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PubMed2001

Periodontal diseases among Quebec adults aged 35 to 44 years.

BACKGROUND: Very little information is available on periodontal diseases in Canadian adults. The purpose of this study was to estimate the prevalence of periodontal problems in Quebec adults aged 35 to 44. METHODS: A total of 2,110 randomly selected Quebec adults were examined between September 1994 and July 1995. The participation rate was 77% for the questionnaire and 44.5% for the oral examination. Measurements for gingival bleeding, calculus, epithelial attachment and periodontal pocket depths were taken for each tooth. RESULTS: More than 80% of examined persons presented with gingival bleeding on at least one tooth, and 75% presented with calculus on at least one tooth. The CPITN indicated that only 5.2% of individuals had no treatment needs, and that one out of 5 necessitated complex treatment. People with low family income, men and persons living in metropolitan areas are at higher risk of having at least one tooth with a pocket >6 mm. Dental health behaviours (regular dental visits, brushing and flossing frequency) were not significantly associated with the presence of periodontal pockets. Finally, individuals were relatively unaware of their periodontal problems. CONCLUSION: Increasing the population s awareness of periodontal diseases will be a major task for public health workers. The dental profession and the dental industry need to develop awareness campaigns to improve prevention, management and control of periodontal problems. It is especially important to target people at risk, in particular men and low-income groups. As well, dental schools and continuing education courses should focus on this problem with the aim of modifying dental practices.

Adult↗
PubMed2001

The storage of household long guns: the situation in Quebec.

This survey on the storage of household firearms in Quebec was conducted in 1994. At that time, 35% (175/504) of survey participants who kept long guns in their homes had failed to comply with Canadian firearm storage regulations. In most cases (85%; n=149), this was because at least one stored long gun was found to be both operable and accessible. Thirty-seven per cent of participants stated that no one, including themselves, had used their firearm(s) in the 12 months preceding the survey. These findings point to two possible ways of dealing with long guns kept in the home: render these weapons inoperable or inaccessible, which would increase the level of compliance with the regulations, and dispose of those no longer in use. The results of this survey have never been published before, and constitute the only information of this kind with respect to Quebec.

Adult↗
PubMedDate not supplied

[Emigration of Quebec physicians: motivation for departure and return].

Since the 80's, outmigration of physicians from Quebec is steadily increasing. About 46 percent of outmigrating doctors explain their move by factors related to their occupational life (higher income, greater opportunity in the academic career, larger amount of resources devoted to the health care system). Nearly 40 percent relate their decision to personal factors (greater job opportunity for their wife/husband, quality of family life...). The factors linked to the context of the receiving place (political climate, linguistic regulations, income tax level...) play a minor role on the migration decision. As concerns the returning physicians, 80 percent explain their decision by personal factors. The factors linked to the occupational life have a lower role. It appears therefore that doctor outmigration from Quebec is not directly determined by manpower policies adopted by the Province during the last two decades, except the policies directly linked to the income level of professionals.

Adult↗
PubMed2001

[The process of evaluation and improvement of medical practice in Quebec].

In Quebec, the evaluation of health care providers' practices is organized for each professional group. It is an official part of the health care regulation policy and is defined by legal texts. Evaluation of medical practices is controlled by physicians through their professional order and consultative medical councils in hospitals. The role of the Collège des Médecins du Québec is to warrant the quality of medical acts. The College watches over the quality of the physician's initial education using a process of agreement for all training departments and for the medical school curriculum. Young graduates must pass the College's examination before being licensed to practice. The College watches over improvements in professional practices via inspections of individual practices and hospitals and continuous education programs. There are three levels of physician supervision: screening for poor practices, inspection, and in-depth investigation. In hospitals, a consultative medical council is in charge of assuring quality medial practice. Mortality and morbidity conferences, claims analysis, audits with explicit evaluation criteria and indicator monitoring are the basic tools used for assessing the quality of medical practice. The Quebec experience demonstrating how a medical profession can organize a full system for evaluating medical practice can be a model for other countries.

Humans↗
PubMed2002

Parental factors associated with regular use of dental services by second-year secondary school students in Quebec.

