Top PDF Physical health in a Canadian Old Order Mennonite community

Physical health in a Canadian Old Order Mennonite community

Physical health in a Canadian Old Order Mennonite community

This study also supports policy action on the determinants that significantly shape health in both groups: coping, number of childhood disorders, BMI and age. These determinants have been found to influence health in many urban populations and people whose life circumstances vary widely, suggesting they transcend the boundaries of OOMs, farmers and rural populations. As such, actions focused on these determinants may offer broad impact across many populations. Approaches could be designed that address the individual, structural and temporal underpinnings of these determinants. For example, psychosocial concerns could be addressed with services that help individuals cope and reduce stress, monitor/control their weight, and maintain their family’s health. Structural concerns could be tackled by investing in community resources that promote healthy lifestyles and alleviate broader economic/social conditions challenging peoples’ ability to cope or maintain health. Concerns about the perpetuation of disadvantage through the life-course could be addressed by ensuring that programs are integrated and sustainable over the life-course, emphasizing the entire age spectrum from children’s health (eg immunization programs, reducing childhood obesity) to healthy aging and age-friendly built environment programs.
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Mental health in a Canadian Old Order  Mennonite community

Mental health in a Canadian Old Order Mennonite community

Social interaction, coping and stress shaped mental health in both groups. The priority that OOMs assign to social interaction is evident from their response to the related SF-12 question. However, the appearance of this determinant in both groups highlights its significance beyond OOMs, which is supported by a broader litera- ture linking low levels of social interaction with higher mortality rates and a range of physical and mental disor- ders [93]. The significant negative impact of social isola- tion on health in seven of eight former Soviet countries is a striking, recent reminder of the importance of this de- terminant [94]. Coping and stress were highly significant for both groups even though they differ on these, indi- cating their central role in shaping mental health across many populations. This interpretation is supported by [45], who found stress and coping to be among the strongest correlates with psychological distress. Refer- ence [95] also found coping and stress to be important to many health outcomes, and coping to be an important mediator between health and income. We explored this mediation effect in OOMs, where the sample size was sufficient (≥500) for mediation testing. Using the meth- odology recommended by [96], we confirmed that all mediation conditions were met, that is: significant rela- tionships existed between the predictor and outcome, predictor and mediator, and mediator and outcome; and the relationship between the predictor and outcome was significantly reduced once the mediator entered the model. Reference [96] also provide methods to test the significance of the mediator effect, and applying these we find that coping is a significant mediator (p = 0.05) that mediates 39% of the total effect of income on mental health. The interaction term (income adequacy x coping) was also significant (p = 0.05) in the OOM regression model.
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7-17-2014 12:00 AM The Reciprocal Influences of the Old Order Mennonite Community and Tourism in St. Jacobs, Ontario

7-17-2014 12:00 AM The Reciprocal Influences of the Old Order Mennonite Community and Tourism in St. Jacobs, Ontario

Everything was self-sufficient here. Every family has farmland. The husband has to work in the field during the day too. They raise fruits such as strawberries and blueberries, and other crops. They make maple syrup, and raise chicken, pigs, and cows. Bread and butter are all self-made. They eat things like vegetable stew and pork stew, mostly German style. Alcohol is only used during religious rituals. They burn wood for cooking. Electricity and gas are basically forbidden and they live a life of waking up together with the sunrise and going to sleep when the sun sets. However, more recently their lifestyle has started to change. There have emerged families who started using electricity, and also some families who started using tractors for farming. Among the most progressive are the Mennonites in the village of the Amish in the state of Penn in the United, who were the earliest Mennonite settlers in the North America. I have heard that they welcome visitors, and even have restaurants and gift shops for tourists. How are the Canadian Mennonites feeling about the introduction of modern technology? “I know they exist, but I do not think they are necessary for our lives.” With a reserved tone, they just reply in this way, indeed like a pacifist. 7 As we can see above, this magazine article was written in order to introduce its Japanese readers to some basic and reliable knowledge about the Old Order Mennonite people. It emphasizes the authenticity and the reliability of the content by highlighting the
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Prevalence of frailty in Canadians 18–79 years old in the Canadian Health Measures Survey

Prevalence of frailty in Canadians 18–79 years old in the Canadian Health Measures Survey

