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[Access to the early diagnosis of dementia in New Brunswick: perceptions of potential users of services depending on the language and the middle of life].

https://arctichealth.org/en/permalink/ahliterature105864
Source
Can J Public Health. 2013;104(6 Suppl 1):S16-20
Publication Type
Article
Date
2013
Author
Sarah Pakzad
Jalila Jbilou
Marie-Claire Paulin
Véronique Fontaine
Denise Donovan
Mathieu Bélanger
Paul-Émile Bourque
Author Affiliation
Université de Moncton. sarah.pakzad@umoncton.ca.
Source
Can J Public Health. 2013;104(6 Suppl 1):S16-20
Date
2013
Language
French
Publication Type
Article
Keywords
Aged
Attitude to Health
Dementia - diagnosis
Early Diagnosis
Female
Health Care Surveys
Health Services Accessibility
Humans
Language
Male
Minority Groups - psychology - statistics & numerical data
New Brunswick
Patient satisfaction
Residence Characteristics - statistics & numerical data
Rural Population
Urban Population
Abstract
The early diagnosis of dementia (EDD) enables the identification of reversible causes of dementia and allows the timely implementation of secondary preventive and therapeutic interventions. This study explores New Brunswick seniors' perceptions of the accessibility and availability of EDD services as well as their satisfaction with them while taking into account their language of use and place of residence (urban or rural).
Self-administered survey exploring perceptions of EDD services in Francophone and Anglophone seniors from rural and urban areas of New Brunswick. Univariate and bivariate analyses were carried out.
Of the 157 participants aged 65 years and over who filled out the survey and whose data were analyzed, 84 identified as Francophone, 72 of whom lived in rural areas. Bivariate analyses showed that linguistic groups were comparable with regard to their perceptions of the availability, access to, and satisfaction with EDD services. However, when taking the geographic dimension into account, linguistic intergroup and intragroup disparities were observed, notably in the areas pertaining to the type of services available in the area.
These results suggest that seniors who live in rural areas of New Brunswick are a particularly vulnerable group with perceived limited access to EDD services in their area.
PubMed ID
24300314 View in PubMed
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Active transportation environments surrounding Canadian schools.

https://arctichealth.org/en/permalink/ahliterature130132
Source
Can J Public Health. 2011 Sep-Oct;102(5):364-8
Publication Type
Article
Author
Sean O'Loghlen
J William Pickett
Ian Janssen
Author Affiliation
School of Medicine, Queen's University, Kingston, ON.
Source
Can J Public Health. 2011 Sep-Oct;102(5):364-8
Language
English
Publication Type
Article
Keywords
Bicycling - statistics & numerical data
Canada
Humans
Motor Activity
Residence Characteristics - statistics & numerical data
Rural Population - statistics & numerical data
Schools - statistics & numerical data
Transportation - legislation & jurisprudence - methods - statistics & numerical data
Urban Population - statistics & numerical data
Walking - statistics & numerical data
Abstract
Walking or cycling to school represents an opportunity for children to engage in physical activity. The study objectives were to: 1) describe active transportation policies, programs, and built environments of Canadian schools and their surrounding neighbourhoods, and 2) document variations based on urban-rural location and school type (primary vs. secondary vs. mixed primary/secondary schools).
397 schools from across Canada were studied. A school administrator completed a questionnaire and responses were used to assess schools' policies and programs related to active transportation and the safety and aesthetics of their respective neighbourhoods. Built environment features in a 1 km-radius circular buffer around each school were measured using geographic information systems.
Greater than 70% of schools had passive policies (e.g., skateboards permitted on school grounds) and facilities (e.g., bicycle racks in secure area to avoid theft) to encourage bicycle and small-wheeled vehicle use. Less than 40% of schools had active programs designed to encourage active transportation, such as organized 'walk to school' days. Garbage in the streets, crime and substance abuse were barriers in most school neighbourhoods. Approximately 42% of schools were located on high-speed roads not amenable to active transportation and 14% did not have a sidewalk leading to the school. Secondary schools had less favourable active transportation policies/programs and neighbourhood safety/aesthetics compared to primary schools. Rural schools had less favourable built environments than urban schools.
Canadian children, particularly those from rural areas, face a number of impediments to active transportation as a method of travelling to school.
PubMed ID
22032103 View in PubMed
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Acute hospital admissions among nursing home residents: a population-based observational study.

