Chronic Diseases And Injuries In Canada[JOURNAL]
Sun
118 papers
A comprehensive profile of the sociodemographic, psychosocial and health characteristics of Ontario home care clients with dementia.
Vu M, Hogan DB, Patten SB … +8 more , Jetté N, Bronskill SE, Heckman G, Kergoat MJ, Hirdes JP, Chen X, Zehr MM, Maxwell CJ
Chronic Dis Inj Can · 2014 Jul · PMID 24991776
INTRODUCTION: This study provides a comprehensive summary of the sociodemographic, psychosocial and health characteristics of a large population-based cohort of Ontario home care clients (aged 50 years and over) with dem...
INTRODUCTION: This study provides a comprehensive summary of the sociodemographic, psychosocial and health characteristics of a large population-based cohort of Ontario home care clients (aged 50 years and over) with dementia and examines the variation in these characteristics in those with co-existing neurological conditions. METHODS: Clients were assessed with the Resident Assessment Instrument-Home Care (RAI-HC) between January 2003 and December 2010. Descriptive analyses examined the distribution of these characteristics among clients with dementia relative to several comparison groups, as well as clients with other recorded neurological conditions. RESULTS: Approximately 22% of clients (n=104 802) had a diagnosis of dementia (average age 83 years, 64% female) and about one in four within this group had a co-existing neurological condition (most commonly stroke or Parkinson disease). About 43% of those with dementia did not live with their primary caregiver. Relative to several comparison groups, clients with dementia showed considerably higher levels of cognitive and functional impairment, aggression, anxiety, wandering, hallucinations/delusions, caregiver distress and a greater risk for institutionalization. Conversely, they showed a lower prevalence of several chronic conditions and lower levels of recent health service use. Depressive symptoms were relatively common in the dementia and other neurological groups. CONCLUSION: Clients with co-existing neurological conditions exhibited unique clinical profiles illustrating the need for tailored and flexible home care services and enhanced caregiver assistance programs.
Are experimental smokers different from their never-smoking classmates? A multilevel analysis of Canadian youth in grades 9 to 12.
Kaai SC, Manske SR, Leatherdale ST … +2 more , Brown KS, Murnaghan D
Chronic Dis Inj Can · 2014 Jul · PMID 24991775
INTRODUCTION: Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental s...
INTRODUCTION: Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental smokers from never smokers in a nationally representative sample of Canadian students in grades 9 to 12. METHODS: School-level data from the 2006 Canadian Census and one built environment characteristic (tobacco retailer density) were linked with data from secondary school students from the 2008-2009 Canadian Youth Smoking Survey and examined using multilevel logistic regression analyses. RESULTS: Experimental smoking rates varied across schools (p < .001). The location (adjusted odds ratio [AOR] = 0.66, 95% CI: 0.49-0.89) of the school (urban vs. rural) was associated with the odds of a student being an experimental smoker versus a never smoker when adjusting for student characteristics. Students were more likely to be experimental smokers if they were in a lower grade, reported low school connectedness, used alcohol or marijuana, believed that smoking can help people relax, received pocket money each week and had a family member or close friend who smoked cigarettes. CONCLUSION: School-based tobacco prevention programs need to be grade-sensitive and comprehensive in scope; include strategies that can increase students' attachment to their school; and address multi-substance use, tobacco-related beliefs and the use of pocket money. These programs should also reach out to students who have smoking friends and family members. Schools located in rural settings may require additional resources.
Are Canadian youth still exposed to second-hand smoke in homes and in cars?
Barisic A, Leatherdale ST, Burkhalter R … +1 more , Ahmed R
Chronic Dis Inj Can · 2014 Jul · PMID 24991774
INTRODUCTION: The objective of this manuscript is to examine the prevalence of youth exposed to second-hand smoke (SHS) in homes and cars, changes in SHS exposure over time, and factors associated with beliefs youth hold...