The aim of this study was to identify the parental factors associated with regular use of dental services by second year secondary school students in Quebec. Data were collected in 1996-97, as part of a provincial survey on the dental health of Quebec students. A stratified probabilistic sample of 1,351 students, representative at the provincial level, was obtained. Data about frequency of use of dental services, parents' socio-economic characteristics, dental insurance (private and public) and parents' utilization of dental services were selected for this study. Half of the students used dental services regularly (i.e., once every 6 months). Multivariate analysis showed that the strongest parental factors associated with regular use were (in decreasing order of importance) the date of the mother's most recent dental visit, dental insurance, household income and the date of the father's most recent dental visit. After adjustment for the parents' socio-economic characteristics and the availability of dental insurance, students with one parent (particularly the mother) who had visited the dentist within the previous year had better odds of using dental services every 6 months, as recommended by professional standards.

Adolescent↗
PubMed1992

Comparison of dental caries and oral hygiene indices for 13- to 14-year-old Quebec children between 1977 and 1989-1990.

A comparison of the principal dental health indices of 13- to 14-year-old Quebec school children between 1977 and 1989-1990 is reported. Data derive from a dental health survey of 1,093 Quebec school children in 1977 and from a province-wide probability sample of 1,342 children in 1989-1990. The most interesting conclusions are: the DMFT index for 13- to 14-year-old children dropped from 9.0 to 4.5; an improvement in the caries treatment level from 26 per cent to 90 per cent is noted; caries treatment needs decreased from 55 per cent to nine per cent; the mean number of extracted teeth per child dropped from a score of 1.6 to a score of 0.03; significant differences in the DMFT index between residential status no longer exist; and no improvement in the oral hygiene condition (OHIS index) is observed. In 1989-1990, 35 per cent of these adolescents had perfect periodontal health. For the others, the principal problems were bleeding gums and/or calculus.

Adolescent↗
PubMed1992

[Intervention framework of the Quebec Healthy Heart Demonstration Project].

Cardiovascular diseases are Canada's primary cause of death and hospitalisation, and are the second major cause of restricted physical activity. Quebec province, with a mortality rate of 399/100,000, has figures even higher than the national average of 323/100,000, and 7 out of every 10 Quebecois present at least one of the major cardio-vascular risk factors. Following an exploratory task force on this question, the Canadian government initiated a partnership programme with the provinces wherein the federal government and provincial governments would each contribute one million Canadian dollars over a five year period for heart disease prevention programmes. Quebec province selected three different projects in which multifactorial, multisectorial community-based programmes were to be implemented. The sites chosen for the projects were: a rural region situated on the banks of the St. Laurence River, a Montreal suburban district, and a multi-ethnic, socio-economic disadvantaged community in downtown Montreal. Despite a common public health approach and the ultimate goal of improving heart health through the lowering of risk factors, each project had its own specific major intervention strategy and primary target population. The projects were linked by a study design to evaluate community and family mechanisms which favour the adoption of low risk behaviours. A coordinating committee was formed to supervise the overall project which included strategic planning, consultancy services to project staff, methodology, development and implementation, and evaluation. Each specific project team was free, however, to choose its particular orientations.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular Diseases↗
PubMed2005

Work and mental health: the experience of the Quebec workforce between 1987 and 1998.

This study examines the distribution of psychological distress in twelve occupational groups over the decade 1987-1998 in the Quebec workforce. Cross-sectional data from the three phases of the Quebec Health and Social Survey are used with n = 9,450 in 1987, n = 10,947 in 1992 and n = 10,960 in 1998, totalling 31,357 workers aged 15 and over. Occupations are classified according to the Canadian Socio-economic Classification of Occupations. Prevalence estimates for occupational groups are computed and logistic regression analyses are conducted controlling for gender, age and marital status. The results show that the prevalence of workers with psychological distress increased sharply between 1987 and 1992 and declined back in 1998 but still increased compared to 1987. However, only non-qualified white collars, semi-qualified blue collars and male non-qualified blue collars show a significant increment in psychological distress over time. Analysis of the differentials in the prevalence of psychological distress gives greater odds of distress for supervisors, semi-qualified white and blue collar workers compared to upper managers. The odds for occupations are stable over time, gender, age and marital status. The odds of female workers significantly decreased in the three phases. It appears that the restructuring of the work environment and the perturbations in the larger society promoted an increase of psychological distress within definite segments of the workforce. The specific contribution of occupation is limited but supervisors and occupations requiring lower qualifications are more at risk regarding mental health at work.

