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Investigating the relationship between beta-blocker and antidepressant use through linkage of the administrative databases of Saskatchewan Health.

The main objectives of this research were to confirm previous reports of an increased risk of antidepressant use subsequent to propranolol therapy, and to determine whether this higher relative risk (RR) is indicative of depressive symptoms as a side-effect of the drug's use. 'New' users of beta-blockers, other antihypertensives or diuretics in two separate years were identified from records of Saskatchewan Health. Incidence of concurrent antidepressants prescribing was determined in the year after initiating therapy with a cohort drug. Medical claims were examined to identify physician services and diagnoses associated with cohort drug and antidepressant prescriptions. Risk of concurrent antidepressant use in new propanolol users aged 20-39 years was approximately double that of new diuretic users [RR 2.2 (1.5-3.3) in 1984 and 2.0 (1.1-3.5) in 1990/91]. When cases with a diagnosis of migraine headache were excluded, the risk of concurrent propranolol/antidepressant use was age- and sex-dependent, but not consistent for the two study years. It was concluded that although the risk of concurrent antidepressant use was greater in younger propranolol users, the risk cannot be solely attributed to depressive side-effects of the drug. The purposes of this paper were to present the methods employed in linking the databases of Saskatchewan Health, describe the results of the analysis, and to highlight the methodologic problems that arose.

Journal Article↗

Mortality experience among employees at a hydrometallurgical nickel refinery and fertiliser complex in Fort Saskatchewan, Alberta (1954-95).

OBJECTIVE: To study the mortality experience of workers at a hydrometallurgical nickel refinery and fertiliser complex in Fort Saskatchewan, Alberta, Canada. METHODS: A total of 1649 male employees of Sherritt International who worked for at least 12 continuous months during the years 1954 to 1978 at the Fort Saskatchewan, Alberta hydrometallurgical nickel refinery and fertiliser complex were followed up for an additional 17 years. Mortality was ascertained from the Canadian mortality data base maintained by Statistics Canada and covered the years 1954-95. Statistics were analysed with Monson's computer program. RESULTS: Total mortality, when compared with the Canadian population, was significantly below expectation. Fewer deaths were found for circulatory disease, ischaemic heart disease, respiratory disease, neoplasms, digestive cancer, and accidents, poisonings, and violence. Among the 718 men in the group exposed to nickel, there were no deaths due to nasal cavity or paranasal sinus cancer. Fewer deaths were found for all causes, circulatory disease, ischaemic heart disease, neoplasms and digestive cancer. Lower death rates were observed than expected for respiratory malignancies and cancer of the bronchus and lung. CONCLUSION: No association was found in this study between exposure to nickel concentrate or metallic nickel in the hydrometallurgical refining process and the subsequent development of respiratory cancer.

Adult↗

The Effect of Plant Height on Tan Spot on Durum Wheat in Southern Saskatchewan.

Tan spot [caused by Pyrenophora tritici-repentis (Died.) Drechs.] is the most important leaf disease of durum wheat (Triticum turgidum L. var. durum). Most of the durum cultivars in western Canada are of conventional height but development of shorter cultivars is desirable. Changes in microenvironment resulting from a height reduction might cause greater leaf spot development. The effect of plant height on tan spot of durum wheat was determined in five pairs of genotypes near-isogenic for plant height and five randomly selected populations, each with a semidwarf and a conventional height parent. These were grown in five environments in Saskatchewan (1996-1998 at Swift Current, 1997-1998 at Indian Head), and evaluated for tan spot reaction in a growth chamber. There was no difference in tan spot reaction under controlled conditions between short and tall genotype(s) in each pair or population, although there were differences within each height category. Under field conditions, short genotypes had either equal or greater disease than tall genotypes. Contrasts between all short and tall genotypes also showed that the tall had less disease in 1998 at Indian Head (9.8 for tall, 10.2 for short) and in all years at Swift Current (9.5 and 9.9 in 1996, 8.1 and 8.7 in 1997, 8.5 and 8.9 in 1998, for tall and short, respectively). However, there was genetic variability within populations, with some short having equal or less disease than tall genotypes. Some of these short genotypes also had a low tan spot lesion type under controlled conditions. We conclude that plant height could affect tan spot development in durum wheat under conditions prevalent in southern Saskatchewan, and that this is probably mediated by canopy density.

Journal Article↗

Ascaris suum in Saskatchewan pigs: an abattoir survey of prevalence and intensity of infection.

