Rates In Canada Research Articles

Geographical disparities in temporal trends of low birth weight in Saskatchewan from 2002/2003 to 2021/2022: insights from a joinpoint regression analysis.

Low birth weight (LBW) is an important public health indicator that is associated with various negative health outcomes in infants. To effectively implement interventions that would improve health outcomes in children, it is important to understand both the historical trends and current levels of LBW rates. In this study, trends and regional differences in LBW rates in Saskatchewan from 2002/2003 to 2021/2022 were assessed. A joinpoint regression analysis was conducted using historical LBW rates, obtained from the Canadian Institute for Health Information database. Data were analysed using average percent change and average annual percent change. Spatial patterns and trends were identified using a choropleth map. From a provincial and national rate of 5.2% in 2002/2003, the LBW rate in Saskatchewan increased to 6.5% in 2021/2022, approaching the national rate of 6.8%. Over the 20-year period, average annual changes for Canada were 1.4% and 1.0% for Saskatchewan. There was a turning point in the study: 2004/2005 for Canada and 2011/2012 for Saskatchewan. Initially, Saskatchewan had stable LBW rates, increasing yearly by 0.1%, while the national rate was 5.7%. However, in recent years, Saskatchewan's rate increased to 1.8% annually, surpassing the national rate of 0.9%. Geographical differences were also observed within Saskatchewan, with the Far North region having the highest LBW rate (9.2%), and the Central West region having the lowest rate (4.3%) in 2021/2022. The Central East, Regina Qu'Appelle, and southern Saskatchewan saw significant upwards trends in LBW rates between 2015/2016 and 2021/2022. There is an increasing trend in LBW rates in Canada and Saskatchewan, as well as geographical disparities within the province. The geographical disparities in LBW rates underscore the need for tailored interventions in high-risk regions in the province.

A Comprehensive Analysis of Skin Cancer Concerns and Protective Practices in Manitoba, Canada, Highlights Lack of Skin Cancer Awareness and Predominance of High-Risk Sun Exposure Behaviors.

The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.

Explaining the Sharp Decline in Birth Rates in Canada and the USA in 2020.

Birth rates in Canada and the USA declined sharply in March 2020 and deviated from historical trends. This decline was absent in similarly developed European countries. We argue that the selective decline was driven by incoming individuals, who would have travelled from abroad and given birth in Canada and the USA, had there been no travel restrictions during the COVID-19 pandemic. Furthermore, by leveraging data from periods before and during the COVID-19 travel restrictions, we quantified the extent of births by incoming individuals. In an interrupted time series analysis, the expected number of such births in Canada was 970 per month (95% CI: 710-1,200), which is 3.2% of all births in the country. The corresponding estimate for the USA was 6,700 per month (95% CI: 3,400-10,000), which is 2.2% of all births. A secondary difference-in-differences analysis gave similar estimates at 2.8% and 3.4% for Canada and the USA, respectively. Our study reveals the extent of births by recent international arrivals, which hitherto has been unknown and infeasible to study.

U.S. macroeconomic news and low-frequency changes in bond yields in Canada, Sweden and the U.K.

This paper investigates the importance of U.S. macroeconomic news in driving low-frequency fluctuations in the term structure of interest rates in Canada, Sweden, and the U.K. We follow two complementary approaches: First, we apply a regression-based framework that aggregates the impact of daily macroeconomic news on bond yields to a lower quarterly frequency. Next, we estimate a macro-finance affine term structure model linking the daily news to lower-frequency changes in bond yields and its expectations and term premia components. Both approaches show that U.S. macroeconomic news is an important source of lower-frequency quarterly fluctuations in bond yields in these open economies, and even more important than their respective domestic macroeconomic news. Furthermore, the macro-finance model shows that U.S. macroeconomic news is particularly important in explaining low-frequency changes in the expectation components of the nominal, real, and break-even inflation rates.

Outdoor Radon Dose Rate in Canada's Arctic amid Climate Change.

Decades of radiation monitoring data were analyzed to estimate outdoor Radon Dose Rates (RnDRs) and evaluate climate change impacts in Canada's Arctic Regions (Resolute and Yellowknife). This study shows that the RnDR involves dynamic sources and complex environmental factors and processes. Its seasonality and long-term trends are significantly impacted by temperatures and soil-and-above water contents. From 2005 to 2022, Yellowknife's RnDR increased by +0.35 ± 0.06 nGy/h per decade, with the fastest increases occurring in cold months (October to March). The rise is largely attributable to water condition changes over time in these months, which also caused enhanced soil gas emissions and likely higher indoor radon concentrations. In Resolute, the RnDR increased between 2013 and 2022 at +0.62 ± 0.19 nGy/h (or 16% relatively) per decade in summer months, with a positive temperature relationship of +0.12 nGy/h per °C. This work also demonstrates the relevance of local climate and terrain features (e.g., typical active layer depth, precipitation amount/pattern, and ground vegetation cover) in researching climate change implications. Such research can also benefit from using supporting monitoring data, which prove effective and scientifically significant. From the perspective of external exposure to outdoor radon, the observed climate change effects pose a low health risk.

Trends of Peanut-Induced Anaphylaxis Rates Before and After the 2017 Early Peanut Introduction Guidelines in Montreal, Canada

Food allergies, particularly peanut, represent the predominant cause of anaphylaxis. Whereas early allergen introduction has emerged as a potential preventive strategy, the precise impact of recent guidelines on peanut-induced anaphylaxis rates in Canada remains unclear. To assess the impact of the 2017 Addendum Guidelines for the Prevention of Peanut Allergy on peanut-induced anaphylaxis rates in Canada. Using a comprehensive longitudinal registry capturing pediatric anaphylaxis presentations to the Montreal's Children's Hospital, we compared children with and without known peanut allergy who presented with peanut-induced anaphylaxis between 2011 and 2019 inclusive, excluding data beyond 2019 owing to the Coronavirus disease 2019 (COVID-19) pandemic. We calculated rates of peanut-induced anaphylaxis presentations per 100,000 age-adjusted all-cause emergency department visits using 4-month intervals. Interrupted time series analysis was used to compare anaphylaxis rate trends before and after 2017 for children ages 0 to 2 and 3 to 17 years. We examined 2,011 cases of pediatric anaphylaxis, including 429 (21%) triggered by peanuts. Compared with pre-guideline estimates, the yearly rate of change of peanut anaphylaxis rates decreased by 7.96 (95% confidence interval -14.57 to -1.36; P= .018) after 2017 among patients with new-onset anaphylaxis in children 2 years of age or younger (n= 109). No significant changes were identified for older patients ages 3 to 17, or in patients with known peanut allergy. Early introduction guidelines in Canada are associated with a reduced risk of new-onset peanut-induced anaphylaxis in young children within a single center in Montreal. Further research is required to assess the impact on a wider population and other food allergens.

P.023 Review of imaging changes, cognitive decline, and dementia risk in cancer survivors after chemotherapy

Background: Cancer survival rates in Canada have been improving, leading to a steady increase in the number of survivors entering the typical ages of dementia onset. Yet, some cancer treatments (e.g. chemotherapy) are neurotoxic and adversely affect normal brain functioning. We conducted a review to examine changes observed in brain imaging and cognitive measures in survivorship, and long-term risk of dementia among cancer survivors. Methods: 91 Primary studies were selected from PubMed. Inclusion criteria were studies investigating the changes in brain imaging, cognition, and future dementia risk among adult survivors who received chemotherapy. Study quality was assessed based on 1) prospective, controlled design, 2) sample size, and 3) validated imaging and cognitive metrics. Results: Imaging studies identified MRI-based structural grey and white matter changes and functional network changes among survivors. Cognitive studies reported heterogeneous impairments in attention, memory, and executive function. In studies that examined dementia risk among cancer survivors, 67% reported lower risk of dementia, while 33% reported no association or a higher risk. Conclusions: While short-term cognitive impairment with associated changes on brain imaging is widely reported, findings concerning future or long-term cognitive impairment are mixed. Studies are warranted to identify potential connections between short-term and long-term cognitive function after cancer treatment.

