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This article provides results from interviews and a focus group conducted at two different points in time in the first year of the COVID-19 pandemic, which explored impacts of the pandemic and adaptation among water advocacy organizations in southern Ontario, Canada. Our findings show that despite the destabilizing and sometimes devastating impact of COVID-19 on grassroots organizations and their programs, by disrupting business as usual the pandemic also created the conditions for experimentation, innovation, the establishment of new capacities and strategic foci. In this paper, we share descriptive narratives from water activists in our geographic area about how they adapted and innovated their work despite the challenges of the pandemic. Our findings illustrate and add nuance to themes emerging in the literature about the impacts of the pandemic on environmental advocacy groups and other nonprofit organizations, and generate new themes for further exploration. [ABSTRACT FROM AUTHOR]

The number of people with dementia worldwide will reach 115.4 million by 2050. This accelerating crisis has sparked research on how to design neighbourhoods for those with early dementia, and how to empower them through built environment changes to remain in their community for as long as possible. There are numerous benefits for persons with dementia who continue access to their neighbourhood: physical activity, sense of dignity, social interaction, autonomy and psychological wellbeing. In this paper, I examine 17 recommendations (urban design and land use strategies) identified as ‘dementia-friendly’, within dementia design and planning literature. Each is then examined against the planning frameworks for a mid-size suburban municipality in Ontario and assessed for its financial impact on a base case subdivision using pro forma analysis. The effect on the financial return for a developer was minimal, demonstrating that establishing these recommendations as policy is viable, through regulation and incentives. [ABSTRACT FROM AUTHOR]

The outbreak of severe acute respiratory syndrome (SARS) in Toronto and other cities in 2003 showed a heightened sensitivity of places in the global economy to rapid changes brought on by the acceleration of social and ecological relationships. The spread of the SARS virus may be a predictable consequence of these processes. The paper investigates how processes of globalisation have affected the transmission and response to SARS within the context of the global cities network. Little work has been done on the relationship of global city formation and the spread of infectious disease. Arguing that this relationship may be central to understanding the intricate capillary structures of the globalised network, the paper focuses on how pathogens interact with economic, political and social factors. These relationships exist both in the network and in global cities themselves, thereby posing new issues for public health and epidemiological efforts at disease containment and tracking. [ABSTRACT FROM AUTHOR]

Based on structured interviews with 104 experienced users in Toronto, Canada, this article examines the perceived costs and benefits of cannabis consumption. A pretested questionnaire that was developed by Cohen and Sas ( 1998 ) in the Netherlands, and later translated for use in the U.S. and Germany as part of a three-city cross-national comparative study [(Reinarman et al . ( 2000 ). Is availability destiny? Drug use prevalence and discontinuance in Amsterdam, San Francisco and Bremen. Paper presented at the 11th International Conference on the Reduction of Drug-Related Harm, St. Helier, Jersey, Channel Islands, April 9-13, 2000; Cohen and Kaal ( 2001 ). The Irrelevance of Drug Policy: Patterns and Careers of Experienced Cannabis Use in the Populations of Amsterdam, San Francisco and Bremen. Centre for Drug Research, University of Amsterdam)] guided data collection on a range of drug effects, including measures of dependence inspired by DSM-IV criteria. The findings support a rational choice view of cannabis use insofar as reported advantages outweigh negative use outcomes. Top reasons for use pertain to relaxation and enhancement of recreational activities followed by coping with stress and anxiety. The frequency of respiratory and throat problems attributed to using cannabis underscores the perceived risk of pulmonary damage due to long-term heavy use. Whereas concerns about use levels nonetheless overshadowed other dependency indicators, including concern for personal health, however, no association was found between amounts nor frequency of use and the number of DSM-IV items reported by respondents. Users acknowledged and accepted the potential for dependence, adapting use levels accordingly when seen as problematic. [ABSTRACT FROM AUTHOR]

Systemic racism and a lack of cultural safety measures in public health systems across Canada have led professionals in this field to form unconscious discriminatory practices towards Indigenous Peoples. In partnership with a public health unit (PHU) in Ontario, Canada, we developed and pilot-tested an intensive online Indigenous cultural safety micro-credential provided to public health professionals working with local First Nations communities and urban Indigenous Peoples. Collaborating with Elders, Knowledge Keepers and Indigenous community members, the Indigenous cultural safety micro-credential highlights the strengths of the community, provides local Indigenous history including treaties, and ensures public health staff are aware of Indigenous protocols and cultural safety terminology. Indigenous community members were filmed and edited for the final micro-credential offering. An Indigenous online cultural safety micro-credential provided knowledge of Indigenous worldviews, socio-political history and contemporary issues while engaging the learner in self-reflection on the 3Ps: power, privilege, and positionality. The development of an online Indigenous cultural safety micro-credential for a small public health unit in Ontario, Canada provided basic knowledge for collaborating with Indigenous Peoples in a culturally respectful way to move towards increased awareness of including Indigenous Peoples in planning, developing and providing appropriate public health programs, services and policies. [ABSTRACT FROM AUTHOR]

