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There have been calls for more research to investigate the sociocultural context of retail food environments. This paper examines how a segment of Ottawa, Ontario, Canada, residents described convenience stores (CS) in their local retail food environments. 84 social media discussions from Ottawa residents pertaining to their local retail food outlets were qualitatively analyzed, and three themes were formulated: 1) CS are interchangeable, 2) CS are not 'real stores,' and 3) CS are dangerous retail food outlets. We argue that these social constructions of CS have implications for healthy food environments and offer suggestions for future research. [ABSTRACT FROM AUTHOR]

The article reports on the findings of investigations conducted by federal, state and local health agencies on the outbreak of Salmonella Oranienburg infections in Northeastern U.S. and Canada in 2006. The illness was associated with eating fruit salad in health-care facilities. Investigation was conducted by the New Hampshire Department of Health and Human Services after Salmonella Oranienburg was identified in stool specimens collected from patients, employees and a cafeteria patron.

Highlights the report on the outbreaks of Salmonella infections which is associated with eating Roma tomatoes in the U.S. and Canada in 2004. Number of culture-confirmed, outbreak associated salmonellosis that were identified in the nine states of the U.S.; Information on the traceback and environmental investigation conducted by the U.S. Food & Drug Administration; Explanation on how Salmonella can enter tomato plants.

Objective: The objective of this scoping review was to map the current literature and resources available on nutrition and food programming for people living with HIV in Canada. This review is phase 1 of a 4-phase project, called FoodNOW (Food to eNhance Our Wellness), a community-based nutritional needs assessment of people living with HIV in Nova Scotia, Canada., Introduction: People living with HIV may experience nutritional challenges, including nutritional deficiencies associated with the virus, food insecurity, and nutrition-drug interactions. Nutritional programming is often required for optimal care for people living with HIV. The literature, however, has not been sufficiently mapped to create a comprehensive picture of available programming. This review has informed the development of subsequent study phases, and will contribute towards shaping and planning food programs, as well as evaluating the need for subsequent systematic reviews., Inclusion Criteria: This review considered literature focused on nutrition and food programming and resources in Canada for people living with HIV. People living with HIV of any age, sex, race, gender identity, or sexual orientation, as well as pregnant and lactating people, were included as the population of interest., Methods: The databases searched were MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premier (EBSCO), Social Services Abstracts (ProQuest), and Scopus. Sources of gray literature searched included government and organization websites, and Google searches. The database search was conducted in July 2021, and the gray literature searches were conducted in August and October 2021. Searches were limited to evidence published or translated in English. Two independent reviewers conducted title and abstract screening, and potentially relevant results were retrieved in full. Full-text screening and data extraction was conducted by 2 independent reviewers using a data extraction tool designed specifically for the scoping review objectives and research inclusion criteria, and any conflicts were resolved through discussion. Results are presented in both tabular and diagrammatic formats, with a narrative summary., Results: A total of 581 results were screened (published and gray literature). A total of 64 results were included in the review. The 6 reasons for exclusion at full-text review were i) not nutrition and food programming (n= 83), ii) not Canadian (n= 37), iii) duplicates (n= 22), iv) not focused on people living with HIV (n= 6), v) conference abstract (n= 1), and vi) not in English (n= 1). A total of 76 resources were located, as some of the 64 included sources offered more than 1 resource. The 76 resources were organized into 6 categories: i) charitable food provision (n = 21; 27.6%), ii) financial aid (n = 14; 18.4%), iii) nutrition care (n =12; 15.8%), iv) providing access to secondary sources (n= 10; 13.2%), v) food and nutrition expertise (n= 10; 13.2%), and vi) population health promotion (n= 9; 11.8%). Recommendations for future research and programming are discussed., Conclusions: This scoping review demonstrates that current programming relies heavily on charitable food provision services for people living with HIV and that there is an unequal distribution of resources across Canada. Program expansion to target diverse populations with more equal distribution across Canada may improve overall health outcomes for people living with HIV. Future research is needed to evaluate the effectiveness of available programming and the needs of end users (people living with HIV and their supports). FoodNOW will build on these findings to further explore and address the needs of people living with HIV., Review Registration: Open Science Framework https://osf.io/97x3r., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of JBI.)

