Incidence of Subsequent Mental Health Disorders and Social Adversity Following Pediatric Concussion: A Longitudinal, Population-Based Study.

Objective: To determine the long-term risk of new adverse psychosocial outcomes among adolescents diagnosed with a concussion compared with those not diagnosed.

Study Design: A retrospective, population-based cohort study was conducted. Adolescents (10-18 years) with a physician-diagnosed concussion between 2000 and 2005 were matched on neighborhood and age with 5 controls without concussion from the general population.

Administrative Data Is Insufficient to Identify Near-Future Critical Illness: A Population-Based Retrospective Cohort Study.

Background: Prediction of future critical illness could render it practical to test interventions seeking to avoid or delay the coming event.

Objective: Identify adults having >33% probability of near-future critical illness.

Research Design: Retrospective cohort study, 2013-2015.

Accuracy of Administrative Hospital Data to Identify Use of Life Support Modalities. A Canadian Study.

Accurately identifying use of life support in hospital administrative data enhances the data's value for quality improvement and research in critical illness. To assess the accuracy of administrative hospital data for identifying invasive mechanical ventilation (IMV), acute renal replacement therapy (RRT), and intravenous vasoactive drugs in unselected adult intensive care unit (ICU) patients. We employed the administrative dataset of the Discharge Abstract Database from the Province of Manitoba during 2007-2012, using nationally standardized diagnosis and procedure codes to identify the three types of life support.

Academic Outcomes in High-School Students after a Concussion: A Retrospective Population-Based Analysis.

Background: Many concussion symptoms, such as headaches, vision problems, or difficulty remembering or concentrating may deleteriously affect school functioning. Our objective was to determine if academic performance was lower in the academic calendar year that students sustain a concussion compared to the previous year when they did not sustain a concussion.

Methods: Using Manitoba Health and Manitoba Education data, we conducted a population-based, controlled before-after study from 2005-2006 to 2010-2011 academic years.

Neurodevelopmental Assessment in Kindergarten in Children Exposed to General Anesthesia before the Age of 4 Years: A Retrospective Matched Cohort Study.

Background: Animal studies demonstrate general anesthetic (GA) toxicity in the developing brain. Clinical reports raise concern, but the risk of GA exposure to neurodevelopment in children remains uncertain.

Methods: The authors undertook a retrospective matched cohort study comparing children less than 4 yr of age exposed to GA to those with no GA exposure.

Sustained Use of Benzodiazepines and Escalation to High Doses in a Canadian Population.

Objective: "Antibenzodiazepine" campaigns have been conducted worldwide to limit the prescribing of these drugs because of concerns about inappropriate use and addiction. The causal relationship between long-term use and escalation to high doses has not been proven. This study assessed the extent of dose escalation among individuals who were long-term users of benzodiazepines or Z-hypnotics.

The effect of neighborhood socioeconomic status on education and health outcomes for children living in social housing.

Objectives: We explored differences in health and education outcomes between children living in social housing and not, and effects of social housing's neighborhood socioeconomic status.

Methods: In this cohort study, we used the population-based repository of administrative data at the Manitoba Centre for Health Policy. We included children aged 0 to 19 years in Winnipeg, Manitoba, in fiscal years 2006-2007 to 2008-2009 (n = 13,238 social housing; n = 174,017 others).

Rates of readmission and death associated with leaving hospital against medical advice: a population-based study.

Background: Leaving hospital against medical advice may have adverse consequences. Previous studies have been limited by evaluating specific types of patients, small sample sizes and incomplete determination of outcomes. We hypothesized that leaving hospital against medical advice would be associated with increases in subsequent readmission and death.

Evaluating the effectiveness of cervical cancer screening invitation letters.

Objective: The objective of this study was to evaluate the effectiveness of an invitation letter on cervical screening participation among unscreened women 30 to 69 years of age.

Methods: A cluster randomized trial design was used in which unscreened women (n=31,452) were randomized by the forward sortation area (FSA) of their postal code to an intervention group that was sent an invitation letter (n=17,068) or a group that was not sent an invitation letter (n=14,384).

