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At least 829 records · Page 46Linked to original sources
PubMed2003

Impact of chronic conditions.

OBJECTIVES: This article compares the impact of various self-reported chronic conditions on health-related quality of life, as measured by the Health Utilities Index 3 (HUI3), for the population aged 12 or older. DATA SOURCE: The data are from the cross-sectional household component of the Health file of the 1996/97 National Population Health Survey. ANALYTICAL TECHNIQUES: The effect of 21 chronic conditions was assessed for the full sample (73,402) and in subgroups by age and sex. All analyses were weighted to represent the Canadian population at the time of the survey. The effect of each chronic condition on the HUI3 was estimated using multivariate linear regression, adjusting for age, sex and co-morbidity. MAIN RESULTS: The average impact of different chronic conditions on health status varies substantially. At younger ages, urinary incontinence and arthritis/rheumatism have the greatest effect on health-related quality of life, while at older ages, Alzheimer's disease and the effects of stroke have a major impact. Assessments of the impact of any specific condition should account for the presence of other conditions.

Adolescent↗
PubMed2003

Factors related to adolescents' self-perceived health.

OBJECTIVES: This analysis examines self-perceived health among Canadian adolescents aged 12 to 17, and factors associated with ratings of very good/excellent health. DATA SOURCE: The data are from cycle 1.1 of the 2000/01 Canadian Community Health Survey (CCHS), conducted by Statistics Canada. The sample consisted of 12,715 adolescents aged 12 to 17. ANALYTICAL TECHNIQUES: Cross-tabulations were used to estimate the prevalence of various characteristics and health behaviours for the 12-to-14 and 15-to-17 age groups. Multiple logistic regression was used to model associations between very good/excellent self-reported health and selected characteristics. MAIN RESULTS: In 2000/01, nearly 30% of 12- to 17-year-olds rated their health as poor, fair or good. At ages 15 to 17, girls were less likely than boys to report very good/excellent health and were more likely to have a chronic condition and to have experienced depression in the past year. When other factors were taken into account, the odds of reporting very good/excellent health were significantly lower for teens who were daily smokers, episodic heavy drinkers, physically inactive during leisure time, infrequent consumers of fruit and vegetables, or obese, compared with teens who did not have these characteristics.

Adolescent↗
PubMed2003

Children who become active.

OBJECTIVES: This article examines factors associated with children aged 4 to 11 becoming and remaining active, and how this differed according to their weight. DATA SOURCE: The data are from the National Longitudinal Survey of Children and Youth: cycle 1 (1994/95) for the cross-sectional analysis, and cycles 1, 2 and 3 (1994/95 to 1998/99) for the longitudinal analysis. ANALYTICAL TECHNIQUES: Estimates of physical activity levels in 1994/95 among acceptable-weight and overweight/obese children are presented by age, sex and selected activities (TV viewing, playing computer/video games, and hours of physical education at school). Logistic regression models were constructed for children who were inactive in 1994/95, focusing on the selected activities as predictors of adopting and maintaining an active lifestyle. MAIN RESULTS: Factors associated with children adopting and maintaining an active lifestyle differed, depending on their weight. For overweight/obese children, but not for acceptable-weight children, a relatively high number of physical education hours was predictive of becoming physically active, while frequent TV viewing lowered the odds.

Body Mass Index↗
PubMed2003

Adolescent self-concept and health into adulthood.

OBJECTIVES: This article examines factors associated with adolescent self-concept and the impact of adolescent self-concept on psychological and physical health and health behaviour in young adulthood. DATA SOURCE: The data are from the household cross-sectional (1994/95) and longitudinal (1994/95 to 2000/01) components of Statistics Canada's National Population Health Survey. ANALYTICAL TECHNIQUES: Scores on self-concept indicators in 1994/95 were compared between the sexes and age groups (12 to 15 versus 16 to 19). Multivariate analyses were used to examine cross-sectional and longitudinal associations between adolescent self-concept and depression, self-perceived health, physical activity and obesity, controlling for other possible confounders. MAIN RESULTS: Self-concept tends to be low among girls compared with boys. Cross-sectionally, adolescent self-concept was associated with household income and emotional support. For girls and for young adolescents, a weak self-concept in 1994/95 was related to the incidence of depression over the next six years; it was also predictive of physical inactivity among boys, and obesity among both sexes. A strong self-concept had a positive long-term effect on girls' self-perceived health.

