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At least 19 recordsLinked to original sources
PubMed1991

Manitoba virus, a new rhabdovirus isolated from Culex tarsalis mosquitoes collected in Manitoba, Canada.

A rhabdovirus, Mn 936-77, was isolated from a pool of two Culex tarsalis collected on August 16, 1977, from Morris, Manitoba. Isolate Mn 936-77 was not pathogenic for suckling Swiss white mice inoculated by the intracerebral route. The virus propagated in three vertebrate cell lines (Vero, primary chick embryo, mouse neuroblastoma), but apparently not in Aedes albopictus C6/36 cells. Isolate Mn 936-77 did not react by amplified enzyme-linked immunosorbant assay with 230 viruses of proven or possible arbovirus etiology or by immunofluorescence with 88 members of the family Rhabdoviridae. Isolate Mn 936-77 appears to be a newly discovered virus for which the name Manitoba virus is proposed.

Animals↗
PubMedDate not supplied

How Baby-Friendly are Manitoba hospitals? The Provincial Infant Feeding Study. Breastfeeding Promotion Steering Committee of Manitoba.

The Breastfeeding Promotion Steering Committee of Manitoba conducted the cross-sectional Provincial Infant Feeding Study in 1996 to examine: correlation between breastfeeding policies and actual practices in Manitoba hospitals; compliance with Baby-Friendly Hospital Initiative (BFHI) criteria; and associations between hospital practices and two-week breastfeeding duration. Three separate surveys obtained information from: administrators concerning hospital policy; nursing staff concerning hospital practices; and all women giving birth in a five-week period, concerning breastfeeding rates and maternal perceptions of hospital practices. The results highlighted the need for policy and practice changes to comply with BFHI criteria. 92% initiated breastfeeding, and 84% were breastfeeding at two weeks postpartum. Independent predictors of weaning included: in-hospital supplementation (adjusted RR = 2.1, 95% CI 1.02-4.36, p = 0.04); temporarily interrupting breastfeeding while in hospital (adjusted RR = 4.9, 95% CI 2.7-8.9, p = 0.0001); no previous breastfeeding experience (adjusted RR = 2.5, 95% CI 1.4-4.4, p = 0.002); and Grade 12 or less maternal education.

Adult↗
PubMed2003

The Medical Humanities Program at the University of Manitoba, Winnipeg, Manitoba, Canada.

The current Medical Humanities Program at the University of Manitoba has evolved from a series of voluntary sessions into an integral element of the curriculum since its inception as the Human Values Program in 1986. With strong academic and financial support, the Medical Humanities Program has greatly benefited from dedicated leadership and a commitment to ongoing curricular review and redevelopment. The current Medical Humanities Program comprises six distinct components: Clinical Ethics; History of Medicine; Law; Complementary and Alternative Medicine; Palliative Care; and Human Values. Each of these components is compulsory and the first five are tested through examinations and assignments. Human Values sessions are designed to be experiential and to explore the human side of medicine as well as the intersections between medicine and the arts, literature, social psychology, and spirituality. The authors outline the origins and evolution of this successful program and describe its current components, student and faculty opinions, funding, advantages, disadvantages, and anticipated growth.

Curriculum↗
PubMed1982

Breast-feeding promotion in Manitoba. Committee on Breast-feeding, Manitoba Pediatric Society.

During the International Year of the Child the Manitoba Pediatric Society undertook professional and public education activities to promote breast-feeding in that province. The objective was a 100% increase in the proportion of mothers who breast-fed their infants for 2 months or longer. Surveys conducted before and after the campaign showed no significant increase in the rate of breast-feeding either at the time of hospital discharge or 2 months later. The infants of Winnipeg residents were more likely to be breast-fed than those of women living on Indian reservations or in any other part of the province (termed "rural"). The rate of bottle-feeding was significantly greater among infants of young unmarried mothers. Future programs to promote breast-feeding should be longer and more intensive, should be directed to the young, to rural residents and to Indian women, and should focus on social and emotional factors as well as nutrition and health benefits.

Adolescent↗
PubMed1997

Mortality, hospital admissions, and medical costs of end-stage renal disease in the United States and Manitoba, Canada.

