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At least 19 recordsLinked to original sources
PubMedDate not supplied

Estimation of the incidence of acute myocardial infarction using record linkage: a feasibility study in Nova Scotia and Saskatchewan. Nova Scotia-Saskatchewan Cardiovascular Disease Epidemiology Group.

The impact of cardiovascular disease prevention and therapeutic interventions may be reflected in the incidence and case-fatality of acute myocardial infarction. Relevant data can be obtained from carefully planned surveillance studies or from existing administrative data. Utilization of the latter is facilitated by record linkage of computerized provincial, regional and national databases. The validity of these data, particularly with respect to diagnostic codes, must be ensured. We estimated the incidence of fatal and non-fatal acute myocardial infarction (AMI) in Nova Scotia and Saskatchewan for 1977. Hospital discharge records from the two provinces for 1977 were linked with the Canadian Mortality Database (Statistics Canada) for residents of the two provinces. Whether an episode was a recurrent or initial one, was determined by a retrospective search through 1974. A random sample of hospital charts was examined for diagnostic validity. A higher incidence of acute myocardial infarction was found in Nova Scotia than in Saskatchewan. The proportion of fatal episodes was higher in Nova Scotia with the greatest difference in mortality occurring in deaths before formal hospitalization. Evaluation of cardiovascular health in the community, including an assessment of time trends as well as regional and provincial differences, is possible using routinely collected administrative data.

Adult↗
PubMed2003

Adapting prehospital care to a large rural geographic area: a review of the Emergency Health Services Nova Scotia implementation.

Nova Scotia is building a system of prehospital care based on four principles: "Fail Safe" government ownership; "Full Service" advanced life support capable; "High Performance" resource efficiency; and "Fiscally Responsible" performance goals, incentives and penalties. Emergency Health Services Nova Scotia exercises funding and regulatory control through service provided by a private contractor. Benefits include improved fleet and equipment management, information systems, 911 dispatch and performance tracking, medical control and paramedic care, and public accountability. Problems include rural dispatch, budget costs, labour issues and stakeholder communication.

Emergency Medical Services↗
PubMed1996

Colonial care: medical attendance among the Mikmaq in Nova Scotia.

In Nova Scotia before Confederation, medical care for native peoples formed an integral part of the fledgling Indian administration. As the colonial authorities became more involved in all aspects of native life, an opportunity for self-advancement was presented to doctors. Practioners among the Mikmaq came from the emerging medical elite. This article argues that their service to the Mikmaq was part of a broader and widespread reform effort. Doctors not only delivered care to the Mikmaq, but they also served the needs of a colonial administration actively seeking to settle natives in reserve communities. The activities of doctors, however, did not go uncontested. This study illustrates the complex interaction among the native administration, the Mikmaq population, and a medical community struggling to organize.

Canada↗
PubMed1992

Trends in incidence and mortality from acute myocardial infarction in Nova Scotia and Saskatchewan 1974 to 1985. The Nova Scotia-Saskatchewan Cardiovascular Disease Epidemiology Group.

OBJECTIVE: To compare trends in incidence and case fatality of acute myocardial infarction (AMI) in Nova Scotia and Saskatchewan, provinces with the highest and lowest rates, respectively. DESIGN: Provincial hospital separation files were linked with mortality files and searched to identify incident cases in 1977, 1981 and 1985. The diagnoses were validated on a random sample of hospital charts with discharge codes 410 and 411 to 414 of the International Classification of Diseases of the World Health Organization. RESULTS: In spite of persisting differences between Nova Scotia and Saskatchewan, standardized AMI mortality and incidence rates in males and females have decreased, although at a slower rate in Saskatchewan. In both provinces the greatest decrease has occurred in male deaths prior to any hospital admission--likely representing cases of sudden death. Excess mortality in Nova Scotia is due predominantly to out-of-hospital deaths. Case fatality rates have declined in both provinces. The proportion of definite and possible AMI was similar in Nova Scotia and Saskatchewan in 1977, but not thereafter. CONCLUSIONS: Along with a decline in ischemic heart disease mortality, there appears to be a decline in AMI incidence in Nova Scotia. Parallel studies of risk factor changes, interventive care and access to care are required to explain the observed phenomena.

Adult↗
PubMedDate not supplied

Congenital anomalies and other birth outcomes among infants born to women living near a hazardous waste site in Sydney, Nova Scotia.

Using data from the Nova Scotia Atlee Perinatal Database, rates of adverse birth outcomes were compared among residents of Sydney, Nova Scotia and residents of Cape Breton County, Nova Scotia (excluding Sydney) with birth outcomes among residents of the rest of Nova Scotia. There was a small but statistically significant increase in the rate of major congenital anomalies in Sydney (2.8%) compared to the rest of Nova Scotia (2.3%) (adjusted RR = 1.25, 95% CI = 1.04-1.51). Rates of anomaly sub-groups were consistently elevated in Sydney compared to the rest of Nova Scotia, but most were not statistically significant. For the most part, the increased rates of congenital anomalies observed among residents of Sydney were not evident in the neighbouring community. Since Sydney and the rest of Cape Breton County share a similar risk factor and socio-demographic profile, other factors likely explain the increased rates observed in Sydney.

