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[Cigarette usage in Quebec from 1985 to 1994: a comparison with Canada].

Smoking is responsible for the highest number of avoidable illnesses and deaths in Canada. Cigarette smoking declined considerably in the adult population between 1965 and 1986, but what has happened over the past decade? Quebec and Canadian public surveys were used to compare types of cigarette use in Quebec and Canada between 1985 and 1994, as well as to compare them by sex. In recent years, the prevalence of smoking has increased among Quebec men only. Differences between Quebec and Canada can be seen in the evolution of the quit rate and the prevalence of smokers. There does not appear to be any indication that differences in cigarette smoking between Quebec and Canada are being eradicated. In Quebec, the evolution of this habit differs according to sex, which indicates that certain factors affect men and women differently. The public survey data make it possible to follow trends in the medium and long term, whereas it is difficult to accurately track the evolution of cigarette smoking from one year to the next, given the small size of the samples in each region and the slow evolution of behaviour.

Adolescent↗

PubMed1997

Fish- and shellfish--borne trematode infections in Canada.

Food-borne trematode infections are endemic in various parts of the world, particularly Southeast Asia. Despite the high prevalence, morbidity and total costs of these infections, they remain poorly recognized by public health authorities and consumers. Factors such as poor sanitation and traditional methods of food preparation hasten the spread of food-borne trematode infections in endemic regions and must be carefully examined in order to develop effective control strategies. There is also a growing risk to consumers in non-endemic countries as a result of international trade. A considerable quantity of freshwater fish and shellfish is imported into Canada from endemic countries in Southeast Asia. Some of these products are imported fresh or processed in such a way that the infective metacercariae may not be destroyed. Further, current inspection procedures in Canada may not detect the presence of all parasites in imported fish products. Therefore, there may be a risk of infection if the fish or shellfish is consumed raw or lightly cooked. Many of the cases of infection in Canada involve recent immigrants from endemic regions who have become infected either before arriving or through the consumption of traditional or ethnic dishes prepared from imported products. International travel and the increasing availability and interest in ethnic foods also contribute to the risk of infection in all Canadians. In addition to these imported trematodes, a number of species are found in freshwater fishes and shellfish in North America and have also caused illness in humans. Although the prevalence of infection remains relatively low in Canada, the need for an increased general awareness of food-borne trematode infections and their causes is indicated.

Animals↗

PubMed2000

Prevalence and determinants of diabetes mellitus among the Métis of western Canada.

Diabetes and its complications are major contributors to morbidity and mortality among Canada's Aboriginal populations. The epidemiology of diabetes among the Métis has not yet been investigated. The purpose of this study was to determine the prevalence of diabetes among the Métis, to identify diabetes risk factors, and to test hypotheses related to diabetes etiology. The source of the data for this research was the Aboriginal Peoples Survey (APS), a postcensal survey conducted by Statistics Canada in 1991. Study populations included the APS self-identified Métis and North American Indians of western Canada. Univariate and multivariate analyses were done to estimate the prevalence of diabetes and to identify diabetes risk factors. Multiple logistic regression was performed to test etiological hypotheses regarding the determinants of diabetes. The crude prevalence of diabetes among the Métis (6%) was slightly less than that reported by North American Indians (7%) and twice the general rate for Canada (3%). Diabetes was significantly associated with age, sex, obesity, and level of education. The APS dataset was useful in establishing diabetes as a significant problem among the Métis. Am. J. Hum. Biol. 12:542-551, 2000. Copyright 2000 Wiley-Liss, Inc.

Journal Article↗

PubMed1997

Cronkhite-Canada syndrome associated with carcinoma of the sigmoid colon: report of a case.

Cronkhite-Canada syndrome is generally accepted as being a benign disorder. We herein present a 66-year-old-male patient with Cronkhite-Canada syndrome who had a carcinoma of the sigmoid colon along with multiple colonic polyps, which included juvenile-type polyps, adenomas, and hyperplastic polyps. In the world literature, there have been 34 cases of Cronkhite-Canada syndrome associated with colorectal carcinoma among the 280 reported cases of this syndrome. This report thus adds to the growing evidence that Cronkhite-Canada syndrome may be a premalignant condition for colorectal carcinoma. A periodic examination of the colon is therefore advised in order to detect any development of colorectal carcinoma at an early stage.

Adenocarcinoma↗

PubMed1992

Comparison of episodic acidification in Canada, Europe and the United States.

