British Columbia Population Research Articles

Characteristics and Health Care Utilization of Different Segments of a Multiethnic Asian Population in Singapore

Descriptive population-level health data are critical components of the evidence base for population health policy. Human populations often display marked heterogeneity in their health status among subgroups of the population. The recent widespread adoption of electronic health records provides opportunities to use routine real-world health care data to examine population health. To report population sociodemographic characteristics, health conditions, health care utilization, and health care costs for different population segments of a multiethnic Asian population divided according to a modified British Columbia Population Segmentation Framework. This population-based cross-sectional study used 2016 data from the Singapore Eastern Regional Health System, the largest Regional Health System in Singapore. Data were obtained from deidentified national-level electronic health records at the Ministry of Health Singapore. Participants included all residents in the Singapore Eastern Regional Health System catchment area in 2016. The descriptive analysis was conducted in August 2018. Socioeconomic profiles, disease prevalence, health care utilization, and cost patterns of population segments. The total size of the study population in 2016 was 1 181 024 residents (576 663 [48.83%] male; median [interquartile range] age, 40 [22-57] years). The population was divided into 8 segments: healthy with no outpatient utilization (493 483 residents), healthy with outpatient utilization (259 909 residents), healthy with inpatient admissions (49 588 residents), low complex (215 134 residents), medium complex (79 350 residents), high complex (44 445 residents), cancer (34 217 residents), and end of life (4898 residents). Overall, the 3 most prevalent conditions were chronic kidney disease (31.89%), hypertension (18.52%), and lipid disorders (18.33%). Distributions of chronic conditions differed across the segments. Different segments had varying health care utilization patterns: the high-complex segment had the highest number of primary care clinic visits (mean [SD], 4.25 [5.46] visits), the cancer segment had the highest number of specialist outpatient clinic visits (mean [SD], 5.55 [8.49] visits), and the end-of-life segment had the highest numbers of accident and emergency department visits (mean [SD], 1.80 [1.88] visits) and inpatient admissions (mean [SD], 1.99 [1.89] admissions) during 2016. For health care costs, specialist outpatient clinic and inpatient care together made up more than 85% of the total cost of nearly 2 billion Singapore dollars. The end-of-life segment contributed approximately 50% of the health care cost per capita of 60 000 Singapore dollars. Different population segments displayed heterogeneity in sociodemographic characteristics, health conditions, health care utilization, and health care cost patterns. This critical health information can be used as baseline data to inform regional and national health priorities for health services research and policy.

Mathematical Model of an Interaction between Bears and Salmon; A Case in British Columbia

An interaction model for the Pacific salmon and bear population in British Columbia is discussed here. The phenomenon is shown during the salmons period of migration back to their birthplace river at the end of their life. During this returning home, a large number of bears from the nearby state come and prey on them. This predation of salmon before spawning is suspected as the cause of the decline in Salmon production. Here a dynamical model involving a specific predator-prey type interaction between Salmon and Bears is constructed in the form of a non-autonomous dynamical system, in which the transition rate from the adult state of salmon to the spawning state is positive only in the month of migration. Dynamical analysis for the stability of the coexistence equilibrium for the autonomous case is shown and sensitivity analysis for the non-autonomous the case is done numerically.

Variation in migration pattern, broodstock origin, and family productivity of coho salmon hatchery populations in British Columbia, Canada, derived from parentage-based tagging.

