investigate the interaction patterns of a subsample of actors with high centrality metrics within these networks to develop an in-depth understanding of evidence circulation processes; and (3) combine these findings in order to assess a policy network's "absorptive capacity" regarding scientific evidence and integrate them into a conceptually sound and empirically grounded framework. The project is divided into two research components. The first component is based on quantitative analysis of ties (relationships) that link nodes (participants) in a network. Network data will be collected through a multi-step snowball sampling strategy. Data will be analyzed structurally using social network mapping and analysis methods. The second component is based on qualitative interviews with a subsample of the Web survey participants having central, bridging, or atypical positions in the network. Interviews will focus on the process through which evidence circulates and enters practice. Results from both components will then be integrated through an assessment of the network's and subnetwork's effectiveness in identifying, capturing, interpreting, sharing, reframing, and recodifying scientific evidence in policy-making processes. Knowledge developed from this project has the potential both to strengthen the scientific understanding of how policy-level knowledge transfer and exchange functions and to provide significantly improved advice

  17. Concentrations, sources and human health risk of inhalation exposure to air toxics in Edmonton, Canada.

    Science.gov (United States)

    Bari, Md Aynul; Kindzierski, Warren B

    2017-04-01

    With concern about levels of air pollutants in recent years in the Capital Region of Alberta, an investigation of ambient concentrations, sources and potential human health risk of hazardous air pollutants (HAPs) or air toxics was undertaken in the City of Edmonton over a 5-year period (2009-2013). Mean concentrations of individual HAPs in ambient air including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and trace metals ranged from 0.04 to 1.73 μg/m 3 , 0.01-0.54 ng/m 3 , and 0.05-3.58 ng/m 3 , respectively. Concentrations of benzene, naphthalene, benzo(a)pyrene (BaP), arsenic, manganese and nickel were far below respective annual Alberta Ambient Air Quality Objectives. Carcinogenic and non-carcinogenic risk of air toxics were also compared with risk levels recommended by regulatory agencies. Positive matrix factorization identified six air toxics sources with traffic as the dominant contributor to total HAPs (4.33 μg/m 3 , 42%), followed by background/secondary organic aerosol (SOA) (1.92 μg/m 3 , 25%), fossil fuel combustion (0.92 μg/m 3 , 11%). On high particulate air pollution event days, local traffic was identified as the major contributor to total HAPs compared to background/SOA and fossil fuel combustion. Carcinogenic risk values of traffic, background/SOA and metals industry emissions were above the USEPA acceptable level (1 × 10 -6 ), but below a tolerable risk (1 × 10 -4 ) and Alberta benchmark (1 × 10 -5 ). These findings offer useful preliminary information about current ambient air toxics levels, dominant sources and their potential risk to public health; and this information can support policy makers in the development of appropriate control strategies if required. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Housing characteristics and their influence on health-related quality of life in persons living with HIV in Ontario, Canada: results from the positive spaces, healthy places study.

    Science.gov (United States)

    Rourke, Sean B; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W; Dunn, James; Hambly, Keith

    2012-11-01

    Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables-including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing-and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

  19. [The stakes of online gambling in Canada: a public health analysis].

    Science.gov (United States)

    Papineau, Elisabeth; Leblond, Jean

    2011-01-01

    Available data show that online gamblers spend more money and dedicate more time to playing compared to gamblers who do not play online, and are more likely to experience gambling problems. Among online players, young people and poker players show higher rates of gambling problems. These observations can be explained in part by such dangerous aspects of online gambling (and also electronic gaming machines) as: immediate and convenient accessibility; ability to pay electronically and to play on credit; anonymity; and the possibility for players to consume alcohol or other drugs while playing. These are elements that could facilitate the development or the intensification of problem gambling. This being said, the public discourse about the inevitability of legalized online gambling is quite unanimous and built upon such arguments as: the imperative duty of the state to protect the population against the dangers of the online gambling black market; and the fact that the medium in itself provides excellent consumer safeguards. A growing number of legislators are following the trend and choosing to establish state control over online gambling. We present some epidemiological and analytical data that challenge some of these assertions and decisions. We recommend a better integration of public health arguments into the commercialization and marketing of online gambling.

  20. Intersectional policy analysis of self-directed mental health care in Canada.

    Science.gov (United States)

    Cook, Judith A; Morrow, Marina; Battersby, Lupin

    2017-06-01

    Recovery from mental illness is influenced by one's social location along multiple dimensions of identity, such as race, class, gender, age, and ability, and by how these social locations are expressed through structural and institutional barriers. This project was developed using an intersectional policy analysis framework designed to promote equity across identity locations-called the multistrand method-to examine the potential use of self-directed care financing approaches in the Canadian mental health system. A panel of 16 diverse stakeholders came together 4 times at structured 6-hr meetings to examine the evidence for self-directed care and explore its application in the Canadian context. Telephone interviews with evidence panel members were conducted to assess their perceptions of the group process and outcomes. Our analysis revealed ways that intersecting strand locations might differentially influence the degree of choice and recovery experienced by self-directed care participants. Individualized resource allocation, draining financial resources from ethnically specific services, unevenness in acceptance of the recovery orientation, and paucity of service options in different geographical regions were identified as contexts in which self-directed care policies could promote inequity. However, greater peer involvement in the model's implementation, use of indigenous community supports, purchase of material goods by economically disenfranchised persons, and access to services from ethnically diverse clinicians in the private sector were identified as equity-promoting model features. By couching their analysis at the level of unique socially-situated perspectives, the group developed detailed policy recommendations and insights into both the potential and limitations of self-directed care. The knowledge gained from our project can be used to develop uniquely Canadian self-directed care models tailored to promote recovery through empowerment and self

  1. The healthfulness and prominence of sugar in child-targeted breakfast cereals in Canada.

    Science.gov (United States)

    Potvin Kent, Monique; Cameron, Cher; Philippe, Sarah

    2017-09-01

    The objective of this study was to compare the nutritional content and healthfulness of child-targeted and "not child-targeted" breakfast cereals and to assess the predominance of added sugar in these products. We collected data on the nutritional content of 262 unique breakfast cereals found in the five largest grocery store chains in Ottawa (Ontario) and Gatineau (Quebec). We noted the first five ingredients and the number of added sugars present in each cereal from the ingredients list. The various cereal brands were then classified as either "healthier" or "less healthy" using the UK Nutrient Profile Model. We assessed each cereal to determine if it was child-targeted or not, based on set criteria. Statistical comparisons were made between child and not child-targeted cereals. 19.8% of all breakfast cereals were child-targeted, and these were significantly lower in total and saturated fat. Child-targeted cereals were significantly higher in sodium and sugar and lower in fibre and protein, and were three times more likely to be classified as "less healthy" compared to not child-targeted cereals. No child-targeted cereals were sugar-free, and sugar was the second most common ingredient in 75% of cereals. Six breakfast cereal companies had child-targeted product lines that consisted entirely of "less healthy" cereals. There is a need for regulations that restrict food marketing to children and youth under the age of 17 on packaging to reduce their appeal to this age group. Children's breakfast cereals also need to be reformulated through government-set targets, or through regulation should compliance be deemed unacceptable.

  2. The role of Indigenous knowledge in environmental health risk management in Yukon, Canada

    Directory of Open Access Journals (Sweden)

    Katelyn A. Friendship

    2012-07-01

    Full Text Available Objectives. This project aimed to gain better understandings of northern Indigenous risk perception related to food safety and to identify the role that Indigenous knowledge (IK plays in risk management processes to support more effective and culturally relevant benefit-risk (B-R management strategies. Study design. The project used an exploratory qualitative case study design to investigate the role and place of IK in the management of environmental contaminants exposure via consumption of traditional foods in Yukon First Nations (YFNs. Methods. Forty-one semi-directive interviews with Traditional Food Knowledge Holders and Health and Environment Decision-makers were conducted. A review and analysis of organizational documents related to past risk management events for the issue was conducted. Thematic content analysis was used to analyze transcripts and documents for key themes related to the research question. Results. There was a recognized need by all participants for better collaboration between scientists and YFN communities. YFNs have been involved in identifying and defining community concerns about past risk issues, setting a local context, and participating in communications strategies. Interviewees stressed the need to commit adequate time for building relationships, physically being in the community, and facilitating open communication. Conducting community-based projects was identified as critical for collaboration and for cooperative learning and management of these issues. Conclusions. The perception of “effective” benefit-risk management is significantly influenced by the efforts made to include local communities in the process. A set of common guiding principles within a process that brings together people and knowledge systems may provide a more effective way forward in cross-cultural, multiple knowledge system contexts for complex benefit-risk issues than a prescriptive rigid framework.

  3. Comparing the risk associated with psychosocial work conditions and health behaviours on incident hypertension over a nine-year period in Ontario, Canada.

    Science.gov (United States)

    Smith, Peter M; Mustard, Cameron A; Lu, Hong; Glazier, Richard H

    2013-01-07

    Hypertension is an increasingly important health concern in Canada. This paper examines the risks associated with psychosocial working conditions compared to health behaviours on the risk of hypertension over a 9-year period in Ontario, Canada. We used data from Ontario respondents to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Information Plan database covering physician services and the Canadian Institute for Health Information database for hospital admissions. We focused on labour market participants aged 35 to 60, who had not been previously diagnosed with hypertension, were not self-employed, and were working more than 10 hours per week, more than 20 weeks in the previous 12 months (N = 6,611). Subjects were followed for a nine-year period to ascertain incidence of hypertension. Low job control was associated with an increased risk of hypertension among men, but not among women. The population attributable fraction associated with low job control among males was 11.8% in our fully adjusted model. There was no consistent pattern of increased risk of hypertension across different levels of health behaviours. Primary prevention efforts to reduce the incidence of hypertension predominantly target modifiable health behaviours. Evidence from this longitudinal cohort suggests that modifiable characteristics of the work environment should also be considered in the design of cardiovascular disease prevention programs, in particular for male labour market participants.

  4. Discrimination and the health of immigrants and refugees: exploring Canada's evidence base and directions for future research in newcomer receiving countries.

    Science.gov (United States)

    Edge, Sara; Newbold, Bruce

    2013-02-01

    Research and practice increasingly suggests discrimination compromises health. Yet the unique experiences and effects facing immigrant and refugee populations remain poorly understood in Canada and abroad. We review current knowledge on discrimination against newcomers in Canada, emphasizing impacts upon health status and service access to identify gaps and research needs. Existing knowledge centers around experiences within health-care settings, differences in perception and coping, mental health impacts, and debates about "non-discriminatory" health-care. There is need for comparative analyses within and across ethno-cultural groups and newcomer classes to better understand factors shaping how discrimination and its health effects are differentially experienced. Women receive greater attention in the literature given their compounded vulnerability. While this must continue, little is known about the experiences of youth and men. Governance and policy discourse analyses would elucidate how norms, institutions and practices shape discriminatory attitudes and responses. Finally, "non-discriminatory health-care" interventions require critical evaluation to determine their effectiveness.

  5. Health and safety matters! Associations between organizational practices and personal support workers' life and work stress in Ontario, Canada.

    Science.gov (United States)

    Zeytinoglu, Isik U; Denton, Margaret; Brookman, Catherine; Davies, Sharon; Sayin, Firat K

    2017-06-21

    The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada. The purpose of this paper is to present evidence on the associations between PSWs' life and work stress and organizational practices of full-time and guaranteed hours, and PSWs' perceptions of support at work and preference for hours. Data come from our 2015 survey of 1543 PSWs. Dependent variables are life and work stress. Independent variables are: objective organizational practices of full-time and guaranteed hours, and subjective organizational practices of perceived support at work, and preferred hours of work. Descriptive statistics, correlations and ordinary least square regression analyses with collinearity tests are conducted. Organizational practices of employing PSWs in full-time or guaranteed hours are not associated with their life and work stress. However, those who perceive support from their organizations are also the ones reporting lower life and work stress. In addition, those PSWs perceiving support from their supervisor report lower work stress. PSWs would like to work in their preferred hours, and those who prefer to work more hours report lower life and work stress, and conversely, those who prefer to work less hours report life and work stress. For PSWs in home and community care, perceived support from their organizations and supervisors, and employment in preferred hours are important factors related to their life and work stress.

  6. Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review.

    Science.gov (United States)

    Clifford, Anton; McCalman, Janya; Bainbridge, Roxanne; Tsey, Komla

    2015-04-01

    This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. A total of 17 electronic databases and 13 websites for the period of 2002-13. Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and non-validated measurement instruments. There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  7. [A comparative study of primary care health promotion practices in Florianópolis, Santa Catarina State, Brazil, and Toronto, Ontario, Canada].

    Science.gov (United States)

    Heidemann, Ivonete Teresinha Schulter Buss; Cypriano, Camilla da Costa; Gastaldo, Denise; Jackson, Suzanne; Rocha, Carolina Gabriele; Fagundes, Eloi

    2018-01-01

    The study aimed to compare the experiences with the organization of universal public healthcare systems in relation to health promotion in primary care units in Florianópolis, Santa Catarina State, Brazil, and Toronto, Ontario, Canada. This was a descriptive exploratory study with a qualitative approach in primary care units. Data were collected with semi-structured interviews containing questions on health promotion practices, with 25 health professionals in Florianópolis and 10 in Toronto. The data were discussed using thematic analysis, identifying the practices, difficulties, and facilities in health promotion. In the two cities, 60% of health professionals and health administrators had not received any specific knowledge on health promotion during their training. As for health promotion skills, health professionals in Toronto identified them with autonomy and social determinants, while in Florianópolis they were related to health education and community participation. In both cities, health promotion practices are targeted to individual and collective activities. The motivation to act comes from interdisciplinarity and the demands raised by the population. Health promotion is a relevant form of care and stimulus for individual and community autonomy, in light of social determinants. Such practices aim at comprehensive health for the community, but there are limits in the teams that still conduct disease-centered activities. Resources are limited, requiring inter-sector actions to improve quality of life. Healthcare centers on the hegemonic model, and progress is needed to achieve a positive approach to health and social determinants.

  8. Ethnic disparities in children's oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada.

    Science.gov (United States)

    Shi, Congshi; Faris, Peter; McNeil, Deborah A; Patterson, Steven; Potestio, Melissa L; Thawer, Salima; McLaren, Lindsay

    2018-01-04

    Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables. We observed significant ethnic disparities in children's oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment. Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for

  9. Effect of a health literacy intervention trial on knowledge about cardiovascular disease medications among Indigenous peoples in Australia, Canada and New Zealand.

    Science.gov (United States)

    Crengle, Sue; Luke, Joanne N; Lambert, Michelle; Smylie, Janet K; Reid, Susan; Harré-Hindmarsh, Jennie; Kelaher, Margaret

    2018-01-24

    To assess the effect of a customised, structured cardiovascular disease (CVD) medication health literacy programme on medication knowledge among Indigenous people with, or at high risk of, CVD. Intervention trial with premeasures and postmeasures at multiple time points. Indigenous primary care services in Australia, Canada and New Zealand. 171 Indigenous people aged ≥20 years of age who had at least one clinical diagnosis of a CVD event, or in Canada and Australia had a 5-year CVD risk ≥15%, and were prescribed at least two of the following CVD medication classes: statin, aspirin, ACE inhibitors and beta blockers. An education session delivered on three occasions over 1 month by registered nurses or health educators who had received training in health literacy and principles of adult education. An interactive tablet application was used during each session and an information booklet and pill card provided to participants. Knowledge about the CVD medications assessed before and after each session. Knowledge at baseline (presession 1) was low, with the mean per cent correct answers highest for statins (34.0% correct answers), 29.4% for aspirin, 26.0% for beta blockers and 22.7% for ACE inhibitors. Adjusted analyses showed highly significant (PIndigenous primary healthcare services in Australia, Canada and New Zealand. The findings from this study have important implications for health services working with populations with low health literacy more generally. ACTRN12612001309875. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Interactions: trade policy and healthcare reform after Chaoulli v. Quebec: is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private and public health insurance?

    Science.gov (United States)

    Crawford, Mark

    2006-01-01

    The insulation of Canada's healthcare system from trade treaty obligations is crucial to the legitimacy of Canada's trade policy. Legal analysis has suggested, however, that competitive and for-profit delivery of the kind contemplated by the Kirby Report and some provinces may make healthcare more vulnerable to challenges under NAFTA and GATS. The Government of Canada has tried to counter this interpretation by stressing the importance of public financing as the principal criterion for exemption of healthcare from trade treaties, but now the potential for private financing of essential medical services indicated by the Supreme Court's decision in Chaoulli v. Quebec has made that line of argument look risky as well. It is apparent that Canada failed to anticipate the possible interactions of domestic, international and constitutional law when it made commitments in the area of private health insurance at the WTO in 1997. Accordingly, the time has come to acknowledge the fragility of the boundary between health and trade policies, to take the risks and costs associated with trade treaty obligations fully into account when undertaking healthcare reform and to strengthen the separation between private and public health insurance.

  11. Alliance members' roles in collective field-building: an assessment of leadership and championship within the Population Health Intervention Research Initiative for Canada.

    Science.gov (United States)

    Di Ruggiero, Erica; Kishchuk, Natalie; Viehbeck, Sarah; Edwards, Nancy; Robinson, Kerry; Riley, Barbara; Fowler, Heather Smith

    2017-12-06

    The Population Health Intervention Research Initiative for Canada (PHIRIC) is a multi-stakeholder alliance founded in 2006 to advance population health intervention research (PHIR). PHIRIC aimed to strengthen Canada's capacity to conduct and use such research to inform policy and practice to improve the public's health by building PHIR as a field of research. In 2014, an evaluative study of PHIRIC at organisational and system levels was conducted, guided by a field-building and collaborative action perspective. The study involved 17 qualitative key informant interviews with 21 current and former PHIRIC Planning Committee and Working Group members. The interviews examined how individuals and organisations were acting as champions and exerting leadership in building the field of PHIR. Founding PHIRIC organisational members have been championing PHIR at organisational and system levels. While the PHIR field has progressed in terms of enhanced funding, legitimacy, profile and capacity, some members and organisations faced constraints and challenges acting as leaders and champions in their respective environments. Expectations about the future of PHIRIC and field-building of PHIR were mixed, where longer-term and founding members of PHIRIC expressed more optimism than recent members. All agreed on the need for incorporating perspectives of decision-makers into PHIR directions and initiatives. The findings contribute to understanding alliance members' roles in leadership and championship for field-building more generally, and for population health and PHIR specifically. Building this field requires multi-level efforts, collaborative action and distributed leadership to create the necessary conditions for PHIRIC members to both benefit from and contribute to advancing PHIR as a field. Lessons from this 'made in Canada' model may be of interest to other countries regarding the structures needed for PHIR field-building.

