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PubMed1988

Newborn urine screening experience with over one million infants in the Quebec Network of Genetic Medicine.

We screened urine for chemical individuality in over 1 million newborn infants, by various chromatographic (thin-layer), chemical and spectrophotometric methods, 12 procedures in all. The programme is part of the Quebec Network of Genetic Medicine. Voluntary urine screening began in 1971 and has evolved with changes in choice of tests and times of sample collection. Urine samples were collected on filter paper at either 5, 14 or 21 days after birth; results were best with the 21-day test. Compliance is over 94% with the latter and over 98% with requests for repeat samples. Screening is centralized in one laboratory; follow-up diagnosis, counselling and management are done at four regional centres. Incidence of phenotypes ranged from 1:4300 live births (for expressed cystinuria alleles) to 1 per million (for hyperargininaemia). Over 20 inherited Mendelian disorders were identified. 30 patients required aggressive medical management. We show how this programme can be used for neuroblastoma screening.

Chromatography, Thin Layer↗
PubMedDate not supplied

[Lack of conviction about vaccination in certain Quebec vaccinators].

A questionnaire was mailed to all vaccinators in Quebec in 1998. The objective of this survey was to document vaccinators' attitudes, knowledge, and practices related to vaccination. Vaccinators generally believe in the security, efficacy and usefulness of vaccines given to young children. However, 41% of nurses do not fully agree with these opinions. More than 94% of pediatricians completely disagree that "certain practices (homeopathy, good eating habits and a healthy lifestyle) can eliminate the need for vaccination", compared with 85% of general practitioners and only 60% of nurses. Less than 25% of doctors recall children who are late in getting their immunizations; approximately 45% of vaccinators are in complete agreement with simultaneous injections of two vaccines; many circumstances are incorrectly seen as contra indications for vaccination. Public health authorities should target systematic interventions towards vaccinators to improve this situation and to increase nurses' conviction regarding the benefits of vaccination.

Adult↗
PubMed1981

Anaesthesia technicians in Quebec: the background and the role.

Anaesthesia technicians are respiratory technologists who received their education in CEGEPs. Every respiratory technologist, when he finishes his course, is specially trained to become an anaesthesia technician. The tasks are delegated to anaesthesia technicians according to the task description of the anaesthetist. This specialist in the current practice must comply with the principles of the art of medicine: he makes a diagnosis by evaluating the risk of each patient who will be anaesthetised and by evaluating the patient's state along the course of anaesthesia and operation; then he decides on the treatment, i.e. he chooses the anaesthetic technique that is suitable for him and he modifies it during the operation according to the needs of the patient. In the diagnosis-treatment procedure, we find a part of decision and a part of execution. It is clear that the decision is reserved exclusively to the anaesthetist but the execution of certain tasks may be delegated to technicians. The task description for the anaesthesia technician has been developed in accordance with these principles and in accord with the new "Guide to Anaesthesia Practice" of the Corporation of Physicians of the Province of Quebec that does not agree with double booking of anaesthetists. Finally, we discuss employment of the technicians in the various operating rooms according to the variety of surgery that is done in each room and the work load that is generated. Experience with this organization has convinced us that the anaesthesia technicians, through their clinical and technical contribution, provide an infrastructure in a department of anaesthesia which permits smooth and efficient functioning of the department. It also relieves the anaesthetist of certain energy-consuming and time-consuming tasks.

Anesthesia↗
PubMed2005

A risk assessment approach to DDE exposure based on the case of the eastern screech-owl (Megascops asio) in apple orchards of southern Quebec,Canada.

As part of a larger study assessing exposure of the Eastern screech-owl to pesticides in apple orchards from consumption of contaminated small-mammal prey, we evaluated the potential for owls in orchards of southern Quebec to be exposed to persistent contaminants with emphasis on DDE. Levels were highest in short-tailed shrews (0.94 to 26.29 microg/g wet wt). Based on a worst-case scenario, it is possible that consumption of small-mammal prey in orchards of the study area may result in exposure to DDE at a level associated with significant eggshell thinning; however, consumption of other prey, (e.g., robins) may represent a more important threat. Other organochlorines and persistent contaminants such as trace metals and PCBs, reported elsewhere, were found at negligible levels only. Based on an evaluation of the data used, we identify critical information required to enhance the proposed risk assessment.

Animals↗
PubMed2002

Spatial and temporal dynamics of hedgerows in three agricultural landscapes of southern Quebec, Canada.

