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Karunanayake CP, Pahwa P, Kirychuk S, Fenton M, Ramsden VR, Seeseequasis J, Seesequasis W, Skomro R, Rennie DC, McMullin K, Russell BP, Koehncke N, Abonyi S, King M, Dosman JA. Sleep Efficiency and Sleep Onset Latency in One Saskatchewan First Nation. Clocks Sleep 2024; 6:40-55. [PMID: 38247884 PMCID: PMC10801613 DOI: 10.3390/clockssleep6010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. METHODS A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. RESULTS More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. CONCLUSIONS Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Punam Pahwa
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - Shelley Kirychuk
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada;
| | - Jeremy Seeseequasis
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | | | - Robert Skomro
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada;
| | - Kathleen McMullin
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Brooke P. Russell
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Niels Koehncke
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - James A. Dosman
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
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Kader SB, Shakurun N, Janzen B, Pahwa P. Impaired sleep, multimorbidity, and self-rated health among Canadians: Findings from a nationally representative survey. J Multimorb Comorb 2024; 14:26335565241228549. [PMID: 38523711 PMCID: PMC10958807 DOI: 10.1177/26335565241228549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/09/2024] [Indexed: 03/26/2024]
Abstract
Background Self-rated health (SRH) is a globally recognized measure of health status. Both impaired sleep (IS) and the presence of multimorbidity are related to poorer SRH, but the precise nature of these associations remains unclear. This study explored the association between IS, multimorbidity, and SRH among Canadian adults. Method We used 2017-18 Canadian Community Health Survey (CCHS) data for this study. The main variable of interest, self-rated health (SRH), measured participants' health on a 5-point Likert scale, later categorized as "good or better" vs. "fair or poor". The primary predictor, IS, was derived from two variables and categorized into four groups: no sleep issues; fewer sleeping hours (<7 hours) only; trouble sleeping only; and fewer hours & trouble sleeping. Multimorbidity was present (yes/no) if a participant indicated being diagnosed with two or more chronic conditions. Results Just over one in ten Canadians reported fair/poor SRH and approximately one-quarter had multimorbidity or experienced few sleep hours in combination with trouble sleeping. The adjusted model indicated greater odds of fair/poor SRH associated with the 40-64 years age group, male sex, and lower socio-economic status. It also suggested the presence of multimorbidity (AOR= 4.63, 95% CI: 4.06-5.28) and a combination of fewer sleep hours and troubled sleep (AOR= 4.05, 95% CI: 2.86-5.74) is responsible for poor SRH. Forty-four percent of the total effect of IS on SRH was mediated by multimorbidity. Conclusion This unique finding highlights the mediating role of multimorbidity, emphasizing the importance of addressing it alongside sleep issues for optimal health outcomes.
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Affiliation(s)
- Shirmin Bintay Kader
- American International University-Bangladesh, Dhaka, Bangladesh
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nahin Shakurun
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Bonnie Janzen
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
- Canadian Centre for Health and Safety in Agriculture (CCHSA), Saskatoon, SK, Canada
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Datta Gupta S, Pahwa P, Engler-Stringer R. An examination of willingness to participate and willingness to pay for a universal school food program in the Canadian context. Public Health Nutr 2023; 26:3266-3277. [PMID: 37728040 PMCID: PMC10755409 DOI: 10.1017/s1368980023002070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/19/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To examine parents'/caregivers' willingness to participate and willingness to pay (WTP) for a cost-shared school food program (SFP) and its associated factors. DESIGN A quantitative survey design was used where WTP for a hypothetical SFP was elicited using a double-bounded dichotomous choice elicitation method. We used a double hurdle (logistic and truncated regression) model to examine WTP and positively or negatively associated factors. SETTING Saskatoon Public School Division elementary schools situated in high-, mid- or low-median-income neighbourhoods. PARTICIPANTS Parents or caregivers of children attending grades 1 to grade 8 in the Saskatoon Public School Division elementary schools. RESULTS 94 % respondents were willing to participate in a SFP while less than two-thirds of participants were willing to pay for such a program. Over 90 % respondents from all the socio-economic groups were willing to participate. Multiple household income earners, higher household income, higher number of children, household food security status and higher academic attainment of parents'/caregivers predicted greater willingness to pay. Mean willingness to pay was $4·68 (CAN), and households reporting moderate or severe food insecurity were likely to be willing to pay significantly less for a SFP. CONCLUSION A cost-shared program might be financially sustainable in Canada if community characteristics such as household food insecurity status, economic participation of women and average household size are kept in mind while determining the price of the program.
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Affiliation(s)
- Suvadra Datta Gupta
- Department of Community Health & Epidemiology, University of Saskatchewan, HSC E-wing 3214, 107 Wiggins Road, Saskatoon, SaskatchewanS7N 5E5, Canada
| | - Punam Pahwa
- Department of Community Health & Epidemiology, University of Saskatchewan, HSC E-wing 3214, 107 Wiggins Road, Saskatoon, SaskatchewanS7N 5E5, Canada
- Canadian Centre for Health and Safety in Agriculture (CCHSA), University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rachel Engler-Stringer
- Department of Community Health & Epidemiology, University of Saskatchewan, HSC E-wing 3214, 107 Wiggins Road, Saskatoon, SaskatchewanS7N 5E5, Canada
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Shafiee M, Lane G, Szafron M, Hillier K, Pahwa P, Vatanparast H. Exploring the Implications of COVID-19 on Food Security and Coping Strategies among Urban Indigenous Peoples in Saskatchewan, Canada. Nutrients 2023; 15:4278. [PMID: 37836563 PMCID: PMC10574453 DOI: 10.3390/nu15194278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/01/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
The COVID-19 pandemic has notably impacted food security, especially among urban Indigenous communities. This study aimed to examine the impact of the pandemic and related lockdown measures on the food security of urban Indigenous peoples in Saskatchewan, Canada. In partnership with Indigenous co-researchers, we designed an online survey disseminated via SurveyMonkey® (San Mateo, CA, USA) from August 2021 to August 2022. This survey detailed background information, the Household Food Security Survey Module (HFSSM), state of food access, and traditional food consumption habits. Of the 130 Indigenous respondents, 75.8% were female, 21.9% male, and 2.3% non-binary, with an average age of 36.2 years. A significant 68.4% experienced food insecurity during the pandemic's first four months. Increased food prices (47.1%) and reduced market availability (41.4%) were the dominant causes. Additionally, 41.8% highlighted challenges in accessing traditional foods. Relying on community resources and government food distribution programs (40.7%) was the most reported coping strategy for those experiencing food insecurity. Notably, 43.6% reported receiving no government financial support during the crisis. This study emphasizes the severe food insecurity among urban Indigenous communities in Saskatchewan during the pandemic. The findings highlight the immediate need for interventions and policies that ensure access to culturally relevant food, especially for future crises.
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Affiliation(s)
- Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.S.); (K.H.)
| | - Ginny Lane
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83843, USA;
| | - Michael Szafron
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
| | - Katherine Hillier
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.S.); (K.H.)
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (M.S.); (K.H.)
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
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Dyck RF, Pahwa P, Karunanayake C, Osgood ND. The Contribution of Gestational Diabetes to Diabetes Risk Among First Nations and Non-First Nations Women in Saskatchewan: Results From the DIP: ORRIIGENSS Project. Can J Diabetes 2023; 47:509-518. [PMID: 37150508 DOI: 10.1016/j.jcjd.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/23/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVES Our aim in this study was to determine the risk for diabetes mellitus (DM) among Saskatchewan First Nations (FN) and non-FN women with prior gestational DM (GDM). METHODS Using Ministry of Health administrative databases, we conducted a retrospective cohort study of DM risk by GDM occurrence among FN and non-FN women giving birth from 1980 to 2009 and followed to March 31, 2013. We determined frequencies and odds ratios (ORs) of DM in women with/without prior GDM after stratifying by FN status, while adjusting for other DM determinants. Survival curves of women until DM diagnosis were obtained by prior GDM occurrence and stratified by ethnicity and total parity. RESULTS De-identified data were obtained for 202,588 women. Of those who developed DM, 2,074 of 10,114 (20.5%) had previously experienced GDM (811 of 3,128 [25.9%]) FN and 1,263 of 6,986 [18.1%] non-FN). Cumulative survival of women with prior GDM until DM was higher for FN than for non-FN women (82% vs 46%), but prior GDM was a stronger predictor of DM within the non-FN cohort (prior GDM vs no GDM: OR, 9.64 for non-FN; OR, 7.05 for FN). Finally, higher total parity interacted with prior GDM to increase DM risk in both groups. With prior GDM and parity ≥3, 93% of FN and 57% of non-FN women subsequently developed DM. CONCLUSIONS GDM is a leading determinant of T2DM among FN and non-FN women, amplified by higher parity. This contributes to earlier onset diabetes, affecting subsequent pregnancies and increasing risk for chronic diabetic complications. It may also factor into higher type 2 DM rates observed in FN women compared with men.
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Affiliation(s)
- Roland F Dyck
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Punam Pahwa
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima Karunanayake
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nathaniel D Osgood
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Computer Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Keshavarz P, Lane G, Pahwa P, Lieffers J, Shafiee M, Finkas K, Desmarais M, Vatanparast H. Dietary Patterns of Off-Reserve Indigenous Peoples in Canada and Their Association with Chronic Conditions. Nutrients 2023; 15:nu15061485. [PMID: 36986215 PMCID: PMC10053984 DOI: 10.3390/nu15061485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Nationally representative nutrition surveys (Canadian Community Health Survey (CCHS) Cycle 2.2, Nutrition 2004 and 2015) were used to examine dietary patterns and their association with socioeconomic/sociodemographic factors and chronic conditions in off-reserve Indigenous population in Canada. A cluster analysis was used to identify dietary patterns (DPs), and the Nutrient Rich Food Index (NRF 9.3) was used as the diet quality score and stratified by age/gender groups. In 2004 (n = 1528), the dominant DPs among Indigenous adults (age = 41 ± 2.3) were "Mixed" (mean NRF = 450 ± 12) and "Unhealthy" among men (mean NRF = 426 ± 18), "Fruits" among women (mean NRF = 526 ± 29), and "High-Fat/High-Sugar" among children (age = 10.2 ± 0.5) (mean NRF = 457 ± 12). In 2015 (n = 950), the dominant DPs were "Unhealthy" (mean NRF = 466 ± 6), "Mixed" (mean NRF = 485 ± 21), Healthy-Like (mean NRF = 568 ± 37), and "Mixed" (mean NRF = 510 ± 9) among adults (age = 45.6 ± 2.2), men, women, and children (age = 10.9 ± 0.3) respectively. The majority of Indigenous peoples had the "Unhealthy" DP with a low diet quality, which may contribute to a high prevalence of obesity and chronic diseases. The income level and smoking status among adults and physical inactivity among children were recognized as important factors that may be associated with the dietary intake of off-reserve Indigenous population.
