Spatial variability of gastroschisis in Canada, 2006-2011: An exploratory analysis.

Objectives: Gastroschisis is a serious birth defect of the abdominal wall that is associated with mortality and significant morbidity. Our understanding of the factors causing this defect is limited. The objective of this paper is to describe the geographic variation in incidence of gastroschisis and characterize the spatial pattern of all gastroschisis cases in Canada between 2006 and 2011.

Integrating environmental and human health databases in the great lakes basin: themes, challenges and future directions.

Many government, academic and research institutions collect environmental data that are relevant to understanding the relationship between environmental exposures and human health. Integrating these data with health outcome data presents new challenges that are important to consider to improve our effective use of environmental health information. Our objective was to identify the common themes related to the integration of environmental and health data, and suggest ways to address the challenges and make progress toward more effective use of data already collected, to further our understanding of environmental health associations in the Great Lakes region.

The association between obstetrical interventions and late preterm birth.

Objective: There is concern that obstetric interventions (prelabor cesarean section and induced delivery) are drivers of late preterm (LP) birth. Our objective was to evaluate the independent association between obstetric interventions and LP birth and explore associated independent maternal and fetal risk factors for LP birth.

Study Design: In this population-based cross-sectional study, the BORN Information System was used to identify all infants born between 34 and 40 completed weeks of gestation between 2005 and 2012 in Ontario, Canada.

Prediction of neonatal outcomes in extremely preterm neonates.

Objective: To develop and validate a statistical prediction model spanning the severity range of neonatal outcomes in infants born at ≤ 30 weeks' gestation.

Methods: A national cohort of infants, born at 23 to 30 weeks' gestation and admitted to level III NICUs in Canada in 2010-2011, was identified from the Canadian Neonatal Network database. A multinomial logistic regression model was developed to predict survival without morbidities, mild morbidities, severe morbidities, or mortality, using maternal, obstetric, and infant characteristics available within the first day of NICU admission.

Relationship of mode of conception and sex concordance with mortality/morbidity in preterm twins.

Objective: To assess the association of mode of conception and sex concordance with neonatal outcomes in very preterm twins.

Study Design: Twin pairs born at gestational age ≤ 32 weeks and admitted to a Level 3 neonatal intensive care unit (NICU) in 2010-2011 were retrospectively identified from the Canadian Neonatal Network™ database. A composite outcome representing neonatal mortality or any severe morbidity (intraventricular hemorrhage grades ≥ 3 or periventricular leukomalacia, retinopathy of prematurity stages ≥ 3, bronchopulmonary dysplasia, or necrotizing enterocolitis stages ≥ 2) was compared between twins conceived using assisted reproduction technologies (ARTs) or spontaneously (SP), and tested for association with sex concordance in individual-level and pair-wise multivariable logistic regression analyses.

Impact of late preterm and early term infants on Canadian neonatal intensive care units.

Objective: To examine the short-term morbidities, mortality, and use of neonatal intensive care unit (NICU) resources for late preterm, early term, and term infants.

Study Design: Infants born between 34 and 40 weeks of gestation and admitted to a Canadian NICU in 2010 were designated late preterm (340/7 to 366/7 weeks), early term (370/7 to 386/7 weeks), or term (390/7 to 406/7 weeks). Mortality, short-term morbidities, and resource utilization were compared between the three groups using chi-square tests and analysis of variance.

Association between congenital anomalies and area-level deprivation among infants in neonatal intensive care units.

Objective: To examine the relationship between area-level material deprivation and the risk of congenital anomalies in infants admitted to neonatal intensive care units (NICUs) across Canada.

Study Design: The Canadian Neonatal Network database was used to identify admitted infants who had congenital anomalies between 2005 and 2009. The association between congenital anomalies and material deprivation quintile was assessed using logistic regression analysis.

The changing epidemiology of preterm twins and triplets admitted to neonatal intensive care units in Canada, 2003 to 2008.

We describe trends in the rates of admission of preterm twin and triplet infants to neonatal intensive care units (NICUs) across Canada and compare their neonatal outcomes over a 6-year period. Temporal trends of admission rates for 5193 twins and triplets < 33 weeks' gestational age to participating NICUs in the Canadian Neonatal Network between 2003 and 2008 were assessed. Trends in infant outcomes were evaluated using logistic regression.

The relationship between temperature and ambulance response calls for heat-related illness in Toronto, Ontario, 2005.

Background: Concern over the adverse effects of heat on human health has led to numerous studies assessing the relationship between heat and mortality. Few studies have quantified the impact of heat on morbidity, including ambulance response calls. This study describes the association between temperature and ambulance response calls for heat-related illness (HRI) in Toronto, Ontario, Canada during the summer of 2005.

Climate change and health in british columbia: projected impacts and a proposed agenda for adaptation research and policy.

This is a case study describing how climate change may affect the health of British Columbians and to suggest a way forward to promote health and policy research, and adaptation to these changes. After reviewing the limited evidence of the impacts of climate change on human health we have developed five principles to guide the development of research and policy to better predict future impacts of climate change on health and to enhance adaptation to these change in BC. We suggest that, with some modification, these principles will be useful to policy makers in other jurisdictions.

Effectiveness of public health interventions in reducing morbidity and mortality during heat episodes: a structured review.

Increasing concern over the impact of hot weather on health has fostered the development of public health interventions to reduce heat-related health impacts. However, evidence of the effectiveness of such interventions is rarely cited for justification. Our objective was to review peer-reviewed and grey literature evaluating interventions aimed at reducing morbidity and/or mortality in populations during hot weather episodes.

Temporal and spatial variation of heat-related illness using 911 medical dispatch data.

Background: The adverse effect of hot weather on health in urban communities is of increasing public health concern, particularly given trends in climate change.

Objectives: To demonstrate the potential public health applications of monitoring 911 medical dispatch data for heat-related illness (HRI), using historical data for the summer periods (June 1-August 31) during 2002-2005 in Toronto, Ontario, Canada.

Methods: The temporal distribution of the medical dispatch calls was described in relation to a current early warning system and emergency department data from the National Ambulatory Care Reporting System (NACRS).

Development of a surveillance case definition for heat-related illness using 911 medical dispatch data.

Objectives: The adverse effects of hot weather on public health are of increasing concern. A surveillance system using 911 medical dispatch data for the detection of heat-related illness (HRI) could provide new information on the impact of excessive heat on the population. This paper describes how we identified medical dispatch call codes, called "determinants", that could represent HRI events.