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PubMed1986

Socio-medical determinants of hospital utilization in Quebec, Canada, 1970-1975.

The relationship between ambulatory physician use and hospitalization was studied using aggregate data in the Province of Quebec, Canada. The analysis showed that the introduction of health insurance covering physician services had a negligible influence on hospitalization. The average length of short-term hospital stays was determined by the proportion of aged population, the proportion of English speaking persons, and the prior level of hospitalization in the medical market areas. Overall, hospital discharge rates remained very constant during the period of six years (1970-1975). There were, however, reductions in hospitalization for infectious diseases, diseases of the blood and blood-forming organs, respiratory diseases, and diseases of the skin and subcutaneous tissue, and increases in the hospitalization rates for neoplasms, circulatory system disorders, musculoskeletal conditions, congenital anomalies, and perinatal morbidity and mortality.

Adult↗

PubMed1995

Prevalence estimates of diabetes and of other cardiovascular risk factors in the two largest Algonquin communities of Quebec.

OBJECTIVE: To compare the prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in the two largest Algonquin communities of Quebec (Canada) with that of other native groups and to describe the different patterns of NIDDM and other cardiovascular risk markers in these communities (River Desert [RD] and Lac Simon [LS]). RESEARCH DESIGN AND METHODS: The population-based study targeted all residents aged 15 years and older. In the age-group considered here (30-64 years), there were 480 eligible subjects and 299 participants (50.8% in RD and 86.9% in LS). All except those with confirmed diabetes underwent an oral glucose tolerance test. Serum triglyceride and lipoprotein cholesterol levels, blood pressure, body mass index (BMI), and waist-to-hip ratio (WHR) were measured. RESULTS: The age-standardized (world population) prevalence of NIDDM in women was twice as high in LS as in RD (48.6% vs. 23.9%). In men, it was 23.9% in LS and 16.3% in RD. Upper-body obesity followed the same pattern. In contrast, high-risk serum low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels were significantly more prevalent in RD than in LS, particularly among men. The rate of high blood pressure was twice as high in men as in women, with little community differences. When we controlled for age, sex, diabetic, and obesity status, mean fasting serum glucose remained significantly higher triglycerides and LDL cholesterol lower in LS than in RD. There was also an independent community effect on WHR but no on BMI. CONCLUSIONS: The prevalence of NIDDM in LS women reaches the rate observed in Pima Indian women. The observed differences between two Algonquin communities suggest a highly heterogeneous pattern of NIDDM and cardiovascular disease risk factors in Amerindian populations, even within a given tribe and a limited geographic area.

Adolescent↗

PubMed1996

Effect of maternal diabetes on the pattern of selected insulin resistance syndrome parameters in normal glucose tolerant subjects of two Algonquin Indian communities in Quebec.

OBJECTIVE: To determine whether a maternal antecedent with diabetes has an effect on insulin resistance syndrome parameters. RESEARCH DESIGN AND METHODS: We studied 352 Algonquin Indians from Quebec aged at least 15 years who had no personal antecedents with diabetes. Data concerned clinical and biological parameters and the parental antecedents with diabetes. RESULTS: For subjects over > 30 years, fasting insulin and cholesterol levels were significantly higher in the group with a maternal history of diabetes than in the group with a paternal history. Significant differences were observed for serum triglyceride, BMI, and subscapular skinfold thickness when comparing subjects with a maternal history and those with no parental history of diabetes. Blood pressure and fasting glucose did not differ according to parental history. CONCLUSIONS: Subjects of maternal antecedents with diabetes have known risk factors for NIDDM. This study does not identify whether there is a genetic or maternal environmental reason for this association.

Adolescent↗

PubMed1991

Substance misuse among native and rural high school students in Quebec.

A questionnaire exploring the smoking habits, past and current use of alcoholic beverages, cannabis, and other illicit drugs was distributed among Francophone and Native high school students in a rural area of Quebec. The lifetime prevalence figures indicated that use of illicit drugs was significantly higher among Native students. This held true particularly for stimulants and inhalants (p less than .001). Figures for the 1-year prevalence indicated that use of stimulants in Native students remained still significantly higher (p less than .01). However, consumption of alcoholic beverages was more important in Francophone students (p less than .05). A gender difference was observed in Native students, females reporting an earlier involvement with most substances under study. This tendency decreased with age. The implications of this study for the prevention of alcohol and substance abuse among rural and Native youths are discussed.

Adolescent↗

PubMed2006

[The beginning of health education in Quebec: 1880-1901].

