In This Issue
- Meet the Dean
- Report from the Chair
- Project Update
- ACHORD Seen & Heard
- Recent Literature
- Meet the Staff
- ACHORD Accolades
- Other ACHORD News
- Spring 2013
- December 2012
- September 2012
- April 2012
- December 2011
- July 2011
- all previous issues
ACHORD Seen & Heard
Agborsangaya CB, Gee M, Johnson ST, Dunbar P, Langlois MF, Leiter L, Pelletier C, Johnson JA. Determinants of Lifestyle Behavior in Type 2 Diabetes: Results of the 2011 Cross-Sectional Survey on Living with Chronic Disease in Canada. BMC Public Health 2013 7;13:451. PMID: 23647616.
Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Health related quality of life and healthcare utilization in multimorbidity: Results of a cross sectional survey. Qual Life Res 2013 22(4):791-9. PMID: 22684529.
Al Sayah F, Lau D, Ishaque S, Johnson JA. Health-related quality of life measures in Arabic-speaking populations: A systematic review on cross-cultural adaptation and measurement properties. Qual Life Res 2013 22(1):213-29. PMID: 22350531.
Baluch A, Humar A, Eurich DT, Egli A, Liacini A, Hoschler K, Campbell P, Berka N, Urschel S, Wilson L, Kumar D. Randomized controlled trial of high-dose intradermal versus standard-dose intramuscular influenza vaccine in organ transplant recipients. Am J Transplant. 2013 Apr;13(4):1026-33. PMID: 23406320.
Eurich DT, Weir DL, Majumdar SR, Tsuyuki RT, Johnson JA, Tjosvold E, Vanderloo SE, McAlister FA. Comparative Safety and Effectiveness of Metformin in Patients with Diabetes and Heart Failure: Systematic Review of Observational Studies involving 34000 Patients. Circ HF 2013 May;6(3):395-402. PMID: 23508758.
Eurich DT, Simpson S, Senthilselvan A, Asche CV, Sandhu-Minhas JK, McAlister FA. Comparative safety and effectiveness of sitagliptin in patients with type 2 diabetes: retrospective population based cohort study. BMJ. 2013 Apr 25;346:f2267. PMID: 23618722. Featured for Commentary Segal J. Should we be reassured about sitagliptin? BMJ 2013;346:f3051. Featured for Commentary MedLinx.
Gamble JM, Johnson JA, Majumdar SR, McAlister FA, Simpson SH, Eurich DT. Evaluating the introduction of a computerized prior-authorization system on the completeness of drug exposure data. Pharmacoepidemiol Drug Saf 2013 22(5):551-5. PMID: 23475736.
Gee M, Pickett WL, Campbell N, Johnson JA, Janssen I. Health behaviors for hypertension management in people with and without coexisting diabetes. J Clin Hyp 2013 15(6):389-96. PMID: 23730987.
Hackam DG, Quinn RR, Ravani P, Rabi DM, et al. The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2013 May;29(5):528-42. PMID: 23541660.
James MT, Tonelli M, Ghali WA, Knudtson ML, Faris P, Manns BJ, Pannu N, Galbraith PD, Hemmelgarn BR; Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease and Alberta Kidney Disease Network Investigators. Renal outcomes associated with invasive versus conservative management of acute coronary syndrome: propensity matched cohort study. BMJ. 2013 Jul 5;347:f4151. PMID: 23833076.
Kahlon S, Eurich DT, Padwal RS, Malhotra A, Minhas-Sandhu JK, Marrie TJ, Majumdar SR. Obesity and outcomes in patients hospitalized with pneumonia. Clin Microbiol Infect. 2013 Aug;19(8):709-16. PMID: 22963453.
Lau D, Eurich DT, Majumdar SR, Katz A, Johnson JA. Effectiveness of Influenza Vaccination in Working Age Adults with Diabetes: A Population Based Cohort Study. Thorax 2013;68:658-663. PMID: 23535212.