The Accumulation of Deficits Model uses an FI to capture frailty based on the presence of signs, symptoms, laboratory values, chronic conditions, and disabilities. An FI was not developed in the three CHMS cycles; therefore, one was constructed using previously pub- lished guidelines [14]. Variables within the FI should increase with age, be associated with poor outcomes, cover a range of physiological systems, cannot be un- common (<1%) or common (>80% by age 80), and more than 5% of variables cannot be missing for an individual. The FI is the ratio of health problems within the index. For example, someone with 6/23 deficits would score 0.26. A 23-item FI was created based on self-reported and laboratory-based variables (Additional file 1: Table S1). While it is recommended that an FI should have 30 vari- ables, we chose a smaller FI due to a large number of missing laboratory variables. Previous studies have used fewer than 30 variables (as low as 15) and are associated with poor outocmes [17–19]. All variables were re-coded as a 0 (absence of deficit) or 1 (presence of deficit). A per- son was deemed frail in the present study if they scored 0.25/1 or higher on the FI [20].
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Exploring the Influence of Childcare Type on Physical Activity and Sedentary Time of a Nationally Representative Sample of Canadian Preschoolers

Exploring the Influence of Childcare Type on Physical Activity and Sedentary Time of a Nationally Representative Sample of Canadian Preschoolers

allowance for 1 or 2 minutes of counts between 0 and 100. It should be noted that most participants well exceeded the 5-hour minimum wear time requirement and collected approximately 12 hours of accelerometry data since accelerometers were worn during all waking hours. After invalid days were removed from the dataset, daily time spent at various activity intensities (i.e., LPA, MVPA, TPA, ST) were determined for valid days based on laboratory-derived cut-points corresponding to each intensity level (Adolph, Puyau, Vohra, Nicklas, Zakeri, & Butte, 2012; Wong, Colley, Connor Gorber, & Tremblay, 2011). Adolph et al.’s (2012) preschooler specific physical activity cut-point for MVPA (288 cp15s) was used, while Wong et al.’s cut point to differentiate sedentary behaviour from LPA (25 cp15s) and to measure TPA was applied (Wong et al., 2011).
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Physical activity interventions impacting health in the community

Physical activity interventions impacting health in the community

In England, a higher proportion of boys (21 per cent) than girls (16 per cent) reported meeting recommendations aged between 5 and 15 years in 2012 (Joint Health Surveys Unit 2013). In boys, the most activity was reported between the ages of 8 and 10 years (26 per cent), whilst for girls, most activity was reported in 5–7 years (23 per cent). In both boys and girls in England, the proportion of children aged 5–15 years meeting recommendations fell between 2008 and 2012. The largest declines were aged 13–15 years for both sexes. Globally, physical activity levels decline with age, and men are more active than women in 137 of the 146 countries for which data are available (Sallis et al. 2016). There is a large decrease in activity, particularly in sport participation once young people leave school (Telama et al. 2005). Due to the prevalence of health inequalities associated with physical inactivity and increasing sedentary behaviour, there is a clear need to develop effective interventions that will lead to population level increases in physical activity.
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Process description and evaluation of Canadian Physical Activity Guidelines development

Process description and evaluation of Canadian Physical Activity Guidelines development

The Healthy Living Program, part of the federal Healthy Living and Chronic Disease Initiative, is a cor- nerstone of the Public Health Agency of Canada's health promotion efforts and a proactive response to the rapid increase in chronic disease across population groups. It aims to lead, foster and support action to address the conditions that support physical activity, healthy eating, and healthy weights for all Canadians and with particular emphasis on sub-populations experiencing health dispar- ities. The Program encompasses a range of initiatives, tools and strategies that seek to directly impact key deter- minants of health; for example by fostering the creation of health-supporting social and physical environments, seeking to optimize personal health practices, and laying the groundwork for healthy child development. The CSEP, in partnership with the Public Health Agency of Canada, led the process to develop each of Canada's Physical Activity Guidelines and Guides [6-15] and con- vened the Steering Committee guiding the process to review current evidence underlying physical activity mea- surement and guidelines in Canada.
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Comment on the Canadian Task Force on the Preventive Health Care on PSA Screening

Comment on the Canadian Task Force on the Preventive Health Care on PSA Screening

2. Digital rectal exam (DRE) has value for the detection of many anal and rectal problems, as well as prostatic abnormalities in addition to prostate cancer. DRE should continue to be performed as a routine part of the periodic health exam. 3. Do not treat men with low-risk prostate cancer, or older men with intermediate-

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Output from the CIHR Canadian HIV Trials Network international postdoctoral fellowship for capacity building in HIV clinical trials

