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Mental health of Canadian youth: A systematic review and meta-analysis of studies examining changes in depression, anxiety, and suicide-related outcomes during the COVID-19 pandemic. 加拿大青少年的心理健康:对研究 COVID-19 大流行期间抑郁、焦虑和自杀相关结果变化的系统回顾和荟萃分析。
IF 4.3 4区 医学 Pub Date : 2024-06-01 Epub Date: 2024-03-13 DOI: 10.17269/s41997-024-00865-x
Marie-Claude Geoffroy, Nicholas Chadi, Samantha Bouchard, Julia Fuoco, Elise Chartrand, Tianna Loose, Anthony Sciola, Jill T Boruff, Srividya N Iyer, Ying Sun, Jean-Philippe Gouin, Sylvana M Côté, Brett D Thombs

Objectives: This systematic review and meta-analysis aims to describe Canadian youth mental health during the COVID-19 pandemic, focusing on changes in anxiety and depressive symptoms and suicidality.

Methods: We searched four databases up to February 2023 for longitudinal or repeated cross-sectional studies reporting on changes in depressive and anxiety symptoms, suicidality, or related services utilization among young people under 25 years old residing in Canada during the COVID-19 pandemic. Random-effects meta-analyses were performed for studies comparing depressive and anxiety symptoms from before to during the first, second, and third COVID-19 waves (up to June 2021), and between COVID-19 waves. Other studies were described narratively. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist.

Synthesis: Of the 7916 records screened, 35 articles met inclusion criteria for this review. Included studies were highly heterogeneous in design, population, and type of change investigated, and many had a high risk of bias. The meta-analyses found that depressive symptoms worsened minimally from pre-pandemic to wave 1 but returned to pre-pandemic levels by wave 2. Anxiety symptoms were broadly comparable from pre-pandemic to waves 1 and 2 but worsened from waves 1 to 3 and from pre-pandemic to wave 1 for girls. The narrative review included several studies that provided inconclusive evidence of increases in services utilization.

Conclusion: The current evidence is limited and highly heterogeneous, making it insufficient to draw definitive conclusions regarding the short- to medium-term impact of the pandemic on youth mental health in Canada. Obtaining better mental health surveillance among Canadian youth is imperative.

目的:本系统综述和荟萃分析旨在描述 COVID-19 大流行期间加拿大青少年的心理健康状况:本系统综述和荟萃分析旨在描述 COVID-19 大流行期间加拿大青少年的心理健康状况,重点关注焦虑和抑郁症状以及自杀率的变化:我们检索了截至 2023 年 2 月的四个数据库,其中包括报告 COVID-19 大流行期间居住在加拿大的 25 岁以下年轻人抑郁和焦虑症状、自杀或相关服务使用情况变化的纵向或重复横断面研究。对比较 COVID-19 第一波、第二波和第三波(截至 2021 年 6 月)之前和期间以及 COVID-19 各波之间抑郁症状和焦虑症状的研究进行了随机效应荟萃分析。其他研究则以叙述方式进行描述。采用乔安娜-布里格斯研究所(Joanna Briggs Institute)改编的检查表对偏倚风险进行评估:在筛选出的 7916 条记录中,有 35 篇文章符合本综述的纳入标准。所纳入的研究在设计、人群和所调查的变化类型方面存在很大差异,许多研究存在较高的偏倚风险。荟萃分析发现,从大流行前到第 1 波,抑郁症状的恶化程度很小,但到第 2 波时又恢复到了大流行前的水平。焦虑症状从大流行前到第 1 波和第 2 波大致相当,但从第 1 波到第 3 波以及从大流行前到第 1 波,女孩的焦虑症状有所恶化。叙述性综述包括几项研究,这些研究没有提供服务利用率增加的结论性证据:结论:目前的证据有限,而且非常不一致,因此不足以就大流行病对加拿大青少年心理健康的中短期影响得出明确的结论。对加拿大青少年的心理健康进行更好的监测势在必行。
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引用次数: 0
Advocating for population health: The role of public health practitioners in the age of artificial intelligence. 倡导人口健康:人工智能时代公共卫生从业人员的角色。
IF 4.3 4区 医学 Pub Date : 2024-06-01 Epub Date: 2024-04-16 DOI: 10.17269/s41997-024-00881-x
Alireza Kamyabi, Ihoghosa Iyamu, Manik Saini, Curtis May, Geoffrey McKee, Alex Choi

