Chronic Diseases And Injuries In Canada[JOURNAL]
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118 papers
Validating the CANRISK prognostic model for assessing diabetes risk in Canada's multi-ethnic population.
Robinson CA, Agarwal G, Nerenberg K
Chronic Dis Inj Can · 2011 Dec · PMID 22153173
INTRODUCTION: Despite high rates of undiagnosed diabetes and prediabetes, suitable risk assessment tools for estimating personal diabetes risk in Canada are currently lacking. METHODS: We conducted a cross-sectional scre...
INTRODUCTION: Despite high rates of undiagnosed diabetes and prediabetes, suitable risk assessment tools for estimating personal diabetes risk in Canada are currently lacking. METHODS: We conducted a cross-sectional screening study that evaluated the accuracy and discrimination of the new Canadian Diabetes Risk Assessment Questionnaire (CANRISK) for detecting diabetes and prediabetes (dysglycemia) in 6223 adults of various ethnicities. All participants had their glycemic status confirmed with the oral glucose tolerance test (OGTT). We developed electronic and paper-based CANRISK scores using logistic regression, and then validated them against reference standard blood tests using test-set methods. We used area under the curve (AUC) summary statistics from receiver operating characteristic (ROC) analyses to compare CANRISK with other alternative risk-scoring models in terms of their ability to discern true dysglycemia. RESULTS: The AUC for electronic and paper-based CANRISK scores were 0.75 (95% CI: 0.73-0.78) and 0.75 (95% CI: 0.73-0.78) respectively, as compared with 0.66 (95% CI: 0.63-0.69) for the Finnish FINDRISC score and 0.69 (95% CI: 0.66-0.72) for a simple Obesity model that included age, BMI, waist circumference and sex. CONCLUSION: CANRISK is a statistically valid tool that may be suitable for assessing diabetes risk in Canada's multi-ethnic population. CANRISK was significantly more accurate than both the FINDRISC score and the simple Obesity model.
Piloting the CANRISK tool in Vancouver Coastal Health.
Papineau D, Fong M
Chronic Dis Inj Can · 2011 Dec · PMID 22153172
INTRODUCTION: Vancouver Coastal Health Authority's Healthy Living Program implemented this pilot study to test and validate the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) developed by the Public Health Age...
INTRODUCTION: Vancouver Coastal Health Authority's Healthy Living Program implemented this pilot study to test and validate the Canadian Diabetes Risk Assessment Questionnaire (CANRISK) developed by the Public Health Agency of Canada as a screening tool for undiagnosed type 2 diabetes mellitus (DM) and prediabetes. Key objectives were to test the feasibility and acceptability of screening urban ethnic groups using the CANRISK, increase awareness of risk factors for DM and preDM and develop resources for lifestyle change. METHODS: The study recruited participants through community groups and churches, intraorganizational emails, primary care clinics and word of mouth. They completed the CANRISK and an oral glucose tolerance test (OGTT) either individually or as part of a group. Groups received a brief diabetes prevention information session. Documents to support lifestyle change were distributed to all participants. RESULTS: Participants (n = 556) were recruited among East Asian, Caucasian, South Asian and Latin American ethnic groups. Of these, 17% had OGTT results in the preDM range and 3% in the DM range. Over 90% of participants reported that the CANRISK wording was clear and that they had received useful information about lowering their diabetes risk. CONCLUSION: The benefit of using an OGTT was in identifying 11% of the sample of participants who had impaired glucose tolerance (IGT) and did not show abnormal fasting plasma glucose (FPG) results. All participants with abnormal laboratory results were provided with follow-up educational interventions in their own language.
Nova Scotia Prediabetes Project: upstream screening and community intervention for prediabetes and undiagnosed type 2 diabetes.
Talbot P, Dunbar MJ
Chronic Dis Inj Can · 2011 Dec · PMID 22153171
INTRODUCTION: Identifying individuals in the prediabetic state may help delay/prevent disease progression to type 2 diabetes mellitus. We explored the feasibility of a household mailing approach for population-based scre...
