Report summary - Mood and Anxiety Disorders in Canada, 2016. / Note de synthèse - Les troubles anxieux et de l'humeur au Canada, 2016.

Mood and Anxiety Disorders in Canada, 2016 is the first publication to include administrative health data from the Canadian Chronic Disease Surveillance System (CCDSS) for the national surveillance of mood and anxiety disorders among Canadians aged one year and older. It features nationally complete CCDSS data up to fiscal year 2009/10, as well as trend data spanning over a decade (1996/97 to 2009/10). The data presented in this report, and subsequent updates, can be accessed via the Public Health Agency of Canada's Chronic Disease Infobase Data Cubes at www.infobase.phac-aspc.gc.ca. Data Cubes are interactive databases that allow users to quickly create tables and graphs using their Web browser. The report demonstrates the Public Health Agency of Canada's commitment to improving data collection and reporting about mental illness, as recommended within Changing Directions, Changing Lives - The Mental Health Strategy for Canada.

RÉSUMÉ: Le rapport Les troubles anxieux et de l'humeur au Canada, 2016 est la première publication à présenter des données administratives sur la santé tirées du Système canadien de surveillance des maladies chroniques (SCSMC) pour la surveillance nationale des troubles de l'humeur et d'anxiété chez les Canadiens d'un an ou plus. Il présente les données nationales complètes les plus récentes du SCSMC jusqu'à l'exercice 2009-2010 ainsi que des données sur les tendances couvrant plus d'une décennie (de 1996-1997 à 2009-2010). Les données présentées ici et leurs mises à jour subséquentes sont consultable à partir des cubes de données de l'Infobase des maladies chroniques de l'Agence de la santé publique du Canada à www.infobase.phac-aspc.gc.ca. Les cubes de données sont des bases de données interactives qui permettent aux utilisateurs de créer rapidement des tableaux et graphiques à l'aide de leur navigateur Web. Le rapport témoigne de l'engagement de l'Agence de la santé publique du Canada à améliorer la collecte de données et la production de rapports sur les troubles mentaux, conformément aux recommandations de Changer les orientations, changer des vies : Stratégie en matière de santé mentale pour le Canada.

Chromatographic, NMR and vibrational spectroscopic investigations of astaxanthin esters: application to "Astaxanthin-rich shrimp oil" obtained from processing of Nordic shrimps.

Astaxanthin (ASTX) is a keto carotenoid, which possesses a non-polar linear central conjugated chain and polar ß-ionone rings with ketone and hydroxyl groups at the extreme ends. It is well known as a super anti-oxidant, and recent clinical studies have established its nutritional benefits. Although it occurs in several forms, including free molecule, crystalline, aggregates and various geometrical isomers, in nature it exists primarily in the form of esters. Marine animals accumulate ASTX from primary sources such as algae. Nordic shrimps (P. borealis), which are harvested widely in the Atlantic Ocean, form a major source of astaxanthin esters. "Astaxanthin-rich shrimp oil" was developed as a novel product in a shrimp processing plant in Eastern Canada. A compositional analysis of the shrimp oil was performed, with a view to possibly use it as a nutraceutical product for humans and animals. Astaxanthin-rich shrimp oil contains 50% MUFAs and 22% PUFAs, of which 20% are omega-3. In addition, the shrimp oil contains interesting amounts of EPA and DHA, with 10%/w and 8%/w, respectively. Astaxanthin concentrations varied between 400 and 1000 ppm, depending on the harvesting season of the shrimp. Astaxanthin and its esters were isolated from the oil and analysed by NMR, FTIR and Micro-Raman spectroscopy. Astaxanthin mono- and diesters were synthesized and used as standards for the analysis of astaxanthin-rich shrimp oil. NMR and vibrational spectroscopy techniques were successfully used for the rapid characterization of monoesters and diesters of astaxanthin. Raman spectroscopy provided important intermolecular interactions present in the esterified forms of astaxanthin molecules. Also discussed in this paper is the use of NMR, FTIR and Micro-Raman spectroscopy for the detection of astaxanthin esters in shrimp oil.

A 16-week randomized controlled trial evaluating the physical activity guidelines for adults with spinal cord injury.

STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To evaluate the effectiveness of the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) to improve aspects of physical fitness. SETTING: Community exercise facility. METHODS: Twenty-three participants (age: 40.4±11.6 years, C1-T11, 12.0±10.0 years post injury) were randomized into PAG training (n=12) or active control (CON, n=11) groups. PAG training was 2x per week for 16 weeks and involved 20 min of aerobic exercise at a moderate to vigorous intensity and three sets of 10 repetitions (at 50-70% 1 repetition maximum; 1RM). Pre- and post-testing included peak exercise and aerobic endurance tests on an arm ergometer and 1RM testing. RESULTS: Nineteen participants (PAG, n=11; CON, n=8) completed the 16-week training program and post-testing. There was a significant (P<0.05) increase in peak aerobic capacity (relative VO2peak: 17.2%, absolute VO2peak: 9.9%) and submaximal power output (26.3%) in the PAG group only. Increases in strength ranged from 11.5-38.9% and were significantly (P<0.05) different from CON for vertical bench press, seated row, and rickshaw press. Adherence to the exercise program was 85.2±8.3% for PAG, 44.4±34.3% for CON (P<0.01). CONCLUSION: The PAG for adults with SCI are sufficient to improve aspects of aerobic and muscular fitness and should be promoted as a means to improve physical capacity. SPONSORSHIP: Ontario Neurotrauma Foundation (ONF), Natural Sciences and Engineering Research Council (NSERC) of Canada.

Exercise equipment preferences among adults with spinal cord injury.

STUDY DESIGN: Cross-sectional. OBJECTIVES: To evaluate exercise equipment preferences and compare cardiometabolic demand for passive hybrid and arm-only exercise among adults with paraplegia (PP) and those with tetraplegia (TP). SETTING: Four community exercise programmes. METHODS: Thirty-six adults (mean age: 41.1±12.1 years) with chronic (11.4±10.7 years post injury) TP (C3-C8; n=17) or PP (T3-T12; n=19) were recruited. Participants completed 20 min of submaximal aerobic exercise at moderate to vigorous intensity on four types of aerobic exercise equipment: arm cycle ergometer (ACE), arm glider (AG), arm-leg recumbent stepper (ALRS), and arm-leg cycle ergometer (ALCE). Participants also completed 3 sets of 10 repetitions of resistance exercise using wall pulleys (WP) and weight stack (WS) equipment. A questionnaire was administered to evaluate equipment preference. Heart rate (HR) and oxygen uptake (VO2) were measured in a subset of participants (n=9) during submaximal aerobic exercise. RESULTS: Arm-only exercise modes were perceived as being safer than passive hybrid exercise modes. There were no differences in perceived enjoyment between equipment types and groups. There were significant group but not equipment differences in HR (TP: 101.4 bpm; PP: 124.9 bpm) and VO2 (TP: 6.5 ml•kg(-1)•min(-1); PP: 10.5 mL•kg(-1)•min(-1)) during submaximal aerobic exercise. CONCLUSION: In this cross-community assessment of exercise equipment preferences after spinal cord injury (SCI), arm-only exercise modes were perceived as safer than hybrid exercise modes and there were no differences between equipment types in physiological responses.

Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation.

STUDY DESIGN: Sixteen-week follow-up study. OBJECTIVE: To evaluate the efficacy of referral from a health-care provider to regular exercise combined with 16 weeks of counselling support following discharge from inpatient or outpatient spinal cord injury (SCI) rehabilitation. SETTING: Two rehabilitation centres in Canada. METHODS: Seventeen participants (age 42.1±10.6 years, C3-T12, ASIA impairment score A-C) were recruited at discharge from inpatient (n=9; 5.2±1.3 months post-injury) or outpatient (n=8; 14.2±3.8 months post-injury) rehabilitation and were given a referral for regular exercise. Telephone counselling support was provided and adherence to the prescribed program was monitored for 16 weeks. RESULTS: There was a nonsignificant difference in exercise adherence rates (percentage of available sessions attended) between participants discharged from inpatient (71.4±44.9%) and those from outpatient (39.5±27.2%) rehabilitation programs. The most common barriers to participation were physical health problems (50%) and transportation (36%). An exercise beliefs questionnaire revealed that participants value exercise at discharge from rehabilitation, despite the common report of a relative lack of confidence in their ability to perform or adapt aerobic and resistance exercises to their specific capabilities. CONCLUSION: A system of direct referral and ongoing counselling support following discharge from either inpatient or outpatient SCI rehabilitation appears to encourage sustained participation, although future health promotion strategies should continue to provide specific information about how to adapt and complete aerobic and resistance exercises. SPONSORSHIP: Rick Hansen Institute and Ontario Neurotrauma Foundation.