Nguyen DT, Leung KK, McIntyre L, Ghali WA, Sauve R. Does integrated management of childhood illness (IMCI) training improve the skills of health workers? A systematic review and meta-analysis. PLoS One. 2013 Jun 12;8(6):e66030. PMID: 23776599.
Rabi DM, Padwal R, Tobe SW, Gilbert RE, Leiter LA, Quinn RR, Khan N; Canadian Hypertensive Education Program and Canadian Diabetes Association. Risks and benefits of intensive blood pressure lowering in patients with type 2 diabetes. CMAJ. 2013 Aug 6;185(11):963-7. PMID: 23734033.
Tricco AC, Antony J, Soobiah C, Hemmelgarn B, Moher D, Hutton B, Yu CH, Majumdar SR, Straus SE. Safety, effectiveness, and cost of dipeptidyl peptidase-4 inhibitors versus intermediate acting insulin for type 2 diabetes: protocol for a systematic review and network meta-analysis. Syst Rev. 2013 Jun 28;2:47. PMID: 23810103.
Vallance JK, Eurich DT, Lavallee C, Johnson ST. Daily pedometer steps among older men: associations with health-related quality of life and psychosocial health. Am J Health Promot. 2013 May-Jun;27(5):294-8. PMID: 23402230.
Abdelmoneim A, Eurich DT, Senthilselvan A, Qiu W, Simpson S. Glyburide, in contrast to gliclazide, has a dose-response relationship with adverse cardiovascular outcomes in type 2 diabetes patients. The 29th International Conference on Pharmacoepidemiology & Therapeutic Risk Management. Montreal, Quebec, Canada. August 25-28, 2013.
Al Sayah F, Rees S, Wozniak L, Majumdar SR, Johnson JA. Patient assessment of chronic illness care within the TeamCare-PCN study: A controlled trial of a collaborative care model for patients with Diabetes. 2013 Canadian Association for Health Services and Policy Research Conference, May 27-30, 2013, Vancouver, BC.
Agborsangaya C, Ngwakongnwi E, Cooke T, Lahtinen M, Johnson JA. Multimorbidity as a driver of health care utilization: Results of the 2012 Health Quality Council of Alberta’s Patient Satisfaction and Experience Survey. 2013 Canadian Association for Health Services and Policy Research Conference, May 27-30, 2013, Vancouver, BC.
Hwang J, Bowen S, Rudnisky C, Johnson JA. Socioeconomic disparities in eye screening services among diabetic patients in Alberta, 1995-2009. 2013 Canadian Association for Health Services and Policy Research Conference, May 27-30, 2013, Vancouver, BC.
Hwang J, Bowen S, Rudnisky C, Johnson JA. Socioeconomic disparities in the use of eye screening services among diabetic patients in Alberta: using the Alberta Diabetes Surveillance System 1995-2009. 2013 Canadian Public Health Association Annual Conference, June 9-12, 2013, Ottawa, ON.
Hwang J, Bowen S, Rudnisky C, Johnson JA. Determinants of Socioeconomic Disparities in Eye Screening Services among Diabetic Patients in Alberta, Canada, 1995-2009. 73rd Annual American Diabetes Association Scientific Sessions, Chicago, IL, June 20-25, 2013. (published only). Diabetes 2013;62(suppl 1):A2659-PO.
Hwang J, Bowen S, Rudnisky C, Johnson JA. Socioeconomic disparities in eye screening services among diabetic patients in Alberta, Canada, 1995-2009. 2013 Academy Health Annual Research Meeting, June 23-25, 2013, Baltimore, MD.
Johnson JA, Al Sayah F, Rees S, Wozniak L, Majumdar SR. Collaborative Primary Care Model for Diabetes and Depression: Results of a Controlled Implementation Trial. [Oral Presentation] 2013 Canadian Association for Health Services and Policy Research Conference, May 27-30, 2013, Vancouver, BC.
Johnson JA, Al Sayah F, Wozniak L, Rees S, Soprovich A, Qui W, Katon W, Majumdar SR. Limited Effectiveness of Collaborative Primary Care Model for Diabetes and Depression: An Implementation Trial. 73rd Annual American Diabetes Association Scientific Sessions, Chicago, IL, June 20-25, 2013. Diabetes 2013;62(suppl 1):A1231P.
