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Using the Severity of Dependence Scale to examine cannabis consumers with impaired control in Canada. 使用严重依赖量表来检查加拿大控制受损的大麻消费者。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-06-21 DOI: 10.25318/82-003-x202300600001-eng
Michelle Rotermann

Background: The 2018 Cannabis Act legalizing the production, sale, and use of cannabis for non-medical purposes renewed interest in the importance of ongoing and more detailed monitoring of cannabis consumption and consequences. Some cannabis users will experience impaired control over their use of cannabis, putting them at risk for cannabis use disorder (CUD, sometimes called addiction) and other harms. Including the Severity of Dependence Scale (SDS) in the annual Canadian Community Health Survey (CCHS) would allow for monitoring of one of the more harmful consequences of cannabis use in the post-legalization period.

Data and methods: Data from the nationally representative 2019-2020 CCHS were used to examine cannabis consumers with and without impaired control. Respondents who used cannabis in the past year were categorized according to their SDS scores: those with impaired control (SDS ≥ 4) versus those without impaired control (SDS < 4). Cross-tabulations were used to examine the sociodemographic, mental health, health behaviour and cannabis exposure characteristics of those with impaired control. Multivariable logistic regression models assessed associations between these characteristics and the risk of impaired control. The prevalence of self-reported cannabis-related problems experienced by consumers-with and without impaired control-is also presented.

Results: In 2019-2020, 4.7% of past-year cannabis consumers scored ≥ 4 on the SDS and were considered to have impaired control. Multivariable logistic regression suggested that the odds of having impaired control remained higher for people who were male, were aged 18 to 24 years, were single or never married, were from lower-income households, were diagnosed with an anxiety or a mood disorder, started consuming cannabis at age ≤ 15, and consumed at least monthly.

Interpretation: A better understanding of the characteristics of cannabis consumers experiencing impaired control (a correlate of future CUD or addiction) could help with the development of more effective education, prevention and treatment strategies.

背景:2018年《大麻法》将非医疗用途大麻的生产、销售和使用合法化,重新引起了人们对持续和更详细地监测大麻消费及其后果的重要性的关注。一些大麻使用者对使用大麻的控制会受损,使他们面临大麻使用障碍(CUD,有时称为成瘾)和其他危害的风险。在年度加拿大社区健康调查中列入依赖严重程度量表,将有助于监测大麻合法化后时期使用大麻的一种较为有害的后果。数据和方法:来自2019-2020年全国代表性CCHS的数据用于检查控制受损和不受损的大麻消费者。根据SDS得分对过去一年使用大麻的受访者进行分类:控制受损者(SDS≥4)与控制未受损者(SDS < 4)。交叉表用于检查控制受损者的社会人口学、心理健康、健康行为和大麻暴露特征。多变量逻辑回归模型评估了这些特征与控制受损风险之间的关联。消费者自我报告的大麻相关问题的患病率-有和没有控制受损-也被提出。结果:2019-2020年,4.7%的过去一年大麻消费者在SDS上得分≥4分,被认为控制受损。多变量逻辑回归表明,年龄在18至24岁之间、单身或未婚、来自低收入家庭、被诊断患有焦虑或情绪障碍、在≤15岁时开始吸食大麻,并且至少每月吸食一次大麻的男性,控制能力受损的几率仍然较高。解释:更好地了解大麻消费者控制受损的特征(与未来CUD或成瘾相关)有助于制定更有效的教育、预防和治疗战略。
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引用次数: 0
Sleep duration, sleep quality and obesity in the Canadian Armed Forces. 加拿大军队的睡眠时间,睡眠质量和肥胖。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-05-17 DOI: 10.25318/82-003-x202300500001-eng
Heather Gilmour, Diane Lu, Jane Y Polsky

Background: Research has identified an association between sleep and obesity in the general population. It is also important to examine this association in a military population.

Data and methods: Data from the 2019 Canadian Armed Forces Health Survey (CAFHS) were used to estimate the prevalence of sleep duration, sleep quality characteristics, overweight and obesity for Regular Force members. The relationship of sleep duration and sleep quality with obesity was assessed with multivariable logistic regression that controlled for sociodemographic, work and health characteristics.

Results: Females were significantly more likely than males to report meeting recommended sleep duration (7 hours to less than 10 hours; 48.7% vs. 40.4%), trouble falling or staying asleep (32.3% vs. 23.5%), or that sleep was not refreshing (64.0% vs. 57.7%). Difficulty staying awake did not differ significantly between males and females (6.3% vs. 5.4%). Obesity, but not being overweight, was significantly more prevalent among those who had short (less than 6 hours) or borderline (6 hours to less than 7 hours) sleep duration, or poor sleep quality. Compared with recommended sleep duration, short sleep duration (adjusted odds ratio [AOR] 1.3; 95% confidence interval [CI]: 1.2 to 1.6) and borderline sleep duration (AOR 1.2; 95% CI: 1.1 to 1.4) were associated with obesity for males, but not females, in fully controlled models. Sleep quality indicators were not independently associated with obesity.

