9 results
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2. Purchasing power.
- Author
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Paper, Position and Lievonen, J. Mark
- Subjects
HEALTH policy ,MEDICAID ,MEDICARE ,MEDICAL care - Abstract
The article discusses how public-sector procurement policies can drive innovation in Canada. It is stated that Canada's public-sector purchasing policies let cost per unit drive decision-making too often. It is noted that in the healthcare sustainability debate, the Canadian life sciences industry should have a role.
- Published
- 2012
3. Utilizing Experience Bundles: A Novel Approach to Improving Quality of Care in Long-Term Care.
- Author
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Gurney L, Yip F, MacPhee M, and Bertoli-Haley S
- Subjects
- Humans, Canada, Family, Quality of Health Care, Long-Term Care, Delivery of Health Care
- Abstract
People-centred care is foundational to healthcare excellence. One urban Canadian long-term care residence recently participated in an initiative titled "Improving the Care Conference Experience" to engage residents and families in annual care conferences. The Institute for Healthcare Improvement introduced "care bundles" to group evidence-based practices within standard processes. For this initiative, one health region's Experience in Care team co-developed, implemented and evaluated an "experience bundle" for inclusive care conferences with key stakeholders including residents, family members, direct care providers and leadership. Our ongoing goal is to collaboratively create a culture shift from "doing to/for" to "doing with.", (Copyright © 2024 Longwoods Publishing.)
- Published
- 2024
- Full Text
- View/download PDF
4. Examining the diet quality of Canadian adults and the alignment of Canadian front-of-pack labelling regulations with other front-of-pack labelling systems and dietary guidelines.
- Author
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Lee JJ, Ahmed M, Julia C, Ng AP, Paper L, Lou WY, and L'Abbé MR
- Subjects
- Humans, Adult, Canada, Nutrition Policy, Sugars, Food Labeling, Diet
- Abstract
Introduction: Canada promulgated mandatory front-of-pack labelling (FOPL) regulations in 2022, requiring pre-packaged foods meeting and/or exceeding recommended thresholds for nutrients-of-concern (i.e., saturated fat, sodium, sugars) to display a "high-in" nutrition symbol. However, there is limited evidence on how Canadian FOPL (CAN-FOPL) regulations compare to other FOPL systems and dietary guidelines. Therefore, the objectives of the study were to examine the diet quality of Canadians using the CAN-FOPL dietary index system and its alignment with other FOPL systems and dietary guidelines., Methods: Nationally representative dietary data from the 2015 Canadian Community Health Survey-Nutrition survey ( n = 13,495) was assigned dietary index scores that underpin CAN-FOPL, Diabetes Canada Clinical Practice (DCCP) Guidelines, Nutri-score, Dietary Approaches to Stop Hypertension (DASH) and Canada's Food Guide (Healthy Eating Food Index-2019 [HEFI-2019]). Diet quality was examined by assessing linear trends of nutrient intakes across quintile groups of CAN-FOPL dietary index scores. The alignment of CAN-FOPL dietary index system compared with other dietary index systems, with HEFI as the reference standard, was examined using Pearson's correlations and к statistics., Results: The mean [95% CI] dietary index scores (range: 0-100) for CAN-FOPL, DCCP, Nutri-score, DASH, and HEFI-2019 were 73.0 [72.8, 73.2], 64.2 [64.0, 64.3], 54.9 [54.7, 55.1], 51.7 [51.4, 51.9], and 54.3 [54.1, 54.6], respectively. Moving from the "least healthy" to the "most healthy" quintile in the CAN-FOPL dietary index system, intakes of protein, fiber, vitamin A, vitamin C, and potassium increased, while intakes of energy, saturated fat, total and free sugars, and sodium decreased. CAN-FOPL showed moderate association with DCCP ( r = 0.545, p < 0.001), Nutri-score ( r = 0.444, p < 0.001), and HEFI-2019 ( r = 0.401, p < 0.001), but poor association with DASH ( r = 0.242, p < 0.001). Slight to fair agreement was seen between quintile combinations of CAN-FOPL and all dietary index scores ( к = 0.05-0.38)., Discussion: Our findings show that CAN-FOPL rates the dietary quality of Canadian adults to be healthier than other systems. The disagreement between CAN-FOPL with other systems suggest a need to provide additional guidance to help Canadians select and consume 'healthier' options among foods that would not display a front-of-pack nutrition symbol., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Lee, Ahmed, Julia, Ng, Paper, Lou and L’Abbé.)
