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Ismail S.J.,Public Health Agency of Canada | Ismail S.J.,University of Alberta | Ismail S.J.,University of Calgary | Langley J.M.,Dalhousie University | And 4 more authors.
Vaccine | Year: 2010

The National Advisory Committee on Immunization (NACI) provides medical, scientific, and public health advice on the use of vaccines in Canada. This article describes the structure and processes of NACI, as well as its approach to evidence-based decision-making. In a rapidly evolving and complex immunization environment, NACI has faced challenges in its endeavour to make thorough and timely evidence-based recommendations. Making population-level recommendations without formally considering the full spectrum of public health science (e.g. cost-effectiveness) presents difficulties in the implementation of NACI's recommendations. Although an improved and more transparent evidence-based NACI decision-making process is now in place, this is continuing to evolve with a current review of structures and processes underway to further improve effectiveness and efficiencies. Crown Copyright © 2010.


Graham R.,Middlesex London Health Unit | McCann M.,Middlesex London Health Unit | Allen N.,University of Western Ontario
Journal of Public Health Management and Practice | Year: 2013

Context: Middle managers are increasingly required to work with, and between, many groups within an organization. This work is known as "boundary spanning," and it has been shown to support information flow throughout the organization. This work has also been reported to assist with the coordination of tasks that require contributions from multiple groups. However, to our knowledge, boundary spanning has never been studied in a public health setting. Objective: To conduct an exploratory study of public health managers' perspectives regarding the frequency with which they engage in boundary-spanning behaviors and the importance of these behaviors in their role. Design: A mixed-methods approach, involving focus group discussion and independent surveys, was used to capture both qualitative and quantitative data. Participants: Fourteen administrative and team public health managers. Setting: An urban-rural public health unit in Ontario, Canada. Results: Many boundary-spanning behaviors were reported to be frequently practiced, and most of the behaviors were identified by the participants as important to their role. Further analysis indicated that the participants' more frequently engaged in the ambassador, coordinator, and scout categories of boundary spanning than behaviors in the guard category. Conclusion: Although only examined with a small sample, boundary spanning appears to be an essential function for public health managers (similar to their colleagues in the private sector). These findings present a rationale and an opportunity for public health leaders to set organizational conditions that foster the most positive type of boundary-spanning, ambassadorial behaviors, which, in turn, can improve group performance. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Sealy P.A.,Public Health Research | Sealy P.A.,University of Western Ontario | Farrell N.,Middlesex London Health Unit | Hoogenboom A.,Middlesex London Health Unit
Journal of Pediatric Nursing | Year: 2011

Purpose: This research examined the prevalence of the use of the sippy cup, as compared to the baby bottle, among children 1 to 4 years of age. Method: Using a population-based telephone surveillance survey in Ontario, caregivers of children 1 to 4 years of age were asked about their child's use of the sippy cup/baby bottle from the Rapid Risk Factor Surveillance System Module: Early Childhood Tooth Decay. Results: Most caregivers reported that children 1 to 4 years of age were currently using the sippy cup (69.7%), with the proportion increasing to 94.4% when including children with past use of the sippy cup. Younger children were significantly more likely to use the sippy cup, and 10.8% of children 4 years of age continued to use the baby bottle. Diluted fruit juice was the most frequently used liquid in the sippy cup (58.2%). Most of the caregivers did not report the use of the sippy cup at night. Conclusion: Caregivers need education as to potential increases in exposure to sugared/acidic liquids through the use of the sippy cup. Future research is needed to understand the extensive and prolonged use of the sippy cup/baby bottle by young children. © 2011 Elsevier Inc.


Battram D.S.,University of Brescia | Beynon C.,Middlesex London Health Unit | He M.,University of Brescia | He M.,Middlesex London Health Unit | He M.,University of Texas at San Antonio
Applied Physiology, Nutrition and Metabolism | Year: 2011

Waist circumference (WC) is a useful tool for predicting health risk, but its use at the population level remains uncertain. This study examined (i) the ability of participants to report their current WC without actual measurement, (ii) the accuracy of reporting WC using self-reported or self-measured WC, and (iii) the reliability and validity of using clothing size (CS) as a proxy to predict WC. Men and women (n = 293), aged 18-80 years, were randomized to either self-report WC or self-measure WC groups. Both completed 2 telephone surveys and their WC was professionally measured. Predictive equations were then developed to determine whether CS could be used as a proxy for WC. Only 66% of participants reported their current WC, although this was underreported (p < 0.05) compared with professionally measured WC. Professionally measured WC correlated strongly with CS for men (r = 0.8; p < 0.01) and women (r = 0.78; p < 0.05), respectively. While predicted WC demonstrated good agreement for men (k = 0.82) with respect to classifying individuals at increased health risk, this was attenuated in women (k = 0.6). Due to the fact that only 66% of participants know their current WC and that both self-report WC and self-measure WC groups underreport actual WC, a reliable and valid proxy for WC is needed. CS presents a reliable and feasible means of obtaining an estimate of WC at the population level in adults and predicting the percentage of the population at increased health risk.