Adolescent↗
PubMed2005

[From Amiens to Quebec: the first milestones of an on-going adventure].

The first two international conferences on local and regional health programmes held in Amiens and Quebec have paved the road for a new public health paradigm. The conferences have served to share experiences from the field to re-think practice and create bridges between health promotion, prevention, care and integration at both the action and decision levels, and amongst diverse actors from the field. The challenges have been put forth, in Amiens in 2001 and in Quebec three years later. The next step is to pursue and enrich these exchanges at the international level reinforcing the Francophone position by capitalising on approaches and tools, and mobilising new partners. The next rendezvous for this on-going adventure is set for the third conference.

Congresses as Topic↗
PubMedDate not supplied

Screening mammography participation and invitational strategy: the Quebec Breast Cancer Screening Program, 1998-2000.

In the Quebec Breast Cancer Screening Program, a personalized letter signed by a regional program physician is sent to every woman in the province 50 to 69 years of age, inviting her to have a screening mammogram. A reminder letter is also frequently sent. The aim of this study was to evaluate the influence of this screening invitational strategy on rates of participation. The population studied was comprised of 684,028 women in Quebec aged 50-69. The baseline (expected) monthly mammography screening rate was estimated from the rate of screening mammograms recorded between the date a woman became eligible for screening and the mailing date of her personalized invitational letter; the observed monthly mammography screening rate was calculated after the mailing of the letter. Compared to baseline (expected) screening rates, observed rates were substantially increased (p<.05). The ratios of observed to expected rates were respectively 3.05 and 2.23 in the second and fourth months, respectively, after the letter mailing, coinciding with the mailing of the initial and reminder letters. In the twelve months after the mailing, the ratio of observed to expected rates was 1.68 (95% CI: 1.67-1.69). Twelve months following the mailing, 30 percent of the women who were letter recipients had undergone a screening mammography, compared to an expected cumulative probability of 20 percent for women not receiving a letter. The strength of this effect was similar to one seen in randomised controlled trials.

Aged↗
PubMed2006

Utilization and cost comparison of current and optimal prescribing of nonsteroidal antiinflammatory drugs in Quebec, Canada.

OBJECTIVE: Clinical practice guidelines recommend prophylactic use of gastroprotective agents (GPA) with nonselective nonsteroidal antiinflammatory drugs (nsNSAID) for patients at risk of gastrointestinal (GI) complications. We estimated the costs of cyclooxygenase-2 selective inhibitors, nsNSAID, and concurrent GPA prescribed in 2002 in Quebec, Canada, and compared these to estimated costs if prescribing followed guideline recommendations. METHODS: We used the Quebec government medical and pharmaceutical claims database (RAMQ). All prescriptions for NSAID and concurrent GPA dispensed between January 1 and December 31, 2002, were evaluated for continuously covered beneficiaries 18 years of age or older. Prescriptions were stratified by patient GI risk factors determined at the dispensing date of each prescription into low-, moderate-, elevated-, and high-risk categories. Five scenarios of "appropriate" NSAID therapy were identified using clinical practice guidelines. The potential effect on the prescription drug budget of implementing each of these scenarios was estimated. RESULTS: In total, 503,671 patients filled 1,863,171 prescriptions for NSAID, representing 41.1 million days of treatment with total expenditures of about dollar 94 million CDN for NSAID and concurrent GPA. Average actual daily costs for coxibs (rofecoxib and celecoxib), celecoxib, nsNSAID, and concurrent GPA were dollar 1.94, dollar 2.06, dollar 1.19, and dollar 2.30, respectively. Prescribing nsNSAID with GPA to all patients at moderate and elevated risks while prescribing NSAID without GPA to patients at low risk, and celecoxib with a GPA to patients at very high risk would have cost dollar 36.4 million more, mainly due to the additional cost of GPA. CONCLUSION: Compared to actual prescribing patterns, a prescribing strategy consistent with clinical practice guidelines can increase drug acquisition costs to the healthcare payer.

