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OBJECTIVES: The purpose of this study is to estimate and compare smoking prevalence over two time periods in a Manitoba First Nation community. METHODS: Data from two independent Diabetes Screening Studies in Sandy Bay First Nation, collected in 2002/2003 (n = 482) and 2011 /2012 (n = 596), were used. Crude prevalence of current and ever smoking as well as current smoke exposure was estimated. Change over time was tested using a [chi square] statistic. RESULTS: The crude prevalence of current smoking was 74.0% (95% confidence interval [CI]: 70.1, 78.0) in 2002/2003 and 80.0% (95% CI: 76.8, 83.2) in 2011/2012. The crude prevalence of ever smoking was 83.0% in 2002/2003 and 91.4% in 2011/2012. The prevalence of both current smoking status and ever smoking were significantly higher in 2011/2012 compared to 2002/2003 (p = 0.020 and p < 0.001 respectively). Among participants who were not current smokers, 58.5% (95% CI: 49.6, 67.4) and 76.5% (95% CI: 68.9, 84.1) reported at least one person who smoked in the home in 2002/2003 and 2011/2012 respectively (p = 0.003). In 2011/2012, 96.5% (95% CI: 94.8, 98.2) of those who reported having any children under the age of 18 living in the home were either a current smoker and/or reported that someone else smoked in the home. CONCLUSION: Public health and policy initiatives are needed to address the increase in smoking prevalence in the study community. KEY WORDS: Smoking; First Nation; Aboriginal; community-based participatory research; sovereignty OBJECTIFS: L'objectif de l'etude est d'estimer et de comparer la prevalence de la cigarette pendant deux periodes dans une collectivite des Premieres Nations au Manitoba. METHODES: Ce sont les donnees de deux Enquetes sur le depistage du diabete dans la Premiere Nation de Sandy Bay recueillies en 2002-2003 (n=482) et en 2011-2012 (n=596) qui ont servi. On a estime la prevalence brute de la cigarette actuelle et jusqu'aujourd'hui de meme que l'exposition actuelle a la fumee. Le changement au fil du temps a ete teste au moyen de la statistique [chi square]. RESULTATS: La prevalence brute actuelle de la cigarette etait de 74,0% (intervalle de confiance [IC] de 95%: 70,1, 78,0) en 2002-2003 et de 80,0% (IC de 95%: 76,8, 83,2) en 2011-2012. La prevalence brute de la cigarette jusqu'aujourd'hui etait de 83,0% en 2002-2003 et de 91,4% en 2011-2012. La prevalence de la cigarette actuelle et jusqu'aujourd'hui etait sensiblement superieure en 2011-2012 par rapport a 2002-2003 (p = 0,020 et p < 0,001 respectivement). Parmi les participants qui ne fumaient pas a ce moment, 58,5% (IC de 95%: 49,6, 67,4) et 76,5% (IC de 95%: 68,9, 84,1) ont declare qu'au moins une personne fumait au foyer en 2002-2003 et en 2011-2012 respectivement (p = 0,003). En 2011-2012, 96,5% (IC de 95%: 94,8, 98,2) de ceux qui declaraient avoir un enfant de moins de 18 ans qui vivait au foyer fumaient ou declaraient que quelqu'un fumait au foyer, ou les deux. CONCLUSION: Des initiatives de sante publique ou politiques sont essentielles pour traiter la prevalence accrue de la cigarette dans la collectivite de l'etude. MOTS CLES: cigarette; Premiere Nation; autochtone; recherche participative axee sur la collectivite; souverainete La traduction du resume se trouve a la fin de l'article. Can j Public Health 2015;106(4):e184-e188 doi: 10.17269/CJPH.106.4940, The harmful effects of smoking are well established and include damage to cardiovascular, respiratory and metabolic systems and development of certain cancers. (1-4) In the general populations of the United [...]

Background: Evidence for a relationship between oxidative stress and osteoporotic fractures in humans is limited. Fluorescent oxidation products (FlOPs, excitation/emission wavelengths 320/420nm denoted FlOP_320; 360/420nm [FlOP_360]; and 400/475nm [FlOP_400]) are global biomarkers of oxidative stress, and reflect oxidative damage to proteins, phospholipids, and nucleic acids. We investigated the association between FlOPs and a recent osteoporotic fracture. Methods: We conducted a case-control study in a Chinese population aged 50 years or older. A recent osteoporotic fracture in the cases was confirmed by x-ray. Cases were matched with community-based non-fracture controls (1:2 ratio) for age (± 4 years) and sex. In addition, we conducted a sensitivity unmatched casecontrol study which included all fracture cases and all eligible non-fracture controls prior to matching. Plasma FlOPs were measured with a fluorescent microplate reader. We used unconditional logistic regression to analyze the association between FlOPs (per 1-SD increase in logarithmic scale) and fracture; odds ratios (OR) and 95% confidence intervals (95% CI) were reported. Results: Forty-four cases and 88 matched controls (mean age: 68.2 years) were included. After covariate adjustment (i.e., body mass index, physical activity, and smoking), higher FlOP_360 (OR = 1.85; 95% CI = 1.03 - 3.34) and FlOP_400 (OR = 13.29; 95% CI = 3.48 - 50.69) levels, but not FlOP_320 (OR = 0.56; 95% CI = 0.27 - 1.15), were associated with increased fracture risk. Subgroup analyses by fracture site and unmatched case-control study found comparable associations of FlOP_360 and FlOP_400 with hip and non-hip fractures. Conclusions: Higher FlOP_360 and FlOP_400 levels were associated with increased risk of fracture, and this association was comparable for hip and non-hip fractures. Prospective studies are warranted to confirm this finding. [ABSTRACT FROM AUTHOR]

