Colleen M Norris

University of Alberta | UAlberta · Faculty of Nursing

( Acta Obstet Gynecol Scand. 2024;103:266–275. doi: 10.1111/aogs.14703) Preeclampsia (PEC) and gestational diabetes mellitus (GDM) have similar risk factors including increased maternal age and obesity. Both conditions are associated with adverse pregnancy outcomes and long-term health issues for mothers and children, and health care resources coul...

Background: Beyond the risk of thromboembolic stroke, people with atrial fibrillation (AF) are substantially burdened with a higher incidence of cardiovascular mortality, even among patients treated with anticoagulants. The reasons behind these outcomes are only partially understood. Social determinants of health (SDOH), strong independent predicto...

Background Post Intensive Care Unit (ICU) survivors face physical, psychological, and cognitive impairments during their recovery phase, adversely affecting their quality of life. Given the scarcity and barriers to access to post-ICU care worldwide, patient-centered adjuncts are worth exploring. Although music interventions have gained recognition...

Background: The COVID-19 pandemic has had a significant impact on healthcare systems worldwide, leading to changes in presentation types, service utilization, and admission rates to emergency departments (ED). This study examines changes in ED visit patterns and triage misclassifications during the pandemic in Alberta, Canada. Methods: We conducted...

Background: Over-the-counter drugs such as ibuprofen are a mainstay of pain relief. Ibuprofen was introduced in 1969, contributing to the absence of reporting on female representation in the clinical trials used as evidence of its safety and efficacy. We assessed the representation of females in the product monographs informing ibuprofen products....

Out-of-hospital mortality rates surged during the early COVID-19 pandemic. While expecting a return to pre-pandemic levels, the evolving patterns of out-of-hospital mortality in Canada remain uncertain. We investigated whether these rates returned to pre-pandemic levels. This retrospective study, employing linked administrative data, analyzed out-o...

Background: Stroke is a leading cause of long-term disability among survivors. Past literature already investigated the biological sex differences in stroke outcome, still limited work on gender differences is published. Therefore, the study aimed at investigating whether biological sex and sociocultural gender of survivors play a role as determina...

Background Women treated with hemodialysis report lower health-related quality of life (HRQoL) compared to men. Whether this is related to sex- (biological) (e.g., under-dialysis due to body composition differences) or gender-specific (sociocultural) factors (e.g., greater domestic/caregiver responsibilities for women) is unknown. We examined the a...

Background Coronary artery disease (CAD) confers increased risks of premature mortality, non-fatal morbidity, and significant impairment in functional status and health-related quality of life. Routine administration of electronic patient-reported outcome measures (PROMs) and its real time delivery to care providers is known to have the potential t...

Mind-body internet- and mobile-based intervention (IMIs) are gaining traction as scalable and effective strategies to manage mental health symptoms experienced by people living with chronic physical conditions. Sex and gender have implications for mind-body IMI participation, adherence, and efficacy. The objective of this secondary analysis was to...

Gender equality has been a crosscutting issue in Horizon 2020 with three objectives: gender balance in decision-making, gender balance and equal opportunities in project teams at all levels, and inclusion of the gender dimension in research and innovation content. Between 2017 and 2022, the EU funded, in collaboration with national agencies, 13 tra...

Background COVID-19 infection is associated with a pro-coagulable state, thrombosis, and cardiovascular events. However, its impact on population-based rates of vascular events is less well understood. We studied temporal trends in hospitalizations for stroke and myocardial infarction in 3 Canadian provinces (Alberta, Ontario, and Nova Scotia) betw...

Background Exercise‐associated secondary amenorrhea results in estrogen deficiency, which may lead to dysfunction in estrogen's normal cardioprotective pathways. Estrogen may be essential in a woman's endothelial adaptations to exercise. The objective of this review was to assess the association between secondary amenorrhea in physically active wom...

Objective Fatigue, headache, problems sleeping and numerous other symptoms have been reported to be associated with long COVID. However, many of these symptoms coincide with symptoms reported by the general population, possibly exacerbated by restrictions/precautions experienced during the COVID-19 pandemic. This study examines the symptoms reporte...

BACKGROUND Cardiac pain has been widely considered to be the primary indicator of coronary artery disease. The presentation of cardiac pain and associated symptoms vary in women, making it challenging to interpret as cardiac, possibly cardiac, or non-cardiac. Women prefer to consult with family and friends instead of seeking immediate medical care....

