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Approaching Etuaptmumk - introducing a consensus-based mixed method for health services research.

https://arctichealth.org/en/permalink/ahliterature263112
Source
Int J Circumpolar Health. 2015;74:27438
Publication Type
Article
Date
2015
Author
Susan Chatwood
Francois Paulette
Ross Baker
Astrid Eriksen
Ketil Lenert Hansen
Heidi Eriksen
Vanessa Hiratsuka
Josée Lavoie
Wendy Lou
Ian Mauro
James Orbinski
Nathalie Pabrum
Hanna Retallack
Adalsteinn Brown
Source
Int J Circumpolar Health. 2015;74:27438
Date
2015
Language
English
Publication Type
Article
Abstract
With the recognized need for health systems' improvements in the circumpolar and indigenous context, there has been a call to expand the research agenda across all sectors influencing wellness and to recognize academic and indigenous knowledge through the research process. Despite being recognized as a distinct body of knowledge in international forums and across indigenous groups, examples of methods and theories based on indigenous knowledge are not well documented in academic texts or peer-reviewed literature on health systems. This paper describes the use of a consensus-based, mixed method with indigenous knowledge by an experienced group of researchers and indigenous knowledge holders who collaborated on a study that explored indigenous values underlying health systems stewardship. The method is built on the principles of Etuaptmumk or two-eyed seeing, which aim to respond to and resolve the inherent conflicts between indigenous ways of knowing and the scientific inquiry that informs the evidence base in health care. Mixed methods' frameworks appear to provide a framing suitable for research questions that require data from indigenous knowledge sources and western knowledge. The nominal consensus method, as a western paradigm, was found to be responsive to embedding of indigenous knowledge and allowed space to express multiple perspectives and reach consensus on the question at hand. Further utilization and critical evaluation of this mixed methodology with indigenous knowledge are required.
PubMed ID
26004427 View in PubMed
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Consumer attitudes and understanding of low-sodium claims on food: an analysis of healthy and hypertensive individuals.

https://arctichealth.org/en/permalink/ahliterature114824
Source
Am J Clin Nutr. 2013 Jun;97(6):1288-98
Publication Type
Article
Date
Jun-2013
Author
Christina L Wong
JoAnne Arcand
Julio Mendoza
Spencer J Henson
Ying Qi
Wendy Lou
Mary R L'Abbé
Author Affiliation
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
Source
Am J Clin Nutr. 2013 Jun;97(6):1288-98
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada
Choice Behavior
Comprehension
Female
Food Labeling - methods
Health Food
Health Knowledge, Attitudes, Practice
Humans
Hypertension - prevention & control
Intention
Male
Middle Aged
Nutrition Surveys
Ontario
Pilot Projects
Questionnaires
Socioeconomic Factors
Sodium, Dietary
Abstract
Sodium-related claims on food labels should facilitate lower-sodium food choices; however, consumer attitudes and understanding of such claims are unknown.
We evaluated consumer attitudes and understanding of different types of sodium claims and the effect of having hypertension on responses to such claims.
Canadian consumers (n = 506), with and without hypertension, completed an online survey that contained a randomized mock-package experiment, which tested 4 packages that differed only by the claims they carried as follows: 3 sodium claims (disease risk reduction, function, and nutrient-content claims) and a tastes-great claim (control). Participants answered the same questions on attitudes and understanding of claims after seeing each package.
Food packages with any sodium claim resulted in more positive attitudes toward the claim and the product healthfulness than did packages with the taste control claim, although all mock packages were identical nutritionally. Having hypertension increased ratings related to product healthfulness and purchase intentions, but there was no difference in reported understanding between hypertensives and normotensives. In general, participants attributed additional health benefits to low-sodium products beyond the well-established relation of sodium and hypertension.
Sodium claims have the potential to facilitate lower-sodium food choices. However, we caution that consumers do not seem to differentiate between different types of claims, but the nutritional profiles of foods that carry different sodium claims can potentially differ greatly in the current labeling environment. Additional educational efforts are needed to ensure that consumers do not attribute inappropriate health benefits to foods with low-sodium claims. This trial was registered at clinicaltrials.gov as NCT01764724.
PubMed ID
23576050 View in PubMed
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Development of a surveillance case definition for heat-related illness using 911 medical dispatch data.