INTRODUCTION: The objective of this manuscript is to examine the prevalence of youth exposed to second-hand smoke (SHS) in homes and cars, changes in SHS exposure over time, and factors associated with beliefs youth hold regarding SHS exposure among a nationally representative sample of Canadian youth. METHODS: Descriptive analysis of SHS exposure in homes and cars was conducted using data from the Canadian Youth Smoking Survey (2004, 2006 and 2008). Logistic regression was conducted to examine factors associated with beliefs youth had about SHS exposure in 2008. RESULTS: In 2008, 21.5% of youth reported being exposed to SHS in their home on a daily or almost daily basis, while 27.3% reported being exposed to SHS while riding in a car at least once in the previous week. Between 2004 and 2008, the prevalence of daily SHS exposure in the home and cars decreased by 4.7% and 18.0% respectively. CONCLUSION: Despite reductions in SHS exposure over time, a substantial number of Canadian youth continue to be exposed to SHS in homes and cars. Further effort is required to implement and evaluate policies designed to protect youth from SHS.
Cancer risk factors and screening in the off-reserve First Nations, Métis and non-Aboriginal populations of Ontario.
Withrow DR, Amartey A, Marrett LD
Chronic Dis Inj Can · 2014 Jul · PMID 24991773
INTRODUCTION: This study describes the prevalence of smoking, obesity, sedentary behaviour/physical activity, fruit and vegetable consumption and alcohol use as well as the uptake of breast, cervical and colorectal cance...
INTRODUCTION: This study describes the prevalence of smoking, obesity, sedentary behaviour/physical activity, fruit and vegetable consumption and alcohol use as well as the uptake of breast, cervical and colorectal cancer screening among First Nations and Métis adults in Ontario and compares these to that of the non-Aboriginal population. METHODS: We used the Canadian Community Health Survey (2007 to 2011 combined) to calculate prevalence estimates for the 3 ethnocultural populations. RESULTS: First Nations and Métis adults were significantly more likely than non-Aboriginal adults to self-report smoking and/or to be classified as obese. Alcohol use exceeding cancer prevention recommendations and inadequate fruit and vegetable consumption were more common in First Nations people than in the non-Aboriginal population. First Nations women were more likely to report having had a Fecal Occult Blood Test in the previous 2 years than non-Aboriginal women. No significant differences across the 3 ethnocultural groups were found for breast and cervical screening among women or colorectal screening among men. CONCLUSION: Without intervention, we are likely to continue to see a significant burden of smoking- and obesity-related cancers in Ontario's Aboriginal population.
Modelling preventive effectiveness to estimate the equity tipping point: at what coverage can individual preventive interventions reduce socioeconomic disparities in diabetes risk?
Manuel DG, Ho TH, Harper S … +3 more , Anderson GM, Lynch J, Rosella LC
Chronic Dis Inj Can · 2014 Jul · PMID 24991772
INTRODUCTION: Most individual preventive therapies potentially narrow or widen health disparities depending on the difference in community effectiveness across socioeconomic position (SEP). The equity tipping point (defi...
INTRODUCTION: Most individual preventive therapies potentially narrow or widen health disparities depending on the difference in community effectiveness across socioeconomic position (SEP). The equity tipping point (defined as the point at which health disparities become larger) can be calculated by varying components of community effectiveness such as baseline risk of disease, intervention coverage and/or intervention efficacy across SEP. METHODS: We used a simple modelling approach to estimate the community effectiveness of diabetes prevention across SEP in Canada under different scenarios of intervention coverage. RESULTS: Five-year baseline diabetes risk differed between the lowest and highest income groups by 1.76%. Assuming complete coverage across all income groups, the difference was reduced to 0.90% (144 000 cases prevented) with lifestyle interventions and 1.24% (88 100 cases prevented) with pharmacotherapy. The equity tipping point was estimated to be a coverage difference of 30% for preventive interventions (100% and 70% coverage among the highest and lowest income earners, respectively). CONCLUSION: Disparities in diabetes risk could be measurably reduced if existing interventions were equally adopted across SEP. However, disparities in coverage could lead to increased inequity in risk. Simple modelling approaches can be used to examine the community effectiveness of individual preventive interventions and their potential to reduce (or increase) disparities. The equity tipping point can be used as a critical threshold for disparities analyses.
Intentional injury hospitalizations in geographical areas with a high percentage of Aboriginal-identity residents, 2004/2005 to 2009/2010.
Oliver LN, Finès P, Bougie E … +1 more , Kohen D
Chronic Dis Inj Can · 2014 Jul · PMID 24991771
INTRODUCTION: This study describes rates of self-inflicted and assault-related injury hospitalizations in areas with a relatively high percentage of residents identifying as First Nations, Métis and Inuit, by injury caus...
