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Sample records for health canada chopra

  1. Chopra, Dr Ishwar Chander

    Indian Academy of Sciences (India)

    Fellow Profile. Elected: 1962 Section: Medicine. Chopra, Dr Ishwar Chander M.R.C.S.. Date of birth: 8 January 1911. Date of death: 18 October 1996. Specialization: Pharmacology, Toxicology and Indian Medicinal Plants Last known address: C-116, Defence Colony, New Delhi 110 024. YouTube; Twitter; Facebook; Blog ...

  2. RD Pachori, A Banerjee and KL Chopra

    Indian Academy of Sciences (India)

    294 R D Pachori, A Banerjee and K L Chopra. 20. 2. 8. 0.7 1.5 2.3 3. 3.9 h) (eV). Figure 2. Variation of g with hy of vacuum-annealed CuInSe2 films (+ 17 at, wt.% Se). Table 1. Auger composition analysis of flash-evaporated CulinSe2 films. Selenium concentration Metal/ in powder Copper Indium Selenium selenium. (at. wt.

  3. Comprehensive school health in Canada.

    Science.gov (United States)

    Veugelers, Paul J; Schwartz, Margaret E

    2010-01-01

    The Canadian education system is among the best in the world academically. In contrast, students' (children and youth) eating and activity levels are so poor that they have led to prevalence rates of overweight that are among the highest in the world. Given the enormous public health burden associated with poor nutrition and physical inactivity, Canada needs to address this health risk. Comprehensive school health (CSH) is a promising approach to promoting healthy eating and active living (HEAL). This article provides a review of CSH and discusses its four essential elements: 1) teaching and learning; 2) social and physical environments; 3) healthy school policy; and 4) partnerships and services. It also provides a common understanding of the implementation and broader benefits of CSH, which, in addition to health, include student learning and self-esteem. The article further discusses some complexities of a rigorous evaluation of CSH, which comprises proof of implementation, impact and positive outcome. Though such an evaluation has yet to be conducted, some studies did confirm successful implementation, and another study observed positive outcomes. Rigorous evaluation is urgently needed to provide a stronger evidence base of the benefits of CSH for learning, self-esteem and disease prevention. This evidence is essential to justify devoting more school time to promote HEAL and more resources to implement and support CSH to the benefit of both learning and health.

  4. 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...

  5. 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.

  6. Health inequities in Canada: intersectional frameworks and practices

    National Research Council Canada - National Science Library

    Hankivsky, Olena; De Leeuw, Sarah

    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...

  7. 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.

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

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

    IDRC-CRDI

    working with policymakers and decision-makers to help make the best health policy decisions, and,. • identifying how nurses, doctors, and other health professionals can better deliver the care that is needed. Global Health Research Initiative. International Development Research Centre. PO Box 8500, Ottawa, ON, Canada ...

  9. Health Consequences to Immigrant Family Caregivers in Canada

    Directory of Open Access Journals (Sweden)

    Juhee Vajracharya Suwal

    2010-12-01

    Immigrant family caregivers were three times more likely than non-immigrants to report a health consequence. Reciprocity played a big role in this outcome. Given the fact that an increasing number of culturally diverse immigrants enter Canada every year and that the immigrant population is aging, more caregivers will be in demand. Policy makers need to find ways to keep immigrant caregivers healthy so that quality care can be given to immigrant older adults and also for maintaining an overall healthy Canada.

  10. 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.

  11. 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 ...

  12. Value for money: an evaluation of health spending in Canada.

    Science.gov (United States)

    Ariste, Ruolz; Di Matteo, Livio

    2017-01-03

    The long-term increase in international health spending sparked concerns about sustainability of health care systems but also the impact of such spending and the value for money from health spending. The period since 1975 has witnessed an increase in per capita health spending in Canada along with improvements in health outcomes. This paper is an economic evaluation of health spending in Canada-an analysis of the cost-effectiveness of aggregate health spending. Estimates of the cost per quality-adjusted life-year (QALY) are made for the whole 1980-2012 period and for four sub-periods of time-1980-1989; 1989-1998; 1998-2007 and 2007-2012. This is done for both the general population as well as Canadian seniors. Under a medium contribution of health spending to life expectancy scenario for the 1980-2012 period, the costs per QALY gained averaged $16,977 and $14,968, respectively for the general population and the seniors. This suggests that the Canadian health system produces relatively good value for money, especially for the seniors. After applying separate adjustments to match total health spending in the US and NHS health spending in the UK, we found that costs per QALY gained in Canada were generally lower than those found for the US, but not for the UK.

  13. International trade regulation and publicly funded health care in Canada.

    Science.gov (United States)

    Ostry, A S

    2001-01-01

    The World Trade Organization (WTO) creates new challenges for the Canadian health care system, arguably one of the most "socialized" systems in the world today. In particular, the WTO's enhanced trade dispute resolution powers, enforceable with sanctions, may make Canadian health care vulnerable to corporate penetration, particularly in the pharmaceutical and private health services delivery sectors. The Free Trade Agreement and its extension, the North American Free Trade Agreement, gave multinational pharmaceutical companies greater freedom in Canada at the expense of the Canadian generic drug industry. Recent challenges by the WTO have continued this process, which will limit the health care system's ability to control drug costs. And pressure is growing, through WTO's General Agreement on Trade in Services and moves by the Alberta provincial government to privatize health care delivery, to open up the Canadian system to corporate penetration. New WTO agreements will bring increasing pressure to privatize Canada's public health care system and limit government's ability to control pharmaceutical costs.

  14. Chinese health beliefs of older Chinese in Canada.

    Science.gov (United States)

    Lai, Daniel W L; Surood, Shireen

    2009-02-01

    Objectives. This study examines the cultural health beliefs held by older Chinese in Canada. Methods. Chinese surnames are randomly selected from the local Chinese telephone directories. Telephone screening is then conducted to identify eligible Chinese people 55 years of age or older to take part in a face-to-face interview to complete a structured survey questionnaire. Results. The results of exploratory factor analysis indicate that the health beliefs of the older Chinese are loaded onto three factors related to beliefs about traditional health practices, beliefs about traditional Chinese medicine, and beliefs about preventive diet. Education, religion, country of origin, length of residency in Canada, and city of residency are the major correlates of the various Chinese health beliefs scales. Discussion. The findings support the previous prescriptive knowledge about Chinese health beliefs and illustrate the intragroup sociocultural diversity that health practitioners should acknowledge in their practice.

  15. Mental health of Latin Americans in Canada: a literature review.

    Science.gov (United States)

    Ginieniewicz, Jorge; McKenzie, Kwame

    2014-05-01

    Latin Americans represent one of the fastest-growing immigrant populations in Canada. But very little is known about their mental health. This paper reviews the literature on the mental health of Latin American immigrants to Canada. The paper also identifies potential areas to expand the research agenda. Twenty-five papers were identified by a comprehensive electronic search undertaken in medical- and humanities-related databases. s are reported in three sections: (1) the rates of mental illness; (2) the risk factors that affect mental health; and (3) the access and barriers to care and services. Findings indicate that despite the diversity of immigration from Latin America to Canada, much of the information on mental health focuses on Central American refugees. The most frequently examined risk factor is displacement as a consequence of political persecution and torture in the home country. Access to mental health services in this population seems to be limited by cultural differences and language barriers. New research on this topic should reflect the growing diversity and heterogeneity of the Latin American population in Canada.

  16. Public health nutrition practice in Canada: a situational assessment.

    Science.gov (United States)

    Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

    2008-08-01

    Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

  17. Primary Health Care in Canada: Systems in Motion

    OpenAIRE

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

    2011-01-01

    Context: 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.

  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. Page 1 436 Inderjit Chopra lb /in. x10" 2.000 1,500 Ç (d) 0.35 O 2 5 ...

    Indian Academy of Sciences (India)

    Figure 10. Variation of elastomeric stiffness with 1/rev (a) and 0.6/rev (b) lag amplitude (Bir & Chopra 1981). Damping of the regressive lag mode as a function. (c) of 0.6/rev lag motion amplitude (u = 0, CT = 0.08), and (d) of advance ratio. (Cr = 0.08, Č = 0.20°) (Bir & Chopra 1981). for static and vibration characteristics ...

  20. Trends in the study of Aboriginal health risks in Canada.

    Science.gov (United States)

    Furgal, Chris M; Garvin, Theresa D; Jardine, Cynthia G

    2010-09-01

    To identify trends in the study of health risk in peer-reviewed and grey literature in Canadian Aboriginal populations from 1960 to 2007. Systematic literature review and analysis. Peer-reviewed literature was searched using 5 electronic library databases. The grey literature was searched using 3 online search engines, 4 agency websites and 2 online compiled databases. The search terms used were "Canada," synonyms for Canadian Aboriginal peoples and "risk." Citations were screened for relevance to Aboriginal populations and risks to aspects of human health. Both literatures show an exponential growth in risk-focused study of Canadian Aboriginal health issues over time. There is a geographic foci in the North with the Prairies and the West under-represented. Risk is most commonly used in relation to general health, environmental, zoonotic infections and chronic diseases in the peer-reviewed literature, and general health or environment in the grey literature. Most publications in both literatures are on generalized Aboriginal populations. When specified, a larger proportion of the publications relate to First Nations people, followed by Inuit. Little literature exists on Métis health risks in Canada. There has been an increase in publications about Aboriginal health risk in Canada over time. Trends reflect a research focus on the North and an increased interest in environment and health issues. Greater attention to mental health, addictions and Métis health is required. The increasing use of a risk-based analytical focus has potential implications for understanding the nature of Aboriginal health today and in the future.

  1. A research review: exploring the health of Canada's Aboriginal youth

    Directory of Open Access Journals (Sweden)

    Ashley Ning

    2012-08-01

    Full Text Available Objective. To compare the current state of health research on Aboriginal and non-Aboriginal youth in Canada. Design. A search of published academic literature on Canadian Aboriginal youth health, including a comprehensive review of both non-Aboriginal and Aboriginal youth research, was conducted using MEDLINE and summarized. Methodology. A MEDLINE search was conducted for articles published over a 10-year period (2000–2010. The search was limited to research articles pertaining to Canadian youth, using various synonyms for “Canada,” “youth,” and “Aboriginal.” Each article was coded according to 4 broad categories: Aboriginal identity, geographic location, research topic (health determinants, health status, health care, and the 12 key determinants of health proposed by the Public Health Agency of Canada (PHAC. Results. Of the 117 articles reviewed, only 34 pertained to Aboriginal youth, while the remaining 83 pertained to non-Aboriginal youth. The results revealed major discrepancies within the current body of research with respect to the geographic representation of Aboriginal youth, with several provinces missing from the literature, including the northern territories. Furthermore, the current research is not reflective of the demographic composition of Aboriginal youth, with an under-representation of Métis and urban Aboriginal youth. Health status of Aboriginal youth has received the most attention, appearing in 79% of the studies reviewed compared with 57% of the non-Aboriginal studies. The number of studies that focus on health determinants and health care is comparable for both groups, with the former accounting for 62 and 64% and the latter comprising 26 and 19% of Aboriginal and non-Aboriginal studies, respectively. However, this review reveals several differences with respect to specific focus on health determinants between the two populations. In non-Aboriginal youth studies, all the 12 key determinants of health of PHAC

  2. CANADA

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

    Hakan Mustafa

    . AAAA. Numéro du fournisseur. Protégé B*. (une fois rempli). RENSEIGNEMENTS GÉNÉRAUX, FISCAUX ET BANCAIRES DU FOURNISSEUR – CANADA. Section 1 : RENSEIGNEMENTS GÉNÉRAUX. Nom du particulier (nom, prénom) ou ...

  3. 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…

  4. Health care technology in Canada (with special reference to Quebec).

    Science.gov (United States)

    Battista, R N; Jacob, R; Hodge, M J

    1994-01-01

    In Canada, all citizens are insured for health services. Health care is a provincial responsibility. The federal role is limited to health care financing, health protection including regulation of pharmaceuticals, and environmental health. The health care system represents a balance among government direction, consumer choice, and provider autonomy. Canada has largely controlled the costs of health care by funding and management mechanisms, the most important of which is the global budget formula used to fund hospitals. This paper discusses the Canadian health care system, with particular emphasis on the province of Quebec. In 1988, the provincial government of Quebec established the first Canadian body dedicated to technology assessment. Since then, a national coordinating office and several other provincial bodies have developed. The work of these and other evaluation efforts has had a growing influence on technology management decisions, particularly those dealing with procurement of capital-intensive technologies. Expanding this influence into the realm of technology use, especially for low-cost, high-volume technologies, remains a challenge.

  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. Aboriginal urbanization and rights in Canada: examining implications for health.

    Science.gov (United States)

    Senese, Laura C; Wilson, Kathi

    2013-08-01

    Urbanization among Indigenous peoples is growing globally. This has implications for the assertion of Indigenous rights in urban areas, as rights are largely tied to land bases that generally lie outside of urban areas. Through their impacts on the broader social determinants of health, the links between Indigenous rights and urbanization may be related to health. Focusing on a Canadian example, this study explores relationships between Indigenous rights and urbanization, and the ways in which they are implicated in the health of urban Indigenous peoples living in Toronto, Canada. In-depth interviews focused on conceptions of and access to Aboriginal rights in the city, and perceived links with health, were conduced with 36 Aboriginal people who had moved to Toronto from a rural/reserve area. Participants conceived of Aboriginal rights largely as the rights to specific services/benefits and to respect for Aboriginal cultures/identities. There was a widespread perception among participants that these rights are not respected in Canada, and that this is heightened when living in an urban area. Disrespect for Aboriginal rights was perceived to negatively impact health by way of social determinants of health (e.g., psychosocial health impacts of discrimination experienced in Toronto). The paper discusses the results in the context of policy implications and future areas of research. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Climate Change, Drought and Human Health in Canada

    Directory of Open Access Journals (Sweden)

    Anna Yusa

    2015-07-01

    Full Text Available 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.

  8. 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

  9. Health information support provided by professional associations in Canada.

    Science.gov (United States)

    Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene

    2012-09-01

    Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Leanne C. Findlay

    2012-06-01

    Full Text Available Objectives. 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. Study design and methods. 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. Results. 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. Conclusions. The findings show that social determinants of health, including both socio-economic and household characteristics, are associated with Inuit child health.

  12. Exclusionary health policy: responding to the risk of poor health among sexual minority youth in Canada.

    Science.gov (United States)

    Ylioja, Thomas; Craig, Shelley L

    2014-01-01

    Measuring indicators of health status and demographics are essential in the population health approach. In Canada, sexual minority youth face increased risk for poor health outcomes in behavioral and mental health indicators, yet the health policy response has been severely lacking. The current population health approach exacerbates the social exclusion of a vulnerable, at-risk population. The authors examine health status through the social determinants of health to highlight the need for including sexual identity, attraction, and behavior in youth population health surveys. Additional interventions that address the social determinants of health are needed.

  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. Health Beliefs and Practices of African Immigrants in Canada.

    Science.gov (United States)

    Cooper Brathwaite, Angela; Lemonde, Manon

    2016-12-01

    A purposive sample of 14 immigrants living in Ontario, Canada, participated in two focus groups. The researchers used semi-structured interviews to collect data and five themes emerged from the data: beliefs about diabetes were centered on diverse factors, preserving culture through food preferences and preparation, cultural practices to stay healthy, cultural practices determined number of servings of fruit and vegetables per day, and engaging in physical activity to stay healthy. Findings indicated how health beliefs and cultural practices influenced behavior in preventing type 2 diabetes (T2D). Future research should focus on other high-risk minority groups (South Asian, Caribbean, and Latin American) to examine their health beliefs and cultural practices and use these finding to develop best practice guidelines, which should be incorporated into culturally tailored interventions. © The Author(s) 2015.

  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. 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.

  17. Assuming policy responsibility for health equity: local public health action in Ontario, Canada.

    Science.gov (United States)

    Raphael, Dennis; Sayani, Ambreen

    2017-10-30

    In Canada's liberal welfare state the public is given little exposure by governmental authorities to the importance of promoting health equity through public policy action on the social determinants of health (SDoH). Not surprisingly, Canada lags in implementing health equity-enhancing public policy. In Ontario, Canada's most populous province, a local public health unit (PHU) took on the task of promoting health equity by developing the video animation Let's Start a Conversation about Health and Not Talk about Health Care at All. In the wake of this work, an additional 17 local PHUs (of 36) adapted it for local use. By placing these activities within Nutbeam's and de Leeuw's concepts of critical health literacy as an essential component of health promotion, we examine how these PHUs came to adopt the video, their intended uses, and supports and barriers encountered. These efforts by local PHUs to promote health equity through action on the SDoH have implications for those in jurisdictions where State attention to these issues is lacking. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  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. Longitudinal trends in mental health among ethnic groups in Canada.

    Science.gov (United States)

    Pahwa, P; Karunanayake, C P; McCrosky, J; Thorpe, L

    2012-06-01

    Immigration continues to transform the ethnic composition of the Canadian population. We investigated whether longitudinal trends in mental distress vary between seven cultural and ethnic groups and whether mental distress within the same ethnic group varies by demographic (immigrant status, sex, age, marital status, place and length of residence), socio-economic (education, income), social support and lifestyle factors. The study population consisted of 14 713 respondents 15 years and older from the first six cycles of the National Population Health Survey (NPHS); 20% reported themselves to be immigrant at Cycle 1, in 1994/1995. The logistic regression model was fitted by modifying a multivariate quasi-likelihood approach, and robust variance estimates were obtained by using balanced repeated replication techniques. Based on the multivariable model and self-reported data, we observed that female respondents were more likely to report moderate/high mental distress than male respondents; younger respondents more than older respondents; single respondents more than those in a relationship; urban-dwellers more than rural-dwellers; less educated respondents more than more educated respondents; current and former smokers more than non-smokers; and those living in a smoking household more than those living in non-smoking households. The relationship between ethnicity and mental distress was modified by immigrant status, sex, social involvement score and education. Confirming other research, we found an inverted U-shaped relationship between length of stay and mental distress: those who had lived in Canada for less than 2 years were less likely to report moderate/high mental distress, while those who had lived in Canada for 2 to 20 years were significantly more likely to report moderate/high mental distress than those who had lived in Canada for more than 20 years. There is a need to develop ethnicity-specific mental health programs targeting those with low education

  20. Strengthening information systems for heart health in Canada.

    Science.gov (United States)

    McFarlane, A; Wielgosz, A

    2009-11-01

    Information plays a key role in monitoring, management, evaluation and policy development related to cardiovascular diseases. Canada currently lacks a comprehensive, integrated pan-Canadian system to address the growing burden of cardiovascular diseases, including reliable and timely data that can be used by policy-makers, health care providers, researchers and the public. Theme Working Group 1 (one of six Theme Working Groups) aimed to address different aspects of the Canadian Heart Health Strategy and Action Plan, with a focus on strengthening information systems. Members of the group, who are experts in the cardiovascular field and/or information systems, defined the scope of the issue, identified gaps and solutions, and discussed priorities. The process is described and suggestions for final recommendations are presented. These suggestions were made taking into consideration the needs of health care providers, patients and consumers, the needs for planning, innovation, evaluation and system improvement, and the needs for information on populations and environments. A sustained integrated system that meets cardiovascular information needs requires a major commitment of expertise, leadership and funding.

  1. Canada's e-health journey and HIMSS Analytics' Canada Information and Communications Technology Study.

    Science.gov (United States)

    Powers, Patrick

    2009-01-01

    In spring 2007, HIMSS Analytics began developing its first Canada Information and Communications Technology (ICT) Study. Less than one year later, 38 RHAs, DHAs and HAs are already on board, with some 20 more scheduled to participate by year's end. Why are so many Canadian provincial healthcare delivery organizations now participating in HIMSS Analytics' Canada ICT Study? The answer is tied to the character of the HIMSS study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the study.

  2. 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.

  3. Future trends in ophthalmology health human resources in Canada.

    Science.gov (United States)

    Bellan, Lorne

    2016-06-01

    Projections of future Canadian ratios of ophthalmologists to population have fluctuated because of changes in numbers of residency spots and retirement rates. Although this ratio plateaued in recent years, the ratio of ophthalmologists to the population over 65 years of age is projected to steadily deteriorate. All graduating residents are going to be needed to meet the upcoming workload, yet current graduates are finding increasing difficulty obtaining full-time positions with operating room privileges. This problem is affecting all specialties who require hospital facilities, and exploration of this problem by the Royal College, Canadian Medical Association (CMA), Resident Doctors of Canada, and council of the Provincial Deputy Ministers of Health is presented. Proposed solutions to the current job shortages include residents starting in positions outside of major metropolitan areas, clinicians in practice giving up some operating room time to make way for new graduates, government increasing infrastructure commensurate with the increased number of medical school positions, and optimizing use of current resources by running operating rooms for longer hours and on the weekends. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  4. The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.

    Science.gov (United States)

    Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

    2017-01-01

    Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.

  5. Matters of life and death: public health issues in Canada

    National Research Council Canada - National Science Library

    Picard, André

    2017-01-01

    .... Matters of Life and Death collects Picard's most compelling columns, covering a broad range of topics including Canada's right-to-die law, the true risks of the Zika virus, the financial challenges...

  6. Ranked Performance of Canada's Health System on the International Stage: A Scoping Review.

    Science.gov (United States)

    Najafizada, Said Ahmad Maisam; Sivanandan, Thushara; Hogan, Kelly; Cohen, Deborah; Harvey, Jean

    2017-08-01

    Since the release of the World Health Report in 2000, health system performance ranking studies have garnered significant health policy attention. However, this literature has produced variable results. The objective of this study was to synthesize the research and analyze the ranked performance of Canada's health system on the international stage. We conducted a scoping review exploring Canada's place in ranked health system performance among its peer Organisation for Economic Co-operation and Development countries. Arksey and O'Malley's five-stage scoping review framework was adopted, yielding 48 academic and grey literature articles. A literature extraction tool was developed to gather information on themes that emerged from the literature. Although various methodologies were used to rank health system performance internationally, results generally suggested that Canada has been a middle-of-the-pack performer in overall health system performance for the last 15 years. Canada's overall rankings were 7/191, 11/24, 10/11, 10/17, "Promising" and "B" grade across different studies. According to past literature, Canada performed well in areas of efficiency, productivity, attaining health system goals, years of life lived with disability and stroke mortality. By contrast, Canada performed poorly in areas related to disability-adjusted life expectancy, potential years of life lost, obesity in adults and children, diabetes, female lung cancer and infant mortality. As countries introduce health system reforms aimed at improving the health of populations, international comparisons are useful to inform cross-country learning in health and social policy. While ranking systems do have shortcomings, they can serve to shine a spotlight on Canada's health system strengths and weaknesses to better inform the health policy agenda. Copyright © 2017 Longwoods Publishing.

  7. Faculties of medicine: important contributors to health human resource planning in Canada.

    Science.gov (United States)

    Busing, Nick; Gold, Irving

    2009-01-01

    Tzountzouris and Gilbert's article "Role of Educational Institutions in Identifying and Responding to Emerging Health Human Resources Needs" makes an interesting contribution to the literature on health human resources (HHR) planning in Canada, focusing specifically on the potential role of educational institutions. In this commentary, we argue that Canada's faculties of medicine are already heavily involved in meeting the HHR needs of Canadians and are extremely well poised to become even more involved in the process of HHR planning. Our faculties of medicine look forward to the time when Canada has a pan-Canadian, multi-professional HHR planning mechanism to which they can contribute.

  8. 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.

  9. Assessment and management of residential radon health risks: a report from the health Canada radon workshop.

    Science.gov (United States)

    Tracy, Bliss L; Krewski, Daniel; Chen, Jing; Zielinski, Jan M; Brand, Kevin P; Meyerhof, Dorothy

    2006-04-01

    Epidemiologic studies of uranium miners and other underground miners have consistently shown miners exposed to high levels of radon to be at increased risk of lung cancer. More recently, concern has arisen about lung cancer risks among people exposed to lower levels of radon in homes. The current Canadian guideline for residential radon exposure was set in 1988 at 800 Bq/m(3). Because of the accumulation of a considerable body of new scientific evidence on radon lung cancer risks since that time, Health Canada sponsored a workshop to review the current state-of-the-science on radon health risks. The specific objectives of the workshop were (1) to collect and assess scientific information relevant to setting national radon policy in Canada, and (2) to gather information on social, political, and operational considerations in setting national policy. The workshop, held on 3-4 March 2004, was attended by 38 invited scientists, regulators, and other stakeholders from Canada and the United States. The presentations on the first day dealt primarily with scientific issues. The combined analysis of North American residential radon and lung cancer studies was reviewed. The analysis confirmed a small but detectable increase in lung cancer risk at residential exposure levels. Current estimates suggest that radon in homes is responsible for approximately 10% of all lung cancer deaths in Canada, making radon the second leading cause of lung cancer after tobacco smoking. This was followed by a perspective from an UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) working group on radon. There were two presentations on occupational exposures to radon and two presentations considered the possibility of radon as a causative factor for cardiovascular disease and for cancer in other organs besides the lung. The possible contribution of environmental tobacco smoke to lung cancers in nonsmokers was also considered. Areas for future research were identified

  10. Migrant Nurses and Federal Caregiver Programs in Canada: Migration and Health Human Resources Paradox.

    Science.gov (United States)

    Salami, Bukola

    2016-06-01

    Despite the links between health human resources policy, immigration policy, and education policy, silos persist in the policy-making process that complicate the professional integration of internationally educated nurses in Canada. Drawing on the literature on nurse migration to Canada through the Live-in Caregiver Program, this paper sheds light on the contradictions between immigration and health human resources policy and their effect on the integration of internationally educated nurses in Canada. The analysis reveals a series of paradoxes within and across immigration and health human resources policy that affect the process of professional integration of this group of health professionals into the nursing workforce in Canada. I will further link the discussion to the recently implemented Caregiver Program, which provides a unique pathway for healthcare workers, including nurses, to migrate to Canada. Given recent introduction of the Canadian Caregiver Program, major policy implications include the need to bridge the gap between health human resources policy and immigration policy to ensure the maximum integration of migrant nurses in Canada.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gosselin, P. [Inst. national de sante publique, Quebec, PQ (Canada); Hrudey, S.E. [Alberta Univ., Edmonton, AB (Canada). Faculty of Medicine and Dentistry, Div. of Analytical and Environmental Toxicology; Naeth, M.A. [Alberta Univ., Edmonton, AB (Canada). Faculty of Agricultural, Life, and Environmental Sciences; Plourde, A. [Alberta Univ., Edmonton, AB (Canada). Dept. of Economics; Therrien, R. [Natural Sciences and Engineering Research Council of Canada, Ottawa, ON (Canada); Laval Univ., Quebec City, PQ (Canada). Dept. of Geology and Geological Engineering; Van Der Kraak, G. [Guelph Univ., ON (Canada). Dept. of Integrative Biology; Guelph Univ., ON (Canada). College of Biological Science; Xu, Z. [Alberta Univ., Edmonton, AB (Canada). Faculty of Engineering

    2010-12-15

    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.

  12. Sense of Community Belonging and Health in Canada: A Regional Analysis

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Chowhan, James

    2012-01-01

    This article investigates the association between sense of community belonging and health among settlements of different size and across the urban to rural continuum in Canada. Using data from the recent 2007/08 Canadian Community Health Survey (CCHS), the objective is to identify the major health, social and geographic determinants of sense of…

  13. 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…

  14. 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.

  15. Influence of revised public health standards on health equity action: a qualitative study in Ontario, Canada.

    Science.gov (United States)

    Hassen, Nadha; Tyler, Ingrid; Manson, Heather

    2017-10-27

    In 2008, a revised set of public health standards was released in the province of Ontario, Canada. The updated Ontario Public Health Standards (OPHS) introduced a new policy mandate that required local public health units (PHUs) to identify "priority populations" for public health programs and services. The aim of this study was to understand how this Priority Populations Mandate (PPM) facilitated or hindered action on health equity or the social determinants of health through PHUs in Ontario. This study used two sets of qualitative data that were part of a larger study. The first set of data was 16 semi-structured key informant interviews with policymakers involved in developing the OPHS and public health practitioners. The second set of data was the qualitative component of a role-based survey sent out to all the 36 PHUs in Ontario. Thematic content analysis was conducted to iteratively develop themes to answer the research question. We identified six factors that both facilitated and hindered action on health equity and social determinants of health action in the province resulting from the OPHS and PPM. These six factors were grouped into three categories or themes: OPHS policy attributes (1. introducing new terminology, 2. allowing flexibility in implementation and 3. ensuring evidence-informed decision-making), health sector context into which the PPM was introduced (4. different understandings of health equity and 5. variability in existing partnerships) and implementation by PHUs (6. requirement to address the PPM). Although the revised OPHS and the PPM facilitated action on health equity and the social determinants of health, on the whole, this objective could have been better met. The mandate within the OPHS could have been strengthened with respect to promoting action on health equity and the social determinants of health through more clearly defined terminology, conveying a guiding health equity vision and uniting different PHU approaches to addressing

  16. [Validation of the equity of access of the OLMCS to health professionals in health regions of Canada].

    Science.gov (United States)

    Warnke, Jan; Bouchard, Louise

    2013-06-13

    Our research uses a regional summary indicator (IHPOLM) to measure the capacity of the health system to provide equitable access to health professionals for 2 million Official Language Minority Community (OLMC) members dispersed across 104 health regions in Canada. The summary indicator IHPOLM compares the official language minority and the official language majority potential access to health professionals. The IHPOLM indicator uses 22 professional health care occupations, representing 79% of the health care workforce in Canada, who communicate directly with their clientele for therapeutic or diagnostic purposes (Statistics Canada, 2006). The IHPOLM indicator revealed that the OLMC population is at a disadvantage in potential access to health professionals capable of providing services in the minority language when compared to the majority language population in 10 of the 13 Canadian provinces/territories. OLMC members are disadvantaged in 13 out of 14 health regions in Ontario, in 16 out of 18 in Québec and in 3 out of 7 in New Brunswick. The summary regional indicator IHPOLM identified OLMC health care access inequalities between the official language minority population and the majority language population in the health care system across the health regions in Canada. The more detailed analysis of IHPOLM for individual health occupations will further improve our knowledge of Official Language Minority Community health access inequalities.

  17. The health of temporary foreign workers in Canada: A scoping review.

    Science.gov (United States)

    Salami, Bukola; Meherali, Salima; Salami, Azeez

    2016-03-16

    Temporary foreign workers contribute to economic prosperity in Canada, but they experience forms of structural inequities and have minimal rights, which can contribute to their ill health. The objective of this scoping review is to examine the extent, range and nature of the Canadian literature on the health of temporary foreign workers and their families in Canada. The review was guided by Arksey and O'Malley's five stages for conducting a scoping review. We performed a comprehensive search of seven databases, which revealed 994 studies. In total, 10 published research papers, which focused exclusively on the health of temporary foreign workers in Canada, were included in the study; these 10 papers represented the findings from 9 studies. The majority of the studies involved seasonal agricultural workers in the province of Ontario (n = 8). Major health issues of temporary foreign workers included mental health, occupational health, poor housing and sanitation, and barriers to accessing health care, including fear of deportation and language barriers. These health issues are highly shaped by temporary foreign workers' precarious immigration status in Canada. Findings from this study demonstrate the need to reduce barriers to health care and to conduct more research on other groups of temporary foreign workers, outside the agricultural sector.

  18. How much might universal health insurance reduce socioeconomic disparities in health? : A comparison of the US and Canada.

    Science.gov (United States)

    Decker, Sandra L; Remler, Dahlia K

    2004-01-01

    A strong association between lower socioeconomic status and worse health has been documented within many countries, but little work has been done to compare the strength of this relationship across countries. We compare the strength of the relationship between income and self-reported health in the US and Canada. We find that being below median income raises the likelihood that a middle-aged person is in poor or fair health by about 15 percentage points in the US, compared with less than 8 percentage points in Canada. We also find that this 7 percentage points stronger relationship between low income and poor health in the US compared with Canada is reduced by about 4 percentage points after age 65, the age at which virtually all US citizens receive basic health insurance through the Medicare programme. Income differences in the probability that an individual lacks a usual source of care are also significantly larger in the US than in Canada before the age of 65, but about the same after age 65. Our results are therefore consistent with the theory that the availability of universal health insurance in the US, or at least some other difference that occurs around the age of 65 in one country but not the other, decreases the difference in the strength of the income-health relationship in the US compared with Canada.

