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 739 records · Page 41Linked to original sources

Position of the American Dietetic Association and Dietitians of Canada: vegetarian diets.

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life-cycle including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fibre, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals. Vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. While a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Adolescent↗

OBSERVATIONS ON THE CLASSIFICATION AND DISTRIBUTION OF PULMONARY EMPHYSEMA IN CANADA.

General principles of epidemiology are reviewed, using as an example the chronic non-specific respiratory diseases in Canada. Lack of agreement in definition and classification seriously hampers the use of governmental statistics to study the epidemiology of these diseases. Though Canada is experiencing a mid-century epidemic of deaths from emphysema, evidence is presented which suggests that provincial variation in this death rate is artificial and is likely apparent because physicians do not categorize deaths from this and related diseases in any similar fashion. Three-year-average age-standardized death rates by provincial areas for emphysema with or without bronchitis, asthma, chronic bronchitis and bronchiectasis are presented in evidence that provincial variation is largely obliterated when all chronic non-specific respiratory diseases are considered as a single nosological unit. Advantages and disadvantages of a recent clinical classification of these diseases are reviewed, and it is concluded that such a classification has a great deal to offer epidemiologists or clinicians studying the cause and natural history of these diseases.

Asthma↗

RADIATION PROTECTION IN CANADA. III. THE ROLE OF THE RADIATION PROTECTION DIVISION IN SAFEGUARDING THE HEALTH OF THE PUBLIC.

The current status of radiation protection in Canada is discussed in the last of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. A radioactive fallout study program has been established involving the systematic collection of air and precipitation samples from 24 locations, soil samples from 23 locations, fresh-milk samples from 16 locations, wheat samples from nine areas and human-bone specimens from various hospitals throughout Canada. A whole-body-counting facility and a special study of fallout in Northern areas have also been initiated. For any age group, the highest average strontium-90 concentration in human bone so far reported has been less than four picocuries per gram of calcium compared with the maximum permissible level of 67 derived from the International Committee on Radiation Protection (ICRP) recommendations. By the end of 1963 a general downward trend of levels of radioactivity detected in other parts of the program has been observed. Programs to assess the contribution to the radiation exposure of members of the population from medical x-rays, nuclear reactor operations and natural background-radiation sources have also been described. The annual genetically significant dose from diagnostic x-ray examinations in Canadian public hospitals has been estimated to be 25.8 mrem. Results from the reactor-environment monitoring programs have not suggested the presence of radioactivity beyond that contributed from fallout.

Air Pollution↗

RADIATION PROTECTION IN CANADA. I.

The current status of radiation protection in Canada has been summarized in the present paper, the first of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. Somatic and hereditary effects of radiation exposure are briefly discussed as a basis for an understanding of the radiation protection standards which have been developed at national and international levels. The rapid increase in use of radioactive materials and x-ray apparatus in medicine, industry and research, and the extensive atmosphere testing of nuclear weapons have led to the development of comprehensive radiation protection activities in Canada, especially in the Department of National Health and Welfare. Well-established lines of communication and liaison exist among the various agencies responsible for these activities.

Atmosphere↗

Q FEVER IN CANADA.

A Canada-wide survey of Q fever was begun in 1958 in co-operation with public health and veterinary laboratories to determine the presence and prevalence of the disease so that medical practitioners might be alerted to the potential dangers existing. Serologic evidence obtained indicated that the Q fever rickettsia now exists in cattle in all provinces of Canada except New Brunswick, Nova Scotia, and Prince Edward Island. Isolations of the rickettsia were obtained from bovine milk samples from Ontario and Quebec. The data suggest that the etiologic agent was not present in the western provinces during the early 1950's but since having been introduced into that area it has established itself successfully, particularly in Alberta. The ease with which the disease in man may be missed is illustrated by a previously unreported case which occurred in 1960 in the Eastern Townships of Quebec.

Alberta↗

CAUSES OF BLINDNESS IN CANADA: AN ANALYSIS OF 24,605 CASES REGISTERED WITH THE CANADIAN NATIONAL INSTITUTE FOR THE BLIND.

A survey of blind persons in Canada, based on registrations with The Canadian National Institute for the Blind (C.N.I.B.), is reported. This is the first study of its type having national scope and based on data registered in a central file. It covered 24,605 living registered blind persons ranging from premature infants to very elderly persons. Causes of blindness are broken down with respect to topography (site and type of lesion) and etiology. In terms of frequency, the principal causes were lesions affecting the globe (e.g. glaucoma, myopia), 36%; the retina, 23%; the lens, 16%; and the optic nerve, 11%. In this study, 32% of the blindness was due to prenatal causes. The prevalence of blindness per 100,000 persons in Canada, based on C.N.I.B. data, was 131, varying among the provinces from 108 to 376. Serious ocular disease was four times more prevalent than blindness; 101,436 such cases (the prevention group) were listed by the C.N.I.B.