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Affiliation(s)
- Pardis Keshavarz
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Ginny Lane
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA
| | - Punam Pahwa
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S0G 5L0, Canada
| | - Jessica Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Kelly Finkas
- Health and Social Development, Cowessess First Nation, Cowessess, SK S0G 5L0, Canada
| | - Marisa Desmarais
- Health and Social Development Department, Community Dietitian, Cowessess First Nation, Cowessess, SK S0G 5L0, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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Shahid R, Chu LM, Arnason T, Pahwa P. Association Between Insulin Resistance and An Inflammatory Marker C-Reactive Protein In A Representative Healthy Adult Canadian Population: Results From The Canadian Health Measures Survey. Can J Diabetes 2023:S1499-2671(23)00061-8. [PMID: 36996968 DOI: 10.1016/j.jcjd.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Insulin resistance (IR) leads to type 2 diabetes mellitus. Multiple IR causes have been identified, including inflammation. This study determines the association between IR and the inflammatory marker C-reactive protein (CRP) in a healthy Canadian population and examines potential differences by sex and age. RESEARCH DESIGN AND METHODS Participants were adults with no self-reported history of diabetes, hemoglobin A1c (HbA1C)<6.5%, fasting blood glucose<7 mmol/L, and who participated in the Canadian Health Measures Survey, Cycle 1-4 (2007-2015). IR was calculated using the homeostasis model IR assessment (HOMA-IR). The crude geometric mean HOMA-IR was calculated using a one-way analysis of variance. The association between CRP levels and HOMA-IR was examined with multivariate linear regression. RESULTS A total 4024 eligible non-diabetic adults with 1,994 (49.5%) men and 2,030 (50.4%) women were identified. Eighty percent subjects were white. Of all subjects 36% of them had CRP ≥2 mg/l. The crude geometric mean HOMA-IR was 1.33 in men and 1.24 in women. Participants with CRP<0.7 mg/l had a crude geometric mean HOMA-IR of 1.15 (1.13-1.16), compared to 1.41 (1.39-1.43) for those with CRP≥2 mg/l. After adjusting for sex, age, race, HDL cholesterol, triglycerides, body mass index, smoking, and diastolic blood pressure, the HOMA-IR-CRP association remained significant. A positive trend for CRP values in men with increasing values of HOMA-IR was observed. However, this trend was not consistent with the increase in women's CRP levels. CONCLUSION Elevated CPR levels are independently associated with IR in men. Prospective cohort studies can confirm the causal relationship between high CRP levels and IR and identify the underlying mechanisms.
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Affiliation(s)
- Rabia Shahid
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada.
| | - Luan Manh Chu
- Provincial Research Data Services, Alberta Health Service, Edmonton, Canada
| | - Terra Arnason
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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Shafiee M, Keshavarz P, Lane G, Pahwa P, Szafron M, Jennings D, Vatanparast H. Food Security Status of Indigenous Peoples in Canada According to the 4 Pillars of Food Security: A Scoping Review. Adv Nutr 2022; 13:2537-2558. [PMID: 35876642 PMCID: PMC9776675 DOI: 10.1093/advances/nmac081] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 01/29/2023] Open
Abstract
Food insecurity is a significant public health problem for Indigenous peoples in Canada. A comprehensive literature review is needed to organize the evidence according to the 4 pillars of food security (i.e., availability, access, utilization, and stability) and identify gaps in the published literature on this topic. Therefore, in this scoping review we aimed to summarize the published research discussing any of the 4 pillars of food security among Indigenous peoples in Canada. We conducted a literature search of the following databases: Ovid Medline, EMBASE, Web of Science (Web of Knowledge), and CINAHL, as well as the Indigenous Studies Portal (up to June 19, 2021). Population-based studies of any design were included, except for review-style articles. Articles published in languages other than English were also excluded. Of the 4687 studies identified by the database searches, 91 met our inclusion criteria. Evidence from these studies indicates that all dimensions of food security among Indigenous peoples in Canada have been impacted. Lack of availability of both traditional and market foods is highlighted among Inuit and First Nation communities. Economic disadvantages, high food prices, and lack of access to transportation are major factors affecting the accessibility pillar of food security. Major factors affecting the utilization pillar of food security are the loss of traditional knowledge and skills, lack of knowledge on market foods, low quality of market foods, and food safety issues. Climate change has affected all 4 pillars of food security among Indigenous peoples. These findings suggest that resolving food insecurity issues among Indigenous peoples in Canada, especially those living in remote communities, requires a culturally specific integrated approach targeting food availability, food cost, food knowledge, food safety, and food quality.
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Affiliation(s)
- Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Pardis Keshavarz
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ginny Lane
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Michael Szafron
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Derek Jennings
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Chu LM, Karunanayake C, Aich P, Hecker M, Pahwa P. Association between liver enzymes and metabolic syndrome in Canadian adults: results from the Canadian health measures survey - cycles 3 &4. J Diabetes Metab Disord 2022; 21:1699-1708. [PMID: 36404860 PMCID: PMC9672191 DOI: 10.1007/s40200-022-01124-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Background The relationship between liver enzymes and Metabolic Syndrome (MetS) in different populations, including Canadians, is not consistent and well understood. We used the Canadian Health Measures Survey data (Cycles 3 and 4) to examine the cross-sectional relationships between select liver biomarkers and MetS in the adult Canadian population. The biomarkers selected were gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), and alkaline phosphatase (ALKP). Methods Fasting blood samples (FBS) were collected from adults above the age of 20 years for Cycle 3 and Cycle 4 (n = 3003). MetS was diagnosed if the subjects had three or more risk determinants according to the Joint Interim Statement criteria. Primary risk factors included quartile cut-offs for each of the biomarkers ALKP, AST, GGT for males and females separately. A multivariable logistic regression technique based on a maximum likelihood approach was used to evaluate the association between quartiles of ALKP, AST, and GGT, other individual and contextual factors, and the prevalence of MetS. Results MetS was prevalent in 32.3% of subjects. BMI was an effect modifier in the relationship between GGT and MetS prevalence, while sex was an effect modifier in the relationship between ALKP and MetS prevalence; and age was an effect modifier in the relationship between AST and MetS prevalence. Conclusions Since the mechanisms to underpin the associations between the liver enzymes activity and MetS are unknown, further epidemiologic investigations using longitudinal designs are necessary to understand these associations.
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Affiliation(s)
- Luan Manh Chu
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research (NISER), HBNI, PO Jatni, Khurda, Odisha 752050 India
| | - Markus Hecker
- School of Environment & Sustainability & Toxicology Centre, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
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10
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Ilesanmi MM, Abonyi S, Pahwa P, Gerdts V, Scwandt M, Neudorf C. Trends, barriers and enablers to measles immunisation coverage in Saskatchewan, Canada: A mixed methods study. PLoS One 2022; 17:e0277876. [PMID: 36417461 PMCID: PMC9683619 DOI: 10.1371/journal.pone.0277876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Many social, cultural, and systemic challenges affect the uptake of measles immunisation services. Prior studies have looked at the caregivers' perspectives, but little is known about the perspectives of the health care providers on the barriers of measles immunisation services in Canada. This study examined measles immunisation coverage trends across the regional health authorities in Saskatchewan and explored the barriers and enablers to measles immunisation coverage from providers' perspectives. The study adopted an explanatory sequential mixed method. We utilized the entire population of 16,582 children under two years of age available in the Saskatchewan Immunisation Management System (SIMS) registry for 2002 and 2013 in aggregate format and interviewed 18 key informants in pre-determined two-stages in 2016 and 2017. The quantitative analysis was done with Joinpoint regression modelling, while the qualitative interview data was analyzed using hybrid inductive and deductive thematic approaches. There was a 16.89%-point increase in measles immunisation coverage in the province from 56.32% to 73.21% between 2002 and 2013. There was also a persistently higher coverage among the affluent (66.95% - 82.37%) than the most deprived individuals (45.79% - 62.60%) in the study period. The annual rate of coverage change was marginally higher among the most deprived (16.81%; and average annual percentage change (AAPC) 2.0, 95% CI 1.7-2.2) than among the affluent group (15.42% and AAPC 3.0; 95% CI 2.0-4.0). While access-related issues, caregivers' fears, hesitancy, anti-vaccination challenges, and resource limitations were barriers to immunisation, improving community engagement, service delivery flexibility, targeted social responses and increasing media role were found useful to address the uptake of measles and other vaccine-preventable diseases immunisation. There is low coverage and inequity in measles immunisation uptake in Saskatchewan from social and institutional barriers. Even though there is evidence of disparity reduction among the different groups, the barriers to increasing measles immunisation coverage have implications for the health of the socio-economically deprived groups, the healthcare system and other vaccination programs. There is a need to improve policy framework for community engagement, targeted programs, and public health discourse.
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Affiliation(s)
- Marcus M. Ilesanmi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- * E-mail:
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Volker Gerdts
- Vaccine and Infectious Disease Organization-International Vaccine Centre (VIDO-InterVac), University of Saskatchewan, Saskatoon, SK, Canada
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael Scwandt
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health, Office of the Chief Medical Health Officer, Vancouver, BC, Canada
| | - Cordell Neudorf
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Health Surveillance & Reporting, Saskatchewan Health Authority (SHA), Saskatoon, SK, Canada
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11
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Dosman JA, Karunanayake CP, Fenton M, Ramsden VR, Seeseequasis J, Mike D, Seesequasis W, Neubuhr M, Skomro R, Kirychuk S, Rennie DC, McMullin K, Russell BP, Koehncke N, Abonyi S, King M, Pahwa P. STOP-Bang Score and Prediction of Severity of Obstructive Sleep Apnea in a First Nation Community in Saskatchewan, Canada. Clocks Sleep 2022; 4:535-548. [PMID: 36278535 PMCID: PMC9624327 DOI: 10.3390/clockssleep4040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/18/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
The STOP-Bang questionnaire is an easy-to-administer scoring model to screen and identify patients at high risk of obstructive sleep apnea (OSA). However, its diagnostic utility has never been tested with First Nation peoples. The objective was to determine the predictive parameters and the utility of the STOP-Bang questionnaire as an OSA screening tool in a First Nation community in Saskatchewan. The baseline survey of the First Nations Sleep Health Project (FNSHP) was completed between 2018 and 2019. Of the available 233 sleep apnea tests, 215 participants completed the STOP-Bang score questionnaire. A proportional odds ordinal logistic regression analysis was conducted using the total score of the STOP-Bang as the independent variable with equal weight given to each response. Predicted probabilities for each score at cut-off points of the Apnea Hypopnea Index (AHI) were calculated and plotted. To assess the performance of the STOP-Bang questionnaire, sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs), and area under the curve (AUC) were calculated. These data suggest that a STOP-Bang score ≥ 5 will allow healthcare professionals to identify individuals with an increased probability of moderate-to-severe OSA, with high specificity (93.7%) and NPV (91.8%). For the STOP-Bang score cut-off ≥ 3, the sensitivity was 53.1% for all OSA and 72.0% for moderate-to-severe OSA. For the STOP-Bang score cut-off ≥ 3, the specificity was 68.4% for all OSA and 62.6% for moderate-to-severe OSA. The STOP-Bang score was modestly superior to the symptom of loud snoring, or loud snoring plus obesity in this population. Analysis by sex suggested that a STOP-Bang score ≥ 5 was able to identify individuals with increased probability of moderate-to-severe OSA, for males with acceptable diagnostic test accuracy for detecting participants with OSA, but there was no diagnostic test accuracy for females.
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Affiliation(s)
- James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Correspondence: (J.A.D.); (C.P.K.); Tel.: +1-306-966-1475 (J.A.D.); +1-306-966-1647 (C.P.K.)
| | - Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Correspondence: (J.A.D.); (C.P.K.); Tel.: +1-306-966-1475 (J.A.D.); +1-306-966-1647 (C.P.K.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Division of Respirology, Critical Care, and Sleep Medicine, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | - Jeremy Seeseequasis
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Delano Mike
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Warren Seesequasis
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Marie Neubuhr
- Willow Cree Health Services, Beardy’s & Okemasis Cree Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada
- Beardy’s & Okemasis Cree Nation Band, P.O. Box 340, Duck Lake, SK S0K 1J0, Canada
| | - Robert Skomro
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Division of Respirology, Critical Care, and Sleep Medicine, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Brooke P. Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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12
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Shahid R, Shoker M, Chu LM, Frehlick R, Ward H, Pahwa P. Impact of low health literacy on patients' health outcomes: a multicenter cohort study. BMC Health Serv Res 2022; 22:1148. [PMID: 36096793 PMCID: PMC9465902 DOI: 10.1186/s12913-022-08527-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background This study aims to assess the health literacy of medical patients admitted to hospitals and examine its correlation with patients’ emergency department visits, hospital readmissions, and durations of hospital stay. Methods This prospective cohort study recruited patients admitted to the general internal medicine units at the two urban tertiary care hospitals. Health literacy was measured using the full-length Test of Functional Health Literacy in Adults. Logistic regression analyses were performed to examine the correlation between health literacy and the desired outcomes. The primary outcome of interest of this study was to determine the correlation between health literacy and emergency department revisit within 90 days of discharge. The secondary outcomes of interest were to assess the correlation between health literacy and length of stay and hospital readmission within 90 days of discharge. Results We found that 50% had adequate health literacy, 32% had inadequate, and 18% of patients had marginal health literacy. Patients with inadequate health literacy were more likely to revisit the emergency department as compared to patients with adequate health literacy (odds ratio: 3.0; 95% Confidence Interval: 1.3–6.9, p = 0.01). In patients with inadequate health literacy, the mean predicted probability of emergency department revisits was 0.22 ± 0.11 if their education level was some high school or less and 0.57 ± 0.18 if they had completed college. No significant correlation was noted between health literacy and duration of hospital stay or readmission. Conclusions Only half of the patients admitted to the general internal medicine unit had adequate health literacy. Patients with low health literacy, but high education, had a higher probability of emergency department revisits.
