Chronic Diseases and Injuries in Canada最新文献

Introduction: Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental smokers from never smokers in a nationally representative sample of Canadian students in grades 9 to 12.

Methods: School-level data from the 2006 Canadian Census and one built environment characteristic (tobacco retailer density) were linked with data from secondary school students from the 2008-2009 Canadian Youth Smoking Survey and examined using multilevel logistic regression analyses.

Results: Experimental smoking rates varied across schools (p < .001). The location (adjusted odds ratio [AOR] = 0.66, 95% CI: 0.49-0.89) of the school (urban vs. rural) was associated with the odds of a student being an experimental smoker versus a never smoker when adjusting for student characteristics. Students were more likely to be experimental smokers if they were in a lower grade, reported low school connectedness, used alcohol or marijuana, believed that smoking can help people relax, received pocket money each week and had a family member or close friend who smoked cigarettes.

Conclusion: School-based tobacco prevention programs need to be grade-sensitive and comprehensive in scope; include strategies that can increase students' attachment to their school; and address multi-substance use, tobacco-related beliefs and the use of pocket money. These programs should also reach out to students who have smoking friends and family members. Schools located in rural settings may require additional resources.

As a result of a number of factors, the treatment of insulin-dependent diabetes has moved away from using insulin of beef or pork origin to using recombinant (biosynthetic) insulin preparations. However, some people with type 1 diabetes can manage their diabetes better using animal-sourced insulin. Despite dwindling options and decreased production, animal-sourced insulin (and pork insulin in particular) is still available on the Canadian market. This communication describes the actions taken by Health Canada with respect to the availability of animal insulin.

Introduction: This study describes the prevalence of smoking, obesity, sedentary behaviour/physical activity, fruit and vegetable consumption and alcohol use as well as the uptake of breast, cervical and colorectal cancer screening among First Nations and Métis adults in Ontario and compares these to that of the non-Aboriginal population.

Methods: We used the Canadian Community Health Survey (2007 to 2011 combined) to calculate prevalence estimates for the 3 ethnocultural populations.

Results: First Nations and Métis adults were significantly more likely than non-Aboriginal adults to self-report smoking and/or to be classified as obese. Alcohol use exceeding cancer prevention recommendations and inadequate fruit and vegetable consumption were more common in First Nations people than in the non-Aboriginal population. First Nations women were more likely to report having had a Fecal Occult Blood Test in the previous 2 years than non-Aboriginal women. No significant differences across the 3 ethnocultural groups were found for breast and cervical screening among women or colorectal screening among men.

Conclusion: Without intervention, we are likely to continue to see a significant burden of smoking- and obesity-related cancers in Ontario's Aboriginal population.

Introduction: Our objective was to estimate the prevalence of symptoms and the proportion of a lifetime physician-based diagnosis of allergic rhinitis (AR) in the province of Quebec among people aged 15 years and older.

Methods: The 2008 Quebec Population Health Survey provided data on the prevalence of symptoms and proportion of lifetime physician-based diagnoses of AR. The prevalence of symptoms was defined as the proportion of individuals who, in the absence of a cold or the flu, had nasal and ocular symptoms in the 12 months before the survey.

Results: The reported prevalence of AR symptoms was 17%, although 9% did not have a diagnosed condition. Reported prevalence was lowest in those aged 65 years and older (12%) and was more common among women (19%) than men (15%). The estimated prevalence of lifetime physician-based diagnosis was 17%.

Conclusion: AR prevalence is high in Quebec with about 1 in 6 people experiencing symptoms. The condition is underdiagnosed and might also be undertreated.

Introduction: The objective of this study was to survey Canadian parents on their attitudes and beliefs about bicycle helmet legislation and to compare responses from parents living in provinces with and without legislation.

Methods: A national survey of 1002 parents of children aged under 18 years was conducted. Chi-square tests were used to compare responses from the surveyed parents in the different jurisdictions.

Results: Responses from parents living in provinces with legislation (n = 640) and without legislation (n = 362) were as follows: concern for injury (63% vs. 68%, nonsignificant [NS]); believe helmets are effective (98% vs. 98%, NS); child always wears a helmet (74% vs. 69%, NS); support legislation for children (95% vs. 83%, p < .001); support legislation for all ages (85% vs. 75%, p < .001); support police enforcement (83% vs. 76%, p = .003); believe legislation decreases the amount of time their child bicycles (5% vs. 8%, NS).