  12. Western Canada beef productivity study : a component of the western Canada study on animal and human health effects associated with exposure to emissions from oil and natural gas field facilities : study design

    International Nuclear Information System (INIS)

    2001-11-01

    A study was conducted to determine if exposure from oil and gas emissions has an impact on animal and human health in western Canada. The study design has been reviewed and endorsed by the Science Advisory Panel of the Western Interprovincial Scientific Studies Association which is composed of 10 internationally renowned scientists with experience in environmental and reproductive epidemiology, animal and human health, and toxicology. The research methodology includes a peer review process to ensure credibility. The five components of the study include: beef cattle productivity; assessment of the immune function in beef cattle; assessment of wildlife reproduction and immune function; exposure monitoring; and, human health. This study provides insight beyond that gained from previous studies. The association between flaring and reproductive outcomes in beef herds was examined. The association between herd location in high sulfur deposition areas and increased risk of reproductive failure was also evaluated. The study includes exposure markers for both sweet gas emissions and sour gas sources. Passive monitors measured volatile organic carbons such as benzene, toluene, ethylbenzene, and xylene. Monitoring was also conducted for other compounds including sulphur dioxide, hydrogen sulphide, particulate matter, and polycyclic aromatic hydrocarbons. Final analysis and assessment of the data should be complete by late 2003 with a report available for peer review at the beginning of 2004. refs

  13. Aluminum smelter-derived polycyclic aromatic hydrocarbons and flatfish health in the Kitimat marine ecosystem, British Columbia, Canada.

    Science.gov (United States)

    Johnson, Lyndal L; Ylitalo, Gina M; Myers, Mark S; Anulacion, Bernadita F; Buzitis, Jon; Collier, Tracy K

    2015-04-15

    From 2000-2004 a monitoring study was conducted to evaluate the impacts of aluminum smelter-derived polycyclic aromatic hydrocarbons (PAHs) on the health of fish in the marine waters of Kitimat, British Columbia, Canada. These waters are part of the historical fishing grounds of the Haisla First Nation, and since the 1950s the Alcan Primary Metal Company has operated an aluminum smelter at the head of the Kitimat Arm embayment. As a result, adjacent marine and estuarine sediments have been severely contaminated with a mixture of smelter-associated PAHs in the range of 10,000-100,000 ng/g dry wt. These concentrations are above those shown to cause adverse effects in fish exposed to PAHs in urban estuaries, but it was uncertain whether comparable effects would be seen at the Kitimat site due to limited bioavailability of smelter-derived PAHs. Over the 5-year study we conducted biennial collections of adult English sole (Parophrys vetulus) and sediment samples at the corresponding capture sites. Various tissue samples (e.g. liver, kidney, gonad, stomach contents) and bile were taken from each animal to determine levels of exposure and biological effects, and compare the uptake and toxicity of smelter-derived PAHs with urban mixtures of PAHs. Results showed significant intersite differences in concentrations of PAHs. Sole collected at sites nearest the smelter showed increased PAH exposure, as well as significantly higher prevalences of PAH-associated liver disease, compared to sites within Kitimat Arm that were more distant from the smelter. However, measures of PAH exposure (e.g., bile metabolites) were surprisingly high in sole from the reference sites outside of Kitimat Arm, though sediment and dietary PAHs at these sites were low, and fish from the areas showed no biological injury. PAH uptake, exposure, and biological effects in Kitimat English sole were relatively lower when compared to English sole collected from urban sites contaminated with PAH mixtures from

  14. Adverse health effects in Canada geese (Branta canadensis) associated with waste from zinc and lead mines in the Tri-State Mining District (Kansas, Oklahoma, and Missouri, USA).

    Science.gov (United States)

    van der Merwe, Deon; Carpenter, James W; Nietfeld, Jerome C; Miesner, John F

    2011-07-01

    Lead and zinc poisoning have been recorded in a variety of bird species, including migrating waterfowl such as Canada Geese (Branta canadensis), at sites contaminated with mine waste from lead and zinc mines in the Tri-State Mining District, Kansas, Oklahoma, and Missouri, USA. The adverse health impacts from mine waste on these birds may, however, be more extensive than is apparent from incidental reports of clinical disease. To characterize health impacts from mine waste on Canada Geese that do not have observable signs of poisoning, four to eight apparently healthy birds per site were collected from four contaminated sites and an uncontaminated reference site, and examined for physical and physiologic evidence of metals poisoning. Tissue concentrations of silver, aluminum, arsenic, barium, cadmium, cobalt, chromium, copper, iron, magnesium, manganese, molybdenum, nickel, lead, selenium, thallium, vanadium, and zinc were determined by inductively coupled plasma mass spectroscopy. Adverse health effects due to lead were characterized by assessing blood δ-aminolevulinic acid dehydratase (ALAD) enzyme activity. Adverse effects associated with zinc poisoning were determined from histologic examination of pancreas tissues. Elevated tissue lead concentrations and inhibited blood ALAD enzyme activities were consistently found in birds at all contaminated sites. Histopathologic signs of zinc poisoning, including fibrosis and vacuolization, were associated with elevated pancreatic zinc concentrations at one of the study sites. Adverse health effects associated with other analyzed elements, or tissue concentrations indicating potentially toxic exposure levels to these elements, were not observed.

  15. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    Directory of Open Access Journals (Sweden)

    Chiang Lu-May

    2006-04-01

    Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

  16. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    Science.gov (United States)

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

  17. Canada`s green plan - The second year. Summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-31

    Canada`s Green Plan is the national strategy and action plan for sustainable development launched by the federal government. The Green Plan`s goal is `to secure for current and future generations a safe and healthy environment and a sound and prosperous economy.` It represents a fundamental shift in the way the federal government views economic development and environmental protection: they are inextricably linked; both are critical to the health and well-being of Canadians. Substantial development has been made in Canada, with advances being made on the Green Plan`s short-term objectives and on our longer term priorities.

  18. Health care access and support for disabled women in Canada: falling short of the UN Convention on the Rights of Persons with Disabilities: a qualitative study.

    Science.gov (United States)

    Gibson, Barbara E; Mykitiuk, Roxanne

    2012-01-01

    The United Nations Convention on the Rights of Persons with Disabilities and other international human rights conventions guarantee the fundamental human rights to physical, social, and psychological health. The purpose of this study was to examine whether these rights are being upheld in Canada for disabled women. An interpretive, qualitative, focus group design was employed. Participants were women 18 to 67 years of age with a self-identified physical, sensory, cognitive, and/or psychiatric impairment. Eleven focus groups were conducted with 74 disabled women from urban and rural settings in Northern Ontario, Manitoba, and Nova Scotia. The data were analyzed for themes using a flexible coding system derived from and consistent with the research objectives and the study's human rights framework. Participants described multiple intersecting factors that impeded or facilitated access to health care. Services included both generic health services and impairment-specific services. Participants experienced a number of barriers accessing professionals, support programs, and services. These are described under three broad themes: 1) Labyrinthine health service 'systems,' 2) assumptions, attitudes, and discriminatory practices, and 3) inadequate sexual health or reproductive services and supports. The results suggest that Canada falls significantly short of guaranteeing disabled women's human rights to access health care supports and services. Access barriers resulted from the inefficiencies and complexities of the multiple agencies and programs that disabled women had to navigate, difficulties accessing information on available services, and negative attitudes of some health and social service providers. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. Pandemic H1N1 in Canada and the use of evidence in developing public health policies--a policy analysis.

    Science.gov (United States)

    Rosella, Laura C; Wilson, Kumanan; Crowcroft, Natasha S; Chu, Anna; Upshur, Ross; Willison, Donald; Deeks, Shelley L; Schwartz, Brian; Tustin, Jordan; Sider, Doug; Goel, Vivek

    2013-04-01

    When responding to a novel infectious disease outbreak, policies are set under time constraints and uncertainty which can limit the ability to control the outbreak and result in unintended consequences including lack of public confidence. The H1N1 pandemic highlighted challenges in public health decision-making during a public health emergency. Understanding this process to identify barriers and modifiable influences is important to improve the response to future emergencies. The purpose of this study is to examine the H1N1 pandemic decision-making process in Canada with an emphasis on the use of evidence for public health decisions. Using semi-structured key informant interviews conducted after the pandemic (July-November 2010) and a document analysis, we examined four highly debated pandemic policies: use of adjuvanted vaccine by pregnant women, vaccine priority groups and sequencing, school closures and personal protective equipment. Data were analysed for thematic content guided by Lomas' policy decision-making framework as well as indicative coding using iterative methods. We interviewed 40 public health officials and scientific advisors across Canada and reviewed 76 pandemic policy documents. Our analysis revealed that pandemic pre-planning resulted in strong beliefs, which defined the decision-making process. Existing ideological perspectives of evidence strongly influenced how information was used such that the same evidentiary sources were interpreted differently according to the ideological perspective. Participants recognized that current models for public health decision-making failed to make explicit the roles of scientific evidence in relation to contextual factors. Conflict avoidance theory explained policy decisions that went against the prevailing evidence. Clarification of roles and responsibilities within the public health system would reduce duplication and maintain credibility. A more transparent and iterative approach to incorporating evidence

  20. 9 CFR 93.418 - Cattle from Canada.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Cattle from Canada. 93.418 Section 93... CONVEYANCE AND SHIPPING CONTAINERS Ruminants Canada 8 § 93.418 Cattle from Canada. (a) Health certificates. Cattle intended for importation from Canada must be accompanied by a certificate issued in accordance...

  1. Quality of evidence considered by Health Canada in granting full market authorisation to new drugs with a conditional approval: a retrospective cohort study.

    Science.gov (United States)

    Lexchin, Joel

    2018-04-28

    This study examines the characteristics of studies that Health Canada uses to grant full marketing authorisation for products given a conditional approval between 1 January 1998 and 30 June 2017. Cohort study. Journal articles listing drugs that fulfilled their conditions and received full marketing authorisation, Notice of Compliance database, Notice of Compliance with conditions website, Qualifying Notices listing required confirmatory studies, clinicaltrials.gov, PubMed, Embase, companies making products being analysed, journal articles resulting from confirmatory studies. None. Characteristics of studies-study design (randomised controlled trials, observational), primary outcome used (clinical, surrogate), blinding, number of patients in studies, patient median age, number of men and women. Eleven companies confirmed 36 publications for 19 products (21 indications). Twenty-nine out of the 36 studies were randomised controlled trials (RCTs) but only 10 stated if they were blinded. Twenty used surrogate outcomes. The median age of patients was 56 (IQR 44-61). The median number of men per study/trial was 184 (IQR 58-514) versus women 141 (IQR 46-263). Postmarket studies required by Health Canada had more rigorous methodology than those required by either the Food and Drug Administration or the European Medicines Agency. There were still deficiencies in these studies. The absence of blinding in the majority of RCTs may introduce bias in their results. The use of surrogate outcomes especially in oncology trials means that improvements in survival are not available. The relatively young age of patients, even for products for cancer, means that predicting how the elderly will respond is often unknown. The almost universal finding that men outnumbered women may make it hard to differentiate responses by sex. These results raise potential concerns about the quality of evidence that Health Canada accepts. © Article author(s) (or their employer(s) unless otherwise stated

  2. Canada's Compassionate Care Benefit: is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

    Science.gov (United States)

    Williams, Allison M; Eby, Jeanette A; Crooks, Valorie A; Stajduhar, Kelli; Giesbrecht, Melissa; Vuksan, Mirjana; Cohen, S Robin; Brazil, Kevin; Allan, Diane

    2011-05-18

    An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB)--a contributory benefits social program aimed at informal P/EOL caregivers--operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the

  3. Differences in Water Consumption Choices in Canada: the Role of Socio-demographics, Experiences, and Perceptions of Health Risks

    OpenAIRE

    Diane P. Dupont; W.L. Adamowicz; Alan Krupnick

    2009-01-01

    In 2000 and 2001 Canadians were shocked by water contamination events that took place in two provinces. In 2004 we undertook an Internet-based survey across Canada that asked respondents to identify in percentage terms their total drinking water consumption according to one of three sources: tap water, bottled water, and home filtered water (either some type of container or an in-tap filter device). In this paper we investigate the determinants of these choices and whether choosing to either ...

  4. Association between home visiting interventions and First Nations families' health and social outcomes in Manitoba, Canada: protocol for a study of linked population-based administrative data.

    Science.gov (United States)

    Brownell, Marni D; Nickel, Nathan C; Enns, Jennifer E; Chartier, Mariette; Campbell, Rhonda; Phillips-Beck, Wanda; Chateau, Dan; Burland, Elaine; Santos, Rob; Katz, Alan

    2017-10-10

    First Nations people are descendants of Canada's original inhabitants. In consequence of historical and ongoing structural injustices, many First Nations families struggle with challenging living conditions, including high rates of poverty, poor housing conditions, mental illness and social isolation. These risk factors impede caregivers' abilities to meet their children's basic physical and psychosocial needs. Home visiting programmes were developed to support child developmental health in families facing parenting challenges. However, whether home visiting is an effective intervention for First Nations families has not been examined. We are evaluating two home visiting programmes in Manitoba, Canada, to determine whether they promote nurturing family environments for First Nations children. This research builds on new and established relationships among academic researchers, government decision-makers and First Nations stakeholders. We will link health, education and social services data from the Manitoba Population Research Data Repository to data from two home visiting programmes in Manitoba. Logistic regression modelling will be used to assess whether programme participation is associated with improved child developmental health, better connections between families and social services, reduced instances of child maltreatment and being taken into out-of-home care by child welfare and reduced inequities for First Nations families. Non-participating individuals with similar sociodemographic characteristics will serve as comparators. We will use an interrupted time series approach to test for differences in outcomes before and after programme implementation and a propensity score analysis to compare differences between participants and non-participants. Approvals were granted by the Health Information Research Governance Committee of the First Nations Health and Social Secretariat of Manitoba and the University of Manitoba Health Research Ethics Board. Our

  5. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

    Science.gov (United States)

    Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

    2016-08-01

    This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

  7. Operationalizing mHealth to improve patient care: a qualitative implementation science evaluation of the WelTel texting intervention in Canada and Kenya.

    Science.gov (United States)

    Bardosh, Kevin Louis; Murray, Melanie; Khaemba, Antony M; Smillie, Kirsten; Lester, Richard

    2017-12-06

    Mobile health (mHealth) applications have proliferated across the globe with much enthusiasm, although few have reached scale and shown public health impact. In this study, we explored how different contextual factors influenced the implementation, effectiveness and potential for scale-up of WelTel, an easy-to-use and evidence-based mHealth intervention. WelTel uses two-way SMS communication to improve patient adherence to medication and engagement in care, and has been developed and tested in Canada and Kenya. We used a comparative qualitative case study design, which drew on 32 key informant interviews, conducted in 2016, with stakeholders involved in six WelTel projects. Our research was guided by the Consolidated Framework for Implementation Research (CFIR), a meta-theoretical framework, and our analysis relied on a modified approach to grounded theory, which allowed us to compare findings across these projects. We found that WelTel had positive influences on the "culture of care" at local clinics and hospitals in Canada and Kenya, many of which stretched beyond the immediate patient-client relationship to influence wider organizational systems. However, these were mediated by clinician norms and practices, the availability of local champion staff, the receptivity and capacity of local management, and the particular characteristics of the technology platform, including the ability for adaptation and co-design. We also found that scale-up was influenced by different forms of data and evidence, which played important roles in legitimization and partnership building. Even with robust research evidence, scale-up was viewed as a precarious and uncertain process, embedded within the wider politics and financing of Canadian and Kenyan health systems. Challenges included juggling different interests, determining appropriate financing pathways, maintaining network growth, and "packaging" the intervention for impact and relevance. Our comparative case study, of a unique

  8. Strategies and Challenges in Recruiting Black Immigrant Mothers for a Community-Based Study on Child Nutritional Health in Ottawa, Canada.

    Science.gov (United States)

    Blanchet, Rosanne; Sanou, Dia; Nana, Constance P; Pauzé, Elise; Batal, Malek; Giroux, Isabelle

    2017-04-01

    There is a need to identify barriers to participation as well as recruitment strategies to engage minority parents of young children in health-oriented research. This paper offers insights on strategies and challenges in recruiting black immigrant mothers living in Ottawa (Canada) for a community-based health-oriented research project among 6-to-12-year-old children. We recruited 259 mother-child dyads. Most participants were recruited by team members during community events, fairs, religious gatherings, etc. Other successful strategies included referral from participants, community partners, and through research team members' networks. Mass media strategies were mostly ineffective. Instant and meaningful incentives, developing community partnerships, building and ensuring study legitimacy and trust, placing convenience of participants ahead of that of research team members, doing community outreach, and taking contact information on the spot, as well as using word-of-mouth were essential to recruiting. This study clearly indicates the importance of adopting multiple recruitment strategies.

  9. Introducing INSPIRE: an implementation research collaboration between the Department of Foreign Affairs, Trade and Development Canada and the World Health Organization.

    Science.gov (United States)

    Blais, Pierre; Hirnschall, Gottfried; Mason, Elizabeth; Shaffer, Nathan; Lipa, Zuzanna; Baller, April; Rollins, Nigel

    2014-11-01

    The government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD) has supported global efforts to reduce the impact of the HIV pandemic. In 2012, WHO and DFATD launched an implementation research initiative to increase access to interventions that were known to be effective in the prevention of mother-to-child transmission of HIV and to learn how these could be successfully integrated with other essential services for mothers and children. In addition to facilitating the implementation research projects, DFATD and WHO promoted four approaches: (1) Country-specific implementation research prioritization exercises, (2) Ministry of Health involvement, (3) Country-led, innovative, high-quality research, and (4) Leveraging regional networks and learning opportunities. While no single aspect of INSPIRE is unique, the process endeavors to promote and support high-quality, rigorous, locally-led implementation research that will have a substantial impact on the health and survival of HIV-infected women and their children.

  10. Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

    Science.gov (United States)

    McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

    2017-08-04

    Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

  11. "Everyone just keeps their eyes closed and their fingers crossed": sexual health communication among black parents and children in Nova Scotia, Canada.

    Science.gov (United States)

    Davis, Antoinette N; Gahagan, Jacqueline C; George, Clemon

    2013-07-22

    Black Canadian youth remain disproportionally affected by an array of social and health issues, including sexually transmitted infections. While research exists in support of the involvement of parents as a key means to prevent or modify harmful behaviours among youth, less is known about how parent-child communication can serve as a prevention intervention strategy within Black families in Canada. This study explores sexual health communication between Black parents and youth in Nova Scotia and identifies facilitators, obstacles and issues that families face in dialoguing about sexual health. Focus groups and in-depth interview sessions were held with a diverse sample of parents of Black youth, health and education professionals, and Black youth in Nova Scotia, as part of a larger study aimed at exploring parent-child communication on sexual health and HIV. The research team worked in partnership with and received feedback from key informants and a community advisory committee throughout the various stages of this study. All sessions were audio-taped with permission and thematic analysis was carried out on the verbatim transcripts. Six key themes emerged from the data analysis in relation to parent-child communication within Black families in Nova Scotia: 1. the gendered nature of [sexual] health communication; 2. fear and uncertainty as obstacles; 3. open and honest dialogue from an early age as a facilitator; 4. media as both a catalyst and a barrier; 5. peers as a catalyst; and 6. time constraints as an obstacle. The findings of this study reveal that parent-child communication regarding sexual health promotion within Black families in Nova Scotia remains varied and is heavily affected by a myriad of intersecting determinants of health faced by Black youth and their parents. Health promotion interventions aimed at fostering and supporting parent-child communication on sexual health must simultaneously target both parents and youth and further, such efforts must

  12. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

    Science.gov (United States)

    Baiden, Philip; Fallon, Barbara

    2018-05-01

    Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice

  13. Aging in Canada: State of the Art and Science

    Science.gov (United States)

    Sheets, Debra J.; Gallagher, Elaine M.