Bacteriological discoveries of the last third of the nineteenth century gave rise to radical shifts in understanding the causes and methods of controlling infectious diseases. In Quebec, between 1880-1900, two physicians and a women's organization led the health education movement. We describe firstly the origins of that movement within the context of public health conditions. Secondly we analyze the content of an educational popular periodical: Le Journal d'hygiène populaire, which the two physicians edited in succession. Lastly, we discuss the establishment and contributions of the Montreal Local Council of Women (MLCW).

Communicable Disease Control↗

PubMed2004

Campylobacteriosis, Eastern Townships, Quebec.

Independent risk factors for campylobacteriosis (eating raw, rare, or undercooked poultry; consuming raw milk or raw milk products; and eating chicken or turkey in a commercial establishment) account for <50% of cases in Quebec. Substantial regional and seasonal variations in campylobacteriosis were not correlated with campylobacter in chickens and suggested environmental sources of infection, such as drinking water.

Adolescent↗

PubMed2005

Anxiety about food supply in cree women with infants in Quebec.

OBJECTIVES: The objectives were to document the prevalence of maternal anxiety about food supply in Cree women who had 9-month-old infants, and to understand maternal and infant characteristics associated with anxiety. STUDY DESIGN: The design was descriptive and combined both cross-sectional and retrospective analyses. METHODS: The study took place in nine Cree communities in northern Quebec. Data on maternal characteristics in pregnancy (age, parity, anemia, smoking status) and infant characteristics (gestational age, birth weight, weight and hemoglobin concentration at 9 months old) were obtained from medical records. At 9 months postpartum, mothers were asked about infant feeding practices, the health of their infant, and the question, "Do you ever worry you don't have enough money to buy your children food to eat?" Affirmative responses were considered evidence for anxiety about food supply. Pricing data was collected for commercial baby food, formula, milk and water in the communities and, for comparison, in the large urban city of Montreal. RESULTS: 245 woman-infant pairs participated. One-fifth (20.8%) of mothers were anxious about food supply. The prevalences of anxiety in women who had anemia, or smoked, during pregnancy, or who bottle-fed their 9-month-old infants, were 44.4%, 27.5% and 24.0%, respectively. The corresponding prevalences of anxiety in women who did not have anemia, who did not smoke, or who breastfed without bottle-feeding at 9-months postpartum, were 19.0%, 13.6% and 6.7%. The adjusted ORs for anxiety were 3.10 (95% CI, 1.11-8.65), 2.12 (95% CI, 1.05-4.29) and 3.87 (95% CI, 1.12-13.36) for anemia, smoking and bottle-feeding, respectively. Prevalences of anemia and infection were comparable between infants of mothers who did and did not express anxiety. However, infants whose mothers had anemia during pregnancy had higher prevalences of anemia (44.0% vs. 24.6%, p = 0.04) and infection (77.8% vs. 50.2%, p = 0.03) at 9 months old. CONCLUSION: Women who had anxiety about food supply for their children had characteristics that distinguished them from women who did not have anxiety. Anxiety was associated with anemia and smoking during pregnancy, and with bottle-feeding at 9 months postpartum.

Anxiety↗

PubMed2004

[Public health nurses in Quebec: an essential contribution that remains to be known].

Public health nurses in Quebec are essential although little is known about their role. Generally trained at the undergraduate level, with additional qualifications in community health, they essentially work in CLSCs in maternal and child health programs, youth clinics or occupational health. In regional public health departments, they also work in the field of infectious disease prevention or other programs. Like their colleagues, they are confronted to the profession's challenges, the most notable being current and future shortage of nurses. However, they can now count on a new. As nurses further develop their practice and orient it even more towards primary prevention and health promotion, they will significantly contribute to the National Public Health Program and to the improvement of population health and wellbeing.

Health Promotion↗

PubMed1984

Serologic studies on brucellosis, leptospirosis and tularemia in moose (Alces alces) in Quebec.

Blood samples were obtained from 208 moose in La Vérendrye and Matane Reserves and in Laurentides Park, Quebec, Canada. Sera were tested for antibodies to Brucella abortus, Leptospira interrogans serovar ballum, canicola, grippotyphosa, hardjo, icterohaemorrhagiae and pomona, and Francisella tularensis. Fifteen sera contained evidence of prior exposure to F. tularensis. Only one animal was a seroreactor to L. interrogans serovar grippotyphosa and none of them had antibodies to B. abortus.

Animals↗

PubMed1987

Echinococcus granulosus (Cestoda: Taeniidae) infections in moose (Alces alces) from southwestern Quebec.

Investigation of the distribution of larval Echinococcus granulosus in a moose population from southwestern Quebec revealed a distinct and stable pattern of infection with a prevalence of 44% (n = 580). Positive correlations between moose age and the intensity, mean cyst weight and biomass of the hydatid cysts suggested a process of continued parasite acquisition and cyst growth. The distribution of cyst sizes within individual moose provided circumstantial evidence of interaction between cysts, perhaps mediated through the host's immunological response.