Interpretation: This study adds to the body of evidence that identifies an association between sleep duration and obesity. The results emphasize the importance of sleep as one of the components of the Canadian Armed Forces Physical Performance Strategy.

背景:研究已经确定了一般人群中睡眠和肥胖之间的联系。在军人群体中研究这种关联也很重要。数据和方法:使用2019年加拿大武装部队健康调查(CAFHS)的数据来估计常规部队成员的睡眠时间、睡眠质量特征、超重和肥胖的患病率。采用控制社会人口统计学、工作和健康特征的多变量logistic回归评估睡眠持续时间和睡眠质量与肥胖的关系。结果:女性比男性更有可能报告达到建议的睡眠时间(7小时至少于10小时;48.7%对40.4%),难以入睡或保持睡眠(32.3%对23.5%),或者睡眠不清爽(64.0%对57.7%)。保持清醒的困难在男性和女性之间没有显著差异(6.3%比5.4%)。在睡眠时间短(少于6小时)或睡眠时间不稳定(6小时至少于7小时)或睡眠质量差的人群中,肥胖(但不超重)明显更为普遍。与推荐睡眠时间相比,短睡眠时间(调整优势比[AOR] 1.3;95%置信区间[CI]: 1.2 ~ 1.6)和临界睡眠时间(AOR 1.2;95% CI: 1.1 - 1.4)在完全控制的模型中,与男性肥胖相关,但与女性无关。睡眠质量指标与肥胖没有独立的联系。解释:这项研究进一步证明了睡眠时间和肥胖之间存在关联。研究结果强调了睡眠作为加拿大武装部队体能表现战略组成部分之一的重要性。
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引用次数: 0
The impact of updated clinical blood pressure guidelines on hypertension prevalence among children and adolescents. 最新临床血压指南对儿童和青少年高血压患病率的影响
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-04-19 DOI: 10.25318/82-003-x202300400001-eng
Tracey Bushnik, Thomas Ferrao, Alexander A Leung

Background: To date, population estimates of hypertension prevalence among children and adolescents in Canada have been based on clinical guidelines in the National High Blood Pressure Education Program's 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP 2004). In 2017, the American Academy of Pediatrics published updated guidelines in Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (AAP 2017), followed by Hypertension Canada in 2020 with its publication of Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children (HC 2020). This study compares national child and adolescent hypertension prevalence estimates based on NHBPEP 2004, AAP 2017 and HC 2020.

Data and methods: Six cycles of data spanning 2007 to 2019 from the Canadian Health Measures Survey were used to compare blood pressure (BP) categories and the prevalence of hypertension by sex and age group under all sets of guidelines for children and adolescents aged 6 to 17. The impact of applying AAP 2017 across time and selected characteristics, the resulting reclassification into a higher BP category under AAP 2017, and differences in hypertension prevalence resulting from applying HC 2020 versus AAP 2017 were examined.

Results: Prevalence of Stage 1 hypertension was higher among children and adolescents aged 6 to 17 under AAP 2017 and HC 2020 than under NHBPEP 2004. Overall hypertension prevalence was also higher, and obesity was a major factor associated with being reclassified into a higher BP category under AAP 2017.

Interpretation: Implementation of AAP 2017 and HC 2020 is associated with significant changes in the epidemiology of hypertension. Understanding the impact of applying updated clinical guidelines may help inform population surveillance efforts to track hypertension prevalence among Canada's children and adolescents.

背景:迄今为止,加拿大儿童和青少年高血压患病率的人口估计是基于2004年国家高血压教育计划关于儿童和青少年高血压的诊断、评估和治疗的第四份报告(NHBPEP 2004)的临床指南。2017年,美国儿科学会(American Academy of Pediatrics)发布了《儿童和青少年高血压筛查和管理临床实践指南》(AAP 2017)的更新指南,随后,加拿大高血压协会(Hypertension Canada)于2020年发布了《成人和儿童高血压预防、诊断、风险评估和治疗综合指南》(HC 2020)。本研究比较了基于NHBPEP 2004、AAP 2017和HC 2020的全国儿童和青少年高血压患病率估计。数据和方法:使用加拿大健康措施调查(Canadian Health Measures Survey) 2007年至2019年的六个周期数据,比较了在所有6至17岁儿童和青少年指南下按性别和年龄组划分的血压(BP)类别和高血压患病率。研究了应用AAP 2017的不同时间和选择特征的影响,在AAP 2017下重新分类到更高的血压类别,以及应用HC 2020与AAP 2017导致的高血压患病率差异。结果:根据AAP 2017和HC 2020, 6至17岁儿童和青少年的1期高血压患病率高于NHBPEP 2004。总体高血压患病率也较高,肥胖是在2017年AAP下被重新分类为高血压类别的主要因素。解释:AAP 2017和HC 2020的实施与高血压流行病学的显著变化相关。了解应用最新临床指南的影响可能有助于为人口监测工作提供信息,以跟踪加拿大儿童和青少年的高血压患病率。
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引用次数: 0
Characterizing polysubstance use: What do we know about use of cigarettes, vaping products, cannabis, and alcohol among Canadians? 表征多物质使用:我们对加拿大人使用香烟、电子烟产品、大麻和酒精的情况了解多少?
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-04-19 DOI: 10.25318/82-003-x202300400002-eng
Christine Czoli, Gabriella Luongo, Trevor Mischki