    2013-01-01

    Canada shares many similarities with other industrialized countries around the world, including a rapidly aging population. What sets Canada uniquely apart is the collaborative approach that has been enacted in the health care system and the aging research initiatives. Canada has tremendous pride in its publicly funded health care system that…

  14. An international comparison of women's occupational health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore: the CIDA-SEAGEP study.

    Science.gov (United States)

    Choi, Bernard C K

    2005-10-01

    An international comparison study of women's occupational health issues was carried out in 2000 for the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore. The study was funded by the Canadian International Development Agency's Southeast Asia Gender Equity Program. The objective was to compare the issues, risk factors, social determinants, and challenges in women's occupational health, according to the status of economic development as defined by the World Bank. Data were collected through 27 key informant interviews of high-ranking government officials and senior researchers, self-administered questionnaires on country or regional statistics and 16 courtesy calls. Results indicated that women's occupational health problems common in these countries or regions included women's long hours of work (double workday), shift work and a caring role for family and friends. Problems reported in developing countries but not developed countries included poor access to training and protective equipment, and insufficient legislation to protect women's rights. Problems reported in developed countries but not in developing countries included obesity, smoking and not including women in health research. This paper provides insights into the changing environment in the workplace, such as increasing participation of women in the paid workforce and changes in gender differences due to the changing country economy, for improving women's occupational health.

  15. Human Factors in the Large: Experiences from Denmark, Finland and Canada in Moving Towards Regional and National Evaluations of Health Information System Usability

    Science.gov (United States)

    Kaipio, J.; Nieminen, M.; Hyppönen, H.; Lääveri, T.; Nohr, C.; Kanstrup, A. M.; Berg Christiansen, M.; Kuo, M.-H.; Borycki, E.

    2014-01-01

    Summary Objectives The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels. Methods Several different methods are discussed in case studies from Denmark, Finland and Canada. They range from small scale qualitative studies involving usability testing of systems to larger scale national level questionnaire studies aimed at assessing the use and usability of health information systems by entire groups of health professionals. Results It was found that regional and national usability studies can complement smaller scale usability studies, and that they are needed in order to understand larger trends regarding system usability. Despite adoption of EHRs, many health professionals rate the usability of the systems as low. A range of usability issues have been noted when data is collected on a large scale through use of widely distributed questionnaires and websites designed to monitor user perceptions of usability. Conclusion As health information systems are deployed on a widespread basis, studies that examine systems used regionally or nationally are required. In addition, collection of large scale data on the usability of specific IT products is needed in order to complement smaller scale studies of specific systems. PMID:25123725

  16. Understanding the Political Economy of the Evolution and Future of Single-Payer Public Health Insurance in Canada (Technical Paper

    Directory of Open Access Journals (Sweden)

    J.C. Herbert Emery

    2010-02-01

    Full Text Available Surprisingly little attention has been paid to how we pay for health care affects how much we spend on health care. In this paper, the author discusses how non-contributory finance and effective subsidization of public health care spending with federal cost sharing crowded out demand for private insurance as voters opted for high levels of public health spending.

  17. An audit of health products advertised for sale on chiropractic Web sites in Canada and consideration of these practices in the context of Canadian chiropractic codes of ethics and conduct.

    Science.gov (United States)

    Page, Stacey A; Grod, Jaroslaw P

    2009-01-01

    This study describes the extent to which chiropractors with Web sites practicing in Canada advertise health products for sale and considers this practice in the context of chiropractic codes of ethics and conduct. Chiropractic Web sites in Canada were identified using a public online business directory (Canada 411). The Web sites were searched, and an inventory of the health products for sale was taken. The influences of type of practice and province of practice on the sale of health product were assessed. Textual comments about health product marketing were summarized. National and provincial codes of ethics were reviewed, and the content on health product advertising was summarized. Two hundred eighty-seven Web sites were reviewed. Just more than half of the Web sites contained information on health products for sale (n = 158, 54%). Orthotics were advertised most often (n = 136 practices, 47%), followed by vitamins/nutritional supplements (n = 53, 18%), pillows and supports (n = 40, 14%), and exercise/rehabilitation products (n = 20, 7%). Chiropractors in solo or group chiropractic practices were less likely to advertise health products than those in multidisciplinary practice (P advertise nutritional supplements (P ethics and conduct varied in their guidelines regarding health product sales. Variations in codes of ethics and in the proportions of practitioners advertising health products for sales across the country suggest that opinions may be divided on the acceptability of health product sales. Such practices raise questions and considerations for the chiropractic profession.

  18. A decade of research in Inuit children, youth, and maternal health in Canada: areas of concentrations and scarcities

    Science.gov (United States)

    Sheppard, Amanda J.; Hetherington, Ross

    2012-01-01

    Inuit Canadians are on average about 20 years younger and have a 10-year lower life expectancy than other Canadians. While there have been improvements in Inuit health status over time, significant health disparities still remain. This paper will review the peer-reviewed literature related to Inuit child, youth, and maternal health between 2000 and 2010, investigate which thematic areas were examined, and determine what proportion of the research is related to each group. Establishing areas of research concentrations and scarcities may help direct future research where it is needed. We followed a systematic literature review and employed peer-reviewed research literature on child, youth, and maternal health which were selected from 3 sources, MEDLINE, CINAHL, and the Circumpolar Health Bibliographic Database. The resulting references were read, and summarized according to population group and thematic area. The thematic areas that emerged by frequency were: infectious disease; environment/environmental exposures; nutrition; birth outcomes; tobacco; chronic disease; health care; policy, human resources; interventions/programming; social determinants of health; mental health and wellbeing; genetics; injury; and dental health. The 72 papers that met the inclusion criteria were not mutually exclusive with respect to group studied. Fifty-nine papers (82%) concerned child health, 24 papers (33%) youth health, and 58 papers (81%) maternal health. The review documented high incidences of illness and significant public health problems; however, in the context of these issues, opportunities to develop research that could directly enhance health outcomes are explored. PMID:22868191

  19. Mental Health Disorders and Publicly Funded Service Use by HIV Positive Individuals: A Population-Based Cross-Sectional Study in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Brown, Hilary K; Antoniou, Tony; Sirotich, Frank; Bansal, Symron; Heifetz, Marina; Roesslein, Kay; Lunsky, Yona

    2017-12-01

    We compared use of community and hospital-based mental health and addiction (MH&A) services by adults with and without HIV. This population-based study examined the probability and intensity of MH&A service use by individuals with (n = 5095) and without HIV (n = 2,753,091) in Ontario, Canada between 2013 and 2014. Adults with HIV were more likely than HIV-negative adults to use MH&A primary and psychiatric care, and to have MH&A emergency department visits and hospital admissions; they also used more of each service. Use of MH&A hospital services was particularly high for persons in the HIV group compared to the no HIV group.

  20. Perceived adverse health effects of heat and their determinants in deprived neighbourhoods: a cross-sectional survey of nine cities in Canada.

    Science.gov (United States)

    Bélanger, Diane; Gosselin, Pierre; Valois, Pierre; Abdous, Belkacem

    2014-10-24

    This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada). The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people <65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having ≥2 diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR<65 = 5.6; OR≥65 = 4.2), and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially.

  1. Perceived Adverse Health Effects of Heat and Their Determinants in Deprived Neighbourhoods: A Cross-Sectional Survey of Nine Cities in Canada

    Directory of Open Access Journals (Sweden)

    Diane Bélanger

    2014-10-01

    Full Text Available This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada. The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people <65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having ≥2 diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR<65 = 5.6; OR≥65 = 4.2, and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially.

  2. eMental Health Experiences and Expectations: A Survey of Youths' Web-Based Resource Preferences in Canada

    OpenAIRE

    Wetterlin, Felicia M; Mar, Marissa Y; Neilson, Erika K; Werker, Gregory R; Krausz, Michael

    2014-01-01

    Background Due to the high prevalence of psychological disorders and the lack of access to care among Canadian youth, the development of accessible services is increasingly important. eMental Health is an expanding field that may help to meet this need through the provision of mental health care using technology. Objective The primary goals of the study are to explore youth experiences with traditional and online mental health resources, and to investigate youth expectations for mental health...

  3. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    OpenAIRE

    Soc?as, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers? experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex worke...

  4. Self-perceived Mental Health Status and Uptake of Fecal Occult Blood Test for Colorectal Cancer Screening in Canada: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Celestin Hategekimana

    2016-06-01

    Full Text Available Background: While colorectal cancer (CRC is one of the most preventable causes of cancer mortality, it is one of the leading causes of cancer death in Canada where CRC screening uptake is suboptimal. Given the increased rate of mortality and morbidity among mental health patients, their condition could be a potential barrier to CRC screening due to greater difficulties in adhering to behaviours related to long-term health goals. Using a population-based study among Canadians, we hypothesize that self-perceived mental health (SPMH status and fecal occult blood test (FOBT uptake for the screening of CRC are associated. Methods: The current study is cross-sectional and utilised data from the Canadian Community Health Survey 2011-2012. Multinomial logistic regression analysis was undertaken to assess whether SPMH is independently associated with FOBT uptake among a representative sample of 11386 respondents aged 50-74 years. Results: Nearly half of the respondents reported having ever had FOBT for CRC screening, including 37.28% who have been screened within two years of the survey and 12.41% who had been screened more than two years preceding the survey. Respondents who reported excellent mental health were more likely to have ever been screened two years or more before the survey (adjusted odds ratio [AOR] = 2.08; 95% CI, 1.00-4.43 and to have been screened in the last two years preceding the survey (AOR = 1.53; 95% CI, 0.86-2.71 than those reported poor mental health status. Conclusion: This study supports the association between SPMH status and FOBT uptake for CRC screening. While the efforts to maximize CRC screening uptake should be deployed to all eligible people, those with poor mental health may need more attention.

  5. Suicide policy in Canada: lessons from history.

    Science.gov (United States)

    Spiwak, Rae; Elias, Brenda; Bolton, James M; Martens, Patricia J; Sareen, Jitender

    2012-07-18

    In Canada, suicide has transitioned from being a criminal activity with much associated stigma, to being a public health concern that needs to be managed by governments and clinicians in a culturally sensitive manner. In Canada and worldwide, the social attitudes toward and legal interpretation of suicide have been dynamic. Much has been proposed in the development of suicide policy in Canada, however Canada is unique in that it remains one of the only industrialized countries without a national suicide prevention strategy. The current article provides a critical review of the history of suicide in Canada, as well as an appraisal of Canadian suicide prevention policies and key government and political milestones that have impacted suicide policy. Current activity regarding a national suicide prevention strategy in Canada is discussed, as well as potential options for clinician involvement.

  6. Health promotion and education: application of the ICF in the US and Canada using an ecological perspective.

    Science.gov (United States)

    Howard, David; Nieuwenhuijsen, Els R; Saleeby, Patricia

    2008-01-01

    Health promotion is an issue comprised of complex and multi-layered concepts that involves a process of enabling people to increase control over and improve their health. The aims and applications of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), with its focus on components of functioning, activities and participation, and environmental factors are salient to health promotion and health education efforts. For individuals with or without disabilities, health promotion occurs within the community in which they reside and is influenced by a complex interaction of personal and environmental factors. The aim of this paper is to discuss how the ICF can be useful in enhancing social change through health promotion and health education for all people, in particular those with disabilities and chronic conditions. In doing so health promotion concepts and the ecological approach linked with the ICF, the relationship of social change and social support to the ICF, the potential role of the ICF for national and local (city) policies, and the role of health professionals in this process will be examined. Building on this body of knowledge, the authors recommend that future research should focus on the relationship between policies and the social participation of people with disabilities in the community, the use of ICF measurement tools to improve the indicators established by the National Organization on Disability, the development of a new ICF core set for community accessibility and inclusion, better interventions to enhance social support, and enhancing the role of professionals in health promotion for people with disabilities or chronic health conditions.

  7. Occurrence of geogenic contaminants in private wells from a crystalline bedrock aquifer in western Quebec, Canada: Geochemical sources and health risks

    Science.gov (United States)

    Bondu, Raphaël; Cloutier, Vincent; Rosa, Eric

    2018-04-01

    Nineteen private wells were investigated in order to evaluate the groundwater quality and the issues associated with well water use in a fractured metasedimentary aquifer of the Canadian Shield, in western Quebec (Canada). Groundwater sampling and analysis reveal that the quality of well water is both a potential aesthetic and health concern for the residents. Aesthetic problems are mainly related to the high levels of hardness and dissolved iron and manganese. Potential health risks are associated with the occurrence of brackish groundwater, high manganese concentrations, and arsenic concentrations exceeding the Canadian guideline value of 10 μg/l. Brackish groundwater is suspected to be derived from the mixing of fresh groundwaters with deep calcium-sodium-chloride brines of the Canadian Shield. The occurrences of iron, manganese and arsenic, primarily derived from the natural weathering of bedrock, are highly dependent on the geochemical conditions in groundwater, particularly the redox potential. Arsenic occurs mainly as arsenite (As(III)) and is thought to be released by the dissolution of iron and manganese oxyhydroxides under reducing conditions. Information obtained from well owners indicates that most households use ion exchange water softeners to minimize aesthetic problems of excessive hardness and dissolved iron and manganese concentrations. Homeowners generally take protective measures to reduce their exposure to arsenic when they are aware of the contamination. The exposure to arsenic and manganese may pose health risks for residents that do not take protective measures. The quality of well water is of paramount importance for human health in rural areas. Information on the contaminant sources and individual mitigation measures is essential to assess the health risks associated with groundwater consumption and to ensure the protection of public health.

  8. Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study

    Science.gov (United States)

    Durbin, Anna; Moineddin, Rahim; Lin, Elizabeth; Steele, Leah S; Glazier, Richard H

    2015-01-01

    Objective While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requires considering the effects of interacting factors. This study assessed the inter-relationship between recent immigration status, living in deprived areas and service use for non-psychotic mental health disorders. Study design Matched population-based cross-sectional study. Setting Ontario, Canada, where healthcare use data for 1999–2012 were linked to immigration data and area-based material deprivation scores. Participants Immigrants in urban Ontario, and their age-matched and sex-matched long-term residents (a group of Canadian-born or long-term immigrants, n=501 417 pairs). Primary and secondary outcome measures For immigrants and matched long-term residents, contact with primary care, psychiatric care and hospital care (emergency department visits or inpatient admissions) for non-psychotic mental health disorders was followed for 5 years and examined using conditional logistic regression models. Intersectionality was investigated by including a material deprivation quintile by immigrant status (immigrant vs long-term resident) interaction. Results Recent immigrants in urban Ontario were more likely than long-term residents to live in most deprived quintiles (immigrants—males: 22.8%, females: 22.3%; long-term residents—both sexes: 13.1%, pimmigrants than for long-term residents. Immigrants used less mental health services than long-term residents. Conclusions This study adds to existing research by suggesting that immigrant status and deprivation have a combined effect on recent immigrants’ care use for non-psychotic mental health disorders. In settings where immigrants are over-represented in deprived areas, policymakers focused on increasing

  9. Review of the knowledge available to date on the effects of tritium exposure on health and the environment in Canada - a tool to guide regulatory compliance monitoring

    International Nuclear Information System (INIS)

    Thompson, P.A.; Hamlat, M.S.; Lane, R.; Mihok, S.; Reinhardt, P.; Bundy, K.

    2011-01-01

    The use of tritium in CANDU (Canadian Deuterium-Uranium) reactors, in industry to produce self-luminescent lights and paints, in oil and gas exploration, in hospitals for diagnostic tests and radio-therapeutics, and in research makes the control of tritium releases generated by these activities particularly important in Canada. Releases are regulated and carefully monitored by the Canadian Nuclear Safety Commission (CNSC). Some special interest and citizen groups, however, claim that the scientific uncertainty regarding the effects of tritium on health and on the environment is such that regulation of the facilities releasing or using tritium may be inadequate. In response to these concerns, the CNSC asked its staff to initiate the 'Tritium Studies' project. As part of the project, the environmental fate of tritium and its health effects were studied through direct field measurements and the review of the latest scientific literature on the subject. The project made it possible to conclude that the tritium radiation protection measures and regulatory mechanisms are adequate in protecting the health and safety of Canadians. (authors)

  10. Taking ad-Vantage of lax advertising regulation in the USA and Canada: Reassuring and distracting health-concerned smokers

    OpenAIRE

    Anderson, Stacey J; Pollay, Richard W; Ling, Pamela M

    2006-01-01

    We explored the evolution from cigarette product attributes to psychosocial needs in advertising campaigns for low-tar cigarettes. Analysis of previously secret tobacco industry documents and print advertising images indicated that low-tar brands targeted smokers who were concerned about their health with advertising images intended to distract them from the health hazards of smoking. Advertising first emphasized product characteristics (filtration, low tar) that implied health benefits. Over...

  11. Unique Measles Virus in Canada

    Centers for Disease Control (CDC) Podcasts

    2017-08-24

    Dr. Shelley Deeks, chief of communicable diseases at Public Health Ontario, discusses a measles outbreak in Canada.  Created: 8/24/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/24/2017.

  12. Nutrition inequities in Canada.

    Science.gov (United States)

    Tarasuk, Valerie; Fitzpatrick, Sandra; Ward, Heather

    2010-04-01

    In Canada, increased morbidity and shorter life expectancy have been found among those with lower incomes and lower levels of education, but there has been little examination of socioeconomic variation in food and nutrient intake. Using data from the 2004 Canadian Community Health Survey, we examined the relationship between household income and education level and adults' and children's intakes of energy, fibre, micronutrients, and number of servings consumed of food groups from Canada's Food Guide. To explore the public health significance of observed associations, we estimated the prevalence of inadequacy for selected nutrients for adults, stratifying by household income, education level, and sex. We found that a higher household income adequacy and (or) higher levels of education were associated with increased consumption of milk and alternatives, and vegetables and fruit, and significantly higher vitamin, mineral, and fibre intakes among both adults and children. The prevalence of inadequate nutrient intakes among adults was higher among adults with the lowest level of income adequacy or educational attainment, compared with others. Our results suggest that the nutritional quality of Canadians' food intakes is, in part, a function of their social position. The impact of policy and program interventions needs to be examined across socioeconomic strata to ensure that actions reduce rather than exacerbate nutrition inequities.

