Search

Resistance to beta-lactam antimicrobials caused by extended-spectrum beta-lactamase (ESBL)-producing organisms is a global health concern. The objectives of this study were to (1) summarise the prevalence of potential ESBL-producing Escherichia coli (ESBL-EC) and Salmonella spp. (ESBL-SA) isolates from agrifood and human sources in Canada from 2012 to 2017, and (2) describe the distribution of ESBL genotypes among these isolates. All data were obtained from the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). CIPARS analysed samples for the presence of ESBLs through phenotypic classification and identified beta-lactamase genes (blaTEM, blaSHV, blaCTX, blaOXA, blaCMY−2) using polymerase chain reaction (PCR) and whole genome sequencing (WGS). The prevalence of PCR-confirmed ESBL-EC in agrifood samples ranged from 0.5% to 3% across the surveillance years, and was detected most frequently in samples from broiler chicken farms. The overall prevalence of PCR-confirmed ESBL-SA varied between 1% and 4% between 2012 and 2017, and was most frequently detected in clinical isolates from domestic cattle. The TEM-CMY2 gene combination was the most frequently detected genotype for both ESBL-EC and ESBL-SA. The data suggest that the prevalence of ESBL-EC and ESBL-SA in Canada was low (i.e.

Shade provides a variety of public health benefits; however, outdoor recreation sites often have limited shade. We conducted semi-structured interviews (n = 13) with shade stakeholders (i.e. individuals with a professional role involving shade design or provision) to gain in-depth understanding of the factors impacting shade provision at public parks. Interview transcripts were analyzed using inductive thematic analysis. Five main themes emerged: (1) attitudes toward shade at parks; (2) designing shade at parks; (3) advantages and disadvantages of natural and built shade; (4) barriers to shade at parks; and, (5) approaches to reduce shade barriers. Shade stakeholders indicated shade is important and necessary and they strive to design shade in park spaces with park user patterns in mind. However, barriers including competing interests, budget, space constraints, and maintenance and operational concerns can limit their ability to do so. Future research should determine strategies to overcome these barriers.

To synthesize peer-reviewed primary research exploring factors associated with perceived stress impacting post-secondary students’ academic success. Methods: A systematic review identified research...

Social inclusion is central to positive life experiences for those with and without intellectual disabilities (ID). Unfortunately, those with ID experience high levels of social isolation. As group homes, one of the most common forms of community living, aim to provide an equitable quality of life for adults with disabilities, significant responsibility of promoting social inclusion falls to them. The intention of this review is to identify the facilitators and barriers associated with social inclusion for people with ID living in group homes to develop an evaluation framework. Five databases were searched, and inclusion/exclusion criteria were used to narrow the results to 21 articles. Four main categories of barriers and facilitators to inclusion became apparent in the literature: (1) Home characteristics and social inclusion, (2) Staff characteristics and social inclusion, (3) Organizational/Leadership characteristics and social inclusion, and (4) Resident characteristics and social inclusion. While the findings from these articles have been divided into four broad categories, it is acknowledged the identified barriers and facilitators are varied and highlight the important role of the group home and surrounding communities in promoting social inclusion of their residents. This review also highlights a gap in current literature surrounding social inclusion for those with ID. Overall, more emphasis on understanding the various pathways to achieving social inclusion from group home residents with ID could contribute to the creation of effective policy and practices.

This study explores female indoor tanners' perceptions of the current, text-only Canadian health warning label (HWL) for tanning equipment, as well as pictorial, evidence-based alternative HWLs. We created 10 test HWLs that depicted skin health effects, eye damage, premature aging, and death. Young women who had tanned indoors in the past year discussed these and the current federal HWL in focus groups. Although the current Canadian HWL was seen as informative, several participants did not recognize it, and many said that they would not read it due to the small text, wordiness, and lack of an image. Graphic images, particularly those depicting permanent conditions affecting the face, eyes, or appearance, were seen as effective. Common criticisms of the images were lack of believability, relatability, and comprehensibility. Although concise text was important for encouraging reading, many participants expressed a desire for more information in the test HWLs. Premature aging was of great concern to many participants, but the images selected for these HWLs were not perceived as effective. Although the text was seen as effective in the death HWLs, most participants dismissed the images. This research has implications for IT HWLs in Canada and globally. These results suggest that graphic images may be impactful in IT HWLs. Images must be supplemented with informative text that increases believability, relatability, and comprehensibility. These modifications would create HWLs that are engaging, informative, and that form part of a wider effort to spread awareness about the harmful effects of IT.

This study measured the effect of various dimensions of social capital on the reporting of stress impacting the academic performance of Canadian undergraduate students. The American College Health Association collects information on undergraduate students’ habits, behaviors, and perceptions of various health topics through the National College Health Assessment-II (NCHA-II) survey. This cross-sectional study utilized the Spring 2019 NCHA-II survey data from 55,284 respondents across 58 Canadian post-secondary institutions. Of this, 31,091 undergraduate students (56.2%) reported being stressed within the past year and were included in our analysis. Nine factors were selected from the questionnaire based on their relevance to social capital in the literature, and an additional seven socio-demographic factors were controlled for in subsequent analyses. The associations between these predictor variables and stress impacting students’ academic performance were examined by fitting univariable and mixed-effects logistic regression models. Our study found having warm and trusting relationships with others, feeling a sense of belongingness, and feeling society is a good place for all individuals significantly decreased the odds of students reporting stress impacting their academic performance. Campuses that support student mental health, institutions that provide information regarding stress reduction, and feeling safe on campus also lowered the odds of students reporting stress adversely affecting their academics. These components of social capital should be targeted at higher education institutions to cultivate social capital, alleviate the implications of stress affecting academic success, and promote interpersonal resiliency skill-building among students.

