Comprehensive school health, the social determinants of health, and the health status of children

As children are becoming increasingly inactive and obese, there is an urgent need for effective early prevention and intervention programs. One solution is a comprehensive school health (CSH) program, a health promotion initiative aimed at educating students about healthy behaviours and lifestyles, which also provides a link between the school, students, families, and the surrounding community. The purpose of this study was to explore the relationship between different components of CSH programs, as well as three determinants of health (gender, social support, socio-economic status), and physical activity, on the aerobic fitness and body mass index (BMI) of children. A newly developed and pilot-tested survey derived from Health Canada's fourpart CSH model (instruction, social support, support services, and a healthy physical environment) was sent to elementary school principals. Data on the gender, physical activity, parental education, and social support levels of students from these schools were gathered from a previous study. Multiple regression procedures were conducted to estimate the relationships between CSH components, the social determinants of health, physical activity, and BMI and aerobic fitness. Results showed that three CSH components were significantly associated with both BMI and aerobic fitness values in children, but accounted for less than 5% of the variance in both variables. Physical activity partially mediated the relationship between the significant CSH components, BMI, and particularly aerobic fitness. Furthermore, the social determinant and physical activity variables played independent roles in aerobic fitness values. No moderating effects of the social determinants were discovered.

The elderly : reminiscing, coping with loss, accepting death

This study investigated loss, death and dying, reminiscing, coping and the process of adaptation from the sUbjective perspective. A number of theories and models of death and dying were reviewed in the background literature search with the focus on reminiscing as a coping phenomenon. The format of the study was audio-taped interviews with ten sUbjects and the recording of their memories and reminiscing of life stories. The sUbjects were required to complete an initial questionnaire in a demographic data collection process. Two separate interviews consisted of a primary data collecting interview and a verification interview four to eight weeks later. An independent chart review completed the data collecting process. Data analysis was by the examination of the emerging themes in the subjects' personal narratives which revealed the sUb-categories of reminiscing, loss (including death and dying), acceptance, hope, love, despair and belief. Belief was shown to be the foundation and the base for living and reminiscing. Reminiscing was found to be a coping phenomenon, within the foundation of a belief system. Both living and reminiscing revealed the existence of a central belief or value with a great deal of importance attached to it. Whether the belief was of a spiritual nature, a value of marriage, tradition, a work ethic or belief in an abstract value such as fate,it gave support and control to the individuals' living and reminiscing process. That which caused despair or allowed acceptance indicated the sUbjects' basic belief and was identified in the story narrations. The findings were significant to health care in terms of education, increased dignity for the elderly and better understanding by society. The profiles represented an average age of 86.3 years with age showing no bearing on the life experiences associated with the emerging themes. Overwhelmingly, belief was shown to be the foundation in reminiscing. A Judeo-Christian cultural value base supported the belief in 90% of the sUbjects; however, different beliefs were clearly shown indicating that belief is central to all thinking beings, in everyday life and in reminiscing. Belief was not necessarily spiritual or a practised or verbalized religion. It was shown to be a way of understanding, a fundamental and single thread tying the individual's life and stories together. The benefits were the outcomes, in that knowledge of an individual's belief can optimize care planning for any age group, and/or setting. The strength of the study was the open question format and the feedback process of data verification. The unrestricted outcomes and non-specificity were significant in a world where dying is everybody's business.

The impact of the Canadian Standardized Test of Fitness and of health counselling on health attitudes and behaviour

