Steven Dukeshire

Chronic conditions and disabilities among seniors: an analysis of population-based health and activity limitation surveys.

PURPOSE To describe the prevalence of disabilities and the medical conditions and risk factors associated with mobility and agility disabilities among seniors. METHODS In the 1986 and 1991 Canadian Census, every fifth person answered a screening question about activity limitation and disabilities. A probability sample of both those reporting and not reporting disability was selected to complete the Health and Activity Limitations Surveys (HALS) in 1986 and 1991. These two cross-sectional surveys conducted five years apart collected detailed activity limitation information about persons over 15 years of age. The current analysis was based on only respondents aged 65 years and older. The sample size for 65 years and older was 38518 in 1986 and 5106 in 1991. A computer link with the Census data provided household income and additional socio-demographic data for all respondents. RESULTS Over 40% of Canadian seniors reported at least one disability, and approximately a quarter of disabled seniors were classified as severely disabled. Mobility and agility disabilities accounted for over 80% of all disabilities reported by seniors, and senior women were more likely than men to report having a mobility or agility disability. Arthritis/rheumatism was reported as the cause of over 30% of all mobility and agility disabilities. CONCLUSIONS The continued monitoring of disabilities through surveys such as HALS will help determine the prevalence as well as aid in the identification of the causes of disabilities. Such information may be used to guide the implementation of appropriate public health interventions that will meet the changing health care needs of seniors.

Diet and anxiety. An exploration into the Orthorexic Society

The modern food system has radically modified the social-anthropological framework that informs food choices. To explore factors that influence food choices within this modified framework, eight focus groups consisting of women 15-45 years old were conducted in Nova Scotia (Canada). Using a grounded theory approach, two main themes emerged centered around (1) perceptions of a changing culinary order that emphasizes individual dietary responsibility and decision making and (2) the confusion/anxiety experienced as participants try to assimilate the information generated by todays modern food system. Participants inextricably linked food and health to the point where it was the central organizing determinant guiding their food selection. They also felt the need to make informed dietary choices, but perceived their search for a healthy diet to be thwarted by the amount, type, and accuracy of information concerning the elements in todays food products. A constant search for accurate information and the instability of what participants consider expert advice contribute to feelings of anxiety around food choices and a sense of futility in their efforts to navigate through the information available. The focus group discussions reflected the emergence of an Orthorexic Society, whereby individuals are socialized to take charge of their own dietary health. They do so constrained by a food system that is increasingly complex, contradictory, and opaque and where commercial dietary regimes offer quick yet incomplete solutions.

Prevalence, Risk Factors and Self-Reported Medical Causes of Seeing and Hearing-Related Disabilities Among Older Adults

The prevalence, risk factors, and medical conditions associated with seeing and hearing disabilities were examined among Canadian adults aged 55 years and older. A probability sample of respondents from the 1986 and 1991 Canadian Census were selected to complete the 1986 and 1991 Health and Activity Limitations Survey (HALS). Seniors, 65 years and older, were more likely than 55–64 year olds to experience a sensory disability. Men were more likely than women to report having hearing disabilities, while women were more likely to report seeing disabilities than men. Increased age and lower total household incomes were associated with a greater likelihood of having a sensory disability. Cataracts and deafness were reported most often as the cause of seeing and hearing ADL restrictions in both age groups. Sensory disabilities are prevalent conditions among older adults. Public health initiatives should focus on hearing and seeing disabilities particularly among seniors, women, and the lower income level population.

Canadians' perceptions of food, diet, and health--a national survey.

Background Poor nutrition is harmful to one’s health as it can lead to overweight and obesity and a number of chronic diseases. Understanding consumer perceptions toward diet and nutrition is critical to advancing nutrition-related population health interventions to address such issues. The purpose of this paper was to examine Canadians’ perceived health and diet status, compared to their actual health status, and general concern about their own diet and beliefs about health. Also analyzed were some of the perceived barriers to eating “healthy” foods, with a focus on the availability of “healthy” processed foods. Methods Two surveys were administered online to a group of Canadian panelists from all ten provinces during May 2010 to January 2011. Thirty thousand were invited; 6,665 completed the baseline survey and 5,494 completed the second survey. Panelists were selected to be nationally representative of the Canadian adult population by age, sex, province and education level, according to 2006 census data. Results Approximately one third of Canadians perceived their health or diet to be very good while very few Canadians perceived their health or diet to be very poor. While the majority of Canadians believed food and nutrition to be very important for improving one’s health, fewer Canadians were concerned about their own diets. The majority of Canadians reported difficulty finding “healthy” processed foods (low in salt and sugar and with sufficient vitamins and minerals). Many also reported difficulty finding healthy foods that are affordable. Conclusion Although consumers believe that nutrition is one of the most important factors for maintaining health, there are still a number of attitudinal and perceived environmental barriers to healthy eating.

Development and evaluation of a web site to improve recovery from hysterectomy.

