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A moral emergency and a medical problem: negotiating the control of venereal disease--the Saskatchewan Venereal Disease Protection Act, 1946.

The author examines Saskatchewan legislation that regulated venereal disease. Although venereal disease legislation was introduced in Saskatchewan in 1919, the centrepiece of this article is The Venereal Disease Prevention Act, 1946. In an attempt to understand the nuances of and underlying rationale for these laws, the author situates the legislation within its social context. The author demonstrates that the trends and contradictions apparent in society's approach to the regulation of venereal disease were reflected in the legislation. The concept of a continuum is used to illustrate the coexistence of two approaches to the control of venereal disease. On one side of the continuum, venereal disease was a moral problem and a taboo subject. Force was the key to controlling venereal disease; involuntary examinations and intrusions into people's personal lives were the solution. On the other side of the continuum, venereal disease was a medical problem. If approached rationally and openly, control of venereal disease was possible; through education and social acceptance of venereal disease as just another illness, people would voluntarily come forward for treatment. The approaches represented at the extreme ends of the continuum did not exist in isolation; these views existed simultaneously, producing contradictory and colourful rhetoric.

Coercion↗

Saskatchewan issues substance abuse plan.

The government of Saskatchewan has produced an action plan for substance abuse that increases funding for prevention and treatment programs. The action plan also provides new funding for supply reduction (i.e., enforcement) measures. Workers in community-based organizations (CBOs) in Saskatchewan have been critical of the action plan.

Humans↗

Dental service use and its correlates in a dentate population: an analysis of the Saskatchewan population health and dynamics survey, 1999-2000.

OBJECTIVES: To document the frequency of self-reported use of dental services within a 2-year period by a sample of dentate Saskatchewan residents aged 18 years and older; explore the correlates associated with dental service use for men and women separately; and examine the age, gender and income distribution of dental insurance coverage. METHODS: The 1999-2000 Saskatchewan Population Health and Dynamics Survey provided a representative sample of 5,003 dentate respondents (mean age 45.5 years; 52.3% women), 18 years and older, randomly selected and interviewed by telephone. RESULTS: Of those interviewed, 77% of the women and 67% of the men reported a dental visit within the previous 2 years. For women, logistic regression analysis indicated that when all other factors were held constant, the odds of dental service use within the last 2 years were higher among those who were aged 18-19 years, had post-secondary education or technical certification, were in the highest household income adequacy category, held dental insurance and engaged in such preventive behaviours as regular general checkups, eye checkups, skin self-examination and not smoking daily. For men, the odds of dental service use within the last 2 years were greater if they had education at or beyond the secondary level, were students, were in the upper or highest income adequacy levels, held dental insurance and engaged in preventive health behaviours such as general checkups, eye checkups and not smoking daily. Dental insurance coverage was strongly associated with household income adequacy and peaked among men and women aged 30-49 years. CONCLUSIONS: This study indicates that the roles of gender, income, education, age, health-related behaviours and resources such as dental insurance should be considered in future public oral health strategies. We propose a conceptual model to aid in understanding the social structural and individual pathways to oral health.

Adolescent↗

Physician management of hyperlipidemia in Saskatchewan: temporal trends and the effect of a CME program.

OBJECTIVE: To assess current trends in the management of hyperlipidemia by Saskatchewan physicians, and to evaluate the effect of a specific continuing medical education (CME) program. DESIGN: Using a quasi-experimental design, physicians in an intervention area received the CME program while those in a comparison area did not. Management of hyperlipidemia was assessed before and after the program via a self-administered questionnaire. SETTING: All family physicians, general internists and cardiologists practising in the two areas were eligible. SUBJECTS: Of 439 eligible physicians, 308 (70%) completed the first survey, while 268 of 447 (60%) completed the second survey. Analysis was conducted on the 221 physicians who completed both surveys. INTERVENTION: Physicians in the intervention area received printed materials and attended a series of seminars between November 1988 and February 1989. Program content was based upon the recommendations of the Canadian Consensus Conference on Cholesterol (1988). MAIN RESULTS: Over the study period the mean level of serum cholesterol considered 'ideal' for a 40- to 60-year-old male decreased significantly from 5.43 to 5.03 mmol/L (P less than 0.001). The mean level at which diet therapy was begun decreased from 6.60 to 5.78 mmol/L (P less than 0.001) with a significantly greater proportion of physicians in the intervention area (58.0%) than in the comparison area (43.2%) initiating therapy in the 5.2 to 5.6 mmol/L range (P = 0.03). The mean level of serum cholesterol at which drug therapy is begun also decreased from 7.59 to 6.82 mmol/L (P less than 0.001), with a significantly greater proportion of physicians in the intervention (41.6%) than in the comparison area (25.0%) starting therapy in the 6.2 to 6.6 mmol/L range (P = 0.03). CONCLUSIONS: The management of hyperlipidemia reported by physicians in Saskatchewan changed dramatically between July 1988 and March 1989. The effect of the CME program is modest in comparison with this large temporal trend. The study provides further evidence that significant changes in the practice patterns of groups of physicians will only occur when the educational process is highly focused and personalized.

