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 811 records · Page 45Linked to original sources
PubMedDate not supplied

Prescription drug benefits and Canada's uninsured.

The Canada Health Act provides a framework for the Canadian health system and a mechanism for federal healthcare funds to flow to the provinces. Presently, the Canada Health Act covers medically necessary hospital, physician and surgical-dental as well as limited long-term care services, but not prescription medication. Though not mandated, each province has chosen to also develop a prescription drug benefit plan. These plans differ with respect to the groups that are covered and the type of coverage provided. In this paper, we describe the key structural elements of the various provincial plans. In addition, using a population-based national health and mental healthcare survey of 33,000 Canadians, we explore the characteristics of the population currently not covered by prescription drug benefits. Finally, we look at a sub-population of Canadians with mental illness with regard to their insurance coverage and use of prescription drugs. Our findings suggest that drug coverage within provinces is working for individuals with chronic physical conditions only. The findings herein reaffirm the need for a national strategy, support the notion that prescription drug coverage is important, and raise questions about the role of employers in providing these benefits.

Adult↗
PubMed2004

Quantitative review of riparian buffer width guidelines from Canada and the United States.

This paper reviewed the provincial, territorial, and state guidelines for the retention of treed riparian buffers after timber harvest in Canada and the United States. Comparisons amongst jurisdictions were facilitated through the use of a standardized template for the classification of waterbodies. Mean buffer widths varied from 15.1 to 29.0 m for different waterbody types when both countries were combined. However, Canadian jurisdictions had wider buffers (except for intermittent streams). In part, this was due to the high percentage of Boreal jurisdictions in Canada and Southeast jurisdictions in the United States. The Boreal region had the widest buffers while Southeastern jurisdictions had the narrowest buffers. Just under half (approximately 44%) of the jurisdictions investigated had three or more modifying factors in the guidelines. Of these, waterbody type, shoreline slope, waterbody size, and presence of fish were the most common. Boreal and Pacific jurisdictions tended to have a more diverse set of waterbody size classes, waterbody types, and other modifying factors. Jurisdictions from the Midwest, Northeast, and Southeast maintained relatively simple 'one-size-fits-all' guidelines. Jurisdictions without modifying factors for slope or presence of fish applied wider baseline buffers than jurisdictions with these factors. A large percentage of jurisdictions (approximately 80%) allowed some selective harvest in buffers. However, these were often accompanied by relatively restrictive prescriptions. In comparison to the ecological recommendations, buffer widths for most jurisdictions were adequate to protect the aquatic biota and habitats but were, generally, less than recommended widths for terrestrial communities. In the future, two management trends are likely to continue, the shift towards more complicated guidelines and the expansion to larger-scale, watershed planning of riparian areas.

Animals↗
PubMed2004

Incidence of Smith-Lemli-Opitz syndrome in Canada: results of three-year population surveillance.

OBJECTIVES: To determine the incidence and point prevalence of Smith-Lemli-Opitz syndrome (SLOS) in Canada; to determine the percentage of mild cases of SLOS; and to determine the age of diagnosis of mildly affected patients. SLOS is a treatable genetic condition that may be difficult to diagnose in its mildest form because of nonspecific clinical markers (two- to three-toe webbing, short upturned nose, and micrognathia). STUDY DESIGN: More than 2000 Canadian pediatricians and pediatric specialists were surveyed monthly for 36 months through a standing national surveillance program. A clinical identification form was designed to identify patients with SLOS or its phenocopies. Clinical information was obtained on all reported cases; suggested cases were investigated by biochemical or molecular analysis. RESULTS: Thirty-five of 86 reports of suggested SLOS were confirmed SLOS. Twelve infants with SLOS were born during the surveillance period, and two additional infants with SLOS were diagnosed prenatally. Twenty-one infants with SLOS were born before the onset of surveillance. CONCLUSIONS: The minimum incidence of SLOS in Canada is 1 in 70,358 live births. The minimum prevalence of SLOS is approximately 1 in 950,000. Eighteen percent of patients were mildly affected; the mean age of diagnosis of mildly affected patients was 5.3 years.

Canada↗
PubMed2005

Cystic fibrosis birth rates in Canada: a decreasing trend since the onset of genetic testing.

OBJECTIVE: To estimate cystic fibrosis (CF) birth rates in Canada from 1971 to 2000 and to assess the population impact of genetic testing in families with a history of CF, after identification of the CF transmembrane conductance regulator gene in 1989. STUDY DESIGN: Age-at-diagnosis data were obtained from the Canadian Cystic Fibrosis Foundation Patient Data Registry and Canadian births for the corresponding years from Canadian Vital Statistics. Estimates of the CF birth rate in each year were based on a nonparametric model that allows the birth rate to vary across the years and adjusts for censoring of currently undiagnosed patients. RESULTS: The overall CF birth rate from 1971-1987 was 1/2714 with no increasing or decreasing trend. Beginning in 1988, 1 year before identification of the CF transmembrane conductance regulator gene, estimated CF birth rates followed a linear decline to an estimated rate of 1/3608 in 2000. CF birth rates may have stabilized in the last few years, but further decline may occur with implementation of carrier screening in the general population. CONCLUSIONS: These results demonstrate the temporal association of genetic testing and declining CF birth rates in Canada. They may assist in decisions relating to the allocation of resources for prenatal and neonatal CF screening programs.

Birth Rate↗
PubMed2004

Occupant restraint use in Canada.

Legislation regarding seat belt use in Canada is a provincial/territorial responsibility. Each of the 13 jurisdictions has enacted legislation and set the penalties regarding non-use of seat belts and appropriate child restraint systems. The federal government regulates occupant restraint systems and child restraints. In addition, Transport Canada (TC) gathers annual survey data on the use of seat belts and child restraints on Canadian roads and provides research support. National coordination toward the Canadian Road Safety Vision 2010 goal of a 40% reduction in fatalities and serious injuries related to non-belt/child restraint use and a 95% restraint usage rate is provided by the Canadian Council of Motor Transport Administrators' (CCMTA) National Occupant Restraint Program (NORP). The paper examines the history of legislation, provincial/territorial penalties, NORP, and TC involvement in promoting the use of occupant restraints.

Accidents, Traffic↗
PubMed2006

The impact of severe acute respiratory syndrome on the use of and requirements for filters in Canada.

This article begins with a brief look at the epidemiology of SARS in Canada and then discusses barrier use and potential containment strategies that could be applied to the respiratory equipment and supportive procedures that have been implicated in the spread of SARS or other respiratory infections. The article ends with a discussion of how practice and regulations have changed in Canada since SARS and some suggestions on how practice or regulations could further improve.

Canada↗
PubMed2005

Introduction of direct-to-consumer advertising of prescription drugs in Canada: an opinion survey on regulatory policy.

BACKGROUND: Canada is strongly influenced by US cross-border direct-to-consumer advertising (DTCA) and has held consultations to discuss introduction of DTCA since 1996. This article describes a survey of Canadian drug policy experts carried out in 2001, during one such legislative review. The survey results are compared to more recent DTCA policy developments. METHODS: We recruited key informants on pharmaceutical policy to complete a faxed questionnaire that queried their opinions on DTCA information quality, effects on drug and health care use, and regulatory issues. Respondents were asked about the evidence they had used to back their opinions. Analysis was descriptive. RESULTS AND DISCUSSION: Of 79 identified potential participants, 60 (76%) participated, 40% of whom were from federal and provincial government; 3% were private insurers; 18%, 15%, and 8% were from health professional groups, consumer groups, and patient groups, respectively; 8% and 7% were from pharmaceutical and advertising industries, respectively. Opinions were highly polarized on the effects of DTCA on drug and health care use. Advertising and pharmaceutical industry respondents were generally positive, public sector, health professional and consumer groups generally negative. Over 80% believed DTCA leads to higher private and public drug costs and more frequent physician visits. Fewer judged billboards or television to be appropriate media for DTCA than magazines or the Internet, and most believed that children and adolescents should not be targeted. CONCLUSION: Given the polarization observed within this survey, we examined how DTCA policy has evolved in Canada since 2001. The federal government has legislative authority over DTCA, but bears few of the additional costs potentially incurred through policy change. These fall to the provinces, which provide an eroding patchwork of public coverage for prescription drugs in the face of rapidly increasing costs. No new federal legislation has been tabled since 2001. However, considerable shifts in administrative policy have occurred, all supportive of expanded advertising. Thus, the law continues to be restrictive but its application less so.

