An Interdisciplinary Population Health Approach to the Radon Health Risk Management in Canada

Authors: Selim M. Khan, James Gomes

Abstract

Radon is a known carcinogen found in indoor air that exists at higher than the federal reference level (200 Bq/m3) in about 10% of Canadian homes. Every year, over 3,000 people die from radon-induced lung cancer, which accounts for 16% of annual lung cancer deaths in Canada. Radon is the leading cause of lung cancer deaths among non-smokers and is second among smokers. Children, women, and smokers from lower income groups are disproportionately affected. Although the Federal Government has reset the guideline (from the previous 600 Bq/m3 down to 200 Bq/m3) and provincial governments revised the building codes to limit exposure, there remain controversies with the latest scientific development in adopting strategies of radon management in Canada.

This review applies an Integrated Population Health Framework to look at the relationships and interactions between population health determinants such as biology and genetics, environment and occupation, and social and economic factors, that influence the health risk of radon. The evidence gathered supports policy analysis with the application of ethical and risk management principles that lead to the identification of efficient and affordable broad-based and population-level preventive strategies. The final inferences enhance the framework by adding critical intervention modalities to Health Canada’s National Radon Program.

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Conflict and disease: A complex relationship

Author: Robert A. Frank 

Societies will always be subjected to situations that test their tolerance thresholds. When a stressor exceeds a society’s capacity to cope, “failure” of the system is often manifested as social unrest, falling along a spectrum of intensity ranging from civil wars and revolutions to riots, strikes, and protests (Braha, 2012). The conflict leading to social unrest is most often initiated by groups on the disadvantaged end of systemic inequalities, as a desperate effort at effecting change (Haas, 1986). Although social unrest is sometimes a necessary vehicle for cultural revolution, the resultant disruption of society invariably creates a volatile environment that is vulnerable to adverse health outcomes (Jovanović, Renn, & Schröter, 2012).

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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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An Overview of the Malaria Epidemic in Sub-Saharan Africa

Author: Sandra M. Konji

Abstract

Malaria is a parasitic disease that is transmitted by mosquitos during their blood meal. The risk of contracting malaria is highest for people in tropical countries, due to the ever-present humid weather that allows yearly infections. Consequently, sub-Saharan Africa has a disproportionately higher rate of death among women and children with malaria. One of the major barriers identified in the efficacy of malaria treatment and prevention is the lack of health education and literacy. The lack of health education has decreased the efficacy of antimalarial drugs, such as Artemether Lumefantrine, due to the distribution and administration of the drug by untrained persons. The lack of incidence and prevalence data makes it difficult to ensure adequate supply of the drug in endemic countries. Furthermore, the lack of knowledge of malaria pathogenesis and transmission has prevented many from promptly seeking treatment and practicing preventative care methods. Recently, the implementation of health education programs by international organizations has allowed local and travelling healthcare practitioners to be educated on the disease and methods of antimalarial drug administration.

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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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Storytelling and Asperger Syndrome: A Key for Social Integration

Author: Alain Nathan Sahin

Abstract

Storytelling is a universal way of communication between human beings. It is inhibited when neurodevelopmental disorders hinder human reciprocity, the understanding of body language, and nuances of language. Asperger Syndrome (AS), one of these disorders, is characterized by social impairment and repetitive patterns of behaviour. Messages cannot be conveyed through storytelling, which causes social isolation and withdrawal of individuals with AS from society. The development of the mirror neuron system in the brain, which incites imitation of peers, might be altered in AS by a mechanism that is not entirely understood. Because mirroring the emotions of others is key to understanding their feelings and perceptions of the world, the “theory of mind” is not formed in individuals with AS as it normally would be. While studies have suggested this impediment, current views and evidence show that people with AS may use storytelling as a powerful tool to integrate themselves into society. Future research should investigate storytelling as an intervention to increase social interaction of individuals with AS.

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Climate Change and Health Inequities: Contribution of the Interventional Approach in Population Health in a Quebec Context

Authors: David Buetti, Rana Annous

(The article is available in French only)

Abstract

In a globalized world, climate change is yet another complex problem faced by public health. This article explores the consequences of climate change on vulnerable populations and the measures to mitigate them from an interventional perspective in population health, in a Quebec context. A literature review was conducted using seven databases related to disciplines in social sciences, health sciences and environment. Given the contribution of non-government agencies to population health, the literature review was complemented by reports from activist and community organizations. Results show that many sectors can collaborate with public health agencies and community-based organizations to reduce climate change and health inequities. In Quebec, three fields of activity seem especially promising: territorial development in urban settings, sustainable transport and mobility, and urban and suburban agriculture.  Arguing for a social ecological framework and a multisectoral collaboration, interventions focused on population health mitigate the consequences of climate change on social and health inequities. Some challenges and research avenues linked to their implementation and continuation are discussed.

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Critique of a Community-Based Population Health Intervention in a First Nations Community: Public Health and Medical Anthropology Perspectives

Author: Selim M. Khan

Abstract

Launched as a community-based partnership endeavour, the Sandy Lake Health and Diabetes Project (SLHDP) aimed to prevent diabetes in a First Nations community (FNC) in Northern Ontario. With active engagement of the key stakeholders, SLHDP conducted a series of studies that explored public health needs, priorities, and the contexts. These led to the adoption of a variety of culturally appropriate health interventions, addressing several health determinants such as health education, physical environments, nutrition, personal health practices, health services, and FNC culture. SLHDP built reciprocal capacity for both the community stakeholders and academic partners, thus evolved as a model of population health intervention. The school components are being scaled-up in other parts of FNCs in Canada. This paper presents a critique from public health and medical anthropology perspectives and draws evidence-based recommendations on how such programs can do better.

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