In a survey of 2500 market weight pigs in a Saskatchewan abattoir, 37% were infected with adult Ascaris suum and in 46% there were milkspot hepatic lesions. A total of 60% of the pigs examined had some evidence of A. suum infection. Most infected pigs contained less than 50 adult ascarids. In a second abattoir survey of a further 2500 market weight pigs, 44% of the animals had milk-spot hepatic lesions. In approximately 12% of the affected pigs these lesions were very severe and a very similar proportion of pigs' livers were condemned or sent for use as animal feed. The results of these surveys are discussed with particular reference to the significance of A. suum infection in growing pigs in Saskatchewan.

Abattoirs↗

Serum IgE levels in white and metis communities in Saskatchewan.

Serum IgE levels and the prevalence of certain atopic diseases have been studied in 819 individuals in 176 white families living in central Saskatchewan and in 275 individuals in 58 Metis families living in northern Saskatchewan. The geometric mean serum IgE level in the white community (81.3) u/ml) was lower than that in the Metis community (275.4 u/ml). The prevalence of asthma, eczema and urticaria was greater in the white than in the Metis community and contrasted with the increased prevalence of helminth infestation as well as of other untreated viral and bacterial diseases in the Metis community. It is suggested that atopic disease is the price paid by some members of the white community for their relative freedom from diseases due to viruses, bacteria and helminths.

Adolescent↗

Muscular dystrophy in Saskatchewan Hutterites.

A slowly progressive form of muscular dystrophy was studied in a Dariusleut Hutterite kindred from a colony in west-central Saskatchewan. The disorder combines some characteristics of the dominantly inherited facio-scapulo-humeral and the recessively inherited limb-girdle types of muscular dystrophy. Intellect, vision, hearing, and sensations were normally preserved. Nerve conduction was also intact. The disorder reported herein resembles a type of muscular dystrophy we previously described in the Manitoba Schmiedeleut Hutterites [Shokeir and Kobrinsky, 1976]. This condition, which affects both sexes, appears to be genetic in origin and recessively inherited.

Consanguinity↗

Validity of the recording of ischaemic heart disease and chronic obstructive pulmonary disease in the Saskatchewan health care datafiles.

The internal validity of the recording of information about ischaemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) in the administrative health care datafiles of the Canadian province of Saskatchewan is investigated. Comparisons between hospital data and medical charts for acute myocardial infarction and chronic airways obstruction patients showed excellent diagnostic agreement: 97 per cent and 94 per cent, respectively. Appropriate physician service claims were identified for 89 per cent of hospitalizations for IHD and COPD and exact concordance between diagnoses in the two datafiles varied between 15 per cent for acute/sub-acute IHD and 80 per cent for asthma; including any physician diagnosis within the same broad category (IHD or COPD) increased concordance to 79-94 per cent for IHD and 64-88 per cent for COPD. Contextual information related to the hospitalizations was clinically and epidemiologically realistic.

Adolescent↗

Effectiveness of voluntary habitat stewardship in conserving grassland: case of operation burrowing owl in Saskatchewan.

There have been no published performance evaluations of nongovernmental, voluntary habitat stewardship programs. The Operation Burrowing Owl (OBO) stewardship program, initiated in 1987, was evaluated for its effectiveness in conservation of grassland habitat during 1986-1993. The 108 OBO sites from 1987 to 88 and 98 randomly selected non-OBO sites that were grassland in 1986 in the Regina-Weyburn, Saskatchewan study area were classified by size and agricultural soil suitability. By 1993, 41 (38%) of the 108 OBO sites had been withdrawn from the program. The 1986 area of grassland was compared with grassland area calculated from digitized 1993 LANDSAT imagery. A correction for satellite inaccuracies was determined. Grassland retention in 1993 was significantly higher at OBO sites (66%) than at random sites (49%), demonstrating that the OBO voluntary program effectively conserved habitat. Also, grassland retention was significantly lower on sites with better agricultural soils, and for sites <12 ha in size. Site type (OBO or random), size and their interaction, followed by agricultural soil suitability, had the greatest effects on grassland retention. During an era of accelerated grassland loss, OBO strongly and positively (statistically significant) affected conservation of grassland sites most at risk: sites <12 ha in size and with good to excellent agricultural soils. This suggests that grassland conservation efforts focus on vulnerable sites (small size and/or good agricultural soils) to provide nesting habitat for burrowing owls. Our study demonstrates that a voluntary stewardship program can significantly increase conservation of habitat.

Agriculture↗

Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

Canada↗

The effect of daytime running lights on crashes between two vehicles in Saskatchewan: a study of a government fleet.