INTRODUCTION: Identifying individuals in the prediabetic state may help delay/prevent disease progression to type 2 diabetes mellitus. We explored the feasibility of a household mailing approach for population-based screening of prediabetes and unidentified type 2 diabetes mellitus, developed standard protocol, and developed and implemented community-based lifestyle programs. METHODS: The 16-item Canadian Diabetes Risk Assessment Questionnaire (CANRISK) was mailed to every household in two rural Nova Scotia communities. In total 417 participants aged 40 to 74 years with no prior diagnosis of diabetes self-administered the CANRISK and completed a 2-hour oral glucose tolerance test (OGTT) at a local health care facility. Those with prediabetes were invited to participate in a Prediabetes Lifestyle Program. RESULTS: Glycemic status was identified as normal, prediabetes or diabetes for 84%, 13% and 3% of participants, respectively. Association between glycemic status and overall CANRISK risk score was statistically significant. Six CANRISK items were significantly associated with glycemic status: body mass index, waist circumference, history of hypertension and hyperglycemia, education and perceived health status. Participants and physicians gave positive feedback on the CANRISK screening process. CONCLUSION: The CANRISK holds promise as a population-based screening tool.
Prediabetes, CANRISK and screening in Canada.
Butler-Jones D
Chronic Dis Inj Can · 2011 Dec · PMID 22153170
Abstract loading — click title to view on PubMed.
Patterns of health services utilization in rural Canada.
Pong RW, DesMeules M, Heng D … +10 more , Lagacé C, Guernsey JR, Kazanjian A, Manuel D, Pitblado JR, Bollman R, Koren I, Dressler MP, Wang F, Luo W
Chronic Dis Inj Can · 2011 · PMID 22047772
CONTEXT OF THIS STUDY: Canadians value ease of access to their health services. Although many studies have focused on accessibility to health services in Canada, few have examined rural-urban differences in this aspect,...
CONTEXT OF THIS STUDY: Canadians value ease of access to their health services. Although many studies have focused on accessibility to health services in Canada, few have examined rural-urban differences in this aspect, particularly from a national perspective. Yet disparities in access to health services exist between rural and urban populations, as do the challenges of delivering health care to more remote areas or to those with small populations. "Canada's Rural Communities: Understanding Rural Health and Its Determinants" is a three-year research project co-funded by the Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC). It involves investigators from the Public Health Agency of Canada, the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University, and other researchers. The first publication of the research project was How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants; this, the second publication, is a descriptive analysis of the utilization patterns of a broad range of health services by rural residents compared to their urban counterparts.
Online resources to enhance decision-making in public health.
Finkle-Perazzo D, Jetha N
Chronic Dis Inj Can · 2011 Sep · PMID 21978641
A virtual front door, the Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention ("the Portal") provides access to evaluated community and population health interventions relevant to chronic d...
A virtual front door, the Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention ("the Portal") provides access to evaluated community and population health interventions relevant to chronic disease prevention and health promotion. Designed to help Canadian public health practitioners and decision makers identify suitable interventions that they can adapt and replicate to meet their needs, the Portal is a highly accessible, easy to use and dynamic. It has a flexible search function and is supported by an extensive array of resources to inform policy and practice. Launched in 2006, the Portal forms a central pillar of the Canadian Best Practices Initiative, which was established by the Public Health Agency of Canada (PHAC) to improve policy and program decision-making by enabling access to the best available evidence on chronic disease prevention and health promotion practices. Throughout each phase of the Portal's development, more and more current public health topics and new decision-making tools have been added. As of February 2011, the Portal provides information on about 357 interventions and access to 58 resources. In this article, we aim to demonstrate the unique role of the Portal within the broader context of other available online resources. We use the concept of a "pyramid of evidence" to compare the Portal with one specific resource, Health-evidence.ca, to illustrate how public health practitioners and decision makers can use these resources together to make better, more evidence-informed decisions.
Can we use medical examiners' records for suicide surveillance and prevention research in Nova Scotia?
Campbell LA, Jackson L, Bassett R … +4 more , Bowes MJ, Donahue M, Cartwright J, Kisely S
Chronic Dis Inj Can · 2011 Sep · PMID 21978640
INTRODUCTION: Medical examiners' records can contribute to our understanding of the extent of suicide in a population, as well as associated sociodemographic and other factors. METHODS: Using a mixed methods approach, th...
INTRODUCTION: Medical examiners' records can contribute to our understanding of the extent of suicide in a population, as well as associated sociodemographic and other factors. METHODS: Using a mixed methods approach, the key objective of this pilot study was to determine the sources and types of information found in the Nova Scotia Medical Examiner Service (NSMES) records that might inform suicide surveillance and targeted prevention efforts. A secondary objective was to describe the one-year cohort of 108 individuals who died by suicide in 2006 in terms of available sociodemographic information and health care use in the year prior to death. RESULTS: Data extraction revealed inconsistencies both across and within files in terms of the types and amounts of sociodemographic and other data collected, preventing correlational analyses. However, linkage of the records to administrative databases revealed frequent health care use in the month prior to death. CONCLUSION: The introduction of systematic data collection to NSMES investigations may yield a comprehensive dataset useful for policy development and population level research.