Academies and Institutes↗

Hypertension surveillance in Canada: minimum standards for assessing blood pressure in surveys.

The last Canadian survey that accurately assessed hypertension treatment and control is over 12 years old. The survey indicated that only 13% of adults with hypertension were treated and controlled. Statistics Canada has announced a new survey that will measure health risks in 2007-2008. A committee of hypertension and survey experts was formed to provide recommendations to ensure the survey would address the minimum surveillance needs of the hypertension community. The committee made several innovative recommendations to improve the reproducibility and standardization of blood pressure assessment. In particular, it was recommended to adopt oscillometric measurement and to have measurements conducted in the absence of study personnel. Continued use of standard Canadian survey questions to assess awareness and treatment of hypertension was recommended to allow comparison with prior surveys. It was also recommended that Canada adopt a specific question on lifestyle changes. The new survey will allow the Canadian hypertension community, and in particular the Canadian Hypertension Education Program, to evaluate the effectiveness of current programs for prevention, treatment and control of hypertension and to revise our strategies based on the results.

Adult↗

Sex bias and underutilization of lipid-lowering therapy in patients with coronary artery disease at academic medical centers in the United States and Canada. Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT) Investigators.

BACKGROUND: The efficacy of lipid-lowering therapy (LLT) has been well established for patients with preexisting coronary artery disease (CAD). However, limited information is available assessing the extent to which these medications are prescribed in academic medical centers. METHODS: The use of LLT for patients with CAD was prospectively evaluated in 825 men and women who were recruited from 16 academic medical centers in the United States and Canada to participate in the Prospective Evaluation of the Vascular Events of Norvasc Trial (PREVENT). The assessment of LLT use during the 3-year trial was evaluated in patients receiving amlodipine therapy and placebo; levels of low-density lipoprotein cholesterol (LDL-C) were used to assess the impact of LLT. RESULTS: Despite a baseline prevalence of LLT in 42% of men (38% in 1994), half of the patients had high levels of LDL-C (>3.36 mmol [>130 mg/dL]). During the subsequent 3 years, the prevalence of elevated LDL-C levels dropped in men (29%) but remained stagnant in women (48%). These changes were associated with increased LLT in men (55%) but not in women (35%) (P = .04). In 1994, the LDL-C target goal (<2.59 mmol/L [<100 mg/dL]) was attained in 17% of men and 6% of women (P = .006). At study completion in 1997, the LDL-C target goal was achieved in 31% of men and only 12% of women (P = .001). CONCLUSIONS: This study highlights the relatively low treatment rates of hyperlipidemia among patients with CAD overall and women in particular who were participating in a clinical trial at academic medical centers in the United States and Canada. Because LLT has been proven to reduce future cardiovascular events, these results suggest that more intensive efforts should be promoted in order to maximize CAD reduction.

Academic Medical Centers↗

Testing models predicting severity of respiratory syncytial virus infection on the PICNIC RSV database. Pediatric Investigators Collaborative Network on Infections in Canada.

OBJECTIVES: To determine the sensitivity and specificity of published prognostic models to predict morbidity resulting from lower respiratory tract disease caused by respiratory syncytial virus in an independent pediatric population and to assess the accuracy of single risk factors in predicting adverse outcome. DESIGN: All articles obtained from a MEDLINE search that used the terms prognosis or sequelae and respiratory syncytial virus, and from the references of these articles, were reviewed. Studies were included if risk factors and outcomes were defined and if information was available in a database of prospectively enrolled patients with respiratory syncytial virus infections. A probability of adverse outcome was assigned to each patient in the cohort using prognostic models described in the articles. A test was considered positive if the probability of the adverse outcome was 5% or more. PATIENTS: Six hundred eighty-nine patients hospitalized with respiratory syncytial virus in seven tertiary care centers across Canada were prospectively enrolled in the Pediatric Investigators Collaborative Network on Infections in Canada database. MAIN OUTCOME MEASURES: The sensitivity and specificity of single predictors and of models in predicting severe disease were determined. RESULTS: The sensitivity of single predictors varied from 17% to 46%. A model that used age and oxygen saturation at admission in previously well infants had a sensitivity of 98% and a specificity of 47% when predicting intensive care unit admission. Another model that included age at hospitalization, gestational age, presence of an underlying condition, and respiratory syncytial virus subtype used to predict the outcome of a high severity index had a sensitivity of 77% and a specificity of 76%. When the above model was modified by exclusion of viral subgroup, sensitivity increased to 94%, but specificity decreased to 46%. CONCLUSION: Previously described prognostic models were generalizable to an independent study population.

Canada↗

Shopping around for hospital services: a comparison of the United States and Canada.