  13. Mental Health Promotion Efforts for Children and Youth in Canada and Beyond: Evidence in Research, Policy and Practice

    Science.gov (United States)

    Whitley, Jessica; Gooderham, Suzanne

    2015-01-01

    Mental health issues continue to present barriers for Canadian children, in terms of both psychological and academic outcomes. Growing numbers of students are placed "at risk" as a result. A mental health promotion approach suggests that students can develop a number of skills and competencies, namely those related to social-emotional…

  14. Breaking down "Healthism": Barriers to Health and Fitness as Identified by Immigrant Youth in St. John's, NL, Canada

    Science.gov (United States)

    Shea, Jennifer M.; Beausoleil, Natalie

    2012-01-01

    In this article, we challenge dominant health and fitness discourses which stress individual responsibility in the attainment of these statuses. We examine the results of an empirical study exploring how a group of 15 Canadian immigrant youth, aged 12-17, discursively construct notions of health and fitness. Qualitative data were collected through…

  15. eMental health experiences and expectations: a survey of youths' Web-based resource preferences in Canada.

    Science.gov (United States)

    Wetterlin, Felicia M; Mar, Marissa Y; Neilson, Erika K; Werker, Gregory R; Krausz, Michael

    2014-12-17

    Due to the high prevalence of psychological disorders and the lack of access to care among Canadian youth, the development of accessible services is increasingly important. eMental Health is an expanding field that may help to meet this need through the provision of mental health care using technology. The primary goals of the study are to explore youth experiences with traditional and online mental health resources, and to investigate youth expectations for mental health websites. A Web-based survey containing quantitative and qualitative questions was delivered to youth aged 17-24 years. Participants were surveyed to evaluate their use of mental health resources as well as their preferences for various components of a potential mental health website. A total of 521 surveys were completed. Most participants (61.6%, 321/521) indicated that they had used the Internet to seek information or help for feelings they were experiencing. If they were going through a difficult time, 82.9% (432/521) of participants were either "somewhat likely" or "very likely" to use an information-based website and 76.8% (400/521) reported that they were either "somewhat unlikely" or "very unlikely" to visit social media websites for information or help-seeking purposes during this time. Most (87.7%, 458/521) participants rated their online privacy as very important. Descriptions of interventions and treatments was the most highly rated feature to have in a mental health-related website, with 91.9% (479/521) of participants regarding it as "important" or "very important". When presented a select list of existing Canadian mental health-related websites, most participants had not accessed any of the sites. Of the few who had, the Canadian Mental Health Association website was the most accessed website (5.8%, 30/521). Other mental health-related websites were accessed by only 10.9% of the participants (57/521). The findings suggest that despite interest in these tools, current eMental Health

  16. Mainstream media and the social determinants of health in Canada: is it time to call it a day?

    Science.gov (United States)

    Raphael, Dennis

    2011-06-01

    This article explores the dearth of coverage of the social determinants of health by the Canadian mainstream media. It is argued that this neglect is primarily a reflection of political and economic societal structures that has been associated with increasing corporate control of the mainstream media. Applying a critical political economy lens, it is argued that the barriers to having the Canadian mainstream media report on the social determinants of health are so numerous that it may indeed be 'time to call it a day' in regard to having them assist in the dissemination of social determinants of health findings. Recognizing this reality should spur the development of alternative means of communicating with the public in order to develop a citizens' movement to create health-promoting public policy. Recent dissemination efforts related to the Social Determinants of Health: The Canadian Facts provide an example of how this might be accomplished.

  17. Empowering the Citizen-Consumer: Re-Regulating Consumer Information to Support the Transition to Sustainable and Health Promoting Food Systems in Canada

    Directory of Open Access Journals (Sweden)

    Sandi Trillo

    2012-09-01

    Full Text Available Both health and sustainability are stated public policy objectives in Canada, but food information rules and practices may not be optimal to support their achievement. In the absence of a stated consensus on the purposes of public information about food, the information provided is frequently determined by the marketers of product. No institution or agency has responsibility for determining the overall coherence of consumer food messages relative to these broader social goals of health and sustainability. Individual firms provide information that shows their products to best advantage, which may contradict what is provided about the product by another firm or government agency. Individual consumers do not have the resources to determine easily the completeness of any firm's messages, particularly in light of the size of food industry advertising budgets. Government rules confound this problem because there is also little coherence between the parts of government that have responsibility for point of purchase, advertising rules, and labelling. The healthy eating messages of health departments are often competing with contradictory messages permitted by the regulatory framework of other arms of government. Investments in programs that successfully promote environmental stewardship in agriculture are undercut in the market because consumers cannot support those efforts with their dollars. This problem exists despite the emergence of “citizen-consumers” who have a broader approach to food purchasing than individual maximization. Only recently have some health professionals and sustainable agriculture proponents turned their attention to these factors and designed interventions that take them into account. In this paper, which builds upon earlier work by MacRae [1], we outline key short, medium and long term initiatives to facilitate the citizen-consumer phenomenon and better support consumers in their efforts to promote health and sustainability

  18. PubMed Central Canada: Beyond an Open Access Repository?

    Science.gov (United States)

    Nariani, Rajiv

    2013-01-01

    PubMed Central Canada (PMC Canada) represents a partnership between the Canadian Institutes of Health Research (CIHR), the National Research Council's Canada Institute for Scientific and Technical Information (NRC-CISTI), and the National Library of Medicine of the US. The present study was done to gauge faculty awareness about the CIHR Policy on…

  19. 75 FR 75157 - Importation of Wood Packaging Material From Canada

    Science.gov (United States)

    2010-12-02

    ... Material From Canada AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Proposed rule... remove the exemption that allows wood packaging material from Canada to enter the United States without... spread of pests via wood packaging material from Canada. DATES: We will consider all comments that we...

  20. How You Pay Determines What You Get: Alternative Financing Options as a Determinant of Publicly Funded Health Care in Canada

    Directory of Open Access Journals (Sweden)

    Ronald D. Kneebone

    2012-06-01

    Full Text Available A Canadian returning home from a visit to a physician has no idea of the cost of providing the service just received. This is true for two reasons. One is because he or she does not receive a bill to pay. The other reason has to do the myriad of ways provincial governments fund the provision of health care. Health care is financed by a wide variety of types of taxation, by intergovernmental transfers determined by opaque and changing rules, by borrowing against future taxes and by drawing down savings. Confusion over how health care is funded creates a fiscal illusion that it is cheaper than it really is; a fiscal illusion that grows larger the less provincial governments rely on taxing individuals. In this paper it is shown that when provincial health spending is financed in ways other than taxation, it grows two to three times more quickly than it would have otherwise. From 2001-2008 alone, these distortions amounted to $6.75 billion at the national level, draining funds from other government services many of which have been shown to keep Canadians healthier and so reduce their demand for health care. Simply put, when Canadians are clear about the true cost of health care they more effectively play the traditional role of consumers by guarding against waste and inefficiency and so contribute to a more efficient and effective publicly-funded health care system.

  1. Information Management at a Health Services Research Organization in Toronto, Ontario, Canada: Moving from Identifiable Data to Coded Data

    Directory of Open Access Journals (Sweden)

    Lisa Thurairasu

    2017-04-01

    The processing practices used at the organization comply with Canadian privacy laws such as the Personal Health Information Protection Act (PHIPA as well as organizational policies and Research Ethics Board approvals. The approaches used to conceal individual identities yet allow linkage to various data sources can be modelled by other health agencies, ministries, and non-health related organizations that work with sensitive data but face challenges in maintaining both privacy and research quality. Our organization strives to make processing as efficient as possible and create maximum linkability to the various data sources in house while upholding privacy and confidentiality.

  2. Reforming health care in Canada: current issues La reforma del sistema de atención a la salud en Canadá: situación actual

    Directory of Open Access Journals (Sweden)

    Enis Baris

    1998-05-01

    Full Text Available This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government’s clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada’s health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness.Este artículo examina los temas más recientes en las reformas del sistema de atención a la salud en Canadá. Los planes de seguridad en el sector salud durante los años sesenta y setenta tuvieron efectos inapropiados en cuanto a que limitaron el poder del gobierno federal para controlar costos y promover un sistema centrado en la atención médico-hospitalaria. Recientemente, varias comisiones provinciales reportaron que las actuales estructuras de gobierno y gestión de los procesos no están actualizadas en términos del nuevo conocimiento, las nuevas realidades fiscales y la evolución en las formas de poder entre los grupos de interés. Sus recomendaciones incluyen formas descentralizadas de gobierno y mayor participación ciudadana. A pesar de que el sistema de atención a la salud en Canadá permanece comprometido a garantizar sus principios centrales, el balance de poder estaría cambiando de los

  3. Branding Asklepios and the Traditional and Variant Serpent Symbol Display Among Health Professional Schools in the United States, Puerto Rico, and Canada: A Cross-Sectional Survey.

    Science.gov (United States)

    Hamann, Claus; Martelon, MaryKate

    2016-05-25

    History supports the staff and single serpent, the asklepian, as the symbol of healing and medicine, yet its confusion with the caduceus (a winged staff with two snakes wrapped around it) persists. No population-based information on serpent symbol use exists. To determine the prevalence of asklepian and caduceus display among Internet images of medical and health professional schools' emblems, and to compare asklepian and caduceus display between medical and health professional schools, examining the effects of school longevity and geographic location on symbol display. This cross-sectional survey examined Internet websites and Google Images associated with medical and other health professional schools in the United States, Puerto Rico, and Canada from 2013 to 2015. The primary outcome was display of a traditional or variant asklepian or caduceus among current and past emblems in Google Images. Odds ratios (ORs) and 95% confidence intervals for the comparison of medical versus other health professional schools were calculated by logistic regression. Differences among schools' longevity were assessed with Student's t-tests and linear regression. Among images of current and past emblems of 482 schools-159 medical schools and 323 health professional schools-107 (22.2%) emblems displayed only the traditional, and 205 (42.5%) any, asklepian. Adjusting for geographic region and longevity, medical schools were 59% less likely than health professional schools to display the traditional asklepian (OR 0.41, 95% CI 0.24-0.71, P=.001), and were 7.7 times more likely than health professional schools to display the traditional caduceus. Medical schools were 8% less likely than health professional schools to display any asklepian (OR 0.92, 95% CI 0.62-1.38, P=.70), and were 3.3 times more likely than health professional schools to display any caduceus. Schools' preference of the asklepian over the caduceus confirmed historical origins. Less asklepian and more caduceus display by

  4. Income inequities in end-of-life health care spending in British Columbia, Canada: A cross-sectional analysis, 2004-2006

    Directory of Open Access Journals (Sweden)

    Hanley Gillian E

    2011-03-01

    Full Text Available Abstract Background This study aimed to measure the income-related inequalities and inequities - the inequalities that remain after accounting for differences in health need - in expenditure on fully publicly covered (hospital and ambulatory and partially publicly covered (prescription drugs services for those in their last year of life in the province of British Columbia (B.C., Canada. We focused on a decedent population for three reasons: to minimize unmeasured need differences among our cohort and therefore isolate income effects; to explore inequities for a high-spending window of health care use; and, because previous studies have found conflicting relationships between income and decedent health care spending, to further quantify this relationship. Methods We used linked administrative databases to describe spending on health services by income for all 58,820 deaths of B.C. residents 65 and older from 2004 to 2006. Regression analyses examined the association between income and health care spending, adjusting for age, sex, health status, cause of death, and other relevant factors. We then used concentration indexes to measure both inequalities and inequities separately for three key types of services. Analyses were also run separately for men and women. Results On average, per capita expenditure on acute health care in the last year of life was $20,705 (CDN2006. In need-adjusted regression analyses, we found decedents in the highest income quintile had 11% lower hospital expenditures, 15% higher specialist expenditures and 23% higher prescription drug expenditures than decedents in the lowest income quintile. Concentration index analysis suggested that spending for all types of care was concentrated among those with higher income before adjusting for need. Need-adjusted equity results mirrored regression findings and suggested patterns of inequities that were more pronounced among male decedents than females. Conclusions Despite the

  5. The evolution of social networks through the implementation of evidence-informed decision-making interventions: a longitudinal analysis of three public health units in Canada.

    Science.gov (United States)

    Yousefi-Nooraie, Reza; Dobbins, Maureen; Marin, Alexandra; Hanneman, Robert; Lohfeld, Lynne

    2015-12-03

    We studied the evolution of information-seeking networks over a 2-year period during which an organization-wide intervention was implemented to promote evidence-informed decision-making (EIDM) in three public health units in Ontario, Canada. We tested whether engagement of staff in the intervention and their EIDM behavior were associated with being chosen as information source and how the trend of inter-divisional communications and the dominance of experts evolved over time. Local managers at each health unit selected a group of staff to get engage in Knowledge Broker-led workshops and development of evidence summaries to address local public health problems. The staff were invited to answer three online surveys (at baseline and two annual follow-ups) including name generator questions eliciting the list of the staff they would turn to for help integrating research evidence into practice. We used stochastic actor-oriented modeling to study the evolution of networks. We tested the effect of engagement in the intervention, EIDM behavior scores, organizational divisions, and structural dynamics of social networks on the tendency of staff to select information sources, and the change in its trend between year 1 and year 2 of follow-up. In all the three health units, and especially in the two units with higher levels of engagement in the intervention, the network evolved towards a more centralized structure, with an increasing significance of already central staff. The staff showed greater tendencies to seek information from peers with higher EIDM behavior scores. In the public health unit that had highest engagement and stronger leadership support, the engaged staff became more central. In all public health units, the engaged staff showed an increasing tendency towards forming clusters. The staff in the three public health units showed a tendency towards limiting their connections within their divisions. The longitudinal analysis provided us with a means to study the

  6. The association between income source and met need among community mental health service users in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Bondy, Susan J; Durbin, Janet

    2012-10-01

    We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

  7. Reinventing primary care: lessons from Canada for the United States.

    Science.gov (United States)

    Starfield, Barbara

    2010-05-01

    Canada is, in many respects, culturally and economically similar to the United States, and until relatively recently, the two countries had similar health systems. However, since passage of the Canada Health Act in the 1970s, that nation's health statistics have become increasingly superior. Although the costs of Canada's health system are high by international standards, they are much lower than U.S. costs. This paper describes several factors likely to be responsible for Canada's better health at lower cost: universal financial coverage through a so-called single payer; features conducive to a strong primary care infrastructure; and provincial autonomy under general principles set by national law.

  8. Making Research Matter Comment on "Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal".

    Science.gov (United States)

    Hunter, David J; Frank, John

    2017-08-13

    We offer a UK-based commentary on the recent "Perspective" published in IJHPM by Thakkar and Sullivan. We are sympathetic to the authors' call for increased funding for health service and policy research (HSPR). However, we point out that increasing that investment - in any of the three countries they compare: Canada, the United States and the United Kingdom- will ipso facto not necessarily lead to any better use of research by health system decision-makers in these settings. We cite previous authors' descriptions of the many factors that tend to make the worlds of researchers and decision-makers into "two solitudes." And we call for changes in the structure and funding of HSPR, particularly the incentives now in place for purely academic publishing, to tackle a widespread reality: most published research in HSPR, as in other applied fields of science, is never read or used by the vast majority of decision-makers, working out in the "real world. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  9. What is the comparative health status and associated risk factors for the Métis? A population-based study in Manitoba, Canada

    Directory of Open Access Journals (Sweden)

    Martens Patricia J

    2011-10-01

    Full Text Available Abstract Background Métis are descendants of early 17th century relationships between North American Indians and Europeans. This study's objectives were: (1 to compare the health status of the Métis people to all other residents of Manitoba, Canada; and (2 to analyze factors in predicting the likelihood of diabetes and related lower limb amputation. Methods Using de-identified administrative databases plus the Métis Population Database housed at the Manitoba Centre for Health Policy, age/sex-adjusted rates of mortality and disease were calculated for Métis (n = 73,016 and all other Manitobans (n = 1,104,672. Diseases included: hypertension, arthritis, diabetes, ischemic heart disease (age 19+; osteoporosis (age 50+; acute myocardial infarction (AMI and stroke (age 40+; total respiratory morbidity (TRM, all ages. Using logistic regression, predictors of diabetes (2004/05-2006/07 and diabetes-related lower-limb amputations (2002/03-2006/07 were analyzed. Results Disease rates were higher for Métis compared to all others: premature mortality before age 75 (4.0 vs. 3.3 per 1000, p Conclusion Despite universal healthcare, Métis' illness and mortality rates are mostly higher. Although elevated diabetes risk persists for the Métis even after adjusting for sociodemographic, healthcare and comorbidity variables, the risk of amputation for Métis appears more related to healthcare access rather than ethnicity.

  10. Water quality and health in northern Canada: stored drinking water and acute gastrointestinal illness in Labrador Inuit.

    Science.gov (United States)

    Wright, Carlee J; Sargeant, Jan M; Edge, Victoria L; Ford, James D; Farahbakhsh, Khosrow; Shiwak, Inez; Flowers, Charlie; Harper, Sherilee L

    2017-07-12

    One of the highest self-reported incidence rates of acute gastrointestinal illness (AGI) in the global peer-reviewed literature occurs in Inuit communities in the Canadian Arctic. This high incidence of illness could be due, in part, to the consumption of contaminated water, as many northern communities face challenges related to the quality of municipal drinking water. Furthermore, many Inuit store drinking water in containers in the home, which could increase the risk of contamination between source and point-of-use (i.e., water recontamination during storage). To examine this risk, this research characterized drinking water collection and storage practices, identified potential risk factors for water contamination between source and point-of-use, and examined possible associations between drinking water contamination and self-reported AGI in the Inuit community of Rigolet, Canada. The study included a cross-sectional census survey that captured data on types of drinking water used, household practices related to drinking water (e.g., how it was collected and stored), physical characteristics of water storage containers, and self-reported AGI. Additionally, water samples were collected from all identified drinking water containers in homes and analyzed for presence of Escherichia coli and total coliforms. Despite municipally treated tap water being available in all homes, 77.6% of households had alternative sources of drinking water stored in containers, and of these containers, 25.2% tested positive for total coliforms. The use of transfer devices and water dippers (i.e., smaller bowls or measuring cups) for the collection and retrieval of water from containers were both significantly associated with increased odds of total coliform presence in stored water (OR transfer device  = 3.4, 95% CI 1.2-11.7; OR dipper  = 13.4, 95% CI 3.8-47.1). Twenty-eight-day period prevalence of self-reported AGI during the month before the survey was 17.2% (95% CI 13

  11. Intersectoral action for health equity as it relates to climate change in Canada: contributions from critical systems heuristics.

    Science.gov (United States)

    Buse, Chris

    2013-12-01

    Intersectoral action (ISA) has been at the forefront of public health policy discussions since the 1970s. ISA incorporates a broader perspective of public health issues and coordinates efforts to address the social, political, economic and environmental contexts from which health determinants operate and are created. Despite being forwarded as a useful way to address and treat complex or 'wicked' problems, such policy issues are still often addressed within, rather than across, disciplinary silos and ISA has been documented to fail more often than it succeeds. This paper contributes to an understanding of ISA by outlining and applying critical systems heuristics (CSH) theory and methods. CSH theory and methods are described and discussed before applying them to the example of addressing climate change and health equity through public health practice. CSH thinking provides useful tools to engage stakeholders, question relations of power that may exist between collaborating partners, and move beyond power inequalities that guide ISA initiatives. CSH is a compelling framing that can improve an understanding of the collaborative relationships that are a prerequisite for engaging in ISA to address complex or 'wicked' policy problems such as climate change. © 2013 John Wiley & Sons Ltd.

