Saskatchewan Health

About: Saskatchewan Health is a government organization based out in Regina, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 442 authors who have published 489 publications receiving 7728 citations.

The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan.

Abstract: A small proportion of the population accounts for the majority of healthcare costs. Mental health and addiction (MHA) patients are consistently high-cost. We aimed to delineate factors amenable to public health action that may reduce high-cost use among a cohort of MHA clients in Saskatoon, Saskatchewan. We conducted a population-based retrospective cohort study. Administrative health data from fiscal years (FY) 2009–2015, linked at the individual level, were analyzed (n = 129,932). The outcome of interest was ≥ 90th percentile of costs for each year under study (‘persistent high-cost use’). Descriptive analyses were followed by logistic regression modelling; the latter excluded long-term care residents. The average healthcare cost among study cohort members in FY 2009 was ~ $2300; for high-cost users it was ~ $19,000. Individuals with unstable housing and hospitalization(s) had increased risk of persistent high-cost use; both of these effects were more pronounced as comorbidities increased. Patients with schizophrenia, particularly those under 50 years old, had increased probability of persistent high-cost use. The probability of persistent high-cost use decreased with good connection to a primary care provider; this effect was more pronounced as the number of mental health conditions increased. Despite constituting only 5% of the study cohort, persistent high-cost MHA clients (n = 6455) accounted for ~ 35% of total costs. Efforts to reduce high-cost use should focus on reduction of multimorbidity, connection to a primary care provider (particularly for those with more than one MHA), young patients with schizophrenia, and adequately addressing housing stability.

Predictors of influenza a molecular viral shedding in Hutterite communities.

Abstract: Background Patterns of influenza molecular viral shedding following influenza infection have been well established; predictors of viral shedding however remain uncertain. Objectives We sought to determine factors associated with peak molecular viral load, duration of shedding, and viral area under the curve (AUC) in children and adult Hutterite colony members with laboratory-confirmed influenza. Methods A cohort study was conducted in Hutterite colonies in Alberta, Canada. Flocked nasal swabs were collected during three influenza seasons (2007-2008 to 2009-2010) from both symptomatic and asymptomatic individuals infected with influenza. Samples were tested by real-time reverse-transcription polymerase chain reaction for influenza A and influenza B, and the viral load was determined for influenza A-positive samples. Results For seasonal H1N1, younger age was associated with a larger AUC, female sex was associated with decreased peak viral load and reduced viral shedding duration, while the presence of comorbidity was associated with increased peak viral load. For H3N2, younger age was associated with increased peak viral load and increased AUC. For pandemic H1N1, younger age was associated with increased peak viral load and increased viral AUC, female sex was associated with reduced peak viral load, while inapparent infection was associated with reduced peak viral load, reduced viral shedding duration, and reduced viral AUC. Conclusions Patterns of molecular viral shedding vary by age, sex, comorbidity, and the presence of symptoms. Predictor variables vary by influenza A subtype.

Predicting weekly variation of Culex tarsalis (Diptera: Culicidae) West Nile virus infection in a newly endemic region, the Canadian prairies.

Abstract: West Nile virus (WNV) spread across most of North America within a short time period after its incursion into the Western Hemisphere. The Canadian prairies had the highest human incidence of WNV disease in Canada, particularly in 2007. Statistical modeling and geographic information systems can be used to develop a predictive model and facilitate the mobilization of targeted disease management strategies. Using data collected between 2005 and 2008, we constructed models integrating abiotic and biotic factors to predict the WNV infection rate in female Culex tarsalis Coquillett, the primary vector of WNV in the Canadian prairies. During the study period, the highest mean Cx. tarsalis infection rate was during week 34 (late August). The Cx. tarsalis infection rate increased with increasing Cx. tarsalis abundance and mean temperature lagged from 1 to 8 wk, but decreased with increasing mean precipitation lagged from 2 to 6 wk. Furthermore, precipitation was a ‘distorter variable’ that altered the association between Cx. tarsalis abundance and the WNV infection rate. Our model clarified how weather influenced the Cx. tarsalis infection rate in the Canadian prairies, a newly and highly WNV endemic region of North America. An understanding of the role of lagged weather variables was essential for providing sufficient lead time to predict WNV occurrence, and for implementing disease control and prevention strategies. Furthermore, it is a useful tool for assessing the potential effects of future climate change on WNV in areas near its northern distributional limit.

Promoting chronic disease management in persons with complex social needs: A qualitative descriptive study:

Abstract: While there are both ethical and practical imperatives to address health inequity issues related to chronic disease management for persons with social complexity, existing programs often do not appropriately address the needs of these individuals. This leads to low levels of participation in programs, suboptimal chronic disease management, and higher health-care utilization. The aims of this project were to describe the challenges related to availability, accessibility, and acceptability faced by socially complex patients with Chronic Obstructive Pulmonary Disease (COPD) who were eligible, but declined enrollment in a traditional Chronic Disease Management Program (CDMP). Using a qualitative descriptive study approach informed by a health equity lens, interviews with participants, managers, and a focus group with providers were used to gather data addressing the above aims. Qualitative data were analyzed using Braun and Clarke's theoretical thematic analysis approach. The ability of participants to manage chronic disease was profoundly influenced by contextual and personal factors, such as poverty, disability, personal attitudes and beliefs (including shame, mistrust, and hopelessness), and barriers inherent in the organization of the health-care system. The existing chronic disease management program did not adequately address the most critical needs of socially complex patients. Challenges with accessibility and acceptability of chronic disease management and health services played important roles in the ways these socially complex participants managed their chronic illness. The individualistic approach to self-management of chronic illness inherent in conventional CDMP can be poorly aligned with the needs, capacity, and circumstances of many socially complex patients. Innovative models of care that promote incremental and guided approaches to enhancing health and improving self-efficacy need further development and evaluation.

Parkinsonism in essential tremor cases: A clinicopathological study.

Abstract: Background Essential tremor and Parkinson's syndrome are two common movement disorders that may co-occur in some individuals. There is no diagnostic neuropathology for essential tremor, but in PD and other Parkinson's syndrome variants, the neuropathology is well known. The spectrum of Parkinson's syndrome variants associated with essential tremor, their clinical features, and course have not been determined in autopsy-confirmed cases. Objectives To identify: diagnostic features of essential tremor/Parkinson's syndrome, different Parkinson's syndrome variants, and long-term clinical profile in such cases. Methods Patients that had an essential tremor diagnosis and a subsequent clinical or pathological diagnosis of Parkinson's syndrome seen in our clinic during 50 years were included. The diagnosis of parkinsonism was made when bradykinesia, rigidity, and resting tremor were all clinically evident. Results Twenty-one cases were included. All the common variants of parkinsonism co-occurred with essential tremor. The most common was PD (67%) followed by PSP. The pathological findings were not predicted clinically in 2 cases that had essential tremor/PD and in all 5 essential tremor/PSP cases. Conclusion In most essential tremor/Parkinson's syndrome patients, the main motor features of parkinsonism-bradykinesia, rigidity, and resting tremor-were identifiable. All known degenerative Parkinson's syndrome variants co-occurred in essential tremor patients. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.