The purpose of this research study was to determine whether or not the use of a single day of Personal Wellness Evaluations would be meaningful enough to change the attitudes of participants toward adopting a healthier lifestyle, or if it was necessary to include regular planned health counselling alon-g with the Personal Wellness Evaluations in order to'observe changes in beliefs, attitudes and behaviours toward active living and the adoption of a healthier lifestyle. Attitudes and behaviours toward physical fitness and healthy lifestyle choices were assessed through a questionnaire composed of the following instruments: Fishbein and Ajzen Attitude and Behaviour Questionnaire, Leisure Behaviour Questionnaire, Ten Centimeter Bipolar Health Continuum, Neugarten Life Satisfaction Assessment, Job Description Index, Selected questions from the Ontario Health Survey, and the Symptom Reporting Questionnaire. Physical fitness evaluation consisted of the Canadian Standardized Test of Fitness, measures of blood pressure, and total cholesterol. The participants were divided into three groups: Group 1- CSTF & health counselling, Group 2- CSTF only, and Group 3- a control group. All three groups received the questionnaire both at the beginning and at the end of the study. Group 1 and Group 2 also participated in fitness testing at these same times, with a three-month time interval between test times. Group 1 also received weekly one-hour health education sessions during the three months between fitness testing. While there were some differences found between the three groups in this study, the results of this study suggested that this three-month workplace wellness program had no impact on the participants' attitudes and behaviours toward health and physical activity. There were no significant differences in the physical fitness measures between Group 1 and Group 2 , nor in the participants' questionnaire responses. These results may be due to the participants' lack of compliance to this wellness program. Employees who 11 participate in a workplace weIlness program must be self-motivated to comply with the program in order to receive the full benefits the program has to offer. Some participants in this study did not have the internal motivation necessary to remain in the study for the three-month period. Future research may consider implementing a workplace wellness program for a longer duration as well as incorporating a specific physical fitness program for the participants to follow. An exercise program could improve the participants' physical fitness, while the health counselling would give the individuals the health education necessary to lead a healthy lifestyle.

Self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey

The purpose of this cross sectional survey design was to examine self-reported health status and lifestyle behaviours of the residents of the Town of Fort Erie, Ontario, as related to the Canadian Community Health Survey. Using a mail-out survey, entitled the Fort Erie Survey of Health (FESH), a probability cluster sampling technique was used to measure self-reported health status (present health, health conditions, health challenges, functional health limitations) and lifestyle behaviour (smoking, alcohol use, drug use, physical activity, fruit and vegetable consumption, body weight, and gaming). Each variable was described and analyzed in relation to socio-economic variables, age and gender. The findings from this study were compared to the Canadian Community Health Survey 2000/2001. Overall, 640 surveys were completed. The majority of Fort Erie residents rated their present health as good and were satisfied with their overall health and quality of life. The main chronic conditions reported were arthritis, back pain and heart disease. Other main health problems reported were vision, sleeping and chronic pain. Overall, 14.6% smoke; 58.8% engaged in physical activity either occasionally or never as opposed to regularly engaging in physical activity; 52.1% did not eat the required daily fruits and vegetables; and 40.0% were in the overweight category. Persons who practiced one healthy lifestyle behaviour were more likely to practice other healthy promoting behaviours. Therefore, health promotion programs are best designed to address multiple risk factors simultaneously. The ffiSH was generally consistent with the Canadian Community Health Survey in the overall findings. A small number of inconsistencies were identified that require further exploration to determine if they are unique to this community.

Characterisation and optimisation of the flavour of health-promoting, plantderived bitterants in functional beverages.

Flavour is a combination of taste, odour, and chemesthetic sensations. Close associations exist between these sensory modalities, and thus, the overall flavour of a food or beverage product can change when the intensity of one or more of these sensations is altered. Strategies to modify flavour are often utilized by the food industry, and are central to the engineering of new and reformulated products. For functional food and beverages, flavour modification is particularly important, as fortifying agents can elicit high levels of less than desirable sensations, such as bitterness and astringency. The application of various flavour modifying strategies can decrease the perceived intensity of these sensations, and in tum, improve the sensory profile of the product. This collection of studies describes the sensory characteristics of experimental functional beverages fortified with trans-resveratrol, (+)-catechin, and/or caffeine, and examines the impact of novel flavour modifying strategies on the perceived flavour of these beverages. In the first study, results demonstrate that the flavour profile of Cabemet Sauvignon wines fortified with 20 mglL and 200 mg/L of trans-resveratrol is not perceived as different compared to control wine (0 mglL). However, Riesling wine fortified with 200 mg/L is perceived as significantly higher in bitterness compared to 20 mglL and control. For some functional food formulations, alternative strategies for flavour modification are needed. Traditional methods, such as the addition of sucrose and sodium chloride, may decrease the perceived 'healthiness' of a product, and thus, may be sub-optimal. In a second study, high and low concentrations of five different bitter inhibiting compounds - 'bitter blockers' - (B-cyclodextrin, homoeridictyol sodium salt, carboxymethylcellulose - low viscosity, zinc sulfate, magnesium sulfate) were tested for their efficacy towards decreasing the bitterness of high and low concentrations of caffeine and (+)catechin - two health-relevant, plant-derived bitterants. B-cyclodextrin and homoeridictyol sodium salt were the most effective blockers at decreasing (+ )-catechin and caffeine, respectively. In addition to bitter blockers, additional flavour modifying strategies, either alone or in combination - may also be successful in functional food formulations. Both sucrose and rebaudioside A - a plant-derived sweetener - were effective at decreasing the bitterness of (+)catechin. When added to (+)-catechin along with B-cyc1odextrin, both sweeteners provided the most effective decrease in bitterness compared to binary, ternary, or quaternary mixtures of (+)catechin together with bitter blockers, sweeteners, andlor odourants. The perceived intensity of sensations elicited by sweeteners and odourants was not affected by the addition of bitter blockers, and thus, their impact within these complex matrices is minimal. In addition, withinmodal (taste-taste) compared to cross-modal (taste-odour) sensory interactions were more effective at decreasing the bitterness of (+ )-catechin. Overall, results from these studies demonstrate that certain novel, alternative flavour modifying approaches may be successful towards lowering the bitterness and astringency elicited by (+ )-catechin and caffeine in aqueous solutions.