OBJECTIVES: National registry data suggest that mortality rates among patients with end-stage renal disease are lower in Canada than in the United States. Casemix and treatment variables, although limited in such instances, do not explain this difference. Using a more complete set of casemix and treatment variables from clinical databases, this study assesses mortality, hospital admission, and the cost of medical care for patients with end-stage renal disease treated in Manitoba, Canada and the United States. METHODS: Mortality rates were compared in patients with end-stage renal disease treated in the Province of Manitoba and a random sample of US patients enrolled in the US Renal Data System Casemix Severity Study. Hospital admission rates and costs of care were compared in Manitoba patients and in patients with end-stage renal disease in a large health care organization in Detroit, Michigan. RESULTS: Levels of serum creatinine, urea, and estimated glomerular filtration rate indicated more severe renal impairment at the outset of treatment in Manitoba than in the United States. Manitoba patients were more than twice as likely to receive kidney transplants as US Renal Data System patients. No patients in Manitoba used reprocessed dialyzers, compared with 57% of US Renal Data System patients. After adjustment for all casemix and treatment variables, the mortality rate was 47% higher in the United States. The hospital admission rate in Detroit was 41% lower than the hospital admission rate in Manitoba, which primarily reflects the doubled rate of transplantation in Manitoba. Adjusted total monthly costs were $503 higher in Detroit than in Manitoba. CONCLUSIONS: The higher mortality rates in the United States cannot be fully explained by adjustments for observable casemix or treatment variables. Further research is needed to identify factors that explain how Manitoba achieves a lower mortality rate while paying less for end-stage renal disease care than the United States.

Diagnosis-Related Groups↗
PubMed1996

Short-term mortality after repair of hip fracture. Do Manitoba elderly do worse?

This article uses administrative data from Manitoba and New England to address the reasons underlying Manitoba's relatively high mortality in the 30 days after hip fracture repair. Both the Manitoba and New England data sets are population based, containing information on individuals 65 years of age or older in Manitoba (1979-1992; n = 10,007) and New England (1984-1985); n = 16,206). Various logistic regression models were estimated on pooled and separate data from Manitoba and New England; the models all showed similar predictive accuracy, having C statistics in the .71 to .74 range. Manitoba postsurgical 30-day mortality rates were greater than the 1984 to 1985 New England rate for each of the 14 years considered. In particular, New England residents with very short waits before hip fracture repair (0 or 1 day) had mortality rates both markedly lower than expected and significantly less than those of Manitobians with such short waits. Attention to the Manitoba hospitals with very poor 30-day survival and to the process surrounding selection of patients for early versus late surgery in Manitoba are clearly in order. The extent to which longer-term survival reflects 30-day survival also is discussed. Our findings highlight the utility of comparative data for understanding quality of care problems within a single region.

Aged↗
PubMed1997

Incidence and prevalence of diabetes in children aged 0-14 years in Manitoba, Canada, 1985-1993.

OBJECTIVE: To estimate the incidence and prevalence of type I diabetes among Manitoba children aged 0-14 years from 1985-1993. RESEARCH DESIGN AND METHODS: The Manitoba Diabetes Database (a population-based database of individuals diagnosed with diabetes based on Manitoba's health insurance system) was used to estimate the annual incidence of diabetes for the years 1985-1993 and the point prevalence of diabetes at 31 March 1993 for Manitoba children aged 0-14 years. The Diabetes Education Resource for Children and Adolescents program database was used to correct incidence and prevalence rates for ascertainment using the two-source capture-recapture method. RESULTS: The overall ascertainment rate of the Manitoba Diabetes Database was 95% for incident cases and 93% for prevalent cases. The average annual incidence was 20.4 per 100,000 for children aged 0-14 years. The annual incidence appears to be stable for all age-groups 0-14 years over the past decade. The point prevalence of diabetes among children was 120.4 per 100,000. CONCLUSIONS: The incidence of type I diabetes in children aged 0-14 years in Manitoba is higher than reported previously in other urban regions of Canada, but similar to population-based estimates from Prince Edward Island. The incidence appears stable in Manitoba over the past decade even in the 0-4 year age-group. The Manitoba Diabetes Database appears to be a highly accurate population-based source of data on the epidemiology of diabetes in children.

Adolescent↗
PubMedDate not supplied

Coronary angiography and bypass surgery in Manitoba and the United States: a first comparison.