In salmonid parentage‐based tagging (PBT) applications, entire hatchery broodstocks are genotyped, and subsequently, progeny can be nonlethally sampled and assigned back to their parents using parentage analysis, thus identifying their hatchery of origin and brood year (i.e., age). Inter‐ and intrapopulation variability in migration patterns, life history traits, and fishery contributions can be determined from PBT analysis of samples derived from both fisheries and escapements (portion of a salmon population that does not get caught in fisheries and returns to its natal river to spawn). In the current study of southern British Columbia coho salmon (Oncorhynchus kisutch) populations, PBT analysis provided novel information on intrapopulation heterogeneity among males in the total number of progeny identified in fisheries and escapements, the proportion of progeny sampled from fisheries versus escapement, the proportion of two‐year‐old progeny (jacks) produced, and the within‐season return time of progeny. Fishery recoveries of coho salmon revealed heterogeneity in migration patterns among and within populations, with recoveries from north and central coast fisheries distinguishing “northern migrating” from “resident” populations. In northern migrating populations, the mean distance between fishery captures of sibs (brothers and sisters) was significantly less than the mean distance between nonsibs, indicating the possible presence of intrapopulation genetic heterogeneity for migration pattern. Variation among populations in productivity and within populations in fish catchability indicated that population selection and broodstock management can be implemented to optimize harvest benefits from hatcheries. Application of PBT provided valuable information for assessment and management of hatchery‐origin coho salmon in British Columbia.

Use of life tables to predict the impact of introducing exotic parasitoids, against the cabbage seedpod weevil in North America

ABSTRACTCabbage seedpod weevil, Ceutorhynchus obstrictus (Coleoptera: Curculionidae), is an invasive alien species that impacts seed production of canola, Brassica napus and B. rapa (Brassicaceae), one of Canada’s major agricultural crops. To determine the need for and potential impact of introduction of one or more natural enemies for biological control it is essential to understand the mortality factors associated with C. obstrictus both in the native range and in the introduced range. Life tables were constructed for Ontario and British Columbia populations to determine the mortality factors affecting C. obstrictus. These were compared with life tables generated in Switzerland, the area of origin of the weevil. Results indicated that introduction of an exotic specialist parasitoid into canola growing regions of Canada would substantially reduce C. obstrictus populations. This study is the first to compare life tables of an invasive pest in the areas of origin and introduction.

Lemongrass and Cinnamon Bark: Plant Essential Oil Blend as a Spatial Repellent for Mosquitoes in a Field Setting.

Plant essential oils (EOs) have been considered as spatial repellents to help disrupt the pathogen transmission cycle of mosquitoes. Our objective was to assess spatial repellency effects of EOs on the tropical yellow fever mosquito, Aedes aegypti (L.) (Diptera: Culicidae) and on local mosquito populations in coastal British Columbia (Canada). In laboratory experiments using protocols of the World Health Organization, three of the solitary EOs tested proved repellent to Ae. aegypti: cinnamon bark, lemongrass, and rosemary. Binary combinations of select EOs enhanced the repellent effect of single EOs through synergistic interactions. The EO blend of geranium and peppermint lowered the RD50 (the dose required to obtain 50% repellency) of each solitary EO by >1,000-fold. Compared with binary EO blends, ternary EO blends were typically less repellent to mosquitoes, possibly due to a dilution effect of the most effective EO constituent(s) in the blend. In field experiments, the EO blend of lemongrass and cinnamon bark expressed spatial repellency towards the cool weather mosquito, Culiseta incidens (Thomson) (Diptera: Culicidae), even when this blend was disseminated from devices as much as 1 m away from a sentinel trap releasing attractive vertebrate host odorants and CO2. Deployment of EOs as spatial repellents in small outdoor gatherings could help protect humans from mosquito-borne diseases, particularly when this tactic is coupled with other tools of mosquito management.

So you think you can cook pot?


