Participation in Physical Activity for Children with Neurodevelopmental Disorders

The purpose of this study was to compare rates of participation for children (4–9 years of age) with neurodevelopmental disorders (NDDs) with and without externalizing behavior problems (EBPs) with children without disability and to examine mediators of the relation between disability and physical activity participation. Data for this study were drawn from Cycle 7 (2006-07) of the Canadian National Longitudinal Survey of Children and Youth (NLSCY). The frequency of children's participation in organized sports or physical activities varied depending on the child's health condition with children with NDDs and both NDDs and EBPs participating least in organized sports or physical activities followed by children with EBPs only. In contrast, there were no statistically significant differences by health group for children's participation in unorganized sports or physical activities. These differences remained even after controlling for the effects of other child and family sociodemographic characteristics, except for children with EBPs only. These findings highlight the importance of considering children's primary and other existing health conditions as well as family sociodemographic characteristics in order to better understand the factors that influence participation in organized physical activities for children with disabilities

What Statistics Canada Survey Data Sources are Available to Study Neurodevelopmental Conditions and Disabilities in Children and Youth?

Researchers with an interest in examining and better understanding the social context of children suffering from neurodevelopmental disabilities can benefit by using data from a wide variety of Statistics Canada surveys as well as the information contained in administrative health databases. Selective use of a particular survey and database can be informative particularly when demographics, samples, and content align with the goals and outcomes of the researcher’s questions of interest. Disabilities are not merely conditions in isolation. They are a key part of a social context involving impairment, function, and social facilitators or barriers, such as work, school and extracurricular activities. Socioeconomic factors, single parenthood, income, and education also play a role in how families cope with children’s disabilities. Statistics indicate that five per cent of Canadian children aged five to 14 years have a disability, and 74 per cent of these are identified as having a neurodevelopmental condition and disability. A number of factors must be taken into account when choosing a source of survey data, including definitions of neurodevelopmental conditions, the target group covered by the survey, which special populations are included or excluded, along with a comparison group, and the survey’s design. Surveys fall into categories such as general health, disability-specific, and children and youth. They provide an excellent opportunity to look at the socioeconomic factors associated with the health of individuals, as well as how these conditions and disabilities affect families. However rich the information gleaned from survey data, it is not enough, especially given the data gaps that exist around the health and well-being of children and older youths. This is where administrative and other data can be used to complement existing data sources. Administrative data offer specific information about neurological conditions that won’t be collected in general population surveys, given the nature of such surveys. While researchers can glean information from survey data such as functional health and disability, social inclusion or exclusion, and the role of social determinants in the lives of these children and their families, administrative data can identify rare neurodevelopmental conditions and disabilities not captured in general surveys. Analyzing information from all these sources can lead to a more nuanced understanding of the economic and social impacts, and functional limitations in daily living, that patients and their families experience with certain neurodevelopmental conditions and disabilities. Statistics Canada surveys offer a plethora of information for researchers interested in neurodevelopmental disabilities and social determinants of health. As these surveys are national in their scope, they provide a wealth of information for statistical analysis from people across Canada. This information can be used to inform researchers, policy makers, and families of people who live with neurodevelopmental conditions and disabilities. For example, sophisticated microsimulation modelling techniques have been conducted to project the health and economic impacts from such disabilities 20 years into the future. Such projections will be vital for policy-makers tasked with designing services and programs to assist these people. Much work remains to be done, however. Statistics Canada has already begun working on the potential for using administrative data to conceptualize childhood disability, as well as using data that has been anonymized in national administrative databases to study the health of Canada’s children. These are excellent bases from which to build future research

Linking Culture and Language to Aboriginal Children’s Outcomes: Lessons from Canadian Data

Aboriginal children have been shown to have poorer health and educational outcomes compared to non-Aboriginal children. Culture is an important determinant of health and well-being, yet it is rarely studied in terms of its association with young children’s outcomes. Language being one component of culture, the revitalization of traditional Aboriginal languages is an important contributor to both individual and community health as well as educational achievement. This paper will summarize multiple studies using data from the Aboriginal Children’s Survey and the Aboriginal Peoples Survey to highlight various outcomes for Aboriginal children in Canada, first in terms of the role of cultural participation, and then specifically speaking an Aboriginal language, on young Aboriginal children’s education and health outcomes. ----- Il a été démontré ailleurs que les enfants autochtones sont en moins bonne santé et ont des résultats scolaires plus faibles relativement aux enfants non autochtones. La culture est un déterminant important de la santé et du bien-être, mais on ne l’étudie que rarement en fonction de son association aux résultats scolaires chez les jeunes enfants. La langue étant un des constituants de la culture, la revitalisation des langues autochtones traditionnelles est un contributeur important à la santé individuelle et communautaire ainsi qu’à la réussite scolaire. Cet article résume plusieurs études en utilisant les données de l’Enquête sur les enfants autochtones et l’Enquête auprès des peuples autochtones pour mettre en évidence divers résultats sur l’éducation et la santé pour les enfants autochtones au Canada – d’abord en termes du rôle de la participation culturelle, puis en ciblant ceux qui parlent une langue autochtone particulière

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Sex-related differences in oncologic outcomes, operative complications and health-related quality of life after curative-intent oesophageal cancer treatment: multicentre retrospective analysis

Background: Oesophageal cancer, in particular adenocarcinoma, has a strong male predominance. However, the impact of patient sex on operative and oncologic outcomes and recovery of health-related quality of life is poorly documented, and was the focus of this large multicentre cohort study. Methods: All consecutive patients who underwent oncological oesophagectomy from 2009 to 2015 in the 20 European iNvestigation of SUrveillance after Resection for Esophageal cancer study group centres were assessed. Clinicopathologic variables, therapeutic approach, postoperative complications, survival and health-related quality of life data were compared between male and female patients. Multivariable analyses adjusted for age, sex, tumour histology, treatment protocol and major complications. Specific subgroup analyses comparing adenocarcinoma versus squamous cell cancer for all key outcomes were performed. Results: Overall, 3974 patients were analysed, 3083 (77.6%) male and 891 (22.4%) female; adenocarcinoma was predominant in both groups, while squamous cell cancer was observed more commonly in female patients (39.8% versus 15.1%, P < 0.001). Multivariable analysis demonstrated improved outcomes in female patients for overall survival (HRmales 1.24, 95% c.i. 1.07 to 1.44) and disease-free survival (HRmales 1.22, 95% c.i. 1.05 to 1.43), which was caused by the adenocarcinoma subgroup, whereas this difference was not confirmed in squamous cell cancer. Male patients presented higher health-related quality of life functional scores but also a higher risk of financial problems, while female patients had lower overall summary scores and more persistent gastrointestinal symptoms. Conclusion: This study reveals uniquely that female sex is associated with more favourable long-term survival after curative treatment for oesophageal cancer, especially adenocarcinoma, although long-term overall and gastrointestinal health-related quality of life are poorer in women

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Neighborhood Factors and Language Outcomes of First Nations Preschoolers Living Off Reserve: Findings from the Aboriginal Children\u27s Survey

Language skills in the preschool period are an important indicator of early development and school readiness for children. However, little is known about the association between aspects of the neighborhood and language outcomes for First Nations children. The purpose of the current study was to examine the effects of neighborhood structural and organization features, as well as the mediation of these effects, on the language outcomes of First Nations children aged 2-5 living off reserve. Data from the Aboriginal Children’s Survey was examined. Both neighborhood structure and neighborhood organization were important for language outcomes. In addition, mediation effects were shown, suggesting that family-level as well as neighborhood structural variables are particularly important for the language outcomes of young First Nation children living off reserve