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  1. Article ; Online: Immigration Status as a Social Determinant of Stroke Care.

    Vyas, Manav V / Kapral, Moira K

    Medical care

    2023  Volume 61, Issue 3, Page(s) 117–119

    MeSH term(s) Humans ; Emigration and Immigration ; Social Determinants of Health ; Stroke ; Emigrants and Immigrants
    Language English
    Publishing date 2023-01-19
    Publishing country United States
    Document type Editorial
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001821
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: National Stroke Surveillance in Canada: Are We There Yet?

    Rastogi, Anuj / Vyas, Manav V

    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

    2023  Volume 50, Issue 6, Page(s) 807–808

    Language English
    Publishing date 2023-01-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 197622-9
    ISSN 0317-1671
    ISSN 0317-1671
    DOI 10.1017/cjn.2022.345
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  3. Article ; Online: Association between migraine and exclusive breastfeeding: A cross-sectional study.

    Vyas, Manav V / Lee, Nathan / Lay, Christine

    Headache

    2024  Volume 64, Issue 5, Page(s) 494–499

    Abstract: Background: Medical conditions may preclude a mother from exclusively breastfeeding her infant; however, the association between migraine and the duration of exclusive breastfeeding is not well known.: Objective: To evaluate the association between ... ...

    Abstract Background: Medical conditions may preclude a mother from exclusively breastfeeding her infant; however, the association between migraine and the duration of exclusive breastfeeding is not well known.
    Objective: To evaluate the association between migraine and the duration of exclusive breastfeeding in a representative sample of Canadian females.
    Methods: We used the Canadian Community Health Survey, a cross-sectional survey, to identify females aged 20-49 years who delivered a baby in the previous 5 years. History of migraine was self-reported. Females reported if they breastfed their baby, and among those who did, they further reported the duration of exclusive breastfeeding. We evaluated the association between migraine and the rate of breastfeeding, and the duration of exclusive breastfeeding adjusting for selected covariates.
    Results: We included 5282 females, of whom 862 (16.3%) had migraine. Compared to females without migraine, females with migraine were less likely to have high income (annual income >$80,000: 362 [42.0] vs. 2276 [51.6]), and more likely to have comorbid mood (176 [20.5] vs. 378 [8.6%]) and anxiety (196 [22.8%] vs. 406 [9.2%]) disorders. Migraine was not associated with breastfeeding (proportion of females who did not breastfeed, migraine vs. no migraine: 114/862 [13.2%] vs. 498/4420 [11.3%]; adjusted odds ratio 1.03; 0.74-1.27); however, females with migraine had lower odds (≥6 months of exclusive breastfeeding: 216/688 [31.4%] vs. 1325/3561 [37.2%]; adjusted odds ratio from ordinal shift analyses 0.84; 0.71-0.99) of longer duration of exclusive breastfeeding than females without migraine.
    Conclusion: Females with migraine exclusively breastfeed their infants for a shorter duration compared to females without migraine, suggesting the need to better support this population through education on the safety and benefits of exclusive breastfeeding and better access to safe and effective treatment of migraine in lactating females.
    MeSH term(s) Humans ; Breast Feeding/statistics & numerical data ; Migraine Disorders/epidemiology ; Female ; Cross-Sectional Studies ; Adult ; Young Adult ; Middle Aged ; Canada/epidemiology ; Health Surveys
    Language English
    Publishing date 2024-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 410130-3
    ISSN 1526-4610 ; 0017-8748
    ISSN (online) 1526-4610
    ISSN 0017-8748
    DOI 10.1111/head.14713
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  4. Article: Investing in Endovascular Thrombectomy Programs: Saving Lives, Saving Money.

    Kuczynski, Andrea M / Vyas, Manav V

    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

    2021  Volume 49, Issue 5, Page(s) 625–626

    MeSH term(s) Brain Ischemia ; Endovascular Procedures ; Humans ; Stroke/surgery ; Thrombectomy ; Treatment Outcome
    Language English
    Publishing date 2021-08-24
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 197622-9
    ISSN 0317-1671
    ISSN 0317-1671
    DOI 10.1017/cjn.2021.200
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  5. Article ; Online: Proportion of Life Spent in Canada and the Incidence of Multiple Sclerosis in Permanent Immigrants.

    Vyas, Manav V / Kapral, Moira K / Alonzo, Rea / Fang, Jiming / Rotstein, Dalia L

    Neurology

    2024  Volume 102, Issue 10, Page(s) e209350

    Abstract: Background and objectives: While immigrants to high-income countries have a lower risk of multiple sclerosis (MS) compared with host populations, it is unknown whether this lower risk among immigrants increases over time. Our objective was to evaluate ... ...

