Xenotransplantation, or the use of animal cells, tissues and organs for humans, has been promoted as an important solution to the worldwide shortage of organs. While scientific studies continue to be done to address problems of rejection and the possibility of animal-to-human virus transfer, socio-ethical and legal questions have also been raised around informed consent, life-long monitoring, animal welfare and animal rights, and appropriate regulatory practices. Many calls have also been made to consult publics before policy decisions are made. This paper describes the Canadian public consultation process on xenotransplantation carried out by the Canadian Public Health Association in an arm's length process from Health Canada, the ministry overseeing government health policy and regulation. Focusing on six citizen for a conducted around the country patterned after the citizen jury deliberative approach, the paper describes the citizen panelists' recommendations to hold off on proceeding with clinical trials and the rationales behind this recommendation. The consultation process is discussed in the context of constructive technology assessment, a framework which argues for broader input into earlier stages of technology innovation, particularly at the technology design stage.
59 years old. Only 1% had attended the course because of their own or a relative's cardiac disease. Ninety-four per cent believed there was a minor to major risk of serious disease transmission while performing CPR. When predicting their willingness to perform CPR in six scenarios, 17% would not start CPR on a young drug addict, 7% would not perform CPR on an unkempt man, while 97% were sure about starting CPR on a relative and 91% on a known person. In four of six scenarios, respondents from rural areas were significantly more positive than respondents from metropolitan areas about starting CPR. In conclusion, readiness to perform CPR on a known person is high among trained CPR rescuers, while hesitation about performing CPR on a stranger is evident. Respondents from rural areas are more frequently positive about starting CPR than those from metropolitan areas.
Cardiovascular disease (CVD) is the leading cause of death in Canadian women. Recent projections suggest that the number of cardiovascular-related deaths among women will continue to increase for at least another decade (Heart & Stroke Foundation of Canada, 2003). Nurses are in pivotal roles to facilitate the development of strategies to promote cardiovascular health and prevent CVD in this population. These strategies must move beyond the current focus on the individual, to encompass the bigger picture of population health promotion. This paper revisits the current state of knowledge of the population-based determinants of cardiovascular health in women, incorporates a Canadian perspective by including relevant epidemiological data, and recommends strategies that extend beyond the individual to the broader community, policy, health services and research domains.
This article describes partial results from a case study of community participation in "New Directions for a Healthy B.C.", a now-abandoned health reform policy. For this study, focus groups were conducted to explore the perspectives of traditionally under-represented citizens in understanding reasons for nonparticipation and to identify strategies for fostering participation in the health reform process. The findings indicate that participating in traditional ways- committee meetings, public fora, completing surveys--was not relevant to the realities of these individuals. Yet, rather than merely refusing to be involved, focus group members extended an invitation for health planning group members to experience their daily lives; an idea that is referred to in the literature as 'experiential participation.' In order to foster broad-based participation in community health initiatives, the findings from this study argue for a new understanding of, and appreciation for what actually constitutes participation.
The purpose of this study was to understand the culture, values, skills and activities of staff involved in education and prevention activities in community-based AIDS Service Organizations (ASOs) in Ontario, Canada, and to understand the role of evaluation research in their prevention programming. In this qualitative study, 33 staff members from 11 ASOs participated in semi-structured interviews that were analyzed using the grounded theory approach. ASO staff experience tension between a historical grassroots organizational culture characterized by responsiveness and relevance and a more recent culture of professionalization. Target populations have changed from being primarily gay men to an almost unlimited variety of communities. Program emphasis has shifted from education and knowledge dissemination to a broadly based mandate of health promotion, community development, and harm reduction. Integration of evidence of effectiveness, social-behavioral theory, or systematic evaluation is uncommon. Understanding these points of tension is important for the nursing profession when it is engaged with ASOs in programming or evaluation research.
Knowledge of molecular biology and genomics continues to expand rapidly, promising numerous opportunities for improving health. However, a key aspect of the success of genomic medicine is related to public understanding and acceptance.
Using community consultations and an online survey, we explored public attitudes and expectations about genomics research.
Thirty-three members of the general public in Newfoundland, Canada, took part in the community sessions, while 1024 Atlantic Canadians completed the online survey. Overall, many participants noted they lacked knowledge about genetics and associated research and took the opportunity to ask numerous questions throughout sessions. Participants were largely hopeful about genomics research in its capacity to improve health, not only for current residents, but also for future generations. However, they did not accept such research uncritically, and a variety of complex issues and questions arose during the community consultations and were reflected in survey responses.
With the proliferation of biobanks and the rapid pace of discoveries in genomics research, public support will be crucial to realize health improvements. If researchers can engage the public in regular, transparent dialogue, this two-way communication could allow greater understanding of the research process and the design of efficient and effective genetic health services, informed by the public that will use them.
The goal of the Community Health Action (CHA) model is to depict community health promotion processes in a manner that can be implemented by community members to achieve their collectively and collaboratively determined actions and outcomes to sustain or improve the health and well-being of their community; the community as a whole, for the benefit of all. The model is unique in its ability to merge the community development process with a compatible community assessment, planning, implementation, and evaluation framework. The CHA model supports community participation leading to community-engaged assessment and change. In this article, the CHA model is depicted, its genesis described, and its utility demonstrated.
In this article, a consideration of the role and meaning of the rural hospital is contextualised within the health reform environment in Saskatchewan (Canada). Individual and community perceptions of the impact of the conversion/closure of a rural hospital are often unheard and more often unheeded. Some researchers suggest hospital conversion/closure is a devastating event in the life of rural communities, yielding long-lasting medical, economic and psychological consequences.
This article examines the concept of critical incidents with the intent of proposing a working definition of the concept. Lazarus and Folkman's (1984) construct of appraisal provides the framework for discussion and re-conceptualisation of critical incidents.
The recommendation is to consider the adoption of an alternate definition of critical incident shifting away from professional or external delineation of an event's meaning. The proposed definition states that a critical incident is any external event that alters an individual's or community's life from the perspective of that individual or community. Finally, the conversion/closure of a rural hospital is considered within this re-conceptualised 'critical incident' definition.
Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.