 Background: With regulations on additional cannabis products including edibles being in the works, Canada is faced with a new layer of food safety challenges as the public becomes increasingly curious about adding cannabis into their diets. Knowledge in both food safety and edible safety is essential to prevent health hazards associated with edible cannabis products. Methods: An online self-administered survey was conducted on a British Columbia population. In addition to demographic data which also included cannabis usage, participants answered two knowledge tests on food safety and edible safety, respectively. The surveys were analyzed for differences in test scores between demographic groups. Results: Users of cannabis edibles have significantly higher knowledge in edible safety than non-users. This was not affected by the purpose or frequency of edible use. A slight positive correlation (0.18) between food safety knowledge and edible safety knowledge suggested the two topic areas to be mutually beneficial. In contrary, knowledge in food safety was not significantly different across all demographic groups. Conclusions: Non-users of cannabis edibles are more at risk of health hazards related to ingestion of cannabis edibles due to lower knowledge in this subject matter and eagerness to experience cannabis products after their legalization. Therefore, there is a need for education programs to help familiarize the public with these products. It is also recommended for the public to strengthen general food safety knowledge because all of it also applies when making edibles.

Living With Dual Diagnosis and Homelessness: Marginalized Within a Marginalized Group

Objective: Concurrent mental and substance use disorders or dual diagnosis are highly prevalent among individuals experiencing homelessness. Studies have indicated that dual diagnosis leads to poorer health outcomes and higher health service utilization among those affected. This study aims to estimate the prevalence of dual diagnoses among homeless populations in British Columbia (BC), Canada, and understand their characteristics and specific factors associated with dual diagnoses. Methods: The BC Health of the Homeless Survey is a cross-sectional study involving the homeless population of three cities in BC. The survey assessed addiction and concurrent disorders with standardized interviews—the Mini-International Neuropsychiatric Interview Plus, the Maudsley Addiction Profile, and the Brief Symptom Inventory—in a sample of 500 individuals who are homeless living in shelters or on the street. We characterized individuals after categorizing them into four groups: those without any current mental disorder, those with substance use disorders only, those with mental disorders only, and those with concurrent substance use and mental disorders. Focusing on the concurrent disorder group, we completed a multivariate analysis comparing individuals with dual diagnosis to those without concurrent disorders. Results: Consistent with previous studies, we found that individuals with dual diagnoses report more severe physical and psychological symptoms. Among the homeless, they were more likely to be Aboriginal and younger and more likely to not make it into a shelter. They also reported substantially more difficulties in getting the health care service that they need. Conclusions: Within this marginalized group, individuals with dual diagnosis were more likely to be from groups considered to be more vulnerable with more complex needs. They were having more problems accessing even basic support, such as shelters and health care. Without a systematic approach in providing appropriate care to individuals with dual diagnosis, the most vulnerable clients are not only the ones likely to suffer the most but also the ones having the most problems meeting their basic needs.

Adaptation of a Canadian culpability scoring tool to Alberta police traffic collision report data

Objective: The objective of this study was to adapt a previously validated Canadian Culpability Scoring Tool (CCST) to Alberta police report data.Methods: Police traffic collision reports from motor vehicle (MV) collisions in Calgary and Edmonton (Alberta, Canada) from 2010 to 2014 were used. Adaptation of the CCST was completed with input from personnel within Alberta Transportation, contributing to face and content validity. Two research assistants, given only the information necessary for scoring, evaluated 175 randomly selected MV–MV collisions. Interrater agreement was estimated using kappa (k) and reported with 95% confidence intervals (CIs). Discussion of disagreements between the research assistants and consultation from Alberta Transportation informed the algorithm used in the Alberta Motor Vehicle Collision Culpability Tool (AMVCCT). The AMVCCT was automated and applied to all motorists involved in collisions. Binary logistic regression was used to examine characteristics of the culpable and nonculpable drivers and their effects were reported using odds ratios (ORs) with 95% CIs.Results: Interrater agreement for the random sample was excellent (k = 0.95; 95% CI, 0.92–0.99). Of those drivers hospitalized, 1,130 (37.54%) were rated not culpable and 1,880 (62.46%) were rated culpable. The odds of being culpable were higher for males than for females (OR = 1.43; 95% CI, 1.23–1.66). The odds of being culpable were higher in those impaired by alcohol than those considered “apparently normal” (OR = 61.10; 95% CI, 22.66–164.75). The odds of being deemed culpable, when compared with drivers >54 years old, were higher for those <25 years old (OR = 1.72; 95% CI, 1.35–2.20) and lower for those in the 40- to 54-year-old age group (OR = 0.78; 95% CI, 0.63–0.96). Driving between 12 a.m. and 6 a.m. resulted in higher odds of being culpable compare with all other 6-h time blocks. Direction and statistical significance remained consistent when applying the tool to all MV collisions. Sensitivity analysis including the removal of single vehicle collisions did not affect the direction or statistical significance of the main results.Conclusions: The AMVCCT identified a culpable group that exhibited characteristics expected in drivers who are at fault in collisions. The age groups 25–39 and 40–54 demonstrated different results than the CCST. However, this is the only difference that exists in the findings of the AMVCCT compared to the CCST and could exist due to differences between the driving populations in Alberta and British Columbia. It is possible to adapt the CCST to provinces outside British Columbia and, in doing so, we can identify risk factors for collision contribution and not-at-fault drivers who represent the driving population.

