Health Research In Canada Research Articles

Making the Case for Human Rights in Global Health Education, Research and Policy

If the 2010 CPHA conference is a bellwether of mainstream Canadian public and global health practice, its dearth of human rights papers suggests that, outside a small scholarly cohort, human rights remain marginal therein. This potential ‘rights gap’ conflicts with growing recognition of the relationship between health and human rights and ergo, the importance of human rights education for health professionals. This gap not only places Canadian health research outside the growing vanguard of academic research on health and human rights, but also ignores a potentially influential tool for achieving health equity. I suggest that human rights make a distinctive contribution to such efforts not replicated within other social justice and equity approaches, making human rights education a crucial complement to other ethical training. These contributions are evident in the normative specificity of the right to health in international law and its legally binding nature, in the success of litigation, the successful advocacy for AIDS treatment and the growing adoption of rights-based approaches to health. Canadian academic and research institutions should take up their rightful place within health and human rights research, education and practice globally, including by ramping up human rights-oriented education for health professionals within Canadian universities.

A Bibliometric Analysis of Digestive Health Research in Canada

Measurement of the impact and influence of medical⁄scientific journals, and of individual researchers has become more widely practiced in recent decades. This is driven, in part, by the increased availability of data regarding citations of research articles, and by increased competition for research funding. Digestive disease research has been identified as a particularly strong discipline in Canada. The authors collected quantitative data on the impact and influence of Canadian digestive health research. The present study involved an analysis of the research impact (Hirsch factor) and research influence (Influence factor) of 106 digestive health researchers in Canada. Rankings of the top 25 researchers on the basis of the two metrics were dominated by the larger research groups at the University of Toronto (Toronto, Ontario), McMaster University (Hamilton, Ontario), and the Universities of Calgary (Calgary, Alberta) and Alberta (Edmonton, Alberta), but with representation by other research groups at the Universities of Manitoba (Winnipeg, Manitoba), Western Ontario (London, Ontario) and McGill University (Montreal, Quebec). Female and male researchers had similar scores for the two metrics, as did basic scientists versus clinical investigators. Strategic recruitment, particularly of established investigators, can have a major impact on the ranking of research groups. Comparing these metrics over different time frames can provide insights into the vulnerabilities and strengths of research groups.

A Bibliometric Analysis of Digestive Health Research in Canada: “Fair Is Foul, and Foul is Fair”

A Bibliometric Analysis of Digestive Health Research in Canada: “<i>Fair Is Foul, and Foul is Fair</i>”

Why Are Some Books Important (and Others Not)?

The book Why Are Some People Healthy and Others Not? The Determinants of Health of Populations represented a milestone in our evolving understanding of the determinants of population health. Building on Marc Lalonde’s earlier A New Perspective on the Health of Canadians, it created a theoretical framework that could incorporate emerging evidence from a wide range of disciplines. Central to its authors’ approach was the observation of heterogeneity, of the systematic differences in health observed when populations are partitioned on characteristics such as income, education, geographic region, etc. The universal observation of a social gradient, of a strong correlation between socio-economic class and health, led to a focus on how the social environment might influence health. Social position strongly influences both the stresses to which individuals are subject, and the resources available to cope with them. Furthermore, healthy and unhealthy responses to stress become “embedded”, learned or conditioned both behaviourally and biologically, thus influencing health over the whole life course. The book’s impact has been remarkable, not merely in academic citations but through its authors’ subsequent work and strategic positions in Canadian health research organizations. The concept of “Population Health” has become part of our shared intellectual heritage.

Why are some books important (and others not)?

The book Why Are Some People Healthy and Others Not? The Determinants of Health of Populations represented a milestone in our evolving understanding of the determinants of population health. Building on Marc Lalonde's earlier A New Perspective on the Health of Canadians, it created a theoretical framework that could incorporate emerging evidence from a wide range of disciplines. Central to its authors' approach was the observation of heterogeneity, of the systematic differences in health observed when populations are partitioned on characteristics such as income, education, geographic region, etc. The universal observation of a social gradient, of a strong correlation between socio-economic class and health, led to a focus on how the social environment might influence health. Social position strongly influences both the stresses to which individuals are subject, and the resources available to cope with them. Furthermore, healthy and unhealthy responses to stress become "embedded", learned or conditioned both behaviourally and biologically, thus influencing health over the whole life course. The book's impact has been remarkable, not merely in academic citations but through its authors' subsequent work and strategic positions in Canadian health research organizations. The concept of "Population Health" has become part of our shared intellectual heritage.

