Chandima Karunanayake

University of Saskatchewan | U of S · Canadian Centre for Health and Safety in Agriculture

The STOP-Bang questionnaire is an easy-to-administer scoring model to screen and identify patients at high risk of obstructive sleep apnea (OSA). However, its diagnostic utility has never been tested with First Nation peoples. The objective was to determine the predictive parameters and the utility of the STOP-Bang questionnaire as an OSA screening...

Objectives: This study was conducted to estimate farm fatality rates and to describe patterns of fatal agricultural injuries on Saskatchewan farms from 2005-2019. Methods: Data on work-related farm fatalities was collected from January 2005 to December 2019 in the Province of Saskatchewan as a part of the injury and mortality surveillance for th...

Sleep disorders have been related to body weight, social conditions, and a number of comorbidities. These include high blood pressure and type 2 diabetes, both of which are prevalent in the First Nations communities. We explored relationships between obstructive sleep apnea (OSA) and risk factors including social, environmental, and individual circ...

Perceived neurocognitive decline is becoming a more common concern, leading to an increased number of referrals to specialists for further investigation and increased stress and anxiety for patients. Subjective cognitive impairment (SCI) refers to the condition of having concerns about one’s memory but performing within the expected range on neuroc...

Study objectives Estimates of sleep duration and quality are lacking for Canadian First Nations peoples. This study examines the prevalence of and risk factors for short/normal/long sleep duration and sleep quality. Methods Five hundred eighty-eight adults participated in the baseline survey of the First Nations Sleep Health Project conducted in 2...

Background: Concern around perceived neurocognitive decline is increasing, leading to increased number of referrals and anxiety for patients. We aimed to explore the likelihood of the “worried well” experiencing neurocognitive decline. Methods: 166 “worried well” patients who attended the Rural and Remote Memory Clinic between 2004 and 2019 were in...

Sleep is crucial for maintaining the recovery and restoration of the body and brain. Less sleep is associated with poor mental and physical performance. Seasonal changes in sleep patterns can be observed. This paper examines seasonal effects on sleep timing, duration, and problems in two Cree First Nation communities in Saskatchewan, Canada. Data w...

Objectives Sleep deprivation is a common problem in Canada and is associated with many health problems. More than a quarter of Canadians get fewer than the recommended sleep hours (<7 hours). This paper examines the prevalence and risk factors for sleep deprivation in two First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eig...

Inadequate housing is commonplace in First Nations in Canada, often leading to environmental impacts on housing such as dampness and mold. First Nations communities suffer from a higher prevalence of respiratory-related health conditions than the general Canadian population. There is limited Canadian literature evaluating the relationship between h...

Background Increasing concern around perceived neurocognitive decline is increasing the number of referrals to specialists and anxiety for patients. We aimed to explore the likelihood of the “worried well” experiencing neurocognitive decline and developing a neurological diagnosis. Methods A total of 166 “worried well” patients who attended the Ru...

Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the...

en Aims To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs). Design A pan‐Canadian cross‐sectional survey. Methods The Nursing Practice in Rural and Remote Canada II survey (2014–2015) used stra...

Depressive symptomatology has long been associated with dementia. The exact form of this association (e.g. whether depression is a risk factor and/or a prodrome) is uncertain. While much research has gone into confirming this link, there has been little investigation into the effects of depression on dementia progression after diagnosis. The aim of...

Objectives: To evaluate a mouth rinse containing tetrapotassium pyrophosphate and sodium tripolyphosphate on supragingival calculus formation in a group consisting initially of forty adults seeking periodontal treatment at a Canadian dental school. Methods: The extent of supragingival calculus in relation to the lingual surfaces of the lower anteri...

Objective: To determine predictors associated with longitudinal changes in CRC prevalence in farm and non-farm rural residents in Saskatchewan, Canada. Methods: Data from the Saskatchewan Rural Health Study were collected from 8,261 individuals nested within 4,624 households at baseline survey in 2010 and 4,867 individuals (2,797 households) at...

BACKGROUND: Spirometric prediction equations are used to evaluate lung function in the clinical setting. However, such equations are not yet available for First Nations populations. The purpose of this study is to derive appropriate spirometric reference equations for a group of Cree First Nations school-aged children and adolescents living in rura...

Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a cross-sectional survey with...

Introduction: The course of dementia may differ between men and women. Men, for example, are more likely to exhibit aggression. It is unclear if sex differences are present at initial presentation. The present study examines sex differences among patients at initial referral to a memory clinic. Materials and methods: Three hundred seventy-five (...

Objective: This study aims to assess the annual changes in lung function among farm and nonfarm adult residences in rural Saskatchewan, Canada. Methods: Data from the Saskatchewan Rural Health Study survey (2010 to 2014) among 724 adults were used. Results: For forced expiratory volume in 1 second (FEV1) measurements, estimates of annual decli...

Background|objective: Nurses provide essential primary care (PC) in rural and remote Canada. We examined the practice context and responsibilities of this little-known understudied workforce. Method: Data from Nursing Practice in Rural and Remote Canada II, a 2014 to 2015 pan-Canadian survey, were analyzed. Results: Of 3,822 respondents, 192 i...

