Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives Recent research has shown that cardiovascular disease (CVD) raises the risk of dementia and other forms of cognitive decline. Generally, these studies are unable to model the time of diagnosis of CVD in their analyses and treat CVD as a time-fixed variable. Our objective was to assess the risk of being diagnosed with dementia for individuals diagnosed with CVD when CVD is time-dependent. Methods We performed a retrospective cohort study using administrative health datasets from the Manitoba Population Research Data Repository in Canada. We constructed a longitudinal dataset to track individuals enrolled in the Manitoba Health Insurance Registry between April 1, 1997 and March 31, 2015. The study population consisted of 496,192 individuals 30 years of age or older who were not diagnosed with CVD or dementia prior to April 1, 1997. Diagnoses of CVD and dementia were based on diagnosis codes from medical claims and hospitalizations and the use of prescription medications. Hazard ratios were then computed using adjusted Cox-proportional hazards analyses. Results Among the CVD subgroups considered, atrial fibrillation, ischemic heart disease, and stroke increased the risk of developing dementia, with stroke doubling one’s risk of being diagnosed with the disease (hazard ratio: 1.95; 95% confidence interval: 1.9, 2.01). Age, lower socioeconomic status, and worsening comorbidities also increased the risk of being diagnosed with dementia. Conclusion A diagnosis of CVD is associated with an increased risk of a future diagnosis of dementia. Promoting good cardiovascular health may serve as an effective measure for preventing dementia. PubDate: 2022-01-13
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives This study investigates measles, mumps, and rubella (MMR) immunization rates during the measles outbreak in Calgary and Edmonton of 2014 stratified by four area-level socio-demographic indicators. This study also leverages this epidemiological data to assess the equity aspect of emergency measures instituted regarding immunization in those two cities. Methods A mixed-methods comparative case study analysis methodology was employed to assess the neighbourhood-level immunization statuses before (2013), during (2014), and after (2015) an active measles outbreak in Calgary and Edmonton, Alberta, Canada. The epidemiological one-dose by age-2 MMR coverage data were stratified using four socio-demographic indicators: median household income, %-homeownership, %-Aboriginal population, and %-immigrant population. Document and content analysis was utilized to investigate the outbreak mitigation strategies deployed in each city. Results The measles outbreak of 2013/2014 involved the entirety of Alberta and led to both provincial and city-specific interventions in which Calgary deployed three mass immunization clinics in 2014, where Edmonton did not. The Calgary coverage data showed an increase in coverage inequalities across all indicators and the Edmonton data showed mixed results in terms of equity gains/losses. Calgary’s additive intervention of three mass immunization clinics in 2014 appears to have contributed to both the higher gross immunization rates in Calgary (90.77%) and an inequitable increase in coverage rates as compared with Edmonton (88.96%), in most cases. Conclusion Public health policy-makers must be cognizant that large-scale public health efforts must be optimized for accessibility across all socio-economic levels to ensure public and population health gains are realized equitably. PubDate: 2022-01-13
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objective Adults in food-insecure households will often sacrifice their own nutritional needs so that children are fed first. This shielding may protect children from malnutrition, but its links to mental health and well-being have not been closely examined. The aim of this study is to explore these links. Methods We used data from three cycles of the Canadian Community Health Survey (n = 28,871 youth, 74,416 adults) to identify shielded children (those who reported not being food insecure but lived in food-insecure households). Using Poisson regression, we examined youth and adult mental health and well-being (mood disorder, anxiety disorder, fair/poor mental health, fair/poor health, and low life satisfaction) in shielding households compared to food-secure households and food-insecure households where children were not shielded. Results About one in six (15.3%) households with children was food insecure. One third of these (6.3%) included children who were shielded from experiencing food insecurity. Shielded youth did not differ significantly from food-secure youth in three of the five outcomes examined. However, unshielded youth, compared to food-secure youth, showed increased risks of every health outcome we investigated. Adults in food-insecure households also reported worse mental health than food-secure adults but better mental health if children were shielded. Conclusion Shielding is associated with reduced risk of common psychiatric outcomes and poor mental health in youth and adults, possibly because it is associated with milder forms of food insecurity. The inability to protect children from having inadequate access to food may compound the psychological strain of food insecurity on mental health and well-being among adults. PubDate: 2022-01-13
