Tobacco smoke exposure and sleep: estimating the association of urinary cotinine with sleep quality. / Exposition à la fumée du tabac et sommeil : estimation de l'association entre concentration de cotinine urinaire et qualité du sommeil.

INTRODUCTION: A majority of studies on tobacco smoke exposure and sleep quality have relied on self-reported smoking, resulting in potential exposure misclassification and biases related to self-report. The objective of this study was to investigate associations between urinary cotinine, a biological marker of tobacco smoke exposure, and sleep quality measures, including sleep duration, sleep continuity or efficiency, sleep satisfaction and alertness during normal waking hours. METHODS: Using data on a national sample of 10 806 adults (aged 18-79 years) from the Canadian Health Measures Survey (2007-2013), we performed binary logistic regression analyses to estimate associations between urinary cotinine concentrations and sleep quality measures, while controlling for potential confounders. Additionally, we performed ordinal logistic regression to assess the association between urinary cotinine concentrations and increased number of sleep problems. RESULTS: Overall, 28.7% of adult Canadian survey respondents had urinary cotinine concentrations above the limit of detection (LOD), nd the prevalence of each sleep problem ranged from 5.5% to 35.6%. Elevated urinary cotinine concentrations (quartile 4 vs.

Obesity and healthy aging: social, functional and mental well-being among older Canadians. / Obésité et vieillissement en santé : bien-être social, fonctionnel et mental chez les personnes âgées au Canada.

INTRODUCTION: Canadians are living longer than before, and a large proportion of them are living with obesity. The present study sought to describe how older participants in the Canadian Longitudinal Study on Aging (CLSA) who are living with obesity are aging, through an examination of measures of social, functional and mental well-being. METHODS: We used data from the first wave of the CLSA for people aged 55 to 85 years in this study. We used descriptive statistics to describe characteristics of this population and adjusted generalized logistic models to assess measures of social, functional and mental well-being among obese participants (body mass index ≥ 30 kg/m2) relative to non-obese participants. Findings are presented separately for females and males. RESULTS: More than half of the participants reported living with a low personal income (less than $50 000); females were particularly affected. Less than half of the participants were obese; those who were had higher odds of multimorbidity than those who were not living with obesity (among those aged 55-64 years: odds ratio [OR] 2.7, 95% CI: 2.0-3.5 males; OR 2.8, 95% CI: 2.2-2.5 females). Low social participation was associated with obesity among older female participants, but not males. Physical functioning issues and impairments in activities of daily living were strongly associated with obesity for both females and males. While happiness and life satisfaction were not associated with obesity status, older females living with obesity reported negative impressions of whether their aging was healthy. CONCLUSION: The odds of multimorbidity were higher among participants who were obese, relative to those who were not. Obese female participants tended to have a negative perception of whether they were aging healthily and had lower odds of involvement in social activities, while both sexes reported impairments in functional health. The associations we observed, independent of multimorbidity in older age, highlight areas where healthy aging initiatives may be merited.

INTRODUCTION: Si les Canadiens vivent plus longtemps qu'avant, bon nombre d'entre eux souffrent cependant d'obésité. Cette étude vise à décrire, par un examen de mesures du bien-être social, fonctionnel et mental, le vieillissement des personnes âgées souffrant d'obésité ayant participé à l'Étude longitudinale canadienne sur le vieillissement (ELCV). MÉTHODOLOGIE: Nous avons extrait des données du premier cycle de l'ELCV portant sur les personnes de 55 à 85 ans. Nous avons utilisé des statistiques descriptives pour caractériser cette population et ajusté des modèles logistiques généralisés pour comparer les mesures du bien-être social, fonctionnel et mental chez les participants souffrant d'obésité (indice de masse corporelle de 30 kg/m2 et plus) et chez les participants n'en souffrant pas. Nos résultats sont présentés en fonction du sexe. RÉSULTATS: Plus de la moitié des participants ont déclaré avoir un revenu personnel relativement faible (moins de 50 000 $), les femmes étant particulièrement affectées. Moins de la moitié des participants souffraient d'obésité et la multimorbidité était plus fréquente parmi ceux souffrant d'obésité que parmi ceux n'en souffrant pas (participants de 55 à 64 ans; rapport de cotes [RC] : 2,7; intervalle de confiance [IC] à 95 % : 2,0 à 3,5 chez les hommes; RC : 2,8; IC à 95 % : 2,2 à 2,5 chez les femmes). La faible participation sociale était associée à l'obésité chez les femmes plus âgées mais pas chez les hommes plus âgés. La présence de problèmes de fonctionnement physique et de limitations dans la vie quotidienne était fortement associée à l'obésité tant chez les femmes que chez les hommes. Bien que le bonheur et la satisfaction à l'égard de la vie ne soient pas associés à l'obésité, les femmes âgées souffrant d'obésité ont déclaré avoir une perception défavorable de leur état de santé. CONCLUSION: La multimorbidité était plus fréquente chez les participants souffrant d'obésité que chez ceux n'en souffrant pas. Les femmes souffrant d'obésité étaient plus nombreuses que les hommes à avoir une perception défavorable de leur état de santé et à ne pas prendre part à des activités sociales. Les participants des deux sexes ont fait état de problèmes de santé fonctionnelle. Les associations observées, qui sont indépendantes de la multimorbidité chez les personnes âgées, mettent en relief les secteurs où des actions en faveur d'un vieillissement en santé pourraient être bénéfiques.