Introduction: Polysubstance use--the use of multiple substances on the same or different occasions--is a risk factor for substance use disorder. However, national surveillance of substance use in Canada has often focused on use of a single substance. To better understand and address polysubstance use, this study characterized the use of vaping products, cigarettes, inhaled cannabis, and alcohol among Canadians aged 15 years and older.

Methods: Nationally representative data from the 2020 Canadian Tobacco and Nicotine Survey were analyzed. Polysubstance use was assessed as use of at least two of the following in the past 30 days: smoking cigarettes, using vaping products (containing nicotine or flavours), using cannabis (in smoked and/or vaped form) and drinking alcohol (daily or weekly frequency).

Results: In 2020, past-30-day use of the examined substances was 4.7% for vaping products (1.5 million), 10.3% for cigarettes (3.2 million), 11.0% for inhaled cannabis (3.4 million), and 37.6% for weekly or daily use of alcohol (11.7 million). Polysubstance use was reported by 12.2% of Canadians (3.8 million) and was more prevalent among young Canadians, men and those who vaped. The most common combination of substances among polysubstance users included inhaled cannabis and weekly or daily use of alcohol (29.0%, or 1.1 million).

Conclusion: The use of vaping products, cigarettes, inhaled cannabis, and alcohol-individually and in combination-is substantial among Canadians. Frequent consumption of alcohol was most prevalent overall and, in contrast to the other examined substances, was common among Canadians of all ages. Findings may inform a polysubstance use approach for prevention policies and programs.

多物质使用——在相同或不同场合使用多种物质——是物质使用障碍的一个危险因素。然而,加拿大对物质使用的国家监测往往侧重于单一物质的使用。为了更好地了解和解决多物质使用问题,这项研究描述了15岁及以上的加拿大人使用电子烟产品、香烟、吸入大麻和酒精的情况。方法:分析2020年加拿大烟草和尼古丁调查中具有全国代表性的数据。多物质使用被评估为在过去30天内至少使用以下两种:吸烟,使用电子烟产品(含有尼古丁或香料),使用大麻(烟熏和/或电子烟形式)和饮酒(每天或每周频率)。结果:2020年,过去30天内使用这些物质的电子烟产品占4.7%(150万),香烟占10.3%(320万),吸入大麻占11.0%(340万),每周或每天使用酒精占37.6%(1170万)。据报告,12.2%的加拿大人(380万)使用多种物质,在加拿大年轻人、男性和吸电子烟的人中更为普遍。多种物质使用者中最常见的物质组合包括吸入大麻和每周或每天使用酒精(29.0%,即110万人)。结论:电子烟产品、香烟、吸入大麻和酒精的使用——无论是单独使用还是组合使用——在加拿大人中都很普遍。总的来说,经常饮酒是最普遍的,与其他被调查的物质相比,在所有年龄段的加拿大人中都很普遍。研究结果可以为预防政策和项目的多物质使用方法提供信息。
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引用次数: 0
Exploring the intersectionality of characteristics among those who experienced opioid overdoses: A cluster analysis. 探索阿片类药物过量患者特征的交叉性:聚类分析。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-15 DOI: 10.25318/82-003-x202300300001-eng
Kenneth Chu, Gisèle Carrière, Rochelle Garner, Kevin Bosa, Deirdre Hennessy, Claudia Sanmartin

Background: As Canada continues to experience an opioid crisis, it is important to understand the intersection between the demographic, socioeconomic and service use characteristics of those experiencing opioid overdoses to better inform prevention and treatment programs.

Data and methods: The Statistics Canada British Columbia Opioid Overdose Analytical File (BCOOAF) represents people's opioid overdoses between January 2014 and December 2016 (n = 13,318). The BCOOAF contains administrative health data from British Columbia linked to Statistics Canada data, including on health, employment, social assistance and police contacts. Cluster analysis was conducted using the k-prototypes algorithm.

Results: The results revealed a six-cluster solution, composed of three groups (A, B and C), each with two distinct clusters (1 and 2). Individuals in Group A were predominantly male, used non-opioid prescription medications and had varying levels of employment. Individuals in Cluster A1 were employed, worked mostly in construction, had high incomes and had a high rate of fatal overdoses, while individuals in Cluster A2 were precariously employed and had varying levels of income. Individuals in Group B were predominantly female; were mostly taking prescription opioids, with about one quarter or less receiving opioid agonist treatment (OAT); mostly had precarious to no employment; and had low to no income. People in Cluster B1 were primarily middle-aged (45 to 65 years) and on social assistance, while people in Cluster B2 were older, more frequently used health services and had no social assistance income. Individuals in Group C were primarily younger males aged 24 to 44 years, with higher prevalence of having experienced multiple overdoses, were medium to high users of health care services, were mostly unemployed and were recipients of social assistance. Most had multiple contacts with police. Those in Cluster C1 predominantly had no documented use of prescription opioid medications, and all had no documented OAT, while all individuals in Cluster C2 were on OAT.

