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PubMed1993

Alberta euthanasia survey: 2. Physicians' opinions about the acceptance of active euthanasia as a medical act and the reporting of such practice.

OBJECTIVE: To ascertain the opinions of Alberta physicians about the acceptance of active euthanasia as a medical act (the "medicalization" of active euthanasia) and the reporting of colleagues practising active euthanasia, as well as the sociodemographic correlates. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Although only 44% of the respondents considered active euthanasia morally "right" at least 70% opted to medicalize the practice if it were legal by restricting it to be performed by physicians and to be taught at medical sites. Even though active euthanasia is criminal homicide in Canada, 33% of the physicians stated that they would not report a colleague participating in the act of anyone, and 40% and 60% stated that they would not report a colleague to medical or legal authorities respectively. Acceptance or rejection of active euthanasia as a medical act was strongly related to religious affiliation and activity (p < 0.01). CONCLUSIONS: This survey about active euthanasia revealed profound incongruities in the opinions of the sample of Alberta physicians concerning their ethical and social duties in the practice of medicine. These data highlight the need for relevant modifications of health education policies concerning biomedical ethics and physicians' obligations to society.

Alberta↗
PubMed1998

"We picked the wrong one to sterilise": the role of nursing in the eugenics movement in Alberta, 1920-1940.

The opening decades of the twentieth century were years in which the Canadian government actively recruited immigrants from the United Kingdom, Europe and the United States to assist in the settlement of western Canada. The immigration waves that followed contained large numbers of non-English speaking people of eastern European heritage. As these numbers increased, the white Anglo-Saxon minority feared a "multiplication of the inferior". Alberta's solution was the passage of the Sterilization Act in 1928 and the creation of the Eugenics Board. The Act remained law until 1972 and its repercussions are facing Alberta courts today. The Act was supported by many prominent first-wave feminists such as Nellie McClung and Emily Murphy. Nurses too supported the Act and the philosophical ideology on which the need for sterilization was based- "an available means for racial improvement." The role nurses played in promoting eugenics in Alberta through referrals to the Eugenics Board and the promotion of birth control material will be explored in the presentation. Contributions made by public health nurses will be included since much of their work was devoted to the socialization of new immigrants to Canada. Class, gender and ethnicity are central themes to this discussion because the majority of individuals who were sterilized were unemployed, female immigrants from eastern Europe. These two decades represent a time in nursing history when the nurse's duty to care was complicated by the attitudes and values of the society in which she existed. Primary sources used include the personal collection of one of Alberta's early birth control nurses, Canadian Journal of Public Health, Canadian Nurse, and Alberta newspapers.

Canada↗
PubMed2004

Longitudinal study of Salmonella species in 90 Alberta swine finishing farms.

The aim of this study was to determine the farm prevalence of Salmonella in 90 Alberta finishing swine farms over a 5-month period, to evaluate Salmonella distribution in the farm environment and to describe Salmonella serovar diversity on these farms. Ten veterinary practitioners selected 90 Alberta swine farms based on an annual production of > or =2000 market pigs per farm and the willingness of the producers to participate in the study. Between May and September 2000, twenty samples were collected from finishing swine and the environment of each farm. The annual production of selected farms represented approximately 25% of the market swine production in Alberta. Participating farms were geographically representative of major swine production areas in Alberta. Sixty (66.7%) farms had at least one Salmonella-positive sample, with confidence interval (CI) of 57.1-77.2%. Salmonella were detected in 14.3% of fecal and 20.1% of environmental samples. The number of Salmonella-positive samples per farm ranged from 1 to 19. Among environmental samples, Salmonella were most frequently recovered from boots (38.6%) and the main drain (31.8%). Twenty-two serovars were detected on the 60 Salmonella-positive farms. Serovars Typhimurium (78 isolates), Derby (71 isolates) and Infantis (47 isolates) were the most common. A single serovar was detected on 58 farms, while 2, 3 and >3 serovars were detected on 15, 10 and 7 farms, respectively. The Salmonella farm status changed frequently over the 5-month period indicating the dynamic nature of Salmonella infections on these farms.

Alberta↗
PubMed1994

A prevalence study of multiple sclerosis in the Crowsnest Pass region of southern Alberta.

