Introduction: La justice sociale, l’empathie et la responsabilité sociale sont des thèmes émergents en médecine dentaire. Plusieurs facultés de médecine dentaire ont commencé à incorporer ces concepts dans leur curriculum, mais nos connaissances sur l’efficacité de ces initiatives sont limitées. L’objectif de cette étude était de comprendre comment les étudiants et enseignants perçoivent l’enseignement de la justice sociale en médecine dentaire au premier cycle. Méthodes : Nous avons effectué une recherche qualitative en utilisant des entretiens semi- dirigés avec des étudiants, professeurs et cliniciens de la Faculté de médecine dentaire de l’Université de Montréal. Nous avons recruté 18 participants en utilisant un échantillonnage déterministe jusqu’à saturation. Les entrevues ont été enregistrées et retranscrites intégralement. Elles ont ensuite été codées avec le logiciel QDA Miner 5.0 (Provalis 2016). Une analyse thématique a été entreprise pour dégager les thèmes émergents en utilisant une méthodologie qualitative. Résultats : Cinq thèmes ont émergé des résultats. Certains étudiants étaient plus enclins à s’intéresser à la justice sociale et à participer aux activités communautaires facultatives. L’enseignement actuel comporte des lacunes incluant un manque d’exposition à certains plans de traitements alternatifs. Certaines barrières à l’enseignement ont été identifiées, le plus important étant un manque de temps dans le curriculum. L’enseignement souhaité de la justice sociale inclurait une prise de conscience accrue et une participation active des étudiants, une prise de responsabilité pour motiver l’action et produire un changement. L’application de la justice sociale en médecine dentaire se traduit par des soins accessibles et adaptés au patient. Conclusion: Les résultats de cette étude fournissent des pistes de réflexion pour le développement d’un curriculum de justice sociale qui pourra être évalué et validé, dans le but de former des dentistes socialement compétents qui prodigueront des soins axés sur le patient. / Introduction : Social justice, empathy and social responsibility are emerging themes in dentistry. Many dental faculties have started incorporating these concepts in their curriculum, but our knowledge of the effectiveness of these initiatives is limited. The objective of this study was to understand how students and educators perceive social justice education in the undergraduate dentistry program. Methods : We performed qualitative research using semi-structured interviews with students, professors and clinical faculty at the Université de Montréal dental school. We recruited 18 participants using purposeful sampling until saturation. The interviews were recorded and transcribed integrally. They were coded using QDA Miner 5.0 (Provalis 2016). Thematic analysis was undertaken to elucidate emerging themes using qualitative methodology. Results : Five themes emerged from the results. Certain students were more inclined to be interested in social justice and participate in voluntary community-based activities. There were gaps in current teaching methods including a lack of exposure to certain alternative treatment plans. Some barriers to teaching were identified, the most important being a lack of time. Desired teaching of social justice would include increased awareness and active student participation, and taking responsibility to motivate action to produce social change. The application of social justice in dentistry involves accessible and adapted care for patients. Conclusion : The results of this study provide insight for the development of a social justice education curriculum in dentistry that can be evaluated and validated in order to form socially competent dentists who can provide patient-centered care to the community.

