Trends in cannabis-related emergency department visits and hospitalizations among children aged 0-11 years in Canada from 2015 to 2021: spotlight on cannabis edibles.

BACKGROUND: Cannabis poisonings among children are of public health concern. Existing evidence from the US and from four provinces in Canada (Quebec, Ontario, Alberta, British Columbia) indicate an increase in pediatric cannabis-related poisonings since the legalization of cannabis. This study evaluates trends in cannabis-related poisoning pediatric emergency department (ED) visits and hospitalizations in Canada and addresses a gap in literature by describing trends and context around cannabis edible-related poisoning cases using data from a Canadian sentinel surveillance system. METHODS: Mixed-methods using data from two administrative data sources and one injury/poisoning sentinel surveillance system to estimate age-specific rates of cannabis-related poisonings ED visits (Ontario and Alberta), edible-related events (sentinel surveillance Canada), and hospitalizations (Canada with the exception of Quebec) among children between the ages of 0 to 11 from 2015/2016 to 2021. Annual absolute changes were calculated to quantify the magnitude of change between each age-specific rate. Joinpoint regression was used for trend analysis. A thematic analysis was completed to gain a better understanding of cannabis edible-related poisoning cases in the ED. RESULTS: The pediatric age-specific rates for cannabis-related poisoning ED visits (average annual percent change (AAPC) Ontario: 98.2%, 95% CI: 79.1, 119.2; AAPC Alberta: 57.4%, 95% CI: 36.7, 81.2), hospitalizations (AAPC: 63.4%, 95% CI: 42.0, 87.9) and cannabis edible-related events (AAPC: 122.8%, 95% CI: 64.0, 202.6) increased significantly from 2015 to 2021. Almost half of all pediatric edible-related events involved gummy edible products (48.8%, n = 143). Based on the thematic analysis, 88% cannabis edible-related events were attributed to inadvertent ingestion due to access to such products or lack of safe storage practices. CONCLUSION: Age-specific rates of cannabis-related poisoning ED visits (Ontario and Alberta) and hospitalizations (Canada with the exception of Quebec) have increased since cannabis legalization, with the largest increase in rates occurring from 2019 to 2020. A similar increase in the rate of cannabis edible-related cases from sentinel surveillance data underscores the importance of monitoring this outcome. Public health messaging and national public health promotion strategies targeted towards raising awareness on the risks associated with consuming illegal cannabis and safe storage of cannabis could help mitigate cannabis poisonings among children.

Heavy episodic drinking and self-reported increased alcohol use during the COVID-19 pandemic: a spotlight on frontline and essential workers in Canada. / Forte consommation épisodique d'alcool et consommation autodéclarée accrue d'alcool pendant la pandémie de COVID-19 : un regard sur les travailleurs de première ligne et les travailleurs essentiels au Canada.

INTRODUCTION: There is evidence that some frontline and essential workers have increased their alcohol use during the COVID-19 pandemic; however, this has not been examined in Canada. METHODS: Using the Survey on COVID-19 and Mental Health 2020, weighted prevalence and 95% confidence intervals of self-reported increased alcohol consumption and heavy episodic drinking were calculated for each of the population groups: frontline workers, essential workers, and nonfrontline or essential workers (NFEW). Logistic regression was used to examine the associations between social determinants of health, mental health and alcohol use for each group. RESULTS: The prevalence of increased alcohol consumption and past-month heavy episodic drinking did not differ across frontline workers, essential workers and NFEW. For the three groups, nonracialized group members had significantly higher odds for both outcomes. Screening positive for either generalized anxiety disorder or mood disorder was significantly associated with increased alcohol consumption across the three groups. For frontline and essential workers, females had significantly lower odds of heavy episodic drinking compared to males. For essential workers only, living in a rural area was significantly associated with lower odds of increased alcohol use, and screening positive for posttraumatic stress disorder was significantly associated with increased odds of heavy episodic drinking. For frontline workers only, living in a rural area was significantly associated with lower odds of heavy episodic drinking. CONCLUSION: While frontline and essential workers were not more likely to report increased alcohol consumption and heavy episodic drinking compared to NFEW, there were some differences in factors associated with alcohol use. Such findings demonstrate the benefit of examining each group separately to provide information for targeted prevention strategies.

Increased alcohol use, heavy episodic drinking, and suicide ideation during the COVID-19 pandemic in Canada.

