An assessment of enhanced biogenic emissions influence on ozone formation in central Alberta,Canada

Emissions from biogenic sources are the primary source of isoprene and monoterpene that contribute to the formation of ozone and secondary organic aerosol (SOA). In this study, we used a regional air quality model to examine the sensitivity of simulated ozone to biogenic emission estimates. We created a new regional database of plant functional type (PFT) and land use and land cover (LULC) based on two satellite data products, the Alberta Vegetation Inventory (AVI) and Earth Observation for Sustainable Development of forests (EOSD).The Model for Emissions for Gases and Aerosols from Nature (MEGAN) biogenic emissions model was used with the new PFT data as well as the default Moderate Resolution Imaging Spectroradiometer (MODIS) PFT to generate biogenic emissions in Alberta. The comparison revealed that the new LULC increased isoprene (ISOP) emissions by 30–40 %, decreased monoterpene emissions by 7–8 %, and increased NO emissions by 65–90 % associated with the new regional plant functional type fractional (PFTf) database. This study further investigated the impact of using Alberta-specific biogenic emission on ambient ozone concentration through the Community Multi-scale Air Quality (CMAQ) modeling system against the default MEGAN emissions. In addition, the result from using the new LULC on the predicted fourth highest daily maximum 8-h ozone concentration were examined, which showed a substantial reduction (6 ppb) in ozone in the urbanized capital region area when compared to the default the LULC with less ozone changes in the rural areas. This is likely due to ozone formation in the urban areas being more sensitive to changes in volatile organic compound (VOC) emissions than the rural areas. As CMAQ tended to overestimate the observed ozone peaks in the urban areas, the use of the enhanced LULC resulted in improved model performance compared to the default LULC database. This study results will be primarily used to understand impact of biogenic emission into air on ambient air quality and secondary to provide strategic advice on air quality management plan and initiatives regarding air issues (e.g., ozone) in the region. Results also can be implied to the relationship between climate change-induced increases in biogenic VOC emissions and ozone concentrations.     

Variations in societal characteristics of spatial disease clusters: examples of colon,lung and breast cancer in Japan

Background  

Spatial analyses and ecological studies are essential for epidemiology and public health. The present study combining these two methods was performed to identify spatial clusters of selected types of cancer in Japan and to determine their societal characteristics focusing on homogeneity among clusters.     

Planning to meet the care need challenge in Alberta, Canada

The Canadian province of Alberta faces challenges in ensuring an adequate supply of nurses to meet care needs. This paper describes the approach adopted by Alberta Health Services (the public health care provider in Alberta) to address this challenge. Planning was undertaken on the basis of care needs rather than starting from a particular professional perspective and highlighted that the needs could be met by Registered Nurses, Licensed Practical Nurses or Healthcare Aides. Six scenarios, representing different potential mixes of Registered Nurses, Licensed Practical Nurses and Healthcare Aides were identified and used as the basis of stakeholder consultations. The paper identifies the workforce outcomes and needs for the different scenarios and the outcomes of the workforce planning process. Copyright © 2012 John Wiley & Sons, Ltd.     

Investigating the early impacts of the COVID-19 pandemic on modifiable risk factors for cancer and chronic disease: a repeated cross-sectional study in Alberta,Canada

ObjectivesThis study contributes to empirical evidence by examining the impact of the first and second waves of the COVID-19 pandemic on modifiable risk factors (MRF) and whether these patterns differ according to level of material deprivation among people living in Alberta.MethodsUsing data from a repeated cross-sectional provincial health survey (Alberta Community Health Survey (ACHS): 2018–2021), we conducted logistic regression analyses examining the impacts of the COVID-19 pandemic on meeting national guidelines on four MRFs (tobacco use, physical activity, fruit and vegetable consumption, alcohol use) (n=11,249). We compared population-level changes in MRFs from one year before the COVID-19 pandemic (March 2019–February 2020) to one year during the pandemic (March 2020–February 2021) in Alberta. We also assessed whether these trends differed by a measure of material deprivation.ResultsCompared to the pre-COVID-19 period, the fully adjusted odds of meeting recommended guidelines for fruit and vegetable consumption (OR=0.42) decreased during the pandemic. Individuals experiencing high material deprivation had lower odds of meeting recommended guidelines for physical activity (OR=0.65) and higher odds of not being current tobacco users (OR=1.36) during the pandemic versus during the pre-pandemic period.ConclusionAt a population level, analyses from the ACHS showed minimal impacts of the first year of the COVID-19 pandemic on MRFs, besides fruit and vegetable consumption. Yet, stratifying results showed statistically significant differences in pandemic impacts on MRFs by level of material deprivation. Therefore, understanding the influence of material deprivation on MRFs during the pandemic is key to tailoring future public health interventions promoting health and preventing cancer and chronic disease.     