The prevalence of chronic pain and pain-related interference in the Canadian population from 1994 to 2008.
Reitsma ML, Tranmer JE, Buchanan DM … +1 more , Vandenkerkhof EG
Chronic Dis Inj Can · 2011 Sep · PMID 21978639
INTRODUCTION: Estimates of the prevalence of chronic pain worldwide and in Canada are inconsistent. Our primary objectives were to determine the prevalence of chronic pain by sex and age and to determine the prevalence o...
INTRODUCTION: Estimates of the prevalence of chronic pain worldwide and in Canada are inconsistent. Our primary objectives were to determine the prevalence of chronic pain by sex and age and to determine the prevalence of pain-related interference for Canadian men and women between 1994 and 2008. METHODS: Using data from seven cross-sectional cycles in the National Population Health Survey and the Canadian Community Health Survey, we defined two categorical outcomes, chronic pain and pain-related interference with activities. RESULTS: Prevalence of chronic pain ranged from 15.1% in 1996/97 to 18.9% in 1994/95. Chronic pain was most prevalent among women (range: 16.5% to 21.5%), and in the oldest (65 years plus) age group (range: 23.9% to 31.3%). Women aged 65 years plus consistently reported the highest prevalence of chronic pain (range: 26.0% to 34.2%). The majority of adult Canadians who reported chronic pain also reported at least a few activities prevented due to this pain (range: 11.4% to 13.3% of the overall population). CONCLUSION: Similar to international estimates, this Canadian population-based study confirms that chronic pain persists and impacts daily activities. Further study with more detailed definitions of pain and pain-related interference is warranted.
A review of screening mammography participation and utilization in Canada.
Doyle GP, Major D, Chu C … +5 more , Stankiewicz A, Harrison ML, Pogany L, Mai VM, Onysko J
Chronic Dis Inj Can · 2011 Sep · PMID 21978638
INTRODUCTION: Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The obje...
INTRODUCTION: Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. METHODS: Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. RESULTS: Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. CONCLUSION: Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.
Priority issues in occupational cancer research: Ontario stakeholder perspectives.
Hohenadel K, Pichora E, Marrett L … +5 more , Bukvic D, Brown J, Harris SA, Demers PA, Blair A
Chronic Dis Inj Can · 2011 Sep · PMID 21978637
INTRODUCTION: Workers are potentially exposed to known and suspected carcinogens in the workplace, many of which have not been fully evaluated. Despite persistent need, research on occupational cancer appears to have dec...
INTRODUCTION: Workers are potentially exposed to known and suspected carcinogens in the workplace, many of which have not been fully evaluated. Despite persistent need, research on occupational cancer appears to have declined in recent decades. The formation of the Occupational Cancer Research Centre (OCRC) is an effort to counter this downward trend in Ontario. The OCRC conducted a survey of the broad stakeholder community to learn about priority issues on occupational cancer research. METHODS: The OCRC received 177 responses to its survey from academic, health care, policy, industry, and labour-affiliated stakeholders. Responses were analyzed based on workplace exposures, at-risk occupations and cancers by organ system, stratified by respondents' occupational role. DISCUSSION: Priority issues identified included workplace exposures such as chemicals, respirable dusts and fibres (e.g. asbestos), radiation (e.g. electromagnetic fields), pesticides, and shift work; and occupations such as miners, construction workers, and health care workers. Insufficient funding and a lack of exposure data were identified as the central barriers to conducting occupational cancer research. CONCLUSION: The results of this survey underscore the great need for occupational cancer research in Ontario and beyond. They will be very useful as the OCRC develops its research agenda.
Screen-based sedentary behaviours among a nationally representative sample of youth: are Canadian kids couch potatoes?
Leatherdale ST, Ahmed R
Chronic Dis Inj Can · 2011 Sep · PMID 21978636
PURPOSE: To determine the percentage of Canadian youth meeting screen-time guidelines and to identify characteristics associated with different screen-time behaviours. METHODS: Using nationally representative data collec...