Kaul P, Savu A, Nerenberg K, Johnson JA. Validity of Gestational Diabetes Mellitus in Canadian Administrative Data. 73rd Annual American Diabetes Association Scientific Sessions, Chicago, IL, June 20-25, 2013. Diabetes 2013;62(suppl 1):A1380P.
Lau D, Eurich DT, Majumdar SR, Katz A, Johnson JA. Effectiveness of influenza vaccination in working-age adults with diabetes: a population-based cohort study. 29th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Montreal, Canada. August 2013.
Weir DL, McAlister FA, Senthilselvan A, Dyck JR, Sandhu-Minhas JK, Eurich DT. “The comparative safety and effectiveness of sitaglitpin in patients with type 2 diabetes and heart failure”. 73rd Scientific Sessions American Diabetes Association. Chicago Illinois, USA. June 21-25, 2013. 29th International Conference on Pharmacoepidemiology & Therapeutic Risk Management. Montreal, Quebec, Canada. August 25-28, 2013.
11th Annual ACHORD Retreat
March 6-7, 2014
The Banff Centre
Banff, Alberta, Canada
Meet the Dean, School of Public Health
The University of Alberta School of Public Health appointed Kue Young to be its Dean, effective August 1, 2013. Dr Young has previously been Professor and TransCanada Chair in Aboriginal Health at the University of Toronto, and Head of the Department of Community Health Sciences at the University of Manitoba, Winnipeg, Canada. A public health physician (MD McGill, MSc Toronto) and biological anthropologist (DPhil Oxford), he has worked as a primary care physician, health administrator, and academic researcher in indigenous communities in northern Canada and other circumpolar regions. Of particular interest to ACHORD is that Dr. Young’s major research interest has been in the prevention and control of emerging chronic diseases such as diabetes and cardiovascular diseases.
Congratulations and welcome Dr. Young. We are very pleased to have you at the helm of the School of Public Health!
Report from the Chair
Hello everyone! Fall is quickly approaching, and as it is every year at this time, ACHORD is as busy as ever! Here is a quick update on what we have been doing since our last newsletter.
First, we are very happy to welcome Dr. Kue Young, the new Dean of the School of Public Health. Dr. Young is very well known to people in the diabetes and public health arenas, and is a very high profile recruit for the School of Public Health and the University of Alberta. We are all looking forward to the leadership Dr. Young will be providing the School in the years ahead.
ACHORD members have attended various meetings/conferences this spring/summer. Some of the events that have been attended by ACHORD members are: CAHSPR in Vancouver, CPHA in Ottawa, Academy Health Annual Research Meeting in Baltimore, and the ADA Meeting in Chicago. In the coming weeks I will be attending the ISPE meeting, the EuroQol Group Annual Meeting; the EASD Meeting to be held in Barcelona, Spain; and the CDA Annual Meeting. Trainees and other ACHORD Faculty will be also be attending the ISPE, EASD and CDA meetings. I have also been asked to speak at the upcoming World Diabetes Congress of the IDF to be held in Melbourne, Australia in December.
My work with the Obesity Diabetes and Nutrition (ODN) Strategic Clinical Network (SCN) has continued over the summer, with a particular focus on the development of SCN-sponsored applications for the Partnership in Research and Innovation in the Health System (PRIHS) grant competition. This special funding opportunity is a partnership between Alberta Health Services (AHS) and Alberta Innovates Health Solutions (AIHS), which was announced at the AIHS SCN Research Connections meeting in Jasper in June. All of the SCN Scientific Directors participated in SCN-focused discussions to highlight priorities for our respective SCNs. We developed two PRIHS grants for the ODN SCN, one focused on care and management of gestational diabetes (co-lead with Lois Donovan in Calgary) and the other on care and rehabilitation of severely obese patients in tertiary care centers in Alberta (co-lead with Mary Forhan and Arya Sharma).