Keeping vehicle lights on to increase vehicle conspicuity during daytime hours has been found to reduce crashes in Scandinavia and the United States. Crashes of vehicles with and without daytime running lights owned by the Central Vehicle Agency of the Province of Saskatchewan were compared to a random selection of crashes drawn from provincial crash files involving vehicles without daytime running lights for the years 1982 through 1989. Daytime two-vehicle crashes involving vehicles approaching from the front or side were reduced by about 28% for the daytime running-light equipped vehicles. A 28% reduction in daytime running-light relevant daytime two-vehicle crashes corresponds to a 15% reduction in all daytime two-vehicle crashes.

Accidents, Traffic↗

Geotoxicology of multiple sclerosis: the Henribourg, Saskatchewan, cluster focus. II. The soil.

The childhood-related, geographically-linked factor which predisposes towards (or protects against) multiple sclerosis (MS) could be one or more chemicals in the environment. Chemical study of the environment or "focus" of an MS cluster may maximize the chances of detecting such an etiological link. The soil chemistry of an MS focus (Henribourg, Saskatchewan) was compared with North American norms, and with the chemistry of soil from a nearby control area with a near-zero incidence of MS and of childhood homes of MS cases. A combination of our present results with those reported in the literature suggests that an environment predisposing to MS may have a number of the following chemical characteristics: Calcareous; with soils (but not necessarily waters) generally low in copper, iron and vanadium; with excess lead, nickel and zinc in the upper soil layer; with waters relatively high in chloride, chromium, molybdenum, nitrate plus nitrite, and zinc; but low in selenium and sulfate. One possible causal pathway to explain the apparent link between the excess rate of MS and some of the curious geochemical findings at Henribourg is presented. Many other possible explanations could equally well be advanced, and methods for testing such alternative hypotheses are proposed.

Canada↗

Geotoxicology of multiple sclerosis: the Henribourg, Saskatchewan, Cluster Focus. I. The water.

Some childhood-related, geographically-linked factor predisposes towards (or protects against) multiple sclerosis (MS). It is quite plausible that this factor could be one or more chemicals in the environment, and that chemical study of the environment or "focus" of an MS cluster might maximize the chances of detecting such an etiological link. The water chemistry of such a focus (Henribourg, Saskatchewan) was compared with North American norms, and with the chemistry of water from a nearby control area with a near-zero incidence of MS and of childhood homes of MS cases. Overall, the results suggest that an environment predisposing to MS may have a number of water chemistry characteristics such as: relative deficiency of selenium and sulfate, but relative abundance of barium, calcium, chloride, chromium, magnesium, manganese, molybdenum, nitrate plus nitrite, strontium and zinc. Possible explanations for the apparent link between the excess rate of MS and the water geochemistry findings at Henribourg are discussed.

Cohort Studies↗

Some socio-geographic aspects of renal transplant cases in Saskatchewan.

The province of Saskatchewan is the oldest and most unique example of providing universal medicare programs in North America. These programs offer full coverage for every resident, and hence strongly influence the treatment of kidney patients requiring dialysis and transplant. The University Hospital at Saskatoon, however, is the only center in the province with a transplant program. An attempt has been made here to determine if there are geographical variations in the transplant program in terms of such factors as distance, location, occupation, age and sex of the patients and the nature of the donors.

Adolescent↗

Validity of rheumatoid arthritis diagnoses listed in the Saskatchewan Hospital Separations Database.

A Saskatchewan hospital separations database was compared to abstracted hospital records to determine the reliability of the database (i.e. accuracy with which the computer data reflect the charts from which they were coded) and the validity of classifying rheumatoid arthritis status with the database (i.e. the extent to which rheumatoid arthritis mentioned in the database reflected the condition of the patient). A sample of hospitalized subjects fell into three categories: 144 who never had a database diagnosis of any arthritis, 146 who had a database diagnosis of osteoarthritis, and 142 who had a database diagnosis of rheumatoid arthritis. These 432 people experienced 1717 hospitalizations eligible to match a hospital database listing by date, and 1618 matched. Of the remaining 99, 35 were relatively recent and probably had not yet been entered into the database, 39 were possibly entered incorrectly, and 25 could not be matched in any way. Of 150 hospitalizations with a database diagnosis of rheumatoid arthritis, this diagnosis was in the hospital record for 125. Chart documentation of rheumatoid arthritis status was greatest for subjects who, according to the database, were hospitalized by a rheumatologist: of 73 subjects in this category, abstractions showed 69.9% met > or = 5 American Rheumatism Association criteria, 15.1% met < 5 criteria but had a rheumatologist's diagnosis of rheumatoid arthritis, 1.3% met < 5 criteria and had a rheumatoid arthritis diagnosis by a non-rheumatologist, and 13.7% had no mention of rheumatoid arthritis or its symptoms in any medical record abstracted. In summary, reliability of the database was excellent, but validity depended on the source of diagnosis.

