The Association of Inadequate and Intensive Prenatal Care With Maternal, Fetal, and Infant Outcomes: A Population-Based Study in Manitoba, Canada.

Objective: Little is known about how prenatal care influences health outcomes in Canada. The objective of this study was to examine the association of prenatal care utilization with maternal, fetal, and infant outcomes in Manitoba.

Methods: This retrospective cohort study conducted at the Manitoba Centre for Health Policy investigated all deliveries of singleton births from 2004-2005 to 2008-2009 (N = 67 076).

Inequities in utilization of prenatal care: a population-based study in the Canadian province of Manitoba.

Background: Ensuring high quality and equitable maternity services is important to promote positive pregnancy outcomes. Despite a universal health care system, previous research shows neighborhood-level inequities in utilization of prenatal care in Manitoba, Canada. The purpose of this population-based retrospective cohort study was to describe prenatal care utilization among women giving birth in Manitoba, and to determine individual-level factors associated with inadequate prenatal care.

Breastfeeding Initiation Associated With Reduced Incidence of Diabetes in Mothers and Offspring.

Objective: To examine associations between breastfeeding initiation and subsequent diabetes among First Nations (indigenous people in Canada who are not Métis or Inuit) and non-First Nations mothers and their offspring with and without gestational diabetes mellitus (GDM).

Methods: This retrospective database study included 334,553 deliveries (1987-2011) in Manitoba with up to 24 years of follow-up for diabetes using population-based databases. Information of breastfeeding initiation before hospital discharge was obtained from hospital abstracts recorded by nurses in postpartum wards.

Exposure to Gestational Diabetes Mellitus: Impact on the Development of Early-Onset Type 2 Diabetes in Canadian First Nations and Non-First Nations Offspring.

Objective: Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life.

Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents.

Background: In Manitoba, Canada, school-based clinics providing sexual and reproductive health services for adolescents have been implemented to address high rates of sexually transmitted infections (STIs) and pregnancies.

Methods: The objectives of this population-based study were to compare pregnancy and STI rates between adolescents enrolled in schools with school-based clinics, those in schools without clinics, and those not enrolled in school. Data were from the PATHS Data Resource held in the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy.

Unconditional Prenatal Income Supplement and Birth Outcomes.

Background And Objectives: Perinatal outcomes have improved in developed countries but remain poor for disadvantaged populations. We examined whether an unconditional income supplement to low-income pregnant women was associated with improved birth outcomes.

Methods: This study included all mother-newborn pairs (2003-2010) in Manitoba, Canada, where the mother received prenatal social assistance, the infant was born in the hospital, and the pair had a risk screen (N = 14 591).

Bereavement after sibling death: a population-based longitudinal case-control study.

The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N=7243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N=21,729) who did not have a sibling die in the study period. Generalized estimating equations were used to compare the two sibling groups in the two years before and after the index child's death on physician-diagnosed mental disorders and treatment utilization, with adjustment for confounding factors including pre-existing mental illness.

A Systematic Review of the Effect of Early Interventions for Psychosis on the Usage of Inpatient Services.

Objectives: To review and synthesize the currently available research on whether early intervention for psychosis programs reduce the use of inpatient services.

Methods: A systematic review was conducted using keywords searches on PubMed, Embase (Ovid), PsycINFO (ProQuest), Scopus, CINAHL (EBSCO), Social Work Abstracts (EBSCO), Social Science Citations Index (Web of Science), Sociological Abstracts (ProQuest), and Child Development & Adolescent Studies (EBSCO). To be included, studies had to be peer-reviewed publications in English, examining early intervention programs using a variant of assertive community treatment, with a control/comparison group, and reporting inpatient service use outcomes.

Trends in pediatric dental surgery for severe early childhood caries in Manitoba, Canada.

Introduction: Caries is the most common chronic disease of childhood, and severe forms may necessitate rehabilitative dental surgery. In this study, administrative data related to pediatric dental surgery performed under general anesthesia to treat severe early childhood caries in Manitoba, Canada, were reviewed to determine trends in pediatric dental surgery, as well as geographic, regional and socio-economic variations in surgical rates.

Methods: The total number of dental surgery cases performed under general anesthesia was obtained from provincial administrative databases for fiscal years from 1997-98 to 2006-07.

Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study.