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Affiliation(s)
- Rabia Shahid
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK7N OW8, Canada.
| | - Muhammad Shoker
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Luan Manh Chu
- Provincial Research Data Services, Alberta Health Services, Edmonton, Canada
| | - Ryan Frehlick
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Heather Ward
- Department of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK7N OW8, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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13
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Kirychuk S, Russell E, Rennie D, Karunanayake C, Roberts C, Seeseequasis J, Thompson B, McMullin K, Ramsden VR, Fenton M, Abonyi S, Pahwa P, Dosman JA. Housing inadequacy in rural Saskatchewan First Nation communities. PLOS Glob Public Health 2022; 2:e0000470. [PMID: 36962499 PMCID: PMC10021235 DOI: 10.1371/journal.pgph.0000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022]
Abstract
Housing and house conditions on First Nation communities in Canada are important determinants of health for community members. Little is known about rural First Nation housing in the Canadian Prairies. The aim was to survey houses in two rural First Nation communities in Saskatchewan, Canada to understand housing conditions, prevalence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Surveys were conducted with an adult member of each household in 144 houses. Surveys assessed: size, age, and number of rooms in the house; number of individuals residing in the house; presence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Houses were mostly two-bedrooms (25.7%) or more (67.4%). Thirty-one percent of houses had six or more people living in the house with crowding present in 68.8% of houses. Almost half of the houses (44.5%) were in need of major repairs. More than half of the houses had water or dampness in the past 12 months in which dripping/puddles and standing water were most commonly identified and were from surface water and plumbing. More than half of the houses indicated that this dampness caused damage. A smell of mold or mildew was present in over half of the houses (52.1%) and 73.3% of these houses indicated that this smell was always present. Housing adequacy including crowding, dampness, and mold are significant issues for houses in these two rural Saskatchewan First Nation communities. Housing inadequacy is more common in these rural communities as compared to Canadian statistics. Housing inadequacy is modifiable and is important to address for multiple reasons, but notably, as a social determinant of health. Federal government strategy to address and redress housing in First Nation communities in Canada is a fiduciary responsibility and critical to reconciliation.
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Affiliation(s)
- Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Department of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Eric Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Clarice Roberts
- Community Member, Montreal Lake Cree Nation, Saskatchewan, Canada
| | | | - Brooke Thompson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Kathleen McMullin
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Mark Fenton
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sylvia Abonyi
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
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14
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Jandaghi P, Hosseini Z, Chilibeck P, Hanley AJ, Deguire JR, Bandy B, Pahwa P, Vatanparast H. The Role of Immunomodulatory Nutrients in Alleviating Complications Related to SARS-CoV-2: A Scoping Review. Adv Nutr 2021; 13:S2161-8313(22)00070-9. [PMID: 34932789 PMCID: PMC8970839 DOI: 10.1093/advances/nmab128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/26/2021] [Accepted: 10/20/2021] [Indexed: 01/21/2023] Open
Abstract
The recent coronavirus disease 2019 (COVID-19) pandemic has warranted the need to investigate potential therapies or prophylaxis against this infectious respiratory disease. There is emerging evidence about the potential role of nutrients on COVID-19 in addition to using medications such as hydroxychloroquine and azithromycin. This scoping review aims to explore the literature evaluating the effect of immunomodulatory nutrients on the outcomes including hospitalization, intensive care unit admission, oxygen requirement, and mortality in COVID-19 patients. A literature search of databases including Medline, EMBASE, CINAHL, Web of Science, Cochrane, Scopus, and PubMed, as well as hand-searching in Google Scholar (up to 10 February 2021) was conducted. All human studies with different study designs and without limitation on publication year were included except for non-English-language and review articles. Overall, out of 4412 studies, 19 met our inclusion criteria. Four studies examined the impact of supplementation with vitamin C, 4 studies - zinc, 8 studies - vitamin D, and 3 studies investigated the combination of 2 (zinc and vitamin C) or 3 (vitamin D, vitamin B-12, and magnesium) nutrients. Although limited data exist, available evidence demonstrated that supplementation with immune-supportive micronutrients such as vitamins D and C and zinc may modulate immunity and alleviate the severity and risk of infection. The effectiveness of vitamin C, vitamin D, and zinc on COVID-19 was different based on baseline nutrient status, the duration and dosage of nutrient therapy, time of administration, and severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. This review indicated that supplementation with high-dose vitamin C, vitamin D, and zinc may alleviate the complications caused by COVID-19, including inflammatory markers, oxygen therapy, length of hospitalization, and mortality; however, studies were mixed regarding these effects. Further randomized clinical trials are necessary to identify the most effective nutrients and the safe dosage to combat SARS-CoV-2.
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Affiliation(s)
- Parisa Jandaghi
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Zeinab Hosseini
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Philip Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Jason R Deguire
- Centre for Population Health Data, Statistics Canada, Ottawa, Canada
| | - Brian Bandy
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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15
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Pahwa P, Chu L, Karunanayake C, Aich P, Hecker M, Saxena A, Griebel P, Niyogi S. Predictive biomarkers of cardiovascular disease in adult Canadian population. J Diabetes Metab Disord 2021; 20:1199-1209. [PMID: 34900772 DOI: 10.1007/s40200-021-00842-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/21/2021] [Indexed: 01/26/2023]
Abstract
Background Elevated levels of the enzymes gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and C-reactive protein (CRP) have been shown to be associated with increased risk of cardiovascular disease (CVD). Objective: To assess cross-sectional relationships between biomarkers GGT, ALT, AST, ALP and CVD in adult Canadian population. Methods The Canadian Health Measures Surveys (CHMSs) are a series of cross-sectional national surveys and collect information on indicators of general health and wellness of Canadians. The CHMS has four components. We used data from the first three components (for Study participants ≥ 20 years) from CHMS cycles 1 through 5. RESULTS Multivariable logistic regression revealed: immigration status [Odds ratio (OR)(95% Confidence Interval (95% CI)) = 0.67 (0.53-0.85), reference category (RC)-no-immigrant] education [1.38(1.10-1.75), RC- > secondary education]; smoking status [ex-smokers: 1.16(0.89-1.51); current smokers: 1.41(0.98-2.05), RC-non-smoker]; and income [middle income: 0.69(0.43-1.10); high income: 0.49(0.29-0.83); RC-lower income] were significantly associated with CVD prevalence. Conclusion The relationship of GGT with CVD prevalence changed among age groups and body mass index categories; was different for males and females; and diabetes was an effect modifier in the relationship between AST and CVD prevalence. Socio-economic factors were significantly associated with CVD prevalence.
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Affiliation(s)
- Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Luan Chu
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research (NISER), HBNI, PO: Khurda, 752050 Jatni, Odisha India
| | - Markus Hecker
- School of Environment & Sustainability & Toxicology Centre, University of Saskatchewan, Saskatoon, Canada
| | - Anurag Saxena
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Philip Griebel
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Som Niyogi
- Department of Biology and Toxicology Centre, University of Saskatchewan, , Saskatoon, Canada
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16
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Karunanayake CP, Fenton M, Skomro R, Ramsden VR, Kirychuk S, Rennie DC, Seeseequasis J, Bird C, McMullin K, Russell BP, Koehncke N, Smith-Windsor T, King M, Abonyi S, Pahwa P, Dosman JA. Sleep deprivation in two Saskatchewan First Nation communities: a public health consideration. Sleep Med X 2021; 3:100037. [PMID: 34169273 PMCID: PMC8220004 DOI: 10.1016/j.sleepx.2021.100037] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/15/2021] [Accepted: 05/21/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Sleep deprivation is a common problem in Canada and is associated with many health problems. More than a quarter of Canadians get fewer than the recommended sleep hours (<7 h). This paper examines the prevalence and risk factors for sleep deprivation in two First Nation communities in Saskatchewan, Canada. Methods The baseline cross-sectional survey was completed between 2018 and 2019 in collaboration with the two Cree First Nation communities in Saskatchewan, Canada. There were five hundred and eighty-eight participants participated in the survey from two communities. A Multivariate logistic regression model was used for analysis. Results The prevalence of sleep deprivation (<7 h of sleep) was 25.4%. The multivariate logistics regression revealed that middle and older age groups, visible mold in the house, and being male with nighttime insomnia symptoms were significantly associated with a higher risk of sleep deprivation among study participants in the study. Conclusions In these two First Nation communities, a higher proportion of the participants reported having sleep deprivation. This was a unique study, which evolved from ongoing research collaboration with two First Nation communities in Saskatchewan, Canada. Findings will be helpful in the management of patients with sleep deprivation in these communities; as well as for co-creating policy with the communities and future research priorities. The prevalence sleep deprivation was about 25% in these two First Nation communities. Association between sleep deprivation and males with nighttime insomnia observed. Another important finding was association between visible mold and sleep deprivation.
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Affiliation(s)
- Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Robert Skomro
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.,Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Donna C Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | | | - Clifford Bird
- Community B, PO Box 250, Montreal Lake, SK S0J 1Y0, Canada
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Brooke P Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.,Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | | | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.,Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.,Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
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17
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Missiuna S, Plante C, Pahwa P, Muhajarine N, Neudorf C. Trends in mental health inequalities in urban Canada. Can J Public Health 2021; 112:629-637. [PMID: 33877585 DOI: 10.17269/s41997-021-00498-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/09/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Canadians do not all enjoy equal levels of health. The presence of income-related health inequalities has been well established in Canada, but there is a lack of consistent reporting of mental health inequalities in Canada's largest cities. This study reports the prevalence and inequalities in mental health outcomes at the city, provincial, and national levels over time. METHODS Self-reported poor mental health, life stress, and physician-diagnosed self-reported mood and anxiety disorder from the Canadian Community Health Survey were pooled over five-year intervals and combined with neighbourhood income information from the Canadian Census. First, prevalence rates were calculated for each interval at the neighbourhood level for urban communities. Second, the distributions of these neighbourhood rates were summarized at the city level and for Canada as a whole using overall prevalence rates and concentration indices of inequality. Finally, trends in these city- and country-level outcomes were also explored. RESULTS At the national level, starting from 2001 to 2005, the prevalence of poor mental health (27.9%), mood disorder (7.3%), and anxiety disorder (6.8%) had significantly increased by 2011-2015. Inequalities were present in 2001-2005 and worsened over time. The prevalence rate at the national level of life stress was 66.6% in 2001-2005 and decreased over time. CONCLUSION The large and increasing values of inequalities and the difference in prevalence rates and inequalities in cities highlight the necessity for mental disorder-specific data and for city-level analysis of inequalities. The next steps in reducing inequalities involve deconstructing the health inequalities, and continued monitoring.
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Affiliation(s)
- Sharalynn Missiuna
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada.
| | - Charles Plante
- Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Diefenbaker Building 141-101 Diefenbaker Place, Saskatoon, Saskatchewan, S7N 5B8, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Cordell Neudorf
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building 107 Wiggins Road, Saskatoon, Saskatchewan, S7N 5E5, Canada
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Khan A, Ahmed S, Zaidi A, Karunanayake C, Dosman JA, Pahwa P. Prevalence of Hormone-Related Cancers (HRCs) at Two-Time Points in Rural Saskatchewan: The Saskatchewan Rural Health Study (SRHS). J Occup Environ Med 2021; 63:e203-e214. [PMID: 33769404 DOI: 10.1097/jom.0000000000002161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence of hormone-related cancers (HRCs) among Saskatchewan rural dwellers and explore associated risk factors. METHODS Data were analyzed from the Saskatchewan Rural Health Study (SRHS), which was a prospective cohort (2010 to 2014). Completed questionnaires were obtained from 4624 (2797) households, with information about 8261 (4867) individuals more than or equal to 18 years at baseline (follow-up). The crude prevalence of HRCs was calculated using appropriate formulae. Adjusted prevalence was calculated using logistic regression based on the generalized estimating equation (GEE). RESULTS Crude prevalence of HRCs was 3.0% at the baseline. Variables significantly associated with HRCs were: exposure to radiation comprising ultraviolet radiation from sunlight as well as ionizing radiation (odds ratio [OR] 3.39; 95% confidence interval [CI]: 2.23, 4.84), previous history of cancer in sibling (OR = 1.51, 95% CI: 1.11, 2.07) and in father (OR = 1.37; 95% CI = 1.01, 1.86). CONCLUSIONS The study informs the Saskatchewan Health Region for health care resource allocation.