  12. Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada.

    Science.gov (United States)

    Cai, Jiaoli; Guerriere, Denise N; Zhao, Hongzhong; Coyte, Peter C

    2017-07-18

    The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations.

  13. Toxoplasmosis and Toxocariasis: An Assessment of Human Immunodeficiency Virus Comorbidity and Health-Care Costs in Canada.

    Science.gov (United States)

    Schurer, Janna M; Rafferty, Ellen; Schwandt, Michael; Zeng, Wu; Farag, Marwa; Jenkins, Emily J

    2016-07-06

    Toxoplasma gondii and Toxocara spp. are zoonotic parasites with potentially severe long-term consequences for those infected. We estimated incidence and investigated distribution, risk factors, and costs associated with these parasites by examining hospital discharge abstracts submitted to the Canadian Institute for Health Information (2002-2011). Annual incidence of serious toxoplasmosis and toxocariasis was 0.257 (95% confidence interval [CI]: 0.254-0.260) and 0.010 (95% CI: 0.007-0.014) cases per 100,000 persons, respectively. Median annual health-care costs per serious case of congenital, adult-acquired, and human immunodeficiency virus (HIV)-associated toxoplasmosis were $1,971, $763, and $5,744, respectively, with an overall cost of C$1,686,860 annually (2015 Canadian dollars). However, the total economic burden of toxoplasmosis is likely much higher than these direct health-care cost estimates. HIV was reported as a comorbidity in 40% of toxoplasmosis cases and accounted for over half of direct health-care costs associated with clinical toxoplasmosis. A One Health approach, integrating physician and veterinary input, is recommended for increasing public awareness and decreasing the economic burden of these preventable zoonoses. © The American Society of Tropical Medicine and Hygiene.

  14. Applying an Ecohealth Perspective in a State of the Environment Report: Experiences of a Local Public Health Unit in Canada

    Directory of Open Access Journals (Sweden)

    Steven Lam

    2014-12-01

    Full Text Available We applied an Ecohealth perspective into a State of the Environment report for Grey Bruce Health Unit and summarized environmental and health data relevant for public health practice. We aimed for comprehensiveness in our data compilation, including: standard media categories (e.g., air, water, land; and ecological indicators (e.g., vectors, forests, wetlands. Data sources included both primary (collected by an organization and secondary (assembled by others. We organized indicators with the Driving forces-Pressure-State-Exposure-Effect-Action (DPSEEA framework created by the World Health Organization. Indicators of air, water and land quality generally appeared to point towards a healthy state. Vector-borne diseases remained low. Forests and wetlands appeared to be in good condition, however more monitoring data was needed to determine trends in their ecological indicators. Data were not available on biodiversity and fish conditions. The results of our application of the DPSEEA framework suggest that routinely collected environmental and health data can be structured into the framework, though challenges arose due to gaps in data availability, particularly for social and gender analyses. Ecohealth approaches had legitimacy with broader healthy community partners but applying such approaches was a complex undertaking.

  15. The DEPICT model for participatory qualitative health promotion research analysis piloted in Canada, Zambia and South Africa.

    Science.gov (United States)

    Flicker, Sarah; Nixon, Stephanie A

    2015-09-01

    Health promotion researchers are increasingly conducting Community-Based Participatory Research in an effort to reduce health disparities. Despite efforts towards greater inclusion, research teams continue to regularly exclude diverse representation from data analysis efforts. The DEPICT model for collaborative qualitative analysis is a democratic approach to enhancing rigour through inclusion of diverse stakeholders. It is broken down into six sequential steps. Strong leadership, coordination and facilitation skills are needed; however, the process is flexible enough to adapt to most environments and varying levels of expertise. Including diverse stakeholders on an analysis team can enrich data analysis and provide more nuanced understandings of complicated health problems. © The Author (2014). Published by Oxford University Press.

  16. Municipal water quantities and health in Nunavut households: an exploratory case study in Coral Harbour, Nunavut, Canada

    Directory of Open Access Journals (Sweden)

    Kiley Daley

    2014-03-01

    Full Text Available Background: Access to adequate quantities of water has a protective effect on human health and well-being. Despite this, public health research and interventions are frequently focused solely on water quality, and international standards for domestic water supply minimums are often overlooked or unspecified. This trend is evident in Inuit and other Arctic communities even though numerous transmissible diseases and bacterium infections associated with inadequate domestic water quantities are prevalent. Objectives: Our objective was to explore the pathways by which the trucked water distribution systems being used in remote northern communities are impacting health at the household level, with consideration given to the underlying social and environmental determinants shaping health in the region. Methods: Using a qualitative case study design, we conducted 37 interviews (28 residents, 9 key informants and a review of government water documents to investigate water usage practices and perspectives. These data were thematically analysed to understand potential health risks in Arctic communities and households. Results: Each resident receives an average of 110 litres of municipal water per day. Fifteen of 28 households reported experiencing water shortages at least once per month. Of those 15, most were larger households (5 people or more with standard sized water storage tanks. Water shortages and service interruptions limit the ability of some households to adhere to public health advice. The households most resilient, or able to cope with domestic water supply shortages, were those capable of retrieving their own drinking water directly from lake and river sources. Residents with extended family and neighbours, whom they can rely on during shortages, were also less vulnerable to municipal water delays. Conclusions: The relatively low in-home water quantities observed in Coral Harbour, Nunavut, appear adequate for some families. Those living in

  17. Radiation protection as part of occupational health and safety in the regulation of uranium mines in Canada

    International Nuclear Information System (INIS)

    Dory, A.B.

    1981-02-01

    The Canadian Atomic Energy Control Board (AECB) is involved in the development of new uranium mines from the early planning stages through the development of the mine-mill facility. As a result, new facilities are designed and developed to a much higher standard of both conventional and radiation health and safety than previously. Radiation is not the most significant cause of injury to the uranium miner, and public attitudes toward radiation may result in overemphasizing these aspects to the detriment of conventional health and safety conditions in the mines. The AECB believes that one dead miner is one too many and bases its regulatory efforts on this belief

  18. Canada's Clean Air Act

    International Nuclear Information System (INIS)

    2006-01-01

    This paper provided an outline of Canada's Clean Air Act and examined some of the regulatory changes that will occur as a result of its implementation. The Act is being introduced to strengthen the legislative basis for taking action on reducing air pollution and GHGs, and will allow the government to regulate both indoor and outdoor air pollutants and GHGs. The Act will require the Ministers of the Environment and Health to establish national air quality objectives, as well as to monitor and report on their attainment. The Canadian Environmental Protection Act will be amended to enable the government to regulate the blending of fuels and their components. The Motor Vehicle Fuel Consumption Standards Act will also be amended to enhance the government's authority to regulate vehicle fuel efficiency. The Energy Efficiency Act will also be expanded to allow the government to set energy efficiency standards and labelling requirements for a wider range of consumer and commercial products. The Act will commit to short, medium and long-term industrial air pollution targets. Regulations will be proposed for emissions from industry; on-road and off-road vehicles and engines; and consumer and commercial products. It was concluded that the Government of Canada will continue to consult with provinces, territories, industries and Canadians to set and reach targets for the reduction of both indoor and outdoor air pollutants and GHG emissions. 6 figs

  19. Fusion Canada issue 21

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-08-01

    A short bulletin from the National Fusion Program highlighting in this issue Europe proposes Canada`s participation in ITER, tritium for JET, CCFM/TdeV-Tokamak helium pumping and TdeV update, ITER-related R and D at CFFTP, ITER Deputy Director visits Canada, NFP Director to Chair IFRC, Award for Akira Hirose. 3 figs.

  20. The impact of intimate partner violence on the health and work of gender and sexual minorities in Canada.

    Science.gov (United States)

    Wathen, C Nadine; MacGregor, Jennifer C D; Tanaka, Masako; MacQuarrie, Barbara J

    2018-06-04

    Intimate partner violence (IPV) has significant impacts on workers and workplaces. This paper examines the experiences of gender and sexual minority (GSM) people in this context. People aged 15 and older completed an online survey on the impacts of IPV at work, and brief health and life quality questions. Of 7918 respondents, 8.5% (n = 672) indicated GSM status. We examined IPV exposure, health and IPV-related work impacts by overall GSM status, and separately by sexual orientation, and gender. GSM respondents were significantly more likely to report IPV and that the IPV continued at or near their workplace, impeded their ability to get to work, negatively impacted their work performance, and their co-workers; they also reported poorer mental health and life quality. While women were significantly more likely to report IPV and various negative work and health outcomes, being a sexual minority had additional independent negative effects. No differences in willingness to disclose IPV were found. Workplace responses to IPV should account for the additional impacts and barriers faced by GSM people in disclosing abuse and seeking help.

  1. Needlestick and other potential blood and body fluid exposures among health care workers in British Columbia, Canada.

    Science.gov (United States)

    Alamgir, Hasanat; Cvitkovich, Yuri; Astrakianakis, George; Yu, Shicheng; Yassi, Annalee

    2008-02-01

    Health care workers have high risk of exposure to human blood and body fluids (BBF) from patients in acute care and residents in nursing homes or personal homes. This analysis examined the epidemiology for BBF exposure across health care settings (acute care, nursing homes, and community care). Detailed analysis of BBF exposure among the health care workforce in 3 British Columbian health regions was conducted by Poisson regression modeling, with generalized estimating equations to determine the relative risk associated with various occupations. Acute care had the majority of needlestick, sharps, and splash events with the BBF exposure rate in acute care 2 to 3 times higher compared with nursing home and community care settings. Registered nurses had the highest frequency of needlestick, sharps, and splash events. Laboratory assistants had the highest exposure rates from needlestick injuries and splashes, whereas licensed practical nurses had the highest exposure rate from sharps. Most needlestick injuries (51.3%) occurred at the patient's bedside. Sharps incidents occurred primarily in operating rooms (26.9%) and at the patient's bedside (20.9%). Splashes occurred most frequently at the patient's bedside (46.1%) and predominantly affected the eyes or face/mouth. The majority of needlestick/sharps injuries occurred during use for registered nurses, during disposal for licensed practical nurses, and after disposal for care aides. The high risk of BBF exposure for some occupations indicates there is room for improvement to reduce BBF exposure by targeting high-risk groups for prevention strategies.

  2. Health Care Service Needs and Correlates of Quality of Life: A Case Study of Elderly Chinese Immigrants in Canada

    Science.gov (United States)

    Chow, Henry P. H.

    2012-01-01

    This study explored the health care service needs and the major correlates of quality of life among 127 community-dwelling elderly Chinese immigrants in a western Canadian city. Participants were interviewed in their homes by trained, bilingual interviewers employing a structured questionnaire that covered a wide range of topics including health…

  3. Communication and language challenges experienced by Chinese and South Asian immigrant parents of children with cancer in Canada: implications for health services delivery.

    Science.gov (United States)

    Gulati, Sonia; Watt, Lisa; Shaw, Nicola; Sung, Lillian; Poureslami, Iraj M; Klaassen, Robert; Dix, David; Klassen, Anne F

    2012-04-01

    Language is an important aspect of health literacy and plays a vital role in families' ability to access and use health information and resources. Our study explored the role of communication and language in the healthcare experiences of immigrant parents of children with cancer living in Canada. We used a grounded theory approach. Chinese and South Asian parents of children 6 months post-diagnosis were recruited from six Canadian pediatric oncology centers. Semi-structured interviews were conducted in Cantonese, Mandarin, Hindi, Punjabi, Urdu, or English. Questions relevant to communication included: how parents navigated the healthcare system; nature of interpreter services and translated materials; and suggestions about how to improve services. Analysis involved line-by-line, focused and theoretical coding, and constant comparison. Thirty-one (62%) parents reported no difficulty communicating with healthcare providers in English, while 13 (26%) parents struggled with English, and six (12%) parents could not communicate in English. Communication challenges influenced parents' role in caring for their child and made it difficult to learn complex medical terminology. Interpreting services were sometimes inadequate or not accessible. Parents occasionally missed out on services and resources, reported limited availability of linguistically and culturally appropriate information, and experienced a lack of social integration in the healthcare process. Language ability played an essential role in parents' healthcare experiences for pragmatic and social purposes. Language challenges can heighten systemic and socio-cultural barriers to accessing health information and resources. The provision of enhanced culturally and linguistically sensitive services may support immigrant families in their caregiving role. Copyright © 2011 Wiley Periodicals, Inc.

  4. 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.

  5. "Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

    Science.gov (United States)

    Ferrazzi, Priscilla; Krupa, Terry

    2016-09-01

    Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The

  6. Characterizing the Use of Telepsychiatry for Patients with Opioid Use Disorder and Cooccurring Mental Health Disorders in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Brittanie LaBelle

    2018-01-01

    Full Text Available Rural patients with opioid use disorder (OUD face a variety of barriers when accessing opioid agonist therapy (OAT and psychiatric services, due to the limited supply of physicians and the vast geographic area. The telemedicine allows for contact between patients and their physician—regardless of physical distance. Objective. We characterize the usage of telemedicine to deliver psychiatric services to patients with OUD in Ontario, as well as traits of treatment-seeking patients with opioid dependence and concurrent psychiatric disorders. Methodology. A retrospective cohort study was conducted using an administrative database for patients who received psychiatric services via telemedicine between 2008 and 2014 and who also had OUD. Results. We identified 9,077 patients with concurrent opioid use and other mental health disorders who had received psychiatric services via telemedicine from 2008 to 2014; 7,109 (78.3% patients lived in Southern Ontario and 1,968 (21.7% in Northern Ontario. Telemedicine was used more frequently to provide mental health services to patients residing in Northern Ontario than Southern Ontario. Conclusion. Telemedicine is increasingly being utilized throughout Ontario for delivering mental health treatment. There is an opportunity to increase access to psychiatric services for patients with opioid dependence and concurrent psychiatric disorders through the use of the telemedicine.

  7. Sexual Orientation Differences in Health and Wellbeing Among Women Living with HIV in Canada: Findings from a National Cohort Study.

    Science.gov (United States)

    Logie, Carmen H; Lacombe-Duncan, Ashley; Wang, Ying; Kaida, Angela; de Pokomandy, Alexandra; Webster, Kath; Conway, Tracey; Loutfy, Mona

    2018-06-01

    Sexual orientation differences in health and wellbeing among women living with HIV (WLH) are underexplored. Limited research available, however, suggests that sexual minority WLH may experience barriers to HIV care. Cross-sectional baseline data was analyzed from a Canadian cohort study with WLH (sexual minority women [SMW]: n = 180; heterosexual women: n = 1240). SMW (median age 38 years, IQR 13) included bisexual (58.9%), lesbian (17.8%) and other sexualities (23.3%). In multivariable analyses adjusting for age, poverty, education, and ethnicity, SMW identity was associated with increased odds of: clinical (80% vs. 100% antiretroviral adherence), intrapersonal (previous/current injection drug use [IDU] vs. no IDU history, depression, lower resilience), interpersonal (childhood abuse, sex work, adulthood abuse), and structural (HIV support services barriers, unstable housing, racial discrimination, gender discrimination) factors in comparison with heterosexual identity. Sexual minority WLH experience social and health disparities relative to heterosexual WLH, highlighting the need for interventions to promote health equity.

  8. Is the UN Convention on the Rights of Persons with Disabilities Impacting Mental Health Laws and Policies in High-Income Countries? A Case Study of Implementation in Canada.

    Science.gov (United States)

    Hoffman, Steven J; Sritharan, Lathika; Tejpar, Ali

    2016-11-11

    Persons with psychosocial disabilities face disparate access to healthcare and social services worldwide, along with systemic discrimination, structural inequalities, and widespread human rights abuses. Accordingly, many people have looked to international human rights law to help address mental health challenges. On December 13, 2006, the United Nations formally adopted the Convention on the Rights of Persons with Disabilities (CRPD) - the first human rights treaty of the 21st century and the fastest ever negotiated. This study assesses the CRPD's potential impact on mental health systems and presents a legal and public policy analysis of its implementation in one high-income country: Canada. As part of this analysis, a critical review was undertaken of the CRPD's implementation in Canadian legislation, public policy, and jurisprudence related to mental health. While the Convention is clearly an important step forward, there remains a divide, even in Canada, between the Convention's goals and the experiences of Canadians with disabilities. Its implementation is perhaps hindered most by Canada's reservations to Article 12 of the CRPD on legal capacity for persons with psychosocial disabilities. The overseeing CRPD Committee has stated that Article 12 only permits "supported decision-making" regimes, yet most Canadian jurisdictions maintain their "substitute decision-making" regimes. This means that many Canadians with mental health challenges continue to be denied legal capacity to make decisions related to their healthcare, housing, and finances. But changes are afoot: new legislation has been introduced in different jurisdictions across the country, and recent court decisions have started to push policymakers in this direction. Despite the lack of explicit implementation, the CRPD has helped to facilitate a larger shift in social and cultural paradigms of mental health and disability in Canada. But ratification and passive implementation are not enough. Further

  9. Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach.

    Directory of Open Access Journals (Sweden)

    John Paul Ekwaru

    Full Text Available The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach.We developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY, from a school system's cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate.The incremental cost-effectiveness ratio(ICER of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER < CA$50,000. In probabilistic sensitivity analysis, APPLE Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICERhealth promotion, such as APPLE Schools is a cost-effective intervention for obesity prevention and reduction of chronic disease risk over the lifetime. Expanding the coverage and allocating resources towards school-based programs like the APPLE Schools program, is likely to reduce the public health burden of obesity and chronic diseases.

  10. Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach.

    Science.gov (United States)

    Ekwaru, John Paul; Ohinmaa, Arto; Tran, Bach Xuan; Setayeshgar, Solmaz; Johnson, Jeffrey A; Veugelers, Paul J

    2017-01-01

    The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) has been recognized as a "best practice" in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project's cost-effectiveness following a life-course approach. We developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY), from a school system's cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate. The incremental cost-effectiveness ratio(ICER) of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICERSchool-based health promotion, such as APPLE Schools is a cost-effective intervention for obesity prevention and reduction of chronic disease risk over the lifetime. Expanding the coverage and allocating resources towards school-based programs like the APPLE Schools program, is likely to reduce the public health burden of obesity and chronic diseases.

  11. Radiation protection as part of occupational health and safety in the regulation of uranium mines in Canada

    International Nuclear Information System (INIS)

    Dory, A.B.

    1982-01-01

    The author establishes that radiation exposure is one of the health hazards of uranium mining and therefore has to be controlled. The jurisdictional framework for this is outlined and the role and functions of the Atomic Energy Control Board are detailed. The author then sets down seven objectives for radiation protection followed by an outline of the Canadian regulatory philosophy including an examination of two possible approaches to regulation of uranium mining and milling, and a sketch of pending new regulations. After setting down what he considers the main concerns of the AECB in mine regulation, the author details the Board's licensing process, compliance activities and relationship with workers. The conclusion includes a call for a more rational approach in considering and therefore dealing with radiation as a workplace hazard

  12. 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.

