An investigation of cancer rates in the Argentia region, Newfoundland and Labrador: an ecological study.

Background: The Argentia region of Newfoundland and Labrador, Canada, was home to a US naval base during a 40-year period between the 1940s and the 1990s. Activities on the base resulted in contamination of the soil and groundwater in the region with chemicals such as heavy metals and dioxins, and residents have expressed concern about higher rates of cancer in their community. This study investigated the rate of cancer diagnosis that is disproportionately high in the Argentia region.

A randomized controlled trial of the effect of an intensive 1-year care management program on measures of health status in independent, community-living old elderly: the Eldercare project.

Background: Primary care practitioners are familiar with the frail elderly and commonly have to deal with their multi-morbidity and their functional decline, both physically and mentally. However, there are well elderly with high quality of life and very few co-morbidities who seldom seek medical care.

Objective: To determine if a nurse-based program of home-delivered care, linked directly with the primary care practitioner or primary care team, would improve quality of life, symptoms, satisfaction with care and utilization of community and medical services, in independent community living old elderly.

The healthy aged: Descriptive analysis by sex of cognitively functioning elderly patients 80 years and older living independently in the community.

Objective: To describe a population of cognitively functioning seniors aged 80 years and older who are livingin dependently in the community.

Design: Descriptive cross-sectional study based on the enrolment cohort of a randomized controlled trial.

Setting: St John's, Nfld.

Dietary N-nitroso compounds and risk of colorectal cancer: a case-control study in Newfoundland and Labrador and Ontario, Canada.

Several N-nitroso compounds (NOC) have been shown to be carcinogenic in a variety of laboratory animals, but evidence of their carcinogenicity in humans is lacking. We aimed to examine the association between NOC intake and colorectal cancer (CRC) risk and possible effect modification by vitamins C and E and protein in a large case-control study carried out in Newfoundland and Labrador and Ontario, Canada. A total of 1760 case patients with pathologically confirmed adenocarcinoma and 2481 population controls were asked to complete a self-administered FFQ to evaluate their dietary intakes 1 year before diagnosis (for cases) or interview (for controls).

Smoking and alcohol consumption patterns among elderly Canadians with mobility disabilities.

Background: Mobility disability is a major adverse health outcome associated with aging and an impediment to older adults' well-being and behaviors in social and leisure activities. It has been shown that lifestyle factors, including smoking and alcohol consumption, have been used as coping strategies to deal with the negative impact of disability. The aim of this study was to determine the prevalence of smoking and alcohol consumption among older Canadians with different levels of mobility disabilities and to examine factors associated with these two lifestyle patterns among those with disabilities.

Dietary patterns and colorectal cancer recurrence and survival: a cohort study.

Objective: To examine the association between dietary patterns and colorectal cancer (CRC) survival.

Design: Cohort study.

Setting: A familial CRC registry in Newfoundland.

Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada.

Background: Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC) risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL) and Ontario (ON), Canada.

Interaction between alcohol drinking and obesity in relation to colorectal cancer risk: a case-control study in Newfoundland and Labrador, Canada.

Background: While substantive epidemiological literature suggests that alcohol drinking and obesity are potential risk factors of colorectal cancer (CRC), the possible interaction between the two has not been adequately explored. We used a case-control study to examine if alcohol drinking is associated with an increased risk of CRC and if such risk differs in people with and without obesity.

Methods: Newly diagnosed CRC cases were identified between 1999 and 2003 in Newfoundland and Labrador (NL).

Reported intake of selected micronutrients and risk of colorectal cancer: results from a large population-based case-control study in Newfoundland, Labrador and Ontario, Canada.

Aim: The impact of micronutrient intake and colorectal cancer (CRC) risk is poorly understood. The objective of this study was to evaluate the associations of selected micronutrients with risk of incident CRC in study participants from Newfoundland, Labrador (NL) and Ontario (ON), Canada.

Materials And Methods: We conducted a population-based study among 1760 case participants and 2481 age- and sex-matched control participants.

Calcium and vitamin D and risk of colorectal cancer: results from a large population-based case-control study in Newfoundland and Labrador and Ontario.

Background: Previous epidemiological studies have been suggestive but inconclusive in demonstrating inverse associations of calcium, vitamin D, dairy product intakes with risk of colorectal cancer (CRC). We conducted a large population-based comparison of such associations in Newfoundland and Labrador (NL) and Ontario (ON).