Objectives: Breastfeeding is associated with improved health. Surveillance data show that breastfeeding initiation rates have increased; however, limited work has examined trends in socio-economic inequalities in initiation. The study's research question was whether socio-economic inequalities in breastfeeding initiation have changed over the past 20 years.

Data resource profile: Pathways to Health and Social Equity for Children (PATHS Equity for Children).

The PATHS Data Resource is a unique database comprising data that follow individuals from the prenatal period to adulthood. The PATHS Resource was developed for conducting longitudinal epidemiological research into child health and health equity. It contains individual-level data on health, socioeconomic status, social services and education.

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).

Exploring the relationship between socioeconomic status and dog-bite injuries through spatial analysis.

Introduction: Despite a reported socioeconomic gradient in health, little is known about relationship between socioeconomic status (SES) and frequency of dog-bite injuries. The primary objective of this study was to compare the frequency of dog-bite injuries, using data on dog-bite injury hospitalizations (DBIH), across different SES areas in Manitoba, Canada. The secondary objective of the study was to assess if frequency and pattern of DBIHs are similar to those of non-canine bite injury hospitalizations (NCBIH) and rabies post-exposure prophylaxis (PEP).

Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: results from a pragmatic cluster randomized controlled trial.

Background: Evaluation of the effectiveness of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website), distributed to patients by their family physician, in improving fecal occult blood test (FOBT) colorectal cancer screening rates.

Methods: A pragmatic, two arm, cluster randomized controlled trial in Winnipeg, Manitoba, Canada (39 medical clinic clusters; 79 fee-for-service family physicians; 2,395 average risk patients). All physicians followed their standard clinical screening practice.

Cause and rate of death in people with schizophrenia across the lifespan: a population-based study in Manitoba, Canada.

Objective: To compare the causes and rates of death for people with and without schizophrenia in Manitoba, Canada.

Method: Using de-identified administrative databases at the Manitoba Centre for Health Policy, a population-based analysis was performed to compare age- and sex-adjusted 10-year (1999-2008) mortality rates, overall and by specific cause, of decedents aged 10 years or older who had 1 diagnosis of schizophrenia (ICD-9-CM code 295, ICD-10-CA codes F20, F21, F23.2, F25) over a 12-year period (N = 9,038) to the rest of the population (N = 969,090).

Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years.

Background: National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally.

Methods: A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance.

Parental bereavement after the death of an offspring in a motor vehicle collision: a population-based study.

Motor vehicle collisions (MVCs) are the leading cause of death in young people in North America. The effects of such deaths on parents have not been systematically studied. Administrative data sets were used to identify all parents (n = 1,458) who had an offspring die in a MVC between 1996 and 2008 in the province of Manitoba, Canada.

Earlier onset of complications in youth with type 2 diabetes.

Objective: To evaluate the risk of complications in youth with type 2 diabetes.

Research Design And Methods: Population-based cohorts of 342 youth (1-18 years of age) with prevalent type 2 diabetes, 1,011 youth with type 1 diabetes, and 1,710 nondiabetic control youth were identified between 1986 and 2007 from a clinical registry and linked to health care records to assess long-term outcomes using ICD-9CM and ICD-10CA codes.

Results: Youth with type 2 diabetes had an increased risk of any complication (hazard ratio 1.

The rising prevalence of asthma: true increase, diagnostic exchange or diagnostic accuracy?

In the midst of frequent reports about "the asthma epidemic," results from a number of studies by the manitoba centre for health policy have shown stable or decreasing prevalence of an overall indicator of respiratory diseases which includes asthma. To resolve these apparently contrary findings, we conducted a time trend analysis using administrative data. results revealed significant potential for diagnostic exchange: asthma prevalence increased, but that of bronchitis decreased.

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.

Where and how people with schizophrenia die: a population-based, matched cohort study in Manitoba, Canada.

Objective: To compare place and cause of death for people with and without schizophrenia in Manitoba, Canada.

Method: By using deidentified administrative databases at the Manitoba Centre for Health Policy, a 1:3 matched cohort of decedents aged ≥ 10 years in fiscal years April 1995-March 2008 (n = 3,943 with schizophrenia; n = 11,827 without schizophrenia) was selected and matched on age, sex, geography, and date of death ± 2 months. Schizophrenia was defined as ICD-9-CM code 295 or ICD-10-CA codes F20, F21, F23.