  19. Health Information Management Workforce Transformation: New Roles, New Skills and Experiences in Canada

    National Research Council Canada - National Science Library

    Candace J Gibson; Kelly J Abrams; Gail F Crook

    2015-01-01

    ..., the role of health information management (HIM) professionals needs to correspondingly change to meet the demands of an increasingly digital workplace. The Canadian Health Information Management Association (CHIMA) is the certifying body and national association for approximately 5,000 HIM professionals acros s Canada. In addition to s etting and a...

  20. The Museum of Health Care at Kingston: its role in the preservation of the legacy of health care in Canada.

    Science.gov (United States)

    Low, James A

    2009-01-01

    Beginning in the 16th century, museums were an important resource for medical education. By the mid 20th century, however, the perceived educational value of museum collections declined and museums adopted the strategy of turning collections into publicly accessible medical history. The Museum of Health Care at Kingston, governed by a Board of Directors, began in 1991. The collection reflective of health care in Canada is available as a research resource through the Museum website and Artefacts Canada. The Museum communicates the history and science of health and health care as it has occurred in Canada to the general public by means of special events, exhibits and educational programs. The outstanding challenge for the Museum, as a not-for-profit institution, is to meet the increasing demands of the annual operating budget and to establish an Endowment Fund to assure long-term financial stability of the Museum.

  1. From benefits evaluation to clinical adoption: making sense of health information system success in Canada.

    Science.gov (United States)

    Lau, Francis; Price, Morgan; Keshavjee, Karim

    2011-01-01

    This article proposes a Clinical Adoption Framework for making sense of health information system (HIS) success in Canada. It extends Canada Health Infoway's Benefits Evaluation Framework with contextual factors that influence HIS adoption by clinicians, which include people, organization, implementation, and the macro environment. Our hypothesis is that successful clinical adoption of an HIS requires explicit recognition, strategies and actions that address the factors described in the framework. Validation of this framework by stakeholders and literature has thus far been favourable. Its potential application with selected evaluation approaches in specific settings, the implications and work ahead are discussed.

  2. Telehealth: Telecommunications Technology in Health Care and Health Education in Canada. New Technologies in Canadian Education Series. Paper 15.

    Science.gov (United States)

    Cervinskas, Jenny

    This examination of the use of telecommunications systems in the health care field in Canada notes that the use of such systems to assist in the delivery of health care at a distance is critical to the remote and isolated regions of the country. The report begins by reviewing the development of 'telemedicine' or 'telehealth' systems using various…

  3. Undocumented migrants in Canada: a scope literature review on health, access to services, and working conditions.

    Science.gov (United States)

    Magalhaes, Lilian; Carrasco, Christine; Gastaldo, Denise

    2010-02-01

    It is estimated that there are 30-40 million undocumented workers worldwide. Although undocumented migration has become an issue of high international relevance, it has been strikingly understudied in Canada, especially with respect to its impact on health. The purpose of this study is to explore the concept of undocumentedness in Canada through a scoping review of peer-reviewed and grey literature written in English, French, Portuguese and Spanish between 2002 and 2008. The specific aims are to: (i) summarize and disseminate current academic and community-based findings on the health, service access and working conditions of undocumented migrants in Canada; (ii) examine the sources and use of evidence; (iii) identify significant gaps in existing knowledge; (iv) set recommendations for policy and research, including considerations on transnationalism, ethics, interdisciplinary approaches, gender differences, resilience, and impact on the children of non-status parents.

  4. The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada

    OpenAIRE

    Stephanie Lake; Thomas Kerr

    2016-01-01

    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 ...

  5. 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.

  6. 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.

  7. Chopra, N N

    Indian Academy of Sciences (India)

    Specialization: Organic Chemistry, Enzymes, Microbiology, Plant Physiology, Blood & Plasma. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. Theory Of Evolution. Posted on 23 January 2018. Joint Statement by the Three Science Academies of India on the teaching of the theory of evolution more.

  8. Chopra, Prof. Kasturi Lal

    Indian Academy of Sciences (India)

    , FNA, FNAE, FNASc. Date of birth: 31 July 1933. Specialization: Physics & Technology of Thin Films, Nanomaterials, Surface Science and Technology, Photovoltaics , Vacuum Technology Address: M-70 Kirti Nagar, New Delhi 110 015, U.T.

  9. 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

  10. 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

  11. Human health impacts of biodiesel use in on-road heavy duty diesel vehicles in Canada.

    Science.gov (United States)

    Rouleau, Mathieu; Egyed, Marika; Taylor, Brett; Chen, Jack; Samaali, Mehrez; Davignon, Didier; Morneau, Gilles

    2013-11-19

    Regulatory requirements for renewable content in diesel fuel have been adopted in Canada. Fatty acid alkyl esters, that is, biodiesel, will likely be used to meet the regulations. However, the impacts on ambient atmospheric pollutant concentrations and human health outcomes associated with the use of biodiesel fuel blends in heavy duty diesel vehicles across Canada have not been evaluated. The objective of this study was to assess the potential human health implications of the widespread use of biodiesel in Canada compared to those from ultralow sulfur diesel (ULSD). The health impacts/benefits resulting from biodiesel use were determined with the Air Quality Benefits Assessment Tool, based on output from the AURAMS air quality modeling system and the MOBILE6.2C on-road vehicle emissions model. Scenarios included runs for ULSD and biodiesel blends with 5 and 20% of biodiesel by volume, and compared their use in 2006 and 2020. Although modeling and data limitations exist, the results of this study suggested that the use of biodiesel fuel blends compared to ULSD was expected to result in very minimal changes in air quality and health benefits/costs across Canada, and these were likely to diminish over time.

  12. 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.

  13. Visits to physicians for oral health-related complaints in Ontario, Canada.

    Science.gov (United States)

    LaPlante, Nancy C; Singhal, Sonica; Maund, Jacquie; Quiñonez, Carlos

    2015-03-12

    Canada's national system of health insurance facilitates equitable access to health care; however, since dental care is generally privately financed and delivered, access to oral health care remains uneven and inequitable. To avoid the upfront costs, many argue that socially marginalized groups should seek oral health care from medical providers. This study therefore explored the rates and numbers of visits to physicians for oral health-related diagnoses in Ontario, Canada's most populated province. A retrospective secondary data analysis of health system utilization in Ontario was conducted for visits to physicians for oral health-related diagnoses. Data for all Ontario Health Insurance Plan (OHIP) approved billing claims were accessed over 11 fiscal years (2001-2011). Age- and sex-adjusted rates were calculated. Approximately 208,375 visits per year, with an average of 1,298/100,000 persons, were made to physicians for oral health-related diagnoses. Women, irrespective of the year, made more visits, and there was an increasing trend in visits made by elderly people. The number of people visiting physicians for oral health reasons is arguably high. The public health system is being billed for services for oral health issues that the provider is not appropriately trained to treat. Provision of timely and accessible oral health care for socially marginalized populations needs to be prioritized in health care policy.

  14. 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.

  15. Observations on primary health care in Ontario, Canada.

    OpenAIRE

    Rimmer, E M

    1990-01-01

    The Canadian health care system has developed very differently from that of its neighbour, the United States of America. It has a publicly financed and administered universal insurance plan which provides good access to high quality medicine, free at the point of delivery. Increasing costs, however, mean that painful political decisions on health will have to be made. Experiments with alternative means of financing primary health care provision and the Canadian approach to postgraduate educat...

  16. Men's Health Promotion in Canada: Current Context and Future Direction

    Science.gov (United States)

    Robertson, Steve; Galdas, Paul M.; McCreary, Donald R.; Oliffe, John L.; Tremblay, Gilles

    2009-01-01

    The issue of "men's health", and how best to promote it, has been gaining increasing attention in both academic and media arenas across the globe. Whilst commentaries on the state of health promotion for men have been provided in countries including Australia and the United Kingdom, no corresponding Canadian-specific insights have yet…

  17. Prioritizing health leadership capabilities in Canada: Testing LEADS in a Caring Environment.

    Science.gov (United States)

    Marchildon, Gregory P; Fletcher, Amber J

    2016-01-01

    This article is the first major empirical test of LEADS in a Caring Environment, the principal leadership capability framework in Canada. The results rank the perceived salience of leadership attributes, given time and budget constraints, while implementing a major organization reform in the Saskatchewan health system. The results also indicate important differences between self-assessed leadership behaviours versus observed behaviours in other leaders that may reflect participants' expectations of managers with designated authority. © 2015 The Canadian College of Health Leaders.

  18. 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.

  19. Measuring positive mental health in Canada: construct validation of the Mental Health Continuum-Short Form.

    Science.gov (United States)

    Orpana, Heather; Vachon, Julie; Dykxhoorn, Jennifer; Jayaraman, Gayatri

    2017-04-01

    Positive mental health is increasingly recognized as an important focus for public health policies and programs. In Canada, the Mental Health Continuum-Short Form (MHC-SF) was identified as a promising measure to include on population surveys to measure positive mental health. It proposes to measure a three-factor model of positive mental health including emotional, social and psychological well-being. The purpose of this study was to examine whether the MHC-SF is an adequate measure of positive mental health for Canadian adults. We conducted confirmatory factor analysis (CFA) using data from the 2012 Canadian Community Health Survey (CCHS)-Mental Health Component (CCHS-MH), and cross-validated the model using data from the CCHS 2011-2012 annual cycle. We examined criterion-related validity through correlations of MHC-SF subscale scores with positively and negatively associated concepts (e.g. life satisfaction and psychological distress, respectively). We confirmed the validity of the three-factor model of emotional, social and psychological well-being through CFA on two independent samples, once four correlated errors between items on the social well-being scale were added. We observed significant correlations in the anticipated direction between emotional, psychological and social well-being scores and related concepts. Cronbach's alpha for both emotional and psychological well-being subscales was 0.82; for social well-being it was 0.77. Our study suggests that the MHC-SF measures a three-factor model of positive mental health in the Canadian population. However, caution is warranted when using the social well-being scale, which did not function as well as the other factors, as evidenced by the need to add several correlated error terms to obtain adequate model fit, a higher level of missing data on these questions and weaker correlations with related constructs. Social well-being is important in a comprehensive measure of positive mental health, and further

  20. The value of connected health information: perceptions of electronic health record users in Canada.

    Science.gov (United States)

    Tharmalingam, Sukirtha; Hagens, Simon; Zelmer, Jennifer

    2016-07-16

    As health care becomes more complex, it becomes more important for clinicians and patients to share information. Electronic health information exchange can help address this need. To this end, all provinces and territories (PTs) in Canada have created interoperable electronic health records (iEHRs). These secure systems offer authorized users an integrated view of a person's healthcare history across the continuum of care. They include information such as lab results, medications, diagnostic images, clinical reports and immunization profiles. This study explores user experiences and perceived outcomes of iEHR use. Surveys conducted between 2006 and 2014 asked iEHR users in six Canadian PTs about system, information and service quality; iEHR use and user satisfaction; and net quality and productivity benefits. The surveys had a core set of questions that used Likert-type scales. Results were synthesized across surveys for each evaluative dimension. Consensus among researchers and subject matter experts on whether to classify the outcomes as positive, mixed/neutral, or negative was established using a modified Delphi technique. A total of 2316 iEHR users responded to the six surveys. Information quality was the most studied area. Results varied across PTs, but positive outcomes were more common than mixed/neutral or negative outcomes by a 19:1:1 ratio across this dimension. The next most frequently studied aspects were user satisfaction, the impact of iEHR use on quality of care, and the impact on productivity. In all three areas, there were more positive than mixed/neutral or /negative results (ratios of 13:1:1, 14:3:1, and 15:2:1respectively). Overall, users of iEHRs that provide secure access to patient information collated from across the health system tend to report positive outcomes, including quality of care and productivity. This study is an important first step in understanding user perspectives on iEHRs and health information exchange more broadly.

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

    Science.gov (United States)

    Maclean, Heather; Glynn, Keva; Ansara, Donna

    2004-01-01

    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. PMID:15345066

  2. Multi-criteria decision analysis for health technology assessment in Canada: insights from an expert panel discussion.

    Science.gov (United States)

    Diaby, Vakaramoko; Goeree, Ron; Hoch, Jeffrey; Siebert, Uwe

    2015-02-01

    Multi-criteria decision analysis (MCDA), a decision-making tool, has received increasing attention in recent years, notably in the healthcare field. For Canada, it is unclear whether and how MCDA should be incorporated into the existing health technology assessment (HTA) decision-making process. To facilitate debate on improving HTA decision-making in Canada, a workshop was held in conjunction with the 8th World Congress on Health Economics of the International Health Economics Association in Toronto, Canada in July 2011. The objective of the workshop was to discuss the potential benefits and challenges related to the use of MCDA for HTA decision-making in Canada. This paper summarizes and discusses the recommendations of an expert panel convened at the workshop to discuss opportunities and concerns with reference to the implementation of MCDA in Canada.

  3. 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

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

    African Journals Online (AJOL)

    In the USA, meaningful discussion on the advantages and disadvantages of the Canadian system has been thwarted by ideological mudslinging by defenders of .... based on past budgets, patient load, inflation and salary ... However, South Africa's health care system is more equitable than the USA system in many ways.

  5. 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...

  6. 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,

  7. 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.

  8. 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

  9. Canada's non-status immigrants: negotiating access to health care and citizenship.

    Science.gov (United States)

    Miklavcic, Alessandra

    2011-01-01

    Illegal immigration in Canada is characterized mainly by non-status immigrants who legally enter Canada and stay after their legal status expires and by failed refugee claimants. For these persons, immigration status or its absence plays an important role in determining the degree of access to Canadian health care. This article situates the clinical setting as a site of contention and negotiation of citizenship and care in social networks as well as pragmatic and discursive strategies. Drawing on the case of a patient who faced imminent deportation and became suicidal, in this article I depict how psychiatrists and other health practitioners embrace "bearing witness" as an ethical practice, which intersects the medical and legal spheres.

  10. First Nations, Inuit and Métis health: Considerations for Canadian health leaders in the wake of the Truth and Reconciliation Commission of Canada report.

    Science.gov (United States)

    McNally, Mary; Martin, Debbie

    2017-03-01

    First Nations, Inuit and Métis peoples living in Canada face profound health disparities relative to non-Indigenous Canadians on almost every measure of health and well-being. Advancing health opportunities for Indigenous peoples require responses at all levels of healthcare delivery and policy. Therefore, it is critical for health leaders and providers within Canada's healthcare institutions, systems, and settings to understand and address the determinants of health unique to Indigenous peoples, including the legacy of colonialism and both long-standing and present-day racism. The Truth and Reconciliation Commission of Canada provides a starting point from which positive responses to injustices can be advanced.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. A Scoping Review of Immigrant Experience of Health Care Access Barriers in Canada.

    Science.gov (United States)

    Kalich, Angela; Heinemann, Lyn; Ghahari, Setareh

    2016-06-01

    Canadian population-based surveys report comparable access to health care services between immigrant and non-immigrant populations, yet other research reports immigrant-specific access barriers. A scoping review was conducted to explore research regarding Canadian immigrants' unique experiences in accessing health care, and was guided by the research question: "What is currently known about the barriers that adult immigrants face when accessing Canadian health care services?" The findings of this study suggest that there are unmet health care access needs specific to immigrants to Canada. In reviewing research of immigrants' health care experiences, the most common access barriers were found to be language barriers, barriers to information, and cultural differences. These findings, in addition to low cultural competency reported by interviewed health care workers in the reviewed articles, indicate inequities in access to Canadian health care services for immigrant populations. Suggestions for future research and programming are discussed.

  13. Engaging civil society through deliberative dialogue to create the first Mental Health Strategy for Canada: Changing Directions, Changing Lives.

    Science.gov (United States)

    Mulvale, Gillian; Chodos, Howard; Bartram, Mary; MacKinnon, Mary Pat; Abud, Manon

    2014-12-01

    Citizen engagement through deliberative dialogue is increasingly being used to address 'wicked problems' in policy-making, such as the development of national mental health policy. In 2012, the Mental Health Commission of Canada (MHCC), a national organization funded by and operating at arm's length from the federal government, released the first Mental Health Strategy for Canada: Changing Directions, Changing Lives (Mental Health Commission of Canada, 2012). Despite much-needed reform, Canada, unlike most other industrialized countries, had never previously developed a national Mental Health Strategy (the Strategy). This was due to a mix of policy factors, including a federalist system of government where primary responsibility for healthcare resides with provincial and territorial governments and a highly diverse set of stakeholder groups with diverging core ideas for mental health reform that were rooted in deeply held value differences. In this case study, we review the essential role that engagement of civil society played in the creation of the Strategy, beginning with the efforts to create a national body to shine the light on the need for mental health reform in Canada, followed by the development of a framework of specific goals based on core principles to guide the development of the Strategy, and ultimately, the creation of the Strategy itself. We discuss the various approaches to civil society engagement in each step of this process and focus in particular on how deliberative approaches helped build trust and common ground amongst stakeholders around complex, and often contentious, issues. The nature and outcomes of the deliberative processes including the key tensions between different stakeholder perspectives and values are described. We close by highlighting the lessons learned in a process that culminated with a Strategy that received strong endorsement from stakeholders across Canada. Mental Health Commission of Canada (2012). Changing Directions

  14. Addressing social and gender inequalities in health among seniors in Canada

    Directory of Open Access Journals (Sweden)

    Plouffe Louise A.

    2003-01-01

    Full Text Available Although canadian seniors enjoy economic security and good health and have made substantial gains in recent decades, this well-being is not equally shared among socioeconomic groups and between men and women. As for younger age groups, income predicts health status in later life, but less powerfully. Potential alternative explanations include an overriding influence of the aging process, the subjective effects of income loss at retirement and the attenuation of the poverty gap owing to public retirement income. Older women are more likely to age in poverty than men, to live alone and to depend on inadequately resourced chronic health care and social services. These differences will hold as well for the next cohort of seniors in Canada. Addressing these disparities in health requires a comprehensive, multisectoral approach to health that is embodied in Canada's population health model. Application of this model to reduce these disparities is described, drawing upon the key strategies of the population health approach, recent federal government initiatives and actions recommended to the government by federal commissions.

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

    Directory of Open Access Journals (Sweden)

    Klazinga Niek S

    2007-02-01

    Full Text Available Abstract 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 cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. Methods We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. Results Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. Conclusion To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed

  16. Avoidable mortality by neighbourhood income in Canada: 25 years after the establishment of universal health insurance.

    Science.gov (United States)

    James, Paul D; Wilkins, Russell; Detsky, Allan S; Tugwell, Peter; Manuel, Douglas G

    2007-04-01

    To examine neighbourhood income differences in deaths amenable to medical care and public health over a 25-year period after the establishment of universal insurance for doctors and hospital services in Canada. Data for census metropolitan areas were obtained from the Canadian Mortality Database and population censuses for the years 1971, 1986, 1991 and 1996. Deaths amenable to medical care, amenable to public health, from ischaemic heart disease and from other causes were considered. Data on deaths were grouped into neighbourhood income quintiles on the basis of the census tract percentage of population below Canada's low-income cut-offs. From 1971 to 1996, differences between the richest and poorest quintiles in age-standardised expected years of life lost amenable to medical care decreased 60% (p<0.001) in men and 78% (p<0.001) in women, those amenable to public health increased 0.7% (p = 0.94) in men and 20% (p = 0.55) in women, those lost from ischaemic heart disease decreased 58% in men and 38% in women, and from other causes decreased 15% in men and 9% in women. Changes in the age-standardised expected years of life lost difference for deaths amenable to medical care were significantly larger than those for deaths amenable to public health or other causes for both men and women (p<0.001). Reductions in rates of deaths amenable to medical care made the largest contribution to narrowing socioeconomic mortality disparities. Continuing disparities in mortality from causes amenable to public health suggest that public health initiatives have a potentially important, but yet un-realized, role in further reducing mortality disparities in Canada.

  17. One little, too little: Counting Canada's indigenous people for improved health reporting.

    Science.gov (United States)

    Elias, Brenda; Busby, Karen; Martens, Pat

    2015-08-01

    The way state governments, worldwide, count or do not count Indigenous peoples has contributed to inconsistent reporting of Indigenous health statistics. To address unreliable reporting in Canada, we reviewed laws on Indian status and the development of a national Indian Registration System (IRS) to track Indian status and eligibility. With this information as a guide, we linked the IRS to the Manitoba provincial health registry systems and were able to identify individuals with Indian status for health reporting. To improve reporting, we identified individuals often missed in this type of linkage. For instance, we identified children and adult children who were eligible for Indian status but not yet registered. Equally as important, we identified individuals not eligible for Indian status but have Indian heritage and/or represent potential individual Indian status eligibility cases before the courts to right a historic form of identity sex discrimination that has made them invisible in Canadian society and health reporting. A familial kinship approach was used to identify Indian children and adult children typically missed when a strict legal entitlement criteria is used for data linkage. Our reflective socio-legal data linkage approach expanded the number of Indian peoples for health reporting purposes and demonstrated a feasible, inclusive way to report on the health of Indians in Canada. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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.

  19. Health Outcomes of Sexual-Minority Youth in Canada: An Overview.

    Science.gov (United States)

    Blais, Martin; Bergeron, Félix-Antoine; Duford, Julie; Boislard, Marie-Aude; Hébert, Martine

    2015-07-01

    The objectives of this review are to (1) document health outcomes among sexual-minority youth (SMY) in Canada; and (2) identify sexual-minority-specific risk and protective factors. We conducted a review of Canadian data published after 2005 on the mental, physical and sexual health outcomes of SMY using relevant keywords. A total of 19 empirical studies and 2 research reports was included. The study reviewed included 53 to 30 588 respondents (total = 81 567). SMY counted for 15.86% of the total sample. Overall, SMY in Canada show negative health outcomes in proportions varying from 7% to 69.4%, the most common issues being psychological distress and maladjustment. SMY are more likely than their heterosexual peers to report psychological distress/malfunctioning, suicidality, substance misuse, condomless intercourse, pregnancy involvement. Main SMY-specific risk factors were family rejection of one's minority sexual orientation, homophobic bullying and victimization, and internalized homophobia. Among the few protective factors that were reported, school and family connectedness, school safety, parental support and sports involvement decreased the odds of negative health outcomes. Canadian data show that SMY are more likely to experience negative health outcomes than their heterosexual peers. These results are consistent with data from around the world. Recommendations for research and intervention are discussed.

  20. Health Outcomes of Sexual-Minority Youth in Canada: An Overview

    Science.gov (United States)

    Blais, Martin; Bergeron, Félix-Antoine; Duford, Julie; Boislard, Marie-Aude; Hébert, Martine

    2016-01-01

    Objectives The objectives of this review are to (1) document health outcomes among sexual-minority youth (SMY) in Canada; and (2) identify sexual-minority-specific risk and protective factors Data Sources We conducted a review of Canadian data published after 2005 on the mental, physical and sexual health outcomes of SMY using relevant keywords. A total of 19 empirical studies and 2 research reports was included. Data Synthesis The study reviewed included 53 to 30 588 respondents (total = 81 567). SMY counted for 15.86% of the total sample. Overall, SMY in Canada show negative health outcomes in proportions varying from 7% to 69.4%, the most common issues being psychological distress and maladjustment. SMY are more likely than their heterosexual peers to report psychological distress/malfunctioning, suicidality, substance misuse, condomless intercourse, pregnancy involvement. Main SMY-specific risk factors were family rejection of one’s minority sexual orientation, homophobic bullying and victimization, and internalized homophobia. Among the few protective factors that were reported, school and family connectedness, school safety, parental support and sports involvement decreased the odds of negative health outcomes. Conclusions Canadian data show that SMY are more likely to experience negative health outcomes than their heterosexual peers. These results are consistent with data from around the world. Recommendations for research and intervention are discussed. PMID:28111592

  1. The Role of Gender and Income in Predicting Barriers to Mental Health Care in Canada.

    Science.gov (United States)

    Slaunwhite, Amanda K

    2015-07-01

    There have been traditionally low rates of health care utilization by persons with mental health issues in developed countries such as Canada due to barriers that discourage health care service use such as waitlists, long distances to health services, and stigma that can be associated with seeking help for mental health issues. This project examined barriers to mental health care using data from the Canadian Community Health Survey (N = 4,134) to understand gender and income-related disparities in access to mental health care services. Data were modeled using logistic regression to determine whether gender and household income predicted experiencing barriers to care. There were significant variations in the barriers to care reported by gender and income. Both men and women from low-income (mental health issues and usefulness of health care services, whereas women were much more likely to report availability or accessibility issues such as a lack of transportation or childcare. The findings of this study demonstrate that despite universal health insurance, there are significant inequities in access to mental health care for low-income Canadians and differences in the types of barriers to care experienced by gender.

  2. Black-White health inequalities in Canada at the intersection of gender and immigration.

    Science.gov (United States)

    Patterson, Andrew C; Veenstra, Gerry

    2016-10-20

    Intersectionality theory proposes that each combination of social categories derived from gender, race and nationality, such as immigrant White man or native-born Black woman, is associated with unique social experiences. We tested the potential of intersectionality theory for explicating racial inequalities in Canada by investigating whether Black-White health inequalities are conditioned by gender and immigrant status in a synergistic way. Our dataset comprised 10 cycles (2001-2013) of the Canadian Community Health Survey. We used binary logistic regression to model Black- White inequalities in hypertension, diabetes, self-rated health, self-rated mental health and asthma separately for native-born women, native-born men, immigrant women and immigrant men. After controlling for potentially confounding factors we found that immigrant Black women had significantly higher odds of hypertension, diabetes and fair/poor self-rated health than immigrant White women. Native-born Black women and immigrant Black men had higher odds of hypertension and diabetes than native-born White women and immigrant White men respectively, and native-born White women were more likely than native-born Black women to report asthma. There were no statistically significant health differences between native-born Black and White men. Socio-economic status, smoking, physical activity and body mass index were implicated in some but not all of these racial health inequalities. None of the three-way interactions between racial identity, gender and immigration status was statistically significant. We found relatively high risks of ill health for Black Canadians in three of the four samples. Overall, however, we found little support for the intersectional hypothesis that Black-White health inequalities in Canada are conditioned by gender and immigrant status in a synergistic way.

  3. 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.

  4. 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

  5. Perceived importance and self-assessment of the skills of Canada's health-system pharmacy managers.

    Science.gov (United States)

    Axworthy, Sheri; MacKinnon, Neil J

    2002-06-01

    The relationship between the perceived importance of managerial skills and self-assessed proficiency in each skill among health-system pharmacy managers in Canada was examined, and the demographic characteristics associated with pharmacy managers who lack these skills were analyzed. Surveys were mailed to 514 health-system pharmacy managers in Canada in July 2000. The survey listed 61 specific managerial skills, under seven general categories. The respondents were asked to rate the level of importance that each of the skills had in their job and rate their proficiency in each skill. Ratings were based on a five-point Likert scale ranging from very high importance or skill level to very low importance or skill level. The response rate was 52.7%. Of the 61 specific managerial skills considered, the majority of respondents identified "Demonstrating ethical conduct" as both the most important skill and their greatest strength. "Understand the operating principles of managed care" was viewed as the least important skill, while "Participating in the implementation of a marketing program" was respondents' greatest weakness. There were significant differences in the mean self-assessed skill levels of the respondents according to their educational background, size of the institution in which they work, and years of managerial experience. Health-system pharmacy managers with a master of business administration degree had a significantly higher overall mean perceived skill level than managers in all other "Education" categories. Managers with a bachelor of science degree in pharmacy had a significantly lower overall mean perceived skill level than those with a bachelor of science degree in pharmacy plus "other" degrees, while managers employed in institutions of 500 or more inpatient beds had a significantly higher overall self-rated mean skill level than managers employed in institutions of 51-100 inpatient beds. A national survey of health-system pharmacy managers in Canada

  6. Recent im/migration to Canada linked to unmet health needs among sex workers in Vancouver, Canada: Findings of a longitudinal study.

    Science.gov (United States)

    Sou, Julie; Goldenberg, Shira M; Duff, Putu; Nguyen, Paul; Shoveller, Jean; Shannon, Kate

    2017-05-01

    Despite universal health care in Canada, sex workers (SWs) and im/migrants experience suboptimal health care access. In this analysis, we examined the correlates of unmet health needs among SWs in Metro Vancouver over time. Data from a longitudinal cohort of women SWs (An Evaluation of Sex Workers Health Access [AESHA]) were used. Of 742 SWs, 25.5% reported unmet health needs at least once over the 4-year study period. In multivariable logistic regression using generalized estimating equations, recent im/migration had the strongest impact on unmet health needs; long-term im/migration, policing, and trauma were also important determinants. Legal and social supports to promote im/migrant SWs' access to health care are recommended.

  7. John G.C. Adams: father of Dental Public Health in Canada.

    Science.gov (United States)

    Kenny, David J; Dale, Anne C; Wencer, David G

    2014-01-01

    John Gennings Curtis Adams (1839-1922), Canada's first resident dental missionary, was the father of Dental Public Health in Canada. He established, personally funded and operated the first free dental hospital in North America for poor children and their mothers in Toronto from 1872, three years before the founding of The Hospital for Sick Children; he later became their first dentist of record. He was a visionary zealot for prevention of decay, dental education, and treatment over extraction. Dr. Adams understood that neither parents (rich or poor) nor physicians were aware of the extent of pathosis present in children's mouths. He petitioned individuals, lobbied politicians and unions and pressured dental organizations on the importance of twice-annual school inspections to demonstrate disease so that parents would seek care for their children. He wanted government-funded dental hospitals like his own to treat those who could not afford care. He realized his objectives and his reforms to prevent suffering, as Toronto school inspections began in 1911 and Toronto's first publicly-funded free dental clinic opened in 1913. He was Canada's first dental philanthropist and a visionary for preventive dentistry.

  8. Changing air mass frequencies in Canada: potential links and implications for human health.

    Science.gov (United States)

    Vanos, J K; Cakmak, S

    2014-03-01

    Many individual variables have been studied to understand climate change, yet an overall weather situation involves the consideration of many meteorological variables simultaneously at various times diurnally, seasonally, and yearly. The current study identifies a full weather situation as an air mass type using synoptic scale classification, in 30 population centres throughout Canada. Investigative analysis of long-term air mass frequency trends was completed, drawing comparisons between seasons and climate zones. We find that the changing air mass trends are highly dependent on the season and climate zone being studied, with an overall increase of moderate ('warm') air masses and decrease of polar ('cold') air masses. In the summertime, general increased moisture content is present throughout Canada, consistent with the warming air masses. The moist tropical air mass, containing the most hot and humid air, is found to increase in a statistically significant fashion in the summertime in 46% of the areas studied, which encompass six of Canada's ten largest population centres. This emphasises the need for heat adaptation and acclimatisation for a large proportion of the Canadian population. In addition, strong and significant decreases of transition/frontal passage days were found throughout Canada. This result is one of the most remarkable transition frequency results published to date due to its consistency in identifying declining trends, coinciding with research completed in the United States (US). We discuss relative results and implications to similar US air mass trend analyses, and draw upon research studies involving large-scale upper-level air flow and vortex connections to air mass changes, to small-scale meteorological and air pollution interactions. Further research is warranted to better understand such connections, and how these air masses relate to the overall and city-specific health of Canadians.