OBJECTIVE: To compare the appropriateness of use of coronary angiography (CA) and bypass surgery (CABS) in the early 1980s in one Canadian hospital and several American hospitals using explicit case-based criteria. Procedure rates were much lower in Canada during this period. SUBJECTS: Canadian subjects, 502 Manitoba residents undergoing CA at one hospital in 1981-82 were tracked forward to determine whether and when they underwent CABS. CA comparisons were made with 351 Canadian patients aged 55 years or older; 1677 American CA patients aged 65 years or older and were drawn in 1981 from three hospitals. Two hundred and forty-five patients undergoing CABS within 12 months of CA made up the Canadian sample. American CABS patients were sampled from three hospitals during 1979-82. Manitoba patients assigned to medical treatment after CA were also appraised. METHODS: Criteria were derived by an American panel of clinicians following a Delphi process; indications were rated appropriate, equivocal and inappropriate. A trained abstractor reviewed charts and assigned ratings. Results of exercise electrocardiograms were not available in the Manitoba data set, hence sensitivity analyses were performed to determine how differing proportions of positive exercise electrocardiograms might affect the Manitoba results. RESULTS: Even assuming only 50% of treadmill tests were positive in the Manitoba sample, the proportion of inappropriate CA was lower in Manitoba than for the American hospitals: 9% versus 15 to 18%. For CABS, only one of the three comparison American hospitals approached the Manitoba hospital level of appropriateness. CONCLUSIONS: In the early 1980s, there was more appropriate use of CA and CABS in a Manitoba hospital compared with several American hospitals. Many Canadian patients undergoing CA and treated medically met American indications for appropriate use of CABS. Whether this represents underprovision of necessary care remains uncertain.

Aged↗
PubMed2005

Epidemiological study of hepatitis B virus infection in Manitoba, Canada, 1992-2003.

In comparison with other Canadian provinces and most Western countries, the province of Manitoba maintains a different vaccination policy for hepatitis B. This policy provides selective antenatal screening for hepatitis B in women and an inoculation program for hepatitis B vaccination for fourth-grade pupils. There has been increasing concern for this policy with regard to its influence on secular trends of acute hepatitis B incidence in Manitoba. This created a need to summarise the epidemiological characteristics of hepatitis B virus (HBV) infection in Manitoba and to allocate finances and human resources for future prevention programs. The Cadham Provincial Laboratory in Winnipeg, a Canadian Public Health Laboratory, is responsible for testing all specimens for diagnosis of various common infectious diseases in Manitoba. During the period from 1 January 1992 to 31 December 2003, a total of 285,946 clinical specimens were submitted to this laboratory, which confirmed 310 cases of acute HBV and 7,556 cases of chronic HBV infection. A total of 18,168 individuals were identified as having vaccine-induced immune status. The incidence rate of acute HBV infection has significantly decreased from 6.52/100,000 person-years in 1996 to 0.86/100,000 person-years in 2003. Annual prevalence rates of chronic HBV infection in Manitoba increased slightly from 42.96 cases/100,000 population in 1992 to 71.47 cases/100,000 population in 2003. Incidence rates were generally higher in men than in women at all age groups, with values of 2.65 and 1.65 per 100,000 population, respectively (chi-square=15.768, p value <0.001). The highest incidence rate for both males and females was observed in the age group 30-34 years. The North Eastman and Winnipeg Regional Health Authorities showed significantly higher incidence rates of acute hepatitis B compared with the other nine Regional Health Authorities. Selective hepatitis B vaccination programs for children in Manitoba had achieved the greatest success in the prevention of vertical and horizontal transmission. There is an urgent need to develop cost-effective harm-reduction strategies for hepatitis B prevention among adults (aged 30-34) and groups at risk in Manitoba.

Adolescent↗
PubMed1993

Weather factors in the prediction of western equine encephalitis epidemics in Manitoba.

