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PubMedDate not supplied

Documenting environmental factors for preventing the handicap creation process: Quebec contributions relating to ICIDH and social participation of people with functional differences.

This article presents the conceptual origins and the usefulness of an holistic model, stressing the role of environmental determinants in the performance of day-to-day activities and the fulfilment of social roles by persons with disabilities. The Quebec Committee on ICIDH contribution to the development of knowledge on the clarification of the relationship of disabled individual-environment and the understanding of the handicap creation process in relation with ICIDH experimentations is presented. Finally, on the basis of anthropological social research conducted in Quebec, the article illustrates a methodology for environmental analysis of the handicap situations of disabled clients in rehabilitation and social integration support programmes.

Activities of Daily Living↗
PubMed2006

[Medical libraries in Quebec of the 18th and 19th centuries: the example of tuberculosis].

Phthisis (tuberculosis) became so prevalent in Europe in the 18th century that, in 1792, Antoine Portal wrote: "there is no disease more common or dangerous than pulmonary phthisis." Obviously, the doctors were concerned about this problem and made efforts to explain it. Numerous hypotheses were advanced on this subject (Richard Morton, for instance, suggested 12 possible causes in his Phthisiologia), and varied by author and region, but they can be grouped into four main categories: a contagious disease; a hereditary condition; a physiological disorder; and a problem resulting from lifestyle. This research concerns the books on this disease procured by medical practitioners in and around Quebec City in the 18th and 19th centuries, dating from 1700-1868, and contained in 27 medical libraries. Following a brief presentation of methodology and the libraries, this article analyzes the books. There were books on phthisis in Quebec City very early in the 18th century, although the majority appeared in the next century. The 18th-century works associated this disease with physiological disorders--particularly "mechanical problems." After 1815, there was a broader diversity of opinions. The books on phthisis most widely consulted from 1700 to 1868 are almost completely unknown today.

History, 18th Century↗
PubMed2002

Estimated absorbable iron intakes in quebec adults.

In the last 30 years, the prevalence of low dietary iron intake has increased, partly because North Americans have been encouraged to choose lower fat foods, including leaner meats. As a result, there has been a decrease in red meat consumption. The objective of this study was to estimate absorbable iron intakes of a representative sample of the Quebec adult population and to compare these results with the new North American recommendations for iron. Dietary intakes were obtained by 24-hour recall and absorbable iron intakes were estimated using Monsen & coworker's model. While 18.9 % and 2.5% of women and men respectively had an iron intake below the estimated average requirement (EAR), 66.2 % and 25.6% had an estimated available iron intake below the recommended level for absorbed iron. Beef consumption had the strongest association with estimated absorbable iron, followed by vegetables. Subjects with a high education level consumed significantly less meat, beef and heme iron than subjects whose education level was low or moderate. These results indicate that there is a need for improving iron intake in the Quebec adult population.

Adolescent↗
PubMed2003

Diet quality among older Quebecers as assessed by simple indicators.

To determine whether older Quebecers are eating adequately and whether summary scores represent diet quality, a representative subset of participants aged 55 to 74 (weighted n=460, 47% male) was studied from the 1990 Enquête québécoise sur la nutrition dataset. Participants' diet quality was scored from adjusted 24-hour recalls. Foods were coded into Canada's Food Guide to Healthy Eating food groups. Usual Dietary Adequacy Score (maximum=18) and Dietary Diversity Score (maximum=4) were calculated from adjusted food guide portions and validated internally in relation to achievement of nutrient recommendations using correlation analysis. Average usual Dietary Adequacy Score (mean +/- standard error) was 14.96 +/- 0.15 (men) and 13.72 +/- 0.15 (women). Only 7% of men and 1% of women achieved the maximum usual score. Forty-four percent of men and 45% of women scored a usual Dietary Diversity Score of 3, and 55% of men and 50% of women achieved 4. Thus, approximately half of older Quebecers showed inadequate dietary variety, and consumed fewer than the minimum recommended number of servings from certain food groups. Summary diet quality indicators are useful for tracking diet quality, and provide critical data for planning nutrition education programs targeting older persons.

Aged↗
PubMed2004

Seasonal vitamin D intake in Quebec preschoolers.