  9. Unmet health care needs among sex workers in five census metropolitan areas of Canada.

    Science.gov (United States)

    Benoit, Cecilia; Ouellet, Nadia; Jansson, Mikael

    2016-10-20

    This paper examines unmet health care needs in one of Canada's most hard-to-reach populations, adult sex workers, and investigates whether their reasons for not accessing health care are different from those of other Canadians. Data gathered in 2012-2013 from sex workers aged 19 and over (n = 209) in five Canadian census metropolitan areas (CMAs) were analyzed to estimate the perceived health, health care access and level of unmet health care needs of sex workers, and their principal reasons for not accessing health care. These data were collected using questions identical to those of the Canadian Community Health Survey (CCHS) Cycle 2.1, 2003. The results were compared with those of residents aged 19 and over in the same CMAs who had participated in the CCHS. Sex workers reported notably worse perceived mental health, poorer social determinants of health (with the exception of income) and nearly triple the prevalence of unmet health care needs (40.4% vs. 14.9%). Those with the greatest unmet health care needs in both groups were younger, unmarried or single and in poorer health, and reported lower income and a weaker sense of community belonging. Even without these within-group risk factors, sex workers were more likely to report unmet health care needs compared with CCHS respondents. Sex workers were also more likely to identify "didn't get around to it", "too busy", "cost", "transportation problems" and "dislike doctors/afraid" as reasons for eschewing care. Equity policies that reduce cost and transportation barriers may go some way in helping sex workers access needed health care. Qualitative research is needed to better understand the realities of sex workers' personal and work lives, including the degree of freedom they have in accessing health care when they need it, but also their experiences when they do manage to engage with the health care system.

  10. 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.

  11. Alcohol use during pregnancy in Canada: how policy moments can create opportunities for promoting women's health.

    Science.gov (United States)

    Poole, Nancy; Greaves, Lorraine

    2013-02-11

    This article addresses the challenge of igniting action on health promotion for women in Canada with respect to alcohol use during pregnancy. We illustrate that accelerated action on health promotion for women that engages multiple levels of players, women-centred and harm-reduction frameworks and a gendered approach to understanding women's lives can be achieved when the right policy moment occurs. We illustrate this by describing the opportunity afforded by the Olympic Games in 2010, where the BC government used the Games to encourage action on women's health promotion and the prevention of alcohol use in pregnancy. We suggest that the 2011 announcement of new low-risk drinking guidelines that recommend lower intake of alcohol for women than for men offers another, to date unused, opportunity.

  12. The state of child and youth mental health in Canada: past problems and future fantasies.

    Science.gov (United States)

    Davidson, Simon

    2011-01-01

    Berezin (1978), a geriatric psychiatrist from Harvard, says that as we get older, our personality does not change, it just gets more so! How can it be then, that in 2010, despite the best efforts of many, the state of child and youth mental health in Canada is unknown to countless people? How can it be that despite the fact that nothing has changed for years, except to get more so, few know about the plight of Canadian child and youth mental health services? How can it be that in Ontario, politicians, regardless of political party (all parties have been in power at some time during the past 20 years), have known the facts about child and youth mental health and have effectively turned a blind eye?

  13. "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

  14. “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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Janna M Schurer

    Full Text Available 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.

  17. 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.

  18. 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)

  19. The transformation experience of the Veterans Health Administration and its relevance to Canada.

    Science.gov (United States)

    Fooks, Cathy; Decter, Michael

    2005-01-01

    Over the past few years, there has been a steady stream of visitors to Canada from the US Veterans Health Administration (VA). Led by the former Under Secretary for Health in the Department of Veterans Affairs, Dr. Ken Kizer, they come to tell the remarkable story of how the VA transformed itself from a hospital-based bureaucracy described as "dangerous, dirty and scandal-ridden" to a healthcare system for veterans recognized for its high-quality, patient-centred care. It is a fascinating story of how a publicly funded healthcare service changed its entire approach to patient care with a quality improvement lens at its core. Fifteen years ago, critics of the VA called for its complete privatization as the only solution to fixing its problems. A team of quality champions set out to prove otherwise. Canada has some lessons to learn. The VA is a compelling role model for Canadian reformers, in large measure, due to its public sector character.

  20. 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

  1. 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…

  2. 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.

  3. 'Perimeteritis' and rural health in Manitoba, Canada: perspectives from rural healthcare managers.

    Science.gov (United States)

    Ramsey, D; Beesley, K B

    2007-01-01

    Rural areas in many parts of the world are facing issues such as economic restructuring, environmental degradation, aging, and depopulation. These issues impact the health and wellbeing of the people living in rural communities. The purpose of this study was to assess rural healthcare managers' understanding of rural community wellbeing. Specifically, definitions were sought for rural, community, health, wellbeing, and healthy rural community. The research reported in this article is based on a set of interviews with each of the 20 healthcare professionals who either managed healthcare centres or administered specialized programs in the rural health care centres in the Assiniboine Regional Health Authority in southwestern Manitoba, Canada. Capitalizing on the open-ended structure of the interviews, respondents were thoughtful and philosophical in their responses. This produced a rich array of definitions of rural, community, health, wellbeing, and healthy rural community. In doing so, the struggles for rural communities in southwestern Manitoba were highlighted. The findings also illustrated that definitions of health and wellbeing do not fit standard biomedical or health determinant models alone. This study was a follow up to another study that employed focus groups to obtain rural resident perceptions of rural, community, wellbeing, and health in southwestern Manitoba. The study reported on here argued that the specific views of healthcare managers were necessary to further illustrate the complexities in understanding definitions of community and condition. The results are consistent with previous research on this topic in southern Manitoba and the recent literature in that there are no universally accepted definitions of rural, community, wellbeing, or health. Further, the study illustrated that professionals charged with managing healthcare services in rural Manitoba maintain very broad definitions of health and wellbeing. Most significantly, the determinants

  4. Framing the issue of ageing and health care spending in Canada, the United Kingdom and the United States.

    Science.gov (United States)

    Gusmano, Michael K; Allin, Sara

    2014-07-01

    Political debates about the affordability of health care programmes in high-income countries often point to population ageing as a threat to sustainability. Debates in the United States, in particular, highlight concerns about intergenerational equity, whereby spending on older people is perceived as a threat to spending on the young. This paper compares how the problem of health spending is defined in Canada, the United Kingdom and the United States by presenting the results of a content analysis of print media during the period 2005-2010. We found that population ageing was cited as an important source of health care cost increases in all three countries but was cited less frequently in Canadian newspapers than in the UK or US papers. Direct claims about intergenerational equity are infrequent among the articles we coded, but newspaper articles in the United States were more likely than those in Canada and the United Kingdom to claim that of high health care spending on older people takes resources away from younger people. In Canada a much larger percentage of articles in our sample either claimed that high health care spending is crowding out other types of government expenditure. Finally, we found that almost no articles in the United States challenged the view that population ageing causes health care spending, whereas in both Canada and the United Kingdom a small, but steady stream of articles challenged the idea that population ageing is to blame for health care spending increases.

  5. Selection and Use of Health Services for Infants' Needs by Indigenous Mothers in Canada: Integrative Literature Review.

    Science.gov (United States)

    Wright, A; Wahoush, O; Ballantyne, M; Gabel, C; Jack, S M

    2018-01-01

    In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates. The use of primary health care is one way to improve health outcomes; however, Indigenous children may use health services less often than non-Indigenous children. To improve health outcomes within this growing population, it is essential to understand how caregivers, defined here as mothers, select and use health services in Canada. This integrative review is the first to critique and synthesize what is known of how Indigenous mothers in Canada experience selecting and using health services to meet the health needs of their infants. Themes identified suggest both Indigenous women and infants face significant challenges; colonialism has had, and continues to have, a detrimental impact on Indigenous mothering; and very little is known about how Indigenous mothers select and use health services to meet the health of their infants. This review revealed significant gaps in the literature and a need for future research. Suggestions are made for how health providers can better support Indigenous mothers and infants in their use of health services, based on what has been explored in the literature to date.

  6. Representations of cosmetic surgery and emotional health in women's magazines in Canada.

    Science.gov (United States)

    Polonijo, Andrea N; Carpiano, Richard M

    2008-01-01

    This research examines how popular women's magazines portray cosmetic surgery and associated emotional health. Articles regarding cosmetic surgery were coded from the top five most circulated English-language women's magazines in Canada between 2002 and 2006 for type of procedure, patient demographics, risk information, and indicators of emotional health. Content analysis techniques were used to identify patterns of portraying the risks and benefits of cosmetic surgery. Content analyses show the articles tend to present readers with detailed physical health risk information. However, 48% of articles discuss the impact that cosmetic surgery has on emotional health, most often linking cosmetic surgery with enhanced emotional well-being regardless of the patient's pre-existing state of emotional health. The articles also tend to use accounts given by males to provide defining standards of female attractiveness. These findings are consistent with arguments in the research literature that women's magazines contribute to the medicalization of the female body. Cosmetic surgery is generally portrayed as a risky--but worthwhile--option for women to enhance both their physical appearance and emotional health. The implications for future research and public education strategies are discussed.

  7. 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.

  8. Perceptions and experiences of environmental health risks among new mothers: a qualitative study in Ontario, Canada

    Science.gov (United States)

    Crighton, E. J.; Brown, C.; Baxter, J.; Lemyre, L.; Masuda, J.R.; Ursitti, F.

    2013-01-01

    There is a growing awareness and concern in contemporary societies about potential health impacts of environmental contaminants on children. Mothers are traditionally more involved than other family members in managing family health and household decisions and thus targeted by public health campaigns to minimise risks. However little is known about how new mothers perceive and experience environmental health risks to their children. In 2010, we undertook a parallel case study using qualitative, in-depth interviews with new mothers and focus groups with public health key informants in two Public Health Units in Ontario Province, Canada. We found that the concern about environmental hazards among participants ranged from having no concerns to actively incorporating prevention into daily life. Overall, there was a common perception among participants that many risks, particularly in the indoor environment, were controllable and therefore of little concern. But environmental risks that originate outside the home were viewed as less controllable and more threatening. In response to such threats, mothers invoked coping strategies such as relying on the capacity of children's bodies to adapt. Regardless of the strategies adopted, actions (or inactions) were contingent upon active information seeking. We also found an optimistic bias in which new mothers reported that other children were at greater risk despite similar environmental circumstances. The findings suggest that risk communication experts must attend to the social and environmental contexts of risk and coping when designing strategies around risk reducing behaviours. PMID:23805055

  9. Canada's International Development Research Centre's eco-health projects with Latin Americans: origins, development and challenges.

    Science.gov (United States)

    Cole, Donald C; Crissman, Charles C; Orozco, A Fadya

    2006-01-01

    Since its founding in 1970, Canada's International Development Research Centre (IDRC) has supported research by concerned Latin American researchers on environments and human health relationships. Framing of such relationships has changed through different periods. Participant observation, bibliographic searches, document review, and interviews with key IDRC staff. From the early years of multiple different projects, IDRC developed more focussed interest in tropical diseases, pesticides, agriculture and human health in the 1980s. The United Nations Conference on Sustainable Development in the early 1990s gave impetus to examination of links between ecosystems and human health or "EcoHealth". Projects in Latin America built on earlier work but extended it in methods (transdisciplinarity, community participation, gendered approach) and scope (broader land use and development paradigm issues tackled). A key IDRC-funded activity in Latin America was "EcoSalud", an Ecuadorian effort, which has worked with farming communities, agricultural researchers, health practitioners and local politicians to advance integrated pest management, better recognize and treat poisonings and improve pesticide-related policies. ONGOING CHALLENGES INCLUDE: mobilizing sufficient resources for the primary prevention focus of EcoHealth activities when primary care infrastructure remains stretched, promoting micro-level change in diverse communities and ecosystems, and addressing power structures at the global level that profoundly affect environmental change.

  10. 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.

  11. Acculturation and nutritional health of immigrants in Canada: a scoping review.

    Science.gov (United States)

    Sanou, Dia; O'Reilly, Erin; Ngnie-Teta, Ismael; Batal, Malek; Mondain, Nathalie; Andrew, Caroline; Newbold, Bruce K; Bourgeault, Ivy L

    2014-02-01

    Although recent immigrants to Canada are healthier than Canadian born (i.e., the Healthy Immigrant Effect), they experience a deterioration in their health status which is partly due to transitions in dietary habits. Since pathways to these transitions are under-documented, this scoping review aims to identify knowledge gaps and research priorities related to immigrant nutritional health. A total of 49 articles were retrieved and reviewed using electronic databases and a stakeholder consultation was undertaken to consolidate findings. Overall, research tends to confirm the Healthy Immigrant Effect and suggests that significant knowledge gaps in nutritional health persist, thereby creating a barrier to the advancement of health promotion and the achievement of maximum health equity. Five research priorities were identified including (1) risks and benefits associated with traditional/ethnic foods; (2) access and outreach to immigrants; (3) mechanisms and coping strategies for food security; (4) mechanisms of food choice in immigrant families; and (5) health promotion strategies that work for immigrant populations.

  12. 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 escitalopram dose exceeding those recommended by the Health 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.

  13. A scoping review of mental health issues and concerns among immigrant and refugee youth in Canada: Looking back, moving forward.

    Science.gov (United States)

    Guruge, Sepali; Butt, Hissan

    2015-02-03

    Youth comprise a significant portion of the total immigrant population in Canada. Immigrant and refugee youth often have different migration trajectories and experiences, which can result in different mental health outcomes. Research is emerging in this area, but study findings have not yet been consolidated. What is known from the existing literature about mental health issues and concerns among immigrant and refugee youth in Canada? We searched Embase, Health Star, Medline, CINAHL, PsycINFO, and Social Science Abstracts databases for the period 1990-2013 for Canadian studies related to the mental health of youth born outside Canada. Seventeen studies met inclusion criteria. Determinants of mental illness included pre-migration experiences, number of years since immigration to Canada, post-migration family and school environment, in- and out-group problems, discrimination, and lack of equitable access to health care. Only a few common categories of mental illness were identified, and the burden of mental illness was shared differently across gender and immigration status, with female youth experiencing more mental health problems than male youth. Some studies identified fewer emotional and behavioural problems among refugee youth; others reported higher rates of psychopathology among refugee youth compared with their Canadian-born provincial counterparts. Pre-migration experiences and the kinds of trauma experienced were important for refugee youth's mental health. Findings also indicated the importance of family involvement, school settings as points of care and services, and in terms of timing, focusing on the first year of arrival in Canada. Professionals must work across health, social, and settlement sectors to address the various pre- and post-migration determinants of mental health and illness, and provide more timely and effective services based on how and when these determinants affect different groups of youth.

  14. Role of health care professionals in multidisciplinary pain treatment facilities in Canada

    Science.gov (United States)

    Peng, Philip; Stinson, Jennifer N; Choiniere, Manon; Dion, Dominique; Intrater, Howard; LeFort, Sandra; Lynch, Mary; Ong, May; Rashiq, Saifee; Tkachuk, Gregg; Veillette, Yves

    2008-01-01

    PURPOSE: To examine the role of health care professionals in multidisciplinary pain treatment facilities (MPTF) for the treatment of chronic pain across Canada. METHODS: MPTF were defined as clinics that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain, and had staff from a minimum of three different health care disciplines (including at least one medical specialty) available and integrated within the facility. Administrative leaders at eligible MPTF were asked to complete a detailed questionnaire on their infrastructure as well as clinical, research, teaching and administrative activities. RESULTS: A total of 102 MPTF returned the questionnaires. General practitioners, anesthesiologists and physiatrists were the most common types of physicians integrated in the MPTF (56%, 51% and 32%, respectively). Physiotherapists, psychologists and nurses were the most common nonphysician professionals working within these MPTF (75%, 68% and 57%, respectively), but 33% to 56% of them were part-time staff. Only 77% of the MPTF held regular interdisciplinary meetings to discuss patient management, and 32% were staffed with either a psychologist or psychiatrist. The three most frequent services provided by physiotherapists were patient assessment, individual physiotherapy or exercise, and transcutaneous electrical nerve stimulation. The three most common services provided by psychologists were individual counselling, cognitive behavioural therapy and psychodynamic therapy. The major roles of nurses were patient assessment, assisting in interventional procedures and patient education. CONCLUSION: Different health care professionals play a variety of important roles in MPTF in Canada. However, few of them are involved on a full-time basis and the extent to which pain is assessed and treated in a truly multidisciplinary manner is questionable. PMID:19225605

  15. Evaluation of a health promoting schools program in a school board in Nova Scotia, Canada.

    Science.gov (United States)

    McIsaac, Jessie-Lee D; Penney, Tarra L; Ata, Nicole; Munro-Sigfridson, Lori; Cunningham, Jane; Veugelers, Paul J; Storey, Kate; Ohinmaa, Arto; Kirk, Sara F L; Kuhle, Stefan

    2017-03-01

    A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive 'school ethos' and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores. Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score. The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain. Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school.

  16. Forecheck, backcheck, health check: the benefits of playing recreational ice hockey for adults in Canada.

    Science.gov (United States)

    Kitchen, Peter; Chowhan, James

    2016-11-01

    More than 1 million Canadian adults play recreational ice hockey. Compared to elite players, very little is known about the physical and health characteristics of people who play the game for fun. Analyzing data from Statistics Canada's 2011/12 Canadian Community Health Survey, the paper found that there is an association between physically active males age 35 or over who play ice hockey regularly (at least once a week) and enhanced health more so than other physically active males. While these players are larger in body size, they have significantly lower rates of diabetes, high blood pressure and heart disease and report significantly higher rates of self-assessed health. Given the potential health benefits associated with this high intensity sport, the paper discusses ways in which participation can be promoted among less physically active adults and people who are new to the game or who have historically lower levels of participation including women and recent immigrants. Finally, the paper argues that compared to the very high costs associated with child and youth hockey, participation in adult recreational ice hockey is quite affordable.

  17. Improving Metabolic and Cardiovascular Health at an Early Psychosis Intervention Program in Vancouver, Canada

    Science.gov (United States)

    Fredrikson, Diane H.; Boyda, Heidi N.; Tse, Lurdes; Whitney, Zachary; Pattison, Mark A.; Ott, Fred J.; Hansen, Laura; Barr, Alasdair M.

    2014-01-01

    Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients’ physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs. PMID:25249985

  18. 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.

  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. 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 (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 pension 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.

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

    Science.gov (United States)

    Joseph, Pamela; Davis, A Darlene; Miller, Ruby; Hill, Karen; McCarthy, Honey; Banerjee, Ananya; Chow, Clara; Mente, Andrew; Anand, Sonia S

    2012-11-07

    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. 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. 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. 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.

  2. The air quality health index and emergency department visits for urticaria in Windsor, Canada.

    Science.gov (United States)

    Kousha, Termeh; Valacchi, Giuseppe

    2015-01-01

    Ambient air pollution exposure has been associated with several health conditions, limited not only to respiratory and cardiovascular systems but also to cutaneous tissues. However, few epidemiological studies examined pollution exposure on skin problems. Basically, the common mechanism by which pollution may affect skin physiology is by induction of oxidative stress and inflammation. Urticaria is among the skin pathologies that have been associated with pollution. Based on the combined effects of three ambient air pollutants, ozone (O₃), nitrogen dioxide (NO₂), and fine particulate matter (PM) with a median aerodynamic diameter of less than 2.5 μm (PM(2.5)), on mortality, the Air Quality Health Index (AQHI) in Canada was developed. The aim of this study was to examine the associations of short-term changes in AQHI with emergency department (ED) visits for urticaria in Windsor-area hospitals in Canada. Diagnosed ED visits were retrieved from the National Ambulatory Care Reporting System (NACRS). A time-stratified case-crossover design was applied to 2905 ED visits (males = 1215; females = 1690) for urticaria from April 2004 through December 2010. Odds ratios (OR) and their corresponding 95% confidence intervals (95%CI) for ED visits associated with increase by one unit of risk index were calculated employing conditional logistic regression. Positive and significant results were observed between AQHI levels and OR for ED visits for urticaria in Windsor for lags 2 and 3 days. A distributed lag nonlinear model technique was applied to daily counts of ED visits for lags 0 to 10 and significant results were obtained from lag 2 to lag 5 and for lag 9. These findings demonstrated associations between ambient air pollution and urticarial confirming that air pollution affects skin conditions.

  3. 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.

  4. Intensive hog farming operations and self-reported health among nearby rural residents in Ottawa, Canada.

    Science.gov (United States)

    Villeneuve, Paul J; Ali, Amira; Challacombe, Laurel; Hebert, Sophie

    2009-09-10

    In 2004, hog farming operations were introduced in the village of Sarsfield in the eastern part of Ottawa, Canada. This study evaluates the health-related quality of life (HRQOL), and the prevalence of respiratory conditions among adults and children who lived in proximity to this farm. A cross-sectional survey was administered to a random sample of residents from seven rural communities in the eastern part of Ottawa, Canada. We analyzed self-reported questionnaire data obtained from 723 adults and 285 children/adolescents. HRQOL was assessed using the SF-36 survey instrument, while data were also collected for sociodemographic characteristics, the prevalence of selected health conditions, and lifestyle related behaviours (e.g., smoking) of participants. Variations in self-reported health according to the residential distance to the hog farm were evaluated using logistic regression and analysis of variance methods. For the most part, the prevalence of selected health conditions among adults and children was not associated with how far they lived from the farm. No associations were observed with migraines, respiratory conditions (asthma, rhinitis, sinusitis, and chronic bronchitis), and allergies. However, a higher prevalence of depression was noted among those who lived within 3 km of the farm relative to those who lived more than 9 km away (odds ratio = 2.01, 95% CI = 1.11, 3.65). Furthermore, individuals who lived closer to the IHF were more likely to worry about environmental issues such as water quality, outdoor and indoor smells, and air pollution. This level of worry also contributed to lower HRQOL scores for individuals who lived closer to the farm. It was also observed that the prevalence of depression was much higher among those who indicated a concern about environmental issues (18.2%) when compared to those who did not (8.0%). While our findings suggest that living in close proximity to an IHF may adversely affect HRQOL these should be interpreted

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

    Science.gov (United States)

    Gore, Dana; Kothari, Anita

    2012-08-14

    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. 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). 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. 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 public health sector may face significant barriers to addressing

  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. The prevalence of over-qualification and its association with health status among occupationally active new immigrants to Canada.

    Science.gov (United States)

    Chen, Cynthia; Smith, Peter; Mustard, Cameron

    2010-12-01

    Occupational over-qualification refers to a situation where an individual's occupational status is lower than would be expected by their training, skills, or experience. The objective of this study is to examine the prevalence of three dimensions of over-qualification among a cohort of new immigrants to Canada, and the associations between each dimension of over-qualification with changes in general and mental health status over a four-year period. This study utilized data from the Longitudinal Survey of Immigrants to Canada. For the purpose of this study, we restricted our sample to those employed respondents who worked before coming to Canada, were planning on working after immigration, were in good health at baseline and were interviewed at 4 years post-arrival (N=2685). We defined three measures of over-qualification based on occupational attainment at 4 years relative to: level of education, previous work experience, and occupational expectation upon arrival in Canada. Regression models explored the associations between each dimension of over-qualification and change in self-reported general and mental health adjusting for a variety of immigrants' personal and immigration-related characteristics. Four years after arriving in Canada, 51.6% of immigrants were overqualified for their jobs based on their education levels, with a lesser extent overqualified based on experience (44.4%) or expectations (42.8%). Respondents experiencing any dimension of over-qualification were more likely to report a decline in mental, but not general, health. These relationships were only mildly attenuated after adjustment for other possible confounding variables. Inclusion of job satisfaction and perceptions of employment situation mediated these relationships to a large extent suggesting they are primary pathways through which over-qualification influences mental health. On average, occupationally active immigrants who were overqualified for their attained occupations in Canada had

  8. 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.

  9. Guidelines for health technologies: specific guidance for oncology products in Canada.

    Science.gov (United States)

    Mittmann, Nicole; Evans, William K; Rocchi, Angela; Longo, Christopher J; Au, Heather-Jane; Husereau, Don; Leighl, Natasha B; Isogai, Pierre K; Krahn, Murray D; Peacock, Stuart; Marshall, Deborah; Coyle, Doug; Taylor, Suzanne C Malfair; Jacobs, Philip; Oh, Paul I

    2012-05-01

    Specific methodological challenges are often encountered during cancer-related economic evaluations. The objective of this study was to provide specific guidance to analysts on the methods for the conduct of high-quality economic evaluations in oncology by building on the Canadian Agency for Drugs and Technologies in Health Guidelines for the Economic Evaluation of Health Technologies (third edition). Fifteen oncologists, health economists, health services researchers, and decision makers from across Canada identified sections in Canadian Agency for Drugs and Technologies in Health guidelines that would benefit from oncology-specific guidance. Fifteen sections of the guidelines were reviewed to determine whether 1) Canadian Agency for Drugs and Technologies in Health guidelines were sufficient for the conduct of oncology economic evaluations without further guidance specific for oncology products or 2) additional guidance was necessary. A scoping review was conducted by using a comprehensive and replicable search to identify relevant literature to inform recommendations. Recommendations were reviewed by representatives of academia, government, and the pharmaceutical industry in an iterative and formal review of the recommendations. Major adaptations for guidance related to time horizon, effectiveness, modeling, costs, and resources were required. Recommendations around the use of final outcomes over intermediate outcomes to calculate quality-adjusted life-years and life-years gained, the type of evidence, the source of evidence, and the use of time horizon and modeling were made. This article summarizes key recommendations for the conduct of economic evaluations in oncology and describes methods required to ensure that economic assessments in oncology are conducted in a standardized manner. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Health human resource planning in Canada: a typology and its application.

    Science.gov (United States)

    Wranik, Dominika

    2008-04-01

    A series of group interviews were conducted with key stakeholders in Canadian health human resource (HHR) planning. Interviews revealed that innovative HHR models arose primarily in response to perceived needs at the front line. At the same time global HHR initiatives were implemented by policy makers based on population level estimates of need. A large disconnect is identified between the top down and the bottom up approaches to HHR planning. This paper makes two important contributions. First, it provides a comprehensive typology of HHR models currently being utilized in Canada. The classification of existing HHR models is a necessary first step to standardized evaluation of effectiveness of various HHR approaches in terms of improving access to care and health outcomes. Second, the creation of a new type of health care professional is proposed--the collaboration agent. The collaboration agent is to provide much needed leadership to bottom up endavours at the front line. Furthermore, the collaboration agent is to mediate between the top and the bottom, thereby improving deficient communication and funding channels.

  11. Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees.

    Science.gov (United States)

    O'Brien, Myles W; Shields, Christopher A; Oh, Paul I; Fowles, Jonathon R

    2017-04-01

    The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% exercise counselling during routine client encounters (48% vs 72% in most sessions; p exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.

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

    OpenAIRE

    Mohammad Hajizadeh

    2016-01-01

    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...

  14. 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.

  15. Health Inequalities, Deprivation, Immigration and Aboriginality in Canada: A Geographic Perspective

    National Research Council Canada - National Science Library

    Robert Pampalon; Denis Hamel; Philippe Gamache

    2010-01-01

    .... It is hypothesized that differences in the magnitude of survival inequalities according to deprivation across Canada are attenuated when immigration and Aboriginal status are accounted for. Methods...

  16. Impact of diabetes mellitus on life expectancy and health-adjusted life expectancy in Canada

    Directory of Open Access Journals (Sweden)

    Loukine Lidia

    2012-04-01

    Full Text Available Abstract The objectives of this study were to estimate life expectancy (LE and health-adjusted life expectancy (HALE for Canadians with and without diabetes and to evaluate the impact of diabetes on population health using administrative and survey data. Mortality data from the Canadian Chronic Disease Surveillance System (2004 to 2006 and Health Utilities Index data from the Canadian Community Health Survey (2000 to 2005 were used. Life table analysis was applied to calculate LE, HALE, and their confidence intervals using the Chiang and the adapted Sullivan methods. LE and HALE were significantly lower among people with diabetes than for people without the disease. LE and HALE for females without diabetes were 85.0 and 73.3 years, respectively (males: 80.2 and 70.9 years. Diabetes was associated with a loss of LE and HALE of 6.0 years and 5.8 years, respectively, for females, and 5.0 years and 5.3 years, respectively, for males, living with diabetes at 55 years of age. The overall gains in LE and HALE after the hypothetical elimination of prevalent diagnosed diabetes cases in the population were 1.4 years and 1.2 years, respectively, for females, and 1.3 years for both LE and HALE for males. The results of the study confirm that diabetes is an important disease burden in Canada impacting the female and male populations differently. The methods can be used to calculate LE and HALE for other chronic conditions, providing useful information for public health researchers and policymakers.

  17. 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

  18. Cancer-related health behaviours and health service use among Inuit and other residents of Canada's north.

    Science.gov (United States)

    McDonald, James Ted; Trenholm, Ryan

    2010-05-01

    This article identifies the extent to which demographic, socio-economic and geographic factors account for differences between Inuit and other Northern Canadian residents in health-related behaviours and health service use related to cancer incidence and diagnosis. The study population includes Inuit, Métis, First Nation and non-Aboriginal residents aged 21-65 who live in Nunavut, Northwest Territories, Labrador, Nunavik and Jamésie in northern Quebec, and the northern regions of Saskatchewan and Manitoba. Data are drawn from confidential versions of the 2000-2001 and 2004-2005 Canadian Community Health Surveys and the 2001 Aboriginal People's Survey produced by Statistics Canada. Multivariate Logistic regression analysis is applied to a set of health-related behaviours including cigarette smoking, binge drinking and obesity, and a set of basic health service use measures including consultation with a physician, consultation with a nurse, Pap smear testing and mammography. We found that significantly higher smoking and binge drinking rates and lower rates of female cancer screening among Inuit are found not to be accounted for by differences in observable demographic and socio-economic characteristics, location of residence or distance from a hospital. As such we conclude that health-related behaviours leading to increased cancer risk and to a lower utilization of diagnostic cancer screening appear to be due to unobserved factors specific to Inuit and their unique social-cultural context. Policy interventions to address these problems may need to be targeted specifically to Inuit Canadians and should not be considered in isolation of their broader health, economic and social environment. Copyright 2010 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Thakkar, Vidhi; Sullivan, Terrence

    2017-04-10

    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 publicly-funded 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. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open

  1. 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.

  2. High-cost health care users in Ontario, Canada: demographic, socio-economic, and health status characteristics.

    Science.gov (United States)

    Rosella, Laura C; Fitzpatrick, Tiffany; Wodchis, Walter P; Calzavara, Andrew; Manson, Heather; Goel, Vivek

    2014-10-31

    Health care spending is overwhelmingly concentrated within a very small proportion of the population, referred to as the high-cost users (HCU). To date, research on HCU has been limited in scope, focusing mostly on those characteristics available through administrative databases, which have been largely clinical in nature, or have relied on ecological measures of socio-demographics. This study links population health surveys to administrative data, allowing for the investigation of a broad range of individual-level characteristics and provides a more thorough characterization of community-dwelling HCU across demographic, social, behavioral and clinical characteristics. We linked three cycles of the Canadian Community Health Survey (CCHS) to medical claim data for the years 2003-2008 for Ontario, Canada. Participants were ranked according to gradients of cost (Top 1%, Top 2-5%, Top 6-50% and Bottom 50%) and multinomial logistic regression was used to investigate a wide range of factors, including health behaviors and socio-demographics, likely associated with HCU status. Using a total sample of 91,223 adults (18 and older), we found that HCU status was strongly associated with being older, having multiple chronic conditions, and reporting poorer self-perceived health. Specifically, in the fully-adjusted model, poor self-rated health (vs. good) was associated with a 26-fold increase in odds of becoming a Top 1% HCU (vs. Bottom 50% user) [95% CI: (18.9, 36.9)]. Further, HCU tended to be of lower socio-economic status, former daily smokers, physically inactive, current non-drinkers, and obese. The results of this study have provided valuable insights into the broader characteristics of community-dwelling HCU, including unique demographic and behavioral characteristics. Additionally, strong associations with self-reported clinical variables, such as self-rated general and mental health, highlight the importance of the patient perspective for HCU. These findings have the

  3. What determines health? To where should we shift resources? Attitudes towards the determinants of health among multiple stakeholder groups in Prince Edward Island, Canada.

    Science.gov (United States)

    Eyles, J; Brimacombe, M; Chaulk, P; Stoddart, G; Pranger, T; Moase, O

    2001-12-01

    The population health perspective has become significant in academic and policy discourse. The purpose of this paper is to assess its significance among health care practitioners and administrators as well as the general public. Respondents in Prince Edward Island, Canada were asked to rank the broad determinants of health and comment on to where resources should be shifted to improve the health of the population. Important variations are noted between the groups with family physicians and front-line staff being similar in perceptions to the general public on most determinants than other groups. The paper concludes with discussion on the relevance of the findings for population health research and health policy.