https://arctichealth.org/en/permalink/ahliterature155337
Source
Can J Public Health. 2008 Jul-Aug;99(4):339-43
Publication Type
Article
Author
Kate L Bassil
Donald C Cole
Rahim Moineddin
Effie Gournis
Brian Schwartz
Alan M Craig
W Y Wendy Lou
Elizabeth Rea
Author Affiliation
Faculty of Health Sciences, Simon Fraser University, Vancouver, BC. kate_bassil@sfu.ca
Source
Can J Public Health. 2008 Jul-Aug;99(4):339-43
Language
English
Publication Type
Article
Keywords
Allied Health Personnel
Canada - epidemiology
Emergency Service, Hospital - statistics & numerical data
Epidemiologic Methods
Focus Groups
Heat Stress Disorders - epidemiology - mortality
Hot Temperature - adverse effects
Humans
Population Surveillance
Public Health
Public Health Practice
Abstract
The adverse effects of hot weather on public health are of increasing concern. A surveillance system using 911 medical dispatch data for the detection of heat-related illness (HRI) could provide new information on the impact of excessive heat on the population. This paper describes how we identified medical dispatch call codes, called "determinants", that could represent HRI events.
Approximately 500 medical dispatch determinants were reviewed in focus groups composed of Emergency Medical Services (EMS) paramedics, dispatchers, physicians, and public health epidemiologists. Each group was asked to select those determinants that might adequately represent HRI. Selections were then assessed empirically using correlations with daily mean temperature over the study period (June 1-August 31,2005).
The focus groups identified 12 determinant groupings and ranked them according to specificity for HRI. Of these, "Heat/cold exposure" was deemed the most specific. The call determinant groupings with the clearest positive associations with daily mean temperature empirically were "Heat/cold exposure" (Spearman's correlation coefficient (SCC) 0.71, p
PubMed ID
18767283 View in PubMed
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Effect of the SARS outbreak on visits to a community hospital emergency department.

https://arctichealth.org/en/permalink/ahliterature164823
Source
CJEM. 2006 Sep;8(5):323-8
Publication Type
Article
Date
Sep-2006
Author
Michael Heiber
W Y Wendy Lou
Author Affiliation
Department of Family and Community Medicine, Scarborough Hospital, Toronto, Ontario, Canada.
Source
CJEM. 2006 Sep;8(5):323-8
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chi-Square Distribution
Child
Child, Preschool
Disease Outbreaks
Emergency Service, Hospital - utilization
Female
Hospitals, Community
Humans
Infant
Male
Middle Aged
Ontario - epidemiology
Retrospective Studies
Severe Acute Respiratory Syndrome - diagnosis - epidemiology
Statistics, nonparametric
Abstract
To examine the effect of severe acute respiratory syndrome (SARS) on visits to a community hospital emergency department (ED) during the early stage of the Toronto outbreak in 2003 and for the same period in 2004. We focused on visits for respiratory illness (SARS-like symptoms) and different age groups.
This study is a retrospective review of ED discharge diagnoses obtained from a computerized database, examining the 4-week period starting March 28 for the years 2001-2004. We obtained the discharge diagnosis, age and visit date for each ED patient during the relevant time intervals, then compared visit data from 2003 and 2004 with a baseline derived from the average number of visits during 2001 and 2002. We constructed groupings based on age and respiratory-illness symptoms.
During the SARS outbreak in 2003, ED visits declined by 21% (95% confidence interval [CI], 18%-24%) over the 4-week study period. The greatest reduction was for combined infant and toddler visits (69%; 95% CI, 58%-79%); these did not recover the following year. However, during the SARS outbreak there was a large increase in the number of visits for respiratory illnesses in adults (61%; 95% CI, 46%-75%) and in teenagers (132%; 95% CI, 82%-182%).
During the SARS outbreak, total ED visits fell. The relative decline was most notable for infants and toddlers. By contrast, there was an increase in respiratory illness-related visits for adults and teenagers. In 2004, the year following the SARS outbreak, visit patterns shifted toward baseline levels, but ED visits by infants and toddlers remained depressed.
PubMed ID
17338843 View in PubMed
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Emergency department presentations for self-harm among Ontario youth.

