Chronic Diseases And Injuries In Canada[JOURNAL]
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118 papers
Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.
Murnaghan D, Morrison W, Griffith EJ … +4 more , Bell BL, Duffley LA, McGarry K, Manske S
Chronic Dis Inj Can · 2013 Sep · PMID 23987222
INTRODUCTION: The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These thre...
INTRODUCTION: The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. METHODS: We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." RESULTS: Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. DISCUSSION: Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.
Estimating cancer risk in relation to tritium exposure from routine operation of a nuclear-generating station in Pickering, Ontario.
Wanigaratne S, Holowaty E, Jiang H … +3 more , Norwood TA, Pietrusiak MA, Brown P
Chronic Dis Inj Can · 2013 Sep · PMID 23987221
INTRODUCTION: Evidence suggests that current levels of tritium emissions from CANDU reactors in Canada are not related to adverse health effects. However, these studies lack tritium-specific dose data and have small numb...
INTRODUCTION: Evidence suggests that current levels of tritium emissions from CANDU reactors in Canada are not related to adverse health effects. However, these studies lack tritium-specific dose data and have small numbers of cases. The purpose of our study was to determine whether tritium emitted from a nuclear-generating station during routine operation is associated with risk of cancer in Pickering, Ontario. METHODS: A retrospective cohort was formed through linkage of Pickering and north Oshawa residents (1985) to incident cancer cases (1985-2005). We examined all sites combined, leukemia, lung, thyroid and childhood cancers (6-19 years) for males and females as well as female breast cancer. Tritium estimates were based on an atmospheric dispersion model, incorporating characteristics of annual tritium emissions and meteorology. Tritium concentration estimates were assigned to each cohort member based on exact location of residence. Person-years analysis was used to determine whether observed cancer cases were higher than expected. Cox proportional hazards regression was used to determine whether tritium was associated with radiation-sensitive cancers in Pickering. RESULTS: Person-years analysis showed female childhood cancer cases to be significantly higher than expected (standardized incidence ratio [SIR] = 1.99, 95% confidence interval [CI]: 1.08-3.38). The issue of multiple comparisons is the most likely explanation for this finding. Cox models revealed that female lung cancer was significantly higher in Pickering versus north Oshawa (HR = 2.34, 95% CI: 1.23-4.46) and that tritium was not associated with increased risk. The improved methodology used in this study adds to our understanding of cancer risks associated with low-dose tritium exposure. CONCLUSION: Tritium estimates were not associated with increased risk of radiationsensitive cancers in Pickering.
Improved estimation of the health and economic burden of chronic disease risk factors in Manitoba.
Krueger H, Williams D, Ready AE … +2 more , Trenaman L, Turner D
Chronic Dis Inj Can · 2013 Sep · PMID 23987220
INTRODUCTION: There are analytic challenges involved with estimating the aggregate burden of multiple risk factors (RFs) in a population. We describe a methodology to account for overlapping RFs in some sub-populations,...
INTRODUCTION: There are analytic challenges involved with estimating the aggregate burden of multiple risk factors (RFs) in a population. We describe a methodology to account for overlapping RFs in some sub-populations, a phenomenon that leads to "double-counting" the diseases and economic burden generated by those factors. METHODS: Our method uses an efficient approach to accurately analyze the aggregate economic burden of chronic disease across a multifactorial system. In addition, it involves considering the effect of body weight as a continuous or polytomous exposure that ranges from no excess weight through overweight to obesity. We then apply this method to smoking, physical inactivity and overweight/obesity in Manitoba, a province of Canada. RESULTS: The annual aggregate economic burden of the RFs in Manitoba in 2008 is about $1.6 billion ($557 million for smoking, $299 million for physical inactivity and $747 million for overweight/obesity). The total burden represents a 12.6% downward adjustment to account for the effect of multiple RFs in some individuals in the population. CONCLUSION: An improved estimate of the aggregate economic burden of multiple RFs in a given population can assist in prioritizing and gaining support for primary prevention initiatives.
