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PubMed2001

IT sophistication in hospitals : a field study in Quebec.

The Quebec health sector has been experiencing a period of great turmoil over the last five years and hospitals are faced with huge pressures from government funding cuts. Several empirical studies in the information systems field have shown that the use of computer-based information systems could have positive impacts on organizational performance. Many agree to say that health care institutions are no exceptions. But if one wishes to identify the effects of IT on the delivery of care, one must be able to characterize IT for operationalization purposes. Our main objective consists in developing and validating a measurement instrument of IT sophistication in hospitals. Such instrument should provide hospital managers with a diagnostic tool capable of indicating the profile of their respective institutions in regard to IT use and comparing this profile to those of other similar health institutions.

Evaluation Studies as Topic↗
PubMed2001

Quebecers with celiac disease: analysis of dietary problems.

The only known treatment for celiac disease is lifelong avoidance of dietary gluten. For many sufferers from celiac disease, this may be difficult to achieve. The purpose of this study was to analyse dietary habits and related problems of adults afflicted with celiac disease. A questionnaire was mailed to 617 current and former members of the Quebec Celiac Foundation to document health, dietary habits, sources of celiac disease treatment information, daily concerns, and level of difficulty in complying with a gluten-free diet. The final sample size was 234 (75% female). Results indicated that over 35% of participants experienced intestinal discomfort at least twice a week. In addition, 66% felt that their consumption of grain products was insufficient. Only 44% said they had received from dietitians a large quantity of information about celiac disease treatment, and only 57% had a high level of confidence in the information received from dietitians. Thirty-six percent reported difficulty in complying with the gluten-free diet. According to a probit analysis, larger region of residence (p<0.02) and concern about preparing meals (p<0.005) were directly related to difficulty in complying, while older age (p<0.05), satisfaction with gluten-free products (p<0.01), and a high level of confidence in treatment information from gastroenterologists and dietitians (p<0.005) were inversely associated with compliance difficulty. Awareness of these results should encourage dietitians to improve their skills in treating celiac disease.

Adolescent↗
PubMed2001

Longitudinal observations (1987-1997) on the prevalence of middle ear disease and associated risk factors among Inuit children of Inukjuak, Nunavik, Quebec, Canada.

The prevalence of middle ear disease in 2-6 year old children in 1997 was compared with that observed in 1987 in the same Inuit community in northern Quebec. Risk and protective factors associated with middle ear disease were also assessed. A total of 122 children participated. The assessments included: otological examination, cerumen sampling for analysis of organochlorine compounds, medical file review, and parent questionnaire regarding environmental and lifestyle factors. Comparison of ear examination results in 1997 and 1987 showed that there had been no change in the prevalence of chronic otitis media [9.4% to 10.8%] and proportion of ear drums with minimal scarring [45.6% to 45.4%], an increase in the proportion of normal ear drums [23.9% to 39.0%], a decrease the proportion with maximal scarring [17.8% to 2.0%] and little difference in the rate of serous otitis media [3.3% to 2.8%]. Factors found to be significantly associated with middle ear disease included: number of persons/bedroom, number of siblings with a history of ear disease, age at first, second and third visit to the nursing station for ear problems, and type of milk (formula vs. non-formula) in bottle fed children.

Anti-Bacterial Agents↗
PubMedDate not supplied

Pulmonary function profiles in Quebec asbestos workers.

Lung function profiles were defined in over 1,000 Quebec chrysotile asbestos workers using five standard tests of lung function, and were related to dust exposure and smoking. Close to half the men (44.3%) had a normal lung function profile and a further 26.5% some function changes but no definite profile. Amongst the remainder restrictive and obstructive function profiles occurred with equal frequency (12.8 and 12.2% respectively). Both were associated with radiologic asbestosis; both occurred infrequently in the absence of the smoking habit. These findings suggest an association between the smoking habit and the harmful effects of asbestos exposure on lung function, and by implication on the development of lung fibrosis. A similar association has been recognized in respect of bronchogenic carcinoma. This experience, in the primary mining and milling of pure chrysotile asbestos, may not be directly applicable to secondary industries concerned with the further processing of this fibre.

Adolescent↗
PubMed1975

Radiological changes over 20 years in relation to chrysotile exposure in Quebec.

Radiological changes in 267 male Quebec chrysotile mine and mill workers, each with five chest films spanning an average of 20 years, were related to age, smoking habit, mining area, duration of employment and average dust concentration before and between films. (1) Abnormality in the earliest film was related mainly to the time since first employment. (2) In 45 (30%) of the 150 men completely normal at earliest film, some radiological abnormality developed during the period of observation: incidence was weakly related to age; in Asbestos, the risk of developing small opacities was lower in smokers than in non-smokers. (3) There was an irregular pattern of correlation, more evident in Thetford Mines than in Asbestos, between radiological progression and various stimulus variables. That associations between radiological responses and measures of asbestos exposure were, as always, weak, despite powerful methodology, indicates that effects are obscured by other factors (including susceptibility) uncorrelated with exposure.

Adult↗
PubMed1992

[Genealogical study of oculopharyngeal dystrophy at Saguenay-Lac-St-Jean, Quebec, Canada].