Adult↗

Pregnancy outcome among native Indians in Saskatchewan.

OBJECTIVE: To determine the difference in pregnancy outcome between native Indians and the provincial population in Saskatchewan. DESIGN: Retrospective analysis of data collected from all birth and death registration forms. SETTING: Saskatchewan. MAIN OUTCOME MEASURES: Incidence of low birth weight and rates of stillbirth and of neonatal and infant death. RESULTS: The neonatal death rate was higher in the Indian population than in the provincial population during the study period; the difference between the two groups in the rate decreased markedly after 1982. The rates of stillbirth and infant death were also higher among the Indians, and the difference persisted during the study period. The incidence of low birth weight and the rate of stillbirth were highest in the youngest and oldest maternal groups in the provincial population; however, the pattern was markedly different among the Indians, teenaged mothers having the best outcomes. CONCLUSION: Further studies are needed to determine the relation between maternal age and fetal outcome among native Indians.

Adolescent↗

Survey of comprehensive accident and injury experience of high school students in Saskatchewan.

Accidents and injuries typically have been studied on the basis of hospital and coroners' reports, by age group, activity, and accident location. The comprehensive accident experience of population groups has not been reported, although Guyer and Gallagher have attempted an estimate for childhood injuries. The accident and injury experience during one year (1982) of all 746 grade 11 and 12 students in three Saskatchewan high schools was surveyed by the Saskatchewan Child Safety Committee. In Part A of the survey, comprehensive information was gathered on the extent and types of accidents and injuries and modes of medical treatment. In Part B of the survey, employment injuries from the summer of 1982 were reviewed. When Part B injuries were used to represent occupational injuries in Part A of the survey, work became the primary source of injuries to students during the year.

Accidents↗

Utilization of general anesthesia by general practitioners in Saskatchewan.

A survey of Saskatchewan general practitioners was carried out to investigate the utilization of general anesthesia for the completion of dental procedures. Of the total number of general practitioners (234) surveyed, 61.5 per cent responded that they had done at least one general anesthesia case during their dental career. With respect to current utilization in the province, 38.4 per cent (90) of the respondents did at least five general anesthesia cases per year. Other variables investigated were: number of cases per year, types of patients treated and adequacy of dental school training. Age of practitioner, year of graduation and community population were found to be significant (p less than 0.001) variables in the utilization of general anesthesia by general practitioners in Saskatchewan.

Adult↗

Factors associated with average daily gain, fever and lameness in beef bulls at the Saskatchewan Central Feed Test Station.

Data obtained from the Saskatchewan Central Feed Test Station in Saskatoon, Saskatchewan, Canada were examined for evidence of factors related to average daily gain and the diseases occurring in 326 beef bulls during the 1983-84 test. Average daily gain was found to be significantly associated with breed, pen assignment and initial test weight but was not associated with disease or age upon arrival at the test station. Lameness was associated with breed and initial weight, while fever (suspected respiratory disease) was associated with age. The predicted odds of lameness was approximately seven times greater in the animal with the heaviest as compared to the lightest initial test weight and the predicted odds of fever was approximately five times greater in the youngest as compared to the oldest animal.

Animals↗

Survival following renal transplantation in Saskatchewan, 1970--74: follow-up study using medical insurance records.

