Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.

INTRODUCTION: The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. METHODS: We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." RESULTS: Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. DISCUSSION: Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.

TITRE: Étude sur les systèmes d'échange des connaissances pour la santé des jeunes et la prévention des maladies chroniques : étude de cas menée dans trois provinces. INTRODUCTION: Les équipes de recherche ont adopté un modèle d'étude de cas utilisant un cadre d'analyse commun dans le but d'étudier trois systèmes provinciaux (Île-du-Prince-Édouard, Nouveau-Brunswick et Manitoba) d'échange des connaissances. Ces trois systèmes visent à générer et utiliser des données probantes lors de l'élaboration des politiques, de la planification des programmes et des évaluations afin d'améliorer la santé des jeunes et de prévenir les maladies chroniques. MÉTHODOLOGIE: Nous avons appliqué un modèle d'étude de cas pour examiner en profondeur les leçons apprises (c.-à-d. les principales conditions ou les principaux processus contribuant au développement de la capacité d'échange des connaissances) à l'aide d'une méthode de collecte de données multiples. Les activités de gestion, de synthèse et d'analyse des données ont été simultanées, itératives et continues. Les leçons apprises ont été classées en sept catégories. RÉSULTATS: L'échange des connaissances est un processus complexe, qui exige des champions et des partenariats de collaboration, une adaptation aux divers intervenants et qui exige aussi que les régions soient préparées. ANALYSE: Dans l'ensemble, les systèmes d'échange des connaissances peuvent accroître la capacité d'échange et d'utilisation des données probantes en allant au-delà de la collecte et de la transmission de données. Leurs aires d'influence sont l'établissement de nouveaux partenariats, des activités élargies d'échange des connaissances et le perfectionnement des approches axées sur les politiques et les pratiques liées à la santé des jeunes et à la prévention des maladies chroniques.

Increased risk of second malignancies in chronic lymphocytic leukaemia patients as compared with follicular lymphoma patients: a Canadian population-based study.

BACKGROUND: Chronic lymphocytic leukaemia (CLL) patients have an increased risk of other malignancies. This may be due to surveillance bias, treatment or immunosuppression. METHODS: Cohort study of 612 consecutively diagnosed CLL patients in a Canadian province, with comparisons to follicular lymphoma (FL) patients. RESULTS: Treated CLL patients had a 1.7-fold increased risk of second cancers compared with untreated CLL patients. As compared with untreated FL patients, untreated CLL patients had a two-fold increased incidence of second malignancies. CONCLUSION: Chronic lymphocytic leukaemia patients have an inherent predisposition to second cancers and the incidence is further increased by treatment.

Effects of socialization in the household on youth susceptibility to smoking: a secondary analysis of the 2004/05 Canadian Youth Smoking Survey.

OBJECTIVE: To determine associations between younger youths' susceptibility to smoking and four household variables related to tobacco socialization: parental and sibling smoking, restrictions on smoking in the home and exposure to smoking in vehicles. METHODS: A secondary analysis of the 2004/05 Canadian Youth Smoking Survey used logistic regression to investigate the relationships between youth susceptibility to smoking, gender, and four household variables related to tobacco socialization. Susceptibility to smoking was operationalized by three levels of smoking experience and intention: non-susceptible non-smoker, susceptible non-smoker and experimenter/smoker. The national survey included 29 243 grade 5 to 9 students from randomly sampled public and private schools in ten provinces. RESULTS: For non-smokers, the odds of being susceptible to smoking increased with having a sibling who smokes, a lack of a total household smoking ban and riding in a vehicle with a smoker in the previous week, when adjusting for all other variables in the model. These variables also increased the odds of being an experimenter/smoker versus a susceptible non-smoker. Parent smoking status was not significant in these models. CONCLUSION: Denormalization messages, through enforced home and vehicle smoking bans, appear to support youth in maintaining a resolve to not smoke, regardless of parental smoking status.

Discrepancies between youth and parent perceptions of their household environment relevant to smoking: a secondary analysis of the 2004/05 Canadian Youth Smoking Survey.

OBJECTIVE: To compare the perceptions of youth in grades 5 to 9 and parents regarding their household environment relevant to smoking socialization. METHODS: We conducted secondary analysis of the 2004/05 Canadian Youth Smoking Survey and corresponding parent survey, and used the McNemar Test to compare youth and parent responses. RESULTS: Results showed statistically significant patterns of disagreement between youth and parent responses at most levels of youth smoking uptake regarding parental smoking, household rules around smoking, and smoking in the home and vehicles. When youth and parents disagreed, the following patterns emerged: non-susceptible, non-smoking youth perceived their parents as non-smokers and youth with more smoking experience perceived their parents as smokers; youth at all levels of smoking uptake perceived fewer rules in the home than parents indicated, more smoking in the home than parents indicated, and exposure to smoking in vehicles in contrast to vehicle smoking bans indicated by parents. CONCLUSION: To the best of our knowledge, this is the first study to compare the perceptions of youth and parents regarding household variables related to the socialization of tobacco use. The discrepancies between youth and parent responses suggest that there is room to improve on establishing household environments that clearly condemn the use of tobacco, which may affect youth susceptibility to future smoking.

Racism, psychological injury, and compensatory damages.

Psychiatrists and other mental health professionals have paid only modest attention to the idea that discriminatory conduct causes emotional suffering for those who are the object of it. However, courts have held that if such racist conduct is willful and outrageous and the ensuing suffering is severe, the plaintiff has a reasonable claim to compensatory damages. The authors trace these developments in the legal arena in both tort actions and complaints under civil rights statutes. They also point out how psychiatrists could be more influential in sharpening considerations about the idea that racism causes psychological injury.

Modern mankind's influence on the natural cycles of phosphorus.

When the molten surface of the earth solidified over 4 X 10(9) years ago the quantity of phosphorus to be contained in the storehouse of the new planet had already been resolved. The phosphorus was locked in an igneous lithosphere as orthophosphate. With the advent of the first primitive rainstorms the slow endless process of liberating the phosphorus from the igneous rock strata had begun. It required about 3 X 10(9) years for this process to supply enough soluble phosphates for the seas of the earth to become saturated with respect to apatites. Today slightly more than half of the phosphate is contained in sedimentary deposits. The established phosphorus cycles of the earth were almost independent of the activities of mankind for more than 4 X 10(9) years. Only in the past 200 years has the influence been worthy of consideration and as late as the 1960s too few reliable data were available for us to assess the status of our activities on the natural cycles. Today a reasonably clear picture is emerging.

Phosphorus, a key to life on the primitive Earth.

The phosphorus of the primitive Earth was present as phosphates. It is strongly probably that a portion of the phosphate was present as condensed phosphates. The primitive Earth was highly deficient in the total available phosphorus until a sufficient quantity of phosphorus weathered from the igneous rocks in which it was entrapped. Approximately three billion years were required for the seas to become saturated. Until this time passed the seas acted as a giant sink for phosphorus, diluting it to the extent that all forms of life were deprived of the vital nutrient. When the seas became saturated, the rate of turn over of the phosphorus increased rapidly. As the seas pulsated, they left the excess precipitate phosphorus as sedimentary rock in locally righ deposits on which life could thrive.