OBJECTIVE: Alcohol use is a known risk factor for suicidality, yet this relationship has not been explored during the pandemic in Canada. As a growing body of evidence demonstrates the negative impact of COVID-19 on alcohol consumption and associated harms in Canada, there is a need to examine this more closely. METHODS: Using the Survey on COVID-19 and Mental Health 2020, we compared the prevalence of suicide ideation among: (1) individuals who reported an increase in alcohol consumption vs those who reported a decrease/no change, and (2) individuals who reported past month heavy episodic drinking vs those who did not. We compared overall unadjusted odds ratios and across a number of sociodemographic and mental health variables. All estimates were weighted to ensure they were nationally representative. RESULTS: The prevalence and likelihood of suicide ideation were significantly higher among people who reported increased alcohol consumption during the pandemic (4.9% vs 2.0%; OR = 2.6, 95% CI: 1.8, 3.7) and people who reported past month heavy episodic drinking (3.4% vs 2.1%; OR = 1.7, 95% CI: 1.2, 2.3). Males and middle-aged and older-aged individuals had the highest odds ratios for increased alcohol consumption and past month heavy episodic drinking with suicide ideation. CONCLUSION: In the Canadian general population during the COVID-19 pandemic, there were significant associations between suicide ideation and increased alcohol use as well as past month heavy episodic drinking across specific sociodemographic subgroups. Future research could explore these associations while adjusting for social determinants of health such as income security, employment, education, social support, stress, and mental health.

RéSUMé: CONTEXTE: La consommation d'alcool est un facteur de risque connu de suicidabilité, mais cette relation n'a pas été explorée pendant la pandémie au Canada. Comme un nombre croissant de preuves démontre les répercussions négatives de la COVID-19 sur la consommation d'alcool et les méfaits associés au Canada, il est nécessaire d'examiner cette question de plus près. MéTHODES: En utilisant l'enquête de 2020 sur la COVID-19 et la santé mentale, nous avons comparé la prévalence des idées suicidaires chez : (1) les individus qui ont déclaré une augmentation de leur consommation d'alcool par rapport à ceux qui ont déclaré une diminution ou aucun changement, et (2) les individus qui ont déclaré une consommation épisodique excessive d'alcool au cours du dernier mois par rapport à ceux qui n'en ont pas déclaré. Nous avons comparé les rapports des cotes globaux non ajustés et selon un certain nombre de variables sociodémographiques et de santé mentale. Toutes les estimations ont été pondérées afin de garantir leur représentativité nationale. RéSULTATS: La prévalence et la probabilité d'idées suicidaires étaient considérablement plus élevées chez les personnes ayant déclaré une consommation d'alcool accrue pendant la pandémie (4,9 % contre 2,0 %; RC=2,6, IC à 95 % : 1,8 à 3,7) et chez les personnes ayant déclaré une consommation épisodique excessive au cours du mois écoulé (3,4 % contre 2,1 %; RC=1,7, IC à 95 % : 1,2 à 2,3). Les hommes, les personnes d'âge moyen et les personnes âgées présentaient les rapports des cotes les plus élevés pour une consommation d'alcool accrue et une consommation épisodique excessive d'alcool au cours du mois précédent avec des idées suicidaires. CONCLUSION: Dans la population générale canadienne, pendant la pandémie de COVID-19, il y avait des associations significatives entre les idées suicidaires et l'augmentation de la consommation d'alcool ainsi que la consommation épisodique excessive d'alcool au cours du dernier mois dans des sous-groupes sociodémographiques précis. Les recherches futures pourraient explorer ces associations tout en ajustant les déterminants sociaux de la santé tels que la sécurité du revenu, l'emploi, l'éducation, le soutien social, le stress et la santé mentale.

Measuring self-reported change in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada. / Mesurer les changements autodéclarés relatifs à la consommation d'alcool et de cannabis au cours de la deuxième vague de la pandémie de COVID 19 au Canada.

This study presents nationally representative estimates of self-reported changes in alcohol and cannabis consumption since the onset of COVID-19 in Canada. We used data from the Survey on COVID-19 and Mental Health (collected from September to December 2020) to calculate the prevalence of self-reported change in alcohol and cannabis consumption. We found that 15.7% of respondents self-reported an increase in alcohol consumption and 5.4% in cannabis consumption since the start of the pandemic. Sociodemographic disparities were also observed, indicating that increased alcohol and cannabis consumption may be more prevalent among certain populations.

From 11 September to 4 December 2020, 15.7% and 5.4% of individuals self-reported an increase in alcohol and cannabis consumption, respectively, compared to before the pandemic. Individuals who reported that their mental health was worse now, compared to before the pandemic, had the highest prevalence of self-reported increase in alcohol and cannabis consumption. Understanding the social determinants of health is critical to the development of harm reduction and mitigation strategies.

Entre le 11 septembre et le 4 décembre 2020, 15,7 % des répondants ont déclaré avoir augmenté leur consommation d'alcool et 5,4 % leur consommation de cannabis par rapport à avant la pandémie. Les personnes ayant déclaré que leur santé mentale était pire au moment de l'Enquête qu'avant la pandémie offraient la prévalence la plus forte en matière d'augmentation de la consommation d'alcool et de cannabis. Il est primordial de comprendre les déterminants sociaux de la santé pour élaborer des stratégies de réduction des méfaits et d'atténuation.

Applying a gendered lens to understanding self-reported changes in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada, September to December 2020. / Adopter une perspective axée sur le genre pour comprendre les changements autodéclarés dans la consommation d'alcool et de cannabis pendant la deuxième vague de la pandémie de COVID 19 au Canada, septembre à décembre 2020.

INTRODUCTION: Increased alcohol and cannabis consumption and related harms have been reported since the beginning of the COVID-19 pandemic. Existing evidence shows that substance use and related harms differ by gender. Yet, no Canadian study has applied a gendered lens to alcohol and cannabis consumption use during this time. Our objectives were to (1) provide gender-specific prevalence estimates of self-reported increased alcohol and cannabis use; and (2) examine gender-specific associations between sociodemographic and mental health variables and alcohol and cannabis use. METHODS: Using data from the Survey on COVID-19 and Mental Health, we calculated nationally representative, gender-specific prevalence estimates and disaggregated them by sociodemographic and mental health variables. Four logistic regression models were used to assess the likelihood of self-reported increased alcohol and cannabis use. RESULTS: The prevalence of self-reported increase in alcohol use (16.2% women; 15.2% men) and cannabis use (4.9% women; 5.8% men) did not differ by gender. For both genders, income, racialized group membership, working in the past week, being a parent/legal guardian of a child aged under 18 and screening positive for depression and anxiety were associated with increased alcohol use. Men and women who were between the ages of 18 to 44, screened positive for depression, or both, were more likely to report increased cannabis use. For women, education was significantly associated with increased alcohol use. For men, being a parent/legal guardian was significantly associated with lower odds of increased cannabis use. CONCLUSION: Sociodemographic factors, as well as depression and anxiety, were similarly associated with increased alcohol and cannabis use for both men and women in the second wave of the pandemic.

Prevalence of alcohol use among women of reproductive age in Canada. / Fréquence de la consommation d'alcool chez les Canadiennes en âge de procréer.

INTRODUCTION: Reporting on alcohol use among women of reproductive age in Canada addresses a major gap in evidence. METHODS: We assessed the prevalence of weekly and heavy alcohol consumption among women aged 15 to 54 years by sociodemographic characteristics, province of residence and concurrent use of other substance(s) using data from the 2019 Canadian Community Health Survey. RESULTS: Of the target population, 30.5% reported weekly and 18.3% reported heavy alcohol consumption in the past year. Prevalence varied by sociodemographic characteristics, province and substance use. The most notable and significant differences were to do with cannabis use and smoking. CONCLUSION: This information can guide health care providers in assessing alcohol consumption and in promoting low-risk alcohol drinking to prevent alcohol exposure during pregnancy.

Determinants of psychological and social well-being among youth in Canada: investigating associations with sociodemographic factors, psychosocial context and substance use. / Facteurs déterminants du bien-être psychologique et social chez les jeunes au Canada : étude des associations avec les facteurs sociodémographiques, le contexte psychosocial et la consommation de substances.

INTRODUCTION: Positive mental health is an essential part of youth's healthy development. For instance, positive mental health is associated with greater self-reported physical health, closer relationships and fewer conduct problems in youth. As positive mental health promotion is a public health priority, examining its potential determinants is important. METHODS: We analyzed data from students in Grades 7-12 (secondary I-V in Quebec), from nine Canadian provinces, who participated in the 2016/2017 Canadian Student Tobacco, Alcohol and Drugs Survey. Psychological and social well-being (PSWB) was assessed using the Children's Intrinsic Needs Satisfaction Scale (CINSS). We conducted linear regression analyses to determine associations of sociodemographic, psychosocial and substance use variables with overall CINSS scores (n = 37 897). RESULTS: In general, youth in Canada reported fairly high PSWB. After adjusting for all included variables, being in a higher grade, being bullied, bullying others, reporting more behavioural problems and using cigarettes, e-cigarettes or cannabis at least once in the past 30 days were associated with lower overall CINSS scores for both male and female students. Reporting more prosocial behaviours was associated with higher overall scores for both sexes. CONCLUSION: A number of sociodemographic, psychosocial and substance use factors are associated with PSWB among youth in Canada. Prospective longitudinal and intervention studies could examine whether changes in these potential risk/protective factors are accompanied by changes in positive mental health.

Trends in Suicide Mortality in Canada by Sex and Age Group, 1981 to 2017: A Population-Based Time Series Analysis: Tendances de la mortalité par suicide au Canada selon le sexe et le groupe d'âge, 1981 - 2017 : Une analyse de séries chronologiques dans la population.

OBJECTIVES: Suicide is a complex global public health issue. The objective of this study was to assess time trends in suicide mortality in Canada by sex and age group. METHODS: We extracted data from the Canadian Vital Statistics Death Database for all suicide deaths among individuals aged 10 years and older based on International Statistical Classification of Diseases and Related Health Problems, Ninth Revision (E950-959; 1981 to 1999) and International Statistical Classification of Diseases and Related Health Problems, 10th Revision (X60-X84, Y87·0; 2000 to 2017) for a 37-year period, from 1981 to 2017. We calculated annual age-standardized, sex-specific, and age group-specific suicide mortality rates, and used Joinpoint Regression for time trend analysis. RESULTS: The age-standardized suicide mortality rate in Canada decreased by 24.0% from 1981 to 2017. From 1981 to 2007, there was a significant annual average decrease in the suicide rate by 1.1% (95% confidence interval, -1.3 to -0.9), followed by no significant change between 2007 and 2017. From 1981 to 2017 and from 1990 to 2017, females aged 10 to 24 and 45 to 64 years old, respectively, had a significant increase in suicide mortality rates. However, males had the highest suicide mortality rates in all years in the study; the average male-to-female ratio was 3.4:1. CONCLUSION: The 3-decade decline in suicide mortality rates in Canada paralleled the global trend in rate reductions. However, since 2008, the suicide rate in Canada was relatively unchanged. Although rates were consistently higher among males, we found significant rate increases among females in specific age groups. Suicide prevention efforts tailored for adult males and young and middle-aged females could help reduce the suicide mortality rate in Canada.

Symptoms of postpartum anxiety and depression among women in Canada: findings from a national cross-sectional survey.

OBJECTIVE: This study presents national estimates on symptoms consistent with postpartum anxiety (PPA) and postpartum depression (PPD) and the association between these conditions and possible risk and protective factors in women who gave birth in Canada. METHODS: Data were collected through the Survey on Maternal Health, a cross-sectional survey administered in Canada's ten provinces between November 2018 and February 2019 among women who gave birth between January 1 and June 30, 2018. A total of 6558 respondents were included. Weighted prevalence estimates were calculated, and logistic regression was used to model the relationship between symptoms consistent with PPA, PPD, and potential risk factors. RESULTS: Overall, 13.8% of women had symptoms consistent with PPA, while the prevalence of having symptoms consistent with PPD was 17.9%. Results of the logistic regression models indicated that women who had a history of depression were 3.4 times (95% CI 2.7-4.2) more likely to experience symptoms consistent with PPA and 2.6 times more likely to experience symptoms consistent with PPD (95% CI 2.2-3.2) compared with those who did not. Women who reported good, fair, or poor physical health were 2.4 times more likely to experience symptoms consistent with PPD (95% CI 2.0-2.9) and 2.0 times more likely to experience symptoms consistent with PPA (95% CI 1.7-2.4) compared with those who reported very good or excellent health. Maternal marital status, other postpartum maternal support, and sense of community belonging were also significant. CONCLUSION: This study highlights that a history of depression and good, fair, or poor physical health are associated with an increased odds of symptoms consistent with PPA and PPD, while other maternal support and sense of community belonging are associated with a decreased odds of these conditions.

RéSUMé: OBJECTIF: La présente étude présente des estimations nationales sur les symptômes correspondant à de l'anxiété post-partum (APP) et à une dépression post-partum (DPP) et sur l'association entre ces affections et les éventuels facteurs de risque et de protection chez les femmes ayant accouché au Canada. MéTHODOLOGIE: Les données ont été recueillies dans le cadre de l'Enquête sur la santé maternelle, une enquête transversale menée dans les dix provinces canadiennes entre novembre 2018 et février 2019 auprès des femmes ayant accouché entre le 1er janvier et le 30 juin 2018. Au total, 6 558 personnes ont répondu à l'enquête. Des estimations de la prévalence pondérée ont été calculées, et une régression logistique a été utilisée pour modéliser la relation entre les symptômes correspondant à de l'APP, à une DPP et aux facteurs de risque possibles. RéSULTATS: Dans l'ensemble, 13,8 % des femmes présentaient des symptômes compatibles avec de l'APP, tandis que la prévalence des symptômes compatibles avec une DPP était de 17,9 %. Les résultats des modèles de régression logistique ont indiqué que les femmes ayant des antécédents de dépression étaient 3,4 fois (IC à 95 % : 2,7 à 4,2) plus susceptibles de présenter des symptômes compatibles avec de l'APP et 2,6 fois plus susceptibles de présenter des symptômes compatibles avec une DPP (IC à 95 % : 2,2 à 3,2) par rapport à celles qui n'en avaient pas. Les femmes qui ont déclaré être en bonne, moyenne ou mauvaise santé physique étaient 2,4 fois plus susceptibles d'éprouver des symptômes correspondant à une DPP (IC à 95 % : 2,0 à 2,9) et 2,0 fois plus susceptibles d'éprouver des symptômes correspondant à de l'APP (IC à 95 % : 1,7 à 2,4) par rapport à celles qui ont déclaré être en très bonne ou en excellente santé. L'état matrimonial de la mère, les autres formes de soutien maternel post-partum et le sentiment d'appartenance à la collectivité étaient également significatifs. CONCLUSION: Cette étude souligne que des antécédents de dépression et une bonne, moyenne ou mauvaise santé physique sont associés à une augmentation de la probabilité de symptômes correspondant à de l'APP et à une DPP, tandis que d'autres formes de soutien maternel et le sentiment d'appartenance à la collectivité sont associés à une diminution de la probabilité de ces affections.

Thoughts of self-harm and associated risk factors among postpartum women in Canada.

BACKGROUND: The prevalence of thoughts of self-harm during the postpartum period is not well documented in Canada. To estimate the prevalence of thoughts of self-harm among postpartum women in Canada, this study explored prevalence by socio-demographic characteristics and examined the associations between thoughts of self-harm and aspects of maternal mental health. METHODS: This study used data from the 2018/2019 Survey on Maternal Health which surveyed women living in the 10 provinces anywhere between 6-13 months postpartum. Participants were asked to report experiencing thoughts of self-harm, rate their mental health, and participate in the abbreviated Edinburgh Postpartum Depression Scale and Generalized Anxiety Disorder (GAD) scale. Adjusted logistic regression analyses were performed to examine associations. RESULTS: Of the 6,558 respondents who agreed to share their data, 10.4% reported thoughts of self-harm since the birth of their child. Of these women, 37.0% reported low mental health, 54.2% had moderate levels of symptoms of postpartum depression (PPD) and 37.1% had symptoms of GAD. Women who experienced low mental health, moderate levels of symptoms of PPD and/or GAD were more likely to report thoughts of self-harm. LIMITATIONS: As thoughts of self-harm and aspects of mental health are self-reported, there is the potential for social desirability bias and underreporting. The cross-sectional survey design did not allow the reporting of thoughts of self-harm at different time points. DISCUSSION: The high proportion of postpartum women in Canada reporting thoughts of self-harm and strong associations with aspects of maternal mental health highlight the need for effective supports during postpartum.

Prevalence of Positive Mental Health and Associated Factors Among Postpartum Women in Canada: Findings from a National Cross-Sectional Survey.

OBJECTIVES: The objectives of this study were to compare the prevalence of three positive mental health (PMH) outcomes (self-rated mental health, life satisfaction, sense of community belonging) in postpartum women to the general population, and to examine the relationship between protective factors and the three PMH outcomes among postpartum women. METHODS: The national cross-sectional Survey on Maternal Health (n = 6558) was analyzed. Analyses were weighted and 95% confidence intervals were calculated. Three adjusted logistic regression models were generated. To compare this sample to the general population of women, estimates from the Canadian Community Health Survey-Annual Component (2018) were used. RESULTS: Compared to the general population of women, a larger proportion of postpartum women reported a strong sense of community belonging. The odds of postpartum women with high self-rated physical health having high self-rated mental health were approximately seven times greater (aOR 6.9, 95% confidence interval [CI] 5.9, 8.1) than postpartum women with lower self-rated physical health. The absence of symptoms of postpartum depression (PPD) or generalized anxiety disorder (GAD) and high self-rated physical health were significantly associated with all three PMH outcomes. Frequent availability of maternal support was associated with greater odds of high life satisfaction (aOR 1.6, 95% CI 1.4, 1.9) and sense of community belonging (aOR 1.4, 95% CI 1.2, 1.6). CONCLUSIONS: Our study demonstrated that availability of maternal support, self-rated physical health and absence of symptoms of PPD or GAD were associated with PMH among postpartum women. As physical health had the strongest association with mental health, we encourage further examination of this relationship.

An update on positive mental health among youth in Canada. / Mise à jour sur la santé mentale positive chez les jeunes au Canada.

The Positive Mental Health Surveillance Indicator Framework (PMHSIF) provides estimates of positive mental health outcomes and associated risk and protective factors for youth aged 12 to 17 years in Canada. This study explored the relationship between sociodemographic factors and psychological and social well-being among youth in Canada using data from the Canadian Student Tobacco, Alcohol and Drugs Survey 2016-2017. Grade and province were significantly associated with psychological and social well-being.

The Quick Stats table presents recent estimates of positive mental health outcomes and determinants among youth in Canada. Over three-quarters of youth have high relatedness (81.8%), a high level of happiness (79.3%), high competence (78.4%) and high self-rated mental health (75.9%). The majority of youth reported high autonomy (73.0%) and life satisfaction (61.0%). Students in middle school (Grades 7­8) were more likely to have higher psychological and social well-being compared to students in high school (Grades 9­12).

Le tableau Statistiques rapides pré- sente des estimations récentes des résultats et des déterminants de la santé mentale positive chez les jeunes au Canada. Plus des trois quarts des jeunes indiquent avoir un niveau élevé d'appartenance (81,8 %), de bonheur (79,3 %), de compétence (78,4 %) et de santé mentale auto- évaluée (75,9 %). La majorité des jeunes ont déclaré jouir d'une grande autonomie (73,0 %) et d'une grande satisfaction à l'égard de leur vie (61,0 %). Les élèves du niveau intermédiaire (de 7e et 8e années) étaient davantage susceptibles de ressentir un bien-être psychologique et social plus élevé que les élèves du secondaire (de la 9e à la 12e année).

An update on positive mental health among adults in Canada. / Mise à jour sur la santé mentale positive chez les adultes au Canada.

This At-a-glance presents updated estimates for the Positive Mental Health Surveillance Indicator Framework for adults aged 18 years and older. Using data from the 2015 and 2017 Canadian Community Health Survey, we calculated the prevalence of positive mental health and associated determinants. Estimates for positive mental health outcomes for adults ranged from 68.1% to 87.1%. We also explored the associations between sociodemographic factors and positive mental health among adults in Canada. Our findings suggest sociodemographic differences in odds of self-rated mental health, happiness, life satisfaction, and psychological and social well-being.

The Quick Stats table presents recent estimates of positive mental health outcomes and associated risk and protective factors among adults in Canada. The majority of adults in Canada have high positive mental health. Out of the five positive mental health outcomes, life satisfaction had the highest prevalence (87.1%) and social well-being the lowest (68.1%). Sociodemographic factors including sex, age group, income quintile, education level, province, urban/rural status and immigration status were significantly associated with positive mental health outcomes.

Le tableau Statistiques rapides présente les estimations les plus récentes en matière de santé mentale positive et de facteurs de risque et de protection connexes chez les adultes au Canada. La majorité des adultes au Canada ont une santé mentale positive élevée. Parmi les cinq résultats en matière de santé mentale positive, la satisfaction à l'égard de la vie a la prévalence la plus élevée (87,1 %), et le sentiment de bien-être social la prévalence la plus faible (68,1 %). Plusieurs facteurs sociodémographiques, à savoir le sexe, le groupe d'âge, le quintile de revenu, le niveau de scolarité, la province, le milieu de résidence (urbain/rural) et le statut vis-à-vis de l'immigration sont associés de manière statistiquement significative aux résultats en matière de santé mentale positive.

Age-Related Eye Disease and Cognitive Function: The Search for Mediators.

PURPOSE: Age-related eye disease may be associated with cognitive decline, but the scientific literature has not been consistent. Furthermore, no studies have been able to explain the relationship. Our objective was to assess whether older adults with age-related macular degeneration (AMD) or glaucoma performed worse on 6 cognitive tests compared with older adults with normal vision and, if so, to understand why. DESIGN: Cross-sectional analysis of hospital-based study (Maisonneuve-Rosemont Hospital Ophthalmology Clinics, Montréal, Canada). PARTICIPANTS: Three hundred thirty-six adults 65 years of age or older with either AMD, glaucoma, or normal vision. METHODS: Cognition was measured with 6 cognitive tests administered orally. Activity levels were measured using the Victoria Longitudinal Study Activity Lifestyle Questionnaire. Visual acuity and visual field were measured. Multiple linear regression was used. Mediation was assessed using structural equation modeling. MAIN OUTCOME MEASURES: Results of the verbal fluency test (animal and letter versions), the digit span test (forward and backward versions), and the logical memory test (immediate and delayed recall). RESULTS: People with glaucoma showed lower scores on 3 cognitive tests than the group with normal vision: the digit span forward and backward tests (ß = -0.8 [95% confidence interval (CI), -1.5 to -0.2] and ß = -0.7 [95% CI, -1.3 to -0.1], respectively) and the logical memory test with immediate recall (ß = -1.3 [95% CI, -2.4 to -0.2]). Activity levels statistically significantly mediated the relationship between glaucoma and the digit span forward test (P = 0.043; percentage of the total effect mediated, 17%). CONCLUSIONS: People with glaucoma showed lower scores on cognitive tests that may depend on verbal working memory and encoding. If confirmed in longitudinal studies, interventions should be developed that are appropriate for a visually impaired population to slow this cognitive decline.

Canadian Chronic Disease Indicators, 2019 - Updating the data and taking into account mental health. / Indicateurs des maladies chroniques au Canada, 2019 ­ Mise à jour des données et prise en compte de la santé mentale.

The 2019 edition of the Canadian Chronic Disease Indicators (CCDI) provides recent estimates of the burden of chronic conditions and measures of general health and associated determinants in Canada. Using data from the CCDI and 2017 Canadian Community Health Survey, we explored the relationship between sociodemographic factors and selfreported mental health. Our findings suggest that sex (males vs females: adjusted odds ratio [aOR] = 1.22); age (65-79 vs 35-49 year age group: aOR = 1.48); education (postsecondary graduate vs less than high school: aOR = 1.68); household income adequacy (highest quintile [Q5] vs lowest [Q1]: aOR = 2.25); and immigrant status (recent immigrants vs nonimmigrants: aOR= 2.29) were significantly associated with higher self-reported mental health.

