Manitoba Research Papers - Academia.edu (original) (raw)

Background Considerations of dignity are often raised in reference to the care of dying patients. However, little research that addresses this issue has been done. Our aim was to identify the extent to which dying patients perceive they are able to maintain a sense of dignity, and to ascertain how demographic and disease-specific variables relate to the issue of dignity in these individuals.

- by and +2
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- Palliative Care, Quality of life, Activities of Daily Living, Manitoba

This research was part of a Health Canada funded initiative developed to provide evidence about the effectiveness of interprofessional education (IPE) interventions to promote collaborative patient-centred care. Health professional students' ratings of health professions and the effect of IPE on those ratings were examined. Participants were divided into three groups (N= 51); control, education, and practice site immersion. Utilizing the Student Stereotypes Rating Questionnaire (SSRQ) which consists of a five point Likert-type scale each group rated health professionals on nine characteristics: academic ability, interpersonal skills, professional competence, leadership, practical skills, independence, confidence, decision-making, and being a team player (Hean, Macleod-Clark, Adams, and Humphris, 2006). Data were collected at four time points; prior to an IPE classroom intervention, following an IPE classroom intervention, following the IPE immersion experience, and four months post IPE immersion experience. Overall, perceptions of other health professions were more positive following the 2.5 day interprofessional education session and immersion experience. Student ratings of the seven professions among the nine characteristics will be presented, highlighting similarities and differences across professional groups. Findings support the incorporation of IPE curricula that address the role and functions of other health care professions to facilitate the development collaborative patient-centred care health care teams.

- by Judy Anderson
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- Nursing, Prejudice, Nurse Education, Qualitative Research

The Dissociative Experiences Scale was administered to a non-clinical sample in Shanghai, China (N = 618) and the results were compared with a previous sample of the general population from Winnipeg, Canada (N = 1055). The Dissociative Disorders Interview Schedule was administered to the 618 Chinese participants and results were compared with those of the Canadian participants (N = 502). In addition, both measures were administered to a sample of Chinese psychiatric inpatients (N = 423) and outpatients (N = 304). Rates of childhood trauma and dissociation were far lower in the Chinese non-clinical sample than in the two Chinese psychiatric patient groups, and far lower than in the

- by Colin Ross
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- Psychology, China, Childhood Sexual Abuse, Child
- by Dieter Schonwetter
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- Dentistry, Dental Education, Curriculum, Manitoba

Bone density measurement plays a key role in the initial diagnostic assessment of osteoporosis and in targeting pharmacologic therapies. The impact of access to dual-energy X-ray absorptiometry (DXA) on physician prescribing habits is unclear, however. We were able to directly evaluate the change in physician osteoporosis testing and prescribing following introduction of a DXA testing service in a geographic region that had previously had very limited access. This evaluation was conducted in the province of Manitoba, Canada, which has a provincially based bone density testing program and maintains a population-based bone density database that can be linked with administrative health data sources including drug prescriptions. The province of Manitoba was geographically partitioned into the urban and rural health regions serviced by the new program (urban new and rural new ) and the remaining urban and rural health regions which had relatively unchanged DXA access during this period (urban control and rural control ). Regression models of DXA testing rates and osteoporosis prescription rates were created for all older women in these regions. There was a statistically significant increase in bone density testing and BMDguided osteoporosis treatment in the urban new and rural new regions following introduction of the DXA testing service, relative to the control regions. Although the overall rate of empiric postfracture and preventive osteoporosis treatment did not show a specific region effect, when analysis was limited to nonhormonal agents there was a significant reduction in preventive and empiric postfracture treatment in some subgroups of women. These results suggest that the local availability of the bone density testing service led to an increase in objective test-guided therapy with some reduction in the use of empiric and preventive strategies and had a neutral effect on overall use of these agents.