Over the past decade, artificial intelligence (AI) has begun to transform Canadian organizations, driven by the promise of improved efficiency, better decision-making, and enhanced client experience. While AI holds great opportunities, there are also near-term impacts on the determinants of health and population health equity that are already emerging. If adoption is unregulated, there is a substantial risk that health inequities could be exacerbated through intended or unintended biases embedded in AI systems. New economic opportunities could be disproportionately leveraged by already privileged workers and owners of AI systems, reinforcing prevailing power dynamics. AI could also detrimentally affect population well-being by replacing human interactions rather than fostering social connectedness. Furthermore, AI-powered health misinformation could undermine effective public health communication. To respond to these challenges, public health must assess and report on the health equity impacts of AI, inform implementation to reduce health inequities, and facilitate intersectoral partnerships to foster development of policies and regulatory frameworks to mitigate risks. This commentary highlights AI's near-term risks for population health to inform a public health response.

过去十年来,人工智能(AI)在提高效率、改善决策和增强客户体验等承诺的推动下,已开始改变加拿大的组织结构。虽然人工智能蕴含着巨大的机遇,但其对健康决定因素和人口健康公平的近期影响也已显现。如果不对人工智能的应用进行监管,那么人工智能系统中有意或无意的偏见很可能会加剧健康不平等。新的经济机遇可能会被已经享有特权的人工智能系统工作者和所有者过度利用,从而强化当前的权力动态。人工智能还可能取代人类互动,而不是促进社会联系,从而对民众福祉产生不利影响。此外,由人工智能驱动的健康误导可能会破坏有效的公共卫生交流。为了应对这些挑战,公共卫生必须评估和报告人工智能对健康公平的影响,为减少健康不公平现象的实施提供信息,并促进跨部门伙伴关系,以推动政策和监管框架的发展,从而降低风险。本评论强调了人工智能对人口健康的近期风险,以便为公共卫生应对措施提供信息。
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引用次数: 0
The impact of the COVID-19 pandemic on social determinants of health, mental health, and substance use among key populations affected by sexually transmitted and blood-borne infections in Canada. COVID-19 大流行对加拿大受性传播和血液传播感染影响的主要人群的健康、心理健康和药物使用的社会决定因素的影响。
IF 4.3 4区 医学 Pub Date : 2024-06-01 Epub Date: 2024-04-30 DOI: 10.17269/s41997-024-00888-4
Herak Apelian, Josephine Aho, Elsie Wong, Joseph Cox

Objectives: We assessed the impact of the COVID-19 pandemic on social determinants of health, mental health, substance use, and access to mental health and harm reduction services among key populations disproportionately impacted by sexually transmitted and blood-borne infections (STBBI).

Methods: Online surveys (2021‒2022) were conducted in Canada among people who use drugs or alcohol (PWUD); African, Caribbean, and Black people (ACB); and First Nations, Inuit, and Métis peoples (FNIM). Descriptive analyses were conducted on social determinants of health, substance use, and access to services, stratified by changes in mental health status since the start of the pandemic.

Results: A total of 3773 participants (1034 PWUD, 1556 ACB, and 1183 FNIM) completed the surveys, with 45.6% reporting a major/moderate impact of the pandemic on their ability to pay bills and 53% experiencing food insecurity since the start of the pandemic. Half (49.4%) of participants reported deteriorating mental health. A higher increase in substance use and related behaviours was seen in those with worsening mental health. Among those using substances, two thirds (69.4%) of those with worsening mental health reported increasing their use of substances alone, compared to 46.9% of those with better/similar mental health. Access to mental health and harm reduction services was low.

Conclusion: These intersecting health issues are among the risk factors for STBBI acquisition and act as barriers to care. Equitable interventions and policies addressing downstream and upstream determinants of health, with meaningful and sustainable leadership from key populations, may improve their health and well-being, to lower STBBI impact and improve future pandemic responses.

