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PubMed1996

Health and social costs of tobacco use in Ontario, Canada, 1979 and 1988.

STUDY OBJECTIVE: This study aimed to estimate the health and social costs of tobacco use in Ontario, Canada. DESIGN: This was a cost-benefit analysis based on cross sectional data in 1988, stratified by age and sex, using an attributable risk model. The total cost of the consequences of tobacco use in the society included those costs attributed to extra deaths, disability, hospitalisation, physician visits, and fire losses, from tobacco use. PARTICIPANTS: The general population of Ontario, Canada. MAIN RESULTS: The total cost of tobacco use in Ontario, Canada in 1988 was estimated to be $3.623 billion--$721 million more than the total customer expenditure on tobacco products. Tobacco use was also found to be responsible for 14% of all adult deaths, 5% of all adult disability days, 14% of all days of hospitalisation, and 3% of all physician visits. Compared with previous results for Ontario (1979) the cost of the consequences of tobacco use had increased by about 25% and consumer expenditure by about 35% over the period, while the excess of consequences over expenditure fell slightly by about 3%. CONCLUSIONS: The annual excess of the social costs of tobacco use over total consumer expenditure is staggering. It is suggested that similar cost-benefit analysis of smoking be carried out at regular intervals to monitor smoking trends in the society, to estimate health and social costs, and to provide information for the setting of targets for tobacco control and healthy public policies.

Adolescent↗
PubMed1996

Psychology in Canada.

This chapter reviews how psychology in Canada evolved over half a century to become the most popular discipline in universities and a respected health-care and helping profession. The organization, journals, and funding of the scientific discipline are described. The importance of DO Hebb's research as the stimulus and foundation for discipline growth and significant research contributions to basic processes is identified. The multicultural mosaic of Canadian society and early research on second-language learning are shown to have influenced cross-cultural and social research. Canadian research contributions to basic processes and to the social and health sciences are reviewed. Although late to begin in Canada, clinical research and the profession of psychology are shown to have substantially developed over the past two decades. With large numbers of quality researchers and practitioners, psychology has a bright future in Canada.

Journal Article↗
PubMed2006

[Cronkhite-Canada syndrome: an acquired, potentially reversible polyposis].

Cronkhite-Canada syndrome is an infrequent, nonadenomatous, acquired polyposis that is associated with ectodermic alterations. The etiopathogenesis and optimal therapeutic management are unknown. We present a case of Cronkhite-Canada syndrome in a 58-year-old man who, after combined treatment with corticosteroids, disodium cromoglycate, loratadine, ciprofloxacin, and zinc, showed complete clinical and partial endoscopic remission. The polypoid lesions of Cronkhite-Canada syndrome can be reversed with medical treatment. Consequently, the natural history of the disease can be modified and its prognosis improved.

Humans↗
PubMed2006

Proliferation of cardiac technology in Canada: a challenge to the sustainability of Medicare.

BACKGROUND: Critics remain skeptical about the long-term sustainability of Medicare in Canada because of the proliferation of health technology and escalating expenditures. The objective of this study was to examine the temporal trends in the utilization and costs of cardiovascular technologies for the evaluation and/or management of patients with ischemic heart disease in Canada. METHODS AND RESULTS: This repeated cross-sectional population-based study of Ontario residents examined the temporal trends in the utilization and costs associated with echocardiography, stress (imaging and nonimaging) testing, coronary angiography, percutaneous coronary intervention (PCI), and bypass surgery between 1992 and 2001. Annual costs increased by nearly 2-fold over the 10-year study period and cumulatively accounted for more than $2.8 billion (Canadian) in expenditures. The proliferation in use of cardiac testing/interventions over time outstripped both demographic shifts and changes in the prevalence of coronary artery disease. Annual increases were widespread for all procedures (P<0.001) and ranged from 2% per year for nonimaging stress tests to 12% per year for PCI, after adjustment for age and sex. Generally, utilization rates were higher among the elderly, males, and those of low socioeconomic status. With few exceptions, annual increases in the utilization rates of cardiac tests and procedures were disproportionately higher among the elderly and women, but they were similar across socioeconomic subgroups. Increases in utilization appeared to reflect referrals toward higher-risk populations. CONCLUSIONS: Although definitive conclusions about the appropriateness of temporal patterns cannot be ascertained, the proliferation of cardiac testing challenges the sustainability of Medicare in Canada, especially given uncertainty as to whether the accompanying incremental rise in total expenditures translates into significant outcome benefits in the population.

