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PubMed1989

AIDS in Canada.

Since the first case of AIDS was diagnosed in 1982, there have been over 2,300 cases, as of February 1989, in Canada. The epidemiological pattern of the cases in Canada follows that of the United States with the exception of intravenous drug users. In 1983, the federal government created a National Advisory Committee which is active in advising the Minister of National Health and Welfare on issues for the control and management of AIDS in Canada. In 1985, a $39 million program was announced. An enhanced program of AIDS control was established in July of 1987 with the creation of the Federal Center for AIDS (FCA). This has involved a substantial increase in financial and personnel resources. Canada plays a significant role internationally vis-à-vis AIDS; $10 million has been provided to the World Health Organization. The FCA is a WHO Collaborating Centre. In June of 1989, Canada will host the Vth International Conference on AIDS in Montreal.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Effectiveness of fish habitat compensation in Canada in achieving no net loss.

Fish habitat loss has been prevalent over the last century in Canada. To prevent further erosion of the resource base and ensure sustainable development, Fisheries and Oceans Canada enacted the habitat provisions of the Fisheries Act in 1976. In 1986, this was articulated by a policy that a "harmful alteration, disruption, or destruction to fish habitat" (HADD) cannot occur unless authorised with legally binding compensatory habitat to offset the HADD. Despite Canada's progressive conservation policies, the effectiveness of compensation habitat in replicating ecosystem function has never been tested on a national scale. The effectiveness of habitat compensation projects in achieving no net loss of habitat productivity (NNL) was evaluated at 16 sites across Canada. Periphyton biomass, invertebrate density, fish biomass, and riparian vegetation density were used as indicators of habitat productivity. Approximately 63% of projects resulted in net losses in habitat productivity. These projects were characterised by mean compensation ratios (area gain:area loss) of 0.7:1. Twenty-five percent of projects achieved NNL and 12% of projects achieved a net gain in habitat productivity. These projects were characterised by mean ratios of 1.1:1 and 4.8:1, respectively. We demonstrated that artificially increasing ratios to 2:1 was not sufficient to achieve NNL for all projects. The ability to replicate ecosystem function is clearly limited. Improvements in both compensation science and institutional approaches are recommended to achieve Canada's conservation goal.

Animals↗
PubMed2007

Demand for human allograft tissue in Canada.

There is relatively little known about the demand for allograft tissues in Canada. The Canadian Council for Donation and Transplantation (CCDT) is a national advisory body that undertook a comprehensive "market survey" to estimate surgical demand for human allograft tissues in Canada. The report "Demand for Human Allograft Tissue in Canada" reflects survey results sent to 5 prominent User Groups. User Groups were identified as orthopaedic surgeons; neurosurgeons; corneal transplant surgeons; plastic surgeons, specifically those at Canadian Burn Units; and cardiac surgeons (adult and paediatric surgery). The demand for allograft grafts was determined and then extrapolated across the total User Group and then increases in allograft tissue use over the next 1-2 years across User Groups were predicted. The overall response rate for the survey was 21.4%. It varied from a low of 19.6% for the orthopaedic survey to a high of 40.5% for the corneal survey. The estimated current demand for allograft tissue in Canada ranges from a low of 34,442 grafts per year to a high of 62,098 grafts per year. The predicted increase in use of allograft tissue over the next 1-2 year period would suggest that annual demand could rise to somewhere in the range of 42,589-72,210 grafts. The highest rated preferences (98% and 94%) were for accredited and Canadian tissue banks, respectively. This study represents a key step in addressing the paucity of information concerning the demand for allograft tissue in Canada.

Canada↗
PubMed2006

Gambling and the older Chinese in Canada.

In Canada, there is a lack of research on gambling among the older adults from ethnic minority groups, especially the older Chinese. In this study, two research questions were used to examine gambling among the older Chinese: (1) What is the pattern of gambling among the older Chinese in Canada? (2) What are the predictors associated with gambling among the older Chinese in Canada? The data for this study were collected as part of a multi-site study on health and well-being of 2272 older Chinese in Canada. Four main questions related to gambling were used in this study. Among the 2257 participants who answered the questions on gambling, 26.6% of them reported that they gambled. Results of the hierarchical logistic regression analysis showed that being male, having lived in Canada longer, having a higher level of social support, having more service barriers, and having a stronger level of Chinese ethnic identity would increase the probability for an older Chinese to participate in gambling. Conversely, having a post-secondary and above level of education and having a higher level of life satisfaction would reduce one's probability of gambling. Although city of residency was also significant in predicting gambling, further analysis showed that its effect was actually caused by other factors including services barriers, social support, life satisfaction, Chinese ethnic identity, and education.

