CLOSE
Advanced searchCitation search
Suggested Terms:
Skip main navigation

Search Result

1 - 17of17
Refine Search
per page:
Relevance
Filters

You do not have any saved searches

  • OPEN ACCESS
    Applying a Bauhaus design approach to conceptualize an integrated system of mental health care: Lessons from a large urban hospital
    FACETS • Vol. 1 • pp. 173 - 186
    We have applied a Bauhaus design lens to inform a visual conceptual framework for a rational mental health care system. We believe that Canada’s healthcare system can often be fragmented and does not always allow for service delivery to easily meet patient care needs. Within our proposed framework, the form of services provided follows patient- and healthcare-centred needs. The framework is also informed by the ethics and values of social responsibility, population health, and principles of quality of care. We review evidence for this framework (based on need, acuity, risk, service intensity, and provider level) and describe patient care pathways from intake/triage to three patient-centred tiers of care: (1) primary care (low needs), (2) acute ambulatory transitional care (moderate needs), and (3) acute hospital and complex care (high needs). Within each tier, various models of care are organized from low to high service intensity as informed by reports from the British Columbia Ministry of Health and the World Health Organization. We hope that our model may help to better conceptualize and organize our mental health care system and help providers clarify roles, responsibilities, and accountabilities to improve quality of care.
  • OPEN ACCESS
    Correction: Applying a Bauhaus design approach to conceptualize an integrated system of mental health care: Lessons from a large urban hospital
    FACETS • Vol. 1 • pp. 245 - 247
  • OPEN ACCESS
    Household food insecurity is independently associated with poor utilization of maternal healthcare services in Bangladesh
    FACETS • Vol. 2 • pp. 969 - 983
    Introduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.
  • OPEN ACCESS
    Fish consumption is inversely associated with type 2 diabetes in Manitoba First Nations communities
    FACETS • Vol. 2 • pp. 795 - 818
    Consumption of fish and n-3 fatty acids (n-3 FAs) has been postulated to prevent type 2 diabetes (T2D). Objective: To explore the association between self-reported T2D and fish consumption, dietary n-3 FAs, and persistent organic pollutants (POP) intake in a regionally representative sample of First Nations (FNs) in Manitoba. Design: Data from the cross-sectional First Nations Food, Nutrition and Environment Study (FNFNES) collected from 706 members of 8 Manitoba FNs in 2010 were used. Household interviews were used to collect social and lifestyle data. The consumption of fish was estimated using a traditional food frequency questionnaire. Fish samples were analyzed for the presence of POP. Multiple logistic regression models adjusted for potential risk factors for T2D were developed. Results: A negative, dose–response relationship was found between fish intake and self-reported T2D. Fish consumptions of 2–3 portions per month and ≥1/week were inversely associated with T2D with odds ratio (OR) values of 0.51 (95% CI: 0.28–0.91) and 0.40 (95% CI: 0.19–0.82), respectively, compared with no fish intake. Similarly, intake of n-3 FAs was negatively associated with T2D (OR = 0.48 (95% CI: 0.30–0.77). Dietary POP intake was not associated with T2D. Conclusion: These findings suggest that the consumption of traditionally harvested fish may have a beneficial effect on T2D in Manitoba FNs.
  • OPEN ACCESS
    Housing characteristics, home environmental factors, and pulmonary function deficit in Chinese children: Results from the Seven Northeast Cities (SNEC) Study
    FACETS • Vol. 3 • No. 1 • pp. 242 - 259
    To assess the effects of housing characteristics and home environmental factors on lung function of Chinese children, 6740 children (aged 6–16 years) were recruited from seven cities in Northeast China in 2012. Performance of lung function was determined by comparison of forced vital capacity (FVC), forced expiratory volume (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF). Multivariate regression models were used to evaluate the associations with lung function deficit. The results showed that housing conditions were associated with lung function deficit in children. The adjusted odds ratios were 0.47 (95% CI: 0.26–0.83) for FVC for “ping-fang” housing compared with “dan-yuan-lou-fang” housing and 2.90 (95% CI: 2.43–3.47) for FEV1 with home renovations completed within two years compared with counterparts. The linear regression models consistently showed a significant association of housing conditions and home environmental factors with lung function measurements across subjects. A residence taller than seven stories was negatively associated with FEV1 (β = −55; 95% CI: −97 to −13). In conclusion, housing conditions and home environmental factors are particularly important to the development of lung function and respiratory health in children. These factors are concerning and action should be taken to improve them.