CONTEXT: Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries. OBJECTIVE: To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket. DESIGN: Cross-sectional telephone survey conducted May 1996 to April 1997. PARTICIPANTS: The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000. MEASURES: Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency. RESULTS: Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; P<.001). Median charges were significantly higher in American hospitals for 6 services, particularly for a total knee replacement ($26805 vs $10651; P<.001). Individual services showed no association between shorter waiting times and higher prices within each country, with the exception of a total knee replacement in the United States. CONCLUSION: US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket.

Canada↗

Relationship of prenatal diagnosis and pregnancy termination to overall infant mortality in Canada.

CONTEXT: Prenatal diagnosis and termination of affected pregnancies can prevent infant deaths due to congenital anomalies, but an effect at the population level has not been shown. OBJECTIVE: To examine the impact of recent changes in congenital anomaly-related fetal and infant deaths on overall population-based infant mortality. DESIGN, SETTING, AND SUBJECTS: Birth cohort-based study of all live births, stillbirths, and infant deaths in Canada (excluding Ontario) for 1991-1998. MAIN OUTCOME MEASURES: Cause-specific infant mortality rates and gestational age-specific fetal death rates. RESULTS: The birth cohort-based infant mortality rate fluctuated between 6.4 and 6.1 per 1000 live births between 1991 and 1995, then dropped to 5.4 per 1000 in 1996 and 5.5 per 1000 in 1997. The rate of infant death from congenital anomalies was stable between 1991 and 1995 but declined by 21% (95% confidence interval, 19%-32%) from 1.86 per 1000 in 1995 to 1.47 per 1000 in 1996 and 1997. Fetal deaths due to pregnancy termination at 20 to 23 weeks' gestation increased dramatically in 1994, while fetal deaths due to congenital anomalies at 20 to 21 weeks increased in 1995 and subsequently. Provinces/territories with high rates of fetal death due to pregnancy termination/congenital anomalies at 20 to 23 weeks had fewer infant deaths due to congenital anomalies. CONCLUSION: A large decrease in infant deaths due to congenital anomalies was associated with the most recent decline in infant mortality in Canada, suggesting that increases in prenatal diagnosis and pregnancy termination for congenital anomalies are related to decreases in overall infant mortality at the population level.

Abortion, Induced↗

Refugee flow or brain-drain? The humanitarian policy and post-Tiananmen mainland Chinese immigration to Canada.

"The humanitarian policy that the Canadian government implemented in response to the 1989 Tiananmen Square crackdown changed a migration system primarily based on personal networks into a brain drain. Post-Tiananmen mainland Chinese immigrants (MCIs) were better educated than those arriving in Canada previously. Among the post-Tiananmen MCIs, those who landed under the policy were better educated than those landing in other categories. The analysis suggests that post-Tiananmen MCIs represented a brain-drain rather than a refugee flow, that the humanitarian policy implicitly contained ideological and human capital concerns in addition to humanitarian concerns, and that Canada benefited from the policy by obtaining human capital as well as satisfying its humanitarian obligations and ideological aspirations."

Americas↗

The effect of domestic and economic stress on suicide rates in Canada and the United States.

The study of the variation in societal suicide rates still is guided primarily by Durkheim's (1897) theory. He proposed primarily a social integration/regulation theory of suicide. One useful way of exploring this theory is from a cross-cultural perspective. Rates of birth, divorce, marriage, and unemployment were analyzed in comparison to rates of suicide from 1950 to 1985 in Canada and the United States. Results generally supported Durkheim's theory except for marriage. There was no association between marriage and suicide in Canada, whereas in the United States marriage had a protective effect once other variables were taken into account. Divorce rates were associated positively and birth rates associated negatively with suicide in both countries. Unemployment rates added little predictive power to suicide rates. A historical perspective and caution about overgeneralizing the results are presented.

Birth Rate↗

Hemoglobin H (Hb H) disease in Canada: molecular diagnosis and review of 116 cases.

Over the past decade, we have characterized at the DNA level a total of 116 hemoglobin H (Hb H) disease patients living in Canada. The majority of patients were of southeast Asian descent (Chinese, Filipino, Laotian, Vietnamese), with a small number being of Mediterranean, Middle Eastern or East Indian background. A total of 15 distinct genotypes were detected, all but one being compound heterozygotes for a two-gene cis deletion and a single-gene deletion (-alpha/-) or a non-deletion mutation of the alpha2-globin gene (alpha(T) alpha/-). Seven different two-gene cis deletions were encountered, along with nine single-gene deletions and point mutations. The wide range of mutations associated with Hb H disease in Canada is a reflection of the population heterogeneity. The diagnosis of Hb H disease at the molecular level is important with respect to genetic counseling and the identification of families at risk for having pregnancies affected with Hb Bart's hydrops fetalis syndrome and/or Hb H disease. Six of the Hb H disease patients in our cohort had spouses who carried single-gene deletions, making these couples at risk for having children with Hb H disease. More important, seven patients had partners who carried two-gene cis deletions. These couples are at reproductive risk for both Hb Bart's hydrops fetalis syndrome and Hb H disease.