The patient history file of a medical care insurance plan can be used for statistical purposes in many ways. This is illustrated by the use of the records of the Saskatchewan Medical Care Insurance Commission to study the survival of patients receiving kidney transplants in the period 1970--74. During this period 48 males and 23 females received at least one renal transplant; these patients represented 34% of all males and 28% of all females undergoing regular renal dialysis. These period prevalence estimates are consistent with calculations based on incidence and point prevalence reported elsewhere. Life-table calculations showed the 4-year survival rate following first kidney transplantation in Saskatchewan to be 45% for all patients, 55% for those less than 45 years of age and 26% for those 45 years of age or older.

Actuarial Analysis↗

Laboratory studies on the transmission of western equine encephalitis virus by Saskatchewan mosquitoes. I. Culex tarsalis.

A Saskatchewan strain of the mosquito Culex tarsalis, transmitted a local strain of western equine encephalitis virus from chick to chick, between four and 44 days after an infective blood meal. At incubation temperatures of 69 and 75 degrees F, 120 transmissions occurred out of a possible 141, and all but seven of these were by single infected mosquitoes. At 75 degrees F virus titers in individual mosquitoes were more uniform and transmission was more efficient, than at 69 degrees F, although infection rates were similar at both temperatures. The minimum concentration of virus required to infect 50% of C.tarsalis was 10(2.5) intracerebral three-week old mouse LD(50) per 0.03 ml of donor blood. These findings provide direct evidence that C. tarsalis of Saskatchewan is a highly efficient vector of western equine encephalitis virus.

Animals↗

Porcine Hemophilus parahemolyticus pneumonia in Saskatchewan. II. Bacteriological and experimental studies.

The incidence of porcine pleuropneumonia caused by Hemophilus parahemolyticus has shown a marked increase in recent years in some countries. Isolation of a strain distinct from European serotypes was made from a natural outbreak of the disease in pigs in Saskatchewan. Experimentally infected pigs did not develop clinical signs but pathologic-anatomic studies of lungs revealed the presence of necrotizing fibrinous pneumonia with intense proliferation of mesenchymal tissue elements. Similar extensive fibroblastic activity had been found to be a typical feature in the natural infection. It is speculated that the Saskatchewan strain may have invasive patterns different from European serotypes.

Animals↗

A serological survey of Leptospira interrogans serotype pomona in Saskatchewan horses.

Leptospira interrogans serotype pomona antibody titres of 1:100 or greater were detected in 12.8% of 408 adult horses from seven of eight sampled herds in Saskatchewan. The geographical distribution of the seropositive horses was widespread throughout the agricultural area of the province. The geographical distribution and the cumulative increase in prevalence with age suggested that serotype pomona is enzootic in the equine population of Saskatchewan.

Animals↗

Tularemia in Canada with a focus on Saskatchewan.

Although rare among humans in Canada, tularemia is often endemic in wildlife. The inhabitants of rural areas are especially likely to be exposed to the causative bacterium, Francisella tularensis, through trapping or through the bites of arthropods. Muskrats have replaced rabbits as the principal source of infection, as illustrated by a familial outbreak of oropharyngeal tularemia in Saskatchewan. In humans the disease has six distinct forms and can be asymptomatic, but it generally comes to medical attention as fever, persistent ulcers and enlarged lymph nodes. Serologic tests will confirm the diagnosis.Bien que la tularémie soit rare chez l'homme au Canada, elle existe souvent à l'état endémique parmi les animaux sauvages. Les habitants des régions rurales sont particuliérement susceptibles d'être exposés à l'agent étiologique, Francisella tularensis, lors du trappage ou par les morsures d'arthropodes. Le rat musqué a maintenant remplacé le lapin comme principale source d'infection, tel que l'illustre une poussée de tularémie oropharyngienne chez une famille de Saskatchewan. Chez l'humain la maladie prend six formes distinctes, et elle peut être asymptomatique, mais elle se présente généralement à l'attention du médecin comme une fièvre accompagnée d'ulcères persistants et d'une tuméfaction ganglionnaire. Les épreuves sérologiques confirment le diagnostic.

Agglutination Tests↗

Fluoroscopic radiation measurement in Saskatchewan.