OBJECTIVE To assess the readability of pet obesity information, document the presence and absence of types of pet obesity information, and perform comparisons between dog and cat obesity information content on websites. SAMPLE 68 websites containing pet obesity content. PROCEDURES Websites were systematically retrieved with a search engine and predefined search terms and phrases. For each website, pet obesity information was scored by use of 2 established readability tools: the simple measure of gobbledygook (SMOG) index and Flesch-Kincaid (FK) readability test. A directed content analysis was conducted with a codebook that assessed the presence or absence of 103 variables across 5 main topics related to pet obesity on each website. RESULTS The mean reading grade levels determined with the SMOG index and FK readability test were 16.61 and 9.07, respectively. Instructions for weight measurement and body condition scoring were found infrequently, as were nonmodifiable risk factors. There was a greater focus on addressing obesity through dietary changes than through increasing physical activity. Few websites recommended regular follow-up appointments with veterinarians. Weight management information and the emphasis on owners’ commitment to achieve their pet's weight loss targets differed among dog- and cat-focused websites. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that pet obesity information on the studied websites was largely inaccessible to pet owners owing to the associated high reading grade levels. Readers of that information would benefit from clarification of information gaps along with provision of guidance regarding navigating online information and counseling on the importance of nutritional and dietary reassessments for individual pets performed by veterinarians.

Successful mitigation of emerging infectious disease requires that the public adopt recommended behaviours, which is directly influenced by effective crisis communication. Social media has become an important communication channel during COVID-19 where official actors, influencers, and the public are co-creating crisis messages. Our research examined COVID-19-related crisis messages across Canadian influencer accounts within news media, politicians, public health and government, science communicators, and brand influencer and celebrities, posted on Instagram between December 2019 and March 2021 for Health Belief Model and Extended Parallel Processing Model constructs and the corresponding public comment sentiment and engagement. Thirty-three influencer accounts resulted in a total of 2,642 Instagram posts collected, along with 461,436 comments, which showed overall low use of constructs in both captions and images. Further, most posts used no combinations (n = 0 or 1 construct per post) of constructs in captions and images and very infrequently used captions that combined threat (severity and susceptibility) with cues to action and efficacy. Brand influencers and celebrities, politicians, and science communicators had above average post engagement while public health and government and news media had lower. Finally, most influencers saw the largest proportion of neutral sentiment comments. Crisis messages must be designed to include combinations of constructs that increase message acceptance and influence risk perception and efficacy to increase the adoption of recommended and mandated behaviours.

Jurisdictions around the world have implemented indoor tanning legislations, which aim to protect all individuals, especially youth, from dangers of artificial ultraviolet radiation exposure. The objective of this study was to conduct a systematic review to synthesize the available peer-reviewed literature to determine whether indoor tanning legislation has impacted the prevalence of youth indoor tanning. Following PRISMA guidelines, six databases were searched in 2016. Reference lists from relevant articles were also searched. An updated literature search was conducted in 2018. Each article was critically appraised using a merged checklist created from two previously validated checklists. All articles meeting the inclusion criteria were retained after appraisal. Seven studies, all conducted in the U.S., met the inclusion criteria. All studies used an observational, cross-sectional design. There were small absolute decreases in youth indoor tanning prevalence after legislation vs before (n = 3, mean = 3% decrease, range = 1%–6% decrease). Prevalence of youth indoor tanning was significantly lower in states with indoor tanning legislation vs states without legislation (n = 4, mean = 5% lower, range = 1%–18% lower). Prevalence of youth indoor tanning was lower in states with longer standing indoor tanning legislation vs states with more recently implemented legislation (n = 2, mean = 9% lower, range = 2%–20% lower). Indoor tanning legislation is generally associated with lower indoor tanning prevalence among youth. The small percent differences equate to millions of youth at the population level. Longer time lapses from legislation implementation to evaluation, coupled with greater enforcement, compliance, legislative stringency, and public education may result in even more pronounced declines in youth indoor tanning prevalence.