INTRODUCTION: This study describes rates of self-inflicted and assault-related injury hospitalizations in areas with a relatively high percentage of residents identifying as First Nations, Métis and Inuit, by injury cause, age group and sex. METHODS: All separation records from acute in-patient hospitals for Canadian provinces and territories excluding Quebec were obtained from the Discharge Abstract Database. Dissemination areas with more than 33% of residents reporting an Aboriginal identity in the 2006 Census were categorized as high-percentage Aboriginal-identity areas. RESULTS: Overall, in high-percentage Aboriginal-identity areas, age-standardized hospitalization rates (ASHRs) for self-inflicted injuries were higher among females, while ASHRs for assault-related injuries were higher among males. Residents of high-percentage Aboriginal-identity areas were at least three times more likely to be hospitalized due to a self-inflicted injury and at least five times more likely to be hospitalized due to an assault-related injury compared with those living in low-percentage Aboriginal-identity areas. CONCLUSION: Future research should examine co-morbidities, socio-economic conditions and individual risk behaviours as factors associated with intentional injury hospitalizations.
Injuries and helmet use related to non-motorized wheeled activities among pediatric patients.
Lindsay H, Brussoni M
Chronic Dis Inj Can · 2014 Jul · PMID 24991770
INTRODUCTION: Patients presenting to emergency departments (ED) for injuries resulting from recreational activities represent a unique source of information on important directions for injury prevention efforts. We descr...
INTRODUCTION: Patients presenting to emergency departments (ED) for injuries resulting from recreational activities represent a unique source of information on important directions for injury prevention efforts. We describe the epidemiology of non-motorized wheeled activity-related injury in pediatric patients presenting to Canadian EDs as well as patients' helmet use. METHODS: Data for the years 2004 to 2009 were abstracted from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national ED injury surveillance program in fifteen hospitals. RESULTS: Most of the 28 618 children aged 1 to 16 years injured during non-motorized wheeled activities were injured while cycling, followed by skateboarding. Most injuries occurred among boys. Children injured on scooters tended to be younger whereas skateboarders were the oldest. On average, the number of all injuries decreased by 6% over the time period. Falls were the most common mechanism of injury; 8.3% of patients had head injuries, which were seen more often among cyclists than other wheeled-activity users. Helmet use was greatest among cyclists (62.2%) and lowest among skateboarders (32.9%). Injured patients presenting to EDs in jurisdictions with legislation mandating helmet use had 2.12 greater odds of helmet use and 0.86 lesser odds of head injury compared with those presenting in jurisdictions without helmet laws. CONCLUSION: These results provide further evidence that legislation mandating helmet use may be an effective way of reducing injury among all wheeled-activity users. The small number of patients who presented with helmet use and protective gear (59.4% overall) suggests that this remains an area for intervention.
Editorial. Bicycle injuries and injury prevention.
Pless IB
Chronic Dis Inj Can · 2014 Jul · PMID 24991769
In 1989, long before this journal added injuries to its title, it published two papers on childhood injuries and I was asked to write an editorial for this occasion. I chose the title "Challenges for Injury Prevention: T...
In 1989, long before this journal added injuries to its title, it published two papers on childhood injuries and I was asked to write an editorial for this occasion. I chose the title "Challenges for Injury Prevention: Two Neglected Aspects" because I thought the papers neglected to mention the inadequacy of injury statistics (at the time there were no emergency department data) and also failed to emphasize the public health importance of childhood injuries. It is instructive, therefore, to compare this issue's offerings with how matters stood nearly 25 years ago and see what progress we've made. Papers in this and the previous issue of this journal discuss bicycle safety in general and helmet use in particular. Although this is a somewhat narrow focus, it serves as one indicator of how the field has evolved and what remains to be done to improve both the science and policy in this domain.
Monitoring chronic diseases in Canada: the Chronic Disease Indicator Framework.
Betancourt MT, Roberts KC, Bennett TL … +3 more , Driscoll ER, Jayaraman G, Pelletier L
Chronic Dis Inj Can · 2014 · PMID 24898593
INTRODUCTION: The Public Health Agency of Canada developed the Chronic Disease Indicator Framework (the Framework) with the goal of systematizing and enhancing chronic disease surveillance in Canada by providing the basi...
