Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Quebec”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

[A geographic analysis of regional disparities in temporal accessibility of emergency services to traffic accident victims in Quebec].

This study provides a geographic analysis of variation in temporal accessibility to emergency services by accident victims within regional municipalities in Quebec. The model employed takes account of various post-accident variables (supply and demand; the service organization) which existed in Quebec in 1987. The study population consisted of 8,989 accident victims who required ambulance service between June 1 and August 31, 1987. The study concludes that the time between the accident and the arrival of the victim at the hospital was longer than one hour (the "Golden Hour") in 25% of the regional municipalities in distant regions and in the areas close to Ontario and the United States. Emergency interventions took less than 40 minutes in suburbs to the North and South of Montreal Island. Forty-eight percent of the variance is linked to the presence and the type of emergency services with an ATLS professional available and 20% is linked with the variables of distance and time.

Accidents, Traffic↗
PubMed1994

Hereditary disorders in the French Canadian population of Quebec. I. In search of founders.

Twenty-eight hereditary disorders are known to cluster in at least one region of Quebec, 24 of them in regions east of Quebec City, including 20 in the northeastern part of the province. Genealogies were reconstructed to identify the probable origin of 21 of these 28 disorders present in the French Canadian population. The results showed that most of the disorders were brought to Nouvelle-France by settlers coming from France in the seventeenth century. Only 249 of the 8483 settlers in Nouvelle-France contributed, as common founders, to these genealogies. The contribution of the province of Perche was significantly higher than expected from its relative weight to the founding nucleus of the French Canadian population in 19 disorders. Furthermore, 34 of the 48 different common founders from Perche were found in more than one disorder.

Cluster Analysis↗
PubMed1994

Hereditary disorders in the French Canadian population of Quebec. II. Contribution of Perche.

In our previous paper (De Braekeleer and Dao 1994) we showed that most of the hereditary disorders present in the French Canadian population of Canada cluster in eastern Quebec. Furthermore, the disorders probably were brought to Nouvelle-France in the seventeenth century by migrants coming from Perche, France. Here, the analysis of several historical, social, and demographic factors shows that, rather than migrants coming from other French provinces, migrants from Perche came from a limited area and settled in eastern Quebec, preferentially on the north shore of the St. Lawrence River. They arrived earlier than the other migrants and had a larger descendance. However, only a limited number of migrants from Perche were found in the founding nucleus of the hereditary disorders. Further analysis shows that the social system had major consequences on migration, marriage, kin network, and family behavior. Therefore the presence and the high frequency of most of the hereditary disorders in the French Canadian population appear to be the result of founder effect and genetic drift.

Cluster Analysis↗
PubMed1994

Questionable prescribing for elderly patients in Quebec.

OBJECTIVE: To estimate the prevalence of questionable and rational high-risk prescribing among elderly people of the three drug groups most commonly implicated in drug-related illness: cardiovascular drugs, psychotropic drugs and nonsteroidal anti-inflammatory drugs (NSAIDs). DESIGN: Retrospective prevalence study; all prescription and billing records for the period Jan. 1 to Dec. 31, 1990, for the study sample were retrieved from the relevant provincial databases of the Régie de l'assurance-maladie du Québec. SETTING: Quebec. PARTICIPANTS: Regionally stratified random sample of 63,268 elderly medicare registrants who made at least one visit to physician in 1990 and were not living in a health care institution for the entire year. MAIN OUTCOME MEASURE: Prescription information was examined for three types of high-risk prescribing: rational and questionable drug combinations, excessive treatment duration and drugs relatively contraindicated for use in elderly people. RESULTS: Overall, 52.6% of the patients experienced one or more events of high-risk prescribing, and 45.6% experienced at least one that was questionable. High-risk prescribing was most prevalent for psychotropic drugs, and questionable prescribing was more frequent than rational prescribing in this drug group. An estimated 30.8% of the total elderly population in Quebec received benzodiazepines for more than 30 consecutive days, 12.9% received a long-acting benzodiazepine, and 13.0% received a questionable high-risk psychotropic drug combination. The prevalence of high-risk prescribing was higher among the women than among the men and increased with age until 75 to 84 years. There were significant unexplained differences between regions in the regional prevalence of high-risk prescribing, particularly of psychotropic drugs. CONCLUSION: The prevalence of questionable high-risk prescribing, especially of psychotropic drugs, is substantial among elderly people. This may be a potentially important and avoidable risk factor for drug-related illness in elderly people.

