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Objectives: The aetiology of mental disorders involves genetic and environmental factors, both reflected in family health history. We examined the intergenerational transmission of multiple mental disorders from parents and grandparents using population-based, objectively measured family histories. Methods: This population-based retrospective cohort study used administrative healthcare databases in Manitoba, Canada and included adults living in Manitoba from 1977 to 2020 with linkages to at least one parent and one grandparent. Index date was when individuals turned 18 or 1 April 1977, whichever occurred later. Mental disorder diagnoses (mood and anxiety, substance use and psychotic disorders) were identified in individuals, parents and grandparents from hospitalization and outpatient records. Cox proportional hazards regression models included sociodemographic characteristics, individual's comorbidity and mental disorder history in a grandparent, mother and father. Results: Of 109,359 individuals with no mental disorder prior to index date, 47.1% were female, 36.3% had a mental disorder during follow-up, and 90.9% had a parent or grandparent with a history of a mental disorder prior to the index date. Both paternal and maternal history of a mental disorder increased the risk of the disorder in individuals. Psychotic disorders had the strongest association with parental history and were mostly influenced by paternal (hazards ratio [HR] 3.73, 95% confidence interval [CI] 2.99 to 4.64) compared to maternal history (HR 2.23, 95% CI, 1.89 to 2.64). Grandparent history was independently associated with the risk of all mental disorders but had the strongest influence on substance use disorders (HR 1.42, 95% CI, 1.34 to 1.50). Conclusions: Parental history of mental disorders was associated with an increased risk of all mental disorders. Grandparent history of mental disorders was associated with a small risk increase of the disorders above and beyond parental history influence. This three-generation study further highlights the need for family-based interventional programs in families affected by mental disorders. Plain Language Summary Title: The Intergenerational Transfer of Mental Illnesses Plain Language Summary: Objectives: Both genetics and environmental factors, such as poverty, maltreatment and parental education, have a role in the development of mental illnesses. Some genetic and environmental risk factors for mental illnesses are shared within families. We conducted a large study to test the extent to which mental illnesses are passed down through generations. Methods: This study used healthcare data from Manitoba, Canada captured during the delivery of healthcare services for administrative purposes. These data included all adults from 1977 to 2020 who had at least one parent and one grandparent with linked data. Mental illnesses were diagnosed in individuals, parents and grandparents by doctors during hospitalizations or physician visits. The illnesses included mood and anxiety, substance use, and psychotic illnesses. We estimated the likelihood of developing a mental illness when parents and/or grandparents had a mental illness as well. Results: The study included 109,359 individuals; a third developed a mental illness during the study period. The majority had a history of a mental illness in a parent or grandparent. We found that a history of mental illness in a mother and father increased the chance of developing the illness. Psychotic illnesses had the strongest relation with parental history. In particular, having a father with a psychotic illness increased the chance of developing the illness by four times. The likelihood of developing a mental illness was higher if a grandparent had a mental illness, above and beyond parental history influence, particularly for substance use disorders. Conclusions: Having a parent or grandparent with a mental illness increases an individual's chance of developing a mental illness. Family-based intervention programs are needed to support families affected by mental illnesses in coping with their heavy burden. [ABSTRACT FROM AUTHOR]