Background: Young-onset dementia (YOD) is defined as the onset of dementia symptoms before the age of 65 years and accounts for 2-8% of dementia. YOD patients and their caregivers face unique challenges in diagnosis and management. We aimed to compare the characteristics of rural YOD and late-onset dementia (LOD) patients at a rural and remote mem...

Introduction: Despite some attention paid to farm stress in the popular press, recent Canadian research examining the mental wellbeing of farming populations relative to other rural dwellers is sparse. International research on the topic has shown inconsistent findings and has mainly focused on men. The objective of the present study was to examin...

Objectives: Because of the immediate and long-term consequences of diabetes in pregnancy (DIP) for mother and child, we compared frequencies of gestational diabetes (GDM) and pre-GDM between First Nations (FN) and non-FN people in Saskatchewan from 1980 to 2009. Methods: Using Ministry of Health administrative databases, we conducted a retrospec...

Objectives: Because of disparities in incidence of diabetes in pregnancy (DIP) among First Nations (FN) and non-First Nations (non-FN) women in Saskatchewan, we compared predictors and early maternal/child complication rates of gestational diabetes (GDM) and pre-GDM between the 2 populations from 1980 to 2013. Methods: Using Ministry of Health a...

Objective: This study examined accessibility of communication tools in the workplace, use of education to update nursing knowledge, and use of information to make specific decisions in practice among registered nurses (RNs) and licensed practical nurses (LPNs) in rural and remote communities in Canada. Methods: Data were analyzed from the cross-sec...

Excessive daytime sleepiness (EDS) is a common problem in general the Canadian population. It can effect day-to-day activities and is also associated with several health issues. This study aimed to investigate the association between co-morbidities and the prevalence of EDS over a four-year period in adults living in two First Nation communities. D...

Rationale: The available spirometric lung function equations in Canadian context have been limited to age and height as predictors and Caucasian ethnicity. The plausible equations with other individual predictors and First Nations populations are missing in the current literature. Objective: To set an initial investigation in terms of study sample...

Registered nurses (RNs) enact their scope of practice in everyday practice through the influences of client needs, the practice setting, employer requirements and policies and the nurse's own level of competence (Canadian Nurses Association 2015). A scope of practice is "dynamic and responsive to changing health needs, knowledge development and tec...

Over the past two decades in Canada, licensed or registered practical nurses (LPNs) have experienced an extension of their educational preparation and scope of practice. Simultaneously, there has been an increase in the number of LPNs employed in rural and remote communities. These changes have influenced the practice environment and LPNs' percepti...

Background: A Will, Power of Attorney, and Advanced Healthcare Directive are critical to guide decision-making in patients with dementia. We identified characteristics that are associated with the existence of these documents in patients who presented to a rural and remote memory clinic (RRMC). Methods: Ninety-five consecutive patients were incl...

Objective: To assess the predictors associated with incidence and longitudinal changes in the prevalence of CB among farm and non-farm resident of rural Saskatchewan, Canada METHODS:: The Saskatchewan Rural Health Study was a prospective study of the lung health of rural dwellers. We obtained information on 4624 households, 8261 individuals (2797...

Snoring may be an important predictor of sleep-disordered breathing. Factors related to snoring among First Nations people are not well understood in a population with high rates of smoking and excess body weight. An interviewer-administered survey was conducted among 874 individual participants from 406 households in 2012 and 2013 in two Canadian...

Obstructive sleep apnea (OSA) is the most common sleep-disordered breathing condition. Patients with OSA symptoms are often not diagnosed clinically, which is a concern, given the health and safety risks associated with unmanaged OSA. The availability of fewer practicing medical specialists combined with longer travel distances to access health car...

Supplemental Table 1. Characteristics of adults who likely required this specialist medical care (n = 2813; 2230 households) by distance quartile.

Objective: The objective of the study was to determine the prevalence and associated risk factors of asthma in Aboriginal adolescents in Canada based on the Canadian Aboriginal Peoples Survey (APS) 2012. Few studies have investigated the prevalence and risk factors of asthma in Aboriginal adolescents in Canada. Methods: Data from the cross-sectiona...

Aims and Objectives The purpose of this study was to empirically test a conceptual model of confidence and competence in rural and remote nursing practice. Background The levels of competence and confidence of nurses practicing in rural settings has been highlighted as essential to the quality of health outcomes for rural peoples. However, there i...

Aim To develop and test the psychometric properties of the Job Resources in Nursing (JRIN) Scale and the Job Demands in Nursing (JDIN) Scale. Design Cross‐sectional survey. Methods A three‐phase process of instrument development and psychometric evaluation was employed: Phase 1: development of a 42‐item JRIN Scale and 60‐item JDIN Scale through e...

PURPOSE: Spirometric prediction equations are used to evaluate lung function in the clinical setting. However, such equations are not yet available for First Nations populations in Canada. The purpose of this study is to derive appropriate spirometric reference equations for a group of Prairie and Woodland Cree First Nations school-aged children an...