Adolescent↗

INR reporting in Canadian medical laboratories. Thrombosis Interest Group of Canada.

A written survey of all licensed medical laboratories in Canada performing coagulation testing was performed to investigate the level of knowledge and overall usage of the INR system for reporting prothrombin time results in medical laboratories. There was an overall response rate of 857 of 1,228 laboratories surveyed. Fifty-seven percent of responding laboratories utilized some format of INR reporting. The ISI of the individual thromboplastin utilized was known by 89% of laboratories. The ISI of the thromboplastin utilized was known to be specific for the particular reagent/instrument combination in 44% of cases. Fifty-five percent of client physicians preferred PT results to be reported in seconds while 42% desired an INR format. The situation in Canada is similar to the United States in that further education regarding the INR system for PT reporting is required by both medical laboratories and physicians.

Administration, Oral↗

mtDNA variation in Inuit populations of Greenland and Canada: migration history and population structure.

We examined 395 mtDNA control-region sequences from Greenlandic Inuit and Canadian Kitikmeot Inuit with the aim of shedding light on the migration history that underlies the present geographic patterns of genetic variation at this locus in the Arctic. In line with previous studies, we found that Inuit populations carry only sequences belonging to haplotype clusters A2 and D3. However, a comparison of Arctic populations from Siberia, Canada, and Greenland revealed considerable differences in the frequencies of these haplotypes. Moreover, large sample sizes and regional information about birthplaces of maternal grandmothers permitted the detection of notable differences in the distribution of haplotypes among subpopulations within Greenland. Our results cast doubt on the prevailing hypothesis that contemporary Inuit trace their all of their ancestry to so-called Thule groups that expanded from Alaska about 800-1,000 years ago. In particular, discrepancies in mutational divergence between the Inuit populations and their putative source mtDNA pool in Siberia/Alaska for the two predominant haplotype clusters, A2a and A2b, are more consistent with the possibility that expanding Thule groups encountered and interbred with existing Dorset populations in Canada and Greenland.

Canada↗

Physician migration to and from Canada: the challenge of finding the ethical and political balance between the individual's right to mobility and recruitment to underserved communities.

Physician migration to and from countries results from many local causes and international influences. These factors operate in the context of an increasingly globalized economy. From an ethical point of view, selective and targeted "raiding" of developing countries' medical workforce by wealthier countries is not acceptable. However, within specific countries, additional factors need to be identified to moderate the situation. I discuss the context in which Canada, a developed country, has struggled with workforce planning, with troubling results. I identify challenges for Canada but emphasize that decisions based on sloppy assumptions or inadequate data can lead to invalid policies, and poorly coordinated implementation can lead to a waste of human capital. Myths and attitudes further complicate physician workforce planning. Implementing recommendations of the recently concluded Task Force on the Licensure of International Medical Graduates will hopefully ameliorate the situation.

Canada↗

Use of health care services by survivors of childhood and adolescent cancer in Canada.

BACKGROUND: The number of survivors of childhood cancer in Canada is growing. The large majority of survivors experience at least 1 adverse late effect of their cancer therapy, which often becomes more severe and clinically apparent with time. The extent of survivors' use of health services in Canada is unknown, although coordinated, continuous, long-term follow-up care has been recommended by numerous investigators. METHODS: Information on reported consultations with healthcare practitioners in the past year was obtained from 2152 survivors of child and adolescent cancer (mean age at diagnosis, 7.3; range, 0-19) and 2432 age- and sex-matched population-based controls through a mailed questionnaire. RESULTS: Similar proportions of survivors (71%) and controls (73%) reported consulting a general practitioner in the past year. Survivors were more likely than controls to consult with any specialist (68% vs. 46%), including an oncologist (29% vs. 0.3%). Survivors' consultations with oncologists increased with concurrent physical health problems (adjusted odds ratio [OR(adj)], 1.7, 95% confidence interval [CI], 1.4-2.1), history of high risk therapy (OR(adj), 2.4, 95% CI, 1.9-2.9), and multiple treatment series (OR(adj), 2.2, 95% CI, 1.7- 3.0), but decreased with time since diagnosis (OR(adj), 0.3, 95% CI, 0.2-0.4). CONCLUSION: Although most survivors reported consulting with at least 1 healthcare practitioner in the past year, the large majority did not report consulting an oncologist and thus may not be receiving optimal follow-up care. Moreover, consultations decreased with time since diagnosis, exactly when risk of late effects increases. This limited preventive care could have major implications on survivors' long-term health.

Adolescent↗