Chronic Diseases and Injuries in Canada最新文献

"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.

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.

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.

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.

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.

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.

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.