Interpretation: The application of machine learning techniques to a multidimensional database enables an intersectional approach to study those experiencing opioid overdoses. The results revealed distinct patient profiles that can be used to better target interventions and treatment.

背景:随着加拿大继续经历阿片类药物危机,了解阿片类药物过量患者的人口统计学、社会经济和服务使用特征之间的交集,以更好地为预防和治疗方案提供信息,这一点很重要。数据和方法:加拿大统计局不列颠哥伦比亚省阿片类药物过量分析文件(BCOOAF)代表了2014年1月至2016年12月期间人们的阿片类药物过量(n = 13,318)。BCOOAF载有与加拿大统计局数据相联系的不列颠哥伦比亚省行政卫生数据,包括卫生、就业、社会援助和警察联系方面的数据。采用k-prototype算法进行聚类分析。结果:结果揭示了一个六簇解决方案,由三组(a, B和C)组成,每组有两个不同的簇(1和2)。a组的个体主要是男性,使用非阿片类处方药,有不同程度的就业。A1组的个人就业,主要从事建筑工作,收入高,致命的过量用药率高,而A2组的个人就业不稳定,收入水平各不相同。B组以雌性为主;主要服用处方阿片类药物,约四分之一或更少的人接受阿片类药物激动剂治疗(OAT);大多数人都不稳定或没有工作;收入很低甚至没有。B1组的人主要是中年人(45至65岁),依靠社会援助,而B2组的人年龄较大,更经常使用保健服务,没有社会援助收入。C组的个人主要是年龄在24至44岁之间的年轻男性,多次过量用药的发生率较高,是保健服务的中高使用者,大多失业,接受社会援助。大多数人都与警方有过多次接触。C1组的患者主要没有处方阿片类药物的使用记录,并且所有患者都没有OAT记录,而C2组的所有患者都在使用OAT。解释:将机器学习技术应用于多维数据库,可以采用交叉方法来研究那些经历阿片类药物过量的人。结果揭示了不同的患者概况,可以用来更好地进行目标干预和治疗。
{"title":"Exploring the intersectionality of characteristics among those who experienced opioid overdoses: A cluster analysis.","authors":"Kenneth Chu,&nbsp;Gisèle Carrière,&nbsp;Rochelle Garner,&nbsp;Kevin Bosa,&nbsp;Deirdre Hennessy,&nbsp;Claudia Sanmartin","doi":"10.25318/82-003-x202300300001-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300300001-eng","url":null,"abstract":"<p><strong>Background: </strong>As Canada continues to experience an opioid crisis, it is important to understand the intersection between the demographic, socioeconomic and service use characteristics of those experiencing opioid overdoses to better inform prevention and treatment programs.</p><p><strong>Data and methods: </strong>The Statistics Canada British Columbia Opioid Overdose Analytical File (BCOOAF) represents people's opioid overdoses between January 2014 and December 2016 (n = 13,318). The BCOOAF contains administrative health data from British Columbia linked to Statistics Canada data, including on health, employment, social assistance and police contacts. Cluster analysis was conducted using the k-prototypes algorithm.</p><p><strong>Results: </strong>The results revealed a six-cluster solution, composed of three groups (A, B and C), each with two distinct clusters (1 and 2). Individuals in Group A were predominantly male, used non-opioid prescription medications and had varying levels of employment. Individuals in Cluster A1 were employed, worked mostly in construction, had high incomes and had a high rate of fatal overdoses, while individuals in Cluster A2 were precariously employed and had varying levels of income. Individuals in Group B were predominantly female; were mostly taking prescription opioids, with about one quarter or less receiving opioid agonist treatment (OAT); mostly had precarious to no employment; and had low to no income. People in Cluster B1 were primarily middle-aged (45 to 65 years) and on social assistance, while people in Cluster B2 were older, more frequently used health services and had no social assistance income. Individuals in Group C were primarily younger males aged 24 to 44 years, with higher prevalence of having experienced multiple overdoses, were medium to high users of health care services, were mostly unemployed and were recipients of social assistance. Most had multiple contacts with police. Those in Cluster C1 predominantly had no documented use of prescription opioid medications, and all had no documented OAT, while all individuals in Cluster C2 were on OAT.</p><p><strong>Interpretation: </strong>The application of machine learning techniques to a multidimensional database enables an intersectional approach to study those experiencing opioid overdoses. The results revealed distinct patient profiles that can be used to better target interventions and treatment.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 3","pages":"3-14"},"PeriodicalIF":5.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Daily accelerometer-measured physical activity patterns and associations with cardiometabolic health among Canadian working adults. 加拿大工作成年人每日加速计测量的身体活动模式及其与心脏代谢健康的关系
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-03-15 DOI: 10.25318/82-003-x202300300002-eng
Aviroop Biswas, Cynthia Chen, Stephanie A Prince, Peter M Smith, Cameron A Mustard

Background: Previous studies examining the cardiometabolic risks associated with physical activity (PA) in workers have predominantly used self-reported measures. Little is known about workers' distinct daily PA patterns and whether these are linked with cardiometabolic risks. This study examined associations between patterns of workers' accelerometer-measured daily PA and four markers of cardiometabolic health.