Evidence of the dangers of indoor tanning and its popularity, including among youth, led the Government of Ontario to pass the Skin Cancer Prevention Act (Tanning Beds) (SCPA) in 2014. This legislation includes prohibiting the sale of indoor tanning services to individuals under 18, requiring warning signs be posted, and other safety regulations. We collected information from Ontario Public Health Units to conduct a process evaluation of the SCPA to: understand legislation implementation; assess available evidence about compliance, inspection, and enforcement; and, note barriers and facilitators related to inspection and enforcement. Data was collected March-April 2018. All 36 Ontario Public Health Units were invited to participate in an online questionnaire about the SCPA. Questions covered complaints, inspection, and enforcement, and used both close- and open-ended questions. Participants from 20 Public Health Units responded to the questionnaire; a response rate of 56%. These agencies reported 485 facilities offer indoor tanning. Since 2014, there have been 242 infractions by tanning facility owner/operators related to the SCPA, with most being uncovered during non-mandatory routine inspections (n = 234, 97%), rather than mandatory complaint-based inspections (n = 8, 3%). Most infractions were related to warning signs (n = 201, 83%). No charges were issued for any infractions. Instead, providing education (n = 90, 62%) and issuing warnings (n = 33, 23%) were the most common enforcement strategies. SCPA amendments are needed, including mandatory, routinely scheduled inspections. In addition to providing education, fines may improve compliance. More resources are required for inspection and enforcement of the SCPA.

Background: State-level legislation regulates the posting of health warning labels (HWLs) in indoor tanning (IT) salons in the United States. Purpose: The purpose of this study was to determine the content and appearance of state-level legislation-mandated IT HWLs. Methods: We conducted a directed content analysis of IT HWLs, evaluating location, health and aesthetic risk information, health communication theory constructs, and visual components. Results: Thirty-three states require IT HWLs: 30 states require one and 3 states require two. Text for 36 labels was analyzed: 94.4% (n = 34) mentioned skin cancer and eye risks, 91.7% (n = 33) mentioned aesthetic risk, and none mentioned death. One label suggested an ultraviolet (UV)-tanning alternative and none addressed barriers to reducing IT. Seventeen electronic labels were available for visual analysis: 5.9% (n = 1) contained a symbol and 11.8% (n = 2) contained an image. Discussion: IT HWLs are widely used and present basic risk information, yet t...

Introduction Canadian provincial and territorial governments have enacted legislation in response to health risks of artificial ultraviolet radiation from indoor tanning. This legislation, which differs from jurisdiction to jurisdiction, regulates the operation of indoor tanning facilities. The content and comprehensiveness of such legislation—and its differences across jurisdictions—have not been analyzed. To address this research gap, we conducted a systematic, comprehensive scan and content analysis on provincial and territorial indoor tanning legislation, including regulations and supplementary information. Methods Legislative information was collected from the Canadian Legal Information Institute database and an environmental scan was conducted to locate supplementary information. Through a process informed by the content of the legislation, previous research and health authority recommendations, we developed a 59-variable codebook. Descriptive statistics were calculated. Results All provinces and one of three territories have legislation regulating indoor tanning. Areas of strength across jurisdictions are youth access restrictions (n = 11), posting of warning signs (n = 11), penalties (n = 11) and restrictions on advertising and marketing targeted to youth (n = 7). Few jurisdictions, however, cover areas such as protective eyewear (n = 4), unsupervised tanning (n = 4), provisions for inspection frequency (n = 4), misleading health claims in advertisements directed toward the general public (n = 2) and screening of high-risk clients (n = 0). Conclusion All provinces and one territory have made progress in regulating the indoor tanning industry, particularly by prohibiting youth and using warning labels to communicate risk. Legislative gaps should be addressed in order to better protect Canadians from this avoidable skin cancer risk.

Introduction Les gouvernements provinciaux et territoriaux du Canada ont adopté des lois en réponse aux risques pour la santé liés au rayonnement ultraviolet émis par les appareils de bronzage. Ces lois, variables d’une administration à l’autre, réglementent le fonctionnement des établissements de bronzage. Leur contenu et leur exhaustivité – et les variations entre administrations – n’ayant pas encore été analysés, nous avons procédé, pour combler cette lacune, à une analyse de contenu systématique et exhaustive des lois et règlements provinciaux et territoriaux sur le bronzage artificiel et nous avons examiné divers renseignements supplémentaires sur le sujet. Méthodologie Nous avons recueilli l’information sur les mesures législatives dans la base de données de l’Institut canadien d’information juridique et nous avons effectué une analyse de contexte pour obtenir des renseignements supplémentaires. En nous fondant sur le contenu des lois, sur les travaux de recherche antérieurs et sur les recommandations des autorités sanitaires, nous avons élaboré un guide de codage à 59 variables. Nous avons également calculé des statistiques descriptives. Résultats Toutes les provinces et l’un des trois territoires ont adopté des lois réglementant le bronzage artificiel. Les points forts observés dans ces administrations sont des restrictions d’accès pour les jeunes (dans 11 cas), l’affichage d’avertissements (dans 11 cas), des sanctions (dans 11 cas) et des restrictions sur la publicité et le marketing ciblant les jeunes (dans 7 cas). Cependant, peu d’administrations mentionnent le port de lunettes de protection (4), le bronzage sans surveillance (4), les dispositions relatives à la fréquence des inspections (4), les allégations trompeuses en matière de santé dans les publicités destinées au grand public (2) et le dépistage des clients présentant un risque élevé (0). Conclusion Toutes les provinces et un territoire ont fait des progrès en réglementant l’industrie du bronzage artificiel, notamment en interdisant aux jeunes d’accéder à ces services et en imposant l’utilisation d’affiches pour avertir des risques. Il reste à combler les lacunes législatives afin de mieux protéger la population canadienne contre ce risque évitable de cancer de la peau.