Divergent population trends following the cessation of legal grizzly bear hunting in southwestern British Columbia, Canada

We conducted DNA capture-recapture monitoring of grizzly bears (Ursus arctos) from 5 to 17 years after hunting was stopped in two adjacent but genetically distinct populations in southwestern British Columbia, Canada. We used spatial capture-recapture and non-spatial Pradel robust design modelling to estimate population density, trends, and the demographic components of population change for each population. The larger population had 21.5 bears/1000 km2 and was growing (λPradel = 1.02 ± 0.02 SE; λsecr = 1.01 ± 4.6 × 10−5 SE) following the cessation of hunting. The adjacent smaller population had 6.3 bears/1000 km2 and was likely declining (λPradel = 0.95 ± 0.03 SE; λsecr = 0.98 ± 0.02 SE). Estimates of apparent survival and apparent recruitment indicated that lower recruitment was the dominant factor limiting population growth in the smaller population. Factors limiting reproductive rates and population density could include poor habitat quality, particularly the abundance of high-energy foods, genetic Allee effects due to a long period of population isolation, or demographic effects affecting infanticide rates. The cessation of hunting was insufficient to promote population recovery for the low density, isolated population. Our research highlights the importance of considering mortality thresholds in addition to small population effects and habitat quality when recovering large carnivore populations.

Exploring the live birth rates of women living with HIV in British Columbia, Canada.

ObjectiveTo evaluate the birth rates of women living with HIV (WLWH) compared to the general population in British Columbia (BC), Canada.MethodsWe retrospectively reviewed clinical and population level surveillance data from 1997 to 2015. Live birth rates from 1997 to 2015 among WLWH aged 15–49 years were compared with those of all BC women. Next, the number of live births among WLWH with a live birth between 1997–2012 and HIV-negative controls matched 1:3 by geocode were compared.ResultsWLWH had a lower birth rate compared to all BC women [31.4 (95%CI, 28.6–34.3) vs. 40.0 (39.3–40.1)/1000 person years]. Stratified by age, WLWH aged 15–24 years had a higher birth rate while WLWH aged 25–49 years had a lower birth rate than BC women (p<0.01). Between 1997 and 2015, birth rates for both populations decreased among women aged 15–24 years, and increased among women aged 25–49 years, most strikingly among WLWH 35–49 years (p<0.01). When comparing WLWH with a live birth to HIV-negative geocode matched controls, WLWH aged 15–24 years (p = 0.03) and aged 25–34 years (p<0.01) had more live births than controls while WLWH aged 35–49 years did not (p = 0.06).ConclusionsOn a population level, WLWH have lower birth rates than the general population. However, this is not observed among WLWH who have ever given birth compared with matched controls, suggesting that sociodemographic factors may play an important role. WLWH are increasingly giving birth in their later reproductive years. Taken together, our data supports the integration of reproductive health and HIV care.

Population genomic evidence for plant glacial survival in Scandinavia.