Data and methods: Working adults (N=8,229; 47% women; average age: 42 years; standard deviation = 0.3) were sampled from the Canadian Health Measures Survey (five cycles: 2007 to 2017). Accelerometer devices measured daily PA, and hierarchical cluster analysis identified distinct activity patterns. Multiple linear regression analyses examined associations between activity patterns and cardiometabolic risk markers (waist circumference, systolic and diastolic blood pressure, and non-high-density lipoprotein [HDL] cholesterol).

Results: Workers were classified into six distinct activity patterns. On average, compared with workers classified in the "lowest activity" pattern, workers with the "moderate consistent activity," "fluctuating moderate activity," "high daytime activity" and "highest activity" patterns were associated with lower waist circumferences; workers with the "fluctuating moderate activity" and "highest activity" patterns were associated with lower systolic blood pressure; the "moderate evening activity" pattern was associated with lower diastolic blood pressure; and workers with the "fluctuating moderate activity," "high daytime activity" and "highest activity" patterns were associated with lower non-HDL cholesterol. "High daytime activity" was associated with lower waist circumference in women, compared with men, and the "moderate consistent activity" and "fluctuating moderate activity" patterns were associated with lower diastolic blood pressure in younger workers (40 years or younger).

Interpretation: Workers with high daily PA levels tended to have the most optimal cardiometabolic health. Some evidence suggested that there are benefits to moderate levels of PA, particularly for lowering waist circumference and non-HDL cholesterol. Findings may assist in identifying workers for PA initiatives to promote cardiometabolic health benefits.

背景:以往研究工人体力活动(PA)与心脏代谢风险相关的研究主要采用自我报告的方法。人们对工人独特的日常PA模式以及这些模式是否与心脏代谢风险有关知之甚少。这项研究调查了工人的加速计测量的每日PA模式与心脏代谢健康的四个标志之间的关系。数据与方法:有工作的成年人(N=8,229;47%的女性;平均年龄:42岁;标准偏差= 0.3)从加拿大健康措施调查(五个周期:2007年至2017年)中取样。加速度计设备测量每日PA,分层聚类分析确定了不同的活动模式。多元线性回归分析检验了活动模式与心脏代谢风险指标(腰围、收缩压和舒张压以及非高密度脂蛋白[HDL]胆固醇)之间的关联。结果:工人被分为六种不同的活动模式。平均而言,与被分类为“最低活动量”模式的工人相比,“中度持续活动量”、“波动适度活动量”、“白天活动量高”和“最高活动量”模式的工人腰围较低;具有“波动适度活动”和“最高活动”模式的工人与较低的收缩压相关;“适度的夜间活动”模式与较低的舒张压相关;“波动适度活动”、“白天高活动”和“最高活动”模式的工人与较低的非高密度脂蛋白胆固醇有关。与男性相比,“白天高强度活动”与女性腰围较低有关,而“适度持续活动”和“波动适度活动”模式与年轻工人(40岁或以下)的舒张压较低有关。解释:每日PA水平高的工人往往具有最理想的心脏代谢健康。一些证据表明,适度的PA水平是有益的,特别是对于降低腰围和非高密度脂蛋白胆固醇。研究结果可能有助于确定PA倡议的工作人员,以促进心脏代谢健康益处。
{"title":"Daily accelerometer-measured physical activity patterns and associations with cardiometabolic health among Canadian working adults.","authors":"Aviroop Biswas,&nbsp;Cynthia Chen,&nbsp;Stephanie A Prince,&nbsp;Peter M Smith,&nbsp;Cameron A Mustard","doi":"10.25318/82-003-x202300300002-eng","DOIUrl":"https://doi.org/10.25318/82-003-x202300300002-eng","url":null,"abstract":"<p><strong>Background: </strong>Previous studies examining the cardiometabolic risks associated with physical activity (PA) in workers have predominantly used self-reported measures. Little is known about workers' distinct daily PA patterns and whether these are linked with cardiometabolic risks. This study examined associations between patterns of workers' accelerometer-measured daily PA and four markers of cardiometabolic health.</p><p><strong>Data and methods: </strong>Working adults (N=8,229; 47% women; average age: 42 years; standard deviation = 0.3) were sampled from the Canadian Health Measures Survey (five cycles: 2007 to 2017). Accelerometer devices measured daily PA, and hierarchical cluster analysis identified distinct activity patterns. Multiple linear regression analyses examined associations between activity patterns and cardiometabolic risk markers (waist circumference, systolic and diastolic blood pressure, and non-high-density lipoprotein [HDL] cholesterol).</p><p><strong>Results: </strong>Workers were classified into six distinct activity patterns. On average, compared with workers classified in the \"lowest activity\" pattern, workers with the \"moderate consistent activity,\" \"fluctuating moderate activity,\" \"high daytime activity\" and \"highest activity\" patterns were associated with lower waist circumferences; workers with the \"fluctuating moderate activity\" and \"highest activity\" patterns were associated with lower systolic blood pressure; the \"moderate evening activity\" pattern was associated with lower diastolic blood pressure; and workers with the \"fluctuating moderate activity,\" \"high daytime activity\" and \"highest activity\" patterns were associated with lower non-HDL cholesterol. \"High daytime activity\" was associated with lower waist circumference in women, compared with men, and the \"moderate consistent activity\" and \"fluctuating moderate activity\" patterns were associated with lower diastolic blood pressure in younger workers (40 years or younger).</p><p><strong>Interpretation: </strong>Workers with high daily PA levels tended to have the most optimal cardiometabolic health. Some evidence suggested that there are benefits to moderate levels of PA, particularly for lowering waist circumference and non-HDL cholesterol. Findings may assist in identifying workers for PA initiatives to promote cardiometabolic health benefits.</p>","PeriodicalId":49196,"journal":{"name":"Health Reports","volume":"34 3","pages":"15-29"},"PeriodicalIF":5.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Health Utilities Index Mark 3 scores for children and youth: Population norms for Canada based on cycles 5 (2016 and 2017) and 6 (2018 and 2019) of the Canadian Health Measures Survey. 儿童和青少年健康公用事业指数3分:根据加拿大健康措施调查第5周期(2016年和2017年)和第6周期(2018年和2019年),加拿大的人口标准。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-15 DOI: 10.25318/82-003-x202300200003-eng
Mariana Molina, Brittany Humphries, Jason R Guertin, David Feeny, Jean-Eric Tarride

