We offer a critique of Canada's approach to domestic food security with respect to international agreements, justiciability and case law, the breakdown of the public safety net, the institutionalisation of charitable approaches to food insecurity, and the need for 'joined-up' food and nutrition policies. We examined Canada's commitments to the right to food, as well as Canadian policies, case law and social trends, in order to assess Canada's performance with respect to the human right to food. We found that while Canada has been a leader in signing international human rights agreements, including those relating to the right to food, domestic action has lagged and food insecurity increased. We provide recommendations for policy changes that could deal with complex issues of state accountability, social safety nets and vulnerable populations, and joined-up policy frameworks that could help realise the right to adequate food in Canada and other developed nations.
Child and adolescent mental disorders are common, with a substantial disease burden, yet services for young people are nationally inadequate. As services should be based on policies and (or) plans, we analyzed the availability and content of child and adolescent mental health policies and plans in all provinces and territories.
The World Health Organization (WHO) framework for Child and Adolescent Mental Health Policy and Plans was applied.
Four provinces in Canada have a child and adolescent mental health policy and (or) plan. The other provinces do not have a policy or plan in place, or else try to integrate these components into existing mental health strategies. Among the policies and plans that exist, there is substantial variability regarding content as well as degree of adherence to the WHO template. Five essential content areas: legislation and human rights, information systems, quality improvement, improving access to and use of psychotropics, and human resource development and training are poorly or very poorly addressed in existing policies and (or) plans.
This lack of specific policy and (or) plans for child and adolescent mental health care and the variability of content in plans that exist may help explain why child and adolescent mental health services are poorly developed across Canada. We suggest that a national child and adolescent mental health policy framework be developed for Canada so that the provinces and territories may be encouraged to create or amend their current child and adolescent mental health frameworks in a manner that may enhance national cohesion and commonly addresses service needs in this population.
Comment In: Can J Psychiatry. 2010 Nov;55(11):746; author reply 74621110467
To examine how the right to participation according to Article 19 of the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) is promoted by personal assistance use in Sweden across age, gender and eligible person categories.
Register data and data from a questionnaire were used (N?=?15,289). Principal component analysis was performed and the internal consistency was tested. Descriptive statistics (?2 test) were used across age, gender and eligible person categories and components.
An uneven distribution of personal assistance across the components Health and Care; Home, Leisure and Social Interaction; and Daily Occupation was found. Significant differences in personal assistance reported were found between children and adults, men and women and between the three eligible person categories.
The discrepancy between reported and expected outcome of personal assistance indicates that Article 19 of the UNCRPD has not been met. The unequal access to participation across age, gender and eligible person categories would seem to further signify that the Act concerning Support and Service for Persons with Certain Functional Impairments is promoting activities of a caring nature rather than fulfilling Article 19 of the UNCRPD, i.e. ensuring full participation in society. IMPLICATIONS FOR REHABILITATION Government assistance allowance were granted for predominantly health and care, i.e. basic needs presenting risk of undermining the intention of participation in society. Men reported more personal assistance use for activities promoting participation than women. The discrepancy found between reported and expected outcome of personal assistance underlines the importance of service providers and administrative officials being sensitive to policy intentions. There is a need of guidelines for service providers and administrative officials to promote disability rights of participation for persons eligible for personal assistance.
The United Nations Convention on the Rights of Persons with Disabilities and other international human rights conventions guarantee the fundamental human rights to physical, social, and psychological health. The purpose of this study was to examine whether these rights are being upheld in Canada for disabled women.
An interpretive, qualitative, focus group design was employed. Participants were women 18 to 67 years of age with a self-identified physical, sensory, cognitive, and/or psychiatric impairment. Eleven focus groups were conducted with 74 disabled women from urban and rural settings in Northern Ontario, Manitoba, and Nova Scotia. The data were analyzed for themes using a flexible coding system derived from and consistent with the research objectives and the study's human rights framework.
Participants described multiple intersecting factors that impeded or facilitated access to health care. Services included both generic health services and impairment-specific services. Participants experienced a number of barriers accessing professionals, support programs, and services. These are described under three broad themes: 1) Labyrinthine health service 'systems,' 2) assumptions, attitudes, and discriminatory practices, and 3) inadequate sexual health or reproductive services and supports.
The results suggest that Canada falls significantly short of guaranteeing disabled women's human rights to access health care supports and services. Access barriers resulted from the inefficiencies and complexities of the multiple agencies and programs that disabled women had to navigate, difficulties accessing information on available services, and negative attitudes of some health and social service providers.
Although international agreements set the framework for research ethics, countries vary in their interpretation and execution. The Government of Canada guidelines are based on the Tri-council policy statement: ethical conduct for research involving humans (2005) and the new CIHR guidelines for health research involving Aboriginal people (2007). In this critical review, we address 3 areas of educational value to practitioners who care for the oral health needs of the public, research trainees and research investigators who advance knowledge pertaining to oral health: protection of human study participants, conflicts of interest and investigator integrity. Its main message is that ethical health care should be supported by a strong foundation of ethical research.
The United States is becoming increasingly pluralistic. Pediatricians must become familiar with the factors that affect the emotional, physical, and spiritual health of their patients that are outside the kin of the traditionally dominant value system. Although many articles have addressed the cultural and ethnic factors, very few have considered the impact of religion. Islam, as the largest and fastest-growing religion in the world, has adherent throughout the world, including the United States, with 50% of US Muslims being indigenous converts. Islam presents a complete moral, ethical, and medical framework that, while it sometimes concurs, at times diverges or even conflicts with the US secular ethical framework. This article introduces the pediatrician to the Islamic principles of ethics within the field of pediatric care and child-rearing. It demonstrates how these principles may impact outpatient and inpatient care. Special attention is also given to adolescent and end-of-life issues.
Social justice is a core value of public health. However, the public health core competencies for Canada document (release 1.0) does not contain any explicit reference to the essential attributes of social justice within the competencies themselves. We argue that social justice attributes should be integrated into the core competencies and propose examples for consideration.