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Affiliation(s)
- Amal Khan
- Department of Community Health and Epidemiology (Dr Khan); Department of Oncology (Dr Ahmed, Dr Zaidi); Canadian Center for Health and Safety in Agriculture (Dr Karunanayake); Distinguished Research Chair, University of Saskatchewan (Dr Dosman); President and CEO, Agrivita Canada Inc. (Dr Dosman); Department of Community Health and Epidemiology (Dr Pahwa), Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
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Dosman JA, Karunanayake CP, Fenton M, Ramsden VR, Skomro R, Kirychuk S, Rennie DC, Seeseequasis J, Bird C, McMullin K, Russell BP, Koehncke N, Smith-Windsor T, King M, Abonyi S, Pahwa P. Prevalence of Insomnia in Two Saskatchewan First Nation Communities. Clocks Sleep 2021; 3:98-114. [PMID: 33525338 PMCID: PMC7931024 DOI: 10.3390/clockssleep3010007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022] Open
Abstract
Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the First Nations Sleep Health Collaborative Project. The prevalence of insomnia was 19.2% among participants with an Insomnia Severity Index score of ≥15. Following the definition of nighttime insomnia symptoms, however, the prevalence of insomnia was much higher, at 32.6%. Multivariate logistic regression modeling revealed that age, physical health, depression diagnosis, chronic pain, prescription medication use for any health condition, and waking up during the night due to terrifying dreams, nightmares, or flashbacks related to traumatic events were risk factors for insomnia among participants from two Saskatchewan Cree First Nation communities.
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Affiliation(s)
- James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Vivian R Ramsden
- West Winds Primary Health Centre, Department of Academic Family Medicine, University of Saskatchewan, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada;
| | - Robert Skomro
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Donna C Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada;
| | | | - Clifford Bird
- Community B, PO Box 250, Montreal Lake, SK S0J 1Y0, Canada;
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Brooke P Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | | | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
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Shafiee M, Vatanparast H, Janzen B, Serahati S, Keshavarz P, Jandaghi P, Pahwa P. Household food insecurity is associated with depressive symptoms in the Canadian adult population. J Affect Disord 2021; 279:563-571. [PMID: 33152560 DOI: 10.1016/j.jad.2020.10.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND It is essential to identify factors associated with depression as it is a highly prevalent and disabling mental disorder. The aim of this study was to examine the association between depressive symptoms and household food security status among the Canadian adult population. METHODS This is a cross-sectional study of the adult population in the five provinces and one territory (Northwest Territories) of Canada using data from the 2015-2016 Canadian Community Health Survey-Annual Component (n=19,118). Depressive symptoms were assessed using the 9-item Patient Health Questionnaire. Household food insecurity was measured using the Household Food Security Survey Module. A weighted logistic regression analysis with robust variance estimation technique was performed. RESULTS Approximately 22% of the Canadian adult population reported mild-to-severe depressive symptoms, and 8.3% were from households classified as food insecure. Household food insecurity remained a predictor of mild-to-severe depressive symptoms after adjustment for other known risk factors (ORajd: 2.87, 95% CI: 2.33-3.55, p<0.001). In the multivariable model, significant associations were also found with multimorbidity, lower household income, a history of illicit drug use, being a current smoker, being a widowed/divorced/separated, obesity, and being a non-drinker. Significant interactions also emerged between employment status and age (p=0.03), employment status and gender (p<0.001), and physical activity level and gender (p<0.001). LIMITATIONS The cross-sectional nature of the study does not allow inferring causality. CONCLUSIONS Household food insecurity is associated with depressive symptoms in Canadian adults. Additional longitudinal research is required to further elucidate the nature of this relationship.
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Affiliation(s)
- Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada; School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Bonnie Janzen
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
| | - Sara Serahati
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Pardis Keshavarz
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Parisa Jandaghi
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada; Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
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21
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Alam MS, Dyck R, Janzen B, Karunanayake C, Dosman J, Pahwa P. Risk factors, incidence, and prevalence of diabetes among rural farm and non-farm residents of Saskatchewan, Canada; a population-based longitudinal cohort study. J Diabetes Metab Disord 2020; 19:1563-1582. [PMID: 33520853 PMCID: PMC7843656 DOI: 10.1007/s40200-020-00693-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Saskatchewan has a high prevalence of diabetes. It is the largest, rurally populated, predominantly agricultural province in Canada. This research aims to determine the risk factors associated with the incidence and longitudinal changes in the prevalence of diabetes among Saskatchewan's adult rural farm and non-farm residents. METHODS The Saskatchewan Rural Health Study (SRHS) is a prospective cohort study conducted in two phases: a baseline survey (2010, 8261 participants) and a follow-up survey (2014, 4867 participants). Generalized estimation equations and survival analysis techniques were used to determine diabetes prevalence and incidence risk factors, respectively. RESULTS Incidence of diabetes among rural residents was 2.75%. Positive family history, high BMI, sleep apnea and an abnormal Epworth Sleepiness Score (ESS) were significant predictors for diabetes incidence. A substantial increase (1.98%) of diabetes prevalence was observed after four years of follow-up. Risk factors of diabetes prevalence were increasing age, male, low income, positive family history, high BMI, hypertension and heart attack. CONCLUSION A mix of individual and contextual factors interacting in complex pathways were responsible for the high incidence and prevalence of diabetes among rural residents. The most original finding of that study was a positive association of sleep apnea, and ESS with incident diabetes warrants further research to identify a causal linkage. Increased diabetes risk among rural male insecticide users indicates an adverse consequence of unprotected chemical exposures in the agricultural field. Urgent population-based preventive measures should initiate to slow the increasing trend of diabetes prevalence among rural residents.
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Affiliation(s)
- Md Saiful Alam
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Roland Dyck
- Department of Medicine, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan S7N0W0 Canada
| | - Bonnie Janzen
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4 Canada
| | - James Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4 Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4 Canada
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22
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Dyck RF, Karunanayake C, Pahwa P, Stang M, Osgood ND. Epidemiology of Diabetes in Pregnancy Among First Nations and Non-First Nations Women in Saskatchewan, 1980‒2013. Part 1: Populations, Methodology and Frequencies (1980‒2009); Results From the DIP: ORRIIGENSS Project. Can J Diabetes 2020; 44:597-604. [DOI: 10.1016/j.jcjd.2019.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/23/2019] [Accepted: 10/16/2019] [Indexed: 01/11/2023]
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23
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Kachuri L, Beane Freeman LE, Spinelli JJ, Blair A, Pahwa M, Koutros S, Hoar Zahm S, Cantor KP, Weisenburger DD, Pahwa P, Dosman JA, McLaughlin JR, Demers PA, Harris SA. Insecticide use and risk of non-Hodgkin lymphoma subtypes: A subset meta-analysis of the North American Pooled Project. Int J Cancer 2020; 147:3370-3383. [PMID: 32574374 PMCID: PMC7689728 DOI: 10.1002/ijc.33164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/12/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
Abstract
Insecticide use has been linked to increased risk of non-Hodgkin lymphoma (NHL), however, findings of epidemiologic studies have been inconsistent, particularly for NHL subtypes. We analyzed 1690 NHL cases and 5131 controls in the North American Pooled Project (NAPP) to investigate self-reported insecticide use and risk of NHL overall and by subtypes: follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL) and small lymphocytic lymphoma (SLL). Odds ratios (OR) and 95% confidence intervals for each insecticide were estimated using logistic regression. Subtype-specific associations were evaluated using ASSET (Association analysis for SubSETs). Increased risks of multiple NHL subtypes were observed for lindane (OR = 1.60, 1.20-2.10: FL, DLCBL, SLL), chlordane (OR = 1.59, 1.17-2.16: FL, SLL) and DDT (OR = 1.36, 1.06-1.73: DLBCL, SLL). Positive trends were observed, within the subsets with identified associations, for increasing categories of exposure duration for lindane (Ptrend = 1.7 × 10-4 ), chlordane (Ptrend = 1.0 × 10-3 ) and DDT (Ptrend = 4.2 × 10-3 ), however, the exposure-response relationship was nonlinear. Ever use of pyrethrum was associated with an increased risk of FL (OR = 3.65, 1.45-9.15), and the relationship with duration of use appeared monotonic (OR for >10 years: OR = 5.38, 1.75-16.53; Ptrend = 3.6 × 10-3 ). Our analysis identified several novel associations between insecticide use and specific NHL subtypes, suggesting possible etiologic heterogeneity in the context of pesticide exposure.
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Affiliation(s)
- Linda Kachuri
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland, USA
| | - John J Spinelli
- Population Oncology, BC Cancer, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland, USA
| | - Manisha Pahwa
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland, USA
| | - Shelia Hoar Zahm
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland, USA
| | - Kenneth P Cantor
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland, USA
| | | | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - John R McLaughlin
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Division of Occupational & Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Shelley A Harris
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational & Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
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Gupta SD, Engler-Stringer R, Pahwa P. Current Prevalence and Risk Factors of Obesity and Examining the Causal Pathway Between Obesity and Food Insecurity in Canadian Adolescents and Young Adults (12–24). Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa063_024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
To determine the prevalence and associated risk factors of obesity in Canadian adolescents and young adults between 12 to 24 years of age and to examine the causal mechanism between food insecurity and obesity using the Canadian Community Health Survey (CCHS): 2015–16 data.
Methods
We analyzed the CCHS 2015–16 data for population aged 12 to 24 from 8 provinces and 2 territories. Obesity was determined from self-reported height and weight measurements. Covariates ranging from socio demographic characteristics, food insecurity, physical activity and daily consumption of fruits and vegetables as well as multiple interaction terms were tested for association with obesity. A multivariable weighted logistic regression model was fitted and strength of association was informed by odds ratios estimates and confidence intervals. Direct and indirect effects of multiple mediators were tested to explore the association between food insecurity and obesity.
Results
More than one-fifth of the Canadian adolescents aged 12 to 24 years were obese and the highest rate of obesity was found in Québec. Household food insecurity significantly predicted obesity among adolescents (OR = 1.818, 95% CI: 1.19–2.75). We observed adolescents that consumed fruits and vegetable 5 to 10 times a day had significantly lower odds of being obese (OR = 0.68, 95% CI: 0.51–0.91). In addition, adolescents from severe food insecure households were three times more likely to be obese compared to the food secure households (OR = 3.18, 95% CI: 1.15–8.94). We also found, interaction between age and sex, age and household food insecurity, times of vegetables and fruits consumption and sex significantly predicted the probability of obesity. We found a marginal mediation effect by self-perceived mental health on the association between household food insecurity and obesity among Canadian adolescents and young adults age 12 to 24 years.
Conclusions
Our findings suggests even in a high income country setting, food insecurity persists and it is a significant predictor of obesity among adolescents and young adults (12–24). Age and sex moderates the association whereas we see a marginal mediation through self-perceived mental health.
Funding Sources
N/A.
