Chronic Diseases and Injuries in Canada最新文献

Introduction: Most televised National Hockey League (NHL) games include violent body checks, illegal hits and fights. We postulated that minor league players imitated these behaviours and that not seeing these games would reduce the rate of injuries among younger hockey players.

Methods: Using a quasi-experimental design, we compared 7 years of televised NHL matches (2002-2009) with the year of the NHL lock-out (2004/2005). Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to identify the injuries and to ascertain whether they were due to intentional contact and illegal acts including fights.

Results: We found no significant differences in the proportions of all injuries and those involving intentional contact, violations or illegal acts among male minor league hockey players during the year when professional players were locked out and the years before and after the lock-out.

Conclusion: We concluded that not seeing televised NHL violence may not reduce injuries, although a possible effect may have been obscured because there was a striking increase in attendance at equally violent minor league games during the lock-out.

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.

Introduction: Over recent decades, two prominent trends have been observed in Canada and elsewhere: increasing prevalence of childhood overweight and obesity, and increasing participation of women (including mothers) in the paid labour force and resulting demand for child care options. While an association between child care and children's body mass index (BMI) is plausible and would have policy relevance, its existence and nature in Canada is not known.

Methods: Using data from the National Longitudinal Survey of Children and Youth, we examined exposure to three types of care at age 2/3 years (care by non-relative, care by relative, care in a daycare centre) in relation to change in BMI percentile (continuous and categorical) between age 2/3 years and age 6/7 years, adjusting for health and sociodemographic correlates.

Results: Care by a non-relative was associated with an increase in BMI percentile between age 2/3 years and age 6/7 years for boys, and for girls from households of low income adequacy.

Conclusion: Considering the potential benefits of high-quality formal child care for an array of health and social outcomes and the potentially adverse effects of certain informal care options demonstrated in this study and others, our findings support calls for ongoing research on the implications of diverse child care experiences for an array of outcomes including those related to weight.

Introduction: Access to Nicotine Replacement Therapy (NRT) is a key public health intervention to reduce smoking. We assessed prevalence and correlates of use of NRT in Ontario, where NRT is available without prescription.

Methods: Participants were a representative sample of 2262 adult smokers in the Ontario Tobacco Survey cohort. Prospectively measured use of NRT over a 6-month period was reported in relation to smoking behaviour and history, attempts to quit, receipt of other supports for cessation supports and attitudes toward NRT.

Results: Overall, 11% of smokers used NRT over the six-month follow-up period. Prevalence was 25% among the 27% of smokers matching clinical guidelines that recommend NRT as a therapeutic option, and low among smokers not trying to quit.

Conclusion: With increasing accessibility of NRT, further surveillance and research are warranted to determine the impact of the reach and benefits of NRT, considering both the general and targeted smoking populations.

Introduction: The purpose of this study was to analyze how child maltreatment surveillance data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) is used by senior child welfare decision makers.

Methods: This triangulation mixed-methods study included quantitative and qualitative methods to facilitate an in-depth exploration from multiple perspectives. We interviewed Ontario child welfare decision makers to measure utilization of the CIS in policy development.

Results: The majority of respondents were aware of the CIS data. Decision makers reported using these data to determine resource allocation, understand reported maltreatment trends and validate findings at their own agencies. Urban agencies used the data more than did rural agencies.

Conclusion: This study is the first to triangulate data to understand and improve utilization of child maltreatment surveillance data. The study participants indicated considerable appreciation of the data and also provided ideas for improvements across the surveillance cycle.

Introduction: Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by neonatal lung injury. The aim of this study was to validate the use of ICD-9 diagnostic codes for BPD in administrative databases to allow for their use in health care utilization analyses.

Methods: The validation process used a retrospective cohort composed of preterm infants, with or without respiratory complications, admitted to the Montréal Children's Hospital, Montréal, Quebec, between 1983 and 1992. BPD subjects were identified using ICD-9 diagnostic codes in the provincial administrative databases (medical services and MED-ECHO) and then matched with subjects with confirmed BPD from the validation cohort. We examined concordance and estimated sensitivity and specificity associated with the use of these diagnostic codes for BPD.

Results: True positive and false negative BPD subjects did not differ significantly according to gestational age, birth weight and Apgar scores. False positive BPD subjects were found to have significantly lower gestational age than true negative subjects. The use of the ICD-9 diagnostic codes for BPD was associated with a specificity between 97.6% and 98.0%. The sensitivity was lower at 45.0% and 52.4% for the medical services and MED-ECHO databases, respectively. Milder cases of BPD tended to be missed more frequently than more severe cases.

