an cities for at least three decades by the time the Canadian Public Health Association was founded in 1910.1 Journals such as the American Journal of Nursing, the Visiting Nursing Quarterly, and the Canadian Nurse provided the profession with compelling accounts of nurses working in a variety of roles to prevent illness and promote the health of vulnerable populations such as: immigrants; the urban poor; infants and children; and isolated families living in rural and northern Canada. The terms “visiting nurse” and “district nurse” were used interchangeably in the journals and textbooks of the time, and in all cases, these nurses were defined as public health nurses (PHNs). Lillian Wald, a registered nurse and social reformer who founded the Henry Street Settlement in New York City in 1895, coined the term PHN in 1893 to describe the nurses who worked in poor and middle-class communities rather than in hospitals or in the homes of wealthy employers.2 Little is known about the earliest Canadian PHNs, but most were likely employed singly or in pairs by charitable or religious organizations who established small community-based outreach programs in many parts of Canada. For example, it is known that a diet dispensary in Montreal employed a district nurse as early as 1885.1 Toronto’s Nursing-at-Home Mission was established in 1889 to support two nurses who worked with poor families living near the Children’s Hospital.1 In 1897, the Victorian Order of Nurses (VON), a national district nursing association modelled on the British Institute of Queen’s Nurses in Britain, was founded in Ottawa.3 In many communities, the VON contracted with local governments or charities to provide PHN programs, and they have continued to do so throughout their history. As well, many voluntary PHN programs were founded by local organizations during this era, including the Margaret Scott Nursing Mission (Winnipeg, 1905),4 the Lethbridge Nursing Mission (1909),5 and the St. Elizabeth Visiting Nurses’ Association (c.1910).6 School health programs, sponsored by local school boards, emerged early in the 20th century. In 1907, the Montreal school board inaugurated the first medical inspection program in Canada.7 Mandated to identify and seek treatment for school-aged children with preventable health problems or communicable conditions, school boards initially hired physicians to work in the schools. However, they soon discovered that the effectiveness of school health programs was significantly enhanced when nurses made home visits to the families of children identified in the school setting as being ill or at risk of developing illness. In 1909, school boards in Winnipeg and Hamilton employed nurses to work with school-aged children and their families.7,8 In addition to the physical inspection of children, school-based PHNs also provided health education programs to children and their families.7-9 In response to the high mortality rates associated with tuberculosis (TB) and prev
{"title":"Public Health Nursing in Early 20th Century Canada","authors":"M. Mckay","doi":"10.17269/CJPH.100.1842","DOIUrl":"https://doi.org/10.17269/CJPH.100.1842","url":null,"abstract":"an cities for at least three decades by the time the Canadian Public Health Association was founded in 1910.1 Journals such as the American Journal of Nursing, the Visiting Nursing Quarterly, and the Canadian Nurse provided the profession with compelling accounts of nurses working in a variety of roles to prevent illness and promote the health of vulnerable populations such as: immigrants; the urban poor; infants and children; and isolated families living in rural and northern Canada. The terms “visiting nurse” and “district nurse” were used interchangeably in the journals and textbooks of the time, and in all cases, these nurses were defined as public health nurses (PHNs). Lillian Wald, a registered nurse and social reformer who founded the Henry Street Settlement in New York City in 1895, coined the term PHN in 1893 to describe the nurses who worked in poor and middle-class communities rather than in hospitals or in the homes of wealthy employers.2 Little is known about the earliest Canadian PHNs, but most were likely employed singly or in pairs by charitable or religious organizations who established small community-based outreach programs in many parts of Canada. For example, it is known that a diet dispensary in Montreal employed a district nurse as early as 1885.1 Toronto’s Nursing-at-Home Mission was established in 1889 to support two nurses who worked with poor families living near the Children’s Hospital.1 In 1897, the Victorian Order of Nurses (VON), a national district nursing association modelled on the British Institute of Queen’s Nurses in Britain, was founded in Ottawa.3 In many communities, the VON contracted with local governments or charities to provide PHN programs, and they have continued to do so throughout their history. As well, many voluntary PHN programs were founded by local organizations during this era, including the Margaret Scott Nursing Mission (Winnipeg, 1905),4 the Lethbridge Nursing Mission (1909),5 and the St. Elizabeth Visiting Nurses’ Association (c.1910).6 School health programs, sponsored by local school boards, emerged early in the 20th century. In 1907, the Montreal school board inaugurated the first medical inspection program in Canada.7 Mandated to identify and seek treatment for school-aged children with preventable health problems or communicable conditions, school boards initially hired physicians to work in the schools. However, they soon discovered that the effectiveness of school health programs was significantly enhanced when nurses made home visits to the families of children identified in the school setting as being ill or at risk of developing illness. In 1909, school boards in Winnipeg and Hamilton employed nurses to work with school-aged children and their families.7,8 In addition to the physical inspection of children, school-based PHNs also provided health education programs to children and their families.7-9 In response to the high mortality rates associated with tuberculosis (TB) and prev","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"29 1","pages":"249 - 250"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86711193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