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives To examine the impact of COVID-19 pandemic on health-related quality of life (HRQL) of adults visiting emergency departments (ED) and primary care (PC) settings in Alberta, Canada, and explore whether this impact varies across demographic subgroups. Methods Data from two repeated cross-sectional surveys that measured HRQL using EQ-5D-5L were used; “pre-COVID” Sept 2019–Feb 2020 (ED, N=5927; PC, N=317), “Wave-1” Mar 2020–Aug 2020 (ED, N=4781; PC, N=375), and “Wave-2” Sept 2020–Jan 2021 (ED, N=4443; PC, N=327). Results In the ED sample, there were decrements in mild–extreme problems of 3.7% in mobility and 4.1% in usual activities from pre-COVID to wave 2. There were very minor changes in mild–extreme problems in self-care (decrement=1.3%), pain/discomfort (decrement=2.6%), and anxiety/depression (decrement=0.9%). In the PC sample, there were increases of 4.8% in mild–extreme pain/discomfort and 10.7% in anxiety/depression from pre-COVID to wave 2. Despite these changes, HRQL of both samples pre-COVID and during waves 1 and 2 was worse than that of the general Alberta population. There were no significant variations in the impact of COVID-19 pandemic on HRQL across age, sex, and income subgroups in the ED survey; however, such variations were observed in the PC survey whereby younger adults, females, and those with high income had the largest HRQL deteriorations. Conclusion The impact of COVID-19 pandemic on HRQL was minimal in adults seeking ED care, but more pronounced in those seen in PC, especially in terms of mental health. Policies around COVID-19 should take into account the needs of certain groups of the population, especially women and young people. PubDate: 2022-01-11
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives The Truth and Reconciliation Commission includes a call to action to close gaps in health outcomes, including type 2 diabetes, of which diet quality must be considered an important mediator. The objectives of this study were to compare diet quality between off-reserve Indigenous and non-Indigenous adults in 2004 and 2015, and examine food security as a predictor of diet quality. Methods We employed a repeated cross-sectional design using the 2004 and 2015 Canadian Community Health Surveys-Nutrition. Both surveys include a representative sample of the Canadian population in the 10 provinces, excluding the northern territories and people living on-reserve. Healthy Eating Index (HEI) values were estimated, using 24-hour dietary recalls, for the Indigenous and non-Indigenous population in each time period. After matching, a generalized linear model was applied to test for differences in HEI between groups across time period, adjusting for household food security. Results Overall, HEI scores were not significantly different for Indigenous men and women in 2015 as compared with 2004, but continued to be lower compared with those of the non-Indigenous population. Indigenous adults reported significantly lower diet quality independent of food security status and other factors. Scores pertaining to percent energy from ‘other’ foods improved in 2015 compared with 2004. Conclusion Dietary disparities persist between Indigenous and non-Indigenous populations. While addressing household food insecurity among Indigenous populations is necessary to improve diet quality, it is not sufficient. Results suggest that factors other than food insecurity and socio-economic status are impacting disparities in diet quality among Indigenous adults. PubDate: 2022-01-11
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives There are sex differences in distribution of fat and in the prevalence of overweight and obesity. We therefore sought to explore sex differences in the prevalence of adiposity-metabolic health phenotypes, in anthropometric and cardio-metabolic parameters, and in the relationship between body mass index (BMI) categories and metabolic health. Methods We conducted a cross-sectional study carried out between January 2018 and June 2019, of a nationally representative sample of the Maltese Caucasian population aged 41 ± 5 years. Metabolic health was defined as presence of ≤ 1 parameter of the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria. Results Males exhibited the unhealthy metabolic phenotype more frequently than women (41.3% vs 27.8%). In total, 10.3% of normal weight men and 6.3% of normal weight women were metabolically unhealthy. Males had a higher median BMI, but a lower proportion of males exhibited an abnormally high waist circumference as compared with females. A significant difference in sex distribution was noted for each body composition phenotype. Conclusion In a contemporary sample of middle-aged individuals, males were more metabolically unhealthy and more insulin resistant than their female counterparts in spite of exhibiting an abnormal waist circumference less frequently and having similar waist index. This suggests that the currently used cut-offs for normal waist circumference should be revised downwards in men. Since even normal weight men were more often metabolically unhealthy than normal weight women, BMI cut-offs may also need to be lowered in men. PubDate: 2022-01-10
