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1.
Pest Manag Sci ; 78(1): 369-378, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34538023

RESUMO

BACKGROUND: Wireworms, the soil-dwelling larvae of click beetles, are a major threat to global agricultural production. This is largely due to their generalist polyphagous feeding capabilities, extended and cryptic life cycles, and limited management options available. Although wireworms are well-documented as economically important pests in the Canadian Prairies, including Manitoba, there are gaps in knowledge on species distributions, subterranean behaviour and life cycles, feeding ecology and damage capacity, and economic thresholds for crop yield loss. RESULTS: We carried out 3 years (2018-2020) of intensive surveillance of larval populations across Manitoba. A total of 31 fields (24 in ≥ 2 consecutive years) were surveyed in early spring using standardized bait trapping approaches. Wireworms were present in 94% of surveyed sites, but the catch within fields varied year to year. While Hypnoidus bicolor predominated (94% of larvae), several other pest species were identified. We then explored the relationships between wireworm trap numbers and agro-environmental factors. The larval catch tended to decrease under conditions of low soil temperatures and increased clay content, coupled with high soil moisture and precipitation during the trapping period. Treatment and cultural methods appeared less influential; however, wheat production in either of the previous two growing seasons was associated with increased wireworm catch. Our models failed to predict a relationship between wireworm catch and crop yields, although infestations were rare in our region. CONCLUSION: Our findings better infer the risks posed by wireworms to crop production in the Canadian Prairies, and the agro-environmental factors that represent the greatest contributors to these risks. This information should be incorporated into future integrated pest management (IPM) strategies for wireworms. © 2021 Her Majesty the Queen in Right of Canada Pest Management Science © 2021 Society of Chemical Industry Reproduced with the permission of the Minister of Agriculture and Agri-Food Canada.


Assuntos
Besouros , Controle de Pragas , Animais , Larva , Manitoba
2.
CMAJ Open ; 9(4): E1181-E1186, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34906994

RESUMO

BACKGROUND: Low-dose codeine products can be purchased without a prescription in most of Canada. We explored trends in the purchasing of these products across the Canadian provinces from 2014 to 2019, evaluating the impact of Health Canada's 2016 announcement of a proposed regulatory change and the 2017 opening of a 60-day public comment period, as well as the impact of Manitoba's 2016 policy change requiring a prescription for the purchase of all codeine products in that province. METHODS: We evaluated population-adjusted monthly purchasing of codeine products from January 2014 to October 2019 using the IQVIA Canadian Drug Store and Hospital Purchases Audit database, stratified by province and over-the-counter (OTC) status. The primary outcomes were change in the monthly volume of low-dose codeine purchased after the 2016 federal regulatory proposal and the 2017 period of public comment across the provinces. Our secondary analysis was the impact of Manitoba's policy change in February 2016 requiring a prescription for low-dose codeine. We conducted a time-series analysis using interventional autoregressive integrated moving average models. RESULTS: Over the study period, 24 120 kg of codeine (3.025 billion units) and 937 867 kg of acetaminophen were sold as OTC, low-dose codeine products across the Canadian provinces. Health Canada's 2016 announcement did not significantly affect OTC codeine purchasing (p = 0.57). The initiation of a 60-day public comment period was associated with a roughly 44% decrease in OTC codeine purchasing (p = 0.03). In Manitoba, purchasing of the same codeine formulations decreased after rescheduling in February 2016 (p < 0.001). We observed no significant change in the rate of purchasing of higher dose codeine formulations in response to scheduling changes in Manitoba (p = 0.22). INTERPRETATION: Although Health Canada's 2016 announcement of a proposed regulatory change did not appear to have an effect on OTC codeine purchasing nationally, the 60-day comment period was associated with a decrease in purchasing. Further, Manitoba's 2016 policy change was associated with a significant and sustained decrease in the overall volume of codeine purchased. Given the potential risks of codeine dependence and acetaminophen toxicity with these products, a national rescheduling strategy should be considered.