Schmallenberg virus: a seroprevalence survey in cattle and sheep, France, winter 2011-2012.

In France, a national surveillance plan to monitor congenital Schmallenberg virus (SBV) outbreaks was set up in January 2012, and has shown that SBV had become widespread throughout the country since mid-2011. However, the number of SBV-infected farms cannot accurately be estimated through congenital SBV reporting alone. Therefore, GDS France (National Animal Health Farmers' Organization) conducted serological investigations in cattle and sheep holdings in several departments in spring 2012 to assess SBV exposure in 2011. A serological study was also conducted in the department of Saône-et-Loire (southern Burgundy) to establish an accurate local overview of circulation of virus in 2011 among cattle. The study was conducted following guidelines elaborated by the French Platform for animal health surveillance. Results indicated differences in within-herd seroprevalence between cattle herds and sheep herds in departments where outbreaks of congenital SBV were reported in early 2012 and a great heterogeneity in seroprevalence between areas (even between areas geographically close to each other). In departments which had been severely affected in early 2012, the overall impact of SBV infection in cattle herds during the 2012-2013 calving season will probably be low. On the other hand, given the low proportion of immunised ewes in sheep SBV outbreaks, sheep flocks which were already affected in early 2012 may once again face congenital cases of SBV.

[Labour epidural analgesia for a parturient with a factor XI deficiency: an ill-considered challenge or a reasonable risk?]. / Analgésie péridurale obstétricale chez une parturiente atteinte d'un déficit en facteur XI : défi inconsidéré ou risque raisonné ?

The authors report the performance of a labour epidural analgesia in a 26-year-old parturient presenting a moderate factor XI (FXI) deficiency. If haemostasis disorders usually contraindicate an epidural analgesia (with a risk of epidural haematoma), a moderate FXI deficiency is not an absolute contraindication to perform such an epidural analgesia. Desmopressin, sometimes used in surgery to reduce the bleeding, was administered to withdraw the catheter in better haemostasis conditions. No neurological signs were observed.

Report summary. Diabetes in Canada: facts and figures from a public health perspective.

"Diabetes in Canada: facts and figures from a public health perspective" is the first comprehensive diabetes surveillance report published by the Public Health Agency of Canada. The report aims to support public health professionals and organizations in developing effective, evidence-based public health policies and programs to prevent and manage diabetes and its complications. The report, developed in collaboration with provincial and territorial governments, the Canadian Diabetes Association, Juvenile Diabetes Research Foundation, CNIB, Health Canada and the academic community, uses data from national health surveys and vital statistics, as well as population-based administrative data from the Canadian Chronic Disease Surveillance System (CCDSS). For the first time, the CCDSS contains data from all 13 Canadian jurisdictions. Using CCDSS data representing cases of diagnosed diabetes among Canadians aged one year and older, Diabetes in Canada presents prevalence and incidence national rates from the fiscal year 2008/2009 and national trends from 1998/1999 onwards. The report also outlines sub-populations at higher risk, ways of reducing the risks of developing the disease and its complications, and estimates of related economic costs. In addition, it contains sections on specific populations, including children and youth and First Nations, Inuit and Métis populations.

The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVES: To conduct a systematic review of evidence surrounding the effects of exercise on physical fitness in people with spinal cord injury (SCI). SETTING: Canada. METHODS: The review was limited to English-language studies (published prior to March 2010) of people with SCI that evaluated the effects of an exercise intervention on at least one of the four main components of physical fitness (physical capacity, muscular strength, body composition and functional performance). Studies reported at least one of the following outcomes: oxygen uptake/consumption, power output, peak work capacity, muscle strength, body composition, exercise performance or functional performance. A total of 166 studies were identified. After screening, 82 studies (69 chronic SCI; 13 acute SCI) were included in the review. The quality of evidence derived from each study was evaluated using established procedures. RESULTS: Most studies were of low quality; however, the evidence was consistent that exercise is effective in improving aspects of fitness. There is strong evidence that exercise, performed 2-3 times per week at moderate-to-vigorous intensity, increases physical capacity and muscular strength in the chronic SCI population; the evidence is not strong with respect to the effects of exercise on body composition or functional performance. There were insufficient high-quality studies in the acute SCI population to draw any conclusions. CONCLUSIONS: In the chronic SCI population, there is good evidence that exercise is effective in improving both physical capacity and muscular strength, but insufficient quality evidence to draw meaningful conclusions on its effect on body composition or functional capacity.