Noncrop areas such as hedgerows in agricultural landscapes can perform several ecological and agronomic functions (e.g., habitat, movement corridors, windbreak, etc.), but their dynamics and drivers of changes are often poorly known. We conducted a study in three agricultural landscapes of southern Quebec, Canada, to assess and compare the spatial and temporal (1958-1997) dynamics of three hedgerow networks in relation to geomorphic conditions (marine, glacial, and mixed deposit) and land-use changes. Hedgerow networks were mapped and described in terms of their structure (density, degree of connectivity, and presence of trees or shrubs) and their relationship to other components of the landscape (connection to woodland). Relationships were assessed in time and space using nonparametric correlation, Mantel test, and principal components analysis (PCA). Results show significant differences between hedgerow structure for the three landscapes and distinct temporal and spatial dynamics that can be related to changes in management practices and agricultural policies. On marine deposits, increases in hedgerow density did not always correspond to an increase in their degree of connectivity, suggesting a possible reduction in network quality. On glacial deposits, hedgerow density declined following abandonment of agricultural land, but rather than disappearing, these linear structures were integrated into adjacent brush or forested areas. Our analysis reveals the complex spatial and temporal dynamics of the hedgerow networks and highlights the need to take into account spatial attributes such as connectivity and connection to woodland to evaluate more accurately overall network quality.

Agriculture↗
PubMed2005

Anatomy of a founder effect: myotonic dystrophy in Northeastern Quebec.

Founder effects are largely responsible for changes in frequency profiles of genetic variants in local populations or isolates. They are often recognized by elevated incidence of certain hereditary disorders as observed in regions of Charlevoix and Saguenay-Lac-Saint-Jean (SLSJ) in Northeastern Quebec. Dominantly transmitted myotonic dystrophy (DM1) is highly prevalent in SLSJ where its carrier rate reaches 1/550, compared with 1/5,000 to 1/50,000 elsewhere. To shed light on the origin of DM1 in this region, we have screened 50 nuclear DM1 families from SLSJ and studied the genetic variation in a 2.05 Mb (2.9 cM) segment spanning the site of the expansion mutation. The markers analyzed included 22 biallelic SNPs and two microsatellites. Among 50 independent DM1 chromosomes, we distinguished ten DM1-associated haplotypes and grouped them into three haplotype families, A, B and C, based on the relevant extent of allele sharing between them. To test whether the data were consistent with a single entry of the mutation into SLSJ, we evaluated the age of the founder effect from the proportion of recombinant haplotypes. Taking the prevalent haplotype A1_21 (58%) as ancestral to all the disease-associated haplotypes in this study, the estimated age of the founder effect was 19 generations, long predating the colonization of Nouvelle-France. In contrast, considering A1_21 as ancestral to the haplotype family A only, yielded the estimated founder age of nine generations, consistent with the settlement of Charlevoix at the turn of 17th century and subsequent colonization of SLSJ. We conclude that it was the carrier of haplotype A (present day carrier rate of 1/730) that was a "driver" of the founder effect, while minor haplotypes B and C, with corresponding carrier rates of 1/3,000 and 1/10,000, respectively, contribute DM1 to the incidence level known in other populations. Other studies confirm that this might be a general scenario in which a major "driver" mutation/haplotype issued from a founder effect is found accompanied by distinct minor mutations/haplotypes occurring at background population frequencies.

Alleles↗
PubMed1988

Characteristics of three- and four-wheeled all-terrain vehicle accidents in Quebec.

During a seven-month survey from May to November 1985, 624 victims injured from three- or four-wheeled all-terrain vehicles (ATVs) were observed in the emergency rooms of 10 regional hospitals in Quebec. A total of 1,100 injuries were identified, including 3 fatal and 104 serious to critical injuries (AIS greater than or equal to 3). These injuries were to the lower limb (29%), the upper limb (28%), the head, neck, and face (26%), and the thorax, abdomen, and pelvis (18%). Close to one-half (45%) of the victims were 19 years old and less; 54% reported wearing helmets. Ten percent of the victims were hospitalized for an average period of 8 days. In 70% of the cases, the vehicle overturned: half of these vehicles turned on the side, 27% toward the back, and 19% flipped forward. Two-thirds of persons injured were involved in accidents in which no external objects were hit by the vehicle; these accidents typically involved vehicle overturns, both on hills and on level ground. Ninety-five percent of the vehicles were in good mechanical condition. The use of these vehicles presents a danger whether used by a child or an adult, by an experienced or an inexperienced rider. The average user may not be aware that three- and four-wheel ATVs demand considerable skill and caution. We suggest the use of accident reconstruction studies for possible engineering solutions.

Accidents, Traffic↗
PubMed1985

Metallic elements in crude and milled chrysotile asbestos from Quebec.

Crude and milled fibers from different asbestos mines in Quebec have been analyzed for their metallic content. Crude fibers present a few metal concentrations that are characteristic for each mine. Manganese and iron can be used as discriminators, zinc and cobalt are constantly present in minute quantities, and calcium is virtually absent from crude fibers. Milled fibers are enriched in metals by factors ranging from 1.3 to greater than 15. Chromium and nickel concentrations are many times higher than in crude fibers and iron content is increased by more than 100%. Total metal content in milled fibers is mainly due to nonchrysotile material.