Episodic acidification is practically a ubiquitous process in streams and drainage lakes in Canada, Europe and the United States. Depressions of pH are often smaller in systems with low pre-episode pH levels. Studies on European surface waters have reported episodes most frequently with minimum pH levels below 4.5. In Canada and the United States, studies have also reported a number of systems that have had minimum pH levels below 4.5. In all areas, change in water flowpath during hydrological events is a major determinant of episode characteristics. Episodic acidification is also controlled by a combination of other natural and anthropogenic factors. Base cation decreases are an important contributor to episodes in circumneutral streams and lakes. Sulphate pulses are generally important contributors to episodic acidification in Europe and Canada. Nitrate pulses are generally more important to episodic acidification in the Northeast United States. Increases in organic acids contribute to episodes in some streams in all areas. The sea-salt effect is important in near-coastal streams and lakes. In Canada, Europe and the United States, acidic deposition has increased the severity (minimum pH reached) of episodes in some streams and lakes.

Journal Article↗

PubMed2006

Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda.

UNLABELLED: The objectives of this study were (1) to describe the process of healthcare priority setting in Ontario-Canada, Norway and Uganda at the three levels of decision-making; (2) to evaluate the description using the framework for fair priority setting, accountability for reasonableness; so as to identify lessons of good practices. METHODS: We carried out case studies involving key informant interviews, with 184 health practitioners and health planners from the macro-level, meso-level and micro-level from Canada-Ontario, Norway and Uganda (selected by virtue of their varying experiences in priority setting). Interviews were audio-recorded, transcribed and analyzed using a modified thematic approach. The descriptions were evaluated against the four conditions of "accountability for reasonableness", relevance, publicity, revisions and enforcement. Areas of adherence to these conditions were identified as lessons of good practices; areas of non-adherence were identified as opportunities for improvement. RESULTS: (i) DESCRIPTION: at the macro-level, in all three countries, cabinet makes most of the macro-level resource allocation decisions and they are influenced by politics, public pressure, and advocacy. Decisions within the ministries of health are based on objective formulae and evidence. International priorities influenced decisions in Uganda. Some priority-setting reasons are publicized through circulars, printed documents and the Internet in Canada and Norway. At the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Hospital departments that handle emergencies, such as surgery, were prioritized. Some of the reasons are available on the hospital intranet or presented at meetings. Micro-level practitioners considered medical and social worth criteria. These reasons are not publicized. Many practitioners lacked knowledge of the macro- and meso-level priority-setting processes. (ii) Evaluation-relevance: medical evidence and economic criteria were thought to be relevant, but lobbying was thought to be irrelevant. Publicity: all cases lacked clear and effective mechanisms for publicity. REVISIONS: formal mechanisms, following the planning hierarchy, were considered less effective, informal political mechanisms were considered more effective. Canada and Norway had patients' relations officers to deal with patients' dissensions; however, revisions were more difficult in Uganda. Enforcement: leadership for ensuring decision-making fairness was not apparent. CONCLUSIONS: The different levels of priority setting in the three countries fulfilled varying conditions of accountability for reasonableness, none satisfied all the four conditions. To improve, decision makers at the three levels in all three cases should engage frontline practitioners, develop more effectively publicized reasons, and develop formal mechanisms for challenging and revising decisions.

Health Personnel↗

PubMed2002

Occurrence and congener profiles of polybrominated diphenyl ethers (PBDEs) in environmental samples from coastal British Columbia, Canada.

Environmental levels and detailed congener profiles (31 congeners and 3 coeluting congener groups) of polybrominated diphenyl ethers (PBDEs) were assessed in a number of biota samples taken over a large geographic range covering harbours and industrial sites on Canada's West Coast. Additionally, PBDE congener profiles were determined using semipermeable membrane devices (SPMDs) deployed in the Fraser River, the river in Western Canada with the largest industrial activity. PBDE levels detected in biota were between 4 and 2300 ng/g lipid and these levels were compared with those reported in selected European biota to provide a wider perspective on PBDE contamination on Canada's West Coast. Thirteen-congener PBDE patterns in the environmental samples were examined using principal component analysis (PCA), and additionally, comparisons were made between the PBDE profiles in the sample groups and commercially used PBDE technical mixtures (e.g., Bromkals) on a percent composition basis. PCA on congener specific data revealed that PBDE patterns are remarkably similar over a wide geographical range in Western Canada, however, the general pattern in environmental samples varies significantly from those of the predominant technical mixtures. Finally, correlations between PBDE and other persistent and toxic co-occurring contaminants found in Dungeness crab were determined.

Animals↗

PubMed2000

The history of mercury emissions from fuel combustion in Maritime Canada.

