Heather Gilmour

Development and validation of prediction algorithms for major depressive episode in the general population.

BACKGROUND To develop and validate sex specific prediction algorithms for 4-year risk of major depressive episode (MDE) using data from a population-based longitudinal cohort. METHODS Household residents from 10 provinces were randomly recruited and interviewed by Statistics Canada. 10,601 participants who were aged 18 years and older and who did not meet the criteria for MDE in the 12 months prior to a baseline interview in 2000/01 were included in algorithm development; data from 7902 participants who were aged 18 and older and who were free of MDE in 2004/05 were used for validation. Validation was also conducted in sub-populations that are of practice and policy importance. MDE was assessed using the World Health Organizations Composite International Diagnostic Interview(CIDI)-Short Form for Major Depression (CIDI-SFMD). RESULTS In the training data, the C statistics for algorithms in men was 0.7953 and was 0.7667 for algorithm in women. The algorithms had good predictive power and calibrated well in the development and validation data. LIMITATIONS The data relied on self-report. MDE was assessed with CIDI-SFMD. It was not feasible to validate the algorithms in different populations from different countries. CONCLUSIONS More studies are needed to further validate and refine these algorithms. However, the ability of a small number of easily assessed variables to predict MDE risk indicates that algorithms are a promising strategy for identifying individuals in need of enhanced monitoring and preventive interventions. Ultimately, application of algorithms may lead to increased personalization of treatment, and better clinical outcomes.

Estimates and determinants of HPV non-vaccination and vaccine refusal in girls 12 to 14 y of age in Canada: Results from the Childhood National Immunization Coverage Survey, 2013.

ABSTRACT Since the introduction of HPV vaccination programs in Canada in 2007, coverage has been below public health goals in many provinces and territories. This analysis investigated the determinants of HPV non-vaccination and vaccine refusal. Data from the Childhood National Immunization Coverage Survey (CNICS) 2013 were used to estimate the prevalence of HPV non-vaccination and parental vaccine refusal in girls aged 12–14 years, for Canada and the provinces and territories. Multivariate logistic regression was used to examine factors associated with non-vaccination and vaccine refusal, after adjusting for potential confounders. An estimated 27.7% of 12–14 y old girls had not been vaccinated against HPV, and 14.4% of parents reported refusing the vaccine. The magnitude of non-vaccination and vaccine refusal varied by province or territory and also by responding parents country of birth. In addition, higher education was associated with a higher risk of refusal of the HPV vaccine. Rates of HPV non-vaccination and of refusal of the HPV vaccine differ and are influenced by different variables. These findings warrant further investigation.

Determinants of non-vaccination and incomplete vaccination in Canadian toddlers

ABSTRACT Vaccination coverage remains suboptimal in Canada and sporadic outbreaks of vaccine-preventable diseases such as measles and pertussis continue to occur. This study was undertaken to identify sociodemographic determinants of total non-vaccination (having never received any vaccine), non-vaccination for measles (0 doses) and incomplete vaccination for pertussis (< 4 doses) among 2-year-old Canadian children. Data from the 2013 Childhood National Immunization Coverage Survey (CNICS) were used. Associations between sociodemographic factors and outcomes were measured by multiple logistic regressions and adjusted odds ratios (aOR) were calculated. A total of 5,477 children were included in the analyses of total non-vaccination, and 3,899 children were included in the analysis of non-vaccination for measles and incomplete vaccination for pertussis. Overall, 2.7% of children (95% CI 2.0–3.3) had received no vaccine at all. Lower parental education, i.e., the responding parent having a high school diploma, trade certificate or less (compared with university graduation) was associated with total non-vaccination (aOR 1.99, 95% CI 1.02–3.91). Non-vaccination for measles was more frequent among children of single parent families (aOR 1.63, 95% CI 1.01–2.61) and those of parents with lower education (aOR 1.86, 95% CI 1.26–2.76). The odds of incomplete vaccination for pertussis was greater among children born outside Canada (aOR 3.10, 95% CI 1.73–5.58), of parents with lower education (aOR 1.92, 95% CI 1.41–2.62), and those whose household income was between

Depression and work impairment.

40,000 and

Validation of self-rated mental health

59,999 (aOR 1.47; 95% CI 1.04–2.07) or lower than

Dependency, chronic conditions and pain in seniors.

40,000 (aOR 1.58, 95% CI 1.13–2.22). Significant regional variation was also found for all outcomes. In conclusion, despite universal access to free childhood vaccines in Canada, regional variation and socioeconomic inequalities in vaccine uptake were still observed. Further analyses are warranted to identify barriers contributing to these variations.