Callaghan C.,Middlesex London Health unit | Mandich G.,Middlesex London Health unit | He M.,Middlesex London Health unit | He M.,University of Texas at San Antonio
Canadian Journal of Dietetic Practice and Research | Year: 2010

Purpose: The Healthy Vending Machine Pilot Project (HVMPP) was a public health initiative intended to create a healthier school nutrition environment by making healthier snacks available in vending machines, while maintaining a profit margin. The HVMPP was evaluated using quantitative and qualitative measures. Methods: Vending machines were stocked with healthier choices and conventional vending products at a 50:50 ratio. The HVMPP was implemented from February to May 2007 in four Ontario secondary schools in Middlesex-London, Elgin, and Oxford counties. Product sales were tracked, and focus groups were conducted to obtain students' opinions about healthy eating and vending choices. Results: "Healthier choice" sales ranged from 14% to 17%. In all schools, vending revenues declined from 0.7% to 66%. A majority of participants had substantial knowledge of healthy eating and were in favour of healthier choices in vending machines; however, price, value, and taste were barriers that led them to purchase these products rarely. Students preferred to have "real" healthy snacks, such as yogurt, fruit, and vegetables, available in schools. Conclusions: Replacing 50% of vending stock with healthier snacks resulted in a decline in vending revenues. Future health programs in schools need to provide "real" healthy snacks, such as low-fat dairy products, fruits, and vegetables.


King G.,Bloorview Research Institute | Shaw L.,University of Western Ontario | Orchard C.A.,University of Western Ontario | Miller S.,Middlesex London Health Unit
Work | Year: 2010

Background: There is a need for tools by which to evaluate the beliefs, behaviors, and attitudes that underlie interprofessional socialization and collaborative practice in health care settings. Method: This paper introduces the Interprofessional Socialization and Valuing Scale (ISVS), a 24-item self-report measure based on concepts in the interprofessional literature concerning shifts in beliefs, behaviors, and attitudes that underlie interprofessional socialization. The ISVS was designed to measure the degree to which transformative learning takes place, as evidenced by changed assumptions and worldviews, enhanced knowledge and skills concerning interprofessional collaborative teamwork, and shifts in values and identities. The scales of the ISVS were determined using principal components analysis. Results: The principal components analysis revealed three scales accounting for approximately 49% of the variance in responses: (a) Self-Perceived Ability to Work with Others, (b) Value in Working with Others, and (c) Comfort in Working with Others. These empirically derived scales showed good fit with the conceptual basis of the measure. Conclusion: The ISVS provides insight into the abilities, values, and beliefs underlying socio-cultural aspects of collaborative and authentic interprofessional care in the workplace, and can be used to evaluate the impact of interprofessional education efforts, in house team training, and workshops. © 2010-IOS Press and the authors. All rights reserved.


Thomas H.M.,Middlesex London Health Unit | Thomas H.M.,University of Western Ontario | Irwin J.D.,University of Western Ontario
BMC Research Notes | Year: 2011

Abstract. Background: In Canada, there are limited occasions for youth, and especially at-risk youth, to participate in cooking programs. The paucity of these programs creates an opportunity for youth-focused cooking programs to be developed, implemented, and evaluated with the goal of providing invaluable life skills and food literacy to this potentially vulnerable group. Thus, an 18-month community-based cooking program for at-risk youth was planned and implemented to improve the development and progression of cooking skills and food literacy. Findings. This paper provides an overview of the rationale for and implementation of a cooking skills intervention for at-risk youth. The manuscript provides information about the process of planning and implementing the intervention as well as the evaluation plan. Results of the intervention will be presented elsewhere. Objectives of the intervention included the provision of applied food literacy and cooking skills education taught by local chefs and a Registered Dietitian, and augmented with fieldtrips to community farms to foster an appreciation and understanding of food, from 'gate to plate'. Eight at-risk youth (five girls and three boys, mean age = 14.6) completed the intervention as of November 2010. Pre-test cooking skills assessments were completed for all participants and post-test cooking skills assessments were completed for five of eight participants. Post intervention, five of eight participants completed in-depth interviews about their experience. Discussion. The Cook It Up! program can provide an effective template for other agencies and researchers to utilize for enhancing existing programs or to create new applied cooking programs for relevant vulnerable populations. There is also a continued need for applied research in this area to reverse the erosion of cooking skills in Canadian society. © 2011 Thomas et al; licensee BioMed Central Ltd.


