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At least 541 records · Page 30Linked to original sources
PubMed1999

Cost of chickenpox in Canada: part II. Cost of complicated cases and total economic impact. The Immunization Monitoring Program-Active (IMPACT).

OBJECTIVE: Primarily, to determine the direct medical costs and productivity losses associated with complicated chickenpox (hospitalized cases) and, secondarily, to quantify the overall economic burden of chickenpox in Canada. METHODS: Direct medical resource consumption patterns were determined by chart review of 160 otherwise healthy children and 40 children with leukemia hospitalized for chickenpox. Children were selected from the database of the Immunization Monitoring Program Active (IMPACT), a network of 11 tertiary-care hospitals in Canada that collected information at the time of hospitalization from January 1991 to March 1996. An additional 26 healthy children hospitalized were recruited prospectively by IMPACT. Productivity losses (time lost from work and daily activities) were assessed by caregiver interviews. Treatment costs were determined from the patient, Ministry of Health, and societal perspectives. RESULTS: The average societal per case cost for complicated chickenpox in healthy children was $7060 and $8398, respectively, from the retrospective and prospective assessments. For children with leukemia, the direct medical cost was estimated at $7228. These costs were combined with a cost established previously for uncomplicated chickenpox. The estimated yearly overall economic impact of chickenpox in Canada was $122.4 million, with $24.0 million attributable to Ministry of Health costs, assuming an estimated yearly incidence of 346 527 cases and a 0.54% rate of hospitalization for healthy children. CONCLUSIONS: Direct medical costs are the major cost driver in the care of complicated chickenpox. However, in the context of the overall economic burden of the disease, uncomplicated chickenpox is the major cost driver, contributing 89% to the total cost.

Canada↗
PubMed2003

Assessing the recovery of lakes in southeastern Canada from the effects of acidic deposition.

Reductions in North American sulfur dioxide (SO2) emissions promoted expectations that aquatic ecosystems in southeastern Canada would soon recover from acidification. Only lakes located near smelters that have dramatically reduced emissions approach this expectation. Lakes in the Atlantic provinces, Quebec and Ontario affected only by long-range sources show a general decline in sulfate (SO4(2-)) concentrations, but with a relatively smaller compensating increase in pH or alkalinity. Several factors may contribute to the constrained (or most likely delayed) acidity response: declining base cation concentrations, drought-induced mobilization of SO4(2-), damaged internal alkalinity generation mechanisms, and perhaps increasing nitrate or organic anion levels. Monitoring to detect biological recovery in southeastern Canada is extremely limited, but where it occurs, there is little evidence of recovery outside of the Sudbury/Killarney area. Both the occurrence of Atlantic salmon in Nova Scotia rivers and the breeding success of Common Loons in Ontario lakes are in fact declining although factors beyond acidification also play a role. Chemical and biological models predict that much greater SO2 emission reductions than those presently required by legislation will be needed to promote widespread chemical and latterly, biological recovery. It may be unrealistic to expect that pre-industrial chemical and biological conditions can ever be reestablished in many lakes of southeastern Canada.

Acid Rain↗
PubMed2005

Emergence success and sex ratio of commercial alfalfa leafcutting bees from the United States and Canada.

Samples of overwintering alfalfa leafcutting bee, Megachile rotundata (F.) (Hymenoptera: Megachilidae), cells were sent to the laboratory as loose cells or in nesting boards from bee managers in the United States and in Canada. X-radiographs of cells were used for determining cell contents. Cells containing live prepupae were incubated, and the sex of emerging adults was recorded daily. Cells from which no adult emerged were dissected to determine the developmental stage of dead bees and sex of dead pupae or adults. Bee cells incubated in commercial settings and placed in alfalfa fields by the same bee managers described above also were evaluated to determine adult emergence success. The proportion of live bees in wood nesting boards from the United States was much lower than the live proportion in polystyrene nesting boards from Canada and loose cells overwintered in the United States. For laboratory-incubated loose cells, survival and sex ratios of bees from Canadian sources were statistically higher than those of U.S. bees, but the onset and duration of emergence times were similar. Fewer bees survived in the commercial setting than in the laboratory. Prepupal mortality was significantly higher than pupal or adult mortality, but there was no significant difference between the sexes in the likelihood of survival during incubation. This study supports the commonly held belief that alfalfa leafcutting bees raised in Canada and then sold to the United States represent a more viable source of bees than most bees produced in the United States.

Animal Husbandry↗
PubMed2005

Migratory songbirds disperse ticks across Canada, and first isolation of the Lyme disease spirochete, Borrelia burgdorferi, from the avian tick, Ixodes auritulus.