In this study, we present an inventory of historical emissions of mercury resulting from combustion of wood, coal and refined petroleum products in Maritime Canada. The pattern of emissions illustrates the strong influences of population growth, industrial development and prevailing fuel preferences in the region. According to our calculations, anthropogenic mercury releases from fuel combustion in Maritime Canada have cumulatively totaled more than 50 tonnes since 1800. We have compiled both high and low estimates of annual mercury releases in this region. Mercury emissions from fuel combustion in Maritime Canada reached a maximum level in the 1940s. At this time, emissions were between 778 (low) and 1494 (high) kg per year, coinciding with the period of most intensive coal use in Maritime Canada. In 1995, emissions were approximately 54% of the level reached in 1940, at 427 (low)-800 (high) kg per year. In presenting this emissions inventory, we hope to refine past estimates with current information on the mercury content of different fuel types, and create a comprehensive database on how mercury emissions from various sources have changed over time.

Journal Article↗

PubMed1999

The contributions of W.D. Stevenson to the development of neurosurgery in Atlantic Canada.

The establishment of a neurosurgical department in Halifax in January 1948 marked the beginnings of the first dedicated neurosurgical service in Atlantic Canada. The development of neurosurgery in Halifax occurred in a receptive place and time. The Victoria General Hospital, the region's largest tertiary care centre, and the Dalhousie University Faculty of Medicine were in a period of growth associated with medical specialization and departmentalization, changes inspired in part by the Flexner Report of 1910. Atlantic Canadians during this period were increasingly looking to specialists for their medical care. Although this social environment encouraged the establishment of surgical specialty services, the development of neurosurgery in Halifax, as in other parts of Canada, was closely associated with the efforts of individual neurosurgeons, such as William D. Stevenson. After training with Kenneth G. McKenzie in Toronto, Stevenson was recruited to Halifax and established the first neurosurgical department in Atlantic Canada. From the outset and over his twenty-six years as Department Head at the Victoria General Hospital and Dalhousie University, Stevenson worked to maintain the department's commitment to clinical practice, medical education, and research. Although Stevenson single-handedly ran the service for several years after its inception, by the time of his retirement in 1974 the neurosurgery department had grown to include five attending staff surgeons who performed over two thousand procedures each year. This paper highlights the importance of Stevenson's contributions to the development of neurosurgery in Atlantic Canada within the context of the social and medical environment of the region.

History, 20th Century↗

PubMed2006

Enteral feeding in end-stage dementia: a comparison of religious, ethnic, and national differences in Canada and Israel.

BACKGROUND: Although enteral feeding in end-stage dementia is thought by many clinicians to be "futile," it is still widely used. We examined rates of tube feeding (gastrostomy or nasogastric) in end-stage dementia in hospitals in both Canada and Israel, and hypothesized that Canadian non-Jewish affiliated hospitals would have the lowest (and Israeli institutions the highest), with Canadian Jewish hospitals exhibiting intermediate rates. METHODS: We conducted a cross-sectional survey of six geriatric long-term hospitals: two in Israel and four in Canada (two Jewish affiliated, two not; two in Ontario, two in Quebec province). Patients with end-stage dementia were assessed and further analyzed for type of feeding. RESULTS: In the six hospitals, 2287 long-term beds were surveyed, of which 1358 (59.4%) were used by demented patients of whom 376 (27.7%) were severely demented (Global Deterioration Scale-level 7). Of these, 24.5% (92) were fed by nasogastric tube or gastrostomy tube. Significant differences in tube-feeding prevalence were found between Canada (11%) and Israel (52.9%), with only 4.7% seen in non-Jewish Canadian institutions. Jewish affiliated hospitals in Canada exhibited an intermediate rate of 19.6%. However, for within-country dyads, wide differences were also found. When we examined patient religion, we found that Canadian non-Jewish patients had the lowest rates (3.2%), Israeli Jewish patients the highest (51.7%), and Canadian Jewish patients exhibited an intermediate rate (19.0%) of tube use. CONCLUSIONS: Despite reservations concerning its utility, feeding tube use is reasonably widespread in patients who have reached the stage of severe dementia. Canadian institutions exhibited a lower prevalence of feeding tube use than did Israeli hospitals. Between-country and between-province differences in practice may be explained by some combination of administrative and/or financial incentives, religion, and culture; within-country and within-ethnic group differences may be caused, at least in part, by differing institutional cultures.

Aged, 80 and over↗

PubMed2006

Burden of Atopic dermatitis in Canada.