Results: Six months after the letters were mailed, 1,010 women in the intervention group (5.

Social gradients in surgical sterilization rates: opposing patterns for males and females.

Objective: The purpose of this study was to analyze population-based rates of surgical sterilization by sex, income, age group, and location of residence (urban, rural, or remote) among a universally insured population.

Methods: The study included all 1.2 million residents of Manitoba.

Concordance with ASCO guidelines for surveillance after colorectal cancer treatment: a population-based analysis.

Purpose: Intensive surveillance after curative treatment of colorectal cancer (CRC) is associated with improved overall survival. This study examined concordance with the 2005 ASCO surveillance guidelines at the population level.

Methods: A cohort of 250 patients diagnosed with stage II or III CRC in 2004 and alive 42 months after diagnosis was identified from health administrative data in Manitoba, Canada.

Papanicolaou test utilization and frequency of screening opportunities among women diagnosed with cervical cancer.

Background: Although the importance of Papanicolaou (Pap) smear test screening in reducing the incidence of cervical cancer is well established, in 1994-95 one in 4 women in Manitoba aged 18 to 69 years reported never having had a Pap test or not having had a Pap test in the last 3 years. The objectives of this study were to examine the screening history of women in Manitoba diagnosed with invasive cervical cancer and to explore whether opportunities for screening were missed.

Methods: In this case-control study women aged 18 years and older who resided in Manitoba and were diagnosed with invasive cervical cancer between 1989 and 2001 were each matched by age and area of residence to 5 controls, (N = 4009).

The relative efficacies of gastroprotective strategies in chronic users of nonsteroidal anti-inflammatory drugs.

Background & Aims: There are numerous gastroprotective strategies recommended for reducing the risk of upper gastrointestinal (GI) complications in long-term users of nonsteroidal anti-inflammatory drugs (NSAIDs). The relative efficacy of the different strategies alone or in combination is uncertain.

Methods: We used the Manitoba Population Health Research Data Repository to perform a population-based matched case-control analysis.

The incidence of methylphenidate use by Canadian children: what is the impact of socioeconomic status and urban or rural residence?

Objective: To examine socioeconomic, demographic, and behavioural factors that influence the incidence of methylphenidate use among children aged 4 to 13 years.

Method: A total of 11,316 children, aged 2 through 11 years, from Cycle 1 (1994-95) of the National Longitudinal Survey of Children and Youth were followed up 2 years later in Cycle 2 (1996-97). The outcome measure was methylphenidate use in Cycle 2.

Influence of direct referrals on time to diagnosis after an abnormal breast screening result.

This study examined the influence of a direct referral process implemented by a population-based provincial breast screening program on the time from screening to first procedure, first procedure to diagnosis, and screening to diagnosis following an abnormal breast screening result. The direct referral process shifted the responsibility for the coordination of diagnostic follow-up procedures from the family physician to the screening program. Three cohorts of women were included: a control cohort (screened prior to the initiation of a direct referral process, n = 1347), a usual care cohort (screened after the initiation of a direct referral process but for whom permission to refer was denied by the family physician, n = 1225), and a direct referral cohort (screened after the initiation of the direct referral process and for whom permission to refer was given by the family physician, n = 1232).

Factor analysis of ethnic variation in the multiple metabolic (insulin resistance) syndrome in three Canadian populations.

This study describes and compares the pattern of risk factor clustering in multiple metabolic (insulin resistance) syndrome (MMS) in three Canadian ethnic groups (Indians, Inuit, non-Aboriginal Canadians). Three cross-sectional, population-based sample surveys in three contiguous regions of Canada were conducted during the late 1980s and early 1990s (Ontario, Manitoba, Northwest Territories). The combined dataset consists of 873 Cree-Ojibwa Indians from northern Ontario and Manitoba, 387 Inuit from the Northwest Territories, and 2,670 non-Aboriginal Canadians (predominantly of European origin) in the province of Manitoba.