Changes in fall-related mortality in older adults in Quebec, 1981-2009.
Gagné M, Robitaille Y, Jean S … +1 more , Perron PA
Chronic Dis Inj Can · 2013 Sep · PMID 23987219
INTRODUCTION: Our purpose was to evaluate changes in fall-related mortality in adults aged 65 years and over in Quebec and to propose a case definition based on all the causes entered on Return of Death forms. METHODS: T...
INTRODUCTION: Our purpose was to evaluate changes in fall-related mortality in adults aged 65 years and over in Quebec and to propose a case definition based on all the causes entered on Return of Death forms. METHODS: The analysis covers deaths between 1981 and 2009 recorded in the Quebec vital statistics data. RESULTS: While the number of fall-related deaths increased between 1981 and 2009, the adjusted falls-related mortality rate remained relatively stable. Since the early 2000s, this stability has masked opposing trends. The mortality rate associated with certified falls (W00-W19) has increased while the rate for presumed falls (exposure to an unspecified factor causing a fracture) has decreased. CONCLUSION: For fall surveillance, analyses using indicators from the vital statistics data should include both certified falls and presumed falls. In addition, a possible shift in the coding of fall-related deaths toward secondary causes should be taken into account.
Chronic bronchitis in Aboriginal people--prevalence and associated factors.
Konrad S, Hossain A, Senthilselvan A … +2 more , Dosman JA, Pahwa P
Chronic Dis Inj Can · 2013 Sep · PMID 23987218
INTRODUCTION: Knowledge about chronic bronchitis (CB) among Aboriginal people in Canada is limited. The aim of this study was to determine the prevalence of CB and its associated factors among Aboriginal people aged 15 y...
INTRODUCTION: Knowledge about chronic bronchitis (CB) among Aboriginal people in Canada is limited. The aim of this study was to determine the prevalence of CB and its associated factors among Aboriginal people aged 15 years plus. METHODS: Logistic regression analysis was used on data from the cross-sectional 2006 Aboriginal Peoples Survey to determine risk factors associated with CB. RESULTS: CB prevalence was 6.6% among First Nations, 6.2% among Métis and 2.4% among Inuit. Prevalence was higher among females than males (7.2% versus 5.0%). Individuals with CB were more likely to be older, living at a lower income, with a lower educational attainment and residing in rural areas. Smoking status and body mass index were also significantly associated with CB, but their effect differed by sex. Obesity was particularly significantly associated with CB among females compared with males, and current smoking and non-smoking status was significantly associated with CB among females but not males. CONCLUSION: These findings identify factors associated with CB among Aboriginal people. As such, they may represent potentially preventable risk factors that can inform health promotion and disease prevention practices.
Hospitalizations for unintentional injuries among Canadian adults in areas with a high percentage of Aboriginal-identity residents.
Finès P, Bougie E, Oliver LN … +1 more , Kohen DE
Chronic Dis Inj Can · 2013 Sep · PMID 23987217
INTRODUCTION: Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospit...
INTRODUCTION: Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospitalization, by cause, in areas with a high percentage of Aboriginal-identity residents. METHODS: Age-standardized hospitalization rates (ASHRs) and rate ratios were calculated based on 2004/2005-2009/2010 data from the Discharge Abstract Database. RESULTS: Falls were the most frequent cause of injury. For both sexes, ASHRs were highest in high-percentage First Nations-identity areas; high-percentage Métis-identity areas presented the highest overall ASHR among men aged 20-29 years, and high-percentage Inuit-identity areas presented the lowest ASHRs among men of all age groups. Some causes, such as falls, presented a high ASHR but a rate ratio similar to that for all causes combined; other causes, such as firearm injuries among men in high-percentage First Nations-identity areas, presented a relatively low ASHR but a high rate ratio. Residents of high-percentage Aboriginal-identity areas have a higher ASHR for hospitalization for injuries than residents of low-percentage Aboriginal-identity areas. CONCLUSION: Residents of high-percentage Aboriginal-identity areas also live in areas of lower socio-economic conditions, suggesting that the causes for rate differences among areas require further investigation.