- Published
- 2023
- Full Text
- View/download PDF
5. Cross-sectional comparisons of dietary indexes underlying nutrition labels: nutri-score, Canadian 'high in' labels and Diabetes Canada Clinical Practices (DCCP).
- Author
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Paper L, Ahmed M, Lee JJ, Kesse-Guyot E, Touvier M, Hercberg S, Galan P, Salanave B, Verdot C, L'Abbé MR, Deschamps V, and Julia C
- Subjects
- Adult, Humans, Cross-Sectional Studies, Canada, Nutritive Value, Biomarkers, Diet, Diabetes Mellitus
- Abstract
Purpose: To assess the cross-sectional association between dietary indexes (DI) that underlie, respectively, the Nutri-score (NS), the proposed Canadian 'High In' Symbol (CHIL) and the Diabetes Canada Clinical Practice Guidelines (DCCP) with food consumption, nutrient intakes and metabolic markers., Methods: 1836 adults (18-74 years) participating in the representative ESTEBAN study, conducted in mainland France in 2014-2016, were included in the analysis. Food consumption was assessed with three repeated 24 h dietary recalls. Anthropometric measurements and biomarkers of metabolic risk (cholesterol-total, LDL (Low Density Lipoprotein), HDL (High Density Lipoprotein)-triglycerides, glucose) were obtained through a clinical examination and fasting blood draw. The DI were assessed for their association with food consumption, dietary intakes and metabolic biomarkers as quintiles and continuous variables using multi-adjusted linear regression. Heathier diets were assigned to lower scores., Results: Correlations between scores ranged from + 0.62 between CHIL-DI and NS-DI to + 0.75 between NS-DI and DCCP-DI. All DIs discriminated individuals according to the nutritional quality of their diets through food consumption and nutrient intakes (healthier diets were associated with lower intakes of energy, added sugars and saturated fat; and with higher intakes of fiber, vitamins and minerals). NS-DI was associated with blood glucose (adjusted mean in Q1 = 5 vs. Q5 = 5.46 mmol/dl, p
trend = 0.001) and DCCP-DI was associated with BMI (Q1 = 24.8 kg/m2 vs. Q5 = 25.8 kg/m2 , ptrend = 0.025), while CHIL showed no significant association with any anthropometric measures or biomarkers., Conclusions: This study provides elements supporting the validity of the nutrient profiling systems underlying front-of-package nutrition labellings (FOPLs) to characterize the healthiness of diets., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)- Published
- 2023
- Full Text
- View/download PDF
6. Recycling Paper-Plastic laminate coffee cups using a Single-Disk Refiner: Energy requirements and recovered fiber quality.
- Author
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Bilek MA, Salem HJ, Korehei R, and Olson JA
- Subjects
- Canada, Recycling, Tensile Strength, Coffee, Plastics
- Abstract
Over 64 billion paper-plastic laminate (PPL) coffee cups are consumed between the United States and Canada annually, the majority accumulating in landfills due to a hydrophobic plastic inner-lining. Recycling can mitigate environmental damage and provide economic value from repurposed products. We found that standard repulping methods were insufficient to separate fiber from plastic due to the low intensity of treatment. To increase process intensity, we mechanically refined shredded PPL coffee cups and Kraft eucalyptus sheets (control) at 2%, 3%, and 4% consistencies with three passes to determine the energy required to separate fibers from plastic and the effects on fiber quality. 2% and 3% consistency PPL cups measured under 40 kWh/tonne of input material for one refiner pass and ∼ 80 kWh/tonne for 4% consistency PPL cups. Recovered fiber fraction totaled 87.7%, 85.3%, and 80.5% of input mass of Kraft eucalyptus and 72.3%, 72.6%, and 79.6% of input mass of PPL cups at 2%, 3%, and 4% consistency, respectively. Fines content of PPL cups jumped from 8% pre-refining to ∼ 30% post-refining while Kraft eucalyptus fibers were unaffected, suggesting that breaking the plastic-fiber bonds results in fines generation. Mean fiber length of PPL cups slightly decreased with consistency and tensile strength improved. Freeness decreased with consistency only in PPL cup samples. These results demonstrate a low energy requirement to effectively separate fiber and plastics in PPL cups as well as minimal impact on fiber quality using existing refining technology, and provides an estimate of the financial costs of local recycling efforts., (Copyright © 2021. Published by Elsevier Ltd.)
- Published
- 2021
- Full Text
- View/download PDF
7. Measuring and Monitoring Healthcare-Associated Infections: A Canadian Collaboration to Better Understand the Magnitude of the Problem.