1910 through the first year of World War I, were a period of shifting public health challenges and the emergence of a distinctive and cohesive Canadian approach to managing them. Driven by the vision and work of a fairly small group of dedicated public health leaders, this half-decade saw rapid growth of the Association, along with remarkably intense activity in the development of Cana-da's public health infrastructure, especially at the provincial level. There had been considerable momentum building in public health management in Canada, especially since the establishment of the first provincial board of health in 1882 in Ontario and with the other provinces following suit over the next two decades. 1 Federally , a Director General of Public Health had been appointed in 1899, 2 but a more significant step was taken in 1906 with the creation of the Commission on Conservation. This was a federal advisory committee focused on the conservation and better utilization of natural resources made up of the ministers of agriculture, mines, and the interior, provincial ministers of natural resources, and university experts. 3 Through the unique expertise of Dr. Peter H. Bryce, Chief Medical Officer of the Department of the Interior, and previously the first secretary of the Provincial Board of Health of Ontario (1882-1903), pressure built for broader federal public health initiatives, though the Commission was careful to tread the provincial jurisdictional line in matters of health. 4 The appointment in 1910 of Dr. Charles Hodgetts to take charge of the Com-mission's Health Branch, following service as the second Secretary of the Ontario Provincial Board of Health, furthered this momentum in Ottawa. 5 However, for most public health and medical professionals , particularly Bryce, and as had been clear in the Canadian medical press from as early as 1874, nothing short of a separate federal department of health would be satisfactory. 6 From their positions in the Commission's Public Health Section, Drs. Bryce and Hodgetts exercised their influence to call together the country's leading public health figures to a special conference Anderson and Coulter were part of a group of five doctors that had been granted an Ontario Charter for such an association. 7 At the Ottawa conference, they offered their Charter to the new Association, which could then apply for federal incorporation – granted in 1912 – along with the right to use The Public Health Journal as its official organ. 10 …
{"title":"The First Five Years: Public Health and the Canadian Public Health Association, 1910–1915","authors":"C. Rutty","doi":"10.17269/CJPH.100.1782","DOIUrl":"https://doi.org/10.17269/CJPH.100.1782","url":null,"abstract":"1910 through the first year of World War I, were a period of shifting public health challenges and the emergence of a distinctive and cohesive Canadian approach to managing them. Driven by the vision and work of a fairly small group of dedicated public health leaders, this half-decade saw rapid growth of the Association, along with remarkably intense activity in the development of Cana-da's public health infrastructure, especially at the provincial level. There had been considerable momentum building in public health management in Canada, especially since the establishment of the first provincial board of health in 1882 in Ontario and with the other provinces following suit over the next two decades. 1 Federally , a Director General of Public Health had been appointed in 1899, 2 but a more significant step was taken in 1906 with the creation of the Commission on Conservation. This was a federal advisory committee focused on the conservation and better utilization of natural resources made up of the ministers of agriculture, mines, and the interior, provincial ministers of natural resources, and university experts. 3 Through the unique expertise of Dr. Peter H. Bryce, Chief Medical Officer of the Department of the Interior, and previously the first secretary of the Provincial Board of Health of Ontario (1882-1903), pressure built for broader federal public health initiatives, though the Commission was careful to tread the provincial jurisdictional line in matters of health. 4 The appointment in 1910 of Dr. Charles Hodgetts to take charge of the Com-mission's Health Branch, following service as the second Secretary of the Ontario Provincial Board of Health, furthered this momentum in Ottawa. 5 However, for most public health and medical professionals , particularly Bryce, and as had been clear in the Canadian medical press from as early as 1874, nothing short of a separate federal department of health would be satisfactory. 6 From their positions in the Commission's Public Health Section, Drs. Bryce and Hodgetts exercised their influence to call together the country's leading public health figures to a special conference Anderson and Coulter were part of a group of five doctors that had been granted an Ontario Charter for such an association. 7 At the Ottawa conference, they offered their Charter to the new Association, which could then apply for federal incorporation – granted in 1912 – along with the right to use The Public Health Journal as its official organ. 10 …","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"1 1","pages":"169-170"},"PeriodicalIF":0.0,"publicationDate":"2009-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89624605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectivesThe development, implementation, and evaluation of policies may play an important role in promoting health behaviours such as physical activity. The Ontario Ministry of Education (OME) recently mandated Memorandum No. 138 requiring daily physical activity (DPA) for Ontario elementary students in grades one through eight. The purpose of this paper is to examine implementation strategies.MethodsHogwood and Gunn’s 10 preconditions for “perfect implementation” are used to examine publicly available Ministry DPA policy documents to assess whether these implementation strategies have been considered in the policy documents.ResultsSeveral preconditions (e.g., allocation of resources, task specification) appear to have been considered, however a number of preconditions (e.g., the sustainability of resources, extent to which the policy is valued, and evaluation plans) thought to be important require additional attention to ensure optimal DPA implementation.ConclusionsAdditional reflection upon Hogwood and Gunn’s implementation preconditions would, in our opinion, assist in facilitating optimal DPA implementation as per Memorandum No. 138.RésuméObjectifsLe développement, la mise en application et l’évaluation des politiques peuvent jouer un rôle important dans la promotion des comportements favorisant la santé, telle l’activité physique. En réponse aux niveaux d’inactivité constatés chez les jeunes, le Ministère de l’Éducation de l’Ontario a récemment rendu obligatoire une politique d’activité physique quotidienne (APQ), Mémorandum no. 138, visant les élèves de la première à la huitième année du cours primaire en Ontario. L’objectif de cette étude est d’examiner les stratégies de mise en application proposées.MéthodesL’examen des documents publics disponibles se rapportant à la politique APQ du Ministère se fera à la lumière des dix conditions préalables à une «mise en application parfaite» selon Hogwood et Gunn, afin d’évaluer si ces stratégies ont été prises en considération dans les documents se rapportant à la politique.RésultatsPlusieurs conditions préalables (ex., l’allocation de ressources) semblent avoir été prises en considération. Cependant, la viabilité des ressources, le degré d’importance accordé à la politique et les plans pour l’évaluation sont des points auxquels une attention plus particulière devra être accordée si l’on veut que la politique APQ soit maintenue en application.ConclusionsBien que la prise en considération de plusieurs des conditions préalables puisse favoriser la mise en application du Mémorandum no. 138, nous concluons que l’examen de conditions préalables additionnelles ainsi qu’une évaluation de la politique peuvent être justifiés comme moyens d’améliorer davantage la mise en application de la politique et d’en déterminer les résultats.