Cause-specific mortality by occupational skill level in Canada: a 16-year follow-up study.
Tjepkema M, Wilkins R, Long A
Chronic Dis Inj Can · 2013 Sep · PMID 23987216
INTRODUCTION: Mortality data by occupation are not routinely available in Canada, so we analyzed census-linked data to examine cause-specific mortality rates across groups of occupations ranked by skill level. METHODS: A...
INTRODUCTION: Mortality data by occupation are not routinely available in Canada, so we analyzed census-linked data to examine cause-specific mortality rates across groups of occupations ranked by skill level. METHODS: A 15% sample of 1991 Canadian Census respondents aged 25 years or older was previously linked to 16 years of mortality data (1991-2006). The current analysis is based on 2.3 million people aged 25 to 64 years at cohort inception, among whom there were 164 332 deaths during the follow-up period. Occupations coded according to the National Occupation Classification were grouped into five skill levels. Age-standardized mortality rates (ASMRs), rate ratios (RRs), rate differences (RDs) and excess mortality were calculated by occupational skill level for various causes of death. RESULTS: ASMRs were clearly graded by skill level: they were highest among those employed in unskilled jobs (and those without an occupation) and lowest for those in professional occupations. All-cause RRs for men were 1.16, 1.40, 1.63 and 1.83 with decreasing occupational skill level compared with professionals. For women the gradient was less steep: 1.23, 1.24, 1.32 and 1.53. This gradient was present for most causes of death. Rate ratios comparing lowest to highest skill levels were greater than 2 for HIV/AIDS, diabetes mellitus, suicide and cancer of the cervix as well as for causes of death associated with tobacco use and excessive alcohol consumption. CONCLUSION: Mortality gradients by occupational skill level were evident for most causes of death. These results provide detailed cause-specific baseline indicators not previously available for Canada.
Status report--enhancing the Canadian Best Practices Portal.
Sims-Jones N, Dyke E
Chronic Dis Inj Can · 2013 Jun · PMID 23735459
Abstract loading — click title to view on PubMed.
Cross-Canada forum--National Population Health Study of Neurological Conditions in Canada.
Caesar-Chavannes CR, MacDonald S
Chronic Dis Inj Can · 2013 Jun · PMID 23735458
Abstract loading — click title to view on PubMed.
Injuries related to consumer products in Canada--a systematic literature review.
Huchcroft SA, McGowan CR, Mo F
Chronic Dis Inj Can · 2013 Jun · PMID 23735457
OBJECTIVES: To conduct a systematic literature review of injury related to certain consumer products. METHODS: Forty-six empirical research reports along with 32 surveillance reports from the Canadian Hospitals Injury Re...
OBJECTIVES: To conduct a systematic literature review of injury related to certain consumer products. METHODS: Forty-six empirical research reports along with 32 surveillance reports from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were examined to determine the approximate number of injuries associated with a given product per year and any trends in frequency. Percentages of injuries that: (1) resulted in hospitalization, (2) appeared to result from the product itself and (3) were associated with risky or inappropriate use and/or non-use of a helmet were also extracted from the reports. RESULTS: Outdoor play and sports equipment appear to be associated with the greatest numbers of injuries. A relatively high proportion of injuries appear to result from inappropriate or risky use of a product and/or inadequate safety precautions. CONCLUSION: This review identified the following areas of concern regarding consumer products and injuries: lack of helmet use by people using in-line skates, sleds, snowboards, downhill skis and personal-powered watercraft; operation of all-terrain vehicles (ATVs) and snowmobiles by alcohol-impaired people; operation of snowmobiles at excessive speeds; poor design of playground equipment; and unsafe storage and use of matches.
Pain and health-related quality of life in people with chronic leg ulcers.