Output from the CIHR Canadian HIV Trials Network international postdoctoral fellowship for capacity building in HIV clinical trials

Abstract: As a response to the human immunodeficiency virus (HIV) epidemic and part of Canadian Institutes for Health Research’s mandate to support international health research capacity building, the Canadian Institutes for Health Research Canadian HIV Trial Network (CTN) developed an international postdoctoral fellowship award under the CTN’s Postdoctoral Fellowship Awards Program to support and train young HIV researchers in resource-limited settings. Since 2010, the fellowship has been awarded to eight fellows in Cameroon, China, Lesotho, South Africa, Uganda and Zambia. These fellows have conducted research on a wide variety of topics and have built a strong network of collaboration and scientific productivity, with 40 peer-reviewed publications produced by six fellows during their fellowships. They delivered two workshops at international conferences and have continued to secure funding for their research, using the fellowship as a step- ping stone. The CTN has been successful in building local HIV research capacity and forming a strong network of like-minded junior low- and middle-income country researchers with high levels of research productivity. They have developed into mentors, supervisors and faculty members, who, in turn, build local capacity. The sustainability of this international fellowship award relies on the recognition of its strengths and the involvement of other stakeholders for additional resources. Keywords: CTN, postdoctoral fellowship, capacity building, clinical trials, networking
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<p>Frailty Phenotype: Evidence of Both Physical and Mental Health Components in Community-Dwelling Early-Old Adults</p>

<p>Frailty Phenotype: Evidence of Both Physical and Mental Health Components in Community-Dwelling Early-Old Adults</p>

Frailty has been identi fi ed among major factors con- tributing to old-age disability. 3,4 According to the Survey of Health, Aging and Retirement in Europe (SHARE), more than 50% of the European community-dwelling adults 50 or more years of age are prefrail or frail. 5 Although a consensus regarding the de fi nition of frailty has not yet been achieved, 6,7 the frailty phenotype diag- nostic criteria developed by Fried and colleagues are the most widely used criteria for population-based studies. 6,8 These criteria consist of fi ve components: unintentional weight loss, exhaustion, low physical activity, slow walk- ing speed at usual pace, and low grip strength, with 1 – 2 positive criteria indicating pre-frailty, and 3 or more posi- tive criteria indicating frailty. 9 Based on the Cardiovascular Health Study, Fried et al not only provided a standardized diagnostic criteria for frailty in community- dwelling older adults but also demonstrated that disability is an outcome of frailty. 9 Subsequent studies con fi rmed the predictive value of Fried frailty phenotype de fi nition for adverse health outcomes in community-dwelling older adults in various populations. 10 – 13
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The development of the Canadian Rural Health Research Society: creating capacity through connection

The development of the Canadian Rural Health Research Society: creating capacity through connection

Although there is a long history of research into the health of rural Canadians, as well as a long history of international research symposia and meetings on rural health issues 1 , the rural health research community remains small and dispersed across the country. Within the last decade, sparked largely by the new research funding opportunities created by the establishment of the Canadian Institutes of Health Research (CIHR), there has been a concerted effort to develop more substantial connections among rural health researchers from many different disciplines and parts of Canada. The Canadian Rural Health Research Society (CRHRS), created by researchers as a means to establish a robust and well- funded rural health research community, has developed as a network of researchers in the four principal areas of rural health research: (i) biomedical; (ii) clinical; (iii) health services and policy; (iv)population and public health.
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GUIDELINES AND MINIMUM REQUIREMENTS TO ESTABLISH SCHOOL OF NURSING

GUIDELINES AND MINIMUM REQUIREMENTS TO ESTABLISH SCHOOL OF NURSING

At least one third of the total number of beds should be for medical patients and one third for surgical patients. The number of beds for male patients should not be less that 1/6 th of the total number of beds i.e. at least 40 beds. There should be minimum of 750 deliveries per year (for annual admission capacity of 20 students) Provision should be made for clinics in health and family welfare and for preventive medicine.