- by Lisa Lix
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- Linear models, Rural Health, Osteoporosis, Health Services

We describe six patients with hepatic carnitine palmitoyl transferase (CPT1 A) deficiency who are members of a large extended Hutterite kindred living in widely scattered communities in the United States and Canadian Prairies. Two patients have significant neurological impairment due to severe recurrent hypoglycemic crises. The remaining four patients with earlier detection and treatment have near normal outcomes. The Canadian and American Hutterite families share two common ancestors who married in 1812, about 60 years before the Hutterites arrived in North America and prior to their subdivision into the three groups (Schmiedeleut, Dariusleut, and the Lehrerleut). These patients share a common haplotype on chromosome 11q13 and are all homozygous for a common CPT1 A G710E mutation, suggesting a founder effect. The clustering of such a rare disorder of fatty acid oxidation prompted us to initiate a pilot DNA-based neonatal screening program to determine the carrier frequency of this mutation in Hutterite newborns with the participation and support of the community. To date our carrier frequency is 1/16, close to the predicted frequency based on diag-nosed patients and number of births. We believe our newborn screening program for CPT1 A deficiency in the Hutterite community will serve as a prototype model for delivery of targeted genetic services to other similar unique genetic isolates.

- by N Buist
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- Genetics, Molecular Genetics, Adolescent, DNA

Objective: To determine the prevalence and impact on mortality of delays in initiation of effective antimicrobial therapy from initial onset of recurrent/persistent hypotension of septic shock.

- by Anand Kumar
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- History, Nursing, Biology, Medicine

BACKGROUND: Cadmium (Cd) is a trace element that has been associated with various human health problems. Cd enters plants, either by direct absorption through leaves or by uptake from soils, allowing Cd into the food chain. Nitrogen (N) fertilizer management is important in optimizing crop yield and protein content of durum wheat, but may influence Cd availability and hence Cd concentration in crops, with the effects being strongly influenced by environmental conditions and crop cultivar.

- by Michele Pisante
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- Engineering, Soil, Agriculture, Manitoba

This paper examines the relationship between community preparedness and response to natural disaster and their level and pattern of community development. This is done by investigating preparation and response to the 1997 Red River Flood by three rural communities in Manitoba, Canada. The communities were selected because of their different ethnic mix and associated level and pattern of community development. The hypothesis was supported that the level and pattern of community development affect community capacity to respond to flooding. Communities characterised by higher levels of physical, human and social capital were better prepared and more effective responders to the flood. However, where the pattern of community development was characterised by high levels of social capital, decision-making processes were complicated.

Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator's guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were...

- by Kristie L Ebi
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- Climate Change, Adaptation, Risk Management, Multidisciplinary

The aim of this study was to evaluate the effect of temperature on growth and aerobic metabolism in clones of Daphnia magna from different thermal regimes. Growth rate (increment in size), somatic juvenile growth rate (increment in mass), and oxygen consumption were measured at 15 and 251C in 21 clones from one northern and two southern sites. There were no significant differences in body size and growth rate (increase in length) at both 15 and 251C among the three sites. Clones from southern site 2 had a higher mass increment than clones from the other two sites at both temperatures. Clone had a significant effect on growth (body length) and body size at both temperatures. As expected, age at maturity was lower at 251C (4.5 days) than at 151C, (11.6 days) and body sizes, after the release of the third clutch, were larger at 151C than at 251C. Northern clones had higher oxygen consumption rates and specific dynamic action (SDA) than southern clones at 151C. By contrast, southern clones from site 1 had a higher oxygen consumption and SDA than subarctic clones at 251C. Clones from southern site 2 had high oxygen consumption rates at both temperatures. Our results reveal important differences in metabolic rates among Daphnia from different thermal regimes, which were not always reflected in growth rate differences.

- by France Dufresne
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- Evolutionary Biology, Genetics, Zoology, Daphnia
- by Thomas Hack
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- Nursing, Social Work, Social Support, Qualitative Research

Incidence and outcomes of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) are not well established at the population level, especially since the widespread use of immunophenotyping. We studied the epidemiology of CLL in Manitoba (Canada) by combining data from a centralized flow cytometry facility and the provincial cancer registry for the period 1998-2003. Of 616 cases identified, 27% of patients identified by flow cytometry were not on the cancer registry. The age-adjusted incidence of 7.99/100,000 is substantially higher than the reported incidence in registry reports. We also noted differences in relative survival based on age and gender.

- by Matthew Seftel and +1
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- Flow Cytometry, Survival Analysis, Leukemia, Chronic Lymphocytic Leukemia

This article outlines a new social reality of global psychopharmaceutical prescribing: the pharmaceutical family, or 'phamily.' Ethnographic case studies from Manitoba, Canada (2002Canada ( to 2004 show how pharmaceutical emplotment, involving a synergy between cultural and drug scripts, can have uncanny consequences for vulnerable groups, such as Aboriginal children. Observations and interview transcripts of high prescribing doctors are analyzed to understand the prescribing logic of using psychoactive medication, such as methylphenidate, in young Aboriginal children diagnosed with FASD and/or ADHD. Pharmaceutical narratives are presented in order to show how non-compliance to psychotropic prescribing can further marginalize Aboriginal children and is related to the history of colonial practices in Canada.