Cyclooxygenase Inhibitors↗
PubMed2006

Prevalence of chronic wounds in Quebec home care: an exploratory study.

Because the prevalence of chronic wounds in Quebec is unknown, researchers conducted a chronic wound prevalence feasibility study in severely ill, elderly, or bedridden home care patients. Questionnaires seeking information about the number of wounds, patient comorbidities, and characteristics of the most severe wound (etiology, location, duration, progress, and treatments) were mailed to the head nurse and home care nurses of 149 local community health centers. Information regarding nurse and general health center needs related to chronic wound prevention and care also was solicited from nurses in 52 health centers. Data were obtained from 488 patients (average age 68.5 years); an overall prevalence rate of 1.4% was determined. Most patients (81%) had one or two wounds and pressure ulcer was the most common etiology (37% of wounds). Wounds had existed for a mean of 26.8 months (range 0 to 180, median 12 months). Most (94%) patients had a family physician but only one third of family physicians were responsible for the wound care provided/prescribed. Lack of time was the most frequently cited reason for not completing the survey. Wound chronicity, severity (44% of pressure ulcers were Stage III), lack of improvement (60% cited no improvement or worsening of ulcer), the absence of protocols and training in some local community service centers, and inappropriate use of therapeutic modalities are important reasons for concern and provide opportunities for improvement. Sample size and the absence of verifiable data limit the external validity of the findings but results indicate that chronic wounds are a common and important concern among home healthcare patients in Quebec. Improvements in data collection and patient protocols of care are needed to facilitate the acquisition of much-needed wound prevalence and outcomes data to help agencies provide optimal patient care.

Activities of Daily Living↗
PubMed2006

[The limited spectrum of pathogenic BRCA1 and BRCA2 mutations in the French Canadian breast and breast-ovarian cancer families, a founder population of Quebec, Canada].

The unique genetic demography of the French Canadian population of Quebec, Canada, has provided a means to study the contribution of BRCA1 and BRCA2, the breast-ovarian cancer susceptibility genes. Here we review BRCA1 and BRCA2 in the context of French Canadian cancer families, a well-characterized founder population known for its contributions to medical genetics. Pathogenic BRCA1 and BRCA2 mutations contribute to a significant proportion of hereditary breast and/or ovarian cancer families of French Canadian descent. BRCA1 and BRCA2 mutations have been reported in approximately 40 % of families with at least three cases of breast and/or ovarian cancer, where breast cancer diagnosis occurred before age 66 years, and where all cases occurred within first-, second- and/or third-degree relatives to index affected cases tested for mutations. The proportion of mutation-positive families was very similar to that reported in independent studies of families not selected for ethnicity. However, 84 % of mutation-positive families were accounted for by one of eight pathogenic mutations in BRCA1 (2953delGTA + C, 3875delGTCT, and 4446C --> T) and BRCA2 (2816insA, 3398delAAAAG, 6085G --> T, 6503delTT, and 8765delAG). Haplotype analyses has suggested that carriers of the most common recurring mutations share a related ancestry. This effect has been attributed to common founders in the French Canadian population of Quebec who emigrated from France in between 1608 and 1759. It is possible that novel highly penetrant cancer susceptibility genes account for a fraction of the 60 % of BRCA mutation-negative French Canadian cancer families. The continued genetic analysis and phenotypic characterization of French Canadian cancer families is warranted given the large family structure of these families are amenable for classical genome-wide linkage analysis for novel breast and ovarian cancer susceptibility genes.

Age Factors↗
PubMed2006

The low seroprevalence of tick-transmitted agents of disease in dogs from southern Ontario and Quebec.

Infectious diseases caused by pathogens transmitted by ticks and other insect vectors are an important cause of morbidity and mortality in both dogs and humans throughout North America. The purpose of this study was to determine the seroprevalence of selected vector-transmitted pathogens in southern Ontario and Quebec. Samples submitted to the Vector Borne Disease Diagnostic Laboratory (VBDDL) at the North Carolina State University College of Veterinary Medicine were evaluated for antibodies to Ehrlichia canis, Anaplasma phagocytophilum, Babesia canis, Bartonella henselae, Borrelia burgdorferi, Bartonella vinsonii subspecies berkhoffii, and Rickettsia rickettsii. Information regarding breed and the city or province from which the sample originated was recorded; however, travel history was unknown for the majority of dogs. Overall seroprevalence to these tick-borne pathogens in southern Ontario and Quebec is low compared with most regions of the United States, suggesting that veterinarians in this region of Canada should pursue diagnostic evidence of infection in dogs with a travel history or prior residence in areas endemic for exposure to tick-borne infections.