https://arctichealth.org/en/permalink/ahliterature114398
Source
Can J Public Health. 2013 Mar-Apr;104(2):e124-30
Publication Type
Article
Author
Jennifer Bethell
Susan J Bondy
W Y Wendy Lou
Astrid Guttmann
Anne E Rhodes
Author Affiliation
Suicide Studies Research Unit, St. Michael's Hospital, Toronto, ON. bethellj@smh.ca
Source
Can J Public Health. 2013 Mar-Apr;104(2):e124-30
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Child
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Incidence
Male
Ontario - epidemiology
Risk factors
Self-Injurious Behavior - epidemiology - therapy
Sex Distribution
Socioeconomic Factors
Abstract
Self-harm is an important public health issue among youth, including as a major risk factor for suicide (a leading cause of death in this age group). This study used population-based emergency department data to describe clinical and demographic characteristics of emergency department presentations for self-harm among youth (12-17 year-olds) in the province of Ontario, Canada.
Administrative data capturing every emergency department visit in Ontario between April 1, 2002 and March 31, 2009 were used to identify and describe self-harm presentations.
Over the 7-year period between 2002/03 and 2008/09, there were 16,835 self-harm presentations by 12,907 youth. Two thirds of self-harm presentations were self-poisonings (almost always with medicinal agents), followed by self-cutting, which accounted for about one quarter. Incidence rates were higher in girls than boys, increased with age, were inversely related to neighbourhood income and were highest in rural areas. Self-harm accounted for about 1 in 100 emergency department presentations by youth, but also a disproportionate number of presentations triaged as high acuity or admitted to hospital (about 1 in 20).
Self-harm is an important public health issue, requiring a comprehensive approach to prevention. Ontario has useful data with which to study emergency department presentations for self-harm, and the similarities between self-harm presentations among Ontario youth and those reported from the United States and Europe suggest generalizability of results between populations. Further research is needed to address the reasons for the geographic differences in frequency of self-harm.
PubMed ID
23618204 View in PubMed
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Exclusive breastfeeding among Canadian Inuit: results from the Nunavut Inuit Child Health Survey.

https://arctichealth.org/en/permalink/ahliterature271871
Source
J Hum Lact. 2014 May;30(2):229-41
Publication Type
Article
Date
May-2014
Author
Kathryn E McIsaac
Wendy Lou
Daniel Sellen
T Kue Young
Source
J Hum Lact. 2014 May;30(2):229-41
Date
May-2014
Language
English
Publication Type
Article
Keywords
Breast Feeding - ethnology - statistics & numerical data
Canada - epidemiology - ethnology
Cross-Sectional Studies
Financial Support
Humans
Inuits - statistics & numerical data
Surveys and Questionnaires
Abstract
Very little population-based research has been conducted around the exclusive breastfeeding practices of Inuit Canadians.
This research aims to assess the distribution of exclusive breastfeeding among Inuit Canadians and to identify factors associated with exclusive breastfeeding as recommended.
We use data from 188 infant-mother dyads who completed the Nunavut Inuit Child Health Survey, a cross-sectional, population-based survey of Inuit children aged 3 to 5 years. A series of multinomial logistic regression models were run to identify factors associated with 4 exclusive breastfeeding durations (= 1 month, > 1- 6.5 months).
Of infants, 23% were exclusively breastfed as recommended (ie, between 5.5 and 6.5 months; 95% CI, 16.2-29.3). Many infants (61%) were exclusively breastfed for less than 5.5 months and 16% (95% CI, 10.9-22.0) were exclusively breastfed for more than 6.5 months. Families receiving income support were less likely to discontinue exclusive breastfeeding before 5.5 months (pOR1-
PubMed ID
24352650 View in PubMed
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Household food security and breast-feeding duration among Canadian Inuit.

https://arctichealth.org/en/permalink/ahliterature274770
Source
Public Health Nutr. 2016 Jul 28;:1-8
Publication Type
Article
Date
Jul-28-2016
Author
Kathryn E McIsaac
David C Stock
Wendy Lou
Source
Public Health Nutr. 2016 Jul 28;:1-8
Date
Jul-28-2016
Language
English
Publication Type
Article
Abstract
There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children.
Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey.
The Canadian Territory of Nunavut in 2007 and 2008.
Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists.
Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14).
Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.
PubMed ID
27465413 View in PubMed
Less detail

Household food security and breast-feeding duration among Canadian Inuit.

