Showing papers in "Canadian Journal of Public Health-revue Canadienne De Sante Publique in 1991"

Perceived barriers to physical activity by older adults.

Abstract: The purpose of this study was to investigate the perceived barriers to physical activity by older adults. 199 volunteers responded to the Perceived Barriers Questionnaire (PBQ). The subjects resided in apartment residences for independent, healthy, older adults. Older adults perceived as many as 17 barriers to physical activity. The number of barriers per subject was significantly related to age and illness or handicap. The remaining factors, gender, income, activity and educational levels, were not related to the number of barriers. There was a significant difference among four specific types of barriers (i.e. Psychological, Administrative, Physical/Health, Knowledge) with barriers of the knowledge dimension being most often identified.

The adequacy of suicide statistics for use in epidemiology and public health

Abstract: In spite of persistent criticisms regarding their validity, official suicide statistics continue to be used in epidemiologic studies that have substantial public health implications. We ask which epidemiologic findings might be affected by underreporting in the suicide rate. We estimate the extent of potential underreporting by comparing Canadian suicide rates with and without deaths of undetermined origin (UDs) added. Our results tend to confirm findings from other jurisdictions, specifically that underreporting is probably higher among females and cases of poisoning and drowning. The highest underreporting in the 1950-82 period was in 1977-1978. Overall, the average potential underreporting was found to be 17.5% for females and 12% for males. Still, underreporting is not sufficiently large that reasonable reformulations of the suicide rate substantially alter findings, suggesting that most epidemiologic conclusions based on official rates are essentially correct. Language: en

An outbreak of Campylobacter jejuni gastroenteritis linked to meltwater contamination of a municipal well.

Abstract: A large outbreak of Campylobacter jujuni gastroenteritis attributed to contamination of an unchlorinated municipal water system was investigated. Unlike most previous summer outbreaks, this one began in early spring and was attributed to meltwater entering one or more municipal wells. 241 suspected cases were documented, but retrospective information from local health care workers suggested a much larger outbreak. 45 laboratory-confirmed cases participated in a case-control study which showed a significant association between infection and amount of town water consumed. Stool specimens from 29 patients were studied with detailed serotyping by the method of Lior, with eight known serotypes and one previously unknown one identified. It is concluded that intensive surveillance of water quality during periods of spring runoff is essential, and that timely reporting of disease outbreak patterns in emergency department settings is necessary to protect the public's health.

Vitamin D deficiency and cancer of the breast: an unprovocative ecological hypothesis.

Abstract: It has been stated recently that atmospheric acid haze containing sulfur dioxide and sulfate crystals may lead to vitamin D deficiencies in exposed populations and increase breast cancer mortality, especially in Montreal. In view of the implications of this hypothesis, we have done a case-control study within the same cohort of women attending the Canadian National Breast Screening Study to check whether a depletion of vitamin D could be detected in the diet of breast cancer patients (n = 108) as compared to controls (n = 322) or a random sample of 1,141 women in our Montreal centre as well as 40 breast cancer cases for which precise food intake data were available by way of a 24-hour dietary journal. The mean daily intake of vitamin D of breast cancer cases was 1.65 +/- 2.48 I.U./kg while in 322 controls matched for age the mean intake was 1.34 +/- 1.17 (S.D.). It has to be pointed out that in the 5 years before diagnosis, cancer patients had not increased significantly their consumption of foods rich in vitamin D, namely milk, cheese, yoghurt, butter and fish. It has also to be stressed that, in relation to the recommended daily intake, twice as many breast cancer patients than controls had a higher consumption of vitamin D.

Promotion of bicycle helmet use among schoolchildren: a randomized clinical trial.

Abstract: Although bicycle helmets have been shown to reduce the rates of head injuries and brain injuries from bicycle mishaps, use of helmets is very uncommon. We compared a comprehensive awareness program to increase bicycle helmet use among schoolchildren to the impact of that same awareness program plus a bicycle helmet subsidy. Results showed no impact of the educational program (no children observed riding to school wore helmets before or after the program). The proportion of helmet wearers at the school that obtained the subsidy increased from 0% to 22% (p = 0.036). An educational program in conjunction with a subsidy may have a significant impact on bicycle helmet use. Language: en

The role of the nurse-examiner in the National Breast Screening Study.