The genealogies of 28 proband affected with oculopharyngeal dystrophy (OPD) distributed in 28 families from Saguenay-Lac-St-Jean, a geographically isolated region of northeastern Quebec, were reconstructed. The analysis of these genealogies showed that the Montmagny and L'Islet counties are the most likely center of diffusion of OPD among the French Canadians, as suggested by Barbeau in 1966. A unique founder couple, J.E.-M.B., common to all 28 genealogies was found. The children of this couple emigrated in the 17th century from Poitou (France), a region where several families with OPD were recently ascertained.

Blepharoptosis↗
PubMedDate not supplied

Deprivation and stroke mortality in Quebec.

Cerebrovascular accidents (CVAs) constitute an important cause of disability and death in Quebec. Among the primary CVA risk factors, certain socioeconomic characteristics of individuals and living environments appear to play a central role. The purpose of this article is to examine the links between material/social forms of deprivation and CVA mortality in a group of 4,339 individuals aged 25 to 74 years who died between 1994 and 1998. The socioeconomic profile of these persons was estimated on the basis of the enumeration area in which they resided. The Poisson regression technique was used to estimate the relative risk (RR) of mortality by deprivation level. Our results show the presence of a mortality gradient for both material and social forms of deprivation, where the relative risks of mortality of the most disadvantaged group and the most advantaged group are, respectively, 1.34 and 1.35. Despite the existence of a system of universal health care, inequalities in mortality persist and need to be taken into account when implementing intervention programs.

Adult↗
PubMed1992

Population genetics of hereditary hemochromatosis in Saguenay Lac-Saint-Jean (Quebec, Canada).

Hereditary hemochromatosis (HH) is an autosomal recessive disorder that has a high prevalence in Caucasian populations. Based on HLA typing in 18 families, the gene frequency was estimated 0.12. The homozygote frequency was 0.014 and the heterozygote frequency was 0.21 in Saguenay Lac-Saint-Jean (SLSJ), a geographically isolated region of northeastern Quebec. The genealogical reconstruction showed that 15 of the 57 obligate carriers of the HH gene could be traced back to a unique ancestor in the 18th century. The mean coefficients of inbreeding and kinship were 17 and 15 times, respectively, higher in the HH group than in three control groups. The values of both coefficients were much higher than those found in other HH populations and in most of the other recessive disorders prevalent in SLSJ.

Consanguinity↗
PubMed2002

[Mediation and adjustment of the rupture of the union: the impact of Quebec law on family mediation].

In September 1997, a new family mediation law came into force in Quebec. This law allows couples with children to be provided with the services of a professional mediator while their application for separation, divorce, child custody, spousal or child support is being negotiated and settled or an existing decision is being reviewed. This article presents and discusses the results of a study that compares the practices and results of family mediation under this law with the previous situation. According to the data, the law provides greater access to mediation for low-income couples.

Adult↗
PubMedDate not supplied

[Governmental measures in Quebec to promote medical practice in remote or isolated areas].

In the Province of Quebec a list of areas designated "remote" and "isolated" is published by the government. The list is revised yearly. The physicians who set up their office in these areas are entitled to receive financial and non financial supports from the government. The list of these supports has expanded broadly during the last 2 decades. Moreover, the government has designed a number of measures aimed at young medical students to attract them to these areas after they are graduated. Certain internal reports in the Ministry of Health and some publications have tried to assess the effects of all these governmental efforts. But an exhaustive appraisal is not yet available.

Community Health Services↗
PubMedDate not supplied

[Policies regarding non-resuscitation and cessation of treatment in Quebec hospitals].

This paper presents the results of a survey addressed between 1987 and 1989 to the directors of professional services of all Quebec hospitals. The objective was to record and analyse withholding and withdrawal of treatment policies, and in particular DNR orders. The paper summarizes the analysis of the principles and ethical values involved in existing policies. It therefore considers descriptive ethics rather than normative ethics, and does not discuss ethical issues in themselves.

Canada↗
PubMed1992

REMEDHOS: the development of a medical and hospital liability database in Quebec.

Confronted in 1985 with the sudden rise of costs for liability protection, the health care sector in Canada took note of the fact that little or no reliable data were available and easily accessible to assess the actual scope and nature of the phenomenon of increasing medical liability suits in Canada. In order to correct this situation, a computerized database was created covering malpractice suits launched against Quebec health care professionals and establishments. This article presents the methodology that was used for the creation of the database; it describes the material that was used, the technical instruments that were developed and the software utilized. It also describes the structure and content of the database and presents its practical application with respect to the areas of risk management, health care evaluation, professional controls and tort reform.

Databases, Factual↗
PubMed2004

Caprine herpesvirus- 1 abortion storm in a goat herd in Quebec.

Numerous abortions were reported on a Quebec goat farm, and caprine herpesvirus-1 (CapHV-1) was confirmed by PCR in several tissues from 3 aborted fetuses. This is the first report of CapHV-1 in Canada. Practitioners and diagnosticians must consider this disease when making a differential diagnosis for caprine abortion.