Cases of western equine encephalitis in horses in 1987 in western USA and Manitoba, Canada were examined by backward trajectory analysis of winds. Culex tarsalis mosquitoes infected with western equine encephalitis virus could have been carried on southerly winds from Texas and Oklahoma to northern USA and from there to Manitoba. The presence of the Polar front over North Dakota and Minnesota at the end of July would have led to the landing of Cx. tarsalis in Montana and Wisconsin and prevented further carriage into Manitoba. Temperatures in southern Texas during the winter months (average daily maximum temperatures 19.7 degrees C and higher) would have permitted continuous transmission of western equine encephalitis virus by Cx. tarsalis in this area. Weather factors involved in outbreaks from 1975-88 were analysed to see if epidemics in Manitoba (23 or more cases in horses) could be predicted. The conditions for epidemics could be defined as follows: (a) the number of cases in horses in USA was 98 or more, (b) winds were southerly with speeds 45 kmh-1 or higher, and (c) counts of Cx. tarsalis females/light trap per day were 3.2 or higher. There were 3 or fewer cases in Manitoba, when the number of cases in USA was 27 or less, even when Cx. tarsalis counts were higher than 3.2. With Cx. tarsalis counts below 3 and/or unsuitable winds, or the Polar front further south, the number of cases in Manitoba was between 0 and 17, even when the number of cases in USA was from 38-172. Without information on the extent of infection further south, the weather variables would probably be more useful in excluding the possibility of an epidemic in Manitoba than in predicting one.

Animals↗
PubMed2006

Spatial analysis of campylobacter infection in the Canadian province of Manitoba.

BACKGROUND: The study describes population level variations in campylobacter incidence within the Canadian province of Manitoba, and the relationship to sociodemographic and landscape related characteristics. Using data derived from the Manitoba Health Public Health Branch communicable disease surveillance database, the study applied a number of spatial and ecological techniques to visualize, explore and model campylobacter incidence for the years 1996 to 2004. Analytical techniques used in the study included spatial smoothing, the spatial scan statistic, the Gini coefficient, and Poisson regression analysis. RESULTS: The study demonstrated marked and statistically significant geographic variability in the rates of campylobacter incidence in Manitoba.. The incidence of campylobacter was observed to be significantly higher in populations living in rural and agricultural areas of the province, with the highest rates occurring in populations living in proximity to high densities of farm animals (cows, pigs, chickens). The study also observed that the age specific pattern of campylobacter incidence in rural Manitoba was very different than the urban pattern, with the incidence rate in the 0-4 year age group seven times higher in rural Manitoba than in the City of Winnipeg. CONCLUSION: The study demonstrates the value of a deploying a diverse set of spatial techniques to better understand the dynamics of an enteric disease such as campylobacter infection. The study concludes that there may be three distinct mechanisms for the transmission of campylobacter in Manitoba which are operating simultaneously. These include broad population exposure to a centralized food system endemically infected with the campylobacter organism, exposure to local level factors such as farm animals or contaminated water, and exposure to campylobacter infection through foreign travel.

Adolescent↗
PubMedDate not supplied

Being born in Manitoba: a look at perinatal health issues.

OBJECTIVE: The Manitoba Centre for Health Policy was commissioned by Manitoba's provincial health department to examine the health of newborns born 1994 through 1998, using three indicators: preterm birth (< 37 weeks gestation), birthweight, and type of infant feeding. METHODS: Data were derived from the Population Health Research Data Repository and the National Longitudinal Survey of Children and Youth 1996. Variation by 12 Regional Health Authorities (RHAs) and by 12 Winnipeg Community Areas (CAs) was examined, as well as associations with the population's health and socioeconomic well-being. RESULTS: Manitoba's preterm birth rate was 6.7% of live births, from 5.3% to 7.4% by RHA, and 5.7% to 8.0% by Winnipeg CA. Manitoba's low birthweight rate (< 2500 g) was 5.3%, from 2.7% to 5.7% by RHA, and 4.4% to 7.2% by Winnipeg CA. The lower the income, the greater the likelihood of low birthweight (p < 0.05). Manitoba's breastfeeding initiation rate was 78%, from 64% to 87% by RHA, and 66% to 90% by Winnipeg CA. The lower the income and the poorer the health status of the population, the lower the breastfeeding rate (p < 0.001). Of those initiating breastfeeding, 42% breastfed for at least six months. CONCLUSION: Factors affecting child health in Manitoba could be addressed through systematic programs both during pregnancy and during the postpartum period, including support for nutritional counselling, promotion of breastfeeding, smoking cessation programs, and social policy decisions designed to overcome disparities within low-income groups and populations with poorer health status.

Birth Rate↗
PubMedDate not supplied

Building a health research relationship between First Nations and the University in Manitoba.