Aged↗
PubMed2005

Comparison of management patterns and clinical outcomes in patients with atrial fibrillation in Canada and the United States (from the analysis of the Atrial Fibrillation Follow-up Investigation of Rhythm Management [AFFIRM] database).

Little is known about differences in practice patterns or outcomes in the management of patients who have atrial fibrillation in Canada compared with those in the United States (US). We evaluated the effect that the country of enrollment may have on the management patterns and clinical outcomes in patients who participated in the AFFIRM study. Three thousand four hundred patients came from the US and 660 from Canada. In the US, patients were more likely to have a history of coronary artery disease (39% vs 35%, p = 0.03), hypertension (72% vs 67%, p = 0.01), or congestive heart failure (24% vs 18%, p = 0.0002). More US participants were <65 years of age (25% vs 19%, p = 0.003). Although at randomization the use of warfarin was comparable, during follow-up Canadians were more likely to be treated with warfarin and to be therapeutically anticoagulated. Mortality rate at 5 years was higher in US patients (24% vs 16%, p = 0.001), and the composite end point (death, disabling stroke, major bleeding, cardiac arrest, or anoxic encephalopathy) was also higher in US patients (30% vs 22%, p = 0.0005). Even after adjusting for known differences in baseline characteristics, the risk of death was lower in Canada (hazard ratio 0.70, p = 0.02). In conclusion, in the AFFIRM study, US subjects were more likely to have preexisting cardiovascular diseases despite being younger (<65 years old) than those in Canada. Effective warfarin therapy was more commonly employed in Canada. After correcting for the known differences in baseline characteristics, Canadian patients who had atrial fibrillation had a lower mortality risk.

Aged↗
PubMed2026

Investing in Canada's nursing workforce: a comprehensive review to inform policy innovations and directions.

BACKGROUND: Health systems worldwide face persistent health workers challenges including nursing shortages, workforce strain, and inequities. In Canada, these challenges have prompted renewed national and provincial reforms to strengthen recruitment, retention, leadership, and sustainability. This paper compares nursing workforce policy directions across Canada, and international jurisdictions to inform policy and planning. METHODS: A cross-country comparative analysis of policies building on a comprehensive national funded review that included an umbrella review of 69 systematic reviews, a comparative policy review of nursing workforce strategies in five jurisdictions, and validation through national horizon-scanning and policy dialogues (n >100). Evidence was analyzed across system, organizational, and individual levels. RESULTS: At the system level, international jurisdictions demonstrate comprehensive, legislated approaches integrating data, governance, and multi-year funding have advanced key nursing strategies. In Canada, the advances show the importance of strategies to have national and provincial/territorial alignment emphasizing leadership, flexibility, and inclusion as key levers. Organizational and individual-level reforms such as mentorship, leadership development, and wellness initiatives are expanding but remain variably evaluated. Experts identified national workforce data strategies and policy integration with embedded evaluation as key enablers to inform scalability and sustainability of implemented strategies. CONCLUSIONS: Canada's nursing workforce reforms are advancing toward coordinated, equity-driven, and evidence-informed strategies. Continued investment in evaluation, leadership, and national integrated data systems along with integrating nursing workforce planning within broader intersectoral planning will consolidate these gains and position Canada as an international leader in sustainable nursing workforce policy.

Canada↗
PubMedDate not supplied

Canada and the International Space Station program: overview and status.

The twelve months since IAF 2000 have been perhaps the most exciting, challenging and rewarding months for Canada since the beginning of our participation in the International Space Station program in 1984. The highlight was the successful launch, on-orbit check out, and the first operational use of Canadarm2, the Space Station Remote Manipulator System, between April and July 2001. The anomalies encountered and the solutions found to achieve this success are described in the paper. The paper describes, also, the substantial progress that has been made, during the twelve months since IAF 2000, by Canada as it continues to complete work on all flight-elements of its contribution to the International Space Station and as we transition into real-time Space Station operations support and Canadian utilization. Canada's contribution to the International Space Station is the Mobile Servicing System (MSS), the external robotic system that is key to the successful assembly of the Space Station, the maintenance of its external systems, astronaut EVA support, and the servicing of external science payloads. The MSS ground segment that supports MSS operations, training, sustaining engineering, and logistics activities is reaching maturity. The MSS Engineering Support Center and the MSS Sustaining Engineering Facility are providing real-time support for on-orbit operations, and a Canadian Payloads Telescience Operations Center is now in place. Mission Controllers, astronauts and cosmonauts from all Space Station Partners continue to receive training at the Canadian Space Agency. The Remote Multi Purpose Room, one element of the MSS Operations Complex, will be ready to assume backroom support in 2002. Canada has completed work on identifying its Space Station utilization activities for the period 2000 through 2004. Also during the past twelve months the CSA drafted and is proceeding with the approval of a Canadian Space Station Commercialization Policy. Canadian astronauts have now participated in three ISS assembly missions--Julie Payette on STS-96, Marc Garneau on STS-97, and Chris Hadfield on STS-100 in April 2001 during which he performed Canada's first EVA and the successful installation of the Space Station Remote Manipulator System.