PURPOSE: Spirometric prediction equations are used to evaluate lung function in the clinical setting. However, such equations are not yet available for First Nations populations in Canada. The purpose of this study is to derive appropriate spirometric reference equations for a group of Prairie and Woodland Cree First Nations school-aged children an...

Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communiti...

Older age, obesity, hypertension, snoring, and excessive daytime sleepiness have been associated with sleep apnea. The objective of this study was to determine the prevalence (crude and adjusted), as well as the risk factors, of sleep apnea in the adult Canadian population. Data from the 2009 Sleep Apnea Rapid Response (SARR) questionnaire were use...

Background: Variations in rural nurses' sense of community and engagement in rural communities are poorly understood, although there is evidence that these are linked to community cohesion and perceived community resilience. Objective: The aim of our research was to develop descriptive profiles of rural nurses who exhibit a sense of community an...

Background: A will, power of attorney and advanced healthcare directive are critical to guide decision-making in people with cognitive decline. We identified characteristics that are associated with the existence of these documents in patients who presented to a rural and remote memory clinic (RRMC). Methods: 95 consecutive patients were included i...

Following publication of the original article [1] the authors notified Production that the names of three authors-Valerie Elliot, Louise Hagel, and Roland Dyck-had been unintentionally omitted in the final online version of the manuscript. The corrected author list is shown in this Correction.

p> OBJECTIVES: To determine among rural-dwelling on-reserve Saskatchewan First Nations people whether racial discrimination is associated with depression, and in turn, if this relationship is moderated by gender. METHODS: As a component of a community-based participatory research project, a cross-sectional, interviewer-administered survey of 874 a...

Although low birth weight (LBW) increases the risk for type 2 diabetes (T2DM), the relationship between high birth weight (HBW) and T2DM is less definitive and largely confined to North American Indigenous populations. We re-examined the relationship between LBW (<2500 g) and HBW (>4000 g) and both T2DM and gestational diabetes (GDM) among First Na...

Objectives To evaluate new mouth rinse containing sea salt, xylitol, and lysozyme on biofilm formation and gingival health in a group of young adults. Methods The subjects were divided into two groups of 15 subjects each: control (A) and experimental group (B). The Turesky modification of Quigley-Hein plaque index was used to evaluate plaque score...

Background: Excessive daytime sleepiness may be determined by a number of factors including personal characteristics, co-morbidities and socio-economic conditions. In this study we identified factors associated with excessive daytime sleepiness in 2 First Nation communities in rural Saskatchewan. Methods: Data for this study were from a 2012–13 bas...

Introduction: In an effort to better understand why cognitively normal patients were referred to a memory clinic, we sought to identify features of "worried well" patients to better identify those more likely to be cognitively normal. Methods: In total, 375 consecutive patients referred by primary care practitioners to a Rural and Remote Memory...

Objective The demanding nature of dental education, both academically and clinically, results in higher levels of perceived stress among its students. The aim of this study was to determine how dental students at the College of Dentistry, University of Saskatchewan perceived stress. During the 2013–2014 academic year, all students were asked to com...

Objectives Less is known about the respiratory health of general farming and non-framing populations. A longitudinal Saskatchewan Rural Health Study (SRHS) was conducted to explore the association between individual and contextual factors with respiratory health outcomes in these populations. Hence, the objectives are to: (i) describe the updated m...

Respiratory diseases, such as bronchitis and pneumonia, are common in First Nations children in Canada. The objectives are to determine prevalence and associated risk factors of bronchitis in children 6–17 years old residing in two reserve communities. The cross-sectional study was conducted in 2013 and children from two First Nations reserve commu...

Aim The study purpose was to provide evidence of validity for the Primary Health Care Engagement (PHCE) Scale, based on exploratory factor analysis and reliability findings from a large national survey of regulated nurses residing and working in rural and remote Canadian communities. Background There are currently no published provider-level instr...

Background Inadequate housing, low family income, household smoking, personal smoking status, and poor schooling are some of the conditions that have been significantly associated with the prevalence and incidence of chronic bronchitis. The aim of the current study was to determine the prevalence of chronic bronchitis (CB) and associated risk facto...

Background and objective: The relationship between farming exposures and pulmonary function in a rural paediatric population was evaluated. Methods: Baseline data collection records of the Saskatchewan Rural Health Study (SRHS), a population-based study, were used. A subset of children (6-14 years old) participated in clinical testing, including...

Background: In an effort to better understand why cognitively normal patients are referred to a memory clinic, we sought to identify features of “worried well” patients to better identify those more likely to be cognitively normal. Methods: Three hundred and seventy-five consecutive patients referred by primary care practitioners to a Rural and Rem...

Background: Dementia is more prevalent in women. Sex differences exist as the disease progresses (e.g. males are more likely to become aggressive). In many medical illnesses (e.g. cardiac disease), there are differences in presentation between men and women. The current study explores sex differences at the patients’ initial presentation to the Rur...

Background: Jacklin et al. (2013) described a rising incidence and a younger onset of dementia in Albertan First Nations compared to non-First Nations patients. Canadian research is limited in Indigenous patients with dementia, leaving it difficult to understand factors contributing to the differences in incidence and prevalence. Methods: 375 patie...

Background In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted...