CLOSE
Advanced searchCitation search
Suggested Terms:
Skip main navigation

Search Result

1 - 20of23
per page:
Relevance
Filters

You do not have any saved searches

  • OPEN ACCESS
    Experiential knowledge, suffering, and vicissitudes of having malaria in the Brazilian Amazon: An ethnographic study
    FACETS • Vol. 2 • pp. 410 - 428
    This paper focuses on the multiple ways in which people who live along the rivers of the Brazilian Amazon, known as ribeirinhos, experience malaria outside of a clinical setting. It describes the local understanding of malaria, strategies to distinguish the illness from other febrile sicknesses, challenges for detecting the disease through biomedical diagnosis methods, and vicissitudes of having malaria. It draws on cases from ribeirinhos from a peri-urban community of Manaus and a rural community from Careiro, State of Amazonas, Brazil. Although malaria is biomedically characterized by the pathogens causing the disease, ribeirinhos have developed other standards to define malaria, including the intensity of the symptoms, the interval between the infections, and the types of medications dispensed to them. In the riverine communities studied, the etiology of malaria includes mosquitoes, microbes, water, wind, sun, and person-to-person transmission. Symptoms of malaria were found to overlap with other febrile sicknesses; hence, ribeirinhos developed skills to monitor how a malaise unfolds in their bodies. Experiential knowledge plays a key role in the early detection of malaria. Individuals who have no previous experience with malaria were found to spend more time seeking health care. Equally important, ribeirinhos perceive that malaria is part of the landscape they inhabit.
  • OPEN ACCESS
    Household food insecurity is independently associated with poor utilization of maternal healthcare services in Bangladesh
    FACETS • Vol. 2 • pp. 969 - 983
    Introduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.
  • OPEN ACCESS
    Fish consumption is inversely associated with type 2 diabetes in Manitoba First Nations communities
    FACETS • Vol. 2 • pp. 795 - 818
    Consumption of fish and n-3 fatty acids (n-3 FAs) has been postulated to prevent type 2 diabetes (T2D). Objective: To explore the association between self-reported T2D and fish consumption, dietary n-3 FAs, and persistent organic pollutants (POP) intake in a regionally representative sample of First Nations (FNs) in Manitoba. Design: Data from the cross-sectional First Nations Food, Nutrition and Environment Study (FNFNES) collected from 706 members of 8 Manitoba FNs in 2010 were used. Household interviews were used to collect social and lifestyle data. The consumption of fish was estimated using a traditional food frequency questionnaire. Fish samples were analyzed for the presence of POP. Multiple logistic regression models adjusted for potential risk factors for T2D were developed. Results: A negative, dose–response relationship was found between fish intake and self-reported T2D. Fish consumptions of 2–3 portions per month and ≥1/week were inversely associated with T2D with odds ratio (OR) values of 0.51 (95% CI: 0.28–0.91) and 0.40 (95% CI: 0.19–0.82), respectively, compared with no fish intake. Similarly, intake of n-3 FAs was negatively associated with T2D (OR = 0.48 (95% CI: 0.30–0.77). Dietary POP intake was not associated with T2D. Conclusion: These findings suggest that the consumption of traditionally harvested fish may have a beneficial effect on T2D in Manitoba FNs.
  • OPEN ACCESS
    The not so over-the-counter status of emergency contraception in Ontario: A mixed methods study with pharmacists
    FACETS • Vol. 2 • pp. 429 - 439
    Introduction: In Canada, the progestin-only dedicated pill is the most widely used method of emergency contraception (EC). This method gained over-the-counter status in Ontario in 2008. Our mixed methods study explored the progestin-only EC knowledge, attitudes, and provision practices of Ontario pharmacists. Methods: From June 2015 to October 2015, we collected 198 mailed surveys from Ontarian pharmacy representatives and conducted 17 in-depth interviews with a subset of respondents. We analyzed these data using descriptive statistics and for content and themes. Results: Results from our English/French bilingual survey indicate that respondents’ knowledge is generally accurate, but confusion persists about the mechanism of action and the number of times the drug can be used in one menstrual cycle. Nearly half (49%) of our survey respondents indicated that progestin-only EC pills are only available behind the counter. Interviewees strongly supported the introduction and promotion of more effective methods of EC in Ontario. Conclusion: Continuing education focusing on both the regulatory status of progestin-only EC and information about the medication appears warranted. Health Canada’s recent approval of ulipristal acetate for use as a post-coital contraceptive may provide a window of opportunity for engaging with health service providers, including pharmacists, about all available modalities of EC in Canada.