Age Factors↗
PubMed1994

[The use of diagnostic and surgical procedures in elderly persons in Quebec].

The rapid aging of the population constitutes a new challenge for the health care delivery system. This paper presents the progression of use of several diagnostic and surgical procedures in the elderly in Quebec from 1981 to 1989. Data were obtained from claims to the Régie de l'assurance maladie du Québec for the years 1981, 1985 and 1989. The rate of coronary artery bypass surgery increased by more than 700% in people 65 years and over between 1981 and 1989. This increase was especially high in the oldest age group (q 75 years). There was also a significant increase in surgery for abdominal aortic aneurysm, while the rate of carotid endarterectomy remained stable for people 65 years and over during this period. The rates of all abdominal surgical procedures examined (appendicectomy, repair of hiatal and inguinal hernia, cholecystectomy and colectomy) were relatively stable in elderly during the study period. Total hip replacement more than doubled in people 65 years and over, while other types of hip arthroplasty significantly decreased over this period. All types of diagnostic procedures examined (coronary angiography, bronchoscopy, gastroduodenoscopy and retrograd cholangio-pancreatography) increased significantly, especially in very old people. This study suggests that surgical care is increasing in the elderly in Quebec. This progression is expected to continue in the coming years so that surgical care of the elderly will become a significant part of our health care delivery system.

Aged↗
PubMed1993

[The Quebec system of indemnification for occupational asthma. Description, efficacy, and costs].

This study describes the Quebec system of compensation for occupational asthma, assessing the functional and social outcome of claimants and estimating the efficiency and cost. Information was obtained on the clinical, functional and social outcome as well as the estimated costs for 134/211 subjects (participation rate of 64%), who received compensation between 1986 and 1988. At the time of assessment (2 years and more after the diagnosis), 93% of participants still demonstrated significant bronchial hyperresponsiveness and 84% required anti-asthma medication. None of the participants remained exposed to the offending agent: 67% were working for the same or another employer, 16% were retired, 8% were retraining for a new job and 8% were still unemployed. Quality of life was mildly affected, more so than for a control group of subjects. The mean interval between the time claims were addressed and the first medicolegal decision was 8.1 months. The mean total cost (including temporary and permanent disability indemnities, medical and technical costs) was $CAN 49,200 (minimum and maximum values of $2,100 and $330,900). We conclude that for subjects with occupational asthma in Quebec: 1) the mean interval for a medicolegal decision to be made is eight months: 2) a minority is still unemployed two to four years after being assessed; 3) the quality of life is more affected than in a control group; 4) the mean cost is close to $CAN 50,000.

Activities of Daily Living↗
PubMedDate not supplied

[Pregnant women's knowledge of prematurity in Quebec].

The objective of this study was to determine pregnant women's knowledge level concerning premature birth. During July of 1990, 465 pregnant women completed a questionnaire evaluating their knowledge of the following dimensions of premature birth: risk factors, symptoms, epidemiology, prevention and self-assessment of risk. The subjects were all francophones, at 16 weeks of less of pregnancy, with characteristics comparable to all pregnant women in Quebec. The study participants considered premature birth to be a serious health problem, and over-estimated the premature birth rate. Fifty-seven percent thought that the rate was 17% or greater. Eighty percent associated premature birth with some morbidity and mortality risks. On the other hand, the risk factors concerning premature birth were poorly known; approximately 50% of the women did not recognize twin pregnancy and a past history of premature delivery as risk factors. Moreover, a third of the women did not recognize the signs and symptoms of premature rupture of membranes and of premature labor. In conclusion, a high proportion of pregnant women in Quebec do not have even minimally adequate knowledge levels concerning the prevention or risks of premature birth.

Adult↗
PubMed1993

Prevalence of diabetes mellitus among the James Bay Cree of northern Quebec.