Asbestos↗
PubMed1984

Hospital power structure and the democratization of hospital administration in Quebec.

In 1973, the Canadian Province of Quebec 'democratized' its hospital boards of directors by replacing the previous 'elite' boards by boards representative of the hospitals' major interest groups. This study looks at the impact of these participatory boards on the distribution of power within hospitals, particularly their effect on the hospital administrators' position of control in relation to their boards of directors and medical staff. Findings include a deterioration in the administrators' sense of organizational control, a weakening of the boards' authority over physicians, and a concentration of decision-making outside of the boardroom.

Community-Institutional Relations↗
PubMed1984

Dental services in Quebec: issues and changes.

This paper describes the dental care delivery system in the province of Quebec (Canada) and shows that it has failed on two counts: the geographical maldistribution of dental manpower and the lack of development of preventive services. The paper discusses these issues in relation to recent changes which have occurred in the last decade, particularly the recognition of dental hygienists and denturists as legitimate providers of dental care in 1973 and the inception of Denticare in 1974.

Dental Health Services↗
PubMed1985

A cost-benefit analysis of the Quebec Network of Genetic Medicine.

Certain serious diseases, including several major genetic disorders, cannot be treated effectively unless they are detected before symptoms appear. In such cases, only systematic population screening can ensure that the necessary preventive treatment can be administered to affected individuals. The question of whether to establish such screening programs, which may be relatively costly, is a pressing problem for many public administrations. This study of the costs and benefits of the Quebec Network of Genetic Medicine has as its main objective the development of an analytical framework which can be generally applied to such problems. In this article, we attempt to evaluate the profitability of the Network to society. For the evaluation of the less tangible costs and benefits, we adopted the minimum profitability principle, which essentially involves establishing a lower bound on the value of the profitability of the Network. The net benefits assessed by this study, although certainly underestimated, are still very significant. Since the Network is administered by a team of researchers, the study also throws some light on the links existing between research and development activities on the one hand and public services on the other, and hence on the general question of the socioeconomic profitability of biomedical research.

Biomedical Research↗
PubMed1986

[Geographical relations between mortality from cancer of the esophagus, cirrhosis of the liver, alcohol and tobacco: case of the Province of Quebec].

This study concerns the geographical relationships between alcohol consumption per capita; smoking and death from cirrhosis of the liver and cancer of the oesophagus in persons of 15 years old and over in Quebec. First, the geographical distribution of variables is analysed. Secondly, we have used methods of correlation and regression in order to evaluate their relation to each other. In the latest case we have chosen the logistic regression model to investigate the simultaneous effects of alcohol and tobacco. The results show that alcohol consumption is closely related to mortality from cirrhosis of the liver. Moreover, there was no significant relation found between total alcohol consumption and oesophageal cancer. These findings can be applied to cases of consumption of wine and spirits.

Adolescent↗
PubMed1989

Respiratory health indicators and acculturation among the Inuit and Cree of northern Quebec: a regional approach using geographic seriation analysis.

The goal of the research reported on is the analysis of the geo-statistical relationships observed between three indicators of respiratory health (acute and chronic bronchitis; pulmonary function) and an index of acculturation. Data used in this work were obtained by means of a field survey that was conducted in the north of Quebec over a 24-month period (1982-1984). With regard to acculturation, a very elusive concept, a Bertin-type geographic seriation technique is used to characterize the levels of modernity of each of the 21 villages involved in this study. Notwithstanding difficulties of measurement, it can be concluded from this analysis that better levels of respiratory health are positively associated, to a degree, with acculturation. This is a very significant result in that it would demonstrate the opposite of what has been tentatively noted in some other studies of the health status of Aboriginal populations.

Acculturation↗
PubMed1990

Correlates of health-care use: Inuit and Cree of northern Quebec.

This case study of the use of health-care services in northern Quebec is the first of a series of reports dealing with the health status, risk factors and access to care of the two major aboriginal populations in this region, the Cree and the Inuit. The focus of the broader study is on the health status and risk factors in these native populations. This research, based on a survey conducted in 1983-84, describes the present health status and health-care system of the Cree and Inuit, then presents a path analysis model of their use of health services. The purpose of this approach is to provide health planners and care providers with useful information and to encourage the development of well-organized and reasonable health-care service delivery to these populations.

Age Factors↗
PubMed1995

[Homogeneity of the spatial distribution of cancers of the female reproductive tract in Quebec].