PURPOSE: To determine the percentage of Canadian youth meeting screen-time guidelines and to identify characteristics associated with different screen-time behaviours. METHODS: Using nationally representative data collected from the 2008/2009 Youth Smoking Survey (YSS), we analyzed three screen-time behaviours, cigarette smoking, weekly spending money, self esteem, region and grade by sex, and conducted four logistic regression models to examine factors associated with more than 2 hours a day of sedentary screen time. RESULTS: Of 51 922 Canadian youth in grades 6 to 12, 50.9% spent more than 2 hours per day in screen-based behaviours. The average daily screen time was 7.8 (± 2.3) hours. Males and current smokers were more likely to report over 2 hours per day watching TV and videos or playing video games, whereas students in higher grades and those with weekly spending money were more likely to report playing or surfing on a computer. Youth with higher self-esteem were less likely to report spending over 2 hours per day in each of the three screen-time behaviours examined. CONCLUSION: Developing a better understanding of the factors associated with more hours of screen time is required to develop and target interventions that reduce screen-time behaviours.
Life with arthritis in Canada: a personal and public health challenge.
O'Donnell S, Lagacé C, McRae L … +1 more , Bancej C
Chronic Dis Inj Can · 2011 Jun · PMID 21733351
"Arthritis" describes more than 100 conditions that affect the joints, the tissues that surround joints and other connective tissue. These conditions range from relatively mild forms of tendonitis and bursitis to systemi...
"Arthritis" describes more than 100 conditions that affect the joints, the tissues that surround joints and other connective tissue. These conditions range from relatively mild forms of tendonitis and bursitis to systemic illnesses, such as rheumatoid arthritis. Life with arthritis in Canada: a personal and public health challenge presents the latest knowledge about arthritis in the Canadian population and its wide-ranging impact. It provides an overview of the impact of arthritis, and is designed to increase public awareness of the importance of prevention and timely management. Although progress has been made on interventions, arthritis remains common, disabling and costly. Increasing participation in physical activity and maintaining a healthy body weight may help to mitigate the effects of arthritis.
Estimates of the treated prevalence of bipolar disorders by mental health services in the general population: comparison of results from administrative and health survey data.
Bulloch AG, Currie S, Guyn L … +3 more , Williams JV, Lavorato DH, Patten SB
Chronic Dis Inj Can · 2011 Jun · PMID 21733350
INTRODUCTION: Informed provision of population mental health services requires accurate estimates of disease burden. METHODS: We estimated the treated prevalence of bipolar disorders by mental health services in the Calg...
INTRODUCTION: Informed provision of population mental health services requires accurate estimates of disease burden. METHODS: We estimated the treated prevalence of bipolar disorders by mental health services in the Calgary Zone, a catchment area in Alberta with a population of over one million. Administrative data in a central repository provides information of mental health care contacts for about 95% of publically funded mental health services. We compared this treated prevalence against self-reported data in the 2002 Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). RESULTS: Of the 63 016 individuals aged 18 years plus treated in the Calgary Zone in 2002-2008, 3659 (5.81%) and 1065 (1.70%) were diagnosed with bipolar I and bipolar II disorder, respectively. The estimated treated population prevalence of these disorders was 0.41% and 0.12%, respectively. We estimated that 0.44% to 1.17% of the Canadian population was being treated by psychiatrists for bipolar I disorder from CCHS 1.2. DISCUSSION: For bipolar I disorder the estimate based on local administrative data is close to the lower end of the health survey range. The degree of agreement in our estimates reinforces the utility of administrative data repositories in the surveillance of chronic mental disorders.
An assessment of the barriers to accessing food among food-insecure people in Cobourg, Ontario.
Tsang S, Holt AM, Azevedo E
Chronic Dis Inj Can · 2011 Jun · PMID 21733349
INTRODUCTION: Low-income people are most vulnerable to food insecurity; many turn to community and/or charitable food programs to receive free or low-cost food. This needs assessment aims to collect information on the ba...
INTRODUCTION: Low-income people are most vulnerable to food insecurity; many turn to community and/or charitable food programs to receive free or low-cost food. This needs assessment aims to collect information on the barriers to accessing food programs, the opportunities for improving food access, the barriers to eating fresh vegetables and fruit, and the opportunities to increasing their consumption among food-insecure people in Cobourg, Ontario. METHODS: We interviewed food program clients using structured individual interviews consisting of mostly opened-ended questions. RESULTS: Food program clients identified barriers to using food programs as lack of transportation and the food programs having insufficient quantities of food or inconvenient operating hours. They also stated a lack of available vegetables and fruit at home, and income as barriers to eating more vegetables and fruit, but suggested a local fresh fruit and vegetable bulk-buying program called "Good Food Box" and community gardens as opportunities to help increase their vegetable and fruit intake. DISCUSSION: Many of the barriers and opportunities identified can be addressed by working with community partners to help low-income individuals become more food secure.