目标:我们评估了 COVID-19 大流行对受性传播和血液传播感染(STBBI)严重影响的关键人群的健康、心理健康、药物使用以及获得心理健康和减低伤害服务的社会决定因素的影响:方法:在加拿大对吸毒或酗酒者(PWUD)、非洲人、加勒比人和黑人(ACB)以及原住民、因努伊特人和梅蒂斯人(FNIM)进行了在线调查(2021-2022 年)。对健康的社会决定因素、药物使用和获得服务的机会进行了描述性分析,并根据大流行开始以来心理健康状况的变化进行了分层:共有 3773 名参与者(其中 1034 名 PWUD、1556 名 ACB 和 1183 名 FNIM)完成了调查,45.6% 的参与者表示大流行对其支付账单的能力产生了重大/中度影响,53% 的参与者自大流行开始以来经历了食品不安全。半数(49.4%)的参与者表示精神健康状况恶化。在精神健康状况恶化的人群中,药物使用和相关行为的增加率较高。在使用药物的人群中,三分之二(69.4%)的精神健康状况恶化者报告说他们增加了药物的单独使用,而在精神健康状况较好/相似的人群中,这一比例仅为 46.9%。获得心理健康和减低伤害服务的机会很少:这些相互交织的健康问题是感染 STBBI 的风险因素之一,也是获得护理的障碍。针对健康的下游和上游决定因素采取公平的干预措施和政策,并由关键人群发挥有意义和可持续的领导作用,可改善他们的健康和福祉,从而降低 STBBI 的影响并改善未来的流行病应对措施。
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引用次数: 0
Evaluating the impact of the Community Helpers Program on adolescents 12-18 years old in Edmonton, Canada. 评估社区互助计划对加拿大埃德蒙顿 12-18 岁青少年的影响。
IF 4.3 4区 医学 Pub Date : 2024-06-01 Epub Date: 2024-04-29 DOI: 10.17269/s41997-024-00878-6
Mohammad Habibullah Pulok, Arthur Novaes de Amorim, Sandra Johansen, Kristin Pilon, Christina Lucente, Vineet Saini

Intervention: Alberta Health Services (AHS) Community Helpers Program (CHP) to enhance mental health among youth.

Research question: Identifying the impact of CHP on mental illness-related acute care use among adolescents aged 12-18 years in Edmonton and determining cost avoidance.

Methods: Using administrative data from AHS, public school catchment area data from the Edmonton Public School Board, and area-level socioeconomic deprivation status indicators from the Pampalon deprivation index, we applied geographical regression discontinuity design to estimate the effect of CHP implementation on depression-, anxiety-, and suicide-related acute care use (emergency department visits and inpatient admissions). Cost data were derived from Interactive Health Data Application of Alberta Health. The study period (2002-2022) included pre (2002-2011) and post (2012-2020) CHP implementation periods.

Results: CHP had statistically significant impact when distance from the boundary (catchment area identifier to divide the sample into treated and control groups) was between 600 and 800 m. About 90 and 80 fewer anxiety- and depression-related visits (per 1000 visits) were observed among individuals aged 12-15 and 16-18 years, respectively, in catchment areas of the public schools where CHP was implemented. Impact of CHP on suicide-related visits was only statistically significant among individuals aged 12-15 years. Annual cost reduction ranged from $161,117 to $269,255 for anxiety- and depression-related visits.

Conclusion: Findings show contextual effect of CHP; i.e., being potentially exposed to the program reduced the likelihood of anxiety- and depression-related visits. Costs of CHP implementation could be compared with the avoided costs to assess economic benefits of implementing CHP.

干预措施:阿尔伯塔省卫生服务机构(AHS)的社区帮助者计划(CHP)旨在提高青少年的心理健康水平:研究问题:确定社区帮助计划对埃德蒙顿 12-18 岁青少年使用与精神疾病相关的急症护理的影响,并确定可避免的成本:通过使用来自埃德蒙顿卫生系统(AHS)的行政数据、埃德蒙顿公立学校委员会(Edmonton Public School Board)的公立学校服务区数据以及来自潘帕隆贫困指数(Pampalon deprivation index)的地区级社会经济贫困状况指标,我们采用地理回归非连续性设计来估算CHP的实施对抑郁、焦虑和自杀相关急症护理使用(急诊就诊和住院)的影响。成本数据来自阿尔伯塔省卫生部的交互式健康数据应用。研究期间(2002-2022年)包括实施CHP前(2002-2011年)和实施CHP后(2012-2020年):当距离边界(将样本分为治疗组和对照组的集水区标识符)的距离在600米至800米之间时,卫生防护中心的影响具有统计学意义。在实施卫生防护中心的公立学校集水区,12-15岁和16-18岁人群中与焦虑和抑郁相关的就诊次数(每1000人次)分别减少了约90次和80次。卫生防护计划对自杀相关就诊的影响仅在 12-15 岁人群中具有统计学意义。在焦虑症和抑郁症相关就诊方面,每年减少的费用从161,117美元到269,255美元不等:研究结果表明了儿童健康防护计划的环境效应,即可能接触到该计划会降低焦虑和抑郁相关就诊的可能性。实施保健计划的成本可与避免的成本进行比较,以评估实施保健计划的经济效益。
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引用次数: 0
Emerging infodemic management strategies focus on technology: They can't forget trust. 新兴的信息管理战略注重技术:不能忘记信任。
IF 4.3 4区 医学 Pub Date : 2024-06-01 Epub Date: 2024-04-15 DOI: 10.17269/s41997-024-00879-5
Robert Steiner