OBJECTIVE: To determine the prevalence of diabetes mellitus among the James Bay Cree in northern Quebec. DESIGN: Chart survey of physician-diagnosed cases of diabetes. The biochemical criteria of the World Health Organization were used to confirm the diagnoses. SETTING: Eight James Bay Cree communities: six remote and two rural. SUBJECTS: All James Bay Cree with diabetes whose names were in a chronic disease registry or on a diabetes clinic list kept at each community clinic. OUTCOME MEASURES: Prevalence rates, both crude and standardized to the 1986 Canadian population, were estimated by sex, age group and type of diabetes. RESULTS: A total of 235 cases of diabetes were confirmed, for a crude prevalence of 2.7%. The age-standardized rate of non-insulin-dependent diabetes mellitus was 6.6% among people 20 years and over. The prevalence increased as the latitude decreased. CONCLUSIONS: Our crude prevalence resembles that in similar native linguistic and cultural groups elsewhere in Canada. Diabetes is becoming an important disease in the Cree population of Quebec. A better understanding of the sociocultural changes in this population is necessary.

Adult↗
PubMedDate not supplied

[Profile of aged traffic victims on the road to Sherbrooke (Quebec)].

This article draws a portrait of the victims, 65 years of age and over, of road accidents in a mid-size Quebec town. By examining four variables--age, sex, condition of the victims and the type of road users--we measured the magnitude and severity of road accident injuries in senior citizens, and identified those road users most at risk. Results indicate that, in the city of Sherbrooke as elsewhere in Quebec, road accident injuries are increasing slowly but constantly in this age group. Analysis of the severity of injuries and of the category of road users, shows that senior citizens have a high degree of vulnerability and are over-represented in statistics dealing with pedestrians who are victims of accidents. We discuss these results and their impact on public health.

Accidents, Traffic↗
PubMed1993

Genealogy and regional distribution of lipoprotein lipase deficiency in French-Canadians of Quebec.

Lipoprotein lipase (LPL) deficiency, an autosomal recessive disorder causing chylomicronemia, has a high prevalence in the French-Canadian population of Quebec. The molecular basis of LPL deficiency has been defined, and two major mutations have been shown to have an uneven geographic distribution. Two mutations, one at residue 188 (M-188) and the other at residue 207 (M-207), are described here; they account for 95% of the mutant alleles. The carrier rate of M-188 was highest in western Quebec (1/326) but that of M-207 was much higher in the eastern part of the province (1/85). Genealogical reconstruction has revealed that both mutations were introduced to the French-Canadian population by migrants from France in the seventeenth century. M-188 is likely to have a Scottish ancestor, whereas M-207 appears to be of French origin.

France↗
PubMed1993

Women in pediatrics: the experience in Quebec.

OBJECTIVES: To compare the practice patterns of female pediatricians in Quebec with those of their male counterparts and to identify specific factors influencing these practice patterns. DESIGN: Matched cohort questionnaire survey. SETTING: Primary, secondary and tertiary care pediatric practices in Quebec. PARTICIPANTS: All 146 female pediatricians and 133 of the 298 male pediatricians, matched for age as well as type and site of practice; 119 (82%) of the female and 115 (86%) of the male pediatricians responded. MAIN OUTCOME MEASURES: Demographic and family data as well as detailed information about the practice profile. RESULTS: The two groups were comparable regarding demographic data, professional work and patient care. Compared with the male respondents, the female pediatricians were younger and saw more outpatients. The mean number of hours worked per week, excluding on-call duty, was 40.5 (standard deviation [SD] 12.4) for the women and 48.9 (SD 12.0) for the men (p < 0.001). The female pediatricians were more likely than their male counterparts to have spouses who were also physicians (40%) or in another profession (45%). The female pediatricians without children worked significantly fewer hours than the male pediatricians with or without children (p < 0.001). Children (p = 0.006), but not the number of children (p = 0.452), had a significant effect on the number of hours worked by the female pediatricians. CONCLUSION: The duality of the role of female physicians as mothers and professional caregivers must be considered during workload evaluations. If the same style of practice and the increase in the proportion of female pediatricians continue, about 20% more pediatricians will be needed in 10 years to accomplish the same workload.

Adult↗
PubMed1995

A microprocessor card software server to support the Quebec health microprocessor card project.

The Quebec Health Smart Card Project is advocating the use of a memory card software server[1] (SCAM) to implement a portable medical record (PMR) on a smart card. The PMR is viewed as an object that can be manipulated by SCAM's services. In fact, we can talk about a pseudo-object-oriented approach. This software architecture provides a flexible and evolutive way to manage and optimize the PMR. SCAM is a generic software server; it can manage smart cards as well as optical (laser) cards or other types of memory cards. But, in the specific case of the Quebec Health Card Project, SCAM is used to provide services between physicians' or pharmacists' software and IBM smart card technology. We propose to expose the concepts and techniques used to provide a generic environment to deal with smart cards (and more generally with memory cards), to obtain a dynamic an evolutive PMR, to raise the system global security level and the data integrity, to optimize significantly the management of the PMR, and to provide statistic information about the use of the PMR.