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Rennie DC, Karunanayake CP, Lawson JA, Kirychuk S, McMullin K, Abonyi S, Seeseequasis J, MacDonald J, Dosman JA, Pahwa P. Domestic Risk Factors for Atopic and non-Atopic Asthma in First Nations Children Living in Saskatchewan, Canada. Children (Basel) 2020; 7:children7050038. [PMID: 32349273 PMCID: PMC7278566 DOI: 10.3390/children7050038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/30/2020] [Accepted: 04/21/2020] [Indexed: 11/16/2022]
Abstract
Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a cross-sectional survey with a clinical component to assess the respiratory health of 351 school-age children living on two rural reserve communities. Asthma was defined as parental report of physician diagnosed asthma or a report of wheeze in the past 12 months. Atopy was determined by a ≥ 3-mm wheal response to any of six respiratory allergens upon skin prick testing (SPT). Important domestic and personal characteristics evaluated included damp housing conditions, household heating, respiratory infections and passive smoking exposure. Asthma and atopy prevalence were 17.4% and 17.1%, respectively. Of those with asthma, 21.1% were atopic. We performed multivariate multinomial logistic regression modelling with three outcomes: non-atopic asthma, atopic asthma and no asthma for 280 children who underwent SPT. After adjusting for potential confounders, children with atopic asthma were more likely to be obese and to live in homes with either damage due to dampness (p < 0.05) or signs of mildew/mold (p = 0.06). Both natural gas home heating and a history of respiratory related infections were associated with non-atopic asthma (p < 0.01). Domestic risk factors for asthma appear to vary by atopic status in First Nations children. Determining asthma phenotypes could be useful in environmental management of asthma in this population.
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Affiliation(s)
- Donna C. Rennie
- College of Nursing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 2Z4, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Correspondence: (D.C.R.); (C.P.K.); Tel.: +1-306-966-7886 (D.C.R.); +1-306-966-1647 (C.P.K.)
| | - Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Correspondence: (D.C.R.); (C.P.K.); Tel.: +1-306-966-7886 (D.C.R.); +1-306-966-1647 (C.P.K.)
| | - Josh A. Lawson
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Shelley Kirychuk
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Kathleen McMullin
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
| | - Jeremy Seeseequasis
- Willow Cree Health Centre, Beardy’s and Okemasis First Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada;
| | - Judith MacDonald
- William Charles Health Centre, Montreal Lake Cree Nation, P.O. Box 240, Montreal Lake, SK S0J 1Y0, Canada;
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
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Janzen B, Karunanayake C, Rennie D, Lawson J, Dosman JA, Pahwa P. Depression and binge drinking in farm and non-farm rural adults in Saskatchewan, Canada. Rural Remote Health 2020; 20:5530. [PMID: 31917596 DOI: 10.22605/rrh5530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Despite some attention paid to farm stress in the popular press, recent Canadian research examining the mental wellbeing of farming populations relative to other rural dwellers is sparse. International research on the topic has shown inconsistent findings and has mainly focused on men. The objective of the present study was to examine the correlates of mental health among rural Saskatchewan women and men, positioning farm/non-farm residence as a main explanatory variable, and depression and binge drinking as measures of mental health. METHODS The cross-sectional sample consisted of 1701 women (47.8% farm) and 1700 men (53.3% farm) who participated in the 2014 phase of the Saskatchewan Rural Health Study, a prospective cohort study primarily examining the respiratory health of rural people in the southern part of the province of Saskatchewan, Canada. Data were collected using mailed self-report questionnaires and included measures of mental health assessing health professional diagnosed depression and binge drinking, in addition to a broad array of demographic characteristics, stressors and resources. Multiple logistic regression was the primary method of analysis; generalized estimating equations were utilized to account for household clustering. All analyses were conducted separately for women and men and by mental health indicator. RESULTS Farm/non-farm residence was related to depression but only under particular circumstances, which in turn differed by gender. In women, non-farm residents with two or more chronic conditions reported more depression than their farm counterparts (odds ratio (OR)=2.62; 95% confidence interval (CI) 1.28-5.36); non-farm men with secondary school education reported greater depression than farm-dwelling men (OR=2.93; 95%CI 1.31-6.59). The remaining correlates of depression were generally consistent with previous research in rural populations, including younger age, being non-partnered (men only), higher stress, greater financial strain (women only) and lower social support (women only). Binge drinking was significantly elevated in non-farm women (OR=1.68; 95%CI 1.21-2.33) and non-farm men (OR=1.70; 95%CI 1.33-2.17) compared to the farming population. Among women only, not having access to a regular family doctor/nurse practitioner was associated with an increased likelihood of binge drinking (OR=2.05; 95%CI 1.13-3.71) compared to women perceiving better access. CONCLUSION The present study is one of very few recently published quantitative studies of the correlates of mental health among farm and non-farm adults in rural Canada. The findings suggest that non-farm dwellers in rural Saskatchewan may be more vulnerable to compromised mental health than their farming counterparts. Additional research employing a longitudinal design and enhanced measurement is required to confirm or refute these findings.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; and College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Koutros S, Harris SA, Spinelli JJ, Blair A, McLaughlin JR, Zahm SH, Kim S, Albert PS, Kachuri L, Pahwa M, Cantor KP, Weisenburger DD, Pahwa P, Pardo LA, Dosman JA, Demers PA, Beane Freeman LE. Non-Hodgkin lymphoma risk and organophosphate and carbamate insecticide use in the north American pooled project. Environ Int 2019; 127:199-205. [PMID: 30928843 PMCID: PMC6513687 DOI: 10.1016/j.envint.2019.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 03/05/2019] [Accepted: 03/08/2019] [Indexed: 05/07/2023]
Abstract
Organophosphates and carbamates have been among the most commonly used insecticides, with both agricultural and residential uses. Previous studies have suggested associations of non-Hodgkin lymphoma (NHL) with some of these chemicals; however, many studies have been limited in their ability to evaluate associations with lymphoma subtypes. We evaluated the use of eleven organophosphate and two carbamate insecticides in association with NHL in the North American Pooled Project, which includes data from case-control studies in the United States and Canada (1690 cases/5131 controls). We used unconditional logistic regression adjusting for potential confounders, including use of other pesticides, to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between these chemicals and NHL overall, and NHL subtypes, i.e., follicular (FL), diffuse large B-cell (DLBCL), small lymphocytic lymphoma (SLL) and others. Ever use of malathion was associated with increased risk of NHL overall (OR = 1.43; 95% CI: 1.14-1.81) compared with never users. Categories using tertiles of duration (<4 yrs., 4-12 yrs., and >12 yrs) also showed a significant exposure-response for increasing years of use of malathion and risk of NHL (OR<4vsUnex = 1.33 (0.88, 2.03), OR4-12vsUnex = 1.42 (1.02, 1.96), OR>12vsUnex = 1.55 (1.05, 2.28, p-trend < 0.01)). In addition, malathion use was statistically significantly associated with FL (OR = 1.58; 95% CI: 1.11-2.27) and DLBCL (OR = 1.61; 95% CI: 1.16-2.22) while there were no apparent associations with SLL or other subtypes, the p-value for heterogeneity across subtypes, however, was not significant. These results support previous studies suggesting an association between insecticide use and NHL overall, and provide new information on associations with NHL subtypes.
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Affiliation(s)
- Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - Shelley A Harris
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada
| | - John J Spinelli
- Population Oncology, BC Cancer, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - John R McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Public Health Ontario, Toronto, Canada
| | | | - Sungduk Kim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Paul S Albert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Linda Kachuri
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Manisha Pahwa
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Canada
| | - Kenneth P Cantor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | | | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada; Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Larissa A Pardo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Dosman JA, Karunanayake CP, McMullin K, Abonyi S, Rennie D, Lawson J, Kirychuk S, Koehncke N, Seeseequasis J, Jimmy L, Ramsden VR, Fenton M, Marchildon GP, King M, Pahwa P. Risk Factors for Snoring in Two Canadian First Nations Communities. Clocks Sleep 2019; 1:117-125. [PMID: 33089158 PMCID: PMC7509670 DOI: 10.3390/clockssleep1010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/15/2019] [Indexed: 11/16/2022] Open
Abstract
Snoring may be an important predictor of sleep-disordered breathing. Factors related to snoring among First Nations people are not well understood in a population with high rates of smoking and excess body weight. An interviewer-administered survey was conducted among 874 individual participants from 406 households in 2012 and 2013 in two Canadian First Nations communities. The survey collected information on demographic variables, individual and contextual determinants of respiratory health and snoring (classified as present versus absent) and self-reported height and weight. Multiple logistic regression analyses were conducted to examine relationships between snoring and potential risk factors adjusting for age and sex. Snoring was present in 46.2% men and 47.0% women. Considering body mass index, 259 people (30.3%) were overweight and 311 (36.4%) were considered obese. The combined current/former smoking rate was 90.2%. Being overweight, obesity, sinus trouble, current smoking status and former smoking were significantly associated with snoring. Exposure to home dampness and mold were suggestive of an association with snoring. To the degree that snoring may be a predictor of possible sleep-disordered breathing, these results indicate that environmental conditions such as smoking and home exposures may be important factors in the pathogenesis of these conditions.
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Affiliation(s)
- James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
- Correspondence: ; Tel.: +1-306-966-1475
| | - Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | | | - Laurie Jimmy
- Community A, PO Box 96, Duck Lake, SK S0K1J0, Canada
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | - Mark Fenton
- Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Gregory P. Marchildon
- Institute of Health Policy, Management and Evaluation, University of Toronto, Suite 425, 155 College Street, Toronto, ON M5T 3M6, Canada
| | - Malcolm King
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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Abstract
Objective: The objective of the study was to determine the prevalence and associated risk factors of asthma in Aboriginal adolescents in Canada based on the Canadian Aboriginal Peoples Survey (APS) 2012. Few studies have investigated the prevalence and risk factors of asthma in Aboriginal adolescents in Canada. Methods: Data from the cross-sectional APS 2012 were analyzed to accomplish the objective. Logistic regression analysis was utilized to determine significant risk factors of lifetime diagnosis of asthma among Aboriginal adolescents. The outcome of interest for adolescents was based on the question: "Do you have asthma that have been diagnosed by a health professional?" Individual, environmental, and contextual factors were tested for an association with lifetime diagnosis of asthma among adolescents. Results: The overall prevalence of lifetime diagnosis of asthma was 16.0%. The prevalence of lifetime diagnosis of asthma was 16.8% for adolescent boys and 15.3% for adolescent girls. Based on multivariable logistic regression analysis, the risk factors of lifetime diagnosis of asthma were: age, income, being overweight, smoking inside the home, having one to two children under 18 years in the household, history of bronchitis, living in an urban residence, education, and geographical location. Female sex was reported to have a protective effect on or reduce risk of the prevalence of lifetime diagnosis of asthma compared to the male sex. Conclusions: Lifetime diagnosis of asthma prevalence appears to be lower in Aboriginal adolescent girls than in adolescent boys. Lifetime diagnosis of asthma prevalence in these adolescents is associated with age, income, education, being overweight, smoking inside the home, history of bronchitis, and location of residence, both geographical region and urban residence. The prevalence of lifetime diagnosis of asthma among Aboriginal adolescent is higher compared to the general adolescent population in Canada.