Public health authorities around the world are planning to manage infodemics as part of their next public health emergency. But the experience of managing communications for Ontario's COVID-19 Science Advisory Table suggests that emerging infodemic management (IM) strategies should include three key principles, which appear to be missing from much of the existing literature: (1) emerging IM strategies should incorporate leadership from epidemiologists who can align infodemic response with underlying disease; (2) they should embrace journalists who mediate trust in crises; and (3) they should acknowledge the unique opportunity for public health leaders to build public trust rapidly in the first days of a crisis-a foundation for all subsequent IM. Standardizing infodemic response may help accelerate interventions during a public health emergency, especially when paired with technology. But over-standardizing the human work of building trust risks losing the infodemic fight before it starts.

世界各地的公共卫生当局都在计划将信息流行病管理作为下一次公共卫生突发事件的一部分。但是,安大略省 COVID-19 科学咨询表的传播管理经验表明,新的信息流行病管理(IM)战略应包括三项关键原则,这似乎是现有文献中缺少的:(1) 新的信息流行病管理战略应包括流行病学家的领导,他们可以将信息流行病响应与潜在的疾病联系起来;(2) 他们应接受在危机中调解信任的记者;(3) 他们应承认公共卫生领导人在危机最初几天迅速建立公众信任的独特机会--这是所有后续信息流行病管理的基础。信息流应对的标准化可能有助于在公共卫生突发事件中加快干预速度,尤其是在与技术相结合的情况下。但是,过度标准化建立信任的人力工作有可能会在信息流开始之前就输掉这场战斗。
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引用次数: 0
The projected health and economic impact of increased colorectal cancer screening participation among Canadians by income quintile. 按收入五分位数分列的加拿大人更多地参与结直肠癌筛查对健康和经济的预期影响。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-03-19 DOI: 10.17269/s41997-024-00868-8
Abisola A Adegbulugbe, Eliya Farah, Yibing Ruan, Jean H E Yong, Winson Y Cheung, Darren R Brenner

Objectives: Disparities in colorectal cancer (CRC) screening uptake by socioeconomic status have been observed in Canada. We used the OncoSim-Colorectal model to evaluate the health and economic outcomes associated with increasing the participation rates of CRC screening programs to 60% among Canadians in different income quintiles.

Methods: Baseline CRC screening participation rates were obtained from the 2017 Canadian Community Health Survey. The survey participants were categorized into income quintiles using their reported household income and 2016 Canadian Census income quintile thresholds. Within each quintile, the participation rate was the proportion of respondents aged 50-74 who reported having had a fecal test in the past two years. Using the OncoSim-Colorectal model, we simulated an increase in CRC screening uptake to 60% across income quintiles to assess the effects on CRC incidence, mortality, and associated economic costs from 2024 to 2073.

Results: Increasing CRC screening participation rates to 60% across all income quintiles would prevent 69,100 CRC cases and 36,600 CRC deaths over 50 years. The improvement of clinical outcomes would also translate to increased person-years and health-adjusted person-years. The largest impact was observed in the lowest income group, with 22,200 cases and 11,700 deaths prevented over 50 years. Increased participation could lead to higher screening costs ($121 million CAD more per year) and lower treatments costs ($95 million CAD less per year), averaged over the period 2024-2073.

Conclusion: Increased screening participation will improve clinical outcomes across all income groups while alleviating associated treatment costs. The benefits of increased participation will be strongest among the lowest income quintile.