During a 3-yr comprehensive study, 196 ixodid ticks (9 species) were collected from 89 passerine birds (32 species) from 25 localities across Canada to determine the distribution of avian-associated tick species and endogenous Lyme disease spirochetes, Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt, and Brenner. We report the following first records of tick parasitism on avian hosts: the rabbit-associated tick, Ixodes dentatus Marx, from Manitoba and Ontario; the mouse tick, Ixodes muris Bishopp and Smith, from British Columbia; and the blacklegged tick, Ixodes scapularis Say, from New Brunswick. Moreover, we provide the first record of the Neotropical tick, Amblyomma humerale Koch (1 nymph), in Canada and its parasitism of any bird. This tick was compared morphologically with nymphs of other Neotropical Amblyomma spp., and genetically, using a 344-bp fragment of the 12S rDNA sequence of 41 New World Amblyomma species. The first collections of the western blacklegged tick, Ixodes pacificus Cooley and Kohls, from passerine species in Alberta and British Columbia, are also reported. Notably, we further report the first isolation of B. burgdorferi from the bird tick, Ixodes auritulus Neumann, collected from an American robin, Turdus migratorius L., on Vancouver Island. Furthermore, B. burgdorferi-positive I. auritulus larvae were collected from a reservoir-competent fox sparrow, Passerella iliaca (Merrem). Our findings indicate that ground-dwelling passerines, in particular, are parasitized by certain ixodid ticks and play an important role across Canada in the wide dispersal of B. burgdorferi-infected ticks and increased risk of Lyme disease exposure.

Animals↗
PubMed2003

Lead and stable lead isotope ratios in soil, earthworms, and bones of American woodcock (Scolopax minor) from eastern Canada.

A study to discriminate among different possible sources of elevated Pb exposure for American woodcock (Scolopax minor) in eastern Canada is described. Undamaged wing bones excised from young-of-the-year woodcock collected from several locations in southern Ontario, southern Quebec, New Brunswick, and Nova Scotia, Canada, along with soil and earthworm (Aporrectodea tuberculata and Lumbricus rubellus) samples from the same sites, were analyzed for total Pb, and stable Pb isotopes. Ignoring six soil samples with high (> 60 microg/g) Pb concentration from the vicinity of Montreal (QC, Canada), the mean soil-Pb concentration for all sites combined was 19 microg/g (dry wt; n = 64), with a mean 206Pb:207Pb ratio of 1.19, values typical for uncontaminated rural soils in eastern North America. In earthworms, Pb concentrations ranged from 2.4 to 865 (microg/g [dry wt], mean = 24 microg/g). Concentrations of Pb in worms and soils were positively correlated (r = 0.71; p < 0.01), and 206Pb:207Pb ratios for worms and soils were also positively correlated (r = 0.54; p < 0.05). However, most young-of-the-year woodcock with high bone-Pb accumulation (> 20 microg/g) had 206Pb:207Pb ratios substantially different from worms and soils sampled from the same areas, even though woodcock feed extensively on soil invertebrates, especially earthworms. The range of 206Pb:207Pb ratios in wing bones of woodcock with elevated Pb exposure was not consistent with exposure to environmental Pb from past gasoline combustion nor Precambrian mining wastes but was consistent with ingestion of spent Pb shotgun pellets.

Animals↗
PubMed1996

Finfish health protection regulations in Canada.

The Fish Health Protection Regulations (FHPR) in Canada were implemented under the Fisheries Act in 1977. These Regulations are based on the principle of controlling the movement of fish and eggs carrying infectious diseases of concern. Source facilities require a history of inspections to demonstrate the absence of named diseases and disease agents. Since the FHPR were implemented, no disease agents of concern are known to have been transferred with egg and fish shipments approved under these Regulations. Changes to the Regulations are needed, however, for the following reasons: -to incorporate new knowledge on salmonid diseases and their distribution -to cover transfers of other finfish species which present a risk of introducing or spreading infectious disease agents to Canada or between provinces -to eliminate unnecessary controls -to specify the new authorities needed to protect effectively the health of fisheries resources -to reflect emerging international standards. The author describes the authority, administration, requirements and procedures for the current FHPR and the corresponding 'Manual of Compliance', and the proposed amendments to the Regulations and Manual. Issues related to fish health protection in Canada are discussed, including the following: -industry concerns with the FHPR -the need for quality assurance/quality control guidelines for diagnostic laboratories -consistency with international trade standards -the need to consider genetic and ecological factors, as well as fish health, when assessing impacts of introductions and transfers.