Advertising↗
PubMed2006

The incidence of schizophrenia in European immigrants to Canada.

OBJECTIVE: The risk for schizophrenia in immigrants to Europe is approximately three times that of native-born populations. Discrimination and marginalization may influence the risk for schizophrenia within migrant populations. The primary objective of the present study was to determine whether the risk associated with migration was also evident 100 years ago. A second objective was to determine whether changing social stresses are associated with changes to the incidence of schizophrenia. METHOD: During the first two decades of the twentieth century, the Provincial Mental Hospital was the sole provider of psychiatric services in British Columbia, Canada. Detailed clinical records have been preserved for 99.5% of 2477 patients who had a psychiatric admission between 1902 and 1913. Diagnoses were made after a detailed file review and 807 patients met DSM-IV criteria for first-episode schizophrenia, schizophreniform disorder, schizoaffective disorder, or psychosis not otherwise specified. Diagnoses had high inter-rater reliability. The incidence of schizophrenia in migrants from Britain or Continental Europe was compared with that in the Canadian-born population using indirect standardization and Poisson models. RESULTS: Migration from Britain or Continental Europe to Canada in the early twentieth century was associated with an increased rate of schizophrenia; IRR=1.54, (95% CI=1.33-1.78). Incidence increased over time in immigrants but not in the native-born population and this increase occurred during a period of economic recession. CONCLUSIONS: Migration was a risk factor for schizophrenia a century ago as it is today. This risk occurred in white migrants from Europe and increased during a period of increased social stress.

Adolescent↗
PubMed2005

Organochlorines and trace elements in upland game birds harvested in Canada.

American woodcock, common snipe, two species of ptarmigan (willow and rock), and three species of grouse (ruffed, spruce, and sharp-tailed) were collected from 21 locations between 1991 and 1994 as part of a nationwide survey of contaminants in game birds harvested in Canada. Breast muscle was analysed for organochlorines (chlorobenzenes, hexachlorocyclohexanes, chlordane-related compounds, DDT metabolites, mirex, dieldrin, and PCBs) and trace elements (Hg, Cd, Se, and As). The concentrations of organochlorine compounds measured in breast muscle of the birds in this survey were very low. Median concentrations for the organochlorines measured were less than 0.001 mg kg-1 in breast muscle of all ptarmigan and grouse species sampled. Only SigmaPCB, SigmaDDT and SigmaCHL were found above trace levels in breast muscle of all of the woodcock, and only SigmaPCB and SigmaDDT were found above trace levels in the snipe. Total Hg was detected only in the woodcock and the snipe whereas Se was above detection levels in all samples of all species except one sample pool of willow ptarmigan from Nunavut. Cadmium was detected in all species except for the spruce and sharp-tailed grouse with the highest overall concentrations found in the ptarmigan species. Arsenic was detected in all of the woodcock and snipe samples but was not found in any of the grouse samples. The highest Hg and As concentrations were both found in snipe sampled from southeastern New Brunswick. Concentrations of As, Hg and Se measured in breast muscle of the birds in this survey were below toxicological threshold levels found in the literature. Concentrations of Cd, however, were elevated in some birds, particularly in willow ptarmigan from the Yukon. Health Canada determined that the organochlorine and trace element levels found in samples of breast muscle of game birds analysed in this study did not pose a health hazard to human consumers and therefore these birds were safe to eat.

Animals↗
PubMed2005

Occurrence of arsenic contamination in Canada: sources, behavior and distribution.