Background: Utility scores are an important tool for evaluating health-related quality of life. Utility score norms have been published for Canadian adults, but no nationally representative utility score norms are available for children and youth.

Data and methods: Health Utilities Index Mark 3 (HUI3) data from two recent cycles of the Canadian Health Measures Survey (i.e., 2016 and 2017, and 2018 and 2019) were used to provide utility score norms for children aged 6 to 11 years and adolescents aged 12 to 17 years. Children younger than 14 years answered the HUI3 under the supervision of an adult, while older children answered without supervision. Utility scores were reported as a weighted average (95% confidence intervals [CIs]) and median values (interquartile range). Utility scores were stratified by sociodemographic and medical characteristics of the child or adolescent. Regression analyses were used to identify predictors of utility scores. All results were weighted using sampling weights provided by Statistics Canada.

Results: Among the 2,297,136 children aged 6 to 11 years and the 2,329,185 adolescents aged 12 to 17 years in the weighted sample, the average utility scores were 0.95 (95% CI: 0.94 to 0.95) and 0.89 (95% CI: 0.87 to 0.90), respectively. Approximately 60% of the children and 34% of the adolescents had a utility score of 1.00. Analyses identified several factors associated with utility scores (e.g., age, chronic condition and income levels), although differences were observed between children and adolescents.

Interpretation: This study provides utility score estimates based on a nationally representative sample of Canadian children and youth. Further research examining the determinants of utility scores of children and adolescents is warranted.

背景:效用评分是评估健康相关生活质量的重要工具。加拿大成年人的效用得分标准已经公布,但没有全国代表性的儿童和青少年效用得分标准。数据和方法:使用加拿大健康措施调查最近两个周期(即2016年和2017年以及2018年和2019年)的健康效用指数标记3 (HUI3)数据提供6至11岁儿童和12至17岁青少年的效用评分标准。14岁以下的儿童在成年人的监督下回答了HUI3,而大一点的儿童在没有监督的情况下回答了HUI3。效用得分以加权平均值(95%置信区间[ci])和中位数(四分位数范围)报告。效用评分根据儿童或青少年的社会人口学和医学特征进行分层。回归分析用于确定效用得分的预测因子。所有结果均使用加拿大统计局提供的抽样权重进行加权。结果:在加权样本中,2,297,136名6至11岁儿童和2,329,185名12至17岁青少年的平均效用得分分别为0.95 (95% CI: 0.94至0.95)和0.89 (95% CI: 0.87至0.90)。大约60%的儿童和34%的青少年效用得分为1.00。分析确定了与效用得分相关的几个因素(例如,年龄、慢性病和收入水平),尽管在儿童和青少年之间观察到差异。解释:这项研究提供了基于加拿大儿童和青少年全国代表性样本的效用评分估计。对儿童和青少年效用分数决定因素的进一步研究是有必要的。
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引用次数: 1
Online digital media use and adolescent mental health. 在线数字媒体的使用与青少年心理健康。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-15 DOI: 10.25318/82-003-x202300200002-eng
Stacie Kerr, Mila Kingsbury

Background: Online digital media are a central part of adolescents' lives, providing opportunities for social connection. However, some research has suggested that online digital media use may be negatively associated with mental health. Little population-based research has examined associations between various types of online digital media use and adolescent mental health.