  • OPEN ACCESS
    Housing characteristics, home environmental factors, and pulmonary function deficit in Chinese children: Results from the Seven Northeast Cities (SNEC) Study
    FACETS • Vol. 3 • No. 1 • pp. 242 - 259
    To assess the effects of housing characteristics and home environmental factors on lung function of Chinese children, 6740 children (aged 6–16 years) were recruited from seven cities in Northeast China in 2012. Performance of lung function was determined by comparison of forced vital capacity (FVC), forced expiratory volume (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF). Multivariate regression models were used to evaluate the associations with lung function deficit. The results showed that housing conditions were associated with lung function deficit in children. The adjusted odds ratios were 0.47 (95% CI: 0.26–0.83) for FVC for “ping-fang” housing compared with “dan-yuan-lou-fang” housing and 2.90 (95% CI: 2.43–3.47) for FEV1 with home renovations completed within two years compared with counterparts. The linear regression models consistently showed a significant association of housing conditions and home environmental factors with lung function measurements across subjects. A residence taller than seven stories was negatively associated with FEV1 (β = −55; 95% CI: −97 to −13). In conclusion, housing conditions and home environmental factors are particularly important to the development of lung function and respiratory health in children. These factors are concerning and action should be taken to improve them.
  • OPEN ACCESS
    “I kind of feel like sometimes I am shoving it under the carpet”: Documenting women’s experiences with post-abortion support in Ontario
    FACETS • Vol. 2 • pp. 754 - 763
    Background: Abortion has been available without criminal restriction in Canada since 1988, and approximately 33 000 terminations take place in Ontario each year. Objectives: This study aimed to explore women’s expressed desire for post-abortion support services, document the priorities expressed by women in seeking post-abortion support, and identify actionable strategies to improve post-abortion support services in Ontario. Methods: Between 2012 and 2014 we conducted in-depth, open-ended interviews with 60 Anglophone women from across Ontario who had recently had an abortion. We aimed to rigorously explore the compounding issues of age and geography on women’s abortion experiences. We analyzed our data for content and themes and reported on the findings related to post-abortion support. Results: One third of our participants expressed a desire for post-abortion support, yet few were able to access a timely, affordable, non-directive service. Women were uncertain about how to find services; most contacted a provider recommended by the clinic or searched online. Women were enthusiastic about a talkline format citing anonymity and convenience as the main advantages. Conclusion: Our results suggest that exploring ways to expand post-abortion support services in Ontario is warranted. A talkline format could provide an anonymous, convenient, non-judgmental, and non-directive way to address this unmet need.
  • OPEN ACCESS
    “It was kind of like if it happens it happens. It wasn’t planned, it wasn’t intentional”: Young mothers’ experiences with subsequent pregnancy in Ottawa, Canada
    FACETS • Vol. 2 • pp. 859 - 871
    Young mothers constitute a vulnerable population in Canada. Teens with children are at significant risk of subsequent pregnancy, a dynamic that can exacerbate health, emotional, and socio-economic challenges. We aimed to understand better the dynamics shaping “rapid repeat pregnancy” among young mothers in Ottawa, explore young mothers’ subsequent pregnancy experiences, and identify how services could be improved in Canada’s capital. In 2016, we conducted in-depth interviews with 10 young mothers and semi-structured interviews with 10 key informants working with pregnant and parenting youth. We analyzed interviews for content and themes using a multi-phased, iterative process. Four major themes emerged: (1) young mothers often plan their pregnancies actively or passively; (2) violence before, during, and after pregnancy is common; (3) mental health and substance abuse issues shape pregnancy risk; and (4) becoming pregnant often serves as a source of motivation for young mothers. Our results further indicate that young mothers have difficulty finding youth-friendly, non-judgmental support services and that integrated, multidisciplinary services offering individually tailored support and building on women’s strengths will likely be more successful in helping young mothers prevent subsequent pregnancies. Increasing awareness about existing services and supporting efforts that approach teen pregnancy comprehensively and holistically appear warranted.
  • OPEN ACCESS
    Antimicrobial resistance gene surveillance in the receiving waters of an upgraded wastewater treatment plant
    FACETS • Vol. 3 • No. 1 • pp. 128 - 138
    Wastewater treatment plants (WWTPs) have been identified as hotspots for antimicrobial resistance genes (ARGs) and thus represent a critical point where patterns in ARG abundances can be monitored prior to their release into the environment. The aim of the current study was to measure the impact of the release of the final treated effluent (FE) on the abundance of ARGs in the receiving water of a recently upgraded WWTP in the Canadian prairies. Sample nutrient content (phosphorous and nitrogen species) was measured as a proxy for WWTP functional performance, and quantitative PCR (qPCR) was used to measure the abundance of eight ARGs, the intI1 gene associated with class I integrons, and the 16S rRNA gene. The genes ermB, sul1, intI1, blaCTX-M, qnrS, and tetO all had higher abundances downstream of the WWTP, consistent with the genes with highest abundance in the FE. These findings are consistent with the increasing evidence suggesting that human activity affects the abundances of ARGs in the environment. Although the degree of risk associated with releasing ARGs into the environment is still unclear, understanding the environmental dimension of this threat will help develop informed management policies to reduce the spread of antibiotic resistance and protect public health.
