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Aim: This study aimed to describe and compare the sociodemographic and health characteristics of people with a current cancer diagnosis (CC), past cancer diagnosis (PC) and never diagnosed with cancer (NC) across three life-course stages: adolescence and young adulthood (AYA) (age 15–39 years), midlife (40–64) and later-life (65+). Subjects and methods: Population-based survey data collected between 2015 and 2018 were used to estimate characteristics by cancer status and life-course stage. Multivariable logistic regression was used to examine associations between cancer status and health after adjusting for sociodemographics and comorbidities. Results: During AYA and midlife, over 20% of the CC group reported dealing with long-term illness as their main activity over the past week. Compared to the NC group, in AYA the PC group were 2.45 times (95% CI 1.37–4.38) more likely to drink 4+ times per week and 1.56 times (95% CI 1.14–2.12) more likely to smoke daily. The odds of meeting physical activity guidelines were lower in the CC than NC group in both midlife (OR = 0.70, 95% CI 0.58–0.85) and later life (OR = 0.85, 95% CI 0.75–0.97). Across the life course, the CC group were more likely than the NC group to report fair to poor health with ORs decreasing from 18.54 (95% CI 8.39–40.97) in AYA to 3.60 (95% CI 3.14–4.12) in later life, and both the CC and PC groups were more likely than the NC group to report multiple chronic conditions. Conclusions: Cancer survivors experience adverse economic and health outcomes across the life course, particularly earlier in their cancer journey. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation interventions implemented in emergency department (ED) settings have resulted in limited success, owing to factors such as lack of time, motivation, and incentives. A dynamic yet simple and effective approach that addresses the fast-paced nature of acute-care ED settings is needed. This study proposes a multi-center randomized controlled trial (RCT) to compare the effectiveness of an easy to deliver proactive, multi-component tobacco treatment intervention to usual care in the ED setting.Methods: This will be a prospective four-site, single-blind, blinded-endpoint (PROBE) RCT. Participants will be recruited directly in the ED and will be approached strictly in order of arrival time. Those randomized to the Quit Card Intervention (QCI) group will receive a "quit kit" which will include: a "Quit Card" worth $300 that can be used at any Canadian pharmacy to purchase any form of nicotine replacement therapy (NRT); a self-help booklet; and proactive enrolment in 6 months of telephone follow-up counseling. The usual care (UC) group will receive a "quit kit" which will include a brochure for a local smoking cessation program. Quit kits for both groups will be delivered in opaque, sealed envelopes, and identical in size and weight so to conceal group allocation from the blinded research coordinator. Randomization will be stratified by site and by the Canadian Triage Acuity Scale (CTAS), a value assigned to each ED patient based on the severity of the condition. An equal number of quit kits will be prepared for each CTAS level. The primary outcome will be bio-chemically verified smoking abstinence at 26 weeks. Secondary outcomes include smoking behavior at weeks 4, 52, and 104 as well as mortality and health care utilization outcomes. Investigators, outcome assessors, and data analysts will be blinded to group allocation until after primary analyses are completed. It is hypothesized that the QCI group will have higher a abstinence rate, improved health outcomes, and decreased healthcare utilization.Discussion: There are few examples of hospital EDs in Canada that systematically initiate tobacco cessation interventions for patients who smoke. Given the high smoking prevalence among ED patients and the relation of tobacco smoking to the majority of ambulatory care sensitive conditions, EDs are a missed opportunity in the initiation of tobacco treatment interventions. We have designed and will test an evidence-based tobacco treatment intervention that is simple and highly scalable.Trial Registration: ClinicalTrials.gov NCT04163081 . Registered on November 14, 2019. [ABSTRACT FROM AUTHOR]