This study explored how a subsection of Canadians perceive older adults' vaccines through a qualitative analysis of comments posted in response to national online news articles. We used reflexive thematic analysis to analyse 147 comments from 31 news article comments sections published between 2015 and 2020 from five different national online news sources (CBC, National Post, Global News, Globe & Mail, and Huffington Post Canada) that focused on three older adults' diseases and vaccines: influenza, pneumococcal pneumonia, and herpes-zoster. Three themes encompassed the similarities and differences in how these three diseases were discussed: (1) the importance of personal experiences on stated stance in vaccine uptake or refusal, (2) questioning vaccine research and recommendations, and (3) criticisms of the government's unequal vaccine opportunities across different Canadian provinces. Our findings identified that perceptions regarding older adult vaccination were dependent on the vaccine type, and, therefore, we make suggestions for future researchers to build on our findings, particularly the need not to treat the research subject of "older adults' vaccines" as one entity. Gaining a better understanding of how older adults' vaccines are perceived in Canada will enable public health professionals to develop effective communication strategies that should ultimately improve vaccination rates for older adults.

Purpose: Written comments are increasingly valued for assessment; however, a culture of politeness and the conflation of assessment with feedback lead to ambiguity. Interpretation requires reading between the lines, which is untenable with large volumes of qualitative data. For computer analytics to help with interpreting comments, the factors influencing interpretation must be understood., Method: Using constructivist grounded theory, the authors interviewed 17 experienced internal medicine faculty at 4 institutions between March and July, 2017, asking them to interpret and comment on 2 sets of words: those that might be viewed as "red flags" (e.g., good, improving) and those that might be viewed as signaling feedback (e.g., should, try). Analysis focused on how participants ascribed meaning to words., Results: Participants struggled to attach meaning to words presented acontextually. Four aspects of context were deemed necessary for interpretation: (1) the writer; (2) the intended and potential audiences; (3) the intended purpose(s) for the comments, including assessment, feedback, and the creation of a permanent record; and (4) the culture, including norms around assessment language. These contextual factors are not always apparent; readers must balance the inevitable need to interpret others' language with the potential hazards of second-guessing intent., Conclusions: Comments are written for a variety of intended purposes and audiences, sometimes simultaneously; this reality creates dilemmas for faculty attempting to interpret these comments, with or without computer assistance. Attention to context is essential to reduce interpretive uncertainty and ensure that written comments can achieve their potential to enhance both assessment and feedback.

Improved measurement in early child development (ECD) is a strategic focus of the WHO, UNICEF and World Bank Nurturing Care Framework. However, evidence-based approaches to monitoring and evaluation (M&E) of ECD projects in low-income and middle-income countries (LMIC) are lacking. The Grand Challenges Canada®-funded Saving Brains® ECD portfolio provides a unique opportunity to explore approaches to M&E of ECD programmes across diverse settings. Focused literature review and participatory mixed-method evaluation of the Saving Brains portfolio was undertaken using an adapted impact framework. Findings related to measurement of quality, coverage and outcomes for scaling ECD were considered. Thirty-nine ECD projects implemented in 23 LMIC were evaluated. Projects used a 'theory of change' based M&E approach to measure a range of inputs, outputs and outcomes. Over 29 projects measured cognitive, language, motor and socioemotional outcomes. 18 projects used developmental screening tools to measure outcomes, with a trade-off between feasibility and preferred practice. Environmental inputs such as the home environment were measured in 15 projects. Qualitative data reflected the importance of measurement of project quality and coverage, despite challenges measuring these constructs across contexts. Improved measurement of intervention quality and measurement of coverage, which requires definition of the numerator (ie, intervention) and denominator (ie, population in need/at risk), are needed for scaling ECD programmes. Innovation in outcome measurement, including intermediary outcome measures that are feasible and practical to measure in routine services, is also required, with disaggregation to better target interventions to those most in need and ensure that no child is left behind., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This paper used netnography and thematic analysis of the comments made in online news articles to understand better the public response to the closure of the only KFC restaurant in Yellowknife, Northwest Territories, Canada, in 2015. While the popular media often cover fast-food restaurant closures, past academic research has not examined the public response to these closures. To begin to fill this gap, we examined the comments sections of five online news articles from the Canadian news outlet, CBC.ca, and reactions shared on Facebook. 239 commenters made 308 publicly available online comments addressing the closure. Key themes in commenter perceptions included pro-closure reactions, which were based on the perceived public health benefits of reduced fast-food consumption, and anti-closure reactions to such factors as the loss of a local landmark and a source of positive memories. The unfavorable reactions appeared to pose a significant barrier to public acceptance of the KFC closure. This paper argues that it is important to examine public perceptions of fast-food closures to understand better what these restaurants mean to individuals and communities. This information, in turn, can be used to promote healthier restaurant-eating in ways that will complement efforts to encourage healthier food choices.

