Canada’s New Food Guide: A Dietitian’s Perspective

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An Exploration of the Methodological Flaws for Assessing Fibre Intakes Among Canadians

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.

Expériences de préposées aux bénéficiaires sur l'utilisation d'un système informatisé de gestion des soins en résidences pour personnes âgéees

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.

A Qualitative Study Exploring Healthy Eating and Physical Activity in Families with Young Children

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.

La Nécessité Des Approches Intersectionnelles en Santé: Le Cas de L’allaitement Maternel

L’intersectionnalité renvoie à des expériences différenciées en fonction de l’articulation de multiples formes d’oppressions ou de privilèges. Le concept est également repris aujourd’hui pour l’étude des inégalités en santé, le plus souvent en se basant sur l’intersection de différents déterminants de la santé. Dans ce texte, l’auteure présente tout d’abord brièvement le concept d’intersectionnalité, puis fait le lien avec les déterminants de la santé. Pour ce faire, l’auteure aborde les raisons qui poussent les chercheur(e)s à se concentrer sur l’intersectionnalité dans le domaine des déterminants de la santé. L’article explique comment le fait de considérer l’articulation des inégalités en termes de « déterminants multiples » affecte la santé; ainsi que comment l’intersectionnalité peut combler des lacunes sur les connaissances de la santé des groupes marginalisés et de la population en général. De plus, l’auteure utilise l’exemple de l’allaitement maternel pour montrer de quelles manières le cadre d’analyse intersectionnelle pourrait être bénéfique pour l’avancement des connaissances sur un sujet précis. Pour conclure, l’auteure aborde les défis méthodologiques qu’ils restent à relever pour faire avancer les connaissances dans ce domaine.

Sortir de la Prostitution de Rue au Canada: L’approche Transdisciplinaire du Modèle Intégré en Santé des Populations

Cet article examine l’influence des déterminants sociaux de la santé sur les trajectoires d’entrée, de maintien et de sortie de la prostitution de rue au Canada. La complexité de la problématique de la prostitution de rue chez les jeunes femmes entraîne de multiples défis quant à la mise en place d’un modèle théorique permettant de cerner les enjeux relatifs à la santé des femmes prostituées. La prostitution de rue étant fortement liée à la toxicomanie et à l’itinérance, entrainant une augmentation des risques de problèmes de santé associés à l’abus de substance, aux infections transmissibles sexuellement et par le sang, à des problèmes de santé mentale, une exposition accrue à la violence physique, émotionnelle et sexuelle et à un taux de mortalité élevé. Il est impératif d’établir un modèle théorique transdisciplinaire permettant de saisir les mécanismes d’entrée, de maintien et de sortie de la prostitution, afin de mieux cibler les interventions en matière de prévention et pour mieux soutenir les femmes désirant quitter la prostitution de rue. De plus, l’approche transdisciplinaire vise à fournir des pistes d’interventions pour promouvoir la sortie du système prostitutionnel et pour guider les recherches futures.

D’un Accès Pour Tous à un Accès Restreint: L’évolution Des Services de Procréation Assistée au Québec

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

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.

Reducing Interprofessional Conflicts in Order to Facilitate Better Rural Care: A Report From a 2016 Rural Surgical Network Invitational Meeting

An invitational meeting organized by the Centre for Rural Health Research con-vened to facilitate respectful dialogue with general surgeons in British Columbia; the objective was 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) made during 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.

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

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.