Tough on Crime? Pfizer and the CIHR

The appointment of Dr. Bernard Prigent, vice-president and medical director of Pfizer Canada, to the Governing Council of the Canadian Institutes of Health Research, outraged many Canadian health researchers. Pfizer has been a "habitual offender," persistently engaging in illegal and corrupt marketing practices, bribing physicians and suppressing adverse trial results. Since 2002 the company and its subsidiaries have been assessed $3 billion in criminal convictions, civil penalties and jury awards. The $2.3-billion settlement in September 2009 - a month before Dr. Prigent's appointment - set a new record for both criminal fines and total penalties. A link with Pfizer might well advance the commercialization of Canadian research - unhindered by law or morality. Is that now the only mandate, Dr. Beaudet?

A New Approach to Health Research in Canada’s North

Over the past four years, despite low resource allocations to the North, northern residents and community organizations have taken significant initiatives towards the development of health research. In this commentary, we present a model for the development of northern health research based on our experiences in establishing the Institute for Circumpolar Health Research (ICHR) in the Northwest Territories. It is hoped that the lessons we have learned will inform decision-makers and encourage them to make strategic investments to support further health research capacity and institutional development within the North. Factors that have enabled the development of a health research institute in the North include leadership, a vision for health research, and the engagement of key partners and stakeholders. Challenges arise in the development of appropriate governance and policy for health research. There is an urgency to target resources to support the development of policies and governance for health research in northern jurisdictions. Both academic and community-based research need to be strengthened.

Six of the top achievements in Canadian health research

In October 2008, the Canadian Institutes of Health Research (CIHR) and CMAJ launched a competition to acknowledge top achievements in Canadian health research ([www.cihr-irsc.gc.ca/e/37888.html][1]). Essays by the winners of the top 2 ranked achievements are available at [www.cmaj.ca][2]. Following

Celebrating 8 projects that improved our world

In October 2008, the Canadian Institutes of Health Research (CIHR) and CMAJ launched a competition to acknowledge top achievements in Canadian health research. These achievements had to have had “a significant impact on health, health care, and health research by improving our understanding of

Income and Health in Canada: Canadian Researchers' Conceptualizations Make Policy Change Unlikely

The research reported here identified and evaluated gaps in Canadian knowledge and research activity concerning the role of income and its distribution in influencing health outcomes. The study consisted of an analysis of 241 recent Canadian research studies, the components of which were compared with 40 U.K. and 40 Finnish studies that applied advanced conceptualizations of the income-health relationship. Canadian health researchers rarely made explicit their conceptualizations of how income was approached in their studies, and most did not identify the structural mechanisms that mediate the income-health relationship. There were few Canadian longitudinal studies capable of illuminating the role of income in health across the lifespan. Many Canadian studies identified pathways by which income might influence health, but these conceptualizations were underdeveloped. Canadian researchers need to strengthen their conceptualizations of how income and its distribution affect health. While empirical research is only one contributor to positive policy change, the narrow nature of Canadian work will do little to influence this process. Interdisciplinary work on the political, economic, and social forces that contribute to income inequalities has the potential, when combined with political and social action, to facilitate public policy in support of health.

