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Background: Good nutrition and access to healthy foods are essential for child growth and development. However, there are concerns that Canadian children do not have a healthy diet, which may be related to dietary choices as well as lack of access to healthy foods. The FANS (Food and Nutrition Security for Children and Youth) study examined the nutrition and food security status of youth in the province of Manitoba, Canada. This paper describes methods, dietary intakes, and body mass index for the FANS study. Methods: This cross-sectional study included 1587 Manitoba grade nine students who completed a self-administered web-based survey. Data was collected on demographic characteristics, dietary intake (24-h recall), food behaviors, food security, and self-report health indicators. Dietary data was compared to national dietary guidelines (Dietary Reference Intakes and Canada's Food Guide). Mean and median nutrient and food group intakes were calculated with corresponding measures of variability. Chi-square tests compared percentage of respondents not meeting key nutrients and food groups. Significant differences in percentage of total servings for each food group were determined by a Kruskal–Wallis test, and differences between different caloric groups were assessed using Dunn's test for post-hoc comparisons. Results: Half of study respondents were female (50.5%). Median energy intake was higher in males (2281 kcal) compared with females (1662 kcal), with macronutrient distribution of 52%, 16%, and 32% for carbohydrates, protein, and fats respectively. Most participants consumed inadequate fibre (94%), vitamin D (90%), and calcium (73%), while median sodium intakes exceeded recommendations for males but not females. A majority of participants did not meet Health Canada's recommendations for food group servings: Vegetables and Fruit (93%), Milk and Alternatives (74%), Meat and Alternatives (57%) and Grain Products (43%). Other Foods, including sugar sweetened beverages and juice, were consumed by most participants. Higher energy consumers had a greater proportion of food servings coming from Other Foods. 72.1% of students were classified as having a healthy weight and 25% were classified as overweight or obese. Conclusion: Poor dietary intakes and body mass index values indicate an urgent need for policy and program strategies to support healthy eating habits and food awareness in Manitoba youth. [ABSTRACT FROM AUTHOR]

As a result of the colonization of Canada, Metis have faced many political and socioeconomic challenges, one of which is the lower educational achievement of Metis students vs other Canadian students. In this study, we examined whether full-time kindergarten (FTK) vs half-time kindergarten (HTK) was associated with improved educational outcomes for Metis students in Manitoba using linked, population-based administrative data from 1998/99-2012/13. The cohort included 271 FTK and 405 HTK Metis students. We used generalized linear models with binomial distribution to calculate predicted probabilities and risk ratios for the outcomes (assessments of numeracy and literacy in Grades 3, 7 and 8; student engagement in Grade 7; high school graduation). However, we observed no significant differences in outcomes between FTK and HTK students, suggesting that FTK is not sufficient to overcome the structural barriers to academic success Metis students may face. [ABSTRACT FROM AUTHOR]

Background: Electronic Medical Records (EMRs) are a rich data source to measure and improve quality of care. As Canadian primary health care (PHC) EMRs mature, there is increasing potential use of EMR data for performance measurement. This study identifies and describes current uses of EMR data for performance measurement and considerations to further its potential in the Canadian context.Methods: We applied a qualitative case study design and descriptive assessment in three phases, consulting multiple data sources including scientific and grey literature, system leaders (n = 41), and clinician/researchers (n = 20). Phases included a multimethod approach to identify initiatives using EMR data for performance measurement across Canadian jurisdictions; in-depth review of current initiatives identified from a healthcare performance intelligence lens; and triangulation and thematic analysis across data sources to explore considerations for advancing performance measurement uses of EMR data in the Canadian context.Results: Six initiatives of EMR data use for performance measurement were identified: one multi-jurisdictional; five jurisdiction-specific in the provinces of British Columbia, Manitoba and Ontario. EMR data uses were predominately for micro-level PHC physician and team performance improvement, with some use for meso-level organization/network-wide improvement. Indicator sets varied in number, though shared emphasis on chronic disease management and prevention/screening and to a lesser extent medication management. Key considerations for governing, resourcing and implementing EMR data for performance measurement were identified.Conclusions: The extent of EMR data use for performance measurement varies across Canada. To further its potential, pan-Canadian data and privacy standards, performance intelligence competencies and renewed core PHC indicators should be prioritized. Experiences across countries, coupled with increasing momentum for performance measurement using real-world data, should be leveraged to avoid unnecessarily slow progress in Canada and abroad. [ABSTRACT FROM AUTHOR]