As is often the case, over time we find ourselves saying goodbye to some staff, and hello to new staff! I am pleased to welcome Mu Lin, Ana Mladenovic and Jennifer Seida. Mu started with us in May as a biostatistician/data analysts. Ana started in mid-June as a research assistant with the ABCD Project. Jennifer started with us in September, as a research associate supporting a variety of projects, including the PRIHS grant activity for the ODN SCN. We also said goodbye to Lisa Tjosvold, who has been our ACHORD Librarian, but now moving to a position with IHE and to Sandra Rees, who has artfully managed our ABCD Project over the past 5 years, who is now pursuing her Masters in Public Health on a full-time basis. We will miss them both, but I want to wish Lisa and Sandra good luck and thank them for their many years of dedicated service. We are also saying congratulations and goodbye to Jongnam Hwang who successfully completed his PhD oral exam on Friday, August 23, 2013. Jongnam is off to a post doctoral fellowship at St. Michael’s Hospital in Toronto, starting on September 1. All the best to you as well Dr. Hwang!
The Alberta’s Caring for Diabetes (ABCD) project team continues to be busy. The two quality-improvement interventions (HEALD and TeamCare) that were supported by our partner PCNs were completed at the beginning of this year. As such, we’ve shifted our attention to data analysis and dissemination of results. The Aquatic Physical Exercise for arthritis and Diabetes (APEXD), is ongoing, lead by Steve Johnson and being run out of the Leduc Recreation Center. The goal of APEXD is to determine efficacy of an aquatic-based physical activity program for glycemic control and functional status indicators in people with diabetes who have limited mobility. To date, 23 participants have been recruited. Recruitment is currently ongoing for the fourth wave of participants who will be entering the pool for weekly sessions in mid-September. The ABCD Advisory Committee and Implementation & Evaluation Steering Committee held a joint meeting on May 14th with the next meeting planned for November 2013. The focus of these meetings is on presentation of intervention results and knowledge translation strategies. The ABCD Cohort study is well underway with recruitment continuing until the end of 2013. I’m happy to report that over 1900 people with type 2 diabetes around the province have joined the study to date with approximately 2/3rd of the participants just completing their year 2 surveys. We look forward to following this cohort for the next several years. Lastly, a new project has been launched under the ABCD umbrella, where we are exploring the value of screening patients for depression and anxiety as they are discharged from hospital and returning to primary care in the community. You can read more on this in the following article.
I hope the information in our newsletter is informative, and if you have any questions about our activities, please do not hesitate to contact us. I will update you again in late fall/early winter with our ongoing activities in ACHORD. Have a great fall!
Screening for Mental Health at Hospital Discharge.
Beginning in Fall 2013, we will be enrolling patients in a new ACHORD study, which is part of the Alberta’s Caring for Diabetes (ABCD) project, extending our research on mental health in patients with diabetes. Patients being discharged from the general internal medicine unit at the University of Alberta will be eligible to participate in this project, which will screen for symptoms of depression or anxiety at the time of discharge, and again at 30 and 120 days post-discharge. We will use two standardized screening tools, the PHQ-9 and the GAD-2. We will also determine if the patients were re-admitted to hospital and if any have started on new anti-depressant medication. The goal of the study is to evaluate whether symptoms of depression or anxiety are an independent predictor of re-admission after discharge from general internal medicine wards and how patients exhibiting these symptoms are managed in the primary care environment after discharge. We hope to enroll a total of 500 patients by Spring 2014.
Recent Literature from the ACHORD Journal Club
(Paper discussed Tuesday, July 9, 2013; Commentary by Calypse Agborsangaya)
Anokye NK, Trueman P, Green C, Pavey TG, Taylor RS. Physical activity and health related quality of life. BMC Public Health. 2012 Aug 7;12:624. doi: 10.1186/1471-2458-12-624, PMID: 22871153.
Rationale for the study?
The objective of the study was to explore the relationship between health related quality of life (HRQoL) and both objective (measured) and subjective (self-reported) physical activity (PA).