Reports of a high prevalence rate for multiple sclerosis in Southern Alberta led to an epidemiologic study of this disease in the Crowsnest Pass and Cardston regions. In Cardston, the prevalence rate for multiple sclerosis was 88 per 100,000. In the Crowsnest Pass, the prevalence rate was 217 per 100,000. Previous epidemiologic studies of the prevalence rate of multiple sclerosis in Western Canada have shown rates between 93 and 111 per 100,000. Two prevalence studies of multiple sclerosis in Barrhead County, Alberta and Westlock County, Alberta show prevalence rates of 196 and 201 per 100,000. The prevalence rate in the Crowsnest Pass is comparable to the prevalence in Barrhead County and Westlock County, Alberta. However, there is no statistically significant difference between prevalence rates in the Cardston and Crowsnest Pass regions and our overall feeling is that the results of studies of small populations should be interpreted with caution.

Adult↗
PubMed2005

Invasive group A streptococcal disease in Alberta, Canada (2000 to 2002).

Invasive group A streptococcal (iGAS) disease was placed under surveillance in Alberta in August 1999. The purpose of this study was to determine the incidence rates of iGAS infections throughout Alberta over a 3-year period (2000 to 2002) and to better understand the epidemiology of iGAS in this province. There were a total of 441 cases of invasive GAS disease over the 3 years examined (average population over 3 years, 3,055,765) and 47 deaths. The incidence in Alberta was 5.0 (2000), 5.7 (2001), and 3.8 (2002) per 100,000. The two main metropolitan regions (Edmonton and Calgary) had the majority of iGAS disease cases (305 cases), producing incidence rates of 4.8 (Edmonton) and 6.9 (Calgary) in 2000, 6.9 (Edmonton) and 6.6 (Calgary) in 2001, and 4.1 (Edmonton) and 3.9 (Calgary) in 2002, as well as deaths attributable to GAS (31 deaths). The three most prevalent M types were M1 (71 cases), M3 (52 cases), and MPT2967 (44 cases). With respect to age, the highest incidence rates occurred in those less than 1 year old (11.7 per 100,000) and those 65 years or older (11.5 per 100,000). Varicella virus infection preceded iGAS disease in 25% of children 8 years of age and under. A seasonal association was observed during the 3 years studied, with the highest number of cases occurring in the winter months and the lowest occurring during the summer months. The data for years 2000 and 2001 show that the metropolitan regions of Alberta experienced some of the highest incidence rates reported in North America in the past decade.

Age Distribution↗
PubMed1994

Regional variations in the prevalence rates of multiple sclerosis in the province of Alberta, Canada.

Multiple sclerosis (MS) prevalence rates were examined for the fiscal years 1984/1985-1988/1989, in the province of Alberta, Canada, by age, sex and census division. Data were derived from the health care records of individuals registered with the Alberta Health Care Insurance Plan which requires registration by all residents of the province (approximately 2.4 million). The overall crude prevalence rate was 216.7 per 100,000 (173.1 for males; 260.3 for females) population. Females had a significantly higher prevalence (p < 0.05) and the rates were highly correlated between the sexes (r = 0.94, p < 0.01). The present study confirms other studies finding a high prevalence rate within the province of Alberta. The prevalence rate for Alberta is among the highest reported in the world indicating that the province appears to be an excess risk area relative to other global locations. Also, the results indicate that MS is unevenly distributed throughout the province which offers support for the involvement of environmental factors related to the onset of this disorder.

Adolescent↗
PubMed2006

Public health preparedness in Alberta: a systems-level study.

BACKGROUND: Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. METHODS/DESIGN: We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. DISCUSSION: The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

Alberta↗
PubMed2006

A costing model for videoconferencing in Alberta.