As a number of seasonal factors affect cutaneous synthesis of vitamin D, especially in young children, our objective was to verify if winter and summer vitamin D intakes in Quebec preschoolers reach the adequate intake of 5 microg/day. A three-month retrospective food frequency questionnaire and a 24-hour food recall were used with parents of 98 children (mean age 56 months) in summer and of 72 of these children (mean age 65 months) in winter. To ensure completeness of data, vitamin D content of foods not covered in the Canadian Nutrient File was taken from other sources. According to the food frequency questionnaire, total vitamin D intakes were 9.7 +/- 4.3 microg/day in summer and 11.6 +/- 4.8 microg/day in winter. Only 10% of children in summer and 7% in winter had an intake below 5 microg/day. The 24-hour food recall vitamin D intake estimate was lower (summer 7.0 +/- 3.8 microg/day, winter 7.2 +/- 4.2 microg/day). This difference could be partly due to a discrepancy in the estimation of multivitamin supplement intake. However, according to both estimates, vitamin D intakes appeared generally adequate in this sample of Quebec preschoolers.

Child Nutritional Physiological Phenomena↗
PubMed2003

Impact of type traits on functional herd life of Quebec Holsteins assessed by survival analysis.

Survival analysis was used to study the effects of composite and descriptive linear type traits on functional herd life of Quebec Holsteins. Functional herd life was defined as the length of life from first calving to death, culling, or censoring, and was adjusted for 305-d milk production. The dataset contained information from 331,105 cows from Quebec province calving for the first time between 1981 and 1995; 58% of the records had type information. Weibull models were fitted to analyze the data. The hazard function was described as the product of a baseline hazard function and the time-independent effects of age at first calving and type, and the time-dependent effects of year of calving, stage of lactation x lactation number, annual change in herd size, 305-d milk production, and herd-year (random). Analyses were done one at a time for each type trait. The strongest relationships between survival and composite type traits were found for final score, mammary system, and feet and legs. Among the linear type traits, the highest impact on functional herd life was found for traits related to the udder.

Animals↗
PubMed2004

[Public health in Quebec at the dawn of the 21st century].

This paper summarises the status of public health in Quebec at the dawn of the 21st century. After introducing the current definition, the author lays out five basic functions of public health in Quebec: knowledge and surveillance of populations health and wellbeing, health protection; prevention of disease, trauma and social problems that influence health; health and wellbeing promotion; and service organization and evaluation. The organization of public health services is then described at the local level (CLSC), regional level (Public health units) and national level (Ministry, Public health directorate and National Institute of Public Health). Finally, the trends and priorities elaborated over the last ten years, as well as the National Public Health Program to be implemented over the next ten years are described.

Forecasting↗
PubMedDate not supplied

The impact of the transcendental meditation program on government payments to physicians in Quebec.

PURPOSE: This study evaluated whether governmental medical payments in Quebec were affected by the Transcendental Meditation (TM) technique. DESIGN: This retrospective study used a pre- and postintervention design in which government payments for physicians' services were reviewed for 3 years before and up to 7 years after subjects started the technique. Payment data were adjusted for aging and year-specific variation (including inflation) using normative data. No separate control group was used; thus it is impossible to determine whether the changes were caused by the TM program or some other factor. SUBJECTS: A volunteer group of 677 provincial health insurance enrollees was evaluated. The subjects had chosen to practice the TM technique before they were selected to enter the study. The subjects (348 men, 329 women) had diverse occupations. Their average age was 38 years and ranged from 18 to 71 years at the start of the TM program. INTERVENTION: The TM technique of Maharishi Mahesh Yogi is a standardized procedure practiced for 15 to 20 minutes twice daily while sitting comfortably with eyes closed. SETTING: Province of Quebec, Canada. RESULTS: During the 3 years before starting the TM program, the adjusted payments to physicians for treating the subjects did not change significantly. After beginning TM practice, subjects' adjusted expenses declined significantly. The several methods used to assess the rate of decline showed estimates ranging from 5% to 7% annually. CONCLUSIONS: The results suggests that the TM technique reduces government payments to physicians. However, because of the sampling method used, the generalizability of these results to wider populations could not be evaluated.

Adolescent↗
PubMedDate not supplied

The impact of the transcendental meditation program on government payments to physicians in Quebec: an update.

PURPOSE: To determine whether practice of the Transcendental Meditation (TM) technique can affect medical expenses. DESIGN: The evaluation was a quasi experimental, longitudinal, cost-minimization study. SETTING: Province of Quebec, Canada. SUBJECTS: This study involved 1418 Quebec health insurance enrollees who practiced the TM technique compared with 1418 subjects who were randomly selected from enrollees of the same age, sex, and region. TM subjects had chosen to begin the technique prior to learning about and choosing to enter the study. MEASURES: This 14-year, pre- and postintervention study retrospectively assessed government payments to physicians for treating the TM and comparison groups. Other medical expense data for individuals were unavailable. Data were inflation-adjusted. For each subject, least squares regression slopes were calculated to estimate pre- and postintervention annual rates of change in payments. We compared the groups' means and 1%, 5%, and 10% trimmed means (robust estimators) of the slopes. RESULTS: Before starting meditation, the yearly rate of increase in payments between groups was not significantly different (p > .17). After commencing meditation, the TM group's mean payments declined 1% to 2% annually. The comparison group's payments increased up to 11.73% annually over 6 years. There was a 13.78% mean annual difference (p = .0017). CONCLUSIONS: The results suggest that the TM technique reduced payments to physicians between 5% and 13% annually relative to comparison subjects over 6 years. Randomized studies are recommended.