Congenital Abnormalities↗
PubMed1998

Urine drug testing for social service agencies in Nova Scotia, Canada.

In Nova Scotia Canada, governmental authorities expressed concern in the late 1980s about the adverse effects of drug use by parents on the welfare of their children. Since 1991, parents with a history of drug abuse may be required to submit to urine drug and alcohol testing when ordered by the Family Courts of this province. The objective of this paper is to present this drug testing program and the results of drug testing on 125 clients from 1994-1996. Urine specimens were collected in the parents' residence by a nurse and transferred directly to the laboratory by the collector or a courier. Specimens were screened by immunoassay and TLC followed by GC-MS confirmation. Results were sent directly to the social worker. In the 3,613 urine specimens analyzed, 50.2% of specimens were negative, 45.6% were positive for one or more drug/metabolite and 4.2% of specimens were dilute (creatinine < 25 mg/dL). The distribution of positive results were: cannabinoids (11.5%), cocaine metabolite (5.0%), benzodiazepines (14.5%), codeine/morphine (7.1%), codeine (6.6%), diphenhydramine (2.2%) and ethyl alcohol (1.6%). Drug testing has been considered a success by these agencies since testing provides an objective indication of recent drug use and the overall prevalence of drug use in this drug abusing population has reduced from 100% to < 50%.

Benzodiazepines↗
PubMedDate not supplied

Home care: the cornerstone of health renewal in Nova Scotia.

Until recently, home care services in Nova Scotia lacked uniformity and were difficult to access. This changed dramatically last June when the province launched Home Care Nova Scotia, the linchpin in the province's plan for health renewal. The program provides chronic and home hospital care to Nova Scotians of all ages, with five additional categories of care planned for the future. Like the 400 other coordinated home care programs in Canada, Home Care Nova Scotia is one alternative to the inappropriate use of acute and long term care facilities. It is also a valued service in its own right within the continuum of health services.

Caregivers↗
PubMed2004

Two cases of Neorickettsia (Ehrlichia) risticii infection in horses from Nova Scotia.

Two horses from Nova Scotia were diagnosed with Potomac horse fever (PHF). Polymerase chain reaction analysis was performed on formalin-fixed colon tissue or whole blood to show the presence of Neorickettsia risticii DNA, the causative agent of PHF. These are the first reported cases of PHF in the Maritime Provinces.

Anaplasmataceae Infections↗
PubMed2004

The effect of deinsuring chlorpropamide on the prescribing of oral antihyperglycemics for Nova Scotia Seniors' Pharmacare beneficiaries.

On behalf of the Nova Scotia Seniors' Pharmacare Program, the Drug Evaluation Alliance of Nova Scotia developed a multicomponent intervention plan to facilitate the removal of chlorpropamide as an insured benefit. Chlorpropamide has caused serious hypoglycemia in seniors to a greater extent than some other agents. Pharmacy administrative claims were used to compute monthly use rates for insulin and each oral antihyperglycemic drug from January 1, 2000-December 30, 2002, in an intervention cohort (patients receiving chlorpropamide) and a control cohort (patients receiving an antihyperglycemic agent other than chlorpropamide). Initially, 630 patients were receiving chlorpropamide therapy. By the time chlorpropamide was deinsured, only 10% of the treatment cohort continued receiving chlorpropamide; shortly after deinsurance, no beneficiaries continued receiving the drug. The antihyperglycemics with the greatest increase in prescription were glyburide and gliclazide. The deinsuring of chlorpropamide and the educational strategies that accompanied it resulted in the selection of more appropriate antihyperglycemics for Nova Scotia seniors.

Aged↗
PubMed2004

Maternal and perinatal outcomes of eclampsia: Nova Scotia, 1981-2000.