To foster trust on social media during a crisis, messages should implement key guiding principles, including call to action, clarity, conversational tone, compassion and empathy, correction of misinformation, and transparency. This study describes how crisis actors used guiding principles in COVID-19 tweets, and how the use of these guiding principles relates to tweet engagement. Original, English language tweets from 10 federal level government, politician, and public health Twitter accounts were collected between 11 March 2020 and 25 January 2021 (n = 6053). A 60% random sample was taken (n = 3633), and the tweets were analyzed for guiding principles. A tweet engagement score was calculated for each tweet and logistic regression analyses were conducted to model the relationship between guiding principles and tweet engagement. Overall, the use of guiding principles was low and inconsistent. Tweets that were written with compassion and empathy, or conversational tone were associated with greater odds of having higher tweet engagement. Across all guiding principles, tweets from politicians and public health were associated with greater odds of having higher tweet engagement. Using a combination of guiding principles was associated with greater odds of having higher tweet engagement. Crisis actors should consistently use relevant guiding principles in crisis communication messages to improve message engagement.

Ultraviolet (UV) radiation from indoor tanning equipment is a known cause of skin cancer; however, little is known about how the availability of indoor tanning salons has been impacted by indoor tanning legislation, including Ontario's Skin Cancer Prevention Act: Tanning Beds (SCPA). Tanning salon listings were obtained from the 2001 to 2017 editions of InfoCanada's Ontario Business to Business Sales and Marketing directories. Using descriptive statistics and regression analysis, we assessed the number of tanning salons before and after: 1) the 2006 International Agency for Research on Cancer (IARC) report on indoor tanning and skin cancer; 2) the 2009 World Health Organization (WHO) reclassification of artificial UV radiation as carcinogenic; and 3) the passing and enactment of Ontario's SCPA in 2013 and 2014, respectively. There were fewer tanning salon listings in the years after vs. before the IARC report, the WHO reclassification, and the passing and enactment of the SCPA. The number of tanning salons in Ontario, Canada has been declining since 2006, which may reflect a decline in indoor tanning bed use. Key public health policy instruments, including legislation and public education, appear to be associated with this trend, suggesting they may contribute to deterring indoor tanning., Highlights • Number of tanning salons in Ontario, Canada decreased from 2006 to 2017. • Number of tanning salons declined after passing and enactment of indoor tanning legislation. • Number of tanning salons declined after international report and decision on carcinogenic nature of tanning devices. • Legislation, expert exhortation, and public education may contribute to declines in tanning salon availability.

Researchers conducted a study to observe the food safety behaviours of 454 vendors at 60 farmers’ markets across the Greater Toronto Area. -- Infographic of Young, I., Chung, A., McWhirter, J., & Papadopoulos, A. (2020). Observational assessment of food safety behaviours at farmers’ markets in Ontario, Canada: a cross-sectional study. Food Control, 108, 106875.

Overview: There has been an increase in the frequency and severity of stress experienced by Canadian post-secondary students, which has adverse implications on their academic success. This work applied the socio-ecological model for health promotion to explore the contextual factors that influence this relationship at the individual, interpersonal, institutional, community, and public policy levels. Methods: Using a qualitative, phenomenological approach, we conducted 38 semi-structured interviews with undergraduate students and on-campus staff who provide services to this population at a post-secondary institution in Southwestern Ontario, Canada. Thematic analysis inductively identified overarching themes among participants’ perspectives. Results: Several positive and negative factors were identified at each socio-ecological model level, demonstrating the complex interplay of demographic, psychological, emotional, social, physical, and academic factors impacting students’ academic stress. Conclusions: A lack of communication and knowledge seems to underlie many factors, highlighting the need to strengthen communication strategies to promote awareness, accessibility, and availability of services and programs on campus. Results also pointed to focusing on proactive, resilience-focused, upstream mental health promotion efforts at post-secondary institutions to reduce stress and improve academic success. This knowledge can help Canadian campuses better address students’ needs.

As critical components of individual well-being, nutrition and physical activity have important physical and psychological implications. Veterinary students face demanding schedules and potentially high rates of psychological distress. Though veterinary students’ strategies for healthy eating have been explored, factors influencing their ability to achieve a healthy diet are less understood. This study assesses incoming veterinary students’ perceived attitudes to their dietary habits and physical activity levels. Incoming students ( n = 322) at five Canadian and five randomly selected US veterinary schools completed a questionnaire inquiring about demographic information, dietary attitudes and habits, and activity levels. More than half (58%) of students perceived their diet to be moderately healthy. A desire to feel better and have more energy was the most reported (79%) motivating factor to modifying personal eating habits and was significantly associated with improved odds of having a perceived healthy diet ( OR = 2.22, p < .024). A busy lifestyle was perceived as a barrier to changing current eating habits by 92% of respondents. Students reporting a desire to maintain their health ( OR = 3.42, p < .001) and moderate ( OR = 2.81, p < .003) or high ( OR = 2.30, p < .044) routine physical activity levels were also more likely to perceive their diet as healthy. Findings show that incoming veterinary students’ perceptions may influence their goals of achieving a healthy lifestyle. An understanding of incoming veterinary students’ barriers and motivators could be applied in future research to assist students in achieving personalized goals.