  13. Building benefits for homemakers: a report to the Minister of National Health and Welfare from the Canada Pension Plan Advisory Board

    National Research Council Canada - National Science Library

    1987-01-01

    ... ̀More effective participation of homemakers in the Canada Pension Plan'. Brought to light are inconsistencies arising from its previous recommendation that an imputed economic value be assigned to the work that homemakers...

  14. Comparing pyloromyotomy outcomes across Canada.

    Science.gov (United States)

    Ednie, Alexander C; Amram, Ofer; Schuurman, Nadine; Yanchar, Natalie L

    2017-05-01

    Changing patterns of referral and management of hypertrophic pyloric stenosis (HPS) in North America have recently been described. Comfort with perioperative management, anesthesia, and corrective surgery have been cited as reasons for these changes. Our primary objective was to assess pyloromyotomy outcomes between different hospital types across Canada. The secondary objective was to geospatially map all pyloromyotomies to identify regions of higher HPS incidence across Canada. Data of all pyloromyotomies done between 2011 and 2013 were acquired from Canadian Institute for Health Information (CIHI). Complication rates and length of hospital stay (LOS) were analyzed. Postal codes for each patient were used to geospatially map regions of higher HPS incidence. A total of 1261 pyloromyotomies were assessed. There was no difference in LOS or complication rates between different hospital types or surgeon group. Open pyloromyotomies were done in 75% of the cases. Several regions of higher HPS incidence were identified across Canada. This study found no difference in complication rate or LOS stay between hospital type and surgeon type across Canada. This may reflect a previously identified referral trend in the United States towards pediatric centers. Several regions of higher HPS incidence were identified, and may aid in identifying genetic elements causing HPS. 2c. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  15. Canada puts emphasis on SMR

    International Nuclear Information System (INIS)

    Anon.

    2017-01-01

    Thanks to hydroelectricity and 16% share of nuclear power, Canada is among the few countries to respect GIEC's 2050 climate objectives: producing 80% of electricity without emitting CO 2 . In the context of a growing power demand, Canada has integrated nuclear energy in its energy scenarios. Small Modular Reactors (SMR) are considered as an efficient means to replace diesel generators used in small isolated communities. Several North America start-ups such as Terrestrial Energy that develops molten salt reactors, have moved to Canada. The British firm Moltex has chosen Canadian Nuclear Safety Authority (CCSN for the certification of its 4. generation reactor. In Ontario, Canada's most populated province, nuclear energy produces 60% of its electricity consumption and has allowed the progressive shutdown of all coal-fed power plants of the province. Between 2000 and 2013 nuclear power increased by 20% whereas the coal share in power production dropped by 27%. The 2014 Toronto Public Health report highlights that since 2004 premature mortality has dropped by 23% and the hospitalization due to air pollution by 41%. (A.C.)

  16. Canada's Fusion Program

    International Nuclear Information System (INIS)

    Jackson, D. P.

    1990-01-01

    Canada's fusion strategy is based on developing specialized technologies in well-defined areas and supplying these technologies to international fusion projects. Two areas are specially emphasized in Canada: engineered fusion system technologies, and specific magnetic confinement and materials studies. The Canadian Fusion Fuels Technology Project focuses on the first of these areas. It tritium and fusion reactor fuel systems, remote maintenance and related safety studies. In the second area, the Centre Canadian de fusion magnetique operates the Tokamak de Varennes, the main magnetic fusion device in Canada. Both projects are partnerships linking the Government of Canada, represented by Atomic Energy of Canada Limited, and provincial governments, electrical utilities, universities and industry. Canada's program has extensive international links, through which it collaborates with the major world fusion programs, including participation in the International Thermonuclear Experimental Reactor project

  17. Fusion Canada issue 13

    International Nuclear Information System (INIS)

    1991-01-01

    A short bulletin from the National Fusion Program. Included in this issue is a report on Canada's plans to participate in the Engineering Design Activities (EDA), bilateral meetings with Canada and the U.S., committee meeting with Canada-Europe, an update at Tokamak de Varennes on Plasma Biasing experiments and boronized graphite tests, fusion materials research at the University of Toronto using a dual beam accelerator and a review of the CFFTP and the CCFM. 2 figs

  18. Reducing inequalities in health and access to health care in a rural Indian community: an India-Canada collaborative action research project.

    Science.gov (United States)

    Haddad, Slim; Narayana, Delampady; Mohindra, Ks

    2011-11-08

    Inadequate public action in vulnerable communities is a major constraint for the health of poor and marginalized groups in low and middle-income countries (LMICs). The south Indian state of Kerala, known for relatively equitable provision of public resources, is no exception to the marginalization of vulnerable communities. In Kerala, women's lives are constrained by gender-based inequalities and certain indigenous groups are marginalized such that their health and welfare lag behind other social groups. The goal of this socially-engaged, action-research initiative was to reduce social inequalities in access to health care in a rural community. Specific objectives were: 1) design and implement a community-based health insurance scheme to reduce financial barriers to health care, 2) strengthen local governance in monitoring and evidence-based decision-making, and 3) develop an evidence base for appropriate health interventions. Health and social inequities have been masked by Kerala's overall progress. Key findings illustrated large inequalities between different social groups. Particularly disadvantaged are lower-caste women and Paniyas (a marginalized indigenous group), for whom inequalities exist across education, employment status, landholdings, and health. The most vulnerable populations are the least likely to receive state support, which has broader implications for the entire country. A community based health solidarity scheme (SNEHA), under the leadership of local women, was developed and implemented yielding some benefits to health equity in the community-although inclusion of the Paniyas has been a challenge. The Canadian-Indian action research team has worked collaboratively for over a decade. An initial focus on surveys and data analysis has transformed into a focus on socially engaged, participatory action research. Adapting to unanticipated external forces, maintaining a strong team in the rural village, retaining human resources capable of analyzing

  19. Reducing inequalities in health and access to health care in a rural Indian community: an India-Canada collaborative action research project

    Directory of Open Access Journals (Sweden)

    Mohindra KS

    2011-11-01

    Full Text Available Abstract Background Inadequate public action in vulnerable communities is a major constraint for the health of poor and marginalized groups in low and middle-income countries (LMICs. The south Indian state of Kerala, known for relatively equitable provision of public resources, is no exception to the marginalization of vulnerable communities. In Kerala, women’s lives are constrained by gender-based inequalities and certain indigenous groups are marginalized such that their health and welfare lag behind other social groups. The research The goal of this socially-engaged, action-research initiative was to reduce social inequalities in access to health care in a rural community. Specific objectives were: 1 design and implement a community-based health insurance scheme to reduce financial barriers to health care, 2 strengthen local governance in monitoring and evidence-based decision-making, and 3 develop an evidence base for appropriate health interventions. Results and outcomes Health and social inequities have been masked by Kerala’s overall progress. Key findings illustrated large inequalities between different social groups. Particularly disadvantaged are lower-caste women and Paniyas (a marginalized indigenous group, for whom inequalities exist across education, employment status, landholdings, and health. The most vulnerable populations are the least likely to receive state support, which has broader implications for the entire country. A community based health solidarity scheme (SNEHA, under the leadership of local women, was developed and implemented yielding some benefits to health equity in the community—although inclusion of the Paniyas has been a challenge. The partnership The Canadian-Indian action research team has worked collaboratively for over a decade. An initial focus on surveys and data analysis has transformed into a focus on socially engaged, participatory action research. Challenges and successes Adapting to

  20. Risky health environments: women sex workers' struggles to find safe, secure and non-exploitative housing in Canada's poorest postal code.

    Science.gov (United States)

    Lazarus, L; Chettiar, J; Deering, K; Nabess, R; Shannon, K

    2011-12-01

    This study explored low-income and transitional housing environments of women sex workers and their role in shaping agency and power in negotiating safety and sexual risk reduction in Vancouver, Canada. A series of 12 focus group discussions were conducted with 73 women currently involved in street-based sex work. These women were purposively sampled for a range of experiences living in low-income housing environments, including homeless shelters, transitional housing, and co-ed and women-only single-room occupancy (SRO) hotels. Drawing on the risk environment framework and theoretical constructs of gender, agency and power, analyses demonstrate that women continue to be vulnerable to violence and sexual and economic exploitation and have reduced ability to negotiate risk reduction resulting from the physical, structural and social environments of current dominant male-centred housing models. Within the physical environment, women described inhabitable housing conditions in SROs with infestations of bedbugs and rats, leading women to even more transitional housing options such as shelters and couch-surfing. In many cases, this resulted in their economic exploitation and increased sexual risk. Within the structural environment, enforcement of curfews and guest policies forced women to accept risky clients to meet curfew, or work outdoors where their ability to negotiate safety and condom use were limited. Certain policies promoted women's agency and mitigated their ability to reduce risks when selling sex. These included flexible curfews and being able to bring clients home. The social environments of co-ed single-room occupancy hotels resulted in repeated violence by male residents and discrimination by male building staff. Women-only shelters and SROs facilitated 'enabling environments' where women developed support systems with other working women that resulted in safer work practices. The narratives expressed in this study reveal the critical need for public

  1. Plasma concentrations of persistent organic pollutants in the Cree of northern Quebec, Canada: results from the multi-community environment-and-health study.

    Science.gov (United States)

    Liberda, Eric N; Tsuji, Leonard J S; Martin, Ian D; Cote, Suzanne; Ayotte, Pierre; Dewailly, Eric; Nieboer, Evert

    2014-02-01

    Historically, resource development has had negative impacts on the traditional lifestyle of First Nation Cree Communities in the Province of Quebec, Canada. In response to the perceived need for fisheries restoration and for managing health concerns associated with environmental pollutants, the Mercury Program in the James Bay Region of Quebec was reconstituted in 2001 and broadened to include a wider range of chemicals of concern. Based on comprehensive surveys of the nine Cree Territory (Eeyou Istchee) communities in this region during the period 2002-2009, blood plasma concentrations are presented of Aroclor 1260, PCB congeners 28, 52, 99, 101, 105, 118, 128, 138, 153, 156, 163, 170, 180, 183, and 187, Aldrin, ß-HCH, α-Chlordane, γ-Chlordane, oxy-Chlordane, trans-Nonachlor, cis-Nonachlor, p,p'-DDT, p,p'-DDE, Hexachloro benzene (HCB), Mirex, PBB 153, PBDE 47, PBDE 99, PBDE 100, PBDE 153, Toxaphene 26, and Toxaphene 50. The organohalogenated compounds were extracted using solid-phase extraction and cleaned on florisil columns before high resolution HRGC-MS analysis. Principal component analysis (PCA) was used to reduce the large number of contaminant variables into a smaller number of uncorrelated variables. ANOVA identified significant differences between age groups, with the older participants having higher body burdens of legacy lipophilic contaminants, but not for the PBDEs. In certain female age groups, plasma concentrations of PBDEs were observed to be lower than for males; conversely, DDT was higher. Among communities, concentrations were different (p<0.001) for all contaminants. This work provides a baseline for the James Bay Eeyou Istchee communities who, to varying degrees, rely on food and other resources from the land and therefore are at higher risk of increased body burdens of legacy persistent organic pollutants (POPs). © 2013.

  2. Developing population segments with different levels of complexity and primary health care needs: An analysis using health administrative data in British Columbia, Canada

    Directory of Open Access Journals (Sweden)

    Julia Langton

    2017-04-01

    We developed population segments designed to account for patient complexity and primary health care needs; as such, segments provide more information than traditional indices of morbidity burden based on counts of chronic conditions. These segments will be used to report information on the quality of primary care. We plan to include conduct validation studies using additional variables (e.g, socio-economic factors, level of vulnerability from patient surveys so that segments more accurately represent the level of complexity and patients’ primary health care needs.

  3. Western Canada study of animal health effects associated with exposure to emissions from oil and gas field facilities : interpretive overview by the science advisory panel

    Energy Technology Data Exchange (ETDEWEB)

    Guidotti, T.; Nielsen, O.; Berhane, K.; Cohen, B.S.; Hunter, B.; Lasley, B.; Martin, W.; Ribble, C.; Thorne, P.; Tollerud, D.; Witschi, H. [Western Interprovincial Scientific Studies Association, Calgary, AB (Canada). Science Advisory Panel

    2006-05-15

    The results of a study to determine if chronic exposure to emissions from the oil and gas industry influence the health and reproductive performance of cattle and wildlife in western Canada was presented. Individual cows in herds from Alberta, Saskatchewan and northeastern British Columbia were monitored in pens and pastures to determine their exposure status. Data on other known risk factors such as the cow's age, breed and body condition were collected. The study measured concentrations of sulphur dioxide (SO{sub 2}); hydrogen sulphide (H{sub 2}S); and volatile organic compounds (VOCs) measured as benzene and toluene. Passive air monitors were located on all occupied pastures and wintering areas for each herd. Information on the location of over 39,000 animals from 205 herds on 3355 different parcels of land was recorded at 2 week intervals. Each animal's exposure was then averaged to create cumulative exposure values for biologically relevant risk periods for each outcome. Exposures to fine particulate matter (PM) and polycyclic aromatic hydrocarbons were measured a total of 365 times near the calving area for 32 herds. Five primary health outcomes were studied: (1) nonpregnancy; (2) length of breeding-to-calving interval; (3) abortion; (4) stillbirth; and (5) calf mortality. No associations were found among any of the exposure measures and the risk of nonpregnancy, abortion or stillbirth. Sulphur-containing exposures showed no associations with secondary outcome measures in the respiratory, immune and nervous systems. An association was found between exposure to SO{sub 2} and the increased risk of calf mortality. Findings also suggested that there was a greater risk of lesions in the calf skeletal or cardiac muscle with increased prenatal exposure to SO{sub 2}. Increased exposure to VOCs contributed to a greater risk of calf respiratory and thyroid lesions, and a lower count of CD4 and CD8 T-lymphocytes in calves. The results of a concurrent study on

  4. Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada

    OpenAIRE

    Townsend, Anne; Cox, Susan M

    2013-01-01

    Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emer...

  5. ‘THE BIGGEST MISTAKE GOD EVER MADE WAS TO CREATE JUNKIES’: UNSAFE INJECTION PRACTICES, HEALTH CARE DISCRIMINATION AND OVERDOSE DEATHS IN MONTREAL, CANADA

    Directory of Open Access Journals (Sweden)

    Jozaghi, Ehsan

    2013-01-01

    Full Text Available Despite the existence of prevention programmes in Montreal, Canada, injection drug users (IDUs continue to share their injection drug equipment. This practice has led to an increase in the incidences of HIV and Hepatitis C (HCV among IDUs since 2003. The present study was conducted to explore factors contributing to the increased risks of this morbidity. Semi-structured qualitative interviews were conducted as drug users were actively involved in their routine activities. The participants’ narratives indicate that IDUs in Montreal are involved in risky injection behaviour that increases HIV, HCV and bacterial transmission. Moreover, IDUs in Montreal are at an increased risk of overdose and death when they are forced to inject in public washrooms or alleys. In addition, many IDUs have placed the general public at risk by discarding their used needles in public parks, sidewalks and public washrooms. Furthermore, many IDUs in Montreal have faced discrimination and are refused treatment by the health care system. Micro- environmental factors, such as a paucity of safe injection sites, inaccessibility of injection equipment and discrimination all seem to be contributing factors in recent increases in HIV and HCV in Montreal.Malgré les programmes de prévention qui existent à Montréal, Canada, les utilisateurs de drogues injectables (UDI continuent de partager leurs seringues. Cette pratique a mené à une augmentation de l’incidence du virus de l’immunodéficience humaine (VIH et du virus de l’hépatite C (VHC parmi les UDI depuis 2003. La présente étude a été menée afin d’examiner les facteurs qui contribuent à l’augmentation des risques de cette morbidité. Des entretiens qualitatifs semi-directifs ont été réalisés pendant que les utilisateurs faisaient usage de drogues. Les commentaires recueillis auprès des participants ont confirmé que les UDI de Montréal adoptent des comportements d’injection qui augmentent les

  6. Environmental radioactivity in Canada, 1980

    International Nuclear Information System (INIS)

    McGregor, R.G.; Meyerhof, D.P.; Quinn, J.M.; Tracy, B.L.

    1983-01-01

    The radiological surveillance program of the Department of National Health and Welfare is conducted to determine levels of environmental radioactivity in Canada and asessing the resulting population exposures. In this report, the results for 1980 from the analyses of air, precipitation, water vapour, drinking water, milk, biota and bone for critical radionuclides are presented. The graphical format is used with extensions of the trend-lines to enable identification of changes in the levels and assessment of their potential health significance. All the levels measured during this period are below the permissible limits recommended by the International Commission for Radiological Protection

  7. Fusion Canada issue 8

    International Nuclear Information System (INIS)

    1989-08-01

    A short bulletin from the National Fusion Program. Included in this issue are Canada-ITER contributions, NET Fuel Processing Loop, Bilateral Meeting for Canada-Europe, report from Tokamak de Varennes and a report from the University of Toronto on materials research for Fusion Reactors. 3 figs

  8. Fusion Canada issue 8

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-08-01

    A short bulletin from the National Fusion Program. Included in this issue are Canada-ITER contributions, NET Fuel Processing Loop, Bilateral Meeting for Canada-Europe, report from Tokamak de Varennes and a report from the University of Toronto on materials research for Fusion Reactors. 3 figs.

  9. Fusion Canada issue 21

    International Nuclear Information System (INIS)

    1993-08-01

    A short bulletin from the National Fusion Program highlighting in this issue Europe proposes Canada's participation in ITER, tritium for JET, CCFM/TdeV-Tokamak helium pumping and TdeV update, ITER-related R and D at CFFTP, ITER Deputy Director visits Canada, NFP Director to Chair IFRC, Award for Akira Hirose. 3 figs

  10. Fusion Canada issue 14

    International Nuclear Information System (INIS)

    1991-05-01

    A short bulletin from the National Fusion Program. Included in this issue is a report on a fusion cooperation agreement between Japan and Canada, an update at Tokamak de Varennes on plasma biasing experiments and boronization tests and a collaboration between Canada and the U.S. on a compact toroid fuelling gun. 4 figs

  11. Environmental radioactivity in Canada 1986

    International Nuclear Information System (INIS)

    1987-01-01

    The radiological surveillance program of the Department of National Health and Welfare is conducted for the purpose of determining levels of environmental radioactivity in Canada and assessing the resulting population exposures. During 1986 the program was strongly influenced by radioactive fallout on Canada resulting from the Chernobyl nuclear reactor accident on April 26, 1986 in the Soviet Ukraine. The Environmental Radiation Hazards Division (ERHD) increased its frequency of analyses of environmental samples immediately following the accident. Interim screening limits for foodstuffs were developed. A measurement program for radioactivity in domestic and imported foods was implemented. The ERHD measurement program was supplemented by additional measurements conducted by many other private and government laboratories. Radiation doses to Canadian from Chernobyl fallout were extremely low with no group in the population receiving more than 10 microsieverts

  12. Canada's hydrocarbon processing evolution

    International Nuclear Information System (INIS)

    Wise, T.H.; Horton, R.