Animals↗
PubMedDate not supplied

[Socio-demographic and soci-professional profile of holistic therapists in Quebec].

A descriptive study of practitioners of holistic therapies in Quebec was done using a questionnaire mailed to the 954 therapists advertising publicly their services. The response rate was 37.9%. This paper presents the sociodemographic and socio-professional data collected. According to the findings, holistic therapists can be found in almost all regions of Quebec with higher concentrations in large urban centers. Their group is almost equally composed of men (51.7%) and women (48.0%) with an age mean of 40.1 years and with a mean of 7 years of experience in their practice. The practice of holistic therapies is the main occupation of most of these practitioners who use a very wide variety of therapies. Acupuncture and its derivatives followed by various types of massotherapies and naturopathy are the most commonly advertised therapies. The great majority of these therapists work in private practice and their average income before deductions was $21,856.38. Due to the legal status of these practices, 10.3% of the respondents declared they had been the object of lawsuits on the part of a professional corporation.

Adult↗
PubMedDate not supplied

Isolation of infectious bursal disease virus from turkeys with arthritic and respiratory symptoms in commercial farms in Quebec.

Infectious bursal disease viruses (IBDVs) were isolated from turkeys showing symptoms of arthritis and respiratory disease in commercial poultry farms in the province of Quebec, Canada. Synovial fluids collected from hock joints of arthritic birds and peripheral blood leukocytes obtained from the birds with respiratory problems were used for virus isolation in embryonated chicken eggs, and Vero and BGM-70 cell cultures. The infected cells were evaluated for the presence of IBDV by indirect immunofluorescence assay using monoclonal antibodies. The viruses were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of viral genome and by electron microscopy. Although one of these turkey isolates tested was neutralized by serotype 1-specific commercial chicken antisera, preliminary results indicated that there are antigenic differences between the Quebec isolate, IBDV QT-1, and the existing strains of IBDV belonging to serotype 1.

Animals↗
PubMed1990

[Medico-legal statistics on occupational asthmna in Quebec between 1986 and 1988].

The authors have carried out a statistical analysis of cases of occupational asthma and other occupational lung diseases submitted to the Ministry of Labour in Quebec between 1986 and 1988. The total number of claims was 913, 993, and 866 respectively for the 3 years of which 61% to 71% were accepted. 41% to 55% were new assessments. Of 228 new claims accepted in 1988, 81 (36%) were for occupational asthma. This number surpassed the number of claims accepted for traditional pneumoconiosis (asbestos = 30, and silicose = 36). Isocyanates were the principle cause of occupational asthma (23% of cases were recognised in 1988) followed by flour, red and white cedar, snow crab process workers, and various pharmaceutical products and grains. In comparison with statistics in 1977, one noticed there was a large reversal of the frequency of certain occupational lung diseases that are recognised, because at that time asbestosis and silicosis were the principle causes of claims put forward and accepted. The authors discuss the statistical bias of occupational lung disease obtained by medico-legal agencies. Although occupational asthma has not been the object of the systematic screening program in the work place and although there is a tendency for workers to avoid or abandon their occupation more often than in the traditional pneumoconioses current protection is sufficient in Quebec to motivate individuals who are possibly suffering from occupational asthma to put in a claim for compensation.

Asthma↗
PubMedDate not supplied

[Decentralized focus of the campaign against AIDS in Quebec].

The aim of this article is to describe the operation of a local health system within the social and public health context in the Province of Quebec, Canada. Following a review of the local health system concept, a description is given of the resources that have been used to combat acquired immunodeficiency syndrome (AIDS) in the city of Quebec and the surrounding region. Some of the results obtained and difficulties encountered are presented, as are prospects for this work in the future.

Acquired Immunodeficiency Syndrome↗