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The prevalence of vision disorders is high among geriatric and hospital inpatient populations, yet they often go undetected, resulting in consequences such as falls or prolonged recovery time. A needs assessment study was conducted to investigate levels of vision and the potential prevalence of unmanaged/undiagnosed ocular disorders among adult inpatients in a hospital-based rehabilitation unit. Cross-sectional study. Inpatient rehabilitation units of an acute care hospital system in Ontario, Canada. Adults (n = 112) in a hospital inpatient rehabilitation unit participated from October 2018 to February 2019. Participants were surveyed regarding their demographic, ocular, and medical data and spectacle wear. Visual acuity, contrast sensitivity, visual fields, and stereoacuity plus the spectacle condition were directly assessed. The majority (75%) were found to have reduced habitual vision while in hospital. Nearly 60% of participants reported at least some difficulty reading a newspaper or distinguishing a face or were "not happy with their vision." This was despite 80% of participants reporting that they had an eye care practitioner and 70% that they had an eye examination within the last 2 years. More than half (51.8%) of the participants received the recommendation to follow up with their eye care practitioner on discharge from the hospital. Reduced vision and vision disorders has a high prevalence among hospital patients in rehabilitation units and should be evaluated at or soon after hospital intake. By incorporating vision screening tools, necessary precautions may be taken to avoid possible falls and promote recovery. [ABSTRACT FROM AUTHOR]

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To describe the sociodemographic, clinical, and treatment characteristics of people who are comatose in Canadian complex continuing care (CCC) and long-term care (LTC) settings, and to make recommendations to promote comprehensive care planning for this population. Retrospective, cross-sectional analysis of population data. All residents in the Canadian provinces of Alberta, Ontario, British Columbia, Manitoba, Nova Scotia, Newfoundland, Saskatchewan, and the territory of Yukon with data available from the fiscal year 2015 (April 1, 2015, to March 31, 2016). Demographic, clinical, and treatment variables were extracted from the Resident Assessment Instrument–Minimum Data Set (MDS 2.0) and were reported using descriptive statistics. Of the LTC and CCC populations, 0.07% and 3.5% were identified as comatose, respectively. Overall, people who are comatose in both CCC or LTC settings are younger and have a longer length of stay than those who are not comatose. A higher proportion of people who are comatose experience active infections and irregular bowel elimination patterns, and those who are comatose were more likely to have a feeding tube and require oxygen therapy or suctioning than those who were not comatose. However, a lower proportion of people who were comatose had documented pain. In LTC, one-quarter of people who are comatose are expected to die within 6 months. Although the prevalence of people who are comatose in LTC and CCC settings is low, this population is complex and has significant care needs that require comprehensive assessment and care planning. [ABSTRACT FROM AUTHOR]

Objective: To assess the nature of the guidance on fiber, a nutrient for which many Canadians' intakes are suboptimal, provided by manufacturers' use of front-of-package references on food in Canadian supermarkets. Design/Setting: Survey of all prepackaged food sold in 3 large supermarkets in Toronto. Variables Measured: Front-of-package references to fiber and other forms of nutrition-related marketing were recorded from all products. For a subsample of breads, Nutrition Facts table information was also collected. Analysis: Descriptive statistics; t test. Results: Front-of-package references to fiber were found on 6% of all foods, but large proportions of high fiber foods bore no front-of-package references to fiber. Many foods making a reference to fiber (17%) are "foods to limit," according to Canada's Food Guide. Front-of-package references to fiber were declared in at least 30 different ways, and 31% used unregulated language. Among breads, use of regulated language was associated with higher fiber content. Conclusions and Implications: Consumers may be faced with challenges in seeking out healthful sources of fiber in the grocery store, given the complexity of existing front-of-package nutrition-related marketing and limited references to fiber in some categories. This work suggests that current nutrition- related marketing cannot function as a substitute for nutrition education. [ABSTRACT FROM AUTHOR]

Abstract: We compared the stability of kinship and non-kin foster placements in the cases handled by one Ontario (Canada) child protection agency in 2008–2010. Non-kin placements were four times more likely than kin placements to end within the first month; this difference then decreased, but kin placements remained significantly more stable in months 2 through 6. Kin placements were also more likely to end successfully by discharge to parents, whereas non-kin placements were much more likely to end because the child moved to another placement. Children''s ages did not differ between placement types, and the stability difference persisted when children who had been physically or sexually abused were distinguished from those who had not. Within kin placements, those that were preceded by a non-kin foster placement were more stable than those that were not, and those involving genealogical, marital or adoptive links of kinship were more stable than placements with unrelated nominal “kin”. Our results generally support the current policy preference for kin placements, but we conclude by discussing why cautious interpretation remains warranted. [Copyright &y& Elsevier]