Handwashing is one of the most effective and low-cost public health measures. However, it is often not practiced frequently enough or correctly by the public. Young adults in particular have poorer intentions to wash their hands, frequency of handwashing, and sanitizer use compared to other age groups. Therefore, there is a need to identify barriers and facilitators affecting hand hygiene within this group. The objective of this qualitative study was to apply the Theoretical Domains Framework to explore factors which influence hand hygiene among young adults aged 18 to 25 years old. An online questionnaire (n = 37) and thematic analysis were used to generate 3 overarching themes. The main findings indicated internal factors such as knowledge and intentions; interpersonal factors such as social norms; and environmental factors such as reminders, cues, accessibility, and cleanliness of handwashing facilities determined the level of hand hygiene practiced among young adults. The findings suggest that behavior change techniques such as social comparisons and tailored messaging to suit the needs of young adults may be more effective at increasing hand hygiene.

OBJECTIVES: To describe the effect of the first year of a ban on UV tanning device (beds, lamps) use among those under 18 years of age in Ontario, Canada. METHODS: Online questionnaires were completed by adolescents in grades 7 to 12, aged less than 18 years: one when the ban was enacted (May 2014) and a second a year later (May 2015). Questionnaires asked grade, age, sex, and about use of UV tanning devices in the previous year. Recent users were asked about length, frequency, and location of use; service refusals and reasons; awareness of signs/warning labels; and use of eye protection. Weighted estimates and confidence intervals were generated. RESULTS: There were 1561 participants in 2014 and 2305 in 2015. No reduction was observed in UV tanning device use (6.9% vs. 7.9%) in the 12 months preceding the survey. In 2015, most respondents used UV tanning devices in beauty establishments, which was a shift away from gyms and fitness centres as seen in 2014. Non-significant increases occurred in the proportions noticing warning signs/labels (57% vs. 71%), required to wear eye protection (92% vs. 99%), and refused service (17% vs. 21%). Most adolescents who were refused service did not use tanning devices that year (72%). CONCLUSION: Use did not change in the year following enactment of a ban on UV tanning devices among youth in Ontario. The ban did lead to improvements in service refusal, awareness of warning signage, and use of eye protection. As service refusal deterred future use, enhanced enforcement is important.

Rising COVID-19 cases in Canada in early 2021, coupled with pervasive mis- and disinformation, demonstrate the critical relationship between effective crisis communication, trust, and risk protective measure adherence by the public. Trust in crisis communication is affected by the communication’s characteristics including transparency, timeliness, empathy, and clarity, as well as the source and communication channels used. Crisis communication occurs in a rhetorical arena where various actors, including public health, news media, and the public, are co-producing and responding to messages. Rhetorical arenas must be monitored to assess the acceptance of messaging. The quality and content of Canadian public health and news media crisis communication on Facebook were evaluated to understand the use of key guiding principles of effective crisis communication, the focus of the communication, and subsequent public emotional response to included posts. Four hundred and thirty-eight posts and 26,774 anonymized comments were collected and analyzed. Overall, the guiding principles for effective crisis communication were inconsistently applied and combined. A limited combination of guiding principles, especially those that demonstrate trustworthiness, was likely driving the negative sentiment uncovered in the comments. Public health and news media should use the guiding principles consistently to increase positive sentiment and build trust among followers.