Animals↗
PubMed1997

Risk analysis and international trade principles applied to the importation into Canada of caprine embryos from South Africa.

Between November 1994 and February 1995 over nine thousand Boer goat embryos were imported into Canada from the Republic of South Africa. This substantial international movement of animal genetics via embryos was achieved through the application of the risk analysis principles prescribed in Section 1.4. of the International Animal Health Code of the Office International des Epizooties (OIE). Integral to the development of the health certification procedures was the application of the fundamental principles of non-discrimination, harmonisation, equivalence and transparency defined in the World Trade Organisation Agreement on Sanitary and Phytosanitary measures. Risk mitigation interventions were founded upon full consideration of the potential for disease transmission by animal embryos as espoused by the International Embryo Transfer Society and the relevant standards contained in Appendix 4.2.3.3. of the OIE International Animal Health Code. All the embryos imported into Canada were implanted into synchronised recipients on arrival. Twenty months later there has been no evidence of disease in either the recipient animals or the resulting animals born in Canada.

Animals↗
PubMed2006

The association between length of stay in Canada and intimate partner violence among immigrant women.

OBJECTIVE: We examined the prevalence of intimate partner violence (IPV) among recent (0-9 years) and nonrecent (>/= 10 years) immigrant women in Canada to determine whether differences in IPV were associated with length of stay in Canada. METHODS: We analyzed data from the 1999 General Social Survey, a national cross-sectional telephone survey. We used weighted logistic regression analysis to examine the effect of length of stay in Canada on IPV and controlled for socio-cultural and other factors associated with IPV. RESULTS: The crude prevalence of IPV was similar among recent and nonrecent immigrant women. However, after adjustment, the risk for IPV was significantly lower among recent immigrant women compared with nonrecent immigrant women. Country of origin, age, marital status, and having an activity limitation (physical/mental disability or health problem) also were associated with a higher risk for IPV. CONCLUSIONS: Our findings have important implications for both prevention and detection of IPV among immigrant women.

Adolescent↗
PubMed1991

Tobacco consumption declining faster in Canada than in the US.

Consumption and prices of tobacco products in Canada and the United States are compared over the period 1981 to 1989. In Canada, consumption has fallen from a higher level and at a faster rate than in the United States (3.52 kg/adult to 2.48 kg/adult vs 3.21 kg/adult to 2.48 kg/adult). With respect to cost, the real tobacco price index in Canada has grown faster than its US counterpart. These results are attributed to higher taxation practices, vigorous legislation, and the leadership role adopted by the Canadian government during the 1980s.

Advertising↗
PubMed1993

Physicians who have practiced in both the United States and Canada compare the systems.

OBJECTIVES: The aim of this study was to examine the US and Canadian systems from the unique perspective of physicians who have practiced in both Canada and the United States. METHODS: Questionnaires were sent to 355 Canadian physicians who graduated from US medical schools and 347 US physicians who graduated from Canadian medical schools. RESULTS: The overall response rate was 59% (65% of US-graduated Canadian physicians and 54% of Canadian-graduated US physicians). Thirty-six percent of the respondents were "dual experience" physicians; that is, they had practiced medicine in both countries after completing their medical training. Physicians who left Canada were more likely than those who left the United States to indicate dissatisfaction with the health care system as a reason for leaving. Respondents expressed greater professional satisfaction with their current country of practice, but overall, dual-experience physicians in the United States favored that system only slightly more than the Canadian system, whereas those in Canada rated the Canadian system significantly better than the US system. CONCLUSIONS: The comparatively weak rating of the US system by dual-experience physicians underlines the need for health care reform.

Attitude of Health Personnel↗
PubMed2004

Potentially inappropriate prescribing in Canada relative to the US.

OBJECTIVE: To explore the prescribing of potentially inappropriate drug therapy in Ontario, Canada where there is a restrictive drug formulary relative to the US where there is no single drug formulary. METHODS: A retrospective, cohort study using an administrative database (Ontario, Canada) compared with published survey results (US). All 1,088,680 community-dwelling adults >or=66 years of age in Ontario, Canada compared with published survey results from 2455 community-dwelling older adults in the US in 1996. Patterns of potentially inappropriate drug prescribing were compared between countries using a list of 33 potentially inappropriate drug therapies. These therapies were classified by an expert panel into three categories: (i) those to always avoid; (ii) those which are rarely appropriate; and (iii) those with only some indications to prescribe. RESULTS: Among the 33 potentially inappropriate drug therapies, 15 (45%) prescribed in the US were not available through Ontario's drug formulary. Potentially inappropriate drug therapies available through the Ontario Drug Benefit Plan (ODB) and also in the US were frequently prescribed in both Ontario and the US. Differences in prescribing patterns of individual drug therapies were noted between the two countries. Specifically, in the rarely appropriate category, diazepam, a long half-life benzodiazepine, was much more frequently dispensed in Ontario than in the US (3.18% vs 1.37%). In contrast, dextropropoxyphene, an opioid with a poor adverse event profile was more frequently prescribed in the US than in Ontario (6.21% vs 0.74%). CONCLUSION: Almost half of the potentially inappropriate drug therapies that are available in the US are unavailable from Ontario's drug formulary. Potentially inappropriate drug therapies that were available through the ODB were frequently prescribed in both countries. Alternative approaches that make information immediately accessible to physicians at the time they make prescribing decisions should be considered to improve prescribing practices.