A mail-out thermoluminescent dosimeter (TLD) system has been used to measure fluoroscopic surface dose rates very 8 weeks in Saskatchewan hospitals since 1976. Incentive for the program came from Saskatchewan radiologists. The mean of the annual dose rates for all units was 30.8 mGy/min (3.08 rads/min). Each year, 30% of the machines varied in output by 100% or more, 8% by 200% or more, and one machine's output increased by 800%. These measurements have allowed prompt correction of excessive dose levels or replacement of offending machines when the dose rate could be lowered sufficiently. No significant difference in surface dose rates between manually controlled units and units with automatic brightness control was found.

Fluoroscopy↗

A serological survey of Leptospira interrogans serotype pomona in Alberta and Saskatchewan striped skunks and possible transmission between cattle and skunks.

The range of known occurrence of Leptospira interrogans serotype pomona is extended to Alberta in striped skunks (Mephitis mephitis); no evidence of L. sejroe was found. Reacting sera from skunks were confined to the southern portion of Alberta and adjacent Saskatchewan, although a number of reactors were found sufficiently further north in Saskatchewan suggesting that a different mode of infection may be functioning there. Of 95 skunk sera from near a dairy farm infected with serotype pomona 40% were reactors. Of 438 skunk sera from other areas only 5.7% were reactors; that difference was suggestive of transmission from cattle to skunks on the dairy farm. Of 22 skunk sera collected near the dairy farm in summer none were reactors, whereas 52% of skunk sera taken the previous and following winters were. That seasonal difference was not evident among sera from other locations.

Alberta↗

The Saskatchewan Clinical Stroke Prevention Project: design.

The Saskatchewan Clinical Stroke Prevention Project aims to examine the process and impact of incorporating enhanced stroke prevention into the routine clinical practice of family physicians. Twenty-four physicians in three practices in Saskatchewan are participating in a staged series of educational interventions over two years to enhance their management of smoking, transient ischemic attack/stroke, atrial fibrillation and hypertension. The components of each intervention include a seminar, printed materials, a one-to-one case discussion or "academic detailing," a self-documented chart audit and changes to the office system. Patients for whom this intervention is targeted are those 55 to 75 years of age presenting for a periodic health examination with one or more of the four main risk factors for stroke. Intervention will consist of counselling on relevant risk factors by the doctor and nurse teams, supported by appropriate patient education materials. Patient follow-up will be carried out according to clinical indications and will be done at least 3, 6, 12 and 24 months after entry into the study. Evaluation comprises measures of the process of implementing change in preventive practice as well as of the impact of such change. The former includes semi-structured interviews and focus groups with physicians, support staff and patients. The latter includes an assessment of knowledge, attitudes and charted practice before and after intervention.

Adult↗

The vitamin A and vitamin E status of horses raised in Alberta and Saskatchewan.

The purpose of the study was to determine normal baseline levels of vitamin A and vitamin E in clinically normal horses under typical field conditions in Saskatchewan and Alberta. Heparinized blood samples were collected from approximately 400 clinically healthy horses selected from 24 locations in Alberta and Saskatchewan during a two-year period. For each horse, historical information including feed type, vitamin supplementation, time of year, sex, and age were recorded. From each blood sample, the plasma vitamin A (all-transretinol) and vitamin E (alpha-tocopherol) levels were measured using high pressure liquid chromatography. Normal baseline plasma vitamin A and vitamin E concentrations recorded during the study were 0.70 mumol/L and 7.65 mumol/L, respectively. The plasma vitamin concentrations were lower in the younger horses. The plasma vitamin levels were higher from May to August, as compared to other times of the year. Horses grazing fresh pasture exclusively during the summer months had plasma vitamin A and vitamin E concentrations that were 27% and 63% greater than horses fed harvested or stored feeds during the same time period. Sex-related differences were not evident in the study. A number of factors may influence the baseline plasma vitamin A and vitamin E levels in horses. Consequently, it is unadvisable to use a single evaluation to assess vitamin status. Multiple sampling from individual horses or sampling from many horses within a herd may reduce the variability and improve the ability to monitor vitamin status from plasma submissions.

Age Factors↗

MDs remain sceptical as chelation therapy goes mainstream in Saskatchewan.

The College of Physicians and Surgeons of Saskatchewan recently agreed to allow physicians to administer chelation therapy. Supporters, relying on anecdotal evidence, say it works wonders in overcoming heart disease, but many physicians remain profoundly sceptical. In Saskatchewan, the college decision has proved popular with patients but has drawn an angry reaction from doctors.

Aged↗