Canadian provincial and territorial governments have enacted legislation in response to health risks of artificial ultraviolet radiation from indoor tanning. This legislation, which differs from jurisdiction to jurisdiction, regulates the operation of indoor tanning facilities. The content and comprehensiveness of such legislation-and its differences across jurisdictions-have not been analyzed. To address this research gap, we conducted a systematic, comprehensive scan and content analysis on provincial and territorial indoor tanning legislation, including regulations and supplementary information.Legislative information was collected from the Canadian Legal Information Institute database and an environmental scan was conducted to locate supplementary information. Through a process informed by the content of the legislation, previous research and health authority recommendations, we developed a 59-variable codebook. Descriptive statistics were calculated.All provinces and one of three territories have legislation regulating indoor tanning. Areas of strength across jurisdictions are youth access restrictions (n = 11), posting of warning signs (n = 11), penalties (n = 11) and restrictions on advertising and marketing targeted to youth (n = 7). Few jurisdictions, however, cover areas such as protective eyewear (n = 4), unsupervised tanning (n = 4), provisions for inspection frequency (n = 4), misleading health claims in advertisements directed toward the general public (n = 2) and screening of high-risk clients (n = 0).All provinces and one territory have made progress in regulating the indoor tanning industry, particularly by prohibiting youth and using warning labels to communicate risk. Legislative gaps should be addressed in order to better protect Canadians from this avoidable skin cancer risk.Les gouvernements provinciaux et territoriaux du Canada ont adopté des lois en réponse aux risques pour la santé liés au rayonnement ultraviolet émis par les appareils de bronzage. Ces lois, variables d’une administration à l’autre, réglementent le fonctionnement des établissements de bronzage. Leur contenu et leur exhaustivité – et les variations entre administrations – n’ayant pas encore été analysés, nous avons procédé, pour combler cette lacune, à une analyse de contenu systématique et exhaustive des lois et règlements provinciaux et territoriaux sur le bronzage artificiel et nous avons examiné divers renseignements supplémentaires sur le sujet.Nous avons recueilli l’information sur les mesures législatives dans la base de données de l’Institut canadien d’information juridique et nous avons effectué une analyse de contexte pour obtenir des renseignements supplémentaires. En nous fondant sur le contenu des lois, sur les travaux de recherche antérieurs et sur les recommandations des autorités sanitaires, nous avons élaboré un guide de codage à 59 variables. Nous avons également calculé des statistiques descriptives.Toutes les provinces et l’un des trois territoires ont adopté des lois réglementant le bronzage artificiel. Les points forts observés dans ces administrations sont des restrictions d’accès pour les jeunes (dans 11 cas), l’affichage d’avertissements (dans 11 cas), des sanctions (dans 11 cas) et des restrictions sur la publicité et le marketing ciblant les jeunes (dans 7 cas). Cependant, peu d’administrations mentionnent le port de lunettes de protection (4), le bronzage sans surveillance (4), les dispositions relatives à la fréquence des inspections (4), les allégations trompeuses en matière de santé dans les publicités destinées au grand public (2) et le dépistage des clients présentant un risque élevé (0).Toutes les provinces et un territoire ont fait des progrès en réglementant l’industrie du bronzage artificiel, notamment en interdisant aux jeunes d’accéder à ces services et en imposant l’utilisation d’affiches pour avertir des risques. Il reste à combler les lacunes législatives afin de mieux protéger la population canadienne contre ce risque évitable de cancer de la peau.All Canadian provinces and one of three territories have enacted indoor tanning legislation. There was a strong emphasis in the legislation on restricting youth access to indoor tanning and advertising and marketing of indoor tanning services to youth. Other well-covered areas were presence of warning signs and indication of penalties for infractions. Areas that likely require stronger legislative action include risk information provided to clients, client protection with respect to areas such as eyewear and exposure dose and restrictions on advertising and marketing to the general public. Very few jurisdictions identified inspection frequency, which may have implications for compliance by indoor tanning businesses.Toutes les provinces et l’un des trois territoires du Canada ont adopté des lois sur le bronzage artificiel. Les lois sur le bronzage artificiel sont très axées sur la restriction de l’accès des jeunes à ces services ainsi que sur la publicité et le marketing destinés aux jeunes. Les mesures législatives en vigueur visent également l’affichage d’avertissements et des sanctions en cas d’infraction. Les domaines qui nécessitent probablement des mesures législatives plus rigoureuses sont l’information sur les risques fournie aux clients, la protection des clients, notamment en ce qui concerne les lunettes de protection et la dose d’exposition, ainsi que les restrictions sur la publicité et le marketing visant le grand public. Très peu d’administrations ont déterminé une fréquence d’inspection, ce qui peut avoir des répercussions sur la conformité aux lois de l’industrie du bronzage artificiel.

Farmers' markets are increasingly popular food venues in Canada. However, they have unique food safety challenges due to their operational characteristics. The purpose of this study was to evaluate the food safety behaviours of farmers' market vendors in the Greater Toronto Area of Ontario, Canada, to identify possible food safety risks and areas for future education and training. The food safety behaviours of vendors selling time-temperature control for safety (TCS) foods were observed throughout 2018 at 60 markets. Observations were conducted discretely and recorded on a standardized form via a smartphone. Data were descriptively analysed, and two selected outcomes were evaluated in multivariable logistic regression models. Prepared foods (50%) were the most commonly sold type of TCS food product among all observed vendors (n = 454). While general cleanliness and sanitation was very high, 27% of vendors did not provide cross-contamination protection methods for at least some of their TCS foods. Similarly, 66% and 48% of vendors who sold foods requiring cold and hot holding (n = 410 and 162, respectively) did not provide temperature control for at least some of their foods. Cold-holding temperature control was more commonly observed among vendors selling raw meat, poultry, and fish, and less commonly observed among those selling ready-to-eat meats; fresh-cut leafy green vegetables, tomatoes, and melons; and cheese and dairy products. A mean of 4.55 (SD = 2.62) behaviours requiring handwashing was observed per vendor across 1356 customer transactions, but only 2.9% of vendors attempted handwashing. Most vendors handled food with their bare hands on at least one occasion (79%); this behaviour was more commonly observed at weekend markets and among vendors engaged in multiple roles, and less commonly observed among vendors selling prepared foods. The study results have identified targeted areas for future food safety education and training with farmers’ markets vendors in Ontario.