Adolescent↗
PubMed2003

Witnessing violence--aggression and anxiety in young children.

OBJECTIVES: This article provides estimates of the percentage of children aged 4 to 7 who witnessed violence at home. Concurrent, short-term (2 years later) and longer-term (4 years later) associations between witnessing violence and overt aggression, indirect aggression, and anxiety are examined. DATA SOURCE: The data are from the cross-sectional and longitudinal components of the first three cycles of Statistics Canada's National Longitudinal Survey of Children and Youth. ANALYTICAL TECHNIQUES: The proportion of children who witnessed violence at home was estimated using weighted cross-sectional data from 1998/99. Multiple logistic regression analysis was used to examine concurrent, short-term and longer-term associations between witnessing violence and overt aggression, indirect aggression, and anxiety. MAIN RESULTS: In 1998/99, an estimated 8% of children aged 4 to 7 were reported to have seen violent behaviour at home. Witnessing violence was concurrently associated with overt aggression for both sexes, indirect aggression among boys, and anxiety among girls. Witnessing violence was predictive of overt aggression two and four years later for both sexes. Girls also had high odds of exhibiting indirect aggression in 1996/97 and anxiety in 1998/99; for boys, elevated anxiety was observed in 1996/97.

Aggression↗
PubMed1992

Perinatal transmission of human immunodeficiency virus-1 infection and maternal immunization strategies for prevention.

OBJECTIVES: To review the current understanding of the epidemiologic and pathogenetic features of human immunodeficiency virus-1 (HIV-1) infection in pregnancy and perinatal HIV infection, and to explore immunization strategies for preventing maternal-infant transmission of HIV. DATA SOURCES: MEDLINE data base and reference lists of articles were used to identify relevant papers. Reports from conferences were noted if the data had not yet been published. METHODS OF STUDY SELECTION: We reviewed all English-language papers pertaining to maternal or fetal infection with HIV, immunology of HIV infection, immunization of pregnant women, or immunization against HIV. DATA EXTRACTION AND SYNTHESIS: Human immunodeficiency virus infection of women is increasing, and vertical transmission of HIV to children is a growing problem. There is evidence for intrauterine, intrapartum, and immediate postpartum transmission, but it is thought that the majority of transmissions occur peripartum by a minor subset of the maternal HIV-1 strains. Diagnostic advances include measurement of HIV-specific immunoglobulin A (IgA) and improved systems for polymerase chain reaction and virus isolation from potentially infected infants. Clinical and immunologic correlates of transmission remain uncertain. CONCLUSIONS: The epidemiology of transmission must be determined in more diverse populations. The timing and pathogenesis of HIV transmission from infected mother to fetus require better description, and improved diagnostic tools are needed. Immunologic and mechanical determinants that prevent transmission in the majority of cases need to be identified more precisely. Clinical trials to evaluate active immunization of HIV-infected pregnant women with candidate AIDS vaccines will potentially help answer many of these questions.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Ontario hospitals--mergers, shorter stays and readmissions.

OBJECTIVES: This article examines the association between readmissions of pneumonia and acute myocardial infarction (AMI) patients to Ontario hospitals in 1998/99, and reductions in length of stay and recent hospital administrative mergers. DATA SOURCE: The data are from the 1998/99 Discharge Abstract Database, maintained by the Canadian Institute for Health Information. ANALYTICAL TECHNIQUES: Cross-tabulations were used to assess unadjusted associations between hospital and patient characteristics and readmission risk. Hierarchical nonlinear models were used to calculate odds of readmission, adjusting for hospital and patient characteristics. MAIN RESULTS: Hospital characteristics that may indicate restructuring--a decrease in mean length of stay or a recent administrative merger--were not associated with readmission of pneumonia or AMI patients within 30 days of discharge. Patients with two or more related hospital admissions in the previous year were at increased risk of readmission.