The Research of the Birth Rate in Canada from 1951 to 2022

The Research of the Birth Rate in Canada from 1951 to 2022

Labour market mismatches in G7 countries: a fractional integration approach

ABSTRACT This paper examines the G7 labour market, analysing unemployment, job vacancies and the spread of both in terms of time series persistence from January 2002 to October 2023. Using fractional integration, we observe the series show long memory and persistence in all G7 countries. These findings differ slightly depending on the specification of the error term. If it is white noise, no evidence of mean reversion is found in any scenario except for US unemployment. With autocorrelated disturbances, mean reversion is found in unemployment rates in Canada, Germany, and the US. In France, this is the case for job vacancies, and in France and Italy, for spread. The UK is the only country that does not display any degree of reversion to the mean in the three series examined. Our results show evidence of a downward trend for unemployment and an upward trend for job vacancies in all G7 countries. Consequently, the reduction of the imbalance unemployment-vacancies seems permanent, which is a positive outcome for advanced economies.

Analysis of the Main Factors Affecting Employment Rates in Canada

The employment rate, as an important indicator of the level of economic development of a country or region, has always been a focus of attention for governments and economists. The purpose of this paper is to analyze the major factors that affect the employment rate in Canada. The scope of the study covers the whole of Canada. This study collected and analyzed the historical employment data, and analyzed the influencing factors of the employment rate through regression analysis and correlation analysis. Based on the results of the study, it can be concluded that a high level of the economy, inflation stabilization and a high level of technology are the main factors for Canadas high employment rate, while issues such as a low fertility rate and unbalanced regional development may limit the further increase of Canadas employment rate. This study is important for understanding the current situation and future direction of the Canadian job market. It also provides a number of policy recommendations to promote employment growth and economic development.

The Baltic and Nordic responses to the first Taliban poppy ban: Implications for Europe & synthetic opioids today

The 2000–2001 and the 2022–2023 Taliban opium bans were and could be two of the largest ever disruptions to a major illegal drug market. To help understand potential implications of the current ban for Europe, this paper analyzes how opioid markets in seven Baltic and Nordic countries responded to the earlier ban, using literature review, key informant interviews, and secondary data analysis.The seven nations’ markets responded in diverse ways, including rebounding with the same drug (heroin in Norway), substitution to a more potent opioid (fentanyl replacing heroin in Estonia), and substitution to one with lower risk of overdose (buprenorphine replacing heroin in Finland). The responses were not instantaneous, but rather evolved, sometimes over several years.This variety suggests that it can be hard to predict how drug markets will respond to disruptions, but two extreme views can be challenged. It would be naive to imagine that drug markets will not adapt to shocks, but also unduly nihilistic to presume that they will always just bounce back with no lasting effects. Substitution to another way of meeting demand is possible, but that does not always negate fully the benefits of disrupting the original market. Nonetheless, there is historical precedent for a European country's opioid market switching to synthetic opioids when heroin supplies were disrupted. Given how much that switch has increased overdose rates in Canada and the United States, that is a serious concern for Europe at present. A period of reduced opioid supply may be a particularly propitious time to expand treatment services (as Norway did in the early 2000s).

Differences in Antihypertensive Medication Prescription Profiles Between 2009 and 2021: A Retrospective Cohort Study of CARTaGENE.