Objective: To study the association between prematurity and grade 3 school performance in a contemporary cohort of children.Methods: Population-based retrospective cohort study in Manitoba, Canada. Children born between 1999 and 2011 who had their grade 3 school performance data available were eligible. Preterm birth (<37 weeks) was the exposure of interest assessed using multivariable logistic regression models. Our primary outcomes were 'needs ongoing help' or 'outside the range' in at least two of each of the (1) four numeracy and (2) three reading competencies.Results: Of the 186 956 eligible children, 101 436 children (7187 preterm (gestational age, median (IQR) 35 weeks (34, 36)) and 94 249 term (40 weeks (39,40)) were included. Overall, 19% of preterm and 14% of term children had the numeracy outcome (adjusted OR (aOR) 1.38; 95% CI 1.29 to 1.47, p<0.001), while 19% and 13% had the reading outcome (aOR 1.38; 1.29 to 1.48, p<0.001). These differences showed a gestational age gradient. Gestational age (for numeracy, <28 weeks aOR 4.93 (3.45 to 7.03), 28-33 weeks 1.72 (1.50 to 1.98), 34-36 weeks 1.24 (1.15 to 1.34); for reading, <28 weeks 3.51 (2.40 to 5.14), 28-33 weeks 1.72 (1.49 to 1.98), 34-36 weeks 1.24 (1.17-1.37)), male sex, small for gestational age and maternal medical and sociodemographic factors were associated with the numeracy and reading outcomes in this cohort.Conclusions and Relevance: Children born preterm had poorer performance in grade 3 numeracy and reading proficiencies than children born full term. All children born preterm, not just those born extremely preterm, should be screened for reading and numeracy performance in school and strategies implemented to address any deficits. [ABSTRACT FROM AUTHOR]

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The approximate degrees of freedom Welch-James (WJ) and Brown-Forsythe (BF) procedures for testing within-subjects effects in multivariate groups by trials repeated measures designs were investigated under departures from covariance homogeneity and normality. Empirical Type I error and power rates were obtained for least-squares estimators and robust estimators based on trimming/Winsorization. The BF and WJ procedures with least-squares estimators produced comparable Type I error rates for the main effect. For the interaction, the former could become conservative, while the latter was liberal when sample sizes were small. When robust estimators were adopted, the WJ test generally controlled the error rate while the BF test was conservative. Both procedures had similar power for the main effect test, while the WJ procedure was more powerful for tests of the interaction when covariances were heterogeneous.

Three approaches to the analysis of main and interaction effect hypotheses in nonorthogonal designs were compared in a 2 x 2 design for data that was neither normal in form nor equal in variance. The Welch-James test with trimmed means and Winsorized variances provided excellent Type I error control. (SLD)

Comparison of six procedures to test for location equality among two or more groups when population variances are heterogeneous suggests that, when the variance homogeneity and normality assumptions are not satisfied, and the design is unbalanced, the use of any of these test statistics with the usual least squares estimators is not recommended. (SLD)

Context: FRAX® estimates 10-year fracture probability from osteoporosis-specific risk factors. Medical comorbidity indicators are associated with fracture risk but whether these are independent from those in FRAX is uncertain. Objective: We hypothesized Johns Hopkins Aggregated Diagnosis Groups (ADG®) score or recent hospitalization number may be independently associated with increased risk for fractures. Methods: This retrospective cohort study included women and men age =40 in the Manitoba BMD Registry (1996-2016) with at least 3 years prior health care data and used linked administrative databases to construct ADG scores along with number of hospitalizations for each individual. Incident Major Osteoporotic Fracture and Hip Fracture was ascertained during average follow-up of 9 years; Cox regression analysis determined the association between increasing ADG score or number of hospitalizations and fractures. Results: Separately, hospitalizations and ADG score independently increased the hazard ratio for fracture at all levels of comorbidity (hazard range 1.2-1.8, all P<0.05), irrespective of adjustment for FRAX, BMD, and competing mortality. Taken together, there was still a higher than predicted rate of fracture at all levels of increased comorbidity, independent of FRAX and BMD but attenuated by competing mortality. Using an intervention threshold of major fracture risk >20%, application of the comorbidity hazard ratio multiplier to the patient population FRAX scores would increase the number of treatment candidates from 8.6% to 14.4%. Conclusion: Both complex and simple measures of medical comorbidity may be used to modify FRAX-based risk estimates to capture the increased fracture risk associated with multiple comorbid conditions in older patients. [ABSTRACT FROM AUTHOR]

Estimates of longitudinal change in the parameters of latent (i.e. unobserved) variables, including means, are affected by non-response on the items or indicators of the latent variable. This study used Monte Carlo simulation and a numeric example to compare four ordinal item non-response methods: non-negative matrix factorization (NNMF), multiple imputation with conditional proportional odds model (POM), full information maximum likelihood (FIML) and complete-case analysis, when estimating the longitudinal change in latent variable means. The mean squared error for the NNMF method was more than 40% lower than for the FIML and POM methods when the latent variable correlations over time were strong, percentage of missing data was 25% or more, and sample size was large. The NNMF method is a promising method to address item non-response. It is relatively efficient when sample size is large, and the percentage of missing data is high but has limitations under other data-analytic conditions. [ABSTRACT FROM AUTHOR]