Adolescent↗
PubMed2002

Loss and recovery of independence among seniors.

OBJECTIVES: This article identifies risk factors associated with the loss and recovery of independence among the household population aged 65 or older. DATA SOURCES: The data are from the longitudinal component of the first two cycles (1994/95 and 1996/97) of Statistics Canada's National Population Health Survey (NPHS). Supplementary information is from the cross-sectional component of the 1998/99 NPHS. ANALYTICAL TECHNIQUES: Cross-tabulations were used to estimate the proportions of seniors who lost or regained independence between 1994/95 and 1996/97. Logistic regression models were used to explore associations between loss or recovery of independence and demographic, behavioural and socioeconomic variables, as well as chronic conditions. MAIN RESULTS: Age, sex and the effects of stroke were significantly related to the loss and recovery of independence among seniors. Bronchitis/emphysema, diabetes, heart disease, weight, physical activity, education and household income were associated with the loss of independence, but not its recovery. Dependent seniors with back problems, urinary incontinence, or who smoked had low odds of regaining independence.

Activities of Daily Living↗
PubMed2002

Disability-free life expectancy by health region.

OBJECTIVES: This article presents a profile of variations in disability-free life expectancy (DFLE) by health region. DATA SOURCES: Mortality data for 1995 through 1997 are from the Canadian Vital Statistics Database. Estimates of disability (major activity limitations) and sociodemographic characteristics are based on data from the 1996 Census. Supplementary information was provided by the Demography and Geography divisions at Statistics Canada. ANALYTICAL TECHNIQUES: DFLE was calculated using a modified version of Sullivan's method. Linear regression using 4 factors representing socio-demographic profiles was used to explain the variation of DFLE by health region. These 4 synthetic variables were determined using principal component analysis. MAIN RESULTS: In 1996, DFLE for both sexes was estimated to be 68.6 years. Estimates by health region varied considerably. Socio-economic status explains a high proportion of the variation of DFLE by health region.

Aged↗
PubMed2001

Patterns of use--alternative health care practitioners.

OBJECTIVES: This article examines consultations with alternative practitioners and the characteristics of people who use such care. DATA SOURCE: The data are from the longitudinal (1994/95 to 1998/99) and cross-sectional (1998/99) household components of Statistics Canada's National Population Health Survey (NPHS). ANALYTICAL TECHNIQUES: Descriptive information about the use of alternative practitioners is presented. Logistic regression is used to compare the odds of consulting alternative practitioners while controlling for a number of related factors. MAIN RESULTS: In 1998/99, about 3.8 million people reported having used the services of an alternative practitioner. Relatively high percentages of women, 25- to 64-year-olds, and people in the Western provinces reported seeking alternative care. When related factors, including chronic pain, were taken into account, asthma and back problems were significantly associated with alternative practitioner use.

Adolescent↗
PubMed2001

Determinants of self-perceived health.

OBJECTIVES: This article examines determinants of self-perceived health. Factors associated with very good/excellent rather than good health are compared with those associated with fair/poor rather than good health. DATA SOURCE: The data are from the household cross-sectional and longitudinal components of the first three cycles (1994/95, 1996/97 and 1998/99) of Statistics Canada's National Population Health Survey (NPHS). ANALYTICAL TECHNIQUES: Cross-tabulations from the 1998/99 NPHS cross-sectional file were used to estimate the prevalence of very good/excellent and fair/poor health by sex and age group. Based on the longitudinal file, predictors of health perceptions in 1998/99 were studied in a multivariate model using generalized logistic regression. MAIN RESULTS: While physical conditions were strongly related to health perceptions, some lifestyle, socio-economic and psychosocial factors were also statistically significant. Heavy smoking, irregular exercise and overweight were associated with fair/poor health ratings. Unhealthy changes in lifestyle were associated with fair/poor rather than good health. Distress, low self-esteem and low socio-economic status were negatively associated with very good/excellent health.