{"title":"Ontario’s Daily Physical Activity Policy for Elementary Schools: Is Everything in Place for Success?","authors":"J. Robertson-Wilson, L. Lévesque","doi":"10.17269/CJPH.100.1769","DOIUrl":"https://doi.org/10.17269/CJPH.100.1769","url":null,"abstract":"ObjectivesThe development, implementation, and evaluation of policies may play an important role in promoting health behaviours such as physical activity. The Ontario Ministry of Education (OME) recently mandated Memorandum No. 138 requiring daily physical activity (DPA) for Ontario elementary students in grades one through eight. The purpose of this paper is to examine implementation strategies.MethodsHogwood and Gunn’s 10 preconditions for “perfect implementation” are used to examine publicly available Ministry DPA policy documents to assess whether these implementation strategies have been considered in the policy documents.ResultsSeveral preconditions (e.g., allocation of resources, task specification) appear to have been considered, however a number of preconditions (e.g., the sustainability of resources, extent to which the policy is valued, and evaluation plans) thought to be important require additional attention to ensure optimal DPA implementation.ConclusionsAdditional reflection upon Hogwood and Gunn’s implementation preconditions would, in our opinion, assist in facilitating optimal DPA implementation as per Memorandum No. 138.RésuméObjectifsLe développement, la mise en application et l’évaluation des politiques peuvent jouer un rôle important dans la promotion des comportements favorisant la santé, telle l’activité physique. En réponse aux niveaux d’inactivité constatés chez les jeunes, le Ministère de l’Éducation de l’Ontario a récemment rendu obligatoire une politique d’activité physique quotidienne (APQ), Mémorandum no. 138, visant les élèves de la première à la huitième année du cours primaire en Ontario. L’objectif de cette étude est d’examiner les stratégies de mise en application proposées.MéthodesL’examen des documents publics disponibles se rapportant à la politique APQ du Ministère se fera à la lumière des dix conditions préalables à une «mise en application parfaite» selon Hogwood et Gunn, afin d’évaluer si ces stratégies ont été prises en considération dans les documents se rapportant à la politique.RésultatsPlusieurs conditions préalables (ex., l’allocation de ressources) semblent avoir été prises en considération. Cependant, la viabilité des ressources, le degré d’importance accordé à la politique et les plans pour l’évaluation sont des points auxquels une attention plus particulière devra être accordée si l’on veut que la politique APQ soit maintenue en application.ConclusionsBien que la prise en considération de plusieurs des conditions préalables puisse favoriser la mise en application du Mémorandum no. 138, nous concluons que l’examen de conditions préalables additionnelles ainsi qu’une évaluation de la politique peuvent être justifiés comme moyens d’améliorer davantage la mise en application de la politique et d’en déterminer les résultats.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"261 1","pages":"125-129"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79663119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infectious Disease Prevention and Control: Remembering 1908 and Imagining 2108","authors":"R. Brunham","doi":"10.1007/BF03405482","DOIUrl":"https://doi.org/10.1007/BF03405482","url":null,"abstract":"","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"24 1","pages":"5 - 6"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90765433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Maunder, M. Leszcz, D. Savage, M. Adam, N. Peladeau, Donna M. Romano, Marci Rose, Rabbi Bernard Schulman
{"title":"Applying the Lessons of SARS to Pandemic Influenza","authors":"R. Maunder, M. Leszcz, D. Savage, M. Adam, N. Peladeau, Donna M. Romano, Marci Rose, Rabbi Bernard Schulman","doi":"10.1007/BF03403782","DOIUrl":"https://doi.org/10.1007/BF03403782","url":null,"abstract":"","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"7 1","pages":"486 - 488"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78792040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Drews, A. Majury, F. Jamieson, G. Riley, T. Mazzulli, D. Low
The Ontario Public Health Laboratories system (OPHL) is in the midst of a six-year plan to implement molecular tools for pandemic influenza diagnostics in one central and three regional public health laboratories. This plan has been formulated as a consequence of: 1) experiences gained through severe acute respiratory syndrome (SARS), and comments of the members of the Expert Panel on SARS and Infectious Disease Control (i.e., the Walker report); 2) a review of pandemic preparedness literature; 3) historical and epidemiologic discussions about previous pandemics; and 4) suggestions made by various pandemic working committees. The OPHL plan includes: 1) an aggressive restructuring of the overall molecular microbiology testing capacity of the OPHL; 2) the ability to shift influenza testing of samples between designated OPHL laboratories; and 3) the development of screening tools for pandemic influenza diagnostic tests. The authors believe that investing in increased molecular testing capacity for regional laboratories outside the greater Toronto area will be beneficial to the OPHL system whether or not an influenza pandemic occurs. Well-trained technologists and microbiologists, and the introduction of new technologies, will facilitate the development of a wide variety of molecular tests for other infectious diseases at public health laboratories geographically distant from Toronto, thus enhancing overall laboratory testing capacity in the province of Ontario.RésuméLe système des laboratoires de santé publique de l’Ontario (LSPO) est à mi-parcours d’un plan de six ans visant à mettre en œuvre des outils moléculaires pour le diagnostic de la grippe pandémique dans un laboratoire central et trois laboratoires régionaux de dépistage sanitaire. Le plan en question a été formulé d’après: 1) les leçons de la crise du syndrome respiratoire aigu sévère (SRAS) et les commentaires des membres du Comité d’experts sur le SRAS et la lutte contre les maladies infectieuses (rapport Walker); 2) l’examen de la documentation sur la préparation à une pandémie; 3) les analyses historiques et épidémiologiques des pandémies antérieures; et 4) les suggestions de divers comités de travail sur les pandémies. Le plan des LSPO englobe: 1) une restructuration approfondie de l’ensemble des outils de dépistage basés sur la microbiologie moléculaire dans les laboratoires; 2) la possibilité de transférer d’un LSPO désigné à un autre l’analyse des échantillons grippaux; et 3) l’élaboration d’outils de sérodiagnostic de la grippe pandémique. Selon les auteurs, le fait d’investir davantage dans la capacité de dépistage moléculaire des laboratoires régionaux à l’extérieur du Grand Toronto serait bénéfique pour le système des LSPO, peu importe si une pandémie de grippe survient ou non. Des technologues et des microbiologistes bien formés, ainsi que l’implantation de nouvelles technologies, faciliteront l’élaboration d’un vaste éventail de tests moléculaires pour d’autres maladies infe
