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Stylianos S.,Psychiatric Patient Advocate Office | Kehyayan V.,Ministry of Health and Long Term Care
American Journal of Orthopsychiatry | Year: 2012

Although rights protection and best interest perspectives are frequently viewed as diametric opposites, mental health advocacy is an important strategy in pursuit of both civil rights and therapeutic goals for people with mental illness. Independent, client-centered advocacy supports the attainment of consumer-identified goals for recovery, equality, and social inclusion and mitigates the negative consequences of stigma and discrimination. Advocacy strives to return decision-making authority to consumers and thus to empower them to play a more central role in their own care, treatment, rehabilitation, and life choices. © 2012 American Orthopsychiatric Association.


Bottorff J.L.,University of British Columbia | Kelly M.T.,University of British Columbia | Oliffe J.L.,University of British Columbia | Johnson J.L.,University of British Columbia | And 2 more authors.
BMC Public Health | Year: 2010

Background. Although researchers have focused on women's smoking during pregnancy and the postpartum period and the influence of household interactions on their tobacco reduction efforts, little attention has been given to parents' efforts to regulate smoking during the child-rearing years. The objective of this study was to examine how parenting young children and gender relations reflected in couple dynamics influence household tobacco use patterns and, specifically, women's tobacco reduction efforts. Methods. As part of a longitudinal, grounded-theory study with 28 couples to examine the place of tobacco in the lives of new parents, each parent participated in one or two individual, semi-structured interviews during the first three years postpartum. Grounded theory methods and a gender relations framework were used to analyze transcribed data. Results. Two different parenting styles that couples adhered to were identified. These parenting styles reflected performances of femininities and masculinities, and were associated with particular smoking patterns. Traditional parenting reinforced by women's alignment with emphasized femininities and men's alignment with hegemonic masculinities placed women with smoking partners at risk for relapse. Women's actions to be supportive partners facilitated couples' continued smoking. In shared parenting dyads, egalitarian practices tended to support successful transitions to smoke-free homes. Women's ability to exert more influence around family decision making, and the acceptance of new masculine identities associated with fatherhood were influential. In non-smoking dyads where the mother, father, or both reduced or stopped smoking, we observed a subtext of potential conflict in the event either the mother or father relapsed. Conclusions. Decisions about tobacco use are made within relationships and social contexts that vary based on each individual's relationship to tobacco, divisions of domestic labour and childcare, and other activities that impact tobacco use. Sensitive approaches to tobacco reduction for women and men must be developed building on greater understanding of gender relations and how tobacco use is integrated in spousal and parental roles. © 2010 Bottorff et al; licensee BioMed aCentral Ltd.


Gilbert J.E.,Policy Research and Analysis | Gilbert J.E.,University of Toronto | Green E.,Nursing and Psychosocial Oncology | Green E.,McMaster University | And 5 more authors.
European Journal of Cancer Care | Year: 2011

The diagnostic phase of cancer care is an anxious time for patients. Patient navigation is a way of assisting and supporting individuals during this time. The aim of this review is to explore patient navigation and its role in the diagnostic phase of cancer care. We reviewed the literature for definitions and models of navigation, preparation for the role and impact on patient outcomes, specifically addressing the role of the nurse in patient navigation. Interviews and focus groups with healthcare providers and managers provided further insight from these stakeholder groups. Common to most definitions of navigation is the navigator's multifaceted role in facilitating processes of care, assisting patients to overcome barriers and providing information and support. Navigation may be provided by laypersons, clerical staff and/or healthcare professionals. In the diagnostic phase it has the potential to affect efficiency of diagnostic testing, patients' experience during this time and preparation for decision-making around treatment options. Patient care during the diagnostic phase requires various levels of navigation, according to individual informational, physical and psychosocial needs. Identifying those individuals who require more support - whether physical or psychosocial - during the diagnostic phase is of critical importance. © 2010 Cancer Care Ontario.


Van Den Heuvel M.,University of Toronto | Van Den Heuvel M.,University of Groningen | Hopkins J.,Niagara Region Public Health | Hopkins J.,McMaster University | And 10 more authors.
BMC Public Health | Year: 2013

Background: The social environment is a fundamental determinant of early child development and, in turn, early child development is a determinant of health, well-being, and learning skills across the life course. Redistributive policies aimed at reducing social inequalities, such as a welfare state and labour market policies, have shown a positive association with selected health indicators. In this study, we investigated the influence of redistributive policies specifically on the social environment of early child development in five countries with different political traditions. The objective of this analysis was to highlight similarities and differences in social and health services between the countries and their associations with other health outcomes that can inform better global early child development policies and improve early child health and development. Methods. Four social determinants of early child development were selected to provide a cross-section of key time periods in a child's life from prenatal to kindergarten. They included: 1) prenatal care, 2) maternal leave, 3) child health care, and 4) child care and early childhood education. We searched international databases and reports (e.g. Organization for Economic Cooperation and Development, World Bank, and UNICEF) to obtain information about early child development policies, services and outcomes. Results: Although a comparative analysis cannot claim causation, our analysis suggests that redistributive policies aimed at reducing social inequalities are associated with a positive influence on the social determinants of early child development. Generous redistributive policies are associated with a higher maternal leave allowance and pay and more preventive child healthcare visits. A decreasing trend in infant mortality, low birth weight rate, and under five mortality rate were observed with an increase in redistributive policies. No clear influence of redistributive policies was observed on breastfeeding and immunization rates. In the analysis of child care and early education, the lack of uniform measures of early child development outcomes was apparent. Conclusions: This paper provides further support for an association between redistributive policies and early child health and development outcomes, along with the organization of early child health and development services. © 2013 van den Heuvel et al.; licensee BioMed Central Ltd.


Wilson E.D.,Ministry of Health and Long Term Care | Garcia A.C.,University of Western Ontario
Canadian Journal of Dietetic Practice and Research | Year: 2011

Purpose: There is increasing global interest in sustainability and the environment. A hospital/health care food service facility consumes large amounts of resources; therefore, efficiencies in operation can address sustainability. Beliefs, attitudes, and behaviours about environmentally friendly practices in hospital/health care food services were explored in this study. Methods: Questionnaires addressed environmentally friendly initiatives in building and equipment, waste management, food, and non-food procurement issues. The 68 participants included hospital food service managers, clinical dietitians, dietary aides, food technicians, and senior management. Data analysis included correlation analysis and descriptive statistics. Results: Average scores for beliefs were high in building and equipment (90%), waste management (94%), and non-food procurement (87%), and lower in food-related initiatives (61%) such as buying locally, buying organic foods, buying sustainable fish products, and reducing animal proteins. Average positive scores for behaviours were positively correlated with beliefs (waste management, p=0.001; food, p=0.000; non-food procurement, p=0.002). Average positive scores for attitude in terms of implementing the initiatives in health care were 74% for building and equipment, 81% for waste management, 70% for non-food procurement, and 36% for food. Conclusions: The difference in food-related beliefs, behaviours, and attitudes suggests the need for education on environmental impacts of food choices. Research is recommended to determine facilitators and barriers to the implementation of green strategies in health care. As food experts, dietitians can lead changes in education, practice, and policy development.

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