https://arctichealth.org/en/permalink/ahliterature134159
Source
BMC Health Serv Res. 2011;11:126
Publication Type
Article
Date
2011
Author
Birgitte Graverholt
Trond Riise
Gro Jamtvedt
Anette H Ranhoff
Kjell Krüger
Monica W Nortvedt
Author Affiliation
Centre for Evidence-Based Practice, Bergen University College, N-5020 Bergen, Norway. bgra@hib.no
Source
BMC Health Serv Res. 2011;11:126
Date
2011
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Confidence Intervals
Female
Hospital Information Systems - statistics & numerical data
Hospital Mortality
Hospitalization - statistics & numerical data
Humans
Length of Stay - statistics & numerical data
Long-Term Care - statistics & numerical data
Male
Norway
Nursing Homes - statistics & numerical data
Poisson Distribution
Residence Characteristics - statistics & numerical data
Risk assessment
Abstract
Nursing home residents are prone to acute illness due to their high age, underlying illnesses and immobility. We examined the incidence of acute hospital admissions among nursing home residents versus the age-matched community dwelling population in a geographically defined area during a two years period. The hospital stays of the nursing home population are described according to diagnosis, length of stay and mortality. Similar studies have previously not been reported in Scandinavia.
The acute hospitalisations of the nursing home residents were identified through ambulance records. These were linked to hospital patient records for inclusion of demographics, diagnosis at discharge, length of stay and mortality. Incidence of hospitalisation was calculated based on patient-time at risk.
The annual hospital admission incidence was 0.62 admissions per person-year among the nursing home residents and 0.26 among the community dwellers. In the nursing home population we found that dominant diagnoses were respiratory diseases, falls-related and circulatory diseases, accounting for 55% of the cases. The median length of stay was 3 days (interquartile range = 4). The in-hospital mortality rate was 16% and 30 day mortality after discharge 30%.
Acute hospital admission rate among nursing home residents was high in this Scandinavian setting. The pattern of diagnoses causing the admissions appears to be consistent with previous research. The in-hospital and 30 day mortality rates are high.
Notes
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PubMed ID
21615911 View in PubMed
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Adding up provincial expenditures on health care for Manitobans: a POPULIS project. Population Health Information System.

https://arctichealth.org/en/permalink/ahliterature201448
Source
Med Care. 1999 Jun;37(6 Suppl):JS60-82
Publication Type
Article
Date
Jun-1999
Author
M. Shanahan
C. Steinbach
C. Burchill
D. Friesen
C. Black
Author Affiliation
Centre for Health Economics Research and Evaluation, University of Sydney, Camperdown NSW, Australia.
Source
Med Care. 1999 Jun;37(6 Suppl):JS60-82
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Community Health Planning - organization & administration
Female
Health Expenditures - statistics & numerical data
Health services needs and demand - economics - statistics & numerical data
Health Services Research
Health Status Indicators
Home Care Services - economics
Hospitalization - economics
Humans
Infant
Information Systems - organization & administration
Male
Manitoba - epidemiology
Mental Health Services - economics
Middle Aged
Mortality
Needs Assessment
Nursing Homes - economics
Residence Characteristics - statistics & numerical data
Sensitivity and specificity
Abstract
Using the POPULIS framework, this project estimated health care expenditures across the entire population of Manitoba for inpatient and outpatient hospital utilization, physician visits, mental health inpatient, and nursing home utilization.
This estimated expenditure information was then used to compare per capita expenditures relative to premature mortality rates across the various areas of Manitoba.
Considerable variation in health care expenditures was found, with those areas having high premature mortality rates also having higher health care expenditures.
PubMed ID
10409018 View in PubMed
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Addressing myths about end-of-life care: research into the use of acute care hospitals over the last five years of life.