Data and methods: Data from 13,600 adolescents aged 12 to 17 were drawn from the 2019 Canadian Health Survey on Children and Youth. Adolescents reported on how frequently they used social media, video or instant messaging, and online gaming, as well as their general mental health, eating disorder symptoms and, for those aged 15 to 17, suicidal ideation and attempt. Logistic regression was used to estimate the odds of each outcome from the frequency of each type of digital media use, stratified by sex.

Results: Associations were noted between the frequency of social media and video and instant messaging use, and general mental health, eating disorder symptoms, and suicidal ideation and attempt. After cybervictimization and sleep adequacy were accounted for, associations with eating disorder symptoms remained significant for girls and boys. Never participating in online gaming was associated with lower odds of lower general mental health and suicidal ideation among girls, but not boys.

Interpretation: Different types of online digital media use are differentially associated with mental health outcomes, and associations differ between sexes. The associations between social media and video or instant messaging, and mental ill health may be partially explained by the experience of cybervictimization and sleep adequacy. More research on online gaming, particularly among girls, is needed to clarify associations with mental health.

背景:在线数字媒体是青少年生活的中心部分,为社会联系提供了机会。然而,一些研究表明,在线数字媒体的使用可能与心理健康负相关。很少有基于人群的研究调查了各种类型的在线数字媒体使用与青少年心理健康之间的关系。数据和方法:来自2019年加拿大儿童和青少年健康调查的13600名12至17岁青少年的数据。青少年报告了他们使用社交媒体、视频或即时通讯以及在线游戏的频率,以及他们的总体心理健康状况、饮食失调症状,以及15至17岁青少年的自杀念头和企图。使用逻辑回归来估计每种数字媒体使用频率的每种结果的几率,并按性别分层。结果:社交媒体、视频和即时通讯的使用频率与一般心理健康、饮食失调症状、自杀意念和企图之间存在关联。在考虑了网络伤害和睡眠不足之后,女孩和男孩的饮食失调症状之间的关联仍然很明显。在女孩中,从不参加网络游戏与较低的总体心理健康和自杀意念的几率有关,而在男孩中则没有。解释:不同类型的在线数字媒体使用与心理健康结果有不同的关联,并且这种关联在性别之间存在差异。社交媒体、视频或即时通讯与精神疾病之间的联系可能部分地可以用网络受害的经历和睡眠不足来解释。需要对网络游戏进行更多的研究,特别是对女孩的研究,以明确其与心理健康的关系。
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引用次数: 2
Mortality inequalities of Black adults in Canada. 加拿大黑人成人死亡率的不平等。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-02-15 DOI: 10.25318/82-003-x202300200001-eng
Michael Tjepkema, Tanya Christidis, Toyib Olaniyan, Jeremiah Hwee

Background: Mortality rates in Canada have been shown to vary by population group (e.g., Indigenous peoples, immigrants) and social economic status (e.g., income levels). Mortality patterns for some groups, including Black individuals, are not as well known. The objective of this study was to assess cause-specific mortality for Black adults living in Canada.

Methods: Mortality inequalities between Black and White cohort members were estimated by sex using Cox proportional hazard models, based on data from the 2001, 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs). The CanCHEC cycles were combined and followed for mortality between Census Day and December 31, 2016 or 2019, resulting in a follow-up period of 15.6, 13.6 or 8.6 years, depending on the CanCHEC cycle.

Results: Ischemic heart disease mortality was the leading cause of death among adult Black males (12.9%) and females (9.8%), as it is for adult White males (16.4%) and females (12.4%). Despite reduced risk of all-cause mortality among Black males and females, compared with White cohort members, there was notable increased risk for some cause-specific mortality. For instance, in the age-adjusted model, among the 25 causes of death examined, Black males had an increased risk of dying from four causes (HIV/AIDS, prostate cancer, diabetes mellitus and cerebrovascular disease), compared with White males. Similarly, Black females were at an increased risk for 6 causes of death (HIV/AIDS, stomach cancer, corpus uteri cancer, lymphomas and multiple myeloma, diabetes mellitus, and endocrine disorders) out of the 27 causes of death examined. These relative increased risks persisted for most causes of death after adjustment for differences in important social determinants of health.

Interpretation: Results showed substantial variability in the risk of dying by cause of death between Black and White cohort members. An important step in reducing health inequities is the routine identification and surveillance of different health outcomes by population groups. This study helps fill that information gap.