This paper investigates responsibility/irresponsibility as an important regulatory strategy, in two distinct but interrelated social sites - people living with AIDS and HIV, and lesbians and gay men, especially within the Canadian province of Ontario. This responsibility/irresponsibility technique of governance is developing in response to the struggles of people with AIDS and community-based AIDS groups and lesbians and gay men and the alternative strategies of regulation articulated through these struggles. Practices of `resistance' and activism alter the grounds of hegemonic regulation/governance and point towards new techniques of governance. I show how responsibilizing and normalizing strategies in the context of social struggles over AIDS and sexual regulation allows for those constructed as `responsible' to be managed through forms of self-regulation and professional forms of governance of their lives. For those who continue to be constructed as `irresponsible' forms of criminal law, policing and public health governance are called into action. [ABSTRACT FROM AUTHOR]

Cultural safety training is a resource that healthcare institutions and staff can rely on to end anti-Indigenous racism in their organisations and to shift service providers' attitudes, beliefs, and knowledge of Indigenous people. The aim of this study was to understand the initial knowledge and interest about Indigenous Peoples that a southern Ontario public health unit's (PHU) staff hold. A cultural safety micro-credential project was developed in consultation with the PHU. An online survey was administered from January to March 2021 to those who were starting the micro-credential during this timeframe (n = 31). Thirty-one staff responded. A majority of the participants indicated that they had some knowledge of Indigenous Peoples and that this knowledge was relevant to their work. The number of interactions with Indigenous Peoples varied by role. Common themes for the open-ended responses included culture, relationships, and supports/services. Many of the open-ended responses highlighted feelings of not knowing enough and wanting to learn more about Indigenous Peoples. These results indicate a shift in attitudes, behaviours, and knowledge of Indigenous Peoples among the PHU staff. Cultural safety training can serve to address knowledge gaps and contribute to creating the systemic change needed to end anti-Indigenous racism in healthcare institutions. [ABSTRACT FROM AUTHOR]

Despite significant engagement with new and emerging issues in public health practice, the public health literature has few theoretical explanations for how new practices emerge, take root, and become institutionalized. In this contribution, we utilize Pierre Bourdieu's sociological concepts of field, habitus and capital, and in-depth interviews with public health practitioners to document and describe the emerging field of public health adaptation to climate change Ontario, Canada. In doing so, we identify and explain three types of climate change action and associated practices – 'wait and see', repackaging existing actions and championing new actions – that practitioners relate to climate change adaptation in Ontario (i.e. business as usual, repackaging existing actions and championing climate new actions). We discuss the typology in relation to the dominant and emerging logics that practitioners ascribe to promoting practical action on this sub-field of environmental health practice to promote a discussion of how social change occurs within a well-established field of professional practice. Findings suggest, that change and innovation can result from exogenous shocks that force practitioners to adopt new practices (e.g. the increasing frequency and intensity of climate-related impacts on health), how the 'rules' of a given field are interpreted by practitioners and made actionable, and through the negotiation of new rules by practitioners with a 'radical habitus' who champion particular issues, albeit resulting in significant professional risk. We discuss these findings in relation to Bourdieu's theory, concluding there is significant room for practitioner agency to cultivate normative dispositions and influence the adoption of policy and practice-change. [ABSTRACT FROM AUTHOR]

A community-based participatory research design informed the development and conduct of a needs assessment with street-level sex workers within a mid-sized city in Ontario, Canada. The research question was: What would help street-level sex workers to live with enhanced safety and dignity within their community? Twenty-four women who accessed a peer-driven drop-in center (SafeSpace) participated in in-depth interviews. Observational data of items requested by women who accessed SafeSpace were also documented over a 6-month time period. The overarching theme of relationships was identified as vital to participants' ability to live and work with enhanced safety and dignity in their community. Subthemes included: Informal/formal surveillance: Relationships to public space(s); Nowhere to go for us: Relationships with/in community services; and You're given the time you need: Relationships in a peer-driven drop-in center for/with/by sex workers. Our findings demonstrate how central relationships are, particularly peer, to enhancing or diminishing sex workers' sense of dignity, self-worth, safety, and enhanced their access to services. [ABSTRACT FROM AUTHOR]