- by Michael J Oldani
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- Pharmacy, Social Marketing, Ethnography, Narrative

Objectives. Prevention strategies are integral to improving the oral health for young Aboriginal children. For such to be effective, it is important to understand the social value that parents and caregivers ascribe to primary teeth. The purpose of this paper is to report caregiver knowledge and attitudes toward preschool oral health and early childhood caries (ECC) from 4 communities in Manitoba. Study Design. Cross-sectional study, including a retrospective interview with caregivers. Methods. Children and their main caregivers served as the sample. Preschoolers underwent a comprehensive dental screening while caregivers completed a questionnaire that explored knowledge and attitudes toward preschool dental health. Caregiver responses were matched with findings from each child's examination. Results. A majority agreed that primary teeth were important, that dental disease could lead to health problems and that a first dental visit should be made by age 1. Caregivers of children with ECC were more likely to believe that caries could not affect a child's health while those who believed primary teeth are important had children with significantly less decay. Conclusions. Most caregivers believed that primary teeth are important and correctly responded to inquiries about knowledge and attitudes toward oral health. Attitudes on the importance of baby teeth and bottle feeding after one year of age, the effect of rotten teeth on childhood health and night-time nursing emerged as variables most associated with the absence/presence of ECC and deft rates. Incorporating such questioning into caries risk assessments may be a useful means to determine a child's risk for ECC. (Int J Circumpolar Health 2007; 66(2) 153-167 )

- by Bob Schroth
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- Child Care, Risk assessment, Oral health, Dental Caries

To explore the factors that predict the retention of nurses working in emergency departments. The escalating shortage of nurses is one of the most critical issues facing specialty areas, such as the emergency department. Therefore, it is important to identify the key influencing and intermediary factors that affect emergency department nurses&amp;amp;amp;#39; intention to leave. As part of a larger study, a cross-sectional survey was completed by 261 registered nurses working in the 12 designated emergency departments within rural, urban community and tertiary hospitals in Manitoba, Canada. Twenty-six per cent of the respondents will probably/definitely leave their current emergency department jobs within the next year. Engagement was the key predictor of intention to leave (P &amp;amp;amp;lt; 0.001). Engagement was also associated with job satisfaction, compassion satisfaction, compassion fatigue, and burnout (P &amp;amp;amp;lt; 0.05). In an ordinal least-squares model (R(2) = 0.44), nursing management, professional practice, collaboration with physicians, staffing resources and shift work emerged as significant influencing factors for engagement. Engagement plays a central role in emergency department nurses intention to leave. Addressing the factors that influence engagement may reduce emergency department nurses&amp;amp;amp;#39; intention to leave. This study highlights the value of research-based evidence as the foundation for developing innovative strategies for the retention of emergency department nurses.

- by Jo-ann Sawatzky
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- Nursing, Psychometrics, Job Satisfaction, Nursing Management

Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1...

- by Katie Ports
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- Psychology, Social Work, Child abuse and neglect, Child
- by Manitoba Law Journal
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- Law, Manitoba, University of Manitoba

All rights reserved. No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a... more

- by David Jayakar
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- Nursing, Health Promotion, Mental Health, Unemployment

The wait time from cancer diagnosis to treatment has been a recent focus of cancer care in Canada. To examine the trends in wait times from patient presentation to treatment (overall health system wait time [OWT]) for colorectal cancer (CRC). Patients with colorectal adenocarcinomas, diagnosed between 2001 and 2005, and their first definitive treatments were identified from the population-based Manitoba Cancer Registry (Winnipeg, Manitoba). By linkage to Manitoba Health and Healthy Living's administrative databases, a patient's first gastrointestinal investigation (abdominal radiological imaging, lower gastrointestinal endoscopy or fecal occult blood test) before CRC diagnosis was identified. The index contact with the health care system was estimated from the date of the visit with the physician who ordered the first gastroenterological investigation. The OWT was defined as the time from the index contact to the first treatment, while diagnostic delay was defined as the tim...