Abstract: The National Breast Screening Study employed 75 nurse-examiners in 12 screening centres across Canada who screened 67,740 women, some of whom received up to 5 annual screening examinations. 17 nurses each performed more than 5,000 physical examinations of the breast, 38 performed 1,000-4,999 and 20 performed less than 1,000. The nurses' accomplishments were impressive: they taught women how to perform breast self-examination and collected data evaluating BSE compliance, they alleviated anxiety in frightened women, they transmitted and explained clinical information to women who had abnormal screening examinations and they enhanced communication between the NBSS and the family physicians. The excellence of their physical examinations is reflected by a sensitivity of 77-83% for all but one screen years in women age 50-59 assigned to physical examination as a single screening modality and by the cancer detection rates which were achieved. Consequently, we recommend that in the future nurse-examiners should be employed in breast screening centres.

A review of the epidemiology, public health importance, treatment and control of head lice.

Abstract: Head lice are cosmopolitan and endemic. While they are not responsible for the spread of any disease, they are the cause of considerable social distress. They can infest anybody and do not discriminate between class or cleanliness. Head lice are transmitted primarily by direct contact. The only satisfactory method to clear an infestation is by chemical treatment. The most effective pediculicides to date are those which contain permethrin (Nix) or malathion (Prioderm). Compliance with product instructions eliminates the need for nit removal after treatment. Treatment of inanimate objects and the environment should be discouraged. To obtain effective control of head lice, the whole community needs to be involved. Parents must be encouraged to screen themselves and their children regularly in the home, and to treat themselves only when necessary.

Factors associated with the prevalence of various self-reported impairments among older people residing in the community.

Abstract: Self-reported data from the Health and Activity Limitation Survey (HALS) and the General Social Survey (GSS) are used to estimate the prevalence of psychological or mental, mobility, agility, seeing and hearing impairments in the elderly population. Multiple impairments are common in the elderly population and the prevalence of the various impairments increases with age in a log-linear manner. Relative risks are estimated for the various impairments on the basis of income, marital status, housing tenure and living arrangements. Among these four variables, low income appears to have the greatest effect.

Self-reported illness and risk behaviours amongst Canadian travellers while abroad.

Abstract: 403 travellers who attended The University of Calgary International Travel Clinic between August 1, 1987 and June 1, 1988, were asked to return a questionnaire detailing health, illness and risk factors while abroad. Of the 296 respondents, most travelled for fewer than 6 weeks time; destinations were primarily areas where chloroquine-resistant Plasmodium falciparum had been reported. Diarrhea was experienced by 57.3% of respondents; eating food purchased from street vendors was found to be a significant risk factor. Travellers who made trips exceeding 60 days' duration were significantly more likely to experience skin rashes, fevers or diarrhea, although it could not be determined whether this was due to their higher likelihood of undertaking high-risk behaviours, or to a higher number of person-days at risk. The findings of this high rate of illness while abroad underscores the need for specific advice on appropriate risk avoidance behaviours when pre-travel medical visits occur. Further prospective studies to determine effectiveness of such advice, and the patterns of illness based on person-days at risk, are required.

Survey of exercise and dietary knowledge and behaviour in persons with type II diabetes.

Abstract: A survey was conducted to assess the potential for an exercise and weight control program for persons with Type II diabetes Questionnaires were sent to 1,000 individuals with diabetes, who were randomly selected from the provincial health records office Physicians and dietitians were the primary sources of information about both exercise and diet Although few respondents participated in organized (77%) or informal (368%) exercise programs, or expressed an interest in participating (368%), the majority (840%) believed that they should get more exercise This points to a gap between attitude and behaviour Activity preferences were similar to those reported previously for all Canadians, however, barriers to participation differed in the present group It was concluded that barriers must be assessed, and behaviour modification included, if diet and exercise programs are to be successful in this population

Factors influencing the acceptance of hepatitis B vaccine by students in health disciplines in Ottawa.