Background Many jurisdictions have enacted indoor tanning legislation in response to the health risks of artificial ultraviolet (UV) radiation exposure. Key components of these legislations include banning minors’ access, requiring parental consent or accompaniment, providing protective eyewear, posting health warning signs, and communicating important health risk information. However, legislation must be complied with to be impactful. Evidence around compliance with indoor tanning legislations has not been synthesized and is an important step toward determining changes in practice due to legislation. Methods A systematic review was conducted to obtain peer-reviewed literature about compliance with indoor tanning legislation worldwide. Six databases were searched, resulting in 12,398 citations. Sixteen studies met the inclusion criteria (peer-reviewed scientific studies, published in English, focused primarily on compliance with indoor tanning legislations, and focused on commercial indoor tanning in indoor tanning facilities). Results Compliance with most aspects of indoor tanning legislation varied widely. There was good compliance for provision of protective eyewear (84 to 100%; mean = 92%; SD = 8). Compliance with age restrictions ranged from 0 to 100% (mean = 65%; SD = 25), while compliance with posting warning labels in the required locations within a tanning facility ranged from 8 to 72% (mean = 44%; SD = 27). Variation in compliance may be due to true differences, study methodology, or temporal trends. Conclusions Variability in compliance with indoor tanning legislation, as found in this systematic review, indicates the legislations may not be having their intended protective effects on the public’s health. The reasons for such low and varied compliance with certain aspects of legislation, and high compliance with other aspects of legislation, deserve further attention in future research to inform best practices around ensuring high and consistent compliance with indoor tanning legislations worldwide. Electronic supplementary material The online version of this article (10.1186/s12889-018-5994-4) contains supplementary material, which is available to authorized users.

OBJECTIVE: Skin cancer is a significant public health problem among Canadians. Knowledge and attitudes about health are informed by mass media. The aim of our study was to describe the volume and nature of coverage of skin cancer and recreational tanning in Canadian women’s magazines. METHODS: Directed content analysis on article text and images in six popular Canadian women’s magazines ( Chatelaine, Canadian Living, Homemakers, Flare, FASHION, ELLE Canada ) from 2000–2012 with attention to risk factors, ultraviolet radiation (UV) exposure and protection behaviours, and early detection. Six popular American women’s magazines were used for a between-country comparison. RESULTS: There were 154 articles (221 images) about skin cancer and tanning published over 13 years. Volume of coverage did not increase in a linear fashion over time. The most common risk factor reported on was UV exposure (39%), with other risk factors less frequently identified. Although 72% of articles promoted sunscreen use, little content encouraged other protection behaviours. Only 15% of articles and 1% of images discouraged indoor tanning, while 41% of articles and 53% of images promoted the tanned look as attractive. Few articles (

Mass media is an influential source of skin cancer and tanning information for the public, but we know little about its content or emphasis. The objective of this research was to describe the volume and nature of skin cancer and tanning messages in 20 popular U.S. men's and women's magazines (2000-2012). We used a directed content analysis to determine frequency information about risk factors and ultraviolet (UV) behaviors in 608 articles and 930 images. Chi-square and Fisher's exact tests determined coverage differences based on content type (text vs. image) and target audience (women vs. men). UV exposure was the most common risk factor mentioned (37.7 %) and sunscreen use the most common behavior encouraged (60.0 %); information about other risk factors and protective behaviors was uncommon. Both articles (25.2 %) and images (36.9 %) promoted the tanned look as attractive. In most cases, images infrequently contained helpful information on skin cancer risk factors and prevention, except for high-SPF sunscreens. Women's magazines published more articles on skin cancer and tanning than men's magazines (456 vs. 159, χ(2) = 143.43, P .01), and the nature of the messages differed between them. Magazine skin cancer and tanning content may contribute to inaccurate public understanding of risks and prevention. These findings are relevant to cancer educators, who may wish to counter potentially harmful messages and enhance positive ones through cancer education efforts.

A major challenge in global health is improving newborn and maternal health. A variety of economic, geopolitical, socio-cultural, and technical factors are involved. Online and mobile technologies hold the potential to improve maternal and newborn health by supporting access to education, improving coordinated care, and facilitating patient support. These online and mobile systems have been designed to address a variety of maternal and newborn health outcomes, including: increasing antenatal care attendance; cessation of unhealthy behaviors, such as smoking and drinking alcohol; and increasing vaccination rates of newborns. The success of these systems, however, is very much dependent on how—and whether—they can effect behavioral changes in culturally appropriate ways. This chapter reviews the design of these systems in both developed and developing countries, the technologies and behavioral frameworks used, and the evaluation outcomes. The acceptance of these new patient support networks requires the trust of patients and healthcare providers. Hence, this chapter also reviews the evolution of these systems, and the potential benefits of, and challenges for, their sustained operation.

The health belief model (HBM) has been widely used to inform health education, social marketing, and health communication campaigns. Although the HBM can explain and predict an individual's willingness to engage in positive health behaviors, its application to, and penetration of the underlying constructs into, mass media content has not been well characterized. We examined 574 articles and 905 images about skin cancer and tanning risks, behaviors, and screening from 20 U.S. women's and men's magazines (2000-2012) for the presence of HBM constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Susceptibility (48.1%) and severity (60.3%) information was common in text. Perceived benefits (36.4%) and barriers (41.5%) to prevention of skin cancer were fairly equally mentioned in articles. Self-efficacy (48.4%) focused on sunscreen use. There was little emphasis on HBM constructs related to early detection. Few explicit cues to action about skin cancer appeared in text (12.0%) or images (0.1%). HBM constructs were present to a significantly greater extent in text versus images (e.g., severity, 60.3% vs. 11.3%, respectively, χ(2) = 399.51, p < .0001; benefits prevention, 36.4% vs. 8.0%, respectively, χ(2) = 184.80, p < .0001), suggesting that readers are not visually messaged in ways that would effectively promote skin cancer prevention and early detection behaviors.