Aged↗
PubMed2005

Modelling the impact of compliance on the costs and effects of long-acting risperidone in Canada.

Schizophrenia is a chronic, relapsing disease that requires more healthcare resources to manage than any other single psychiatric illness. The main cost of treatment is hospitalization as a result of the exacerbation of symptoms often caused by poor compliance. Although the costs of hospitalization and relapse have been well documented, the differential effects of various medications on healthcare expenditure are still being determined. The aim of the present study was to estimate the cost effectiveness of long-acting risperidone in the treatment of high-risk, non-compliant patients with schizophrenia over a 5-year period in Canada. A discrete event model was developed comparing three scenarios, each with a different starting treatment: haloperidol depot, long-acting risperidone or oral risperidone. Second and third-line treatment options were olanzapine and clozapine, respectively, for all three scenarios. On the basis of 3000 simulated patient characteristics, the model generated individual patient histories. Outcomes included the number and duration of psychotic episodes, the cumulative Positive and Negative Syndrome Scale (PANSS) score and direct medical costs. The time horizon of the model was 5 years and a 5% discount rate was used for costs and effects. The perspective of the model was that of the Canadian healthcare system. After 5 years, treatment with long-acting risperidone saved Canada dollars 6908 and Canada dollars 13,130 (discounted) and avoided 0.28 and 0.54 relapses per patient, compared with haloperidol depot and oral risperidone, respectively. In this model, initiating treatment of high-risk, non-compliant patients with schizophrenia with long-acting risperidone was the dominant strategy. With long-acting risperidone, direct costs were lower and clinical effectiveness was greater, compared with haloperidol depot or oral risperidone, during years 4 and 5.

Administration, Oral↗
PubMed1984

Hospital bed planning in Canada: a survey analysis.

The need to plan health and especially hospital care delivery systems is becoming more critical in this period of severe financial constraints and even cutbacks of services. This article reports on a survey of hospital planning norms and bed requirements methodologies in Canada conducted in 1977 and 1980. The comparison and assessment of approaches to bed need determination in the Canadian provinces, together with some recommendations, are preceded by a review of basic hospital planning methods and their use in a number of selected countries. The literature review and the analysis conducted reveal that the "formula method" (beds per 1000 population) is the most common approach used to define and to allocate the "optimum" number of beds in the countries reviewed and in Canada. Despite its shortcomings, this method appears to have many advantages (e.g., simplicity, equity, flexibility). In general, provincial authorities use similar factors in the calculation of the number of beds to be provided, the most important ones being the size of the projected geographic population or population served by age groups. The acute care bed guidelines in Canada range from 3.5 per 1000 population in southern Ontario to 5.0 in Saskatchewan and Alberta. Extended care bed guidelines are much more spread between provinces. The analysis underlines the difficulties faced by the planner and the researcher in comparing bed guidelines due to significant definition and content differences between provinces. It finally leads to the observation that hospital planning remains arbitrary and appears to be more designed to ration the supply of services and to contain overall expenditures than to really try to meet the "need" of the population for hospital services.

Bed Occupancy↗
PubMed2002

The economic cost of diabetes in Canada, 1998.