- by Emma Shu
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- Gastroenterology, Manitoba, Registries, Waiting lists
- by C. Ateah and +1
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- Nursing, Prejudice, Nurse Education, Qualitative Research

Despite use of the term dignity in arguments for and against a patient's self-governance in matters pertaining to death, there is little empirical research on how this term has been used by patients who are nearing death. The objective of this study was to determine how dying patients understand and define the term dignity, in order to develop a model of dignity in the terminally ill. A semi-structured interview was designed to explore how patients cope with their advanced cancer and to detail their perceptions of dignity. Interviews were audiotaped and transcribed verbatim. A consecutive sample of 50 consenting patients with advanced terminal cancer were recruited over a 15-month period of time from an urban extended care hospital housing a specialized unit for palliative care. This unit provides both inpatient services, and coordinates end-of-life care community based programming. Data were analysed using latent content analysis and constant comparison techniques. Four members of the research team independently coded the transcribed data, to develop conceptually meaningful categories of responses. Operational definitions were written for major categories, themes and sub-themes. Three major categories emerged from the qualitative analysis, including illness-related concerns; dignity conserving repertoire; and social dignity inventory. These broad categories and their carefully defined themes and sub-themes form the foundation for an emerging model of dignity amongst the dying. The concept of dignity and the dignity model offer a way of understanding how patients face advancing terminal illness. This will serve to promote dignity and the quality of life of patients nearing death. #

- by Linda Kristjanson
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- Sociology, Anthropology, Palliative Care, Content Analysis

This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress.

- by Linda Kristjanson
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- Nonparametric Statistics, Spirituality, Australia, Quality of life

- by Linda Kristjanson
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- Ethics, Perception, Design, Behavior

This study presents a technoeconomic analysis of wheat straw densification in Canada’s prairie province of Manitoba as an integral part of biomass-to-cellulosic-ethanol infrastructure. Costs of wheat straw bale and pellet transportation and densification are analysed, including densification plant profitability. Wheat straw collection radius increases nonlinearly with pellet plant capacity, from 9.2 to 37 km for a 2–35 tonnes h−1 plant. Bales are cheaper under 250 km, beyond which the cheapest feedstocks are pellets from the largest pellet plant that can be built to exploit economies of scale. Feedstocks account for the largest percentage of variable costs. Marginal and average cost curves suggest Manitoba could support a pellet plant up to 35 tonnes h−1. Operating below capacity (75–50%) significantly erodes a plant’s net present value (NPV). Smaller plants require higher NPV break-even prices. Very large plants have considerable risk under low pellet prices and increased processing costs.► We analysed wheat straw bales versus pellets as feedstocks for cellulosic ethanol. ► Distance and pellet plant capacity influence ethanol plant feedstock costs. ► Smaller plants require higher net present value break-even prices. ► Manitoba can sustain a pellet plant up to 35 tonnes h−1 pellet plant. ► Large plants have considerable risk at low pellet prices and capacity.

- by Lope Tabil Jr. and +1
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- Biomass, Multidisciplinary, Investments, Manitoba

A successful mixed farmer from north-central Saskatchewan, Robert
Weir was federal minister of Agriculture in R.B. Bennett’s Conservative government during the worst years of the Great Depression and the prolonged drought that devastated grain farmers in the Palliser Triangle. Weir’s original policies for agricultural recovery in Canada were of very limited assistance to wheat growers in the relatively arid south of the Prairie Provinces. Faced with worsening economic, social and political conditions on the prairies, Weir eventually introduced a major program of soil and water conservation and drought land reclamation through the Prairie Farm Rehabilitation Act, an initiative that was soon claimed by Jimmy Gardiner and the federal Liberal government under William Lyon Mackenzie King.