Animals↗

PubMed1989

Serological evidence of bovine herpesvirus 1-related virus infection in the white-tailed deer population on Anticosti Island, Quebec.

High white-tailed deer (Odocoileus virginianus) population densities and the occurrence of harsh environmental conditions are present on Anticosti Island, located in the Gulf of Saint-Lawrence (Quebec, Canada). This island is the northernmost region of white-tailed deer distribution in northeastern North America. The aim of this work was to determine whether a herpesvirus serologically related to bovine herpesvirus 1 (BHV1) may occur in a stressed white-tailed deer population. One hundred one deer sera were collected from apparently healthy animals during the hunting season from September to late November 1985. Fifty-three percent of tested deer were positive to the seroneutralization test using Colorado strain of BHV1 virus. Higher percentages of seropositivity were observed in animals of both sexes greater than 4-yr-old. Analysis of antibody titers in seropositive animals according to age suggests that BHV1-related viral infection is endemic in the Anticosti Island deer population. It is postulated that environmental stress may induce immunosuppression of certain infected and/or carrier animals in their population that shed virus for long periods of time.

Age Factors↗

PubMed2001

Mycoplasmosis in evening and pine grosbeaks with conjunctivitis in Quebec.

An outbreak of conjunctivitis affected evening grosbeaks (Coccothraustes vespertinus) and pine grosbeaks (Pinicola enucleator) in Quebec (Canada) during the winter 1998-99. One to 30% of the individuals from these two species were sick at 13 feeding stations. Sick birds were thin and had unilateral or bilateral catarrhal and lymphoplasmacytic conjunctivitis and rhinitis, and mucopurulent infra-orbital sinusitis. Mycoplasmal organisms were isolated in cultures in an affected evening grosbeak and identified as Mycoplasma gallisepticum by direct immunofluorescence. Random amplified polymorphic DNA (RAPD) fingerprinting of this isolate resulted in a banding pattern that was identical to patterns of M. gallisepticum isolates made from similar lesions in house finches (Carpodacus mexicanus) and American gold finches (Carduelis tristis) throughout eastern North America. Mycoplasma gallisepticum was identified by polymerase chain reaction in another evening grosbeak and a pine grosbeak. These observations suggest that the same strain of M. gallisepticum is the likely etiology for the observed disease in evening and pine grosbeaks in Canada and represent an extension of the host-species range for the ongoing epidemic of M. gallisepticum conjunctivitis in eastern North America.

Animals↗

PubMed1991

Stakeholders as partners: the challenges of partnership in Quebec mental health policy.

The notion of partnership has swept our society's image makers' imagination and invaded our policy designers' conception of the desirable, the rational, and the marketable. This is particularly true in the field of mental health which is now earnestly investing in its operationalization. This paper presents the case of Quebec, a province which has legislated partnership within its recent mental health policy. The author examines the many responses this concept has provoked among the key stakeholders involved. Such an analysis provides us with a unique and direct insight into the many challenges government-legislated partnership is to meet in the human services, if it is ever to be viable.

Attitude of Health Personnel↗

PubMed1999

Trends in hospital stay for five congenital malformations in the province of Quebec (1983-1995).

OBJECTIVE: The aim of this study was to examine the evolution of hospital stays and utilization of outpatient facilities for the treatment of five congenital malformations (choanal atresia, isolated cleft lip, isolated cleft palate, branchial cyst-sinus and thyroglossal duct cyst-sinus). METHOD: A retrospective review of MED-ECHO data for the province of Quebec from 1983 to 1995 was conducted. RESULTS: For three of the five studied malformations (cleft palate, branchial cyst-sinus, and thyroglossal duct cyst-sinus), there has been a trend toward reduced hospital stay and increased utilization of out-patient facilities. CONCLUSION: There has been a general tendency to reduce hospital stays even in procedures with potential airway and bleeding complications.

Branchioma↗

PubMed1999

Consensus on ambulatory care among Quebec otolaryngologists.

OBJECTIVES: The aims of this study were to obtain consensus on the suitability (or nonsuitability) of outpatient facilities for 15 ENT surgical procedures, to identify the factors involved in the decision making, and to use the Delphi method to evaluate it for this purpose. METHOD: A prospective study of 26 practising otolaryngologists in the Province of Quebec, using the Delphi method (3 rounds), was conducted. Fifteen adult and nine paediatric surgical procedures were included. RESULTS: Consensus (85% agreement) was obtained for eight procedures: septoplasty, rhinoplasty, endoscopic sinus surgery, otoplasty, mastotympanoplasty, lymph node biopsy, and branchial cyst excision (outpatient procedures) and tracheostomy (inpatient procedure). CONCLUSION: The Delphi method has been useful in initiating a process of rationalization about outpatient surgery.