Introduction. Des recherches antérieures ont suggéré que le mode de rémunération des médecins peut avoir une influence sur l’exhaustivité des demandes de remboursement lors de l’estimation des maladies chroniques. Le but de cette étude est d’estimer l’exhaustivité des données sur la facturation des médecins dans l’optique de déterminer des cas de diabète. Méthodologie. Nous avons utilisé les données administratives de huit provinces canadiennes pour la période du 1er avril 2014 au 31 mars 2016. Nous avons divisé la cohorte de patients en deux groupes mutuellement exclusifs en fonction du mode de rémunération de leur médecin : médecins rémunérés à l’acte pour ceux payés uniquement de cette façon et médecins non rémunérés à l’acte pour les autres. À l’aide des données sur les ordonnances de médicaments hypoglycémiants (source de nos données de référence), nous avons évalué si les cas de maladie avaient été déterminés avec la même exactitude en fonction du mode de rémunération. Nous avons ensuite corrigé les taux d’incidence du diabète afin d’optimiser l’exhaustivité des cas déterminés. Résultats. La cohorte comprenait 86 110 patients. Dans l’ensemble, des proportions égales de patients ont reçu leurs médicaments hypoglycémiants de la part de médecins rémunérés à l’acte et de médecins non rémunérés à l’acte. Globalement, le mode de rémunération des médecins a eu peu d’effet sur le pourcentage de cas de diabète omis (14,8 % chez les médecins rémunérés à l’acte contre 12,2 % chez les médecins non rémunérés à l’acte). Toutefois, la différence de cas omis entre les médecins rémunérés à l’acte et ceux non rémunérés à l’acte était très variable d’une province à l’autre, allant de -1,0 % en Nouvelle-Écosse à 29,9 % à Terre-Neuve-et-Labrador. La différence entre les taux observés d’incidence de la maladie et les taux corrigés était également variable d’une province à l’autre, allant de 22 % à l’Île-du-Prince-Édouard à 4 % en Nouvelle-Écosse. Conclusion. La différence entre le nombre de cas omis selon le mode de rémunération des médecins est variable d’une province à l’autre. Cette perte de données contribue probablement à une sous-estimation de l’incidence de la maladie. Il serait possible d’appliquer la méthode que nous avons utilisée à d’autres maladies chroniques pour lesquelles des données de traitement pharmacologique pourraient servir de données de référence. [ABSTRACT FROM AUTHOR]

Résumé: S'il est de plus en plus établi que les études supérieures améliorent les perspectives professionnelles, l'inégalité de leur rendement suscite des inquiétudes croissantes. Les auteurs utilisent un nouveau jeu de données administratives couplées couvrant l'ensemble des étudiants diplômés d'une université australienne entre 2005 et 2011 pour comparer, sur dix ans, la trajectoire professionnelle de publics défavorisés à l'aune de différents critères (position socio‐économique, origine ethnique, lieu de résidence, migration, incapacité) à celle de leurs homologues favorisés. Ils constatent une grande hétérogénéité des trajectoires en termes de revenu et de perception de prestations sociales. Ces résultats ont d'importantes implications pour les politiques visant à améliorer l'équité sociale sur le marché du travail. [ABSTRACT FROM AUTHOR]

Contexte : Bien que le Canada dispose à la fois d’un système national de surveillance active et de données administratives pour la surveillance passive des infections associées aux soins de santé (IASS), chacun des deux systèmes présente des forces et des faiblesses au niveau de la collecte et de la communication des données. La surveillance active et la surveillance passive fonctionnent de manière indépendante, ce qui donne parfois des résultats divergents. Pour comprendre les divergences qui existent entre les données administratives sur la santé et les données issues de la surveillance active, un examen de la portée a été réalisé. Méthodes : Des recherches ont été menées dans les bases de données Medline, Embase et Cumulative Index to Nursing and Allied Health Literature, ainsi que dans la littérature grise pour trouver des études en anglais et en français évaluant l’utilisation de données administratives, seules ou en comparaison avec les données issues de la surveillance traditionnelle et réalisées au Canada entre 1995 et le 2 novembre 2020. Après avoir extrait les renseignements pertinents des articles sélectionnés, un résumé descriptif des résultats a été présenté, accompagné de suggestions pour améliorer les systèmes de surveillance, dans le but d’optimiser la qualité globale des données. Résultats : Seize articles répondaient aux critères d’inclusion, dont douze études observationnelles et quatre revues systématiques. Ces études ont démontré que l’utilisation d’une seule source de données administratives n’était pas assez précise pour la surveillance des IASS, par rapport à la surveillance active traditionnelle. Cependant, la combinaison de différentes sources de données ou la combinaison de données administratives et de données issues de la surveillance active en améliore la précision. Les systèmes de surveillance électronique peuvent également renforcer la surveillance en augmentant la capacité à détecter les IASS potentielles. Conclusion : Bien que la surveillance active des IASS ait produit les résultats les plus précis et demeure la norme d’excellence en la matière, l’intégration des données issues de la surveillance active et passive peut être optimisée. Les données administratives peuvent être utilisées pour renforcer la surveillance active traditionnelle. De futures études sont nécessaires pour évaluer la faisabilité et les avantages des solutions potentielles proposées pour l’utilisation des données administratives pour la surveillance et la déclaration des IASS au Canada.