This article is a reflection of a student's experience in a new and innovative placement in the office of a coroner in rural and remote areas of northwestern Ontario. It is a reflection on the significance of the registered nurse in this role, and how it has evolved to consider the deeply holistic, relational, and moral nature of death investigation practice for nurses. It intertwines narrative and focused literature review to enhance discussion of the significance of the role nurses can play in death investigation specifically to serve communities in Northwestern Ontario. [ABSTRACT FROM AUTHOR]

New permanent residents to Ontario can experience difficulties accessing health services due to the 3-month residency requirement for provincial healthcare coverage. This scoping literature review, which included peer-reviewed articles and gray literature from 1993-2013, examined the effects of the 3-month waiting period on the health of new permanent residents to Ontario, public health, and the health-care system. At the individual level, issues of affordability, pre-existing conditions, and quality of care were prominent throughout the literature. At a systems level, the policy was found to constrain various health-care settings, pose a risk to public health, and compound health-care system costs. [ABSTRACT FROM AUTHOR]

The move towards partnerships and collaborative governance models has been advocated in global health discussions for many years now. A case example methodology was applied to this study. It was composed of a document review and semi-structured interviews with key informants from five environment and public health partnerships in the province of Ontario, Canada. These case examples highlight the merits and the challenges of diverse partnerships, and the importance of governance and leadership models, scaling up (and out) impact, and cross-cultural communications to these arrangements. Further work is required to articulate situations in which public health partnerships can be strengthened. [ABSTRACT FROM PUBLISHER]

The emerging challenge of managing increasing volumes of urban sewage has resulted in municipalities pursuing sustainable ways to manage urban biosolids and their by-products. Using content analysis of public debates, and situating the debate within science, policy and facility siting literature, this study examines claims and counterclaims relating to the siting of a biosolid processing facility in rural Ontario. The equivocal evidence on the health and environmental effects of biosolids resulted in a heated “expert versus lay” debate. The study critically evaluates the importance of trust and the shifting role of scientific evidence in politicised settings, while making relevant policy recommendations. [ABSTRACT FROM PUBLISHER]

Purpose: Despite the relatively high prevalence of aphasia, research indicates that, world-wide, public awareness of aphasia is lacking. Of the surveys that have been conducted internationally, none has studied the Canadian public's awareness of aphasia. The purpose of the present survey was to assess public awareness and basic knowledge of aphasia of individuals in southern Ontario, Canada. Method: Using the same questionnaire that has been used in other countries, face-to-face surveys were conducted in public places (e.g. parks) at various locations in southern Ontario. Respondents were asked questions pertaining to their awareness and knowledge of aphasia. The number of surveys retained for analysis was 831. In addition to an evaluation of public awareness and knowledge of aphasia, the potential influences of age, gender, and occupation were analysed. For those who had heard of aphasia, questions were asked to determine how or where they had heard of aphasia. Result: Consistent with the literature, overall public awareness and basic knowledge of aphasia in southern Ontario was found to be limited. The factors of age, gender and occupation were found to influence the results. Conclusion: This investigation supports the need for better promotion of aphasia awareness to the public in southern Ontario and, by extension, in Canada. [ABSTRACT FROM AUTHOR]

Framed as a public health problem, school bullying led public health agencies to design anti-bullying programmes. The public health approach is invested with hope by those who are looking for an alternative to the punitive logic. Using a Foucaultian approach and a discourse analysis method, this research focuses on the way an anti-bullying intervention programme designed by a public health agency governs school bullying. The findings reveal two major logics at play. Firstly, the programme espouses the new public health model and, accordingly, governs bullying as a systemic risk rather than an individual problem. Secondly, the programme is also anchored in the classical punitive rationality. Public health and punitive logics, far from being mutually exclusive, are rather intertwined. This dual logic contributes to the ‘dangerization’ of school bullying. [ABSTRACT FROM PUBLISHER]