Background: The management of chronic pain, including neuropathic pain (NeP), is a major public health issue. However, there is a paucity of data evaluating pain management strategies in real-life settings., Objective: To inform policy makers about the economic value of managing chronic NeP in academic centres by conducting a subeconomic assessment of a Canadian multicentre cohort study aimed at determining the long-term outcomes of the management of chronic NeP in academic pain centres. Specific questions regarding the economic value of this type of program were answered by a subset of patients to provide further information to policy makers., Methods: Baseline demographic information and several pain-related measurements were collected at baseline, three, six and 12 months in the main study. A resource use questionnaire aimed at determining NeP-related costs and the EuroQoL-5 Dimension were collected in the subset study from consenting patients. Statistical analyses were conducted to compare outcomes over time and according to responder status., Results: A total of 298 patients were evaluated in the present economic evaluation. The mean (± SD) age of the participants was 53.7±14.0 years, and 56% were female. At intake, the mean duration of NeP was >5 years. Statistically significant improvements in all pain and health-related quality of life outcomes were observed between the baseline and one-year visits. Use decreased over time for many health care resources (eg, visits to the emergency room decreased by one-half), which resulted in overall cost savings., Conclusion: The results suggest that increased access to academic pain centres should be facilitated in Canada.

This prospective observational cohort study addressed the long-term clinical effectiveness of the management of chronic neuropathic noncancer pain at 7 Canadian tertiary pain centers. Patients were treated according to standard guidelines and were followed at 3, 6, 12, 18, and 24 months. Standard outcome measures for pain, mood, quality of life, and overall treatment satisfaction were administered, with the primary outcome measure designated as the composite of 30% reduction in average pain intensity and 1-point decrease in the mean Interference Scale Score (0-10) of the Brief Pain Inventory at 12 months relative to baseline. Of 789 patients recruited, mean age was 53.5 ± 14.2 years (55% female) and mean duration of pain was 4.88 ± 5.82 years. Mean average pain intensity (0-10) at baseline was 6.1 ± 1.9. All standard outcome measures showed statistically significant improvement at 12 months relative to baseline (P < .001). However, only 23.7% attained clinically significant improvement in pain and function at 12 months as the primary outcome measure. Univariable analyses showed poorer outcomes at 12-month follow-up with longer duration of pain (P = .002), greater cigarette use (P = .01), more disability compensation (P = .001), and higher opioid doses at baseline and at 12 months (P < .02). Our present treatment modalities provide significant long-term benefit in only about a quarter of patients with neuropathic pain managed at tertiary care pain clinics. Opioid therapy may not be beneficial for the long term. Perspective: Evidence-based treatment of chronic neuropathic pain provides long-term benefit in only about one-quarter of patients seen in tertiary care centers. Opioid therapy may not be beneficial., (Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Objective: The present exploratory, descriptive study aimed to determine the designated time for mandatory pain content in curricula of major Canadian universities for students in health science and veterinary programs before being licensed., Method: Major Canadian university sites (n=10) were chosen where health science faculties included at least medicine (n=10) and nursing (n=10); many also included dentistry (n=8), pharmacy (n=7), physical therapy (n=8) and/or occupational therapy (n=6). These disciplines provide the largest number of students entering the workforce but are not the only ones contributing to the health professional team. Veterinary programs (n=4) were also surveyed as a comparison. The Pain Education Survey, developed from previous research and piloted, was used to determine total mandatory pain hours., Results: The majority of health science programs (67.5%) were unable to specify designated hours for pain. Only 32.5% respondents could identify specific hours allotted for pain course content and/or additional clinical conferences. The average total time per discipline across all years varied from 13 h to 41 h (range 0 h to 109 h). All veterinary respondents identified mandatory designated pain content time (mean 87 h, range 27 h to 200 h). The proportion allotted to the eight content categories varied, but time was least for pain misbeliefs, assessment and monitoring/follow-up planning., Conclusions: Only one-third of the present sample could identify time designated for teaching mandatory pain content. Two-thirds reported 'integrated' content that was not quantifiable or able to be determined, which may suggest it is not a priority at that site. Many expressed a need for pain-related curriculum resources.

