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Epidemiology of diabetes mellitus in Prince Edward Island.

In Prince Edward Island, all diabetic inhabitants who register annually with the Provincial Department of Health can obtain prescribed hypoglycemic medications and urine testing materials free of charge. Since 1964, this drug program has served as an informal register of the diabetic patients living on the island. Based on the data available, the following observations are made: (1) The prevalence rate of diabetes increased from 0.89% in 1966 to 1.53% in 1977. The prevalence rates increased from 0.05% in the less than 9-yr age group to 8.4% in the greater than 90-yr age group. The prevalence rate of diabetes among school children was 0.19%. (2) The incidence rate was 1.89/1000 in 1977. The highest incidence rate was in the greater than 40-yr age group and the lowest in the less than 10-yr age group. (3) Fourteen and a half percent of the diabetic persons were treated with diet alone, 52.7% with oral agents, and 32.5% with insulin in 1977. (4) In 1978, the cost per diabetic person for providing benefits was: oral agent = $14.88, insulin = $84.75, urine testing materials = $9.29, and education = $38.08.

Adolescent↗

Stakeholder evaluation of a high-risk prenatal nutrition intervention program in Prince Edward Island.

Since 1971, a Prince Edward Island prenatal program has provided nutrition support to pregnant women at high risk for poor birth outcomes. Provincial changes in the delivery of health care services since 1986 have caused concern that the program is becoming less effective. The current research was designed to evaluate stakeholders satisfaction with the program; it was part of a larger study conducted in 1998 and 1999 to evaluate overall program effectiveness. Nutritionists (n=9), referring health professionals (n=57), and clients (n=50) completed a survey. The results indicated that program satisfaction was high for all stakeholders. Perceived program strengths included the counselling approach, program quality, food and income supplements, and accessibility. Perceived program weaknesses included inadequate staff/time, administrative requirements, limited communication/awareness, the counselling approach, and difficulty contacting clients. Recommendations for improvement fall into four key areas: staff services, program delivery, the counselling approach, and communication. The findings suggest that the components of prenatal education considered important vary among clients and staff, and that the relationship developed between staff and clients during counselling is an important contributor to program success.

Cross-Sectional Studies↗

Healthy Hearts at work: Prince Edward Island Heart Health Program CSC worksite pilot project.

Prince Edward Island experiences a higher-than-average death rate from cardiovascular disease. The Prince Edward Island Heart Health Program is a health promotion/disease prevention research project of Health Canada and the Prince Edward Island Department of Health and Social Services. This paper describes and evaluates a worksite program, based on the principles of community mobilization, that was initiated with the Civil Service Commission of the Prince Edward Island government. The building of a partnership, the risk appraisal session administered in the workplace, the establishment of an Employee Wellness Committee, and subsequent programming which has occurred in the workplace were the key components in the process. Collaboration with the partner agency and participation of employees in the planning process has resulted in the delivery of programs which could not have been achieved by one of the agencies alone, without many additional resources. It is hoped that these characteristics of collaboration and employee participation will also result in sustainability of this initiative when PEI Heart Health is no longer involved.

Cardiovascular Diseases↗

Prince Edward Island Heart Health Dissemination Research Project: establishing a sustainable community mobilization initiative.

This paper provides an overview of the Prince Edward Island Heart Health Program (PEIHHP) Dissemination Research Project. Prince Edward Island (PEI) is a small province in the Atlantic region of Canada with a population of 137,980. The Island's economy is dependent on the fishery, agriculture, and tourism industries. Although unemployment rates are high (14.4%), Prince Edward Island has the lowest poverty rate in the country at 15.2%, high levels of social support (86%), and the second lowest rate of high chronic stress (Report on the Health of Canadians, 1996, 1999).

Cardiovascular Diseases↗

Antibodies to snowshoe hare virus of the California group in the snowshoe hare (Lepus americanus) and domestic animal populations of Prince Edward Island.

This study, the first of arbovirus activity in Prince Edward Island, has shown antibodies to the snowshoe hare strain of the California encephalitis group virus to be present in sera of wild and domestic animals; 15.35% of snowshoe hare, 20% of equine. and 2.5% of bovine sera were positive for hemagglutination inhibition antibody, confirmed by virus neutralization procedures.

Animals↗

Re-hospitalizations after myocardial infarction on Prince Edward Island: analysis of the reasons.

