Tag Archives: Health Services

Access for All to Restricted Access: The Evolution of Assisted Procreation Services in Quebec

Author: Andréanne Chaumont

(The article is available in French only)

Que savez-vous des lois entourant la procréation assistée du Ministère de la Santé du Québec? Débuté par le projet de loi no23 en 2010, le programme de procréation assistée a été sujet de grands débats aux seins du corps médical et médiatique québécois dès sa genèse. Sa couverture médiatique est revenue en force en 2014 avec l’adoption de la Loi favorisant l’accès aux services de médecine de famille et de médecine spécialisée (loi no20) dans le cadre de la réforme du système de santé québécois (Gouvernement du Québec, 2015). Le texte ici-bas offre un survol de la couverture médiatique de l’évolution aux services de procréation assistée au Québec (SPA) jusqu’à aujourd’hui.

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The Global Burden of Surgical Disease: An Analysis of Inaccessible Surgical Care in Low and Middle Income Countries

Authors: Chau Huynh, Minh NQ Huynh

Abstract

Worldwide, 4.8 billion people do not have access to safe, adequate surgical care and anaesthetic management. Surgical care has been deemed “the neglected child of global health,” a startling reminder of the disparities in health services. The provision of surgical interventions can avert 11% of the global burden of disease and 1.5 million deaths each year. Many obstacles exist for low- and middle-income countries (LMIC) to progress towards accessible surgical care. The first challenge is delivering cost-effective surgical care despite financial constraints and political turmoil. Foreign aid was established to alleviate the financial burden and its contributions have been pivotal. However, based on the political climate in certain countries, funds are siphoned to government sectors other than health care. Moreover, the lack of infrastructure, equipment, and personnel in LMIC compound the issue. The other challenge is determining if surgery is as feasible and effective as non-surgical health interventions. Surgical care is crucial and this paper aims to assess the challenges that limit its stature in global health discussions. The paper will address the influence of financing, infrastructure, workforce, service delivery, and information management on surgical care, and the current resolutions, such as humanitarian aid missions.

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Reducing interprofessional conflicts in order to facilitate better rural care: A report from a 2016 Rural Surgical Network Invitational Meeting

Author: Hayley Pelletier

Abstract

An invitational meeting organized by the Centre for Rural Health Research convened to facilitate respectful dialogue with general surgeons in British Columbia to clearly understand concerns and address questions around rural family physicians with enhanced surgical skills (FPESS). In particular, the meeting focused on interprofessional challenges that hinder the adoption of a network model between general surgeons and FPESS. This report summarizes the findings (n=5) and recommendations (n=8) from the meeting. The meeting underscored the need for more thoughtful discussions to develop interprofessional trust and support between general surgeons and FPESS through an integrated health care system and proper networks.

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Healthcare in Cuba: Defining Features and Future Trends

In 2016, Cuba made headlines for the status of its economic embargo with the US, its increasing foreign investments through tourism, and the death of Fidel Castro. Besides these recent events, in a sense foreshadowing Cuba’s future political and economic paths, throughout the 20th century, Cuba’s healthcare system has been acclaimed as one of the best healthcare systems in the world with very good health outcomes for the Cuban people. For example, infant mortality is lower than in the US and the life expectancy is 77.5 years of age (WHO, 2016). What are the Cuban healthcare system’s defining features? Will recent events alter some of its key aspects?

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Finding Potential in Another Mother’s Breastmilk

In Canada, the primary cause of mortality in infancy and long-term disability in children is being born at very low birth weight (<1500g or <3.3lbs; Saigal & Doyle, 2008). If these infants are fed their mother’s milk in the neonatal intensive care unit (NICU) they experience fewer severe infections (Hylander, Strobino, & Dhanireddy, 1998; Patel et al., 2013), improved feeding tolerance (Schanler, Shulman, & Lau, 1999; Sisk, Lovelady, Gruber, Dillard, & O’Shea, 2008), lower colonization of pathogenic bacteria (Yoshioka, Iseki, & Fujita, 1983), and increased neurocognitive development (Anderson, Johnstone, & Remley, 1999). However, due to many reasons related to preterm birth, as many as 70% of mothers cannot provide a sufficient amount of breastmilk to meet the demands of these infants, therefore, a supplement is necessary (Callen & Pinelli, 2005). Currently in Canada, either pasteurized donor breastmilk (donor milk) or preterm formula is used as a supplement to mother’s milk.