  4. The moderating effect of sociodemographic factors on the predictive power of self-rated health for mortality in Canada

    Directory of Open Access Journals (Sweden)

    James Falconer

    2017-04-01

    Full Text Available Self-rated health is a reliable predictor for mortality, but its predictive power varies depending on social characteristics. This study tests the moderating effect of age, sex, education, and income on the power of self-rated health to predict mortality in Canada using data from the National Population Health Survey. Predictive power trajectories are modelled using time-series generalized estimating equation logistic regression. Findings show that self-rated health is a predictor for mortality up to 14 years prior to death in Canada, and is weakly moderated by income and education, and age/sex interactions. Self-rated health remains reliable across population sub-groups in Canada. La santé auto-évaluée est un prédicteur fiable de la mortalité, mais son pouvoir prédictif varie en fonction des caractéristiques sociales. Cette étude examine l'effet modérateur de l'âge, du sexe, de l'éducation, et du revenu sur le pouvoir de la santé auto-évaluée pour prédire la mortalité au Canada utilisant des données de l'Enquête nationale sur la santé de la population. Les trajectoires de puissance prédictive sont modélisées avec une régression logistique de l'équation d'estimation généralisée. Les résultats montrent que la santé auto-évaluée est un prédicteur de la mortalité jusqu'à 14 ans avant le décès au Canada, et est faiblement modérée par le revenu, l'éducation, et les interactions entre l'âge et le sexe. La santé auto-évaluée demeure valide parmi les sous-groupes de la population du Canada.

  5. 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.

    2010-01-01

    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

  6. 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

  7. 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

  8. 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.

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

    Science.gov (United States)

    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. Methods 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). Results 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. Conclusions The results suggest that there is

  10. 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

  11. How do economic evaluations inform health policy decisions for treatment and prevention in Canada and the United States?

    Science.gov (United States)

    Husereau, Don; Culyer, Anthony J; Neumann, Peter; Jacobs, Philip

    2015-06-01

    Canadian and US health systems have often been characterized as having vastly different approaches to the financing and delivery of healthcare, with Canada portrayed as more reliant on rationing based on costs. In this article, we examine the similarities and differences between the two countries, the evolution and current role of health economic evaluation, and the roles played by health economists. We suggest both countries have similarly used economic evaluation to a limited extent for drug and immunization decisions, with variability in use more of a reflection of the incompleteness of both systems and their inherent institutional barriers rather than political ideology.

  12. 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.

  13. 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 (population (Prefugees 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.

  14. Confronting the Growing Crisis of Cardiovascular Disease and Heart Health Among Aboriginal Peoples in Canada.

    Science.gov (United States)

    Reading, Jeffrey

    2015-09-01

    Although the prevalence of cardiovascular disease (CVD) has been decreasing worldwide, Aboriginal populations of Canada (including First Nations, Métis, and Inuit Peoples) continue to experience a rapidly growing burden of CVD morbidity and mortality. This article provides a succinct summary of the current crisis of CVD among Canadian Aboriginal peoples, including how and why it originated, elucidates the underlying population health risks driving higher rates of aboriginal CVD, and articulates the urgent need for community-engagement solutions and innovations in the areas of prevention, treatment and care, rehabilitation services, aboriginal-specific CVD surveillance, and advanced knowledge. In the past, particularly in rural and remote communities, Aboriginal Peoples' survival depended (and often still does) on hunting, fishing, and other forms of traditional food-gathering. However, the traditional life is being changed for many Aboriginal communities, resulting in significantly impaired dietary options and the undermining of a long-established way of life that was healthy and physically active. Reclaiming CVD health and well-being requires replacement of the calorie-dense and nutritionally inadequate diets of highly processed store-bought foods with fresh and nutritionally balanced diets and addressing the physically inactive lifestyles that together have contributed to an increase in CVD prevalence. Furthermore, disparities exist for hospital-based treatment experiences for patients from areas with high proportions of Aboriginal Peoples vs those with low proportions of Aboriginal Peoples. It is crucial to investigate and develop concrete plans to reduce the burden of CVDs among Aboriginal Peoples by improved prevention and treatment in a community-centred way. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Steensma, C; Loukine, L; Orpana, H; McRae, L; Vachon, J; Mo, F; Boileau-Falardeau, M; Reid, C; Choi, B C

    2016-10-01

    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. 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. 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 years of HALE observed for men with

  16. 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

  17. 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.

  18. 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

  19. How Safe and Innovative Are First-in-Class Drugs Approved by Health Canada: A Cohort Study.

    Science.gov (United States)

    Lexchin, Joel

    2016-11-01

    First-in-class drugs use a unique mechanism of action. This study assessed the therapeutic innovativeness and safety of these drugs approved by Health Canada from 1997-2012. A list of new drugs was compiled and a database from the Food and Drug Administration was used to determine first-in-class status. Post-market safety warnings and drugs withdrawn for safety reasons were identified from the MedEffect Canada website. Therapeutic innovation evaluations came from the Patented Medicine Prices Review Board (PMPRB) and Prescrire International. The proportion of first-in-class drugs that were innovative was compared to the proportion of non-first-in-class drugs that were innovative. Kaplan-Meier survival curves assessed safety. In all, 462 drugs were approved by Health Canada during the period under study. Among these, 345 were evaluated by PMPRB and/or Prescrire, and first-in-class data were available for 292. Ninety-eight of the 292 were first-in-class and 16 were innovative compared to 9 of 194 drugs that were not-first-in-class. There was no difference in safety between the two groups. Overall, the benefit-to-harm ratio of first-in-class drugs, as measured by post-market safety warnings/withdrawals, is better than those that were not-first-in-class. Copyright © 2016 Longwoods Publishing.

  20. The Devil Is in the Details! On Regulating Cannabis Use in Canada Based on Public Health Criteria

    Science.gov (United States)

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

    2017-01-01

    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. PMID:28812798

  1. 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.

  2. 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.

  3. 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.

  4. Is Canada odd? A comparison of European and Canadian approaches to choice and regulation of the public/private divide in health care.

    Science.gov (United States)

    Flood, Colleen M; Haugan, Amanda

    2010-07-01

    Choice is often touted as a means for change within health care systems. Yet 'choice', in this context, takes at least three distinct forms: choice between providers within a publicly funded health care system; choice between competing insurers within a universal plan; and, lastly, choice as between privately financed health care and universal public coverage. In Canada, it is this last form of choice that is under active debate; particularly in light of the Supreme Court of Canada's decision in Chaoulli, which found a regulation banning private health insurance for medically necessary care was unconstitutional. The argument is frequently made that Canada is an outlier from other countries in having regulation that effectively precludes this kind of choice. This issue is likely to become of concern again in upcoming constitutional challenges where applicants are looking to overturn through judicial challenges Canada's medicare system. This article tests that argument of whether Canada truly is 'odd' from a comparative policy perspective by exploring regulation of choice of privately financed health care in several European countries - the Netherlands, Germany, Sweden, England and France. We highlight commonalities as well as differences, showing the extent to which these countries employ regulation to fetter growth of a large privately financed sector. The article's thesis is that Canada, in employing more intrusive forms of regulation, is not an outlier per se but at one point in a regulatory spectrum.

  5. Skin cancer (Basal cell carcinoma, squamous cell carcinoma, and malignant melanoma): new cases, treatment practice, and health care costs in new brunswick, Canada, 2002-2010.

    Science.gov (United States)

    Pilgrim, Wilfred; Hayes, Robert; Hanson, Dana W; Zhang, Bin; Boudreau, Bonnie; Leonfellner, Suzanne

    2014-10-01

    In Canada, there is no formal process for registering nonmelanoma skin cancer (NMSC); thus, the epidemiology, treatment practices, and associated health costs are not well known. To investigate trends in new cases of skin cancer, treatment practices, and health care costs in New Brunswick, Canada. Data were extracted from the Provincial Cancer Registry and New Brunswick administrative health databases for 2002-2010. New cases: Basal Cell Carcinoma (BCC) was the most common skin cancer diagnosed, and incidence rates significantly increased between 1992 and 2010.Treatment practice: Dermatologists managed the majority (45%) of the overall skin cancer treatments.Health care costs: NMSC accounted for ∼80% of the health care costs for skin cancer and was dominated by BCC. Development of best practice treatment guidelines for NMSC in New Brunswick would improve future health care efficiencies, and standard protocols for registering new cases of NMSC in Canada would strengthen surveillance and reporting capacity.

  6. 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.

  7. Small mammals as sentinels of oil sands related contaminants and health effects in northeastern Alberta, Canada.

    Science.gov (United States)

    Rodríguez-Estival, Jaime; Smits, Judit E G

    2016-02-01

    The extraction of bitumen in areas of northeastern Alberta (Canada) has been associated with the release of complex mixtures of metals, metalloids, and polycyclic aromatic compounds (PACs) to the environment. To mitigate effects on ecosystems, Canadian legislation mandates that disturbed areas be reclaimed to an ecologically sustainable state after active operations. However, as part of reclamation activities, exposure to, and effects on wildlife living in these areas is not generally assessed. To support successful reclamation, the development of efficient methods to assess exposure and health effects in potentially exposed wildlife is required. In the present study, we investigated the usefulness of two native mammalian species (deer mouse Peromyscus maniculatus, and meadow vole Microtus pennsylvanicus) as sentinels of oil sands related contaminants by examining biomarkers of exposure and indicators of biological costs. Tissue residues of 31 metals and metalloids in kidneys and muscle, activity of the hepatic detoxification enzyme EROD (as a biomarker of exposure to organic contaminants), body condition, and the relative mass of liver, kidney, spleen, and testes were compared in animals from one reclaimed area and a reference site. Deer mice from the reclaimed site had higher renal levels of Co, Se and Tl compared to animals from the reference site, which was associated with reduced body condition. Lower testis mass was another feature that distinguished mice from the reclaimed site in comparison to those from the reference site. One mouse and one vole from the reclaimed site also showed increased hepatic EROD activity. In marked contrast, no changes were evident for these variables in meadow voles. Our results show that deer mouse is a sensitive sentinel species and that the biomarkers and indicators used here are efficient means to detect local contamination and associated biological effects in native mammals inhabiting reclaimed areas on active oil sands mine

  8. 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

  9. National efforts to improve health information system safety in Canada, the United States of America and England.

    Science.gov (United States)

    Kushniruk, Andre W; Bates, David W; Bainbridge, Michael; Househ, Mowafa S; Borycki, Elizabeth M

    2013-05-01

    In this paper we review progress as well as challenges encountered in Canada, the United States and England with regard to ensuring safety of health information technology. A review of major programs and initiatives for ensuring safety of health information technology in the three countries was conducted. Published literature and Web resources from national programs were reviewed for relevant information. It was found that in all three countries the issue of technology-induced error has been recognized as being of critical importance. The three countries have developed approaches for dealing with the issue that have some commonalities; however, they are at varying different stages of maturity, with England having the longest standing and most well developed safety programs, while Canada and the United States are at earlier stages. The types of approaches employed have included work on developing standards related to usability and interface design, certifications, directives from regulatory bodies, educational initiatives in health information technology (HIT) safety as well as research into safer HIT design and implementation methods. HIT promises to lead to improved patient safety. However, it has become recognized that if not designed and deployed appropriately, such systems can lead to new types of errors. Based on this recognition, a variety of initiatives are being undertaken in Canada, the United States and England to promote the safe design, procurement and deployment of HIT. It is concluded that improved approaches to system design, testing, regulation, error reporting, safety education and cross-country collaboration will be needed to further promote safer HIT. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. Language proficiency, gender and self-reported health: an analysis of the first two waves of the longitudinal survey of immigrants to Canada.

    Science.gov (United States)

    Pottie, Kevin; Ng, Edward; Spitzer, Denise; Mohammed, Alia; Glazier, Richard

    2008-01-01

    Most immigrants to Canada now come from Asia, the Middle East, the Caribbean and Africa, where cultures and languages often differ significantly from the Canadian context. Subgroups of immigrants experience disparities in health. Inability to communicate in an official language in Canada may be a marker of risk for poor health due to both pre- and post-migration factors. We aimed to study the relationship between language proficiency and self-reported health. We conducted a cross-sectional analysis of the first two surveys of the Longitudinal Survey of Immigrants to Canada (2001, 2003), a population-based cohort study of new immigrants to Canada. Specifically, we used logistic regression analyses to examine the relationship between self-reported health and language proficiency by sex, controlling for a range of health determinants at 6 months (wave 1) and 2 years (wave 2) after arrival. After controlling for covariates (age, sex, education, region of birth, immigrant class, job satisfaction, access to health care), analysis of the wave 1 survey showed that poor proficiency in English or French is significantly related to the self-reported poor health (OR=2.0, pwave 2 survey (OR=1.9, pwave 1 survey OR=2.6, p wave 2 survey OR=2.2, p<0.01), not for men. The association between poor language proficiency and poor self-reported health, and particularly its significantly greater impact on women, has implications for language training, health care and social services, and health information.

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

    Energy Technology Data Exchange (ETDEWEB)

    Noble, B.F. [Univ. of Saskatchewan, Dept. of Geography, Saskatoon, SK (Canada)]. E-mail: b.noble@usask.ca; Bronson, J.E. [Stantec Consulting, Saskatoon, SK (Canada)]. E-mail: Jbronson@stantec.com

    2005-12-15

    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. HIV-Related Stigma and Overlapping Stigmas Towards People Living With HIV Among Health Care Trainees in Canada.

    Science.gov (United States)

    Wagner, Anne C; Girard, Todd; McShane, Kelly E; Margolese, Shari; Hart, Trevor A

    2017-08-01

    HIV continues to be a stigmatized disease, despite significant advances in care and concerted effort to reduce discrimination, stereotypes, and prejudice. Living with HIV is often associated with a multitude of overlapping and intersecting experiences which can, in and of themselves, also be stigmatized, and which may exacerbate HIV-related stigma. The consequences of these stigmatizing experiences are particularly impactful when the stigmatizing individual is a health care provider, as this can influence access to and quality of care. The current study empirically investigates a model of overlapping stigmas (homophobia, racism, sexism, stigma against injection drug use and stigma against sex work) potentially held by health care provider trainees in Canada to determine how these constructs overlap and intersect, and to assess whether HIV-related stigma may have unique attributes. Understanding overlapping stigmas can help inform targeted, stigma-informed training for health care trainees in order to provide effective, compassionate care for people living with HIV.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. 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

  18. Occupational Stigma as a Primary Barrier To Health Care For Street-Based Sex Workers in Canada

    Science.gov (United States)

    Lazarus, Lisa; Deering, Kathleen N; Nabess, Rose; Gibson, Kate; Tyndall, Mark W; Shannon, Kate

    2011-01-01

    Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire data from a community-based cohort of women in street-based sex work in Vancouver, Canada (2006–8). Of a total of 252 women, 141 (58.5%) reported occupational sex work stigma (defined as hiding occupational sex work status from family, friends and/or home community), while 125 (49.6%) reported barriers to accessing health services in the previous six months. In multivariable analysis, adjusting for socio-demographic, interpersonal and work environment risks, occupational sex work stigma remained independently associated with an elevated likelihood of experiencing barriers to health access. Study findings indicate the critical need for policy and societal shifts in views of sex work as a legitimate occupation, combined with improved access to innovative, accessible and non-judgmental health care delivery models for street-based sex workers that include the direct involvement of sex workers in development and implementation. PMID:22084992

  19. Implementation of evidence-informed practice through central network actors; a case study of three public health units in Canada.

    Science.gov (United States)

    Yousefi Nooraie, Reza; Marin, Alexandra; Hanneman, Robert; Lohfeld, Lynne; Dobbins, Maureen

    2017-03-15

    Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The social position of individuals in formal and informal social networks, and the relevance of formal roles in relation to EIDM are important factors identifying key EIDM players in public health organizations. We assessed the role of central actors in information sharing networks in promoting the adoption of EIDM by the staff of three public health units in Canada, over a two-year period during which an organization-wide intervention was implemented. A multi-faceted and tailored intervention to train select staff applying research evidence in practice was implemented in three public health units in Canada from 2011 to 2013. Staff (n = 572) were asked to identify those in the health unit whom they turned to get help using research in practice, whom they considered as experts in EIDM, and friends. We developed multi-level linear regression models to predict the change in EIDM behavior scores predicted by being connected to peers who were central in networks and were engaged in the intervention. Only the group of highly engaged central actors who were connected to each other, and the staff who were not engaged in the intervention but were connected to highly engaged central actors significantly improved their EIDM behavior scores. Among the latter group, the staff who were also friends with their information sources showed a larger improvement in EIDM behavior. If engaged, central network actors use their formal and informal connections to promote EIDM. Central actors themselves are more likely to adopt EIDM if they communicate with each other. These social communications should be reinforced and supported through the implementation of training interventions as a means to promoting EIDM.

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

    Directory of Open Access Journals (Sweden)

    Mohan Sailesh

    2011-01-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  1. How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

    Science.gov (United States)

    2013-01-01

    Background In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance. Methods This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists’ offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study. Results Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists’ willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement. Conclusions The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions. PMID:24192504

  2. 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)

    Lucas, Philippe

    2012-01-03

    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. 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. 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"). 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 help inform policy changes that will

  3. 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

  4. 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

  5. Use of mental health care for nonpsychotic conditions by immigrants in different admission classes and by refugees in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Lin, Elizabeth; Moineddin, Rahim; Steele, Leah S; Glazier, Richard H

    2014-01-01

    Most Canadian newcomers are admitted in the economic, family, or refugee class, each of which has its own selection criteria and experiences. Evidence has shown various risks for mental health disorders across admission classes, but the respective service-use patterns for people in these classes are unknown. In this study, we compared service use for nonpsychotic mental health disorders by newcomers in various admission classes with that of long-term residents (i.e., Canadian-born persons or immigrants before 1985) in urban Ontario. In this population-based matched cross-sectional study, we linked health service databases to the Ontario portion of the Citizenship and Immigration Canada database. Outcomes were mental health visits to primary care physicians, mental health visits to psychiatrists, and emergency department visits or hospital admissions. We measured service use for recent immigrants (those who arrived in Ontario between 2002 and 2007; n = 359 673). We compared service use by immigrants in each admission class during the first 5 years in Canada with use by age- and sex-matched long-term residents. We measured likelihood of access to each service and intensity of use of each service using conditional logistic regression and negative binomial models. Economic and family class newcomers were less likely than long-term residents to use primary mental health care. The use of primary mental health care by female refugees did not differ from that of matched long-term residents, but use of such care by male refugees was higher (odds ratio 1.14, 95% confidence interval 1.09-1.19). Immigrants in all admission classes were less likely to use psychiatric services and hospital services for mental health care. Exceptions were men in the economic and family classes, whose intensity of hospital visits was similar to that of matched long-term residents. Immigrants in all admission classes generally used less care for nonpsychotic disorders than longterm residents

  6. 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

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

    Science.gov (United States)

    Veenstra, Gerry

    2011-01-17

    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. 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. 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. 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 intersections of multiple kinds and

  8. RADIATION PROTECTION IN CANADA. III. THE ROLE OF THE RADIATION PROTECTION DIVISION IN SAFEGUARDING THE HEALTH OF THE PUBLIC.

    Science.gov (United States)

    BIRD, P M

    1964-05-09

    The current status of radiation protection in Canada is discussed in the last of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. A radioactive fallout study program has been established involving the systematic collection of air and precipitation samples from 24 locations, soil samples from 23 locations, fresh-milk samples from 16 locations, wheat samples from nine areas and human-bone specimens from various hospitals throughout Canada. A whole-body-counting facility and a special study of fallout in Northern areas have also been initiated. For any age group, the highest average strontium-90 concentration in human bone so far reported has been less than four picocuries per gram of calcium compared with the maximum permissible level of 67 derived from the International Committee on Radiation Protection (ICRP) recommendations. By the end of 1963 a general downward trend of levels of radioactivity detected in other parts of the program has been observed. Programs to assess the contribution to the radiation exposure of members of the population from medical x-rays, nuclear reactor operations and natural background-radiation sources have also been described. The annual genetically significant dose from diagnostic x-ray examinations in Canadian public hospitals has been estimated to be 25.8 mrem. Results from the reactor-environment monitoring programs have not suggested the presence of radioactivity beyond that contributed from fallout.

  9. Psychotherapy Knowledge Translation and Interpersonal Psychotherapy: Using Best-Education Practices to Transform Mental Health Care in Canada and Ethiopia.

    Science.gov (United States)

    Ravitz, Paula; Wondimagegn, Dawit; Pain, Clare; Araya, Mesfin; Alem, Atalay; Baheretibeb, Yonas; Hanlon, Charlotte; Fekadu, Abebaw; Park, Jamie; Fefergrad, Mark; Leszcz, Molyn

    2014-01-01

    Psychotherapies, such as Interpersonal Psychotherapy (IPT), that have proven effective for treating mental disorders mostly lie dormant in consensus-treatment guidelines. Broadly disseminating these psychotherapies by training trainers and front-line health workers could close the gap between mental health needs and access to care. Research in continuing medical education and knowledge translation can inform the design of educational interventions to build capacity for providing psychotherapy to those who need it. This paper summarizes psychotherapy training recommendations that: adapt treatments to cultural and health organizational contexts; consider implementation barriers, including opportunity costs and mental health stigma; and engage local opinion leaders to use longitudinal, interactive, case-based teaching with reflection, skills-coaching, simulations, auditing and feedback. Community-based training projects in Northern Ontario, Canada and Ethiopia illustrate how best-education practices can be implemented to disseminate evidence-supported psychotherapies, such as IPT, to expand the therapeutic repertoire of health care workers and improve their patients' clinical outcomes.

  10. 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.

  11. 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

  12. Substance Use, Health, and Functioning Characteristics of Medical Marijuana Program Participants Compared to the General Adult Population in Ontario (Canada).

    Science.gov (United States)

    Fischer, Benedikt; Ialomiteanu, Anca R; Aeby, Samantha; Rudzinski, Katherine; Kurdyak, Paul; Rehm, Jürgen

    2017-01-01

    Existent profiles of Medical Marijuana Program (MMP) participants indicate common and co-morbid chronic diseases, yet evidence on disability or functioning as well as comparisons with general populations are largely lacking. This study compared health, substance use, and functioning status among formally approved MMP participants with the general adult population in Ontario (Canada). A community-recruited sample (n = 53) of MMP participants was compared to a sub-sample (n = 510) of the representative Centre for Addiction and Mental Health (CAMH) Monitor (2015 cycle) survey of Ontario general population adults (ages 18+) based on identical telephone-based interviews regarding substance use, health, and functioning measures. Means and standard deviations for all indicators were computed by sex, controlled for age and education, and compared by regression techniques. MMP participants were more likely to be male, younger, and less socio-economically integrated; they indicated more common psychoactive substance (e.g., tobacco, daily cannabis) and psychotropic medication use, as well as overall worse physical and mental health and functioning status. Marked differences between MMP participants and general population adults were observed. MMPs appear to attract individuals with complex chronic health problems; however, little is known about the impact of MMP participation on these.

  13. 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

    2013-08-28

    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.

  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".

    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.

  15. 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

  16. Declining rates of health problems associated with crack smoking during the expansion of crack pipe distribution in Vancouver, Canada.

    Science.gov (United States)

    Prangnell, Amy; Dong, Huiru; Daly, Patricia; Milloy, M J; Kerr, Thomas; Hayashi, Kanna

    2017-02-03

    Crack cocaine smoking is associated with an array of negative health consequences, including cuts and burns from unsafe pipes, and infectious diseases such as HIV. Despite the well-established and researched harm reduction programs for injection drug users, little is known regarding the potential for harm reduction programs targeting crack smoking to reduce health problems from crack smoking. In the wake of recent crack pipe distribution services expansion, we utilized data from long running cohort studies to estimate the impact of crack pipe distribution services on the rates of health problems associated with crack smoking in Vancouver, Canada. Data were derived from two prospective cohort studies of community-recruited people who inject drugs in Vancouver between December 2005 and November 2014. We employed multivariable generalized estimating equations to examine the relationship between crack pipe acquisition sources and self-reported health problems associated with crack smoking (e.g., cut fingers/sores, coughing blood) among people reported smoking crack. Among 1718 eligible participants, proportions of those obtaining crack pipes only through health service points have significantly increased from 7.2% in 2005 to 62.3% in 2014 (p < 0.001), while the rates of reporting health problems associated with crack smoking have significantly declined (p < 0.001). In multivariable analysis, compared to those obtaining pipes only through other sources (e.g., on the street, self-made), those acquiring pipes through health service points only were significantly less likely to report health problems from smoking crack (adjusted odds ratio: 0.82; 95% confidence interval: 0.73-0.93). These findings suggest that the expansion of crack pipe distribution services has likely served to reduce health problems from smoking crack in this setting. They provide evidence supporting crack pipe distribution programs as a harm reduction service for crack smokers.

  17. 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

  18. 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…

  19. 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.

  20. An international comparison of the association among literacy, education, and health across the United States, Canada, Switzerland, Italy, Norway, and Bermuda: implications for health disparities.

    Science.gov (United States)

    Yamashita, Takashi; Kunkel, Suzanne R

    2015-04-01

    The relationship between education and health is well-established, but theoretical pathways are not fully understood. Economic resources, stress, and health behaviors partially explain how education influences health, but further study is needed. Previous studies show that health literacy mediates the education-health relationship, as do general literacy skills. However, little is known whether such mediation effects are consistent across different societies. This study analyzed data from the International Assessment of Adult Literacy and Life Skills Survey conducted in Canada, the United States, Italy, Norway, Switzerland, and Bermuda to investigate the mediation effects of literacy on the education-health relationship and the degree of such mediation in different cultural contexts. Results showed that literacy skills mediated the effect of education on health in all study locations, but the degree of mediation varied. This mediation effect was particularly strong in Bermuda. This study also found that different types of literacy skills are more or less important in each study location. For example, numeracy skills in the United States and prose (reading) literacy skills in Italy were stronger predictors of health than were other literacy skills. These findings suggest a new direction for addressing health disparities: focusing on relevant types of literacy skills.

  1. 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.

  2. Executive summary: report on Health Canada survey of ultraviolet radiation and electric and magnetic fields from compact fluorescent lamps

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-12-15

    This report details the levels of ultraviolet and electromagnetic emissions from a sample of 30 compact fluorescent lamps (CFLs). It is based on the results of tests designed to measure spectral irradiance data and calculate recommended maximum daily UVR (ultraviolet radiation) exposure. This survey dealt with widely used standard incandescent lamps which are generally CFLs. So it is important to identify whether the ultraviolet radiation and electromagnetic emissions from CFLs exceed current exposure guidelines or not. The lamp selection was carried out under supervision of the of Natural Resources Canada and it was done using the criteria which specify that the lamps have integrated electronic ballasts and be of the screw-in type or can be used with a screw-in adapter. Fortunately, the results show that CFLs do not pose any risk to the health of the general population either from ultraviolet radiation or from the associated electric and magnetic fields.

  3. A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada.

    Science.gov (United States)

    McPherson, Charmaine; Ploeg, Jenny; Edwards, Nancy; Ciliska, Donna; Sword, Wendy

    2017-02-01

    The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.

  4. 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.

  5. Are health promotion and prevention interventions integrated into occupational therapy practice with older adults having disabilities? Insights from six community health settings in Québec, Canada.

    Science.gov (United States)

    Turcotte, Pier-Luc; Carrier, Annie; Desrosiers, Johanne; Levasseur, Mélanie

    2015-02-01

    Increasingly, health-care systems should promote seniors' health and prevent disability. As they enable engagement in meaningful activities within the individuals' living environment, community occupational therapists have great potential to contribute to health promotion and prevention. Despite this potential, little is known about current health promotion and prevention activities in occupational therapy community practice. This study thus aimed to: (1) identify health promotion and prevention interventions used with seniors having disabilities, and (2) explore barriers to integrating such interventions into practice. Secondary data analysis of a qualitative study was carried out using thematic saliency analysis. Eleven community occupational therapists working with seniors having disabilities were recruited in six community health settings in Québec, Canada. Observations of 12 home visits, followed by 12 semi-structured interviews, were conducted with occupational therapists. Most interventions involved optimising independence in personal care and mobility. Explicit health promotion interventions were limited and included enabling healthy lifestyles by increasing health literacy and empowerment. Meaningful activities (leisure, community participation) were not targeted. Barriers to integrating health promotion into practice were clients' complex health conditions and limited openness to change combined with organisational and professional obstacles, such as a misunderstanding of occupational therapists' role in health promotion. Health promotion and prevention interventions are not intentionally integrated into community occupational therapy practice with seniors having disabilities. As a result, seniors' needs to engage in meaningful activities might remain unmet. Overcoming barriers to integrating health promotion and prevention in practice could help improve population health and wellbeing. © 2015 Occupational Therapy Australia.

  6. 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…

  7. 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.

  8. Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

    Directory of Open Access Journals (Sweden)

    Kiss Alex

    2010-02-01

    Full Text Available Abstract Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years and for a longer duration (mean 4.8 vs. 2.9 years. Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively. Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2 but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3. Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

  9. 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

  10. Pharmacists and Natural Health Products: A systematic analysis of professional responsibilities in Canada

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    Farrell J

    2008-03-01

    Full Text Available Natural health products such as herbs, vitamins and homeopathic medicines are widely available in Canadian pharmacies. Purpose: to conduct a systematic analysis of Canadian pharmacy policies and guidelines to explore pharmacists’ professional responsibilities with respect to natural health products.Methods: Legislation, codes of ethics, standards of practice and guidance documents that apply to the practice of pharmacy in each Canadian jurisdiction were systematically collected and examined to identify if, and how, these instruments establish professional duties in regard to natural health products.Results: The majority of Canadian jurisdictions now include some explicit reference to natural health products in standards of practice policy or guideline documents. Often natural health products are simply assumed to be included in the over-the-counter (OTC product category and thus professional responsibilities for OTCs are relevant for natural health products. A minority of provinces have specific policies on natural health products, herbals or homeopathy. In addition, the National Association of Pharmacy Regulatory Authorities’ Model Standards of Practice specifically refers to natural health products. Most policy documents indicate that pharmacists should inquire about natural health product use when counselling patients and, when asked, should provide accurate information regarding the efficacy, toxicity, side effects or interactions of natural health products. Public messaging also indicates that pharmacists are knowledgeable professionals who can provide evidence-based information about natural health products.Conclusions: Explicit policies or guidelines regarding pharmacists’ professional responsibilities with respect to natural health products currently exist in the majority of Canadian jurisdictions.

  11. Some Comparisons Between Health Care in the United States and Canada.

    Science.gov (United States)

    Lyle, William M.; Robinson, Barbara E.

    1990-01-01

    The article compares health care costs, insurance claims paid to practitioners, distribution of health care costs, numbers and ratios of practitioners, infant and neonatal mortality rates, for-profit organizations, underserved groups, technology, quality control, cure vs. care, prevention, and specific health care problems in the United States and…

  12. Examining the relationship between social support availability, urban center size, and self-perceived mental health of recent immigrants to Canada: a mixed-methods analysis.