Assuntos
Analgésicos Opioides , Codeína , Controle de Medicamentos e Entorpecentes/métodos , Hospitais , Medicamentos sem Prescrição , Farmácias , Medicamentos sob Prescrição , Acetaminofen , Analgésicos não Narcóticos , Composição de Medicamentos , Humanos , Manitoba
3.
CMAJ Open ; 9(4): E1149-E1158, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34906990

RESUMO

BACKGROUND: There were large disruptions to health care services after the onset of the COVID-19 pandemic. We sought to describe the extent to which pandemic-related changes in service delivery and access affected use of primary care for children overall and by equity strata in the 9 months after pandemic onset in Manitoba and Ontario. METHODS: We performed a population-based study of children aged 17 years or less with provincial health insurance in Ontario or Manitoba before and during the COVID-19 pandemic (Jan. 1, 2017-Nov. 28, 2020). We calculated the weekly rates of in-person and virtual primary care well-child and sick visits, overall and by age group, neighbourhood material deprivation level, rurality and immigrant status, and assessed changes in visit rates after COVID-19 restrictions were imposed compared to expected baseline rates calculated for the 3 years before pandemic onset. RESULTS: Among almost 3 million children in Ontario and more than 300 000 children in Manitoba, primary care visit rates declined to 0.80 (95% confidence interval [CI] 0.77-0.82) of expected in Ontario and 0.82 (95% CI 0.79-0.84) of expected in Manitoba in the 9 months after the onset of the pandemic. Virtual visits accounted for 53% and 29% of visits in Ontario and Manitoba, respectively. The largest monthly decreases in visits occurred in April 2020. Although visit rates increased slowly after April 2020, they had not returned to prerestriction levels by November 2020 in either province. Children aged more than 1 year to 12 years experienced the greatest decrease in visits, especially for well-child care. Compared to prepandemic levels, visit rates were lowest among rural Manitobans, urban Ontarians and Ontarians in low-income neighbourhoods. INTERPRETATION: During the study period, the pandemic contributed to rapid, immediate and inequitable decreases in primary care use, with some recovery and a substantial shift to virtual care. Postpandemic planning must consider the need for catch-up visits, and the long-term impacts warrant further study.


Assuntos
COVID-19/epidemiologia , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Distribuição por Idade , Assistência Ambulatorial/estatística & dados numéricos , COVID-19/virologia , Criança , Pré-Escolar , Estudos Transversais , Bases de Dados Factuais , Emigrantes e Imigrantes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Manitoba/epidemiologia , Ontário/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Vigilância da População , População Rural
4.
Curr Oncol ; 28(5): 3629-3648, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34590606

RESUMO

The 21st annual Western Canadian Gastrointestinal Cancer Consensus Conference (WCGCCC) was held in Calgary, Alberta, 20-21 September 2019. The WCGCCC is an interactive multi-disciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists, pathologists, radiologists, and allied health care professionals such as dietitians and nurses participated in presentation and discussion sessions to develop the recommendations presented here. This consensus statement addresses current issues in the management of hepato-pancreato-biliary (HPB) cancers.


Assuntos
Neoplasias Gastrointestinais , Alberta , Consenso , Neoplasias Gastrointestinais/terapia , Humanos , Manitoba , Saskatchewan
5.
BMJ Open ; 11(9): e052936, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521679

RESUMO

INTRODUCTION: Decades of research demonstrate that First Nations, Metis and Inuit (FN/M/I) populations have differential access to diagnostic and therapeutic healthcare. Emerging evidence shows that this continues to be the case during the SARS-CoV-2 pandemic. In an effort to rectify these differences in access to care, our team, which is co-led by FN/M/I partners, will generate and distribute evidence on COVID-19 diagnostic testing and vaccination in high-priority FN/M/I populations in Manitoba, with the goal of identifying system-level and individual-level factors that act as barriers to equitable care and thereby informing Indigenous-led public health responses. METHODS AND ANALYSIS: Our nations-based approach focuses on FN/M/I populations with separate study arms for each group. Linked administrative health data on COVID-19 diagnostic testing and vaccinations are available on a weekly basis. We will conduct surveillance to monitor trends in testing and vaccination among each FN/M/I population and all other Manitobans, map the geographic distribution of these outcomes by health region and tribal council, and identify barriers to testing and vaccination to inform public health strategies. We will follow the course of the pandemic starting from January 2020 and report findings quarterly. ETHICS AND DISSEMINATION: Ethics approvals have been granted by the University of Manitoba Research Ethics Board and from each of our FN/M/I partners' organisations. Our team is committed to engaging in authentic relationship-based research that follows First Nations, Metis and Inuit research ethics principles. Our FN/M/I partners will direct the dissemination of new information to leadership in their communities (health directors, community health organisations) and to decision-makers in the provincial Ministry of Health. We will also publish in open-access journals. The study will create ongoing capacity to monitor Manitoba's pandemic response and ensure potential health inequities are minimised, with learnings applicable to other jurisdictions where detailed administrative data may not be available.