In the province of Prince Edward Island (PEI), which has a small homogeneous population of approximately 140,000 people, cardiovascular disease is the leading cause of death accounting for 37% of the total deaths. Next to Newfoundland, this province ranks second highest in Canada for its incidence of cardiovascular disease. This high incidence of cardiovascular disease in this population has been attributed to smoking, physical inactivity, hypertension and obesity. In examining provincial comparisons across Canada, PEI has the highest proportion of physically inactive adults at 68%. PEI has the second highest proportion of adults, 15 years and older, who are daily or occasional smokers at 65% and who have high blood pressure at 12%. PEI has the third highest proportion of adults who are overweight. At the Queen Elizabeth Hospital in Charlottetown, PEI, where the researcher has conducted her study, during the period of January 1997 and December 1997, 192 patients were admitted with the diagnosis of acute myocardial infarction (AMI). The average length of stay in hospital for these patients was 10.3 days. This is high compared to the national average of 6.6 days in hospital. During a one year period, 111 of these 192 patients were re-admitted to hospital with a related cardiovascular diagnosis. This equates to a 57.8% readmission rate for post MI patients. These re-hospitalizations are both costly to health care and disruptive to the quality of life of the individual and his or her family. There is evidence that a portion, approximately 50% of these re-hospitalizations, are due mainly to psychosocial factors and not to unavoidable clinical reasons. A cross-sectional design representing this one year period was used in a chart audit with an analysis done to determine factors associated with re-hospitalization of post MI patients. This article will offer insight regarding the results of this analysis as well as future recommendations for patients being discharged home follow an AMI. The significance of the research lies in its collection of data focusing on behaviors and attitudes around cardiovascular risk factor modification which will enable effective planning and evaluation of health promotion programs, policies, and legislation.

Aged↗

Isolation of the Lyme disease spirochete, Borrelia burgdorferi, from Ixodes dammini (Acari: Ixodidae) collected on Prince Edward Island, Canada.

Studies were undertaken to monitor for the presence of Borrelia burgdorferi, the etiologic agent of Lyme disease, on Prince Edward Island, Canada. Gut contents were removed for culturing from seven engorged ticks collected in 1991-1992 including five Ixodes dammini (Spielman, Clifford, Piesman & Corwin) and two I. scapularis (Say) removed from a dog that had recently traveled to the southern United States. B. burgdorferi was recovered from one I. dammini that had been removed from a cat in Charlottetown in October 1991. The cat had not traveled off the island. Immunofluorescent antibody (IFA) studies on sera from 75 dogs, 7 cats, and 8 white-tailed deer (Odocoileus virginianus) collected on Prince Edward Island between 1989 and 1992 revealed one reactor with an IFA titer > or = 1:256. The reactor was a dog with a history of travel to the United States. This report documents the first isolate of B. burgdorferi in Atlantic Canada, possibly because of the introduction of I. dammini on migratory birds. Serological studies do not indicate widespread occurrence of B. burgdorferi on Prince Edward Island.

Animals↗

Ambient air concentrations of pesticides used in potato cultivation in Prince Edward Island, Canada.

Ambient air concentrations of nine selected pesticides used in potato cultivation were investigated on Prince Edward Island by collecting samples during the summer of 1998 at three potato farm sites and one non-agricultural site. In 1999, air samples were collected at a single potato farm site during local application of pesticides. The fungicide chlorothalonil was the only pesticide detected in every sample in both years, even in samples with a duration as little as 5 h. In 1998, maximum (45-458 ng m(-3)) and mean (22-193 ng m(-3)) concentrations of chlorothalonil from composite 42 h samples were one to two orders of magnitude greater at agricultural sites than at the non-agricultural site (3.9 and 2.5 ng m(-3), respectively). Maximum and mean concentrations of chlorothalonil from combined 24 h samples at the farm site in 1999 were higher than those measured in 1998 (636 and 284 ng m(-3), respectively). The ubiquitous presence in air of relatively high concentrations of chlorothalonil in agricultural areas on Prince Edward Island is likely related to its repeated use on potato farms where fungicides account for 80-90% of pesticides applied. Eight of nine pesticides were detected at farm sites in 1998 and they are ranked by mean concentration from highest to lowest as follows: chlorothalonil, methamidophos, azinphos-methyl, alpha-endosulfan, beta-endosulfan, pirimicarb, metobromuron, metribuzin, metalaxyl and fluazifop-P-butyl. Concentrations of metalaxyl, pirimicarb, metobromuron and fluazifop-P-butyl in air are among the first reported values for these pesticides. Five pesticides were detected at the Summerside farm in 1999, but only two fungicides (chlorothalonil and metalaxyl) were used locally, while the presence of metribuzin, alpha-endosulfan and methamidophos in air was not associated with local application. Evidence of pesticide drift was observed for chlorothalonil, alpha-endosulfan and methamidophos, and these pesticides were identified as being of high concern in terms of potential wildlife exposure on the Island.

Agriculture↗

A trap, neuter, and release program for feral cats on Prince Edward Island.

A new program to address the feral cat population on Prince Edward Island was undertaken during the spring and summer of 2001. Feral cats from specific geographic areas were trapped, sedated, and tested for feline leukemia virus and feline immunodeficiency virus. Healthy cats were neutered, dewermed, vaccinated, tattooed, and released to their area of origin. A total of 185 cats and kittens were trapped and tested during a 14-week period; 158 cats and kittens as young as 6 weeks of age were neutered and released. Twenty-three adult cats were positive for feline leukemia virus, feline immunodeficiency virus, or both, and were euthanized.

Animals↗

A cohort study of coagulase negative staphylococcal mastitis in selected dairy herds in Prince Edward Island.

The epidemiology and importance of coagulase negative staphylococcal (CNS) mastitis in Prince Edward Island had not been documented. To investigate this, a cohort of 84 cows at seven farms were quarter sampled eight times over a lactation, commencing with samples taken prior to drying off in the previous lactation. Thirteen species of CNS were isolated. The quarter prevalence of CNS mastitis varied from 4.8% to 6.4% in the first five months of lactation and increased to 14.2 to 16.6% in the last four months of lactation. The geometric mean somatic cell counts (SCC) for quarters infected with CNS and uninfected quarters were 90 x 10(3) and 64 x 10(3) respectively (difference significant at p > 0.005). The two month new infection risk of CNS was 9.0% while the two month elimination risk was 74.4%. Infection with CNS did not alter the risk of subsequent infection with Staphylococcus aureus. The results from this project support the classification of CNS as a minor pathogen in mastitis control programs.

Animals↗

Hepatitis C in Prince Edward Island: a descriptive review of reported cases, 1990-1995.

INTRODUCTION: The prevalence of hepatitis C in Canada is not known. There is limited information on most small area populations such as Prince Edward Island. METHODS: A retrospective approach was used to obtain detailed information on all cases of hepatitis C identified in Prince Edward Island from December 1990 to September 1995. Cases were reviewed for demographic, clinical and risk factor information, including blood donation and transfusion histories. RESULTS: There were 54 RIBA confirmed cases of hepatitis C infection included in the Prince Edward Island Hepatitis C Database, of which 38 (70%) were males. Age ranged from 18 to 76 years, with a mean age of 38 years. Twenty-eight (52%) of the cases had a history of injection drug use, and 24 (44%) had received blood or blood products in the past. There were five cases with neither of these risk factors identified. DISCUSSION: The results suggest that, in this small, primarily rural population, injection drug use is the most common means of hepatitis C transmission, followed by receipt of blood or blood products.

Adolescent↗

Seroepidemiology of Q fever among cats in New Brunswick and Prince Edward Island.

The indirect microimmunofluorescence test was used to determine the presence of antibodies to phase I and phase II Coxiella burnetii antigens in New Brunswick and Prince Edward Island cats. Twenty of 104 (19.2%) New Brunswick cats tested had antibodies to phase II antigen; five of these (4.8%) also had antibodies to phase I antigen. Six of 97 (6.2%) Prince Edward Island cats tested had antibodies to phase I and phase II antigens. Our data suggest that cats may be important in the epidemiology of Q fever in these provinces.

Animals↗

Immunity to rubella in prepubertal girls in Prince Edward Island.

A survey of rubella immunity was conducted among prepubertal girls in Prince Edward Island. Of the 431 girls enrolled in grade 4 in a random sample of schools 83% had a school record of having been vaccinated after their first birthday. A screening test of finger-prick samples revealed that 95% of the girls with a written history of vaccination after their first birthday were immune, 79% of those vaccinated before their first birthday or for whom the date of vaccination was uncertain were immune, and 40% of unvaccinated girls were immune. Of the 49 susceptible girls 43 were vaccinated; all but 2 were found to be immune on retesting. The findings support the recommendation of the National Advisory Committee on Immunization to vaccinate all prepubertal girls without a written history of rubella vaccination after their first birthday.

Child↗

A survey of biological productivity of Prince Edward Island swine herds.

Sow and feeder pig productivity were measured on a random sample of 32 Prince Edward Island swine farms (each producing over 1000 market hogs per year). Productivity parameters could be arranged in a hierarchy, with the highest level on farrow-finish operations represented by pigs weaned per sow per year. The 17 farrow-finish farms in this study averaged 19.6 (+/- 2.2 SD) pigs weaned per sow per year. Large variation between farms was observed with a range from 16.2 to 24.9 pigs weaned per sow per year. The major opportunities for improving productivity, as compared to reviewed targets, lie in reducing the average weaning age, reducing preweaning mortality, and reducing non-productive sow days per parity. The 14 feeder operations were characterized by 0.58 +/- 0.07 kg average daily gain. Average daily gain was negatively correlated with mortality (r = -0.662, p = 0.010), suggesting that herds that achieved a high rate of gain also had lower mortality.

Agriculture↗

Seroepidemiology of Q fever in Nova Scotia and Prince Edward Island.

The prevalence of Coxiella burnetti infection (Q fever) was determined among Nova Scotia (N.S.) and Prince Edward Island (P.E.I.) blood donors by using the complement fixation and microimmunofluorescence (IF) test. The complement fixation and IF antibody tests measured antibody prevalence for the phase II or phase I and II antigens, respectively. Complement-fixing antibodies to phase II antigen were detected in 4.1% of 997 N.S. and 5.0% of 219 P.E.I. blood donors. Anti-phase II antibodies were detected by microimmunofluorescence in 11.8 and 14.6% of the blood donors in the two provinces, respectively. Anti-phase I antibodies were detected among 2.8% of the N.S. blood donors and 6.3% of the P.E.I. blood donors. Comparison of rates of anti-phase II IF by counties in N.S. revealed that there was at least one county where infection by C. burnetti is hyperendemic. Rates of antibody prevalence were similar in all three areas of P.E.I. examined. We conclude that "Q fever" is endemic in N.S. and P.E.I. and that the microimmunofluorescence test is more suitable than the complement fixation test for seroepidemiologic studies.

Adolescent↗

Herd prevalence and incidence of Streptococcus agalactiae in the dairy industry of Prince Edward Island.

Herd prevalence and incidence of mastitis caused by Streptococcus agalactiae was determined for dairy cattle on Prince Edward Island during December 1992 and June 1994. For each census, bulk tank milk samples from all dairy herds (n = 452) in the province were tested on two occasions, and the results were interpreted in parallel. The combined sensitivity of the testing protocol was estimated to be 91%. The confirmatory latex agglutination test had previously reported specificities approaching 100%. Therefore, the estimated specificity of the testing protocol was assumed to be 100%. The apparent prevalence of S. agalactiae in December 1992 and in June 1994 was 17.7 and 13.1%, respectively. Based on the characteristics of the test, the estimated true prevalence was 18.9% in December 1992 and 14.4% in June 1994. Infection with S. agalactiae was associated with elevated bulk tank somatic cell count (SCC) and elevated standard plate counts. Economic losses associated with S. agalactiae were attributed to production losses (associated with bulk tank SCC), milk quality penalties (associated with bulk tank SCC and standard plate count), and decreases in milk quality (associated with bulk tank SCC). For herds that had been negative for S. agalactiae in December 1992, evaluation in June 1994 yielded an incidence of new infections of 3.51 per 100 herds per year.

Animals↗

Smoking cessation, physicians, and medical office staff. Clinical tobacco intervention in Prince Edward Island.

OBJECTIVE: To assess attitudes and self-reported behaviours of physicians and medical office staff in Prince Edward Island concerning clinical tobacco intervention (CTI). DESIGN: Mail survey of PEI primary care physicians and their medical office staff. Most surveys were not mailed back but picked up in person by research staff. SETTING: Primary care settings in PEI. PARTICIPANTS: All active primary care physicians in PEI identified in the Canadian Medical Association database and medical office staff. Respondents included 63/88 (71.6%) physicians and 59/88 (67.0%) medical office staff. Fifty-seven physicians and medical office staff surveys overlapped. MAIN OUTCOME MEASURES: Attitudes and self-reported behaviours in CTI. RESULTS: More than 70% of the time, 68.3% of physicians reported asking new patients about their smoking behaviour and 66.7% reported that they listen to and acknowledge patients' feelings and fears about stopping smoking. Close to half (43.3%) of physicians reported thinking about or planning to do more CTI. Physicians and medical office staff reported that staff had limited involvement in methods to cue smoking interventions. Only half (50.8%) of physicians reported that their offices are well set up to identify smokers and to help them quit smoking. Offices were well set up for CTI if physicians perceived that office staff had an active role in CTI and if follow-up visits were frequently arranged. CONCLUSIONS: This study identified apparent opportunities for improving CIT, particularly in the areas of physician training, involvement of medical office staff, and awareness of billing codes. This could improve the quality of preventive care for patients in PEI.

Adult↗

The obstetric trials and tribulations of Dr. John Mackieson, Charlottetown, Prince Edward Island, 1827-1857.

For 30 years, from 1827 to 1857, Dr. John Mackieson, a medical practitioner in Charlottetown, Prince Edward Island, Canada, kept a detailed account of complicated obstetric cases. An analysis of this casebook provides a unique profile of obstetric complications and their management in eastern Canada 150 years ago. The main causes of maternal death were puerperal sepsis and hemorrhage. The reported perinatal deaths most often were associated with traumatic vaginal delivery.

History, 19th Century↗