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    Chadwick, Kathryn A; Collins, Patricia A

    2015-03-01

    The experiences of settlement in a new country (e.g., securing housing and employment, language barriers) pose numerous challenges for recent immigrants that can impede their health and well-being. Lack of social support upon arrival and during settlement may help to explain why immigrant mental health status declines over time. While most urban centers in Canada offer some settlement services, little is known about how the availability of social supports, and the health statuses of recent immigrants, varies by city size. The objective of this mixed-methods study was to examine the relationship between self-perceived mental health (SPMH), social support availability, and urban center size, for recent immigrants to Canada. The quantitative component involved analysis of 2009-2010 Canadian Community Health Survey data, selecting for only recent immigrants and for those living in either large or small urban centers. The qualitative component involved in-depth interviews with managers of settlement service organizations located in three large and three small urban centers in Canada. The quantitative analysis revealed that social support availability is positively associated with higher SPMH status, and is higher in small urban centers. In support of these findings, our interviews revealed that settlement service organizations operating in small urban centers offer more intensive social supports; interviewees attributed this difference to personal relationships in small cities, and the ease with which they can connect to other agencies to provide clients with necessary supports. Logistic regression analysis revealed, however, that recent immigrants in small urban centers are twice as likely to report low SPMH compared to those living in large urban centers. Thus, while the scope and nature of settlements services appears to vary by city size in Canada, more research is needed to understand what effect settlement services have on the health status of recent immigrants to

  13. Deviant Constructions: How Governments Preserve Colonial Narratives of Addictions and Poor Mental Health to Intervene into the Lives of Indigenous Children and Families in Canada

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    de Leeuw, Sarah; Greenwood, Margo; Cameron, Emilie

    2010-01-01

    Colonial projects in Canada have a long history of violently intervening into the personal lives and social structures of Indigenous peoples. These interventions are associated with elevated rates of addictions and mental health issues among Indigenous peoples. In this paper we employ an indigenized social determinants approach to mental health…

  14. Health care experiences of Indigenous people living with type 2 diabetes in Canada.

    Science.gov (United States)

    Jacklin, Kristen M; Henderson, Rita I; Green, Michael E; Walker, Leah M; Calam, Betty; Crowshoe, Lynden J

    2017-01-23

    Indigenous social determinants of health, including the ongoing impacts of colonization, contribute to increased rates of chronic disease and a health equity gap for Indigenous people. We sought to examine the health care experiences of Indigenous people with type 2 diabetes to understand how such determinants are embodied and enacted during clinical encounters. Sequential focus groups and interviews were conducted in 5 Indigenous communities. Focus groups occurred over 5 sessions at 4 sites; 3 participants were interviewed at a 5th site. Participants self-identified as Indigenous, were more than 18 years of age, lived with type 2 diabetes, had received care from the same physician for the previous 12 months and spoke English. We used a phenomenological thematic analysis framework to categorize diabetes experiences. Patient experiences clustered into 4 themes: the colonial legacy of health care; the perpetuation of inequalities; structural barriers to care; and the role of the health care relationship in mitigating harm. There was consistency across the diverse sites concerning the root causes of mistrust of health care systems. Patients' interactions and engagement with diabetes care were influenced by personal and collective historical experiences with health care providers and contemporary exposures to culturally unsafe health care. These experiences led to nondisclosure during health care interactions. Our findings show that health care relationships are central to addressing the ongoing colonial dynamics in Indigenous health care and have a role in mitigating past harms. © 2017 Canadian Medical Association or its licensors.

  15. New Directions in Health Sciences Libraries in Canada: Research and Evidence based Practice Are Key.

    Science.gov (United States)

    Ganshorn, Heather; Giustini, Dean

    2017-07-15

    This article is the second in a new series in this regular feature. The intention of the series is to look at important global developments in health science libraries. These articles will serve as a road map, describing the key changes in the field and exploring factors driving these changes. The present article by two Canadian librarians identifies important national developments which are shaping the profession such as the centralisation of health care services, the challenge of providing consumer health information in the absence of a national strategy, government recognition of the need to recognise and respond to the health needs of indigenous peoples and the growing emphasis on managing research data. Although their profession is strong, health science librarians must find ways of providing enhanced services with fewer staff and demonstrate value to organisations. JM. © 2017 Health Libraries Group Health Information & Libraries Journal.

  16. Assessing health care in Canada's North: what can we learn from national and regional surveys?

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    T. Kue Young

    2015-07-01

    Full Text Available Background: Health surveys are a rich source of information on a variety of health issues, including health care. Objectives: This article compares various national and regional surveys in terms of their geographical coverage with respect to the Canadian North, especially their Aboriginal population, and the comparability of the survey contents relating to health care. Methods: Three surveys were selected as providing some information on health care, with separate estimates for the North and its Aboriginal populations. They are the Canadian Community Health Survey (CCHS, Aboriginal Peoples Survey (APS and the First Nations Regional Health Survey (RHS. Results: Different surveys focus on different categories of Aboriginal people, and no single survey has covered all categories of Aboriginal people in the North consistently. RHS is targeted at the on-reserve First Nations population only. APS and CCHS sample the off-reserve First Nations population as well as Métis and Inuit. To achieve adequate sample size for North–South comparisons and comparisons among Aboriginal groups within the North, several cycles of the biennial/annual CCHS can be merged, producing a large data set with consistent coverage of topics using comparable questions. The content areas of the 3 surveys can be broadly categorized as health status, health determinants and health care. Substantial variation exists across surveys in the domains covered. There are also changes over time in terms of definitions, questions and even basic concepts. The available health care content of the 3 surveys focus on access to different types of health services, contact with different categories of health professionals, unmet health needs and the use of preventive services. Many important dimensions of health care are not covered. Not all these basic indicators are available for the North or its Aboriginal populations. Conclusions: A comprehensive survey of health care in the North with

  17. 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

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

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    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.

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

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    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. 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

  1. 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

  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 content analysis of Twitter suggest that the 2013 Movember 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. 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.

  4. 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

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    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.

  5. Community health clinical education in Canada: part 1--"state of the art".

    Science.gov (United States)

    Cohen, Benita E; Gregory, David

    2009-01-01

    This paper presents the findings of a survey of community health clinical education in twenty-four Canadian pre-licensure baccalaureate nursing programs. A qualitative research design was used, involving a content analysis of Canadian course syllabi and supporting documents for community health courses. This study afforded a cross-sectional understanding of the "state of the art" of community health clinical education in Canadian schools of nursing. Clinical course conceptual approaches, course objectives, types of clinical sites, format and number of clinical hours, and methods of student evaluation are identified. The findings suggest the need for a national dialogue or consensus building exercise regarding curriculum content for community health nursing. Informing this dialogue are several strengths including the current focus on community health (as opposed to community-based) nursing education, and a solid socio-environmental perspective informing clinical learning and practice. The national data set generated by this study may have relevance to nursing programs globally.

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

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    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.

  7. (2012 30 Windsor Y B Access Just 247 SO LONG AS YOU HAVE YOUR HEALTH: HEALTH CARE DISTRIBUTION IN CANADA AND PROCEDURALIST HUMAN RIGHTS

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    Alana Klein

    2012-10-01

    Full Text Available Health resource distribution in Canada has been criticized for being opaque and increasingly inequitable, with its disproportionate emphasis on curative over preventive care. Yet there has been relatively little scrutiny of priority-setting in publicly funded health care in Canada from bodies monitoring the international human right to health. Recently, however, domestic health governance on the one hand, and international health and human rights on the other, have converged around the promotion of evidence-based policy, accountability, transparency and participation as drivers of more equitable distribution of health care resources. This paper tracks the paths toward this convergence. The emphasis in health policy was largely driven by cost containment and service integration concerns, while democratic and institutional concerns around socio-economic rights protection are at the root of the health and human rights shift toward proceduralist approaches. This shared emphasis nonetheless opens new terrains of struggle for human rights approaches to health care distribution in Canada, around (i managing indeterminacy in social determinants of health; (ii addressing power imbalances that shape how health information is produced, communicated, and acted upon and (iii the role of fundamental normative values that limit substantive policy around health. La distribution des ressources en santé au Canada a été critiquée en raison de son caractère opaque et de plus en plus inéquitable, et de l’importance disproportionnée accordée aux soins curatifs par rapport aux mesures préventives. De plus, relativement peu d’études concernant les priorités établies en matière de services de santé publics au Canada ont été faites par des organismes de contrôle du droit, reconnu dans des instruments internationaux, de tout être humain à la santé. Cela dit, récemment, la gouvernance nationale de la santé, d’une part, et le droit à la sant

  8. 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.

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

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    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.

  10. Whole-of-society approach for public health policymaking: a case study of polycentric governance from Quebec, Canada.

    Science.gov (United States)

    Addy, Nii A; Poirier, Alain; Blouin, Chantal; Drager, Nick; Dubé, Laurette

    2014-12-01

    In adopting a whole-of-society (WoS) approach that engages multiple stakeholders in public health policies across contexts, the authors propose that effective governance presents a challenge. The purpose of this paper is to highlight a case for how polycentric governance underlying the WoS approach is already functioning, while outlining an agenda to enable adaptive learning for improving such governance processes. Drawing upon a case study from Quebec, Canada, we employ empirically developed concepts from extensive, decades-long work of the 2009 Nobel laureate Elinor Ostrom in the governance of policy in nonhealth domains to analyze early efforts at polycentric governance in policies around overnutrition, highlighting interactions between international, domestic, state and nonstate actors and processes. Using information from primary and secondary sources, we analyze the emergence of the broader policy context of Quebec's public health system in the 20th century. We present a microsituational analysis of the WoS approach for Quebec's 21st century policies on healthy lifestyles, emphasizing the role of governance at the community level. We argue for rethinking prescriptive policy analysis of the 20th century, proposing an agenda for diagnostic policy analysis, which explicates the multiple sets of actors and interacting variables shaping polycentric governance for operationalizing the WoS approach to policymaking in specific contexts. © 2014 New York Academy of Sciences.

  11. 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.

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

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    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.

  13. 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.

  14. 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.

  15. Pharmacists and Natural Health Products: A systematic analysis of professional responsibilities in Canada

    OpenAIRE

    Farrell J; Ries NM; Boon H

    2008-01-01

    Natural health products such as herbs, vitamins and homeopathic medicines are widely available in Canadian pharmacies. Purpose: to conduct a systematic analysis of Canadian pharmacy policies and guidelines to explore pharmacists’ professional responsibilities with respect to natural health products.Methods: Legislation, codes of ethics, standards of practice and guidance documents that apply to the practice of pharmacy in each Canadian jurisdiction were systematically collected and examined ...

  16. 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.

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

    OpenAIRE

    Marie-Josée Fleury; Jean-Marie Bamvita; Guy Grenier; Jean Caron

    2015-01-01

    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 mo...

  18. Differences in water consumption choices in Canada: the role of socio-demographics, experiences, and perceptions of health risks.

    Science.gov (United States)

    Dupont, Diane; Adamowicz, W L Vic; Krupnick, Alan

    2010-12-01

    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 factors that influence these choices and whether choosing to either filter or purchase water is linked to perceptions of health concerns with respect to tap water. A series of one-way analysis of variance (ANOVA) tests suggest that the presence of children in a household and self-reported concern that tap water causes health problems lead to significantly greater consumption of bottled water or filtered water and significantly less tap water consumption. In order to examine these choices in a multivariate framework, we estimate a multinomial logit model. Factors yielding higher probabilities of a respondent being primarily a bottled water drinker (relative to the choice of tap water) include: higher income, unpleasant taste experiences with tap water, non-French-speaking, and being a male with children in one's household. Similar factors yield higher probabilities of a respondent being primarily a filtered tap water drinker. An important finding is that two key variables linking a person's health perceptions regarding tap water quality are significant factors leading to the choice of either filtered tap water or bottled water over tap water. They are: a variable showing the degree of health concerns a respondent has with respect to tap water and a second variable indicating whether the respondent believes bottled water is safer than tap water.

  19. 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.

  20. 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.

  1. Examining the relationship between communities' 'age-friendliness' and life satisfaction and self-perceived health in rural Manitoba, Canada.

    Science.gov (United States)

    Menec, Verena H; Nowicki, Scott

    2014-01-01

    seniors. None of the community characteristics were related to life satisfaction and self-perceived health, nor was degree of rurality. The concept of age-friendliness has been garnering considerable attention from policy-makers as a way to promote healthy aging. For example, in Canada, several provinces have launched age-friendly initiatives. Although causality cannot be inferred from the present, cross-sectional study, the findings are encouraging as they show that age-friendliness is associated with enhanced life satisfaction and self-perceived health in a rural context. The study further supports the notion that a wide range of domains within the community environment are important in older adults' lives and need to be considered. Public policy initiatives, such as the Province of Manitoba's Age-Friendly Initiative, may thus be one approach to enhancing healthy aging in rural settings.

  2. 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/.

  3. 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

  4. Personal Health Information in Canada: A Comparison of Citizen Expectations and Legislation

    Science.gov (United States)

    Peekhaus, Wilhelm

    2008-01-01

    This paper explores whether the Canadian legislative protections in place to safeguard medical privacy meet the expectations of Canadians. An overview of current governance systems designed to protect the privacy of personal health information at both the federal and provincial levels is first presented. This is followed by an empirical analysis…

  5. 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…

  6. 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.

  7. 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

  8. Challenges to evidence-based health promotion: a case study of a Food Security Coalition in Ontario, Canada.

    Science.gov (United States)

    Meyer, Samantha B; Edge, Sara S; Beatty, Jocelyn; Leatherdale, Scott; Perlman, Chris; Dean, Jennifer; Ward, Paul R; Kirkpatrick, Sharon I

    2017-03-30

    Developing the evidence base for health promotion can be challenging because interventions often have to target competing determinants of health, including social, structural, environmental and political determinants; all of which are difficult to measure and thus evaluate. Drawing on a case study of food insecurity, which refers to inadequate access to food due to financial constraints, we illustrate the challenges faced by community-based organizations in collecting data to form an evidence base for the development and evaluation of collective programmes aimed at addressing food insecurity. Interviews were conducted with members of a multi-stakeholder coalition (n = 22 interviewees; n = 10 organizations) who collectively work to address food insecurity in their community through a range of community-based programmes and services. Member organizations also provided a list of measures currently used to inform programme and service development and evaluation. Data were collected in a city in Southern Ontario, Canada between May and September 2015. Participants identified four barriers to collecting data: Organizational needs and philosophies; concerns surrounding clientele wellbeing and dignity; issues of feasibility; and restrictive requirements imposed by funding bodies. Participants also discussed their previous successes in collecting meaningful data for identifying impact. Our results point to the challenge of generating data suitable for developing and evaluating programmes aimed at broader determinants of health, while maintaining the primary goal of meeting clients' needs. Documenting change at intermediate- and macro-levels would provide evidence for the collective effectiveness of current programmes and services offered. However, appropriate resources need to be invested to allow for scientific evaluation. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. 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.

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

    OpenAIRE

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

    2016-01-01

    Purpose This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students. Methods 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 watc...

  11. Animal health policy principles for highly pathogenic avian influenza: shared experience from China and Canada.

    Science.gov (United States)

    Stephen, C; Ninghui, L; Yeh, F; Zhang, L

    2011-08-01

    Animal health policy for highly pathogenic avian influenza (HPAI) must, for the time being, be based on expert opinion and shared international experience. We used the intellectual capital and knowledge of experienced Chinese and Canadian practitioners and policy makers to inform policy options for China and find shared policy elements applicable to both countries. No peer-reviewed comprehensive evaluations or systematic regulatory impact assessments of animal health policies were found. Sixteen guiding policy principles emerged from our thematic analysis of Chinese and Canadian policies. We provide a list of shared policy goals, targets and elements for HPAI preparedness, response and recovery. Policy elements clustered in a manner consistent with core public health competencies. Complex situations like HPAI require complex and adaptive policies, yet policies that cross jurisdictions and are fully integrated across agencies are rare. We encourage countries to develop or deploy capacity to undertake and publish regulatory impact assessments and policy evaluation to identify policy needs and provide a basis for evidence-based policy development. © 2010 Blackwell Verlag GmbH.

  12. 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.

  13. "Just as Canadian as Anyone Else"? Experiences of Second-Class Citizenship and the Mental Health of Young Immigrant and Refugee Men in Canada.

    Science.gov (United States)

    Hilario, Carla T; Oliffe, John L; Wong, Josephine P; Browne, Annette J; Johnson, Joy L

    2017-11-01

    In recet years, the experiences of immigrant and refugee young men have drawn attention worldwide. Human-induced environmental disasters, local and global conflicts, and increasingly inequitable distributions of wealth have shaped transnational migration patterns. Canada is home to a large immigrant and refugee population, particularly in its urban areas, and supporting the mental health and well-being of these communities is of critical importance. The aim of this article is to report findings from a qualitative study on the social context of mental health among immigrant and refugee young men, with a focus on their migration and resettlement experiences. Informed by the conceptual lens of social context, a thematic narrative analysis approach was used to examine qualitative data from individual and group interviews with 33 young men (age 15 to 22 years) self-identified as immigrants or refugees and were living in Greater Vancouver, western Canada. Three thematic narratives were identified: a better life, living the (immigrant) dream, and starting again from way below. The narratives characterized the social context for immigrant and refugee young men and were connected by a central theme of negotiating second-class citizenship. Implications include the need for mental health frameworks that address marginalization and take into account the contexts and discourses that shape the mental health of immigrant and refugee populations in Canada and worldwide.

  14. The Raising of Minimum Alcohol Prices in Saskatchewan, Canada: Impacts on Consumption and Implications for Public Health

    Science.gov (United States)

    Zhao, Jinhui; Giesbrecht, Norman; Macdonald, Scott; Thomas, Gerald; Wettlaufer, Ashley

    2012-01-01

    Objectives. We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada. Methods. We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention. Results. A 10% increase in minimum prices significantly reduced consumption of beer by 10.06%, spirits by 5.87%, wine by 4.58%, and all beverages combined by 8.43%. Consumption of coolers decreased significantly by 13.2%, cocktails by 21.3%, and liqueurs by 5.3%. There were larger effects for purely off-premise sales (e.g., liquor stores) than for primarily on-premise sales (e.g., bars, restaurants). Consumption of higher strength beer and wine declined the most. A 10% increase in minimum price was associated with a 22.0% decrease in consumption of higher strength beer (> 6.5% alcohol/volume) versus 8.17% for lower strength beers. The neighboring province of Alberta showed no change in per capita alcohol consumption before and after the intervention. Conclusions. Minimum pricing is a promising strategy for reducing the public health burden associated with hazardous alcohol consumption. Pricing to reflect percentage alcohol content of drinks can shift consumption toward lower alcohol content beverage types. PMID:23078488

  15. The raising of minimum alcohol prices in Saskatchewan, Canada: impacts on consumption and implications for public health.

    Science.gov (United States)

    Stockwell, Tim; Zhao, Jinhui; Giesbrecht, Norman; Macdonald, Scott; Thomas, Gerald; Wettlaufer, Ashley

    2012-12-01

    We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada. We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention. A 10% increase in minimum prices significantly reduced consumption of beer by 10.06%, spirits by 5.87%, wine by 4.58%, and all beverages combined by 8.43%. Consumption of coolers decreased significantly by 13.2%, cocktails by 21.3%, and liqueurs by 5.3%. There were larger effects for purely off-premise sales (e.g., liquor stores) than for primarily on-premise sales (e.g., bars, restaurants). Consumption of higher strength beer and wine declined the most. A 10% increase in minimum price was associated with a 22.0% decrease in consumption of higher strength beer (> 6.5% alcohol/volume) versus 8.17% for lower strength beers. The neighboring province of Alberta showed no change in per capita alcohol consumption before and after the intervention. Minimum pricing is a promising strategy for reducing the public health burden associated with hazardous alcohol consumption. Pricing to reflect percentage alcohol content of drinks can shift consumption toward lower alcohol content beverage types.

  16. Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes.

    Science.gov (United States)

    Kirk, Sara F L; Kuhle, Stefan; McIsaac, Jessie-Lee D; Williams, Patty L; Rossiter, Melissa; Ohinmaa, Arto; Veugelers, Paul J

    2015-11-01

    Food security (FS) exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their needs. The present research sought to determine whether students from households experiencing moderate or severe food insecurity (FI) had poorer diet quality, higher body weights and poorer psychosocial outcomes than students from households classed as having high FS or marginal FI status. Population-based survey conducted in schools. Multiple regression analysis was used to explore associations between FS status (high FS; marginal, moderate, severe FI), dietary behaviours and intake, and health-related outcomes (body weight, quality of life, mood, peer relationships, externalizing problems). Nova Scotia, Canada. Grade 5 students (n 5853), aged 10-11 years, with complete information on FS status and student outcomes. In this sample, rates of household FS were 73·5% (high FS), 8·3% (marginal FI) 10·2% (moderate FI) and 7·1% (severe FI status). Students living in households experiencing moderate or severe FI had poorer diet quality, higher BMI and poorer psychosocial outcomes than students classed as having high FS or marginal FI. These findings provide important evidence for policy makers on the prevalence of FI among families in Nova Scotia with grade 5 children and its relationship with childhood nutrition, psychosocial and quality of life factors, and weight status.

  17. The impact of primary care reform on health system performance in Canada: a systematic review.

    Science.gov (United States)

    Carter, Renee; Riverin, Bruno; Levesque, Jean-Frédéric; Gariepy, Geneviève; Quesnel-Vallée, Amélie

    2016-07-30

    We aimed to synthesize the evidence of a causal effect and draw inferences about whether Canadian primary care reforms improved health system performance based on measures of health service utilization, processes of care, and physician productivity. We searched the Embase, PubMed and Web of Science databases for records from 2000 to September 2015. We based our risk of bias assessment on the Grading of Recommendations Assessment, Development and Evaluation guidelines. Full-text studies were synthesized and organized according to the three outcome categories: health service utilization, processes of care, and physician costs and productivity. We found moderate quality evidence that team-based models of care led to reductions in emergency department use, but the evidence was mixed for hospital admissions. We also found low quality evidence that team-based models, blended capitation models and pay-for-performance incentives led to small and sometimes non-significant improvements in processes of care. Studies examining new payment models on physician costs and productivity were of high methodological quality and provided a coherent body of evidence assessing enhanced fee-for-service and blended capitation payment models. A small number of studies suggested that team-based models contributed to reductions in emergency department use in Quebec and Alberta. Regarding processes of diabetes care, studies found higher rates of testing for blood glucose levels, retinopathy and cholesterol in Alberta's team-based primary care model and in practices eligible for pay-for-performance incentives in Ontario. However pay-for-performance in Ontario was found to have null to moderate effects on other prevention and screening activities. Although blended capitation payment in Ontario contributed to decreases in the number of services delivered and patients seen per day, the number of enrolled patients and number of days worked in a year was similar to that of enhanced fee

  18. Standardizing nursing information in Canada for inclusion in electronic health records: C-HOBIC.

    Science.gov (United States)

    Hannah, Kathryn J; White, Peggy A; Nagle, Lynn M; Pringle, Dorothy M

    2009-01-01

    The Canadian Health Outcomes for Better Information and Care (C-HOBIC) project introduced systematic use of standardized clinical nursing terminology for patient assessments. Implemented so far in three Canadian provinces, C-HOBIC comprises an innovative model for large-scale capture of standardized nursing-sensitive clinical outcomes data within electronic health records (EHRs). To support this activity, nursing assessment and outcomes concepts were mapped to the International Classification for Nursing Practice (ICNP(R)). By comparing serial data on a patient across multiple time points, the C-HOBIC model can generate nursing-sensitive patient outcome reports. A principle benefit of the C-HOBIC model is that it provides nurses with information critical to planning for and evaluating patient care. Inclusion of nursing information in either provincial databases or EHRs in three Canadian provinces promotes continuity of patient care across sectors of the healthcare systems in those provinces and also facilitates aggregation and analysis by administrators and policy makers. The C-HOBIC model provides standardized, consistent, interoperable clinical information that reflects nursing practice throughout the Canadian healthcare System.

  19. 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.

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

    Science.gov (United States)

    Fleury, Marie-Josée; Bamvita, Jean-Marie; Grenier, Guy; Caron, Jean

    2015-10-16

    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.

  1. 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 (pSick 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.

  2. 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.

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

    Science.gov (United States)

    Fleury, Marie-Josée; Bamvita, Jean-Marie; Grenier, Guy; Caron, Jean

    2015-01-01

    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. PMID:26501306

  4. 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.

  5. Sociodemographic and neighbourhood determinants of health-related quality of life among grade-five students in Canada.

    Science.gov (United States)

    Wu, X Y; Ohinmaa, A; Veugelers, P J

    2010-09-01

    To describe the health-related quality of life (HRQOL) of grade-five students in Alberta, Canada, and to assess how this correlates with sociodemographic and neighbourhood characteristics. In 2008, we conducted a comprehensive population-based survey among 3,421 grade-five students aged primarily 10-11 years from 148 schools and their parents that included questions on sociodemographic and neighbourhood factors. The HRQOL of the students was assessed using the EQ-5D Canadian English child version (EQ-5D-Y). We applied multilevel multivariable linear regression to examine the independent importance of sociodemographic and neighbourhood factors for the EQ-5D-Y index and EQ-5D-Y Visual Analogue Scale (VAS) score. In five EQ-5D-Y dimensions, problems with 'walking', 'looking after myself', 'usual activities', 'pain or discomfort' and 'worried, sad or unhappy' were reported by 8.1% (n = 288), 6.5% (n = 215), 11.8% (n = 431), 46.0% (n = 1600), and 37.7% (n = 1292) of students, respectively. Their mean EQ-5D-Y index was 0.86 and mean EQ-5D-Y VAS was 80.4. Children from families reporting higher educational attainment reported higher HRQOL both in terms of a higher EQ-5D-Y index and in terms of a higher EQ-5D-Y VAS. Also, children residing in neighbourhood characterized as providing good satisfaction and facilities reported higher HRQOL. Public health initiatives to improve HRQOL among children are suggested to take into account the influence of different sociodemographic and neighbourhood characteristics such that priority is given to those residing in towns, rural areas and dissatisfying neighbourhoods with poor access to recreational facilities and stores for fresh products.

  6. Health Technology Assessment (HTA) Case Studies: Factors Influencing Divergent HTA Reimbursement Recommendations in Australia, Canada, England, and Scotland.

    Science.gov (United States)

    Allen, Nicola; Walker, Stuart R; Liberti, Lawrence; Salek, Sam

    2017-03-01

    To evaluate the national regulatory, health technology assessment (HTA), and reimbursement pathways for public health care in Australia, Canada, England, and Scotland, to compare initial Canadian national HTA recommendations with the initial decisions of the other HTA agencies, and to identify factors for differing national HTA recommendations between the four HTA agencies. Information from the public domain was used to develop a regulatory process map for each jurisdiction and to compare the HTA agencies' reimbursement recommendations. Medicines that were reviewed by all four agencies and received a negative recommendation from only one agency were selected as case studies. All four countries have a national HTA agency. Their reimbursement recommendations are guided by both clinical efficacy and cost-effectiveness, and the necessity for patient input. Their activities, however, vary because of different mandates and their unique political, social, and population needs. All have an implicit or explicit quality-adjusted life-year threshold. The seven divergent case studies demonstrate examples in which new medicine-indication pairs have been rejected because of uncertainties surrounding a range of factors including cost-effectiveness, comparator choice, clinical benefit, safety, trial design, and submission timing. The four HTA agencies selected for inclusion in this study share common factors, including a focus on clinical efficacy and cost-effectiveness in their decision-making processes. The differences in recommendations could be considered to be due to an individual agency's approach to risk perception, and the comparator choice used in clinical and cost-effectiveness studies. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. (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.

  8. Evaluation of the New World Health Organization Case Definition of Severe Acute Respiratory Infection for Influenza Surveillance During the Peak Weeks of Two Influenza Seasons in Quebec, Canada.

    Science.gov (United States)

    Amini, R; Gilca, R; Douville-Fradet, M; Boulianne, N; De Serres, G

    2017-09-01

    During the peak of the 2012-2013 and 2014-2015 influenza seasons in Quebec, Canada, the sensitivity of the new World Health Organization (WHO) case definition of severe acute respiratory infection (SARI) in definition for influenza surveillance in children should be interpreted with caution according to the specific surveillance goals. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010.

    Science.gov (United States)

    Steensma, Colin; Loukine, Lidia; Choi, Bernard C

    2017-03-01

    The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. "Compression" refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. "Expansion" refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE. We estimated LE using mortality and population data from Statistics Canada. We took health-related quality of life (i.e. morbidity) data used to calculate HALE from the National Population Health Survey (1994-1999) and the Canadian Community Health Survey (2000-2010). We built abridged life tables for seven time intervals, covering the period 1994 to 2010 and corresponding to the year of each available survey cycle, for females and males, and for each of the 10 Canadian provinces. National and provincial trends were assessed at birth, and at ages 20 years and 65 years. We observed an overall average annual increase in HALE that was statistically significant in both Canadian females and males at each of the three ages assessed, with the exception of females at birth. At birth, HALE increased an average of 0.2% (p = .08) and 0.3% (p morbidity from 1994 to 2010 at the national level in Canada. However, our results suggested an expansion of morbidity in NL and PEI. Our study indicates the importance of continued tracking of the secular trends of life expectancy and HALE in Canada in order to verify the presence of compression or expansion of morbidity. Further study should be undertaken to understand what is driving the observed expansion of morbidity in NL and in PEI.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Monique Potvin Kent

    2017-09-01

    Full Text Available Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.

  12. Air quality in the Industrial Heartland of Alberta, Canada and potential impacts on human health

    Science.gov (United States)

    Simpson, Isobel J.; Marrero, Josette E.; Batterman, Stuart; Meinardi, Simone; Barletta, Barbara; Blake, Donald R.

    2015-01-01

    The “Industrial Heartland” of Alberta is Canada’s largest hydrocarbon processing center, with more than 40 major chemical, petrochemical, and oil and gas facilities. Emissions from these industries affect local air quality and human health. This paper characterizes ambient levels of 77 volatile organic compounds (VOCs) in the region using high-precision measurements collected in summer 2010. Remarkably strong enhancements of 43 VOCs were detected, and concentrations in the industrial plumes were often similar to or even higher than levels measured in some of the world’s largest cities and industrial regions. For example maximum levels of propene and i-pentane exceeded 100 ppbv, and 1,3-butadiene, a known carcinogen, reached 27 ppbv. Major VOC sources included propene fractionation, diluent separation and bitumen processing. Emissions of the measured VOCs increased the hydroxyl radical reactivity (kOH), a measure of the potential to form downwind ozone, from 3.4 s−1 in background air to 62 s−1 in the most concentrated plumes. The plume value was comparable to polluted megacity values, and acetaldehyde, propene and 1,3-butadiene contributed over half of the plume kOH. Based on a 13-year record (1994–2006) at the county level, the incidence of male hematopoietic cancers (leukemia and non-Hodgkin lymphoma) was higher in communities closest to the Industrial Heartland compared to neighboring counties. While a causal association between these cancers and exposure to industrial emissions cannot be confirmed, this pattern and the elevated VOC levels warrant actions to reduce emissions of known carcinogens, including benzene and 1,3-butadiene. PMID:25685050

  13. 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.

  14. 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.

  15. Assessing potential health risks to fish and humans using mercury concentrations in inland fish from across western Canada and the United States

    Science.gov (United States)

    Lepak, Jesse M; Hooten, Mevin B.; Eagles-Smith, Collin A.; Tate, Michael T.; Lutz, Michelle A.; Ackerman, Joshua T.; Willacker, James J.; Jackson, Allyson K.; Evers, David C.; Wiener, James G.; Pritz, Colleen Flanagan; Davis, Jay

    2016-01-01

    Fish represent high quality protein and nutrient sources, but Hg contamination is ubiquitous in aquatic ecosystems and can pose health risks to fish and their consumers. Potential health risks posed to fish and humans by Hg contamination in fish were assessed in western Canada and the United States. A large compilation of inland fish Hg concentrations was evaluated in terms of potential health risk to the fish themselves, health risk to predatory fish that consume Hg contaminated fish, and to humans that consume Hg contaminated fish. The probability that a fish collected from a given location would exceed a Hg concentration benchmark relevant to a health risk was calculated. These exceedance probabilities and their associated uncertainties were characterized for fish of multiple size classes at multiple health-relevant benchmarks. The approach was novel and allowed for the assessment of the potential for deleterious health effects in fish and humans associated with Hg contamination in fish across this broad study area. Exceedance probabilities were relatively common at low Hg concentration benchmarks, particularly for fish in larger size classes. Specifically, median exceedances for the largest size classes of fish evaluated at the lowest Hg concentration benchmarks were 0.73 (potential health risks to fish themselves), 0.90 (potential health risk to predatory fish that consume Hg contaminated fish), and 0.97 (potential for restricted fish consumption by humans), but diminished to essentially zero at the highest benchmarks and smallest fish size classes. Exceedances of benchmarks are likely to have deleterious health effects on fish and limit recommended amounts of fish humans consume in western Canada and the United States. Results presented here are not intended to subvert or replace local fish Hg data or consumption advice, but provide a basis for identifying areas of potential health risk and developing more focused future research and monitoring efforts.

  16. Modelling the social determinants of health and simulating short-term and long-term intervention impacts for the city of Toronto, Canada.