The Alberta Telehealth Network uses a provincial scheduling system, which allows use of the network to be monitored via reporting procedures. We developed a province-wide costing model for videoconferencing in Alberta, including administrative, clinical and educational activities. In 2003, there were 212 different videoconferencing sites. During the year, 5766 videoconferencing sessions were provided and in these sessions the sites were connected to the network a total of 21,596 times. About 27% of the connections were from providing sites and about 73% of the connections were from receiving sites. On average, one site in the telehealth system was connected to another site about 100 times, and the average videoconferencing session included about 3.8 sites, varying from mainly two sites in clinical sessions to 4.2 sites in administrative sessions and 6.1 sites in educational sessions. The total cost of videoconferencing in Alberta for administrative, clinical and educational activities was about CA $5.74 million in 2003. About 52% of the annual cost was for educational sessions, 34% for administrative meetings and 14% for clinical consultations. The average cost of videoconferencing at a single site ranged from $223.48 (for providing clinical consultations) to $278.57 (for receiving educational sessions). The costing model provides information for decision-makers about the cost of videoconferencing activities and can be used in the development of a sustainable telehealth system in Alberta.

Alberta↗
PubMed2005

Nighttime impaired driving in rural Alberta.

A nighttime roadside survey of rural Alberta drivers was conducted to quantify the nature and extent of impaired driving on Alberta's rural roads during nighttime. The survey also sought to describe driver demographics and information about the trip, such as origin and destination, among rural Alberta's nighttime drivers. Surveys were administered to drivers of vehicles that were randomly sampled at rural locations in Alberta between the hours of 10:00 PM and 4:00 AM between 22 August and 1 September 2001. Drivers who agreed to participate were asked a series of short questions. The interview concluded with the driver providing a breath sample to measure the driver's BAC level. Of the drivers surveyed, 3% had a BAC that was over the legal limit of 80 mg%. A total of 13% of drivers tested had detectable amounts of alcohol in their system.

Accidents, Traffic↗
PubMed1986

Parelaphostrongylus odocoilei (Nematoda: Protostrongylidae) and a protostrongylid nematode in woodland caribou (Rangifer tarandus caribou) of Alberta, Canada.

Two size-groups of dorsal-spined, first-stage, nematode larvae were found in feces of woodland caribou, Rangifer tarandus caribou (Gmelin), in Alberta from 1976-1982. Larvae from caribou feces in northeastern Alberta were 451 +/- 17 micrograms in length, while those from west-central Alberta were 362 +/- 18 micrograms in length. Larvae collected from west-central Alberta developed to the infective stage, experimentally, in the terrestrial gastropod Triodopsis multilineata (Say) and were infective to captive mule deer fawns, Odocoileus H. hemionus (Rafinesque). Adult nematodes, identified as Parelaphostrongylus odocoilei (Hobmaier and Hobmaier, 1934), were recovered from the skeletal muscles of the mule deer.

Alberta↗
PubMed1999

Assessment of physician performance in Alberta: the physician achievement review.

The College of Physicians and Surgeons of Alberta, in collaboration with the Universities of Calgary and Alberta, has developed a program to routinely assess the performance of physicians, intended primarily for quality improvement in medical practice. The Physician Achievement Review (PAR) provides a multidimensional view of performance through structured feedback to physicians. The program will also provide a new mechanism for identifying physicians for whom more detailed assessment of practice performance or medical competence may be needed. Questionnaires were created to assess an array of performance attributes, and then appropriate assessors were designated--the physician himself or herself (self-evaluation), patients, medical peers, consultants and referring physicians, and non-physician coworkers. A pilot study with 308 physician volunteers was used to evaluate the psychometric and statistical properties of the questionnaires and to develop operating policies. The pilot surveys showed good statistical validity and technical reliability of the PAR questionnaires. For only 28 (9.1%) of the physicians were the PAR results more than one standard deviation from the peer group means for 3 or more of the 5 major domains of assessment (self, patients, peers, consultants and coworkers). In post-survey feedback, two-thirds of the physicians indicated that they were considering or had implemented changes to their medical practice on the basis of their PAR data. The estimated operating cost of the PAR program is approximately $200 per physician. In February 1999, on the basis of the operating experience and the results of the pilot survey, the College of Physicians and Surgeons of Alberta implemented this innovative program, in which all Alberta physicians will be required to participate every 5 years.

Alberta↗
PubMed2001

Emigration patterns of cancer cases in Alberta, Canada.