背景:加拿大的死亡率已显示因人口群体(如土著人民、移民)和社会经济地位(如收入水平)而异。包括黑人在内的一些群体的死亡模式并不为人所知。本研究的目的是评估居住在加拿大的黑人成年人的死因特异性死亡率。方法:基于2001年、2006年和2011年加拿大人口普查健康与环境队列(CanCHECs)的数据,使用Cox比例风险模型按性别估计黑人和白人队列成员之间的死亡率不平等。将CanCHEC周期合并并跟踪人口普查日至2016年12月31日或2019年12月31日之间的死亡率,根据CanCHEC周期的不同,随访期为15.6年、13.6年或8.6年。结果:缺血性心脏病死亡是成年黑人男性(12.9%)和女性(9.8%)的主要死亡原因,成年白人男性(16.4%)和女性(12.4%)也是如此。尽管与白人队列成员相比,黑人男性和女性的全因死亡率风险降低,但某些特定原因的死亡率风险明显增加。例如,在年龄调整模型中,在检查的25种死亡原因中,与白人男性相比,黑人男性死于四种原因(艾滋病毒/艾滋病、前列腺癌、糖尿病和脑血管疾病)的风险更高。同样,在检查的27种死亡原因中,黑人女性有6种死亡原因(艾滋病毒/艾滋病、胃癌、子宫癌、淋巴瘤和多发性骨髓瘤、糖尿病和内分泌紊乱)的风险增加。在对健康的重要社会决定因素的差异进行调整后,这些相对增加的风险在大多数死亡原因中仍然存在。解释:结果显示黑人和白人队列成员因死亡原因导致的死亡风险存在显著差异。减少卫生不公平现象的一个重要步骤是按人口群体对不同的卫生结果进行常规识别和监测。这项研究有助于填补这一信息空白。
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引用次数: 3
Five-year cancer survival by stage at diagnosis in Canada. 加拿大5年癌症分期生存率。
IF 5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-01-18 DOI: 10.25318/82-003-x202300100001-eng
Larry F Ellison, Nathalie Saint-Jacques

Background: Cancer survival estimates provide insights into the effectiveness of early detection and treatment. The stage of cancer at diagnosis is an important determinant of survival, reflecting the extent and spread at the time of disease detection. This work provides stage-specific, five-year survival results not previously available for Canada.

Data and methods: Data reflect the population-based Canadian Cancer Registry death-linked analytic file covering the period from 2010 to 2017. The stage at diagnosis was determined by the Collaborative Stage Data Collection System. Five-year net survival (NS) estimates for Canada excluding Quebec were derived using the Pohar Perme estimator for the five most commonly diagnosed cancers.

Results: Except for prostate cancer, NS decreased monotonically with increased stage at diagnosis. For example, female breast cancer NS estimates were 100% (stage I), 92% (stage II), 74% (stage III) and 23% (stage IV). Apart from lung cancer, stage I NS exceeded 90% for all cancers studied. The largest sex-specific difference in NS was for lung cancer stage I (female 66%; male 56%). Stage-specific NS generally decreased with age, particularly for early-stage lung cancer. Between the 2010-to-2012 and 2015-to-2017 periods, NS improved among stage IV prostate, female breast and lung cancer cases, as well as for stage I and III lung cancer cases; however, it did not improve at any stage for colon or rectal cancer cases.

Interpretation: The work highlights the importance of detecting cancer early, when treatment is most effective. It demonstrates some progress in stage-specific survival among top cancers in Canada and offers data to inform health policy, including screening, and clinical decisions regarding cancer treatment.

背景:癌症生存评估为早期发现和治疗的有效性提供了见解。癌症在诊断时的分期是生存的重要决定因素,反映了疾病检测时的程度和扩散。这项工作提供了特定阶段的5年生存结果,这是加拿大以前没有的。数据和方法:数据反映了2010年至2017年期间基于人群的加拿大癌症登记处死亡相关分析文件。诊断阶段由协同阶段数据采集系统确定。加拿大(不包括魁北克)的5年净生存(NS)估计值是使用Pohar Perme估计值对5种最常诊断的癌症得出的。结果:除前列腺癌外,NS随诊断分期增加而单调下降。例如,女性乳腺癌的NS估计分别为100% (I期)、92% (II期)、74% (III期)和23% (IV期)。除肺癌外,所有癌症的I期NS均超过90%。NS的性别差异最大的是肺癌I期(女性66%;男性的56%)。分期特异性NS通常随着年龄的增长而下降,尤其是早期肺癌。在2010- 2012年和2015- 2017年期间,IV期前列腺癌、女性乳腺癌和肺癌患者以及I期和III期肺癌患者的NS有所改善;然而,在结肠或直肠癌病例的任何阶段,它都没有改善。解释:这项工作强调了早期发现癌症的重要性,因为早期治疗最有效。它展示了加拿大主要癌症在特定阶段生存方面取得的一些进展,并为卫生政策提供了数据,包括筛查和有关癌症治疗的临床决策。
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引用次数: 4
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Health Reports
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