Quaternary glaciations have played a major role in shaping the genetic diversity and distribution of plant species. Strong palaeoecological and genetic evidence supports a postglacial recolonization of most plant species to northern Europe from southern, eastern and even western glacial refugia. Although highly controversial, the existence of small in situ glacial refugia in northern Europe has recently gained molecular support. We used genomic analyses to examine the phylogeography of a species that is critical in this debate. Carex scirpoidea Michx subsp. scirpoidea is a dioecious, amphi-Atlantic arctic-alpine sedge that is widely distributed in North America, but absent from most of Eurasia, apart from three extremely disjunct populations in Norway, all well within the limits of the Weichselian ice sheet. Range-wide population sampling and variation at 5,307 single nucleotide polymorphisms show that the three Norwegian populations comprise unique evolutionary lineages divergent from Greenland with high between-population divergence. The Norwegian populations have low within-population genetic diversity consistent with having experienced genetic bottlenecks in glacial refugia, and host private alleles that probably accumulated in long-term isolated populations. Demographic analyses support a single, pre-Weichselian colonization into Norway from East Greenland, and subsequent divergence of the three populations in separate refugia. Other refugial areas are identified in North-east Greenland, Minnesota/Michigan, Colorado and Alaska. Admixed populations in British Columbia and West Greenland indicate postglacial contact. Taken together, evidence from this study strongly indicates in situ glacial survival in Scandinavia.

Validation of a one year fracture prediction tool for absolute hip fracture risk in long term care residents

BackgroundFrail older adults living in long term care (LTC) homes have a high fracture risk, which can result in reduced quality of life, pain and death. The Fracture Risk Scale (FRS) was designed for fracture risk assessment in LTC, to optimize targeting of services in those at highest risk. This study aims to examine the construct validity and discriminative properties of the FRS in three Canadian provinces at 1-year follow up.MethodsLTC residents were included if they were: 1) Adults admitted to LTC homes in Ontario (ON), British Columbia (BC) and Manitoba (MB) Canada; and 2) Received a Resident Assessment Instrument Minimum Data Set Version 2.0. After admission to LTC, one-year hip fracture risk was evaluated for all the included residents using the FRS (an eight-level risk scale, level 8 represents the highest fracture risk). Multiple logistic regressions were used to determine the differences in incident hip or all clinical fractures across the provinces and FRS risk levels. We examined the differences in incident hip or all clinical fracture for each FRS level across the three provinces (adjusted for age, BMI, gender, fallers and previous fractures). We used the C-statistic to assess the discriminative properties of the FRS for each province.ResultsDescriptive statistics on the LTC populations in ON (n = 29,848), BC (n = 3129), and MB (n = 2293) are: mean (SD) age 82 (10), 83 (10), and 84 (9), gender (female %) 66, 64, and 70% respectively. The incident hip fractures and all clinical fractures for FRS risk level were similar among the three provinces and ranged from 0.5 to 19.2% and 1 to 19.2% respectively. The overall discriminative properties of the FRS were similar between ON (C-statistic = 0.673), BC (C-statistic = 0.644) and MB (C-statistic = 0.649) samples.ConclusionFRS is a valid tool for identifying LTC residents at different risk levels for hip or all clinical fractures in three provinces. Having a fracture risk assessment tool that is tailored to the LTC context and embedded within the routine clinical assessment may have significant implications for policy, service delivery and care planning, and may improve care for LTC residents across Canada.