Abstract: Few students in health care disciplines are immunized against hepatitis B. In order to determine the immunization prevalence and identify the factors influencing the intentions of students to accept hepatitis B vaccine, we administered a questionnaire to 435 university and community college students in health care disciplines in Ottawa where there was no hepatitis B immunization program. We found that only 14% of the students had been immunized. There was significant variability among student groups in their perceptions of the risk of acquiring hepatitis B, beliefs about the efficacy of the vaccine, and their willingness to pay for it. The need for a low-cost vaccine was demonstrated by the fact that only 35% of students would pay the wholesale price of the vaccine ($100), but 94% said they would pay $15.

Childhood lead exposure in Trail revisited.

Abstract: We sought to identify modifiable determinants of elevated blood lead levels in preschool children; to compare the current situation with past information; to determine historical trends in environmental lead contamination in Trail; and to find a basis for identifying appropriate precautions and protection against future lead exposure. In Phase 1, blood samples were drawn from all children aged 2 to 5. In Phase 2, children in the highest and lowest quartile of blood leads were surveyed by questionnaire. Environmental samples of drinking water, paint, housedust, soil and vegetables were taken from their residences, and soil samples were collected from nearby parks. The average blood lead level was 13.8 micrograms/dl, range 4 to 30 micrograms/dl. This is approximately 40% lower than in 1975, when a previous survey was done, but is high compared to other places in Canada. The study of environmental determinants of lead revealed that soil lead levels and, secondarily, housedust lead levels are the principal determinants of high blood lead. Children with high blood leads also tended to concentrate in neighbourhoods near the lead-zinc smelter.

Changes in alcohol consumption with age.

Abstract: We report the results of an analysis of alcohol consumption data collected in a telephone survey of all adults in a sample of households in metropolitan St. John's in 1985. Regression analyses showed that the age-related decline in total alcohol consumption is a result of changes in the amount of alcohol consumed per drinking occasion rather than a decrease in the number of drinking occasions. Increased education is associated with increased drinking occasions, but decreased consumption per occasion. A large part of the gender difference in comparison can be explained by the fact that males are larger and have a larger percent body water, although differences in body composition cannot explain age-related changes in consumption. Health and happiness were not related to alcohol consumption.

Do vitamin and mineral supplements improve the dietary intake of elderly Canadians

Abstract: The prevalence of nutritional supplementation and the relationship of the adequacy of the diet to the use of nutritional supplements was investigated in a group of 82 healthy, free-living elderly Canadians. Dietary data included a seven-day food record and the reported daily intake of vitamin or mineral supplements. 43% of the men and 62% of the women reported using vitamin and/or mineral supplements during the preceding year. Current use (at the time of interview) was reported in 35% of the study subjects. Supplement users did not differ from non-users in terms of dietary intake from diet alone for any of the nutrients compared. Few subjects corrected inadequate intakes by the use of nutrient supplements; in fact, most supplements were consumed by those not at risk of deficiency for the particular vitamin or mineral. Reliance upon vitamin and/or mineral supplementation for adequate nutrient intake without a dietary evaluation is not recommended.

Public health response to an identified environmental toxin: managing risks to the James Bay Cree related to cadmium in caribou and moose.

Abstract: At the request of Cree political and health authorities and using indirect measures of exposure, we estimated the risk to the James Bay Cree of renal impairment related to the long-term consumption of the liver and kidney of moose and caribou contaminated by environmental cadmium. The low risk of disease was weighed against the possible detriment from activities to convince the Crees to avoid a traditional albeit occasional component of their subsistence diet. Our approach to the assessment and management of this specific environmental hazard is of general interest.

The knowledge, attitudes and concerns of hospital staff about AIDS.

Abstract: Staff from 3 Toronto hospitals were surveyed for knowledge, attitudes and concerns about AIDS. 70% of the 1,366 respondents had direct clinical experience with persons with AIDS. Data were analyzed according to hospital setting and professional group: physicians, nurses, technologists and supervisory staff. No setting difference was observed and although statistically significant differences (at the .001 level) were observed between professional groups, these differences are small and have little practical importance. In general, subjects answered 68% of the knowledge questions correctly. All attitudes and concerns were inversely associated to knowledge (Pearson r range was -.31 to -.20). Multivariate analysis demonstrated that knowledge and concern about contagion are important mediating variables (multiple r = .40) for other attitudes and concerns.

Assessing independence in community living.