    Abstract Background and objectives: While immigrants to high-income countries have a lower risk of multiple sclerosis (MS) compared with host populations, it is unknown whether this lower risk among immigrants increases over time. Our objective was to evaluate the association between proportion of life spent in Canada and the hazard of incident MS in Canadian immigrants.
    Methods: We conducted a population-based retrospective cohort study in Ontario, using linked health administrative databases. We followed immigrants, who arrived in Ontario between 1985 and 2003, from January 1, 2003, to December 31, 2016, to record incident MS using a validated algorithm based on hospital admission or outpatient visits. We derived proportion of life spent in Canada based on age at arrival and time since immigration obtained from linked immigration records. We used multivariable proportional hazard models, adjusting for demographics and comorbidities, to evaluate the association between proportion of life in Canada and the incidence of MS, where proportion of life was modelled using restricted cubic spline terms. We further evaluated the role of age at migration (15 or younger vs older than 15 years), sex, and immigration class in sensitivity analyses.
    Results: We included 1.5 million immigrants (49.9% female, mean age 35.9 [SD 14.2] years) who had spent a median of 20% (Q1-Q3 10%-30%) of their life in Canada. During a mean follow-up of 13.9 years (SD 1.0), 934 (0.44/100,000 person-years) were diagnosed with MS. Compared with the median, a higher risk of MS was observed at higher values of proportion of life spent (e.g., hazard ratio [70% vs 20% proportion of life] 1.38; 1.07-1.78). This association did not vary by sex (
    Discussion: The risk of incident MS in immigrants varied with the proportion of life spent in Canada, suggesting an acculturation effect on MS risk. Further work is required to understand environmental and sociocultural factors driving the observed association.
    MeSH term(s) Humans ; Multiple Sclerosis/epidemiology ; Multiple Sclerosis/ethnology ; Male ; Female ; Emigrants and Immigrants/statistics & numerical data ; Adult ; Incidence ; Retrospective Studies ; Middle Aged ; Ontario/epidemiology ; Young Adult ; Adolescent ; Canada/epidemiology ; Cohort Studies ; Age Factors
    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000209350
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  6. Article: Does Self-Reported BMI Modify the Association Between Stroke and Depressive Symptoms?

    Meshkat, Shakila / Tassone, Vanessa K / Wu, Michelle / Duffy, Sophie F / Boparai, Josheil K / Jung, Hyejung / Lou, Wendy / Vyas, Manav V / Bhat, Venkat

    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

    2024  , Page(s) 1–7

    Abstract: Background: Depressive symptoms are common in stroke survivors. While obesity has been associated with stroke and depression, its influence on the association between stroke and depressive symptoms is unknown.: Methods: Cross-sectional data from 2015 ...

    Abstract Background: Depressive symptoms are common in stroke survivors. While obesity has been associated with stroke and depression, its influence on the association between stroke and depressive symptoms is unknown.
    Methods: Cross-sectional data from 2015 to 2016 Canadian Community Health Survey was used. History of stroke was self-reported and our outcome of interest was depressive symptoms in the prior 2 weeks, measured using the 9-item Patient Health Questionnaire. Self-reported body mass index (BMI) was modeled as cubic spline terms to allow for nonlinear associations. We used multivariable logistic regression to evaluate the association between stroke and depressive symptoms and added an interaction term to evaluate the modifying effect of BMI.
    Results: Of the 47,521 participants, 694 (1.0%) had a stroke and 3314 (6.5%) had depressive symptoms. Those with stroke had a higher odds of depressive symptoms than those without (aOR = 3.13, 95% CI 2.48, 3.93). BMI did not modify the stroke-depressive symptoms association (P
    Conclusion: The association between stroke and depressive symptoms is not modified by BMI, needing additional work to understand the role of obesity on depression after stroke.
    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 197622-9
    ISSN 0317-1671
    ISSN 0317-1671
    DOI 10.1017/cjn.2024.41
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  7. Article ; Online: Determinants, Prevention, and Incidence of Cardiovascular Disease Among Immigrant and Refugee Populations.

    Vyas, Manav V / Redditt, Vanessa / Mohamed, Sebat / Abraha, Mosana / Sheth, Javal / Shah, Baiju R / Ko, Dennis T / Ke, Calvin

    The Canadian journal of cardiology

    2024  

    Abstract: Immigration policies shape the composition, socioeconomic characteristics, and health of migrant populations. The health of migrants is also influenced by a confluence of social, economic, environmental, and political factors. Immigrants and refugees ... ...

