Category Archives: IJHS 2 (2)

IJHS volume 2, issue 2

The Disability Experience: Living with a Birth Defect Resulting from Thalidomide Exposure

Authors: Émilie M. MEYERS & Jeffrey W. JUTAI

Abstract

The drug, Thalidomide, is a classic example of how medicine has the potential to cause us harm. The market flooding of this drug in the 1950’s resulted in the birth of 8 to 10 thousand children with birth defects. Today in Canada this tragedy still affects the lives of approximately 125 individuals. How do these individuals live their lives and what has been the overall impact of their impairment? This article explores the lived experience of a woman born with upper limb phocomelia as a result of Thalidomide exposure. A one hour unstructured face-to-face interview was conducted. Permission was received from the interviewee to make a voice recording of the interview allowing for a more concrete data review. The interview uncovered 6 primary themes indicating that a physical impairment resulting from thalidomide can have a minimal impact on an individual’s overall quality of life, as long as sufficient support and a positive self identity is present. The interviewee’s accounts suggest that living with disability is a unique experience that can lead to positive outcomes. The ultimate conclusion of this paper is that more extensive research is needed to further represent the voices of the disability community.

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Case Based Learning Teaching Methodology in Undergraduate Health Sciences Health Sciences Cased Based Learning Pilot Project

Authors: Kaitlyn BROWN, Mary COMMANDANT, Adi KARTOLO, Casey ROWED, Agatha STANEK, Heebah SULTAN, Kabir TOOR, & Victoria WININGER

Abstract

Case-based learning (CBL) is an interactive teaching approach involving small-group discussion to determine a range of solutions for a presented patient case. In light of the success that the approach has achieved in numerous professional and undergraduate programs, a pilot project was introduced in 2009 by senior health sciences students, who acted as CBL facilitators, at the University of Ottawa for undergraduate courses in the Interdisciplinary School of Health Sciences (ISHS). In collaboration with faculty professors, the facilitators developed CBL sessions consisting of patient cases that were reflective of the core objectives of health sciences courses. A total of 144 undergraduate students from three ISHS courses took part in these sessions; they were evaluated based on the calibre of their participation and a quiz. The quiz consisted of 5 questions that evaluated the students’ mastery of the concepts covered in the CBL session. The students also completed an evaluation of the pilot project. On a nominal scale of one to five, the students on average scored 4.13 out of a possible 5.00 (SD 1.48) marks on the quiz. In the evaluation, the students rated the project as having an overall learning benefit of 3.82 on a nominal scale of one to four. The evaluation indicates that the students perceived the program as having significant learning value and the quiz marks confirmed that CBL promoted the application of lecture content to practical scenarios. These preliminary findings suggest that implementing CBL in ISHS would enhance students’ academic experience. Further sessions based on this model would improve from more rigorous pre- and post-session assessments.

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A critique of Gender Identity Disorder and its application

Authors: Stefan MACDONALD-LABELLE

Abstract

For some, Gender Identity Disorder (GID) becomes the only way to achieve sex reassignment surgery (SRS). It will be shown that GID acts as a problematic regulatory mechanism based on its application.

It will be argued that GID normalizes a dichotomous view of gender. In this way, GID’s implicit applications allow the mental health professional to assert their views of what proper gendered behavior is, further normalizing a binary view of gender.

Insurance companies require a GID diagnosis in order to provide economic assistance to those wishing to undergo sex reassignment surgery. Those who cannot afford to transition must fall under GID’s gaze in order to achieve SRS. This will be shown to be unacceptable and a way in which GID operates as a regulatory mechanism.

Appealing to a GID diagnosis can further stigmatize the individual who wishes to transition due to the necessitation of distress as an explicit mechanism of diagnosis. Having to fall under GID may internalize the negative aspects of the diagnosis.

A criticism of GID as a form of psychopathology will be given and also be linked to the idea of GID as a regulatory apparatus. It will be shown that there should be no link between ethical discomfort and GID-free sex reassignment surgery. Also, it will be shown that psychopathology has normalizing capabilities that further entrench gender binaries.

It is important to consider the removal of GID from the DSM, but, as a condition, still offer funding for sex reassignment surgery without having to appeal to a mental health professional’s assessment.