Hopman WM, Buchanan M, VanDenKerkhof EG … +1 more , Harrison MB
Chronic Dis Inj Can · 2013 Jun · PMID 23735456
INTRODUCTION: Venous leg ulceration is associated with pain and poor health-related quality of life (HRQL). The purpose of this study was to identify demographic and clinical characteristics associated with pain and decr...
INTRODUCTION: Venous leg ulceration is associated with pain and poor health-related quality of life (HRQL). The purpose of this study was to identify demographic and clinical characteristics associated with pain and decreased HRQL in patients with active venous ulcers. METHODS: Baseline data were combined from two trials that took place between 2001 and 2007 (n = 564). Pain was measured using the Numeric Pain Scale (NPS), and HRQL was measured using the Medical Outcomes Survey 12-item Short Form (SF-12), which generates a Physical (PCS) and Mental Component Summary (MCS). Analyses included logistic and linear regression (for pain and HRQL, respectively). RESULTS: Mean age was 66.5 years; 47% were male. Median NPS score was 2.2 (out of 10) and mean PCS and MCS scores were 38.0 and 50.5, respectively (scores are standardized to a mean of 50 representing average HRQL). Younger age, living with others, and arthritis were associated with pain. Poorer PCS was associated with being female, venous/mixed ulcer etiology, larger ulcers, longer ulcer duration, cardiovascular disease, arthritis and higher pain intensity. Poorer MCS was associated with younger age, longer ulcer duration, comorbidity and higher pain intensity. CONCLUSION: Research is needed to test strategies to reduce pain and possibly improve HRQL in high risk groups.
Identifying cases of congestive heart failure from administrative data: a validation study using primary care patient records.
Schultz SE, Rothwell DM, Chen Z … +1 more , Tu K
Chronic Dis Inj Can · 2013 Jun · PMID 23735455
INTRODUCTION: To determine if using a combination of hospital administrative data and ambulatory care physician billings can accurately identify patients with congestive heart failure (CHF), we tested 9 algorithms for id...
INTRODUCTION: To determine if using a combination of hospital administrative data and ambulatory care physician billings can accurately identify patients with congestive heart failure (CHF), we tested 9 algorithms for identifying individuals with CHF from administrative data. METHODS: The validation cohort against which the 9 algorithms were tested combined data from a random sample of adult patients from EMRALD, an electronic medical record database of primary care physicians in Ontario, Canada, and data collected in 2004/05 from a random sample of primary care patients for a study of hypertension. Algorithms were evaluated on sensitivity, specificity, positive predictive value, area under the curve on the ROC graph and the combination of likelihood ratio positive and negative. RESULTS: We found that that one hospital record or one physician billing followed by a second record from either source within one year had the best result, with a sensitivity of 84.8% and a specificity of 97.0%. CONCLUSION: Population prevalence of CHF can be accurately measured using combined administrative data from hospitalization and ambulatory care.
Deprivation and food access and balance in Saskatoon, Saskatchewan.
Cushon J, Creighton T, Kershaw T … +2 more , Marko J, Markham T
Chronic Dis Inj Can · 2013 Jun · PMID 23735454
INTRODUCTION: We explored food access and balance in Saskatoon, Saskatchewan, Canada in relation to material and social deprivation. METHODS: We mapped the location of all large supermarkets and fast food retailers in Sa...
INTRODUCTION: We explored food access and balance in Saskatoon, Saskatchewan, Canada in relation to material and social deprivation. METHODS: We mapped the location of all large supermarkets and fast food retailers in Saskatoon. Supermarket accessibility index scores and food balance scores were compared to material and social deprivation indexes to determine significant associations. RESULTS: Our results indicate that the poorest access to supermarkets occurred in areas west of the South Saskatchewan River and also in suburban areas around the perimeter of the city. Areas west of the river are some of the most deprived areas in the city. Saskatoon's mean food balance ratio of 2.3 indicates that access favours fast food. However, we did not find a clear pattern or clear socio-economic gradient for most measures. CONCLUSION: This study highlights the importance of contextual studies of food access. This study also highlighted a number of other issues that should be explored in the Saskatoon context such as individual-level food consumption patterns, mobility, temporal dimensions of food access and economic access as well as interventions that could improve food access in the city.