https://arctichealth.org/en/permalink/ahliterature190268
Source
J Palliat Care. 2002;18(1):29-38
Publication Type
Article
Date
2002
Author
Donna M Wilson
Corrine D Truman
Author Affiliation
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Source
J Palliat Care. 2002;18(1):29-38
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Alberta
Attitude to Death
Attitude to Health
Female
Health Services Research
Hospital Bed Capacity - statistics & numerical data
Hospital Costs - statistics & numerical data - trends
Hospitalization - statistics & numerical data - trends
Humans
Length of Stay - statistics & numerical data - trends
Male
Middle Aged
Residence Characteristics - statistics & numerical data
Sex Distribution
Socioeconomic Factors
Terminal Care - statistics & numerical data - trends - utilization
Abstract
Despite very little confirming evidence, one of the most pervasive beliefs about dying is that terminally ill people receive a great deal of health care in the last few days, weeks, or months of life. A secondary analysis of 1992/93 through 1996/97 Alberta inpatient hospital abstracts data was undertaken to explore and describe hospital use over the five years before death by all Albertans who died in acute care hospital beds during the 1996/97 year (n = 7,429). There were four key findings: (1) hospital use varied, but was most often low, (2) the last hospital stay was infrequently resource intensive, (3) age, gender, and illness did not distinguish use, and (4) most ultra-high users were rural residents, with the majority of care episodes taking place in small, rural hospitals.
PubMed ID
12001400 View in PubMed
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The adequacy of pharmaceutical treatment of schizophrenia in Quebec varies with age, but is not influenced by sex or neighbourhood deprivation.

https://arctichealth.org/en/permalink/ahliterature107816
Source
Can J Psychiatry. 2013 Aug;58(8):456-65
Publication Type
Article
Date
Aug-2013
Author
Frederieke M Brouwers
Josiane Courteau
Jean-Pierre Grégoire
Jocelyne Moisan
Sophie Lauzier
Alain Lesage
Marie-Josée Fleury
Alain Vanasse
Author Affiliation
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Quebec.
Source
Can J Psychiatry. 2013 Aug;58(8):456-65
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Antipsychotic Agents - therapeutic use
Cohort Studies
Drug Prescriptions - statistics & numerical data
Female
Humans
Male
Middle Aged
Quebec - epidemiology
Residence Characteristics - statistics & numerical data
Schizophrenia - drug therapy - epidemiology
Sex Factors
Socioeconomic Factors
Young Adult
Abstract
Though high discontinuation rates for antipsychotics (APs) by patients with schizophrenia are frequently reported, the percentage of patients receiving pharmaceutical treatment for schizophrenia in routine practice in accordance with international clinical guidelines is unknown. Further, it is unknown if these rates are influenced by levels of neighbourhood deprivation or by a patient's age or sex. Our study aims to investigate if inequalities in AP treatment could be observed between patients living in neighbourhoods with the highest levels of material and social deprivation and those with the lowest deprivation levels, between patients from different age groups, or between men and women.
We conducted a secondary analysis of medical-administrative data of a cohort of adult patients in the province of Quebec with a medical contact for schizophrenia in a 2-year period (2004-2005). We assessed the proportion of patients that filled at least 1 prescription for an AP and received adequate pharmaceutical treatment, defined as being in possession of APs at least 80% of the time as outpatients during a 2-year follow-up period.
Among the 30 544 study patients, 88.5% filled at least 1 prescription for an AP, and 67.5% of the treated patients received adequate treatment. Though no clinically significant differences were observed by deprivation or sex, younger age was associated with lower proportions of patients receiving adequate treatment (46% of treated patients aged between 18 and 29 years, compared with 72% aged between 30 and 64 years, and 77% aged 65 years and over).
In Quebec's routine practice, over 70% of treated patients aged 30 and over received adequate pharmacological treatment, regardless of sex or neighbourhood socioeconomic status. In contrast, in patients aged between 18 and 29 years this percentage was 47%. This is a discouraging finding, especially because optimal treatment in the early phase of disease is reported to result in the best long-term outcomes.
PubMed ID
23972107 View in PubMed
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Adolescents from affluent city districts drink more alcohol than others.

