RESUMO
INTRODUCTION: En novembre 2006, le ministère de la Santé et des Services sociaux mettait en place un comité technique provincial sur la transformation des horaires de travail des techniciens ambulanciers paramédicaux (TAP) et le déploiement dynamique de la flotte ambulancière dans certaines régions du Québec. Le mandat de ce comité technique consistait à proposer au ministère de la Santé et des Services sociaux, des recommandations sur les meilleures façons d'améliorer l'organisation des services ambulanciers au Québec, ce en accordant une attention particulière aux réalités régionales. Plus spécifiquement, il s'agissait, tout en préservant la qualité des services préhospitaliers à la population, d'initier un ensemble de mesures devant aboutir à la transformation des horaires de travail de faction des TAP en horaires à l'heure, ainsi que de procéder à un positionnement stratégique des véhicules ambulanciers sur les territoires desservis. Suite à l'examen des propositions de projets, le comité technique retint cinq projets pilotes à l'échelle provinciale afin d'expérimenter cette nouvelle approc
Assuntos
Pesquisa sobre Serviços de Saúde/métodos , Serviços Pré-Hospitalares , Garantia da Qualidade dos Cuidados de Saúde/métodos , Análise Custo-Eficiência , Avaliação em Saúde/economia , Projetos Piloto , Avaliação da Tecnologia BiomédicaRESUMO
OBJECTIVES: To identify dietary transition stages based on dietary patterns of adult Haitians having lived in Montreal for various lengths of time, and to assess associated dietary quality. SUBJECTS: One hundred and eighty-one Haitians aged 25-60 years were recruited by the modified random digit dialling method. DESIGN: Socio-economic, diet and lifestyle variables were documented by questionnaire. Three non-consecutive 24-hour dietary recalls were conducted over a 3-month period. Dietary patterns were studied using cluster analysis, and their association with proportion of lifetime in Canada and with socio-economic status (SES) was examined. Diet quality criteria were micronutrient adequacy and healthfulness based on dietary recommendations of the World Health Organization. RESULTS: Four dietary phenotypes were identified which could roughly represent stages of dietary transition or acculturation (Traditional, Pre-Western, Western and Modern). Subjects in the 'Traditional' cluster were older and had lived for a significantly lower proportion of their lifetime in Canada; they also tended to be of lower SES. Diet quality was significantly higher in the 'Traditional' than the 'Western' type, particularly with respect to healthfulness. A significantly lower proportion of subjects complying with limited intake of total fat ( < 30%) and cholesterol ( < 45%) was observed in the 'Western' compared with other diet phenotypes. Less than 15% of all subjects consumed enough dietary fibre, irrespective of diet type. CONCLUSION: Dietary transition stages could be identified on the basis of food patterns of Haitians according to the proportion of their lifetime in Canada. Encouraging the youth to retain the traditional food culture in its positive aspects would appear relevant