Summary of the study
Using data from the national Health Survey for England 2008, a cross-sectional survey, the authors determined the relationship between health related quality of life (HRQoL) and measures of physical activity (PA). The sample included 5537 adults aged 40-60 years, and patient characteristics were got through an interview that was closely followed by a nurse’s visit. HRQoL was measured using EuroQol’s EQ-5D. The explanatory variable, PA, was determined based on its indicators: walking, sports & exercise, accelerometer measures and self-reported PA.
Considering that the utility score of the EQ-5D, the EQ-5D index score, was the main outcome variable with values ranging from 0 (death) to 1 (complete health), the authors fitted Tobit regressions with upper censoring to model study associations. It was observed that different measures of PA are associated with better HRQoL, and that objective indicators of PA show better HRQoL compared to subjective measures.
The study entails a rigorous methodological exercise with statistical adjustment for socio-demographic and clinical characteristics. The finding that objective measures of PA, compared to subjective measures, are associated with better HRQoL is intriguing.
An important limitation of the study is that the magnitude of the outcome variable (EQ-5D index score) using the Tobit regression model in this study was interpreted as if it were derived from a linear regression. A Tobit regression model is a hybrid model: the first part entailing a linear regression model for values before the upper limit of the point of censoring (in this case 1) and a second part described by the probability of censoring for each values. Thus, the coefficients derived from a Tobit model are inherently different from those of a linear regression and should not be interpreted as a magnitude of difference. That is, although a 3% (or 0.03) difference in EQ-5D index score is considered to be clinically relevant (based on studies using linear regression models), a Tobit regression coefficient of 0.03 will not be given similar interpretation.
Meet the Staff
Mu Lin, PhD Candidate
Mu completed his BSc degree major in Applied Mathematics in 2007 at Huazhong University of Science and Technology, Wuhan, China. The enthusiasm in Mathematics and Statistics eventually led Mu to the University of Alberta in Fall 2007 for his master program in Statistics in the Mathematical and Statistical department. He completed his MSc degree in September 2009 and started his PhD program in Statistics in fall 2009. He is now a PhD candidate and will defend his thesis in October 2013.
Working in ACHORD is a great opportunity for him to apply his knowledge of Statistics and bio statistics into health science related research. He is also excited to learn from the experienced people in the ACHORD Group and help with data analysis. Mu is also a super fan of soccer and badminton. In his spare time, he plays soccer almost every weekend.
Ana Mladenovic, MSc
Assistant Research & Evaluation Coordinator, ABCD
Ana completed a Bachelor of Arts degree in Anthropology and English at the University of Alberta in 2010. A focus on medical anthropology, along with her mother’s diagnosis with breast cancer in 2008, sparked Ana’s interests in chronic diseases and epidemiology. After working and volunteering with non-profit organizations in Edmonton’s inner city, Ana undertook a Masters of Public Health at the University of Queensland in Australia, where she studied with the Cancer Prevention Research Centre, focusing on health promotion interventions for breast cancer survivors. Soon after completing her Masters in June 2013, Ana joined ACHORD. She plans to continue developing her research skills and begin a PhD within the next two years, with an ultimate career goal of research and teaching in an academic environment. Ana is also a foodie, enjoys traveling, reading, distance running and Bikram yoga.
Congratulations to the following students/trainees on their latest accomplishments:
Fatima Al Sayah on receiving the Faculty of Graduate Studies and Research 2013 Graduate Student Teaching Award and one of 20 FGSR Dissertation Fellowship Awards
Gaetanne Murphy on successfully completing her MSc Final Exam
Jongnam Hwang on successfully completing his PhD Final Exam
Daniala Weir on receiving an Alberta Innovates-Health Solutions Graduate Studentship, Alberta Diabetes Institute Graduate Studentship, Canadian Institutes for Health Research Frederick Banting and Charles Best Graduate Scholarship and the Queen Elizabeth II Graduate Scholarship
Other ACHORD News
Mu Lin, Data Analyst with ACHORD
Ana Mladenovic, our Assistant Research and Evaluation Coordinator with ABCD
Jennifer Seida, Research Associate with the SCN ODN
Dr. Kue Young, Dean of the School of Public Health
Welcome Back to:
Allison Soprovich from maternity leave