Astronauts↗
PubMedDate not supplied

Canada's National Forest Inventory (responding to current information needs).

Canada's current National Forest Inventory is a periodic compilation of existing inventory material from across the country. While the current approach has many advantages, it lacks information on the nature and rate of changes to the resource, and does not permit projections or forecasts. Being a compilation of inventories of different dates, the current national forest inventory cannot reflect the current state of the forests and therefore cannot be used as a satisfactory baseline for monitoring change. The current format of Canada's National Forest Inventory has served its purpose by providing national statistical compilations and reporting. However, its useful life is coming to a conclusion. To meet new demands, Canada is considering a new National Forest Inventory design consisting of a plot-based system of permanent observational units located on a national grid. The objective of the new inventory design is to assess and monitor the extent, state and sustainability of Canada's forests in a timely and accurate manner. Details of the new inventory design are described. A strategy to respond to Canada's national and international forest reporting commitments through a National Forest Information System is also discussed.

Canada↗
PubMed1999

A review of anthrax in Canada and implications for research on the disease in northern bison.

During the first half of the century, the majority of anthrax outbreaks in Canada occurred in the southern portions of Ontario and Quebec and were often associated with pastures contaminated by effluent from textile industries dealing with imported animal materials. In 1952, introduction of Federal regulations requiring disinfection of these materials greatly reduced the incidence of anthrax in eastern Canada. Since 1962, domestic outbreaks of the disease have been reported almost exclusively in cattle in the western prairie provinces. Between 1962 & 1993, nine anthrax epizootics have been recorded in the bison herds of the Northwest Territories and northern Alberta resulting in the deaths of at least 1309 animals. During the northern epizootics there has been a strong sex bias in mortalities with the majority of carcasses being sexually mature bulls. The northern epizootics occur during drought conditions in the late summer, preceded by a wet spring, and end with the arrival of coolers weather. It has been hypothesized that stress factors associated with these meteorological conditions coupled with breeding stress during the late summer rut may predispose the bulls to infection. Alternatively, the meteorological conditions may work to concentrate anthrax spores in the environment into low lying wallows preferentially utilized by the bulls. Recent genetic analyses of Bacillus anthracis isolates from Canada and the United States have identified that, while closely related to isolates from domestic outbreaks, isolates from northern bison epizootics form their own distinct strain. This suggests that the establishment of anthrax in northern Canada was a singular event that occurred prior to the first recognized epizootic in 1962. A review of the agricultural history of northern Canada has identified several situations in the first half of the century which may have provided the opportunity for the transfer of anthrax from cattle to the indigenous bison.

Animals↗
PubMed1998

Determinants of preterm birth rates in Canada from 1981 through 1983 and from 1992 through 1994.

BACKGROUND: The rates of preterm birth have increased in many countries, including Canada, over the past 20 years. However, the factors underlying the increase are poorly understood. METHODS: We used data from the Statistics Canada live-birth and stillbirth data bases to determine the effects of changes in the frequency of multiple births, registration of births occurring very early in gestation, patterns of obstetrical intervention, and use of ultrasonographic dating of gestational age on the rates of preterm birth in Canada from 1981 through 1983 and from 1992 through 1994. All births in 9 of the 12 provinces and territories of Canada were included. Logistic-regression analysis and Poisson regression analysis were used to estimate changes between the two three-year periods, after adjustment for the above-mentioned determinants of the likelihood of preterm births. RESULTS: Preterm births increased from 6.3 percent of live births in 1981 through 1983 to 6.8 percent in 1992 through 1994, a relative increase of 9 percent (95 percent confidence interval, 7 to 10 percent). Among singleton births, preterm births increased by 5 percent (95 percent confidence interval, 3 to 6 percent). Multiple births increased from 1.9 percent to 2.1 percent of all live births; the rates of preterm birth among live births resulting from multiple gestations increased by 25 percent (95 percent confidence interval, 21 to 28 percent). Adjustment for the determinants of the likelihood of preterm birth reduced the increase in the rate of preterm birth to 3 percent among all live births and 1 percent among singleton births. CONCLUSIONS: The recent increase in preterm births in Canada is largely attributable to changes in the frequency of multiple births, obstetrical intervention, and the use of ultrasound-based estimates of gestational age.