安大略省公共卫生实验室系统(OPHL)正在实施一项六年计划，在一个中央和三个区域公共卫生实验室实施用于大流行性流感诊断的分子工具。本计划是根据以下因素制定的:1)从严重急性呼吸系统综合症(萨斯)中获得的经验，以及萨斯和传染病控制专家小组成员的意见(即沃克报告);2)大流行防范文献综述;3)关于以往大流行的历史和流行病学讨论;4)各大流行病工作委员会提出的建议。OPHL计划包括:1)对OPHL的整体分子微生物检测能力进行积极重组;2)能够在指定的OPHL实验室之间转移流感样本检测;3)大流行性流感诊断检测筛查工具的开发。作者认为，无论流感大流行是否发生，投资于增加大多伦多地区以外的区域实验室的分子检测能力将有利于OPHL系统。训练有素的技术人员和微生物学家以及新技术的引进，将有助于在远离多伦多的公共卫生实验室开发各种各样的其他传染病分子检测方法，从而提高安大略省实验室的总体检测能力。在安大略公共卫生实验室系统(LSPO)中，有6个试验点，分别是:1 .在安大略公共卫生实验室系统(LSPO)中，有6个试验点，分别是:1 .在安大略公共卫生实验室中，有3个试验点，分别是:1 .在安大略公共卫生实验室中，有3个试验点，分别是:1 .在安大略公共卫生实验室中，有3个试验点，分别是:1 .在安大略公共卫生实验室中，有3个试验点。1)关于呼吸系统综合症和呼吸系统综合症危机的报告(关于呼吸系统综合症和呼吸系统综合症的报告)和关于呼吸系统综合症和呼吸系统疾病感染控制的报告专家委员会成员的评论(rapport Walker);2) l 'examen de la documentation sur la pracimparation une pandacimmie;3) les analyses historiques et sampidsammiologiques des pandsammies and samrieures;因此，我不建议人们用其他的方法来解决这些问题。LSPO包膜计划:1)重组重组后的l 'ensemble des outils de danci.9ail.comast.comass.microbiologie molculaire danci.les laboratories;2) la possible it de transfersamicrer d 'un LSPO danci.com/ untre l 'analyse des samchantillons grippaux;3) l ' samlabationd ' outils de ssamuresdiagnostic de la grippe pandsammique。如果你的上司是你，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司，你的上司。技术和微生物学方面的研究进展，新技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展，技术方面的研究进展。
{"title":"A Decentralized Molecular Diagnostic Testing Plan for Pandemic Influenza in the Ontario Public Health Laboratory System","authors":"S. Drews, A. Majury, F. Jamieson, G. Riley, T. Mazzulli, D. Low","doi":"10.17269/CJPH.99.1683","DOIUrl":"https://doi.org/10.17269/CJPH.99.1683","url":null,"abstract":"The Ontario Public Health Laboratories system (OPHL) is in the midst of a six-year plan to implement molecular tools for pandemic influenza diagnostics in one central and three regional public health laboratories. This plan has been formulated as a consequence of: 1) experiences gained through severe acute respiratory syndrome (SARS), and comments of the members of the Expert Panel on SARS and Infectious Disease Control (i.e., the Walker report); 2) a review of pandemic preparedness literature; 3) historical and epidemiologic discussions about previous pandemics; and 4) suggestions made by various pandemic working committees. The OPHL plan includes: 1) an aggressive restructuring of the overall molecular microbiology testing capacity of the OPHL; 2) the ability to shift influenza testing of samples between designated OPHL laboratories; and 3) the development of screening tools for pandemic influenza diagnostic tests. The authors believe that investing in increased molecular testing capacity for regional laboratories outside the greater Toronto area will be beneficial to the OPHL system whether or not an influenza pandemic occurs. Well-trained technologists and microbiologists, and the introduction of new technologies, will facilitate the development of a wide variety of molecular tests for other infectious diseases at public health laboratories geographically distant from Toronto, thus enhancing overall laboratory testing capacity in the province of Ontario.RésuméLe système des laboratoires de santé publique de l’Ontario (LSPO) est à mi-parcours d’un plan de six ans visant à mettre en œuvre des outils moléculaires pour le diagnostic de la grippe pandémique dans un laboratoire central et trois laboratoires régionaux de dépistage sanitaire. Le plan en question a été formulé d’après: 1) les leçons de la crise du syndrome respiratoire aigu sévère (SRAS) et les commentaires des membres du Comité d’experts sur le SRAS et la lutte contre les maladies infectieuses (rapport Walker); 2) l’examen de la documentation sur la préparation à une pandémie; 3) les analyses historiques et épidémiologiques des pandémies antérieures; et 4) les suggestions de divers comités de travail sur les pandémies. Le plan des LSPO englobe: 1) une restructuration approfondie de l’ensemble des outils de dépistage basés sur la microbiologie moléculaire dans les laboratoires; 2) la possibilité de transférer d’un LSPO désigné à un autre l’analyse des échantillons grippaux; et 3) l’élaboration d’outils de sérodiagnostic de la grippe pandémique. Selon les auteurs, le fait d’investir davantage dans la capacité de dépistage moléculaire des laboratoires régionaux à l’extérieur du Grand Toronto serait bénéfique pour le système des LSPO, peu importe si une pandémie de grippe survient ou non. Des technologues et des microbiologistes bien formés, ainsi que l’implantation de nouvelles technologies, faciliteront l’élaboration d’un vaste éventail de tests moléculaires pour d’autres maladies infe","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"173 1","pages":"387 - 390"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74289108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Egeland, Daneen Dénommé, Pierre Lejeune, D. Pereg
BackgroundCulturally acceptable and validated instruments for assessing physical activity among Indigenous Peoples are lacking. Given the current trends in obesity, health behaviour surveillance tools are needed to evaluate trends and to determine the effectiveness of health promotion efforts aimed at curbing the obesity epidemic.ObjectiveTo evaluate whether the International Physical Activity Questionnaire (IPAQ) scores correlate with anthropometric indices in an Iiyiyiu Aschii community (Cree Territory of northern Québec, Canada).MethodsA cross-sectional study was carried out in a Cree community as part of a larger research effort entitled, “Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Longitudinal Study in Iiyiyiu Aschii”. Randomly selected adult participants (n=161) underwent an anthropometric assessment and answered the IPAQ which was administered by bilingual research assistants. Concurrent validity of the IPAQ was evaluated by the extent to which the physical activity scores were related to anthropometric measures.ResultsSignificant