The Canadian Chronic Disease Indicators Quick Statistics table shows estimates of the burden of chronic conditions, measures of general health and associated determinants of health. In 2017, more than two-thirds (70.3%) of the population in Canada reported having "excellent" or "very good" mental health. Age, sex, province of residence, income quintile, education level and immigration status were sociodemographic factors significantly associated with self-reported mental health.

Le tableau Statistiques rapides sur les Indicateurs des maladies chroniques au Canada présente les estimations du fardeau des maladies chroniques ainsi que les mesures de la santé générale et des déterminants connexes de la santé. En 2017, plus des deux tiers (70,3 %) de la population du Canada ont déclaré avoir une « excellente ¼ ou une « très bonne ¼ santé mentale. L'âge, le sexe, la province de résidence, le quintile de revenu, le niveau d'études et le statut vis-à-vis de l'immigration étaient des facteurs sociodémographiques corrélés de façon significative à la santé mentale auto-déclarée.

Continuous Electroencephalography Monitoring for Critically Ill Neonates: A Canadian Perspective.

BACKGROUND: Continuous EEG monitoring, in the form of amplitude-integrated (aEEG) or conventional EEG (cEEG), is used in the neonatal intensive care unit (NICU) to detect subclinical central nervous system pathologies, inform management, and prognosticate neurodevelopmental outcomes. To learn more about provider attitudes and current practices in Canada, we evaluated neurologist and neonatologist opinions regarding NICU EEG monitoring. METHODS: A 15-item electronic questionnaire was distributed to 114 pediatric neurologists and 176 neonatologists working across 25 sites. RESULTS: The survey was completed by 87 of 290 physicians. Continuous EEG monitoring is utilized by 97% of pediatric neurologists and 92% of neonatologists. Neurologists and neonatologists differ in their EEG monitoring preferences. For seizure detection and diagnosis of encephalopathy, significantly more neonatologists favor aEEG alone or in combination with cEEG, whereas most neurologists prefer cEEG (p = 0.047, 0.001). There is a significant difference in the perceived gaps in monitoring patients with cEEG between neonatologists (13% would monitor more) and neurologists (41% would monitor more) (p = 0.007). Half of all respondents (53%) reported that they would be interested in attending an education session on neonatal EEG monitoring. CONCLUSIONS: Canadian neurologists and neonatologists do not agree on the best monitoring approach for critically ill neonates. Furthermore, neonatologists perceive a smaller cEEG monitoring gap as compared with neurologists. However, many participants from both specialties would like to increase long-term EEG monitoring in the NICU setting. Facilitating access to EEG monitoring and enhancing education may help to address these needs.

La surveillance continue par électroencéphalographie dans le cas de nouveau-nés gravement malades : une perspective canadienne. Contexte: La surveillance continue par électroencéphalographie (EEG), que ce soit à amplitude intégrée (EEGai) ou conventionnelle (EEGc), est utilisée dans les unités de soins intensifs néonatals (USIN) afin de détecter des pathologies sous-cliniques du système nerveux central, de fournir des indications en matière de prise en charge et d'établir des pronostics quant à l'évolution neuro-développementale de ces nouveau-nés. Afin d'en savoir plus au sujet des attitudes des prestataires de soins et des pratiques actuelles dans ce domaine au Canada, nous avons cherché à évaluer les points de vue de neurologues et de néonatologistes en ce qui regarde la surveillance continue par EEG dans les USIN. Méthodes: Un questionnaire en ligne abordant 15 aspects a été envoyé à 114 neuro-pédiatres et à 176 néonatologistes travaillant dans 25 établissements différents. Résultats: Ce sondage a été complété par 87 médecins sur 290. Il en ressort que la surveillance continue par EEG est utilisée par 97 % des neuro-pédiatres et par 92 % des néonatologistes. Cela dit, les neuro-pédiatres et les néonatologistes n'ont pas les mêmes préférences quant à l'utilisation de cet examen. Quand il s'agit de détecter des crises convulsives et de diagnostiquer des cas d'encéphalopathie, on remarque qu'un nombre nettement plus élevé de néonatologistes favorisent la seule EEGai ou la combinent avec la EEGc tandis que davantage de neurologues ont dit préférer la seule EEGc (p = 0,047 ; p = 0,001). Qui plus est, on peut dénoter une différence notable entre les néonatologistes et les neurologues en ce qui a trait aux écarts perçus de surveillance des patients au moyen de la EEGc, 13 % des premiers assurant une surveillance supérieure alors qu'ils sont 41 % parmi les deuxièmes à assurer une surveillance supérieure (p = 0,007). Enfin, plus de la moitié des répondants (53 %) ont affirmé être intéressés à assister à des séances de formation portant sur la surveillance continue par EEG destinée aux nouveau-nés. Conclusions: Les neurologues et les néonatologistes canadiens divergent quant à la meilleure approche de surveillance dans le cas de nouveau-nés gravement malades. En outre, les néonatologistes ont tendance à percevoir un écart de surveillance moins important si on les compare aux neurologues. Néanmoins, nombreux sont les répondants formés dans ces deux spécialités qui souhaiteraient augmenter à long terme la surveillance par EEG dans les USIN. Le fait de faciliter l'accès à ces examens et d'améliorer l'enseignement pourrait ainsi permettre de répondre aux besoins.