Computer Security↗
PubMed1995

Médicarte software developed for the Quebec microprocessor health card project.

The Quebec Patient Smart Card Project is a Provincial Government initiative under the responsibility of the Rgie de l'assurance-maladie du Québec (Quebec Health Insurance Board). Development, implementation, and assessment duties were assigned to a team from Université Laval, which in turn joined a group from the Direction de la santé publique du Bas-St-Laurent in Rimouski, where the experiment is taking place. The pilot project seeks to evaluate the use and acceptance of a microprocessor card as a way to improve the exchange of clinical information between card users and various health professionals. The card can be best described as a résumé containing information pertinent to an individual's health history. It is not a complete medical file; rather, it is a summary to be used as a starting point for a discussion between health professionals and patients. The target population is composed of persons 60 years and over, pregnant women, infants under 18 months, and the residents of a small town located in the target area, St-Fabien, regardless of age. The health professionals involved are general practitioners, specialists, pharmacists, nurses, and ambulance personnel. Participation in the project is on a voluntary basis. Each health care provider participating in the project has a personal identification number (PIN) and must use both an access card and a user card to access information. This prevents unauthorized access to a patient's card and allows the staff to sign and date information entered onto the patient card. To test the microprocessor card, we developed software based on a problem-oriented approach integrating diagnosis, investigations, treatments, and referrals. This software is not an expert system that constrains the clinician to a particular decisional algorithm. Instead, the software supports the physician in decision making. The software was developed with a graphical interface (Windows 3.1) to maximize its user friendliness. A version of the software was developed for each of the four groups of health care providers involved. In addition we designed an application to interface with existing pharmaceutical software. For practical reasons and to make it possible to differentiate between the different access profiles, the information stored on the card is divided in several blocks: Identification, Emergency, History (personal and family), Screening Tests, Vaccinations, Drug Profile, General follow-up, and some Specific follow-ups (Pregnancy, Ophthalmology, Kidney failure, Cardiology, Pediatrics, Diabetes, Pneumology, Specific parameters). Over 14,000 diagnoses and symptoms are classified with four levels of precision, the codification being based on the ICPC (International Classification for Primary Care). The software contains different applications to assist the clinician in decision making. A "Drug Advisor" helps the prescriber by detecting possible interactions between drugs, giving indications (doses) and contraindications, cautions, potential side-effects and therapeutic alternatives. There is also a prevention module providing recommendations for vaccination and periodic examinations based on the patient's age and sex. The pharmaceutical, vaccination, and screening tests data banks are updated every six months. These sections of the software are accessible to access card holders at any times, even without a patient card, and constitute in themselves an interesting clinical tool. We developed a software server (SCAM) allowing the different applications to access the data in a memory card regardless of the type of memory card used. Using a single high level command language, this server provides a standardized utilization of memory cards from various manufacturers. It ensures the compatibility of the applications using the card as a storage medium. (abstract truncated)

Aged↗
PubMed1996

[Trends in the level of edentulism in Quebec between 1980 and 1993].

Level of edentulism is a good indicator of a populations' bucco-dental health. Thus, the evolution of this phenomena enables us to seek any modification of adults' bucco-dental health. The percentage of adults in Quebec aged 18 and over who are completely edentulous decreased from 26 per cent in 1980 to 20 per cent in 1993. During the same period, the percentage of adults aged 18 and over who are only partially edentulous decreased from 18 per cent to 13 per cent. We note on one hand that this decrease is more prominent among younger adults and among anglophones and on the other hand that income and education are more strongly associated with edentulism in 1993 than in 1980. In 1980, individuals with lower levels of education were three times more edentulous (partially or totally) than those with higher levels of education (73 per cent versus 25 per cent). In 1993, this ratio increased to six times (72 per cent versus 12 per cent). It appears, therefore, that while edentulism has generally decreased in Quebec, it is more concentrated among certain high risk groups.

Adolescent↗
PubMed1996

Apolipoprotein E polymorphism in a French Canadian population of northeastern Quebec: allele frequencies and effects on blood lipid and lipoprotein levels.