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Setting In Alberta, a small team of specialized public health experts typically complete case investigation and contact tracing. High COVID-19 case counts and a shortage of trained public health professionals required a rapid and significant adaptation of staffing models to meet the population’s needs. Intervention A tiered, interdisciplinary staffing model, based on those in critical care, was developed, piloted, and implemented in the Alberta Health Services’ Communicable Disease Control department in late 2020 to complete case investigation and contact tracing. The final model included novice, non-regulated professionals divided into pods of four to six investigators, led by an experienced regulated investigator. Team leads oversaw five pods. Communicable disease nurses provided an additional tier of clinical expertise. During the model development, roles and responsibilities of team members were delineated, ratios for supervision were tested, and rapid training was provided. Outcomes The tiered staffing model began in November 2020 with staff members in two pods. At its peak in early May 2021, 72 pods of 502 non-regulated members, 134 regulated investigators, and 4 communicable disease nurses completed 780–973 case investigations daily, or 40–45% of all positive cases in Alberta. In comparison, the same number of regulated investigators working independently in the traditional staffing model without non-regulated pods completed, on average, 249 case investigations daily. Implications A tiered staffing model can be effective at maximizing the skills of the experienced members of the case investigation team to maintain case investigation and contact tracing activities during a pandemic. PubDate: 2022-01-10
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objective To identify the association between educational level and physical activity (PA) in specific domains according to sex, among residents of 26 Brazilian state capitals and the Federal District. Methods This is a cross-national survey, with data obtained from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL), in 2017, conducted with individuals ≥ 18 years old (n = 53,034). The education level (classified as ≤ 4 years, 5 to 8 years, 9 to 11 years, and ≥ 12 years of education) and PA of participants (meeting PA recommendations and performing this active behaviour) in the commuting, domestic, leisure, and work domains were self-reported. Binary logistic regression was used to analyze the data obtained from the survey. Results Males and females with higher education were less likely to meet PA recommendations (males: OR = 0.68 [95% CI 0.52–0.91]; females: OR = 0.41 [0.34–0.48]) and perform the active behaviour (males: OR = 0.73 [0.57–0.93]; females: OR = 0.27 [0.23–0.32]) in the domestic domain. In the work domain, the two outcomes were associated with education only for males, indicating that those with more years of education had less chance of meeting PA recommendations (OR9 to 11 years = 0.61 [0.46–0.83]; OR≥12 years = 0.21 [0.15–0.30]) and performing it (OR9 to 11 years = 0.64 [0.49–0.84]; OR≥12 years = 0.25 [0.18–0.34]). However, more years of education seemed to positively influence meeting PA recommendations (males: OR9-11 years = 2.26 [1.79–2.87]; OR≥12 years = 2.91 [2.28–3.72]; females: OR5-8 years = 1.26 [1.04–1.54]; OR9-11 years = 1.81 [1.52–2.16]; OR≥12 years = 2.69 [2.25–3.22]) and practicing this behaviour (males: OR5-8 years = 1.29 [1.01–1.63]; OR9-11 years = 2.54 [2.04–3.17]; OR≥12 years = 3.31 [2.64–4.16]; females: OR5-8 years = 1.23 [1.03–1.46]; OR9-11 years = 1.75 [1.51–2.01]; OR≥12 years = 2.94 [2.53–3.40]) in leisure time for both sexes. Conclusion Education level appears to be an important determinant in the relationship with PA in its different domains, especially in the leisure and domestic domains, for both sexes. PubDate: 2022-01-06
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Setting In January 2021, the COVID-19 vaccine became available to First Nations, Métis, and Inuit (FNMI) over the age of 65 living in First Nations communities or Métis settlements in Alberta. In March, vaccine eligibility in Alberta expanded to include FNMI peoples of younger ages and in urban settings. The Métis Nation of Alberta (MNA) and other Indigenous organizations recognized that FNMI populations might be better served by tailored vaccine programs. Intervention The MNA is the government for the Métis people in Alberta. During the COVID-19 pandemic, the MNA has supported its citizens, through financial and mental wellness support, access to personal protective equipment, and messaging regarding public health orders. When vaccines became available, culturally appropriate virtual vaccine information sessions were provided. In March 2021, the MNA delivered the first Métis-led COVID-19 vaccination clinic. Unique to the clinic’s success was the location, online booking process, and community presence. The clinic focused on cultural safety, including the availability of Indigenous health professionals to community members, and cultural reference points throughout the clinic. Outcomes In the first MNA clinic, over 1300 people were vaccinated. Visitors shared appreciation for the culturally specific aspects of the clinic, which contributed to increased safety and comfort. Implications Based on the success of the first Métis-led vaccination clinic, similar services in communities with high numbers of Métis people have been approved. This innovative practice initiative could provide a model of COVID-19 vaccine service delivery that could be used to meet the needs of Métis citizens in other jurisdictions in Canada. PubDate: 2022-01-05
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives The First Nations people experience significant challenges that may influence the ability to follow COVID-19 public health directives on-reserve. This study aimed to describe experiences, perceptions and circumstances of an Alberta First Nations community, related to COVID-19 public health advice. We hypothesized that many challenges ensued when following and implementing advice from public health experts. Methods With First Nations leadership and staff, an online cross-sectional survey was deployed between April 24 and June 25, 2020. It assessed the appropriateness of public health advice to curb COVID-19 within this large First Nations community. Both quantitative and qualitative data were captured and described. Results A total of 106 adults living on-reserve responded; over 80% were female. Difficulty accessing food was significant by employment status (p = 0.0004). Those people with lower income found accessing food (p = 0.0190) and getting essential medical care (p = 0.0060), clothing (p = 0.0280) and transportation (p = 0.0027) more difficult. Some respondents described lost income associated with COVID-19 experiences, as well as difficulties accessing essential supplies. Respondents found “proper handwashing” most easy (98%) and “keeping a distance of 2 m from others” most difficult (23%). Many respondents found following public health advice within their personal domain easy and put “family safety” first but experienced some difficulties when navigating social aspects and obligations, particularly when unable to control the actions of others. People stated wanting clear information, but were sometimes critical of the COVID-19 response. Conclusion First Nations people face many additional challenges within the COVID-19 response, driven in part by ongoing issues related to significant societal, economic, and systemic factors. PubDate: 2022-01-03
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives To test the efficacy of calorie labelling for alcoholic and non-alcoholic beverages on restaurant menus on noticing calorie information, calorie knowledge, and perceived and actual influence on hypothetical beverage orders. Methods Participants included upper-level university students of legal drinking age residing in Ontario, Canada (n = 283). Using a between-groups experiment, participants were randomized to view one of two menus: (1) No Calorie Information (control), and (2) Calorie Information adjacent to each beverage. Participants completed a hypothetical ordering task, and measures related to noticing calorie information, calorie knowledge, and actual and perceived influence of calorie information on beverages ordered were assessed. Linear, logistic, and multinomial logistic regression models were used to examine the four outcomes. Results The odds of noticing calorie information were significantly higher in the Calorie Information (72.6%) versus No Calorie Information condition (8.0%) (OR = 43.7, 95% CI: 16.8, 113.8). Compared to those in the No Calorie Information condition, participants in the Calorie Information condition had significantly lower odds of responding ‘Don’t know’ (OR = 0.04, 95% CI: 0.02, 0.09), underestimating (OR = 0.06, 95% CI: 0.02, 0.2), and overestimating (OR = 0.05, 95% CI: 0.02, 0.2) versus accurately estimating calories in beverages ordered. No significant differences were observed between menu labelling conditions in the calories in beverages ordered or the perceived influence of calorie information on the number of beverages ordered. Conclusion Exposure to menus with calorie information increased consumers noticing the calorie information, and accurately estimating calories in alcoholic and non-alcoholic beverages ordered. These results have implications for policy-makers considering mandatory menu labelling policy inclusive of alcoholic beverages. PubDate: 2022-01-03
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Résumé Il ne fait désormais aucun doute que l’exposition au raz-de-marée d’informations en santé tantôt fondées sur les données probantes, tantôt sans fondement et même fallacieuses est un enjeu de santé publique. Le vocable infodémie est utilisé pour désigner ces phénomènes. Les études menées depuis deux décennies ont permis de mesurer l’ampleur de la surcharge d’informations et la qualité des informations auxquelles sont exposées les populations. Certains effets néfastes ont aussi été documentés. Il apparaît urgent de mobiliser et structurer les systèmes de santé publique en mobilisant toutes les expertises nécessaires à la lutte contre la désinformation en santé et la gestion de l’infodémie. Pour cela, nous lançons un appel à la réflexion autour de trois axes soit, l’infosphère comme un déterminant social de la santé, le développement de compétences en infodémiologie et finalement, le développement, la cocréation et l’évaluation d’interventions conséquentes pour mieux gérer l’infodémie et lutter contre la désinformation. Nous pensons que les leçons tirées collectivement d’une intégration réussie de l’infosurveillance, de l’infodémiologie et d’une recherche interventionnelle conséquente dans nos systèmes de santé publique serviront à mieux aborder les enjeux associés à l’infodémie. PubDate: 2022-01-03