Arthritis, Rheumatoid↗

Risk factors for squamous cell carcinoma of the skin in Saskatchewan, Canada.

Completed questionnaires regarding suspected risk factors for skin cancer were completed by 178 cases of SCC of the skin in Saskatchewan, Canada, and 284 age- sex- and location-matched controls. Significant risk factors identified using chi2 analyses were: farming, family history of skin cancer, light eye color, blond or red hair color, skin types I or II, obvious freckles in childhood, history of severe sunburn, and the use of the herbicide 2,4-Dichlorophenoxy acetic acid. The following relative risks were identified: (1) All cases of SCC of the skin and matched controls: agricultural occupation 1.49, history of severe sunburn 1.49. (2) All men with SCC of the skin and matched controls: history of severe sunburn 1.36 (3) All women with SCC of the skin and matched controls: agricultural occupation 1.83, and skin types I or II 1.48. No association was noted on our study between a history of psoriasis and development of SCC. Neither was an association between smoking and SCC found.

Carcinoma, Squamous Cell↗

Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients.

PURPOSE: To measure prevalence, incidence, and mortality of cardiovascular outcomes among persons with chronic obstructive pulmonary disease (COPD) and to assess the extent these outcomes differ from persons without COPD. METHODS: Retrospective cohort study in longitudinal health care databases maintained by the government of Saskatchewan, Canada. Subjects were persons age 40 years or older who were diagnosed with COPD during 1997-2000 and who received two or more prescriptions for bronchodilators within 6 months of diagnosis. Each subject was matched by age and sex to two controls without COPD or asthma. RESULTS: Of COPD patients (n = 11,493), 54% were male, and 74% were 65 years or older. Prevalence of all cardiovascular diseases was higher in the COPD group than in the comparison group. After adjusting for cardiovascular risk, odds ratios of prevalence were: arrhythmia 1.76 (confidence interval [CI]: 1.64-1.89), angina 1.61 (CI: 1.47-1.76), acute myocardial infarction 1.61 (CI: 1.43-1.81), congestive heart failure 3.84(CI: 3.56-4.14), stroke 1.11 (CI: 1.02-1.21), pulmonary embolism 5.46 (CI: 4.25-7.02). Risk of hospitalization due to each cardiovascular cause was elevated in the COPD group. The risk ratio for cardiovascular mortality was 2.07 (CI: 1.82-2.36) and all cause mortality was 2.82 (CI: 2.61-3.05). CONCLUSIONS: Persons with diagnosed and treated COPD are at increased risk for hospitalizations and deaths due to cardiovascular diseases.

Aged↗

A qualitative analysis of the use of community treatment orders in Saskatchewan.

This study examined the opinions of patients who have been placed on a community treatment order (CTO), their relatives, mental health clinicians and representatives of community agencies about the use of CTOs in Saskatchewan. Patients were assessed using indepth interviews, while their relatives, mental health professionals and representatives of community agencies took part in facilitated focus groups. Patients had contradictory feelings about CTOs. Most experienced some degree of coercion while on the orders but many believed that CTOs provided necessary structure in their lives. Clinicians were more consistently positive but recognized the difficult choices in balancing the subject's right to self-determination with the benefits of a treatment order. Family members viewed CTOs as necessary to control a chaotic situation caused by the subject's limited insight.

Ambulatory Care↗

Prediction of human cases of West Nile virus by equine cases, Saskatchewan, Canada, 2003.

In 2003, an outbreak of West Nile virus (WNV) occurred in Saskatchewan, Canada from July to September. One-hundred thirty-three horse cases and 947 human cases were recorded and data were analyzed retrospectively for evidence of clustering to determine if clinical infection in the horse population could be used to estimate human risk of infection with WNV. Kulldorff's scan statistic was used to identify spatial-temporal clusters in both the human and horse cases. In most areas, human clusters were not preceded by horse clusters. In one area, a significant cluster of horse cases preceded human cases by 1 week; however, 1 week does not provide sufficient time for human-health authorities to act and provide advance warning for the public.

Animals↗