  • OPEN ACCESS
    Parental overweight is associated with less encouragement of child dietary balance and variety and involvement in meal planning and preparation
    FACETS • Vol. 3 • No. 1 • pp. 155 - 163
    Little is known about how the body composition of parents of preschool-aged children is associated with their food parenting practices. In this study, we examined associations between parental body composition and food parenting practices in a sample of Canadian families with preschool-aged children. We conducted a cross-sectional analysis of 68 parents and 52 preschool-aged children. Measures included height, weight, waist circumference (WC), and percentage of fat mass (%FM) measured by BOD POD™. Parents completed an adapted version of the Comprehensive Feeding Practices Questionnaire. To account for correlated observations within families, we used generalized estimating equations with linear regression modelling to examine associations between parent body composition and food parenting practices, with child body mass index (BMI) z-score, child sex, parental sex, and family household income entered as covariates in all models. Parent BMI, WC, and %FM were each significantly and inversely associated with the encouragement of a balanced diet (
    cover
     = −0.021, p = 0.006;
    cover
     = −0.007, p = 0.038;
    cover
     = −0.010, p = 0.034, respectively) and child involvement in meal planning and preparation (
    cover
     = −0.082, p = 0.002;
    cover
     = −0.025, p = 0.032;
    cover
     = −0.038, p = 0.049, respectively). We provide preliminary evidence that overweight/obesity may be associated with select food parenting practices in Canadian families with preschool-age children. Parental body composition may be an important consideration in intervention strategies that target food parenting practices.
  • OPEN ACCESS
    Substitute foods are more likely than their traditional food counterparts to display front-of-package references
    FACETS • Vol. 3 • No. 1 • pp. 455 - 468
    Innovative, highly processed foods are often designed to “substitute” for traditional, less-processed items in the diet. Yet, concerns about the unhealthfulness of diets high in highly processed foods are growing. Their dominance in the diet has been hypothesized to relate, in part, to the strategic use of on-package nutrition promotion. Our goal was to compare front-of-package (FOP) labelling on highly processed products that appear to have been explicitly designed as substitutes for traditional foods with the FOP labelling on their traditional counterparts. FOP references were recorded from packaged foods in three major Toronto grocery stores (N = 20520). Foods were categorized as substitute or traditional counterparts if these had (1) immediate interchangeability within the diet, (2) inherently different formulation, and (3) the substitute was more heavily processed than its traditional counterpart. Eight substitute–traditional pairs were identified, comprising 18% of products in the data set. Substitute foods were more likely than traditional products to bear FOP nutrition, “organic”, and “natural” references. Substitute foods bore 1.21 times more FOP references, the majority of which highlighted nutrients inherent to the traditional counterpart. Our findings support the contention that highly processed foods may be displacing less-processed foods at least in part through the use of strategic on-package marketing.
  • OPEN ACCESS
    Defining modifiable barriers to uptake of dietary recommendations in Chinese immigrants with type 2 diabetes: a qualitative study
    FACETS • Vol. 4 • No. 1 • pp. 551 - 565
    The objective is to support development of a nutritional intervention for Chinese immigrants with diabetes by defining current deficiencies and identifying modifiable factors and mechanisms of change. Semi-structured interviews conducted with 13 ethnic Chinese with type 2 diabetes identified modifiable problems related to culturally relevant diabetes resources and low cultural acceptability of recommended diets. These factors could be addressed through creation of resources developed in partnership with Chinese-speaking health care professionals and persons with diabetes.
  • OPEN ACCESS
    Easing the disruption of COVID-19: supporting the mental health of the people of Canada—October 2020—an RSC Policy Briefing
    FACETS • Vol. 5 • No. 1 • pp. 1071 - 1098
    The COVID-19 pandemic has had a significant impact on the mental health of the people of Canada. Most have found it challenging to cope with social distancing, isolation, anxiety about infection, financial security and the future, and balancing demands of work and home life. For some, especially those who have had to face pre-existing challenges such as structural racism, poverty, and discrimination and those with prior mental health problems, the pandemic has been a major impact.The Policy Briefing Report focuses on the current situation, how the COVID-19 pandemic has exacerbated significant long-standing weaknesses in the mental health system and makes specific recommendations to meet these challenges to improve the well-being of the people of Canada.The COVID-19 pandemic has had a detrimental effect on mental health of people in Canada but the impact has been variable, impacting those facing pre-existing structural inequities hardest. Those living in poverty, and in some socially stratified groups facing greater economic and social disadvantage, such as some racialized and some Indigenous groups and those with preexisting mental health problems, have suffered the most. Some occupational groups have been more exposed to the virus and to psychological stress with the pandemic. The mental health care system was already overextended and under resourced. The pandemic has exacerbated the problems. The care system responded by a massive move to virtual care. The future challenge is for Canada to strengthen our knowledge base in mental health, to learn from the pandemic, and to provide all in Canada the support they need to fully participate in and contribute to Canada’s recovery from the pandemic.