This article analyses the consumption of alcohol amongst Canadian soldiers based in the East Sussex town of Hastings in 1917. It shows that more relaxed restrictions on alcohol in Britain to those in Canada, all provinces and eventually the federal government had prohibited alcohol by 1918, proved too much of a temptation for some Canadians, who were caught up in instances of drunkenness, disorder and petty crime. The wide availability of alcohol in the town coupled with poor administration and scattered billets provided a fertile environment for ill-discipline. This caused tension between some in the community and the Canadians. Another theme which started to emerge in Hastings was that Canada was more socially advanced than Britain. The motherland's reluctance to completely ban alcohol was viewed as archaic and backwards. For some Canadians, this warranted a loosening of the attachment to Britain and the Empire in favour of Canada. The Canadian's experience of alcohol in Hastings may, therefore, point to how Canada was moving away from Britain and the Empire and strengthening its own sense of self. This aspect warrants further research. [ABSTRACT FROM AUTHOR]

Background: Knowledge brokering is a knowledge translation approach that has been gaining popularity in Canada although the effectiveness is unknown. This study evaluated the effectiveness of generalised, exclusively email-based prompts versus a personalised remote knowledge broker for delivering evidence-based mood management interventions within an existing smoking cessation programme in primary care settings.Methods: The study design is a cluster randomised controlled trial of 123 Ontario Family Health Teams participating in the Smoking Treatment for Ontario Patients programme. They were randomly allocated 1:1 for healthcare providers to receive either: a remote knowledge broker offering tailored support via phone and email (group A), or a generalised monthly email focused on tobacco and depression treatment (group B), to encourage the implementation of an evidence-based mood management intervention to smokers presenting depressive symptoms. The primary outcome was participants' acceptance of a self-help mood management resource. The secondary outcome was smoking abstinence at 6-month follow-up, measured by self-report of smoking abstinence for at least 7 previous days. The tertiary outcome was the costs of delivering each intervention arm, which, together with the effectiveness outcomes, were used to undertake a cost minimisation analysis.Results: Between February 2018 and January 2019, 7175 smokers were screened for depression and 2765 (39%) reported current/past depression. Among those who reported current/past depression, 29% (437/1486) and 27% (345/1277) of patients accepted the mood management resource in group A and group B, respectively. The adjusted generalised estimating equations showed that there was no significant difference between the two treatment groups in patients' odds of accepting the mood management resource or in the patients' odds of smoking abstinence at follow-up. The cost minimisation analysis showed that the email strategy was the least costly option.Conclusions: Most participants did not accept the resource regardless of remote knowledge broker strategy. In contexts with an existing KT infrastructure, decision-makers should consider an email strategy when making changes to a programme given its lower cost compared with other strategies. More research is required to improve remote knowledge broker strategies.Trial Registration: ClinicalTrials.gov, NCT03130998 . Registered April 18, 2017, (Archived on WebCite at www.webcitation.org/6ylyS6RTe ). [ABSTRACT FROM AUTHOR]

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In 1916, Canadians were swept up in the rhetoric of a purifying Holy War. The citizen soldier became the embodiment of Christ in the ultimate fight against evil. As the mirror for the nation, he reflected the moral character and aspirations of purity. The behaviour of soldiers stationed in Calgary were publically scrutinised, especially as to their use of alcohol. The evils of alcohol galvanised various groups to move towards Prohibition as the ultimate war measure. This directly affected military recruitment efforts and served to alienate the soldier and the reality of his experiences from the home front. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article examines attitudes to alcohol and their relationship with the development of laws relating to alcohol in Great Britain in the period 1914-1918. The countries adopting alcohol prohibition includes Belgium and Canada. It observes why the British government resisted pressure to implement radical measures to regulate alcohol. It also explores the links of the temperance movement to the Liberal Party.