Objective: Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age., Methods: Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data")., Results: Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources., Conclusions: The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood., Plain Language Title: Prevalence of child mental health disorders according to different data sources in Canada., Competing Interests: Data AccessThe datasets generated and analyzed during the current study are from the All Our Families Study and Alberta Health/Alberta Health Services. All Our Families data can be made available from the Study Lead, Dr. Suzanne Tough, via http://allourfamiliesstudy.com/. Administrative data may be requested through Alberta Health/ Alberta Health Services. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Pharmacologic treatment of type 2 diabetes mellitus (T2DM) follows a stepwise approach. Typically, metformin monotherapy is first-line treatment, followed by other noninsulin antihyperglycemic agents (NIAHAs) or progression to insulin if glycated hemoglobin (A1C) targets are not achieved. We aimed to describe real-world patterns of basal insulin initiation in people with T2DM and A1C not at target despite treatment with at least 2 NIAHAs., Methods: A retrospective cohort study was conducted using administrative health data from Alberta, Canada, among adults with T2DM, indexed on the first test with 7.0% < A1C < 9.5% (April 1, 2011, to March 31, 2019), with at least 2 previous NIAHAs but no insulin. Kaplan-Meier (KM) methodology was used to analyze time to basal insulin initiation, with stratification by index A1C. Annual patient status was categorized into 5 groups: basal insulin initiation, death, NIAHA intensification, no change in therapy (subgroups of A1C <7.1% and A1C ≥7.1% [clinical inertia]), or discontinuance., Results: The cohort included 14,083 individuals. The KM cumulative probability of initiating basal insulin was 7.7% (95% confidence interval [CI] 7.3% to 8.2%) at 1 year, increasing to 43.1% (95% CI 42.1% to 44.1%) at 8 years of follow-up. Higher A1C levels were associated with greater proportions of basal insulin initiation. By year 8, proportions with NIAHA intensification and clinical inertia were 12.1% and 19.3%, respectively, relative to year 7., Conclusions: Despite current clinical practice guidelines recommending achieving A1C targets within 6 months, less than half of the individuals with T2DM and clear indications for basal insulin initiated treatment within 8 years. Efforts to reduce delays in basal insulin initiation are needed., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Copyright of ALTER: European Journal of Disability Research, Journal Europeen de Erche sur le Handicap is the property of European Society for Disability Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease and a leading cause of morbidity/mortality in Canada. We evaluated the burden of T2DM in Alberta, Canada, by estimating the 5-year period prevalence of T2DM and rates of comorbidities and complications/conditions after T2DM., Methods: We conducted a population-based, retrospective study linking administrative health databases. Individuals with T2DM (≥18 years of age) were identified between 2008-2009 and 2018-2019 using a published algorithm, with follow-up data to March 2020. The 5-year period prevalence was estimated for 2014-2015 to 2018-2019. Individuals with newly identified T2DM, ascertained between 2010-2011 and 2017-2018 with a lookback period between 2008-2009 and 2009-2010 and a minimum 1 year of follow-up data, were evaluated for subsequent cardiovascular, diabetic, renal, and other complication/condition frequencies (%) and rates (per 100 person-years). Complications/conditions were stratified by atherosclerotic cardiovascular disease (ASCVD) status at index and age., Results: The 5-year period prevalence of T2DM was 11,051 per 100,000 persons, with the highest prevalence in men 65 to <75 years of age. There were 195,102 individuals included in the cohort (mean age 56.7±14.7 years). The most frequently reported complications/conditions (rates per 100 person-years) were acute infection (23.10, 95% confidence interval [CI] 23.00 to 23.30), hypertension (17.30, 95% CI 16.80 to 17.70), and dyslipidemia (12.20, 95% CI 11.90 to 12.40). Individuals who had an ASCVD event/procedure and those ≥75 years of age had higher rates of complications/conditions., Conclusions: We found that over half of the individuals had hypertension or infection after T2DM. Also, those with ASCVD had higher rates of complications/conditions. Strategies to mitigate complications/conditions after T2DM are required to reduce the burden of this disease on individuals and health-care systems., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

The dwelling as home is imbued with specific meanings for its inhabitants, even while they remain embedded within a broader network of social and spatial relations. One such set of relations are those with neighbours who can enhance sense of home, but also potentially undermine it. This article explores how problematic relations with neighbours can lead to a form of 'home unmaking' through the erosion of home as haven, autonomy and status. Drawing on 3930 cases of neighbour disputes in south-east Queensland, Australia, the article illustrates the opportunities afforded by administrative records as naturally-occurring data on everyday experiences of home and its unmaking, as well as the challenges that arise from using datasets never intended for research purposes. [ABSTRACT FROM AUTHOR]