Birth Rate↗
PubMed1999

Comparison of growth status of patients with cystic fibrosis between the United States and Canada.

BACKGROUND: Differences in growth status of patients with cystic fibrosis (CF) between the United States and Canada were reported in the 1980s based on analysis of data from 2 regional CF centers. OBJECTIVE: We evaluated the current growth status of the entire CF population in the United States and Canada in view of recent advances in the treatment of CF. DESIGN: Growth data from the 1992-1994 CF Patient Registries were analyzed. RESULTS: Mean height and weight were at approximately the 30th percentile for children with CF in the United States. Mean height and weight were 4-5 percentiles higher in children with CF in Canada than in those in the United States (P < 0.01), but percentages of ideal weight (104%) were similar in both populations. In adults with CF, mean height was similar at the 37th percentile; however, weight (26th compared with the 21st percentiles) and percentage of ideal weight (93% compared with 90%) were significantly higher in Canada than in the United States. Differences related to sex and age were similar in both countries for all indexes, which showed a high prevalence of underweight in infants and in older patients, but little sex discrepancy. CONCLUSION: We observed substantially smaller differences in the growth indexes of CF patients between the United States and Canada compared with results from the 1980s. These findings reflect significant improvements in the nutritional status of US patients in recent years. However, caution is required in the direct comparison of mean percentiles from reports using different growth standards because there are systematic differences in growth standards, which affect, in particular, the comparison of growth in males and females.

Adolescent↗
PubMed2005

Prevalence of diarrhoea in the community in Australia, Canada, Ireland, and the United States.

BACKGROUND: Studies in several countries have estimated the prevalence of diarrhoea in the community. However, the use of different study designs and varying case definitions has made international comparisons difficult. METHODS: Similar cross-sectional telephone surveys were conducted in Australia, Canada, Ireland (including Northern Ireland), and the United States over 12 month periods between 2000 and 2002. Each survey asked about diarrhoea in the four weeks before the interview. For this comparative analysis, uniform definitions were used. RESULTS: Questionnaires were completed for 6087 respondents in Australia, 3496 in Canada, 9903 in Ireland, and 14,647 in the United States. In the four weeks prior to interview, at least one episode of diarrhoea was reported by 7.6% of respondents in Canada, 7.6% in the United States, 6.4% in Australia, and 3.4% in Ireland. The prevalence of diarrhoea was consistently higher in females. In all countries, the prevalence of diarrhoea was highest in children <5 years and lowest in persons > or =65 years of age. When diarrhoea and vomiting was considered, the prevalence was almost identical in the four studies (range: 2.0-2.6%). Despite different health care structures, a similar proportion of respondents sought medical care (approximately one in five). Antibiotic usage for the treatment of diarrhoea was reported by 8.3% of respondents in the United States, 5.6% in Ireland, 3.8% in Canada, and 3.6% in Australia. CONCLUSIONS: Diarrhoea is a common illness among persons in the community in Australia, Canada, Ireland, and the United States. With similar methodologies and a standard case definition, age and sex patterns and health care seeking behaviour were remarkably consistent between countries.

Adolescent↗
PubMed1995

Breast cancer mortality among immigrants in Australia and Canada.