This paper describes the emergence of a formal partnership between Manitoba First Nations and researchers in the Department of Community Health Sciences at the University of Manitoba. This partnership reflects two decades of a working relationship in Manitoba involving university researchers and First Nations communities, as well as new and innovative approaches to developing organizations, training initiatives and projects that strengthen First Nations principles of governance. The emerging trust that has developed between the Manitoba First Nations and the University has made it possible to extend this partnership into building further research capacity and evidence-based decision-making among First Nations. Discussions between the Assembly of Manitoba Chiefs and the Northern Health Research Unit resulted in the development of a Manitoba First Nations Centre for Aboriginal Health Research. Its mission is to initiate, coordinate and support research activities designed to assist First Nations and Aboriginal communities and organizations in their efforts to promote healing, wellness and improved health services in their communities. Much of the health research described in this journal was facilitated through this partnership, which demonstrated the value of partnerships and new funding opportunities to better address the health information needs of First Nations communities, particularly at a time when Aboriginal communities were highly skeptical of the value of academic research.

Community Participation↗
PubMed1993

Comparison of the dental health status of six-year-old children in Manitoba.

The caries rates of six-year-old Manitoba children from a non-fluoridated Northern community were compared with those of a representative group of southern Manitoba children from non-fluoridated areas. All of the surveyed children became eligible for dental treatment coverage under Manitoba Health's Children's Dental Program approximately two months prior to the survey. Access to dental care was equivalent for all children. Screening (data collection) was completed by Manitoba Dental Health staff and was based on standard World Health Organization (WHO) criteria. The initial assessment of the data indicated that the Northern Manitoba children experienced an average of 82 per cent more decay per child than the southern group. Caries treatment requirements in the north were 59 per cent greater than in the south. The southern Manitoba children were almost twice as likely to be caries free than the Northern children. Closer examination of the Northern data, based on a socioeconomic delineation, indicated that the Northern middle- to high-income group experienced 24 per cent more decay per child than the southern group. The Northern middle- to low-income group experienced 124 per cent more decay per child than the southern group. In this study, it was demonstrated that although increased dental caries experience was closely related to geographic location, socioeconomic factors may play an even greater role in dental caries experience.

Analysis of Variance↗
PubMed2004

Comparison of anti-infective drug use in elderly persons in Manitoba, Nova Scotia, and Saskatchewan, Canada: relationship to drug insurance reimbursement policies.

BACKGROUND: Antimicrobial drug resistance continues to be a concern. Inappropriate use of antimicrobial agents is a well-documented contributory factor in the development of resistance. Canadian publicly funded drug insurance (pharmacare) programs have various approaches to reimbursement for antimicrobial drugs and promoting the appropriate prescribing of these agents. OBJECTIVE: The objective of this study was to examine changes in antimicrobial use over a 3-year period in relation to the reimbursement policies of the public drug insurance programs for elderly persons in Manitoba, Nova Scotia, and Saskatchewan. METHODS: The pharmacare databases of the 3 provincial drug insurance programs were accessed for fiscal years 1995/96, 1996/97, and 1997/98. Antimicrobial drug use was reported as mean age- and sex-standardized defined daily doses (DDDs) dispensed per 1000 beneficiaries per year. Provincial antimicrobial drug use was compared and related to provincial reimbursement policies. RESULTS: The rates and types of antimicrobial drugs dispensed to elderly beneficiaries of the Manitoba, Nova Scotia, and Saskatchewan pharmacare programs varied. Between fiscal years 1995/96 and 1997/98, DDDs of antimicrobials per 1000 beneficiaries per year decreased by 11.5% in Saskatchewan and increased by 1.2% in Manitoba and 6.2% in Nova Scotia. Rates of use of broadspectrum agents such as amoxicillin/clavulanate, azithromycin, clarithromycin, and fluoroquinolones were lower in the provinces that had reimbursement guidelines. Even when reimbursement policies were similar, as for fluoroquinolones in Manitoba and Saskatchewan, rates of use varied markedly, possibly as a result of the method of implementing the reimbursement guidelines. Use of fluoroquinolones, macrolides, penicillins, beta-lactamase-resistant penicillins, and tetracyclines was lower and use of sulfonamides and trimethoprim was greater in Saskatchewan than in Nova Scotia and Manitoba. CONCLUSIONS: The reimbursement guidelines of provincial drug insurance programs are among the factors affecting the use of antimicrobial agents. Both the type of reimbursement policy and the policy implementation mechanism affected the rate of utilization. Further research is needed to link drug-use information with data such as antimicrobial resistance patterns, diagnoses, physician visits, and hospitalizations.

Aged↗