Risk factors associated with women's reproductive life and sexual growth do not adequately predict cancer incidence of the breast, uterus and ovary. The heterogeneous worldwide distribution of these cancers could imply that some environmental and cultural risk factors are involved in their cancerogenesis. The few attempts made so far to unravel their spatial structures at a geographic scale facilitating the search for exogenous risk factors have proved inconclusive. This study reports the results of a spatial analysis of the cancer incidence rates for breast, cervix, endometrium and ovary among Community Health Departments (CHD) in Quebec using a spatial autocorrelation method. Correlograms built according to four definitions of the inter-CHDs distance indicate that breast and ovary incidence rates follow quite similar spatial gradients attesting to their etiologic affinity. They also suggest that the spatial distribution of endometrial cancer follows a gradient divergent from that of breast and ovary cancers, and that the CHDs' spatial scale does not suitably describe the distribution of cervical cancer. The demonstration of a structured spatial distribution for breast, endometrium and ovary cancers in Québec strengthen the hypothesis that cultural or environmental risk factors are involved in their etiology. But, the observed disparities in the spatial structure of these cancers imply that their etiologic specificity may be greater than their biologic bond would suggest.

Adolescent↗
PubMed1992

Serological characterization of Actinobacillus pleuropneumoniae strains isolated from pigs in Quebec.

A total of 3306 isolates of A. pleuropneumoniae originating from lung tissues of pigs that died of acute pleuropneumonia and 140 isolates recovered from tonsils or nasal cavities of apparently healthy pigs from chronically infected herds were serotyped. Various serotyping methods, such as slide agglutination, tube agglutination, ring precipitation, coagglutination, immunodiffusion, indirect hemagglutination and counterimmunoelectrophoresis either alone or in combination were used. The techniques used for serotyping continued to evolve during the last 10 years depending on the problem encountered in serotyping. Antisera prepared in rabbits against formalinized whole cell suspensions of reference strains of A. pleuropneumoniae of serotypes 1 to 12 were employed for serotyping. Serotype 1 was predominant ranging from 55 to 87% from year to year during the last 10 years with an average prevalence of 68%. Serotype 5 was second in prevalence ranging from 9 to 30% with a mean of 23%. Both subtypes of serotype 5 (5a and 5b) were present in Quebec. Serotypes 3, 6, 7, 8, 10 and 12 were isolated in small numbers together accounting for about 9%. Serotypes 4, 9 and 11 were not present. Cross-reactions were observed among isolates of serotypes 3, 6 and 8, and 1, 9 and 11 and were easily differentiated from each other by quantitation of type and group specific antigens by coagglutination and immunodiffusion tests. Serotypes 1, 5 and 7 were isolated most frequently from tonsils of pigs from chronically infected herds. Prevalence of different serotypes in different countries has also been reviewed.

Actinobacillus Infections↗
PubMed1991

The descriptive epidemiology of hysterectomy, Province of Quebec, 1981-1988.

This study reports the descriptive epidemiology of hysterectomy in the Province of Quebec, Canada, from 1981 to 1988. Data on hysterectomies (n = 150,849) among women 15 years and older were obtained from MED-ECHO, a computerized database of hospital discharge summaries. Hysterectomy rates were established, with denominators consisting of the estimated female populations with a uterus. From 1981 to 1988, the age-adjusted rate for hysterectomy declined from 100.4 to 67.4 per 10,000 women with a uterus. Curves representing age-specific rates of hysterectomy revealed a consistent bimodal pattern over time, a first peak occurring in women aged 40 to 44 years, and a second in women aged 65 to 69. Hysterectomy rates for elective conditions such as leiomyoma, endometriosis, disorders of menstruation, and prolapse decreased consistently over time. The proportion of women who had a hysterectomy and simultaneous bilateral oophorectomy declined from 35% in 1981 to 30% in 1988. Despite the substantial decline in the frequency of hysterectomy over the 8-year period, at rates prevailing in 1988, three of ten women would have had a hysterectomy by the age of 60.

Adolescent↗
PubMed1994

Influence of attitudes on the intention to use condoms in Quebec sexually active male adolescents.

PURPOSE: The purpose of this study was to determine the influence of attitudes and other variables on the intention to use condoms in sexually active male adolescents. METHODS: The survey was conducted from April to June 1989 on a sample of 433 sexually active boys aged 12-19 years registered in secondary schools in Laval, Quebec. RESULTS: Information on condoms provided by parents, peers, school, or media had no positive effect on male adolescents' intention to use condoms. Having a favorable attitude towards contraceptive responsibility, however, was significantly associated with the outcome variable. Endorsement of this responsibility seemed short-lived being replaced by the birth control pill in older adolescents. The study also found that in younger adolescents, intention to use condoms was significantly associated with supportive parental attitudes. CONCLUSIONS: The results of this study highlight the importance of developing strategies to encourage sexually active male adolescents to assume greater responsibility for using condoms, and suggest that in order for programs to be effective, STD and acquired immunodeficiency syndrome prevention should be done at younger ages while encouraging parents to take a greater role in sex education.

Adolescent↗