Assuntos
COVID-19 , Inuítes , Teste para COVID-19 , Canadá , Estudos de Coortes , Humanos , Manitoba/epidemiologia , SARS-CoV-2 , Vacinação
6.
Int J Equity Health ; 20(1): 206, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34526038

RESUMO

INTRODUCTION & BACKGROUND: Global persistence of health inequities for Indigenous peoples is evident in ongoing discrepancies in health and standards of living. International literature suggests the key to transformation lies in Indigenous efforts to control Indigenous health and healthcare. Previous authors have focused upon participation, structural transformation, and culturally appropriate healthcare recognized as a political right as fundamental tenets of Indigenous control. Contextualizing Indigenous health and wellness falls within a growing discussion on decolonization - a resituating of expertise that privileges Indigenous voice and interests. METHODS: The study is a qualitative, grounded theory analysis, which is a constructivist approach to social research allowing for generation of theory in praxis, through interactions and conversations between researchers and participants. One hundred eighty-three interviews with additional focus groups were held between 2013-15 in eight Manitoba First Nation communities representing different models of health delivery, geographies, accessibilities, and Indigenous language groups. Community research assistants and respected Elders participated in data collection, analysis and interpretation. Line-by-line coding and constant comparative method led to the discovery of converging themes. FINDINGS: Ultimately four main themes arose: 1) First Nation control of healthcare; 2) traditional medicine and healing activities; 3) full and meaningful community participation; and 4) cleaning up impacts of colonization. Joint analyses and interpretation of findings revealed substantial evidence that communities were looking profoundly into problems of improperly delivered services and health inequities. Issues were consistent with those highlighted by international commissions on reconciliation, health, Indigenous rights and liberties. To those documents, these findings add ground upon which to build the transformative agenda. RESULTS & DISCUSSION: Communities discussed the need for creation of protocols, constitution and laws to ensure growth of a decolonizing agenda. Inclusive to the concept are holistic, preventative, traditional health perspectives, and Indigenous languages. Colonization impacts were of critical concern and in need of undoing. Sharing of social and political efforts is seen as pivotal to change and includes all members of communities.


Assuntos
Atitude Frente a Saúde , Serviços de Saúde do Indígena , Canadenses Indígenas , Atitude Frente a Saúde/etnologia , Serviços de Saúde do Indígena/organização & administração , Humanos , Canadenses Indígenas/psicologia , Manitoba , Pesquisa Qualitativa
7.
PLoS One ; 16(8): e0249809, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351924

RESUMO

We aimed to examine rates of breast and cervical cancer screening in women with immune-mediated inflammatory diseases (IMID), including inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) versus a matched cohort with IMID; and examine the association of psychiatric comorbidity with screening in these populations. We conducted a retrospective cohort study in Manitoba, Canada using administrative data. We identified women with IBD, MS and RA, and controls without these IMID matched on age and region. Annually, we identified individuals with any active mood/anxiety disorder. Using physician claims, we determined the proportion of each cohort who had cervical cancer screening within three-year intervals, and mammography screening within two-year intervals. We modeled the difference in the proportion of the IMID and matched cohorts who underwent mammography; and pap tests using log-binomial regression with generalized estimating equations, adjusting for sociodemographics, comorbidity and immune therapy use. We tested for additive interactions between cohort and mood/anxiety disorder status. During 2006-2016, we identified 17,230 women with IMID (4,623 with IBD, 3,399 with MS, and 9,458 with RA) and 85,349 matched controls. Having an IMID was associated with lower (-1%) use of mammography; however, this reflected a mixture of more mammography in the IBD cohort (+2.9%) and less mammography in the MS (-4.8 to -5.2%) and RA (-1.5%) cohorts. Within the IBD, MS and RA cohorts, having an active mood/anxiety disorder was associated with more mammography use than having an inactive mood/anxiety disorder. The MS and RA cohorts were less likely to undergo Pap testing than their matched cohorts. In the absence of an active mood/anxiety disorder, the IBD cohort was more likely to undergo Pap testing than its matched cohort; the opposite was true when an active mood/anxiety disorder was present. Among women with an IMID, mood/anxiety disorder influence participation in cancer screening.


