Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CANADA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed2006

Towards an epidemiological understanding of the effects of long-term institutional changes on population health: a case study of Canada versus the USA.

This paper uses a comparative case study of Canada and the USA to argue that, in order to fully understand the associations between population health and the socioeconomic environment we must begin to place importance on the dynamic aspect of these factors--examining them as they evolve over time. In particular, for institutional and policy shifts that often unfold over decades, population health must attend to these big, slow moving processes by adopting a historical perspective to the knowledge base. We compare Canada and the USA on basic health outcomes and a range of determinants of health for which routine data have been collected for all or most of the period between 1950 and the present. During the analysis that follows, we are able to establish that, at the level of society (i) greater economic well being and spending on health care does not yield better health outcomes, that (ii) public provision and income redistribution trump economic success where population health is concerned, and (iii) that the gradual development of public provision represents the buildup of social infrastructure that has long-lasting effects on health status. Our case study shows what can be gleaned from a comparative perspective and a long-term view. The long view allows us to detect the gradual divergence in health status between these two societies and to trace potential institutional causes that would otherwise go unnoticed. The perspective introduced here, and in particular the comparison of Canada and the USA, provides strong support for the use of cross-national comparative work, and a historical perspective on the investigation of societies that successfully support population health.

Canada↗
PubMed2006

An innovative model for regulating supplement products: natural health products in Canada.

On 1 January 2004, Health Canada officially added a new term to the global list of synonyms for dietary supplements: natural health products (NHP). Developed with the intent of providing Canadian consumers with ready access to NHP that are safe, effective, and of high quality, the Natural Health Products Regulations (the NHP regulations) are applicable to the sale, manufacture, packaging, labelling, importation, distribution, and storage of NHP, and are administered by the recently formed Natural Health Products Directorate (NHPD) within Health Canada. This paper provides an overview of the process for regulating supplement products in Canada.

Canada↗
PubMed2001

An inventory of information on blindness and visual impairment in Canada.

BACKGROUND: Several health databases contain information on blindness and visual impairment in Canada. Such databases may permit studies of the outcomes, predictors, economic costs and meta-analysis of ocular health problems and visual disability. In this paper we summarize the existing public health information on blindness and visual impairment in Canada. METHODS: A systematic search was performed to find the information in three areas: health administrative databases, health surveys and registries. Both literature searching and Internet searching were performed. The institutions were notified by email or telephone that information pertaining to vision and blindness was desired. When necessary, we visited the institution to obtain the information. RESULTS: Health administrative databases contain information on a wide cross-section of diagnoses but are usually limited in detail and seldom provide longitudinal information. Health surveys have a limited amount of systematic information on vision-related questions and rely exclusively on self-reporting. Registries exist on a wide range of visual topics. The Canadian National Institute for the Blind (CNIB) has the most comprehensive registry. INTERPRETATION: This is the first attempt at summarizing all the public health information on blindness and visual impairment in Canada. The present population-based ocular information has numerous shortcomings. More comprehensive validation of large registries, such as that of the CNIB, is needed to provide the foundation for a longitudinal ocular surveillance system. Such a system could guide research on risk factors and the effect of treatment, economic analyses, and public policy for ocular research and service allocation.

Blindness↗
PubMed1999

Toxaphene and other chlorinated compounds in human milk from northern and southern Canada: a comparison.

Human milk from residents of northern Canada (Keewatin) was compared to that in national surveys of southern Canada with respect to residues of toxaphene, PCBs, PCDD/PCDFs, chlordane, and several other persistent organic compounds. Concentrations of toxaphene were approximately ten-fold higher in specimens from Keewatin than from the south. Toxaphene concentrations in samples from the Great Lakes Basin collected in 1992 were not significantly (p < 0.05) different from those of the rest of Canada; however they were significantly (p < 0.05) lower than concentrations reported in a 1986 survey. Hexachlorobenzene, trans nonachlor and oxychlordane were three to five times higher in concentration in the Keewtin samples than in samples reported in the 1992 national survey. Total PCB congeners, DDTs, PCDD/PCDFs, and other chlorinated compounds were not significantly higher in northern samples.

Canada↗
PubMed2002

Comparative study of the temporal evolution of atmospheric lead deposition in Scotland and eastern Canada using blanket peat bogs.

The temporal evolution of atmospheric lead deposition and its possible sources were assessed in eastern Canada and in western Scotland, using blanket peat bogs as geochemical archives. Short cores were taken from two remote sites located close to the sea. Significant lead enrichments in the upper layers at both sites reflect the increasing emission of lead into the atmosphere due to anthropogenic activities during the last century. At the Scottish site, a region under aeolian influence from Europe, anthropogenic derived lead could be recognized by the distinctive unradiogenic composition (206Pb/207Pb ratios down to approximately 1.115), being clearly different from the pre-industrial values (206Pb/207Pb approximately 1.166). In contrast, the lead pollution in eastern Canada (influenced by North American sources) is identified by a more radiogenic lead isotope composition (206Pb/207Pb ratios up to approximately 1.199) compared to preindustrial values (206Pb/207Pb approximately 1.161). Emission inventories and isotope characteristics suggest that industrial (coal burning, mining) and traffic (leaded gasoline) outputs are the most likely sources during the first and the second half of the 20th century, respectively, in both, western Scotland and eastern Canada alike. The Scottish record is in line with previous studies of past atmospheric lead deposition. However, the Canadian deposit suggests that the wind derived, pre-industrial lead, is less radiogenic as previously implied using sediment archives. These results are thus the first to report pre-industrial lead isotope ratios and concentrations of atmospheric derived aerosols in North America.

Air Pollutants↗
PubMed2001

Risk factors, atherosclerosis, and cardiovascular disease among Aboriginal people in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP).

BACKGROUND: Little is known about the rates of cardiovascular disease (CVD), atherosclerosis, and their risk factors among Canada's Aboriginal people. To establish the relative prevalence of risk factors, atherosclerosis, and CVD, we undertook a population-based study among people of Aboriginal and European ancestry in Canada. METHODS: We randomly recruited 301 Aboriginal people from the Six Nations Reservation, and 326 people of European origin from Hamilton, Toronto, and Edmonton, Canada. Clinical CVD was defined by history or electrocardiographic findings, atherosclerosis was measured by B-mode carotid ultrasonography, and conventional and new CVD risk factors were measured using standardised methods. FINDINGS: Aboriginal people had significantly more carotid atherosclerosis (mean of the maximum intimal-medial thickness 0.82 (SD 0.20) mm vs 0.78 (0.20) mm, p=0.027), and had a higher frequency of CVD (18.5% vs 7.6%, p=0.00002) compared with Europeans. Aboriginal people had significantly higher rates of smoking, glucose intolerance, obesity, abdominal obesity, and substantially higher concentrations of fibrinogen, and plasminogen activator inhibitor-1. Aboriginal people had significantly higher rates of unemployment and a lower annual household income. For any given income level, Aboriginal people had higher rates of risk factors and CVD compared with the Europeans. INTERPRETATION: A significant proportion of Aboriginal people live in poverty which is associated with high rates of CVD and CVD risk factors. Improvement of the socioeconomic status of Aboriginal people might be a key to reduce CVD in this group.

Adult↗
PubMed2003

New technologies and potential cost savings related to morbidity and mortality reduction in Class III/IV heart failure patients in Canada.

BACKGROUND: Heart failure affects 1-2% of the Canadian population. The 1-year mortality rates in New York Heart Association Class III/IV heart failure patients range from 11 to 44%. This study evaluates costs associated with current management of Class III/IV heart failure and potential savings if morbidity and mortality are reduced. OBJECTIVES: To construct an economic model to evaluate the components of treating Class III/IV heart failure patients in Canada and the resulting direct medical costs. The model also estimates the potential savings that could result from the introduction of a new technology such as cardiac resynchronization therapy that reduces morbidity and mortality. METHODS: The model evaluates costs of pharmacological therapy, medical care, laboratory and diagnostic tests, and complications, most commonly hospitalization. Estimates are based on a literature review, expert opinion, and standard cost sources using widely accepted health economic methods. RESULTS: The model, under conservative assumptions, estimates that Class III/IV heart failure costs between CAD$1.4 billion and CAD$2.3 billion in Canada overall. Costs are substantial on the provincial level as well and are estimated to be approximately CAD$700 million, CAD$500 million, and CAD$300 million in Ontario, Québec, and British Columbia, respectively. New treatments could bring substantial savings depending on their effectiveness-measured as reduction in morbidity and mortality-and the number of patients who receive that treatment. Potential savings in Canada could reduce the total annual costs for this group of patients by approximately 10% or up to CAD$200 million annually. CONCLUSIONS: The high level of morbidity and mortality in Class III/IV heart failure patients and costs associated with their care are an impetus for the development of new therapies such as cardiac resynchronization therapy, that could deliver long-term benefits including increased exercise tolerance, reduced hospitalizations, and improved quality of life. Successful therapies could provide substantial savings and present a favorable economic profile in the treatment of heart failure. In order to ensure that appropriate technologies are commercialized and marketed, prospective evaluation of new therapies should include critical assessment of direct medical costs in addition to evaluating morbidity, quality of life and survival.

Biomedical Technology↗
PubMed2003

Implementation of provincial/territorial health goals in Canada.

During the past two decades, policy makers in most of Canada's provinces and territories developed broad population-level goal statements about desired health or health and social outcomes. The health goals development process used in each province/territory has been described in government documents and studied by a small number of researchers. However, there is a lack of published research examining the implementation and use of the health goals since they were developed. To begin to fill this gap, we conducted a study between 1998 and 2000 that examined the implementation of provincial/territorial health goals in Canada. Our findings indicate that as the 1990s drew to a close, provincial/territorial health goals were not being used explicitly by policy makers at either provincial/territorial or regional levels in most provinces in Canada to guide health policy and program development, implementation, or evaluation. Instead, the majority of health ministry and regional policy makers were employing strategic/business plans that, at best, reflected or were similar to the original provincial/territorial health goals. Moreover, even though all provinces and the NWT/Nunavut had health goals associated with broad social, economic, and physical environment health determinants, regional-level policy makers were giving priority to health care system goals over all other types of goals. We discuss our findings in relation to studies about health goals in other countries, and we suggest implications that our findings have for both future research and health policy.

Canada↗
PubMed1992

The rebirth of midwifery in Canada: an historical perspective.

The history of midwifery in Canada, beginning in the 17th century in New France, is characterised by periods of suppression and rebirth. At present, the long standing dominance of the medical establishment is giving way to the demand of women to assume greater control over the birthing process. Several provinces in Canada are in the process of obtaining midwifery legislation designed to strengthen, support and legalise the practice of midwifery. Lack of supportive legislation has discouraged the practice of midwifery. Though midwifery care has not been readily accessible, women have persisted in their search for care by a midwife. In response, female friends with a variety of educational preparation have found ways to prepare themselves and respond to women's need for an expert in normal birth. From an historical analysis of midwifery in Canada it would appear that a primary factor influencing midwifery's rebirth has been the power and determination of women to demedicalise normal birth and return it to the domain of women.

Canada↗
PubMed2001

Temporal and biogeographic comparisons of PCBs and persistent organochlorine pollutants in the blubber of fin whales from eastern Canada in 1971-1991.

Concentrations of PCB congeners and organochlorine (OC) pesticides were studied in archived fin whale (Balaenoptera physalus) blubber samples collected in 1971-1972 from Newfoundland (Nfld) and Nova Scotia (NS) with the objective of obtaining a historical perspective on contaminant levels and proportions at a time when many persistent OCs were still in use. Concentrations of sigmaPCBs and sigmaDDTs in the blubber of 17 fin whales from historical whaling stations in 1971-1972 were generally in agreement with previously reported values for fin whales from Atlantic Canada. Although some differences in sex and body length (age) distribution of samples occurred, significant differences were detected in the concentrations and patterns of PCBs, DDTs and chlordanes in whales from Nfld and NS, supporting ecological evidence that whales from these regions represent relatively separate stocks. Temporal and geographical variations were examined by comparing data to those reported for fin whales from the St Lawrence Estuary (StL) in 1991 by Gauthier et al. (1997a). Significantly higher levels of sigmaDDT, sigmaCHL and HCB were found in the NS (1971-1972) stock compared with the StL (1991) animals, and in HCB between the Nfld stock (1971-1972) and the StL (1991) animals, as well as higher p,p'-DDE/sigmaDDT and lower p,p'-DDT/sigmaDDT ratios in the 1991 whales suggesting that temporal trends in these whales between the 1970s and 1990s were consistent with those in other marine mammals in Atlantic Canada. Evidence also suggests that geographical variations in patterns may occur for individuals from two relatively distinct stocks of fin whales in Atlantic Canada (NS, Nfld) and perhaps for one population (StL) related to, but recognisably different from the NS stock.