- by Gregory Marchildon
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- Environmental History, Canadian Political History, Drought, Agriculture

Studies have shown that anthocyanins present in berry fruits have some beneficial health effects such as reducing age-associated oxidative stress and possessing anti-inflammatory properties. Therefore, six Manitoba berries (wild blueberry, Saskatoon berry, raspberry, chokecherry, strawberry, and seabuckthorn) were studied for their anthocyanin compositions (mg/100 g) on dry weight basis. Saskatoon berry and wild blueberry showed a high content of total anthocyanins (562.4 and 558.3 mg/100 g, respectively) that were not significantly (P > 0.05) different from each other. The corresponding values for other berries: raspberry (365.2 mg/100 g), chokecherry (177.39 mg/100 g), and strawberry (97.5 mg/100 g) were significantly different from each other (P < 0.05), and the total anthocyanin content of seabuckthorn was negligible (0.84 mg/100 g). Fifteen major anthocyanins were isolated from Manitoba berries. Saskatoon berry and wild blueberry contained higher amounts of delphinidin 3-glucoside (Dp-3-glc), malvidin 3-glucoside (Mv-3-glc), and malvidin 3-galactoside (Mv-3-gal). Dp-3-glc was 263.8 (mg/100 g) in Saskatoon berry and 84.4 (mg/100 g) in wild blueberry, whereas the corresponding values for Mv-3-glc in these berries were 47.4 and 139.6 (mg/100 g), respectively. Raspberry, strawberry, and chokecherry contained higher amounts of cyanidin 3-glucoside (Cy-3-glc), cyanidin 3-rutinoside (Cy-3-rut), and pelargonidin 3-glucoside (Pg-3-glc). The total anthocyanin content of Manitoba fruits followed the order: Saskatoon berry and blueberry (high anthocyanin berries), raspberry and chokecherry (medium anthocyanin berries), strawberry (low anthocyanin berries), and seabuckthorn (negligible anthocyanin berries). This study demonstrated that Saskatoon berries and wild blueberries have high potential value for fruit growers as well as the food and nutraceutical manufacturers because of their high anthocyanin contents.

- by Trust Beta
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- Engineering, Manitoba, Pigments, Pigment

Background: Coleoptera is the most diverse order of insects (>300,000 described species), but its richness diminishes at increasing latitudes (e.g., ca. 7400 species recorded in Canada), particularly of phytophagous and detritivorous species. However, incomplete sampling of northern habitats and a lack of taxonomic study of some families limits our understanding of biodiversity patterns in the Coleoptera. We conducted an intensive biodiversity survey from 2006-2010 at Churchill, Manitoba, Canada in order to quantify beetle species diversity in this model region, and to prepare a barcode library of beetles for sub-arctic biodiversity and ecological research. We employed DNA barcoding to provide estimates of provisional species diversity, including for families currently lacking taxonomic expertise, and to examine the guild structure, habitat distribution, and biogeography of beetles in the Churchill region. Results: We obtained DNA barcodes from 3203 specimens representing 302 species or provisional species (the latter quantitatively defined on the basis of Molecular Operational Taxonomic Units, MOTUs) in 31 families of Coleoptera. Of the 184 taxa identified to the level of a Linnaean species name, 170 (92.4%) corresponded to a single MOTU, four (2.2%) represented closely related sibling species pairs within a single MOTU, and ten (5.4%) were divided into two or more MOTUs suggestive of cryptic species. The most diverse families were the Dytiscidae (63 spp.), Staphylinidae (54 spp.), and Carabidae (52 spp.), although the accumulation curve for Staphylinidae suggests that considerable additional diversity remains to be sampled in this family. Most of the species present are predatory, with phytophagous, mycophagous, and saprophagous guilds being represented by fewer species. Most named species of Carabidae and Dytiscidae showed a significant bias toward open habitats (wet or dry). Forest habitats, particularly dry boreal forest, although limited in extent in the region, were undersampled.

- by Dirk Steinke and +1
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- Evolutionary Biology, Ecology, Biodiversity, Phylogeny
- by Lisa Sattenspiel
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- Evolutionary Biology, Nutrition and Dietetics, Anthropology, Population Dynamics

OBJECTIVE: We examined medical, educational and social risks to children of teen mothers and children of nonadolescent mothers with a history of teen birth (prior teen mothers) and considered these risks at both the individual and... more

- by Leslie L. Roos
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- Medical Education, Adolescent, Social Class, Pregnancy

Risk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother's teenage childbearing or an older sister's teenage pregnancy more strongly predicts teenage pregnancy. This study used linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP). The original cohort consisted of 17,115 women born in Manitoba between April 1, 1979 and March 31, 1994, who stayed in the province until at least their 20(th) birthday, had at least one older sister, and had no missing values on key variables. Propensity score matching (1:2) was used to create balanced cohorts for two conditional logistic regression models; one examining the impact of an older sister's teenage pregnancy and the other analyzing the effect of the mother's teenage childbearing. The adjusted odds of becoming pregnant between ages 14 and 19 for teens with at least one older sister having a teenage p...