Conclusion: The specificity of the use of ICD-9 diagnostic codes for BPD in the Quebec provincial health care databases is adequate to allow its routine use. Its lower sensitivity for milder cases will likely result in an underestimation of the impacts of BPD on the long-term health care utilization of preterm infants.

Introduction: Our objective was to explore self-management practices, health services use and information-seeking for type 2 diabetes care among adult men and women from four recent immigrant communities in Toronto.

Methods: A structured questionnaire was adapted for the Canadian context and translated into 4 languages. A total of 184 participants with type 2 diabetes-130 recent immigrants and 54 Canadian-born-were recruited in both community and hospital settings.

Results: Recent immigrants were significantly less likely than the Canadian-born group to perform regular blood glucose and foot checks and significantly more likely than the Canadian-born group to be non-smokers, participate in regular physical activity and reduce dietary fat. Recent immigrants were significantly less likely than the Canadian-born group to use a specialist, alternative provider and dietician and less likely to report using dieticians, nurses and diabetes organizations as sources of diabetes-related information. Important differences were observed by sex and country of origin.

Conclusion: Findings suggest that diabetes prevention and management strategies for recent immigrants must address linguistic, financial, informational and systemic barriers to information and care.

Introduction: Due to space constraints, bunk beds are a common sleeping arrangement in many homes. The height and design of the structure can present a fall and strangulation hazard, especially for young children. The primary purpose of this study was to describe bunk bed-related injuries reported to the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990-2009.

Methods: CHIRPP is an injury and poisoning surveillance system operating in 11 pediatric and 4 general emergency departments across Canada. Records were extracted using CHIRPP product codes and narratives.

Results: Over the 20-year surveillance period, 6002 individuals presented to Canadian emergency departments for an injury associated with a bunk bed. Overall, the frequency of bunk bed-related injuries in CHIRPP has remained relatively stable with an average annual percent change of 21.2% (21.8% to 20.5%). Over 90% of upper bunk-related injuries were due to falls and children 3-5 years of age were most frequently injured (471.2/100 000 CHIRPP cases).

Conclusion: Children with bunk bed-related injuries continue to present to Canadian emergency departments, many with significant injuries. Injury prevention efforts should focus on children under 6 years of age.

"Diabetes in Canada: facts and figures from a public health perspective" is the first comprehensive diabetes surveillance report published by the Public Health Agency of Canada. The report aims to support public health professionals and organizations in developing effective, evidence-based public health policies and programs to prevent and manage diabetes and its complications. The report, developed in collaboration with provincial and territorial governments, the Canadian Diabetes Association, Juvenile Diabetes Research Foundation, CNIB, Health Canada and the academic community, uses data from national health surveys and vital statistics, as well as population-based administrative data from the Canadian Chronic Disease Surveillance System (CCDSS). For the first time, the CCDSS contains data from all 13 Canadian jurisdictions. Using CCDSS data representing cases of diagnosed diabetes among Canadians aged one year and older, Diabetes in Canada presents prevalence and incidence national rates from the fiscal year 2008/2009 and national trends from 1998/1999 onwards. The report also outlines sub-populations at higher risk, ways of reducing the risks of developing the disease and its complications, and estimates of related economic costs. In addition, it contains sections on specific populations, including children and youth and First Nations, Inuit and Métis populations.

Introduction: This study examines (1) time trends in the prevalence of selected unhealthy behaviours among adolescents aged 12 to 17 years, (2) the most commonly adopted combinations of unhealthy behaviours, and (3) socio-economic and sociodemographic correlates of unhealthy behaviours among adolescents.

Methods: A secondary analysis used data collected from 13 198 Canadian Community Health Survey (CCHS) respondents in 2000/2001 and 11 050 CCHS respondents in 2007/2008.

Results: Although the proportion of adolescents consuming a healthy diet increased over the study period, about 50% are still consuming insufficient amounts of fruit and vegetables. In both cycles over one-third of adolescents aged 15 to 17 years reported drinking alcohol regularly. Income level, education level, sex, and language spoken at home were significantly associated with the odds of engaging in unhealthy behaviours among those aged 12 to 14 years, while income level was no longer associated with the odds of engaging in unhealthy behaviours among those aged 15 to 17 years. For both age groups, a language other than French or English spoken in the home was associated with a low risk of unhealthy behaviours.

Conclusion: There was a general decrease in unhealthy behaviours among younger adolescents aged 12 to 14 years.