BACKGROUND: Atopic dermatitis (AD) is relatively common worldwide; costs associated with the disease have been reported recently for various countries, but no estimates of costs in Canada are currently available. The objective of this study was to estimate the costs associated with AD in Canada, assessed from resource use determined for a Canadian setting. METHODS: Seventy-six patients in Ontario with AD were surveyed to determine information about severity of disease, healthcare practitioner visits, over-the-counter medication use, household expenses and absenteeism relating to their condition. Based on this information, costs were determined based on the Ontario billing schedule, estimated prescription use, reported out-of-pocket expenses and stated family income. Data about sleep disturbance and concern over topical corticosteroid use were also obtained. RESULTS: Patients reported an average of 3.6 publicly funded doctor visits per year for AD; 58% of these visits were to general practitioners and 28% to dermatologists. The annual per patient expenditure was estimated to be 282, 454 Canadian dollars and 1242 Canadian dollars for patients with mild, moderate and severe AD, respectively. The total cost of AD in Canada was estimated to be 1.4 billion Canadian dollars annually. More than half of the patients experienced sleep disturbances owing to their condition, and 71% reported having concerns about topical corticosteroid use. CONCLUSIONS: Although the cost per patient of AD in Canada is relatively low, owing to the prevalence of the disease, the total cost to society is large. Most of the cost is borne by patients and their employers, primarily owing to indirect costs associated with absenteeism.

Adolescent↗

PubMed1971

Fine structure of Rickettsia canada in tissues of Dermacentor andersoni Stiles.

Preliminary observations on growth and developmental fine structure of Rickettsia canada in various organs and tissues of the hard tick, Dermacentor andersoni Stiles, are reported. R. canada is typically rod-shaped, being delimited with a three-layered wall having a velvety coating adsorbed to its exterior surface. A finely reticulated cytoplasmic matrix containing prominent ribosomes is delimited with a three-layered unit membrane. Average length and width of these organisms are 1.6 by 0.4 mum. Although R. canada produces a generalized infection in D. andersoni, hypodermal and muscle tissues experience heaviest growth. Three morphologically distinct rickettsial forms were observed in individual hypodermal cells: (i) typical growth forms with a finely reticulated cytoplasmic matrix and distinct ribosomes; (ii) atypical forms with lightly to densely staining cytoplasm and a coagulated appearance in which ribosomes cannot be distinguished from the matrix; and (iii) forms with crystalline bodies that have a striated to beaded lattice structure and, at times, a fibrillar body in the cytoplasm as well. Occasional finger-like to irregular invaginations of the plasma membrane are noted. Intranuclear growth was demonstrated by electron microscopy in gut epithelial cells only. Growth and development of R. canada were manifest in all tissues examined.

Animals↗

PubMed2004

Phenotypic and genetic characterization of a unique variant of serogroup C ET-15 meningococci (with the antigenic formula C:2a:P1.7,1) causing invasive meningococcal disease in Quebec, Canada.

Serogroup C Neisseria meningitidis belonging to the electrophoretic type (ET) ET-15, a variant of ET-37, is endemic in Canada. Like other serogroup C ET-37 meningococci, the endemic ET-15 strains are usually found to carry the serotype and serosubtype antigens of 2a:P1.5,2. In 2001, a sudden increase in the number of cases of serogroup C meningococcal disease in Quebec, Canada, was caused by an antigenic variant of the ET-15 strain. This antigenic variant carries the unique serosubtype marker of P1.7,1. Strains of C:2a:P1.7,1 meningococci were not isolated in Canada in large numbers prior to 2001, and the characteristics of these meningococcal strains linked to an outbreak in Quebec, Canada, are described in the present study.

Antigenic Variation↗

PubMed1999

Canada goose (Branta canadensis) droppings as a potential source of pathogenic bacteria.

Canada goose droppings, collected in parks to which the public had access, were screened for a range of bacteria that could be pathogenic in man. Droppings of Canada geese, and other waterfowl, did contain such bacteria, including some that are well-known causes of illness in man. These bacteria, plus a species of Salmonella that was experimentally inoculated into droppings, were shown to survive and multiply in the droppings for up to one month after their deposition by geese. Canada geese ranged further from water than other waterfowl species and thus distributed their droppings over a larger area of park grassland. This more widespread distribution of their droppings leads Canada geese to pose a greater potential health risk than other waterfowl studied here, but variations in human responses to challenge with bacteria, and variations in human and waterfowl behaviour in public parks, renders quantification of this risk impossible.

Animals↗

PubMed1982

The amino acid sequence of Canada goose (Branta canadensis) and mute swan (Cygnus olor) hemoglobins. Two different species with identical beta-chains.

The amino acid sequences of the alpha- and beta-chains from the major hemoglobin component (HbA) of Canada goose (Branta canadensis) and mute swan (Cygnus olor) are given. The alpha-chains are of the alpha A-type, since alpha D-type was expressed but only found in low concentrations. By homologous comparison, greylag goose hemoglobin (Anser anser) and Canada goose hemoglobin alpha-chains differ by two exchanges, and beta-chains by three exchanges. A valine substitution for threonine was found at position alpha 34 (B15). This exchange is a result of a two point mutation. Thus, there are three nucleotide mutations in alpha-chains, as in beta-chains. Substitutions in positions alpha 34 (B15) and beta 125 (H3) have modified intersubunit contacts (alpha 1 beta 1-contacts). A comparison of mute swan hemoglobin with greylag goose hemoglobin shows four exchanges in alpha-chains and three in beta-chains. Canada goose and mute swan have identical beta-chains, while alpha-chains differ in two amino acids. One of these exchanges is implicated in one of the alpha 1 beta 1-contact points (alpha 34) where isoleucine substitution for valine was found. Comparison of hemoglobins from different species in the same tribe (Anserini) shows a high homology between Canada goose and mute swan hemoglobins.

Amino Acid Sequence↗

PubMed1991

Multicentric intramuscular lipomatosis/fibromatosis in free-flying white-fronted and Canada geese.

Over a period of 9 yr, seven white-fronted geese (Anser albifrons) and one Canada goose (Branta canadensis) with multiple intramuscular mesenchymal tumors were encountered in Saskatchewan (Canada) and one similarly affected Canada goose was seen on Prince Edward Island (Canada). The tumors in these birds consisted either of adipose tissue, fibroblastic tissue, or a mixture of both types of tissues. The high prevalence of this condition in white-fronted geese suggested a genetic influence.

Animals↗

PubMed2000

An assessment of the validity of a computer system for probabilistic record linkage of birth and infant death records in Canada. The Fetal and Infant Health Study Group.

Studies on the validity of probabilistic record linkage are sparse. We performed a probabilistic linkage to link the 1984-1994 birth records (obtained from the Canadian Birth Data Base) with 1984-1995 infant death records (from the Canadian Mortality Data Base) in Canada. We extracted the linked birth-death records for Nova Scotia and Alberta (from January 1990 to December 1991) obtained from Statistics Canada's vital registration data and compared them with corresponding records from provincial data (primarily hospital records). The results showed that over 99% of infant deaths (153/155) in the Nova Scotia provincial data were successfully located in the linked Statistics Canada file; the corresponding figure for Alberta neonatal deaths was also 99% (365/367). The distributions of gestational age and birth weight in matched cases demonstrated high agreement between the two data sources. We conclude that the computer system for probabilistic linkage developed by Statistics Canada using the available personal identifying variables in the Canadian Birth Data Base and the Canadian Mortality Data Base is valid.

Alberta↗

PubMed2004

Cryptosporidiosis: a brief literature review and update regarding Cryptosporidium in feces of Canada geese (Branta canadensis).

Canada geese are increasingly abundant in Ohio, with large nesting populations throughout the state, and goose feces contaminate grassy areas and pavements in many public, commercial, and residential sites. In 1999 the authors found a high prevalence of Giardia, Campylobacter, and especially Cryptosporidium in collected feces of Canada geese. The purpose of this follow-up study was to survey known Canada geese sites in three counties in Ohio (Lucas, Ottawa, and Wood) and to determine the prevalence of sites testing positive for Cryptosporidium. The sites included golf courses, cemeteries, public parks, and health care and teaching facilities. At each of 11 sites, 12 goose feces of wet and loose appearance were collected and manually compressed into one composite sample representing that site. The samples were tested for Cryptosporidium with a sensitive monoclonal enzyme immunoassay (EIA) method. In 2000 and 2001, nine of 11 sites (81.8 percent) and nine of 10 sites (90 percent), respectively, were positive for Cryptosporidium. The species or genotypes of Cryptosporidium found in the geese feces and their potential to infect humans is unknown. A survey of the literature indicates, however, that while C. parvum (human genotype) is the main cause of cryptosporidiosis in humans, C. parvum (zoonotic genotypes), C. meleagridis (bird genotype), and C. felis (cat genotype) have occasionally been isolated from infected people. Further research is required to define the public health importance of Cryptosporidium in feces of Canada geese and other bird species.

Animals↗