- by Leslie L. Roos
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- Nursing, Adolescent, Pregnancy, Manitoba

This study examined Pap test utilization, Pap test results, and cervical cancer incidence among First Nations (FN) women living in Manitoba, Canada taking into account age group, time period, and area of residence. Six population-based data sources were linked at an individual level. Negative binomial regression was used to compare Pap test utilization and results between FN and all other Manitoba (AOM) women. Poisson regression was used to compare cervical cancer incidence. Among women younger than 25 years, FN were more likely than AOM women to have had a Pap test (Rate Ratio (RR)=1.37, 95% Confidence Interval (CI) 1.22-1.53, 18-19 year olds; RR=1.17, 95% CI 1.05-1.31, 20-24 year olds). There was no difference in Pap test use for women 25-29 or 30-39 years. FN 40 years and older were less likely to have a Pap test than AOM women (RR=0.84, 95% CI 0.75-0.93, 40-49 years old; RR=0.71, 95% CI 0.63-0.79, 50-59 years old; RR=0.59, 95% CI 0.52-0.66, 60-69 years old). FN were more likely than AOM women to have a high (RR=1.88, 95% CI 1.65-2.13) or low-grade Pap test result (RR=1.60, 95% CI 1.48-1.73). The invasive cervical cancer incidence rate was double for FN women 25 to 39 years of age (21.9 per 100,000, FN; 10.2 per 100,000, AOM,

- by Natalie Biswanger
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- Geography, Cancer Prevention, Adolescent, Manitoba

The present study examined community/tribe, peer/family, and individual correlates of suicidal behaviour in a representative on-reserve sample of First Nations adolescents. Data came from the 2002-2003 Manitoba First Nations Regional Longitudinal Health Survey of Youth. Household interviews were conducted with adolescents ages 12-17 (n=1,125) from 23 First Nations communities in Manitoba.

- by Bruce Tefft
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- Depression, Adolescent, Child, Child Abuse
- by Leah Geller
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- Dementia, Aging, Transportation, Housing for the Elderly (Architecture)
- by Thomas Hack and +2
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- Nonparametric Statistics, Spirituality, Australia, Quality of life

We report on an ethnographic study of payment and banking practices in India. Currently a mobile payment mechanism is being developed in India and we were interested to see how it would fit with various current payment systems for various types of users. Therefore we studied a variety of current payment situations and gained an understanding of the banking and payment practices and needs of a diverse community. Our aim was to inform the development of interface elements, applications and services that would support the needs we uncovered. We describe our findings and the design ideas they provoked.

- by Jon Chorover
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- Nursing, Nutrition and Dietetics, Health Promotion, Health Behavior

Purpose Response shift (RS), a change in the meaning of an individual's self-evaluation of a target construct, such as health-related quality of life (HRQOL), can affect the interpretation of change in measures of the construct collected over time. This study proposes new statistical methods to test for reprioritization RS, in which the relative importance of HRQOL domains changes over time.

- by Tolu Sajobi and +1
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- Pain, Quality of life, Discriminant Analysis, Manitoba

Background and objectives: First Nations (FN) patients on peritoneal dialysis experience poor outcomes. Whether discrepancies exist regarding the microbiology, rate of infections, and outcomes between FN and non-FN peoples remains unknown. Design, setting, participants, & measures: All adult peritoneal dialysis patients (n ‫؍‬ 727) from 1997 to 2007 residing in Manitoba, Canada, were included. Parametric and nonparametric tests were used as necessary. Negative binomial regression was used to determine the relationship of rates of exit site infections (ESIs) and peritonitis between FN and non-FN peoples. Results: A total of 161 FN and 566 non-FN subjects were included in the analyses. The unadjusted relative rates of peritonitis and ESIs in FN subjects were 132.7 and 86.0/100 patient-years compared with 87.8 and 78.2/100 patient-years in non-FN populations, respectively. FN subjects were more likely to have culture-negative peritonitis (36.5 versus 20.8%, P < 0.0001) and Staphylococcus ESIs (54.1 versus 32.9%, P < 0.0001). The crude and adjusted rates of peritonitis were higher in FN subjects for total episodes and culture-negative and gram-negative peritonitis. Catheter removal because of peritonitis was similar in both groups (42.9 versus 38.1% for FN and non-FN subjects, respectively; P ‫؍‬ 0.261).

