In early May 2003, a small group of four, including three family physicians and a media person, visited various family medicine education and training facilities in Edmonton, Alberta, Canada. This paper is a brief discussion of what knowledge and insight was gained during this trip.
Alberta* ; Canada* ; Education ; Humans ; Physicians, Family

OBJECTIVES: To explore alcohol perceptions and their association hazardous alcohol use in the populations of Alberta, Canada and Queensland, Australia. METHODS: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey was analyzed. Regression analyses were used to explore the association between alcohol perceptions and its association with hazardous alcohol use. RESULTS: Greater hazardous alcohol use was found in Queenslanders than Albertans (p < 0.001). Overall, people with hazardous alcohol were less likely to believe that alcohol use contributes to health problems (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.27 to 0.78; p < 0.01) and to a higher risk of injuries (OR, 0.54; 95% CI, 0.33 to 0.90; p < 0.05). Albertans with hazardous alcohol use were less likely to believe that alcohol contributes to health problems (OR, 0.48; 95% CI, 0.26 to 0.92; p < 0.05) and were also less likely to choose a highly effective strategy as the best way for the government to reduce alcohol problems (OR, 0.63; 95% CI, 0.43 to 0.91; p=0.01). Queenslanders with hazardous alcohol use were less likely to believe that alcohol was a major contributor to injury (OR, 0.39; 95% CI, 0.20 to 0.77; p < 0.01). CONCLUSIONS: Our results suggest that people with hazardous alcohol use tend to underestimate the negative effect of alcohol consumption on health and its contribution to injuries. In addition, Albertans with hazardous alcohol use were less in favor of strategies considered highly effective to reduce alcohol harm, probably because they perceive them as a potential threat to their own alcohol consumption. These findings represent valuable sources of information for local health authorities and policymakers when designing suitable strategies to target alcohol-related problems.
Alberta ; Alcohol Drinking ; Australia ; Canada ; Queensland

BACKGROUND AND PURPOSE: We developed a novel method named Gray-matter Volume Estimate Score (GRAVES), measuring early ischemic changes on Computed Tomography (CT) semi-automatically by computer software. This study aimed to compare GRAVES and Alberta Stroke Program Early CT Score (ASPECTS) with regards to outcome prediction and inter-rater agreement. METHODS: This was a retrospective cohort study. Among consecutive patients with ischemic stroke in the anterior circulation who received intra-arterial therapy (IAT), those with a readable pretreatment CT were included. Two stroke neurologists independently measured both the GRAVES and ASPECTS. GRAVES was defined as the percentage of estimated hypodense lesion in the gray matter of the ipsilateral hemisphere. Spearman correlation analysis, receiver operating characteristic (ROC) comparison test, and intra-class correlation coefficient (ICC) comparison tests were performed between GRAVES and ASPECTS. RESULTS: Ninety-four subjects (age: 68.7+/-10.3; male: 54 [54.9%]) were enrolled. The mean GRAVES was 9.0+/-8.9 and the median ASPECTS was 8 (interquartile range, 6-9). Correlation between ASPECTS and GRAVES was good (Spearman's rank correlation coefficient, 0.642; P<0.001). ROC comparison analysis showed that the predictive value of GRAVES for favorable outcome was not significantly different from that of ASPECTS (area under curve, 0.765 vs. 0.717; P=0.308). ICC comparison analysis revealed that inter-rater agreement of GRAVES was significantly better than that of ASPECTS (0.978 vs. 0.895; P<0.001). CONCLUSIONS: GRAVES had a good correlation with ASPECTS. GRAVES was as good as ASPECTS in predicting a favorable clinical outcome, but was better than ASPECTS regarding inter-rater agreement. GRAVES may be used to predict the outcome of IAT.
Alberta ; Cohort Studies ; Humans ; Male ; Retrospective Studies ; ROC Curve ; Stroke