    2000-01-01

    The development of petroleum refining, petrochemicals and natural gas industries in Canada are discussed together with future issues and prospects. Figures give data on (a) refined products trade 1998; (b) refining capacity; (c) product demand 1980-1999; (d) refinery crude runs and capacity; (e) refining and marketing, historical returns 1993-1999; (f) processing power index for Canada and USA; (g) ethylene capacity; (eye) Montreal petrochemical capacities; (j) Sarnia petrochemical capacities in 2000; (k) Alberta petrochemicals capacities 2001; (l) ethylene net equivalent trade; (m) ethylene costs 1999 for W. Canada and other countries. It was concluded that the hydrocarbon processing business continues to expand in Canada and natural gas processing is likely to increase. Petrochemicals may expand in W. Canada, possibly using feed stock from the Far North. Offshore developments may stimulate new processing on the E. Coast

  13. Energy in Canada

    International Nuclear Information System (INIS)

    1987-11-01

    This discussion paper was prepared by the Department of Energy, Mines and Resources Canada to provide information about Canada's resource potential, the contribution of energy to the Canadian economy, Canada's place in the world energy market, and the outlook for the development of Canadian energy resources. In addition, it provides background information on issues such as: energy and the environment, energy security, Canadian ownership of energy resources, energy R and D, and energy conservation. Finally, it concludes with an indication of some of the key challenges facing the energy sector. The paper is intended to inform the public and to serve as a reference document for those participating in the review of Canada's energy options. The paper was prepared before Canada and the U.S. agreed in principle on a free trade agreement (FTA) and does not include a discussion of the FTA or its potential impacts on the energy sector

  14. Advancing ecohealth in Canada | IDRC - International Development ...

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

    The Canadian Community of Practice in Ecohealth (CoPEH-Canada) seeks solutions to inter-linked ... Successes and impact ... Read more about their contribution to EcoHealth 2012 and join them in Montréal when they host EcoHealth 2014.

  15. Global Affairs Canada | IDRC - International Development Research ...

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

    For example, Vietnamese and Canadian research teams developed micronutrient-enriched instant flours and baby cereals using local crops and local processing facilities. Global Affairs Canada, IDRC, and the Canadian Institutes of Health Research are collaborating to improve health outcomes for African mothers and ...

  16. All projects related to Canada | Page 5 | IDRC - International ...

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

    Project. After a decade of laboratory and pilot plant work in Canada and India, ... countries where there are shortages of mental health specialist resources. ... rates in the world, Nigeria has identified maternal and child health as a priority issue.

  17. Differentiating Canada: The Future of the Canada-US Relationship

    Directory of Open Access Journals (Sweden)

    Wendy Dobson

    2010-11-01

    Full Text Available Turbulence will mark the world economy in the coming decade as Canada’s traditional trading partners in North America and Europe struggle with slow growth and rising structural unemployment and move, as they must, to restore the health of their public finances. Settling for the status quo is not a compelling option as the US border thickens and Canada stays on the sidelines in two areas vital to its long-term interest: climate change policy and trade liberalization. In this context, the Policy Brief evaluates the strategic options for Canada’s long-standing economic relationship with the United States. The authors propose a two-part proactive strategy. The first part is for Canada to differentiate its economy by building on its macroeconomic, financial and energy strengths relative to the United States and by shaping a best-practice North American climate change policy. The second part of the strategy is to deepen NAFTA by participating in the Trans-Pacific Partnership (TPP, a comprehensive, highquality FTA that has strategic attention of the US administration. Any country can join by accepting the agreement’s provisions. The TPP offers at least two strategic opportunities: a comprehensive negotiation in which Canada, the United States and Mexico could upgrade NAFTA and a way to diversify and deepen trade and investment liberalization with major economies in the Asia-Pacific region.

  18. Survey of the Definition of Fetal Viability and the Availability, Indications, and Decision Making Processes for Post-Viability Termination of Pregnancy for Fetal Abnormalities and Health Conditions in Canada.

    Science.gov (United States)

    Hull, Danna; Davies, Gregory; Armour, Christine M

    2016-06-01

    The purpose of this study was to explore the definition of fetal viability and the availability, indications, and decision making processes for post-viability termination of pregnancy for fetal abnormalities and health conditions in Canada. An online survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Geneticists, and the Canadian Society for Maternal-Fetal Medicine who provide direct counselling to, or management of, prenatal patients in Canada (total sample size 815). Results of this study showed that the majority of respondents indicated that their centre will offer post-viability termination of pregnancy (98/123; 80 %). Sixty-seven percent (68/101) of respondents reported the definition of fetal viability to be 24 weeks' gestation. Most respondents reported that a collaborative decision making process was used to determine if post-viability termination of pregnancy would be offered (136/170; 80 %). For conditions presumed to be lethal/likely lethal, the majority of respondents would "sometimes" or "always" offer post-viability termination of pregnancy, whereas for conditions presumed to have a mild effect, the majority of respondents would "rarely" or "never" offer post-viability termination of pregnancy. Ninety percent (77/86) of respondents reported that perinatal hospice is offered as an alternative to termination of pregnancy. In conclusion, this study suggests that although post-viability termination is available in many provinces in Canada, variation in the definition of fetal viability and indications appear to exist. While these variations may lead to unequal access to post-viability termination of pregnancy across Canada, they might also represent the complexity of the decision making process and the importance of examining individual factors to ensure that the most appropriate decision is made in each case.

  19. ATLAS-Canada Network

    Energy Technology Data Exchange (ETDEWEB)

    Gable, I; Sobie, R J [HEPnet/Canada, Victoria, BC (Canada); Bedinelli, M; Butterworth, S; Groer, L; Kupchinsky, V [University of Toronto, Toronto, ON (Canada); Caron, B; McDonald, S; Payne, C [TRIUMF Laboratory, Vancouver, BC (Canada); Chambers, R [University of Alberta, Edmonton, AB (Canada); Fitzgerald, B [University of Victoria, Victoria, BC (Canada); Hatem, R; Marshall, P; Pobric, D [CANARIE Inc., Ottawa, ON (Canada); Maddalena, P; Mercure, P; Robertson, S; Rochefort, M [McGill University, Montreal, QC (Canada); McWilliam, D [BCNet, Vancouver, BC (Canada); Siegert, M [Simon Fraser University, Burnaby, BC (Canada)], E-mail: igable@uvic.ca (and others)

    2008-12-15

    The ATLAS-Canada computing model consists of a WLCG Tier-1 computing centre located at the TRIUMF Laboratory in Vancouver, Canada, and two distributed Tier-2 computing centres in eastern and western Canadian universities. The TRIUMF Tier-1 is connected to the CERN Tier-0 via a 10G dedicated circuit provided by CANARIE. The Canadian institutions hosting Tier-2 facilities are connected to TRIUMF via 1G lightpaths, and routing between Tier-2s occurs through TRIUMF. This paper discusses the architecture of the ATLAS-Canada network, the challenges of building the network, and the future plans.

  20. Canada's nuclear export policy

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, R W; Wonder, E F [Carleton Univ., Ottawa, Ontario (Canada)

    1978-01-01

    The factors influencing the evolution of Canada's nuclear export policy are examined. Initially, nuclear technology was exported to establish an industry in Canada and to share the technology with other countries. After 1974 an increasingly broad range of political and social factors were taken into account and safeguards became the dominant factor. The indirect impacts of the new policy fall into two groups. One consists of the effects of Canada's leadership in taking a tough stand on safeguards. The second group of effects involve the concern of other countries about access to secure energy supplies and advanced technology.

  1. Canada's nuclear export policy

    International Nuclear Information System (INIS)

    Morrison, R.W.; Wonder, E.F.

    1978-01-01

    The factors influencing the evolution of Canada's nuclear export policy are examined. Initially, nuclear technology was exported to establish an industry in Canada and to share the technology with other countries. After 1974 an increasingly broad range of political and social factors were taken into account and safeguards became the dominant factor. The indirect impacts of the new policy fall into two groups. One consists of the effects of Canada's leadership in taking a tough stand on safeguards. The second group of effects involve the concern of other countries about access to secure energy supplies and advanced technology. (O.T.)

  2. Radiation oncology in Canada.

    Science.gov (United States)

    Giuliani, Meredith; Gospodarowicz, Mary

    2018-01-01

    In this article we provide an overview of the Canadian healthcare system and the cancer care system in Canada as it pertains to the governance, funding and delivery of radiotherapy programmes. We also review the training and practice for radiation oncologists, medical physicists and radiation therapists in Canada. We describe the clinical practice of radiation medicine from patients' referral, assessment, case conferences and the radiotherapy process. Finally, we provide an overview of the practice culture for Radiation Oncology in Canada. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Canada's hydrogen energy sector

    International Nuclear Information System (INIS)

    Kimmel, T.B.

    2009-01-01

    Canada produces the most hydrogen per capita of any Organization of Economic Cooperation and Development (OECD) country. The majority of this hydrogen is produced by steam methane reforming for industrial use (predominantly oil upgrading and fertilizer production). Canada also has a world leading hydrogen and fuel cell sector. This sector is seeking new methods for making hydrogen for its future energy needs. The paper will discuss Canada's hydrogen and fuel cell sector in the context of its capabilities, its demonstration and commercialization activities and its stature on the world stage. (author)

  4. Healthcare in Canada's North: Are We Getting Value for Money?

    Science.gov (United States)

    Young, T Kue; Chatwood, Susan; Marchildon, Gregory P

    2016-08-01

    To determine if Canadians are getting value for money in providing health services to our northern residents. Secondary analyses of data from Statistics Canada, the Canadian Institute of Health Information and territorial government agencies on health status, health expenditures and health system performance indicators. Per capita health expenditures in Canada's northern territories are double that of Canada as a whole and are among the highest in the world. The North lags behind the rest of the country in preventable mortality, hospitalization for ambulatory care sensitive conditions and other performance indicators. The higher health expenditure in the North is to be expected from its unique geography and demography. If the North is not performing as well as Canada, it is not due to lack of money, and policy makers should be concerned about whether healthcare can be as good as it could be. Copyright © 2016 Longwoods Publishing.

  5. Canada's nuclear power programme

    International Nuclear Information System (INIS)

    Peden, W.

    1976-01-01

    Although Canada has developed the CANDU type reactor, and has an ambitious programme of nuclear power plant construction, there has been virtually no nuclear controversy. This progress was seen as a means to bring Canada out of the 'resource cow' era, and onto a more equal footing with technologically elite nations. However the Indian nuclear explosion test, waste storage problems, contamination problems arising from use of uranium ore processing waste as land fill and subsidised sale of nuclear power plants to Argentina and South Korea have initiated public and parliamentary interest. Some economists have also maintained that Canada is approaching over-supply of nuclear power and over-investment in plant. Canada has no official overall energy production plan and alternative sources have not been evaluated. (JIW)

  6. Fusion Canada issue 20

    International Nuclear Information System (INIS)

    1993-03-01

    Fusion Canada's publication of the National Fusion Program. Included in this issue is the CFFTP Industrial Impact Study, CCFM/TdeV Update:helium pumping, research funds, and deuterium in beryllium - high temperature behaviour. 3 figs

  7. Wait times in Canada.

    Science.gov (United States)

    MacKinnon, Janice Christine

    2017-07-01

    A significant barrier to accessing healthcare in Canada is long waiting lists, which can be linked to the way that Medicare was structured. After significant pressure, provincial governments began to address wait times. An example of a successful strategy to reduce wait times for elective surgery is the Saskatchewan Surgical Initiative, which saw wait times in the province change from being among the longest in Canada to the shortest.

  8. Canada's radiation scandal?

    International Nuclear Information System (INIS)

    1990-12-01

    In July 1990, Greenpeace distributed a 16-page treatise entitled 'Canada's Radiation Scandal' to a wide audience. The bottom line of the Greenpeace critique was that 'Canada's radiation limits are among the worst in the developed world'. This is a commentary on the Greenpeace pamphlet from the Atomic Energy Control Board (AECB), the body that sets and enforces radiation standards covering the use of nuclear energy in Canadian industry, science and medicine

  9. Uranium in Canada

    International Nuclear Information System (INIS)

    1985-09-01

    In 1974 the Minister of Energy, Mines and Resources (EMR) established a Uranium Resource Appraisal Group (URAG) within EMR to audit annually Canada's uranium resources for the purpose of implementing the federal government's uranium export policy. A major objective of this policy was to ensure that Canadian uranium supplies would be sufficient to meet the needs of Canada's nuclear power program. As projections of installed nuclear power growth in Canada over the long term have been successively revised downwards (the concern about domestic security of supply is less relevant now than it was 10 years ago) and as Canadian uranium supply capabilities have expanded significantly. Canada has maintained its status as the western world's leading exporter of uranium and has become the world's leading producer. Domestic uranium resource estimates have increased to 551 000 tonnes U recoverable from mineable ore since URAG completed its last formal assessment (1982). In 1984, Canada's five primary uranium producers employed some 5800 people at their mining and milling operations, and produced concentrates containing some 11 170 tU. It is evident from URAG's 1984 assessment that Canada's known uranium resources, recoverable at uranium prices of $150/kg U or less, are more than sufficient to meet the 30-year fuelling requirements of those reactors that are either in opertaion now or committed or expected to be in-service by 1995. A substantial portion of Canada's identified uranium resources, recoverable within the same price range, is thus surplus to Canadian needs and available for export. Sales worth close to $1 billion annually are assured. Uranium exploration expenditures in Canada in 1983 and 1984 were an estimated $41 million and $35 million, respectively, down markedly from the $128 million reported for 1980. Exploration drilling and surface development drilling in 1983 and 1984 were reported to be 153 000 m and 197 000 m, respectively, some 85% of which was in

  10. Environmental radioactivity in Canada 1987

    International Nuclear Information System (INIS)

    1988-01-01

    The radiological surveillance program of the Department of National Health and Welfare is conducted for the purpose of determining levels of environmental radioactivity in Canada and assessing the resulting population exposures. A study was initiated to evaluate the contamination by cesium-137, of caribou, a major source of food in northern communities. Work on development of methods proceeded for the determination of radon, carbon-14, polonium-210, radium-228 and isotopic uranium in samples. Monitoring continued of fallout contamination from Chernobyl of imported foods. All measurements made during 1987 are below the limits recommended by the International Commission on Radiological Protection

  11. Environmental radioactivity in Canada - 1982

    International Nuclear Information System (INIS)

    Tracey, B.L.

    1984-01-01

    The radiological surveillance program of the Department of National Health and Welfare is conducted for the purpose of determining levels of environmental radioactivity in Canada and assessing the resulting population exposures. Special investigations were carried out during 1982 on metabolism of natural radionuclides and on the accumulation of radon in energy-efficient homes. The pre-operational phase of the monitoring program at the Point Lepreau Nuclear Generating Station was completed. Dose commitments have been estimated for the ongoing natural radioactivity, fallout and reactor studies. All measurements made during the year are below the limits recommended by the International Commission on Radiological Protection

  12. Environmental radioactivity in Canada, 1981

    International Nuclear Information System (INIS)

    McGregor, R.G.; Quinn, J.M.; Tracy, B.L.

    1983-01-01

    The radiological surveillance program of the Department of National Health and Welfare is conducted for the purpose of determining levels of environmental radioactivity in Canada and assessing the resulting population exposures. Special investigations were carried out during 1981 on bottled mineral waters and in conjunction with unusual occurences at nuclear reactor sites and a uranium refinery. Dose commitments have been estimated for the ongoing natural radioactivity, fallout and reactor studies. All measurements made during the year are below the limits recommended by the International Commission on Radiological Protection

  13. Radioactive waste mangement in Canada

    International Nuclear Information System (INIS)

    Didyk, J.P.

    1976-01-01

    The objectives of the Canadian radioactive waste management program are to manage the wastes so that the potential hazards of the material are minimized, and to manage the wastes in a manner which places the minimum possible burden on future generations. The Atomic Energy Control Board regulates all activities in the nuclear field in Canada, including radioactive waste management facility licensing. The Atomic Energy Control Act authorizes the Board to make rules for regulating its proceedings and the performance of its functions. The Atomic Energy Control Regulations define basic regulatory requirements for the licensing of facilities, equipment and materials, including requirements for records and inspection, for security and for health and safety

  14. Terrorism in Canada.

    Science.gov (United States)

    Kollek, Daniel

    2003-01-01

    This paper reviews terrorism in Canada, assessing the incidence and nature of terrorist activity, the potential targets of terrorist attacks, risk factors to Canadian nationals and institutions, and the responses of the Canadian government in dealing with the threat and the effectiveness of those responses. Despite the fact that there have been no recent high-profile terrorist events in Canada, this country has a serious terrorism problem, the key manifestation of which is the multitude of terrorist organizations that have designated Canada as a base of operations. In addition, Canadians have been attacked overseas and Canadian organizations, both local and abroad, are potential targets of terrorist activity. Canadian attempts to deal with terrorism through foreign and domestic policy have been ineffective, primarily because the policies have been poorly enforced. Until recently, terrorist organizations legally could raise funds in Canada, in direct contravention of international treaties signed by Canada. It is possible that the ineffectiveness in enforcing the anti-terrorism legislation stems from hope that placating terrorist organizations, and the countries that support them, will prevent Canada from becoming a target. Unfortunately evidence from other countries has shown this strategy to be ineffective.

  15. 1996 report on occupational radiation exposures in Canada

    International Nuclear Information System (INIS)

    1997-01-01

    Statistics are provided on occupational radiation exposures of monitored workers in Canada. The information is based on the data in the National Dose Registry maintained by the Radiation Protection Bureau of Health Canada. The Registry is a centralized record-keeping system containing dose information on all monitored workers in Canada. It includes records from the National Dosimetry Services (NDS), as well as data submitted by nuclear power generating stations, Atomic Energy of Canada Ltd., uranium mines, and private dosimeter processing companies. About 80 percent of the records are from the NDS. 9 refs., 4 tabs

  16. Tuberculosis in Canada: Detection, Intervention and Compliance

    Directory of Open Access Journals (Sweden)

    Katya Richardson

    2014-11-01

    Full Text Available This paper provides an overview of the current state of TB in Canada by referencing information presented at the workshop, “Tuberculosis: Detection, Prevention, and Compliance.” The workshop took place on November 14 and 15, 2012 in Ottawa. The workshop was organized by the Centre for Disease Modeling and the Public Health Agency of Canada as a two-day knowledge translation event that was comprised of scientific and policy focused presentations designed to address four key objectives: (1 Evaluate the success of current tuberculosis (TB health policies and control strategies in Canada and for specific Canadian sub-populations; (2 Determine the impact of detection, intervention, compliance, and education strategies in terms of TB incidence and prevalence; (3 Develop targets for future interventions by identifying key characteristics of TB epidemics that impact the success of TB health policies and control strategies; (4 Leverage our existing ties with public health decision makers, aboriginal health organizations, and organizations serving the homeless to develop a research community that is based on close collaboration, and will foster national TB control efforts. The workshop elicited robust discussions between experts from a variety of academic disciplines and government officials. A summary of the information presented, comments shared, and questions posed, will provide a comprehensive understanding of the status of TB in Canada and future directions to be taken for improved control of the disease.

  17. Understanding Canada's International Trade Policy. "Understanding Economics" Series No. 4.

    Science.gov (United States)

    Cornell, Peter M.

