Six provinces canadiennes ont interdit la vente de malbouffe dans les écoles afin d'améliorer la santé des enfants en s'attaquant entre autres à l'obésité. Cette mesure a été appliquée à différents moments et de façons différentes selon les provinces, et l'on observe également des différences à l'intérieur des provinces selon le nombre d'années pendant lesquelles des jeunes ont fréquenté l'école après la mise en place de la mesure. L'auteur de cet article montre, à l'aide d'une analyse de données de l'Enquête sur la santé dans les collectivités canadiennes, que chaque année pendant laquelle la malbouffe a été interdite est associée à une diminution de l'indice de masse corporelle d'environ 0,05. L'auteur montre également que, chez les élèves qui avaient fréquenté pendant cinq ans ou plus une école où la malbouffe était interdite, l'indice de masse corporelle diminuait de l'équivalent d'environ deux livres pour un individu mesurant six pieds et cinq pouces. Mots clés : obésité, malbouffe, santé des écoliers, nutrition scolaire Six Canadian provinces have banned the sale of junk food on school property to address child health issues such as obesity. Differences in the timing of the introduction of provincial policies provide variation in treatment across provinces, and variation within provinces comes from differences across students in the number of years of schooling during which junk food was banned. Using data from cycles of the Canadian Community Health Survey, I find that each year of a junk food ban is associated with a decline of about 0.05 body mass index. Students exposed to five or more years of a junk food ban had lower body mass index equivalent to a decrease of about two pounds for an individual who is five feet, six inches tall.

Background: A large literature search suggests a relationship between hospital/surgeon caseload volume and surgical complications. In this study, we describe associations between post-operative maternal complications following Caesarean section and provider caseload volume, provider years since graduation, and provider specialization, while adjusting for hospital volumes and patient characteristics. Methods: Our analysis is based on population-based discharge abstract data for the period of April 2004 to March 2014, linked to patient and physician universal coverage registry data. We consider all hospital admissions (N = 20,914) in New Brunswick, Canada, where a Caesarean Section surgery was recorded, as identified by a Canadian Classification of Health Intervention code of 5.MD.60.XX. We ran logistic regression models to identify the odds of occurrence of post-surgical complications during the hospital stay. Results: Roughly 2.6% of admissions had at least one of the following groups of complications: disseminated intravascular coagulation, postpartum sepsis, postpartum hemorrhage, and postpartum infection. The likelihood of complication was negatively associated with provider volume and provider years of experience, and positively associated with having a specialization other than maternal-fetal medicine or obstetrics and gynecology. Conclusions: Our results suggest that measures of physician training and experience are associated with the likelihood of Caesarean Section complications. In the context of a rural province deciding on the number of rural hospitals to keep open, this suggests a trade off between the benefits of increased volume versus the increased travel time for patients.

Our results suggest that patients admitted for hip replacements in New Brunswick can expect to have similar risk of death regardless of whether they are admitted to see a provider with high or low THA volumes and of whether they are admitted to the province's larger or smaller hospitals.

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Due to the COVID-19 pandemic, all Rwandan schools were closed in March 2020; they started to reopen in November 2020. To understand the Rwandan schools' level of preparedness to teach remotely during this unprecedented emergency, and for the eventual return to school, we conducted phone surveys with school leaders and teachers in 298 secondary schools in August 2020. Drawing from knowledge mobilization theory and quantitative data, our results indicate that there were gaps in school leaders' and teachers' access to technology and training, a lack of preparedness that could inform policy and practice in future emergencies. Our findings reveal that, before the pandemic, the male teachers in Rwanda had more access than the female teachers to both technological devices and online experience, and that the teachers from well-resourced schools were more likely than teachers from regular schools to own some kind of device to use for teaching. We found that the teachers whose school leaders had received guidance on how to continue education during the school closures were more likely to receive their support. Two additional findings were that younger teachers were more likely than the older ones to support their students during the school closures, and that the school leaders and teachers we surveyed believed that students from low-income families and rural areas benefitted the least from remote learning. These findings indicate that, in Rwanda, the level of preparedness to support schooling during the COVID-19 emergency was negatively affected by preexisting and ongoing inequalities in access to both material and nonmaterial resources.

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