    Science.gov (United States)

    Mahamoud, Aziza; Roche, Brenda; Homer, Jack

    2013-09-01

    There is a substantial body of evidence highlighting the importance of the social determinants of health in shaping the health of urban populations in Canada. The low socio-economic status of marginalized, disadvantaged, and precarious populations in urban settings has been linked to adverse health outcomes including chronic and infectious disease, negative health behaviours, barriers to accessing health care services, and overall mortality. Given the dynamic complexities and inter-relationships surrounding the underlying drivers of population health outcomes and inequities, it is difficult to assess program and policy intervention tradeoffs, particularly when such interventions are studied with static models. To address this challenge, we have adopted a systems science approach and developed a simulation model for the City of Toronto, Canada, utilizing system dynamics modelling methodology. The model simulates changes in health, social determinants, and disparities from 2006 and projects forward to 2046 under different assumptions. Most of the variables in the model are stratified by ethnicity, immigration status, and gender, and capture the characteristics of adults aged 25-64. Intervention areas include health care access, behaviour, income, housing, and social cohesion. The model simulates alternative scenarios to help demonstrate the relative impact of different interventions on poor health outcomes such as chronic disease rates, disability rates, and mortality rate. It gives insight into how much, and how quickly, interventions can reduce mortality and morbidity. We believe this will serve as a useful learning tool to allow diverse stakeholders and policy makers to ask "what if" questions and map effective policy directions for complex population health problems, and will enable communities to think about their health futures. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Social, cultural, and land use determinants of the health and well-being of Aboriginal peoples of Canada: A path analysis

    Science.gov (United States)

    Kant, Shashi; Vertinsky, Ilan; Zheng, Bin; Smith, Peggy M

    2013-01-01

    We explored the contributions of social, cultural, and land use (SCLU) factors to Aboriginal well-being and health using path analysis and data collected from 2 of 614 First Nations in Canada. Information gathered from a structured questionnaire with questions related to seven domains of well-being and contributing factors led to key findings: (i) the SCLU domain is the most important; (ii) the most important SCLU factors are the percentage of household meals of traditional diets and the impact of government regulations on land use; (iii) the most important Health domain factors are the prevalence of mental and psychological problems and the quality of health services; and (iv) the SCLU factors of access to cultural sites, the freedom to participate in spiritual activities, and the impact of government regulations on social and cultural life have a profound effect on mental health. Improving Aboriginal well-being and health may depend on incorporating SCLU factors into new, holistic policies. PMID:23760133

  18. Social, cultural, and land use determinants of the health and well-being of Aboriginal peoples of Canada: a path analysis.

    Science.gov (United States)

    Kant, Shashi; Vertinsky, Ilan; Zheng, Bin; Smith, Peggy M

    2013-08-01

    We explored the contributions of social, cultural, and land use (SCLU) factors to Aboriginal well-being and health using path analysis and data collected from 2 of 614 First Nations in Canada. Information gathered from a structured questionnaire with questions related to seven domains of well-being and contributing factors led to key findings: (i) the SCLU domain is the most important; (ii) the most important SCLU factors are the percentage of household meals of traditional diets and the impact of government regulations on land use; (iii) the most important Health domain factors are the prevalence of mental and psychological problems and the quality of health services; and (iv) the SCLU factors of access to cultural sites, the freedom to participate in spiritual activities, and the impact of government regulations on social and cultural life have a profound effect on mental health. Improving Aboriginal well-being and health may depend on incorporating SCLU factors into new, holistic policies.

  19. 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)

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

    2017-11-03

    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. 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. South Asian youth (n=10) engaged in thoughtful, candid dialogue about their mental health and service access barriers. 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. 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. 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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Canada's World : a Deliberative Dialogue | IDRC - International ...

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

    Call for proposals for the Joint Canada-Israel Health Research Program 2018 competition. IDRC, the Israel Science Foundation, the Azrieli Foundation, and the Canadian Institutes of Health Research announce the call for proposals for the fourth round of the Joint Canada-Israel Health... View moreCall for proposals for the ...

  1. 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.

  2. 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.

  3. Re: making health and care systems fit for and ageing population. Why we wrote it, who we wrote it for, and how relevant it might be to Canada.

    Science.gov (United States)

    Oliver, David

    2014-12-01

    In response to the commentary((1)) in this month's Canadian Geriatrics Journal by Andrew and Rockwood on the recent paper I co-wrote with King's Fund colleagues-"Making Health and Care Systems Fit for an Ageing Population"((2))-I wanted to pen a very personal response, not least because of my visits to health systems in Ontario and Alberta and conversations with many Canadian colleagues that are fresh in my mind. The paper was certainly the most important and influential thing I have written, and was an attempt to weave all the elements of good practice in health care for older people into one overarching narrative. Whilst its biggest target audience is UK health services, I hope it has some relevance to Canada and might stimulate some constructive conversations.

  4. Indigenous knowledge translation: baseline findings in a qualitative study of the pathways of health knowledge in three indigenous communities in Canada.

    Science.gov (United States)

    Smylie, Janet; Kaplan-Myrth, Nili; McShane, Kelly

    2009-07-01

    To acquire an understanding of the pathways of health information dissemination and use by Indigenous community members, the researchers applied an Indigenous participatory action research approach in partnership with one urban Inuit, one urban Métis, and one semirural First Nations community in Ontario, Canada. A descriptive community case study was conducted in each community through the use of focus groups, key informant interviews, and document inquiry. Results were corroborated by the communities. Each of the three community consultations generated distinct and striking data about health information sources and dissemination strategies; decision-making processes; locally relevant concepts of health, local health services, and programs; community structures; and mechanisms of interface with noncommunity systems. In addition, several crosscutting themes were identified. The participatory research approach successfully engaged community partners. These findings support the hypothesis that understanding local Indigenous processes of knowledge creation, dissemination, and utilization is a necessary prerequisite to effective knowledge translation in Indigenous contexts.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Cohen S Robin

    2011-05-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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

  11. The Mountain of Health: The Perceptions and Perceived Expectations of Youth Living with Type 2 Diabetes in Winnipeg, Manitoba, Canada, Through a Grounded Theory Study.

    Science.gov (United States)

    Huynh, Elizabeth

    2017-11-08

    The objective of this study was to explore youth's perceptions of diabetes management. The study included 8 Manitoban youth with type 2 diabetes (n=7 girls). Each youth participated in a semistructured interview in person, via Skype or over the phone. The constructivist grounded theory methodologic approach guided the analysis of the data. Discussions about diabetes and health and its management revealed 2 viewpoints: 1) youth's perceptions and 2) youth's perceptions of health-care providers' expectations. The Mountain of Health was used to conceptualize the complex nature of diabetes management. Youth perceived that health-care providers prioritized physical health-behaviour changes in order to achieve successful diabetes management. Conflictingly, many youth described their mental and emotional health as taking precedence over their physical health. Future interventionists should be aware of the vast incongruence in patients' perceptions of health in type 2 diabetes and their perceptions of health-care providers' expectations during the development of interventions. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  12. Predicting health literacy among English-as-a-second-Language older Chinese immigrant women to Canada: comprehension of colon cancer prevention information.

    Science.gov (United States)

    Todd, Laura; Hoffman-Goetz, Laurie

    2011-06-01

    Inadequate health literacy has been identified as a barrier to the utilization of health-care services, including cancer screening. This study examined predictors of health literacy among 106 older Chinese immigrant women to Canada and how colon cancer information presented in their first versus second language affected health literacy skill. Only 38.7% of the women had adequate health literacy based on Short Test of Functional Health Literacy for Adults, and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the cancer information was significantly lower among women who received the information in English compared with those who received the information in Chinese. Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure of health literacy used and language of the information. Presentation of cancer prevention information in one's first rather than second language improves health literacy but does not eliminate comprehension difficulties for older ESL Chinese immigrants.

  13. The predictors of self-rated health and the relationship between self-rated health and health service needs are similar across socioeconomic groups in Canada.

    Science.gov (United States)

    Smith, Peter M; Glazier, Richard H; Sibley, Lyn M

    2010-04-01

    To examine if there are systematic differences in the predictors of self-rated health (SRH) and to examine the relationship between SRH and health care utilization across socioeconomic groups. We used cross-sectional data from the Canadian Community Health Survey linked to the Ontario Health Insurance Plan (N=17,109). We examined relative differences in the factors associated with different levels of SRH across socioeconomic groups (as assessed by education and household income) using probit models separately for men and women. We then examined differences in expected health care costs, as assessed by adjusted clinical group weights using administrative health care records, between socioeconomic groups within the same level of SRH. We found limited differences across the predictive ability of a broad range of physical, mental, health service/care utilization, and health behavior variables on SRH across socioeconomic groups. In addition, no differences were found in the expected health care utilization costs across socioeconomic groups within the same level of SRH. The results of this study suggest that SRH assesses a broad variety of factors, including physical health status, mental health status, health service/care utilization, and health behaviors, relatively equally across socioeconomic groups, measured as either education or income. Copyright 2010 Elsevier Inc. All rights reserved.

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

    OpenAIRE

    Diane P. Dupont; Adamowicz, W.L. (Vic); 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 ...

  15. 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.

  16. Lifestyle modifications to prevent and control hypertension. 3. Recommendations on alcohol consumption. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada.

    Science.gov (United States)

    Campbell, N R; Ashley, M J; Carruthers, S G; Lacourcière, Y; McKay, D W

    1999-05-04

    low-risk drinking guidelines (i.e., healthy adults who choose to drink should limit alcohol consumption to 2 or fewer standard drinks per day, with consumption not exceeding 14 standard drinks per week for men and 9 standard drinks per week for women). (3) Hypertensive patients should also be advised to limit alcohol consumption to the levels set out in the Canadian low-risk drinking guidelines. These recommendations are similar to those of the World Hypertension League, the National High Blood Pressure Education Program Working Group on Primary Prevention of Hypertension and the previous recommendations of the Canadian Coalition for High Blood Pressure Prevention and Control and the Canadian Hypertension Society. They have not been clinically tested. The low-risk drinking guidelines are those of the Addiction Research Foundation of Ontario and the Canadian Centre on Substance Abuse. The Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Laboratory Centre for Disease Control at Health Canada, and the Heart and Stroke Foundation of Canada. The low-risk drinking guidelines have been endorsed by the College of Family Physicians of Canada and several provincial organizations.

  17. Depressive symptoms, diet quality, physical activity, and body composition among populations in Nova Scotia, Canada: report from the Atlantic Partnership for Tomorrow's Health.

    Science.gov (United States)

    Yu, Zhijie M; Parker, Louise; Dummer, Trevor J B

    2014-04-01

    To investigate the association between depressive symptoms and diet quality, physical activity, and body composition among Nova Scotians. 4511 men and women aged 35-69 years were recruited to the Atlantic Partnership for Tomorrow's Health study from 2009 through 2010 in Nova Scotia, Canada. Depressive symptoms were assessed by using the Patient Health Questionnaire. Anthropometric indexes and body composition were measured. Current antidepressant use, habitual diet intake, physical activity, and potential confounders were collected through questionnaires. In multivariable regression analyses, depressive symptoms were positively associated with all obese indexes after controlling for potential confounders (all P for trendobesity and abdominal obesity (OR 1.84; 95% confidence interval [CI], (1.50, 2.25) and 1.56 (95% CI, 1.30, 1.87) for obesity and 1.46 (95% CI, 1.20, 1.77) and 1.88 (95% CI, 1.58, 2.24) for abdominal obesity, respectively). Depressed individuals were less likely to have a high quality diet or engage in high levels of physical activity compared with their non-depressed counterparts. Depressive symptoms are associated with higher levels of obesity, poor diet, and physical inactivity among Nova Scotians in Canada. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Menthol addition to cigarettes using breakable capsules in the filter. Impact on the mainstream smoke yields of the health Canada list constituents.

    Science.gov (United States)

    Dolka, C; Piadé, J-J; Belushkin, M; Jaccard, G

    2013-10-21

    Cigarettes with menthol capsules embedded in the filter have been introduced recently in many countries. At the same time, concerns have been expressed that filter performance could be affected by the crushing of the capsule therein, altering mainstream smoke constituent yields, ultimately with the potential to impact the toxicity of these products. The present study investigates the possible mechanisms underlying differences in smoke constituent deliveries following the crushing of a menthol capsule in a cigarette filter. It also includes results from a market survey of a selection of commercial cigarette brands with menthol capsules representing the different designs for this type of product available in different markets worldwide. The yields of 46 Health Canada smoke components were determined according to the International Organization for Standardization (ISO) machine-smoking regime. Data obtained from measurements using cigarettes with the capsule crushed and uncrushed were compared. Except for the intended presence of menthol flavors in smoke, no meaningful differences were identified in the yields of the remaining measured particulate-phase smoke constituents. Regarding the gas-phase smoke constituents, it was found that the delivery of lipophilic volatiles was reduced when the capsule was crushed. Delivery of the other measured gas-phase components remained unaffected. The results from investigations performed in this study did not show any meaningful increase in the yield of smoke constituents listed by Health Canada as a result of crushing the menthol capsule in the cigarette filter.

  19. Identifying gaps in asthma education, health promotion, and social support for Mi'kmaq families in Unama'ki (Cape Breton), Nova Scotia, Canada.

    Science.gov (United States)

    Watson, Rob; Castleden, Heather; Masuda, Jeffrey; King, Malcolm; Stewart, Miriam

    2012-01-01

    Asthma is the most common chronic condition affecting Aboriginal youth aged 8 to 12 years in Canada. Research investigating psychosocial challenges associated with asthma is limited. This study examines support resources, support-seeking strategies, support and education needs, and intervention preferences of Aboriginal youth with asthma and their caregivers in an effort to encourage community-wide, health-promoting behaviors. We employed a community-based participatory research design to conduct interviews with 21 youths aged 8 to 12 years and 17 caregivers from 5 Mi'kmaq communities in Unama'ki (Cape Breton) Nova Scotia, Canada. After conducting interviews that explored existing and desired social, educational, and health support in participating communities, we held a 2-day asthma camp to engage participants in asthma education, social support networking, and cultural activities. At the camp, we collected data through participant observation, sharing circles, focus groups, and youth drawings of their experiences living with asthma. Our study yielded 4 key findings: 1) asthma triggers included household mold, indoor smoking, pets, season change, strenuous exercise, extreme cold, and humidity; 2) social and educational support is lacking in Mi'kmaq communities despite a strong desire for these services; 3) cultural, linguistic, and geographic barriers to accessing support exist; and 4) family members are primary support resources. Improved support and educational resources are needed to foster effective Mi'kmaq asthma support networks. Future asthma interventions for marginalized populations must be culturally meaningful and linguistically accessible to those using and providing asthma support.

  20. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada.

    Science.gov (United States)

    Cléroux, J; Feldman, R D; Petrella, R J

    1999-05-04

    of moderate rhythmic exercise of the lower limbs, such as brisk walking or cycling, 3 or 4 times per week to reduce blood pressure, (2) Exercise should be prescribed as an adjunctive therapy for people who require pharmacologic therapy for hypertension, especially those who are not receiving beta-blockers. (3) People who do not have hypertension should participate in regular exercise as it will decrease blood pressure and reduce the risk of coronary artery disease, although there is no direct evidence that it will prevent hypertension. These recommendations agree with those of the World Hypertension League, the American College of Sports Medicine, the report of the US Surgeon General on physical activity and health, and the US National Institutes of Health Consensus Development Panel on Physical Activity and Cardiovascular Health. These guidelines have not been clinically tested. The Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Laboratory Centre for Disease Control at Health Canada, and the Heart and Stroke Foundation of Canada.

  1. An International Comparison of Women's Health Issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong, and Singapore: The CIDA-SEAGEP Study

    Directory of Open Access Journals (Sweden)

    Bernard Choi

    2004-01-01

    Full Text Available This was an international study of women’'s health issues, based on an Official Study Tour in Southeast Asia (the Philippines, Thailand, Malaysia, Hong Kong, and Singapore and Canada. The objectives of the study were to identify and compare current gaps in surveillance, research, and programs and policies, and to predict trends of women’''s health issues in developing countries based on the experience of developed countries. Key informant interviews (senior government officials, university researchers, and local experts, self-administered questionnaires, courtesy calls, and literature searches were used to collect data. The participating countries identified women's health as an important issue, especially for reproductive health (developing countries and senior’'s health (developed countries. Cancer, lack of physical activity, high blood pressure, diabetes, poverty, social support, caring role for family, and informing, educating, and empowering people about women's health issues were the main concerns. Based on this study, 17 recommendations were made on surveillance, research, and programs and policies. A number of forthcoming changes in women’'s health patterns in developing countries were also predicted.

  2. Validation of algorithms to determine incidence of Hirschsprung disease in Ontario, Canada: a population-based study using health administrative data

    Directory of Open Access Journals (Sweden)

    Nasr A

    2017-11-01

    Full Text Available Ahmed Nasr,1,2 Katrina J Sullivan,1 Emily W Chan,1 Coralie A Wong,3 Eric I Benchimol2–5 1Department of Pediatric Surgery, Children’s Hospital of Eastern Ontario, 2Faculty of Medicine, University of Ottawa, 3Institute for Clinical Evaluative Science (ICES University of Ottawa, 4CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Eastern Ontario, 5School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Objective: Incidence rates of Hirschsprung disease (HD vary by geographical region, yet no recent population-based estimate exists for Canada. The objective of our study was to validate and use health administrative data from Ontario, Canada to describe trends in incidence of HD between 1991 and 2013.Study design: To identify children with HD we tested algorithms consisting of a combination of diagnostic, procedural, and intervention codes against the reference standard of abstracted clinical charts from a tertiary pediatric hospital. The algorithm with the highest positive predictive value (PPV that could maintain high sensitivity was applied to health administrative data from April 31, 1991 to March 31, 2014 (fiscal years 1991–2013 to determine annual incidence. Temporal trends were evaluated using Poisson regression, controlling for sex as a covariate.Results: The selected algorithm was highly sensitive (93.5% and specific (>99.9% with excellent predictive abilities (PPV 89.6% and negative predictive value >99.9%. Using the algorithm, a total of 679 patients diagnosed with HD were identified in Ontario between 1991 and 2013. The overall incidence during this time was 2.05 per 10,000 live births (or 1 in 4,868 live births. The incidence did not change significantly over time (odds ratio 0.998, 95% confidence interval 0.983–1.013, p = 0.80.Conclusion: Ontario health administrative data can be used to accurately identify cases of HD and describe

  3. 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

  4. 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.

  5. Western Canada study of animal health effects associated with exposure to emissions from oil and natural gas field facilities. Study design and data collection II. Location of study herds relative to the oil and gas industry in Western Canada.

    Science.gov (United States)

    Waldner, Cheryl L

    2008-01-01

    During the late part of 2000 and early months of 2001, project veterinarians recruited 205 beef herds to participate in a study of the effects of emissions from the upstream oil and gas industry on cattle reproduction and health. Researchers developed herd-selection criteria to optimize the range of exposure to facilities, including oil and gas wells, battery sites, and gas-gathering and gas-processing facilities across the major cattle-producing areas of Western Canada. Herds were initially selected on the basis of a ranking system of exposure potential on the basis of herd-owner reports of the locations of their operations in relation to oil and gas industry facilities. At the end of the study, researchers summarized data obtained from provincial regulatory agencies on facility location and reported flaring and venting volumes for each herd and compared these data to the original rankings of herd-exposure potential. Through this selection process, the researchers were successful in obtaining statistically significant differences in exposure to various types of oil and gas facility types and reported emissions among herds recruited for the study.

  6. Raiders of the Lost Art: A review of published evaluations of inpatient mental health care experiences emanating from the United Kingdom, Portugal, Canada, Switzerland, Germany and Australia.

    Science.gov (United States)

    Cutcliffe, John R; Santos, Jose Carlos; Kozel, Bernd; Taylor, Petrea; Lees, David

    2015-10-01

    Forming interpersonal therapeutic relationships with mental health Service Users remains a key aspect of the practice of Psychiatric/Mental Health nurses. Given the omnipresence of the concept within the relevant literature the reader could be forgiven for asking: why would Psychiatric/Mental Health nurses opine about something so basic, so ubiquitous and so central to the theory and practice of our discipline? While the authors could locate no substantive argument that refutes the role or value of such relationships, a sizable, growing and reasonably consistent body of work has emerged, which appears to indicate that this centrality and value is not necessarily reflected in many clinical practice settings. Accordingly, we draw on the published evaluations of mental health care emanating from the United Kingdom, Portugal, Canada, Switzerland, Germany and Australia, compare these findings and highlight similarities or/and congruence and discuss a range of issues arising out of the findings. Alas, the findings seem to depict a mental health care inpatient experience that is often devoid of warm therapeutic relationships, respectful interactions, information or choice about treatment and any kind of formal/informal 'talk therapy'. Instead such care experiences are personified by: coercion, disinterest, inhumane practices, custodial and controlling practitioners and a gross over use of pharmacological 'treatments'. © 2015 Australian College of Mental Health Nurses Inc.

  7. 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…

  8. "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

  9. 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

  10. 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

    2018-02-08

    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

  11. Canadian Public Health Laboratory Network laboratory guidelines for congenital syphilis and syphilis screening in pregnant women in Canada.

    Science.gov (United States)

    Singh, Ameeta E; Levett, Paul N; Fonseca, Kevin; Jayaraman, Gayatri C; Lee, Bonita E

    2015-01-01

    Despite universal access to screening for syphilis in all pregnant women in Canada, cases of congenital syphilis have been reported in recent years in areas experiencing a resurgence of infectious syphilis in heterosexual partnerships. Antenatal screening in the first trimester continues to be important and should be repeated at 28 to 32 weeks and again at delivery in women at high risk of acquiring syphilis. The diagnosis of congenital syphilis is complex and is based on a combination of maternal history and clinical and laboratory criteria in both mother and infant. Serologic tests for syphilis remain important in the diagnosis of congenital syphilis and are complicated by the passive transfer of maternal antibodies which can affect the interpretation of reactive serologic tests in the infant. All infants born to mothers with reactive syphilis tests should have nontreponemal tests (NTT) and treponemal tests (TT) performed in parallel with the mother's tests. A fourfold or higher titre in the NTT in the infant at delivery is strongly suggestive of congenital infection but the absence of a fourfold or greater NTT titre does not exclude congenital infection. IgM tests for syphilis are not currently available in Canada and are not recommended due to poor performance. Other evaluation in the newborn infant may include long bone radiographs and cerebrospinal fluid tests but all suspect cases should be managed in conjunction with sexually transmitted infection and/or pediatric experts.

  12. Eastern Canada

    Energy Technology Data Exchange (ETDEWEB)

    Bryant, R.G.; Roliff, W.A.; Sealey, R.; Palonen, P.A.

    1981-10-01

    Uncertainty of increased taxation of petroleum revenues proposed under the Canadian national energy program effected a minor slowdown of the rapid exploration in 1980. Total numbers of wells drilled in eastern Canada were: Ontario, 224; Quebec, 3; Nova Scotia, 1; and the Atlantic offshore, 13. Much of the Ontario drilling, 123 wells, was for development purposes. The success ratio on exploratory drilling in Ontario was 34.7, while all Quebec and Nova Scotia wells were dry. Production of oil and gas declined by 16.8% and 18.5% in New Brunswick. Oil production in Ontario increased by 1.2%. The increase in gas production of 14.3% to almost 443,535.5 x 10/sup 3/m/sup 3/ was due almost entirely to development of known fields underlying Lake Erie. The exploration of offshore eastern Canada continued at a stable rate, with 12 wells completed. Of these, 2 were in the Gulf of St. Lawrence, 3 on the Grand Banks, 6 on the Labrador Shelf, and 1 in Davis Strait. All wells were abandoned or suspended at year end, although discoveries of hydrocarbon were made in Davis Strait and the Grand Banks. The early exploration stage, combined with record water depths, prevented any of these wells from being put into production, although testing will be continued on the most promising shows. Seismic exploration increased to approximately 30,000 km in the Atlantic offshore areas. In addition, 1,420.94 km was shot in Lake Erie. Onshore seismic exploration accounted for 1,078.67 km in Ontario, 350 km in Nova Scotia and 242.76 km in Quebec. 3 figures, 8 tables.

  13. All projects related to canada | Page 22 | IDRC - International ...

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

    2017-03-22

    , VULNERABLE GROUPS, Climate change. Region: Malawi, Canada. Program: Food, Environment, and Health. Total Funding: CA$ 566,860.00. Support for Communities affected by Mining in Canada and around the Globe. Project. Founded ...

  14. The association between health information technology adoption and family physicians' practice patterns in Canada: evidence from 2007 and 2010 National Physician Surveys.

    Science.gov (United States)

    Sarma, Sisira; Hajizadeh, Mohammad; Thind, Amardeep; Chan, Rick

    2013-08-01

    To describe the association between health information technology (HIT) adoption and family physicians' patient visit length in Canada after controlling for physician and practice characteristics. HIT adoption is defined in terms of four types of HIT usage: no HIT use (NO), basic HIT use without electronic medical record system (HIT), basic HIT use with electronic medical record (EMR) and advanced HIT use (EMR + HIT). The outcome variable is the average time spent on a patient visit (visit length). The data for this study came from the 2007 and 2010 National Physician Surveys. A log-linear model was used to analyze our visit length outcome. The average time worked per week was found to be in the neighbourhood of 36 hours in both 2007 and 2010, but users of EMR and EMR + HIT were undertaking fewer patient visits per week relative to NO users. Multivariable analysis showed that EMR and EMR + HIT were associated with longer average time spent per patient visit by about 7.7% (pCanada relative to NO users, but this association weakened in the multivariable analysis of 2010. Copyright © 2013 Longwoods Publishing.

  15. Quality of end-of-life cancer care in Canada: a retrospective four-province study using administrative health care data.

    Science.gov (United States)

    Barbera, L; Seow, H; Sutradhar, R; Chu, A; Burge, F; Fassbender, K; McGrail, K; Lawson, B; Liu, Y; Pataky, R; Potapov, A

    2015-10-01

    The quality of data comparing care at the end of life (eol) in cancer patients across Canada is poor. This project used identical cohorts and definitions to evaluate quality indicators for eol care in British Columbia, Alberta, Ontario, and Nova Scotia. This retrospective cohort study of cancer decedents during fiscal years 2004-2009 used administrative health care data to examine health service quality indicators commonly used and previously identified as important to quality eol care: emergency department use, hospitalizations, intensive care unit admissions, chemotherapy, physician house calls, and home care visits near the eol, as well as death in hospital. Crude and standardized rates were calculated. In each province, two separate multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Overall, among the identified 200,285 cancer patients who died of their disease, 54% died in a hospital, with British Columbia having the lowest standardized rate of such deaths (50.2%). Emergency department use at eol ranged from 30.7% in Nova Scotia to 47.9% in Ontario. Of all patients, 8.7% received aggressive care (similar across all provinces), and 46.3% received supportive care (range: 41.2% in Nova Scotia to 61.8% in British Columbia). Lower neighbourhood income was consistently associated with a decreased likelihood of supportive care receipt. We successfully used administrative health care data from four Canadian provinces to create identical cohorts with commonly defined indicators. This work is an important step toward maturing the field of eol care in Canada. Future work in this arena would be facilitated by national-level data-sharing arrangements.

  16. 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.

  17. 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

  18. Needs, Risks, and Context in Sexual Health Among Temporary Foreign Migrant Farmworkers in Canada: A Pilot Study with Mexican and Caribbean Workers.

    Science.gov (United States)

    Narushima, Miya; McLaughlin, Janet; Barrett-Greene, Jackie

    2016-04-01

    Every year Canada hosts approximately 40,000 temporary foreign migrant farmworkers (MFWs). They are predominantly Mexican and Caribbean married men or single mothers who leave their families for months at a time over a span of many years. This pilot study investigated their knowledge about HIV/AIDS, attitudes towards condoms and their use, and perceived barriers to accessing sexual health services. A survey (n = 103) and four focus groups (n = 21) were conducted in Ontario's Niagara Region. The results suggest that MFWs commonly face vulnerabilities to HIV/AIDS, STIs and other sexual health issues due to personal, social-cultural, environmental and structural factors. The findings highlight the need for increasing culturally and gender sensitive sexual health education and harm reduction outreach and providing information about local health care systems and resources for MFWs. The study also calls for further community-based research and actions to reduce MFWs' perceived access barriers to health care services.

  19. 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 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.

  20. Building the capacity of health authorities to influence land use and transportation planning: Lessons learned from the Healthy Canada by Design CLASP Project in British Columbia.

    Science.gov (United States)

    Miro, Alice; Perrotta, Kim; Evans, Heather; Kishchuk, Natalie A; Gram, Claire; Stanwick, Richard S; Swinkels, Helena M

    2014-08-06

    The main objective of the Healthy Canada by Design CLASP Initiative in British Columbia (BC) was to develop, implement and evaluate a capacity-building project for health authorities. The desired outcomes of the project were as follows: 1) increased capacity of the participating health authorities to productively engage in land use and transportation planning processes; 2) new and sustained relationships or collaborations among the participating health authorities and among health authorities, local governments and other built environment stakeholders; and 3) indication of health authority influence and/or application of health evidence and tools in land use and transportation plans and policies. This project was designed to enhance the capacity of three regional health authorities, namely Fraser Health, Island Health and Vancouver Coastal Health, and their staff. These were considered the project's participants. The BC regions served by the three health authorities cover the urban, suburban and rural spectrum across relatively large and diverse geographic areas. The populations have broad ranges in socio-economic status, demographic profiles and cultural and political backgrounds. The Initiative provided the three health authorities with a consultant who had several years of experience working on land use and transportation planning. The consultant conducted situational assessments to understand the baseline knowledge and skill gaps, assets and objectives for built environment work for each of the participating health authorities. On the basis of this information, the consultant developed customized capacity-building work plans for each of the health authorities and assisted them with implementation. Capacity-building activities were as follows: researching health and built environment strategies, policies and evidence; transferring health evidence and promising policies and practices from other jurisdictions to local planning contexts; providing training and

  1. Politics and partnerships: challenges and rewards of partnerships in workplace health research in the healthcare sector of British Columbia, Canada.

    Science.gov (United States)

    Yassi, Annalee; Tomlin, Katrina; Sidebottom, Claire; Rideout, Karen; De Boer, Henrietre

    2004-01-01

    In British Columbia (BC), Canada, a partnership of researchers, healthcare employers, and healthcare unions reduced high injury rates through examining determinants of healthy workplaces and designing, implementing, and evaluating interventions. Over 51 million dollars (Canadian) was saved from the BC healthcare budget over two years, largely attributable to the collaborative effort. Challenges and rewards of the process were determined from interviews and workshops with researchers and community stakeholders, and by obtaining direct input to this report. Challenges included maintaining communication and trust between partners, preserving partnerships during restructuring and labor disputes, and maintaining involvement and support of front-line workers and senior management. As all partners recognized the importance of the research agenda, the stakeholders remained committed to working through the challenges, and have consequently achieved considerable success.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Amanda J. Sheppard

    2012-07-01

    Full Text Available 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.

  4. Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada.

    Science.gov (United States)

    Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate

    2016-10-01

    Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth.

  5. Facilitators and barriers to occupational health and safety in small and medium-sized enterprises: a descriptive exploratory study in Ontario, Canada.

    Science.gov (United States)

    Nowrouzi, Behdin; Gohar, Basem; Nowrouzi-Kia, Behnam; Garbaczewska, Martyna; Chapovalov, Olena; Myette-Côté, Étienne; Carter, Lorraine

    2016-09-01

    The purpose of this particular study was to test a newly created instrument in describing the facilitators and barriers to occupational health and safety in small and medium-sized enterprises (SMEs) in Ontario, Canada. A cross-sectional design was used to identify the occupational health and safety culture of SMEs in public and private sectors in Ontario. A total of 153 questionnaires were completed. The majority of respondents were female (84%) with a mean age of 49.8 years (SD 10.6). Seventy-four percent were supervisors. Seventy percent of respondents were from the private sector while 30% derived from the public sector including healthcare, community services, and non-profit organizations. Further, conducting regular external safety inspections of the workplace was found to be statistically associated with a safe work environment 2.88 95% CI [1.57, 5.27]. Strategies and training opportunities that focus on how to adapt occupational health and safety legislation to the nature and diversity of SMEs are recommended. Furthermore, employers may use such information to improve safety in their SMEs, while researchers can hopefully use such evidence to develop interventions that are applicable to meeting the occupational health and safety needs of SMEs.