Cette article vise à analyser les comorbidités de l'accident vasculaire cérébral (AVC) ischémique aigu et celles influençant sa létalité hospitalière. Nous avons étudié les patients âgés de 25 ans et plus, résidant en Wallonie et admis dans un hôpital belge pour un AVC durant les années 2013 et 2014. Les données médico-administratives analysées sont issues du résumé hospitalier minimum qui enregistre toutes les hospitalisations de la Wallonie. Pour la mise en évidence des profils de comorbidités, une analyse factorielle des correspondances a été effectuée. Une régression logistique a été employée pour analyser les comorbidités influençant la létalité hospitalière. Les facteurs de risque d'AVC varient en fonction de l'âge. Les problèmes cardiaques sont davantage présents chez les personnes âgées de 85 ans et plus. L'hypertension artérielle, l'hypercholestérolémie et le diabète sont plus marqués entre 65 et 84 ans. La surcharge pondérale est plus présente entre 55 et 74 ans. Les personnes ayant une dépendance à l'alcool ou au tabac ont souvent 65 ans et moins. L'âge, les maladies ischémiques et l'arythmie cardiaque sont les facteurs de risque augmentant la létalité. Il y a cependant une diminution de la létalité en présence d'hypertension artérielle, d'hypercholestérolémie, de surcharge pondérale et de dépendance au tabac ou à l'alcool. Cette étude démontre que les bases de données médico-administratives et les méthodes statistiques factorielles sont parfaitement adaptées pour confirmer les facteurs de risque liés à l'AVC ischémiques. Ce type d'étude permettra de cibler avec plus de précision les actions de prévention secondaire et tertiaire de l'AVC. The aim of the study consists of analyzing the comorbidities of acute ischemic stroke and those influencing its hospital lethality. We considered patients from Wallonia aged 25 years or more and admitted to a Belgian hospital for an acute ischemic stroke in 2013 and 2014. The analyzed medico-administrative data are taken from the Minimum Hospital Summary. A factorial correspondence analysis (FCA) was used to demonstrate the comorbidities profiles. A logistic regression was used to analyse the comorbidities influencing hospital lethality by ischemic stroke. The stroke risk factors vary according to the age. Cardiac problems are more common in older people aged 85 years or more. High blood pressure, hypercholesterolemia and diabetes are more present between 65- and 84-year-olds. Overweight is more present between 55 and 74-year-olds. People who are addicted to alcohol or tobacco are often 65 years or younger. The logistic regression showed that age and heart problems are the risk factors that increase lethality. However there is a lethality diminution in the presence of high blood pressure, hypercholesterolemia, overweight and addiction to alcohol or tobacco. This study demonstrates that medico-administrative databases and factorial statistical methods are perfectly adapted to confirm the ischemic stroke risk factors. This type of study will allow to target with more precision the secondary and tertiary prevention actions of stroke. [ABSTRACT FROM AUTHOR]

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Objectives: Our aim in this study was to determine the test characteristics of algorithms using hospitalization and physician claims data to predict gestational diabetes (GDM)., Methods: Using population-level health-care administrative data, we identified all pregnant women in Ontario in 2019. The presence of GDM was determined based on glucose screening laboratory results. Algorithms using hospitalization records and/or physician claims were tested against this "gold standard." The selected algorithm was applied to administrative data records from 1999 to 2019 to determine GDM prevalence in each year., Results: Identifying GDM based on either a diabetes mellitus code on the delivery hospitalization record, OR at least 1 physician claim with a diabetes diagnosis code with a 90-day lookback before delivery yielded a sensitivity of 95.9%, a specificity of 99.2% and a positive predictive value of 87.6%. The prevalence of GDM increased from 4.2% of pregnancies in 1999 to 12.0% in 2019., Conclusion: Algorithms using hospitalization or physician claims administrative data can accurately identify GDM., (Copyright © 2022 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