Post-North American Free Trade Agreement (NAFTA) trade liberalisation combined with post-9/11 border securitisation means North America increasingly relies on pools of temporary foreign labour, particularly in the agricultural and service sectors. Despite being temporary, these workers often spend most of their years on foreign soil, living and working in isolated rural communities, far from their own families and communities. Migrants' mental and physical health suffers due to hazardous and stressful working conditions, sub-standard housing, lack of social support and limited access to health and social welfare services. Assuming access to health is a basic human right, who is responsible for the health of temporary foreign migrant workers? Is it the nation-state? or the Employers and/or unions? or Civil society? Research and practice show that a combined multisector approach is best; however, such initiatives are often uneven due to questions of sovereignty and citizenship rights. Community-based organisations (CBOs) have emerged to advocate for and serve migrants' social and welfare needs; analysis of CBO projects reveals an uneven application of rights to migrants. Using a comparative case study from Canada, this project contributes to understanding how civil-society helps to activate different types of health care rights for migrants, and to create an informed policy that provides migrant workers with access to a wider range of human and health rights. [ABSTRACT FROM PUBLISHER]

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Objectives. Aboriginal communities have a high prevalence of diabetes and heart disease, and limited resources to address them. The objective of this study was to test the effectiveness of prioritizing care with audit and feedback on cholesterol management of diabetic patients. Study design. A controlled before-after intervention trial was conducted among health care providers in Oji-Cree reserves in Sioux Lookout Zone, Ontario. Two communities were randomized to receive an interactive educational workshop and chart audit with feedback on cholesterol management; 2 control communities received usual care. Methods. The primary outcome measure used was the proportion of patients on statins, and the secondary outcome measure was the proportion of patients with LDL>2.5 mmol/L or TC/HDL>4.0 on statins. Outcomes were assessed by chart review at baseline and 10 months post-intervention. Results. Patients in the 2 intervention communities (n=170) and the 2 controls (n=170) were comparable at baseline. The intervention did not increase the proportion of diabetic patients on statins overall or in the subset of patients with elevated cholesterol. The proportion of patients with elevated cholesterol on statins went from 46% to 53% (p=0.48) in the intervention group and from 47% to 50% (p=0.25) in the control group. Conclusions. Audit and feedback listing patients requiring treatment did not increase statin prescription rates in diabetic patients in remote Aboriginal settings. This may be due to elevated baseline rates, the low intensity of feedback and the constraints of the practice environment, such as low staffing and high staff turnover. [ABSTRACT FROM AUTHOR]

In 1996, in Geneva, the World Health Assembly declared the violence as a major and growing public health problem. Others have gone further in describing (sexual) violence against women as a weapon of terror. In the local community of Hamilton, Ontario Canada (population approximately 500,000), domestic violence represents 25% of the workload of the local police service. The literature has shown that violence in general, and domestic violence in particular, presents tremendous social and health impacts for individuals and communities. In this local community, however, an evaluation of a recently piloted cutting edge domestic violence response system highlights how difficult it is to place domestic violence on the policy and/or public health agendas. Qualitative interviews with 23 key stakeholders were undertaken to assess their views on the success of the program. While overall findings indicate that the success of this brief (11 month) pilot project was limited, important insights emerged around responding to the domestic violence issue, at the community level. [ABSTRACT FROM AUTHOR]

The article presents a report on the assessment of health risks related to aluminum, aluminum oxide, and aluminum hydroxide exposure. The study was carried out by the McLaughlin Centre for Population Health Risk Assessment at the University of Ottawa, Ontario, and was sponsored by the U.S. Environmental Protection Agency and the International Aluminum Institute. The report examines the use of aluminum compounds in different products including in household, food industry, pharmaceutical, and industrial use. An overview of the report is provided.

In May 2000, the water transportation system in Walkerton, Ontario (a small town with 4800 residents) became contaminated with E. coli bacteria, eventually causing seven people to die and 2300 to become sick. The 700-page report from a comprehensive public inquiry into this tragedy provided a rich source of data about the outbreak itself and the factors leading up to it. That report was used to test the explanatory adequacy of Rasmussen's framework for risk management in a dynamic society. Close agreement was observed between the predictions of the framework and the causes contributing to the Walkerton outbreak. The sequence of events reveals a complex interaction between all of the levels in a complex sociotechnical system spanning strictly physical factors, the unsafe practices of individual workers, inadequate oversight and enforcement by local government and a provincial regulatory agency and budget reductions imposed by the provincial government. Furthermore, the dynamic forces that led to the accident had been in place for some time—some going back 20 years—yet the feedback to reveal the safety implications of these forces was largely unavailable to the various actors in the system. Rasmussen's framework provides a theoretical basis for abstracting from the details of this particular incident, thereby highlighting generalizable lessons that might be used to ensure the safety of other complex sociotechnical systems. [ABSTRACT FROM AUTHOR]