INTRODUCTION: The Public Health Agency of Canada developed the Chronic Disease Indicator Framework (the Framework) with the goal of systematizing and enhancing chronic disease surveillance in Canada by providing the basis for consistent and reliable information on chronic diseases and their determinants. METHODS: Available national and international health indicators, frameworks and national health databases were reviewed to identify potential indicators. To make sure that a comprehensive and balanced set of indicators relevant to chronic disease prevention was included, a conceptual model with "core domains" for grouping eligible indicators was developed. Specific selection criteria were applied to identify key measures. Extensive consultations with a broad range of government partners, non-governmental organizations and public health practitioners were conducted to reach consensus and refine and validate the Framework. RESULTS: The Framework contains 41 indicators organized in a model comprised of 6 core domains: social and environmental determinants, early life / childhood risk and protective factors, behavioural risk and protective factors, risk conditions, disease prevention practices, and health outcomes/status. Also planned is an annual release of updated data on the proposed set of indicators, including national estimates, breakdowns by demographic and socioeconomic variables, and time trends. CONCLUSIONS: Understanding the evidence related to chronic diseases and theirdeterminants is key to interpreting trends and crucial to the development of public health interventions. The Framework and its related products have the potential of becoming an indispensable tool for evidence-informed decision making in Canada.
Cancer in Canada fact sheet series #1 - thyroid cancer in Canada.
Shaw A, Semenciw R, Mery L
Chronic Dis Inj Can · 2014 Feb · PMID 24618383
The incidence of thyroid cancer is increasing more rapidly than that of any other cancer in Canada, while mortality has remained low and stable. In the last 10 years the number of thyroid cancer cases has increased 144%...
The incidence of thyroid cancer is increasing more rapidly than that of any other cancer in Canada, while mortality has remained low and stable. In the last 10 years the number of thyroid cancer cases has increased 144% from 1709 to 4172 cases per year. Thyroid cancer is three times more common in females than males. 40% of thyroid cancers are diagnosed in Canadians under 45 years of age. Some of the apparent increase in incidence is likely due to improved and more widely available diagnostic techniques.
An environmental scan of policies in support of chronic disease self-management in Canada.
Liddy C, Mill K
Chronic Dis Inj Can · 2014 Feb · PMID 24618382
INTRODUCTION: The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives. METHODS: Th...
INTRODUCTION: The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives. METHODS: This descriptive study was conducted as an environmental scan, consisting of an Internet search of government and other publicly available websites, and interviews with jurisdictional representatives identified through the Health Council of Canada and academic networking. RESULTS: We interviewed 16 representatives from all provinces and territories in Canada and found 30 publicly available and relevant provincial and national documents. Most provinces and territories have policies that incorporate aspects of chronic disease self-management. Alberta and British Columbia have the most detailed policies. Both feature primary care prominently and are not disease specific. Both also have provincial level implementation of chronic disease self-management programming. Canada's northern territories all lacked specific policies supporting chronic disease self-management despite a significant burden of disease. CONCLUSION: Engaging patients in self-management of their chronic diseases is important and effective. Although most provinces and territories have policies that incorporate aspects of chronic disease self-management, they were often embedded within other initiatives and/or policy documents framed around specific diseases or populations. This approach could limit the potential reach and effect of self-management.
Impact of individual and ecological characteristics on small for gestational age births: an observational study in Quebec.
Savard N, Levallois P, Rivest LP … +1 more , Gingras S
Chronic Dis Inj Can · 2014 Feb · PMID 24618381
INTRODUCTION: We evaluated associations between ecological variables and the risk of very small for gestational age (VSGA) birth in Quebec in 2000-2008. METHODS: Ecological variables came from the Canadian Community Heal...
INTRODUCTION: We evaluated associations between ecological variables and the risk of very small for gestational age (VSGA) birth in Quebec in 2000-2008. METHODS: Ecological variables came from the Canadian Community Health Survey, the Canadian census and Quebec's birth registry; individual variables also came from Quebec's birth registry. Odds ratios (ORs) adjusted for mother's age, academic qualification, parity, marital status and country of birth were estimated using multilevel logistic regression (generalized estimating equations method). RESULTS: Births in neighbourhoods with a high proportion of people leading a sedentary lifestyle (OR: 1.07, 95% confidence interval [CI]: 1.01-1.11) and those with a high/middle proportion of residents with food insecurity (OR: 1.09, 95% CI: 1.05-1.15; OR: 1.05, 95% CI: 1.01-1.11) had higher odds of VSGA birth. Those with middle proportion of married residents had lower odds of VSGA birth (OR: 0.94, 95% CI: 0.90-0.98).