Media coverage of Canada's obesity epidemic: illustrating the subtleties of surveillance medicine

Obesity was once considered a lifestyle issue; recently it has become an ‘epidemic’. Media coverage presents an opportunity to explore this phenomenon. A framing analysis was conducted on obesity media coverage in one representative Canadian newspaper in 1996, 2000 and 2005/06. The analysis finds that by 2005, an obesity epidemic is unquestioned. However, it does not support others’ findings that obesity is attributed to the decline of western civilization and blamed on lazy individuals who overeat. To relate obesity to such factors flies in the face of capitalistic progress, which demands continued production and consumption. Obesity in Canadian media is presented almost as an opportunity: an obstacle impeding national progress, but one that with a great deal of collective, focused effort, can be overcome. Armstrong's ‘surveillance medicine’, where responsibility for one's health is internalized, focuses the discussion. In turn, the analysis builds on Armstrong's concept, illustrating that the downloading of responsibility to the citizen is not a one-way transfer. The state may benefit by shifting the responsibility for health to the individual, but there are benefits to reclaiming that responsibility at times. An epidemic provides an opportunity to strengthen national pride and enhance an increasingly significant Canadian health research enterprise, thereby stimulating the economy and positioning the country as a world leader. This does not suggest that calling obesity an epidemic serves no population health goals, but simply highlights that by creating a groundswell of concern that in turn justifies immediate action, it does much more.

Looking at Research Through a Different Lens: The Canadian Institute of Gender and Health

In 2001, a national research institute devoted to the study of inter-relationships among sex, gender, and health was created by the Canadian Institutes of Health Research (CIHR) as the first of its kind in the world. Established with a vision "to transform understanding of the impact of gender and sex on health across the lifespan and ensure its application in health research in Canada," the Institute of Gender and Health (IGH) supports research to address how sex (biological factors) and gender (sociocultural experiences) interact with other factors that influence health to create conditions and problems that are unique, more prevalent, more serious, or different with respect to risk factors or effective interventions for women, men, girls, and boys.

Members' of Parliament knowledge of and attitudes toward health research and funding

Establishment of the Canadian Institutes of Health Research (CIHR) in 2000 resulted in increased funding for health research in Canada. Since 2001, the number of proposals submitted to CIHR that, following peer review, are judged to be of scientific merit to warrant funding, has grown by 77%. But many of these proposals do not receive funding because of budget constraints. Given the role of Members of Parliament in setting government funding priorities, we surveyed Members of Parliament about their knowledge of and attitudes toward health research, health research funding and CIHR. All Members of Parliament were invited to participate, or to designate a senior aide to participate, in a 15-minute survey of knowledge of and attitudes toward health research, health research funding and CIHR. Interviews were conducted between July 15, 2006, and Dec. 20, 2006. Responses were analyzed by party affiliation, region and years of service as a Member of Parliament. A total of 101 of 308 Members of Parliament or their designated senior aides participated in the survey. Almost one-third of respondents were senior aides. Most of the respondents (84%) were aware of CIHR, but 32% knew nothing about its role. Participants believed that health research is a critical component of a strong health care system and that it is underfunded. Overall, 78% felt that the percentage of total government spending directed to health research funding was too low; 85% felt the same way about the percentage of government health care spending directed to health research. Fifty-four percent believed that the federal government should provide both funding and guidelines for health research, and 66% believed that the business sector should be the primary source of health research funding. Participants (57%) most frequently defined health research as study into cures or treatments of disease, and 22% of participants were aware that CIHR is the main federal government funding organization for health research. Participants perceived health research to be a low priority for Canadian voters (mean ranking 3.8/10, with 1 being unimportant and 10 being extremely important [SD 1.85]). Our results highlight significant knowledge gaps among Members of Parliament regarding health research. Many of these knowledge gaps will need to be addressed if health research is to become a priority.