Pleistocene glacial cycles and physical barriers influence phylogeographic structure in Black-capped Chickadees (Poecileatricapillus), a widespread North American passerine

The nonmigratory Black-capped Chickadee (Poecile atricapillus (Linnaeus, 1766)) has a continent-wide distribution extending across large parts of North America. To investigate the phylogeographic structure and verify possible refugia during the last glacial maximum, we sequenced a 678 bp region of the mitochondrial control region from 633 Black-capped Chickadees at 35 sites across North America and performed paleoecological distribution modeling. Two genetically distinct groups were found using multiple analyses: one in Newfoundland (Canada) and a widespread continental group, with additional substructure evident in western continental populations. While gene flow is low throughout the range, it is especially low in peripheral populations. The Newfoundland population has remained isolated from continental populations for at least 65 000 years and contains a number of fixed nucleotide differences. Within the continental populations, Black-capped Chickadees are subdivided into Pacific Coast, Alaska (USA), southeast Rockies, and main-northeast groups consistent with late Pleistocene vicariance events. Evidence of secondary contact was identified between Pacific and main-northeast populations in northwest British Columbia (Canada) and between southeast Rockies and main-northeast groups in Montana (USA). Paleoecological distribution modeling predicted suitable habitat in Alaska, off the coast of Newfoundland, and several locations across the southern United States during the last glacial maximum, whereas suitable habitat during the last interglacial was more similar to the contemporary distribution.

On the origin of orphan hybrids between Aquilegia formosa and Aquilegia flavescens.

We report the investigation of an Aquilegia flavescens × A. formosa population in British Columbia that is disjunct from its parents—the latter species is present locally but ecologically separated, while the former is entirely absent. To confirm hybridity, we used multivariate analysis of floral characters of field-sampled populations to ordinate phenotypes of putative hybrids in relation to those of the parental species. Microsatellite genotypes at 11 loci from 72 parental-type and putative hybrid individuals were analysed to assess evidence for admixture. Maternally inherited plastid sequences were analysed to infer the direction of hybridization and test hypotheses on the origin of the orphan hybrid population. Plants from the orphan hybrid population are on average intermediate between typical A. formosa and A. flavescens for most phenotypes examined and show evidence of genetic admixture. This population lies beyond the range of A. flavescens, but within the range of A. formosa. No pure A. flavescens individuals were observed in the vicinity, nor is this species known to occur within 200 km of the site. The hybrids share a plastid haplotype with local A. formosa populations. Alternative explanations for this pattern are evaluated. While we cannot rule out long-distance pollen dispersal followed by proliferation of hybrid genotypes, we consider the spread of an A. formosa plastid during genetic swamping of a historical A. flavescens population to be more parsimonious.

The British Columbia Asthma Prediction System (BCAPS): A Surveillance System to Forecast the Public Health Impacts of Wildfire Smoke

Smoke from severe wildfires during the summers of 2015 and 2017 affected most of the population of British Columbia (BC), Canada. Asthma-related health outcomes are consistently elevated when populations are exposed to wildfire smoke in BC. Timely information during smoke events is important to inform the actions of public health authorities. We developed a surveillance system using short-term wildfire smoke forecasts to predict the potential health impacts of smoke over the coming days and provide this information to public health authorities in easy-to-interpret daily reports.The BCAPS framework is modular such that different data, modelling approaches, and visualizations can be applied. We used daily fine particulate matter (PM2.5) measurements, daily counts of asthma-related population health outcomes, and PM2.5 forecasts to predict and visualize smoke exposures and their health impacts across different geographic areas over the coming 48 hours. We applied BCAPS retrospectively during a 2015 smoke event using a Bayesian latent process model to forecast health outcomes. We prospectively applied BCAPS in 2017 using random forest models to predict PM2.5 exposure and health outcomes.Daily PM2.5 measurements ranged from 0.03 µg/m3 to 301.2 µg/m3 during the 2015 event and from 0.05 µg/m3 to 293.8 µg/m3 in 2017. Daily PM2.5 and daily counts of asthma-related physician visits and medication dispensations were increased during smoky periods in 2015 and 2017. In general, BCAPS predicted the smoke-related increases in asthma outcomes with good accuracy, though performance was dependant on the performance of the smoke forecasts. In 2017 there was a marked decrease in population response to smoke towards the end of the season even though PM2.5 concentrations remained high.Integrating data from multiple sources into a modular framework such as BCAPS can usefully predict the health impacts of smoke exposure in a timely manner to inform public health decision-making and action.