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High daily doses of benzodiazepines among Quebec seniors: prevalence and correlates

High daily doses of benzodiazepines among Quebec seniors: prevalence and correlates

Subjects were categorized according to whether they had filled one of more prescriptions for benzodiazepines dur- ing the 365 days following screening and then further categorized as to whether or not any of their benzodi- azepine prescriptions were for high daily doses. A pre- scription was defined as a high daily dose if the prescribed dosage was higher than the Defined Daily Dose (DDD) for that particular benzodiazepine [20]. The DDD is the unit of daily drug consumption set by the World Health Organization (WHO) to allow estimation regional per capita consumption of drugs regions when only sales data are available. In this study the DDDs for benzodiazepines were used to differentiate a standard dose of the drug and a high dose. The DDD's for study benzodiazepines are compared with the manufacturers' prescribing guidelines in use just prior to the study peri- od [21] and the diazepam equivalents [22] in Table 1. Patient gender, age (66–69, 70–74, 75–79, 80+ years), subjective anxiety (whether the patient reported "prob- lems with his/her nerves" during the year prior to screening), and score on the 3MS (< 78 versus 78+, max- imum score in cognitively intact = 100) were extracted from CSHA1 data. Using all prescriptions filled during the year prior to CSHA1 screening, a Chronic Disease Score (CDS) [23] was calculated for each patient. The CDS provides a measure of health status by considering the number and severity of chronic diseases for which a patient is receiving pharmacotherapy. A score of 4 or more represents relatively poor health. Higher scores on the CDS have been associated with increased risk of hos- pitalization and death [23,24]. In addition, use of benzo- diazepines during the previous year was ascertained by examining the RAMQ data for the presence of a benzodi-
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A snapshot of the prevalence of physical activity amongst older, community dwelling people in Victoria, Australia: patterns across the 'young-old' and 'old-old'

A snapshot of the prevalence of physical activity amongst older, community dwelling people in Victoria, Australia: patterns across the 'young-old' and 'old-old'

Given the variable agreement with the physical activity messages amongst the oldest age group in the present study, it seems pertinent to build a behavioural approach into any intervention seeking to encourage the old-old to become physically active. Relatively few intervention studies have focused on the old-old [32]. Simons and Andel [33] trialled two types of supervised physical activ- ity in people with a mean age of 83.5 years. They found similar levels of improvement in functional status (albeit with no between group analyses) amongst those who fol- lowed a walking program and those completing a progres- sive resistance training program. For some 'frail' older people, walking may be a more feasible option in the long term, although they may require initial lower limb strength training to enable independent walking.
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Single item measures of self rated mental health: a scoping review

Single item measures of self rated mental health: a scoping review

Three studies examined SRMH and health service satis- faction. In 2000, Rohland et al. examined American Medicaid patients to determine the relationship between mental health service satisfaction, SRMH, and life satis- faction. The authors found correlations between all three variables for people with schizophrenia but not for those with affective, anxiety or adjustment disorders [51]. Follow-up study is needed to clarify the relationship bet- ween service satisfaction and SRMH amongst groups of differing diagnoses to identify whether other variables could be responsible for this effect. In 2007, Raleigh et al. in England found that people with fair or poor SRMH were less likely to be satisfied with mental health services. SRMH was the strongest predictor among all study variables (ethnicity, age, living alone, employment status, and hospital admissions) [52]. Eselius in 2008 found that evaluations of managed behavioural health plans varied by SRMH. Those with excellent or good SRMH gave higher ratings to the plan than those with fair or poor SRMH [53].
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“Still learning and evolving in our approaches”: patient and stakeholder engagement among Canadian community-based primary health care researchers

“Still learning and evolving in our approaches”: patient and stakeholder engagement among Canadian community-based primary health care researchers

This study examined how Canadian primary health care researchers have perceived their engagement with pa- tients and other stakeholders in the course of CIHR’s five-year funding initiative for 12 CBPHC Innovation Teams. The findings show the complex and multi-fa- ceted nature of patient and other stakeholder engage- ment in these projects. Respondents indicated that they encountered a number of challenges in the course of their engagement activities, such as communication, time, and even finding appropriate stakeholder representatives with whom to engage. Nevertheless, the responses also show that researchers have engaged patients and other stake- holders in a way that closely aligns with the goals articu- lated in CIHR’s SPOR Patient Engagement Framework [5]. The challenges respondents outlined regarding this en- gagement, and the efforts teams undertook to clarify roles and expectations, communicate effectively, and be flexible and adaptable certainly indicate that the interaction has been active, and suggest that it has also been meaningful, at least for the researchers. Although only infrequently mentioned by respondents, the funding requirement that CBPHC teams comprise both decision-makers and clini- cians, and that they consult with patients, undoubtedly had an influence on the nature and level of their engage- ment. Interestingly, however, the majority of the teams that reported engaging patients went beyond the CIHR- mandated level, to actively collaborate with these stake- holders throughout the research process, rather than sim- ply seeking feedback on aspects of the research.
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Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

