Sodium consumption is an important factor related to hypertension, and the subsequent development of cardiovascular disease. 24 hour urine collection is the current gold standard for population-based surveillance of dietary sodium intake, yet such measures are challenging and lacking in Canada. To develop initial estimates of dietary sodium intake and to explore underlying methodological issues in a 24-hour urine sodium survey, a feasibility investigation was conducted in Champlain Health Region of Eastern Ontario. 507 participants were enlisted from an existing Champlain Community Heart Health Study in 2009. Urine sample eligibility was based on adequate urine volume, self-reported completion status, no menstruation, and plausible creatinine levels (Creatinine excretion rate is used to determine the accuracy of 24h urine collection). Valid urine collection data were stratified by age, sex, Body Mass Index (BMI) and urban/rural distribution. Participation rates were low among younger and older populations. A significant number of urine samples were disqualified. The sodium level was highly dependent on creatinine based exclusion criteria, resulting in estimated mean sodium intake varying between 3648 and 6274 mg/day. The level of sodium excretion was highest in the obese followed by the overweight, and lowest in those with a normal/low BMI. The mean sodium level in the urban population was lower than in the rural population; the level for men was slightly higher than for women but similar in the younger (40-55) and older age groups (55-69). In terms of recommended thresholds for daily sodium intake, 99% of adults (ages 40-69) exceeded the Institute of Medicine's Adequate Intake (AI) levels, and 87% exceeded the Tolerable Upper Limit (UL). A recommended limit of 2000 mg. announced recently by Hypertension Canada was exceeded by 90.6%. This study highlights some of the challenges in conducting a 24 hour urinary sodium survey including engaging a broad representation of a community and obtaining sufficiently complete samples. The selection of creatinine based exclusion/inclusion criteria significantly affects the population sodium intake levels, thus calling for a consensus on the methodology. The high estimated sodium intake in the Champlain community calls for broad as well as targeted public health interventions. A targeted approach to reduce sodium intake is indicated given the correlation between BMI and urinary sodium levels as well as the observed urban-rural difference. The extent to which our findings apply to the rest of Canada should be determined from surveys repeated in other Canadian communities.

Hospitalizations and mortality for stroke have been declining. However, stroke remains a leading cause of death and disability for Canadians. This study provides an overall picture of the burden of hospitalized stroke in Canada. Acute care hospital separations from the most recent three fiscal years (2007/08 to 2009/10) with a primary diagnosis of stroke (ICD-10-CA: I60-I69) were identified. The number of stroke hospitalizations, average length of stay (LOS), and discharge dispositions, by age, gender, and province/territory were calculated using IBM/Cognos Data Cubes. The number of stroke hospitalizations remained steady over the three years. The proportion by gender was similar, with males accounting for 51.7% of stroke hospitalizations in 2007/08, 52.3% in 2008/09, and 52.2% in 2009/10. There were more male than female stroke hospitalizations in younger age groups, and more female than male hospitalizations after 80 years of age. The average LOS was 15.3 days over the three years, with females staying longer than males (16.5 vs. 14.1 days). Longer LOS was seen in PEI (22.3 days), NS (21.3 days), and MB (19.9 days); shorter LOS was seen in NB (13.5 days), ON (13.9 days), and SK (14.6 days). The average rate of discharge home was 41.4% over the three years (males: 45.6%; females: 36.8%). Higher rates of discharge home were seen in PEI (57.2%), NT (50.3%), and BC (48.5%); lower rates were seen in NL (22.8%), ON (33.7%), and SK (38.8%). The average in-hospital case-fatality rate was 15.5% (males: 13.6%; females: 17.5%). Higher rates of case-fatality were in NL (18.2%) and NS (17.8%); lower rates were in AB (13.2%), PEI (13.8%), and NB (13.9%). Further, the overall rate for transfer to another health care facility was 43.2% (males: 40.8%; females: 45.7%). In comparison, hospitalized cardiovascular diseases (I00-I99) over the three years had a shorter LOS (8.6 days, males: 7.9; females: 9.7), and a higher discharge home rate (61.6%, males: 64.3%; females: 57.6%), a lower in-hospital case fatality rate (6.6%, males: 5.7%; females: 7.7%). This study provides an overall picture of hospitalized stroke across Canada. In general, stroke hospitalizations have a longer hospital stay, higher in-hospital case fatality, and lower rate of discharge home, which increases the burden per case on the Canadian health care system. Further, characteristics of stroke hospitalizations varied across Canadian provinces and territories. Significant differences in stroke management in Canada need to be addressed.

This study aims to estimate the prevalence of type 1 and type 2 diabetes among Canadian adults.

The licence to operate large CO 2 emission sources is challenging the power and coal industry worldwide and they will require technologies such as CCS to meet the expectations of the community. Overcoming the numerous policy and technical issues will require prompt and insightful decision processes and collaboration between governments and industries. Delay in achieving such outcomes will make the climate mitigation challenge that much more difficult to accomplish. The ZeroGen experience has shown that there are substantial challenges faci ng the future CCS business, which can be summarised into; community acceptance, legal and regulatory risk, commercial uncertainty, and capability in terms of both skills and knowledge. Unlike the oil and gas industry, the power and coal fossil fuel energy based industries are unfamiliar with deep subsurface technologies. To make a difference in terms of emissions reductions from coal fired power stations, the CCS business dealing with geological storage will require significant technology transfer and/or a service industry to rival the current worldwide gas industry.

In 1854, a physician named John Snow identified the source of a cholera outbreak in London, England, as a public water pump on Broad Street in the Soho area of the city. His remedy was to remove the handle of the pump. For actions such as these, John Snow is considered to be one of the great public health and epidemiology pioneers ( 1. Young T.K. Population Health: Concepts and Methods. Oxford University Press, Toronto, ON2005 Google Scholar ).

Prostate cancer is the most commonly diagnosed cancer among Canadian men, excluding non-melanoma skin cancer. Prostate cancer incidence increases almost exponentially with age; most cases are diagnosed in men aged 65 years or older. With the possible exception of animal fat consumption, no known widespread modifiable risk factors have been identified. Although the prognosis is good if appropriate treatment occurs in the early stages of disease, the ability of existing early detection techniques to decrease mortality has not yet been demonstrated. The considerable economic and societal burden of prostate cancer and its treatment, coupled with the projected large increase in the number of new prostate cancer cases as the population ages, make this disease a very important public health issue.