Adult↗
PubMed2002

Asthma and COPD among aboriginals in Alberta, Canada.

BACKGROUND: Aboriginals in Canada bear a disproportionately higher burden of some chronic illnesses than nonaboriginals. Although there is a greater prevalence of smoking, poor housing, and overcrowding in aboriginal than nonaboriginal communities, the rates of office and emergency visits for asthma and COPD among aboriginals are not well known. STUDY OBJECTIVE: To determine whether aboriginals require higher rates of asthma and COPD emergency and office visits than nonaboriginals. SETTING: Population-based cohort of people residing in Alberta, Canada (population 2.8 million) between April 1, 1996, and March 31, 1997. DESIGN: Retrospective cohort study. RESULTS: We observed that aboriginals were 2.1 times (95% confidence interval [CI], 2.0 to 2.2) and 1.6 times (95% CI, 1.6 to 1.6) more likely to have an emergency and office visit for asthma or COPD, respectively, when compared to age-matched and sex-matched nonaboriginals. However, they were 55% (95% CI, 52 to 58%) less likely to see a specialist and 66% (95% CI, 63 to 70%) less likely to undergo spirometry than nonaboriginals. CONCLUSIONS: These findings indicate that aboriginals bear a disproportionately higher burden of asthma and COPD than nonaboriginals. However, lower use of spirometry and specialist services suggests that there might be access barriers to quality health care for aboriginals in Canada.

Adolescent↗
PubMedDate not supplied

Detection of avian pneumovirus in wild Canada (Branta canadensis) and blue-winged teal (Anas discors) geese.

Choanal cleft swab samples from 770 wild Canada geese (Branta canadensis) and 358 blue-winged teal (Anas discors), captured for relocation or banding, were examined for the presence of avian pneumovirus (APV) RNA by reverse transcription (RT)-polymerase chain reaction (PCR) and for virus isolation. The swab samples were pooled into groups of 5 or 10. Sixty eight of 102 (66.7%) pooled goose samples were RT-PCR positive for APV RNA. Thirteen of 52 (25.0%) pooled blue-winged teal samples were RT-PCR positive for APV RNA. APV RNA-positive samples were inoculated onto chick embryo fibroblasts (CEF) and QT-35 cells. Infectious APV was isolated from five Canada goose pooled samples in CEF and from one Canada goose pool in QT-35 cells but not from blue-winged teal.

Animals↗
PubMed2004

Harbor seals (Phoca vitulina) in British Columbia, Canada, and Washington State, USA, reveal a combination of local and global polychlorinated biphenyl, dioxin, and furan signals.

The harbor seal (Phoca vitulina) can serve as a useful indicator of food web contamination by persistent organic pollutants (POPs) because of its high trophic level, wide distribution in temperate coastal waters of the Northern Hemisphere, and relative ease of capture. In 1996 through 1997, we live-captured 60 harbor seal pups from three regions, spanning remote (Queen Charlotte Strait, BC, Canada), moderately industrialized (Strait of Georgia, BC, Canada), and heavily industrialized (Puget Sound, WA, USA) marine basins straddling the Canada-United States border. Biopsy samples of blubber were taken and analyzed for congener-specific polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs) by using high-resolution gas chromatography-high-resolution mass spectrometry. Harbor seals in Puget Sound were heavily contaminated with PCBs, whereas seals from the Strait of Georgia had relatively high concentrations of PCDDs and PCDFs. Pattern evaluation and principal components analysis suggested that proximity to sources influenced the mixture to which seals were exposed, with those inhabiting more remote areas being exposed to lighter PCB congeners (those with lower Henry's law constant and K(ow)) that disperse more readily through atmospheric and other processes. Total toxic equivalents to 2,3,7,8-tetrachlorodibenzo-p-dioxin for the PCBs, PCDDs, and PCDFs suggest that Puget Sound seals are at greatest risk for adverse health effects, and that PCBs represent the class of dioxinlike contaminants of greatest concern at all sites.

Adipose Tissue↗
PubMed2000

Breast cancer screening in the United States and Canada, 1994: socioeconomic gradients persist.