    Abstract Immigration policies shape the composition, socioeconomic characteristics, and health of migrant populations. The health of migrants is also influenced by a confluence of social, economic, environmental, and political factors. Immigrants and refugees often face various barriers to accessing health care because of factors such as lack of familiarity with navigating the health care system, language barriers, systemic racism, and gaps in health insurance. Social determinants of health and access to primary care health services likely influence the burden of cardiovascular risk factors among immigrants. The relatively low burden of many cardiovascular risk factors in many immigrant populations likely contributes to the generally lower incidence rates of acute myocardial infarction, heart failure, and stroke in immigrants compared with nonimmigrants, although cardiovascular disease incidence rates vary substantially by country of origin. The "healthy immigrant effect" is the hypothesis that immigrants to high-income countries, such as Canada, are healthier than nonimmigrants in the host population. However, this effect may not apply universally across all immigrants, including recent refugees, immigrants without formal education, and unmarried immigrants. As unfolding sociopolitical events generate new waves of global migration, policymakers and health care providers need to focus on addressing social and structural determinants of health to better manage cardiovascular risk factors and prevent cardiovascular disease, especially among the most marginalized immigrants and refugees.
    Language English
    Publishing date 2024-02-21
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/j.cjca.2024.02.011
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  8. Article ; Online: Proportion of life spent in Canada and stroke incidence and outcomes in immigrants.

    Vyas, Manav V / Fang, Jiming / Austin, Peter C / Kapral, Moira K

    Annals of epidemiology

    2022  Volume 74, Page(s) 58–65

    Abstract: Background: To evaluate the association between the proportion of life spent in a host nation and stroke incidence and outcomes among Canadian immigrants.: Methods: We conducted a retrospective cohort study of 1.2 million adult Canadian immigrants ( ... ...

    Abstract Background: To evaluate the association between the proportion of life spent in a host nation and stroke incidence and outcomes among Canadian immigrants.
    Methods: We conducted a retrospective cohort study of 1.2 million adult Canadian immigrants (mean age 40 [±14.6] years, 50.5% women) who were followed between 2003 and 2018 using linked administrative health data. Using multivariable cause-specific hazard models, we evaluated the overall and sex-specific associations between the proportion of life spent in Canada (φ), modeled as restricted cubic splines, and ischemic stroke incidence and outcomes.
    Results: Compared to the median proportion of life in Canada (φ = 0.2), a J-shaped association between the proportion of life in Canada and ischemic stroke incidence and outcomes was observed. The adjusted hazard ratios of stroke incidence increased with both progressively lower and higher levels of φ [e.g., (HR
    Conclusions: Stroke incidence and outcomes among immigrants varies with the proportion of life spent in Canada. Future work should identify factors driving the observed associations and the sex differences.
    MeSH term(s) Adult ; Canada/epidemiology ; Emigrants and Immigrants ; Female ; Humans ; Incidence ; Ischemic Stroke ; Male ; Retrospective Studies ; Stroke/epidemiology
    Language English
    Publishing date 2022-07-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1074355-8
    ISSN 1873-2585 ; 1047-2797
    ISSN (online) 1873-2585
    ISSN 1047-2797
    DOI 10.1016/j.annepidem.2022.07.002
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  9. Article ; Online: Migraine and sun avoidance behaviors in Canadian adults.

    Vyas, Manav V / Saposnik, Gustavo / Lay, Christine

    Headache

    2021  Volume 61, Issue 10, Page(s) 1579–1580

    MeSH term(s) Adult ; Avoidance Learning ; Canada ; Cross-Sectional Studies ; Female ; Health Behavior ; Humans ; Male ; Migraine Disorders/complications ; Photophobia/complications
    Language English
    Publishing date 2021-11-02
    Publishing country United States
    Document type Letter
    ZDB-ID 410130-3
    ISSN 1526-4610 ; 0017-8748
    ISSN (online) 1526-4610
    ISSN 0017-8748
    DOI 10.1111/head.14227
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  10. Article: Association Between Stroke Severity and Serum Troponin in Acute Stroke.

    Kuczynski, Andrea M / Rzyczniak, Grace / Cheong, Gee Hung Leo / Famiyeh, Petra / Vyas, Manav V

    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

    2023  , Page(s) 1–3

    Abstract: Serum troponin is often elevated in patients with acute stroke and its mechanism is unknown. In a retrospective single-center cohort study, we evaluated the association between stroke severity and serum troponin in 187 patients with acute stroke using ... ...

    Abstract Serum troponin is often elevated in patients with acute stroke and its mechanism is unknown. In a retrospective single-center cohort study, we evaluated the association between stroke severity and serum troponin in 187 patients with acute stroke using multivariable modified Poisson models. A one-point increase in the National Institutes of Health Stroke Scale (measure of stroke severity) was associated with a marginally higher serum troponin level in adjusted models (aIRR 1.03; 1.01-1.05,
    Language English
    Publishing date 2023-12-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 197622-9
    ISSN 0317-1671
    ISSN 0317-1671
    DOI 10.1017/cjn.2023.323
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