Abortion, Veterinary↗
PubMed2004

Lack of evidence of Brucella ovis infection in rams in Quebec.

A study was conducted to estimate the seroprevalence of Brucella ovis infection in rams in the Estrie and Bas-Saint-Laurent regions (Quebec). Rams sera (n = 258) were serologically evaluated from 224 rams in 30 commercial flocks and from 34 rams at 2 slaughterhouses by using an enzyme linked immunosorbent assay. Epididymides and testes were examined by palpation on farms and microscopically for culled rams. No ram was seropositive to Brucella ovis or had lesions suggestive of brucellosis from the farm or slaughterhouse surveys.

Abattoirs↗
PubMedDate not supplied

[Utilization of preventive dental services by recent immigrants in Quebec].

OBJECTIVES: Studies conducted in Canada show that recent immigrants tend to under-utilize preventive services provided by the health care system. The objective of our study was to learn whether this phenomenon also applies to dental care. METHODS: Our sample was composed of 5,795 women who live in Quebec and are between 30 and 44 years old. These women filled out a self-administered questionnaire regarding their immigration status and their habits concerning dental visits. In our analyses, we compared the use of dental services of recent immigrants (10 years or less in Canada), long-term immigrants (more than 10 years), and non-immigrants (Canadians of origin). RESULTS: 55% of recent immigrants are preventive service users compared to 69% of long-term immigrants and 76% of non-immigrants. The financial barrier partly explains this result: immigrants often have a modest income and rarely benefit from dental coverage. However, having private dental insurance does not in itself explain the gap between these groups. This suggests that there is a cultural barrier in dental services access. CONCLUSIONS: Under-use of preventive services by immigrants is not limited to the medical field, it extends to dental services as well. In order to facilitate immigrants' adaptation to the health system, we recommend that the government provide them with free dental services that respect their culture.

Adult↗
PubMed2004

Dental care pathway of Quebecers after a broken filling.

OBJECTIVES: The objectives were to 1) describe the dental care pathway of adults after sustaining a broken filling, and particularly, the patient delay in seeking care as well as the continuity of care, and 2) identify factors associated with the decisions taken. BASIC RESEARCH DESIGN: In 1998-99, 5,469 Quebec women aged 30 to 44 years completed a self-administered questionnaire in which they indicated whether they had experienced a dental problem in the previous 12 months. From then on, the questions identified the decisions they made during the process of consulting a dentist. RESULTS: 32.4% of the respondents had experienced a dental problem within the last 12 months. Among them, 38.0% reported a broken filling. 65.1% of those who identified a broken filling decided immediately to consult a dentist and 34.9% chose to wait and see. Patient delay was over one month in 44.0% of the cases. When asked by the dentist to come back in order to complete the treatment. 90.6% agreed, 3.2% decided to consult another dentist, and 6.21% chose not to consult. Logistic regression analyses show that patient delay was associated with low income, low degree of inconvenience (symptoms), low degree of perceived seriousness, and absence of a family dentist. CONCLUSIONS: This study reveals important social disparities: after sustaining a broken filling, which remains an important problem in industrialised societies, patient delay, interruption of the dental care episode and extraction are more frequent in low-income groups. It also reveals that a wait-and-see attitude is more frequent than an interruption of the dental care episode after the first visit.

Adult↗
PubMed1992

Incidence of cystic fibrosis in Saguenay-Lac-St.-Jean (Quebec, Canada).

The incidence of cystic fibrosis (CF) in Saguenay-Lac-St.-Jean, a geographically isolated region of Quebec, was estimated to be 1 in 902 during the period 1975-1988. The carrier rate was calculated to be 1 in 15 inhabitants. The high incidence of CF in Saguenay-Lac-St.-Jean is probably the result of a founder effect and genetic drift for one or more mutations. Historical, demographic, and social factors also may have contributed to the high incidence.

Carrier State↗
PubMedDate not supplied

[Is it possible to sustain health promotion programs in private companies? The case of four Quebec private companies of blue collar workers].

OBJECTIVE: Sustained health promotion programmes in the workplace (HPPW) continues to be a public health challenge. This article presents an evaluation of the implementation and sustainability of such programmes in private blue-collar companies in Quebec to shed light on issues specific to this type of setting. METHOD: A multiple case (4 sites), longitudinal (7 years) and interpretive study method was used. The interpretation framework considered that the implementation and sustainability of HPPW in companies are the result of organizational learning in health promotion, determined by the strategies of individuals in a position of control who shape the decisional processes related to these programmes. RESULTS: After seven years of observation, two of the four sites had continued their HPPW, although these programmes were no longer applied within these companies. The health promotion organizational learning processes in both sites were defined according to targeted organizational purposes set by the decision-makers who supported HPPW. However, these gains were largely lost when HPPW were no longer retained as a component of their organizational development strategy. DISCUSSION: The organizational conditions that are conducive to HPPW are difficult to put together and sustain in companies like those in our study. Businesses implement these programmes mainly for the organizational benefits they expect to reap in the short term, whereas improvement in the health of workers in the longer term is not a priority.

Feasibility Studies↗