Purpose Patients with coronary artery disease (CAD) experience significant angina symptoms and lifestyle changes. Revascularization procedures can result in better patient-reported outcomes (PROs) than optimal medical therapy (OMT) alone. This study evaluates the impact of response shift (RS) on changes in PROs of patients with CAD across treatment...

Purpose Unsupervised item-response theory (IRT) models such as polytomous IRT based on recursive partitioning (IRTrees) and mixture IRT (MixIRT) models can be used to assess differential item functioning (DIF) in patient-reported outcome measures (PROMs) when the covariates associated with DIF are unknown a priori. This study examines the consisten...

This final chapter of the Canadian Women’s Heart Health Alliance “ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women” presents ATLAS highlights from the perspective of current status, challenges, and opportunities in cardiovascular care for women. We conclude with 12 specific recommendations for actionable next...

There are fundamental sex-specific differences in cardiovascular (CV) physiology and cardiovascular disease (CVD) pathophysiology. Estrogen, a sex steroid hormone (SSH), has three receptors through which it enacts genomic and non-genomic actions. Estrogen has direct and indirect physiological effects on CV function. The roles of progesterone and te...

Introduction Preeclampsia and gestational diabetes mellitus share risk factors such as obesity and increased maternal age, which have become more prevalent in recent decades. We examined changes in the prevalence of preeclampsia and gestational diabetes between 2005 and 2018 in Denmark and Alberta, Canada, and investigated whether the observed tren...

Introduction The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most used tools to measure health-related quality of life in heart failure. Despite extensive use in research, evidence on the MLHFQ’s internal structure validity remains heterogeneous and inconclusive. There are no known reviews that systematically summarise t...

Introduction/Background: At heart ’s novel core feature set includes a Heart Check, Wellness Check, and a Library, with an interactive Chatbot to manage its content and conversations. at heart is the first of its kind; there are no previous trials of an intervention rigorously developed and tested. Goals/Aims: The overall goal of this study was to...

Introduction: Atrial fibrillation (AF) is associated with a heightened risk of adverse cardiovascular outcomes. Current prediction models often overlook potential sex differences, as well as the combined influence of gendered social determinants of health (SDOH) with traditional cardiovascular risk factors. The objective of this study is to compare...

Despite significant progress in medical research and public health efforts, gaps in knowledge of women’s heart health remain across epidemiology, presentation, management, outcomes, education, research, and publications. Historically, heart disease was viewed primarily as a condition in men and male individuals, leading to limited understanding of...

The impact of the presence or absence of sex hormones on women’s health is woefully underresearched. Fundamentally, women’s bodies are now understood to spend considerable time under widely fluctuating hormonal influences, including puberty, pregnancy, peripartum, and menopause, and a woman’s vessels are therefore preset for functional and physiolo...

Introduction: Metabolic syndrome (MetS), a cluster of five interconnected factors, is the main contributor to cardiovascular disease. Although sex and gender-related elements have been linked to MetS and its components, the association has not been explored among Canadians with and without MetS. This study aimed to examine sex and gender differenc...

Background Cardiovascular diseases (CVDs) are the leading cause of premature death for Canadian women, which may be due partly to a lack of awareness of the presentation of acute coronary events in emergency departments (EDs). To address an identified gap in women’s cardiovascular care, we sought to describe the clinical and comorbid factors of wom...

Objective: The objective of this review is to assess the association between secondary amenorrhea in physically active women and cardiovascular disease risk. Introduction: It is well established that a woman's risk of cardiovascular disease greatly increases after menopause. The sharp decline in estrogen is seen as a causal factor. Exercise-indu...

Background: Spontaneous Coronary Artery Dissection (SCAD) is a serious, non-iatrogenic and non-traumatic cardiac event that predominantly affects females, with a high risk of recurrence. Secondary prevention strategies are not well understood in this population. Therefore, the aim of this systematic review is to determine the current evidence on s...

Women vs men have major differences in terms of risk-factor profiles, social and environmental factors, clinical presentation, diagnosis, and treatment of cardiovascular disease. Women are more likely than men to experience health issues that are complex and multifactorial, often relating to disparities in access to care, risk-factor prevalence, se...