Methods: A case control study design was used.

Tobacco smoking and colorectal cancer: a population-based case-control study in Newfoundland and Labrador.

Objective: Newfoundland and Labrador (NL) has the highest incidence rate of both colorectal cancer (CRC) and smoking prevalence in Canada. The objective of this study was to examine if CRC is associated with smoking in this population.

Methods: Newly diagnosed cases identified between 1999 and 2003 were frequency-matched by 5-year age group and sex with controls selected from the residents of NL through random digit dialing.

Pickled meat consumption and colorectal cancer (CRC): a case-control study in Newfoundland and Labrador, Canada.

Objective: Although a large body of epidemiological research suggests that red meat intake increases the risk of colorectal cancer, little is known regarding how such an association varies across populations and types of red meat. The objective of this study was to assess whether an association exists between the intakes of total red meat and pickled red meat and the risk of colorectal cancer in study subjects residing in Newfoundland and Labrador.

Methods: This case-control study of 1,204 residents of Newfoundland and Labrador was part of a larger study on colorectal cancer.

Sorry, You Can't Have That Information: Data Holder Confusion Regarding Privacy Requirements for Personal Health Information and the Potential Chilling Effect on Health Research.

This study, conducted in Newfoundland and Labrador, assessed the level of awareness, perceptions and concerns of healthcare providers, health researchers, data managers and the general public about the collection, use and disclosure of personal health information (PHI) for research purposes. Data collection involved surveys and follow-up focus groups with participants. Results indicate a poor understanding generally with regard to privacy rights and responsibilities.

How important are out-of-pocket costs to rural patients' cancer care decisions?

Objective: We examined the importance of 5 items (stage of illness, personal feelings, travel costs, drug costs and child care costs) in the cancer treatment decisions of urban and rural residents after they had started treatment for their cancer.

Methods: We surveyed 484 adults who presented for care at cancer clinics in Newfoundland and Labrador from September 2002 to June 2003. Respondents rated the importance of each of the 5 items in their cancer care decisions on a 5-point Likert scale, which was later collapsed into 2 categories, "important" and "not important.

Validity of random-digit-dialing in recruiting controls in a case-control study.

Objectives: To evaluate whether the participating controls represented the underlying population in a colorectal cancer case-control study in a geographically isolated North American population.

Methods: The characteristics of the study controls recruited through Random-digit-dialing (RDD) were compared with those in the corresponding target population estimates.

Results: Participating controls were more likely to have higher levels of education and income and were less likely to be smokers.

Planning for end-of-life care: findings from the Canadian Study of Health and Aging.

Steps involved in formalizing end-of-life care preferences and factors related to these steps are unclear in the literature. Using data from the third wave of the Canadian Study of Health and Aging (CSHA-3), we examined the relations between demographic and health predictors, on the one hand, and three outcomes, on the other (whether participants had thought about, discussed , or formalized their end-of-life preferences), and considered, as well, whether relations existed among the three outcomes. Canadian region of residence, female gender, and more years of education predicted having thought about preferences; region of residence, female gender, and lack of cognitive impairment predicted discussion of preferences; and region of residence and not being married predicted whether formal documents were in place.

On the rock, in a hard place: challenges in working with advocacy and care provider groups.

Researchers from Memorial University of Newfoundland collaborated with a patient advocacy organization and the provincial cancer care provider on a study showing substantial variation in out-of-pocket costs for patients travelling to access cancer treatment. While the partnered research phase of the study proceeded smoothly, the successful dissemination of the findings--and the resulting government and media interest--created pressure for the provincial cancer care provider. This agency distanced itself from the study and ended its role in what has proved to be an otherwise successful partnership.

Prostate cancer screening attitudes and continuing education needs of primary care physicians.

Background: In May 2003, a survey questionnaire was distributed to all licensed primary care physicians in Newfoundland and Labrador. The objective was to examine the attitudes, self-reported practices, and continuing medical education (CME) preferences of primary care physicians as they pertain to prostate cancer screening.

Methods: Data was obtained from 485 primary care physicians using self-reports of prostate cancer screening practices, attitudes towards prostate cancer screening, and CME preferences.