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Affiliation(s)
- Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Khalid Amin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Pahwa P, Rana M, Pickett W, Karunanayake CP, Amin K, Koehncke N, Elliot V, Hagel L, Lawson J, Rennie D, Kirychuk S, Janzen B, Dyck R, Dosman J. Correction to: Cohort profile: the Saskatchewan Rural Health Study—adult component. BMC Res Notes 2018; 11:191. [PMID: 29580295 PMCID: PMC5868068 DOI: 10.1186/s13104-018-3294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 02/22/2018] [Indexed: 11/22/2022] Open
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Karunanayake CP, Dosman JA, Rennie DC, Lawson JA, Kirychuk S, Fenton M, Ramsden VR, Seeseequasis J, Abonyi S, Pahwa P. Incidence of Daytime Sleepiness and Associated Factors in Two First Nations Communities in Saskatchewan, Canada. Clocks Sleep 2018; 1:13-25. [PMID: 33089152 PMCID: PMC7509673 DOI: 10.3390/clockssleep1010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/18/2018] [Indexed: 11/25/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communities. The data for this study involved 317 individuals aged 18 years and older who participated in baseline and follow-up evaluations (after four years) of the First Nations Lung Health Project, which was conducted in Saskatchewan in 2012–2013 and 2016. Both at baseline and follow-up survey after four years, an Epworth Sleepiness Scale (ESS) score >10 was considered to be abnormal. Logistic regression models were used to assess relationships between abnormal ESS and covariates at baseline. In 2016, 7.6% (24/317) of the participants reported an ESS >10 with the mean being 12.8 ± 2.0. For the same group, the mean ESS at baseline was 6.9 ± 2.2. The incidence of subjective EDS based on the ESS >10 was estimated at 7.6% over four years. This study showed an association between incidence of subjective EDS and less money left over at end of the month, having a house in need of repairs, having water or dampness in the past 12 months, and damage caused by dampness.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Correspondence: ; Tel.: +1-306-966-1647
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Joshua A. Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada
| | | | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
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Hernández-Ronquillo L, Thorpe L, Pahwa P, Téllez-Zenteno JF. Secular trends and population differences in the incidence of epilepsy. A population-based study from Saskatchewan, Canada. Seizure 2018; 60:8-15. [DOI: 10.1016/j.seizure.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 10/14/2022] Open
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Ahmed S, Iqbal M, Le D, Iqbal N, Pahwa P. Travel distance and use of salvage palliative chemotherapy in patients with metastatic colorectal cancer. J Gastrointest Oncol 2018; 9:269-274. [PMID: 29755765 DOI: 10.21037/jgo.2017.12.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Salvage palliative chemotherapy in metastatic colorectal cancer has been associated with significant improvement in survival. However, not all patients receive all available therapies. Travel burden can affect patient access and use of future therapy. The present study aims to determine relationship between travel distance (TD) and salvage palliative chemotherapy in patients with metastatic colorectal cancer. Method A patient cohort diagnosed with metastatic colorectal cancer during 2006-2010 in the province of Saskatchewan, Canada was studied. Logistic regression analyses were performed to assess relationship between travel distance and subsequent line therapies. Results The median age of 264 eligible patients was 62 years [interquartile range (IQR): 53-72]. The patients who received salvage systemic therapy had a median distance to travel of 60.0 km (IQR: 4.7-144) compared with 88.1 km (IQR: 4.8-189) if they did not receive second- or third-line therapy (P=0.06). In multivariate analysis distance to the cancer center <100 km, odds ratio (OR) 1.69 (95% CI: 1.003-2.84), no metastasectomy, OR 1.89 (95% CI: 1.03-3.46), and absence of comorbid illness as per Charlson comorbid index, OR 1.45 (95% CI: 1.19-1.77) were correlated with the use of second- and subsequent line therapies. Conclusions Our result revealed that travel distance to the cancer center greater than 100 km was associated less frequent use of second or subsequent line therapies in patients with metastatic colorectal cancer.
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Affiliation(s)
- Shahid Ahmed
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, Saskatoon, Canada.,Division of Oncology, University of Saskatchewan, Saskatoon, Canada
| | | | - Duc Le
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, Saskatoon, Canada.,Division of Oncology, University of Saskatchewan, Saskatoon, Canada
| | - Nayyer Iqbal
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, Saskatoon, Canada.,Division of Oncology, University of Saskatchewan, Saskatoon, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
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Ahmed S, Iqbal N, Haider K, Chalchal HI, Le D, Alvi R, Zaidi A, Pahwa P. Social and contextual factors and their relationship with the use of palliative chemotherapy in patients with metastatic colorectal cancer (mCRC): A retrospective cohort study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
849 Background: Although there is evidence that social and contextual factors such as living alone are associated with outcomes in cancer patients, little is known about their influence on the use of palliative chemotherapy in mCRC. We previously reported various patient-and tumor-related factors that correlate with the use of palliative chemotherapy in mCRC (Oncology. 2015;88:289). In this study we examine social and contextual factors including marital status, having children and distance to cancer center for their association with the use of chemotherapy in patients with mCRC. Methods: A cohort of 569 patients with mCRC diagnosed from 2006-2010 in Saskatchewan was evaluated. Logistic regression analyses were performed to assess relationship between the use of chemotherapy and various variables. Results: Median age was 69 yrs (IQR 59-77) and M:F was 59:41. 326 (57%) patients received chemotherapy. Significant differences were noted between the chemotherapy vs. no chemotherapy groups with respect to median age (62 vs. 76 year, p < 0.001), WHO performance status (PS) > 1 (18 vs. 58%, p < 0.001), comorbid illness (24 vs 63%, p < 0.001), low albumin (61 vs. 89%, p < 0.001), anemia (61 vs. 87%, p < 0.001), elevated alkaline phosphatase (53 vs. 84% < 0.001), elevated creatinine (6 vs. 11%, p = 0.025), hyponatremia (20 vs. 14%, p = 0.03), primary tumor resection (61 vs 47%, p = 0.001), metastasectomy (21 vs. 9%, p < 0.001), mean distance to cancer center (98.7±113.6 vs. 127.8±124.6 km, p < 0.001), married/partnered (67 vs 33%, p < 0.001), and having children (64 vs. 36%, p < 0.001), respectively. On multivariate logistic regression analysis after adjustment of other variables, WHO PS > 1 (HR 5.1; 95%CI: 3.1-81.), not having children (3.3, 1.78-6.2, < 0.001), elevated alkaline phosphatase (HR 2.9; 95%CI: 1.8-4.8), and low albumin (HR 2.2; 95%CI: 1.2-3.8), were correlated with low rates of chemotherapy. Marital status or travel distance did not correlate with use of chemotherapy. Conclusions: Our results show that use of chemotherapy in patients with mCRC significantly varies in those with and without children. Future study are required to explore this difference.
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Affiliation(s)
- Shahid Ahmed
- University of Saskatchewan, Saskatoon, SK, Canada
| | - Nayyer Iqbal
- Saskatoon Cancer Center, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kamal Haider
- Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Duc Le
- Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK, Canada
| | - Riaz Alvi
- Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK, Canada
| | - Adnan Zaidi
- Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- University of Saskatchewan, Saskatoon, SK, Canada
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Janzen B, Karunanayake C, Rennie D, Katapally T, Dyck R, McMullin K, Fenton M, Jimmy L, MacDonald J, Ramsden VR, Dosman J, Abonyi S, Pahwa P. Racial discrimination and depression among on-reserve First Nations people in rural Saskatchewan. Can J Public Health 2018; 108:e482-e487. [PMID: 29356653 DOI: 10.17269/cjph.108.6151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/25/2017] [Accepted: 07/01/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine among rural-dwelling on-reserve Saskatchewan First Nations people whether racial discrimination is associated with depression, and in turn, if this relationship is moderated by gender. METHODS As a component of a community-based participatory research project, a cross-sectional, interviewer-administered survey of 874 adults living on 2 Cree First Nation reserves in rural north-central Saskatchewan was conducted during May-August in 2012 and 2013. Self-reported, health-provider diagnosis of depression was the dependent variable and experiences of interpersonal racial discrimination was the primary exposure. Chi-square and multiple logistic regression were the main analytic techniques. Generalized estimating equations were applied to account for clustering within households. RESULTS Overall, 64% of participants reported being treated unfairly in 1 or more situations because of their ethnicity; 38% indicated discrimination occurring in 3 or more situations. Nineteen percent reported a diagnosis of depression. Adjusted analyses indicated that compared to those with no experience of racial discrimination, those reporting 1-2 and 3 or more situations were 1.77 times (95% CI: 1.06-2.95) and 1.91 times (95% CI: 1.19-3.04) more likely to have diagnosed depression respectively. The relationship between racial discrimination and depression was not modified by gender, although women were 1.85 times (95% CI: 1.24-2.76) more likely to report depression than men. CONCLUSION Interpersonal racial discrimination was associated with depression among First Nations women and men in rural Saskatchewan. Research directed at identifying the most efficacious interventions, programs and policies to combat racism is required to advance the goal of health equity.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK.
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van der Spuy I, Karunanayake CP, Dosman JA, McMullin K, Zhao G, Abonyi S, Rennie DC, Lawson J, Kirychuk S, MacDonald J, Jimmy L, Koehncke N, Ramsden VR, Fenton M, Marchildon GP, King M, Pahwa P. Determinants of excessive daytime sleepiness in two First Nation communities. BMC Pulm Med 2017; 17:192. [PMID: 29233159 PMCID: PMC5726026 DOI: 10.1186/s12890-017-0536-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 11/29/2017] [Indexed: 12/27/2022] Open
Abstract
Background Excessive daytime sleepiness may be determined by a number of factors including personal characteristics, co-morbidities and socio-economic conditions. In this study we identified factors associated with excessive daytime sleepiness in 2 First Nation communities in rural Saskatchewan. Methods Data for this study were from a 2012–13 baseline assessment of the First Nations Lung Health Project, in collaboration between two Cree First Nation reserve communities in Saskatchewan and researchers at the University of Saskatchewan. Community research assistants conducted the assessments in two stages. In the first stage, brochures describing the purpose and nature of the project were distributed on a house by house basis. In the second stage, all individuals age 17 years and older not attending school in the participating communities were invited to the local health care center to participate in interviewer-administered questionnaires and clinical assessments. Excessive daytime sleepiness was defined as Epworth Sleepiness Scale score > 10. Results Of 874 persons studied, 829 had valid Epworth Sleepiness Scale scores. Of these, 91(11.0%) had excessive daytime sleepiness; 12.4% in women and 9.6% in men. Multivariate logistic regression analysis indicated that respiratory comorbidities, environmental exposures and loud snoring were significantly associated with excessive daytime sleepiness. Conclusions Excessive daytime sleepiness in First Nations peoples living on reserves in rural Saskatchewan is associated with factors related to respiratory co-morbidities, conditions of poverty, and loud snoring.
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Affiliation(s)
- Ina van der Spuy
- School of Physical Therapy, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Kathleen McMullin
- First Nations University of Canada, Prince Albert Campus, 1301 Central Avenue, Prince Albert, SK, S6V 4W1, Canada
| | - Gaungming Zhao
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | | | - Laurie Jimmy
- Community B, Montreal Lake, Saskatoon, SK, Canada
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK, S7M 3Y5, Canada
| | - Mark Fenton
- Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Gregory P Marchildon
- Institute of Health Policy, Management and Evaluation, University of Toronto, Suite 425, 155 College Street, Toronto, ON, M5T 3M6, Canada
| | - Malcolm King
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada. .,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
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Ahmed S, Pahwa P, Le D, Chalchal H, Chandra-Kanthan S, Iqbal N, Fields A. Primary Tumor Location and Survival in the General Population With Metastatic Colorectal Cancer. Clin Colorectal Cancer 2017; 17:e201-e206. [PMID: 29221688 DOI: 10.1016/j.clcc.2017.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent evidence from clinical trials suggests that primary tumor location in patients with metastatic colorectal cancer correlates with differential outcomes, and patients with tumors originating in the right side of the colon have inferior survival. We conducted a large population-based cohort study using individual patient data to confirm the prognostic importance of primary tumor location in the general population with metastatic colorectal cancer. METHODS A cohort of 1947 patients who were diagnosed with metastatic colorectal cancer from 1992 to 2010 was studied. Ascending and transverse colon cancers were defined as right-sided tumors. Cox proportional multivariate analyses were done to determine prognostic significance of primary tumor location. RESULTS The median age was 70 years (interquartile range, 60-78 years), and the male to female ratio was 1.3:1. Twenty-nine percent had World Health Organization performance status of > 1. Seven-hundred and seventy (39%) patients had right-sided tumors, and 908 (47%) received chemotherapy. The median overall survival of patients with right-sided tumors was 14 months (95% confidence interval [CI], 12.7-15.3 months) compared with 20.5 months (95% CI, 18.5-22.5 months) of patients with left-sided tumors (P < .001). On multivariate analysis, right-sided tumors (hazard ratio [HR], 1.40; 95% CI, 1.20-1.60), no metastasectomy (HR, 2.40; 95% CI, 1.90-2.90), intact primary tumor (HR, 1.60; 95% CI, 1.32-1.90), an elevated carcinoembryonic antigen level (HR, 1.54; 95% CI, 1.30-1.90), lack of combination chemotherapy (HR, 1.52; 95% CI, 1.31-1.80), stage IVb disease (HR, 1.50; 95% CI, 1.17-1.86), leukocytosis (HR, 1.44; 95% CI, 1.28-1.73), and World Health Organization performance status > 1 (HR, 1.30; 95% CI, 1.10-1.55) were correlated with inferior survival. CONCLUSIONS Our results confirm that individuals with metastatic colorectal cancer and right-sided tumors who received chemotherapy have inferior survival independent of other known prognostic variables. Future studies are required to understand the underlying pathophysiology.