inverse correlations were observed between the IPAQ Total MET score and % body fat (r = -.19, p=0.01) and the IPAQ Vigorous MET score and % body fat (r = -.26, p=0.001), but not for waist circumference or BMI. Walkers (6–7 days/wk for =60 minutes/day), however, had a waist circumference that was, on average, 5 cm smaller than non-walkers in age- and sex-adjusted linear regression analyses (ß=-4.97; SE=2.5; p=0.05).DiscussionThe results indicate that the IPAQ holds promise as a culturally adaptable questionnaire for the Iiyiyiuch. However, modifications will help improve its acceptability for community members.RésuméContexteOn manque d’instruments culturellement acceptables et validés pour analyser l’activité physique chez les peuples indigènes. Il faudrait disposer d’outils de surveillance des habitudes de santé pour évaluer les tendances actuelles de l’obésité et déterminer l’efficacité des mesures de promotion de la santé qui visent à freiner l’épidémie d’obésité.ObjectifDéterminer si les scores obtenus au questionnaire international d’activité physique (IPAQ) présentent une corrélation avec les indices anthropométriques dans l’Iiyiyiu Aschii (un territoire cri du Nord du Québec, au Canada).MéthodeNous avons mené une étude transversale dans une communauté crie dans le cadre d’une étude plus vaste intitulée « Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Longitudinal Study in Iiyiyiu Aschii ». Des participants d’âge adulte sélectionnés au hasard (n=161) ont fait l’objet d’une évaluation anthropométrique et répondu aux questions de l’IPAQ, |lequel a été administré par des adjoints à la recherche bilingues. Pour évaluer la validité concourante de l’IPAQ, |nous avons calculé le niveau d’association entre les scores d’activité physique et les mesures anthropométriques.RésultatsDes corrélations inverses significatives ont été observées entre le score total selon l’
{"title":"Concurrent Validity of the International Physical Activity Questionnaire (IPAQ) in an Iiyiyiu Aschii (Cree) Community","authors":"G. Egeland, Daneen Dénommé, Pierre Lejeune, D. Pereg","doi":"10.17269/CJPH.99.1655","DOIUrl":"https://doi.org/10.17269/CJPH.99.1655","url":null,"abstract":"BackgroundCulturally acceptable and validated instruments for assessing physical activity among Indigenous Peoples are lacking. Given the current trends in obesity, health behaviour surveillance tools are needed to evaluate trends and to determine the effectiveness of health promotion efforts aimed at curbing the obesity epidemic.ObjectiveTo evaluate whether the International Physical Activity Questionnaire (IPAQ) scores correlate with anthropometric indices in an Iiyiyiu Aschii community (Cree Territory of northern Québec, Canada).MethodsA cross-sectional study was carried out in a Cree community as part of a larger research effort entitled, “Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Longitudinal Study in Iiyiyiu Aschii”. Randomly selected adult participants (n=161) underwent an anthropometric assessment and answered the IPAQ which was administered by bilingual research assistants. Concurrent validity of the IPAQ was evaluated by the extent to which the physical activity scores were related to anthropometric measures.ResultsSignificant inverse correlations were observed between the IPAQ Total MET score and % body fat (r = -.19, p=0.01) and the IPAQ Vigorous MET score and % body fat (r = -.26, p=0.001), but not for waist circumference or BMI. Walkers (6–7 days/wk for =60 minutes/day), however, had a waist circumference that was, on average, 5 cm smaller than non-walkers in age- and sex-adjusted linear regression analyses (ß=-4.97; SE=2.5; p=0.05).DiscussionThe results indicate that the IPAQ holds promise as a culturally adaptable questionnaire for the Iiyiyiuch. However, modifications will help improve its acceptability for community members.RésuméContexteOn manque d’instruments culturellement acceptables et validés pour analyser l’activité physique chez les peuples indigènes. Il faudrait disposer d’outils de surveillance des habitudes de santé pour évaluer les tendances actuelles de l’obésité et déterminer l’efficacité des mesures de promotion de la santé qui visent à freiner l’épidémie d’obésité.ObjectifDéterminer si les scores obtenus au questionnaire international d’activité physique (IPAQ) présentent une corrélation avec les indices anthropométriques dans l’Iiyiyiu Aschii (un territoire cri du Nord du Québec, au Canada).MéthodeNous avons mené une étude transversale dans une communauté crie dans le cadre d’une étude plus vaste intitulée « Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Longitudinal Study in Iiyiyiu Aschii ». Des participants d’âge adulte sélectionnés au hasard (n=161) ont fait l’objet d’une évaluation anthropométrique et répondu aux questions de l’IPAQ, |lequel a été administré par des adjoints à la recherche bilingues. Pour évaluer la validité concourante de l’IPAQ, |nous avons calculé le niveau d’association entre les scores d’activité physique et les mesures anthropométriques.RésultatsDes corrélations inverses significatives ont été observées entre le score total selon l’","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"132 1","pages":"307-310"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79639020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveThe purpose of the study was to explore and provide feedback on local stakeholders’ experiences with the Global Fund to Fight AIDSObjectiveTuberculosis and Malaria (GFATM) as it related to capacity building for tuberculosis (TB) services in Nicaragua.MethodsAn ethnomethodological approach was used to capture the experiences of three different groups: service providers, service recipients, and decision-makers. Data collection involved reviewing secondary texts and records, participant observation, and in-depth interviews and focus groups in both rural and urban municipalities.ResultsStakeholders felt that Nicaragua’s Global Fund project improved TB control, built human resource capacity and strengthened community involvement in TB programming; however, they noted several contextual and structural threats to sustainable capacity development. The nature of the GFATM’s performance-based evaluation de-emphasized qualitative assessment and, at times, created pressure to meet numeric targets at the risk of decreasing quality. Contextual challenges often determined or limited the potential sustainability of activities. Two examples (training volunteer health workers and establishing TB Clubs) from the broader study are