Adult↗
PubMed2001

Food insecurity in Canadian households.

OBJECTIVES: This article examines the prevalence of food insecurity in Canada, the characteristics of people most likely to live in households lacking sufficient funds for food, and several related health problems. DATA SOURCE: The data are from the cross-sectional household component of the 1998/99 National Population Health Survey and the Food Insecurity Supplement to that survey. ANALYTICAL TECHNIQUES: Cross-tabulations were used to estimate the percentage of Canadians experiencing food insecurity and the prevalence of five selected health outcomes among people who were and were not food insecure. Multivariate logistic regression was used to assess the association of several socio-demographic and economic factors with food insecurity and to determine the association of food insecurity with the selected health outcomes. MAIN RESULTS: In 1998/99, 10% of Canadians, or about 3 million people, were living in food-insecure households. Low-income households, households depending on social assistance, lone-parent families headed by women, tenants, children, and Aboriginal people had significantly high odds of experiencing food insecurity. Food insecurity was significantly associated with poor/fair health, multiple chronic conditions, obesity, distress and depression.

Adolescent↗
PubMed2001

Heart disease, family history and physical activity.

OBJECTIVES: This article examines the association of family history of heart disease and leisure-time physical activity with incident heart disease. DATA SOURCE: The data are from the 1994/95, 1996/97 and 1998/99 longitudinal household components of Statistics Canada's National Population Health Survey. This study is based on information provided by 9,255 respondents aged 20 or older who reported that, in 1994/95, they were free of diagnosed heart disease and in good health. ANALYTICAL TECHNIQUES: Multiple logistic regression was used to estimate the association of family history and physical activity with a new diagnosis of heart disease, while controlling for age, sex, educational attainment, smoking, high blood pressure, diabetes, and body mass index. MAIN RESULTS: When family history and other risk factors were taken into account, people who, in 1994/95, engaged in regular physical activity at a moderate level or beyond had lower odds of receiving a new diagnosis of heart disease than did sedentary individuals. People with a family history of heart disease who regularly participated in at least moderate physical activity had lower odds of developing heart disease than did their sedentary counterparts.

Adult↗
PubMed2001

Starting and sustaining physical activity.

OBJECTIVES: This article examines factors associated with starting or sustaining physical activity during leisure time. DATA SOURCE: The data are from the longitudinal household components of the National Population Health Survey. The sample consisted of 11,026 respondents who were aged 20 and older in 1994/95. ANALYTICAL TECHNIQUES: Multiple logistic regression was used to identify variables that independently predicted the adoption or maintenance of leisure-time physical activity. MAIN RESULTS: Among people who had been inactive in 1994/95, the two-year incidence of starting at least moderate physical activity by 1996/97 or 1998/99 was 24 cases per 100 person-years. For people who had been at least moderately active in 1994/95, the two-year incidence of ceasing to maintain that level of activity was 32 cases per 100 person-years. Many predictors of starting or sustaining activity were the same: sex, age, educational attainment, smoking, and sense of mastery. However, some factors were significant for one sex only. For instance, overweight and the presence of children were deterrents for women, but not for men. Social involvement and smoking status were significant for men, but not for women.

Adult↗
PubMed2004

Spatial relationships among asthma prevalence, health care utilization, and pollution sources in neighborhoods of Buffalo, New York.