Visual images play an important role in educating the public about skin cancer prevention. The objectives of this systematic review were to: 1) determine how visual images are evaluated in skin cancer and tanning qualitative research studies (including theoretical and methodological approaches) and 2) summarize and discuss the image-related findings of the studies with respect to cancer education and public health. Seven databases were searched (PubMed-MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) using multiple search terms, including MeSH terms, resulting in 5330 citations. Studies were included if they were in English, peer-reviewed, qualitative in design or methodology, dealt with skin cancer or UV exposure, used visual images, and had a focus on the public or patients (i.e., not medical professionals). Eight studies met the inclusion criteria: seven content analyses and one focus group study. Content analysis studies in this review suggest the mass media portray Caucasian men and women as unprotected from the sun and with tanned skin, and thus, may inform behaviors related to skin cancer risk. The focus group study suggests visible minorities may benefit from the incorporation of images of melanoma on ethnic skin in cancer education materials. None of the studies used visual communication theory to explicitly guide the research, nor were standardized tools used for image assessment. The lack of guiding theory and standardized assessment instruments can introduce bias in how images are selected and used in research on skin cancer education.

The health and social conditions of First Nations, Inuit, and Metis peoples in Canada remain important policy concerns. The life course has been proposed by some as a framework for analysis that could assist in the development of policies that would improve the economic and social inclusion of Aboriginal peoples. In this paper we support the goal of applying a life-course perspective to policies related to Aboriginal peoples but suggest that the framework needs to consider the unique relationship between Aboriginal peoples and public policies. We provide some illustrations using data from the 2001 Aboriginal Peoples Survey.

Mothers, caregivers, and healthcare providers in 163 countries have used paper and electronic home-based records (HBRs) to facilitate primary care visit. These standardized records have the potential to empower women, improve the quality of care for mothers and children and reduce health inequities. This review examines experiences of women, caregivers and providers with home-based records for maternal and child health and seeks to explore the feasibility, acceptability, affordability and equity of these interventions. We systematically searched MEDLINE, MEDLINE In-Process, MEDLINE Ahead of Print, Embase, CINAHL, ERIC, and PsycINFO for articles that were published between January 1992 and December 2017. We used the CASP checklist to assess study quality, a framework analysis to support synthesis, and GRADE-CERQual to assess the confidence in the key findings. Of 7,904 citations, 19 studies met our inclusion criteria. In these studies, mothers, caregivers and children shared HBR experiences in relation to maternal and child health which facilitated the monitoring of immunisations and child growth and development. Participants’ reports of HBRs acting as a point of commonality between patient and provider offer an explanation for their perceptions of improved communication and patient-centered care, and enhanced engagement and empowerment during pregnancy and childcare. Healthcare providers and nurses reported that the home-based record increased their feeling of connection with their patients. Although there were concerns around electronic records and confidentiality, there were no specific concerns reported for paper records. Mothers and other caregivers see home based records as having a pivotal role in facilitating primary care visits and enhancing healthcare for their families. The records’ potential could be limited by users concerns over confidentiality of electronic home-based records, or shortcomings in their design. Health systems should seize the opportunity HBRs provide in empowering women, especially in the contexts of lower literacy levels and weak health care delivery systems.

RÉSUMÉLe vieillissement de la population des Indiens inscrits laisse croire que les conditions socioéconomiques et l'état de santé des aînés revêtiront une importance de plus en plus grande pour les collectivités et les responsables de l'élaboration des politiques. Nous avons adapté l'indice du développement humain du Programme des Nations Unies pour le développement à l'aide des données provenant du Recensement du Canada et du Registre des Indiens afin de voir si les améliorations observées au niveau des connaissances, du niveau de vie et de la santé de la population des Indiens inscrits entre 1981 et 2001 sont également observées au sein de la population des Indiens inscrits plus âgés. Nous constatons que les niveaux absolus de bien-être des Indiens inscrits plus âgés se sont améliorés, mais que les écarts avec les autres aînés canadiens se sont accentués, notamment en ce qui a trait au revenu et à l'espérance de vie des hommes.

The mass media is an influential source of skin cancer information for the public. In 2009, the World Health Organization’s International Agency for Research on Cancer classified UV radiation from tanning devices as carcinogenic. Our objective was to determine if media coverage of skin cancer and recreational tanning increased in volume or changed in nature after this classification. We conducted a directed content analysis on 29 North American popular magazines (2007–2012) to investigate the overall volume of articles on skin cancer and recreational tanning and, more specifically, the presence of skin cancer risk factors, UV behaviors, and early detection information in article text (n = 410) and images (n = 714). The volume of coverage on skin cancer and recreational tanning did not increase significantly after the 2009 classification of tanning beds as carcinogenic. Key-related messages, including that UV exposure is a risk factor for skin cancer and that indoor tanning should be avoided, were not reported more frequently after the classification, but the promotion of the tanned look as attractive was conveyed more often in images afterwards (p