Abstract: Community health professionals are frequently faced with the dilemma of assessing "independence in community living" in individuals with physical limitations. However, the validity of standardized assessment of "independence in community living" continues to be limited. Standardized assessment tools are unable to capture the true meaning of "community living" and "independence" being articulated through the Independent Living Movement by people who have physical limitations. We use examples from our experience with the Community Living Skills Project in Nova Scotia to highlight three limitations of standardized assessment of individuals in light of the Independent Living Movement's interpretation of "independence in community living". Standardized assessments were unable to attend to and integrate the complexities of interactional elements, individual differences and the concept of "independence" as personal control and mutual dependence. We conclude that individual assessment requires tools with greater sophistication than those currently available. This discussion is important since individual assessment guides decisions which have far reaching effects on people's lives and on the demands placed on limited health and social services.

Women's perception of teratogenic risk.

Abstract: Administration of the Visual Analog Scale (VAS) to 80 women who presented to the Canadian organization, Motherisk, in 1986 revealed an exaggerated perception of risk of teratogenic effects among women exposed to drugs and chemicals in early pregnancy. The 69 exposed to nonteratogenic agents assigned a mean risk of 24% for major malformations in the initial interview; after counseling, however, the risk was perceived to be only 14.5%. On the other hand, the mean risk score assigned by the 11 women exposed to known teratogenic agents remained unchanged at 36% after counseling. There was no association between estimation of risk and the number of preparations consumed, age, parity, or socieconomic status. The misperceptions of risk documented in this survey reflect a tendency in the popular literature to assign risks to drugs such as aspirin that are not proven to have adverse effects on a developing fetus. This is an important area for counselors to address, given the impact of risk perception on the decision to continue or terminate pregnancy. A follow-up study of 78 Motherisk clients who had indicated at presentation (prior to counseling) a greater than 50% inclination to terminate their pregnancy revealed that 61 decided, on the basic of counseling, to continue with the pregnancy; 57 of these women delivered normal, healthy infants, while the remaining 4 miscarried.

The benefits and challenges of a fitness and lifestyle enhancement program for correctional officers.

Abstract: This paper documents the benefits and difficulties encountered in the development of an on-site exercise and lifestyle enhancement program for correctional officers. 25 male correctional officers participated in a 6.5-week strength and aerobic training program integrated with penitentiary duties. 21 officers were available for retesting. The program was associated with decreases in body weight, skinfold thickness, cholesterol levels and increases in HDL-cholesterol, chest girth, strength scores and muscular endurance. Resting heart rates and systolic blood pressures were reduced but there was no significant change in maximal oxygen consumption. Furthermore, there were favourable changes in smoking and alcohol consumption, sleeping patterns, nutritional habits and tolerance of stress. These results are probably typical of what can be expected from a program of this type. We conclude that a brief at-work exercise and health enhancement program can exert positive but modest influences on the fitness, health and lifestyle of correctional officers, without undermining security of the institution. However, if this type of program is to achieve beneficial effects on health and fitness, a number of difficulties must be addressed.

Predictors of pesticide poisoning.

Abstract: The analysis of 1,026 reports of suspected pesticide poisonings to the regional Poison Control Centre at the Hospital for Sick Children, Toronto consisted of 597 (58.2%) cases less than six years of age. Age was the strongest predictor: there was a risk of 3.1 that young children would encounter rodenticide poisoning compared to that of insecticides; a ten-fold risk of having symptoms from pesticide poisoning if the victim was over five years of age; an increased risk of 5.9 of exposure to moderate or large amounts of pesticide, compared to small quantities, for those over five years of age; and there was less treatment referral for young children, and a 5.7 risk of being referred if the victim was over the age of five years. Other significant predictor variables include the type of person making the inquiry (lay or physician/nurse), the calendar season of the event, and the location (metropolitan or nonmetropolitan) of the event.

Lung cancer in women in the Niagara Region, Ontario: a case-control study.

Abstract: A case-control study of the etiology of lung cancer in women was conducted in the Niagara Region of Ontario, because of local concerns about a high incidence of lung cancer. 51 female patients with lung cancer and 45 matched controls were interviewed. Information was collected about active and passive smoking, occupation and residential history. There was a strong association between active cigarette smoking and lung cancer (ever/never odds ratio 10.0; p less than .001) and 85% of the cases of lung cancer were attributed to active cigarette smoking. No other factors were significantly associated with lung cancer; there was weak evidence of an association between urban environment during childhood and lung cancer (p = 0.07). Associations between lung cancer and air pollution, and residential history, were not demonstrated, contrary to public perception. Thus, a previously reported excess of lung cancer in Niagara females is most likely attributable to cigarette smoking.