目的:在加拿大,不同社会经济地位的人在接受结直肠癌(CRC)筛查方面存在差异。我们使用 OncoSim-Colorectal 模型评估了将不同收入五分位数的加拿大人的 CRC 筛查项目参与率提高至 60% 所带来的健康和经济结果:基线 CRC 筛查参与率来自 2017 年加拿大社区健康调查。调查参与者根据其报告的家庭收入和 2016 年加拿大人口普查收入五分位数阈值被划分为收入五分位数。在每个五分位数中,参与率是 50-74 岁受访者中报告在过去两年中进行过粪便检测的比例。我们使用 OncoSim-Colorectal 模型模拟了不同收入五分位数的 CRC 筛查参与率提高到 60% 的情况,以评估 2024 年至 2073 年期间对 CRC 发病率、死亡率和相关经济成本的影响:将所有收入五分位人群的 CRC 筛查参与率提高到 60%,将在 50 年内预防 69,100 例 CRC 病例和 36,600 例 CRC 死亡。临床结果的改善还将增加人年和健康调整人年。最低收入组的影响最大,50 年内可预防 2.22 万例病例和 1.17 万例死亡。平均到 2024-2073 年期间,筛查参与度的提高可导致筛查成本的增加(每年增加 1.21 亿加元)和治疗成本的降低(每年减少 9500 万加元):结论:提高筛查参与率将改善所有收入群体的临床治疗效果,同时降低相关治疗费用。提高筛查参与率对收入最低的五分之一人群的益处最大。
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引用次数: 0
Sociodemographic factors associated with vaccine hesitancy in the South Asian community in Canada. 加拿大南亚社区中与疫苗犹豫不决有关的社会人口因素。
IF 4.3 4区 医学 Pub Date : 2024-05-07 DOI: 10.17269/s41997-024-00885-7
Baanu Manoharan, Rosain Stennett, Russell J de Souza, Shrikant I Bangdiwala, Dipika Desai, Sujane Kandasamy, Farah Khan, Zainab Khan, Scott A Lear, Lawrence Loh, Rochelle Nocos, Karleen M Schulze, Gita Wahi, Sonia S Anand

Objective: South Asians represent the largest non-white ethnic group in Canada and were disproportionately impacted by the COVID-19 pandemic. We sought to determine the factors associated with vaccine hesitancy in South Asian Canadians.

Methods: We conducted a cross-sectional analysis of vaccine hesitancy using data collected at the baseline assessment of a prospective cohort study, COVID CommUNITY South Asian. Participants (18 + years) were recruited from the Greater Toronto and Hamilton Area in Ontario (ON) and the Greater Vancouver Area in British Columbia (BC) between April and November 2021. Demographic characteristics and vaccine attitudes measured by the Vaccine Attitudes Examination (VAX) scale were collected. Each item is scored on a 6-point Likert scale, and higher scores reflect greater hesitancy. A multivariable linear mixed effects model was used to identify sociodemographic factors associated with vaccine hesitancy, adjusting for multiple covariates.

Results: A total of 1496 self-identified South Asians (52% female) were analyzed (mean age = 38.5 years; standard deviation (SD): 15.3). The mean VAX score was 3.2, SD: 0.8 [range: 1.0‒6.0]. Factors associated with vaccine hesitancy included: time since immigration (p = 0.04), previous COVID-19 infection (p < 0.001), marital status (p < 0.001), living in a multigenerational household (p = 0.03), age (p = 0.02), education (p < 0.001), and employment status (p = 0.001).

Conclusion: Among South Asians living in ON and BC, time since immigration, prior COVID-19 infection, marital status, living in a multigenerational household, age, education, and employment status were associated with vaccine hesitancy. This information can be used to address vaccine hesitancy in the South Asian population in future COVID-19 waves or pandemics.

目的:南亚人是加拿大最大的非白人族群,受 COVID-19 大流行的影响尤为严重。我们试图确定与南亚裔加拿大人疫苗犹豫不决有关的因素:我们利用前瞻性队列研究 COVID CommUNITY 南亚人基线评估中收集的数据,对疫苗接种犹豫进行了横断面分析。2021 年 4 月至 11 月期间,我们从安大略省(ON)的大多伦多和汉密尔顿地区以及不列颠哥伦比亚省(BC)的大温哥华地区招募了参与者(18 岁以上)。研究人员收集了人口统计学特征和疫苗态度量表(VAX)所测量的疫苗态度。每个项目均采用李克特 6 点量表评分,分数越高,表示越犹豫。采用多变量线性混合效应模型来确定与疫苗犹豫相关的社会人口因素,并对多个协变量进行调整:共分析了 1496 名自我认同的南亚人(52% 为女性)(平均年龄 = 38.5 岁;标准差 (SD):15.3)。平均 VAX 得分为 3.2,标准差:0.8 [范围:1.0-6.0]。与疫苗接种犹豫不决相关的因素包括:移民时间(P = 0.04)、既往感染 COVID-19(P = 0.05)、疫苗接种犹豫不决(P = 0.05)和疫苗接种犹豫不决(P = 0.05):在居住在安大略省和不列颠哥伦比亚省的南亚人中,移民时间、曾感染 COVID-19、婚姻状况、生活在多代同堂的家庭中、年龄、教育程度和就业状况与疫苗接种犹豫不决有关。在未来的 COVID-19 感染潮或大流行中,这些信息可用于解决南亚人群的疫苗犹豫不决问题。
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引用次数: 0
Occupational patterns of opioid-related harms comparing a cohort of formerly injured workers to the general population in Ontario, Canada. 阿片类药物相关伤害的职业模式,将加拿大安大略省曾受过伤害的工人群组与普通人群进行比较。
IF 4.3 4区 医学 Pub Date : 2024-04-24 DOI: 10.17269/s41997-024-00882-w
Nancy Carnide, Gregory Feng, Chaojie Song, Paul A Demers, Jill S MacLeod, Jeavana Sritharan