Metabolic syndrome and chronic disease.
Rao DP, Dai S, Lagacé C … +1 more , Krewski D
Chronic Dis Inj Can · 2014 Feb · PMID 24618380
INTRODUCTION: Metabolic syndrome (MetS) is a combination of risk markers that appear to promote the development of chronic disease. We examined the burden of MetS in Canada through its current and projected association w...
INTRODUCTION: Metabolic syndrome (MetS) is a combination of risk markers that appear to promote the development of chronic disease. We examined the burden of MetS in Canada through its current and projected association with chronic disease. METHODS: We used measures from the Canadian Health Measures Survey 2007-2009 to identify the prevalence of MetS in Canadian adults and examine associations between sociodemographic factors and major chronic diseases. We estimated the projected cumulative incidence of diabetes and percent risk of a fatal cardiovascular event using the Diabetes Population Risk Tool (DPoRT) and Framingham algorithms. RESULTS: After adjusting for age, we found that 14.9% of Canadian adults had MetS. Rates were similar in both sexes, but higher in those who are non-Caucasian or overweight or obese (p < .001 for all three). The importance of MetS for public health was demonstrated by its significant association with chronic disease relative to the general population, particularly for diagnosed (11.2% vs. 3.4%) and undiagnosed (6.0% vs. 1.1%) type 2 diabetes. The ten-year incidence estimate for diabetes and mean percent risk of a fatal cardiovascular disease (CVD) event were higher in those with MetS compared to those without (18.0% vs. 7.1% for diabetes, and 4.1% vs. 0.8% for CVD). CONCLUSION: MetS is prevalent in Canadian adults and a high proportion of individuals with MetS have diagnosed or undiagnosed chronic conditions. Projection estimates for the incidence of chronic disease associated with MetS demonstrate higher rates in individuals with this condition. Thus, MetS may be a relevant risk factor in the development of chronic disease.
Prevalence of self-reported hysterectomy among Canadian women, 2000/2001-2008.
Stankiewicz A, Pogany L, Popadiuk C
Chronic Dis Inj Can · 2014 Feb · PMID 24618379
BACKGROUND: Hysterectomy is one of the most frequently performed surgical procedures among Canadian women. The consequence is a population that no longer requires cervical cancer screening. The objective of our analysis...
BACKGROUND: Hysterectomy is one of the most frequently performed surgical procedures among Canadian women. The consequence is a population that no longer requires cervical cancer screening. The objective of our analysis was to provide more accurate estimates of eligible participation in cervical screening by estimating the age-specific prevalence of hysterectomy among Canadian women aged 20 to 69 by province and territory between 2000/2001 and 2008. METHODS: Self-reported hysterectomy prevalence was obtained from the 2000/2001, 2003 and 2008 Canadian Community Health Survey. Age-specific prevalence and 95% confidence intervals (CIs) were estimated for Canada and provinces and territories for the three time periods. RESULTS: Interprovincial variations in hysterectomy prevalence were observed among women in each age group and time period. Among women aged 50 to 59, prevalence was as high as 35.1% (95% CI: 25.8-44.3) (p<.01) in 2008 and appeared to decrease in all provinces from 2000/2001 to 2008. CONCLUSION: Interprovincial and time period variation suggest that using hysterectomy prevalence to adjust the population eligible for cervical cancer screening may be helpful to inform more comparable screening participation rates. In addition, both cervical cancer incidence and mortality rates can be adjusted by hysterectomy to ensure estimates across time and provinces and territories are also comparable.
Coroners' records on suicide mortality in Montréal: limitations and implications in suicide prevention strategies.
Houle J, Guillou-Ouellette C
Chronic Dis Inj Can · 2014 Feb · PMID 24618378
INTRODUCTION: In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-preve...