  • OPEN ACCESS
    Substitute foods are more likely than their traditional food counterparts to display front-of-package references
    FACETS • Vol. 3 • No. 1 • pp. 455 - 468
    Innovative, highly processed foods are often designed to “substitute” for traditional, less-processed items in the diet. Yet, concerns about the unhealthfulness of diets high in highly processed foods are growing. Their dominance in the diet has been hypothesized to relate, in part, to the strategic use of on-package nutrition promotion. Our goal was to compare front-of-package (FOP) labelling on highly processed products that appear to have been explicitly designed as substitutes for traditional foods with the FOP labelling on their traditional counterparts. FOP references were recorded from packaged foods in three major Toronto grocery stores (N = 20520). Foods were categorized as substitute or traditional counterparts if these had (1) immediate interchangeability within the diet, (2) inherently different formulation, and (3) the substitute was more heavily processed than its traditional counterpart. Eight substitute–traditional pairs were identified, comprising 18% of products in the data set. Substitute foods were more likely than traditional products to bear FOP nutrition, “organic”, and “natural” references. Substitute foods bore 1.21 times more FOP references, the majority of which highlighted nutrients inherent to the traditional counterpart. Our findings support the contention that highly processed foods may be displacing less-processed foods at least in part through the use of strategic on-package marketing.
  • OPEN ACCESS
    Defining modifiable barriers to uptake of dietary recommendations in Chinese immigrants with type 2 diabetes: a qualitative study
    FACETS • Vol. 4 • No. 1 • pp. 551 - 565
    The objective is to support development of a nutritional intervention for Chinese immigrants with diabetes by defining current deficiencies and identifying modifiable factors and mechanisms of change. Semi-structured interviews conducted with 13 ethnic Chinese with type 2 diabetes identified modifiable problems related to culturally relevant diabetes resources and low cultural acceptability of recommended diets. These factors could be addressed through creation of resources developed in partnership with Chinese-speaking health care professionals and persons with diabetes.
  • OPEN ACCESS
    How did the introduction of mifepristone impact the availability of abortion care in Ottawa? A qualitative study with abortion patients
    FACETS • Vol. 5 • No. 1 • pp. 559 - 570
    In 2017, mifepristone and misoprostol became available for early pregnancy termination as the combination pack Mifegymiso® in Ottawa, Ontario, Canada. We conducted 40 semi-structured telephone interviews with Ottawa residents who had abortions before mifepristone’s introduction (n = 20) and after mifepristone–misoprostol became available (n = 20) to explore their experiences obtaining care. We audio-recorded and transcribed all interviews and analyzed these data for content and themes using deductive and inductive techniques. Prior to the introduction of mifepristone, our participants reported obtaining abortion care at two facilities and many faced long wait times. Those who had an abortion after mifepristone became available reported obtaining care from a wider array of providers and few waited more than two weeks. However, several mifepristone–misoprostol users reported having to go through a process that involved as many as 10 health service encounters. Both groups reflected positively on their abortion experiences, but some patients who obtained mifepristone–misoprostol outside of an abortion clinic did not feel as well informed as they would have liked. The introduction of mifepristone appears to have expanded the number of service delivery points and reduced wait times for those seeking abortion care in Ottawa. Identifying ways to expand access to medication abortion information and streamline services appears warranted.
  • OPEN ACCESS
    Drinking water perception and consumption in Canadian subarctic Indigenous communities and the importance for public health
    FACETS • Vol. 7 • pp. 343 - 359
    Resource development and climate change are increasing concerns regarding safe water for Indigenous people in Canada. A research study was completed to characterize the consumption of water and beverages prepared with water and identify the perception of water consumption in Indigenous communities from the Northwest Territories and Yukon, Canada. As part of a larger research program, data for this study were available from a 24-hour recall dietary survey (n = 162), a health messages survey (n = 150), and an exposure factor survey (n = 63). A focus group was conducted with Elders in an on-the-land camp setting. The consumption of water-based beverages in winter was 0.9 L/day on average, mainly consisting of tea and coffee. Of the 81% of respondents who reported consuming water-based beverages in the previous 24 hours of the survey, 33% drank more bottled water than tap water. About 2% of respondents consumed water from the land (during the winter season). Chlorine smell was the main limiting factor reported to the consumption of tap water. Results from the focus group indicated that Indigenous knowledge might impact both the perception and consumption of water. These findings aim to support public health efforts to enable people to make water their drink of choice.