Factors in the utilization of the small non-metropolitan hospital in Alberta,Canada

This paper examines factors which determine the utilization of the small (100 beds or less) non-metropolitan acute care hospital. Explanatory variables represent both demand and supply dimensions. Measures of utilization include average length of stay and per capita patient days, separations, surgical visits, mothers delivered and emergency outpatient visits. The analysis used multiple regression and explained from 62 to 93% of the variation in the utilization measures. Both supply and demand variables showed considerable predictive power. Key explanatory variables include bed supply, patient flow, population characteristics (especially age) and physician manpower.     

Perceptions of preventable medical errors in Alberta, Canada.

OBJECTIVE: (i) To compare public perceptions of the frequency, responsibility, causes and solutions for preventable medical errors for persons who report and do not report having experienced a preventable medical error while receiving healthcare services in Alberta, Canada. (ii) To describe public opinion about confidentiality and disclosure of preventable medical error. (iii) To examine the relationship between reporting preventable medical error and perceived quality of the healthcare system. METHODS: Population-based telephone survey. Households selected by random digit dialing and individual in household selected by most recent birthday. Province of Alberta, Canada. Representative sample of adult Albertans (N = 1500). Public perceptions of the frequency, responsibility, causes and solutions for preventable medical error; opinions about confidentiality and disclosure; perceived quality of the healthcare system. RESULTS: Five hundred and fifty-nine (37.3%; 95% CI 34.8-39.8%) of 1500 respondents reported that they or a family member had ever experienced a preventable medical error while receiving health care in Alberta, Canada. Respondents who reported a preventable medical error were more likely to believe that preventable medical errors occur with greater frequency, were less likely to think that their doctor would tell them if a preventable medical error was made in their care, and tended to rate the quality of the healthcare system less favourably. CONCLUSION: This paper provides healthcare managers and policymakers with insight into the public's perceptions of preventable medical error and may facilitate the development of strategies to improve patient safety, public confidence and public satisfaction with the healthcare system.     

A comparison of spatial clustering and cluster detection techniques for childhood leukemia incidence in Ohio, 1996 – 2003

Background  

Spatial cluster detection is an important tool in cancer surveillance to identify areas of elevated risk and to generate hypotheses about cancer etiology. There are many cluster detection methods used in spatial epidemiology to investigate suspicious groupings of cancer occurrences in regional count data and case-control data, where controls are sampled from the at-risk population. Numerous studies in the literature have focused on childhood leukemia because of its relatively large incidence among children compared with other malignant diseases and substantial public concern over elevated leukemia incidence. The main focus of this paper is an analysis of the spatial distribution of leukemia incidence among children from 0 to 14 years of age in Ohio from 1996–2003 using individual case data from the Ohio Cancer Incidence Surveillance System (OCISS).     

A weighted average likelihood ratio test for spatial clustering of disease

We consider methods proposed for detecting localized spatial clustering. We propose a new test statistic, the weighted average likelihood ratio test, as an alternative to the spatial scan (maximum likelihood ratio) test statistic. Two different types of weights are considered. We propose an unbiased cluster selection criterion and evaluate the bias of the tests through simulation. We also examine the power of the tests through simulations and apply the methods to the well-known New York leukaemia data.     

Universal Design for the rural walks of life: operationalizing walkability in Bonnyville,Alberta, Canada

Many Canadians have low levels of physical activity, including walking. One public health response is to improve opportunities for walking, or walkability, by changing community built environments. While urban walkability research is expanding, it does not readily apply to smaller, rural communities, leaving a significant knowledge gap. This participatory research project operationalized rural walkability using Universal Design principles to promote walking in a vibrant rural community. A literature review examining rural walkability supplemented local data from a related study. Simultaneously, local partners were engaged to operationalize walkability and iteratively develop a walking map responsive to community priorities of inclusivity and community engagement. The walkability literature was severely limited in evidence and theory for rural settings; conventional urban walkability constructs did not fit the geography, degree of rural-ness, nor primary purposes of walking by residents. This challenged the cogency of current rationales for walkability as a socio-structural response to the obesity epidemic, which may undervalue the individual benefits and public good inherent to walking and equitable supports for walkability. The Bonnyville Community Walking Map was developed using Universal Design principles, providing a tool for all residents, including seniors and others with limited mobility. Consideration of Universal Design can enhance equity and transferability of walkability research across settings, and prompt reconsideration of walkability as access to pedestrian spaces for embodied and vulnerable pedestrians. This research is among the earliest in Canada to investigate theoretical and empirical bases for operationalizing walkability in rural settings in broader efforts to foster health-promoting community environments.     