Assuntos
Transtornos de Ansiedade/complicações , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/psicologia , Transtornos do Humor/complicações , Neoplasias do Colo do Útero/diagnóstico , Adulto , Transtornos de Ansiedade/psicologia , Artrite Reumatoide/complicações , Artrite Reumatoide/psicologia , Neoplasias da Mama/psicologia , Estudos de Casos e Controles , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/psicologia , Manitoba , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Estudos Retrospectivos , Neoplasias do Colo do Útero/psicologia
8.
CMAJ Open ; 9(3): E818-E825, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34446461

RESUMO

BACKGROUND: One in 5 people in Canada have a disability affecting daily activities, and, for rural patients, accessing lifelong physiatry care to improve function and manage symptoms requires complex and expensive travel. We compared the costs of new outreach physiatry clinics with those of conventional urban clinics in Manitoba. METHODS: Six outreach clinics were held from January 2018 to September 2019 in the remote communities of St. Theresa Point and Churchill, Manitoba. A general physiatry population was seen in these clinics, including patients with musculoskeletal and neurologic conditions seen in consultation and follow-up. We performed a societal cost-minimization analysis comparing outreach clinic costs to estimated costs of standard care at conventional outpatient clinics in Winnipeg. Outcomes of interest included direct costs to government health services and patients, and indirect opportunity cost of travel time. We calculated total costs, average cost per clinic visit and incremental costs for outreach clinics compared to conventional urban clinics. Costs were inflated to 2020 Canadian dollars. RESULTS: Thirty-one patients (48 visits) were seen at the outreach clinics. The total cost of providing outreach clinics, $33 136, was 21% of the estimated cost of standard care, $158 344. When only direct costs were included, outreach clinics cost an estimated 24% of conventional care costs. The average unit cost per outreach visit was $690, compared to $3299 per conventional visit, for an incremental cost of -$2609 per outreach visit. INTERPRETATION: An outreach physiatry visit in Manitoba cost an estimated 21% of a conventional urban outpatient visit, or 24% when only direct costs were included, with costs savings largely related to travel. Outreach physiatry care in this model provides substantial cost savings for the public health care system as the primary payer, and can reduce the travel cost burden for patients who do not have public travel funding.


Assuntos
Instituições de Assistência Ambulatorial , Acesso aos Serviços de Saúde , Doenças Musculoesqueléticas , Doenças do Sistema Nervoso , Medicina Física e Reabilitação , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/organização & administração , Efeitos Psicossociais da Doença , Custos e Análise de Custo , Estado Funcional , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Manitoba/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/reabilitação , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/reabilitação , Medicina Física e Reabilitação/economia , Medicina Física e Reabilitação/organização & administração , Garantia da Qualidade dos Cuidados de Saúde , Centros de Reabilitação/economia , Centros de Reabilitação/normas , Saúde da População Rural/economia , Saúde da População Rural/normas , Transporte de Pacientes/economia , Transporte de Pacientes/estatística & dados numéricos
9.
BMC Health Serv Res ; 21(1): 758, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332563

RESUMO

BACKGROUND: Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. METHODS: Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. RESULTS: The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. CONCLUSIONS: A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns.


Assuntos
Algoritmos , Alberta , Colúmbia Britânica , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Manitoba , Ontário/epidemiologia , Quebeque , Reino Unido
10.
Health Syst Reform ; 7(1): e1943814, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34375567

RESUMO

The First Nations in Manitoba, Canada, are calling for active recognition and incorporation of holistic traditional healing and medicine ways and approaches by the mainstream healthcare system that has hitherto tended to ignore all but biomedical approaches. This request for recognition requires elaboration on areas of opportunity for collaboration that could positively influence both Indigenous and allopathic medicine. We discuss pathways to an integrated healthcare system as community-based primary healthcare transformation. A community-based participatory research approach was used to engage eight Manitoba First Nations communities. One hundred and eighty-three (183) in-depth, semi-structured key informant interviews were completed in all communities. Grounded theory guided data analysis using NVivo 10 software. We learned that increased recognition and incorporation of traditional healing and medical methods would enhance a newly envisioned funded health system. Elders and healers will be meaningfully involved in the delivery of community-based primary health care. Funding for traditional healing and medicines are necessary components of primary health care. An overall respect for Indigenous health knowledge would aid transformation in community-based primary health care. Recognition of and respect for traditional healing, healers, medicines, therapies, and approaches is also recommended as part of addressing the legacy and intergenerational impact of assimilative policies including Indian residential schools as the Truth and Reconciliation Commission of Canada has stated in its Calls to Action.


