According to the 2004 Canadian Community Health Survey-Nutrition, the majority of Canadians are consuming fibre below the adequate intake (AI) level. Although an intervention by Health Canada to improve fibre intakes may seem appropriate, there is insufficient evidence to warrant an intervention given the methodological flaws for assessing fibre intakes in the Canadian population. This paper explores these limitations by reviewing how the AI for fibre was developed, by examining how fibre intakes are assessed by the 2004 Canadian Community Health Survey-Nutrition, and by outlining the limitations of using an AI to draw conclusions about fibre inadequacy. Recognizing the pitfalls of this methodology is the first step to improving the assessment of fibre intakes in Canada, which is needed before any intervention by Health Canada is implemented.
Continue reading An Exploration of the Methodological Flaws for Assessing Fibre Intake Among Canadians
On January 22, 2019, Health Canada unveiled the ninth version of Canada’s Food Guide. This was a necessary overhaul as the previous version, Eating Well with Canada’s Food Guide, hadn’t been updated since 2007 (Health Canada, 2007). Canada’s Food Guide is a tool developed by Health Canada to provide a basic tool to improve nutrition education and literacy in Canadians. The previous food guide received scrutiny from health professionals and the general public claiming it was outdated and influenced by the food industry, thereby adversely affecting its credibility (Health Canada, 2015). The newest version was produced in consultation with Canadians, including the general public, policy makers, and healthcare professionals and provides nutrition recommendations that align with the current nutrition research. The new Food Guide has many improvements; however, there are still some areas that lack inclusiveness for all Canadians.
Continue reading Canada’s New Food Guide: A Dietitian’s Perspective
Authors: Antonia Arnaert, Norma Ponzoni, Zoumanan Debe, France Morisette
(The article is available in French only)
Despite the increasing use of computerized care management systems in residences for older adults, there is very little evidence on the perceptions of caregivers regarding this technology, specifically the perceptions of orderlies. The purpose of this qualitative study is to explore the experiences of 17 orderlies vis-à-vis the use of the software “Soins Organisation Facilité Intérêt” (SOFI) in two senior residences in Quebec. Transcripts from four focus groups were analyzed using an inductive approach. All attendants agreed that the software was a positive asset that allowed them to better organize their tasks and documentation. In addition, they expressed the desire to use SOFI in their workflow to improve communication between themselves and with other professionals within the institution to participate in decision-making around quality of care. Finally, they insisted on the absolute necessity of having this technology be adapted to the working environment, both in its digital presentation and in its physical form, in order for it to be easy to access and use. The presence of software meeting the identified criteria enabled them to improve their performance through increased autonomy and their commitment to daily practice.
Continue reading Beneficiary attendant experiences on the use of a computerized care management system in senior’s homes
Authors: Rowena Merritt, Michelle Vogel, Patrick Ladbury
Overweight and obesity in childhood affects health long-term. Parent attitudes and behaviours play major roles in their child’s weight despite no consensus on appropriate and effective family-focused interventions to successfully tackle childhood obesity. This research aims to explore caregiver perceptions, attitudes, and behaviours around children’s diet, exercise, and weight in East Sussex. In-depth qualitative interviews with mothers, fathers, and grandparents of children aged 2-11 years were conducted. Caregivers wanted to influence their children’s diet and exercise habits but were unable due to perceived and actual barriers. Barriers included cost, time, and a lack of control over food choices as children aged. Moreover, caregivers admitted to providing unhealthy sweets and snacks to please their children. While caregivers openly discussed their own weight concerns, they were less likely to discuss concerns about their children’s or grandchildren’s weight. When asked about the ideal amount of exercise, caregivers found it easy to describe a regime for adults but did not know the ideal amount of exercise for children. Many caregivers found it difficult to quantify exercise when it came to their children because children naturally played in ways that could be considered exercise. Family-based interventions should begin in early childhood and promote walking and dog-walking as forms of exercise, parental education on childhood exercise guidelines, and preparing and eating healthy home-cooked meals in the home.
Continue reading A Qualitative Study Exploring Healthy Eating and Physical Activity in Families with Young Children
Author: Annick Vallières
(The article is available in French only)
Intersectionality is a concept that describes the various ways multiple forms of oppression or privilege are interconnected. Today, the concept also applies to the interconnection of different determinants of health in the study of health inequalities. This article describes the concept of intersectionality and how it relates to determinants of health by stating the factors that drive researchers to focus on intersectionality within the scope of determinants of health. It also explains how treating interconnected inequalities as multiple determinants affects people’s health, and how intersectionality can fill the gaps in knowledge surrounding the health of marginalized groups and the general population. The example of breastfeeding is used to show how the intersectional analysis framework could benefit the advancement of knowledge on a specific topic. In conclusion, the article addresses the methodological challenges that are left to overcome to advance the knowledge in this area.
Continue reading THE NEED FOR AN INTERSECTIONAL APPROACH TO HEALTH: THE CASE OF BREASTFEEDING
Author: Émilie Lessard
(The article is available in French only)
This article examines the influence of social determinants of health on the entry into, the continuance in, and the exit out of street-level prostitution in Canada. The complexity of street-level prostitution in young women creates multiple challenges in implementing a theoretical model to identify issues affecting the health of prostituted women. Street-level prostitution, being closely linked to substance abuse and homelessness, leads to increased health risks associated with drug dependence, sexually transmitted and blood-borne infections, mental health problems, increased exposure to physical, emotional and sexual abuse, and a high mortality rate. It is imperative to establish a transdisciplinary theoretical model to understand the entry, the continuance and the exit mechanisms of prostitution to better target preventative interventions and better support women wishing to leave street-level prostitution. The transdisciplinary approach also aims to provide courses of intervention for leaving the prostitution system and for guiding future research.
Continue reading EXITING STREET-LEVEL PROSTITUTION IN CANADA: THE TRANSDISCIPLINARY APPROACH OF THE INTEGRATED MODEL IN POPULATION HEALTH
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.
Continue reading Access for All to Restricted Access: The Evolution of Assisted Procreation Services in Quebec
Authors: Chau Huynh, Minh NQ Huynh
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.
Continue reading The Global Burden of Surgical Disease: An Analysis of Inaccessible Surgical Care in Low and Middle Income Countries
Author: Salomé Aubert
Sedentary behaviour has been identified as a specifically deleterious personal practice on multiple levels of health of individuals at all ages, including the pediatric population (i.e., 0 to 18 years of age). The aims of this paper are to (I) summarize the literature concerning the definition, the characteristics, the context, the determinants and the consequences of sedentary behaviour among children and youth; (II) propose a conceptual model that summarizes these findings; and finally (III) highlight research gaps in the literature. Sedentary behaviours are common and complex behaviours that can potentially affect the health of children and youth on the physiological and psychological levels. Those deleterious effects on health can vary depending on how they are accumulated throughout the day, for example with or without interruption, or in which context. While childhood engagement in sedentary behaviours is too high in the majority of countries where it has been assessed, developing research and policies that target the reduction of sedentary behaviours among children and youth must be ranked as a top priority for all public health organizations worldwide. Although further research is needed concerning the identification of the specific determinants and consequences of different types and patterns of sedentary behaviours in various contexts, the Conceptual Model for the Study and Understanding of Children and Youth’s Sedentary Behaviour, which I have proposed in this paper, gives an overview of the topic and supports the development of policy and further research.
Continue reading An overview of scientific-based knowledge on sedentary behaviour among the pediatric population – A conceptual model development
Author: Hayley Pelletier
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.
Continue reading Reducing interprofessional conflicts in order to facilitate better rural care: A report from a 2016 Rural Surgical Network Invitational Meeting