INTRODUCTION: In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-prevention planning actions. METHODS: This study analyzes all coroners' records on suicide in Montréal from 2007 to 2009 to (1) determine the usefulness of the data available; (2) develop a profile of cases; (3) examine local differences by comparing two areas, one with the highest suicide rate and the other with the lowest. RESULTS: The data collected revealed the lack of a systematic, standardized procedure for recording information about deaths by suicide. The rates of missing data varied, but were very high for antecedents of suicide attempts and recent events that could have precipitated the suicide. We observed differences in the characteristics of suicide cases according to area of residence. CONCLUSION: By adopting a standardized procedure for collecting information on cases of suicide, coroners could provide local decision makers with a more accurate portrait of the people who die by suicide in their area. Local adjustments may improve suicide prevention strategies.
Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index.
Pampalon R, Hamel D, Gamache P … +2 more , Simpson A, Philibert MD
Chronic Dis Inj Can · 2014 Feb · PMID 24618377
INTRODUCTION: Despite the widespread use of deprivation indices in public health, they are rarely explicitly or extensively validated, owing to the complex nature of the exercise. METHODS: Based on the proposals of Briti...
INTRODUCTION: Despite the widespread use of deprivation indices in public health, they are rarely explicitly or extensively validated, owing to the complex nature of the exercise. METHODS: Based on the proposals of British researchers, we sought to validate Quebec's material and social deprivation index using criteria of validity (content, criterion and construct validity), reliability and responsiveness, as well as other properties relevant to public health (comprehensibility, objectivity and practicality). RESULTS: We reviewed the international literature on deprivation indices, as well as publications and uses of the Quebec index, to which we added factual data. CONCLUSION: Based on the review, it appears that the Quebec index responds favourably to the proposed validation criteria and properties. However, additional validations are required to better identify the contextual factors associated with the index.
Canadian parents' attitudes and beliefs about bicycle helmet legislation in provinces with and without legislation.
Parkin PC, Degroot J, Macpherson A … +2 more , Fuselli P, Macarthur C
Chronic Dis Inj Can · 2014 Feb · PMID 24618376
INTRODUCTION: The objective of this study was to survey Canadian parents on their attitudes and beliefs about bicycle helmet legislation and to compare responses from parents living in provinces with and without legislat...
INTRODUCTION: The objective of this study was to survey Canadian parents on their attitudes and beliefs about bicycle helmet legislation and to compare responses from parents living in provinces with and without legislation. METHODS: A national survey of 1002 parents of children aged under 18 years was conducted. Chi-square tests were used to compare responses from the surveyed parents in the different jurisdictions. RESULTS: Responses from parents living in provinces with legislation (n = 640) and without legislation (n = 362) were as follows: concern for injury (63% vs. 68%, nonsignificant [NS]); believe helmets are effective (98% vs. 98%, NS); child always wears a helmet (74% vs. 69%, NS); support legislation for children (95% vs. 83%, p < .001); support legislation for all ages (85% vs. 75%, p < .001); support police enforcement (83% vs. 76%, p = .003); believe legislation decreases the amount of time their child bicycles (5% vs. 8%, NS). CONCLUSION: Parents are highly supportive of bicycle helmet legislation in Canada. They believe that bicycle helmets are effective and that legislation does not decrease the amount of time a child spends bicycling. There was also a high level of support for legislation across all ages, and for police enforcement.
Cyclist head and facial injury risk in relation to helmet fit: a case-control study.
Romanow NR, Hagel BE, Williamson J … +1 more , Rowe BH
Chronic Dis Inj Can · 2014 Feb · PMID 24618375
INTRODUCTION: We examined the effect of bicycle helmet fit and position on head and facial injuries. METHODS: Cases were helmeted cyclists with a head (n=297) or facial (n=289) injury. Controls were helmeted cyclists wit...
INTRODUCTION: We examined the effect of bicycle helmet fit and position on head and facial injuries. METHODS: Cases were helmeted cyclists with a head (n=297) or facial (n=289) injury. Controls were helmeted cyclists with other injuries, excluding the neck. Participants were interviewed in seven Alberta emergency departments or by telephone; injury data were collected from charts. Missing values were imputed using chained equations and custom prediction imputation models. RESULTS: Compared with excellent helmet fit, those with poor fit had increased odds of head injury (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.06-10.74). Compared with a helmet that stayed centred, those whose helmet tilted back (OR = 2.90, 95% CI: 1.54-5.47), shifted (OR = 1.91, 95% CI: 1.01-3.63) or came off (OR = 6.72, 95% CI: 2.86-15.82) had higher odds of head injury. A helmet that tilted back (OR = 4.81, 95% CI: 2.74-8.46), shifted (OR = 1.83, 95% CI: 1.04-3.19) or came off (OR = 3.31, 95% CI: 1.24-8.85) also increased the odds of facial injury. CONCLUSION: Our findings have implications for consumer and retail education programs.