OBJECTIVE: To determine the prevalence of eclampsia and the associated maternal and perinatal outcomes in the province of Nova Scotia. METHODS: From the Nova Scotia Atlee Perinatal Database, the population-based rates of preeclampsia, eclampsia, and HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome for the period 1988 to 2000 were determined. A retrospective case review was then performed of all women with eclampsia at the tertiary maternity hospital in Halifax, Nova Scotia, Women's Hospital, IWK Health Centre, for the years 1981 to 2000. RESULTS: In the province of Nova Scotia from 1988 to 2000, there were 142,362 births. Thirty-nine women developed eclampsia (0.27/1000). Over this time interval, the prevalence of severe preeclampsia fell from 2.08% to 1.63%, and the diagnosis of HELLP syndrome increased from 0.03% to 0.31%. At the Women's Hospital, IWK Health Centre, between 1981 and 2000, there were 31 cases of eclampsia in 105,651 deliveries (0.29/1000). Sixty-one percent of first convulsions occurred antepartum, 13% occurred intrapartum, and 26% occurred postpartum. Eighty-one percent of women reported prodromal symptoms. Sixty-one percent of the women received anti-hypertensive therapies, 48% received antiepileptic therapies, and 97% received magnesium sulfate. Ten percent of the women had convulsions while on magnesium sulfate therapy. Antepartum eclampsia was associated with increased rates of general anaesthesia (26%) and Caesarean section (79%). There were no maternal deaths, but the rate of major maternal complications was 32%. The perinatal mortality rate was 64 in 1000 deliveries, and the rate of severe perinatal complications was 56%. CONCLUSION: The incidence of eclampsia in Nova Scotia is 0.27 per 1000 deliveries. Although rare, this condition is associated with significant maternal and perinatal morbidity.

Adult↗
PubMed2002

Diet quality and cancer incidence in Nova Scotia, Canada.

Cancer rates in the province of Nova Scotia, Canada, are among the highest in the country and coincide with elevated rates of risk factors such as smoking, poor diet, and obesity. To investigate the importance of diet on cancer, using data from the 1990 Nova Scotia Nutrition Survey, we developed a diet quality score reflecting compliance with 17 nutrient recommendations. The survey data were subsequently linked with the provincial cancer registry, and the relationship between diet quality and cancer was quantified using logistic regression. Our results support an inverse relationship between diet quality and cancer, although limited statistical power resulting from our small study sample did not reveal any statistically significant relationships. We estimated that cancer incidence could potentially be reduced by approximately 35% through improved diet quality. On the basis of poor diet, nutrition-related factors (high body mass index), our estimates of the preventable fraction of cancer, and the high provincial cancer rates, we recommend health promotion strategies aimed at improving diet quality in Nova Scotia.

Adolescent↗
PubMedDate not supplied

Development of a computer linkage system for a blood recipient notification program in Nova Scotia.

OBJECTIVES: To assess the potential uses of computer-assisted record linkage in the surveillance of infectious diseases, using the Nova Scotia blood recipient notification program as the example. METHODS: We developed a computer-assisted, multiple-pass, probabilistic record linkage to link records for blood recipients identified by the Nova Scotia notification program (Nova Scotia Phase I Blood Bank File information) with corresponding Nova Scotia Health Card Registration File records to obtain current mailing addresses to contact potentially living recipients. We used variables available from both files (e.g., name, date of birth, gender, and health care registration number) to link records, after eliminating duplicates/deceased cases. RESULTS: Among 23,925 eligible records in the Nova Scotia Phase I Blood Bank File (1984-1990), there were 1,818 (7.8%) duplications and 8,675 deceased cases, leaving 13,432 cases for linkage. 8,713 (65%) cases were successfully linked to the 1998 Health Card Registration Data File for current mailing addresses. INTERPRETATION: Multiple-pass linkage seems acceptable for maximizing detection of correctly matched records for look-back projects. To overcome quality/lack of information obstacles, future look-back linkages should explore the use of supplementary data files (tax files, voter lists, license files, other provincial databases) to obtain most current addresses.

Disease Notification↗
PubMedDate not supplied

Drug therapy in multiple sclerosis: a study of Nova Scotia senior citizens.

We conducted a study to determine the types and costs of drugs used by Nova Scotia senior citizens with multiple sclerosis (MS) compared with the types and costs of drugs used by all senior citizens in Nova Scotia. Administrative claims databases from the Nova Scotia Seniors Pharmacare program for persons aged 65 years or older were linked to the Dalhousie Multiple Sclerosis Research Unit (DMSRU) clinical database (1980-1994). Analyses compared persons with MS aged 65 years or older who attended the DMSRU at least once with the general population of senior citizens. Not all persons with MS attended the DMSRU. In aggregate, Pharmacare costs in 1993-1994 for patients with MS aged 65 years or older (N = 52) were $975.00 Canadian per capita compared with $590.00 Canadian for all senior citizens in Nova Scotia (N = 108,646). Thus average drug costs for the senior citizens with MS were 65% greater than those for all senior citizens covered by Nova Scotia's comprehensive, publicly funded Pharmacare program. Compared with other senior citizens, those with MS more frequently received alpha-blockers, anticholinergics, cholinergics, tricyclic antidepressants, anticonvulsants, antifatigue agents, antispasticity agents, and antibiotics for bladder infections.

Aged↗
PubMed2001

Capacity building for health promotion and chronic disease prevention--Nova Scotia's experience.