In contrast to inequalities in health that stem from biological differences brought about by age or genetics, social inequalities in health are mutable and avoidable as they are affected by public policies. In recognition of the importance of these social influences on population health and inequalities, the World Health Organization adopted, in 2012, resolution WHA62.14 endorsing the Rio Political Declaration on Social Determinants of Health. With this resolution, member states recognize the existence of social determinants of health (SDH) and pledge to implement actions outlined in the Rio declaration, including to "monitor progress and increase accountability to inform policies on SDH." From 7 to 9 May 2014, the Quebec Inter-University Centre for Social Statistics held an international conference in Montreal. "Social Policy and Health Inequalities: An International Perspective" had as its primary objective showcasing leading-edge international research on the impact of social policies and programs on health inequalities in high-income countries. More specifically, the conference aimed to encourage international exchanges in order to demonstrate the range of research practices and outputs as well as to stimulate debate among the key stakeholders in this research process: organizations that produce statistics, researchers, and knowledge users. [ABSTRACT FROM AUTHOR]

Objective: Our aim in this study was to determine the best administrative data case definition for pregestational diabetes exposure., Methods: We compared the performance of case definitions for pregestational diabetes exposure within the administrative health data housed in the Manitoba Population Health Research Repository at the Manitoba Centre for Health Policy with an identified population of women in whom the diagnosis of pregestational diabetes was known from the clinical database of the Manitoba Diabetes Education Resource for Children and Adolescents (DER-CA) (August 12, 1989 through January 28, 2015). The DER-CA database contains maternal diabetes status during pregnancy and also includes women diagnosed with type 2 diabetes in childhood whose pregnancies were thus all complicated by pregestational diabetes exposure. Linkage of mother-child dyads is possible within the Repository. Diagnosis codes from the International Classification of Diseases---ninth or tenth revision and physician tariff codes were used to identify diabetes in the biologic mothers of children with type 2 diabetes identified from the DER-CA database. The timing of the diagnosis of diabetes in the mother with respect to the gestational age of the pregnancy was determined., Results: The best administrative definition of pregestational diabetes exposure was any incident code for diabetes in the mother before the pregnancy of the index child or within the first 25 weeks of pregnancy (sensitivity: 84.77%; positive predictive value: 92%)., Conclusion: The definition cited can be used to define pregestational diabetes exposure in studies utilizing administrative data., (Copyright © 2021 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Objective: Although national guidelines advocate for earlier diabetes screening in high-risk ethnic groups, little evidence exists to guide clinicians on the age at which screening should commence. The purpose of this study was to determine age equivalency thresholds for diabetes risk across a broad range of ethnic populations., Methods: This population-based, retrospective cohort study used linked administrative health and immigration records for 592,376 individuals in Ontario, Canada. Adjusted incidence rates by ethnicity, sex and age were used to derive ethnic-specific age thresholds for risk., Results: Diabetes incidence rates in South Asians reached an equivalent risk as that experienced by a 40-year-old Western European man (3.7 per 1,000 person-years) by 25 years of age. For all other non-European ethnic groups, the equivalent risk was experienced between 30 and 35 years of age. These risk differentials persisted despite controlling for covariates., Conclusions: We found a 15-year difference in age equivalency of risk across ethnic groups., (Copyright © 2020 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Objectives: Considerable attention has been paid to the rising costs of the use of blood glucose test strips (BGTS). Insulin users have generally been treated as a single homogeneous group, resulting in policies that cap usage (8.2 strips/day) in provincial drug insurance programs. The objective of this study was to conduct a utilization review of BGTS by insulin users and to evaluate use patterns against current insulin use patterns and BGTS policy., Methods: BGTS usage was examined in a cohort of insulin users with type 1 and type 2 diabetes over a 12-year period (2001 to 2013) using the population-based administrative data in Manitoba, Canada., Results: Total BGTS strip use increased by 121%, from $4.3 to $9.5 million. However, the number of insulin users also increased by 115%. Use has been stable at 1.5 strips per day per person since 2004 by insulin users with type 2 diabetes but has risen from 1.9 to 3.0 strips per day per person in those with type 1 diabetes. Mean daily test strip use was below the number of daily tests recommended for patients using insulin as per the current Canadian guidelines, with 11% and 15% of insulin users with type 1 and type 2 diabetes not claiming any BGTS use and a further 15% (type 1) and 28% (type 2) using fewer than 1 strip per day., Conclusions: BGTS use per insulin user has been stable for most of the past decade, and the vast majority of use falls well below provincial insurance caps. The amount of low-level testing (0 to <1 strip/day) suggests that greater attention should be directed to ensuring a safe level of testing by all insulin users., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)