Order to create a General Board of Health in the Town of Niagara, June 25, 1832

In the early nineteenth century, a widespread outbreak of cholera occurred in continental Europe, eventually spreading to the British Isles. The disease subsequently spread to Canada as impoverished British immigrants seeking a better life arrived in the country. To help curb the spread of the disease, local Boards of Health were created.

Order to create a General Board of Health in the Town of Niagara, June 25, 1832.

In the early nineteenth century, a widespread outbreak of cholera occurred in continental Europe, eventually spreading to the British Isles. The disease subsequently spread to Canada as impoverished British immigrants seeking a better life arrived in the country. To help curb the spread of the disease, local Boards of Health were created.

Determining the Effectiveness of the Therapeutic Recreation Specialist - Certified Training at Baycrest Health Sciences

The purpose of this study was to determine the effectiveness of the “Champion” training of the Therapeutic Recreation Specialist – Certified (TRSC) at Baycrest Health Sciences (BHS). BHS recently implemented a new model for Therapeutic Recreation Services that employs the model of champion for implementation of both best and next practices within the organization. This mixed methods study used both case study and program evaluation in order to understand whether the training that comprised of five different topics allowed the six participants to develop the skills needed to be champions. The results supported that learning did occur during the training and that the experience was positive for the participants. The overall finding from this study is that while the training was useful, the participants did not feel confident about utilizing these skills without further training; hence, this training can only be considered an introduction to the concepts presented.

The environment as a tool for health towards a definition of the individual boundary process = L'environnement comme outil de santé vers une définition du processus de gestion des frontières personnelles

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Social Media Use in Medical and Health Professional Education: Role of the Librarian on a Faculty Steering Committee

Objective: An interprofessional steering committee was created at Université de Montréal’s Faculty of Medicine to examine how social media are integrated in medical and health professional education in universities across the globe, and to propose a strategic plan for integrating social media in the Faculty’s various curricula. This presentation will summarize the steering committee’s work and describe the librarian’s contribution. Methods: The Committee’s project leader first conducted a literature search on best practices of social media in medical and health professional curricula. A reference website was then created (mse.med.umontreal.ca) to provide easy access to a large number of the articles and resources reviewed. A steering committee was constituted and 11 meetings were held over a 9-month period. The Committee comprised 18 members and included assistant deans, academic program directors, professors, communication advisors, undergraduate and graduate students and a librarian. An online survey on social media use by students and professors of the Faculty was conducted, ten pilot projects were put forward and a three-year strategic plan was proposed. Results: A total of 1508 students and 565 professors participated in the survey. Results showed that both groups had a strong interest in learning how social media could be integrated in academic and professional activities. Participants reported concern with risks associated with social media use and expressed the need for a Faculty policy and guidelines. The librarian’s contribution to the steering committee included: writing posts on the website’s internal blog, assisting in the design of the survey questionnaires and writing the final report’s survey results chapter. She also proposed two pilot projects: creating a social media learning portal and an altmetrics workshop. Conclusions: Based on the literature review and the survey results, the Committee affirmed the importance of integrating social media in the various study programs of the Faculty of Medicine. Despite the restricted timeline, this interprofessional steering committee was able to carry out its mandate because of the leadership and expertise of each of its members. As the librarian had the most experience with the use of social media in a professional context, her knowledge was instrumental in assisting the project leader in a group mainly composed of social media non-users.