offered here to highlight these challenges from health systems and community perspectives.ConclusionsCurrent approaches to GFATM evaluation and accountability may compromise its positive impacts on capacity building in Nicaragua. Greater consideration needs to be given to ensuring more comprehensive evaluation of project implementation.RésuméObjectifNous avons voulu analyser et rendre compte de l’expérience vécue par les intervenants locaux à l’égard du renforcement des capacités des services de lutte contre la tuberculose au Nicaragua dans le cadre d’un projet du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme.MéthodeAu moyen d’une approche ethnométhodologique, nous avons recueilli les expériences de trois groupes: les fournisseurs de services, les bénéficiaires de services et les décideurs. Pour recueillir les données, nous avons examiné des documents écrits et des relevés préexistants, observé des participants et tenu des entretiens en profondeur et des groupes de discussion dans des municipalités rurales et urbaines.RésultatsSelon les intervenants, le projet du Fonds mondial au Nicaragua a amélioré la prophylaxie de la tuberculose et renforcé les capacités des ressources humaines et la participation communautaire aux programmes de lutte contre la tuberculose; plusieurs menaces contextuelles et structurelles à un renforcement durable des capacités nous ont cependant été signalées. Comme l’évaluation du Fonds mondial était axée sur le rendement, l’aspect qualitatif était moins accentué, ce qui a parfois poussé les intervenants à respecter les objectifs chiffrés aux dépens de qualité. Les difficultés contextuelles ont souvent déterminé ou limité la durabilité potentielle des activités. Nous présentons ici de
本研究的目的是探讨当地利益攸关方与全球抗击艾滋病、结核病和疟疾基金(GFATM)在尼加拉瓜结核病服务能力建设方面的经验，并提供反馈。方法采用民族方法学方法，对服务提供者、服务接受者和决策者这三个不同群体的经验进行分析。数据收集包括审查二手文本和记录、参与观察、深入访谈和在农村和城市城市的焦点小组。利益攸关方认为，尼加拉瓜的全球基金项目改善了结核病控制，建立了人力资源能力，加强了社区对结核病规划的参与;但是，他们注意到对可持续能力发展的若干环境和结构威胁。GFATM基于绩效的评估的性质不强调质量评估，有时造成了在质量下降的风险下实现数字目标的压力。背景挑战往往决定或限制活动的潜在可持续性。这里提供了来自更广泛研究的两个例子(培训志愿卫生工作者和建立结核病俱乐部)，从卫生系统和社区的角度强调这些挑战。结论:目前的GFATM评估和问责方法可能会损害其对尼加拉瓜能力建设的积极影响。需要更多地考虑确保对项目执行情况进行更全面的评价。目的:在尼加拉瓜，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析，从经验和能力的角度分析。3 .从种族角度出发，采用统一的方法，从三个群体的经验出发:从服务方面出发，从服务方面出发，从服务方面出发，从其他方面出发，从其他方面出发。在这些组织中，有许多人审查了文件、薪金、相关薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金、薪金和薪金。3 .尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目、尼加拉瓜联合项目;累赘对环境和结构构成威胁，对联合国的执行构成威胁。累赘的累赘是指与独立的累赘和累赘有关的累赘。Comme i ' m atresvaluation du fondial mondial顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心顺心。“困难”是指，“背景”是指，“解决”是指，“限期”是指，“持久”是指，“潜力”是指，“活动”是指，“限期”。有两种情况(如:交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织、交换器组织)。ConclusionLes方法actuelles d”et de responsabilisation du昏聩全世界范围的pourraient compromettre les运用我们德儿子项目关于renforcement des capacites盟尼加拉瓜。我将起草一份文件，将所有的薪金和薪金加在一起，将所有的薪金和薪金加在一起。
{"title":"The Global Fund and Tuberculosis in Nicaragua","authors":"K. Plamondon, L. Hanson, R. Labonté, S. Abonyi","doi":"10.17269/CJPH.99.1667","DOIUrl":"https://doi.org/10.17269/CJPH.99.1667","url":null,"abstract":"ObjectiveThe purpose of the study was to explore and provide feedback on local stakeholders’ experiences with the Global Fund to Fight AIDSObjectiveTuberculosis and Malaria (GFATM) as it related to capacity building for tuberculosis (TB) services in Nicaragua.MethodsAn ethnomethodological approach was used to capture the experiences of three different groups: service providers, service recipients, and decision-makers. Data collection involved reviewing secondary texts and records, participant observation, and in-depth interviews and focus groups in both rural and urban municipalities.ResultsStakeholders felt that Nicaragua’s Global Fund project improved TB control, built human resource capacity and strengthened community involvement in TB programming; however, they noted several contextual and structural threats to sustainable capacity development. The nature of the GFATM’s performance-based evaluation de-emphasized qualitative assessment and, at times, created pressure to meet numeric targets at the risk of decreasing quality. Contextual challenges often determined or limited the potential sustainability of activities. Two examples (training volunteer health workers and establishing TB Clubs) from the broader study are offered here to highlight these challenges from health systems and community perspectives.ConclusionsCurrent approaches to GFATM evaluation and accountability may compromise its positive impacts on capacity building in Nicaragua. Greater consideration needs to be given to ensuring more comprehensive evaluation of project implementation.RésuméObjectifNous avons voulu analyser et rendre compte de l’expérience vécue par les intervenants locaux à l’égard du renforcement des capacités des services de lutte contre la tuberculose au Nicaragua dans le cadre d’un projet du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme.MéthodeAu moyen d’une approche ethnométhodologique, nous avons recueilli les expériences de trois groupes: les fournisseurs de services, les bénéficiaires de services et les décideurs. Pour recueillir les données, nous avons examiné des documents écrits et des relevés préexistants, observé des participants et tenu des entretiens en profondeur et des groupes de discussion dans des municipalités rurales et urbaines.RésultatsSelon les intervenants, le projet du Fonds mondial au Nicaragua a amélioré la prophylaxie de la tuberculose et renforcé les capacités des ressources humaines et la participation communautaire aux programmes de lutte contre la tuberculose; plusieurs menaces contextuelles et structurelles à un renforcement durable des capacités nous ont cependant été signalées. Comme l’évaluation du Fonds mondial était axée sur le rendement, l’aspect qualitatif était moins accentué, ce qui a parfois poussé les intervenants à respecter les objectifs chiffrés aux dépens de qualité. Les difficultés contextuelles ont souvent déterminé ou limité la durabilité potentielle des activités. Nous présentons ici de","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"96 1","pages":"355-358"},"PeriodicalIF":0.0,"publicationDate":"2008-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76400323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Policy decisions about public health services differ from those for personal health services. Both require trade-offs between such policy goals as liberty, security, efficiency, and equity. In public health, however, decisions about who will approve, pay