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Planning and delivery of health services – an article review on urban aboriginal mobility in Canada: examining the association with healthcare utilization

Author: Ankit Dhawan

Abstract

An article from Social Science and Medicine, written by Snyder and Wilson (2012), examined the use of healthcare services by urban Aboriginal populations in Canada. Using the Behavioural Model of Health Services Use (BMHSU), predisposing, enabling, and need factors were organized and used for data analysis. Specifically, a comparison was made between conventional (physicians and nurses) and traditional (traditional healers) health service utilization in Toronto and Winnipeg. In addition to the geographical and educational factors, the results of the research recognized mobility as a significant predisposing complement to healthcare utilization.

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The Development of Scoring Criteria for a New Picture Naming Task

Authors: Ferzin MahavaChristine SheppardLaura MonettaVanessa Taler

Abstract

Objective: The purpose of the study was to develop a scoring system for a novel naming task suitable for assessing naming performance in younger (18-30 years) and older (65+ years) adults in monolingual English, monolingual French, and English-French bilingual groups. This novel naming task will serve as an important health service to help diagnose and assess cognitively impaired older individuals, while also serving as an educational tool for healthcare providers.

Materials and Methods: The Naming Task consists of 120 images organized in the same randomized order, and are shown on a white background displayed on a computer screen using PowerPoint. Participants are instructed to name the image displayed. Monolinguals completed the test in their native language and bilinguals completed the test in English only, French only, and a bilingual administration. Scoring criteria was established based on the responses from testing.

Results: Strict and lenient scoring criteria developed for the Naming Task are presented. Eight items were removed from the original Naming Task due to quality and/or clarity, inability to name the image, or too many alternate responses. Performance in mono-lingual English and French was similar in younger and older adults for strict and lenient scoring. Bilinguals performed better with bilingual administration and worse with French administration, where scores were the lowest of all age and language groups.

Conclusion: The Naming Task appears to be suitable for monolingual French and English individuals. Results suggest that a bilingual administration should be used when testing English-French bilinguals.

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Transmission of Human Papillomavirus Without Sexual Contact

Authors: Naweed Ahmed, Wakqas Kayani, Sahab Jamshidi, Suneil Bapat, Ahmed ImamovicPanteha Tavassol

Abstract

Human papillomavirus (HPV) is one of the most common sexually transmitted infections. There are four common HPV strains: 6, 11, 16, and 18. Strains 6 and 11 cause genital warts, while strains 16 and 18 are asymptomatic in males and may progress to cervical cancer in females. Although uncommon, a small percentage of males and females have been diagnosed with HPV without previous sexual contact. In this case report, we discuss a case conducted on a 15-year-old South Asian male who contracted an unknown low-risk strain of HPV with no history of sexual contact. HPV is highly infectious, however in the majority of cases the immune system is able to clear the infection, preventing the appearance of genital warts. In cases such as these, it is important to help control the spread of viral infections. Several determinants of health are involved in and affect the trans-mission of HPV, including income and social status, social support networks, education and literacy, culture, social and physical environments, and health services. To aid in the prevention of HPV, sexual education should be taught at early ages within schools and the Gardasil® vaccine should be administered to both females and males at an early age to reduce the burden of disease and the incidence of HPV.

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A Healthcare Lesson: Comparing Chaoulli v. Quebec (2005) and Cambie Surgery Centre v. British Columbia (2016)

Publicly insured healthcare in Canada, also known as Medicare, is currently being reviewed in a judicial case in the Supreme Court of British Columbia. The lawsuit filed by Cambie Surgery Centre is calling for allowing “medically necessary services” – those covered by public insurance – to be privately insured in order to improve access to care. Health services researchers, policy makers and citizens alike, are worried of the outcome of this 8-month provincial trial, as it is suggested that an outcome in favour of Cambie’s position would lead to a complete overhaul of Canada’s public healthcare system. In the midst of heated debates, we tend to forget that just over a decade ago, a similar legal battle challenging the extent of public insurance in Canada occurred in the province of Quebec. How are these two cases similar or different? What are the implications of each? What are lessons that can be learnt?

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Choice in childbirth: VBAC

Childbirth is a ubiquitous experience among mothers. Birth can occur in many ways, from medication-free natural labour, to cesarean section. Mothers in Canada can, for the most part, choose how they want to deliver. However, women with a prior cesarean section have a more difficult choice to make. They can choose to have a repeat cesarean section, or to attempt a vaginal birth after cesarean – a VBAC. How do women make this decision, and how can healthcare providers support them?

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