Aims This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences. Participants and design Subjects were 10 466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study. Setting Canada. Measurements The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion). Findings Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking. Conclusions Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution. [ABSTRACT FROM AUTHOR]

Copyright of Revue Anthropologie et Sociétés is the property of Anthropologie et Societies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the context of the family in Western society, alcohol often has been viewed as a problem. This article traces how the use of beverage alcohol in Canada related to the family in the transition from the preindustrial to late-twentieth-century era. Powerful temperance movements in the nineteenth century, and divisive prohibition policies in the early twentieth, attempted to protect the material and moral health of the family. Although liquor laws and social attitudes became more open starting in the 1930s, the medicalized discourse on alcoholism in the 1940s and 1950s was linked to notions of the family. Liberalization of retail and on-premise sales of alcohol in the 1960s and 1970s attempted to portray moderate drinking by adults as "normal" family activity. In the last quarter of the century, a neotemperance movement, reacting to issues such as impaired and driving and teenage drinking, suggested that alcohol's relationship to the family remained highly ambiguous. [ABSTRACT FROM AUTHOR]

Unlabelled: BACKGROUND⁄, Objective: Alcoholic liver disease (ALD) is a controversial yet established indication for liver transplantation (LT), and there is emerging evidence supporting a survival benefit in selected patients with severe acute alcoholic hepatitis. The aim of the present survey was to describe policies among Canadian transplant centres for patients with ALD., Methods: A survey was distributed to the medical directors of all seven liver transplant centres in Canada., Results: All seven liver transplant programs in Canada participated in the survey. Every centre requires patients to have a minimum of six months of abstinence from alcohol before listing for LT. Completion of a rehabilitation program is only mandatory in one program; the remaining programs do not mandate this if patients have demonstrated prolonged abstinence, and sufficient insight and social supports. No program considers LT for patients with severe acute alcoholic hepatitis, although six of the seven programs are interested in exploring a national policy. Random alcohol checks for waitlisted patients are performed routinely on patients listed for ALD at only one centre; the remaining centres only perform checks if there is clinical suspicion. In the past five years, the mean (± SD) number of patients per centre with graft dysfunction from recidivism was 10±4.36; a mean of 2.5±4.36 patients per centre developed graft failure., Conclusions: With minor exceptions, LT policies for subjects with ALD are uniform across Canadian transplant programs. Presently, no centres perform LT for acute alcoholic hepatitis, although there is broad interest in exploring a national policy. Recidivism resulting in graft loss is a rare phenomenon.

Objective: to establish national standards of care for the screening and recording of alcohol use and counselling on alcohol use of women of child-bearing age and pregnant women based on the most up-to-date evidence., Evidence: published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in May 2009 using appropriate controlled vocabulary (e.g., pregnancy complications, alcohol drinking, prenatal care) and key words (e.g., pregnancy, alcohol consumption, risk reduction). Results were restricted to literature published in the last five years with the following research designs: systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment (HTA) and HTA-related agencies, national and international medical specialty societies, clinical practice guideline collections, and clinical trial registries. Each article was screened for relevance and the full text acquired if determined to be relevant. The evidence obtained was reviewed and evaluated by the members of the Expert Workgroup established by the Society of Obstetricians and Gynaecologists of Canada. The quality of evidence was evaluated and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care., Values: the quality of evidence was rated using the criteria described by the Canadian Task Force on Preventive Health Care (Table 1)., Sponsor: the Public Health Agency of Canada and the Society of Obstetricians and Gynaecologists of Canada., Endorsement: these consensus guidelines have been endorsed by the Association of Obstetricians and Gynecologists of Quebec; the Canadian Association of Midwives; the Canadian Association of Perinatal, Women's Health and Neonatal Nurses (CAPWHN); the College of Family Physicians of Canada; the Federation of Medical Women of Canada; the Society of Rural Physicians of Canada; and Motherisk. SUMMARY STATEMENTS: 1. There is evidence that alcohol consumption in pregnancy can cause fetal harm. (II-2) There is insufficient evidence regarding fetal safety or harm at low levels of alcohol consumption in pregnancy. (III) 2. There is insufficient evidence to define any threshold for low-level drinking in pregnancy. (III) 3. Abstinence is the prudent choice for a woman who is or might become pregnant. (III) 4. Intensive culture-, gender-, and family-appropriate interventions need to be available and accessible for women with problematic drinking and/or alcohol dependence. (II-2)., Recommendations: 1. Universal screening for alcohol consumption should be done periodically for all pregnant women and women of child-bearing age. Ideally, at-risk drinking could be identified before pregnancy, allowing for change. (II-2B) 2. Health care providers should create a safe environment for women to report alcohol consumption. (III-A) 3. The public should be informed that alcohol screening and support for women at risk is part of routine women's health care. (III-A) 4. Health care providers should be aware of the risk factors associated with alcohol use in women of reproductive age. (III-B) 5. Brief interventions are effective and should be provided by health care providers for women with at-risk drinking. (II-2B) 6. If a woman continues to use alcohol during pregnancy, harm reduction/treatment strategies should be encouraged. (II-2B) 7. Pregnant women should be given priority access to withdrawal management and treatment. (III-A) 8. Health care providers should advise women that low-level consumption of alcohol in early pregnancy is not an indication for termination of pregnancy. (II-2A).