Although blood pressure (BP) control is critical to prevent cardiovascular diseases, hypertension control rates in Canada are in decline. To assess this issue, we sought to evaluate the differences in antihypertensive medication prescription profiles in the province of Quebec between 2009 and 2021. This is a retrospective cohort study. We used data from the CARTaGENE population-based cohort linked to administrative health databases. Participants with any drug claim in the 6 months prior to the end of follow-up were included. Guideline-recommended antihypertensive drug prescription profiles were assessed at the time of enrollment (2009-2010) and end of follow-up (March 2021). Prescriptions practices from the 2 time periods were compared using Pearson's chi-square tests. A sensitivity analysis was performed by excluding participants in which antihypertensive drugs may not have been prescribed solely to treat hypertension (presence of atrial fibrillation/flutter, ischemic heart disease, heart failure, chronic kidney disease, or migraines documented prior to or during follow-up). Of 8447 participants included in the study, 31.4% and 51.3% filled prescriptions for antihypertensive drugs at the beginning and end of follow-up. In both study periods, guideline-recommended monotherapy was applied in most participants with hypertension (77.9% vs 79.5%, P = .3), whereas optimal 2 and 3-drug combinations were used less frequently (62.0% vs 61.4%, P = .77, 51.9% vs 46.7%, P = .066, respectively). Only the use of long-acting thiazide-like diuretics (9.5% vs 27.7%, P < .001) and spironolactone as a fourth-line agent (8.3% vs 15.9%, P = .054) increased with time but nonetheless remained infrequent. Results were similar in the sensitivity analysis. Specific indication of the prescribed antihypertensive medications and follow-up BP data was not available. Application of hypertension guidelines for the choice of antihypertensive drugs remains suboptimal, highlighting the need for education initiatives. This may be an important step to raise BP control rates in Canada.

Exploring Gender Diversity and Trauma- and Violence-Informed Sport for Development

The COVID-19 pandemic exacerbated gender-based violence (GBV) rates in Canada, especially affecting young women and gender-diverse youth. Trauma- and violence-informed physical activity and sport for development (SFD) are recognized strategies for supporting survivors of violence, preventing GBV, and challenging gender norms. This paper explores the potential of trauma- and violence-informed approaches with a Canadian SFD organization, focusing on programs aimed to promote gender diversity and address GBV. Grounded in intersectional feminism and queer theory, findings from interviews with SFD staff and participants (n = 15) revealed challenges in maintaining a trauma- and violence-informed approach in a heteronormative sporting space. In conclusion, further research on trauma-informed SFD is crucial due to increasing GBV rates in sport.

Effect of the COVID-19 Pandemic on Stillbirths in Canada and the United States

ObjectiveThere is uncertainty regarding the effect of the COVID-19 pandemic on population rates of stillbirth. We quantified pandemic-associated changes in stillbirth rates in Canada and the United States. MethodsWe carried out a retrospective study that included all live births and stillbirths in Canada and the United States from 2015 to 2020. The primary analysis was based on all stillbirths and live births at ≥20 weeks gestation. Stillbirth rates were analyzed by month, with March 2020 considered to be the month of pandemic onset. Interrupted time series analyses were used to determine pandemic effects. ResultsThe study population included 18 475 stillbirths and 2 244 240 live births in Canada and 134 883 stillbirths and 22 963 356 live births in the United States (8.2 and 5.8 stillbirths per 1000 total births, respectively). In Canada, pandemic onset was associated with an increase in stillbirths at ≥20 weeks gestation of 1.01 (95% confidence interval [CI] 0.56–1.46) per 1000 total births and an increase in stillbirths at ≥28 weeks gestation of 0.35 (95% CI 0.16–0.54) per 1000 total births. In the United States, pandemic onset was associated with an increase in stillbirths at ≥20 weeks gestation of 0.48 (95% CI 0.22–0.75) per 1000 total births and an increase in stillbirths at ≥28 weeks gestation of 0.22 (95% CI 0.12–0.32) per 1000 total births. The increase in stillbirths at pandemic onset returned to pre-pandemic levels in subsequent months. ConclusionThe COVID-19 pandemic’s onset was associated with a transitory increase in stillbirth rates in Canada and the United States.