Evolution of the determinants of chronic liver disease in Quebec.
Sanabria AJ, Dion R, Lúcar E … +1 more , Soto JC
Chronic Dis Inj Can · 2013 Jun · PMID 23735453
INTRODUCTION: Chronic liver diseases (CLDs) are a worldwide problem. Morbidity and mortality due to CLDs could be avoided or reduced by targeting the main risk factors, including obesity and alcohol use. METHODS: To desc...
INTRODUCTION: Chronic liver diseases (CLDs) are a worldwide problem. Morbidity and mortality due to CLDs could be avoided or reduced by targeting the main risk factors, including obesity and alcohol use. METHODS: To describe the evolution of the key determinants of CLDs in Quebec, we studied the trends in obesity, alcohol use, viral hepatitis B and C, CLD mortality and hospitalization rates, and the liver cancer incidence rate between January 1, 1981, and December 31, 2009. RESULTS: We observed an increase in the obesity indicators among young men and in alcohol use among adolescent girls and middle-aged women. The overall hepatitis B and C incidence and CLD mortality rates are falling. However, liver cancer and mortality rates, especially among men and the elderly, are on the rise. CONCLUSION: These results highlight the importance of targeted public health interventions and of maintaining or improving access to care for CLDs.
Emergency department presentations for injuries associated with inflatable amusement structures, Canada, 1990-2009.
McFaull SR, Keays G
Chronic Dis Inj Can · 2013 Jun · PMID 23735452
INTRODUCTION: Inflatable amusement attractions, structures that are air-supported and inflated by a blower, have recently gained popularity. The purpose of this study was to describe the epidemiology of inflatable-relate...
INTRODUCTION: Inflatable amusement attractions, structures that are air-supported and inflated by a blower, have recently gained popularity. The purpose of this study was to describe the epidemiology of inflatable-related injuries presenting to Canadian emergency departments. METHODS: The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system presently operating in the emergency departments of all 11 pediatric and 4 general hospitals across Canada. The CHIRPP was searched for cases of injuries associated with commercial inflatable amusement structures. RESULTS: Overall, 674 cases were identified over the 20-year surveillance period, during which time the average annual percent increase was 24.6% (95% CI: 21.6, 27.7). Children aged 2 to 9 years were the most frequently injured (59.3/100,000 CHIRPP cases), and fractures accounted for 34.5% of all injuries. DISCUSSION: A sharp increase in emergency department visits for injuries associated with commercial inflatable amusement structures has been observed in recent years. Injury mechanisms could be mitigated by product design modifications and stricter business operational practices.
Quantifying Canadians' use of the Internet as a source of information on behavioural risk factor modifications related to cancer prevention.
Richardson CG, Hamadani LG, Gotay C
Chronic Dis Inj Can · 2013 Jun · PMID 23735451
INTRODUCTION: The purpose of this study was to quantify the frequency and timing of Canadians' Internet searches for information on modifying cancer prevention-related behavioural risk factors. METHODS: We used the Googl...
INTRODUCTION: The purpose of this study was to quantify the frequency and timing of Canadians' Internet searches for information on modifying cancer prevention-related behavioural risk factors. METHODS: We used the Google AdWords Keyword tool to estimate the number of Internet searches in Canada from July 2010 to May 2011 for content associated with the keywords "physical activity / exercise," "healthy eating / weight loss" and "quit smoking." RESULTS: For "physical activity / exercise," 663 related keywords resulted in 117 951 699 searches. For "healthy eating / weight loss," 687 related search terms yielded 98 277 954 searches. "Quit smoking" was associated with 759 related keywords with 31 688 973 searches. All search patterns noticeably peaked in January 2011. CONCLUSION: Many Canadians are actively searching for information on the Internet to support health behaviour change associated with cancer prevention, especially during the month of January. To take advantage of this opportunity, key stakeholders in cancer prevention need to identify knowledge translation priorities and work with health agencies to develop evidence-based strategies to support Internet-facilitated behaviour change.