Objectives: The role of work-related injuries as a risk factor for opioid-related harms has been hypothesized, but little data exist to support this relationship. The objective was to compare the incidence of opioid-related harms among a cohort of formerly injured workers to the general population in Ontario, Canada.

Methods: Workers' compensation claimants (1983-2019) were linked to emergency department (ED) and hospitalization records (2006-2020). Incident rates of opioid-related poisonings and mental and behavioural disorders were estimated among 1.7 million workers and in the general population. Standardized incidence ratios (SIRs) and 95% confidence intervals (CI) were calculated, adjusting for age, sex, year, and region.

Results: Compared to the general population, opioid-related poisonings among this group of formerly injured workers were elevated in both ED (SIR = 2.41, 95% CI = 2.37-2.45) and hospitalization records (SIR = 1.54, 95% CI = 1.50-1.59). Opioid-related mental and behavioural disorders were also elevated compared to the general population (ED visits: SIR = 1.86, 95% CI = 1.83-1.89; hospitalizations: SIR = 1.42, 95% CI = 1.38-1.47). Most occupations and industries had higher risks of harm compared to the general population, particularly construction, materials handling, processing (mineral, metal, chemical), and machining and related occupations. Teaching occupations displayed decreased risks of harm.

Conclusion: Findings support the hypothesis that work-related injuries have a role as a preventable risk factor for opioid-related harms. Strategies aimed at primary prevention of occupational injuries and secondary prevention of work disability and long-term opioid use are warranted.

目的:有人假设工伤是造成阿片类药物相关伤害的风险因素,但支持这种关系的数据却很少。该研究旨在比较加拿大安大略省曾受过工伤的工人群体与普通人群中阿片类药物相关伤害的发生率:方法:将工伤索赔者(1983-2019 年)与急诊科 (ED) 和住院记录(2006-2020 年)联系起来。估算了 170 万工人和普通人群中阿片类药物相关中毒以及精神和行为障碍的发病率。计算了标准化发病率(SIR)和95%置信区间(CI),并对年龄、性别、年份和地区进行了调整:结果:与普通人群相比,在急诊室(SIR = 2.41,95% CI = 2.37-2.45)和住院记录(SIR = 1.54,95% CI = 1.50-1.59)中,这部分曾经受伤的工人与阿片类药物有关的中毒事件均有所上升。与普通人群相比,与阿片类药物相关的精神和行为障碍也有所上升(急诊室就诊:SIR=1.86,95% CI=1.83-1.89;住院:SIR=1.42,95% CI=1.38-1.47)。与普通人群相比,大多数职业和行业的伤害风险较高,尤其是建筑、材料处理、加工(矿物、金属、化学)和机械加工及相关职业。教师职业的伤害风险较低:研究结果支持这一假设,即工伤是阿片类药物相关伤害的一个可预防风险因素。有必要制定旨在初级预防工伤和二级预防工作致残及长期使用阿片类药物的策略。
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引用次数: 0
Transitioning to a guaranteed annual income and the impact on activities of daily living in older adults: Evidence from public pensions in Canada using the CLSA. 向保证年收入过渡及其对老年人日常生活活动的影响:加拿大公共养老金使用 CLSA 提供的证据。
IF 4.3 4区 医学 Pub Date : 2024-04-22 DOI: 10.17269/s41997-024-00875-9
Laura J Jiménez, Daniel J Dutton

Objective: Statistically model the likelihood of changes in the activities of daily living (ADLs) over time for three groups of older adults: those on a pension at all time periods, those never on a pension, and those who transition onto a public pension.

Methods: Our study used data from the Canadian Longitudinal Study on Aging (CLSA), a large national survey. We used data from baseline (2010-2015) and the first follow-up wave (2015-2018). We used logistic regression to model the likelihood of ADL changes in males and females by pension receipt status, controlling for several potential confounders and allowing for the impact of public pensions to be modified by baseline income.