Misogyny in Health Professions? An Analysis of the Dalhousie Dentistry Scandal

Commentaire / Commentary

Rashtriya Swasthya Bhima Yojana-Comprehensive Health Insurance Scheme (Rsby-Chis) In Kerala: A Study On The Effectiveness And Utilization Of The Scheme With Special Reference To Ernakulam And Wayanad Districts

Health insurance has become a necessity for the common man, next to food, clothing and shelter. The financing of health expense is either catastrophic or sometimes even frequently contracted illnesses, is a major cause of mental agony for the common man. The cost of care may sometimes result in the complete erosion of the family savings or may even lead to indebtedness as many studies on causes of rural indebtedness bear testimony (Jayalakshmi, 2006). A suitable cover by way of health insurance is all that is required to cope with such situations. Health care insurance rightly provides the mechanism for both individuals and families to mitigate the financial burden of medical expenses in the present context. Hence a well designed affordable health insurance policy is the need of the hour.Therefore, it is very significant to study the extent to which the beneficiaries in Kerala make use of the benefits provided by a social health insurance scheme like RSBY-CHIS. Based on the above pertinent points, this study assumes national relevance even though the geographical area of the study is limited to two districts of Kerala. The findings of the study will bring forth valuable inputs on the services availed by the beneficiaries of RSBYCHIS and take appropriate measures to improve the effectiveness of the scheme whereby maximum quality benefit could be availed by the poorest of the poor and develop the scheme as a real dawn of the new era of health for them

An Interview with Stephanie Meakin of the Faculty of Health Sciences regarding developing leadership skills in students.

Mp3 format

Interdisciplinary Pedagogical Experience for Health Human Resources Focused on the Holistic Promotion of Health and the Prevention of the Disease

The object of this experience is to offer the students the opportunity to take part in the construction of a pedagogic strategy centred on the ludic, for the promotion of the integral health and the prevention of the disease with an educational community; directed to supporting and qualifying the well-being so much individually as group. The project is designed to five years, about interdisciplinary character (Speech Therapy, Medicine, Psychology, Nursery, Occupational Therapy), interinstitutional (Universidad del Rosario, Universidad de San Buenaventura y Universidad de Cundinamarca) and intersectorial (Education and Health). It considers the different actors of the educational community and school and the home as propitious scenes for the strengthening potential, beside being the fundamental spaces for the construction of knowledges and learnings concerning the integral health. To achieve the target, one has come constructing from the second semester of 2003, one pedagogic strategy centred on the ludic and the creativity, from which they are planned, they develop and evaluate the actions of promotion of skills, values, behaviors and attitudes in the care of the health and the prevention of disease, orientated to the early, opportune and effective detection of risk factors and problematic of the development that they affect the integral health. The above mentioned strategy raises a so called scene Bienestarópolis: A healthy world for conquering, centred on prominent figures, spaces and elements that alternate between the fantasy and the reality to facilitate the approximation, the interiorización and the appropriation of the integral health. Across this one, the children motivated by the adults enter an imaginary world in that theirs desires, knowledges and attitudes are the axis of his development. Since Vigotsky raises it, in the game the child realizes actions in order to adapt to the world that surrounds it acquiring skills for the learning. The actions of the project have involved 410 children and 25 teachers, of the degrees Zero, The First and The Second of basic primary; 90 parents of family, and an average of 40 students and 8 teachers of the already mentioned disciplines.

Conceptuals Mentefactos as a Didactic-Pedagogical Strategy of the Basic Concepts in the Sampling Theory Applyed to the Health Research

In populational sampling it is vitally important to clarify and discern: first, the design or sampling method used to solve the research problem; second, the sampling size, taking into account different components (precision, reliability, variance); third, random selection and fourth, the precision estimate (sampling errors), so as to determine if it is possible to infer the obtained estimates from the target population. The existing difficulty to use concepts from the sampling theory is to understand them with absolute clarity and, to achieve it, the help from didactic-pedagogical strategies arranged as conceptual “mentefactos” (simple hierarchic diagrams organized from propositions) may prove useful. This paper presents the conceptual definition, through conceptual “mentefactos”, of the most important populational probabilistic sampling concepts, in order to obtain representative samples from populations in health research.