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Affiliation(s)
- Shahid Ahmed
- Saskatoon Cancer Canter, Saskatchewan Cancer Agency, Saskatoon, SK, Canada; Division of Oncology, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Duc Le
- Saskatoon Cancer Canter, Saskatchewan Cancer Agency, Saskatoon, SK, Canada; Division of Oncology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Haji Chalchal
- Division of Oncology, University of Saskatchewan, Saskatoon, SK, Canada; Allan Blair Cancer Center, Saskatchewan Cancer Agency, Regina, SK, Canada
| | | | - Nayyer Iqbal
- Saskatoon Cancer Canter, Saskatchewan Cancer Agency, Saskatoon, SK, Canada; Division of Oncology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Anthony Fields
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
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Luu J, Kirychuk S, Karunanayake C, Lawson J, Pahwa P, Rennie D, Hagel L, Dosman J. ACCESS TO ROUTINE MEDICAL CARE AND CARDIOVASCULAR DISEASE OUTCOMES IN A RURAL CANADIAN POPULATION. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rennie D, Lawson J, Karunanayake C, Dosman J, Pahwa P, Senthiselvan A. Predictors of early and late onset asthma in a rural population of children: The Saskatchewan Rural Health Study. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pahwa P, Smith S, Livesley N. ISQUA17-2417STRENGTHENING QUALITY IMPROVEMENT WORK IN HOSPITALS BY USING WHATS APP: EXPLORATORY QUALITATIVE STUDY FROM INDIAN HOSPITAL. Int J Qual Health Care 2017. [DOI: 10.1093/intqhc/mzx125.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pahwa P, Karunanayake CP, Rennie DC, Lawson JA, Ramsden VR, McMullin K, Gardipy PJ, MacDonald J, Abonyi S, Episkenew JA, Dosman JA. Prevalence and associated risk factors of chronic bronchitis in First Nations people. BMC Pulm Med 2017; 17:95. [PMID: 28662706 PMCID: PMC5492442 DOI: 10.1186/s12890-017-0432-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 05/29/2017] [Indexed: 01/29/2023] Open
Abstract
Background Inadequate housing, low family income, household smoking, personal smoking status, and poor schooling are some of the conditions that have been significantly associated with the prevalence and incidence of chronic bronchitis. The aim of the current study was to determine the prevalence of chronic bronchitis (CB) and associated risk factors among First Nations people. Methods An interviewer-administered survey was conducted as part of the First Nations Lung Health Project in 2012 and 2013 with 874 individuals from 406 households in two First Nations communities located in the province of Saskatchewan, Canada. The questionnaire collected information on individual and contextual determinants of health and a history of ever diagnosed with CB (outcome variable) from the two communities participating in the First Nations Lung Health Project. Clustering effect within households was adjusted using Generalized Estimating Equations. Results The prevalence of CB was 8.9% and 6.8% among residents (18 years and older) of community A and community B respectively and was not significantly different. CB prevalence was positively associated with odour or musty smell of mildew/mould in the house [ORadj (95% CI) = 2.33 (1.21, 4.50)], allergy to house dust [3.49 (1.75, 6.97)], an air conditioner in home [2.33 (1.18, 4.24)], and increasing age [0.99 (0.33, 2.95), 4.26 (1.74, 10.41), 6.08 (2.58, 14.33)]. An interaction exposure to environmental tobacco smoke in the house*body mass index showed that exposure to household smoke increased the risk of CB for overweight and obese participants (borderline). Some of the variables of interest were not significantly associated with the prevalence of CB in multivariable analysis, possibly due to small numbers. Conclusions Our results suggest that significant determinants of CB were: increasing age; odour or musty smell of mildew/mould in the house; allergy to house dust; and, body mass index. Modifiable risk factors identified were: (i) community level-housing conditions (such as mould or mildew in home, exposure to environmental tobacco smoke in house); and, (ii) policy level-remediation of mould, and obesity. Trial registration Not applicable.
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Affiliation(s)
- Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada. .,Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, S7N 2Z4, SK, Canada.
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, S7M 3Y5, SK, Canada
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | | | | | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, S7N 2Z4, SK, Canada
| | - Jo-Ann Episkenew
- Deceased, Former Faculty of Indigenous Peoples' Health Research Centre, University of Regina, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, Royal University Hospital, 104, Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
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Balakrishnan L, Rennie D, Dosman J, Pahwa P, Karunanayake C, Hagel L, Lawson J. Lung function in relation to farm dwelling and farming activities in rural dwelling children. Respirology 2017; 22:1320-1328. [PMID: 28653785 DOI: 10.1111/resp.13097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/10/2017] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE The relationship between farming exposures and pulmonary function in a rural paediatric population was evaluated. METHODS Baseline data collection records of the Saskatchewan Rural Health Study (SRHS), a population-based study, were used. A subset of children (6-14 years old) participated in clinical testing, including anthropometric measures and pulmonary function testing (PFT), using spirometry (n = 584). PFTs followed ATS criteria and all statistical analyses were controlled for age, sex and height. RESULTS Among clinical testing participants, 47.5% were females and 54.5% were farm dwelling. Of those living on farms, 77.5% were livestock farms. Mean percent predicted value (PPV) for forced expiratory volume in 1 s (FEV1 ) and forced vital capacity (FVC) among children living on a farm were 104.8% and 105.4%, respectively. Mean PPV for FEV1 and FVC among children not living on a farm were 102.7% and 101.4%, respectively. After adjustment, higher FEV1 (=0.079, SE = 0.033, P = 0.03) and FVC (=0.110, SE = 0.039, P = 0.006) were seen among children living on a farm. A trend towards lower FEV1 /FVC ratio (-0.013, SE = 0.008, P = 0.09) among children living on a farm was seen compared with children not living on a farm. Higher FVC and lower FEV1 /FVC ratio were seen in children who regularly emptied grain bins (P < 0.05). Trends towards higher FEV1 (P = 0.14) and FVC (P = 0.08) were also seen with children living on a farm in the first year of life. Since the majority of the population was Caucasian (91%), the results were not race-corrected. CONCLUSION We addressed the lack of knowledge regarding the association between lung function and rural exposures, and found that differences in lung function were seen between children living on a farm and not living on a farm in rural areas and certain farming activities, specifically emptying grain bins, where lung function was generally better in those living on a farm.
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Affiliation(s)
- Lakshmi Balakrishnan
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima Karunanayake
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Louise Hagel
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joshua Lawson
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Chu LM, Pahwa P. Prevalence and associated factors for self-reported asthma in a Canadian population: The Canadian Community Health Survey, 2014. J Asthma 2017; 55:26-34. [PMID: 28346028 DOI: 10.1080/02770903.2017.1310228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Asthma prevalence is increasing among adults, yet limited information regarding the association between adult asthma and environmental and personal exposures is available using large nationally representative population-based survey. OBJECTIVE To determine the prevalence of asthma and associated factors for self-reported asthma in a Canadian population aged 12 years and older by using the Canadian Community Health Survey (CCHS) 2014 cross-sectional cohort. METHODS We used data from the 2014 CCHS. Asthma was determined through self-reported health professional diagnosis. Information regarding covariates of importance, such as socio-economic status, life style variables, was obtained. A weighted logistic regression analysis was performed with appropriate technique for clustering effects. RESULTS Estimated self-reported asthma prevalence of 8.1% in the greater than 12 years old Canadian population was observed. We found that a substantial proportion of Canadians (aged 12 and older) reported having asthma and geographical differences and differences between specific provinces in asthma prevalence. Women had higher prevalence of asthma than men, but the relationship depended on age and body mass index (BMI). Interactions between household income and smoking status were observed to predict the probability of asthma. CONCLUSIONS Additional studies are needed to determine which factors influence the asthma prevalence between sex, BMI as well as smoking status and household income and its interactions with each other.
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Affiliation(s)
- Luan M Chu
- a College of Medicine and Canadian Center for Health and Safety in Agriculture , University of Saskatchewan , Saskatoon , Canada
| | - Punam Pahwa
- b Department of Community Health and Epidemiology and Canadian Center for Health and Safety in Agriculture , University of Saskatchewan , Saskatoon , Canada
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Lawson JA, Chu LM, Rennie DC, Hagel L, Karunanayake CP, Pahwa P, Dosman JA. Prevalence, risk factors, and clinical outcomes of atopic and nonatopic asthma among rural children. Ann Allergy Asthma Immunol 2017; 118:304-310. [PMID: 28087381 DOI: 10.1016/j.anai.2016.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of time and cost constraints, objective classification of atopic and nonatopic asthma has been limited in large epidemiologic studies. However, as we try to better understand exposure-outcome associations and ensure appropriate treatment of asthma, it is important to focus on phenotype-defined asthma classification. OBJECTIVE To compare atopic and nonatopic asthma in rural children with regard to risk factors and clinical outcomes. METHODS We conducted a cross-sectional study in rural Saskatchewan, Canada, in 2011. Parents of 6- to 14-year-old children completed a health and exposure survey. Skin prick tests were completed in a subsample of 529 children. Asthma was based physician diagnosis. Asthma status was defined as no asthma, nonatopic asthma, and atopic asthma. RESULTS Asthma prevalence was 14.7% of which 32.1% of cases were atopic. After adjustment, early respiratory illness and a family history of asthma were predictors of childhood asthma, regardless of atopic status (P < .05). Being overweight and having a dog in the home were associated with an increased risk of nonatopic asthma (P < .05). A mother with a history of smoking increased the risk of atopic asthma (P = .01). Compared with those with nonatopic asthma, in the past 12 months, children with atopic asthma were more likely to report a sneezy, runny, or blocked nose or have shortness of breath (odds ratio >2), whereas those with nonatopic asthma were more likely to have parents who missed work (odd ratio >3). Those with nonatopic asthma had significantly lower forced expiratory volume in 1 second compared w2ith those with atopic asthma. CONCLUSION Exposures may contribute differentially to atopic and nonatopic asthma and result in differential clinical presentation or burden. The study of these characteristics is important for etiologic understanding and management decisions.
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Affiliation(s)
- Joshua A Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Luan M Chu
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Louise Hagel
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima P Karunanayake
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Rennie DC, Lawson JA, Karunanayake CP, Pahwa P, Chen Y, Chu L, Dosman JA. Farm Exposure and Atopy in Men and Women: The Saskatchewan Rural Health Study. J Agromedicine 2016; 20:302-9. [PMID: 26237720 DOI: 10.1080/1059924x.2015.1042612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Associations between farming exposures and atopy can vary by timing of exposure and sex. We examined associations between adult atopy, sex, and farm living in a rural Canadian population. In 2010, we conducted a baseline survey of 11,982 households located in four agricultural regions of Saskatchewan, Canada. Of the 7225 adults aged 18-75, 1658 underwent clinical assessments including skin testing. Of these, 1599 participants underwent skin prick testing to four common allergens. We defined atopy as >3 mm reaction to any of four allergens compared with saline control. Farming exposures were farm living in the first year of life and current farm living. All analyses were stratified by sex. The prevalence of atopy was 17.8% and was higher in men than women (P < .001). The most common allergy was to grasses (8.8%) followed by house dust mite (HDM) mixed (8.1%). Atopy was lower in those subjects with an early farm exposure (P = .08) and who were female (P = .03). After adjusting for education, age, and smoking status, both current and early farm exposures were associated with decreased sensitization to cat atopy in women that was stronger with current exposure (P < .05). Men had significantly decreased atopic sensitization to Alternaria with an early farm exposure and increased atopic sensitization to HDM with a current farm exposure. In this rural population, the protective effect of an early farm exposure for any atopy was weak overall. The impact of farming exposures on atopy was allergen dependent and varied by sex.