Adult↗
PubMed2006

[Differences and similarities in perception of schizophrenia between physicians and the general population in Quebec].

This paper presents results concerning the perceptions and attitudes of Quebec physicians towards patients with schizophrenia and compares data obtained from a previous poll to data drawn from answers of five common questions asked to the general population. A short questionnaire with 5 items selected earlier from a broader questionnaire submitted to the general population, has been distributed to Quebec physicians. These items inquired about the perceptions and attitudes of physicians towards schizophrenia. A randomized sample of physicians was performed. Three thousand and five hundred (3 500) physicians were selected and distributed questionnaires. A response rate of 29 %, a little more than one thousand (1003 responses) was observed, 46 % women and 54 % men. The authors have found significant differences between physicians and the general population in the tendency of wanting to offer help to those suffering from schizophrenia (physicians = 58 % versus general population : 45 %). Also, a higher percentage of physicians (72 %) have expressed feelings of compassion towards patients with schizophrenia versus 27 % in the general population. Results indicate that physicians, with a family member suffering from schizophrenia, are less comfortable discussing openly about the family member's illness (26 % versus 48 %). With regards to preconception of the severity of schizophrenia, in the field of health, and more specifically mental health, there are no differences observed amongst the physicians and the general population.

Adult↗
PubMed1999

Respiratory nematodiases in raptors in Quebec.

This is a retrospective study on wild raptors submitted to the Université de Montréal (Quebec, Canada) from 1989 to 1996. Cyathostoma spp. (Nematoda: Syngamidae) adults and/or eggs were found in air sacs, lungs, bronchi, and trachea of 12 raptors (Falconiformes and Strigiformes) from Quebec, Canada, belonging to eight different species, five of which are first host records for this parasite: barred owl (Strix varia), snowy owl (Nyctea scandiaca), northern harrier (Circus cyaneus), northern goshawk (Accipiter gentilis), and broad-winged hawk (Buteo platypterus). The infection was considered fatal in four birds, while no significant clinical signs were observed in the other cases. Major pathologic changes included diffuse pyogranulomatous air sacculitis, pneumonia, and bronchitis. A few unidentified larval nematodes embedded in a granuloma were found in the lungs of an additional Coopers' hawk (Accipiter cooperii); they were not considered clinically significant. A dead nematode, surrounded by necrotic inflammatory cells, was found in the air sac of a northern goshawk. The presence of nematodes in air sacs or lungs should be considered in wild raptors demonstrating respiratory problems.

Air Sacs↗
PubMed1998

Quebec prostate cancer mortality dropped in 1996.

OBJECTIVE: To monitor incidence and mortality rates of prostate cancer in the province of Quebec. DESIGN: Population-based incidence and mortality trends. SETTING: Entire population of the province of Quebec between 1979 and 1996. MAIN OUTCOME MEASURES: Age-standardized incidence rates and mortality for prostate cancer. RESULTS: Prostate cancer mortality increased regularly until 1989, were stable between 1989 and 1995 and dropped in 1996 by 15%. Incidence rates increased steadily from 1989 until 1993 by an average of 9% per year. CONCLUSION: The rise in incidence is due to the increasing use of prostate specific antigen as a screening test for prostate cancer. The reasons for the reduction in prostate cancer mortality are unknown but are likely to reflect improved treatment modalities.

Age Factors↗
PubMedDate not supplied

Reform of the Quebec healthcare system.

This article briefly describes issues surrounding the reform process in Quebec and discusses its major thrusts--regionalization, definition of healthcare objectives, strengthening frontline services and greater use of outpatient services--and their effect on institutions which must above all come to terms with the reduction of the provincial deficit. Fewer human resources, longer waiting periods, institutional autonomy and the creation of integrated networks are some of the issues of current concern to the Quebec healthcare community.

Delivery of Health Care, Integrated↗
PubMed1999

Quebec child mental health survey: prevalence of DSM-III-R mental health disorders.