for, and deliver services are often accompanied by decisions on when and how to compel individual behaviour. Policy becomes complex because different stakeholders interpret evidence differently: stakeholders may assign different weights to policy goals and may even define the same goals differently. In the debate over mandatory annual influenza vaccination for health care workers, for example, proponents as well as opponents of mandatory vaccination may convey arguments in security terms. Those in favour of mandatory vaccination emphasize subclinical infections and duty of care (public security) while those opposed emphasize risk of adverse events (personal security). Proponents assert less worker absenteeism (efficiency) while opponents stress coercion and alternate personal infection control measures (liberty and individual rights/responsibilities). Consequently, stakeholders talk past each other. Determining the place of mandatory influenza vaccination for health care workers thus demands reconciling policy trade-offs and clarifying the underlying disputes hidden in the language of the policy debate.RésuméLes décisions concernant l’orientation des services de santé publique diffèrent de celles qui portent sur les services de santé individuelle. Les deux nécessitent des compromis entre les objectifs visés, que ce soit la liberté, la sécurité, l’efficacité ou l’équité. En santé publique toutefois, quand on a décidé qui doit approuver, payer et fournir les services, il faut souvent décider en plus quand et comment imposer des comportements individuels. Les politiques de santé publique sont donc plus complexes, car les différents intervenants interprètent les données différemment: ils n’accordent pas nécessairement la même importance à chaque objectif stratégique et peuvent même définir autrement des objectifs identiques. Dans le débat sur l’imposition ou non du vaccin antigrippal annuel aux travailleurs de la santé, par exemple, les partisans et les adversaires de la vaccination obligatoire peuvent invoquer la sécurité dans leurs arguments. Ceux qui sont pour la vaccination obligatoire insistent sur les infections subcliniques et le devoir de diligence (la sécurité publique), tandis que ceux qui sont contre insistent plutôt sur le risque d’effets secondaires (la sécurité personnelle). Les partisans préconisent une diminution de l’absentéisme chez les travailleurs (l’efficacité), tandis que les adversaires mettent en garde contre la coercition et préfèrent d’autres mesures personnelles de contrôle des infections (liberté et droits/responsabilités individuels). On assiste par conséquent à un dialogue de sourds. Si l’on veut déterminer l’importance à accorder à la vaccination antigrippale obligatoir
公共卫生服务的政策决定不同于个人卫生服务的政策决定。两者都需要在自由、安全、效率和公平等政策目标之间进行权衡。然而，在公共卫生领域，关于由谁来批准、支付和提供服务的决定往往伴随着关于何时以及如何强迫个人行为的决定。政策变得复杂是因为不同的利益相关者对证据的解释不同:利益相关者可能对政策目标赋予不同的权重，甚至可能以不同的方式定义相同的目标。例如，在对卫生保健工作者强制每年接种流感疫苗的辩论中，强制疫苗接种的支持者和反对者都可能从安全角度传达论点。赞成强制接种疫苗的人强调亚临床感染和注意义务(公共安全)，而反对接种疫苗的人强调不良事件的风险(个人安全)。支持者主张减少工人缺勤(效率)，而反对者强调强制和替代的个人感染控制措施(自由和个人权利/责任)。因此，干系人会各执一词。因此，确定卫生保健工作者强制接种流感疫苗的地点需要协调政策权衡，并澄清隐藏在政策辩论语言中的潜在争议。关于公共服务导向的决定，不同的单位，不同的单位，不同的单位，不同的单位，不同的单位，不同的单位，不同的单位，不同的单位，不同的单位。两种不同的交换条件，即交换交换条件，交换交换条件，交换交换条件，交换交换条件，交换交换条件，交换交换条件，交换交换条件，交换交换条件。En santuque toutefois，即对一个已获得批准的电子邮件的批准，付款人等四项服务，将对已获得批准的电子邮件的批准，以及对已获得批准的个人的评论施加影响。莱斯·德·桑特政治publique是所以+复合物,汽车不同intervenants interpretent Les数据differemment: ils n 'accordent不是necessairement la meme重要性每一目的内et peuvent meme值autrement des目的identiques。例如，不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者不接种疫苗者。在接种疫苗的过程中，有义务对感染进行持续监测，对感染进行持续监测，对感染进行持续监测，对感染进行持续监测，对感染进行持续监测，对感染进行持续监测，对感染进行持续监测，对感染进行持续监测。(1)“有效的，有效的”;(2)“有效的，有效的”;(3)“有效的，有效的”;(3)“有效的，有效的”;(3)“有效的，有效的”;(3)“有效的，有效的”;(3)“有效的，有效的”;(3)“有效的”。关于协助，一致同意，对话和声音。因此，如果你想让你的上司知道你的上司对你的上司的重要性，那么你的上司就会知道你的上司是什么人，你的上司是什么人，你的上司是什么人。
{"title":"What’s Public? What’s Private?","authors":"C. Mah","doi":"10.17269/CJPH.99.1639","DOIUrl":"https://doi.org/10.17269/CJPH.99.1639","url":null,"abstract":"Policy decisions about public health services differ from those for personal health services. Both require trade-offs between such policy goals as liberty, security, efficiency, and equity. In public health, however, decisions about who will approve, pay for, and deliver services are often accompanied by decisions on when and how to compel individual behaviour. Policy becomes complex because different stakeholders interpret evidence differently: stakeholders may assign different weights to policy goals and may even define the same goals differently. In the debate over mandatory annual influenza vaccination for health care workers, for example, proponents as well as opponents of mandatory vaccination may convey arguments in security terms. Those in favour of mandatory vaccination emphasize subclinical infections and duty of care (public security) while those opposed emphasize risk of adverse events (personal security). Proponents assert less worker absenteeism (efficiency) while opponents stress coercion and alternate personal infection control measures (liberty and individual rights/responsibilities). Consequently, stakeholders talk past each other. Determining the place of mandatory influenza vaccination for health care workers thus demands reconciling policy trade-offs and clarifying the underlying disputes hidden in the language of the policy debate.RésuméLes décisions concernant l’orientation des services de santé publique diffèrent de celles qui portent sur les services de santé individuelle. Les deux nécessitent des compromis entre les objectifs visés, que ce soit la liberté, la sécurité, l’efficacité ou l’équité. En santé publique toutefois, quand on a décidé qui doit approuver, payer et fournir les services, il faut souvent décider en plus quand et comment imposer des comportements individuels. Les politiques de santé publique sont donc plus complexes, car les différents intervenants interprètent les données différemment: ils n’accordent pas nécessairement la même importance à chaque objectif stratégique et peuvent même définir autrement des objectifs identiques. Dans le débat sur l’imposition ou non du vaccin antigrippal annuel aux travailleurs de la santé, par exemple, les partisans et les adversaires de la vaccination obligatoire peuvent invoquer la sécurité dans leurs arguments. Ceux qui sont pour la vaccination obligatoire insistent sur les infections subcliniques et le devoir de diligence (la sécurité publique), tandis que ceux qui sont contre insistent plutôt sur le risque d’effets secondaires (la sécurité personnelle). Les partisans préconisent une diminution de l’absentéisme chez les travailleurs (l’efficacité), tandis que les adversaires mettent en garde contre la coercition et préfèrent d’autres mesures personnelles de contrôle des infections (liberté et droits/responsabilités individuels). On assiste par conséquent à un dialogue de sourds. Si l’on veut déterminer l’importance à accorder à la vaccination antigrippale obligatoir","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"13 1","pages":"192 - 194"},"PeriodicalIF":0.0,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75048568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
