Saskatchewan Population Research Articles

HPV Self-Sampling for Cervical Cancer Screening in Under-Screened Saskatchewan Populations: A Pilot Study.

Of all cancers in female Canadians, the most rapidly increasing incidence is that of cervical cancer. The objective of this pilot study was to assess how HPV self-sampling might improve cervical cancer screening participation in both urban and rural settings in Saskatchewan, one of the most sparsely populated provinces in Canada. Study groups consisted of n = 250 participants to whom self-swabbing kits were mailed with instructions and n = 250 participants to whom kits were handed out in 6 urban and rural clinics. The inclusion criteria selected subjects aged 30-69 years who were Saskatchewan residents for at least 5 years with valid health coverage, had a cervix, and had no record of cervical cancer screening in 4 years. The returned samples were analyzed for specific HPV strains using the Roche Molecular Diagnostics Cobas 4800® System. The overall response rate was ~16%, with the response to the handout distribution being roughly double that of the mailout. While HPV positivity did not differ across the distribution groups, participants at a specific inner-city clinic reported significantly higher positivity to at least one HPV strain as compared to any other clinic and all mailouts combined. For this high-risk population, in-person handout of self-sampling kits may be the most effective means of improving screening.

46 Patterns of referrals for evaluation of Autism Spectrum Disorder in the pediatric population of Saskatchewan as a predictor of diagnostic outcome

Abstract Background The Alvin Buckwold Child Development Program (ABCDP) serves Northern and Central Saskatchewan as a tertiary diagnostic centre for Autism Spectrum Disorder (ASD) but data is lacking on referrals and diagnostic outcome. Objectives This study aimed to assess if referral patterns are associated with diagnostic outcome of ASD. Design/Methods We conducted a retrospective cross-sectional study of patients from the ABCDP who were referred and assessed for ASD, or who received a diagnosis of ASD, from January 1st, 2016 to December 31st, 2018. Predictor variables were the referring clinician type and referral content. Suspicion for ASD from referrals were reported as being concerning for one, both or none of the DSM-5 core criteria for ASD (social communication and interaction “criteria A”; restricted and repetitive behaviors “criteria B”). When available, speech-language pathologist (SLP) reports were reviewed to identify concerns of social communication. The main outcome was a diagnosis or not of ASD. Risk ratio (RR) and odds ratio (OR) were estimated by simple logistic regression models to assess the association between individual variables of referral patterns and diagnosis of ASD. Results The final dataset included 527 patients after excluding 128 patients (123 were not seen at our center and 5 had a virtual assessment of ASD). A total of 365 patients received a diagnosis of ASD, 140 did not receive a diagnosis, 21 had their diagnosis deferred and one had this information missing. Referrals by physiotherapist (PT) were 46% more likely than other sources of referrals to lead to a diagnosis of ASD (RR=1,46; 95% CI 1,37-1,54; p=0,022). Referrals by SLP were 25% more likely than other sources of referrals to lead to a diagnosis of ASD (RR=1,25; 95% CI 1,12-1,39; p<0,0001). Referrals identifying concerns of social communication in SLP reports were 29% more likely than other sources of referrals to lead to a diagnosis of ASD (RR=1,29; 95% CI 1,16-1,43; p<0,0001). Using no criteria as reference group, referrals with concerns of criteria A were about 2.7 times more likely to lead to a diagnosis of ASD (OR=2,69; 95% CI 1,427-5,054; p=0,002). Conclusion In our study population, we found that certain referring clinician type (SLP, PT) and content of referrals (concerns for social communication in SLP reports, main concerns related to criteria A) are more likely to lead to a diagnosis of ASD. These findings could be used to identify referrals with a higher risk of ASD and allocate resources accordingly.

COVID-19 vaccine hesitancy and refusal and associated factors in an adult population in Saskatchewan, Canada: Evidence from predictive modelling.

BackgroundA high population level of vaccination is required to control the COVID-19 pandemic, but not all Canadians are convinced of the value and safety of vaccination. Understanding more about these individuals can aid in developing strategies to increase their acceptance of a COVID-19 vaccine. The objectives of this study were to describe COVID-19 vaccine acceptance, hesitancy and refusal rates and associated factors in Saskatchewan, Canada.MethodsThis is a cross-sequential study that consisted of pooled responses from weighted samples of 9,252 Saskatchewan adults (≥18 years) across nine rounds of data collection between May 4, 2020 and April 3, 2021. The outcome variable was vaccine intention: vaccine acceptance, hesitancy, and refusal. The independent variables were layered into socio-demographic factors, risk of exposure to coronavirus, mitigating behaviours, and perceptions of COVID-19. Data were analyzed using multinomial logistic regression and a classification and regression tree.ResultsSeventy-six percent of the respondents indicated that they had been or were willing to be vaccinated, 13% had not yet decided, and the remaining 11% said they would not be vaccinated. Factors that increased the likelihood of vaccine refusal and hesitancy were lower education level, financial instability, Indigenous status, and not being concerned about spreading the coronavirus. Perceiving COVID-19 to be more of a threat to one’s community and believing that one had a higher risk of illness or death from COVID-19 decreased the likelihood of both vaccine refusal and hesitancy. Women and newcomers to Canada were more likely to be unsure about getting vaccinated. Respondents who did not plan to be vaccinated were less likely to wear face masks and practice physical distancing.ConclusionWhile many Canadians have voluntarily and eagerly become vaccinated already, reaching sufficient coverage of the population is likely to require targeted efforts to convince those who are resistant or unsure. Identifying and overcoming any barriers to vaccination that exist within the socio-demographic groups we found were least likely to be vaccinated is a crucial component.

Incidence and trends of limb amputation in first nations and general population in Saskatchewan, 2006-2019.

BackgroundThere is conflicting evidence whether limb amputation (LA) disproportionately affects indigenous populations. To better understand this disparity, we compared the LA incidence rate between First Nations persons registered under the Indian Act of Canada (RI) and the general population (GP) in Saskatchewan.MethodsWe used Saskatchewan’s retrospective administrative data containing hospital discharge LA cases, demographic characteristics (age and sex), and residents population reported in the database stratified by RI and GP from 2006–2019. The LA cases for each stratified group were first disaggregated into three broad categories: overall LA (all reported LA), primary LA (first reported LA), and subsequent LA (revision or contralateral LA), with each category further split into the level of amputation defined as major amputation (through/above the ankle/wrist joint) and minor amputation (below the ankle/wrist joint). LA rates were calculated using LA cases as the numerator and resident population as the denominator. Joinpoint and negative binomial regressions were performed to explore the trends further.ResultsOverall, there were 1347 RI and 4520 GP LA cases reported in Saskatchewan from 2006–2019. Primary LA made up approximately 64.5% (869) of RI and 74.5% (3369) of GP cases, while subsequent LA constituted 35.5% (478) of RI and 25.5% (1151) of GP cases. The average age-adjusted LA rate was 153.9 ± 17.3 per 100,000 in the RI cohort and 31.1 ± 2.3 per 100,000 in the GP cohort. Overall and primary LA rates for the GP Group declined 0.7% and 1.0%, while subsequent LA increased 0.1%. An increased LA rate for all categories (overall 4.9%, primary 5.1%, and subsequent 4.6%) was identified in the RI group. Overall, minor and major LA increased by 6.2% and 3.3%, respectively, in the RI group compared to a 0.8% rise in minor LA and a 6.3% decline in major LA in the GP group. RI females and males were 1.98–1.66 times higher risk of LA than their GP counterparts likewise, RI aged 0–49 years and 50+ years were 2.04–5.33 times higher risk of LA than their GP cohort. Diabetes mellitus (DM) was the most prevalent amputation predisposing factor in both groups with 81.5% of RI and 54.1% of GP diagnosed with DM. Also, the highest proportion of LA was found in the lowest income quintile for both groups (68.7% for RI and 45.3% for GP).ConclusionSaskatchewan’s indigenous individuals, specifically First Nations persons registered under the Indian Act of Canada, experience LA at a higher rate than the general population. This disparity exists for all variables examined, including overall, primary, and subsequent LA rates, level of amputation, sex, and age. Amplification of the disparities will continue if the rates of change maintain their current trajectories. These results underscore the need for a better understanding of underlying causes to develop a targeted intervention in these groups.

No decrease in incidence of arthroscopic meniscectomy in a Canadian province.

Arthroscopic meniscectomy (APM) is the most common procedure in orthopedic surgery, despite increasing evidence questioning its benefit over conservative management for treatment of degenerative meniscal tears. The purpose of this study is to determine the epidemiology and trends of APM in Saskatchewan, a Canadian province, over a 20year period. Physician billing codes were used to identify patients who underwent APM in Saskatchewan between January 1, 1998 and December 31, 2017. Records were obtained from eHealth Saskatchewan, a provincial health database. Data was analyzed for overall incidence and age-specific trends of APM. A total of 35,099 APMs were performed during the study period. The population of Saskatchewan ranged from 992,314 to 1,150,782 (median 1,017,368) during this time interval, with 81 orthopedic surgeons performing APM. Overall incidence rate of APM did not change significantly over time. No decrease was observed in patients presumed to have degenerative tears (≥ 50years). The number of meniscectomies in patients ≥ 50years was significantly greater during the second decade of study compared to the first (OR 1.48, p < 0.01). Conversely, the increase in incidence rate among older patients was not statistically significant (R2 = 0.125, n.s.). Overall incidence rate of APM in Saskatchewan has not decreased during the last 20years. Furthermore, APM frequency increased over time for individuals ≥ 50years. Several regional factors may have contributed to these findings, including the large proportion of Saskatchewan residents engaged in physically demanding work and barriers to accessing physiotherapy services. Given recent evidence disputing the benefit of APM over conservative measures, this study highlights the need for improved dissemination of evidence, as well as the importance of an individualized treatment plan to address patient-specific factors. Level IV.

Higher mortality rates associated with rheumatoid arthritis in Saskatchewan, Canada, 2001-2019.

To estimate provincial all-cause mortality rates of Saskatchewan people with rheumatoid arthritis (RA) for comparison with the general population over time and between different geographic regions. Saskatchewan provincial administrative health databases (2001-2019) were utilized as data sources. Two RA case definitions were employed: (1) ≥ 3 physician billing diagnoses, at least 1 from a specialist (rheumatologist, general internist or orthopaedic surgeon) within 2years; (2) ≥ 1 hospitalization diagnosis (ICD-9 code 714, and ICD-10-CA codes M05, M06). Data from these definitions were combined to create an administrative data RA cohort. All-cause mortality rates across geographic regions, between rural/urban residences and between sexes were examined. Over an 18-year span, between fiscal-year 2001-2002 and fiscal-year 2018-2019, age- and sex-adjusted mortality rates ranged from 17.10 to 21.04 (95%CI 14.77, 19.44; 18.03, 24.05)/1000 RA person-years, compared with mortality rates for the general Saskatchewan population without RA, which ranged from 9.37 to 10.88 (95%CI 9.23, 9.51; 10.72, 11.05)/1000 person-years. Fiscal-year mortality rate ratios ranged from 1.82 to 2.13 (95%CI 1.56, 2.13; 1.83, 2.46). Provincial mortality rates were higher in men than in women for both general and RA populations. Northern Saskatchewan mortality rates were significantly higher in the general population but did not achieve significance compared with other provincial regions for the RA population. Regression analysis identified age, male sex, RA and geographic region as factors contributing to increased mortality. A trend towards lower mortality rates over time was observed. Higher mortality rates were observed in the RA population overall. Men had higher mortality rates, as did residents of Northern Saskatchewan compared with residents of other regions for the general population.

Shoulder Dysfunction in Breast Cancer Survivors: Can Treatment Type or Musculoskeletal Factors Identify Those at Higher Risk?

Background and Objective: Breast cancer is the most commonly diagnosed cancer in Canadian women. Breast cancer survivors are known to experience shoulder dysfunction, but the influence of musculoskeletal and treatment factors has yet to be investigated in a Saskatchewan population, which was the purpose of this study. Methods: Two study designs were used to assess risk factors for dysfunction: (1) a cross-sectional Web-based questionnaire and (2) prospective cohort analysis of preoperative musculoskeletal assessment combined with postoperative Shoulder Pain and Disability Index (SPADI) score. Data from the survey were summarized and analyzed using χ2 tests (P &lt; .05), while nonparametric measures were used to calculate temporal differences and associations between musculoskeletal risk factors and disability. Results: Commonly reported shoulder problems after treatment were stiffness (63.5%), restricted range of motion (61.9%), and changes in arm/hand sensation (61.9%). Axillary lymph node dissection and radiation therapy were associated with more shoulder problems than other treatment types. SPADI scores increased by an average of 8.1% from baseline to 3 months postsurgery. A clinically significant 18% increase between these time points was moderately associated with a history of shoulder problems and restricted humeral extension preoperatively (average = 37.7° vs 48.9°). Conclusions: Breast cancer survivors from Saskatchewan have a high prevalence of shoulder problems following treatment. Clinically significant impairments in shoulder function are associated with select treatment types and preoperative impairments. These results can be used to identify high-risk patients before cancer treatment and direct their rehabilitation.

Distribution of alfalfa weevil (Coleoptera: Curculionidae) and its parasitoids on the Canadian Prairies, with a key to described species of NearcticBathyplectes(Hymenoptera: Ichneumonidae)

AbstractThis study recorded distribution and size of alfalfa weevil (Hypera postica(Gyllenhal); Coleoptera: Curculionidae) populations in Saskatchewan, Canada, from 2001 to 2014. The spread of alfalfa weevil across the province, originally southwest to southeast, was northward and westward during this time. By 2014, only northwestern and west central areas remained relatively alfalfa weevil free. From a minor pest in 2001, the alfalfa weevil increased to be the principal insect pest of alfalfa (Medicago sativaLinnaeus; Fabaceae) in 2014. The parasitoidBathyplectes curculionis(Thomson) (Hymenoptera: Ichneumonidae) had a similar distribution. Other parasitoids collected includedOomyzus incertus(Ratzeburg) (Hymenoptera: Eulophidae) andMicroctonus colesiDrea (Hymenoptera: Braconidae). Conservation of these parasitoids is an important step in maximising their effectiveness as alfalfa weevil biocontrol agents. Molecular sequencing of the DNA barcoding region of specimens identified morphologically asB. curculionisindicated moderately high levels of sequence divergence among specimens (up to 5.8%); however, interspecific genetic variation between other species ofBathyplectesFörster was also high. Therefore, we conclude thatB. curculioniswas the onlyBathyplectesspecies collected in our study. An illustrated key to the described species ofBathyplectesin North America is provided, as well as DNA barcodes of most species, including five distinct barcodes in theBathyplectes curculionis–B. exiguus(Gravenhorst) species complex.

Predictors of hospitalization in a Canadian MS population: A matched cohort study

ObjectiveHospitalizations are the most costly component of healthcare in Canada, and hospitalization rates are higher in the multiple sclerosis (MS) population compared to the general population. This study aimed to examine predictors of hospitalizations in the MS population in Saskatchewan, Canada. MethodsThis retrospective cohort study used population-based health administrative data from Saskatchewan, Canada from 1996 to 2016. Subjects with MS were identified using a validated definition (≥3 hospital, physician, or drug claims for MS). Up to five general population controls were identified for each MS case and matched on sex, age, and geographical location. The rate of hospitalizations and reason for admission were determined for each case and control. Negative binomial (hospitalization rate) and binary logistic (reason for admission) regression models fitted with generalized estimating equations were used to test the following potential predictors: sex, age, median household income, calendar year, prior hospitalizations, and comorbidity status. ResultsWe identified 4,878 MS cases (11,744 hospitalizations), and 23,662 matched controls (32,541 hospitalizations). Higher comorbidity burden, older age, and prior hospital admissions were associated with an increased rate of all-cause hospitalizations for both cohorts. Males were more likely to be hospitalized than females for all-cause (adjusted rate ratio: 1.20; 95% CI: 1.07 – 1.34) and MS-specific (adjusted odds ratio: 1.34; 95% CI 1.15 – 1.55) hospitalizations. The rate of MS-specific hospitalizations decreased with age, and there was no association with comorbidity or prior hospitalizations. A diagnosis of MS was associated with decreased odds of hospitalization due to neoplasms, diseases of the circulatory system, and mental health and behavioural disorders. ConclusionIncreased age, comorbidity, and prior hospital admissions are predictors of all-cause hospitalizations. Conversely, MS-related hospitalizations decreased as subjects aged, and there was no association with comorbidity. Our results highlight that reasons for hospitalizations can differ by age, and clinicians should consider this when managing patients, as they make efforts to reduce hospitalizations in the MS population.

The Homesteaders: From Confederation to the Great War by Sandra Rollings-Magnusson

Reviewed by: The Homesteaders: From Confederation to the Great War by Sandra Rollings-Magnusson Bill Waiser The Homesteaders: From Confederation to the Great War. By Sandra Rollings-Magnusson. Regina: University of Regina Press, 2018. xi + 175 pp. Figures, endnotes, bibliography. $39.95 CDN $29.95 USD, paper. It was a Saskatchewan success story. Six years after entering confederation as a province, Saskatchewan's population almost doubled, making it the third most populous province in Canada. The reason for the dramatic growth was settlers—lots of them. More people applied for homesteads in western Canada in the first decade of the twentieth century than during the entire previous century. In fact, for the years 1906 through 1911, three out of every five [End Page 106] homestead entries in the three prairie provinces were in Saskatchewan. Sandra Rollings-Magnusson tells this story in The Homesteaders. The work is an informative and intimate portrait of the Saskatchewan homesteading experience, largely in the words of those who settled the land. In 1955, as part of the province's diamond jubilee celebrations, the Provincial Archives of Saskatchewan sent questionnaires to homesteading families with an invitation to provide information in a number of areas. Thirty-five hundred responses were received—and Rollings-Magnusson has mined every one in preparing the book. The Homesteaders documents the recollections of those who won the prairie gamble—in other words, those who stayed on the land and successfully met their homestead requirements. The book not only describes the challenges that prospective settlers faced in turning their pioneer holdings into working farms, but also examines other day-to-day activities such as cooking, schooling, or social events. Rollings-Magnusson makes great use of the questionnaires to talk about these experiences. And she has nicely complemented the text with the rich photographic record. Anyone with farming roots will get lost in the book for several hours. What is generally missing, though, are those that failed to prove up. Success could be elusive—dependent on any combination of factors—and 2 of every 5 (40 percent) gave up. Their voices are understandably absent from the questionnaires. But their story needs to be told. The homesteading system assumed that all the land was of equal value, and settlers on marginal land found themselves in an impossible situation. Rollings-Magnusson also rightly notes that it was a white settlement frontier, that settlers of color were not welcome. But immigrants from continental Europe also faced discrimination from the dominant Anglo-Canadian society, and their treatment needs greater examination. Finally, Rollings-Magnusson explains that Indigenous people were not part of the settlement experience—had no future in the region—and are consequently missing from the story. But they didn't disappear. Indigenous people helped settlers in any number of ways—from cutting hay and fence posts to picking rocks to serving as midwives. Indeed, until large-scale mechanization arrived on the prairies, Indigenous people were a vital part of the farm labor force. That contribution needs to be recaptured to come to a better, fuller understanding of Saskatchewan's great success story. Bill Waiser Department of History University of Saskatchewan Copyright © 2020 Center for Great Plains Studies, University of Nebraska–Lincoln

OLDER ADULTS AND THE WORLD CAFé APPROACH: CROSS-GENERATIONAL INITIATIVES IN RESEARCH AND EDUCATION

In Canada, numbers of older adults are considered to be increasing, and by 2036, it is expected that seniors will reach 25% of the total population. Since 2009, the Saskatchewan Population Health and Evaluation Research Unit (SPHERU) has developed an interdisciplinary approach to a community-based research program focused on rural older adults. The world café approach is recognized as collaborative and ideal for encouraging dialogue, sharing knowledge, and developing action plans. Set up like a café, four to six participants at each table engage in a series of three conversational rounds lasting approximately 20 minutes each. At the end of each round, participants move to different tables while the facilitator(s) remain at their original tables. We incorporated a world café approach in three distinct research projects, facilitating a total of five world café events. For each of these events, we also engaged with graduate and undergraduate students who were trained to serve as table facilitators. Participating students represented a variety of disciplines including social work, nursing, and gerontology. Older adults participating in the world café events reported positive experiences and appreciation for the opportunity to discuss new information. Student facilitators identified their participation as a “real life” learning and networking opportunity that enhanced their classroom experiences. Challenges identified included issues related to individual mobility, and issues related to noise and sound quality for those with hearing deficiencies. A community-based approach to research is effective when engaging with this population, and a word café event brings seniors directly into the discussion.

Passive and Active Surveillance for Ixodes scapularis (Acari: Ixodidae) in Saskatchewan, Canada.

Passive and active surveillance for the blacklegged tick, Ixodes scapularis Say, in the Canadian province of Saskatchewan was conducted over a 9-yr period (2009-2017). More than 26,000 ixodid ticks, representing 10 species, were submitted through passive surveillance. Most (97%) of these were the American dog tick, Dermacentor variabilis (Say). Of the 65 I. scapularis adults submitted, 75% were collected from dogs. Infection rates of Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti in I. scapularis were 12%, 8%, and 0%, respectively. Although the I. scapularis submitted by passive surveillance were collected from five of seven ecoregions in central and southern Saskatchewan, they were most frequent in the Moist Mixed Grassland and Aspen Parklands. In contrast, no I. scapularis were collected from the extensive field sampling conducted at multiple sites in different ecoregions across the province. Hence, there is no evidence of I. scapularis having established a breeding population in Saskatchewan. Nonetheless, continued surveillance for blacklegged ticks is warranted given their important role as a vector of medically and veterinary important pathogens, and because they have recently become established across much of the southern portions of the neighboring province of Manitoba.

Resilience of Farm Women Working the Third Shift

ABSTRACTBackground: We examined physical health and work experiences in a Saskatchewan population of farm women, and determined how participation in the “third shift” (a phenomenon where women engage in off-farm employment, farm labor, and as homemakers) relates to their demographic, physical health, and work experiences. Materials and Methods: This is a cross-sectional epidemiological study. Reports from 980 women who lived or worked on Saskatchewan farms were analyzed to describe their health status, comorbidities, use of medications, and exposures to farm work. Regression models were used to explore determinants of participation in the third shift. Results: Two hundred and sixteen were women [22.0%] engaged in the “third shift”, and these women consistently reported significantly longer mechanized and non-mechanized farm work hours. Compared to women not involved in the third shift, participants in the third shift were more likely to be: 41–50 years of age [ORAdj 2.06 (1.12, 3.77)], and involved in beef cattle production [ORAdj 1.62 (1.05–2.49)], large animal chores [ORAdj 1.66 (1.04–2.66)], use of shovels/pitchforks [ORAdj 1.67 (1.08–2.57)], combine operation [ORAdj 1.72 (1.08–2.74)], and have higher levels of education [e.g., ORAdj 0.46 (0.29–0.72) for high school or less]. Descriptively, reduced engagement in the third shift was associated with “fair or poor” health status [ORCrude 0.32 (0.14–0.76)] and more co-morbidities [e.g., ORCrude 0.50 (0.33, 0.75) for 2 or more versus none reported]. Conclusion: This study found that farm women often report high levels of work, including engagement in the third shift. Women engaged in the third shift are also generally healthier than non-engaged women, consistent with a healthy worker effect.

“I’m not really healed … I’m just bandaged up”: Perceptions of healing among former students of Indian residential schools

Attempts at resolution between former students of Indian residential schools and the non-Aboriginal Canadian population began with the signing of the Indian Residential Schools Settlement Agreement in 2006. The Settlement Agreement outlined provisions for the Truth and Reconciliation Commission to document the stories of former students and for the Resolution Health Support Program to offer emotional and cultural support to former students and their families. Although former students have catalogued their stories through the Truth and Reconciliation Commission process, experiences of healing from the events of Indian residential schools remain relatively unknown. The purpose of this qualitative study was to explore the perceptions of healing among former Indian residential school students. In partnership with an Aboriginal support agency in a small Saskatchewan city, we interviewed 10 Aboriginal people affected by residential schools. The focus of the interviews was to generate participants’ conceptions and experiences of healing regarding their residential school experiences. We found all participants continued to experience physical, mental, emotional, and/or spiritual impacts of residential school attendance. Disclosure of their experiences was an important turning point for some participants. Their efforts to move on varied from attempting to “forget” about their experience to reconnecting with their culture and/or following their spiritual, religious, or faith practices. Participants also noted the profound intergenerational effects of residential schools and the need for communities to promote healing. The findings will be used to guide an assessment of the healing needs among this population in Saskatchewan.

Identifying superusers of health services with mental health and addiction problems: Putting the Canadian Institutes of Health Research Strategy for Patient Oriented Research into action