OBJECTIVES: This study compared rates of annual mammography screening across socioeconomic status between the United States and Canada in 1994. METHODS: Population-based cross-sectional surveys were used to compare the rates. RESULTS: Screening rates were higher in the United States than in Canada for women aged 50 to 69 years (47.3% vs 38.8%; P < .01). Women with higher education and with higher incomes were more likely to receive screening in both countries, with no significant differences between countries. CONCLUSIONS: For women aged 50 to 69 years, screening rates in Canada have substantially increased relative to those in the United States. However, disparities in screening across levels of socioeconomic status persist in both countries.

Age Factors↗
PubMed2004

Development of a community-based medical rehabilitation programme in the Kivalliq Region of Nunavut, Canada.

OBJECTIVE: In 2000, the University of Manitoba and the Department of Health and Social Services of Nunavut, Canada, jointly embarked upon the development of a community-based medical rehabilitation programme in the Kivalliq Region of Canada's central Arctic. Two main objectives were identified in moving forward with the implementation of a rehabilitation programme. Firstly, to conduct a region wide community needs assessment for rehabilitation services for all age groups of all residents of the Kivalliq Region of Nunavut. Secondly, to provide information from which a community-based rehabilitation therapy programme could be developed. METHODS: A community needs assessment of the Kivalliq Region was carried out to guide the implementation of physiotherapy, occupational therapy and speech language pathology services. RESULTS: There are now two physiotherapists, one occupational therapist, and one speech language pathologist providing rehabilitation services to the residents of the Kivalliq Region of Nunavut. The results of this needs assessment, the challenges and successes of this medical rehabilitation programme are discussed. CONCLUSION: The total population of the service area is approximately 8,000 people, the significant majority of whom self-report as Inuit, and are widely dispersed over eight communities. Despite the challenges in terms of culture, geography and recruitment of introducing a rehabilitation program in Canada's north, the residents of the Kivalliq Region now have a viable model of receiving rehabilitative intervention in their home communities.

Community Health Services↗
PubMed2005

Indoor environmental quality in homes of asthmatic children on the Elsipogtog Reserve (NB), Canada.

OBJECTIVE: To inspect houses and analyze settled dust from 26 homes with asthmatic children in the Elsipogtog Reserve, New Brunswick, for contaminants known to be associated with respiratory symptoms. This pilot observational study was conducted in order to enable larger research into housing and health in Aboriginal communities. METHODS: Twenty-six homes were subject to an informed inspection and settled dust collection from the child's bedroom. The fine dust (< 300 microm) was analyzed for endotoxin, house dust mite and fungal glucan concentrations, as well as for building-associated fungi. RESULTS: The percentage of homes in this study that had mould damage was slightly higher than in much larger studies in other parts of Canada. Qualitatively, the causes of the water and mould damage were similar to those found in a larger study in nearby PEI. However, in a few cases, the type of damage found in Elsipogtog was at a more advanced stage. House dust mite allergens, endotoxin and fungal glucan concentrations in settled dust included values that have been associated with increased respiratory symptoms. This selection of houses was, on average, cleaner than many homes studied in Canada. CONCLUSION. Although the range of mould damage observed in this study was similar to that seen elsewhere in Canada, the underlying causes tended to reflect more serious maintenance problems. A systematic evaluation of mould damage, on a community-wide basis, is a useful process to set priorities for repair.

Air Pollution, Indoor↗
PubMed1982

Identification of an isolate of Rickettsia canada from California.

A strain of Rickettsia canada was recovered in 1980 an adult rabbit tick, Haemaphysalis leporispalustris, taken from a black-tailed jack rabbit, Lepus californicus, in Mendocino County, California. In all examined biologic characteristics, this isolate, CA410, is indistinguishable from the prototype, strain 2678, isolated in Ontario, Canada, in 1963. These similarities include serologic and immunologic reactivity in laboratory mice and guinea pigs, cultural characteristics in Vero cells, chick embryo cells and embryonated eggs, low pathogenicity for mice, meadow voles and guinea pigs, unusual resistance to streptomycin, morphology by electron microscopy, and molar percentages of guanine plus cytosine of the deoxyribonucleic acids. Recovery of this second strain in the same species of tick, but far removed in time and place from the origin of the prototype, provides evidence that R. canada is an established, ecologically stable, rickettsia in North America.