a 15-year-old boy living in lesotho has about a 10% chance of reaching the age of 60 years, whereas a 15-year-old swede has a 91% chance. sir Michael Marmot often uses this example when discussing the work of the WhO commission on the social Determinants of health which began its work in 2005 and is due to submit its final report in 2008. One does not need to go to foreign countries to get a sense of the importance of social and economic factors in health. a stroll through most of our canadian cities and towns will do as well. For example, the life expectancy at birth for men born in the low-income Montreal neighbourhood of the «clsc des Faubourgs» is 67.8 years compared to 78.4 years for those born in the contiguous territory of the «clsc Metro» neighbourhood just a few streets to the West.1 indeed, there are many examples throughout the country that clearly show that health inequalities are alive and well in canada. although canada has in many ways been central to the development of the concepts of population health, it has to a great extent been less than successful in applying its lessons in its own backyard. the lalonde Report, the Ottawa charter for health promotion, and more recently the work of the canadian institute for advanced Research all contributed substantially to redefining the principles of public health and social interventions to promote a just and healthy society for all citizens. in this vein, the upcoming cpha annual conference (halifax, June 1-4) is focused on the social determinants of health. the conference theme “Reducing health inequalities through evidence and action” was chosen to take stock of the upcoming WhO report and the large body of scientific evidence, and to set the stage for actions to promote health equity within the country and abroad. environmental interventions have always been central to public health, from hippocrates’ On Airs, Waters, and Places to John snow removing the handle of the broad street pump. today, the social environment, including social and economic inequities, are at the root of many diseases worldwide. the canadian public health community must be at the forefront of the interventions and research required to deal with this challenge. Removing that handle will seem like child’s play compared to the tasks ahead, but we, like snow, cannot shy away from our collective responsibility.
一名生活在莱索托的15岁男孩活到60岁的几率约为10%，而一名15岁的瑞典男孩活到60岁的几率为91%。Michael Marmot爵士在讨论世卫组织健康问题社会决定因素委员会的工作时经常使用这个例子，该委员会于2005年开始工作，并将于2008年提交其最后报告。人们不需要到国外去了解社会和经济因素对健康的重要性。在我们加拿大的大多数城市和城镇漫步也可以。例如，出生在低收入的蒙特利尔“clsc des Faubourgs”社区的男性出生时预期寿命为67.8岁，而出生在西边几条街的“clsc Metro”社区的男性出生时预期寿命为78.4岁。实际上，全国各地有许多例子清楚地表明，健康不平等现象在加拿大仍然存在。虽然加拿大在许多方面对人口健康概念的发展起着核心作用，但在很大程度上，它在将其经验教训应用于自己的后院方面并不成功。《拉隆德报告》、《渥太华促进健康宪章》以及最近加拿大高级研究所的工作都对重新确定公共卫生和社会干预原则作出了重大贡献，以促进为所有公民建立一个公正和健康的社会。本着这一精神，即将召开的卫生保健协会年会(6月1日至4日，哈利法克斯)将重点讨论健康的社会决定因素。会议选择“通过证据和行动减少卫生不平等”为主题，是为了评估即将发布的世卫组织报告和大量科学证据，并为在国内外促进卫生公平的行动奠定基础。环境干预一直是公共卫生的核心，从希波克拉底的《论空气、水和地方》到约翰·斯诺拆除宽阔街道水泵的把手。今天，社会环境，包括社会和经济不平等，是全世界许多疾病的根源。加拿大公共卫生界必须站在应对这一挑战所需的干预和研究的最前线。与未来的任务相比，移除这个手柄似乎是小儿科，但我们就像雪一样，不能回避我们的集体责任。
{"title":"The Social Determinants of Health: An Imperative for Canadian Public Health","authors":"G. Paradis","doi":"10.17269/CJPH.99.1601","DOIUrl":"https://doi.org/10.17269/CJPH.99.1601","url":null,"abstract":"a 15-year-old boy living in lesotho has about a 10% chance of reaching the age of 60 years, whereas a 15-year-old swede has a 91% chance. sir Michael Marmot often uses this example when discussing the work of the WhO commission on the social Determinants of health which began its work in 2005 and is due to submit its final report in 2008. One does not need to go to foreign countries to get a sense of the importance of social and economic factors in health. a stroll through most of our canadian cities and towns will do as well. For example, the life expectancy at birth for men born in the low-income Montreal neighbourhood of the «clsc des Faubourgs» is 67.8 years compared to 78.4 years for those born in the contiguous territory of the «clsc Metro» neighbourhood just a few streets to the West.1 indeed, there are many examples throughout the country that clearly show that health inequalities are alive and well in canada. although canada has in many ways been central to the development of the concepts of population health, it has to a great extent been less than successful in applying its lessons in its own backyard. the lalonde Report, the Ottawa charter for health promotion, and more recently the work of the canadian institute for advanced Research all contributed substantially to redefining the principles of public health and social interventions to promote a just and healthy society for all citizens. in this vein, the upcoming cpha annual conference (halifax, June 1-4) is focused on the social determinants of health. the conference theme “Reducing health inequalities through evidence and action” was chosen to take stock of the upcoming WhO report and the large body of scientific evidence, and to set the stage for actions to promote health equity within the country and abroad. environmental interventions have always been central to public health, from hippocrates’ On Airs, Waters, and Places to John snow removing the handle of the broad street pump. today, the social environment, including social and economic inequities, are at the root of many diseases worldwide. the canadian public health community must be at the forefront of the interventions and research required to deal with this challenge. Removing that handle will seem like child’s play compared to the tasks ahead, but we, like snow, cannot shy away from our collective responsibility.","PeriodicalId":9525,"journal":{"name":"Canadian Journal of Public Health","volume":"10 1","pages":"85"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79909274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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