A procedure for detecting childhood cancer clusters near hazardous waste sites in Florida

Despite over 20 years of research on childhood cancer clusters and hazardous waste sites, little evidence has been produced to indicate a causal relationship. Nevertheless, the perception of a childhood cancer cluster being located near a hazardous waste site can raise fear and uncertainty, and it demands attention from health officials. To investigate this public health concern, the author used the spatial-scan statistical software SaTScan to detect childhood cancer clusters and their proximity to National Priority List (NPL), or Superfund, sites in Florida. In the ecological study reported here, "most likely" clusters were defined as those with a p-value of < .05. Distance served as a proxy for exposure; a geographical information system (GIS) was used to determine the number of clusters within a predetermined distance of an NPL site. Spatial clusters were found to occur randomly throughout the state, with most clusters being identified in the more populated counties, and clusters less likely to occur near an NPL site. This article attempts to explain the utility of an emerging public health surveillance tool for detecting cancer clusters near hazardous waste sites. Despite several epidemiological limitations of the study, as well as the fact that there are other environmental exposure hazards such as Toxic Release Inventory facilities and landfills, the SaTScan program proved useful as a surveillance tool for generating more in-depth studies.     

Home care before and after hospitalization for acute myocardial infarction in Alberta, Canada

Home care services are provided to about 10% of those admitted to hospital for acute myocardial infarction and about 20% of those discharged from hospital. The use of home care in patients with an acute myocardial infarction is growing in Alberta over the brief time span of this four year study. Those that received home care prior to a hospitalization for acute myocardial infarction were "old and frail" with a high mortality rate during and after hospitalization. The provision of home care after hospitalization selected those patients that stay in hospital longer and required more hospital care. BACKGROUND: The use of home care before and after hospitalization for acute myocardial infarction is described. METHODS: Hospital discharge abstracts were used to identify patients hospitalized in alberta, canada for acute myocardial infarction which were then linked to home care administrative data. RESULTS: There were 12,648 patients with acute myocardial infarction from April 1, 1995 until March 31, 1999. Home care within 60 days prior to hospitalization was provided for 8.7% of patients with acute myocardial infarctions (n = 1097) which significantly (p = 0.023) increased from 7.6% in the fiscal year 1995/6 to 9.5% in the fiscal year 1998/9. Home care within 60 days after hospitalization was provided to 16.4% of patients with acute myocardial infarctions (n = 2076) which significantly (p < 0.000) increased from 14.1% in the fiscal year 1995/6 to 18.1% in fiscal year 1998/9. Recipients of home care were significantly older, had more comorbidities, and greater severity of illness, but were less likely to undergo coronary artery revascularization during hospitalization. After multivariate adjustment, length of hospital stay, 60 day re-admissions, and mortality were higher in those receiving home care post hospitalization. Nearly half of those receiving home care prior to hospitalization died within one year. 80% of those receiving home care prior to admission also received home care services after hospitalization. CONCLUSION: Those patients who received home care prior to a hospitalization for acute myocardial infarction were "old and frail" with a high mortality rate during and after hospitalization. The provision of home care after hospitalization selected those patients that stay in hospital longer and required more hospital care.     

Temporal clusters of Salmonella serovars in humans in Alberta, 1990-2001

BACKGROUND: Temporal clusters of salmonellosis are believed to occur but have not been quantitatively explored, thus, our objectives were to describe trends, seasonal patterns, and clusters of salmonellosis in humans in Alberta by examining isolates reported through passive surveillance systems. METHODS: Cases of salmonellosis reported through Notifiable Disease Records between January 1990 and December 2001 were obtained from Alberta Health and Wellness. Least squares regression was used to characterize the distribution (long-term trends and seasonal patterns) of isolates. A cluster detection test was used to determine if and when isolates of specific serovars aggregated in time, over and above the background distribution. Comparisons were made to temporal patterns in Alberta livestock and to known outbreaks in humans. RESULTS: S. Typhimurium, Enteritidis, Hadar, Heidelberg, and Thompson were the five most common serovars of the 9,188 isolates reported. The annual number of isolates was relatively stable over time, with a distinct summertime seasonal pattern. Clusters were observed in 23 of 32 serovars examined. More clusters occurred in September and October than in other months, and in 1998 through 2001 than in the early to mid-1990s. Also, more clusters were of short duration than long. INTERPRETATION: Short-duration clusters likely indicate a point source of infection, while long-duration clusters may indicate exposure to a persistent common source or the occurrence of secondary infections. A sharp increasing trend and a large cluster of S. Heidelberg may have public health implications. Surveillance activities focussed on similarities between common serovars, trends, and temporal clusters in humans and animals, and studies on factors associated with autumn clusters may be useful in preventing outbreaks in humans.