  • OPEN ACCESS
    A media surveillance analysis of COVID-19 workplace outbreaks in Canada and the United States
    FACETS • Vol. 7 • pp. 1185 - 1198
    A media surveillance analysis was conducted to identify COVID-19 workplace outbreaks and associated transmission risk for new and emerging occupations. We identified 1,111 unique COVID-19 workplace outbreaks using the Factiva database. Occupations identified in the media articles were coded to the 2016 National Occupational Classification (V1.3) and were compared and contrasted with the same occupation in the Vancouver School of Economics (VSE) COVID Risk/Reward Assessment Tool by risk rating. After nurse aides, orderlies, and patient service associates (n = 109, very high risk), industrial butchers and meat cutters, and poultry preparers and related workers had the most workplace outbreaks reported in the media (n = 79) but were rated as medium risk for COVID-19 transmission in the VSE COVID Risk Tool. Outbreaks were also reported among material handlers (n = 61) and general farm workers (n = 28), but these occupations were rated medium–low risk and low risk, respectively. Food and beverage services (n = 72) and cashiers (n = 60) were identified as high-risk occupations in the VSE COVID Risk Tool. Differences between the media results and the risk tool point to key determinants of health that compound the risk of COVID-19 exposure in the workplace for some occupations and highlight the importance of collecting occupation data during a pandemic.
  • OPEN ACCESS
    The association of typical and atypical symptoms with in-hospital mortality in older adults with COVID-19: a multicentre cohort study
    FACETS • Vol. 7 • pp. 1199 - 1213
    Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106; 6.2%). The most common atypical symptoms were anorexia (n = 598; 33.5%), weakness (n = 519; 23.9%), and delirium (n = 449; 25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.62–2.62), tachycardia (aOR 1.87; 95% CI 1.14–3.04), and delirium (aOR 1.52; 95% CI 1.18–1.96) were independently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presentations in older adults.
  • OPEN ACCESS
    An analysis of Canada's declared live wildlife imports and implications for zoonotic disease risk
    FACETS • Vol. 8 • pp. 1 - 18
    In Canada, there have been calls for increased research into and surveillance of wildlife trade and associated zoonotic disease risks. We provide the first comprehensive analysis of Canadian live wildlife imports over a 7-year period (2014–2020), based on data from federal government databases obtained via Access to Information requests. A total of 1 820 313 individual animals (including wild-caught and captive-bred animals but excluding fish, invertebrates, Columbiformes (pigeons), and Galliformes (game birds)), from 1028 documented import records, were imported into Canada during 2014–2020. Birds were the most imported taxonomic class (51%), followed by reptiles (28%), amphibians (19%), and mammals (2%). In total, 22 taxonomic orders from 79 countries were recorded as imported. Approximately half of the animals (49%) were imported for the exotic pet market. Based on existing literature and a review of the Canadian regulatory apparatus, we gesture to these importations' potential implications for zoonotic disease risk and discuss potential biosecurity challenges at the Canadian border. Finally, we identify data gaps that prevent an extensive assessment of the zoonotic disease risk of live wildlife imports. We recommend data collection for all wildlife importation and improved coordination between agencies to accurately assess zoonotic disease risk.
  • OPEN ACCESS
    Urgent and long overdue: legal reform and drug decriminalization in Canada
    FACETS • Vol. 9 • pp. 1 - 28
    The International Guidelines on Human Rights and Drug Policy recommend that states commit to adopting a balanced, integrated, and human rights-based approach to drug policy through a set of foundational human rights principles, obligations arising from human rights standards, and obligations arising from the human rights of particular groups. In respect of the Guidelines and standing obligations under UN Treaties, Canada must adopt stronger and more specific commitments for a human rights-based, people-centered, and public health approach. This approach must commit to the decriminalization of people who use drugs and include the decriminalization of possession, purchase, and cultivation for personal consumption. In this report, we will first turn to the legal background of Canada's drug laws. Next, we will provide an overview of ongoing law reform proposals from civil society groups, various levels of government, the House of Commons, and the Senate. We end with a three-staged approach to reform and a series of targeted recommendationscr.