Cancer registries are a unique source of data for population-based analysis of survival of cancer cases, but information on current vital status is essential. This paper describes a method to determine the last known vital status of cases and the emigration pattern of cancer cases diagnosed in Alberta. Data from the Alberta Cancer Registry (ACR) for the years 1985 1993 (83,446 cases), were linked to the Alberta Health Care Insurance Plan (AHCIP) registration file to identify cases that had left the province, and the date they emigrated. Ninety-nine percent of the ACR cases linked correctly to the AHCIP registration file. Three percent of cases had left Alberta by March 1998; For the first five years of follow-up between 0.6% and 0.8% of cases alive at the beginning of each year of follow-up left the province in the succeeding year. Seven percent of those diagnosed under 45 years of age left the province compared to less than 2% of those aged 65 and over. There was no difference in emigration patterns between the sexes. The cancer sites with good prognosis tended to have the highest proportion of emigrants.

Alberta↗
PubMed2002

The epidemiology of tuberculosis among foreign-born persons in Alberta, Canada, 1989-1998: identification of high risk groups.

BACKGROUND: To date, there have been no comprehensive epidemiological studies in Canada of the incidence rates of tuberculosis among foreign-born persons. Accurate rate estimates are needed to develop cost-effective strategies for the prevention, control, and ultimate elimination of tuberculosis. METHODS: Most new immigrants to Canada settle in one of four provinces: Ontario, British Columbia, Quebec and Alberta. Data from the provincial reporting system for tuberculosis, from Statistics Canada censuses and population estimates of Treaty Status Indians provided by the Department of Indian and Northern Affairs Canada, were used to estimate the rate of tuberculosis in Alberta's Canadian-born and foreign-born population between 1989 and 1998. RESULTS: Age-adjusted tuberculosis case rates per 100,000 person-years were 19.4 and 61.9 in the foreign-born and Canadian-born Treaty Indians-approximately 10 times and 30 times, respectively, higher than the rate in the remainder of the Canadian-born population (2.1/100,000 person-years). Age-specific rates in male and female foreign-born persons were highest at ages 15-34 and > or = 65 years, whereas rates in Canadian-born non-Treaty and Treaty males and females increased incrementally, with a single peak at > or = 65 years. Tuberculosis case rates in the foreign-born varied significantly according to World Bank region and country of birth. By far the highest rates were seen in immigrants to Canada from Asia, in particular Vietnam, the Philippines, China, Hong Kong and India. Most (90%) tuberculosis patients from these countries had not been identified as requiring medical surveillance in Canada after arrival. CONCLUSION: Immigrants to Alberta from Asia and Treaty Status Indians are at high risk for tuberculosis. Physicians in Alberta who care for foreign-born persons should be aware that their patients are at increased risk for tuberculosis, even if they have been medically cleared during the legal immigration process.

Adolescent↗
PubMed2004

Transmission characteristics of tuberculosis in the foreign-born and the Canadian-born populations of Alberta, Canada.

SETTING: All notified cases of tuberculosis in the province of Alberta, Canada, 1994-1998. OBJECTIVE: To compare the transmission characteristics of tuberculosis among foreign-born and Canadian-born cases. DESIGN: Retrospective analysis using DNA fingerprinting (IS6110 restriction fragment length polymorphism and spoligotyping) and patient information from the Alberta Tuberculosis Registry. Transmission indexes were determined by calculating the average number of culture-positive pulmonary cases generated by a single source case. RESULTS: Of the 750 cases of active tuberculosis, 437 (58.3%) were in the foreign-born. DNA fingerprinting of Mycobacterium tuberculosis isolates from all 573 culture-positive cases over the 5 years from 1994 to 1998 showed that there was significantly less clustering among foreign-born isolates (9.8%) compared to Canadian-born non-Aboriginal (28.8%) and Aboriginal (44.7%) isolates. The transmission index was significantly higher for males, lower for those > or =65 years of age, and higher for Aboriginals. CONCLUSION: Although cases of tuberculosis in the foreign-born constitute the majority in Alberta, there is little transmission to other foreign-born or to Canadian-born individuals. Transmission of tuberculosis among the Aboriginal population remains a significant problem in Alberta.

Adult↗
PubMed2005

Use of seat belts in rural Alberta: an observational analysis.