Following surgery, information received upon discharge for recovery at home varies depending on the hospital, and the information is typically given to the patient all at once rather than timed to the recovery process. To address these information challenges, a Web site to help women recovering at home after hysterectomy was developed and evaluated. The Web site was designed to guide the hysterectomy patient through her postsurgical recovery by providing timely and relevant information tailored to the patient’s stage of recovery. The Web site required patients to complete a checkup assessing 18 symptoms related to their recovery, and advice was given on how to deal with any symptom the patient had. The Web site also provided care tips specific to the patient’s day of recovery along with general information regarding hysterectomy and recovery. Thirty-one women participated in the evaluation, which consisted of preoperative and postoperative surveys as well as a telephone interview. Results indicated that patients frequently used and were highly satisfied with the Web site. Patients reported that the Web site was easy to use and informative, helped to guide their recovery, reduced worry and anxiety, and helped to inform decisions of when and how to contact health professionals. Based on the findings, the Web site represents a potentially cost-effective means to aid women recovering from hysterectomy.

Satisfaction/dissatisfaction and choice tactic refinement for potatoes

Purpose – The North American fresh potato market has been in decline for over ten years, yet little consumer research has penetrated beyond the factors influencing the purchase decision. The purpose of this study is to provide a deeper understanding of the purchase decision for the fresh potato by exploring the linkages between the choice tactics employed in the store, post‐purchase evaluations in the home and the value orientations motivating consumption.Design/methodology/approach – For this study, semi‐structured focus groups were conducted and analyzed using framework analysis.Findings – This study presents a choice tactic formation and refinement model for the fresh potato that illustrates a feedback process between in‐home evaluations of the fresh potato and the four choice tactics employed at the point of purchase (potato size, color, shape and size uniformity). Each evaluative outcome related back to one of three value orientations (taste, health and lifestyle). Only two of the value orientations ...

Understanding consumer choices for Ontario produce

Research has demonstrated growing public interest in local food and that this interest is driven by a number of factors including supporting local farmers, reducing the distance food travels, sustaining the environment, and food safety and quality. However, there has been very little research relating factors to actual purchase behavior. This study begins to fill that gap by relating consumer beliefs and values toward local foods with activities that support local foods as well as the actual purchase behavior for 22 fresh produce items. Data were collected through an Ontario-wide, web-based survey that is part of a longitudinal panel regarding food issues. Results from 1879 completed surveys indicated consumers had positive perceptions of local food and felt responsible for buying local, but also experienced barriers when trying to do so. Positive perceptions toward local food and a greater sense of personal responsibility to buy local were positively associated and higher barriers negatively associated with the likelihood of engaging in activities related to supporting local food as well as buying fresh produce items that were produced in Ontario. Implications of these findings are discussed in the context that consumers seem to have an overall orientation or schema to buying local in general, rather than a highly specific schema directed to one or a few particular products.

Diagnosis of adverse events after hysterectomy with postoperative self-care web applications: A pilot study:

Increased pressures from multiple sources are leading to earlier patient discharge following surgery. Our objective was to test the feasibility of self-care web applications to inform women if, when, and where to seek help for symptoms after hysterectomy. We asked 31 women recovering at home after hysterectomy at two centers to sign into a website on a schedule. For each session, the website informed them about normal postoperative symptoms and prompted them to complete an interactive symptom questionnaire that provided detailed information on flagged responses. We interviewed eight women who experienced an adverse event. Six of these women had used the web application regularly, each indicating they used the information to guide them in seeking care for their complications. These data support that self-care applications may empower patients to manage their own care and present to appropriate health care providers and venues when they experience abnormal symptoms.

Benchmarks and Blinders: How Canadian Women Utilize the Nutrition Facts Table

Purpose: To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits.Methods: Thirteen Canadian females were interviewed about how they use the NFT in their food choices.Results: Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find “real food.” NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term “blinders” reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain “benchmark” established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision.Conclusions: Findings suggest that NFTs should be redesigned. Some ideas fo...Purpose: To better understand how consumers use the Nutrition Facts Table (NFT) in their everyday shopping decisions and food consumption habits.Methods: Thirteen Canadian females were interviewed about how they use the NFT in their food choices.Results: Different elements of the front of the package served different purposes. Health claims and health checks drew attention to the product, but were not highly trusted. Ingredient lists were used to find “real food.” NFTs were considered important with each participant reporting an individualized strategy for using the NFT characterized by the application of benchmarks and blinders. The term “blinders” reflected only seeing and using one specific nutrient by assessing whether or not it exceeded a certain “benchmark” established by the participant. Therefore, the level of one specific nutrient determined the healthfulness of the product and the subsequent purchase/consumption decision.Conclusions: Findings suggest that NFTs should be redesigned. Some ideas fo...

Slicing, Dicing, Spicing, and Pricing: Factors Influencing Purchase and Consumption of Fresh Potatoes

Abstract To better understand potential reasons for a North American decline in fresh potato consumption, a region-wide survey (n = 1009) was undertaken in eastern Canada. Results were examined comparing high- and low-frequency potato users on a variety of factors, including beliefs, attitudes, barriers, needs, and satisfaction with potatoes. Respondents indicated positive perceptions pertaining to potato nutrition, taste, preparation, and overall enjoyment. Multiple logistic regression analysis suggested two variables—age and the perceived importance of potatoes for the everyday meal—were strong predictors of high versus low frequency of potato consumption. Respondents judged the ability to see the potato in the package, potato firmness, and locally produced as point-of-purchase characteristics particularly important when buying fresh potatoes. However, respondents also indicated that their needs were not fully met and expressed relatively low levels of satisfaction when purchasing potatoes. Based on the results, suggestions are provided for improving the marketing of fresh potatoes.