Assuntos
Serviços de Saúde Comunitária , Prestação Integrada de Cuidados de Saúde , Idoso , Canadá , Humanos , Manitoba , Atenção Primária à Saúde
11.
PLoS One ; 16(7): e0253650, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242266

RESUMO

OBJECTIVES: We investigated the spatial disparities and factors associated with gastric cancer (GC) Incidence in Manitoba. METHODS: We combined information from Manitoba Cancer registry and Census data to obtain an age-sex adjusted relative risk (IRR) of GC incidence. We geocoded the IRR to the 96 regional health authority districts (RHADs) using the postal code conversion file (PCCF). Bayesian spatial and spatio-temporal Poisson regression models were used for the analysis. RESULTS: Adjusting for the effect of socio-economic score index (SESI), Indigenous, and immigrant population, 25 districts with high overall GC risk were identified. One unit increase in SESI was associated with reduced risk of cardia GC (CGC) by 14% (IRR = 0.859; 95% CI: 0.780-0.947) and the risk of non-cardia GC (NCGC) by approximately 10% (IRR = 0.898; 95% CI: 0.812-0.995); 1% increase in regional Indigenous population proportion reduced the risk of CGC by 1.4% (IRR = 0.986; 95% CI: 0.978-0.994). In the analysis stratified by sex, one unit increase in SESI reduced the risk of CGC among women by 26.2% (IRR = 0.738; 95% CI: 0.618-0.879), and a 1% increase in Indigenous population proportion reduced the risk of CGC among women by 1.9% (IRR = 0.981; 95% CI: 0.966-0.996). CONCLUSION: Our results support a significant association between SESI and NCGC. We report regional variation of GC IRR and a varying temporal pattern across the RHADs. These results could be used to prioritize interventions for regions with high and progressive risk of GC.


Assuntos
Disparidades nos Níveis de Saúde , Fatores Socioeconômicos , Neoplasias Gástricas/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Geografia , Humanos , Incidência , Canadenses Indígenas/estatística & dados numéricos , Masculino , Manitoba/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco
12.
J Appl Res Intellect Disabil ; 34(6): 1582-1591, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34196454

RESUMO

BACKGROUND: Complete physical examinations (CPE) can identify health disparities in persons with intellectual or developmental disabilities. The objective of this study was to determine and compare rates of CPE among Manitoba adults with and without intellectual or developmental disabilities over time and to identify factors that were associated with receiving a CPE. METHOD: A retrospective cohort study using linked administrative health and non-health data from 1995 to 2015 was conducted. Poisson and logistic regression were used to calculate CPE rates and examine factors associated with CPE. RESULTS: The rates of CPE are decreasing over time and are higher among Manitobans with an intellectual or developmental disability. Characteristics such as being male, living rurally, low socioeconomic status, and high continuity of care led to lower odds of receiving a CPE. CONCLUSIONS: The current state of CPE provision to adults with intellectual or developmental disabilities in Manitoba is encouraging but needs improvement.


Assuntos
Deficiências do Desenvolvimento , Deficiência Intelectual , Adulto , Criança , Deficiências do Desenvolvimento/epidemiologia , Humanos , Deficiência Intelectual/epidemiologia , Masculino , Manitoba , Exame Físico , Estudos Retrospectivos
13.
BMC Public Health ; 21(1): 1421, 2021 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-34275450

RESUMO

BACKGROUND: Self testing for HIV is a targeted intervention with the potential to increase the access, uptake and frequency of HIV testing and more effectively reach the undiagnosed, especially in priority populations. The objectives of this study were to (1) evaluate the INSTI HIV self-test performance compared with laboratory reference testing, (2) document if intended users can perform the steps to use the HIV self-test device, and (3) document if intended users can successfully interpret contrived positive, negative, and invalid results. Study was intended to be submitted to Health Canada for review for regulatory approval purposes. METHODS: The study used a cross-sectional design and recruited consenting adults who were representative of intended users of HIV self-testing from four community sites across Ontario, Québec, and Manitoba between August 2019 and March 2020. The results of the observed HIV self-test were compared with results of the Abbott Architect HIV Ag/Ab Combo test. Usability outcomes for critical (e.g., lancing finger, blood droplet into bottle, shaking bottle four times) and noncritical self-test procedure steps were also determined. RESULTS: Overall, 77% (n = 522) of participants were between 18 and 45 years of age, 61% (n = 410) were male, 71% (n = 480) had some college or more education, and 45% (n = 307) were employed; identity for race and ethnicity: Caucasian (44%; n = 296), African, Caribbean or Black (17%; n = 113), Indigenous [First Nations, Métis or Inuit] (14%; n = 95), Asian (16%; n = 106), Latin American (7%; n = 46). Primary performance analysis on 678 completed HIV self-tests revealed a positive percent agreement of 100% (5/5, 95% CI: 43.6-97.0%) and a negative percent agreement of 99.5% (614/617, 95% CI: 98.6-99.8%) with the comparator method. The overall percent agreement of results interpretation between participant and observer was 93.5% (n = 633). For the 708 participants who took part in the usability study, the average success rate for steps determined to be "critical" for successful completion of the test was 92.4%. 97% (n = 670) of participants found the instructions easy to follow, and 95% (n = 655) of participants indicated that they would use the test again. Of the 404 participants who interpreted the strong positive, weak positive, negative, and invalid contrived results, successful interpretation ranged from 90.6% (for weak positive, n = 366) to 99.3% (for negative, n = 401). CONCLUSIONS: The addition of a regulatory-approved self-test into the Canadian HIV testing landscape could significantly increase HIV testing rates. Having a blood-based HIV self-test approved in Canada can offer an accurate, acceptable, and simple alternative to facility-based HIV testing, particularly when impacted by Coronavirus pandemic restrictions.


Assuntos
Infecções por HIV , Autoteste , Adulto , Região do Caribe , Estudos Transversais , Infecções por HIV/diagnóstico , Humanos , Masculino , Manitoba , Pessoa de Meia-Idade , Ontário , Estudos Prospectivos , Quebeque
14.
Can Vet J ; 62(7): 725-728, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34219781

RESUMO

Bordetella bronchiseptica is a promiscuous bacterium that infects a variety of species but has not been reported in free-ranging polar bears (Ursus maritimus). Sera from 385 polar bears from the western Hudson Bay region, 1986 to 2017, were tested for reactivity to B. bronchiseptica with enzyme-linked immunosorbent assays using anti-canine IgG and Streptococcus protein G as secondary reagents. Sera from bears had variable reactivity to B. bronchiseptica antigens, and there was no difference among bears that had a history of coming near the town of Churchill, Manitoba, and bears that did not. Although the sources of exposure were not determined, equivalent results in both groups suggest that potential exposure to humans (aside from handling during sampling) and their animals (dogs) was not an important co-factor in sero-positivity to B. bronchiseptica.


Assuntos
Bordetella bronchiseptica , Ursidae , Animais , Anticorpos Antibacterianos , Canadá , Cães , Manitoba
15.
Curr Oncol ; 28(3): 2239-2247, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208635

RESUMO

Unwarranted clinical variation in healthcare impacts access, productivity, performance, and outcomes. A strategy proposed for reducing unwarranted clinical variation is to ensure that population-based data describing the current state of health care services are available to clinicians and healthcare decision-makers. The objective of this study was to measure variation in colorectal cancer surgical treatment patterns and surgical quality in Manitoba and identify areas for improvement. This descriptive study included individuals aged 20 years or older who were diagnosed with invasive cancer (adenocarcinoma) of the colon or rectum between 1 January 2010 and 31 December 2014. Laparoscopic surgery was higher in colon cancer (24.1%) compared to rectal cancer (13.6%). For colon cancer, the percentage of laparoscopic surgery ranged from 12.9% to 29.2%, with significant differences by regional health authority (RHA) of surgery. In 86.1% of colon cancers, ≥12 lymph nodes were removed. In Manitoba, the negative circumferential resection margin for rectal cancers was 96.9%, and ranged from 96.0% to 100.0% between RHAs. The median time between first colonoscopy and resection was 40 days for individuals with colon cancer. This study showed that high-quality colorectal cancer surgery is being conducted in Manitoba along with some variation and gaps in quality. As a result of this work, a formal structure for ongoing measuring and reporting surgical quality has been established in Manitoba. Quality improvement initiatives have been implemented based on these findings and periodic assessments of colorectal cancer surgery quality will continue.


Assuntos
Neoplasias do Colo , Laparoscopia , Neoplasias Retais , Humanos , Manitoba/epidemiologia , Reto
16.
PLoS One ; 16(6): e0252952, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34111202

RESUMO

Given the climate crisis and its cumulative impacts on public health, effective communication strategies that engage the public in adaptation and mitigation are critical. Many have argued that a health frame increases engagement, as do visual methodologies including online and interactive platforms, yet to date there has been limited research on audience responses to health messaging using visual interventions. This study explores public attitudes regarding communication tools focused on climate change and climate-affected Lyme disease through six focus groups (n = 61) in rural and urban southern Manitoba, Canada. The results add to the growing evidence of the efficacy of visual and storytelling methods in climate communications and argues for a continuum of mediums: moving from video, text, to maps. Findings underscore the importance of tailoring both communication messages and mediums to increase uptake of adaptive health and environmental behaviours, for some audiences bridging health and climate change while for others strategically decoupling them.


Assuntos
Promoção da Saúde/métodos , Doença de Lyme/epidemiologia , Mudança Climática , Medicina Baseada em Evidências , Grupos Focais , Mapeamento Geográfico , Humanos , Manitoba , Saúde Pública , Envio de Mensagens de Texto , Gravação em Vídeo
17.
Can Vet J ; 62(5): 469-476, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33967285

RESUMO

The objectives of the study were to describe the regional and provincial incidence rates and the weekly distribution of 842 reported West Nile virus (WNV) cases in horses in Canada between 2003 and 2019. This study also investigated characteristics of cases reported to the Canadian Food Inspection Agency (CFIA) between 2015 and 2019. The western region (British Columbia, Alberta, Saskatchewan, and Manitoba) had higher incidence rates than the eastern region (Ontario, Quebec, and Atlantic provinces) and overall, Saskatchewan registered the highest incidence. Over the study period, an earlier weekly preliminary onset of WNV cases was observed in the western region. The vast majority of cases were unvaccinated (96%), most cases were Quarter Horses (68%) and the risk of mortality was 31.9%. The findings of this study may be useful in informing veterinary equine practitioners about measures to prevent WNV disease in horses in Canada.


Assuntos
Doenças dos Cavalos , Vírus do Nilo Ocidental , Alberta , Animais , Colúmbia Britânica , Inspeção de Alimentos , Doenças dos Cavalos/epidemiologia , Cavalos , Manitoba , Ontário , Quebeque , Estudos Retrospectivos , Saskatchewan/epidemiologia
18.
Neurology ; 97(1): e13-e22, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34011575

RESUMO

OBJECTIVE: To test the hypotheses that overall survival and cancer-specific survival after breast cancer diagnosis would be lower in persons with multiple sclerosis (MS) as compared to persons without MS using a retrospective matched cohort design. METHODS: We applied a validated case definition to population-based administrative data in Manitoba and Ontario, Canada, to identify women with MS. We linked the MS cohorts to cancer registries to identify women with breast cancer. Then we selected 4 breast cancer controls without MS matched on birth year, cancer diagnosis year, and region. We compared all-cause survival between cohorts using Cox proportional hazards regression adjusting for age at cancer diagnosis, cancer diagnosis period, income quintile, region, and Elixhauser comorbidity score. We compared cancer-specific survival between cohorts using a multivariable cause-specific hazards model. We pooled findings between provinces using meta-analysis. RESULTS: We included 779 patients with MS and 3,116 controls with breast cancer. Most patients with stage data (1,976/2,822 [70.0%]) were diagnosed with stage I or II breast cancer and the mean (SD) age at diagnosis was 57.8 (10.7) years. After adjustment for covariates, MS was associated with a 28% increased hazard for all-cause mortality (hazard ratio [HR] 1.28; 95% confidence interval [CI] 1.08-1.53), but was not associated with altered cancer-specific survival (HR 0.98; 95% CI 0.65-1.46). CONCLUSION: Women with MS have lower all-cause survival after breast cancer diagnosis than women without MS. Future studies should confirm these findings in other populations and identify MS-specific factors associated with worse prognosis.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/mortalidade , Esclerose Múltipla/complicações , Esclerose Múltipla/mortalidade , Adolescente , Adulto , Idoso , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Renda , Manitoba/epidemiologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
19.
Environ Monit Assess ; 193(6): 339, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-33988761

RESUMO

About one-half of the homes on First Nations (FN) reserves in Manitoba, Canada, receive piped water from a water treatment plant (WTP). Many other homes (31%) are equipped with cisterns that are filled by a water truck, and our objective was to determine how the use of cisterns affects drinking water safety relative to drinking water piped directly to homes from the WTP. The study included belowground concrete cisterns, belowground fiberglass cisterns, and aboveground polyethylene cisterns stored in insulated shelters, and all the data collection methods showed that the tap water in homes with cisterns were relatively more contaminated with coliform bacteria than the tap water in piped homes. The frequency and severity of Escherichia coli and total coliform contamination were numerically greater in drinking water samples from belowground concrete and fiberglass cisterns than in piped water samples in each community, and the contamination of belowground cisterns by coliform bacteria was greatest in late spring. As well, data obtained under the Access to Information Act showed no statistical differences in the percent of satisfactory samples (no detects) between 2014 and 2018, suggesting no clear indication of improved water quality in any of the Tribal Councils in which these three and other communities are a member off. Our results point to the need for additional treatment of drinking water in homes supplied by belowground concrete or fiberglass cisterns and replacement of belowground cisterns with aboveground cisterns or piped water to reduce the risk of water-borne illnesses.


Assuntos
Água Potável , Canadá , Água Potável/análise , Monitoramento Ambiental , Manitoba , Microbiologia da Água , Abastecimento de Água
20.
Vaccine ; 39(26): 3473-3479, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34023134

RESUMO

IMPORTANCE: The success in ending the COVID-19 pandemic rests partly on the mass uptake of the COVID-19 vaccine. Little work has been done to understand vaccine willingness among older adolescents and young adults. This is important since this age group may be less likely to adhere to public health guidelines. OBJECTIVE: To understand willingness of getting a vaccine and reasons for vaccine hesitancy among a sample of older adolescents and young adults. DESIGN: Data were from the Well-Being and Experiences study (The WE Study), a longitudinal community-based sample of older adolescents and young adults collected from Winnipeg, Manitoba, Canada from 2017 to 2020 (n = 664). SETTING: The study setting was a community-based observational longitudinal study. PARTICIPANTS: Participants for the study were aged 14 to 17 years old at baseline in 2016-17 (n = 1000). Data were also collected on one parent/caregiver. Waves 2 (n = 747) and 3 (n = 664) were collected in 2019 and 2020, respectively. EXPOSURES: The main exposures were sociodemographic factors, health conditions, COVID-19 knowledge, and adversity history. MAIN OUTCOMES: The main outcomes were COVID-19 vaccine willingness, hesitancy, and reasons for hesitancy. RESULTS: Willingness to get a COVID-19 vaccine was 65.4%. Willingness did not differ by age, sex, or mental health conditions, but did differ for other sociodemographic characteristics, physical health conditions, COVID-19 knowledge, practicing social/physical distancing, and adversity history. The most common reasons for not wanting a vaccine were related to safety, knowledge, and effectiveness. Sex differences were noted. CONCLUSIONS AND RELEVANCE: Increasing uptake of the COVID-19 vaccine among older adolescents and young adults may rely on targeting individuals from households with lower income, financial burden, and adversity history, and generating public health messaging specifically aimed at vaccine safety, how it works to protect against illness, and why it is important to protect oneself against a COVID-19 infection.


Assuntos
COVID-19 , Vacinas , Adolescente , Vacinas contra COVID-19 , Canadá , Feminino , Humanos , Estudos Longitudinais , Masculino , Manitoba , Pandemias , Saúde Pública , SARS-CoV-2 , Vacinação , Adulto Jovem
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