- by Paul Komenda
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- Risk assessment, Manitoba, Regression Analysis, Risk factors

Objectives: To identify predictors of survival in a retrospective multicentre cohort of patients with cardiogenic shock undergoing coronary angiography and to address whether complete revascularization is associated with improved survival in this cohort. Background: Early revascularization is the standard of care for cardiogenic shock. Coronary bypass grafting and percutaneous intervention have complimentary roles in achieving this revascularization. Methods: A total of 210 consecutive patients (mean age 66 6 12 years) at two tertiary centres from 2002 to 2006 inclusive with a diagnosis of cardiogenic shock were evaluated. Univariate and multivariate predictors of in-hospital survival were identified utilizing logistic regression. Results: ST elevation infarction occurred in 67% of patients. Thrombolysis was administered in 34%, PCI was attempted in 62% (88% stented, 76% TIMI 3 flow), CABG was performed in 22% (2.7 grafts, 14 valve procedures), and medical therapy alone was administered to the remainder. The overall survival to discharge was 59% (CABG 68%, PCI 57%, medical 48%). Independent predictors of mortality included complete revascularization (

- by D. ROBERTS
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- Risk assessment, Catheterization, Manitoba, Registries

- by Thomas Hack and +2
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- Sociology, Anthropology, Death, Palliative Care
- by Lori Wazny, Pharm.D.
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- Calcium, Treatment Outcome, Phosphorus, Manitoba

The assessment of the adequacy of sampling locations is an important aspect in the validation of an effective and efficient water quality monitoring network. Two geostatistical approaches (e.g., kriging and Moran's I) are presented to assess multiple sampling locations. A flexible and comprehensive framework was developed for the selection of multiple sampling locations of multiple variables which was accomplished by coupling geostatistical approaches with principal component analysis (PCA) and fuzzy optimal model (FOM). The FOM was used in the integrated assessment of both multiple principal components and multiple geostatistical approaches. These integrated methods were successfully applied to the assessment of two independent water quality monitoring networks (WQMNs) of Lake Winnipeg, Canada, which respectively included 14 and 30 stations from 2006 to 2010.

- by Bahaa Khalil
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- Spatial Analysis, Fuzzy Logic, Water quality, Principal Component Analysis

Background. Estimates of US childhood asthma prevalence were affected by the 1997 National Health Interview Survey (NHIS) redesign. In 1997, only 5.5% of children were estimated to have asthma compared with 7.5% in 1995. The contribution of the survey redesign to this reported decline is unknown. Objective. To examine the impact of the NHIS 1997 redesign on childhood asthma prevalence estimates. Methods. In 1988, 50% of children from the core NHIS participated in a Child Health Supplement (CHS). The CHS questions differ from those in the core NHIS and are similar to the new asthma questions used in the 1997 NHIS. First, childhood asthma prevalence estimates from the 1988 core NHIS and the CHS were directly compared. A second comparison was limited to the sample participating in both the core NHIS and the CHS. For this sample, the percent difference between core NHIS and CHS estimates was calculated for 6 race/age strata (black and white, ages 0-4, 5-10, and 11-17 years). The 1997 estimates for each stratum were adjusted by these differences, and a new adjusted 1997 estimate was produced using the 1997 population distribution for each stratum. Results. The first method resulted in an 18.6% difference between asthma prevalence estimates from the 1988 core NHIS and CHS (5.1% vs. 4.3%). Simply inflating the 1997 asthma prevalence estimate of 5.5% by 18.6% yielded an adjusted estimate of 6.5%. The second stratification method produced an adjusted 1997 asthma prevalence estimate of 7.3%. Conclusion. The redesigned NHIS likely produces lower asthma prevalence estimates than the previous NHIS. Adjusting the 1997 estimate to compensate for the redesign suggests that childhood asthma prevalence has plateaued since 1995, not declined.

- by Michael Moffatt
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- Adolescent, Multivariate Analysis, Pregnancy, Smoking
- by Colleen Metge and +1
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- Adolescent, Medicine, Schools, Pregnancy
- by Barbara Triggs-raine
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- Information Systems, Genetics, Genomics, Haplotypes