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Roche M.M.,Newfoundland and Labrador Center for Health Information | Wang P.P.,Memorial University of Newfoundland
Diabetes Care | Year: 2013

OBJECTIVE-To compare risk of all-cause mortality, cardiovascular disease (CVD)mortality, acute myocardial infarction (AMI)mortality, strokemortality, and hospitalizations formales and females with and without diabetes and those with diabetes diagnosed early and late. RESEARCH DESIGN AND METHODS-We conducted a population-based retrospective cohort study including 73,783 individuals aged 25 years or older in Newfoundland and Labrador, Canada (15,152 with diabetes; 9,517 with late diagnoses). RESULTS-Males and females with diabetes had an increased risk of all-cause mortality, CVD mortality,AMImortality, and CVD hospitalizations compared with individuals without diabetes, and the risk was stronger in females than in males. For females, risks of all-cause mortality (hazard ratio [HR] 1.85 [95% CI 1.74-1.96]) and CVD hospitalizations (2.57 [2.24-2.94]) were significantly higher compared with their male counterparts (1.59 [1.51-1.69] and 1.92 [1.72- 2.14]). Females with diabetes diagnosed late had an increased risk of CVDmortality (6.54 [4.80- 8.91]) and CVD hospitalizations (5.22 [4.31-6.33]) compared with females without diabetes, and both were significantly higher compared with their male counterparts (3.44 [2.47-4.79]) and (3.33 [2.80-3.95]). CONCLUSIONS-Females with diabetes have a greater risk of mortality than males with diabetes. CVD has a greater impact on females with diabetes than males, especially when diagnosed at a later stage. Different management strategies should be considered for males and females and those with early and late diagnoses of diabetes. © 2013 by the American Diabetes Association.


Roche M.M.,Newfoundland and Labrador Center for Health Information | Wang P.P.,Memorial University of Newfoundland
Journal of Clinical and Translational Endocrinology | Year: 2014

Aims To examine the factors associated with diabetes, a late diabetes diagnosis, and whether these factors are different for males and females. Methods Cross-sectional study including 7101 individuals aged ≥25 years in Newfoundland and Labrador, Canada (466 with diabetes; 332 diagnosed late). Logistic regression analysis was used to determine the factors associated with a diabetes diagnosis and late diabetes diagnosis. Results For males, overweight/obesity (HR, 1.35; 95% CI, 1.06-1.72) was positively associated with diabetes while being a regular/occasional drinker (HR, 0.53; 95% CI, 0.32-0.88) was inversely associated with diabetes. Living in a rural area (HR, 1.47; 95% CI, 1.01-2.15), receiving social assistance (HR, 2.80; 95% CI, 1.52-5.15), having poor self perceived health (HR, 2.06; 95% CI, 1.32-3.21), and considering most days stressful (HR, 1.45; 95% CI, 1.01-2.10) were positively associated with diabetes for females. No factors were significantly associated with a late diabetes diagnosis for males. Having a low education (OR, 0.33; 95% CI, 0.11-0.99) was inversely associated with a late diabetes diagnosis for females. Conclusions Different factors are associated with diabetes for males and females. Disadvantaged females appear to be at the greatest risk. The factors associated with a late diabetes diagnosis were also different for males and females. Females with lower education levels are diagnosed with diabetes earlier than females with higher education levels. Certain risk factors appear to impact males and females differently and more research is needed on how males and females develop diabetes and when they are diagnosed. © 2014 Published by Elsevier Inc. All rights reserved.


Worrall G.,St. Johns University | Knight J.,Memorial University of Newfoundland | Knight J.,Newfoundland and Labrador Center for Health Information
Canadian Family Physician | Year: 2011

Objective: To examine the relationship between continuity of family physician care and all-cause mortality and acute hospitalizations in older people with diabetes. Design: Retrospective cohort study of administrative health databases. Continuity of family physician care for elderly patients newly diagnosed with diabetes was estimated by 3 continuity indexes using physician claims data. The relationship of continuity of family physician care to mortality and acute hospitalizations was investigated. Setting: The province of Newfoundland and Labrador. Participants: A total of 305 family practice patients 65 years of age or older with diabetes. Main outcome measures: Death rate and hospitalization rate during a 3-year period. Results: Overall, continuity of family physician care was high. In the 3 years examined, the higher-continuity group had lower rates of hospitalization (53.5% vs 68.2%) and death (8.6% vs 18.5%) than the lower-continuity group. Conclusion: The findings suggest an association between higher continuity of family physician care and reductions in likelihood of death and hospitalizations in older people with diabetes.


Edwards N.M.,Newfoundland and Labrador Center for Health Information | Audas R.P.,Memorial University of Newfoundland
Canadian Journal of Public Health | Year: 2010

Objectives: The objective of this study was to investigate whether any observed trends in birthweight are accompanied by changes in maternal socio-demographic characteristics, including age, marital status, and education. Methods: We conducted a population-based study of term singletons born in Newfoundland and Labrador, Canada, between 1992 and 2005 (N=66,638). Large-sample significance tests for two population proportions were used to test whether differences in mean birthweight, the proportion of low and high birthweight infants, and differences in maternal socio-demographic characteristics between 1992-95 and 2002-05 were statistically significant. Chi-square tests were used to test for associations between birthweight group and maternal age, education and marital status. Multivariate logistic regression was used to examine the interaction of these effects across time periods. Results: Of the 66,638 infants included in the study, 54,256 (81.4%) were born in the normal birthweight range (2500-4000 grams) while 11,305 (17.0%) were high birthweight (>4000 grams) and 1,077 (1.6%) were low birthweight (<2500 grams). The rate of low birthweight significantly decreased from 1992 to 1995 compared to the period 2002 to 2005 (1.9% to 1.3%: p<0.01). The rate of high birthweight significantly increased over the same two time periods (16.2% to 17.5%: p<0.01). Mean birthweight increased from 3529 grams to 3566 grams (p<0.01). Compared to women who had babies from 1992 to 1995, women who gave birth from 2002 to 2005 were more likely to be older, have higher levels of education, and never have been married. Birthweight outcomes were significantly associated with mother's age, education and marital status. Conclusion: Changes in maternal demographics are associated with the upward shift in birthweight in Newfoundland and Labrador. © Canadian Public Health Association, 2010. All rights reserved.


MacDonald D.,Newfoundland and Labrador Center for Health Information
Radiology management | Year: 2011

Referring physicians in theWestern Health Authority of Newfoundland and Labrador were administered a survey before and after PACS was implemented across all acute sites in the province.The survey had 31.7% and 35.0% response rates, respectively. There was considerable support found for PACS both pre- and post-implementation in the areas of exam access and review, PACS functionality, quality of reports, efficiency, and site-to-site professional consultations.There was limited support that PACS reduced hospital length of stay. Surveys such as the one employed in this study provide an opportunity to measure the perceived benefit and challenges of PACS in a relatively cost effective manner.

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