Muscle fatigue characteristics in paralyzed muscle after spinal cord injury.

STUDY DESIGN: The study design used is cross-sectional. OBJECTIVES: The aim of this study is to examine muscle contractile and excitability characteristics during fatigue of the tibialis anterior in six individuals with chronic spinal cord injury (SCI) and matched able-bodied (AB) controls. SETTING: McMaster University, Hamilton, ON, Canada. METHODS: Muscle compound action potential (M-wave) characteristics, muscle twitch properties, and summated force were examined during a 2 min fatigue protocol of intermittent bursts at 30 Hz (4 s tetanus, 2 s rest) or maximal voluntary contraction (MVC). Evoked twitch responses were followed during a recovery period. RESULTS: M-wave amplitude was smaller in SCI (2.5 ± 1.6 mV in SCI, 5.7 ± 3.2 mV in AB) at baseline, but there was no change in M-wave amplitude or area during fatigue in either group. There was an increase in M-wave duration toward the end of recovery in the SCI group. Peak torque (PT) was not different between groups at baseline (3.8 ± 1.8 Nm in SCI, 3.7 ± 0.6 Nm in AB); PT potentiated significantly during fatigue in the AB, but not SCI group. There was significantly greater fatigue of both PT (43% decline) and summated force (57% decline) in the SCI group compared with the AB group (13% increase and 22% decline for PT and MVC, respectively). CONCLUSION: The dorsiflexor muscles in people with SCI are significantly more fatiguable than those in AB controls, but decreases in muscle excitability do not seem to be an important contributor to the increased fatiguability. The mechanisms behind the increased fatigue must lie distal to the muscle membrane.

Wavelet-based estimation of the hemodynamic responses in diffuse optical imaging.

Diffuse optical imaging uses light to provide a surrogate measure of neuronal activation through the hemodynamic responses. The relative low absorption of near-infrared light enables measurements of hemoglobin changes at depths reaching the first centimeter of the cortex. The rapid rate of acquisition and the access to both oxy and deoxy-hemoglobin leads to new challenges when trying to uncouple physiology from the signal of interest. In particular, recent work provided evidence of the presence of a 1/f noise structure in optical signals and showed that a general linear model based on wavelets can be used to decorrelate the structured noise and provide a superior estimator of response amplitude when compared with conventional techniques. In this work the wavelet techniques are extended to recover the full temporal shape of the hemodynamic responses. A comparison with other models is provided as well as a case study on finger-tapping data.

The length-tension relationship of human dorsiflexor and plantarflexor muscles after spinal cord injury.

STUDY DESIGN: A cross-sectional design. OBJECTIVES: To examine the length-tension relationship of dorsiflexion (DF) and plantarflexion (PF) muscle groups in seven individuals with chronic spinal cord injury (SCI; C2-T7; age 43+/-10.1 years) and compare it with a group of age and sex-matched able-bodied (AB) controls. SETTING: McMaster University, Hamilton, ON, Canada. METHODS: Isometric single twitch properties, 0.5-s tetanic contractions (SCI) and maximal voluntary contractions (AB) were measured at nine joint angles from 20 degrees DF to 20 degrees PF. RESULTS: In the DF muscles, peak-evoked twitch (PT) torque occurred at 20 degrees PF for SCI (3.4+/-1.1 N m) and AB (3.8+/-1.4 N m) with no difference in peak torque between groups, whereas peak summated force occurred at 10 degrees PF in AB and 20 degrees PF in SCI (P<0.01). In the PF muscles, PT torque occurred at 15 degrees DF in AB (18.6+/-2.6 N m) and at 5 degrees DF (6.8+/-3.3 N m; P<0.01) in SCI, and peak-summated force occurred at 15 degrees DF in AB. The SCI group did not show any change in PF peak-summated force with varying joint angles. Rates of contraction and relaxation were not different between the two groups. CONCLUSIONS: The results suggest a significant change in the length-tension relationship of the PF muscles after SCI, but no change in the DF muscle group. Rehabilitation programs should focus on maintaining PF muscle length in order to optimize muscle strength and function after SCI.