<p>  </p> <p>Food insecurity describes the lack of access to foods and affects 10.2% of general U.S. households and 27% of low-income households in 2021. Food insecurity is a pervasive public health concern in the United States and has been linked to poor dietary intake and diet quality, overweight and obesity (especially among women), and risk of other chronic diseases, such as diabetes, hypertension and dyslipidemia. </p> <p>To better understand food security status and address its associated health and dietary outcomes among low-income populations, a conceptualized model was built and served as research framework for the dissertation, including 1) internal factors and motivations, such as traits related to self-efficacy and sufficiency that may influence diet and health; 2) external factors of temporary support, such as financial benefits from assistance programs that low-income populations are eligible for that may influence diet and health; and 3) external factors of potentially long-term support, such as nutrition education programs targeting low-income groups that may foster internalized knowledge that could sustain impact and improvement of diet and health in the long-term. Each chapter of this dissertation addresses a component of the model.</p> <p>Cross-sectional analysis of a sample of rural veterans using food pantries quantified psychological traits related to self-motivation and efficacy including grit and help seeking, at the individual and internal factors level of the conceptualized model, and their links to food security and resource use, and revealed an inverse association between grit score and risk of food insecurity. The findings provided evidence for future interventions targeting food insecurity improvement to include education and resources that address traits related to self-efficacy, such as grit, among low-income populations to improve health outcomes directly or through improving food security or use of resources. </p> <p>Using nationally representative data, the second study investigated relationships between food assistance through the Supplemental Nutrition Assistance Program (SNAP) participation, a type of societal level external support, and dietary outcomes among low-income older U.S. adults. There were no differences in dietary quality, usual nutrient intake or risk of inadequacy between SNAP participants and eligible nonparticipants. Furthermore, results revealed a high prevalence of not meeting the Estimated Average Requirement from dietary sources for several nutrients (vitamins A, C, D, E, calcium, and magnesium) but the prevalence was lower when nutrients from dietary supplements were included. The results highlight a need for continued effort to improve nutrient and dietary intake among low-income older adults.</p> <p>External factors of potentially long-term support (e.g. nutrition education and food assistance) were evaluated for relationships with body mass index. A longitudinal sample of low-income women interested in participating in nutrition education through SNAP-Education (SNAP-Ed) was examined to determine the relationship between nutrition education (SNAP-Ed) and food assistance program participation through (SNAP, WIC), separately and in combination, with long-term changes in body mass index. No differences in changes of weight status over time were observed by nutrition education, food assistance, or combination participation. The prevalence of obesity was high among this sample, calling for targeted obesity prevention interventions and further support of healthy lifestyle promotion among low-income populations. </p> <p>The findings shown in this dissertation further reveal a high health burden among low-income groups. The studies filled several research gaps described in the conceptualized model. The results may be used to inform future tailored interventions to address food insecurity, dietary and health outcomes at individual and societal levels, incorporating internal motivation and external support to mediate health and dietary risks among low-income population.</p>

<p dir="ltr">Digital Health technologies have revolutionized healthcare delivery, offering innovative solutions that enhance access, improve patient outcomes, and optimize the use of resources. Despite this advancement, health outcomes remain disparate across different social groups, with underprivileged populations at an increased risk of poor health outcomes due to inadequate access to care. Digital Health technologies serve as a critical intervention in mitigating these disparities, particularly for groups affected by geographical, economic, and infrastructural barriers.<br><br>The purpose of this study was to conduct a review of the current state of Digital Health technologies, including Software as a Medical Device (SaMD), Wearable Health, Portable Diagnostic Devices, and remote care platforms, and their impact on healthcare accessibility. Employing qualitative methodology, this metasynthesis emphasized an important discovery: the need for a paradigm shift among stakeholders in healthcare towards integrated and digitally-driven patient care. This shift requires more than just an understanding of new technologies. It demands a fundamental re-evaluation of patient care methods and the orchestration of the entire healthcare system towards integrated digital practices. Importantly, this study found that the pace of digitalization must be carefully managed and cultural factors must be considered and signals the urgency for a balanced approach to digital integration in healthcare.</p>

This thesis examines how cultural competency operates as a regime of governmentality. Inspired by Foucauldian genealogy, institutional ethnography, and Said’s concept of contrapuntality, this thesis problematizes the seamless production of racialized bodies in relation to mental disorder. I begin by elaborating a theoretical framework for interpreting race and madness as mutually constructed ordering practices. I then analyze what cultural competence produces and sustains in a position paper published by the Ontario Federation of Community Mental Health and Addiction Programs. I argue the Federation dismisses ongoing institutional violence—suggesting it is simply the perception, as opposed to the everyday reality, of discrimination that causes problems such as low educational attainment among youth of colour. To further support this claim, I deconstruct narratives of low self-esteem, maladaptive coping, depression, and denial of mental illness in the community needs assessments of two of the Federation’s member organizations: Hong Fook and Across Boundaries.