How we identify and count Aboriginal people--does it make a difference in estimating their disease burden?
Chan WW, Ng C, Young TK
Chronic Dis Inj Can · 2013 Sep · PMID 23987224
INTRODUCTION: We examined the concordance between the Canadian Community Health Survey (CCHS) "identity" and "ancestry" questions used to estimate the size of the Aboriginal population in Canada and whether the different...
INTRODUCTION: We examined the concordance between the Canadian Community Health Survey (CCHS) "identity" and "ancestry" questions used to estimate the size of the Aboriginal population in Canada and whether the different definitions affect the prevalence of selected chronic diseases. METHODS: Based on responses to the "identity" and "ancestry" questions in the CCHS combined 2009-2010 microdata file, Aboriginal participants were divided into 4 groups: (A) identity only; (B) ancestry only; (C) either ancestry or identity; and (D) both ancestry and identity. Prevalence of diabetes, arthritis and hypertension was estimated based on participants reporting that a health professional had told them that they have the condition(s). RESULTS: Of participants who identified themselves as Aboriginal, only 63% reported having an Aboriginal ancestor; of those who claimed Aboriginal ancestry, only 57% identified themselves as Aboriginal. The lack of concordance also differs according to whether the individual was First Nation, Métis or Inuit. The different method of estimating the Aboriginal population, however, does not significantly affect the prevalence of the three selected chronic diseases. CONCLUSION: The lack of concordance requires further investigation by combining more cycles of CCHS to compare discrepancy across regions, genders and socio-economic status. Its impact on a broader list of health conditions should be examined.
Methodology of the 2009 Survey on Living with Chronic Diseases in Canada--hypertension component.
Bienek AS, Gee ME, Nolan RP … +7 more , Kaczorowski J, Campbell NR, Bancej C, Gwadry-Sridhar F, Robitaille C, Walker RL, Dai S
Chronic Dis Inj Can · 2013 Sep · PMID 23987223
INTRODUCTION: The Survey on Living with Chronic Diseases in Canada--hypertension component (SLCDC-H) is a 20-minute cross-sectional telephone survey on hypertension diagnosis and management. Sampled from the 2008 Canadia...
INTRODUCTION: The Survey on Living with Chronic Diseases in Canada--hypertension component (SLCDC-H) is a 20-minute cross-sectional telephone survey on hypertension diagnosis and management. Sampled from the 2008 Canadian Community Health Survey (CCHS), the SLCDC-H includes Canadians (aged ≥ 20 years) with self-reported hypertension from the ten provinces. METHODS: The questionnaire was developed by Delphi technique, externally reviewed and qualitatively tested. Statistics Canada performed sampling strategies, recruitment, data collection and processing. Proportions were weighted to represent the Canadian population, and 95% confidence intervals (CIs) were derived by bootstrap method. RESULTS: Compared with the CCHS population reporting hypertension, the SLCDC-H sample (n = 6142) is slightly younger (SLCDC-H mean age: 61.2 years, 95% CI: 60.8-61.6; CCHS mean age: 62.2 years, 95% CI: 61.8-62.5), has more post-secondary school graduates (SLCDC-H: 52.0%, 95% CI: 49.7%-54.2%; CCHS: 47.5%, 95% CI: 46.1%-48.9%) and has fewer respondents on hypertension medication (SLCDC-H: 82.5%, 95% CI: 80.9%-84.1%; CCHS: 88.6%, 95% CI: 87.7%-89.6%). CONCLUSION: Overall, the 2009 SLCDC-H represents its source population and provides novel, comprehensive data on the diagnosis and management of hypertension. The survey has been adapted to other chronic conditions--diabetes, asthma/chronic obstructive pulmonary disease and neurological conditions. The questionnaire is available on the Statistics Canada website; descriptive results have been disseminated by the Public Health Agency of Canada.
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