Purpose: To examine the role of health care professionals in multidisciplinary pain treatment facilities (MPTF) for the treatment of chronic pain across Canada., Methods: MPTF were defined as clinics that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain, and had staff from a minimum of three different health care disciplines (including at least one medical specialty) available and integrated within the facility. Administrative leaders at eligible MPTF were asked to complete a detailed questionnaire on their infrastructure as well as clinical, research, teaching and administrative activities., Results: A total of 102 MPTF returned the questionnaires. General practitioners, anesthesiologists and physiatrists were the most common types of physicians integrated in the MPTF (56%, 51% and 32%, respectively). Physiotherapists, psychologists and nurses were the most common nonphysician professionals working within these MPTF (75%, 68% and 57%, respectively), but 33% to 56% of them were part-time staff. Only 77% of the MPTF held regular interdisciplinary meetings to discuss patient management, and 32% were staffed with either a psychologist or psychiatrist. The three most frequent services provided by physiotherapists were patient assessment, individual physiotherapy or exercise, and transcutaneous electrical nerve stimulation. The three most common services provided by psychologists were individual counselling, cognitive behavioural therapy and psychodynamic therapy. The major roles of nurses were patient assessment, assisting in interventional procedures and patient education., Conclusion: Different health care professionals play a variety of important roles in MPTF in Canada. However, few of them are involved on a full-time basis and the extent to which pain is assessed and treated in a truly multidisciplinary manner is questionable.

Purpose: The objective of this survey was to examine the services offered by multidisciplinary pain treatment facilities (MPTFs) across Canada and to compare access to care at these MPTFs., Methods: A MPTF was defined as a clinic that advertised specialized multidisciplinary services for the diagnosis and management of patients with chronic pain, having a minimum of three different health care disciplines (including at least one medical speciality) available and integrated within the facility. The search method included approaching all hospital and rehabilitation centre administrators in Canada, the Insurance Bureau of Canada, the Workplace Safety and Insurance Board or similar body in each province. Designated investigators were responsible for confirming and supplementing MPTFs from the preliminary list for each province. Administrative leads at each eligible MPTF were asked to complete a detailed questionnaire regarding their MPTF infrastructure, clinical, research, teaching and administrative activities., Results: Completed survey forms were received from 102 MPTFs (response rate 85%) with 80% concentrated in major cities, and none in Prince Edward Island and the Territories. The MPTFs offer a wide variety of treatments including non-pharmacological modalities such as interventional, physical and psychological therapy. The median wait time for a first appointment in public MPTFs is six months, which is approximately 12 times longer than non-public MPTFs. Eighteen pain fellowship programs exist in Canadian MPTFs and 64% engage in some form of research activities, Conclusion: Canadian MPTFs are unable to meet clinical demands of patients suffering from chronic pain, both in terms of regional accessibility and reasonable wait time for patients' first appointment.

The assessment of depression in patients with advanced cancer presents a difficult clinical challenge. Reported prevalence rates of depression in cancer patients range from 3.7% to 58%. Studies using structured diagnostic interviews and clearly defined diagnostic criteria are presented. The current literature suggests that among hospitalized cancer patients with significant levels of physical impairment at least 25% suffer from clinically important depression. Risk of suicide and recent literature regarding early wish to die are also discussed.