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Affiliation(s)
- Donna C Rennie
- a Canadian Centre for Health and Safety in Agriculture , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
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Janzen B, Karunanayake C, Rennie D, Pickett W, Lawson J, Kirychuk S, Hagel L, Senthilselvan A, Koehncke N, Dosman J, Pahwa P. Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population. Lung 2016; 195:43-52. [PMID: 27738826 DOI: 10.1007/s00408-016-9950-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/01/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION To investigate the association of individual and contextual exposures with lung function by gender in rural-dwelling Canadians. METHODS A cross-sectional mail survey obtained completed questionnaires on exposures from 8263 individuals; a sub-sample of 1609 individuals (762 men, 847 women) additionally participated in clinical lung function testing. The three dependent variables were forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Independent variables included smoking, waist circumference, body mass index, indoor household exposures (secondhand smoke, dampness, mold, musty odor), occupational exposures (grain dust, pesticides, livestock, farm residence), and socioeconomic status. The primary analysis was multiple linear regression, conducted separately for each outcome. The potential modifying influence of gender was tested in multivariable models using product terms between gender and each independent variable. RESULTS High-risk waist circumference was related to reduced FVC and FEV1 for both genders, but the effect was more pronounced in men. Greater pack-years smoking was associated with lower lung function values. Exposure to household smoke was related to reduced FEV1, and exposure to livestock, with increased FEV1. Lower income adequacy was associated with reduced FVC and FEV1. CONCLUSION High-risk waist circumference was more strongly associated with reduced lung function in men than women. Longitudinal research combined with rigorous exposure assessment is needed to clarify how sex and gender interact to impact lung function in rural populations.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - William Pickett
- Department of Public Health Sciences, Queens University, Kingston, ON, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Louise Hagel
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - James Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.,Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
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Karunanayake CP, Rennie DC, Hildebrand C, Lawson JA, Hagel L, Dosman JA, Pahwa P. Actual Body Weight and the Parent's Perspective of Child's Body Weight among Rural Canadian Children. Children (Basel) 2016; 3:children3030013. [PMID: 27527235 PMCID: PMC5039473 DOI: 10.3390/children3030013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 07/22/2016] [Accepted: 07/28/2016] [Indexed: 01/04/2023]
Abstract
The prevalence of being overweight during childhood continues to increase in the USA and Canada and children living in rural areas are more at risk than their urban counterparts. The objectives of this study were to evaluate how well the parent’s perception of their child’s weight status correlated with objectively measured weight status among a group of rural children and to identify predictors of inaccurate parental perceptions of child’s weight status. Participants were children from the Saskatchewan Rural Health Study conducted in 2010. Self-administered questionnaires were distributed through rural schools to parents of children in grades one to eight. Parents reported their child’s height and weight and rated their child’s weight status (underweight, just about the right weight, or overweight). Standardized body mass index (BMI) categories were calculated for clinically measured height and weight and for parental report of height and weight for 584 children. Logistic regression analysis was performed to identify predictors of misclassification of the parent’s perception of child’s weight status adjusting for potential confounders. Clinically measured overweight was much higher (26.5%) compared to parental perceived overweight (7.9%). The misclassification of the child’s BMI was more likely to occur if the child was a boy (odds ratio (OR) = 1.58) or non-Caucasian (OR = 2.03). Overweight was high in this group of rural children and parental perception of weight status underestimated the actual weight status of overweight school-age children. Parental reporting of child weight status has implications for public health policy and prevention strategies. Future research should focus on assessing longitudinal effects of parental misperceptions of child’s weight status.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Correspondence: ; Tel.: +306-966-1647
| | - Donna C. Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Carole Hildebrand
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
| | - Joshua A. Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Medicine, College of Medicine, University of Saskatchewan, 5D40 Health Sciences Building, Box 19, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Louise Hagel
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Medicine, College of Medicine, University of Saskatchewan, 5D40 Health Sciences Building, Box 19, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 104, Clinic Place, Saskatoon, SK S7N 5E5, Canada
| | - the Saskatchewan Rural Health Study Team
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Box 23, 104, Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (D.C.R.); (C.H.); (J.A.L.); (L.H.); (J.A.D.); (P.P.);
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48
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Presutti R, Harris SA, Kachuri L, Spinelli JJ, Pahwa M, Blair A, Zahm SH, Cantor KP, Weisenburger DD, Pahwa P, McLaughlin JR, Dosman JA, Freeman LB. Pesticide exposures and the risk of multiple myeloma in men: An analysis of the North American Pooled Project. Int J Cancer 2016; 139:1703-14. [DOI: 10.1002/ijc.30218] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Roseanna Presutti
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto ON Canada
- Prevention and Cancer Control; Cancer Care Ontario; Toronto ON Canada
| | - Shelley A. Harris
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto ON Canada
- Prevention and Cancer Control; Cancer Care Ontario; Toronto ON Canada
- Department of Epidemiology; Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
- Department of Occupational and Environmental Health; Dalla Lana School of Public Health, University of Toronto; Toronto ON Canada
| | - Linda Kachuri
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto ON Canada
- Prevention and Cancer Control; Cancer Care Ontario; Toronto ON Canada
- Department of Epidemiology; Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
- Lunenfeld-Tanenbaum Research Institute; Toronto ON Canada
| | - John J. Spinelli
- British Columbia Cancer Agency Research Centre and University of British Columbia; Vancouver BC Canada
| | - Manisha Pahwa
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto ON Canada
- Prevention and Cancer Control; Cancer Care Ontario; Toronto ON Canada
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics; U.S. National Cancer Institute; Bethesda MD
| | - Shelia Hoar Zahm
- Division of Cancer Epidemiology and Genetics; U.S. National Cancer Institute; Bethesda MD
| | - Kenneth P. Cantor
- Division of Cancer Epidemiology and Genetics; U.S. National Cancer Institute; Bethesda MD
| | | | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture
- Department of Community Health and Epidemiology; University of Saskatchewan; Saskatoon SK Canada
| | - John R. McLaughlin
- Department of Epidemiology; Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
- Lunenfeld-Tanenbaum Research Institute; Toronto ON Canada
- Public Health Ontario; Toronto ON Canada
| | - James A. Dosman
- Department of Community Health and Epidemiology; University of Saskatchewan; Saskatoon SK Canada
| | - Laura Beane Freeman
- Division of Cancer Epidemiology and Genetics; U.S. National Cancer Institute; Bethesda MD
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Ahmed S, Leis A, Chandra-Kanthan S, Fields A, Reeder B, Iqbal N, Haider K, Le D, Pahwa P. Surgical Management of the Primary Tumor in Stage IV Colorectal Cancer: A Confirmatory Retrospective Cohort Study. J Cancer 2016; 7:837-45. [PMID: 27162543 PMCID: PMC4860801 DOI: 10.7150/jca.14717] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/16/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Observational studies have suggested that patients with stage IV colorectal cancer who undergo surgical resection of the primary tumor (SRPT) have better survival. Yet the results are not confirmed in the setting of a randomized controlled trial. Lack of randomization and failure to control prognostic variables such as performance status are major critiques to the findings of the observational studies. We previously have shown that SRPT, independent of chemotherapy and performance status, improves survival of stage IV CRC patients. The current study aims to validate our findings in patients with stage IV CRC who were diagnosed during the period of modern chemotherapy. METHODS A cohort of 569 patients with stage IV CRC diagnosed during 2006-2010 in the province of Saskatchewan was evaluated. Cox regression model was used for the adjustment of prognostic variables. RESULTS Median age was 69 years (59-95) and M: F was 1.4:1. Fifty-seven percent received chemotherapy, 91.4% received FOLFIRI or FOLFOX & 67% received a biologic agent. Median overall survival (OS) of patients who underwent SRPT and received chemotherapy was 27 months compared with 14 months of the non-resection group (p<0.0001). Median OS of patients who received all active agents and had SRPT was 39 months (95%CI: 25.1-52.9). On multivariate analysis, SRPT, hazard ratio (HR):0.44 (95%CI: 0.35-0.56), use of chemotherapy, HR: 0.33 (95%CI: 0.26-0.43), metastasectomy, HR: 0.43 (95%CI: 0.31-0.58), second line therapy, HR: 0.50 (95%CI: 0.35-0.70), and third line therapy, HR: 0.58 (95%CI: 0.41-0.83) were correlated with superior survival. CONCLUSIONS This study confirms our findings and supports a favorable association between SRPT and survival in patients with stage IV CRC who are treated with modern therapy.
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Affiliation(s)
- Shahid Ahmed
- 1. Saskatchewan Cancer Agency;; 2. Department of Oncology , University of Saskatchewan;; 3. Department of Community Health and Epidemiology, University of Saskatchewan
| | - Anne Leis
- 3. Department of Community Health and Epidemiology, University of Saskatchewan
| | | | | | - Bruce Reeder
- 3. Department of Community Health and Epidemiology, University of Saskatchewan
| | - Nayyer Iqbal
- 1. Saskatchewan Cancer Agency;; 2. Department of Oncology , University of Saskatchewan
| | - Kamal Haider
- 1. Saskatchewan Cancer Agency;; 2. Department of Oncology , University of Saskatchewan
| | - Duc Le
- 1. Saskatchewan Cancer Agency;; 2. Department of Oncology , University of Saskatchewan
| | - Punam Pahwa
- 3. Department of Community Health and Epidemiology, University of Saskatchewan;; 6. Division of Biostatistics, Department of Community Health and Epidemiology, University of Saskatchewan
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Ahmed S, Leis A, Chandra-Kanthan S, Fields A, Zaidi A, Abbas T, Le D, Reeder B, Pahwa P. Regional Lymph Nodes Status and Ratio of Metastatic to Examined Lymph Nodes Correlate with Survival in Stage IV Colorectal Cancer. Ann Surg Oncol 2016; 23:2287-94. [PMID: 27016291 DOI: 10.1245/s10434-016-5200-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although lymph nodes status and the ratio of metastatic to examined lymph node (LNR) are important prognostic factors in early-stage colorectal cancer (CRC), their significance in patients with metastatic disease remains unknown. The study aims to determine prognostic importance of nodal status and LNR in patients with stage IV CRC. METHODS A cohort of 1109 eligible patients who were diagnosed with synchronous metastatic CRC in Saskatchewan during 1992-2010 and underwent primary tumor resection was evaluated. We conducted the Cox proportional multivariate analyses to determine the prognostic significance of nodal status and LNR. RESULTS Median age was 70 years (22-98) and M:F was 1.2:1. Rectal cancer was found in 26 % of patients; 96 % had T3/T4 tumor, and 82 % had node positive disease. The median LNR was 0.36 (0-1.0). Fifty-four percent received chemotherapy. Median overall survival of patients who had LNR of <0.36 and received chemotherapy was 29.7 months (95 % CI 26.6-32.9) compared with 15.6 months (95 % CI 13.6-17.6) with LNR of ≥0.36 (P < .001). On multivariate analyses, no chemotherapy (HR 2.36 [2.0-2.79]), not having metastasectomy (HR 1.94 [1.63-2.32]), LNR ≥0.36 (HR 1.59 [1.38-1.84]). nodal status (HR 1.34 [1.14-1.59]), and T status (HR 1.23 [1.07-1.40]) were correlated with survival. Test for interaction was positive for LNR and high-grade cancer (HR 1.51 [1.10-2.10]). CONCLUSIONS Our results suggest that nodal status and LNR are important prognostic factors independent of chemotherapy and metastasectomy in stage IV CRC patients.
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Affiliation(s)
- Shahid Ahmed
- Saskatchewan Cancer Agency, Saskatoon, SK, Canada. .,Department of Oncology, University of Saskatchewan, Saskatoon, SK, Canada. .,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Anne Leis
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Anthony Fields
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Adnan Zaidi
- Saskatchewan Cancer Agency, Saskatoon, SK, Canada.,Department of Oncology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Tahir Abbas
- Saskatchewan Cancer Agency, Saskatoon, SK, Canada.,Department of Oncology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Duc Le
- Saskatchewan Cancer Agency, Saskatoon, SK, Canada.,Department of Oncology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Bruce Reeder
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
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