For the economic evaluations, the difference in per- spective of analysis, type of economic analysis, and healthcare system will be discussed narratively. To allow direct comparisons across countries and years, we will convert reported costs estimates to 2014 United States (US) dollars. International exchange rate based on pur- chasing power parities (PPP) will be use to convert cost estimates to US dollars, and gross domestic product (GDP) deflators will be use to convert cost estimates to 2014. PPP and GDP are available from the World Economic Outlook Database (http://www.imf.org/external/ data.htm). Results comparing chiropractic to other types of care will be summarized using Slavin’s [36] qualitative best-evidence synthesis approach, which as- sumes that the strength of a relationship between vari- ables is based on the quantity and quality of the evidence available. This approach aims to provide meth- odological rigor by clearly and concisely articulating the synthesis criteria and was recently used in a number of systematic reviews related to occupational health [37-39]. The level of evidence uncovered for the findings of inter- est will be assessed using a 5-point ordinal scale (strong, moderate, limited, mixed, and insufficient evidences) de- fined by Slavin [36]. The appropriate level of evidence for each finding will be assessed in a stepwise manner by first determining if criteria for the highest level of evidence (that is, strong) are fulfilled and, if they are, no further evaluation is performed. If those criteria are not fulfilled, those for the next lowest level of evidence are then assessed, continuing until the appropriate level of evidence can be assigned to the various review findings. The criteria for each level of evidence are the following:
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Public Interest in Communications: Beyond Access to Needs

Public Interest in Communications: Beyond Access to Needs

Why is the right to communication and information crucial in an information society? The short answer is to address global, national and local inequalities arising from neo- liberal media and communication policy changes. A more in-depth answer would benefit from considering Amartya Sen’s research for the United National Development Programme on equality in order to address inequalities (Sen, 1992, p. 12). The solution he offers is the capabilities approach, which is grounded on the principles of freedom and distributive rights. Capabilities offer the freedom to choose a life one has reason to value (Sen, 1999, p.74). The concept also involves functionings – agency or doings – the various things a person may do or value such as having adequate nourishment, good health, self-respect and taking part in community life (Ibid, p. 75).
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Community engagement in US and Canadian medical schools

Community engagement in US and Canadian medical schools

Several limitations exist with this study. First, for the purpose of this survey, the definition of the term ‘service’ inferred community engagement, not care to individuals in practice settings, primary service to the university, or the concept of medicine as a service profession. Many medical schools utilize a definition of service linked solely to the provision of clinical care. Second, data collection involved utilizing medical schools’ Web sites and the Internet for primary data abstraction. While this data collection tech- nique is novel, it could underestimate the activities that are occurring at any given time on community engagement, and it thus should receive validation by actual activities that are occurring. However, this data collection technique could also overestimate actual accomplishments that have occurred by crediting activities based on the Web site without knowing when they occurred or their magnitude of impact. Such limitations may be lowered by the pervasive use of the Web by universities to share information and advertise their institution to their potential and current faculty and students and the larger community. While concerns could exist that wealthier medical schools might have better Web sites, with more information posted, the fact that this study found an inverse relationship between medical school NIH funding and indicators of engagement makes this concern unlikely. Third, only one coder initially coded all Web sites. However, to limit bias, two coders reviewed any Web sites where ques- tions existed, and a small sample of sites without questions were reviewed by the second coder without any changes occurring. Finally, while this study occurred in 2006, and the need for updated data is already apparent, the pressing financial pressures on medical schools for clinical income
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Dental care use in Ontario: the Canadian community health survey (CCHS)

Dental care use in Ontario: the Canadian community health survey (CCHS)

the past year than non-smokers [27]. Our results also suggested that those who smoked usually visited a den- tist for emergencies only compared to non-smokers. This could be due in part to the fact that smokers tend to engage in health-seeking behavior rather than pre- ventive care behavior, even though regular dental visits are highly recommended for averting future periodontal disease, tooth loss, and other oral health complexities [28]. Interestingly, our results revealed that those who consumed alcohol at least once per week were less likely to report having poor dental care use. This result was not in concordance with a longitudinal study in Sweden, which found that individuals with high alcohol use reported having more irregular dental visits than those with lower alcohol use In fact, previous studies have Table 1 Characteristics of the total sample and those with dental visits ≥ 1 year and emergency dental visits in Ontario, the Canadian Community Health Survey (CCHS), 2014 (Continued)
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