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The over-prescription of Ritalin for suspected cases of ADHD

Authors: Jason Y. C. CHAN, Talisa A. DENNIS & Melissa A. MACLEOD

Abstract

Methylphenidate (Ritalin), the current leading form of treatment for Attention Deficit Hyperactivity Disorder (ADHD), has seen a dramatic increase in prescription rate over the past ten years. No contemporary biological basis for ADHD diagnosis results in physicians making their diagnoses based on behavioural symptoms such as hyperactivity and inability to focus. Considering that these symptoms are behaviours that anyone may express at one point in their life, the risk of over-diagnosis of the disease increases. This may subsequently lead to over-prescription of Ritalin. This paper aims to evaluate and identify the causes and effects of Ritalin over-prescription. Key literature on ADHD reveals that the diagnostic criteria for ADHD has undergone various modifications since the disease was first identified; therefore, different experts may have different opinions on what are regarded as symptoms of the disorder. Furthermore, recent research has demonstrated that Ritalin can increase cognitive performance in both healthy individuals and in ADHD patients. Such data indicates that Ritalin has the potential to be abused by healthy individuals looking to increase their cognitive performance. Correspondingly, Ritalin has been reported to be used by college students to boost their academic performance. In addition, the over-prescription of Ritalin raises several ethical issues: as children are the most common age group to be diagnosed with the disease, critics question whether prescribing a drug for a behaviourally based diagnosed disease is appropriate; also it is thought that the drug may affect the originality and creativity of the children which may hinder their personal development. While alternative behavioural therapy is available for the disorder, it tends to be more expensive and time consuming than a drug prescription; this may explain why Ritalin remains the dominant form of treatment. This paper concludes that the prescription of drugs for ADHD should be cautioned and that more time and resources should be invested on developing consistent diagnostic criteria as well as potential alternative treatments to drugs for the disorder.

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Quelle est la part des régimes publics d’assurance-médicaments aux résultats de santé ? Une étude de cas multiples au Nouveau-Brunswick, en Ontario, et au Québec

Authors : Marika ALARY-VANASSE & Sanni YAYA
Article in French only.

Abstract

Canadian provincial and territorial drug plans vary considerably in terms of eligibility criteria, and most of the insurance plans provided are subject to caps, cost sharing and exclusions. In fact, Canadians have unequal access to prescription medications, depending on their socio-economic status and place of residence. This comes at time then the effects of population aging, an increasing number of people with multiple chronic illnesses and innovations in the prescription medications field have brought about an increase in spending on these products. The question raised by this study is does a province with a better prescription drug plan have a healthier population?

This study compared coverage of prescription drug plans among  people 65 years old and over in three provinces: New Brunswick, Ontario and Quebec. The results of our study suggest that senior citizen health does not seem to improve. Therefore, it is imperative that additional research be conducted to determine the true impact of prescription drug plans on health outcomes. This would allow for the creation of tailor-made, better-targeted programs and policies to meet community needs more adequately.

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Ride Forward – An evaluation of Cycling in Two Ottawa Neighborhoods

Authors: Michael BORGHESE, Melissa BROOKS, Steven EARL & Jennifer NADDAF

Abstract

Outdoor cycling (bicycling) is a low-impact form of exercise that improves cardiovascular fitness, muscle tone, range of motion and flexibility. It is an activity that may be beneficial to one’s physical, emotional, and mental health and well-being. The benefits to one’s social and emotional health and wellness may be derived from the social networking associated with being a member of a cycling community.

The purpose of this project is to provide recommendations to improve the current and future state of cycling in the Sandy Hill Community Centre’s catchment areas of Old Ottawa East and Sandy Hill, two communities in Ottawa, Ontario, Canada. A preliminary needs assessment was conducted, and recommendations were generated from the information gathered.In order to begin the needs assessment we required much information, such as the opinions and attitudes of community members regarding cycling.

Through the extensive research of other current programs and groups offered both in Ottawa and other cities such as Montreal,Quebec, Canada and Portland, Oregon, United States we have found that the best cities provide a wide-range of cycling utilities for its citizens to accommodate different lifestyles.From the general knowledge that we gained from the research of other cities we designed a survey to identify the specific needs of Ottawa, and more specifically our target population of Sandy Hill and Old Ottawa East catchments areas.

Information was then synthesized into a list of recommendations, as well as solutions to current problems. The recommendations generated from the data gathered from the needs assessment include the development of various community programs, such as a cycling resource centre, cycling buddy system, cycling groups, safe-cycling education, and a bike share initiative.The data gathered from the needs assessment also indicated a priority need for the regular maintenance of roads and bicycle lanes.

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