Conclusion: Parents are highly supportive of bicycle helmet legislation in Canada. They believe that bicycle helmets are effective and that legislation does not decrease the amount of time a child spends bicycling. There was also a high level of support for legislation across all ages, and for police enforcement.

Introduction: In Montréal, the characteristics of suicide cases may vary between different areas. The information collected by coroners during their investigations of suicides could be used to support local suicide-prevention planning actions.

Methods: This study analyzes all coroners' records on suicide in Montréal from 2007 to 2009 to (1) determine the usefulness of the data available; (2) develop a profile of cases; (3) examine local differences by comparing two areas, one with the highest suicide rate and the other with the lowest.

Results: The data collected revealed the lack of a systematic, standardized procedure for recording information about deaths by suicide. The rates of missing data varied, but were very high for antecedents of suicide attempts and recent events that could have precipitated the suicide. We observed differences in the characteristics of suicide cases according to area of residence.

Conclusion: By adopting a standardized procedure for collecting information on cases of suicide, coroners could provide local decision makers with a more accurate portrait of the people who die by suicide in their area. Local adjustments may improve suicide prevention strategies.

Introduction: We examined the effect of bicycle helmet fit and position on head and facial injuries.

Methods: Cases were helmeted cyclists with a head (n=297) or facial (n=289) injury. Controls were helmeted cyclists with other injuries, excluding the neck. Participants were interviewed in seven Alberta emergency departments or by telephone; injury data were collected from charts. Missing values were imputed using chained equations and custom prediction imputation models.

Results: Compared with excellent helmet fit, those with poor fit had increased odds of head injury (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.06-10.74). Compared with a helmet that stayed centred, those whose helmet tilted back (OR = 2.90, 95% CI: 1.54-5.47), shifted (OR = 1.91, 95% CI: 1.01-3.63) or came off (OR = 6.72, 95% CI: 2.86-15.82) had higher odds of head injury. A helmet that tilted back (OR = 4.81, 95% CI: 2.74-8.46), shifted (OR = 1.83, 95% CI: 1.04-3.19) or came off (OR = 3.31, 95% CI: 1.24-8.85) also increased the odds of facial injury.

Conclusion: Our findings have implications for consumer and retail education programs.

Background: Hysterectomy is one of the most frequently performed surgical procedures among Canadian women. The consequence is a population that no longer requires cervical cancer screening. The objective of our analysis was to provide more accurate estimates of eligible participation in cervical screening by estimating the age-specific prevalence of hysterectomy among Canadian women aged 20 to 69 by province and territory between 2000/2001 and 2008.

Methods: Self-reported hysterectomy prevalence was obtained from the 2000/2001, 2003 and 2008 Canadian Community Health Survey. Age-specific prevalence and 95% confidence intervals (CIs) were estimated for Canada and provinces and territories for the three time periods.

Results: Interprovincial variations in hysterectomy prevalence were observed among women in each age group and time period. Among women aged 50 to 59, prevalence was as high as 35.1% (95% CI: 25.8-44.3) (p<.01) in 2008 and appeared to decrease in all provinces from 2000/2001 to 2008.

Conclusion: Interprovincial and time period variation suggest that using hysterectomy prevalence to adjust the population eligible for cervical cancer screening may be helpful to inform more comparable screening participation rates. In addition, both cervical cancer incidence and mortality rates can be adjusted by hysterectomy to ensure estimates across time and provinces and territories are also comparable.

Introduction: We evaluated associations between ecological variables and the risk of very small for gestational age (VSGA) birth in Quebec in 2000-2008.

Methods: Ecological variables came from the Canadian Community Health Survey, the Canadian census and Quebec's birth registry; individual variables also came from Quebec's birth registry. Odds ratios (ORs) adjusted for mother's age, academic qualification, parity, marital status and country of birth were estimated using multilevel logistic regression (generalized estimating equations method).

Results: Births in neighbourhoods with a high proportion of people leading a sedentary lifestyle (OR: 1.07, 95% confidence interval [CI]: 1.01-1.11) and those with a high/middle proportion of residents with food insecurity (OR: 1.09, 95% CI: 1.05-1.15; OR: 1.05, 95% CI: 1.01-1.11) had higher odds of VSGA birth. Those with middle proportion of married residents had lower odds of VSGA birth (OR: 0.94, 95% CI: 0.90-0.98).