Background Gender‐related factors are psycho‐socio‐cultural characteristics and are associated with adverse clinical outcomes in acute myocardial infarction, independent of sex. Whether sex‐ and gender‐related factors contribute to the substantial heterogeneity in hospital length of stay (LOS) among patients with non–ST‐segment–elevation myocardial...

Sharing health data for research purposes across international jurisdictions has been a challenge due to privacy concerns. Two privacy enhancing technologies that can enable such sharing are synthetic data generation (SDG) and federated analysis, but their relative strengths and weaknesses have not been evaluated thus far. In this study we compared...

Aims To map the existing body of heart failure (HF) telehealth interventions for vulnerable populations, and to conduct an intersectionality‐based analysis utilizing a structured checklist. Design A scoping review and intersectionality‐based analysis. Data Sources The search was conducted in March 2022 in the following databases: MEDLINE, CINAHL,...

Brain aging is a naturally occurring process resulting in the decline of cognitive functions and increased vulnerability to develop age‐associated disorders. Fluctuation in lipid species is crucial for normal brain development and function. However, impaired lipid metabolism and changes in lipid composition in the brain have been increasingly recog...

Objective: Mental health issues are closely associated with symptoms and outcomes of cardiovascular diseases (CVDs). The magnitude of this problem is alarmingly high in low and middle-income countries (LMICs). This systematic review and meta-analysis aimed to examine the effectiveness of psychosocial interventions on mental health outcomes among p...

Background: Rural Canadian populations face many challenges due to their geographical isolation, including inaccessible and inequitable primary health care. Specifically, pregnant women are at risk of not receiving prenatal care (PNC) due to physical and social barriers. Inadequate PNC can have detrimental effects on both maternal and neonatal heal...

Simple Summary Cardiovascular diseases represent the leading cause of mortality and morbidity worldwide, and age is an important contributing factor. Preclinical models are crucial for exploring and understanding the physiology of the heart and age-related changes, as well as cardiac pathological aspects. In line with this, the Octodon degus (O. de...

Background: Canadian Emergency Departments (ED) use the five-point Canadian Triage Acuity Scale (CTAS) to prioritize patients according to acuity. CTAS scores are used to make decisions on patient flow, staffing complement, and funding. Variations in triage can lead to mis-categorization and delayed care for critically ill patients. Edmonton zone q...

Magnesium (Mg) has a vital role in the human body, and the kidney is a key organ in the metabolism and excretion of this cation. The objective of this work is to compile the available evidence regarding the role that Mg plays in health and disease, with a special focus on the elderly population with chronic kidney disease (CKD) and the eventual sex...

Introduction Very little is known about how the COVID-19 pandemic has affected the health of residents and the healthcare system in Alberta, Canada. The purpose of this study is to establish an observational study to characterise the health of residents in Alberta, Canada, over time, covering a population that tested negative or positive for COVID-...

Aims The aim of this study was to elucidate whether sex and gender factors influence access to health care and/or are associated with cardiovascular (CV) outcomes of individuals with diabetes mellitus (DM) across different countries. Methods Using data from the Canadian Community Health Survey (8.4% of respondent reporting DM) and the European Hea...

Background Emergency departments use triage to ensure that patients with the highest level of acuity receive care quickly and safely. Triage is typically a nursing process that is documented as structured and unstructured (free text) data. Free-text triage narratives have been studied for specific conditions but never reviewed in a comprehensive ma...

Introduction Unpaid caregiving, care provided by family/friends, is a public health issue of increasing importance. COVID-19 worsened the mental health conditions of unpaid caregivers, increasing substance/drug use and early development of chronic disease. The impact of the intersections of race and ethnicity, sex, age and gender along with unpaid...

Background Evidence suggests that intensive care unit (ICU) survivors often suffer long-term complications such as post–intensive care syndrome (PICS) and post-traumatic stress disorder (PTSD) from critical illness and ICU stay. PICS and PTSD affect both ICU survivors and their families, which overburdens the healthcare systems. Lack of evidence on...

Hypertension (HTN) is a critical primary modifiable risk factor for the development of cardiovascular diseases, with recognized sex-based differences. While sex refers to one’s biological genetic makeup and attributes, gender encompasses the individual’s psycho-socio-cultural characteristics, including their environment and living conditions. The i...