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives People experiencing homelessness are at increased risk of SARS-CoV-2 infection. This study reports the point prevalence of SARS-CoV-2 infection during testing conducted at sites serving people experiencing homelessness in Toronto during the first wave of the COVID-19 pandemic. We also explored the association between site characteristics and prevalence rates. Methods The study included individuals who were staying at shelters, encampments, COVID-19 physical distancing sites, and drop-in and respite sites and completed outreach-based testing for SARS-CoV-2 during the period April 17 to July 31, 2020. We examined test positivity rates over time and compared them to rates in the general population of Toronto. Negative binomial regression was used to examine the relationship between each shelter-level characteristic and SARS-CoV-2 positivity rates. We also compared the rates across 3 time periods (T1: April 17–April 25; T2: April 26–May 23; T3: May 24–June 25). Results The overall prevalence of SARS-CoV-2 infection was 8.5% (394/4657). Site-specific rates showed great heterogeneity with infection rates ranging from 0% to 70.6%. Compared to T1, positivity rates were 0.21 times lower (95% CI: 0.06–0.75) during T2 and 0.14 times lower (95% CI: 0.04–0.44) during T3. Most cases were detected during outbreak testing (384/394 [97.5%]) rather than active case finding. Conclusion During the first wave of the pandemic, rates of SARS-CoV-2 infection at sites for people experiencing homelessness in Toronto varied significantly over time. The observation of lower rates at certain sites may be attributable to overall time trends, expansion of outreach-based testing to include sites without known outbreaks, and/or individual site characteristics. PubDate: 2021-12-17
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives This paper analyzes results from focus groups held with women physicians in British Columbia which explored questions around how gender norms and roles influenced their experiences during COVID-19. Methods Four virtual focus groups were organized between July and September 2020. Participants (n = 27) were voluntarily recruited. Data were analyzed using applied thematic analysis. Results In addition to the COVID-19-related changes experienced across the profession, women physicians faced distinct challenges related to an increase in unpaid care responsibilities, and often felt excluded from, and occasionally dismissed by, leadership. Women leaders often felt their contributions were unrecognized and undervalued. Participants drew strength from other women leaders, peer networks, and professional support, but these strategies were limited by unpaid care and emotional labour demands, which were identified as increasing risk of burnout. Discussion Even though women physicians hold a degree of relative privilege, unpaid care work and gender norms contribute to distinct secondary effects of COVID-19. Women physicians link these to pre-pandemic assumptions (within families and communities) that women would absorb care deficits at their own cost. Health system leadership continues to reflect a masculine normative experience wherein the personal and professional are separated, and which devalues the emotional labour often associated with feminine leadership. The strategies participants employed to address negative impacts, while demonstrating resourcefulness and peer support, reflect individualistic responses to social-structural challenges. There is a need for greater recognition of women’s contributions at home and work, increased representation in decision-making, and practical supports such as childcare and counselling. PubDate: 2021-12-17
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objectives The Canadian workforce has experienced significant employment losses during the COVID-19 pandemic, in part as a result of non-pharmaceutical interventions to slow COVID-19 transmission. Health consequences are likely to result from these job losses, but without historical precedent for the current economic shutdown they are challenging to plan for. Our study aimed to use population risk models to quantify potential downstream health impacts of the COVID-19 pandemic and inform public health planning to minimize future health burden. Methods The impact of COVID-19 job losses on future premature mortality and high-resource health care utilization (HRU) was estimated using an economic model of Canadian COVID-19 lockdowns and validated population risk models. Five-year excess premature mortality and HRU were estimated by age and sex to describe employment-related health consequences of COVID-19 lockdowns in the Canadian population. Results With federal income supplementation like the Canadian Emergency Response Benefit, we estimate that each month of economic lockdown will result in 5.6 new high-resource health care system users (HRUs), and 4.1 excess premature deaths, per 100,000, over the next 5 years. These effects were concentrated in ages 45–64, and among males 18–34. Without income supplementation, the health consequences were approximately twice as great in terms of both HRUs and premature deaths. Conclusion Employment losses associated with COVID-19 countermeasures may have downstream implications for health. Public health responses should consider financially vulnerable populations at high risk of downstream health outcomes. PubDate: 2021-12-07
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: A Correction to this paper has been published: https://doi.org/10.17269/s41997-021-00555-y PubDate: 2021-12-01
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Hybrid journal (It can contain Open Access articles)
[2469 journals]
