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Accessing health care utilization databases for health research: a Canadian longitudinal study on aging feasibility study.

https://arctichealth.org/en/permalink/ahliterature147705
Source
Can J Aging. 2009 Sep;28(3):287-94
Publication Type
Article
Date
Sep-2009
Author
Parminder S Raina
Susan A Kirkland
Christina Wolfson
Karen Szala-Meneok
Lauren E Griffith
Homa Keshavarz
Jennifer Uniat
Linda Furlini
Camille L Angus
Geoff Strople
Amélie Pelletier
Author Affiliation
McMaster Evidence-based Practice Center, McMaster University, Canada. praina@mcmaster.ca
Source
Can J Aging. 2009 Sep;28(3):287-94
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Aging
Canada
Databases, Factual
Epidemiologic Research Design
Feasibility Studies
Health Services - utilization
Humans
Longitudinal Studies
Medical Record Linkage
National Health Programs - statistics & numerical data
Abstract
ABSTRACTOne of the keys to the success of the Canadian Longitudinal Study on Aging (CLSA) will be the leveraging of secondary data sources, particularly health care utilization (HCU) data. To examine the practical, methodological, and ethical aspects of accessing HCU data, one-on-one qualitative interviews were conducted with 53 data stewards and privacy commissioners/ombudsmen from across Canada. Study participants indicated that obtaining permission to access HCU data is generally possible; however, they noted that this will be a complex and lengthy process requiring considerable and meticulous preparatory work to ensure proper documentation and compliance with jurisdictional variations along legislative and policy lines.
PubMed ID
19860983 View in PubMed
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Applicability of a toolkit for geriatric rehabilitation outcomes.

https://arctichealth.org/en/permalink/ahliterature164623
Source
Disabil Rehabil. 2007 Jan 30;29(2):97-109
Publication Type
Article
Date
Jan-30-2007
Author
Claudine Auger
Louise Demers
Johanne Desrosiers
Francine Giroux
Bernadette Ska
Christina Wolfson
Author Affiliation
Research Centre, Montréal Geriatric University Institute, Canada. claudine.auger@umontreal.ca
Source
Disabil Rehabil. 2007 Jan 30;29(2):97-109
Date
Jan-30-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Caregivers
Female
Geriatric Assessment
Health Services for the Aged - organization & administration
Health status
Humans
Leisure Activities
Male
Mental Status Schedule
Outcome Assessment (Health Care) - methods
Patient satisfaction
Quebec
Questionnaires
Recovery of Function
Rehabilitation - organization & administration
Social Support
Abstract
To field test the applicability of a multidimensional toolkit for geriatric rehabilitation outcomes which includes nine standardized tools. Applicability is defined as context- and population-specific pragmatic qualities of an assessment tool such as respondent and examiner burden, score distribution and format compatibility.
A sample of 48 older adults representing four diagnostic groups, as well as 26 caregivers, were assessed at home in the first month after discharge from intensive rehabilitation (T1) and 2 months later (T2). Pre-determined qualitative and quantitative applicability criteria were coded and compared at T1 and T2, as well as responsiveness.
A higher respondent burden was found for three self-report tools, as well as a ceiling effect on social functioning tools. Respondent burden, examiner burden and score distribution remained stable or diminished at T2. Format compatibility deteriorated only for the mobility test due to a higher proportion of non ambulatory participants (17%). Low to moderate associations between the tools corroborated that they were not redundant (rPearson
PubMed ID
17364761 View in PubMed
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Ascertainment of chronic diseases in the Canadian longitudinal study on aging (CLSA), systematic review.

https://arctichealth.org/en/permalink/ahliterature147706
Source
Can J Aging. 2009 Sep;28(3):275-85
Publication Type
Article
Date
Sep-2009
Author
Parminder S Raina
Christina Wolfson
Susan A Kirkland
Homa Keshavarz
Lauren E Griffith
Christopher Patterson
Jennifer Uniat
Geoff Strople
Amélie Pelletier
Camille L Angus
Author Affiliation
McMaster Evidence-based Practice Center, McMaster University, Canada.
Source
Can J Aging. 2009 Sep;28(3):275-85
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Aging
Algorithms
Canada
Chronic Disease - epidemiology
Humans
Longitudinal Studies
Mass Screening
Pilot Projects
Abstract
ABSTRACTStandard clinical diagnostic procedures are often inappropriate and frequently not feasible to apply in population-based studies, yet ascertaining accurate disease status is essential. We conducted a systematic review to identify algorithms, criteria, and tools used to ascertain 17 chronic diseases, and assessed the feasibility of developing algorithms for the CLSA. Of the 29,616 citations screened, 668 papers met all inclusion criteria. We determined that the information included in a disease algorithm will differ by condition type. The diagnosis of some symptomatic conditions, such as osteoarthritis and arthritis, will require substantiation by clinical criteria (e.g., x-rays, bone density measurement) while other conditions, such as depression, will rely solely on self-report. Asymptomatic conditions, such as hypertension, are more difficult to ascertain by self-report and will require additional physiologic measures (e.g., blood pressure) as well as laboratory measures (e.g., glucose). This pilot study identified the tools necessary to develop disease ascertainment algorithms.
PubMed ID
19860982 View in PubMed
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Assembling a toolkit to measure geriatric rehabilitation outcomes.

https://arctichealth.org/en/permalink/ahliterature174726
Source
Am J Phys Med Rehabil. 2005 Jun;84(6):460-72
Publication Type
Article
Date
Jun-2005
Author
Louise Demers
Johanne Desrosiers
Bernadette Ska
Christina Wolfson
Rossitza Nikolova
Isabelle Pervieux
Claudine Auger
Author Affiliation
Research Centre, Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada.
Source
Am J Phys Med Rehabil. 2005 Jun;84(6):460-72
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Health Services for the Aged - organization & administration
Health status
Humans
Leisure Activities
Male
Mental health
Middle Aged
Outcome Assessment (Health Care) - methods
Pain Measurement
Patient satisfaction
Pilot Projects
Quebec
Recovery of Function
Rehabilitation - organization & administration
Abstract
To gather and assemble relevant patient-based outcome measures with emphasis placed on the older adults' level of functioning and activity performance.
The study was conducted in two phases. First, a set of relevant measurement instruments was identified, and their was value analyzed according to general characteristics and metrologic criteria. Second, this "toolkit" was pretested on 22 older adults with respect to the burden of assessment and the quality of the data.
The toolkit includes eight measurement instruments related to mobility, basic activities of daily living, independent living, leisure, physical functioning, psychologic functioning, social functioning, and caregiver status. Participants' acceptance of the toolkit was high, with all subjects completing the toolkit in two sessions (30-90 mins each). The leisure participation and satisfaction measure was the most difficult to complete. Distributional properties were adequate to ascertain variability between subjects, except for a ceiling effect found for the social functioning measure.
Measurement tools that are used in combination are needed to optimize the applicability and utility of outcome results. The toolkit has the potential to become a valuable method for researchers and clinicians reporting geriatric rehabilitation outcomes.
PubMed ID
15905661 View in PubMed
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Body size and the risk of multiple sclerosis in Norway and Italy: the EnvIMS study.

https://arctichealth.org/en/permalink/ahliterature268967
Source
Mult Scler. 2015 Apr;21(4):388-95
Publication Type
Article
Date
Apr-2015
Author
Kristin Wesnes
Trond Riise
Ilaria Casetta
Jelena Drulovic
Enrico Granieri
Trygve Holmøy
Margitta T Kampman
Anne-Marie Landtblom
Klaus Lauer
Andreas Lossius
Sandra Magalhaes
Tatjana Pekmezovic
Kjetil Bjørnevik
Christina Wolfson
Maura Pugliatti
Kjell-Morten Myhr
Source
Mult Scler. 2015 Apr;21(4):388-95
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Body mass index
Body Size
Case-Control Studies
Child
Female
Humans
Italy - epidemiology
Male
Multiple Sclerosis - epidemiology
Norway - epidemiology
Obesity - epidemiology
Odds Ratio
Risk factors
Young Adult
Abstract
Obesity may be a risk factor for developing multiple sclerosis (MS).
We examined if body size influences the risk of MS in a population-based, case control study.
A total of 953 cases and 1717 controls from Norway and 707 cases and 1333 controls from Italy reported their body size by choosing a silhouette 1 to 9 (largest) every fifth year from age 5 to 30 and at time of study. The body size-related MS risk was defined by odds ratios (ORs) in logistic regression analyses adjusting for age, smoking and outdoor activity.
In Norway a large body size (silhouettes 6-9) compared to silhouette 3 increased the risk of MS, especially at age 25 (OR 2.21; 95% CI 1.09-4.46 for men and OR 1.43; 95% CI 0.90-2.27 for women). When comparing silhouette 9 to 1, we found a significant dose-response from age 10 until age 30 peaking at age 25 (sex-adjusted OR 2.83; 95% CI 1.68-4.78). The association was present for at least 15 years prior to disease onset. No significant associations were found in Italy.
Obesity from childhood until young adulthood is a likely risk factor for MS with a seemingly stronger effect in Norway than in Italy.
PubMed ID
25182290 View in PubMed
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The Canadian community health survey as a potential recruitment vehicle for the Canadian longitudinal study on aging.

https://arctichealth.org/en/permalink/ahliterature147709
Source
Can J Aging. 2009 Sep;28(3):243-9
Publication Type
Article
Date
Sep-2009
Author
Christina Wolfson
Parminder S Raina
Susan A Kirkland
Amélie Pelletier
Jennifer Uniat
Linda Furlini
Camille L Angus
Geoff Strople
Homa Keshavarz
Karen Szala-Meneok
Author Affiliation
Division of Clinical Epidemiology, McGill University Health Centre, Allan Memorial Institute, Canada. christina.wolfson@mcgill.ca
Source
Can J Aging. 2009 Sep;28(3):243-9
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Canada
Cooperative Behavior
Feasibility Studies
Feedback
Female
Health Surveys
Humans
Informed consent
Interviews as Topic
Longitudinal Studies
Male
Middle Aged
Patient Selection
Pilot Projects
Abstract
ABSTRACTThe goal of the Canadian Longitudinal Study on Aging (CLSA) is to recruit 50,000 participants aged 45 to 85 years of age and follow them for at least 20 years. The sampling and recruitment processes for a study of this scope and magnitude present important challenges. Statistics Canada was approached to collaborate with the CLSA with the goal of determining whether the Canadian Community Health Survey (CCHS) could be used as a recruitment vehicle for the CLSA. In this pilot study conducted in 2004, it was determined that 63.8 per cent and 75.8 per cent of the respondents agreed to share their contact information and their survey responses with the CLSA, respectively. The most commonly reported concerns were confidentiality/privacy issues, lack of interest, and commitment issues. This pilot study identified some challenges to the use of the CCHS as a recruitment vehicle for the CLSA.
PubMed ID
19860979 View in PubMed
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The Canadian longitudinal study on aging (CLSA).

https://arctichealth.org/en/permalink/ahliterature147711
Source
Can J Aging. 2009 Sep;28(3):221-9
Publication Type
Article
Date
Sep-2009
Author
Parminder S Raina
Christina Wolfson
Susan A Kirkland
Lauren E Griffith
Mark Oremus
Christopher Patterson
Holly Tuokko
Margaret Penning
Cynthia M Balion
David Hogan
Andrew Wister
Hélène Payette
Harry Shannon
Kevin Brazil
Author Affiliation
McMaster Evidence-based Practice Center, McMaster University, Canada.
Source
Can J Aging. 2009 Sep;28(3):221-9
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Biological Markers
Canada
Epidemiologic Research Design
Female
Health Behavior
Health Services - utilization
Humans
Life Style
Longitudinal Studies
Male
Mental health
Middle Aged
Neuropsychological Tests
Physical Examination
Research Support as Topic
Social Support
Abstract
ABSTRACTCanadians are living longer, and older persons are making up a larger share of the population (14% in 2006, projected to rise to 20% by 2021). The Canadian Longitudinal Study on Aging (CLSA) is a national longitudinal study of adult development and aging that will recruit 50,000 Canadians aged 45 to 85 years of age and follow them for at least 20 years. All participants will provide a common set of information concerning many aspects of health and aging, and 30,000 will undergo an additional in-depth examination coupled with the donation of biological specimens (blood and urine). The CLSA will become a rich data source for the study of the complex interrelationship among the biological, physical, psychosocial, and societal factors that affect healthy aging.
PubMed ID
19860977 View in PubMed
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Caregiver acceptance of adverse effects and use of cholinesterase inhibitors in Alzheimer's disease.

https://arctichealth.org/en/permalink/ahliterature159050
Source
Can J Aging. 2007;26(3):205-12
Publication Type
Article
Date
2007
Author
Mark Oremus
Christina Wolfson
Alain C Vandal
Howard Bergman
Qihao Xie
Author Affiliation
Centre for Clinical Epidemiology and Community Studies, S.M.B.D. Jewish General Hospital, Montreal. oremusm@mcmaster.ca
Source
Can J Aging. 2007;26(3):205-12
Date
2007
Language
English
Publication Type
Article
Keywords
Aging
Alzheimer Disease - drug therapy
Appetite
Caregivers - psychology
Cholinesterase Inhibitors - administration & dosage - adverse effects
Decision Making
Female
Humans
Male
Middle Aged
Quebec
Questionnaires
Risk assessment
Weight Loss
Abstract
Caregivers play a determining role in choosing treatments for persons with Alzheimer's disease. The objective of this study was to examine caregivers' willingness to have persons with Alzheimer's disease continue taking cholinesterase inhibitors in the event that any 1 of 11 adverse effects was to occur. Data were gathered via postal questionnaire from 375 caregivers in Montreal. Sixty-four per cent of caregivers responded ( n = 201), and most (> or =59%) were willing to continue treatment if persons with Alzheimer's disease suffered from weight loss or loss of appetite. However, most (> or =53%) were not willing to continue treatment in the event of headache, dizziness, nausea, diarrhea, vomiting, drop in blood pressure, insomnia, muscle cramps, or stomach bleeding. The use of cholinesterase inhibitors by persons with Alzheimer's disease was positively associated with caregivers' willingness to accept greater numbers of adverse effects (adjusted relative risk = 1.97; 95% CI = 1.11 to 3.61). Caregivers appear to make a risk-benefit assessment when they decide whether or not care-recipients should continue pharmacotherapy in the event of adverse effects.
PubMed ID
18238727 View in PubMed
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Delirium in older emergency department patients discharged home: effect on survival.

https://arctichealth.org/en/permalink/ahliterature186138
Source
J Am Geriatr Soc. 2003 Apr;51(4):443-50
Publication Type
Article
Date
Apr-2003
Author
Ritsuko Kakuma
Guillaume Galbaud du Fort
Louise Arsenault
Anne Perrault
Robert W Platt
Johanne Monette
Yola Moride
Christina Wolfson
Author Affiliation
Department of Epidemiology and Biostatistics, McGill University, Montreal, Qc, Canada. ritsuko.kakuma@mail.mcgill.ca
Source
J Am Geriatr Soc. 2003 Apr;51(4):443-50
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Comorbidity
Delirium - complications - diagnosis
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Male
Mortality
Patient Discharge
Prognosis
Prospective Studies
Quebec
Abstract
To determine whether prevalent delirium is an independent predictor of mortality in older patients seen in emergency departments (EDs) and discharged home without admission.
Prospective study with 18 months of follow-up.
EDs in two Montreal hospitals.
From a cohort study of prognosis for delirium (107 delirious and 161 nondelirious subjects), 30 delirious and 77 nondelirious subjects aged 66 and older who were discharged home without admission were identified.
Detailed interviews with patients and their proxies and review of medical charts were performed at enrollment. Trained lay interviewers determined delirium status using the Confusion Assessment Method. Subjects were followed up at 6-month intervals for a total of 18 months. Dates of death were obtained from the Ministère de la Santé et des Service Sociaux (Ministry of Health and Social Services). Survival analysis was performed using the Cox proportional hazards modeling adjusting for potential confounding variables.
The analysis revealed a statistically significant association between delirium and mortality after adjustments for age, sex, functional level, cognitive status, comorbidity, and number of medications for the first 6 months of follow-up (hazard ratio = 7.24; 95% confidence interval = 1.62-32.35). The subjects whose delirium was not detected by the ED physician or nurse had the highest mortality over 6 months (30.8%). The mortality of delirious subjects detected in the ED was similar to that of the nondelirious subjects (11.8 vs 14.3%).
The results of this study suggests that nondetection of delirium in the ED may be associated with increased mortality within 6 months after discharge. Further research is necessary to examine the effectiveness of improving detection on subsequent prognosis of older patients with delirium.
PubMed ID
12657062 View in PubMed
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Detection and prevalence of abuse of older males: perspectives from family practice.

https://arctichealth.org/en/permalink/ahliterature159833
Source
J Elder Abuse Negl. 2007;19(1-2):47-60, table of contents
Publication Type
Article
Date
2007
Author
Mark J Yaffe
Deborah Weiss
Christina Wolfson
Maxine Lithwick
Author Affiliation
McGill University, Department of Family Medicine and St. Mary's Hospital, 3830 Lacombe Ave, Montreal, QC, Canada H3T 1M5. mark.yaffe@mcgill.ca
Source
J Elder Abuse Negl. 2007;19(1-2):47-60, table of contents
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude of Health Personnel
Canada - epidemiology
Diagnosis, Differential
Elder Abuse - diagnosis - statistics & numerical data
Family Practice - statistics & numerical data
Female
Geriatric Assessment - statistics & numerical data
Health Care Surveys
Humans
Male
Medical History Taking - statistics & numerical data
Middle Aged
Physician-Patient Relations
Prevalence
Primary Health Care - statistics & numerical data
Sex Factors
Abstract
Family doctors' frequent contact with seniors put them in reasonable positions to detect elder abuse and initiate referral to adult protective services. Since doctor reporting is low, however, this paper explores whether the gender of patient and/or doctor impacts on identification of elder mistreatment, or creates differential detection of one gender over the other. Use of the validated Elder Abuse Suspicion Index (EASI), and a structured social work evaluation, is described to provide some gender-based data from Canadian family practice. Specifically, while the prevalence of elder abuse is estimated to range from 12.0% to 13.3%, the specific prevalence was found for females to be 13.6% to 15.2% and for males 9.1% to 9.7%.
PubMed ID
18077269 View in PubMed
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47 records – page 1 of 5.