Results: The magnitudes of the estimates indicated that those who transition to a public pension are less likely to report ADL degradation and more likely to report ADL improvement compared to those with no public pension. In the lowest baseline income group, those who transitioned onto a pension at follow-up had a 15% (male) or 11% (female) lower likelihood of reporting degraded ADL scores compared to those not receiving a pension at follow-up. Those who transitioned onto a pension in the lowest income group were more likely to report an improved ADL score at follow-up.

Conclusion: Our results could provide evidence for the potential health benefits of more comprehensive guaranteed annual income programs beyond the pension program. The penalty of being low-income was mitigated by the stability of the pension income in terms of ADL improvement or degradation.

目标:为三组老年人建立日常生活活动(ADLs)随时间变化的可能性统计模型:在所有时间段都领取养老金的老年人、从未领取养老金的老年人以及过渡到公共养老金的老年人:我们的研究使用了加拿大老龄化纵向研究(CLSA)的数据,这是一项大型的全国性调查。我们使用了基线(2010-2015 年)和第一次随访(2015-2018 年)的数据。我们采用逻辑回归法,根据养老金领取情况对男性和女性ADL发生变化的可能性进行建模,同时控制了几个潜在的混杂因素,并允许公共养老金的影响因基线收入而有所改变:估计值的大小表明,与没有公共养老金的人相比,过渡到公共养老金的人报告日常活动能力下降的可能性较小,而报告日常活动能力改善的可能性较大。在基线收入最低的群体中,与随访时未领取养老金的人相比,随访时过渡到养老金的人报告ADL评分下降的可能性低15%(男性)或11%(女性)。最低收入组中过渡到养老金的人更有可能在随访时报告ADL评分有所改善:我们的研究结果可以证明,除养老金计划外,更全面的年收入保障计划也可能带来健康益处。从ADL改善或降低的角度来看,养老金收入的稳定性减轻了对低收入者的惩罚。
{"title":"Transitioning to a guaranteed annual income and the impact on activities of daily living in older adults: Evidence from public pensions in Canada using the CLSA.","authors":"Laura J Jiménez, Daniel J Dutton","doi":"10.17269/s41997-024-00875-9","DOIUrl":"https://doi.org/10.17269/s41997-024-00875-9","url":null,"abstract":"<p><strong>Objective: </strong>Statistically model the likelihood of changes in the activities of daily living (ADLs) over time for three groups of older adults: those on a pension at all time periods, those never on a pension, and those who transition onto a public pension.</p><p><strong>Methods: </strong>Our study used data from the Canadian Longitudinal Study on Aging (CLSA), a large national survey. We used data from baseline (2010-2015) and the first follow-up wave (2015-2018). We used logistic regression to model the likelihood of ADL changes in males and females by pension receipt status, controlling for several potential confounders and allowing for the impact of public pensions to be modified by baseline income.</p><p><strong>Results: </strong>The magnitudes of the estimates indicated that those who transition to a public pension are less likely to report ADL degradation and more likely to report ADL improvement compared to those with no public pension. In the lowest baseline income group, those who transitioned onto a pension at follow-up had a 15% (male) or 11% (female) lower likelihood of reporting degraded ADL scores compared to those not receiving a pension at follow-up. Those who transitioned onto a pension in the lowest income group were more likely to report an improved ADL score at follow-up.</p><p><strong>Conclusion: </strong>Our results could provide evidence for the potential health benefits of more comprehensive guaranteed annual income programs beyond the pension program. The penalty of being low-income was mitigated by the stability of the pension income in terms of ADL improvement or degradation.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Design and implementation of the Our Health Counts (OHC) methodology for First Nations, Inuit, and Metis (FNIM) health assessment and response in urban and related homelands. 设计并实施 "我们的健康至关重要"(OHC)方法,用于第一民族、因努伊特人和 梅蒂斯人(FNIM)的健康评估以及城市和相关家园的应对措施。
IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-15 DOI: 10.17269/s41997-024-00867-9
Janet Smylie, Cheryllee Bourgeois, Marcie Snyder, Raglan Maddox, Stephanie McConkey, Michael Rotondi, Conrad Prince, Brian Dokis, Michael Hardy, Serena Joseph, Amanda Kilabuk, Jo-Ann Mattina, Monica Cyr, Genevieve Blais

Objectives: Methods for enumeration and population-based health assessment for First Nations, Inuit, and Metis (FNIM) living in Canadian cities are underdeveloped, with resultant gaps in essential demographic, health, and health service access information. Our Health Counts (OHC) was designed to engage FNIM peoples in urban centres in "by community, for community" population health assessment and response.