A Preliminary Assessment of Short-Term Social and Substance Use-Related Outcomes Among Clients of Integrated Safer Opioid Supply Pilot Programs in Toronto, Canada

AbstractCanada is experiencing an ongoing overdose crisis, driven by a toxic unregulated drug supply. Integrated safer supply pilot programs offer pharmaceutical alternatives, coupled with comprehensive support services, to individuals using unregulated drug supply who are at high risk of overdose. We collected data from December 2020 to January 2023 on clients receiving safer opioid supply from five frontline service providers in Toronto, Canada, using interviewer-administered questionnaires. We assessed the incidence rate ratio of self-reported overdose comparing pre- and post-enrolment in the programs and examined changes in the prevalence of social and substance use outcomes post-enrolment. Forty-one participants were recruited, of whom 26 were followed up for a median of eight months (interquartile range, 5.0–11.7). The incidence rate ratio of overdose comparing post-enrolment to pre-enrolment was 0.20 (95% confidence interval, 0.09–0.43). Participants reported several positive social and substance use outcomes at follow-up, including a reduction in reliance on the unregulated supply and reduced criminal activity. Future implementation of integrated safer opioid supply pilot programs with larger sample sizes and rigorous epidemiological designs could help further illustrate the potential impacts of these programs in reducing overdose rates in Canada.

Development of Interventions to Support Provincial Implementation of the Baby-Friendly Initiative: A Study Protocol.

Breastfeeding is internationally recognized as the optimal form of infant nutrition. The Baby-Friendly Initiative (BFI) is an evidence-informed program that leads to improved breastfeeding outcomes. Despite the benefits of breastfeeding, Nova Scotia has one of the lowest breastfeeding rates in Canada. Additionally, only two birthing hospitals in the province have BFI designation. We aim to address this gap using a sequential qualitative descriptive design across three phases. In Phase 1, we will identify barriers and facilitators to BFI implementation through individual, semi-structured interviews with 40 health care professionals and 20 parents. An analysis of relevant policy and practice documents will complement these data. In Phase 2, we will develop implementation interventions aimed at addressing the barriers and facilitators identified in Phase 1. An advisory committee of 10-12 administrative, clinical, and parent partners will review these interventions. In Phase 3, the interventions will be reviewed by a panel of 10 experts in BFI implementation through an online survey. Feedback on the revised implementation interventions will then be sought from 20 health system and parent partners through interviews. This work will use implementation science methods to support integrated and sustained implementation of the BFI across hospital/community and rural/urban settings in Nova Scotia. This study was not registered.

Understanding COVID-19 vaccine hesitancy in Canada

While Canada has had relatively high vaccination rates against COVID-19, specifically during earlier waves of the pandemic, vaccine hesitancy has continued to serve as a significant barrier to adequate protection against the virus and, more recently, booster vaccine uptake. This paper explores the processes underlying Canadians’ perceptions of COVID-19 vaccines and their decisions to take or refuse them, as well as how public policy and health messaging about vaccination has influenced vaccination attitudes and behaviors. Our focus group interviews with 18 vaccinated and unvaccinated adult Canadians conducted during October 2021 reveal that, in some respects, COVID-19 vaccine hesitancy conforms to prior knowledge about some of the factors that affect vaccine attitudes (e.g., the influence of known medical providers) but deviates from current theoretical frameworks regarding general vaccine hesitancy. Specifically, these frameworks emphasize a lack of scientific knowledge and literacy (“knowledge deficit” accounts) or individuals’ inability to incorporate rational risk perceptions into initial emotional responses to vaccines (“emotionality/irrationality” accounts). In contrast to the knowledge deficit account, we find that expressions of COVID-19 vaccine hesitancy were most frequently associated with an information surplus or inability to prioritize information from multiple and often contradictory sources. Furthermore, top-down pro-vaccination messaging often triggered significant pushback against what participants perceived as moral shaming of the unvaccinated. Our findings demonstrate the necessity for a new framework to understand and address vaccine hesitancy. A better theoretical account of vaccine hesitancy has important implications for future vaccination efforts, specifically within the context of new variants and low booster vaccination rates in Canada.