Individuals with cancer are vulnerable to infection with SARS-CoV-2, the virus causing COVID-19. Physical distancing, the reallocation of health care resources, and the implementation of procedures to reduce the spread of COVID-19 may also have serious consequences for people with cancer. We evaluated the impact of COVID-19 on new cancer diagnoses and oncology care in Manitoba, Canada using an interrupted time series design and data from the Manitoba Cancer Registry and CancerCare Manitoba's (CCMB) electronic medical record. In April 2020, there was a 23% decrease in new cancer diagnoses, a 21% decrease in pathology reports, and a 43% reduction in surgical resections. There was no difference in new cancer diagnoses by August 2020, surgery by July 2020, and pathology reports by September 2020. From April 2020 to June 2021, there was a 13% decrease in radiotherapy (RT) fractions, an 18% decrease in UCC visits, and a 52% decrease in in-person visits. There was no change in intravenous chemotherapy visits per month, first RT visits, or overall patient visits. The impact of COVID-19 on shifts in the stage at diagnosis and survival will be assessed in future analyses. [ABSTRACT FROM AUTHOR]

Worldwide, Indigenous teens die by suicide and have more suicidal attempts than any other adolescent population and are overrepresented in every suicide statistic category. This study provides a new lens to look at Indigenous youth suicide through the perspectives of their parents, thereby giving them a voice in prevention and interventions. The findings of this qualitative study show that to help with their healing process, Indigenous parents require a connection to spirituality and culture, social supports, and an understanding that healing is lifelong, after the death or attempt of suicide by their child. Recommendations from this study are that Western systems adapt to focus on spirituality and culture in healing, as well as promote the destigmatization of suicide within Indigenous communities so that social supports can increase for parents who have experienced loss by suicide or suicide attempts by their children. In addition, professional helpers require more training in loss and grief, culturally relevant healing practices, and need to centre Indigenous knowledge in the creation of future intervention and postvention services. [ABSTRACT FROM AUTHOR]

Overwater nesting structures for ducks have been used primarily to increase mallard (Anas platyrhynchos) production where success of ground-nesting hens was low (<1 5%), such as in the Prairie Pothole Region (PPR) in North America. However, managers have inquired about recommended numbers of nest structures for small wetlands (i.e., <2 ha) based on duck-production and benefit-cost evaluations, but such data were not avail- able. Therefore, we conducted an experiment in the PPR in Manitoba, Canada, in 2001 and 2002 to test the effects of different treatment numbers of nest structures/wetland (1, 2, or 4) and wetland area (≤0.4 or 0.45-1.5 ha) on use of structures by nesting ducks, nest success, and number of ducklings produced, as well as to evaluate cost-benefits of the structures. Across duck species, mean use of structures by nesting hens increased 56% between years (F1,107=14.29, P<0.001); however, by year 2 use did not differ among treatment numbers of structures and averaged 78% (t157=-0.15-1.08, P#x2265;0.28). Apparent nest success averaged 99% across treatment numbers of structures in 2001, but it did not differ among treatments (F2,72 = 0.93, P=0.40) and decreased to an overall 48% in 2002, largely due to egg predation by corvids. Mean number of ducklings departing structures did not vary between years (F1,54 = 2.38, P = 0.13), but treatment number of structures influenced mean number of ducklings (pooled over 2001 and 2002) exiting structures (F2,54=4.54, P = 0.02). Mean numbers of ducklings departing 1 and 2 structures/wetland did not differ (t54=0.29, P=0.77; pooled X...=4.61 ducklings), but each respective mean was nearly twice that from 4 structures/wetland (t54 = 2.26-2.51, P≤0.03). Neither wetland area nor any interactions influenced any analysis (F1-2,54-157=0-1.11, P≥0.33). We concluded that 2 structures/wetland was cost-effective ($2.16/fledged duc < [U.S.]) for consideration among other management strategies to increase nest success of mallards in the PPR; however, managers should monitor duckling production from structures to determine whether our initial recommendation from a single study area warrants change. [ABSTRACT FROM AUTHOR]

Objectives: To assess the ability of an Adjusted Clinical Group (ACG)-based morbidity measure to assess the overall health service needs of populations. Data Sources/Study Setting. Three population-based secondary data sources: registration and health service utilization data from fiscal year 1995-1996; mortality data from vital statistics reports from 1996-1999; and Canadian census data. The study included all continuously enrolled residents in the universal health care plan in Manitoba.Study Design: Using 60 small geographic areas as the units of analysis, we compared a population-based "ACG morbidity index," derived from individual ACG assignments in fiscal year 1995-1996, with the standardized mortality ratio (ages < 75 years) for 1996-1999. Key variables included a population-based socioeconomic status measure and age- and sex-standardized physician utilization ratios.Data Extraction Methods: The ACGs were assigned based on the complement of diagnoses assigned to persons on physician claims and hospital separation abstracts. The ACG index was created by weighting the ACGs using average health care expenditures.Principal Findings: The ACG morbidity index had a strong positive linear relationship with the subsequent rate of premature death in the small areas of Manitoba. The ACG index was able to explain the majority of the relationships between mortality and both socioeconomic status and physician utilization.Conclusions: In Manitoba, ACGs are closely related to premature mortality, commonly accepted as the best single indicator for health service need in populations. Issues in applying ACGs in settings where needs adjustment is a primary objective are discussed. [ABSTRACT FROM AUTHOR]