To demonstrate the usefulness of primary data collection using clinician-rated and self-rated standardized measures to describe adult day program (ADP) populations and address programming issues such as identifying members at risk of dropping out. One ADP in London, Ontario, and 2 ADPs in Toronto, Ontario, Canada. A total of 223 community-dwelling older adults were recruited across the 3 different programs. The interRAI Community Health or Home Care Assessment and self-rated psychosocial assessments were collected on program enrollment. Data analyses included descriptive statistics, comparison of the populations between ADPs, and multinomial regression models to assess reasons for program withdrawal. Mean ages across the 3 programs ranged from 78.3 to 83.8 years and the proportion of women ranged from 49.3% to 56.6%. Compared with one of the ADPs, members from 2 other ADPs exhibited higher use of mobility aids (P <.001), higher levels of cognitive impairment (P <.05), increased risk for institutionalization (P <.001), lower levels of depression (P <.01), and greater need for supervision for basic and instrumental activities of daily living (P <.01). Members assessed to be at higher risk for institutionalization and have increased medical complexity showed possible association with program withdrawal at one ADP. The tools were useful in identifying differences in physical and psychosocial characteristics of members across the 3 ADPs. Information collected from interRAI and self-rated psychosocial assessments may be helpful in the development of individualized care plans, program services, and recommendations that target transitional care. By understanding member profiles and reasons for withdrawal, ADPs may be able to develop strategies to help members stay in the program and live in the community longer. [ABSTRACT FROM AUTHOR]

This study aimed to investigate if exercise therapy and polypharmacy was associated with frailty state transitions for home care service recipients. Longitudinal cohort-study using client-level health information collected using interRAI home care (RAI-HC) assessments. Population-based study with Canadian home care clients in Alberta, British Columbia, Ontario and the Yukon. Home care clients aged 65 years and older. A Markov chain multistate transition logistic regression model was used to calculate ORs for state transitions with exercise therapy and polypharmacy as independent variables. In total, 250,428 home care clients experiencing 402,005 frailty state transitions were included in the analyses. At baseline, 39.4% of clients were categorized as nonfrail, 30.2% were categorized as prefrail, and 30.4% were categorized as frail. Nonfrail clients using polypharmacy were more likely to become prefrail (OR 1.16) and frail (OR 1.11). Pre-frail clients using polypharmacy were more likely to become frail (OR 1.06), and they were less likely to become nonfrail (OR 0.80). Frail clients using polypharmacy were significantly less likely to become prefrail (OR 0.82) or nonfrail (OR 0.62). Nonfrail clients who participated in exercise therapy were more likely to become prefrail (OR 1.05). Prefrail clients who participated in exercise therapy were more likely to become nonfrail (OR 1.26). Frail clients who participated in exercise therapy were more likely to become nonfrail (OR 1.27) and prefrail (OR 1.12). This study suggests that frailty among home care clients can be reversed. Frailty state improvement occurred significantly more often among home care clients receiving exercise therapy and significantly less often among clients with polypharmacy. [ABSTRACT FROM AUTHOR]

Abstract Objectives To examine whether several food purchasing behaviors (ie, sources of meals or snacks) are associated with adolescents' sugar-sweetened beverage (SSB) consumption and whether these associations vary by province. Design Cross-sectional observational study. Setting Alberta and Ontario, Canada. Participants Secondary school students from Alberta (n = 3,300) and Ontario (n = 37,999) participating in year 2 (2013–2014) of the Cannabis Use, Obesity, Mental Health, Physical Activity, Alcohol Use, Smoking, Sedentary Behavior (COMPASS) study. Main Outcome Measures Participants' self-reported frequency of consuming 3 SSB types (soft drinks, sweetened coffees/teas, and energy drinks) in a typical week. Analysis Hierarchical Poisson regression analyses. Results Participants from Alberta had a significantly ( P <.05) higher rate of consuming SSBs and purchasing meals or snacks from school food outlets compared with their Ontario counterparts. Most of the food purchasing behaviors were significantly ( P <.05) and positively associated with greater rates of SSB consumption. Meal or snack purchases on weekends (vs weekdays) and from food outlets off school property (vs on school property) had a greater association with SSB consumption. Eating a home-packed lunch was protective against SSB consumption across models. Conclusions and Implications Adolescents' food purchasing behaviors have a significant impact on their propensity for SSB consumption. These data demonstrate potentially important contexts for SSB consumption and have implications for possible settings and strategies for future interventions to reduce adolescents' SSB intake. [ABSTRACT FROM AUTHOR]