Knowledge translation in health research: A novel approach to health sciences education

The salient role of knowledge translation process, by which knowledge is put into practice, is increasingly recognized by various research stakeholders. However, medical schools are slow in providing medical students and health professionals engaged in research with the sufficient opportunities to examine more closely the facilitators and barriers to utilization of research evidence in policymaking and implementation, or the effectiveness of their research communication strategies. Memorial University of Newfoundland now offers a knowledge translation course that equips students of community health and applied health research with the knowledge and skills necessary for conducting research, that responds more closely to the needs of their communities, and for improving the utilization of their research by a variety of research consumers. This case study illustrates how the positive research outcomes resulted from implementing the knowledge translation strategies learned in the course. Knowledge translation can be useful also in attracting more funding and support from research agencies, industry, government agencies and the public. These reasons offer a compelling rationale for the standard inclusion of knowledge translation courses in health sciences education

"Disease breeders among us" Canadian press coverage of immigrant tuberculosis : a critical discourse analysis

Since 1987 the highest proportion of tuberculosis (TB) in Canada is associated with immigrants. This high burden is typically linked in the public health literature to country of birth, low education, and various barriers to primary care. The role of poverty and material deprivation in the etiology of immigrant TB is understated. Racializing TB and its carriers highlights the dual focus of TB control: guarding the health of the nation at the borders by excluding the sick and by monitoring of those immigrants already in the country. By neglecting social determinants of immigrant TB and reasons for their unequal distribution, the current TB control policies perpetuate the high burden of TB in the immigrant population. -- The racializing character of these policies is grounded in discourse about "inherently inferior and diseased" immigrants' bodies, which was central to the development of TB control in Canada at the beginning of twentieth century. In this work I critically examine the discourses about immigrant TB that were (re)produced by the Canadian press. I look at the relationship between the (re)produced discourses and the current TB control policies, and also at the historical, political and socio-cultural context in which particular newspaper discourses were rooted and reproduced. In this work, I demonstrate that the racializing discourse continues to be (re)produced by the Canadian press. In this way, the Canadian press reinforces the racializing character of current immigrant TB control. In this work, I call for the implementation of TB control policies which would address social determinants of immigrant TB and for fair and balanced reporting on immigrants' health affairs

Mental health of St. John's immigrants: concepts, determinants and barriers

"Canada is in one respect like the kingdom of Heaven: those who come at the eleventh hour will receive the same treatment as those who have been in the field tor a long time. We want to share with them our lands, our laws, our civilization... Let them take their share in the life of this country... Let them be electors as well as citizens. We do not want or wish that any individual should forget the land of his origin. Let them look to the past but let them still more look to the future. Let them look to the land of their ancestors, but let them look also to the land of their children. Let them become Canadians ..." Sir Wilfrid Laurier, 1905. -- Immigration-related difficulties and excessive social stress are the reasons for immigrants' vulnerability toward developing mental illness. In addition, immigrants experience numerous organizational, communication and financial harriers to utilizing mental health services. Very little is known about the mental health concerns of immigrants in St. John's, where both ethnospecific infrastructure and cultural diversity is very limited. For this reason, this qualitative inquiry examines, through the personal experiences and perspectives of eight St. John's immigrants, their concepts and determinants of mental health, as well as the barriers to their utilizing mental health services. In addition, this inquiry evaluates how the local mental health promotion programs and healthcare services address immigrants' mental health needs. The goal of this study is to increase the understanding of mental health providers and policy makers about the determinants of immigrants' mental health, which can then inform the development of accessible and appropriate support mechanisms tailored to the mental health needs of the St. John's immigrant population. -- The findings that emerged from a thematic analysis of the semi-structured, open-ended interviews conducted show that St. John's immigrants understand mental health in broad holistic terms and do not see any clear-cut boundaries between mental health and illness. Moving to Canada challenges immigrants' stereotypes about mental illness, but also exposes them to the ideology of medicalization, according to which the reason for their mental unwellness lies in defective biological processes rather than in faulty sociopolitical structures. There are several key determinants that shape immigrants· mental well-being: the lack of social support, resources and information, financial difficulties, and unemployment. Furthermore, their cultural identities are often not appreciated or understood. These factors contribute to immigrants' stress, and their feelings of loneliness and isolation. As a result, some suffer from depression and seek professional medical attention. However, the mental health promotion programs and services only reflect immigrants' mental health needs and concerns to a very small extent and have a limited ability to address immigrants' vulnerability to developing mental illness. In addition, immigrants encounter several barriers to utilizing these services: for instance, lack of information, culture, language, waiting times, and finances. -- This study supports previous research calling for major changes across different levels of health care, social, economic and political systems. In order to improve the mental well-being and integration of St. John's immigrants, several suggestions arc proposed to health and social services providers so as to address the lack of support, information and resources for immigrants, as well as unemployment, cultural conflicts and the barriers to utilizing mental health services that immigrants experience

Aboriginal Women and the Canadian Criminal Justice System: Examining the Aboriginal Justice Strategy through the Lens of Structural Social Work

The purpose of this policy review was to critically examine the Aboriginal Justice Strategy (AJS), which is a federal governmental program founded in 1991 to combat the problem of high rates of criminality in the Aboriginal population in Canada. Considering the high recidivism rates of AJS program participants, we suggest the AJS is not as effective in achieving its objectives. Looking at this strategy through a lens of structural social work, we found that it is inattentive to the impact of structural factors on criminality in some Aboriginal communities, groups, and individuals. Also, the strategy does not take into consideration gender-based factors that influence the interaction of Aboriginal men and women with the criminal justice system, which is profoundly different. Moreover, the strategy is inattentive to the five pathways that often bring Aboriginal women into contact with the criminal justice system - poverty, violence, sex trade, mental illness, and addiction. These pathways are inherently linked to the primary structures of colonialism, racism, and sexism, which continue to oppress Aboriginal women in Canada. For these reasons, we proposed that gender-based analysis would be useful for an improved understanding of these pathways. We also provided several recommendations for lowering the rates of crime committed by Aboriginal women, which include, state supported economic investments for community development, job creation, education attainment, and employability skills as well as policies against homelessness and supports for trauma, addictions, and mental health issues

The need for gender-based analysis in health research of tuberculosis in Canada: The case of (in)visible minority foreign-born women

Sex and gender play a critical role in distinct experiences of health and illness between women and men. To highlight health differences and reduce health inequities between sexes and genders, researchers make use of sex- disaggregated data. However, these data are insufficient to comprehensively explain and address health inequities between sexes and genders. Therefore, the inclusion of gender analysis in health research is essential. In this article we exemplify the need for engendering health research that includes and moves beyond the analysis of sex-disaggregated data on tuberculosis in Canada. We show that these data are insufficient to explain the unequal distribution of tuberculosis among women and men from different Canadian populations. The absence of gender-based data masks important experiences of tuberculosis among some groups of visible minority foreign-born women making them thus invisible in the current policies designed to control TB in Canada. Gender analysis in health research of tuberculosis is central for an improved understanding of the gendered context of the disease and development of more effective gender- responsive health policies