Emerging adult perceptions of higher-risk cannabis consumption behaviours

BackgroundEmerging adults have the highest cannabis consumption rates in Canada and are among the most vulnerable to cannabis-related harms. Since certain cannabis consumption behaviours carry greater risks of harm, the Lower-Risk Cannabis Use Guidelines (LRCUG) provide harm reduction strategies. To address a critical gap in the literature, the current study examined emerging adults’ awareness of the guidelines and perceptions of higher-risk cannabis consumption behaviours identified within the LRCUG.MethodsEmerging adults (N = 653) between the ages of 18–25 years were recruited from across Canada. Participants were presented with five vignettes depicting a character’s cannabis consumption behaviours. Each vignette focused on a unique aspect of the character’s consumption (frequency, polysubstance use, family history of mental illness, method of consumption, and potency). Participants were randomly assigned to one of three conditions within each of the five vignettes that were altered to capture varying levels of risk (e.g. weekly, almost daily, or daily consumption). Following each vignette, participants were asked to respond to four items relating to overall risk of harm, cognitive health, physical health, and mental health.ResultsParticipants perceived: (1) frequent consumption to be associated with greater risks than less frequent consumption; (2) simultaneous consumption of cannabis and tobacco as being associated with higher risk of harm, yet no difference between simultaneous consumption of cannabis and alcohol or cannabis consumption alone; (3) consuming cannabis with a family history of psychosis or substance use disorder as being associated with greater overall risk than consumption with no family history; (4) smoking and vaping cannabis as associated with more risk than ingesting edibles; and (5) higher-potency THC-dominant strains as being associated with more risk than lower-potency CBD-dominant strains, yet no difference between the two higher-potency THC-dominant strains.ConclusionsWhile emerging adults seemed to appreciate the risks associated with some cannabis consumption behaviours, they had difficulty identifying appropriate levels of harm of other higher-risk behaviours. Through an improved understanding of emerging adult perceptions, effective education campaigns should be designed to improve the awareness of cannabis risks and encourage the uptake of harm reduction awareness and strategies.

Poster (Health Services, Economics and Policy Change) ID 2001712

Background/Objectives Collaborative research with community members has been identified as “one of the best ways to support rapid application of research evidence” by focusing research to the needs of users. As funders and researchers rush to bridge the gap in healthcare delivery, there arises a need to build on integrated knowledge translation (IKT) best practices to support equitable PLEX compensation. This research will help determine the monetary value of PLEX when participating in research. Methodology An environmental scan of healthcare funders, institutions and organizations patient partners /lived experience compensation rates in Canada, United States, and select countries from 2010-2023 provided a baseline data set. A systematic scan of published literature and grey literature of this nascent field, PLEX compensation rates was synthesized from this analysis and aligned with the SPOR guidelines. A third party conducted a check of the data abstraction to ensure high data quality. Results Early results indicate a wide range of patient compensation rates from $40-200 a session with limited information on SCI-specific compensation. Conclusion This research provides a rationale for fair and equitable compensation of PLEX, with a compensation matrix based on the level of engagement.

Insurance approval rates for collagenase clostridium histolyticum prior to discontinuation: a Canada-wide analysis.

Collagenase Clostridium histolyticum (CCh), the first approved non-surgical treatment for Peyronie's disease (PD), was withdrawn from the European, Canadian, and Asian markets due to poor demand and lack of government reimbursement options. We sought to assess insurance approval rates and usage of CCh across Canada to understand the factors that led to its withdrawal. Data on patients prescribed CCh for PD or Dupuytren's contracture was obtained through collaboration with BioScript Solutions to assess the association of variables with insurance approval and prescription filling. We identified 3297 insurance coverage applications for Xiaflex® from April 2018 to June 2020. Of all applications for PD, 92.9% applications were approved while 7.1% were rejected. Despite the withdrawal of CCh from Canadian markets, coverage application approval rates for 2018, 2019, and 2020 were 86.5%, 90.1%, and 89.1%, respectively. Of 2921 approved applications, 88.8% prescriptions were filled. For the 376 rejected applications, 66.4% of prescriptions were filled. Overall, 90% of the cost of Xiaflex® was covered in Canada among those with extended health benefits, with an out-of-pocket expense of $210.4. Insurance coverage requests for Xiaflex® were approved at a high rate in Canada with approved patients being very likely to proceed with therapy, despite interprovincial variation.