Adipose Tissue↗
PubMed2003

Health status and Canada's immigrant population.

Given the framework of the 1984 Canada Health Act, the health status of immigrants should be similar to average levels within whole of Canada. Yet, assuming equality of health status between immigrant and non-immigrants, or between immigrant groups is likely an unrealistic and simplistic assumption, given unseen barriers affecting accessibility, the restructuring of the Canadian health care system, and problems with the provision of health care resources to the immigrant population. Using the National Population Health Survey, this paper focuses upon the health status of the immigrant population relative to that of non-immigrants within Canada, with reference to diagnosed conditions, self-assessed health, and the Health Utilities Index Mark 3. Findings indicate that, with the exception of the most recent arrivals, immigrants experience worse health status across most dimensions relative to non-immigrants. Multivariate analysis reveals that age, income adequacy, gender, and home ownership are dimensions upon which health status differs between the two groups.

Adolescent↗
PubMed2000

Income-related health inequality in Canada.

This study uses data from the 1994 National Population Health Survey and applies the methods developed by Wagstaff and van Doorslaer (1994, measuring inequalities in health in the presence of multiple-category morbidity indicators. Health Economics 3, 281-291) to measure the degree of income-related inequality in self-reported health in Canada by means of concentration indices. It finds that significant inequalities in self-reported ill-health exist and favour the higher income groups--the higher the level of income, the better the level of self-assessed health. The analysis also indicates that lower income individuals are somewhat more likely to report their self-assessed health as poor or less-than-good than higher income groups, at the same level of a more 'objective' health indictor such as the McMaster Health Utility Index. The degree of inequality in 'subjective' health is slightly higher than in 'objective' health, but not significantly different. The degree of inequality in self-assessed health in Canada was found to be significantly higher than that reported by van Doorslaer et al. (1997, income related inequalities in health: some international comparisons, Journal of Health Economics 16, 93-112) for seven European countries, but not significantly different from the health inequality measured for the UK or the US. It also appears as if Canada's health inequality is higher than what would be expected on the basis of its income inequality.

Canada↗
PubMed2003

On-line sources of toxicological information in Canada.

This paper will provide an overview of the on-line resources available in toxicology in Canada. It will describe a brief history of The Society of Toxicology of Canada, with reference to other societies and also provide information on education, research and other resources related to toxicology. Toxicology in Canada emerged as a distinct and vibrant discipline following the thalidomide tragedy of the 1960s. In the pharmaceutical industry and government, toxicology was readily established as an essential component of drug development and safety, and as the need for toxicologists expanded, training programs were established, usually in collaboration with departments of pharmacology. In the last two to three decades other disciplines, environmental biology, analytical chemistry and epidemiology joined the ranks of toxicology. The on-line sources of toxicology information are rapidly expanding. This article describes those sources considered by the authors to be important from a national and international perspective. The majority of these sources are professional organizations and government agencies.

Canada↗
PubMed2001

Symptom expectation after minor head injury. A comparative study between Canada and Lithuania.

OBJECTIVES: The purpose of the present study is to compare the frequency and nature of expected symptoms in Lithuania (a country where the chronic post-concussive syndrome is largely unknown) with that in Canada. METHODS: A symptom checklist was administered to two subject groups selected from local companies in Kaunas, Lithuania, and Edmonton, Canada, respectively. Subjects were asked to imagine having suffered head trauma with loss of consciousness in a motor vehicle accident, and to check off symptoms they expected might arise from the injury. For symptoms they anticipated, they were asked to select the period of time they expected those symptoms to persist. RESULTS: In both the Lithuanian and Edmontonian groups, the pattern of symptoms anticipated closely resembled the acute symptoms commonly reported by accident victims with minor head injury. Yet, while many Edmontonians also anticipated symptoms to last months or years, very few Lithuanian subjects selected any symptoms as being likely to persist in a chronic manner. CONCLUSIONS: In Lithuania, despite the frequent experience of minor head injury in motor vehicle accidents, there is a very low rate of expectation of any chronic sequelae from such an injury, contrasting greatly with the response shown in Canada, where the prevalence of the chronic post-concussive syndrome is higher. Symptom expectation in some countries may be an important factor in the development of the chronic post-concussive syndrome.

Brain Injury, Chronic↗
PubMed2001

Cross-cultural study of symptom expectation following minor head injury in Canada and Greece.