Getting serious about Canadian health research

<h3>Background</h3> Patients with life-limiting illnesses should have opportunities to contribute to medical education so that professional learning is relevant to their needs and priorities. The potential contribution of children and parents using hospice services to medical education has not been fully explored. <h3>Aims</h3> 1. To explore perceptions of a ‘good doctor’ amongst children/parents using hospice services 2. To collaborate with children/parents and staff to develop materials for educating medical students about living with life-limiting illnesses 3. To assess feasibility of student-led action research projects in a children9s hospice <h3>Methods</h3> An INSPIRE Award from the Academy of Medical Sciences funded an undergraduate medical student to undertake this work with clinical and academic supervision. Prospective ethical approval was received. Children (n=7), parents (n=5), and staff (n=6) volunteers were recruited from a hospice to participate in audio-recorded semi-structured focus groups, individual interviews or activity workshops. Participants discussed what newly qualified doctors needed to know about caring for children with life-limiting conditions and what makes a ‘good doctor’. Data were transcribed for qualitative thematic analysis. Findings were refined by participant feedback. <h3>Results</h3> Key themes among participants included the importance of treating children as individuals, communicating honestly and sensitively, ensuring two-way dialogue between clinicians and families and actively listening to all involved in children9s care. Staff, parents and children in the hospice were willing and able to make valuable contributions to undergraduate medical education by sharing their knowledge and experiences. This paper will present methodological insights, thematic findings, and educational materials (for undergraduate medical students and service development) created from the project. <h3>Conclusions</h3> Parents, children and staff in hospices are willing to participate in action research. This project provided the student researcher with transferable qualitative research skills. Further work is required to fully explore and understand opportunities for collaboration between children9s hospices and medical schools.

Place and Health Research in Canada

Place and Health Research in Canada

Industrial health research in Canada

[The author responds:] Yves Morin's comments in response to my CMAJ article[1][1] are true and not true. We control pharmaceutical prices, but do we do so adequately? We control the content of advertising, but certainly not the promotion of brand names. In any event, I was writing about the problem

Industrial health research in Canada

In his commentary on the pharmaceutical industry, Henry Mintzberg recommends several measures that are already in place in Canada.[1][1] He recommends firmer regulation of pricing, but Canada is unique in that it has 2 levels of price control, at the federal and provincial levels. He also recommends

The development of the Canadian Rural Health Research Society: creating capacity through connection

The organization of rural health research in Canada has been a recent development. Over the past 8 years, rural and remote researchers from more than 15 universities and agencies across Canada have engaged in a process of research capacity building through the development of a network, the Canadian Rural Health Research Society (CRHRS) among the scientifically and geographically diverse researchers and their community partners. The purpose of this article is to discuss the development of the CRHRS as well as the challenges and lessons learned about creating networks and building capacity among rural and remote health researchers. Key elements of network development have included identifying and developing multidisciplinary research groupings, maintaining ongoing connections among researchers, and promoting the sharing of expertise and resources for research training. The focus has been on supporting research excellence among networks of researchers in smaller centres. Activities include a national annual scientific meeting, the informal formation of several regional and national research networks in specific areas, and the development of training opportunities. Challenges have included the issues of sustaining communication, addressing a range of networking and capacity-enhancement needs, cooperating in an environment that rewards competition, obtaining resources to support a secretariat and research activities, and balancing the demands to foster research excellence with the needs to create infrastructure and advocate for adequate research funding. The CRHRS has learned how to begin to support researchers with diverse interests and needs across sectors and wide geographical areas, specifically by: (1) focusing on research development through creating and supporting trusting connections among researchers; (2) building the science first, followed by infrastructure development; (3) making individual researchers the nodes in the network; (4) being inclusive by accommodating a wide variety of researchers and researcher strengths; (5) emphasizing social exchange, knowledge exchange, and mentoring in annual scientific meetings; (6) taking opportunities to develop separate projects while finding ways to link them; (7) finding a balance between advancing the science and advocating for adequate funding and appropriate peer review; (8) developing a network organizational structure that is both stable and flexible; and (9) maintaining sustained visionary leadership.

Health science research in Hungary

We read with great interest the paper by Judith Hall and associates on interdisciplinary health research in Canada.[1][1] In the 1990s, Canada contributed significantly to the development of education and research in the health sciences in Hungary after the social and political changes that occurred

Editorial: Advancing the Mexico agenda for health systems research – from clinical efficacy to population health

1 Netherlands Society for Tropical Medicine and International Health (NVTG), Wageningen, The Netherlands 1 2 Institute for Medical Technology Assessment, ErasmusMC, Rotterdam, The Netherlands 3 Department of Public Health, University Medical Centre Nijmegen, Nijmegen, The Netherlands 4 ETC Crystal, Leusden, The Netherlands 5 Institute of Health Policy and Management, ErasmusMC, Rotterdam, The Netherlands