The Quebec Child Mental Health Survey (QCMHS) was conducted in 1992 on a representative sample of 2400 children and adolescents aged 6 to 14 years from throughout Quebec. Prevalences of nine Axis-I DSM-III-R (American Psychiatric Association, 1987) mental health disorders were calculated based on each informant (for 6-11-year-olds: child, parent, and teacher; for 12-14-year-olds: child and parent). Informant parallelism allows the classification of results of the demographic variables associated with disorders in the logistic regression models. This strategy applies to group variables (correlates of disorders) whereas informant agreement applies to individual diagnoses. Informant parallelism implies that results for two informants or more are in the same direction and significant. In the QCMHS, informant parallelism exists for disruptive disorders, i.e. in two ADHD regression models (child and parent) higher rates among boys and young children, and in three oppositional/conduct disorders regression models (child, parent, and teacher) higher rates among boys. No informant parallelism is observed in the logistic regression models for internalizing disorders, i.e. the patterns of association of demographic variables with anxiety and depressive disorders vary across informants. Urban-rural residence does not emerge as a significant variable in any of the logistic regression models. The overall 6-month prevalences reach 19.9% according to the parent and 15.8% according to the child. The implications of the results for policy makers and clinicians are discussed.

Adolescent↗
PubMed1985

The Quebec health care system in the Canadian context: impact on medical practice.

Despite their close kinship, the United States and Canada have evolved very different health care systems. Apart from the fundamental difference of voluntary versus compulsory insurance, the contrasts are most pronounced in the case of Quebec, whose approach to health care reform is the most radical of the Canadian provinces. Key features of the Quebec health care system include mechanisms for the planning and coordination of services and institutions, for the evaluation of health programs, and for regulation of the health professions, especially medicine. Freedom to choose a specialty and practice location is relatively tempered and constrained. Compensation is negotiated via physicians' unions. Physicians mostly practice on a fee-for-service basis and make claims to a single government authority which, in the process, acquires many data about physician practice.

Canada↗
PubMedDate not supplied

Evaluation of the midwifery pilot projects in Quebec: an overview. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

In 1990, the province of Quebec adopted a law authorizing the evaluation of the practice of midwifery through eight pilot projects. The projects, which took the form of birth centres outside hospitals, started operating in 1994. The objectives of the evaluation were 1) to compare midwives' services to current physician services with regard to maternal and neonatal mortality and morbidity, the use of obstetrical intervention, individualization and continuity of care as perceived by clients, and cost; and 2) to identify the professional and organizational factors associated with the integration of midwives into the health care system. A mixed evaluative design was used: a multiple case study with each pilot project representing a case and a cohort study where 1,000 women followed by midwives in the birth centres were matched with 1,000 women followed by physicians in the usual hospital-based services. Various quantitative and qualitative data collection instruments were used. Overall, many results were favourable to midwifery practice, while some were favourable to medical care. Following the evaluation, the Government of Quebec decided to legalize the practice of midwifery.

Birthing Centers↗
PubMed2000

[Delivery of home health care. Survey of the Quebec region].

OBJECTIVE: To describe the characteristics of home health care delivered by general practitioners and to identify the conditions that facilitate or hinder development of this practice. DESIGN: Mailed survey. SETTING: Quebec city region. PARTICIPANTS: General practitioners in private practice, family practice units, community health centres, or hospitals. MAIN OUTCOME MEASURES: A self-administered questionnaire was used to gather information on volume of home care provided, characteristics of clients and visits, methods of follow up, and factors that promoted or hindered home care. RESULTS: Of the 487 physicians surveyed, 58.1% (283) made housecalls to a clientele consisting mainly of elderly patients (87.6%): 42% saw fewer than five patients per week, and 31% spent 2 hours or less per week on housecalls. Close to two thirds (64%) devoted 15 to 30 minutes to these visits, and 90.2% said they used community health centres for assessment or home follow up of their patients. Difficulties with scheduling and methods of remuneration reportedly hampered development of this practice. CONCLUSION: Home care practice is widespread around Quebec city, but represents only a small portion of the clinical work of many GPs.

Delivery of Health Care↗
PubMed2000

A deprivation index for health and welfare planning in Quebec.

Given that one of the goals of public health policy in Quebec and Canada is to reduce social inequalities in health and welfare, it is surprising, to say the least, that most information systems in this field make no mention of people's socio-economic characteristics. The present article proposes an index to reflect the material and social dimensions of deprivation as this concept has been developed by Peter Townsend and other authors. The article describes the method used to create the index, which uses census data and tools developed by Statistics Canada to match postal codes with enumeration areas. Examples are provided of the use of the index in information systems covering three aspects of health and welfare in Quebec: deaths, hospitalizations and births. The value of the information provided by this index in planning health and social services is demonstrated.

Adult↗