ABSTRACT&#x0D; ObjectiveWe were funded by Canadian Institutes of Health Research Strategy for Patient Oriented Research (CIHR-SPOR) to use administrative data to identify people with mental health and/or addiction (MHA) problems, and determine characteristics that lead to them becoming a superuser of health services. The aim of the CIHR-SPOR is to ensure that research improves healthcare systems and practices. Their approach is to fundamentally change the ivory tower nature of research to make it more inclusive, user friendly, and timely. An essential component of the CIHR-SPOR is engaging patients as partners at all stages of the research. In this presentation we will describe the challenges, successes, and failures of engaging patients as part of the research team.&#x0D; ApproachIn Saskatchewan, Canada, we engaged with community programs to determine the ‘on-the-ground’ reality of people living with MHA problems. Our discussions revealed that First Nations and Métis People are highly overrepresented in the MHA patient population. For example, they comprise 15% of the Saskatchewan population yet 70% of patients receiving treatment at a local methadone clinic. For this reason, we are focusing our efforts on engaging with this specific patient population.&#x0D; ResultsWe encountered a number of barriers to finding patient advisors. First, patient advisors available through institutional programs are not representative of our target population, being more affluent, well-educated, and Caucasian. There are currently no formal avenues to identify and invite members of the target population to join the research team and so we are using personal connections and team building to identify patients advisors. Second, complicated institutional policies on reimbursement for patient advisors impede participation by low income individuals. Third, we are concerned the socioeconomic disparities common in this vulnerable population may impede their full and honest participation as a patient advisor.&#x0D; ConclusionsPatients and their family members are invaluable members of the research team. However, a power differential often exists between team members and patients due to socioeconomic differences, including race and education. Stigmatized health conditions such as MHA problems can exacerbate the feelings of a power differential. All of these things can prevent genuine involvement by patients. The most important step in successfully involving these untraditional team members is building trust through unconditional acceptance and respect for each individual’s lived experience. Building trust takes time and so patient engagement cannot be expected to follow a rigid schedule.

Examining the Supply of and Demand for Physiotherapy in Saskatchewan: The Relationship between Where Physiotherapists Work and Population Health Need.

Purpose: This research examined the association between the distribution of physiotherapists in Saskatchewan relative to population health characteristics and self-reported physiotherapy use. Methods: Using a cross-sectional design, de-identified data were collected from the 2013 Saskatchewan College of Physical Therapy membership renewals (n=643), and Saskatchewan population health characteristics data were obtained from the 2009-2012 Canadian Community Health Surveys (CCHSs). Age- and sex-adjusted proportions of selected population health characteristics were calculated and stratified by health region and rural-urban location; both were determined, for physiotherapists and CCHS participants, using postal codes. The association between physiotherapy distribution and physiotherapy use was calculated, and geospatial mapping techniques were used to display physiotherapist distribution across the province relative to population health characteristics. Results: Across health regions, a positive correlation (r=0.655, p<0.029) was found between physiotherapist distribution and self-reported physiotherapy use. Mapping population health characteristics according to physiotherapist distribution demonstrated an imbalance between supply and distribution of physiotherapists and population health needs and demands. Conclusion: There is a discrepancy in Saskatchewan among the distribution of physiotherapists, self-reported physiotherapy use, and population health characteristics, especially in rural settings. These findings provide insight into which areas are in need of increased physiotherapy services.

Physiologic specialization of Puccinia triticina, the causal agent of wheat leaf rust, in Canada in 2010

Puccinia triticina Eriks., the causal agent of wheat leaf rust, was collected across Canada in 2010 to determine the virulence spectrum present in the pathogen population. From 314 infected leaf collections, 399 single pustule isolates were recovered, including 341 from Manitoba and Saskatchewan, 38 from Ontario, nine from Quebec and 11 from Prince Edward Island (PEI). When analysed for virulence on 16 standard differential lines, 41 different virulence phenotypes were identified. The most common were MLDS (26.1%), TDBJ (22.8%) and TDBG (11.8%). In Manitoba and Saskatchewan, the most common phenotypes were MLDS (29.6%), TDBJ (25.5%) and TDBG (13.8%), which were also abundant in 2009. In Ontario, the most common were MBTN (23.7%), TDBJ (10.5%), MCGJ, MCTN and MLDS (each at 7.9%), whereas in Quebec, each of the nine isolates analysed had a different phenotype. In PEI, the more commonly isolated phenotypes were MBNQ (six isolates), MBTN and MHNQ (two isolates each). Each population had unique virulence phenotypes, and the eastern populations were more diverse than the Manitoba and Saskatchewan population. Virulence trends from previous years continued in 2010, with increasing levels of virulence found for Lr9 and Lr17 while decreasing virulence was found for Lr2a, Lr14a and Lr24. There was no virulence found in 2010 for Lr19, Lr21, Lr22a, Lr29, Lr32 or Lr52.

Predictors of Cognitive Decline in a Rural and Remote Saskatchewan Population With Alzheimer's Disease.