Background: Inconsistent findings regarding the relationship between alcohol consumption and depression, including whether the relationship is J-shaped or U-shaped, may be at least partly due to the types of measures used for both alcohol consumption and depression., Methods: We conducted a general population survey using random digit dialing (RDD) and computer-assisted telephone interviewing (CATI) with 6,009 males and 8,054 females aged 18 to 76 years. The survey included 4 types of alcohol measures (frequency, usual and maximum quantity per occasion, volume, and heavy episodic drinking) covering both the past week and the past year, and 2 types of depression measures (meeting DSM criteria for a clinical diagnosis of major depression, recent depressed affect)., Results: The overall relationship between depression and alcohol consumption did not vary by gender or type of depression measure but did vary significantly by type of alcohol measure, with the strongest relationship found for heavy episodic drinking and high quantity per occasion. There were also significant gender interactions with both depression and alcohol measures, with females showing a stronger relationship than males when depression was measured as meeting the criteria for major depression and when alcohol consumption was measured as quantity per occasion or heavy episodic drinking. There was some evidence of a J-shaped relationship, that is, greater depression among abstainers compared with those who usually drank 1 drink and never drank as much as 5 drinks for both former drinkers and lifetime abstainers when depression was measured as recent symptoms of depression but the J shape was found only for former drinkers when depression was measured as meeting the criteria for major depression and did not reach statistical significance in some analyses., Conclusions: The results of the present study suggest that measurement and gender are key issues in interpreting findings on the relationship between alcohol and depression. First, depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. Second, the overall relationship between depression and alcohol consumption is stronger for women than for men only when depression is measured as meeting a clinical diagnosis of major depression and not when measured as recent depressed affect. Finally, while there was some evidence that former drinkers had slightly higher rates of major depression and higher scores on recent depressed affect compared with light drinkers, there was no evidence that light drinking was protective for major depression when compared with lifetime abstainers, although light drinkers did report fewer recent symptoms of depressed affect.

This paper provides an overview of the context, definition, and key features of the harm reduction approach, and provides several examples of current programs in various countries. Both licit and illicit drugs are included in these illustrations. Some of the critical issues, and the strategies needed to advance harm reduction, are discussed. [Translations are provided in the International Abstracts Section of this issue.]

Of three communities changing their alcohol control policies, only Frobisher Bay, the most isolated, experienced a noticeable decrease in arrests for assault and public drunkenness.

Alcohol policy in North America is dominated by moderation and abstinence-based modalities that focus on controlling population-level alcohol consumption and modifying individual consumption patterns to prevent and reduce alcohol-related harms. However, conventional alcohol policies and interventions do not adequately address harms associated with high-risk drinking among individuals experiencing severe alcohol use disorder (AUD) and structural vulnerability such as poverty and homelessness. In this commentary we address this gap in alcohol harm reduction, and highlight the lack of, and distinct need for, alcohol-specific harm reduction for people experiencing structural vulnerability and severe AUD. These individuals, doubly impacted by structural oppression and severe AUD, engage in various high-risk drinking practices that contribute to a unique set of harms that conventional abstinence-based treatments and interventions fail to adequately attend to. Managed alcohol programs (MAPs) have been established to address these multiple intersecting harms, and though gaining momentum across Canada, have had a hard time finding their place within the harm reduction movement. We illustrate how MAPs play a crucial role in the harm reduction movement in their ability to not only address high-risk drinking practices among structurally marginalized individuals, but to respond to harms associated with broader structural inequities such as poverty and homelessness. [ABSTRACT FROM AUTHOR]