OBJECTIVES: The purpose of the present study is to compare the frequency and nature of expected symptoms in Greece (a country where the chronic post-concussive syndrome is largely unknown) with that in Canada. METHODS: A symptom checklist was administered to two subject groups selected from local companies in Patras, Greece, and Edmonton, Canada, respectively. Subjects were asked to imagine having suffered head trauma with loss of consciousness in a motor vehicle accident and to check off symptoms, they expected might arise from the injury. For symptoms they anticipated, they were asked to select the period of time they expected those symptoms to persist. RESULTS: In both the Greek and Edmontonian groups, the pattern of symptoms anticipated closely resembled the acute symptoms commonly reported by accident victims with minor head injury. Yet, while many Edmontonians also anticipated symptoms to last months or years, very few Greek subjects selected any symptoms as being likely to persist in a chronic manner. CONCLUSIONS: In Greece, despite the frequent experience of minor head injury in motor vehicle accidents, there is a very low rate of expectation of any chronic sequelae from such an injury, contrasting greatly with the response shown in Canada, where the prevalence of the chronic post-concussive syndrome is higher. Symptom expectation in some countries may be an important factor in the development of the chronic post-concussive syndrome.

Adult↗
PubMed1997

Critical care in Canada. The North American difference.

Critical care medicine in Canada has evolved into a multidisciplinary service, teaching, and research activity. Pressure on existing funding models for the delivery of health care in Canada is leading to substantial change in the hospital sector. Although not explicitly targeted for change, pre-existing models of critical care delivery will be caught in the acute care services, redesign (that results from the health care restructuring because of the substantial impact that delivering critical care services has on overall hospital budgets). Although starting from different perspectives, the Canadian and American health care systems seem to be converging in their health care redesign principles, with themes such as integration, regionalization, physician payment reform, health care worker redesign, and global budgeting common through the multiplicity of plans being articulated. What critical care will look like in its major domains (service, education, and research) in the year 2001 is difficult to foresee at this time. In this context, therefore, change occurring in Canada's critical care system will be no less challenging than what will occur in the United States or other health care systems. For the resources we have developed for the critically ill patient population to survive health care redesign, we must improve our way of working together internationally, to understand and benchmark best practices and to share ideas for the most effective critical care systems.

Aged↗
PubMed2003

2020 healthcare management in Canada: a new model home next door.

The Commission on the Future of Health Care in Canada asked whether Medicare is sustainable in its present form. Well, Medicare is not sustainable for at least six reasons. Given a long list of factors, such as Canada's changing dependency ratio, the phenomenon of diminishing returns from increased taxation, competing provincial expenditure needs, low labour and technological productivity in government-funded healthcare, the expectations held by baby boomers, and the evolving value sets of Canadians--Medicare will impoverish Canada within the next couple of decades if not seriously recast. As distasteful as parallel private-pay, private-choice healthcare may be to some policy makers and providers who grew up in the 1960s, the reality of the 2020s will dictate its necessity as a pragmatic solution to a systemic problem.

Canada↗
PubMed1997

Canada deserves a national health system.

A defining--some would say peculiar--feature about Canada and Canadians is the strong position that we give social programs within our national identity. FORUM presents an essay by Dr. Thomas Noseworthy based on an address to the annual meeting of the Association of Canadian Medical Colleges in April 1996. In it, Dr. Noseworthy calls for a national health system. He sees the federal government retaining an important role in preserving medicare and, in fact, strengthening its powers in maintaining national consistency and standards. Dr. Noseworthy's views are contrary to the governmental decentralization and devolution of powers occurring across the country. In a "point/counterpoint" exchange on this issue, we have invited commentaries from three experts. Raisa Deber leads off by noting that while a national health system may be desirable, constitutional provisions would be an obstacle. Governments, says Deber, have an inherent conflict of interest between their responsibility for maintaining the health care system and their desire to shift costs. Michael Rachlis reminds us that medicare fulfills important economic as well as social objectives. It helps to support Canada's business competitiveness among other nations. The problem, say Rachlis, is that public financing of health care does not ensure an efficient delivery system. Michael Walker offers some reality orientation. He observes that Canada's health care system is based upon ten public insurance schemes with widely different attributes. While he supports a minimum standard of health care across the country, citizens should be able to purchase private medical insurance and have access to a parallel private health care delivery system. Ultimately, this debate is about who should control social programs: the provinces or the federal government? We'll let you, the readers, decide.

Canada↗