The economic burden of traumatic spinal cord injury in Canada.
Krueger H, Noonan VK, Trenaman LM … +2 more , Joshi P, Rivers CS
Chronic Dis Inj Can · 2013 Jun · PMID 23735450
INTRODUCTION: The purpose of this study is to estimate the current lifetime economic burden of traumatic spinal cord injury (tSCI) in Canada from a societal perspective, including both direct and indirect costs, using an...
INTRODUCTION: The purpose of this study is to estimate the current lifetime economic burden of traumatic spinal cord injury (tSCI) in Canada from a societal perspective, including both direct and indirect costs, using an incidence-based approach. METHODS: Available resource use and cost information for complete/incomplete tetraplegia and paraplegia was applied to the estimated annual incidence of tSCI, by severity, in Canada. RESULTS: The estimated lifetime economic burden per individual with tSCI ranges from $1.5 million for incomplete paraplegia to $3.0 million for complete tetraplegia. The annual economic burden associated with 1389 new persons with tSCI surviving their initial hospitalization is estimated at $2.67 billion. CONCLUSION: While the number of injuries per year in Canada is relatively small, the annual economic burden is substantial.
CSEB Student Conference 2012 abstract winners.
Chronic Dis Inj Can · 2013 Mar · PMID 23470177
Chronic Diseases and Injuries in Canada (CDIC) was pleased to manage, once again, the student abstract contest for the Canadian Society for Epidemiology and Biostatistics (CSEB) Student Conference, which was held at the...
Chronic Diseases and Injuries in Canada (CDIC) was pleased to manage, once again, the student abstract contest for the Canadian Society for Epidemiology and Biostatistics (CSEB) Student Conference, which was held at the University of Saskatchewan in May 2012. An editorial panel from the Public Health Agency of Canada judged 42 abstract submissions and selected the top 7 to be published in this issue of the journal.
Report summary--Health-Adjusted Life Expectancy in Canada: 2012 Report by the Public Health Agency of Canada.
Public Health Agency of Canada Steering Committee on Health-Adjusted Life Expectancy
Chronic Dis Inj Can · 2013 Mar · PMID 23470176
Abstract loading — click title to view on PubMed.
Unintentional injury mortality and external causes in Canada from 2001 to 2007.
Chen Y, Mo F, Yi QL … +2 more , Jiang Y, Mao Y
Chronic Dis Inj Can · 2013 Mar · PMID 23470175
INTRODUCTION: To understand the distribution pattern and time trend of unintentional injury mortalities is crucial in order to develop prevention strategies. METHODS: We analyzed vital statistics data from Canada (exclud...
INTRODUCTION: To understand the distribution pattern and time trend of unintentional injury mortalities is crucial in order to develop prevention strategies. METHODS: We analyzed vital statistics data from Canada (excluding Quebec) for 2001 to 2007. Mortality rates were age- and sex-standardized to the 2001 Canadian population. An autoregressive model was used for time-series analysis. RESULTS: Overall mortality rate steadily decreased but unintentional injury mortality rate was stable over the study period. The three territories had the highest mortality rates. Unintentional injury deaths were less common in children than in youths/adults. After 60, the mortality rate increased steadily with age. Males were more likely to die of unintentional injury, and the male/female ratio peaked in the 25- to 29-year age group. Motor vehicle crashes, falls and poisoning were the three major causes. There was a substantial year after year increase in mortality due to falls. Deaths due to motor vehicle crashes and drowning were more common in summer months, and deaths caused by falls and burns were more common in winter months. CONCLUSION: The share of unintentional injury among all-cause mortality and the mortality from falls increased in Canada during the period 2001 to 2007.
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