Methods: The OHC methodology was designed to advance Indigenous self-determination and FNIM data sovereignty in urban contexts through deliberate application of Indigenous principles and linked implementation strategies. Three interwoven principles (good relationships are foundational; research as gift exchange; and research as a vehicle for Indigenous community resurgence) provide the framework for linked implementation strategies which include actively building and maintaining relationships; meaningful Indigenous community guidance, leadership, and participation in all aspects of the project; transparent and equitable sharing of project resources and benefits; and technical innovations, including respondent-driven sampling, customized comprehensive health assessment surveys, and linkage to ICES data holdings to generate measures of health service use.

Results: OHC has succeeded across six urban areas in Ontario to advance Indigenous data sovereignty and health assessment capacity; recruit and engage large population-representative cohorts of FNIM living in urban and related homelands; customize comprehensive health surveys and data linkages; generate previously unavailable population-based FNIM demographic, health, and social information; and translate results into enhanced policy, programming, and practice.

Conclusion: The OHC methodology has been demonstrated as effective, culturally relevant, and scalable across diverse Ontario cities.

目标:对居住在加拿大城市的原住民、因纽特人和梅蒂斯人(FNIM)进行查点和基于人口的健康评估的方法尚不完善,因此在基本的人口、健康和医疗服务获取信息方面存在差距。我们的健康计数(OHC)旨在让城市中心的原住民、因纽特人和梅蒂斯人参与 "由社区、为社区 "的人口健康评估和应对措施:我们的健康数据 "方法旨在通过慎重应用土著原则和相关的实施战略,在城市环境中推进土著自决和土著民族数据主权。三个相互交织的原则(良好的关系是基础;研究是礼物交换;研究是土著社区复兴的工具)为关联实施战略提供了框架,其中包括积极建立和维护关系;有意义的土著社区指导、领导和参与项目的各个方面;透明和公平地分享项目资源和利益;以及技术创新,包括受访者驱动的抽样、定制的综合健康评估调查,以及与 ICES 数据库的链接,以生成健康服务使用的衡量标准:OHC 在安大略省的六个城市地区取得了成功,推动了土著数据主权和健康评估能力的发展;招募并吸引了居住在城市和相关家园的大量具有人口代表性的 FNIM 群体;定制了综合健康调查和数据链接;生成了以前无法获得的基于人口的 FNIM 人口、健康和社会信息;并将结果转化为强化的政策、计划和实践:OHC 方法已被证明是有效的、与文化相关的,并可在安大略省不同城市推广。
{"title":"Design and implementation of the Our Health Counts (OHC) methodology for First Nations, Inuit, and Metis (FNIM) health assessment and response in urban and related homelands.","authors":"Janet Smylie, Cheryllee Bourgeois, Marcie Snyder, Raglan Maddox, Stephanie McConkey, Michael Rotondi, Conrad Prince, Brian Dokis, Michael Hardy, Serena Joseph, Amanda Kilabuk, Jo-Ann Mattina, Monica Cyr, Genevieve Blais","doi":"10.17269/s41997-024-00867-9","DOIUrl":"10.17269/s41997-024-00867-9","url":null,"abstract":"<p><strong>Objectives: </strong>Methods for enumeration and population-based health assessment for First Nations, Inuit, and Metis (FNIM) living in Canadian cities are underdeveloped, with resultant gaps in essential demographic, health, and health service access information. Our Health Counts (OHC) was designed to engage FNIM peoples in urban centres in \"by community, for community\" population health assessment and response.</p><p><strong>Methods: </strong>The OHC methodology was designed to advance Indigenous self-determination and FNIM data sovereignty in urban contexts through deliberate application of Indigenous principles and linked implementation strategies. Three interwoven principles (good relationships are foundational; research as gift exchange; and research as a vehicle for Indigenous community resurgence) provide the framework for linked implementation strategies which include actively building and maintaining relationships; meaningful Indigenous community guidance, leadership, and participation in all aspects of the project; transparent and equitable sharing of project resources and benefits; and technical innovations, including respondent-driven sampling, customized comprehensive health assessment surveys, and linkage to ICES data holdings to generate measures of health service use.</p><p><strong>Results: </strong>OHC has succeeded across six urban areas in Ontario to advance Indigenous data sovereignty and health assessment capacity; recruit and engage large population-representative cohorts of FNIM living in urban and related homelands; customize comprehensive health surveys and data linkages; generate previously unavailable population-based FNIM demographic, health, and social information; and translate results into enhanced policy, programming, and practice.</p><p><strong>Conclusion: </strong>The OHC methodology has been demonstrated as effective, culturally relevant, and scalable across diverse Ontario cities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
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Canadian Journal of Public Health-Revue Canadienne De Sante Publique
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