The influence of primary health care organizational models on patients' experience of care in different chronic disease situations.
Pineault R, Provost S, Hamel M … +2 more , Couture A, Levesque JF
Chronic Dis Inj Can · 2011 Jun · PMID 21733348
OBJECTIVES: To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by pat...
OBJECTIVES: To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. METHODS: We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no-chronic-disease group. RESULTS: Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.
Estimating gestational age at birth: a population-based derivation-validation study.
Urquia ML, Stukel TA, Fung K … +2 more , Glazier RH, Ray JG
Chronic Dis Inj Can · 2011 Jun · PMID 21733347
INTRODUCTION: Information on newborn gestational age (GA) is essential in research on perinatal and infant health, but it is not always available from administrative databases. We developed and validated a GA prediction...
INTRODUCTION: Information on newborn gestational age (GA) is essential in research on perinatal and infant health, but it is not always available from administrative databases. We developed and validated a GA prediction model for singleton births for use in epidemiological studies. METHODS: Derivation of estimated GA was calculated based on 130 328 newborn infants born in Ontario hospitals between 2007 and 2009, using linear regression analysis, with several infant and maternal characteristics as the predictor (independent) variables. The model was validated in a separate sample of 130 329 newborns. RESULTS: The discriminative ability of the linear model based on infant birth weight and sex was reasonably approximate for infants born before the 37th week of gestation (r2 = 0.67; 95% CI: 0.65-0.68), but not for term births (37-42 weeks; r2 = 0.12; 95% CI: 0.12-0.13). Adding other infant and maternal characteristics did not improve the model discrimination. CONCLUSION: Newborn gestational age before 37 weeks can be reasonably approximated using locally available data on birth weight and sex.
Patterns of fatal machine rollovers in Canadian agriculture.
DeGroot JM, Isaacs C, Pickett W … +1 more , Brison RJ
Chronic Dis Inj Can · 2011 Jun · PMID 21733346
INTRODUCTION: Our objectives were to examine the activities and circumstances associated with agricultural machine-related rollover fatalities. METHODS: We identified agricultural machine rollover fatalities recorded by...
INTRODUCTION: Our objectives were to examine the activities and circumstances associated with agricultural machine-related rollover fatalities. METHODS: We identified agricultural machine rollover fatalities recorded by the Canadian Agricultural Injury Surveillance Program (CAISP) in 1990-2005. We determined sideways and backwards rollovers by year, age and sex of the victims, agricultural season, machine type, and the activity, circumstances and location of the injury event. RESULTS: The annual rate of rollover fatalities in Canada was 9.1 per 100,000 farm operations. Rollover fatalities decreased to 30% of baseline over the 16-year study period (p = .004). Fatal rollovers most often occurred among men aged 50-69 years and 60-79 years for sideways and backwards rollovers, respectively. DISCUSSION: Sideways rollovers occur when driving across an incline or at the edge of a ditch bordering a roadway or field. Backwards rollovers occur when driving up an incline, towing or extracting stuck machines, pulling stumps or trees, and towing implements or logs. Primary prevention programs for rollover injuries should target these identified patterns of injury.
Non-communicable diseases--finally on the global agenda.
Wielgosz AT
Chronic Dis Inj Can · 2011 Jun · PMID 21733345
After the UN Millennium Development Goals were declared in September 2000 (see Table 1), one of the major short-comings recognized world-wide was the lack of mention of non-communicable diseases (NCDs). While AIDS and ma...
After the UN Millennium Development Goals were declared in September 2000 (see Table 1), one of the major short-comings recognized world-wide was the lack of mention of non-communicable diseases (NCDs). While AIDS and malaria were included, none of the leading and universal non-communicable causes of death made the list. There was no mention of cardiovascular diseases, cancer or diabetes, even though these place a far greater burden on global health and economic development than the infectious diseases, and are predicted to continue to increase in epidemic proportions. After much public discussion and intense lobbying, a significant-and uncommon-achievement occurred: on May 13th, 2010, the United Nations General Assembly voted in favour of convening a summit on non-communicable diseases, to take place in September 2011.
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