  • OPEN ACCESS
    Socioeconomic settings and food consumption patterns of 2–5-year-old children in developed countries: a scoping review
    FACETS • Vol. 6 • pp. 1495 - 1509
    Introduction: Early childhood overweight and obesity, as a result of unhealthy dietary habits and sedentary life, is a growing global public health concern, particularly in Canada. There are limited data on how socioeconomic factors influence dietary habits of young children living in developed countries. Methods: We conducted a scoping review to examine the existing literature on how socioeconomic settings influence food consumption patterns of children 2–5 years old in developed countries. The inclusion criteria were relevant articles in the English language between 2007 and 2019. Results: From the initial 1854 articles, only 12 articles from Europe, Canada, and the United States met the inclusion criteria. There are differences in eating patterns of preschool-aged children based on parental education, whereas income level did not have a clear influence on dietary patterns. The existing studies suffer from a variety of limitations that limit a cohesive conclusion. Conclusion: Studies with children 2–5 years old are scarce. Parental education seems to influence the dietary habits of young children, whereas the role of income is not clear. There is a need for further high-quality research, preferably longitudinal studies, to inform health promotion initiatives and preventive strategies to facilitate healthy growth and development in young children.
  • OPEN ACCESS
    Seeking shelter: homelessness and COVID-19
    FACETS • Vol. 6 • pp. 925 - 958
    Those experiencing homelessness in Canada are impacted inequitably by COVID-19 due to their increased exposure, vulnerability of environment and medical comorbidities, and their lack of access to preventive care and treatment in the context of the pandemic. In shelter environments one is unable to effectively physically distance, maintain hygiene, obtain a test, or isolate. As a result, unique strategies are required for this population to protect them and those who serve them. Recommendations are provided to reduce or prevent further negative consequences from the COVID-19 pandemic for people experiencing homelessness. These recommendations were informed by a systematic review of the literature, as well as a jurisdictional scan. Where evidence did not exist, expert consensus from key providers and those experiencing homelessness throughout Canada was included. These recommendations recognize the need for short-term interventions to mitigate the immediate risk to this community, including coordination of response, appropriate precautions and protective equipment, reducing congestion, cohorting, testing, case and contact management strategies, dealing with outbreaks, isolation centres, and immunization. Longer-term recommendations are also provided with a view to ending homelessness by addressing the root causes of homelessness and by the provision of adequate subsidized and supportive housing through a Housing First strategy. It is imperative that meaningful changes take place now in how we serve those experiencing homelessness and how we mitigate specific vulnerabilities. These recommendations call for intersectoral, collaborative engagement to work for solutions targeted towards protecting the most vulnerable within our community through both immediate actions and long-term planning to eliminate homelessness.
  • OPEN ACCESS
    Fundamental limitations of contact tracing for COVID-19
    FACETS • Vol. 6 • pp. 1993 - 2001
    Contact tracing has played a central role in COVID-19 control in many jurisdictions and is often used in conjunction with other measures such as travel restrictions and social distancing mandates. Contact tracing is made ineffective, however, by delays in testing, calling, and isolating. Even if delays are minimized, contact tracing triggered by testing of symptomatic individuals can only prevent a fraction of onward transmissions from contacts. Without other measures in place, contact tracing alone is insufficient to prevent exponential growth in the number of cases in a population with little immunity. Even when used effectively with other measures, occasional bursts in call loads can overwhelm contact tracing systems and lead to a loss of control. We propose embracing approaches to COVID-19 contact tracing that broadly test individuals without symptoms, in whatever way is economically feasible—either with fast and cheap tests that can be deployed widely, with pooled testing, or with screening of judiciously chosen groups of high-risk individuals. These considerations are important both in regions where widespread vaccination has been deployed and in those where few residents have been immunized.
  • OPEN ACCESS
    COVID-19 epidemiology in Canada from January to December 2020: the pre-vaccine era
    FACETS • Vol. 6 • pp. 760 - 822
    This paper summarizes COVID-19 disease epidemiology in Canada in the pre-vaccine era—from January through to December 2020. Canadian case numbers, risk factors, disease presentations (including severe and critical disease), and outcomes are described. Differences between provinces and territories in geography, population size and density, health demographics, and pandemic impact are highlighted. Key concepts in public health response and mitigation are reviewed, including masking, physical distancing, hand washing, and the promotion of outdoor interactions. Adequate investment in public health infrastructure is stressed, and regional differences in screening and testing strategies are highlighted. The spread of COVID-19 in Canadian workplaces, long-term care homes, and schools is described and lessons learned emphasized. The impact of COVID-19 on vulnerable populations in Canada—including Indigenous Peoples, ethnic minorities and newcomers, people who use drugs, people who are homeless, people who are incarcerated, and people with disabilities—is described. Sex and gender disparities are also highlighted. Author recommendations include strategies to reduce transmission (such as test–trace–isolate), the establishment of nationally standardized definitions and public reporting, the protection of high risk and vulnerable populations, and the development of a national strategy on vaccine allocation.