Systematic Review and Meta-Analysis: Adolescent Depression and Long-Term Psychosocial Outcomes.

OBJECTIVE: Experiencing depression in adolescence can disrupt important developmental processes, which can have longstanding effects on socioeconomic status and relationships. The objective of this article was to systematically review the evidence examining associations between adolescent depression and adult psychosocial outcomes. METHOD: Five databases (MEDLINE, Embase, PsycINFO, CINAHL, and ERIC) were searched for articles published from 1980 through March 2017. Eligible articles were peer reviewed, published in English, had prospective cohort study designs, and contrasted adult psychosocial outcomes in those with versus without adolescent depression. Outcomes with sufficient data were pooled using random-effects meta-analyses, with summary measures reported as odds ratios (ORs). A protocol for this review was registered on PROSPERO (CRD42017059662). RESULTS: Of the 4,988 references screened for inclusion, 31 articles comprising 136 analyses were included for review. Twenty-four cohorts were represented. Seventy-seven analyses across 10 outcomes were meta-analyzed, with remaining analyses summarized narratively. Meta-analyses suggested that adolescent depression was associated with outcomes including, but not limited to, failure to complete secondary school (OR 1.76, 95% CI 1.29-2.39), unemployment (OR 1.66, 95% CI 1.29-2.14), and pregnancy/parenthood (OR 1.38, 95% CI 1.06-1.81). CONCLUSION: This review demonstrates that adolescent depression is associated with a myriad of adult psychosocial outcomes. Many are linked and can lead to the propagation of difficulties across the lifespan. These findings can have important implications for encouraging the provision of targeted mental health care early in development to improve life chances.

Age-Related Eye Disease and Participation in Cognitive Activities.

Studies have found a benefit to living a cognitively active life in older age. Our goal was to quantify participation in cognitively stimulating activities in adults with and without age-related eye disease. We conducted a cross-sectional hospital-based study in Montreal, Canada of older adults (n = 303) having either age-related macular degeneration (AMD) (n = 96), glaucoma (n = 93), or normal vision (n = 114). To be eligible, the AMD group had to have bilateral late stage AMD with a better eye visual acuity of 20/30 or worse. The glaucoma group had to have a diagnosis of bilateral primary open-angle glaucoma with visual field mean deviation < = -4 dB in their better eye. Further inclusion criteria included age ≥ 65 and a Mini-Mental State Exam Blind score ≥ 10. Cognitive activities were measured using the Victoria Longitudinal Study Activity Questionnaire. Linear regression was used. Patients with AMD (ß = -4.2, 95% confidence interval (CI) -6.0, -2.4) and glaucoma (ß = -1.8, 95% CI -3.3, -0.3) participated in fewer cognitive activities per month compared to those with normal vision after adjusting for age, sex, education, diabetes, number of comorbidities, cognition, and cataract. People with AMD and glaucoma participated in fewer cognitive activities, which could put them at risk for future cognitive impairment.

[Assessment of a self-administered questionnaire identifying occupational exposures among lung cancer patients]. / Évaluation d'un auto-questionnaire de repérage des expositions professionnelles chez les patients atteints de cancer bronchopulmonaire.

Ten to 29% of lung cancers might be linked to occupational factors but 60% of them are not compensated. The PROPOUMON project aimed to improve the identification, recognition and compensation of occupational lung cancer as occupational disease using a self-administered questionnaire (AQREP). One objective was to assess the AQREP, comparing it with the questionnaire drawn up by the French Language Pneumology Society (Q-SPLF). From March 2014 to September 2015, 90 lung cancer patients treated at the Centre Léon-Bérard responded to the AQREP and Q-SPLF. The two physicians in charge of the consultation assessed independently whether or not a consultation was indicated. A certificate for the compensation process was proposed when a suspicion of high or average imputability was identified. Analysis of the questionnaires was concordant for 73% of the patients. The AQREP has a sensitivity of 72% and a specificity of 73%. Its positive and negative predictive values were 62 and 82%. The information provided by 24 patients were discordant between questionnaires. In two patients with discordant evaluation (AQREP+/Q-SPLF-; AQREP-/Q-SPLF+), one Initial Medical Certificate (IMC) was written. This study made it possible to conclude that AQREP is relevant for the identification of potentially occupational lung cancers. Collegial discussion of complex cases might be considered. The project is currently been extended to other centers and to lymphoma.