BACKGROUND: By moving between geographic regions with differing levels of breast cancer risk, migrant populations of women provide a unique opportunity to examine the impact of exposure to new environments and lifestyles on breast cancer risk. Breast cancer incidence and mortality rates for the majority of migrant groups originating from countries with low breast cancer risk have been found to increase toward the rates observed in destination countries with populations at higher risk for this disease. Because very little information exists on migrants from high- to low-risk countries, it is not known whether rates for these groups decrease or whether migrant groups generally experience increases in breast cancer rates. PURPOSE: To address these questions, we determined the breast cancer mortality rates for women from both lower and higher risk countries who had immigrated to Australia and Canada and compared these rates with those exhibited by the population in the origin country and by the destination native-born population. METHODS: Individual mortality records covering the years 1984 through 1988 and 1986 census data for Australia and Canada were obtained. Direct age-standardized mortality rates and rate ratios (and their 95% confidence intervals) were calculated for immigrant groups in Australia and Canada. Age-standardized rate ratios by length of residence in Australia were calculated. Weighted regression analyses of observed and expected mortality changes were performed. RESULTS: In Australia, the mortality rates for 12 (75%) of 16 immigrant groups from lower risk countries and 10 (71.4%) of 14 groups from higher risk countries shifted toward the rate of native-born Australians. In Canada, the rates for 12 (60%) of 20 immigrant groups from lower risk countries and four (80%) of five groups from higher risk countries converged to the rate of native-born Canadians. Overall, the extent of convergence (shift of immigrant's mortality rate in origin country toward rate of native-born population) was 50% for immigrants in Australia and 38% for immigrants in Canada. Although there was not a consistent pattern of convergence with length of residence in Australia, after 30 or more years, the mortality rates of 15 (83.3%) of 18 immigrant groups had shifted toward the rate of the native-born Australians. Because of the small number of deaths in many of the immigrant groups studied, the observed differences in the breast cancer mortality age-standardized rates between the origin country and immigrant group, although often substantial, were seldom statistically significant. CONCLUSIONS: Breast cancer mortality rates among women in the majority of immigrant groups shifted from the rate observed in their country of origin toward the rate of the native-born population in the destination country. IMPLICATIONS: These findings indicate that environmental and lifestyle factors associated with the new place of residence influence the breast cancer rates of immigrants and also suggest that, since most migrants migrate as adults, the risk of breast cancer can be altered in later life.

Adult↗
PubMed1994

The changing spectrum of AIDS index diseases in Canada.

OBJECTIVE: To describe the changing spectrum of AIDS index diseases in Canada over a 10-year period from 1981 to 1991. DESIGN: A descriptive, population-based study. SETTING: Canada. PATIENTS: All cases of AIDS in Canada reported by the Division of HIV/AIDS Epidemiology of the Department of National Health and Welfare. MAIN OUTCOME MEASURES: Age-standardized rates of initial AIDS manifestations (1987 Centers for Disease Control and Prevention case definition), by year of diagnosis among adults in Canada. RESULTS: A total of 6641 adult AIDS cases were examined. The rate of Pneumocystis carinii pneumonia (PCP) peaked in 1989 with a rate of 3.18 per 100,000, declining to 2.74 per 100,000 in 1991 (P = 0.894). Similarly, the rate of Kaposi's sarcoma (KS) stabilized during this interval from 1.06 per 100,000 in 1987 to 1.14 per 100,000 in 1991 (P = 0.189). In contrast, the rates of all other AIDS-defining illnesses increased from 1.48 per 100,000 in 1987 to 3.43 per 100,000 in 1991 (P = 0.001). For these other AIDS index diseases, significant rate increases were observed for esophageal candidiasis, cytomegalovirus (CMV) diseases, wasting syndrome, toxoplasmosis, and Mycobacterium avium complex (MAC) disease. CONCLUSIONS: Our study shows a leveling and decline in incidence of KS and PCP, respectively, and a concomitant increase of other diagnoses, especially esophageal candidiasis, CMV, wasting syndrome, toxoplasmosis, and MAC disease in Canada. These findings highlight the importance of developing specific strategies to prevent emerging AIDS index diseases and serve as a cautionary note to practicing clinicians, indicating the relative widening of the spectrum of HIV index diseases.

AIDS-Related Opportunistic Infections↗
PubMed1994

Indirect costs of HIV/AIDS mortality in Canada.

OBJECTIVE: To estimate and compare the societal impact of HIV infection and AIDS with other selected causes of male mortality in terms of the indirect costs of future production lost. DESIGN: Descriptive, population-based economic evaluation study. PATIENTS: All men aged 25-64 years for whom HIV/AIDS or another selected disease was listed as the underlying cause of death in Canada from 1987 to 1991, as reported to Statistics Canada. SETTING: Canada. MAIN OUTCOME MEASURES: Present value of future earnings lost for men using a human capital approach based on potential years of life lost in men aged 25-64 years. RESULTS: Assuming a 2% annual growth in earnings and a 3% annual real discount rate, the present value of the total loss of future production for all men aged 25-64 years who died in Canada during 1987-1991 was estimated to be 39.74 billion 1990 US$. Deaths due to HIV/AIDS accounted for 5.3% of this total loss or 2.11 billion in 1990 US$. Future production loss due to HIV/AIDS more than doubled during the period from 1987 to 1991, from 0.27 to 0.60 billion 1990 US$. The loss in future earnings attributable to HIV/AIDS was exceeded only by that of ischaemic heart disease (15.2%), suicide (9.4%), motor vehicle accidents (6.6%), and lung cancer (6.6%). In total, these five causes of death accounted for 43.1% of the total indirect cost of production lost for men aged 25-64 years during the 5-year period. CONCLUSION: Our findings demonstrated HIV/AIDS mortality is already having a dramatic impact on future wealth production in Canada. If the past trend continues, the production lost in 1994 should exceed 0.86 billion 1990 US$ and will account for more than 10% of the total annual loss for men aged 25-64 years.