Background Acute kidney replacement therapy (KRT) is delivered to acutely ill patients to support organ function and life in the Intensive Care Unit (ICU). Implementing standardized acute KRT pathways can ensure its safe and effective management. At present, there is no standardized approach to the management of acute KRT in Alberta ICUs. Methods...

Introduction: Atrial fibrillation (AF) is associated with a high risk of adverse outcomes. Social determinants of health (SDOH) are gendered (unevenly distributed between females and males) and associated with outcomes in cardiovascular diseases. Little is known about their impact in AF. We evaluated the association between gendered SDOH and advers...

Introduction: Coronary revascularization guidelines emphasize shared decision-making (SDM) for chronic CAD management. Decision aids that provide individualized estimates of benefits & risks could improve the relevance & evidence base of SDM. This study sought to develop & internally validate a clinical prediction model for 3-year MACE (death/MI/st...

COVID-19 research has relied heavily on convenience-based samples, which—though often necessary—are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common...

Objective: The COVID-19 pandemic influences mental health drastically. Therefore, our aim was to investigate whether biological sex and gender-related factors are associated with mental health during the COVID-19 pandemic. Materials and Methods: The International COVID-19 Awareness and Responses Evaluation Study is an international multiwave cross-...

Background Cardiovascular diseases (CVD) remain the leading cause of death for women. However, systematic inequalities exist in how women experience clinical cardiovascular (CV) policies, programs and initiatives. Methods In collaboration with the Heart and Stroke Foundation of Canada (HSFC), a question regarding female-specific CV protocols in an...

Background Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. There is an upsurge of cardiovascular diseases (CVDs) in sub-Saharan Africa (SSA). Irrespective of biological sex, gender-relat...

Background Previous studies of the effect of sex on after out-of-hospital cardiac arrest (OHCA) outcomes focused on survival to hospital discharge and 1-month survival. Studies on the effect of sex on neurological function after OHCA are still limited. The objective of this study was to identify the predictors of favorable neurological outcome and...

Background: There is an upsurge of cardiovascular diseases (CVDs) in sub-Saharan Africa (SSA). Irrespective of biological sex, gender-related factors could be the precursor of these conditions. Objective: To examine the associations between biological sex, gender-related variables, and cardiovascular health (CVH) risk factors in SSA countries....

Introduction: Gendered-psycho-socio-cultural factors have been shown to play a significant role in disease manifestation, control and management of hypertension (HTN), and their relationship varies in males and females. We investigated the role of sex and gender in HTN prevalence and country-level differences in Canadian and European populations. M...

Cardio-pulmonary diseases, which were once regarded as a man's illness, have been one of the leading causes of morbidity and mortality for both men and women in many countries in recent years. Both gender and sex influence the functional and structural changes in the human body and therefore play an important role in disease clinical manifestation,...

The congenital heart disease (CHD) population now comprises an increasing number of older persons in their 6th decade of life and beyond. We cross-sectionally evaluated patient-reported outcomes (PROs) in persons with CHD aged 60 years or older, and contrasted these with PROs of younger patients aged 40–59 years and 18–39 years. Adjusted for demogr...

Objective The objective of this review is to evaluate the effectiveness of psychosocial interventions on mental health outcomes in adult patients with Cardiovascular Diseases (CVDs) living in low- and middle-income countries (LMICs). Introduction Mental health issues are highly prevalent among patients with CVDs leading to poor disease prognosis,...

Introduction. This exploratory study investigates women’s health information practices by examining how women perceive and interpret heart health information from organizations such as Heart & Stroke Canada that are targeted specifically to them. Method. Focus groups were conducted with women (45 – 90 years) with heart disease and without heart dis...

Objective: Given the role of sociocultural gender in shaping human behaviours, the main objective of this study was to examine whether sex and gender-related factors were associated with the public's adherence to COVID-19-recommended protective health behaviours. Design: This was a retrospective analysis of the survey that captured data on peopl...

Globally, vascular diseases are a leading cause of morbidity and mortality. Many of the most significant risk factors for vascular disease have a gendered dimension, and sex differences in vascular diseases incidence are apparent, worldwide. In this narrative review, we provide a contemporary picture of sex and gender-related determinants of vascul...