https://arctichealth.org/en/permalink/ahliterature278664
Source
Addiction. 2015 Oct;110(10):1595-604
Publication Type
Article
Date
Oct-2015
Author
Willy Pedersen
Anders Bakken
Tilmann von Soest
Source
Addiction. 2015 Oct;110(10):1595-604
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Alcoholic Intoxication - epidemiology
Alcoholism - epidemiology
Cities
Cross-Sectional Studies
Female
Humans
Income - statistics & numerical data
Linear Models
Male
Multilevel Analysis
Norway - epidemiology
Parents
Religion
Residence Characteristics - statistics & numerical data
Social Class
Social norms
Socioeconomic Factors
Surveys and Questionnaires
Underage Drinking - statistics & numerical data
Abstract
To estimate the level of alcohol consumption and problems among adolescents in city districts in Oslo, Norway with different socio-economic composition; to test whether differences in alcohol consumption are related to district differences in socio-demographic characteristics; and to analyse whether such associations remain significant after controlling for individual-level variables.
Cross-sectional survey using multi-level linear regression analyses with individual responses at the lowest level and city-district data at the highest level.
Oslo, Norway.
A total of 6635 secondary school students, in 62 schools, living in 15 different city districts.
Frequency of alcohol consumption and alcohol intoxication; alcohol problems; and individual characteristics such as immigrant status, religious involvement and parental norms with regard to alcohol. Socio-economic indicators in city districts, such as education, income and unemployment, were combined into a district-level socio-economic index (DLSI).
DLSI scores were related positively to alcohol use (r?=?0.31, P?
PubMed ID
26032427 View in PubMed
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Adults' use of health services in the year before death by suicide in Alberta.

https://arctichealth.org/en/permalink/ahliterature129450
Source
Health Rep. 2011 Sep;22(3):15-22
Publication Type
Article
Date
Sep-2011
Author
Kenneth B Morrison
Lory Laing
Author Affiliation
Alberta Children and Youth Services, Edmonton, Alberta, T5K 2N2. ken.morrison@gov.ab.ca
Source
Health Rep. 2011 Sep;22(3):15-22
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alberta - epidemiology
Case-Control Studies
Female
Health Services - utilization
Humans
Insurance Claim Review - statistics & numerical data
Male
Mental Disorders - complications - diagnosis
Middle Aged
Residence Characteristics - statistics & numerical data
Risk factors
Sex Factors
Socioeconomic Factors
Suicide - statistics & numerical data
Abstract
The suicide rate in Alberta is consistently above the Canadian average. Health care use profiles of those who die by suicide in Alberta are currently unknown.
Death records were selected for people aged 25 to 64 with suicide coded as the underlying cause of death from April 1, 2003 to March 31, 2006. The death records were linked to administrative records pertaining to physician visits, emergency department visits, inpatient hospital separations, and community mental health visits. The control group was the Alberta population aged 25 to 64 who did not die by suicide. Frequency estimates were produced to determine the characteristics of the study population. Odds ratios relating to demographics, exposure to health care services, and case-control status were estimated with logistic regression.
Almost 90% of suicides had a health service in the year before their death. Suicides averaged 16.6 visits per person, compared with 7.7 visits for non-suicides. Much of the health service use among people who died by suicide appears to have been driven by mental disorders.
Information about health service delivery to those who die by suicide can guide prevention and intervention efforts.
PubMed ID
22106785 View in PubMed
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Affiliation to youth gangs during adolescence: the interaction between childhood psychopathic tendencies and neighborhood disadvantage.