Apolipoprotein E phenotypes and plasma lipid and lipoprotein levels were determined in 435 individuals (233 men, 202 women) of French Canadian descent living in northeastern Quebec. This region is known for its high frequency of mutant genes responsible for rare genetic disorders. Total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride levels were adjusted for age, height, weight, body mass index (BMI), and waist circumference using regressions performed separately in men and in premenopausal and postmenopausal women. The APOE allele frequencies in this population-based sample were 0.137, 0.749, and 0.114 for the *2, *3, and *4 alleles, respectively. APOE2 (APOE 2,2 and APOE 3,2) subjects had lower total and LDL cholesterol levels than APOE3 (APOE 3,3) subjects. In APOE4 (APOE 4,3 and APOE 4,4) men and postmenopausal women levels of total and LDL cholesterol and triglycerides were significantly higher than in the corresponding APOE3 subjects. The *2 allele was also found to be associated with higher triglyceride levels in men and postmenopausal women. Men of the APOE4 group also presented lower HDL cholesterol levels. Although the impact of APOE polymorphism on blood lipid and lipoprotein levels in this French Canadian population is similar to what has been reported in other white populations, the frequency of the *2 allele is among the highest ever reported. This finding is discussed in terms of the founder effect characterizing the Quebec population.

Abnormalities, Multiple↗
PubMed1996

Quebec employs user-pay philosophy in launching drug-insurance plan.

The Quebec government has introduced a new provincial drug-insurance scheme that by January 1997 will provide coverage to all Quebecers. The first phase of the measure, which was instituted for reasons that were partly financial and partly social, came into effect in August, to the chagrin of the province's welfare recipients and elderly. They are the first to pay 25% of the cost of prescriptions under the new copayment plan.

Aged↗
PubMedDate not supplied

[Geo-pathologic considerations on the most frequent tumors in Quebec presented in 1984-1986 and 1989-1991].

This study describes the geographical variations in the incidence of, and mortality due to, the most frequent cancers in Quebec. They are breast, colon and tracheal, bronchial, and lung cancers in women and prostate, colon and trachea, bronchial and lung cancers in men. Data for the periods 1984 to 1986 and 1989 to 1991 for the whole of the Quebec Community Health Department are reviewed. A direct method of standardization, with the world population as the reference population, was used to allow comparison of geographical units. The ranking correlation method was used to test correlations for the various cancer sites. There were significant coefficients between the two periods only for lung cancer for both sexes, for both incidence and mortality. The spatial autocorrelation method was used to determine the presence or absence of a geographical configuration from the estimated rates. Moran I values were positive and significant for the two periods for lung cancer associated mortality and for the incidence of breast cancer. This implicates local factors (probably associated with lifestyle). The results for the incidence of lung cancer among men and women were similar for the period 1989 to 1991. The advantages and limitations of the methods used and also the data available are considered.

Breast Neoplasms↗
PubMed1997

Studies of a second family with the Quebec platelet disorder: evidence that the degradation of the alpha-granule membrane and its soluble contents are not secondary to a defect in targeting proteins to alpha-granules.

We recently described a Quebec family with an autosomal dominant bleeding disorder characterized by mildly reduced-low normal platelet counts, an epinephrine aggregation defect, multimerin deficiency, and proteolytic degradation of several, soluble alpha-granular proteins. Similar clinical features led us to investigate a second family with an unexplained, autosomal dominant bleeding disorder. The affected individuals had reduced to normal platelet counts, absent platelet aggregation with epinephrine, and multimerin deficiency. Their platelet alpha-granular proteins factor V, thrombospondin, von Willebrand factor, fibrinogen, fibronectin, osteonectin, and P-selectin were proteolyzed and comigrated with the degradation products found in patients from the other family. However, their platelet albumin, IgG, external membrane glycoproteins, CD63 (a lysosomal and dense granular protein), calpain, and plasma von Willebrand factor were normal, indicating restriction in the proteins proteolyzed. Electron microscopy studies indicated preserved alpha-granular ultrastructure, despite degradation of soluble and membrane alpha-granular proteins. Immunoelectron microscopy studies of the patients' platelets indicated that fibrinogen, von Willebrand factor, P-selectin, multimerin, and factor V were within alpha-granules, with normal to reduced labeling for these proteins. Pathologic proteolysis of alpha-granular contents, rather than a defect in targeting proteins to alpha-granules, may be the cause of the protein degradation in the Quebec platelet disorder.

Adult↗