The lows of getting high: sentinel surveillance of injuries associated with cannabis and other substance use.

OBJECTIVES: Cannabis is a widely used illicit substance that has been associated with acute injuries. This study seeks to provide near real-time injury estimates related to cannabis and other substance use from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) database. METHODS: Data from the eCHIRPP database, years 2011 to 2016, were analyzed via data mining, descriptive, logistic regression, and sensitivity analyses. Drug use trends over time for cannabis and/or other substances (alcohol, illicit drugs, and medications) were assessed. Descriptive statistics (intent, external cause, and nature of injury) and proportionate injury ratios (PIR) associated with cannabis use are presented. RESULTS: Cannabis use was observed in 184 cases/100,000 eCHIRPP cases, and related injuries were mostly identified as unintentional (66.8%). Poisoning (68.5%) and intoxication (69.4%) were the external cause and nature of injury most associated with these events, and hospitalization was recorded for 14.3% of cases. Per 100,000 eCHIRPP cases, cannabis was used alone in 72.4 cases, and in combination with alcohol, illicit drugs, or medications in 74.6 cases, 11.3 cases, and 7.9 cases, respectively. Relative to non-use, the PIR of hospitalization was not significant for cannabis-only users of either sex (males: PIR 1.0, 95% CI 0.6-1.7, females: PIR 0.9, 95% CI: 0.5-1.7). CONCLUSION: Cannabis use injuries are rare, but can occur when cannabis is used with or without other substances. As Canada considers legislative changes, our finding of cases related to unintentional injury, poisoning, and intoxication suggests areas that might benefit from health literacy efforts.

Status report -- Childhood overweight and obesity in Canada: an integrative assessment. / Rapport d'étape -- Embonpoint et obésité chez les enfants au Canada : une évaluation globale.

INTRODUCTION: Obesity is a complex risk factor for chronic disease that is associated with a number of socioecological determinants. In this status report, we provide an overview of the socioecological framework that is now guiding our ongoing surveillance efforts in the area of childhood overweight and obesity. This framework considers individual risk and protective factors (sociodemographic, lifestyle, psychosocial and early-life) through the lens of the life stage, levels of influence and environments in which these factors play a role. METHODS: Using data from the Canadian Community Health Survey and the Canadian Health Measures Survey, univariate and bivariate analyses were used to report on behavioural, psychosocial, and early life factors associated with excess weight among Canadian children. RESULTS: Estimates of early-life (e.g. breastfeeding), behavioural (e.g. physical activity), and psychosocial factors (e.g. sense of community) are presented as they relate to age group, sex, income adequacy and weight status. CONCLUSION: Building upon our recent reporting on trends in and sociodemographic factors associated with childhood obesity in Canada, this work illustrates the remaining risk and protective factors shown in our surveillance framework. This analysis supports the shift towards a holistic appraisal of determinants related to healthy weights.

INTRODUCTION: L'obésité est un facteur de risque complexe des maladies chroniques associé à un certain nombre de déterminants socioécologiques. Ce rapport d'étape fournit un aperçu du cadre socioécologique qui guide actuellement nos efforts de suivi de l'embonpoint et de l'obésité chez les enfants. Ce cadre intègre différents facteurs de risque et de protection (facteurs sociodémographiques, liés au mode de vie, psychosociaux et en début de vie) et tient compte de l'étape de vie, des niveaux d'influence et de l'environnement au sein desquels ces facteurs jouent un rôle. MÉTHODOLOGIE: Nous avons effectué des analyses univariées et bivariées fondées sur les données de l'Enquête sur la santé dans les collectivités canadiennes et de l'Enquête canadienne sur les mesures de la santé pour rendre compte des facteurs comportementaux, des facteurs psychosociaux et des facteurs en début de vie associés à un surplus de poids chez les enfants canadiens. RÉSULTATS: Les estimations liées aux facteurs en début de vie (p. ex. l'allaitement), aux facteurs comportementaux (p. ex. l'activité physique) et aux facteurs psychosociaux (p. ex. le sentiment d'appartenance à la collectivité) sont présentées en fonction du groupe d'âge, du sexe, de la suffisance du revenu et du poids. CONCLUSION: Cette étude, qui s'appuie sur notre publication récente sur les tendances en matière d'obésité chez les enfants au Canada et les facteurs sociodémographiques qui y sont associés, présente les facteurs de risque et de protection intégrés à notre cadre de surveillance. D'après notre analyse, une évaluation plus globale des déterminants associés au maintien d'un poids santé est nécessaire.