Animals↗
PubMed1998

A survey of provider experiences and perceptions of preferential access to cardiovascular care in Ontario, Canada.

BACKGROUND: The public health insurance system in Canada is predicated on equal access to care for persons in need. OBJECTIVE: To determine the views and experiences of Ontario physicians and hospital administrators in providing patients with preferential access to specialized cardiovascular care on the basis of nonclinical factors. DESIGN: Survey with self-administered questionnaire. SETTING: Ontario, Canada. PARTICIPANTS: All Ontario cardiologists (n = 268), cardiac surgeons (n = 68), and hospital chief executives (n = 218) and random samples of internists (n = 300) and family physicians (n = 300). MEASUREMENTS: Elicited responses (yes or no) to questions on whether and why preferential access occurred and whether the respondents had been personally involved in such a situation. RESULTS: After undeliverable surveys and respondents no longer involved with acute care were excluded, the eligible response rate was 71.3% (788 of 1105 respondents). More than 80% of physicians and 53% of hospital chief executives had been personally involved in managing a patient who had received preferential access on the basis of factors other than medical need. Patients deemed most likely to receive such treatment were those with personal ties to the treating physicians (93% [95% CI, 91% to 95%]), high-profile public figures (85% [CI, 82% to 87%]), and politicians (83% [CI, 80% to 86%]). Physicians were significantly more likely than chief executives to indicate that hospital board members (81% and 68%; P < 0.001) and donors to hospital foundations (63% and 42%; P < 0.001) would receive preferential access. Most respondents indicated that preferential access was more likely to be provided if patients or families were well informed, aggressive, or potentially litigious. The survey did not permit estimation of the frequency of episodes of preferential access. CONCLUSIONS: Although equality of access is a cornerstone principle of Canada's universal health care system, some access to specialized cardiovascular services occurs preferentially on the basis of factors other than clinical need. The actual magnitude and consequences of this phenomenon remain unknown.

Attitude of Health Personnel↗
PubMed1987

Lead poisoning in Canada geese on Plum Island, Massachusetts.

During December 1983 and early January 1984, about 200 Canada geese (Branta canadensis) died of lead poisoning at Parker River National Wildlife Refuge on Plum Island, Massachusetts. In an effort to determine the source of lead, 100 bottom samples were taken from a refuge impoundment where much of the mortality/morbidity occurred. An average of 157,150 pellets/ha was found with a range of 64,582 to 322,910 pellets/ha. Water levels in this impoundment were low when Canada geese arrived, making shot more readily available to the geese and contributing to the outbreak. To minimize the risk of Canada geese being exposed to lead shot poisoning at this location in the future, we recommend several corrective manipulations of habitat.

Animals↗
PubMed1992

Prevalence of spindle cell sarcomas among wild Canada geese from southern Illinois.

Over a 6-yr period, two cases of neoplastic disease were diagnosed among 1,272 wild Canada geese (Branta canadensis interior) collected in Illinois (USA), Wisconsin (USA), and Ontario, Canada. One juvenile goose of each sex was involved. In both cases > 35 discrete masses were observed subdermally, intramuscularly, and within the body cavity. The tumors, diagnosed as spindle cell sarcomas, are among the most commonly observed neoplasms in free-living North American waterfowl. Based on our data, we suggest that these neoplasms occur with extremely low prevalence (0.002%) in free-living Canada geese.

Animals↗
PubMed1997

Comparison of three formulations of alpha-chloralose for immobilization of Canada geese.

The effectiveness of an alpha-chloralose (AC)-corn oil suspension, an AC-margarine mixture, and AC tablets were compared for immobilizing Canada geese (Branta canadensis). Responses to AC immobilization also were compared in male and female Canada geese. There was no difference in mean time to first effects or mean time to capture between male and female geese dosed with 30 mg/kg AC in orally-administered bread baits. Recovery times (< or = 24 hr) also were similar between sexes. Mean (+/-SE) time to first effects for geese immobilized with AC tablets in bread baits (19 +/- 3 min) was significantly less than mean time to first effects for geese immobilized with AC in margarine (28 +/- 6 min) or AC in corn oil (32 +/- 7 min) applied to bread baits (n = 12 geese/treatment). Respective mean times to capture geese immobilized with AC tablets, AC-margarine, and AC-corn oil were not significantly different at 62 +/- 25, 89 +/- 48, and 88 +/- 30 min, respectively. Ten, 11 and, seven geese immobilized with AC tablets, AC-margarine, and AC-corn oil recovered within 24 hr, respectively; all geese recovered within 28 hr. Male and female Canada geese respond similarly to AC immobilization, at least during molt, and AC mixed with margarine or AC in tablet form is at least as effective as the presently used AC-corn oil suspension. AC tablets or AC-margarine also would be more practical for some field situations. Additional development of AC tablets will be required prior to field use for capturing nuisance waterfowl.