- Author
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MacLaurin A, Amaratunga K, Couris C, Frenette C, Galioto R, Hansen G, Happe J, Neudorf K, Pelude L, Quach C, and Rose SR
- Subjects
- Canada epidemiology, Hospitals, Humans, Infection Control, Long-Term Care, Patient Safety, Cross Infection diagnosis, Cross Infection epidemiology, Epidemiological Monitoring
- Abstract
Patients should never have to worry about getting an infection while in hospital. Yet every year, many hospitalized Canadians continue to acquire an infection during their hospital stay and experience increased morbidity and mortality as a result of these healthcare-associated infections (HAIs) (PHAC 2019b). Measuring and monitoring HAIs provide key data to better understand the magnitude of the problem. In Canada, there are inconsistencies in the use of standardized HAI case definitions and surveillance practices. These inconsistencies make it difficult to provide benchmarks and set targets to help reduce the rate of HAIs in Canadian hospitals., (Copyright © 2020 Longwoods Publishing.)
- Published
- 2020
- Full Text
- View/download PDF
8. The 2018 decision to establish an Advisory Council on adding pharmaceuticals to universal health coverage in Canada.
- Author
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Grignon M, Longo CJ, Marchildon GP, and Officer S
- Subjects
- Canada, Costs and Cost Analysis, Humans, Advisory Committees organization & administration, Decision Making, Prescription Drugs economics, Universal Health Insurance economics
- Abstract
Canada is the only Universal Health Insurance country in the OECD without universal insurance for outpatient prescription drugs, a situation generally perceived as unfair and inefficient. In June 2018, the federal government launched an Advisory Council on the Implementation of National Pharmacare, to report in 2019 on the best strategy to implement a national Pharmacare program that would provide all Canadians access to affordable outpatient prescription drugs. The Council was asked to consider three options: a universal public plan for all Canadians; a public catastrophic insurance plan that would kick off once spending on prescription drugs reaches a given threshold; and a more modest patching of existing gaps, providing coverage to those who are not eligible to any form of insurance. Beyond the relative consensus around the ideas that gaps in coverage should be filled to make drugs affordable to all, and that the costs of drugs are too high in Canada, the Council faces the challenge of addressing three underlying issues: 1) what amount of income redistribution will result from each of the three options; 2) how much savings would the implementation of a single payer generate? 3) what role restricting a national formulary would play in achieving those savings, and what would be the political consequences of narrowing the formulary?, (Copyright © 2019. Published by Elsevier B.V.)
- Published
- 2020
- Full Text
- View/download PDF
9. The ecology of "fecal indicator" bacteria commonly found in pulp and paper mill water systems.
- Author
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Gauthier F and Archibald F
- Subjects
- Bioreactors, Canada, Ecosystem, Enterobacteriaceae classification, Enterobacteriaceae growth & development, Enterococcus classification, Enterococcus growth & development, Enterococcus isolation & purification, Escherichia coli growth & development, Escherichia coli isolation & purification, Escherichia coli pathogenicity, Humans, Industrial Waste, Paper, Refuse Disposal, Water Pollution, Enterobacteriaceae isolation & purification, Feces microbiology, Water Microbiology
- Abstract
Coliform bacteria have long been used to indicate fecal contamination of water and thus a health hazard. In this study, the in-mill water and external effluent treatment systems of seven typical Canadian pulp and paper mills were all shown to support the growth of numerous coliforms, especially Klebsiella Spp., Escherichia coli. Enterobacter spp., and Citrobacter spp. In all mills and most sampled locations, klebsiellas were the predominant coliforms. Although all but one of the mills had no sewage input and most disinfected their feed (input) water, all contained the most typical fecal indicator bacterium, E. coli. Many of the mill coliforms were classified as fecal coliforms by standard "MPN" and metabolic tests, but this was shown to be due to their thermotolerance, not their origin. Mill coliforms were shown not to be just simple transients from feedwater or furnish (wood), but to be continuously growing, especially in some of the primary clarifiers. Isolated mill coliforms grew very well on a sterilized raw combined mill effluent. The fecal streptococci (enterococci), alternative indicators of fecal health hazards, were common in all mills in the absence of sewage. Ten strains of E. coli isolated from four mills were all shown to be non-toxigenic strains of harmless serotypes. No salmonellas were found. Therefore, the use of total coliform, fecal coliform, enterococci, or E. coli counts as indicators of fecal contamination, and thus of health hazard in pulp and paper mill effluents or biosolids (sludges) known to be free of fecal input is invalid.
- Published
- 2001
- Full Text
- View/download PDF
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