BACKGROUND AND PURPOSE: We developed a novel method named Gray-matter Volume Estimate Score (GRAVES), measuring early ischemic changes on Computed Tomography (CT) semi-automatically by computer software. This study aimed to compare GRAVES and Alberta Stroke Program Early CT Score (ASPECTS) with regards to outcome prediction and inter-rater agreement. METHODS: This was a retrospective cohort study. Among consecutive patients with ischemic stroke in the anterior circulation who received intra-arterial therapy (IAT), those with a readable pretreatment CT were included. Two stroke neurologists independently measured both the GRAVES and ASPECTS. GRAVES was defined as the percentage of estimated hypodense lesion in the gray matter of the ipsilateral hemisphere. Spearman correlation analysis, receiver operating characteristic (ROC) comparison test, and intra-class correlation coefficient (ICC) comparison tests were performed between GRAVES and ASPECTS. RESULTS: Ninety-four subjects (age: 68.7+/-10.3; male: 54 [54.9%]) were enrolled. The mean GRAVES was 9.0+/-8.9 and the median ASPECTS was 8 (interquartile range, 6-9). Correlation between ASPECTS and GRAVES was good (Spearman's rank correlation coefficient, 0.642; P<0.001). ROC comparison analysis showed that the predictive value of GRAVES for favorable outcome was not significantly different from that of ASPECTS (area under curve, 0.765 vs. 0.717; P=0.308). ICC comparison analysis revealed that inter-rater agreement of GRAVES was significantly better than that of ASPECTS (0.978 vs. 0.895; P<0.001). CONCLUSIONS: GRAVES had a good correlation with ASPECTS. GRAVES was as good as ASPECTS in predicting a favorable clinical outcome, but was better than ASPECTS regarding inter-rater agreement. GRAVES may be used to predict the outcome of IAT.
Alberta ; Cohort Studies ; Humans ; Male ; Retrospective Studies ; ROC Curve ; Stroke

OBJECTIVE: To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. METHODS: A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or < 5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. RESULTS: The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. CONCLUSION: Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.
Alberta ; Classification ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Motor Skills

PURPOSE: The Alberta Stroke Program Early CT Score (ASPECTS) was devised to quantify the extent of early ischemic changes in the middle cerebral artery territory on brain CT. We performed a systematic review and meta-analysis of studies that presented clinical outcomes and baseline ASPECTS in ischemic stroke patients managed with endovascular methods to validate the use of ASPECTS for risk prognostication. MATERIALS AND METHODS: We searched the MEDLINE, EMBASE, and Cochran databases for observational or interventional studies that reported clinical outcomes and baseline ASPECTS in ischemic stroke patients treated with endovascular methods. Data were pooled to perform a meta-analysis for comparisons of clinical outcomes between high and low ASPECTS patients. RESULTS: A meta-analysis of 13 studies (six observational and seven interventional) revealed favorable outcomes (mRS sore 0-2 at 90 days) for high baseline ASPECTS (odds ratio=2.22; 95% CI: 1.74-2.86). CONCLUSION: High ASPECTS is a predictor of favorable outcome after endovascular therapy for ischemic stroke.
Alberta* ; Brain ; Humans ; Middle Cerebral Artery ; Stroke* ; Thrombectomy

BACKGROUND: There are conflicting data in the literature regarding aspirin resistance. This study evaluated the effect of biochemical aspirin resistance on initial stroke severity in acute stroke patients who had taken aspirin. METHODS: We reviewed acute ischemic stroke patients who were already on aspirin. Biochemical aspirin resistance was defined as an aspirin reaction unit score of > or =550, as evidenced by the VerifyNow-Aspirin assay, which was performed after 4 days of continuous aspirin medication. Initial stroke severity was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores at day 4, which were dichotomized into mild (0-7) and severe (> or =8). Modified Rankin Scale scores were determined at 3 months. The Alberta Stroke Program Early CT Scores (ASPECTS) were assessed on initial diffusion-weighted imaging (DWI). We examined the relationships between biochemical aspirin resistance and initial stroke severity. RESULTS: Nine of 106 patients (8.5%) had biochemical aspirin resistance. The initial stroke severity was significantly associated with DWI-ASPECTS (p<0.001), initial C-reactive protein level (p=0.005), biochemical aspirin resistance (p=0.009), and stenosis or occlusion of the relevant artery (p=0.029). Multivariate analysis showed that biochemical aspirin resistance [odds ratio (OR), 15.24; 95% confidence interval (CI), 2.49-93.31; p=0.003] and initial C-reactive protein level (per 1 mg/dL; OR, 2.43; 95% CI, 1.47-4.00; p=0.001) were independently associated with initial stroke severity (NIHSS score > or =8). However, biochemical aspirin resistance was not associated with clinical outcome at 3 months (p=0.366). CONCLUSIONS: Biochemical aspirin resistance was independently associated with initial stroke severity. This suggests that detection of biochemical aspirin resistance in acute ischemic stroke is useful when choosing the optimal treatment.
Alberta ; Arteries ; Aspirin ; C-Reactive Protein ; Constriction, Pathologic ; Humans ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Stroke