OBJECTIVE: This paper details an observational study that estimates rates for wearing seat belts in rural Alberta and compares them with rates derived from a similar study conducted in 1999. METHOD: Direct observations of drivers and front-seat passengers of 72,593 light-duty vehicles were carried out at 334 survey locations in communities with populations of fewer than 25,000, throughout northern, central and southern Alberta. In addition to seat belt use, information collected included vehicle type, gender of drivers and passengers and, at intersections controlled by a stop sign, whether or not the vehicle came to a complete stop. RESULTS: The results indicate that in 2001 in rural Alberta the estimated proportion of driver and front-seat passengers of light-duty vehicles using seat belts was 76.1%. When compared with 1999 data, this represents a 6.9% increase in seat belt wearing rates. The data was desegregated further to show differential wearing rates between drivers of different vehicle types, males and females, drivers and passengers, and between those who came to a complete stop at a stop sign and those who did not. The time of day in which data collection took place also had some influence on seat belt wearing rates. DISCUSSION: This study contributes valuable information to programs and initiatives that aim to increase the use of seat belts in rural Alberta.

Accidents, Traffic↗
PubMed2006

Additional skills training for rural physicians. Alberta's rural physician action plan.

PROBLEM ADDRESSED: Rural physicians in Alberta identified access to special skills training and upgrading skills as an important practice requirement. OBJECTIVE OF PROGRAM: The Rural Physician Action Plan in Alberta developed an Enrichment Program to assist physicians practising in rural Alberta communities to upgrade their existing skills or gain new skills. The Enrichment Program aimed to provide a single point of entry to skills training that was individualized and based on the needs of rural physicians. PROGRAM DESCRIPTION: Two experienced rural physicians were engaged as "skills brokers" to help rural physicians requesting additional skills training or upgrading to find the training they required. Physicians interested in applying for the Enrichment Program consulted one of the brokers. Each applicant was assigned a preceptor. Preceptors confirmed learning objectives with trainees, provided the required training in keeping with agreed-upon learning objectives, and ensured trainees were evaluated at the end of the training. CONCLUSION: The program has helped rural physicians upgrade their skills and gain new skills. More Alberta rural physicians are now able to pursue additional training and return to practise new skills in their rural and remote communities than in the past.

Alberta↗
PubMedDate not supplied

A study of mortality near sour gas refineries in southwest Alberta: an epidemic unrevealed.

Concerns about excesses in a wide array of adverse health outcomes have been expressed for over 25 years by a rural population in southwestern Alberta, living downwind from natural gas refineries. Among these has been the perception that deaths have occurred more frequently than ought to have been expected. As part of a large field epidemiologic study undertaken during the summer of 1985 to investigate possible health effects in this area, a residential cohort study was carried out to study mortality. The cohort was defined as all those individuals who resided in the area in 1970. A total of 30,175 person-years of risk within Alberta were experienced by this cohort during 1970-84. The deaths during this period were enumerated by resident reports and by manual record linkage with the death records of the Alberta Bureau of Vital Statistics. Age- and sex-standardized mortality ratios, based on expected rates from 2 pre-specified demographically similar, non-metropolitan Southern Alberta populations, were 0.88 and 0.84 respectively, neither of which was significantly different from unity. These data cannot address the question of etiology but they can do much to allay the anxieties of a community convinced it had experienced an epidemic of death.

Adult↗
PubMed1980

Characteristics of bat rabies in Alberta.

Rabies in bats was monitored in Alberta from 1971 to 1978 Big brown bats replaced silver-haired bats as the species most frequently reported rabid during these years. Rabies infection was comparatively high among little brown bats in central Alberta in 1973 and has subsequently declined. Only one rabid little brown bat was discovered in southern Alberta which is populated by a different subspecies. Outbreaks of rabies in little brown and big brown bat colonies tended to be brief events. Observations of free-ranging bats with probable furious rabies suggested that bats do not generally identify humans as targets for attack. Independent trends in infection rates suggested that spread of rabies is primarily intraspecific but there is evidence that migratory bats play a role in introduction and maintenance of rabies in northern temperate bat communities. The dynamics of bat rabies in Alberta are discussed.

Alberta↗