Reliability of cancer mortality statistics in Ontario: a comparison of incident and death diagnoses, 1979-1983.

Abstract: We compared the underlying cause of cancer death listed on death certificates, to the registry diagnosis from the incident file in the Ontario Cancer Registry (OCR). For the 68,772 cancer deaths having both a registry diagnosis and a cancer cause of death, 79.3% agreed between the two sources at the third digit level of ICD-9; this rose to 85.8% when sites were aggregated into about 30-site groups (positive predictive value 85.8%, sensitivity 82.9%). The most common sites, accounting for greater than 80% of all cancer deaths, all had agreement rates above 80%. Sites of questionable reliability, comprising less than 10% of all cancer deaths, included liver and larynx, and most other ill-defined and unspecified sites. Recommendations to improve the quality of published cancer mortality statistics include combining colon and rectum, and the non-Hodgkin's lymphomas. Caution in the use and interpretation of statistics for cancers of the liver and larynx is suggested owing to poor reliability.

Apparent nutrient intakes of Canadians: continuing nutritional challenges for public health professionals.

Abstract: The apparent nutrient intake patterns of 4774 households in 15 urban areas across Canada were analyzed using the first public use data tape of Statistics Canada's Family Food Expenditure Survey of 1984. This study addresses the paucity of population-based information about the nutritional adequacy of Canadian eating patterns. Considerable nutrient deficits were identified. The particularly vulnerable population groups were the poor, female-headed households, and male-headed households with spouses working outside the home or with no spouses. Controlling for income, senior households were less vulnerable.

Sexually transmitted diseases and condoms: high school students' knowledge, attitudes and behaviours.

Abstract: Researchers conducted a survey of 199 students enrolled 2 public high schools in Alberta in Canada to learn of their knowledge about sexually transmitted diseases (STDs) and knowledge attitude and behaviors about condoms and their use. 41% were sexually active. 41% of these students did not or rarely used condoms. 44% had =or+ 3 partners. 61% of those with =or+ 3 partners used condoms and 56% with 1 partner used them. Knowledge of STDs and condom use stood high regardless of sex or sexual activity. 93% of the boys 80% of the girls 88% of sexually active and 87% of nonsexually active students stated it was their responsibility to carry condoms if they are sexually active. Moreover 96% of the boys 78% of the girls 81% of sexually active and 91% of nonsexually active students said they would use a condom during sexual intercourse. Nevertheless males and sexually active students did express some negative attitudes towards condoms such as reduce sensation and interference with sexual spontaneity. Nonsexually active students tended to view condom use as a negative stigma (p<.05). Most students claimed to be more likely to buy condoms from condom vending machines in the rest rooms than from stores (p<.05). Sexual partners had the largest influence on students especially sexually active students to have or not have sexual intercourse followed by concerns about STDs friends and family. Further the large majority of all students especially females and sexually active students said they would choose their sexual partner carefully because of the concern for AIDS and other STDs. They also tended to be monogamous and avoided high risk groups. In conclusion no reliable differences occurred between attitudes towards condoms and use or nonuse of condoms to explain behavior. Future studies should be designed to center on factors that influence sexual behavior.

Fatalities among British Columbia fallers and buckers 1981-7

Abstract: In Canada, the forest industry has the highest rate of lost time injury (161 per thousand workers in 1986) and has the highest fatality rate (1.04 per thousand workers in 1986) of all industries. A retrospective case series of fatal accidents occurring among those employed as fallers or buckers in the British Columbia Forest Industry was studied. 87 cases were found and the files of the provincial coroner were accessed to provide data on these accidents. Due to a lack of denominator data, no risk factors could be identified by several hypotheses for future research were developed. These included: the possibility that lack of work experience and young age may play a role in these accidents, the observation that there are "peaks of incidence" just before noon, on Mondays and Thursdays and in January. There was also the surprising finding of the lack of toxicological evidence indicating impairment of any of these workers. Future directions for research are discussed. Language: en