  6. 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.

  7. Describing the linkages of the immigration, refugees and citizenship Canada permanent resident data and vital statistics death registry to Ontario's administrative health database.

    Science.gov (United States)

    Chiu, Maria; Lebenbaum, Michael; Lam, Kelvin; Chong, Nelson; Azimaee, Mahmoud; Iron, Karey; Manuel, Doug; Guttmann, Astrid

    2016-10-21

    Ontario, the most populous province in Canada, has a universal healthcare system that routinely collects health administrative data on its 13 million legal residents that is used for health research. Record linkage has become a vital tool for this research by enriching this data with the Immigration, Refugees and Citizenship Canada Permanent Resident (IRCC-PR) database and the Office of the Registrar General's Vital Statistics-Death (ORG-VSD) registry. Our objectives were to estimate linkage rates and compare characteristics of individuals in the linked versus unlinked files. We used both deterministic and probabilistic linkage methods to link the IRCC-PR database (1985-2012) and ORG-VSD registry (1990-2012) to the Ontario's Registered Persons Database. Linkage rates were estimated and standardized differences were used to assess differences in socio-demographic and other characteristics between the linked and unlinked records. The overall linkage rates for the IRCC-PR database and ORG-VSD registry were 86.4 and 96.2 %, respectively. The majority (68.2 %) of the record linkages in IRCC-PR were achieved after three deterministic passes, 18.2 % were linked probabilistically, and 13.6 % were unlinked. Similarly the majority (79.8 %) of the record linkages in the ORG-VSD were linked using deterministic record linkage, 16.3 % were linked after probabilistic and manual review, and 3.9 % were unlinked. Unlinked and linked files were similar for most characteristics, such as age and marital status for IRCC-PR and sex and most causes of death for ORG-VSD. However, lower linkage rates were observed among people born in East Asia (78 %) in the IRCC-PR database and certain causes of death in the ORG-VSD registry, namely perinatal conditions (61.3 %) and congenital anomalies (81.3 %). The linkages of immigration and vital statistics data to existing population-based healthcare data in Ontario, Canada will enable many novel cross-sectional and longitudinal studies to

  8. Mexico-Canada Knowledge Translation Partnership | IDRC ...

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

    Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and Caribbean Zika Virus ...

  9. 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.

  10. 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

  11. Integrated spatial health assessment of yellow perch (Perca flavescens) populations from the St. Lawrence River (QC, Canada), part B: cellular and transcriptomic effects.

    Science.gov (United States)

    Bruneau, Audrey; Landry, Catherine; Giraudo, Maeva; Douville, Mélanie; Brodeur, Philippe; Boily, Monique; Gagnon, Pierre; Houde, Magali

    2016-09-01

    Multi-biological level assessments have become great tools to evaluate the health of aquatic ecosystems. Using this approach, a complementary study was designed to evaluate the health of yellow perch (Perca flavescens) populations in the St. Lawrence River (Quebec, Canada). In the present study, stress responses were compared at the transcriptomic, cellular, and tissue levels in yellow perch collected at six sites along the river: Lake St. François, Lake St. Louis (north and south), Beauregard Island and Lake St. Pierre (north and south). These results complement the physiological and chemical parameters as well as pathogen infection investigated in a companion paper published in the present issue. Thiobarbituric acid reactive substance (TBARS) analyses indicated the presence of oxidative stress in fish collected in the southern part of Lake St. Louis and at the downstream sites of Lake St. Pierre. High lipid peroxidation levels were found in the muscle of yellow perch caught at Beauregard Island, located downstream of the Montreal's wastewater treatment plant, suggesting an impact of the municipal effluent on redox homeostasis. Transcriptomic results indicated the down-regulation of genes related to lipid, glucose, and retinoid in southern Lake St. Pierre as well as a decrease in retinoid storage. Overall, biochemical and molecular markers indicated that the health status of yellow perch followed a decreasing gradient from upstream to downstream of the St. Lawrence River. This gradient is representative of the cumulative negative impacts of human activities on water and habitat quality along the river.

  12. Distribution of Ticks and the Risk of Lyme Disease and Other Tick-Borne Pathogens of Public Health Significance in Ontario, Canada.

    Science.gov (United States)

    Clow, Katie M; Ogden, Nicholas H; Lindsay, L Robbin; Michel, Pascal; Pearl, David L; Jardine, Claire M

    2016-04-01

    Over the past two decades, the northward spread of Ixodes scapularis across Ontario, Canada, has accelerated and the risk of Lyme disease has increased. Active surveillance is a recognized and effective method for detecting reproducing populations of I. scapularis. In this study, we conducted field sampling consistent with an active surveillance approach from May to October 2014 at 104 sites in central, eastern, and southern Ontario to determine the current distribution of I. scapularis and other tick species, and enhance our understanding of the geographic risk associated with Borrelia burgdorferi and other tick-borne pathogens of public health significance in this region. I. scapularis was present at 20 of the 104 sites visited. Individuals of the tick species Dermacentor variabilis, Haemaphysalis leporispalustris, and Ixodes dentatus were also collected. I. scapularis was positive by PCR for B. burgdorferi at five sites. These sites formed a significant spatial cluster in eastern Ontario. No ticks were PCR positive for Borrelia miyamotoi, Anaplasma phagocytophilum, and Babesia microti. This study provides an up-to-date picture of the distribution of I. scapularis and other tick species, and the risk of B. burgdorferi and other pathogens of public health significance in central, eastern, and southern Ontario. This information may allow for more effective surveillance efforts and public health interventions for Lyme disease and other tick-borne diseases in this region.

  13. Communities of practice as a professional and organizational development strategy in local public health organizations in Quebec, Canada: an evaluation model.

    Science.gov (United States)

    Richard, Lucie; Chiocchio, François; Essiembre, Hélène; Tremblay, Marie-Claude; Lamy, Geneviève; Champagne, François; Beaudet, Nicole

    2014-02-01

    Communities of practice (CoPs) are among the professional development strategies most widely used in such fields as management and education. Though the approach has elicited keen interest, knowledge pertaining to its conceptual underpinnings is still limited, thus hindering proper assessment of CoPs' effects and the processes generating the latter. To address this shortcoming, this paper presents a conceptual model that was developed to evaluate an initiative based on a CoP strategy: Health Promotion Laboratories are a professional development intervention that was implemented in local public health organizations in Montreal (Quebec, Canada). The model is based on latest theories on work-group effectiveness and organizational learning and can be usefully adopted by evaluators who are increasingly called upon to illuminate decision-making about CoPs. Ultimately, validation of this conceptual model will help advance knowledge and practice pertaining to CoPs as well as professional and organizational development strategies in public health. Copyright © 2014 Longwoods Publishing.

  14. 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.

  15. 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…

  16. All projects related to canada | Page 15 | IDRC - International ...

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

    Topic: INFORMATION SYSTEMS, DATA COLLECTING, HEALTH STATISTICS, HEALTH PLANNING, PRIMARY HEALTH CARE, COMMUNITY PARTICIPATION. Region: Nigeria, South of Sahara, United States, Canada, Sweden, South Africa. Program: Maternal and Child Health. Total Funding: CA$ 17,397,789.00.

  17. Readability of Ebola Information on Websites of Public Health Agencies, United States, United Kingdom, Canada, Australia, and Europe.

    Science.gov (United States)

    Castro-Sánchez, Enrique; Spanoudakis, Elpiniki; Holmes, Alison H

    2015-07-01

    Public involvement in efforts to control the current Ebola virus disease epidemic requires understandable information. We reviewed the readability of Ebola information from public health agencies in non-Ebola-affected areas. A substantial proportion of citizens would have difficulty understanding existing information, which would potentially hinder effective health-seeking behaviors.

  18. Realizing Potential: Improving Interdisciplinary Professional/Paraprofessional Health Care Teams in Canada's Northern Aboriginal Communities through Education.

    Science.gov (United States)

    Minore, Bruce; Boone, Margaret

    2002-01-01

    To address shortages of health professional human resources and overcome cultural barriers, interdisciplinary health care teams in most northern Canadian aboriginal communities include paraprofessionals recruited locally. This paper identifies factors fundamental to effective team functioning, arguing for an extension of the information on…

  19. 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…

  20. 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…

  1. 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

    2018-02-01

    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. To investigate whether smokers' knowledge of toxic constituents and perceived smoking-related risks increased after adding this information to HWLs and how knowledge of toxic constituents is associated with perceptions of smoking-related risks. Data come from a longitudinal, online cohort of 4,621 adult smokers surveyed every 4 months from September 2012 (Wave 1) to January 2014 (Wave 5) in Australia, Canada, and Mexico, with the United States being surveyed from Waves 2 to 5. Generalized estimating equation models estimated the association between perceived smoking-related risk at follow-up and prior wave knowledge of toxic constituents, adjusting for attention to HWLs, sociodemographics, and smoking-related characteristics. Between 2012 and 2014, knowledge of toxic constituents increased in Australia, Canada, and Mexico ( p information about toxic constituents on prominent HWLs not only increases smoker's knowledge of toxic constituents, but that it may also reinforce the effects of HWL messages about specific, smoking-related health outcomes.

  2. 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

  3. 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.

  4. 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

  5. Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

    Science.gov (United States)

    Landry, Michel D; Raman, Sudha; Al-Hamdan, Elham

    2010-07-01

    The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.

  6. 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

  7. 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)

    2016-01-01

    Background 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. Objective 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. Methods 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. Results 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. Conclusions Schools’ preference of the asklepian over the caduceus confirmed

  8. 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

  9. Rural-urban migration patterns and mental health diagnoses of adolescents and young adults in British Columbia, Canada: a case-control study

    Directory of Open Access Journals (Sweden)

    D'Angiulli Amedeo

    2010-05-01

    those not migrating between rural communities. No differences were found for diagnoses of neurotic disorders, personality disorder, alcohol dependence, and nondependent drug abuse. Conclusions This study provides some compelling evidence of the protective role of rural environments in the development of specific mental health conditions (i.e., depression, adjustment reaction, and acute reaction to stress among the children of sawmill workers in Western Canada.

  10. 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

  11. 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.

  12. 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.

  13. Use of concurrent mixed methods combining concept mapping and focus groups to adapt a health equity tool in Canada.

    Science.gov (United States)

    Guichard, Anne; Tardieu, Émilie; Dagenais, Christian; Nour, Kareen; Lafontaine, Ginette; Ridde, Valéry

    2017-04-01

    The aim of this project was to identify and prioritize a set of conditions to be considered for incorporating a health equity tool into public health practice. Concept mapping and focus groups were implemented as complementary methods to investigate the conditions of use of a health equity tool by public health organizations in Quebec. Using a hybrid integrated research design is a richer way to address the complexity of questions emerging from intervention and planning settings. This approach provides a deeper, operational, and contextualized understanding of research results involving different professional and organizational cultures, and thereby supports the decision-making process. Concept mapping served to identify and prioritize in a limited timeframe the conditions to be considered for incorporation into a health equity tool into public health practices. Focus groups then provided a more refined understanding of the barriers, issues, and facilitating factors surrounding the tools adoption, helped distinguish among participants' perspectives based on functional roles and organizational contexts, and clarified some apparently contradictory results from the concept map. The combined use of these two techniques brought the strengths of each approach to bear, thereby overcoming some of the respective limitations of concept mapping and focus groups. This design is appropriate for investigating targets with multiple levels of complexity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Nurse-led health promotion interventions improve quality of life in frail older home care clients: lessons learned from three randomized trials in Ontario, Canada.

    Science.gov (United States)

    Markle-Reid, Maureen; Browne, Gina; Gafni, Amiram

    2013-02-01

    This paper explores the lessons learned from a series of three randomized controlled trials that included 498 community-living frail older adults (≥65 years) using home care services in Southern Ontario, Canada. Each study was designed to evaluate the effectiveness of different multi-component nurse-led health promotion and disease prevention (HPDP) interventions. The nurse-led HPDP interventions were 6- or 12-month multi-component and evidence-based strategies targeting known risk factors for functional decline and frailty. Across the three studies, a common approach was used to measure the change in health-related quality of life (HRQOL) (SF-36) and the costs of use of health services (Health and Social Services Utilization Inventory) from baseline to the end of the intervention. The main lesson learned from the three studies is that nurse-led HPDP interventions for frail older home care clients provide greater improvements in HRQOL compared with usual home care. Such approaches are highly acceptable to this population and can be implemented using existing home care resources. Nurse-led HPDP interventions should include multiple home visits, multidimensional screening and assessment, multi-component evidence-based HPDP strategies, intensive case management, inter-professional collaboration, providers with geriatric training and experience, referral to and coordination of community services, and theory use. The results of the three trials underscore the need to reinvest in nurse-led HPDP interventions in home care to optimize HRQOL and promote ageing in place in the target population of frail older adults. More studies are needed to evaluate the effectiveness of additional nurse-led HPDP interventions in other contexts and settings. © 2011 Blackwell Publishing Ltd.

  15. Systematic approach to evaluating and confirming the utility of a suite of national health system performance (HSP) indicators in Canada: a modified Delphi study.

    Science.gov (United States)

    Fekri, Omid; Leeb, Kira; Gurevich, Yana

    2017-04-12

    Evaluating an existing suite of health system performance (HSP) indicators for continued reporting using a systematic criteria-based assessment and national consensus conference. Modified Delphi approach with technical and leadership groups, an online survey of stakeholders and convening a national consensus conference. A national health information steward, the Canadian Institute for Health Information (CIHI). A total of 73 participants, comprised 61 conference attendants/stakeholders from across Canada and 12 national health information steward staff. Indicator dispositions of retention, additional stakeholder consultation, further redevelopment or retirement. 4 dimensions (usability, importance, scientific soundness and feasibility) typically used to select measures for reporting were expanded to 18 criteria grouped under the 4 dimensions through a process of research and testing. Definitions for each criterion were developed and piloted. Once the definitions were established, 56 of CIHI's publicly reported HSP indicators were evaluated against the criteria using modified Delphi approaches. Of the 56 HSP indicators evaluated, 9 measures were ratified for retirement, 7 were identified for additional consultation and 3 for further research and development. A pre-Consensus Conference survey soliciting feedback from stakeholders on indicator recommendations received 48 responses (response rate of 79%). A systematic evaluation of HSP indicators informed the development of objective recommendations for continued reporting. The evaluation was a fruitful exercise to identify technical considerations for calculating indicators, furthering our understanding of how measures are used by stakeholders, as well as harmonising actions that could be taken to ensure relevancy, reduce indicator chaos and build consensus with stakeholders. 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/.

  16. Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada

    Directory of Open Access Journals (Sweden)

    Alter David A

    2012-08-01

    Full Text Available Abstract Background The extent to which uncomplicated obesity among an otherwise healthy middle-aged population is associated with higher longitudinal health-care expenditures remains unclear. Methods To examine the incremental long-term health service expenditures and outcomes associated with uncomplicated obesity, 9398 participants of the 1994–1996 National Population Health Survey were linked to administrative data and followed longitudinally forward for 11.5 years to track health service utilization costs and death. Patients with pre-existing heart disease, those who were 65 years of age and older, and those with self-reported body mass indexes of 2 at inception were excluded. Propensity-matching was used to compare obesity (+/− other baseline risk-factors and lifestyle behaviours with normal-weight healthy controls. Cost-analyses were conducted from the perspective of Ontario’s publicly-funded health care system. Results Obesity as an isolated risk-factor was not associated with significantly higher health-care costs as compared with normal weight matched controls (Canadian $8,294.67 vs. Canadian $7,323.59, P = 0.27. However, obesity in combination with other lifestyle factors was associated with significantly higher cumulative expenditures as compared with normal-weight healthy matched controls (CAD$14,186.81 for those with obesity + 3 additional risk-factors vs. CAD$7,029.87 for those with normal BMI and no other risk-factors, P  Conclusions The incremental health-care costs associated with obesity was modest in isolation, but increased significantly when combined with other lifestyle risk-factors. Such findings have relevance to the selection, prioritization, and cost-effective targeting of therapeutic lifestyle interventions.

  17. Interlocking oppressions: the effect of a comorbid physical disability on perceived stigma and discrimination among mental health consumers in Canada.

    Science.gov (United States)

    Bahm, Allison; Forchuk, Cheryl

    2009-02-01

    People living with mental health problems often face stigma and discrimination; however, there is a lack of research that examines how comorbid conditions affect this perceived stigma. This study sought to determine whether people who have a comorbid physical and psychiatric disability experience more stigma than those with only a psychiatric disability. It also looked at how perceived stigma and discrimination affect physical and mental health. A secondary analysis on data from interviews with 336 former and current clients of the mental health system in a mid-size Canadian city in 2005 was performed. Of these, 203 (60.4%) reported they had a psychiatric disability, 112 (33.0%) reported that they had a physical disability, with 74 reporting both a psychiatric and a physical disability. People with a self-reported psychiatric disability and a self-reported comorbid physical disability faced more overall perceived discrimination/stigma (P = 0.04), than those with a psychiatric disability alone. Perceived discrimination/stigma was positively correlated with psychiatric problem severity (P = 0.02), and negatively correlated with self-rated general health (P disability on the perceived stigma for those living with a mental illness, and also strengthen the knowledge that stigma and discrimination have a negative impact on health. Healthcare providers should recognise this negative impact and screen for these comorbid conditions. Policy-makers should take measures such as improving access to housing and employment services to help reduce stigma and discrimination against this particularly vulnerable group.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Municipal water quantities and health in Nunavut households: an exploratory case study in Coral Harbour, Nunavut, Canada.

    Science.gov (United States)

    Daley, Kiley; Castleden, Heather; Jamieson, Rob; Furgal, Chris; Ell, Lorna

    2014-01-01

    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. 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. 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. 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. The relatively low in-home water quantities observed in Coral Harbour, Nunavut, appear adequate for some families. Those living in overcrowded households, however, are accessing water in quantities more

  3. 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

  4. 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

    2015-03-13

    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. Matched population-based cross-sectional study. Ontario, Canada, where healthcare use data for 1999-2012 were linked to immigration data and area-based material deprivation scores. 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). 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. 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%, pdeprived circumstances was associated with greater use of mental health services, but increases were smaller for immigrants than for long-term residents. Immigrants used less mental health services than long-term residents. 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 immigrants

  5. Radiation Protection in Canada

    Science.gov (United States)

    Bird, P. M.

    1964-01-01

    The current status of radiation protection in Canada is discussed in the last of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. A radioactive fallout study program has been established involving the systematic collection of air and precipitation samples from 24 locations, soil samples from 23 locations, fresh-milk samples from 16 locations, wheat samples from nine areas and human-bone specimens from various hospitals throughout Canada. A whole-body-counting facility and a special study of fallout in Northern areas have also been initiated. For any age group, the highest average strontium-90 concentration in human bone so far reported has been less than four picocuries per gram of calcium compared with the maximum permissible level of 67 derived from the International Committee on Radiation Protection (ICRP) recommendations. By the end of 1963 a general downward trend of levels of radioactivity detected in other parts of the program has been observed. Programs to assess the contribution to the radiation exposure of members of the population from medical x-rays, nuclear reactor operations and natural background-radiation sources have also been described. The annual genetically significant dose from diagnostic x-ray examinations in Canadian public hospitals has been estimated to be 25.8 mrem. Results from the reactor-environment monitoring programs have not suggested the presence of radioactivity beyond that contributed from fallout. PMID:14143681

  6. Study Canada: An Overview.

    Science.gov (United States)

    Monahan, Robert L.; And Others

    The document presents the first of five units on Canada developed for classroom use in American secondary schools. This unit, an overview of Canada, offers a sequence of information sheets for students and class activity suggestions for teachers which use a comparative approach stressing an understanding of Canada from the viewpoints of both…

  7. 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…

  8. Health-related Quality of Life in Pediatric Patients With Chronic Hepatitis B Living in the United States and Canada.

    Science.gov (United States)

    Schwarzenberg, Sarah Jane; Ling, Simon C; Cloonan, Yona Keich; Lin, Hsing-Hua S; Evon, Donna M; Murray, Karen F; Rodriguez-Baez, Norberto; Rosenthal, Philip; Teckman, Jeffrey; Schwarz, Kathleen B

    2017-05-01

    The aim of the study was to determine whether selected sociodemographic and hepatitis B virus (HBV)-specific clinical factors are associated with health-related quality of life (HRQoL) among pediatric patients chronically infected with HBV. Children with chronic HBV enrolled in the Hepatitis B Research Network completed the Child Health Questionnaire at study entry. Caregivers of children 5 to <10 years completed the parent-reported form (CHQ-Parent Report Form); youth 10 to <18 years completed the child-reported CHQ-Child Report Form. We examined univariable associations of the Child Health Questionnaire scores with selected independent variables: sex, adoption status, maternal education, alanine aminotransferase (U/L), aspartate aminotransferase-to-platelet ratio index, and HBV-specific symptom count. A total of 244 participants (83 young children 5-<10 years, 161 youth 10-<18 years) were included, all HBV treatment-naïve. Among young children, increased alanine aminotransferase level was negatively associated with CHQ-Parent Report Form psychosocial summary t score (r = -0.28, P = 0.01). No other subscale comparisons for young children were statistically significant. Among youth, adoption was associated with better physical functioning and general health (P < 0.01). Higher maternal education was associated with better role/functioning-physical and -emotional scores (P < 0.05). Maternal education and adoption status were linked with adoption associated with higher maternal education. Increased symptom count in youth was associated with worse HRQoL in subscales measuring bodily pain, behavior, mental health, and self-esteem (P < 0.01). Although overall HRQoL is preserved in children with chronic HBV, some sociodemographic and HBV-related clinical factors were associated with impaired HRQoL in our pediatric patients at baseline. Measurement of HRQoL can focus resources on education and psychosocial support in children and families most in need.

  9. Estimating the number of coronary artery bypass graft and percutaneous coronary intervention procedures in Canada: a comparison of cardiac registry and Canadian Institute for Health Information data sources.

    Science.gov (United States)

    Gurevich, Yana; McFarlane, Anne; Morris, Kathleen; Jokovic, Aleksandra; Peterson, Gail M; Webster, Gregory K

    2010-01-01

    Provincial cardiac registries and the Canadian Institute for Health Information (CIHI) pan-Canadian administrative databases are invaluable tools for understanding Canadian cardiovascular health and health care. Both sources are used to enumerate cardiovascular procedures performed in Canada. To examine the level of agreement between provincial cardiac registry data and CIHI data regarding procedural counts for coronary artery bypass grafts (CABGs) and percutaneous coronary interventions (PCIs). CIHI staff obtained CABG and PCI counts from seven provinces that, in 2004, performed these procedures and had a cardiac registry (ie, British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Nova Scotia, and Newfoundland and Labrador). Structured mail questionnaires, and e-mail and telephone follow-ups elicited information from a designated registry respondent. The CIHI derived its counts of CABG and PCI procedures by applying the geographical boundaries, procedural definitions and analytical case criteria used by the cardiac registries to CIHI inpatient and day procedure databases. Steps were taken to reduce double-counting procedures when combining results from the two CIHI databases. Two measures were calculated: the absolute difference between registry and CIHI estimates, and the per cent agreement between estimates from the two sources. All seven cardiac registries identified as eligible for the study participated. Agreement was high between the two sources for CABG (98.8%). For PCI, the level of agreement was high (97.9%) when CIHI sources were supplemented with day procedure data from Alberta. The high level of agreement between cardiac registry and CIHI administrative data should increase confidence in estimates of CABG and PCI counts derived from these sources.

  10. 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.

  11. Can we move beyond burden and burnout to support the health and wellness of family caregivers to persons with dementia? Evidence from British Columbia, Canada.

    Science.gov (United States)

    Lilly, Meredith B; Robinson, Carole A; Holtzman, Susan; Bottorff, Joan L

    2012-01-01

    After more than a decade of concerted effort by policy-makers in Canada and elsewhere to encourage older adults to age at home, there is recognition that the ageing-in-place movement has had unintended negative consequences for family members who care for seniors. This paper outlines findings of a qualitative descriptive study to investigate the health and wellness and support needs of family caregivers to persons with dementia in the Canadian policy environment. Focus groups were conducted in 2010 with 23 caregivers and the health professionals who support them in three communities in the Southern Interior of British Columbia. Thematic analysis guided by the constant comparison technique revealed two overarching themes: (1) forgotten: abandoned to care alone and indefinitely captures the perceived consequences of caregivers' failed efforts to receive recognition and adequate services to support their care-giving and (2) unrealistic expectations for caregiver self-care relates to the burden of expectations for caregivers to look after themselves. Although understanding about the concepts of caregiver burden and burnout is now quite developed, the broader sociopolitical context giving rise to these negative consequences for caregivers to individuals with dementia has not improved. If anything, the Canadian homecare policy environment has placed caregivers in more desperate circumstances. A fundamental re-orientation towards caregivers and caregiver supports is necessary, beginning with viewing caregivers as a critical health human resource in a system that depends on their contributions in order to function. This re-orientation can create a space for providing caregivers with preventive supports, rather than resorting to costly patient care for caregivers who have reached the point of burnout and care recipients who have been institutionalised. © 2011 Blackwell Publishing Ltd.

  12. Pharmacy information systems in Canada.

    Science.gov (United States)

    Barnett, Jeff; Jennings, Heather

    2009-01-01

    The goal of Canada Health Infoway is to provide at least 50% of all Canadians with an electronic health record (EHR) by 2010. The goal of the Infoway Drug Information Systems Program is to develop an interoperable drug information system that will keep each patient's medication history: prescribed and dispensed drugs, allergies, ongoing drug treatment, etc. Drug and drug-interaction checks will be performed automatically and added to the patients' drug profiles. Physicians and pharmacists will be supplied with data to support appropriate and accurate prescribing and dispensing, thereby avoiding adverse drug interactions and drug-related deaths [1]. This paper describes Canadian developments in pharmacy eHealth. It presents the results of the Pharmacy Informatics Pharmacy Special Networks (PSN) survey about computer systems used in hospital pharmacies across Canada including information concerning Computerized Provider Order Entry (CPOE) systems deployed; which may reduce the number of errors in orders.

  13. The effect of health care reform on academic medicine in Canada. Editorial Committee of the Canadian Institute for Academic Medicine.

    OpenAIRE

    Hollenberg, C H

    1996-01-01

    Although Canadian health care reform has constrained costs and improved efficiency, it has had a profound and mixed effect on Canadian academic medicine. Teaching hospitals have been reduced in number and size, and in patient programs have shifted to ambulatory and community settings. Specialized care programs are now multi-institutional and multidisciplinary. Furthermore, the influence of regional planning bodies has grown markedly. Although these changes have likely improved clinical servic...

  14. Identifying Distinct Geographic Health Service Environments in British Columbia, Canada: Cluster Analysis of Population-Based Administrative Data

    OpenAIRE

    Lavergne, M. Ruth

    2016-01-01

    Definitions of ?urban? and ?rural? developed for general purposes may not reflect the organization and delivery of healthcare. This research used cluster analysis to group Local Health Areas based on the distribution of healthcare spending across service categories. Though total spending was similar, the metropolitan areas of Vancouver and Victoria were identified as distinct from non-metropolitan and remote communities, based on the distribution of healthcare spending alone. Non-metropolitan...

  15. "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

  16. Toxoplasmosis and Toxocariasis: An Assessment of Human Immunodeficiency Virus Comorbidity and Health-Care Costs in Canada

    OpenAIRE

    Schurer, Janna M.; Rafferty, Ellen; Schwandt, Michael; Zeng, Wu; Farag, Marwa; Jenkins, Emily J.

    2016-01-01

    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) ca...

  17. 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.

  18. The impact of antidepressant treatment on population health: synthesis of data from two national data sources in Canada

    Directory of Open Access Journals (Sweden)

    Patten Scott B

    2004-11-01

    Full Text Available Abstract Background In randomized, controlled trials, antidepressant medications have been shown to reduce the duration of major depressive episodes and to reduce the frequency of relapse during long-term treatment. The epidemiological impact of antidepressant use on episode duration and relapse frequency, however, has not been described. Methods Data from two Canadian general health surveys were used in this analysis: the National Population Health Survey (NPHS and the Canadian Community Health Survey (CCHS. The NPHS is a longitudinal study that collected data between 1994 and 2000. These longitudinal data allowed an approximation of episode incidence to be calculated. The cross-sectional CCHS allowed estimation of episode duration. The surveys used the same sampling frame and both incorporated a Short Form version of the Composite International Diagnostic Interview. Results Episodes occurring in antidepressant users lasted longer than those in non-users. The apparent incidence of major depressive episodes among those taking antidepressants was higher than that among respondents not taking antidepressants. Changes in duration and incidence over the data collection interval were not observed. Conclusions The most probable explanation for these results is confounding by indication and/or severity: members of the general population who are taking antidepressants probably have more highly recurrent and more severe mood disorders. In part, this may have been due to the use of a brief predictive diagnostic interview, which may be prone to detection of sub-clinical cases. Whereas antidepressant use increased considerably over the data-collection period, differences in episode incidence and duration over time were not observed. This suggests that the impact of antidepressant medications on population health may have been less than expected.

  19. 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

  20. A social network-informed latent class analysis of patterns of substance use, sexual behavior, and mental health: Social Network Study III, Winnipeg, Manitoba, Canada.

    Science.gov (United States)

    Hopfer, Suellen; Tan, Xianming; Wylie, John L

    2014-05-01

    We assessed whether a meaningful set of latent risk profiles could be identified in an inner-city population through individual and network characteristics of substance use, sexual behaviors, and mental health status. Data came from 600 participants in Social Network Study III, conducted in 2009 in Winnipeg, Manitoba, Canada. We used latent class analysis (LCA) to identify risk profiles and, with covariates, to identify predictors of class. A 4-class model of risk profiles fit the data best: (1) solitary users reported polydrug use at the individual level, but low probabilities of substance use or concurrent sexual partners with network members; (2) social-all-substance users reported polydrug use at the individual and network levels; (3) social-noninjection drug users reported less likelihood of injection drug and solvent use; (4) low-risk users reported low probabilities across substances. Unstable housing, preadolescent substance use, age, and hepatitis C status predicted risk profiles. Incorporation of social network variables into LCA can distinguish important subgroups with varying patterns of risk behaviors that can lead to sexually transmitted and bloodborne infections.

  1. Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada-a qualitative study.

    Science.gov (United States)

    Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

    2014-06-02

    decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Rural-urban disparities in the management and health issues of chronic diseases in Quebec (Canada) in the early 2000s.

    Science.gov (United States)

    Vanasse, Alain; Courteau, Josiane; Cohen, Alan A; Orzanco, Maria Gabriela; Drouin, Catherine

    2010-01-01

    The 'Commission on the Future of Health Care in Canada' recognized that people living in rural and remote areas of Canada are at a disadvantage in health status, access to care and health professionals, and it considers the fight against these problems as a national priority. Although some attention has been paid to the prevalence of chronic diseases, very few studies have studied specifically the management and health issues in populations with chronic diseases in relation to rurality. The objective of this study was to describe systematic gaps across rural and urban populations in incidence, mortality, morbidity, material and human resources utilization, and drug management for three important chronic diseases: atherosclerosis, osteoporosis and diabetes. Three retrospective population-based cohort studies were used. Three study populations were selected: an atherosclerotic population including patients newly hospitalized for a myocardial infarction (MI), an osteoporotic population including the at risk population who have suffered from a fragility fracture (FF) and, finally, a diabetic population that includes only incident cases of diabetes patients. For each of the three chronic diseases, variables were selected and classified in six categories: incidence, mortality, morbidity, material resources utilization, physician consultation and drug treatment. The Statistical Area Classification (SAC) was used as the rurality definition and contains six categories including two urban areas--Census Metropolitan Areas (CMA), or metropolitan areas, and Census Agglomeration (CA), or small towns--and four rural areas: Strong, Moderate, Weak and No Metropolitan influenced zones (MIZ), depending on the proportion of the workforce that commutes to urban areas. Each disease-related variable was described using age- and sex-adjusted rates. For comparing rates between rurality classes, the adjusted relative risks were calculated using the CMA as the reference group. The X2 was

  3. Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.