Physical activity and non-movement behaviours: their independent and combined associations with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is a prevalent risk condition associated with a higher risk of chronic conditions, including diabetes and cardiovascular diseases. Physical activity and non-movement behaviours (NMB), including sleep, screen time and sedentary activity, have been associated with MetS. In light of the increasing prevalence of NMBs, and the moderate rates of physical activity guideline adherence in Canada, this analysis examines the independent and combined associations of NMB and physical activity with MetS. METHODS: Data on Canadians 18 years and older from the Canadian Health Measures Survey (n = 2901) were used to examine the moderating effect of moderate-to-vigorous physical activity (MVPA) guideline adherence (150 minutes or more of MVPA/week, based on accelerometer) on the association of NMBs (sleep based on self-report, screen time based on self-report, and sedentary time based on accelerometer) with MetS. Logistic regression analyses were conducted and sampling weights were applied to represent the Canadian adult population. RESULTS: A graded association between PA and MetS was observed, with those achieving less MVPA than guidelines having a higher odds of MetS (OR 2.9, 95 % CI: 1.9-4.5 for < 75 mins/week of MVPA, and OR 1.8, 95 % CI: 1.2-2.8 for 75-150 mins/week, as compared to those accumulating 150 mins/week or more). When examining the moderating effect of PA on the association between NMBs and MetS, we found that (1) for participants who met guidelines, no level of any NMB was significantly associated with MetS and (2) for those who did not achieve guidelines, there was an increased odds of MetS based on excess NMB time(OR 3.2, 95 % CI: 1.5-6.8 for 1.4-2.1 h/day and OR 4.4, 95 % CI: 2.5-7.9 for ≥2.1 h/day of screen time and 75-150 mins/week of MVPA, OR 1.7, 95 % CI: 1.1-2.5 for ≥8 h/day of sleep time and <75 mins/week of MVPA, and OR 2.2, 95 % CI: 1.3-3.8 for 9.2-10.3 h/day of sedentary time and <75 mins/week of MVPA). CONCLUSIONS: Adhering to physical activity guidelines may mitigate the associations of NMBs with MetS. Given the novel findings that associations between NMBs and MetS were not significant among Canadians meeting PA guidelines, these results suggest the beneficial role of physical activity to prevent chronic disease risk.

Elevated plasma gas6 levels are associated with venous thromboembolic disease.

Growth arrest-specific 6 (gas6), a novel vitamin K-dependent protein, has been demonstrated to have a role in thrombus stabilization as gas6 null mice are resistant to lethal venous and arterial thrombosis. However, the association between gas6 and venous thromboembolism has not been elucidated in humans. The present study aims to assess the role of gas6 in human venous thromboembolic (VTE) disease. Using a highly specific ELISA method, we measured plasma levels of gas6 in plasma samples obtained from 279 patients with VTE and 79 healthy volunteers. Medication history, comorbid conditions and VTE characteristics were documented. Mean gas6 levels were higher in patients with VTE as compared to healthy volunteers, being 46 ±11 ng/ml and 35 ±6.4 ng/ml respectively (P < 0.001). Odds ratios (OR) for VTE given elevated (≥90th percentile of healthy volunteers) gas6 levels were estimated in regression models in the whole study population. After adjustment for age, sex, medications and comorbidity, subjects with elevated gas6 had an increased risk of VTE (OR of 16.3 (95% CI 5.8-45.7, P < 0.001) compared to those with lower levels of gas6. This association remains significant even among patients with a comparable age distribution. Among patients with VTE, mean gas levels showed a trend of higher levels in those with more extensive thrombi. There was no correlation between elevated gas6 levels and recurrent VTE. In conclusion, we demonstrate an association between VTE and elevated gas6 levels consistent with in vivo murine models of thrombosis. This constitutes a potential novel mechanism for thrombosis in humans and may aid in the understanding of the pathophysiology of VTE.