The proportion of youth who abstain from alcohol use decreases during adolescence but little attention has focused on factors associated with abstinence. No research has examined this question for Indigenous youth, many of whom live in communities experiencing high rates of alcohol-related health problems. Using data from a longitudinal study of Indigenous youth (n = 649, ages 10-17 years) in the U.S. and Canada, the current study investigates factors associated promoting or decreasing abstaining from alcohol use. Results from generalized linear growth models demonstrate that abstinence declines significantly during adolescence. In concurrent models, caretaker monitoring and school adjustment increased the odds of abstaining, and frequency of smoking cigarettes and number of best friends who drink decreased the odds. In lagged analysis, only school adjustment, smoking, and peer drinking remained significant. Time-stable characteristics moderated several time-varying associations. This study has important implications for programs aimed at encouraging alcohol abstinence. [ABSTRACT FROM AUTHOR]

The 1920s American alcohol prohibition is notorious but not unique. Quite a few countries went through a vigorous struggle. But it is in Canada in 1898 that the very first national referendum on prohibition in the world took place. In this article, we focus on this rare and neglected event in Canadian history, in which the government came close but finally did not impose prohibition. In our empirical analysis, we use census district-level data to investigate how the shares of Yes, No and Abstentions vary according to four sets of factors: religious, demographic, social and economic. Our results confirm the literature on temperance and prohibition with religion [Evangelicals against Catholics and Anglicans] as the key explanatory variable, followed by the heterogeneity of the population, measured by the proportion of foreign-born. Urbanization has also the expected (although small) impact. Results for wealth are mixed. The economic interest rationale is not confirmed but that can be explained by the historical context. [ABSTRACT FROM AUTHOR]

Proposes a reconceptualization of militancy to reflect the nomothetic goals of the new temperance movement and examines the effect of selected socio-demographic variables and problems with others' alcohol use on the formation of nomothetic militancy toward alcohol use among a sample of Canadian abstainers and drinkers. Use of National Alcohol and Other Drugs Survey; Selected regression statistics; Discussion; Conclusion.

Abstract: Background: Low threshold methadone maintenance (MMT) was developed for clients who do not have abstinence as a treatment goal. We explored how MMT programs in Canada defined low threshold and the challenges they faced. Methods: Using semi-structured interviews, we collected data from clients (n =46), nurses/counsellors (n =15) and physicians (n =9) at three low threshold MMT programs. All participants were asked to define low threshold MMT and describe how it was implemented in practice. Interviews were taped, transcribed, verified and analysed using an iterative thematic coding technique. Results: Low threshold MMT was defined by an explicit rejection of abstinence from opiates and other drugs as an over-arching treatment goal. In the absence of guidelines defining a set of practices as low threshold, programs implemented practices they believed would reduce barriers to admission and help retention. There was not always agreement between professional groups or across the programs regarding these practices. For physicians, there was a tension between accepting poly-drug use during treatment as a means to improve retention, with an obligation to do more good than harm for their patients. Missed prescribing appointments generated few to severe consequences and revealed differential focus on reducing barriers versus encouraging client ‘ownership’ of treatment. Differences of opinion regarding appropriate urine drug testing practices revealed power dynamics between medical and non-medical staff. Conclusion: Our findings show that there are potentially more ways to reduce barriers to MMT than those presented in the current literature. Our findings are important given the growing number of people with opiate dependence across the world and calls to increase access to MMT. To fully develop the low threshold model, it will be important to evaluate what policies and practices can achieve the goals of reducing barriers to admission and improving retention in treatment. [Copyright &y& Elsevier]