    Science.gov (United States)

    Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan

    2014-01-01

    The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued. © 2013.

  4. Komentovaný překlad: "Les enfants et les drogues : guide de prévention pour les parents (Alberta Health Services, Canada, AHS/RCMP 2008, s. 5-27)

    OpenAIRE

    Pěchoučková, Kamila

    2017-01-01

    The bachelor thesis Commented translation: Les enfants et les drogues : guide de prévention pour les parents (Alberta Health Services, Canada, AHS/RCMP 2008) consists of two parts. First part introduces translation of a French text to Czech. Second part focuses on a commentary of this translation. Firstly, the commentary includes a translation analysis focused on extratextual and intratextual factors. Next part deals with the main translation problems and their solutions. The last part of com...

  5. 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...

  6. 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.

  7. Demographic and urban form correlates of healthful and unhealthful food availability in Montréal, Canada.

    Science.gov (United States)

    Daniel, Mark; Kestens, Yan; Paquet, Catherine

    2009-01-01

    This study sought to extend previous analyses of food insecurity in Montreal by examining the relationship between neighbourhood sociodemographic and urban form variables and sources of food both unhealthful (fast-food outlets, FFO) and healthful (stores selling fruits and vegetables, FVS). Densities of FFO and FVS were computed for 862 Census tract areas (CTA) (defined as census tract with a 1-km buffer around its limits) for the Montréal Census Metropolitan Area (CMA). Predictor variables included CTA socio-demographic characteristics reflecting income, household structure, language, and education, and urban form measures, specifically, densities of local roads, main roads, expressways and highways. Food source densities were regressed on CTA characteristics using stepwise regression. Socio-demographic and urban form measures explained 60% and 73% of the variance in densities of FFO and FVS, respectively. FFO were more prevalent in CTA with higher proportions of full-time students and households speaking neither French nor English; lower proportions of married individuals, children and older adults; and more high-traffic roads. FVS were more prevalent in CTA with higher proportions of single residents, university-educated residents and households speaking neither French nor English; lower proportion of French-speakers; and more local roads. Median household income was not related to the density of FFO or FVS. The availability of healthful and unhealthful food varies across the Montréal CMA. Areas with lower education and more French-speaking households have a lesser availability of FVS. The association of FFO with high-traffic roadways and areas with high school attendance suggests a point for intervention via commercial zoning changes.

  8. Costs of health services utilization of people with fetal alcohol spectrum disorder by sex and age group in Alberta, Canada.

    Science.gov (United States)

    Thanh, Nguyen Xuan; Jonsson, Egon

    2014-01-01

    To estimate the annual health services utilization (HSU) cost per person with FASD by sex and age; the lifetime HSU cost per person with FASD by sex, and the annual HSU cost of FASD for Alberta by sex. The HSU costs of FASD including physician, outpatient, and inpatient services were described by sex and age. The costs per person-year were estimated by multiplying the average number of hospitalizations, outpatient visits, and physician visits per person-year by the average cost of each service. The annual HSU cost of FASD for Alberta was estimated by multiplying the annual HSU cost per person with FASD by the number of people living with FASD in Alberta in 2012. The lifetime HSU cost per person with FASD was estimated by sex for several lifespans ranging from 10 to 70 years. The annual cost of HSU for people with FASD in Alberta was $259 million, of which FAS accounted for 26%. The annual HSU cost per person with FAS and FASD were $6,200 and $5,600, respectively. The incremental annual HSU cost per person with FAS is $4,100 and with FASD is $3,400 as compared to the general population. The lifetime (70 years) HSU cost per person with FAS was $506,000 and with FASD was $245,000. Males had higher HSU costs than females. HSU costs of FAS and FASD varied greatly by age group. The findings suggest that FASD is a public health issue in Alberta and can be used for economic evaluations of FASD intervention and/or prevention in the province.

  9. Estimation of the health impact and cost-effectiveness of influenza vaccination with enhanced effectiveness in Canada.

    Directory of Open Access Journals (Sweden)

    David N Fisman

    Full Text Available INTRODUCTION: The propensity for influenza viruses to mutate and recombine makes them both a familiar threat and a prototype emerging infectious disease. Emerging evidence suggests that the use of MF59-adjuvanted vaccines in older adults and young children enhances protection against influenza infection and reduces adverse influenza-attributable outcomes compared to unadjuvanted vaccines. The health and economic impact of such vaccines in the Canadian population are uncertain. METHODS: We constructed an age-structured compartmental model simulating the transmission of influenza in the Canadian population over a ten-year period. We compared projected health outcomes (quality-adjusted life years (QALY lost, costs, and incremental cost-effectiveness ratios (ICERs for three strategies: (i current use of unadjuvanted trivalent influenza vaccine; (ii use of MF59-adjuvanted influenza vaccine adults ≥65 in the Canadian population, and (iii adjuvanted vaccine used in both older adults and children aged < 6. RESULTS: In the base case analysis, use of adjuvanted vaccine in older adults was highly cost-effective (ICER = $2111/QALY gained, but such a program was "dominated" by a program that extended the use of adjuvanted vaccine to include young children (ICER = $1612/QALY. Results were similar whether or not a universal influenza immunization program was used in other age groups; projections were robust in the face of wide-ranging sensitivity analyses. INTERPRETATION: Based on the best available data, it is projected that replacement of traditional trivalent influenza vaccines with MF59-adjuvanted vaccines would confer substantial benefits to vaccinated and unvaccinated individuals, and would be economically attractive relative to other widely-used preventive interventions.

  10. 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.

  11. Health-related quality-of-life and receipt of women-centered HIV care among women living with HIV in Canada.

    Science.gov (United States)

    Carter, Allison; Loutfy, Mona; de Pokomandy, Alexandra; Colley, Guillaume; Zhang, Wendy; Sereda, Paul; O'Brien, Nadia; Proulx-Boucher, Karène; Nicholson, Valerie; Beaver, Kerrigan; Kaida, Angela

    2017-04-07

    We measured health-related quality of life (HRQOL) using the SF-12 among women living with HIV (WLWH) in Canada between August 2013 and May 2015. We investigated differences by perceived receipt of women-centered HIV care (WCHC), assessed using an evidence-based definition with a 5-point Likert item: "Overall, I think that the care I have received from my HIV clinic in the last year has been women-centered" (dichotomized into agree vs. disagree/neutral). Of 1308 participants, 26.3 percent were from British Columbia, 48.2 percent from Ontario, and 25.5 percent from Québec. The median age was 43 years (interquartile range = 36-51). Most (42.2 percent) were White, 29.4 percent African/Caribbean/Black, and 21.0 percent Indigenous. Overall, 53.4 percent perceived having received WCHC. Mean physical and mental HRQOL scores were 43.8 (standard deviation [SD] = 14.4) and 41.7 (SD = 14.2), respectively. Women perceiving having received WCHC had higher mean physical (44.7; SD = 14.0) and mental (43.7; SD = 14.1) HRQOL scores than those not perceiving having received WCHC (42.9; SD = 14.8 and 39.5; SD = 14.0, respectively; p < .001). In multivariable linear regression, perceived WCHC was associated with higher mental (β = 3.48; 95 percent confidence interval: 1.90, 5.06) but not physical HRQOL. Improving HRQOL among Canadian WLWH, which was lower than general population estimates, is needed, including examining the potential of WCHC as an effective model of clinical care.

  12. 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

  13. 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

  14. Health outcomes and the transition experience of HIV-infected adolescents after transfer to adult care in Québec, Canada.

    Science.gov (United States)

    Kakkar, Fatima; Van der Linden, Dimitri; Valois, Silvie; Maurice, Francois; Onnorouille, Marion; Lapointe, Normand; Soudeyns, Hugo; Lamarre, Valerie

    2016-07-26

    Little is known on outcomes after transition to adult care among adolescents with perinatal HIV infection. Though there is data from other chronic pediatric diseases suggesting increased morbidity and mortality following transfer to adult care, this has not well been studied among the first wave of survivors of perinatal HIV infection. The primary objective of this study was to determine outcomes after transition to adult care among a cohort of HIV-infected adolescents in Québec, Canada. Secondary objectives were to document participant experiences with the transition process, identify barriers to successful transition, and potential changes to improve the transition process. Clinic records were reviewed to identify all perinatally-infected youth who transitioned from the Centre Maternel et Infantile sur le Sida pediatric HIV clinic (Montreal) at age 18 to an adult care provider between 1999 and 2012. Transitioned patients were contacted using last available patient or parental listed phone number on hospital record, internet based telephone directory, or social media. A standardized questionnaire was administered by telephone or in-person interview, and copies of current medical records obtained from treating physicians. Forty-five patients were transferred between 1999 and 2012, among whom 25 consented to the study, eight were lost to follow-up, eight refused participation, and four were deceased. Overall 76 % of patients remained engaged in care, defined by at least one physician visit within 6 months of the interview. Over 50 % reported difficulty with adherence to their current drug regimens. At one-year post-transfer, there was a decrease in the proportion of patients with CD4 count >500 cells/mm(3) from 64 to 29 %, and a statistically significant decrease in absolute CD4 count (mean 370 vs 524 cells/mm(3), p = 0.04.). The majority (92 %) of participants felt that 18 was too young an age to transfer to adult care, and provided suggestions for

  15. 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.

  16. Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance

    Directory of Open Access Journals (Sweden)

    Angela Kaida

    2015-12-01

    Full Text Available Introduction: Women represent nearly one-quarter of the 71,300 people living with HIV in Canada. Within a context of widespread HIV-related stigma and discrimination and on-going risks to HIV disclosure, little is known about the influence of growing social, legal and public health surveillance of HIV on sexual activity and satisfaction of women living with HIV (WLWH. Methods: We analyzed baseline cross-sectional survey data for WLWH (≥16 years, self-identifying as women enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS, a multisite, longitudinal, community-based research study in British Columbia (BC, Ontario (ON and Quebec (QC. Sexual inactivity was defined as no consensual sex (oral or penetrative in the prior six months, excluding recently postpartum women (≤6 months. Satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women. Multivariable logistic regression analysis examined independent correlates of sexual inactivity. Results: Of 1213 participants (26% BC, 50% ON, 24% QC, median age was 43 years (IQR: 35, 50. 23% identified as Aboriginal, 28% as African, Caribbean and Black, 41% as White and 8% as other ethnicities. Heterosexual orientation was reported by 87% of participants and LGBTQ by 13%. In total, 82% were currently taking antiretroviral therapy (ART, and 77% reported an undetectable viral load (VL<40 copies/mL. Overall, 49% were sexually inactive and 64% reported being satisfied with their current sex lives, including 49% of sexually inactive and 79% of sexually active women (p<0.001. Sexually inactive women had significantly higher odds of being older (AOR=1.06 per year increase; 95% CI=1.05–1.08, not being in a marital or committed relationship (AOR=4.34; 95% CI=3.13–5.88, having an annual household income below $20,000 CAD (AOR: 1.44; 95% CI=1.08–1.92, and reporting high (vs. low HIV-related stigma (AOR=1.81; 95% CI=1.09–3.03. No independent

  17. Canada improving child nutrition in Vietnam | CRDI - Centre de ...

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

    14 déc. 2015 ... IDRC and Global Affairs Canada, through the Canadian International Food Security Research Fund (CIFSRF), are contributing $1.16 million to support researchers from Vietnam's National Institute of Nutrition and Canada's Ryerson University to implement proven methods to improve children's health.

  18. Canada-Latin America and the Caribbean Research Exchange ...

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

    Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and Caribbean Zika Virus ...

  19. Inaugural recipients of the Hopper-Bhatia Canada Fund | IDRC ...

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

    2018-01-31

    Jan 31, 2018 ... Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and ...

  20. All projects related to Canada | Page 10 | IDRC - International ...

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

    ... Nigeria, Senegal, Canada, Burkina Faso. Program: Maternal and Child Health. Total Funding: CA$ 2,600,000.00. Scaling up development, production of CBPP vaccine for cattle in Kenya. Project. This project will allow researchers from Canada and Kenya to field trial a vaccine for contagious bovine pleuropneumonia.

  1. 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, ...

  2. All projects related to Canada | Page 2 | IDRC - International ...

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

    2015-12-01

    Malignant brain tumours are the most common cause of death among children with cancer, but there is no known cure. This project will advance research in this important field. Start Date: December 1, 2015. Topic: BRAIN, MATERNAL AND CHILD HEALTH, CANCER, THERAPY, CANADA. Region: India, Canada, Israel.

  3. 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.

  4. All projects related to Canada | Page 17 | IDRC - International ...

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

    Project. Under "Healthy China 2020," universal basic healthcare coverage will be provided to all Chinese by 2020. Topic: CASE STUDIES, ACCESS TO HEALTH CARE, HEALTH SYSTEM, PUBLIC HEALTH, HEALTH POLICY. Region: China, Canada. Program: Maternal and Child Health. Total Funding: CA$ 1,874,950.00.

  5. Coeur en santé St-Henri--a heart health promotion programme in a low income, low education neighbourhood in Montreal, Canada: theoretical model and early field experience.

    Science.gov (United States)

    Paradis, G; O'Loughlin, J; Elliott, M; Masson, P; Renaud, L; Sacks-Silver, G; Lampron, G

    1995-10-01

    Coeur en santé St-Henri is a five year, community based, multifactorial, heart health promotion programme in a low income, low education neighbourhood in Montreal, Canada. The objectives of this programme are to improve heart-healthy behaviours among adults of St-Henri. This paper describes the theoretical model underlying programme development as well as our early field experience implementing interventions. The design of the intervention programme is based on a behaviour change model adapted from social learning theory, the reasoned action model, and the precede-proceed model. The Ottawa charter for health promotion provided the framework for the development of specific interventions. Each intervention is submitted to formative, implementation, and impact evaluations using simple and inexpensive methods. The target population consists of adults living in St-Henri, a neighbourhood of 23,360 residents. Because of costs constraints, the intervention strategy targets women more specifically. The community is one of the poorest in Canada with 46% of the population living below the poverty line and 20% being very poor. The age-sex adjusted ischaemic heart disease mortality in 1985-87 was 317 per 100,000 compared with 126 per 100,000 in an affluent adjacent neighbourhood. Thirty nine distinct interventions have been developed and tested in the community, eight related to tobacco, 10 to diet, seven to physical activity, and 14 which are multifactorial. The interventions include smoking cessation and healthy recipes contests, a menu labelling and healthy food discount programme in restaurants, a point of choice nutrition education campaign, healthy eating and smoking cessation workshops, a walking club, educational material, print and electronic media campaigns, heart health fairs, and community events. An integrated heart health promotion programme is feasible in low income urban neighbourhoods but not all interventions are successful. Such a programme requires

  6. Echinococcus multilocularis in Urban Coyotes, Alberta, Canada

    Science.gov (United States)

    Catalano, Stefano; Lejeune, Manigandan; Liccioli, Stefano; Verocai, Guilherme G.; Gesy, Karen M.; Jenkins, Emily J.; Kutz, Susan J.; Fuentealba, Carmen; Duignan, Padraig J.

    2012-01-01

    Echinococcus multilocularis is a zoonotic parasite in wild canids. We determined its frequency in urban coyotes (Canis latrans) in Alberta, Canada. We detected E. multilocularis in 23 of 91 coyotes in this region. This parasite is a public health concern throughout the Northern Hemisphere, partly because of increased urbanization of wild canids. PMID:23017505

  7. Canadian Public Health Laboratory Network laboratory Guidelines for the Use of Serological Tests (excluding point-of-care tests for the Diagnosis of Syphilis in Canada

    Directory of Open Access Journals (Sweden)

    Paul N Levett

    2015-01-01

    Full Text Available Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum, is an infection recognized since antiquity. It was first reported at the end of the 15th century in Europe. Infections may be sexually transmitted as well as spread from an infected mother to her fetus or through blood transfusions. The laboratory diagnosis of syphilis infection is complex. Because this organism cannot be cultured, serology is used as the principal diagnostic method. Some of the issues related to serological diagnoses are that antibodies take time to appear after infection, and serology screening tests require several secondary confirmatory tests that can produce complex results needing interpretation by experts in the field. Traditionally, syphilis screening was performed using either rapid plasma reagin or Venereal Disease Research Laboratory tests, and confirmed by treponemal tests such as MHA-TP, TPPA or FTA-Abs. Currently, that trend is reversed, ie, most of the laboratories in Canada now screen for syphilis using treponemal enzyme immunoassays and confirm the status of infection using rapid plasma reagin or Venereal Disease Research Laboratory tests; this approach is often referred to as the reverse algorithm. This chapter reviews guidelines for specimen types and sample collection, treponemal and non-treponemal tests utilized in Canada, the current status of serological tests for syphilis in Canada, the complexity of serological diagnosis of syphilis infection and serological testing algorithms. Both traditional and reverse sequence algorithms are recommended and the algorithm used should be based on a combination of local disease epidemiology, test volumes, performance of the proposed assays and available resources.

  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. All projects related to Canada | Page 25 | IDRC - International ...

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

    Topic: REFUGEES, DISPLACED PERSONS, IMMIGRATION, RESETTLEMENT, SOCIAL INTEGRATION, HUMANITARIAN ASSISTANCE. Region: North and Central America, South America, Colombia, Ecuador, Canada. Program: Governance and Justice. Total Funding: CA$ 218,745.00. Effective and Sustainable Health ...

  10. All projects related to canada | Page 5 | 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.

  11. 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.

  12. All projects related to Canada | Page 7 | IDRC - International ...

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

    Project. In Mali and Burkina Faso, maternal and child mortality rates remain high. Topic: MATERNAL AND CHILD HEALTH, HEALTH SERVICES, INFORMATION DISSEMINATION, HEALTH FINANCING, PUBLICATIONS, AFRICA. Region: Burkina Faso, Mali, Canada. Program: Maternal and Child Health. Total Funding: CA$ ...

  13. All projects related to Canada | Page 4 | IDRC - International ...

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

    The Fourth Global Symposium on Health Systems Research, to be held in Vancouver from November 14-18, 2016, will be the largest global health conference held in Canada in recent years. Topic: MATERNAL AND CHILD HEALTH, AFRICA SOUTH OF SAHARA, CAUSES OF DEATH, HEALTH PERSONNEL, INFANT ...

  14. All projects related to canada | Page 20 | IDRC - International ...

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

    Online Learning for Mobile Technology Applications in Health Surveys. Project. In light of the increased use of personal digital assistants (PDIs) in data collection and management, HealthBridge Foundation of Canada (HealthBridge) is developing online training for mobile technology applications in health research.

  15. Canada Among Nations 2014. Crisis and Reform: Canada and the ...

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

    2014-05-28

    May 28, 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. Published by the Centre for International Governance Innovation, Crisis and Reform: Canada and the ...

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

    Science.gov (United States)

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

    2014-08-15

    The objective of this paper is to explore approaches to understanding the usability of health information systems at regional and national levels. 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. 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. 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.

  17. Cronobacter spp. (Enterobacter sakazakii): advice, policy and research in Canada.

    Science.gov (United States)

    Pagotto, Franco J; Farber, Jeffrey M

    2009-12-31

    Although the number of reported cases of Cronobacter infection in Canada is low, Health Canada has been actively studying this organism since 1991. After reviewing the situation at the national level and due to health concerns with powdered formulae and its international trade, in 2003, Health Canada raised this issue at the international level by proposing to revise the Code of Practice for Powdered Formulae for Infants and Young Children at the Codex Alimentarius Committee of Food Hygiene. Canada volunteered to chair the Working Group that would be developing the Code, and the Code was completed in four years. The Code contributed to an improvement in the hygienic conditions in plants manufacturing Powdered Infant Formula (PIF), resulting in a lower level of product contamination with Cronobacter species. Canada has produced a document detailing Good Manufacturing Practices (GMPs) for Infant Formula in Canada. Health Canada uses the GMPs as a basis for assessing the manufacturing information received in pre-market notifications for new or changed infant formulas. Health Canada does not have microbiological criteria for Cronobacter spp. in PIF; however, we are currently working on developing these criteria. At present, there are no active or passive surveillance systems for Cronobacter spp. in Canada, although this has been discussed. Health Canada has recently adapted and condensed FAO/WHO guidelines to develop a draft guidance document for the hygienic preparation and handling of PIF in home and hospitals/care settings, which outline requirements for parents, caregivers, and staff in hospitals and day-care centres. Health Canada's Bureau of Microbial Hazards conducts research on the ecology, biology and pathogenesis of Cronobacter spp. Some of the research projects include specific aspects of molecular typing, virulence studies involving animal models, as well as in vitro tissue culture work to examine adhesion and invasion. Collaborative research is also being

  18. Indian Arts in Canada

    Science.gov (United States)

    Tawow, 1974

    1974-01-01

    A recent publication, "Indian Arts in Canada", examines some of the forces, both past and present, which are not only affecting American Indian artists today, but which will also profoundly influence their future. The review presents a few of the illustrations used in the book, along with the Introduction and the Foreword. (KM)

  19. 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...

  20. The butterflies of Canada

    National Research Council Canada - National Science Library

    Layberry, Ross A; Hall, Peter W; Lafontaine, J. Donald

    1998-01-01

    ... for the close to three hundred butterfly species recorded in Canada, including descriptions of early stages, subspecies, and key features that help distinguish similar species. Each species of butterfly has an individual distribution map, generated from a database of more than 90,000 location records. More than just a field guide to identifying Canadian butterfli...

  1. Acid precipitation in Canada

    Science.gov (United States)

    P. W. Summers; D. M. Whelpdale

    1976-01-01

    The total annual emissions of sulfur oxides and nitrogen oxides in Canada are estimated to be 7.2 x 106 tons and 1.4 x 106 tons, respectively. These figures represent 5% and 2%, respectively, of the estimated worldwide anthropogenic emissions. Nearly two-thirds of the Canadian SO2 emissions come from...

  2. eHealth advances in support of people with complex care needs: Case examples from Canada, Scotland and the United States.

    OpenAIRE

    Gray, Carolyn Steele; Mercer, Stewart; Palen, Ted; McKinstry, Brian; Hendry, Anne

    2017-01-01

    Introduction: Information technology in health care, also referred to as eHealth technology, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs and their caregivers. In particular eHealth technologies such as electronic medical records, telemonitoring systems, web-based portals and mobile health (mHealth) can enable information sharing between providers, clients and their families to improve integration of ...

  3. Evolving Perspectives on Lyme Borreliosis in Canada

    Science.gov (United States)

    Sperling, JLH; Middelveen, MJ; Klein, D; Sperling, FAH

    2012-01-01

    With cases now documented in every province, Lyme borreliosis (LB) is emerging as a serious public health risk in Canada. Controversy over the contribution of LB to the burden of chronic disease is maintained by difficulty in capturing accurate Canadian statistics, especially early clinical cases of LB. The use of dogs as sentinel species demon-strates that potential contact with Borrelia burgdorferi spirochetes, as detected by C6 peptide, extends across the country. Dissemination of infected ticks by migratory birds and rapid establishment of significant levels of infection have been well described. Canadian public health response has focused on identification of established populations of the tick vectors, Ixodes scapularis and I. pacificus, on the assumption that these are the only important vectors of the disease across Canada. Strains of B. burgdorferi circulating in Canada and the full range of their reservoir species and coinfections remain to be explored. Ongoing surveys and historical records demonstrate that Borrelia-positive Ixodes species are regu-larly present in regions of Canada that have previously been considered to be outside of the ranges of these species in re-cent modeling efforts. We present data demonstrating that human cases of LB are found across the nation. Consequently, physician education and better early diagnoses are needed to prevent long term sequelae. An international perspective will be paramount for developing improved Canadian guidelines that recognize the complexity and diversity of Lyme borreliosis. PMID:23091570

  4. Does Grade Level Relate to School-Based Youth Health Center Utilization among Male Youth? Quantitative Findings from a Mixed-Methods Study in Nova Scotia, Canada

    Science.gov (United States)

    Gahagan, Jacqueline C.; Jason, Timothy; Leduc, Derek

    2012-01-01

    Background: Male adolescents underutilize youth health centers' (YHC) services despite facing a variety of significant health issues. The purpose of our study was to explore adolescent males' perceptions of health service needs, utilization of YHC services, and barriers and facilitators for such utilization as a function of school grade among a…

  5. Active Canada 20/20: A physical activity plan for Canada.

    Science.gov (United States)

    Spence, John C; Faulkner, Guy; Costas Bradstreet, Christa; Duggan, Mary; Tremblay, Mark S

    2016-03-16

    Physical inactivity is a pressing public health concern. In this commentary we argue that Canada's approach to increasing physical activity (PA) has been fragmented and has lacked coordination, funding and a strategic approach. We then describe a potential solution in Active Canada 20/20 (AC 20/20), which provides both a national plan and a commitment to action from non-government and public sectors with a view to engaging corporate Canada and the general public. It outlines a road map for initiating, coordinating and implementing proactive initiatives to address this prominent health risk factor. The identified actions are based on the best available evidence and have been endorsed by the majority of representatives in the relevant sectors. The next crucial steps are to engage all those involved in public health promotion, service provision and advocacy at the municipal, provincial and national levels in order to incorporate AC 20/20 principles into practice and planning and thus increase the PA level of every person in Canada. Further, governments, as well as the private, not-for-profit and philanthropic sectors, should demonstrate leadership and continue their efforts toward providing the substantial and sustained resources needed to recalibrate Canadians' habitual PA patterns; this will ultimately improve the overall health of our citizens.

  6. All projects related to canada | Page 4 | IDRC - International ...

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

    Malawi has the highest preterm delivery rate in the world. Topic: MATERNAL AND CHILD HEALTH, HEALTH FACILITIES, DECISION MAKING, MALAWI, TRAINING, SOUTHEAST ASIA. Region: Malawi, Canada. Program: Maternal and Child Health. Total Funding: CA$ 981,153.00. Community-Based Cause of Death Study ...

  7. Canada's NHI needs fiscal realism, hospital autonomy, consumer responsibility.

    Science.gov (United States)

    Detwiller, L F

    1980-04-01

    Government-sponsored health care programs must have limits if they are to be effective and cost-cutting. Canada's experience with a national health insurance plan indicates that long-range planning, a measurable definition of health, and consumer responsibility are necessary ingredients.

  8. Midwifery education in Canada.

    Science.gov (United States)

    Butler, Michelle M; Hutton, Eileen K; McNiven, Patricia S

    2016-02-01

    This article is part of a special series on midwifery education and describes the approach to midwifery education in Canada We begin with an overview of the model of midwifery practice introduced in Canada in the 1990s. We describe the model of midwifery education developed and report how it is implemented, with particular attention to the two longest established programs. Midwifery education programs in Ontario and British Columbia. Midwifery education programs in Canada are offered at the undergraduate baccalaureate level at universities and are typically four years in length. Programs are competence-based and follow a spiral curriculum. The first semesters focus on on core sciences, social sciences and introduction to midwifery concepts. Students spend fifty percent of the program in clinical practices with community-based midwives. Innovative education models enable students to be placed in distant placements and help to align theoretical and practice components. Clinically active faculty adds to the credibility of teaching but bring its own challenges for midwifery educators. The Canadian model of midwifery education has been very effective with low attrition rates and high demand for the number of places available. Further program expansion is warranted but is contingent on the growth of clinical placements. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Patterns of adolescent physical activity, screen-based media use, and positive and negative health indicators in the U.S. and Canada.

    Science.gov (United States)

    Iannotti, Ronald J; Kogan, Michael D; Janssen, Ian; Boyce, William F

    2009-05-01

    To examine: (1) how adolescent physical activity (PA) and screen-based media use (SBM) relate to physical and social health indicators, and (2) crossnational differences in these relationships. Essentially identical questions and methodologies were used in the Health Behavior in School-Aged Children cross-sectional surveys of nationally representative samples of American (N = 14,818) and Canadian (N = 7266) students in grades 6 to 10. Items included questions about frequency of PA, SBM, positive health indicators (health status, self-image, quality of life, and quality of family and peer relationships), and negative health indicators (health complaints, physical aggression, smoking, drinking, and marijuana use). In regression analyses controlling for age and gender, positive health indicators were uniformly positively related to PA while two negative health indicators were negatively related to PA. However, PA was positively related to physical aggression. The pattern for SBM was generally the opposite; SBM was negatively related to most positive health indices and positively related to several of the negative health indicators. The notable exception was that SBM was positively related to the quality of peer relationships. Although there were crossnational differences in the strength of some relationships, these patterns were essentially replicated in both countries. Surveys of nationally representative samples of youth in two countries provide evidence of positive physical and social concomitants of PA and negative concomitants of SBM. These findings suggest potential positive consequences of increasing PA and decreasing SBM in adolescents and provide further justification for such efforts.

  10. At the crossroads: Hazard assessment and reduction of health risks from arsenic in private well waters of the northeastern United States and Atlantic Canada

    Science.gov (United States)

    Zheng, Yan; Ayotte, Joseph

    2015-01-01

    This special issue contains 12 papers that report on new understanding of arsenic (As) hydrogeochemistry, performance of household well water treatment systems, and testing and treatment behaviors of well users in several states of the northeastern region of the United States and Nova Scotia, Canada. The responsibility to ensure water safety of private wells falls on well owners. In the U.S., 43 million Americans, mostly from rural areas, use private wells. In order to reduce As exposure in rural populations that rely on private wells for drinking water, risk assessment, which includes estimation of population at risk of exposure to As above the EPA Maximum Contaminant Level, is helpful but insufficient because it does not identify individual households at risk. Persistent optimistic bias among well owners against testing and barriers such as cost of treatment mean that a large percentage of the population will not act to reduce their exposure to harmful substances such as As. If households are in areas with known As occurrence, a potentially large percentage of well owners will remain unaware of their exposure. To ensure that everyone, including vulnerable populations such as low income families with children and pregnant women, is not exposed to arsenic in their drinking water, alternative action will be required and warrants further research.

  11. Ethnic identity of older Chinese in Canada.

    Science.gov (United States)

    Lai, Daniel W L

    2012-06-01

    In Canada's multicultural society, ethnic identity is important to the elderly and can influence areas such as access to services, health promotion and care. Often, the complex nature of ethnic identity is underestimated when looking at cultural groups. This study aims to: (a) validate the factor structure of a Chinese ethnic identity measure for older Chinese in Canada, (b) examine the level of ethnic identity of the participants, and (c) examine the correlates of ethnic identity in these older individuals. Using data from a large, national research project on the elderly Chinese in Canada, this study analyzed the results gathered from a total of 2,272 participants. Principal component analysis, maximum-likelihood confirmatory factor analysis, and multiple regression analysis were performed. The results indicated that ethnic identity of the older Chinese is a multi-dimensional construct made up of three factors: (a) culture related activities, (b) community ties, (c) linkage with country of origin, and (d) cultural identification. The findings have provided a better understanding of how ethnic identity can be measured among the aging Chinese population in Canada.

  12. Alcohol use among immigrants in Ontario, Canada.

    Science.gov (United States)

    Agic, Branka; Mann, Robert E; Tuck, Andrew; Ialomiteanu, Anca; Bondy, Susan; Simich, Laura; Ilie, Gabriela

    2016-03-01

    This study examined prevalence of alcohol consumption among immigrants and the Canadian-born populations of Ontario by ethnic origin, and the association between ethnicity, country of birth, age at arrival, length of residence in Canada and drinking measures. Data were derived from the Centre for Addiction and Mental Health (CAMH) Monitor, a cross-sectional survey of Ontario adults, conducted between January 2005 and December 2010 (n = 13,557). The prevalence of alcohol consumption and risk drinking was generally lower among foreign-born than Canadian-born respondents, but significant variations across ethnic groups were found. In general, foreign-born respondents of European descent reported higher rates of alcohol use and risk drinking than foreign-born respondents from other ethnic groups. We also observed that ethnicity effects varied by whether or not respondents were born in Canada, and by the age at which they arrived in Canada. While previous studies generally found an increase in immigrants' alcohol consumption with years in Canada, our data suggest that longer duration of residence may have either positive or negative effects on immigrants' alcohol use, depending on the country of origin/traditional drinking pattern. More research is needed to explore determinants of alcohol use and risk drinking among immigrants and to identify those groups at highest risk. © 2015 Australasian Professional Society on Alcohol and other Drugs.