https://arctichealth.org/en/permalink/ahliterature290128
Source
Public Health Nutr. 2017 Jan; 20(1):64-71
Publication Type
Journal Article
Date
Jan-2017
Author
Kathryn E McIsaac
David C Stock
Wendy Lou
Author Affiliation
1Dalla Lana School of Public Health,University of Toronto,30 Bond Street,Toronto,Ontario,Canada,M5B 1W8.
Source
Public Health Nutr. 2017 Jan; 20(1):64-71
Date
Jan-2017
Language
English
Publication Type
Journal Article
Keywords
Breast Feeding
Canada - epidemiology
Child, Preschool
Cross-Sectional Studies
Family Characteristics
Female
Food Supply
Health Surveys
Humans
Inuits
Lost to Follow-Up
Male
Proportional Hazards Models
Socioeconomic Factors
Time Factors
Abstract
There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children.
Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey.
The Canadian Territory of Nunavut in 2007 and 2008.
Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists.
Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14).
Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.
PubMed ID
27465413 View in PubMed
Less detail

Hyperbaric oxygen therapy and diabetic foot ulcers: knowledge and attitudes of Canadian primary care physicians.

https://arctichealth.org/en/permalink/ahliterature143621
Source
Can Fam Physician. 2010 May;56(5):444-52
Publication Type
Article
Date
May-2010
Author
A Wayne Evans
Richard Gill
Aurelia O Valiulis
Wendy Lou
Ted S Sosiak
Author Affiliation
Hyperbaric Medicine Unit, Toronto General Hospital, Ontario.
Source
Can Fam Physician. 2010 May;56(5):444-52
Date
May-2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Clinical Competence
Diabetic Foot - psychology - therapy
Family Practice - standards
Female
Health Care Surveys
Humans
Hyperbaric Oxygenation
Male
Middle Aged
Abstract
To explore physicians' knowledge of and attitudes toward hyperbaric oxygen therapy (HBOT) in order to better understand current diabetic foot ulcer management practices and to determine potential barriers to HBOT use.
A 24-item questionnaire.
Primary Care Today conference in Toronto, Ont, in May of 2006.
Physician attendees, 313 of whom completed the survey.
Self-reported knowledge of and attitudes toward HBOT.
Less than 10% of respondents had a good knowledge of HBOT, but 57% had a good attitude toward HBOT. Knowledge of and attitude toward HBOT were positively correlated (P
Notes
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PubMed ID
20463275 View in PubMed
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Increasing access to chronic disease self-management programs in rural and remote communities using telehealth.

https://arctichealth.org/en/permalink/ahliterature114879
Source
Telemed J E Health. 2013 Jun;19(6):467-73
Publication Type
Article
Date
Jun-2013
Author
Susan B Jaglal
Vinita A Haroun
Nancy M Salbach
Gillian Hawker
Jennifer Voth
Wendy Lou
Pia Kontos
James E Cameron
Rhonda Cockerill
Tarik Bereket
Author Affiliation
Women's College Research Institute, Department of Physical Therapy, University of Toronto, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario M5G 1V7, Canada. susan.jaglal@utoronto.ca
Source
Telemed J E Health. 2013 Jun;19(6):467-73
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Disease - therapy
Female
Health Services Accessibility
Humans
Male
Middle Aged
Ontario
Questionnaires
Rural Population
Self Care
Socioeconomic Factors
Telemedicine
Abstract
This study examined whether a telehealth chronic disease self-management program (CDSMP) would lead to improvements in self-efficacy, health behaviors, and health status for chronically ill adults living in Northern Ontario, Canada. Two telehealth models were used: (1) single site, groups formed by participants at one telehealth site; and (2) multi-site, participants linked from multiple sites to form one telehealth group, as a strategy to increase access to the intervention for individuals living in rural and remote communities.
Two hundred thirteen participants diagnosed with heart disease, stroke, lung disease, or arthritis attended the CDSMP at a preexisting Ontario Telemedicine Network studio from September 2007 to June 2008. The program includes six weekly, peer-facilitated sessions designed to help participants develop important self-management skills to improve their health and quality of life. Baseline and 4-month follow-up surveys were administered to assess self-efficacy beliefs, health behaviors, and health status information. Results were compared between single- and multi-site delivery models.
Statistically significant improvements from baseline to 4-month follow-up were found for self-efficacy (6.6±1.8 to 7.0±1.8; p
Notes
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PubMed ID
23570277 View in PubMed
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27 records – page 1 of 3.