  • OPEN ACCESS
    The association of typical and atypical symptoms with in-hospital mortality in older adults with COVID-19: a multicentre cohort study
    FACETS • Vol. 7 • pp. 1199 - 1213
    Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106; 6.2%). The most common atypical symptoms were anorexia (n = 598; 33.5%), weakness (n = 519; 23.9%), and delirium (n = 449; 25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.62–2.62), tachycardia (aOR 1.87; 95% CI 1.14–3.04), and delirium (aOR 1.52; 95% CI 1.18–1.96) were independently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presentations in older adults.
  • OPEN ACCESS
    How not to manage a pandemic, and how to recover from it: Lessons from Ecuador
    FACETS • Vol. 7 • pp. 1367 - 1384
    Since the initial outbreak in December 2019, the COVID-19 pandemic has resulted in more than four million deaths worldwide. Ecuador initially experienced one of the worst coronavirus outbreaks in the world. The pandemic quickly overwhelmed health care systems resulting in excess deaths of 37 000 from March to October, 2020. The public health measures taken to stop the spread of the virus had a devastating impact on the economy. There was a sharp contraction (7.8%) in Ecuador’s GDP in 2020. Furthermore, income poverty and inequality increased dramatically. The lasting effects of the pandemic will be harder to overcome. This article recounts and analyzes the COVID-19 pandemic in Ecuador, to draw lessons from this complex experience, and from the benefit of limited but important successes. We also aim to provide suggestions for best practices moving forward.
  • OPEN ACCESS
    Prospective cohort study of Helicobacter pylori infection on the risk of nonalcoholic fatty liver disease
    FACETS • Vol. 9 • pp. 1 - 8
    To investigate the epidemiological connection between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H. pylori). 6,478 retired and active workers, aged 22-69 years, were included in the study. Their baseline measures of height, weight, waist measurement, body mass index, blood pressure, fasting blood sugar, plasma lipid, liver function index, glycosylated hemoglobin, abdominal ultrasonography, and findings from the line “13 C urea breath test” H. pylori test were analyzed, and follow-up with consistent baseline methods and criteria was performed annually. Over a 4-year period, the prevalence of NAFLD increased by 16.9%, with 612 (18.7%) of those who tested positive for H. pylori developing NAFLD, whereas 484 (15.1%) of those who did not test positive for H. pylori were later diagnosed with new NAFLD (χ2 = 14.862, P < 0.05). One of the risk factors identified in the univariable Cox regression model for NAFLD was H. pylori (Hazard Ratio = 1.297; 95.0% confidence interval (CI) 1.150,1.485, P < 0.000); however, H. pylori continued to be an independent factor affecting the risk of NAFLD even after accounting for gender, age, and aspects of the metabolic syndrome (Hazard Ratio = 1.240; 95.0% CI 1.077,1.429, P = 0.003). The growth of NAFLD may be correlated with H. pylori infection.
  • OPEN ACCESS
    Poor mental health negatively impacts farmers personally, interpersonally, cognitively, and professionally
    FACETS • Vol. 9 • pp. 1 - 16
    Farmers globally face significant occupational stressors and are reported to experience high levels of depression, anxiety, burnout, suicide ideation, and suicide. While the impacts of high stress and poor mental health have been well-studied in the general population, and to some extent, in specific occupations, the impacts on farmers are understudied. The objective here was to explore the lived experience of high stress and (or) poor mental health in Canadian farmers, including the perceived impacts. Using a phenomenological approach within a constructivist paradigm, we conducted 75 one-on-one research interviews with farmers and people who work closely with farmers, in Ontario, Canada, between July 2017 and May 2018. We analysed the data via thematic analyses and identified four major themes. Participants described myriad negative impacts of farmers’ high stress and (or) poor mental health: (1) personally, (2) interpersonally, and (3) cognitively, which ultimately negatively impacted them (4) professionally, including consequences for productivity, animals, and farm success. The data described far-reaching, interconnected impacts of high stress and poor mental health on participants, the people and animals in their lives, and most aspects of their farming operations, financial viability, and success. Farmer stress, mental health, and well-being are important considerations in promoting sustainable, successful agriculture.