Adult↗

PubMedDate not supplied

Increased nursing-time requirements due to pressure sores in long-term-care residents in Quebec.

OBJECTIVE: To test the hypothesis that pressure sores significantly influence the nursing workload, after taking confounding factors into account, i.e., patients' characteristics simultaneously associated with the occurrence of pressure sores and the nursing-time requirements. DESIGN: Retrospective analysis of administrative data for a cohort of long-term-care residents (Planification Informatisée des Soins Infirmiers Requis database). Two methods were used to control for confounding factors: analysis of covariance and sample restriction. SETTING: Long-term-care institutions of Quebec, except exclusively psychiatric and private centers. PATIENTS: Data was available for the 13,555 residents aged 65 or more whose health status changed during the year 1993-1994. RESULTS: Prevalence of sores was 4.0% (544/13,555). Before any adjustments were made, residents with pressure sores needed, on average, 63 minutes more than the residents without pressure sores. Two confounding factors were identified: dependence in the activities of daily living and physical mobility. Analysis of covariance showed that the adjusted increase in daily nursing care was 19 minutes. In the second analysis, a restricted homogeneous sample for the confounding factors was used (5,849 patients, including 414 patients with pressure sores). According to this method, the adjusted increase in daily nursing care was 17 minutes. In both analyses, the increase was noticeable in the spheres of alimentation, mobilization, and treatments. CONCLUSIONS: The presence of pressure sores significantly influences the nursing workload, even after eliminating the influence of confounding factors. Because nursing time can be translated into cost, effective prevention strategies and strategies of reducing the costs of treating sores should be analyzed.

Aged↗

PubMed1988

Mental health promotion in the local community service centres in Quebec.

The definition of the concepts of mental health and mental health promotion have been much discussed in Quebec for a number of years. The authors of this article present their point of view on the role the Local Community Service Centres (LCSCs) could play in implementing a mental health action plan. On the basis of a definition of the concepts of mental health and mental health promotion and an outline of the goals and objectives of mental health promotion, the authors discuss certain areas of intervention for the various sectors of practice in the LCSCs. Their article closes with some cautions about the limitations of health promotion in the LCSCs.

Community Mental Health Centers↗

PubMed1999

Reference values of plasma apolipoproteins A-I and B, and association with nonlipid risk factors in the populations of two Canadian provinces: Quebec and Saskatchewan. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To determine the population distribution of apolipoproteins A-I and B, and the relationship of apolipoprotein B to lipid risk factors for coronary artery disease. DESIGN: A stratified random sample of men and women aged 18 to 74 years selected from the provinces of Saskatchewan and Quebec in 1989 and 1990. OUTCOME MEASURES: Plasma concentrations of apolipoproteins A-I and B, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol and nonhigh density lipoprotein cholesterol for subjects who provided a fasting blood sample. MAIN RESULTS: Apolipoprotein B mean values increased with age from 0.80 g/L at age 18 to 24 years to a maximum of 1.16 g/L in the 45 to 54 year age group for men. For women, the values increased more gradually from 0.81 g/L for ages 18 to 24 to 1.19 g/L at ages 65 to 74 years. The distribution of apolipoprotein A-I was unrelated to age. Means for men varied from 1.35 g/L to 1.42 g/L and for women from 1.50 g/L to 1.61 g/L. Apolipoprotein B was strongly correlated with nonhigh density lipoprotein cholesterol (r2=0.89), and this was used to define apolipoprotein B concentrations less than 1.04 g/L as indicating low risk for coronary artery disease, from 1.04 g/L to less than 1.22 g/L as moderate risk, from 1.22 g/L to less than 1.40 g/L as high risk, and 1.40 g/L or greater as very high risk. The prevalence of high risk plasma apolipoprotein B levels was higher in men and women with triglycerides greater than 2.3 mmol/L. Apolipoprotein A-I was strongly correlated with high density lipoprotein cholesterol (r2=0.67), and this was use to identify apolipoprotein A-I concentrations of less than 1.20 g/L as a risk factor and 1.65 g/L or greater as an antirisk factor for coronary artery disease. The prevalence of apolipoprotein A-I of less than 1. 20 g/L was 19% in men and 6% in women, whereas the prevalence of apolipoprotein AI 1.65 g/L or greater was 9% in men and 28% in women. CONCLUSION: Reference values for plasma apolipoproteins A-I and B in a Canadian population random sample are given. Plasma apolipoprotein B and apolipoprotein A-I provide information that is complementary to that provided by low density lipoprotein and high density lipoprotein cholesterol levels.

Adolescent↗