Recently there has been increasing anxieties concerning arsenic related problems. Occurrence of arsenic contamination has been reported worldwide. In Canada, the main natural arsenic sources are weathering and erosion of arsenic-containing rocks and soil, while tailings from historic and recent gold mine operations and wood preservative facilities are the principal anthropogenic sources. Across Canada, the 24-h average concentration of arsenic in the atmosphere is generally less than 0.3 microg/m3. Arsenic concentrations in natural uncontaminated soil and sediments range from 4 to 150 mg/kg. In uncontaminated surface and ground waters, the arsenic concentration ranges from 0.001 to 0.005 mg/L. As a result of anthropogenic inputs, elevated arsenic levels, above ten to thousand times the Interim Maximum Acceptable Concentration (IMAC), have been reported in air, soil and sediment, surface water and groundwater, and biota in several regions. Most arsenic is of toxic inorganic forms. It is critical to recognize that such contamination imposes serious harmful effects on various aquatic and terrestrial organisms and human health ultimately. Serious incidences of acute and chronic arsenic poisonings have been revealed. Through examination of the available literature, screening and selecting existing data, this paper provides an analysis of the currently available information on recognized problem areas, and an overview of current knowledge of the principal hydrogeochemical processes of arsenic transportation and transformation. However, a more detailed understanding of local sources of arsenic and mechanisms of arsenic release is required. More extensive studies will be required for building practical guidance on avoiding and reducing arsenic contamination. Bioremediation and hyperaccumulation are emerging innovative technologies for the remediation of arsenic contaminated sites. Natural attenuation may be utilized as a potential in situ remedial option. Further investigations are needed to evaluate its applicability.

Arsenic↗
PubMed2004

Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada.

This paper combines multiple cross-sections of data drawn from the National Population Health Survey and Canadian Community Health Survey to confirm the existence of the 'healthy immigrant effect', specifically that immigrants are in relatively better health on arrival in Canada compared to native-born Canadians, and that immigrant health converges with years in Canada to native-born levels. The paper finds robust evidence that the healthy immigrant effect is present for the incidence of chronic conditions for both men and women, and results in relatively slow convergence to native-born levels. There is only weak evidence in terms of self-assessed health status. The inclusion of controls for region of origin and year of arrival does not account for the observed effects, although region of origin is an important determinants of immigrant health. The paper then considers some alternative explanations for the observed differences, and support is found for the idea that the healthy immigrant effect reflects convergence in physical health rather than convergence in screening and detection of existing health problems.

Adult↗
PubMed2005

Long-run consequences of parental paid work hours for child overweight status in Canada.

This paper explores the connection between the labour market and child overweight status in Canada. The labour market is a social institution which plays a critical role in determining how families live their day-to-day lives, for example, how much time and which parts of the day are available for cooking, eating and exercise. Using longitudinal data from the Statistics Canada National Longitudinal Survey of Children and Youth, we find that a history of higher hours of paid work by mothers (but not fathers) is associated with a higher probability of being 'at risk of overweight'/overweight for children aged 6-11. The policy implication we draw from this work is that additional support to better enable parents to engage in paid work without penalty to their own health or that of their children is clearly warranted.

Adult↗
PubMed2006

The development of West Nile virus safety policies by Canadian blood services: guiding principles and a comparison between Canada and the United States.

To address the emerging threat of West Nile virus (WNV) to the blood supply, Canadian Blood Services (CBS) made a series of policy decisions that were either similar to those adopted in the United States or more stringent than policies formulated in the United States at the same time. More stringent Canadian policies included the development of an in-house WNV RNA assay, the stockpiling of frozen plasma components in the winter for transfusion in WNV-affected areas in the summer, a special recruitment campaign for red blood cell collections before the start of the 2003 WNV season, and an inventory exchange (ie, WNV-tested for untested red blood cells) initiated 2 weeks after the onset of WNV screening, as well as the implementation of targeted individual-donation WNV testing on August 2, 2004, in the absence of any positive donors or clinical cases of WNV infection in Canada. The general principles that guided CBS decision making with regard to WNV safety included application of the precautionary principle, harmonization with policies in the United States, a consideration of logistic issues, compliance with Health Canada requests, responsiveness to public expectations about transfusion safety, and transparency in decision making with timely communication to stakeholders. Before implementing WNV blood safety policies, CBS assessed their impact on blood availability. When policies were implemented, data were obtained quickly to ensure that the prior impact assessments were accurate. This review discusses the guiding principles affecting CBS policy development and compares CBS WNV safety policies to policies adopted in the United States.

Antibodies, Viral↗
PubMed2006

Survival analysis of liver transplant patients in Canada 1997-2002.

UNLABELLED: Liver transplantation is an important health care issue for Canadians. Very few studies have assessed survival and determinants of survival in liver transplant patients in Canada. METHODS: We carried out an epidemiological analysis of 1 year survival and determinants of 1 year survival in liver transplant patients, using Canadian Organ Replacement Registry data (1997-2002). Survival curves were plotted by the Kaplan-Meier method. Cox proportional hazards analysis was applied to evaluate hazard ratios with different age groups, gender, ethnicity, blood groups, donor type, pretransplantation medical status, and HBV infection status. RESULTS: A total of 1164 liver transplant patients were included in the analysis. One-year survival rate was 84.7%. Male recipients had a 21% higher risk of developing organ failure than females. Recipients over 60 years of age had a 5% lower survival probability in comparison with recipients below 20 years of age. Pacific Islanders and Aboriginals had 32% and 9% lower survival probabilities, respectively, in comparison with Caucasians. Type B blood recipients had a 12% higher survival probability, whereas type AB blood recipients had a 7% lower survival probability compared with type O blood recipients. Twenty-six live organ recipients had 40% higher survival probabilities than 1138 cadaveric organ recipients. Patients with fulminant hepatitis (status 3F) had the highest survival, while patients with fulminant failure in ICU with intubation/ventilation (status 4F) had the lowest survival. One hundred sixty-seven recipients with positive HBsAg antigen showed 10% lower survival probability than 997 cases with negative HBsAg antigen. CONCLUSION: In Canada, the first year survival rate is about 85%, which is comparable with other industrialized countries. Type of donor organs and recipient gender, ethnicity, ABO blood group, pretransplantation medical status, and HBV infection status had significant affects on the recipient survival.

Canada↗
PubMed2006

Estimating vaccine effectiveness against laboratory-confirmed influenza using a sentinel physician network: results from the 2005-2006 season of dual A and B vaccine mismatch in Canada.

INTRODUCTION: We report a case-control design using a sentinel physician network to estimate vaccine effectiveness (VE) against laboratory-confirmed, medically attended influenza (LC-MAI) and provide results for the 2005-2006 season of dual A and B vaccine mismatch in Canada. METHODS: Participants were patients >or=5 years of age presenting with influenza-like illness (ILI) to a sentinel physician in British Columbia, Canada between November 1, 2005 and April 30, 2006. Cases were participants in whom influenza was identified; controls tested negative for influenza A and B by PCR, R-mix and culture. Isolates were characterized by gene-sequencing and hemagglutination-inhibition (HI) assays. Odds ratios (OR) for LC-MAI in vaccinated versus non-vaccinated persons were derived with adjustment for age and chronic conditions. VE was estimated as [1-OR (vaccinated/unvaccinated)]. RESULTS: The sample included 442 patient visits: median age was 26 years, 10% were >or=65 years, 15% had a chronic condition and 22% received the 2005-2006 trivalent inactivated influenza vaccine >or=2 weeks before ILI onset. Two hundred and six participants were positive for influenza; 107 (52%) had influenza A/H3N2 and 99 (48%) had influenza B/Victoria lineage. Gene sequencing identified mutations away from the vaccine strain at key antigenic binding sites of the hemagglutinin (HA) protein of H3N2 isolates; the neuraminidase (NA) protein was conserved. Based on HI assays, three-quarters of influenza A and all B isolates were mismatched to the 2005-2006 vaccine. Point estimates for VE against LC-MAI were in the range of 50 to 70% for both types of influenza. CONCLUSION: 2005-2006 was the third consecutive season of vaccine mismatch based on varying HA for the A/H3N2 component and the third also for the B component since 2001. Vaccine mismatch resulted in diminished VE but substantial cross-protection. More timely detection of drift variants through gene sequencing of isolates facilitates interpretation of VE results. Since it may be more antigenically conserved, the vaccine content and contribution of NA to overall VE should be further evaluated for both A and B components. Infrastructure for real-time epidemiologic assessment of vaccine performance is important annually and in preparation for a pandemic.

Adolescent↗
PubMed2006

A dynamic model for assessing universal Hepatitis A vaccination in Canada.

Vaccination against Hepatitis A virus (HAV) in Canada is currently targeted toward high-risk groups. However, universal vaccination has been adopted in several other countries with a similar disease burden. Here we develop an age-structured compartmental model of HAV transmission and vaccination in Canada to assess potential universal vaccination strategies. The model predicts that universal vaccination at age 1 (respectively 4, 9, 15), with phasing out of targeted vaccination, would reduce reported incidence by 60% (respectively 52, 36, 31%) and mortality attributable to HAV by 56% (respectively 45, 26, 25%), relative to continued targeted vaccination, over 80 years.

Adolescent↗
PubMed2000

Position of the American Dietetic Association and Dietitians of Canada: nutrition intervention in the care of persons with human immunodeficiency virus infection.

Human immunodeficiency virus (HIV) targets the immune system, making an infected person susceptible to infection and neoplasm because of an impaired ability to mount an adequate immune response. Malnutrition and its complications can further render an HIV-infected person susceptible to opportunistic infection and reduced effectiveness and tolerance to medications and other therapies. Though effective antiretroviral treatments have dramatically reduced death rates in the United States and Canada, HIV-infected people face a lifetime of vigilant polypharmacy to control HIV and associated complications. Malnutrition, various forms of tissue wasting, fat accumulation, increased lipid levels, and risk of additional chronic disease have become central issues in health care plans. It is the position of the American Dietetic Association and Dietitians of Canada that efforts to optimize nutritional status, including medical nutrition therapy and nutrition-related education, should be components of the total health care provided to people infected with human immunodeficiency virus HIV.

Adolescent↗
PubMed1997

Management of unstable angina pectoris and non-Q-wave acute myocardial infarction in the United States and Canada (the TIMI III Registry).

Management of Q-wave acute myocardial infarction (AMI) has been shown to differ between the United States and Canada, with more catheterization and revascularization procedures performed in the United States, but with little or no apparent difference in clinical outcomes. No previous studies have evaluated management differences for the acute coronary syndromes of unstable angina pectoris and non-Q-wave AMI. We therefore compared treatments and outcomes between 14 United States and 4 Canadian tertiary care centers participating in an observational registry of all consecutive admissions for unstable angina or non-Q-wave AMI between 1990 and 1993. A random, stratified sample was selected for detailed assessment and follow-up. There were 1,733 patients enrolled in United States centers and 642 in Canadian ones. In United States centers patients were less likely to receive intravenous nitroglycerin, heparin, beta blockers, calcium antagonists, or > or = 2 anti-ischemic agents. Coronary arteriography during index hospitalization was equally frequent in both countries (63.4% vs 66.9%, p = 0.781), but at 6 weeks and 1 year coronary arteriography was slightly less frequent in the United States patients. Revascularization by coronary angioplasty or bypass surgery was equivalent at 6 weeks and 1 year; however, there were trends toward less angioplasty and more bypass surgery in the United States than in Canada. Patients at United States centers stayed in the hospital fewer days than patients at Canadian centers (mean 8.2 vs 12.1 days, p <0.001). Death or AMI by 6 weeks was not different (4.8% vs 4.4%, p = 0.633), nor was it different at 1 year (10.0% vs 10.2%, p = 0.836). The combined outcome of death, AMI, or recurrent ischemia was more common in United States than in Canadian patients at 6 weeks (18.4% vs 13.9%, p = 0.004). Our findings indicate that United States physicians and hospitals did not consistently utilize more resources and were not more aggressive than their Canadian counterparts when treating acute coronary syndromes during this period.

Aged↗