Acquired Immunodeficiency Syndrome↗
PubMed2006

The epidemiology of inflammatory bowel disease in Canada: a population-based study.

BACKGROUND: Previously, we have demonstrated a high incidence and prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in the Canadian province of Manitoba. However, the epidemiology of inflammatory bowel disease (IBD) in other regions of Canada has not been defined. The aim of this study was to estimate the incidence and prevalence of CD and UC in diverse regions of Canada and the overall burden of IBD in Canada. METHODS: We applied a common case identification algorithm, previously validated in Manitoba to the provincial health databases in British Columbia (BC), Alberta (AB), Saskatchewan (SK), Manitoba (MB), and Nova Scotia (NS) to determine the age-adjusted incidence rates per 100,000 person-years for 1998-2000 and prevalence per 100,000 for mid 2000 and to estimate the IBD burden in Canada. Poisson regression was used to assess differences in incidence rates and prevalence by gender, age, and province. RESULTS: The incidence rate for CD ranged from 8.8 (BC) to 20.2 (NS), and for UC ranged from 9.9 (BC) to 19.5 (NS). The prevalence of CD was approximately 15- to 20-fold higher than the incidence rate, ranging from 161 (BC) to 319 (NS). This was similar for the prevalence of UC, which ranged from 162 (BC) to 249 (MB). Adjusting for age and province, the female:male ratio for incidence ratio was 1.31 (p < 0.0001) for CD and 1.02 (n.s.) for UC and was mostly stable across the five provinces. CONCLUSIONS: Approximately 0.5% of the Canadian population has IBD. Canada has the highest incidence and prevalence of CD yet reported.

Adolescent↗
PubMed2000

Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics.

OBJECTIVE: To compare the relation between mortality and income inequality in Canada with that in the United States. DESIGN: The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, was calculated and these measures were examined in relation to all cause mortality, grouped by and adjusted for age. SETTING: The 10 Canadian provinces, the 50 US states, and 53 Canadian and 282 US metropolitan areas. RESULTS: Canadian provinces and metropolitan areas generally had both lower income inequality and lower mortality than US states and metropolitan areas. In age grouped regression models that combined Canadian and US metropolitan areas, income inequality was a significant explanatory variable for all age groupings except for elderly people. The effect was largest for working age populations, in which a hypothetical 1% increase in the share of income to the poorer half of households would reduce mortality by 21 deaths per 100 000. Within Canada, however, income inequality was not significantly associated with mortality. CONCLUSIONS: Canada seems to counter the increasingly noted association at the societal level between income inequality and mortality. The lack of a significant association between income inequality and mortality in Canada may indicate that the effects of income inequality on health are not automatic and may be blunted by the different ways in which social and economic resources are distributed in Canada and in the United States.

Canada↗
PubMedDate not supplied

Respirology manpower in Canada--A report for the Canadian Thoracic Society Education Committee.

A report on adult and pediatric respirology manpower in Canada was prepared from data supplied by the Royal College of Physicians and Surgeons of Canada (RCPSC), and from program directors (and other colleagues) at universities across Canada. The data support a significant deficiency of adult respirologists in Canada, which is estimated to be from 10%, based on a 10-year-old outdated RCPSC recommendation, to 20%, based on equalization with the 'best' province, to as high as 50%, based on long waiting lists, particularly for respiratory sleep problems, and estimates obtained from academic centres across Canada. Although there are less data available for pediatric respirology, a similar approach suggests a 50% to 100% shortfall in pediatric respirologists. Output from Canadian training programs in adult and pediatric respirology is not likely to meet this need. We recommend that steps be taken urgently to provide sufficient resources for training adult and pediatric respirologists, and to ensure that funding is provided for subspecialist positions in the community.

Canada↗