    Written for secondary school Canadian students, the document examines Canada's international trade policy. It is arranged in three sections. Part I discusses the affect of Canada's trade policy on the individual citizen. Tariffs and non-tariff barriers to trade such as import licenses, preferential purchasing agreements, health and safety…

  18. Canada-Africa Prevention Trials Network : Building African Capacity ...

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

    Canada-Africa Prevention Trials Network : Building African Capacity for HIV/AIDS Prevention Trials. The Canada-Africa Prevention Trials Network (CAPT Network) was formed through a capacity building grant from the Global Health Research Initiative (GHRI). The Network comprises eight African centres (four in Uganda, ...

  19. Canada: variations on a common theme

    Directory of Open Access Journals (Sweden)

    Raisa B. Deber

    2010-12-01

    Full Text Available Canada faces health care challenges common to all industrialized countries – how to ensure timely access to high quality care, close to home, at an affordable cost. Addressing these challenges is complicated by interjurisdictional variation in both how health care is managed and delivered, and in health outcomes. Canada can be described as a non-system of 10 provincial and three territorial health insurance plans which mandate publicly-funded coverage for medically necessary hospital and physician services, based upon common principles and shaped by a federal governance structure that affords substantial power and autonomy to the provinces/territories over matters of health and health care. This article first examines the structural context of the health care system in Canada, including the range of services publicly funded, the public-private mix, and the complexities of current governance arrangements. It then discusses several issues affecting health policy reform: costs versus access; questions of sustainability, quality, and performance; human resources capacity; and the provision of public and population health services.

  20. Health of tree swallows (Tachycineta bicolor) nesting in pesticide-sprayed apple orchards in Ontario, Canada. II. Sex and thyroid hormone concentrations and testes development.

    Science.gov (United States)

    Bishop, C A; Van Der Kraak, G J; Ng, P; Smits, J E; Hontela, A

    1998-12-25

    To investigate the effects of pesticides on wild birds, sex (17beta-estradiol; testosterone) and thyroid (triiodothyronine (T3) hormone concentrations, body mass, and testes mass were measured and the development of testes was evaluated in wild tree swallows (Tachycineta bicolor) nesting in four sprayed apple orchards and three nonsprayed sites in southern Ontario, Canada, in 1995-1996. In orchards, birds were exposed to asmany as 11 individual spray events and five sprays of mixtures of chemicals. Residues of organochlorine pesticides, PCBs, lead, and arsenic concentrations were low and not variable among sites except p,p'-DDE concentrations, which ranged from 0.36 to 2.23 microg/g wet weight in eggs. These persistent compounds were not correlated with any endocrine response measured in tree swallows. In 16-d-old male tree swallow chicks, body mass and concentrations of 17beta-estradiol (estradiol), testosterone, and T3 in plasma showed no significant differences between sprayed and nonsprayed groups and among sites within those groups. However, T3 concentrations were slightly elevated in the sprayed group compared to the nonsprayed group, and there was a significant and positive correlation between T3 and the number of mixtures of sprays applied during egg incubation through chick rearing. In 16-d-old female chicks, there were no significant differences among spray treatments or sites and no correlations with spray exposure for testosterone, estradiol, or T3 in plasma. Body mass was correlated positively with T3 and negatively with estradiol but showed no differences among spray exposure groups or sites. Histology of testes of 16-d-old male chicks indicated there were no significant differences among sprayed and nonsprayed birds in testes mass, area, or diameter, or the presence of Leydig cells in the interstitium, the distribution of the Sertoli cells, or the occurrence of heterophils in the testicular interstitium. For the percentage of spermatogonia present on

  1. Uranium in Canada

    International Nuclear Information System (INIS)

    1987-09-01

    Canadian uranium exploration and development efforts in 1985 and 1986 resulted in a significant increase in estimates of measured uranium resources. New discoveries have more than made up for production during 1985 and 1986, and for the elimination of some resources from the overall estimates, due to the sustained upward pressure on production costs and the stagnation of uranium prices in real terms. Canada possesses a large portion of the world's uranium resources that are of current economic interest and remains the major focus of inter-national uranium exploration activity. Expenditures for uranium exploration in Canada in 1985 and 1986 were $32 million and $33 million, respectively. Although much lower than the $130 million total reported for 1979, expenditures for 1987 are forecast to increase. Exploration and surface development drilling in 1985 and 1986 were reported to be 183 000 m and 165σ2 000 m, respectively, 85 per cent of which was in Saskatchewan. Canada has maintained its position as the world's leading producer and exporter of uranium. By the year 2000, Canada's annual uranium requirements will be about 2 100 tU. Canada's known uranium resources are more than sufficient to meet the 30-year fuel requirements of those reactors in Canada that are either in operation now or expected to be in service by the late 1990s. A substantial portion of Canada's identified uranium resources is thus surplus to Canadian needs and available for export. Annual sales currently approach $1 billion, of which exports account for 85 per cent. Forward domestic and export contract commitments totalled 73 000 tU and 62 000 tU, respectively, as of early 1987

  2. Canada's uranium policies

    International Nuclear Information System (INIS)

    Smith, K.L.; Williams, R.M.

    1991-01-01

    The purpose of this paper is to provide an update on the Canadian Government policies which affect the uranium industry and, where appropriate, to provide some background on the development of these policies. This review is timely because of two recent announcements by the Minister of Energy, Mines and Resources - one concerning the Canadian Government's renewed commitment to maintain the nuclear power option for Canada, and the other concerning some adjustments to Canada's uranium export policy. The future of Canada's nuclear industry was subject to a thorough review by the Canadian Government during 1989. This review occurred at a time when environmental issues were attracting increasing attention around the world, and the environmental advantages of nuclear power were becoming increasingly recognised. The strong support for the nuclear industry in Canada is consistent with the government's long-standing efforts to maintain Canada's position as a reliable and competitive supplier of uranium. This paper is particularly devoted to an outline of the results of the uranium export policy review. (author)

  3. Building Canada: Phase One

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2004-04-15

    The 'Building Canada' program modelled after the 'Building America' program, aims at increasing energy efficiency and affordability, primarily for single family homes. The program takes a holistic and whole house view, employing a systems approach and is committed to continuous improvement through testing, evaluation, retesting and novel construction practices. The program's objective is to re-engineer house designs so that builders can take advantage of advanced products and achieve maximum efficiency. Building Canada aims to achieve its objectives through partnership with the housing industry, focusing on increasing energy efficiency while reducing construction time, using and wasting fewer materials, forestalling call backs, and reducing overall costs. The Building Canada procedures encompass marketing, research of builder's operations, re-engineering mechanical systems, framing components and techniques, moisture control and thermal performance, construction, resolution of problems in re-engineered homes, and discussion of results in demonstration homes. The program as a whole is built on the feasibility study of a Building Canada program carried out in Nova Scotia and Ontario. Some of the results of this pilot study summarized in this report indicate that the Building Canada is not suitable for use by small builders. Benefits are most likely to be realized by only by builders constructing more than 100 homes annually.

  4. Canada's upstream petroleum industry : 1997 perspective

    International Nuclear Information System (INIS)

    1997-06-01

    A review of the trends and activities in the upstream petroleum industry during 1996 were presented, emphasizing the significance of the industry' contribution to Canada's economy. Among the areas included were highlights of Canada's hydrocarbon reserves, conventional production, frontier production, and non-conventional (oil sands) production. New market opportunities and activities in the pipeline transportation sector were also discussed. Environmental issues including health and safety received due attention. In this regard, the industry's efforts to work with government and other stakeholders to ensure that requirements for land use are balanced with the need to protect wilderness and wildlife habitat, received special mention. 16 figs

  5. Canada's green plan - The second year. Summary

    International Nuclear Information System (INIS)

    1993-01-01

    Canada's Green Plan is the national strategy and action plan for sustainable development launched by the federal government. The Green Plan's goal is 'to secure for current and future generations a safe and healthy environment and a sound and prosperous economy.' It represents a fundamental shift in the way the federal government views economic development and environmental protection: they are inextricably linked; both are critical to the health and well-being of Canadians. Substantial development has been made in Canada, with advances being made on the Green Plan's short-term objectives and on our longer term priorities

  6. Canada's domestic nuclear issues

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    The Interfaith Program for Public Awareness of Nuclear Issues (IPPANI) is a committee of representatives of religious groups in Toronto, a group of people concerned about the moral and ethical implications of the operation of Canada's nuclear industry and of its exports to other countries. The faith groups represented are the Anglican Diocese of Toronto, the Baha'i Community of Canada, the Jewish Community of Toronto, the Roman Catholic Archdiocese of Toronto and the United Church of Canada Toronto Conference. Wishing to encourage the Canadian government to enquire into this broad question, the faith groups established IPPANI and assigned to it the task of enhancing their knowledge of the nuclear industry. IPPANI was to develop an effective set of questions to be placed before governments and to promote public discussion so that governments might become more responsive to these issues

  7. Cardiac Rehabilitation Series: Canada

    Science.gov (United States)

    Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander

    2015-01-01

    Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018

  8. Canada Among Nations 2014. Crisis and Reform: Canada and the ...

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

    28 mai 2014 ... This 28th edition of the Canada Among Nations series examines the 2008 global financial crisis, its impact on Canada, and the country's historic and current role in the international financial system.

  9. Landfill gas management in Canada

    International Nuclear Information System (INIS)

    David, A.

    1997-01-01

    Landfill gas produced from solid waste landfills is one of the most significant sources of anthropogenic methane in Canada. Methane, a potent greenhouse gas, is 24.5 times more powerful than carbon dioxide by weight in terms of global climate change. Landfill gas recovery plays an important role in Canada's commitment to stabilize greenhouse gas emissions at 1990 levels by the year 2000 under the United Nations Framework Convention on Climate Change. Landfill gas is a potentially harmful emission that can be converted into a reliable environmentally-sustainable energy source used to generate electricity, fuel industries and heat buildings. The recovery and utilization of landfill gas is a win-win situation which makes good sense from local, regional and global perspectives. It provides the benefits of (1) reducing the release of greenhouse gases that contribute to global warming; (2) limiting odors; (3) controlling damage to vegetation; (4) reducing risks from explosions, fires and asphyxiation; (5) converting a harmful emission into a reliable energy source; and (6) creating a potential source of revenue and profit. Canadian landfills generate about 1 million tons of methane every year; the equivalent energy of 9 million barrels of oil (eight oil super tankers), or enough energy to meet the annual heating needs of more than half a million Canadian homes. Currently, twenty-seven facilities recover and combust roughly 25% of the methane generated by Canadian landfills producing about 3.2 PJ (10 15 Joules) of energy including 80 MW of electricity and direct fuel for nearby facilities (e.g., cement plants, gypsum board manufacturers, recycling facilities, greenhouses). This paper reviews landfill gas characteristics; environmental, health and safety impacts; landfill gas management in Canada; the costs of landfill gas recovery and utilization systems; and on-going projects on landfill gas utilization and flaring

  10. Canada's green plan: Summary. Le plan vert du Canada: Resume

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    A summary is presented of Canada's Green Plan, a comprehensive action plan to ensure a healthy environment for the future. The plan defines targets and schedules which will drive federal environmental initiatives, and incorporates concepts of sustainable development. Elements of the plan include initiatives to combat and prevent water pollution; control ocean dumping; control smog-causing emissions; provide tighter air pollution standards; provide for sound waste management according to the principles of reduce, reuse, recycle, and recover; assess and control chemical wastes; sustain Canadian forests and maintain their diversity while shifting forest management from sustained yield to sustainable development; maintain and enhance environmental sustainability in the agro-food sector and the fishery sector; preserve and protect national parks and wildlife; and preserve and enhance the integrity, health, biodiversity and productivity of Arctic ecosystems. With respect to global-scale problems, measures will be taken to stabilize greenhouse gas emissions, limit acid rain-related emissions, and phase out the use of ozone-depleting substances. The plan also intends to improve Canada's capability to respond to environmental emergencies, improve environmental decision-making by strengthening and building of partnerships, promote environmental science research and development, and make effective and balanced use of enviromental laws, with market-based approaches for environmental protection.

  11. All projects related to Canada | Page 7 | IDRC - International ...

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

    Topic: MEDICAL RESEARCH, VACCINES, SEXUALLY TRANSMITTED DISEASES, TRAINING, STUDENTS, AFRICA SOUTH OF SAHARA. Region: North of Sahara, South of Sahara, Canada. Program: Maternal and Child Health. Total Funding: CA$ 743,000.00. Scaling Research Results: Design and Evaluation. Project.

  12. All projects related to Canada | Page 4 | IDRC - International ...

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

    Topic: BRAIN, MATERNAL AND CHILD HEALTH, CANCER, THERAPY, CANADA ... obesity and overweight rates in Ecuador through a civil society-led marketing ... This project aims to alleviate food insecurity and malnutrition in Colombia.

  13. All projects related to canada | IDRC - International Development ...

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

    Program: Canada-Israel Health Research Program ... Notch as master regulator of breast cancer subtype and intratumoural heterogeneity ... dialogue and engagement in the transition process and to promote economic growth that benefits all.

  14. Canada-U.S. Border Air Quality Strategy Border Reports

    Science.gov (United States)

    View reports on two airshed pilot studies that explored the human health effects of air pollution in the United States and Canada, plus a report on the feasibility of transboundary emissions cap and trade program.

  15. All projects related to Canada | Page 17 | IDRC - International ...

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

    ... Communication, Miscellaneous, Natural Resources, Science and Technology, Social Policy ... Project. Point-of-sale advertising refers to the display of promotional materials where ... HealthBridge : Information and Communication Technologies for Data Collection and Management ... Region: Morocco, Canada, France.

  16. Cultural and Contextual Adaptation of an eHealth Intervention for Youth Receiving Services for First-Episode Psychosis: Adaptation Framework and Protocol for Horyzons-Canada Phase 1.

    Science.gov (United States)

    Lal, Shalini; Gleeson, John; Malla, Ashok; Rivard, Lysanne; Joober, Ridha; Chandrasena, Ranjith; Alvarez-Jimenez, Mario

    2018-04-23

    eHealth interventions have the potential to address challenges related to access, service engagement, and continuity of care in the delivery of mental health services. However, the initial development and evaluation of such interventions can require substantive amounts of financial and human resource investments to bring them to scale. Therefore, it may be warranted to pay greater attention to policy, services, and research with respect to eHealth platforms that have the potential to be adapted for use across settings. Yet, limited attention has been placed on the methods and processes for adapting eHealth interventions to improve their applicability across cultural, geographical, and contextual boundaries. In this paper, we describe an adaptation framework and protocol to adapt an eHealth intervention designed to promote recovery and prevent relapses in youth receiving specialized services for first-episode psychosis. The Web-based platform, called Horyzons, was initially developed and tested in Australia and is now being prepared for evaluation in Canada. Service users and service providers from 2 specialized early intervention programs for first-episode psychosis located in different provinces will explore a beta-version of the eHealth intervention through focus group discussions and extended personal explorations to identify the need for, and content of contextual and cultural adaptations. An iterative consultation process will then take place with service providers and users to develop and assess platform adaptations in preparation for a pilot study with a live version of the platform. Data collection was completed in August 2017, and analysis and adaptation are in process. The first results of the study will be submitted for publication in 2018 and will provide preliminary insights into the acceptability of the Web-based platform (eg, perceived use and perceived usefulness) from service provider and service user perspectives. The project will also provide

  17. Leaving Sweden behind: Gains in life expectancy in Canada.

    Science.gov (United States)

    Auger, Nathalie; Le Serbon, Emilie; Rostila, Mikael

    2015-06-01

    Sweden and Canada are known for quality of living and exceedingly high life expectancy, but recent data on how these countries compare are lacking. We measured life expectancy in Canada and Sweden during the past decade, and identified factors responsible for changes over time. We calculated life expectancy at birth for Canada and Sweden annually from 2000 to 2010, and determined the ages and causes of death responsible for the gap between the two countries using Arriaga's method. We determined how population growth, ageing, and mortality influenced the number of deaths over time. During 2000-2010, life expectancy in Canada caught up with Sweden for men, and surpassed Sweden by 0.4 years for women. Sweden lost ground owing to a slower reduction in circulatory and tumour mortality after age 65 years compared with Canada. Nonetheless, population ageing increased the number of deaths in Canada, especially for mental and nervous system disorders. In Sweden, the number of deaths decreased. In only one decade, life expectancy in Canada caught up and surpassed Sweden due to rapid improvements in circulatory and tumour mortality. Population ageing increased the number of deaths in Canada, potentially stressing the health care system more than in Sweden. © 2015 the Nordic Societies of Public Health.

  18. Nuclear power in Canada

    International Nuclear Information System (INIS)

    1980-01-01

    The Canadian Nuclear Association believes that the CANDU nuclear power generation system can play a major role in achieving energy self-sufficiency in Canada. The benefits of nuclear power, factors affecting projections of electric power demand, risks and benefits relative to other conventional and non-conventional energy sources, power economics, and uranium supply are discussed from a Canadian perspective. (LL)

  19. Fusion Canada issue 7

    International Nuclear Information System (INIS)

    1989-05-01

    A short bulletin from the National Fusion Program. Included in this issue are CFFTP highlights on the Karlsruhe Isotope Separation System, a report on ITER tritium process systems, an experimental update on Tokamak de Varennes and Canada-U.S. bilateral technical collaboration topics. 2 figs

  20. Fusion Canada issue 17

    International Nuclear Information System (INIS)

    1992-05-01

    A short bulletin from the National Fusion Program. Included in this issue is a report on increased funding for the Canadian Fusion Program, news of the compact Toroid fuelling gun, an update on Tokamak de Varennes, the Canada - U.S. fusion meeting, measurements of plasma flow velocity, and replaceable Tokamak divertors. 4 figs

  1. Fusion Canada issue 9

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-11-01

    A short bulletin from the National Fusion Program. Included in this issue is a report on availability of Canadian Tritium, an ITER update, a CCFM update on Tokamak and the new team organization, an international report on Fusion in Canada and a Laser Fusion Project at the University of Toronto. 3 figs.

  2. Suicide in Canada

    National Research Council Canada - National Science Library

    Leenaars, Antoon A

    1998-01-01

    ... provides long-awaited information that focuses specifically on Canada. It addresses suicide as a multidimensional problem with biological, psychological, cultural, sociological, personal, and philosophical aspects. The contributions integrate both critical analysis and personal experience. There are accounts from Inuit elders, fr...

  3. Fusion Canada issue 22

    International Nuclear Information System (INIS)

    1993-10-01

    A short bulletin from the National Fusion Program highlighting in this issue a bi-lateral meeting between Canada and Japan, water and hydrogen detritiation, in-situ tokamak surface analysis, an update of CCFM/TdeV and tritium accounting Industry guidance in Fusion, fast probe for plasma-surface interaction. 4 figs

  4. Fusion Canada issue 28

    International Nuclear Information System (INIS)

    1995-06-01

    A short bulletin from the National Fusion Program highlighting in this issue the Canada - US fusion meeting in Montreal, fusion breeder work in Chile, new management at CFFTP