Factors affecting litter size in Western Gartersnake (&lt;i&gt;Thamnophis elegans&lt;/i&gt;) in British Columbia: place, time, and size of mother

Life-history traits of organisms are influenced by both genetic and environmental factors. We used counts of offspring in captive-born litters to determine how geographic location, year-to-year variation, and body size of mother affected litter size of Western Gartersnake (Thamnophis elegans) in four widely separated populations in British Columbia. Litter size varied significantly among populations, but that variation was largely explained by differences in maternal body size among populations; that is, larger females had larger litters. With maternal size treated as a covariate, there was no further significant effect of location or of different years within sites on litter size. The overall regression, pooled over sites and years, between litter size and size of mother accounted for 55% of the total variation in litter size. Nonetheless, the significant variation in body size among locations calls for explanation and the consequent differences in litter size could be important demographically. Presumably, the large amount of unexplained residual variation reflects other differences, beyond body size, between individual mothers. Such differences among individuals might be determined by genetics or by environmental effects such as foraging success, but our data cannot address this question.

16-Year Survival of the Canadian Collaborative Cohort of Related Dementias

Background Survival estimates are integral to care for patients diagnosed with dementia. Few Canadian studies have carried out long-term follow-up of well-described cohorts, analyzing survival related to multiple risk factors. Methods Survival analysis of an inception cohort enrolled at a British Columbia (BC) tertiary dementia referral clinic between 1997 and 1999 was undertaken. Vital status was completed for 168 patients diagnosed with dementia. An evaluation of the effects of demographics, vascular risk factors, cognitive and functional ratings, apolipoprotein 4-status, and cholinesterase use on survival was performed using a log-rank test and time-dependent Cox regression. Survival of this dementia cohort was compared with the age-matched life expectancy of persons in BC. Results In all, 158/168 (94.0%) subjects died over 16.6 years, with a median survival of 7.08 years. Risk factors associated with shorter survival in dementia groups included age of onset ≥80 (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.05-2.32); greater functional disability (Disability Assessment for Dementia<55% [HR 1.47, 95% CI 1.04-2.08]); and cumulative medical illness severity (Cumulative Illness Rating Scale≥7 [HR 1.51, 95% CI 1.08-2.12)]. Compared with the BC population, years of potential life lost for dementia subjects aged <65 was 15.36 years, and for dementia subjects aged ≥80 it was 1.82 years. Conclusions Survival in dementia subjects is shorter than population life expectancies for each age strata, with greatest impact on younger patients. For people diagnosed with dementia, age ≥80 years, cumulative medical illness severity, and functional disabilities are the most significant survival predictors and can be used to guide prognosis.

Childhood Trauma and Lifetime Traumatic Brain Injury Among Individuals Who Are Homeless.

To study the association of childhood trauma and lifetime prevalence of traumatic brain injury (TBI) among individuals who are homeless. Cross-sectional survey. Three cities in British Columbia, Canada. Five hundred individuals who are homeless and 19 years of age or older in 2009. Traumatic brain injury was identified with National Survey of Homeless Assistance Providers and Clients (NSHAPC) and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). The relationship between childhood trauma and TBI was explored using multivariable logistic regression approach, adjusting for age, gender, any psychiatric diagnosis (anxiety disorder, mood disorder, psychosis), alcohol dependence, and substance dependence. The effect of number of childhood trauma types on TBI was also explored using multiple variables logistic regression approach adjusting for the same covariates. The prevalence of TBI was 63.6% and childhood maltreatment was 87.7% among the sample population. During childhood of 487 participants included in the analysis, 57.7% experienced physical abuse, 62.8% physical neglect, 45.8% sexual abuse, 62.4% emotional abuse, and 55.2% emotional neglect. After adjustment, childhood trauma (adjusted odds ratio [aOR] = 2.26; 95% confidence interval [CI], 1.04-5.02), childhood physical abuse (aOR = 2.13; 95% CI, 1.19-3.87; n = 487), and childhood emotional abuse (aOR = 1.95; 95% CI, 1.09-3.51; n = 487) were significantly associated with history of TBI. After adjustment, having 4 different types of childhood trauma (aOR = 2.81; 95% CI, 1.11-7.31) was significantly associated with higher odds of reporting TBI history. Childhood trauma is significantly associated with lifetime prevalence of TBI in homeless populations in British Columbia, Canada, indicating an added level of vulnerability in this population. In addition, these findings suggest a potential role for childhood trauma prevention strategies and services mindful of the patients' history of trauma for this particularly vulnerable population.