Graham R.,Middlesex London Health Unit | Sibbald S.L.,University of Western Ontario
Healthcare Papers | Year: 2012

Healthcare policy and hospital administration are dynamic and growing fields, oriented toward shaping the future. In an effort to understand where these fields have come from, as well as some of the reoccurring challenges faced, we conducted a retrospective analysis. Our research identified progress and major accomplishments, as well as issues that continue to challenge the field in five key areas: (1) the evolution of nursing, (2) funding and legislation, (3) hospital design, construction and technology, (4) patient care and infection control and (5) leadership. To explore these areas, a thematic content review was conducted on the 12 inaugural issues of Hospital Administration in Canada, a hospital administration periodical from 1962. All written content was reviewed, coded and categorized into major themes that represented the major hospital administration topics of 50 years ago. In this article, five prominent themes are explored and farther illustrated using key stories and milestones from 1962.


Tucker P.,University of Western Ontario | Van Zandvoort M.M.,Middlesex London Health Unit | Burke S.M.,University of Western Ontario | Irwin J.D.,University of Western Ontario
BMC Public Health | Year: 2011

Background. Physical activity offers numerous physiological and psychological benefits for young children; however, many preschool-aged children are not engaging in sufficient activity. The home environment, inclusive of parent role modeling, has been identified as influencing preschoolers' physical activity. This study sought to examine childcare providers' perspectives of the importance of parents and the home environment for supporting the physical activity behaviours of preschool-aged children (aged 2.5-5 years) attending childcare. Methods. A heterogeneous sample of childcare providers (n = 84; response rate 39%) working at childcare facilities in London, Ontario participated. Thirteen semi-structured focus groups were conducted in London centres between February 2009 and February 2010. Focus groups were audio recorded and transcribed verbatim and inductive content analysis was used to code and classify themes. A number of strategies were used to verify the trustworthiness of the data. Results. Childcare providers acknowledged their reliance on parents/guardians to create a home environment that complements the positive physical activity messaging children may receive in childcare. Moreover, childcare staff highlighted the need for positive parent role modeling and parent support to encourage active healthy lifestyles among young children. Conclusion. This study's findings highlight the need for increased parent-caregiver partnering in terms of communication and cooperation in service of promoting appropriate amounts of physical activity among London preschoolers. © 2011 Tucker et al; licensee BioMed Central Ltd.


Velikonja D.,Hamilton Health Sciences | Velikonja D.,McMaster University | Warriner E.M.,Hamilton Health Sciences | Warriner E.M.,McMaster University | And 2 more authors.
Brain Injury | Year: 2013

Primary objective: To evaluate the impact of combined Axis I and II emotional profiles, demographic and psychosocial variables on coping responses in an Acquired Brain Injury (ABI) population using the Personality Assessment Inventory (PAI) and the Coping Response Inventory (CRI). Research design: This was a retrospective study examining the relationship between coping styles with affective, demographic and psychosocial variables using a multi-dimensional profile analysis. Methods and procedures: Participants completed the PAI and CRI during a regular clinical visit at the ABI Program (n = 100). Profile data was divided into seven established sub-types and analysed with coping responses. Traumatic (TBI; n = 78) and non-traumatic (n = 24) brain-injured individuals comprised the sample. Main outcomes and results: Previous findings were confirmed showing that highly symptomatic patients primarily use negative coping strategies. Also, affective symptoms, gender, relationship status, perceived stress and psychosocial supports mediate the use of different negative coping responses. Interesting, anxiety-based symptoms were associated with positive responses similar to asymptomatic ABI patients. Conclusions: Coping strategies adopted by brain-injured individuals are mediated by Axis I and II symptoms as well as psychosocial support, stress, marital status and gender. As a result, this has implications for developing treatment strategies. © 2013 Informa UK Ltd.

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