OBJECTIVES: This article aimed to compare alcohol consumption between the populations of Queensland in Australia and Alberta in Canada. Furthermore, the associations between greater alcohol consumption and socio-demographic characteristics were explored in each population. METHODS: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey were analyzed. Regression analyses were used to explore the associations between alcohol risk and socio-demographic characteristics. RESULTS: A higher rate of hazardous alcohol use was found in Queenslanders than in Albertans. In both Albertans and Queenslanders, hazardous alcohol use was associated with being between 18 and 24 years of age. Higher income, having no religion, living alone, and being born in Canada were also associated with alcohol risk in Albertans; while in Queenslanders, hazardous alcohol use was also associated with common-law marital status. In addition, hazardous alcohol use was lower among respondents with a non-Catholic or Protestant religious affiliation. CONCLUSIONS: Younger age was associated with greater hazardous alcohol use in both populations. In addition, different socio-demographic factors were associated with hazardous alcohol use in each of the populations studied. Our results allowed us to identify the socio-demographic profiles associated with hazardous alcohol use in Alberta and Queensland. These profiles constitute valuable sources of information for local health authorities and policymakers when designing suitable preventive strategies targeting hazardous alcohol use. Overall, the present study highlights the importance of analyzing the socio-demographic factors associated with alcohol consumption in population-specific contexts.
Alberta* ; Alcohol Drinking ; Australia* ; Canada* ; Marital Status ; Protestantism ; Queensland* ; Risk Factors ; Surveys and Questionnaires

OBJECTIVE: To evaluate concurrent validity between the Korean-Ages and Stages Questionnaires (K-ASQ) and the Denver Developmental Screening Test II (DDST II), and to evaluate the validity of the K-ASQ as a screening tool for detecting developmental delay of Korean children. METHOD: A retrospective chart review was done to examine concurrent validity of the screening potentials for developmental delay between the K-ASQ and the DDST II (n=226). We examined validity of the K-ASQ compared with Capute scale (n=141) and Alberta Infant Motor Scale (AIMS) (n=69) as a gold standard of developmental delay. Correlation analysis was used to determine the strength of the associations between tests. RESULTS: A fair to good strength relationship (k=0.442, p<0.05) was found between the K-ASQ and the DDST II. The test characteristics of the K-ASQ were sensitivity 76.3-90.2%, specificity 62.5-76.5%, positive likelihood ratio (PLR) 2.41-3.40, and negative likelihood ratio (NLR) 0.16-0.32. CONCLUSION: Evidence of concurrent validity of the K-ASQ with DDST II was found. K-ASQ can be used for screening of developmental delay.
Alberta ; Humans ; Infant ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: The outcome for older stroke patients who undergo endovascular revascularization remains unsatisfactory. We aimed to determine the effect of the extent of baseline ischemia on outcome according to age, testing the hypothesis that the restorative capacity for recovery is only marginal in older patients. METHODS: Two hundred and thirteen patients who underwent endovascular revascularization due to occlusion in the M1 segment of the middle cerebral artery (with or without internal carotid artery occlusions) were selected for analysis. Patients were categorized into three age groups: group A (<66 years), group B (66–75 years), and group C (>75 years). Using pretreatment diffusion-weighted imaging (DWI), the Alberta Stroke Program Early CT Score (ASPECTS) and lesion volume were independently measured and analyzed in relation to a favorable outcome. RESULTS: A favorable outcome was achieved in 111 of 213 patients overall: in 60 of the 94 (63.8%) patients in group A, in 36 of the 70 (51.4%) patients in group B, and in 15 of the 49 (30.6%) patients in group C (p=0.001). In older stroke patients (group C), a DWI ASPECTS ≥9 and lesion volume ≤5 mL were found to predict a favorable outcome, which was more restrictive than the cutoffs for their younger counterparts (groups A and B; DWI ASPECTS ≥8 and lesion volume ≤20 mL). CONCLUSIONS: The age-adjusted pretreatment DWI lesion volume and ASPECTS may represent useful surrogate markers for functional outcome according to age. The use of more-restrictive inclusion criteria for older stroke patients could be warranted, although larger studies are necessary to confirm these findings.
Aging ; Alberta ; Biomarkers ; Carotid Artery, Internal ; Diffusion ; Humans ; Ischemia* ; Middle Cerebral Artery ; Reperfusion ; Stroke*