OBJECTIVE: In Canada, diabetes poses a significant health problem, and current estimates of its economic burden have not incorporated the total cost of the disease. The objective of this study was to quantify the direct medical- and mortality-related productivity cost of diabetes in Canada for 1998. RESEARCH DESIGN AND METHODS: Direct medical costs included hospital services, physician services, and medicines consumed by people with diabetes. These costs were based on a top-down costing methodology that allocated 1998 total medical expenditures to diabetes. The prevalence of diagnosed and undiagnosed diabetes and the relative risk of complications in people with diabetes were used to estimate the proportion of medical services that were consumed by people with diabetes. Mortality-related productivity losses were calculated using the human capital approach. RESULTS: After varying the assumptions in a sensitivity analysis, the total economic burden (in U.S. dollars) of diabetes and its chronic complications in Canada for 1998 was likely to be between $4.76 and $5.23 billion. In those people just with diagnosed diabetes, the direct medical costs associated with diabetes care, before considering any complications, were $573 million. Of the costs associated with the complications of diabetes, cardiovascular disease was by far the greatest, at $637 million. CONCLUSIONS: Cardiovascular disease was the major contributor to the direct costs of diabetes. The preventive management of diabetes should receive priority attention, and the prevention of cardiovascular disease in the patient with diabetes should become an imperative.

Acute Disease↗
PubMed1990

Suicide in adolescents: a comparison of Canada and the United States.

This paper explores the rate of suicide in teenagers in Canada by comparing this to the United States' rate. The data clearly show that the rates of suicide in late (15 to 19 yr.) adolescent boys is higher in Canada, suggesting that Canada may be facing a relative crisis. These findings are interpreted to suggest that there is a greater need for Canadian sociocultural research and response.

Adolescent↗
PubMed1998

Syringe exchange in Canada: good but not enough to stem the HIV tide.

This article provides a historical perspective on the development of syringe exchange in Canada, the Canadian legal and policy context, evaluation and monitoring strategies, and current challenges facing HIV prevention efforts among injecting drug users. Despite the fact that it is legal to sell, exchange, or provide an IDU with a syringe and there are no laws in Canada requiring a physician's prescription to justify possession of a syringe, policy development and programming have not been adequate to hold HIV at bay in several cities across the country. Although there have been concerted efforts by syringe and needle exchange programs to increase the supply of injecting equipment, HIV prevalence continues to rise, provoking a rethinking of the role of syringe exchange. In a coordinated strategy for HIV prevention among drug users in Canada, needle and syringe exchange is not itself in question; however, ghettoization and needle quota systems may have had an adverse impact on prevention programming. A national action plan has been developed which aims to decentralize both methadone maintenance and syringe and needle exchange programs, increase access to detoxification and treatment modalities, and advocate for changes in the criminal justice system and law enforcement practices.

Canada↗
PubMed2006

Screening for glaucoma in Canada: a systematic review of the literature.

BACKGROUND: To provide a recommendation on screening for glaucoma in Canada based on a review of recent evidence available in the literature. METHODS: A systematic literature review was performed to identify publications from MEDLINE, EMBASE, HealthSTAR, and Cochrane databases from 1990 to 2005. Relevant articles were categorized as economic studies, epidemiologic and intervention studies, or policy papers. Web sites and publications from provincial, state, national, and international health authorities were reviewed for policy recommendations and guidelines. RESULTS: We identified 39 articles (34 epidemiology and intervention, and 5 economic studies) for the review. From the economic studies, 2 were simple cost analyses and 3 were full economic evaluations (cost-effectiveness). Gaps were observed from these economic studies, where incremental cost-effectiveness analyses of modelled screening programmes were not observed. A large number of alternatives (i.e., screening techniques) and diverse outcome measures were found in the 34 epidemiology and intervention studies. This shows that evidence on the effectiveness of glaucoma screening programmes is available to be used in future modelled analyses. Neutral recommendation made by the Canadian Task Force on Periodic Health Examination regarding glaucoma screening in Canada could be related to the lack of reliable data and models used in past cost-effectiveness analyses. INTERPRETATION: A need exists to reevaluate the cost-effectiveness of a screening programme for glaucoma in Canada with updated efficacy and cost data. Health and monetary benefits could be improved compared with current practice and decision-makers would have the best available data when reevaluating the policy on screening for glaucoma.

Canada↗
PubMed1995

The Medical Profession in Upper Canada reconsidered: politics, medical reform, and law in a colonial Society.

This study explores some of the important questions raised but not answered in William Canniff's standard century-old study, The Medical Profession in Upper Canada, 1783-1850. Primarily based on the original medical licenses issued between 1819 and 1841, an array of manuscript material belonging to the Civil Secretary of Upper Canada and the Colonial Office, and documents pertaining to the Medical Board of Upper Canada, this article argues that the disallowance of legislation for the establishment of a colonial College of Physicians and Surgeons in 1839 can only be fully understood in the context of demographic, political, and medical developments which included factors such as ethnicity, tensions between the colony and mother country, and rivalry between medical schools. It explains why the issues of the 1830s continued into the 1840s and undermined any possibility by the profession of forming a single, self-regulating, and unified medical body for licensing and educating practitioners.

Canada↗