  • OPEN ACCESS
    Implementing and improving designated care partner programs in three Ontario long-term care homes
    FACETS • Vol. 8 • pp. 1 - 12
    Long-term care (LTC) residents have an increased risk of social isolation and loneliness, and these risks were exacerbated by pandemic policies that restricted visitors. The designated care partner (DCP) program was introduced in some LTC homes to allow designated family members to safely enter the homes and provide support for residents. We undertook a developmental evaluation (DE) to support the development and implementation of the DCP program in three Ontario LTC homes during the COVID-19 pandemic. Data were collected from 65 staff and DCPs through seven iterations of a DE process. Analysis used directed and inductive coding and theming procedures to create a description of the DCP experience. Themes illustrated the barriers and facilitators to the DCP program and revealed a pervasive deficit of care due to inadequate funding, staff shortages, and an acrimonious relationship between staff and family members. Our project demonstrated a need for additional resources and stronger partnerships between staff and family caregivers.
  • OPEN ACCESS
    Social determinants of food insecurity experienced by Ecuadorian women during the COVID-19 pandemic of Summer 2020: an online survey at the individual level
    FACETS • Vol. 9 • pp. 1 - 14
    The COVID-19 pandemic has amplified concerns about food insecurity, prompting its investigation. An online pilot survey anonymously gathered responses from a non-probabilistic sample of 2058 Ecuadorian women. The Food and Agriculture Organization's Food Insecurity Experience Scale was used to measure moderate or severe food insecurity (MSFI). Data quality was assessed using the Rasch item response theory model; this is a single-parameter logistic model that considers food insecurity severity as a latent trait. The analysis produced MSFI prevalence rates with 90% confidence level margins of error (90%MoE). The highest MSFI was found in women: lacking resources for personal expenses (29.53%, 90%MoE = 3.21) compared to those who had them (12.47, 90%MoE = 1.40); who live in the Amazon region (21.37, 90%MoE = 4.24) versus those living in Highlands (17.66%, 90%MoE = 1.77) or in Coast (13.44%, 90%MoE = 2.40); with three or more children (20.97%, 90%MoE = 4.71) against those without children (12.63%, 90%MoE = 3.57); who experienced income reduction during confinement (18.31%, 90%MoE = 2) compared to those who did not (15.71%, 90%MoE = 1.85); and who are rural (18.13%, 90%MoE = 2.83) versus urban residents (16.63%, 90%MoE = 1.55). This study highlights that the most vulnerable Ecuadorian women experienced the highest food insecurity levels during lockdown, emphasizing the need to consider the intersection between income and sociodemographic factors and their impact on women's food insecurity in future research and policymaking.
  • OPEN ACCESS
    Development of an age-adjusted, activity-based contact probability model for infectious diseases
    FACETS • Vol. 9 • pp. 1 - 11
    The COVID-19 pandemic highlighted the importance of gathering restrictions in slowing the spread of communicable disease. Many restrictions on activities were applied without identifying how effective the restrictions might be in curtailing disease spread. We present a model that estimates the probability of contacting an infected individual as a function of prevalence and self-reported or hypothesized activities. The model incorporates an age adjustment factor to account for differences between the age demographics of infected versus activity participants. The age adjustment factor was important to include when the difference in prevalence between age groups was sufficiently large, and prevalence and activity group sizes were moderate. We applied our contact probability model to two scenarios to demonstrate how the model may inform the development of public health measures. Our model presents a method for estimating contact probability that could be adopted by jurisdictions considering facility closures or group size limits, or for individuals evaluating their own behaviours in future outbreaks or pandemics.
  • OPEN ACCESS
    Did the COVID-19 pandemic disrupt food security in West African rural communities? Survey results from four regions of Senegal and Burkina Faso
    FACETS • Vol. 9 • pp. 1 - 16
    Transboundary rural communities in West Africa play an important role in the exchange of goods, mainly food, among countries. The COVID-19 pandemic restricted these activities due to the closure of the borders. Semi-structured interviews were conducted in two regions of Senegal and Burkina Faso to examine the impacts of these restrictions on the pillars (availability, access, utilization, and stability) of food security in rural areas on men and women. The data set included 230 interviews, and they were analyzed through thematic content analysis. The results showed a decrease in agricultural production in all the communities due to mainly lack of labor force, and limited access to inputs, resulting in increased post-harvest losses. The disruption of trade and border and market closures affected rural families engaged in transboundary trade. Farmers experienced a sharp loss of household income leading to debts and decapitalization. Availability and diversity of and access to food was also heavily affected. Food security greatly varied among the communities and between countries. Perceptions also varied between men and women in terms of production, mobility, and food consumption. The restriction measures have triggered a spiral of effects and responses seriously impacting long-term food security in already highly vulnerable countries.