Diagnostic Yield of Laboratory Methods and Value of Viral Genotyping during an Outbreak of Mumps in a Partially Vaccinated Population in British Columbia, Canada.

Mumps remains endemic in North America despite routine use of the measles, mumps, and rubella (MMR) vaccine. In 2016, an outbreak of mumps in British Columbia, Canada, provided an opportunity to determine the diagnostic utility of laboratory testing methods. Specimens from patients with clinical mumps were tested for infection using a commercial enzyme-linked immunosorbent assay (ELISA) for antibody detection and an in-house reverse transcriptase PCR (RT-PCR) targeting viral fusion and small hydrophobic (SH) genes. Viral genotyping was performed by SH gene sequencing. Laboratory data was linked with epidemiologic case data. Of the 139 confirmed cases, 94 (68%) had reported or documented history of MMR vaccination. Specimens were typically collected 1 day (for buccal and IgM tests) or 2 days (for urine tests) after symptom onset. Most confirmed cases (69%) were confirmed by buccal swab RT-PCR. Among cases tested by multiple methods, the percent positivity for buccal swab RT-PCR was 90% (96/107) compared to 43% (30/69) for both IgM ELISA and urine RT-PCR. Mumps IgM detection was higher in confirmed cases with no history of vaccination than in those with history (64% versus 34%, P = 0.02). The outbreak strain was identified as genotype G related to MuVi/Sheffield.GBR/1.05 but with conserved variations in five nucleotides within the SH gene that allowed linkage of geographically distinct cases. In conclusion, RT-PCR of buccal specimens had the highest diagnostic yield during a mumps outbreak in a partially vaccinated population. To optimize mumps diagnostic potential, clinicians should collect specimens depending on when the patient presents for care and their immunization history.

Public perceptions about climate change mitigation in British Columbia's forest sector.

The role of forest management in mitigating climate change is a central concern for the Canadian province of British Columbia. The successful implementation of forest management activities to achieve climate change mitigation in British Columbia will be strongly influenced by public support or opposition. While we now have increasingly clear ideas of the management opportunities associated with forest mitigation and some insight into public support for climate change mitigation in the context of sustainable forest management, very little is known with respect to the levels and basis of public support for potential forest management strategies to mitigate climate change. This paper, by describing the results of a web-based survey, documents levels of public support for the implementation of eight forest carbon mitigation strategies in British Columbia’s forest sector, and examines and quantifies the influence of the factors that shape this support. Overall, respondents ascribed a high level of importance to forest carbon mitigation and supported all of the eight proposed strategies, indicating that the British Columbia public is inclined to consider alternative practices in managing forests and wood products to mitigate climate change. That said, we found differences in levels of support for the mitigation strategies. In general, we found greater levels of support for a rehabilitation strategy (e.g. reforestation of unproductive forest land), and to a lesser extent for conservation strategies (e.g. old growth conservation, reduced harvest) over enhanced forest management strategies (e.g. improved harvesting and silvicultural techniques). We also highlighted multiple variables within the British Columbia population that appear to play a role in predicting levels of support for conservation and/or enhanced forest management strategies, including environmental values, risk perception, trust in groups of actors, prioritized objectives of forest management and socio-demographic factors.