To determine the predictors of cognitive decline in a rural and remote population with Alzheimer's disease (AD), we examined the association between cognitive change and sociodemographic, clinical, and functional data at the initial day of diagnosis. Simple linear regression analysis and multiple regression analysis were used to determine the predictors of cognitive decline as measured by the difference in the Mini-Mental State Examination over 1 year. Our sample included 72 patients with AD. Age at the clinic day appointment was 75.3 (standard deviation [SD] = 7.44). History of hypertension and decreased ability to carry out activities of daily living were statistically significant and predicted greater cognitive decline at 1 year. Many previously suggested predictors of cognitive decline were not evidenced in this study. This research helps identify clinically useful predictors of decline in a rural and remote population with AD.

Race Characterization of Puccinia striiformis f. sp. tritici, the Cause of Wheat Stripe Rust, in Saskatchewan and Southern Alberta, Canada and Virulence Comparison with Races from the United States.

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici, has been common across Saskatchewan, Canada since 2000. Fifty-nine isolates of P. striiformis f. sp. tritici, the majority of which were collected between 2011 and 2013 from Saskatchewan and southern Alberta, were analyzed for virulence frequency and diversity and compared with isolates characterized in the Pacific Northwest and Great Plains regions of the United States. In all, 31 wheat differentials, including 20 near-isogenic lines and 1 triticale variety, differentiated 59 P. striiformis f. sp. tritici isolates into 33 races, of which one race, C-PST-1, represented 31% of the isolates. None of the races were virulent on Yr5, Yr15, or YrSP. Virulence frequency ranged from 65 to 98% on YrA, Yr2, Yr8, Yr9, Yr27, Yr29, Yr32, YrSu, 'Heines VII', and 'Nord Deprez'. Race C-PST-6 was virulent on the greatest number of the differentials (n = 25) and C-PST-18 on the fewest (n = 14). Discriminant analysis of principal components and multivariate cluster analyses detected three and four major groups, respectively, which differed from each other in terms of virulence spectrum and year of collection. The diversity of the P. striiformis f. sp. tritici population in southern Alberta was greater than in Saskatchewan, which indicated that, although P. striiformis f. sp. tritici is primarily windborne over great distances and does not usually overwinter, there are detectable differences in virulence between these regions of western Canada. Comparative analyses of virulence frequency of Saskatchewan or southern Alberta isolates with isolates representing races from the Great Plains and the Pacific Northwest of the United States indicated greater similarity of Saskatchewan races to the Great Plains despite strong correlations with both parts of the United States. This suggests that the P. striiformis f. sp. tritici population in Saskatchewan is a mixture of inoculum from both parts of the United States.

Glyphosate-resistant kochia (Kochia scoparia L. Schrad.) in Saskatchewan and Manitoba

Beckie, H. J., Gulden, R. H., Shaikh, N., Johnson, E. N., Willenborg, C. J., Brenzil, C. A., Shirriff, S. W., Lozinski, C. and Ford, G. 2015. Glyphosate-resistant kochia (Kochia scoparia L. Schrad.) in Saskatchewan and Manitoba. Can. J. Plant Sci. 95: 345–349. Previous surveys have documented the occurrence of glyphosate-resistant (GR) kochia in Alberta in 2011 and 2012. To determine the incidence of GR kochia in Saskatchewan and Manitoba, a stratified-randomized survey of 342 sites (one population per site) in southern and central regions of Saskatchewan and a similar survey of 283 sites in southern Manitoba was conducted in the fall of 2013. Mature plants were collected, seed threshed, and progeny screened by spraying with a discriminating glyphosate dose of 900 g ae ha–1 under greenhouse conditions. Screening confirmed 17 GR kochia populations in nine municipalities in west-central or central Saskatchewan, but only two GR populations from different municipalities in the Red River Valley of Manitoba. While the majority of GR kochia populations in Saskatchewan originated in chemical-fallow fields, some populations were found in cropped fields (wheat, Triticum aestivum L.; lentil, Lens culinaris Medik.; GR canola, Brassica napus L.) and non-cropped areas (oil well, roadside ditch). In Manitoba, the two populations occurred in fields cropped to GR corn (Zea mays L.) and soybean (Glycine max L. Merr.). Agronomic and economic impact of this GR weed biotype is compounded because of consistent multiple resistance to acetolactate synthase-inhibiting herbicides. However, GR kochia is susceptible to dicamba, an increasingly important auxinic herbicide used for control of this multiple-resistant weed biotype.