https://arctichealth.org/en/permalink/ahliterature162669
Source
J Abnorm Child Psychol. 2007 Dec;35(6):1035-45
Publication Type
Article
Date
Dec-2007
Author
Véronique Dupéré
Eric Lacourse
J Douglas Willms
Frank Vitaro
Richard E Tremblay
Author Affiliation
Department of Psychology and Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montréal, Montréal, QC, Canada. veronique.dupere@umontreal.ca
Source
J Abnorm Child Psychol. 2007 Dec;35(6):1035-45
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Canada - epidemiology
Child
Cohort Studies
Follow-Up Studies
Humans
Juvenile Delinquency - psychology - statistics & numerical data
Longitudinal Studies
Male
Mental Disorders - epidemiology - psychology
Peer Group
Predictive value of tests
Prospective Studies
Residence Characteristics - statistics & numerical data
Risk factors
Social Behavior
Socioeconomic Factors
Vulnerable Populations - psychology - statistics & numerical data
Abstract
Because youth gangs tend to cluster in disadvantaged neighborhoods, adolescents living in such neighborhoods are more likely to encounter opportunities to join youth gangs. However, in the face of these opportunities, not all adolescents respond in the same manner. Those with preexisting psychopathic tendencies might be especially likely to join. In this study, we tested whether a combination of individual propensity and facilitating neighborhood conditions amplifies the probabilities of youth gang affiliation. A subset of 3,522 adolescents was selected from a nationally representative, prospective sample of Canadian youth. Psychopathic tendencies (i.e., a combination of high hyperactivity, low anxiety, and low prosociality as compared to national norms) were assessed through parent reports, while neighborhood characteristics (i.e., concentrated economic disadvantage and residential instability) were derived from the 2001 Census of Canada. Our results indicated that neighborhood residential instability, but not neighborhood concentrated economic disadvantage, interacted with individual propensity to predict youth gang membership. Adolescents with preexisting psychopathic tendencies appeared especially vulnerable mainly if they were raised in residentially unstable neighborhoods.
PubMed ID
17610153 View in PubMed
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Alcohol misuse, gender and depressive symptoms in community-dwelling seniors.

https://arctichealth.org/en/permalink/ahliterature154879
Source
Int J Geriatr Psychiatry. 2009 Apr;24(4):369-75
Publication Type
Article
Date
Apr-2009
Author
Philip D St John
Patrick R Montgomery
Suzanne L Tyas
Author Affiliation
Section of Geriatric Medicine, Department of Medicine, Centre on Aging, University of Manitoba, Winnipeg, Canada. pstjohn@hsc.mb.ca
Source
Int J Geriatr Psychiatry. 2009 Apr;24(4):369-75
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcoholism - epidemiology - psychology
Cross-Sectional Studies
Depressive Disorder - epidemiology - psychology
Female
Geriatric Assessment
Humans
Male
Manitoba - epidemiology
Questionnaires
Residence Characteristics - statistics & numerical data
Risk factors
Sex Factors
Social Support
Socioeconomic Factors
Abstract
Alcohol misuse in seniors has been studied in clinical samples and in small communities, but relatively few studies are population-based. Objectives are: (1) to describe the characteristics of seniors who score 1 or more on the CAGE (Cut down; Annoyed; Guilty; Eye-opener) questionnaire of alcohol problems; (2) to determine if depressive symptoms are associated with alcohol misuse after accounting for other factors.
Cross-sectional study of community-dwelling older people (65+ years) sampled from a representative population registry in Manitoba, Canada. Participants were initially interviewed in 1991-1992 and reinterviewed in 1996-1997. Data from Time 2 were used; 1,028 persons were included in the analyses. Sociodemographic characteristics, the CAGE questionnaire, Activities of Daily Living (ADLs) and instrumental ADLs (IADLs), the Center for Epidemiologic Studies-Depression (CES-D) scale and the Mini-Mental State Examination (MMSE) were assessed by trained interviewers.
Males were more likely to score positive on the CAGE questionnaire. After adjusting for gender, age, and education, there was a strong association between depressive symptoms and alcohol misuse. Poor self-rated health and impairments in IADLs were also associated with alcohol misuse.
Male gender, depressive symptoms, and poor functional status were associated with alcohol misuse in this population-based study. Attention to depressive symptoms and functional status may be important in the care of seniors with alcohol misuse. Alternatively, physicians should enquire about alcohol use in seniors with functional impairment or depressive symptoms.
Notes
Comment In: Int J Geriatr Psychiatry. 2009 Apr;24(4):434-5; author reply 433-419301300
PubMed ID
18837057 View in PubMed
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383 records – page 1 of 39.