This thesis examines how cultural competency operates as a regime of governmentality. Inspired by Foucauldian genealogy, institutional ethnography, and Said’s concept of contrapuntality, this thesis problematizes the seamless production of racialized bodies in relation to mental disorder. I begin by elaborating a theoretical framework for interpreting race and madness as mutually constructed ordering practices. I then analyze what cultural competence produces and sustains in a position paper published by the Ontario Federation of Community Mental Health and Addiction Programs. I argue the Federation dismisses ongoing institutional violence—suggesting it is simply the perception, as opposed to the everyday reality, of discrimination that causes problems such as low educational attainment among youth of colour. To further support this claim, I deconstruct narratives of low self-esteem, maladaptive coping, depression, and denial of mental illness in the community needs assessments of two of the Federation’s member organizations: Hong Fook and Across Boundaries.

Made available in DSpace on 2011-05-04T12:36:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / Trata-se do estudo do caso do Estado do Rio de Janeiro, no período compreendido entre 2003 e 2006. Analisa o papel da instância estadual na distribuição geográfica (municipal e regional) dos recursos financeiros para o financiamento do Sistema Único de Saúde e propõe-se contribuir para a operacionalização de formas mais justas de alocação dos recursos. O estudo empírico, de natureza quantitativa, analisou as receitas públicas realizadas pelos municípios do estado RJ e as despesas liquidadas pelo Estado RJ durante o mesmo período. A análise constou de três momentos. Primeiro: evolução das condições de financiamento em saúde do governo estadual e do conjunto dos municípios do Estado do Rio de Janeiro. Segundo: possibilidade de interferência do governo estadual na capacidade de gasto dos municípios do Estado RJ. Terceiro: alocação equitativa de recursos segundo critérios de necessidades de saúde. As distintas fontes de receitas foram agrupadas de modo a conferir certa racionalidade na compreensão de como se estrutura o financiamento do SUS considerando a lógica federativa que preside ao sistema de partilha de recursos no caso geral do Brasil e, especificamente, no caso do Estado RJ. O estudo foi norteado pela concepção de equidade operacionalizada através da definição de igualdade de oportunidades de Sen (2008), além da definição de igualdade de condições, da tipologia de Turner (1986). Observou-se que os critérios de alocação entre as esferas federativas não foram suficientes para garantir a equidade. Os municípios, tanto quanto as regiões de saúde, apresentam condições de financiamento bastante díspares, relacionadas às características do desenvolvimento regional, à importância de determinadas fontes de recursos em detrimento de outras, às condições de elegibilidade para o recebimento de transferências constitucionais e legais, à capacidade fiscal e a outras condições. A principal fonte de financiamento da saúde no Estado RJ é a receita própria municipal. As transferências federais para a Atenção Básica não modificam essa disparidade inter-regional. As transferências federais para a média e alta complexidade favorecem os municípios com maior capacidade instalada, consolidando as desigualdades existentes. Os recursos estaduais transferidos aos municípios não alteram as características das desigualdades no financiamento da saúde. / This is the case study of Rio de Janeiro, in the period between 2003 and 2006. Examines the role of the instance state in the geographical distribution (municipal and regional) financial resources for financing the Health System and aims to contribute to the operation of more equitable allocation of resources. The empirical, quantitative, reviewed the revenue made by municipalities in RJ and RJ expenses paid by the State during the same period.The analysis consisted of three stages. First, changing conditions in health funding from the state government and all the municipalities of Rio de Janeiro. Second, the possibility of government interference in state spending capacity of municipalities in the state RJ. Third, equitable allocation of resources according to criteria of health needs. The different sources of revenue were grouped so as to give some rationality in the understanding of how to structure the financing of SUS considering the logic which governs the federal system of resource sharing in the general case of Brazil and, specifically, in the case of RJ State.The study was guided by the concept of equality operationalized through the establishment of equal opportunities Sen (2008), beyond the definition of equal conditions of the typology of Turner (1986). It was observed that the criteria for allocation between the federal spheres were not sufficient to ensure equality. The municipalities, as far as health regions, have conditions of very disparate funding related to the characteristics of regional development, the importance of certain sources of funds over others, the eligibility criteria for receiving legal and constitutional transfers, the fiscal capacity and other conditions.The main source of health financing in the State's own revenues RJ municipalities. Federal transfers for Primary Health Care not alter the interregional disparity. Federal transfers to the medium and high complexity favor the municipalities with greater capacity, reinforcing existing inequalities. The state funds transferred to municipalities do not alter the characteristics of inequalities in health financing.