Administration, Oral↗
PubMed2006

Plague as a mortality factor in Canada lynx (Lynx canadensis) reintroduced to Colorado.

As part of a species recovery program, 129 Canada lynx (Lynx canadensis) originating from British Columbia, the Yukon, Manitoba, and Quebec, Canada, and Alaska, USA, were reintroduced to southwestern Colorado, USA, from 1999 to 2003. Of 52 lynx mortalities documented by October 2003, six lynx, including a female and her 5-mo-old kitten, had evidence of Yersinia pestis infection as determined by fluorescent antibody test and/or culture. Postmortem findings in these lynx were characterized by pneumonia, ranging from acute suppurative pneumonia, to multifocal necrotizing pneumonia, to fibrinous bronchopneumonia. Histopathologic examination of lung revealed multiple areas of inflammation and consolidation, areas of edema and hemorrhage, and bacteria surrounded by extensive inflammation. Spleens had severe lymphoid depletion and hypocellular red pulp. Lymphadenomegaly was observed in only one plague-affected lynx. We hypothesize that these Canada lynx were exposed to Y. pestis by infected prey, and these are the first reports of plague in this species.

Animals↗
PubMed2000

Montreal Food Bank Users' Intakes Compared With Recommendations of Canada's Food Guide to Healthy Eating.

Demand for food assistance in Canada has grown throughout the 1990s. In a survey of the sociodemographic and nutritional characteristics of 428 adult food bank users, we used results of four 24-hour recall interviews to determine the number of servings from Canada's Food Guide to Healthy Eating food groups these clients were consuming. Our intent was to use a resource familiar to diverse audiences to describe the food intake of Montreal-area food bank clients. No age group and neither gender met the minimum target intake level for milk products. Mean intake of grain products and meat and alternatives met or exceeded minimum recommended levels. Women between the ages of 18 and 49 years consumed fewer servings of vegetables and fruit than the recommended minimum (4.9+/-3.2 servings). In general, food bank users' mean intakes were no worse than those of the Quebec general population, although their intake of milk products was lower. However, the mean number of food group servings varied greatly and reflected very low intakes by some food-bank clients. Nutrition education based on Canada's Food Guide to Healthy Eating may be one approach that food banks can take to help clients broaden the number and variety of foods consumed.

Journal Article↗
PubMedDate not supplied

Income inequality and health. Coastal communities in British Columbia, Canada.

OBJECTIVE: An imbalance in the distribution of economic resources, i.e., income inequality, is a characteristic of a community that may influence the aggregate health of the population. In North America, income inequality seems to be strongly related to mortality rates among American communities such as states and metropolitan areas but largely irrelevant for health at similar levels of geopolitical aggregation in Canada. This article summarizes relevant international and North American evidence and then explores relationships between income inequality and mortality rates among coastal communities in the province of British Columbia, Canada. METHODS: Cross-sectional analysis was conducted among twenty-four coastal communities in British Columbia, utilizing four measures based on the 1996 Census to measure income inequality and crude, age-standardized and age- and gender-specific mortality rates averaged over the five-year period 1994-98 to measure health. RESULTS: The three valid measures of income inequality were positively and significantly related to the crude mortality rate but were not significantly related to the age-standardized mortality rate. Two of the inequality measures were related to mortality rates for males aged 0-44 and for males aged 45-64 before but not after controlling for mean household income. DISCUSSION: Health researchers have yet to report a meaningful relationship between income inequality and population health within Canada. At the risk of committing the ecological fallacy, these findings provisionally support a psycho-social interpretation of the individual-level relationship between income and health wherein members of these communities compare themselves to an encompassing community, e.g., all Canadians.

Adolescent↗