The purpose of this paper is to report on the capacity building efforts that took place during the dissemination research phase of Heart Health Nova Scotia (HHNS). HHNS, a health promotion research team, is funded by Health Canada and the Nova Scotia Department of Health. It is located in Halifax, Nova Scotia, a province of 937,000 people situated on the east coast of Canada. It has been a member of the Canadian Heart Health Initiative since its inception in 1989. The first phase of the program, Demonstration, was successfully completed in December 1995 (Heart Health Nova Scotia, 1995). In 1996, HHNS entered its second phase, Dissemination Research, which was conducted between April 1996 and March 2001 in the Western Health Region of Nova Scotia. This was completed in collaboration with organizations, community groups, and government agencies who joined HHNS to form the Heart Health Partnership (HHP) (Heart Health Nova Scotia, 2001). The main aim of this phase of the initiative was to build and research organizational capacity for health promotion and chronic disease prevention.

Diffusion of Innovation↗
PubMed1999

Underuse of acetylsalicylic acid in individuals with myocardial infarction, ischemic heart disease or stroke: data from the 1995 population-based Nova Scotia Health Survey.

OBJECTIVE: To determine current patterns of acetylsalicylic acid (ASA) use in Nova Scotia for individuals with self-reported myocardial infarction, stroke or ischemic heart disease. DESIGN: Descriptive, cross-sectional, population-based study using data from the 1995 Nova Scotia Health Survey (NSHS). The NSHS was based on a probability sample and was representative of the Nova Scotia adult population by age, sex and region. Survey data were obtained by standardized home interviews conducted by trained public health nurses. SETTING: The province of Nova Scotia in 1995. PARTICIPANTS: Survey respondents who reported having a myocardial infarction, stroke or ischemic heart disease were assessed. RESULTS: Among those who reported a history of myocardial infarction, stroke or ischemic heart disease, 55% (95% CI 47% to 63%), 49% (95% CI 38% to 61%) and 54% (95% CI 39% to 68%), respectively, reported using ASA at the time of the survey. Overall, only 53% of those with cardiovascular disease were using ASA. Exclusion of persons with potential contraindications to ASA did not significantly increase these proportions. CONCLUSIONS: ASA appears to be underused in those at high risk for future vascular events. Further research is required to investigate determinants of ASA use and to increase appropriate use of ASA.

Adolescent↗
PubMed1995

Prevalence of smoking among pregnant women in Nova Scotia from 1988 to 1992.

OBJECTIVE: To determine the prevalence of smoking during pregnancy in Nova Scotia and to identify women at high risk of smoking during pregnancy. DESIGN: Population-based descriptive study. SETTING: All hospitals providing obstetric services in Nova Scotia. PATIENTS: All 60 754 women residing in Nova Scotia who had a baby in hospital between 1988 and 1992; smoking data were available for 57,750 (95.1%) of them. OUTCOME MEASURES: Proportion of women who smoked during pregnancy and the maternal smoking rates by age, marital status, parity, attendance at prenatal classes and residence. RESULTS: Overall, 32.4% of the women smoked at some point during their pregnancy. The rate was highest among the women less than 20 years of age (47.0%) and decreased with each increasing 5-year age interval. Overall, the unmarried women were 2.1 times as likely to smoke as the married women. The smoking rates were highest among the women who were para 3 or greater regardless of age (women less than 20 were excluded here, since very few had such a parity). Of the nulliparous women, those who attended prenatal classes were less likely to smoke during pregnancy than those who did not attend. There was no relation between urban or rural residence and smoking rates. The smoking rates decreased little between 1988 and 1992 and in fact increased among the women 35 and over and among those who were para 3 or greater. CONCLUSIONS: The smoking rates among pregnant women in Nova Scotia changed little between 1988 and 1992. Therefore, it seems that current strategies for smoking cessation have not been successful. Since prenatal classes are more likely to attract nonsmokers than smokers, other avenues for education and cessation are necessary.

Adult↗
PubMed1983

Voluntary regionalization and associated trends in perinatal care: the Nova Scotia Reproductive Care Program.

The Nova Scotia Reproductive Care Program is a system of voluntary regionalization that involves the 37 hospitals in the province that provide obstetric care to a population of 850,000. Between 1971 and 1980, the perinatal mortality rate in the central tertiary care unit for nonreferred patients fell progressively from 12.5 per 1,000 total births to 5.16. For all cases, including high-risk referrals, this rate has fallen from 12.7 to 7.2. During the same interval, the perinatal mortality rate for the province's seven regional hospitals fell from 18.7 to 12.2, and that for the 28 community hospitals fell from 18.4 to 7.0. Analysis of these reductions by fitted trend lines demonstrates statistical significance. Further analysis demonstrates that, with regionalization of perinatal services, it is possible to reduce the perinatal mortality rate in small community hospitals to levels that approximate those of a sophisticated tertiary care hospital.

Female↗