In this retrospective study, the authors investigate the spatial distributions of asthma cases in relation to major traffic corridors and the Peace Bridge Complex in Buffalo, New York, and assess possible contributions of other U.S. Environmental Protection Agency (U.S. EPA)--identified pollution release sources. Multiple data sources, including emergency room visits, outpatient visits, and hospital discharge databases are utilized to evaluate whether an association exists between the addresses of diagnosed asthma cases and release sources. Using a two-factor multilevel model, this study finds a statistically significant association between proximity to source and diagnosed asthma (p < .025). The authors further observe that two-thirds of the asthmatic sufferers resided between 204 and 700 meters from pollution sources and that over 40 percent who utilized health care lived within walking distance of the health care facility they patronized. Using Turnbull's method, the authors detect notable geographic asthma clusters in areas within the city of Buffalo, in North Tonawanda, along major roadways, and in the communities adjoining the Peace Bridge Complex. The authors also find local clusters in Buffalo's west side using Turnbull's method, and a significant global cluster using Besag and Newell's method. One-quarter of the case address locations were within 700 meters of identified clusters. The Score Test methods of Lawson and Waller and of Bithell also find statistically significant associations between three previously identified U.S. EPA focus sites and increased risk of asthma. Correlation of these findings with air quality assessments, especially with respect to traffic-related pollution, however, would be required for a definitive link to be made between an increased risk of asthma and identified pollution sources.

Air Pollutants↗
PubMed2001

Trends in colorectal cancer incidence and mortality.

OBJECTIVES: This article examines recent trends in the incidence of and mortality from colorectal cancer among Canadian men and women, then further analyzes trends by three subsites. DATA SOURCES: Incidence data for colorectal cancer were obtained from the National Cancer Incidence Reporting System and from the Canadian Cancer Registry. Mortality data were extracted from the Canadian Vital Statistics Database. Supplementary data on nutrition are from the National Population Health Survey. ANALYTICAL TECHNIQUES: Age-standardized incidence and mortality rates were calculated for men and women. Age-specific incidence and mortality rates were calculated by 10-year age groups. Joinpoint analysis was applied to detect statistically significant changes in linear trends. MAIN RESULTS: Since the mid-1980s, colorectal cancer incidence has been declining, with steeper rates of decrease among women. Decreasing rates of colorectal cancer are limited to tumours located in the distal colon and rectum; the incidence of cancers of the proximal colon has not changed over time.

Adult↗
PubMed2004

Influenza vaccination.

OBJECTIVES: This article compares influenza vaccination rates in 1996/97 and 2000/01 and describes the characteristics of adults who were vaccinated. DATA SOURCES: The data on influenza vaccination are from the 1996/97 National Population Health Survey and the 2000/01 Canadian Community Health Survey, both conducted by Statistics Canada. Data on hospitalizations and deaths are from the Hospital Mortality Data Base and the Canadian Mortality Data Base, respectively. ANALYTICAL TECHNIQUES: Cross-tabulations were used to estimate rates of vaccination among seniors, people with chronic conditions, and the total population aged 20 or older. Multiple logistic regression was used to assess relationships between being vaccinated and selected characteristics. MAIN RESULTS: Between 1996/97 and 2000/01, the percentage of Canadians aged 20 or older who reported having had a flu shot the previous year rose from 16% to 28%. Rates were higher for seniors and people with chronic conditions. The odds of vaccination were high for residents of middle-to-high income households, people with at least some postsecondary education, former smokers, and people with a regular doctor. Smokers and people who reported their health as good to excellent had lower odds of being vaccinated.

Adult↗
PubMed2004

Alcohol and drug use in early adolescence.

OBJECTIVES: This analysis presents the prevalence of substance use among young adolescents. The extent to which factors such as peer behaviour, parenting practices and school commitment and achievement are associated with drinking to intoxication and other drug use is investigated. DATA SOURCE: The data are from the 1998/99 National Longitudinal Survey of Children and Youth. Analysis is based on a cross-sectional file from 4,296 respondents aged 12 to 15. ANALYTICAL TECHNIQUES: Prevalence estimates for alcohol and drug use were calculated by sex. Logistic regression models were fitted to estimate the odds of drinking to intoxication and drug use, adjusted for socio-demographic factors, peer and parent substance use, parenting practices, school commitment/attachment, emotional health and religious attendance. MAIN RESULTS: In general, drinking to intoxication and drug use were more common among 14- and 15-year-olds than among 12- and 13-year-olds. The odds of drinking to intoxication and drug use were highest among adolescents whose friends used alcohol or drugs or were often in trouble, who reported low commitment to school, or whose parents had a hostile and ineffective parenting style.

Adolescent↗