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PubMed1997

[Drugs and criminal issues: assessment of research in Quebec].

Although research on the link between drugs and crime is not a major concern for many Quebec researchers, the last five years have been the scene of an increasing number of studies on the subject. These studies can be divided in four groups: 1) criminal policies; 2) studies on prevalence; 3) relation between drugs and crime; 4) intervention and its impact. Results of these studies put additional pressure for adequate treatment of addicts having problems with the law. Social workers in rehabilitation centres have thus noticed an increasing number of addicts who had or were going through problems with the law. Yet a great proportion of addicts having problems with the justice system are not reached by rehabilitation services: it is those people who present the most deteriorated bio-social profile. Is it really worthwhile to intervene with this type of clientele? The answer is yes as long they can be kept in treatment sufficiently long. In any case, the simple judiciarization of a person says nothing of his character (e.g. violent, liar or fraudulent) or of his pathology (e.g. psychopath, sociopath ...). In fact, given the illicit nature of certain drugs, the simple fact of using can lead to criminalization. The challenge in research in this field will consist in better defining factors related to perseverance in treatment and therapeutic ingredients associated to the desired impact.

Crime↗

PubMed1998

The delay to thrombolysis: an analysis of hospital and patient characteristics. Quebec Acute Coronary Care Working Group.

OBJECTIVE: To describe the various components of the delay to thrombolytic treatment for patients with acute myocardial infarction (MI) and to identify the hospital and patient characteristics related to these delays. DESIGN: Cohort analysis from a hospital registry of patients receiving thrombolytic treatment. SETTING: Forty acute care hospitals in Quebec. SUBJECTS: All 1357 patients who received thrombolysis between January 1995 and May 1996. MAIN OUTCOME MEASURES: Time from onset of symptoms to arrival at hospital and the various components of the in-hospital delay. RESULTS: The median delay before presentation to hospital was 98 (interquartile range [IR] 56 to 180) minutes and was longer for women (p < 0.001), patients over 65 years of age (p < 0.001) and patients with diabetes mellitus (p < 0.01). The median time from arrival at hospital to thrombolysis was 59 (IR 41 to 89) minutes, the medical decision-making component taking a median of 12 (IR 4 to 27) minutes. Women (p < 0.005), older patients (p < 0.001) and patients with a past history of MI (p < 0.001) had increased in-hospital delays to thrombolysis. Delays were longer in community hospitals (p < 0.05) and low-volume centres (p < 0.01) and when a cardiologist made the decision to administer thrombolysis (p < 0.001). Multivariate analysis showed that increased age (odds ratio 1.5, 95% confidence interval 1.3 to 1.7, p < 0.001) and having the medical decision made by a cardiologist (odds ratio 1.8, 95% confidence interval 1.6 to 2.0, p < 0.001) were independently associated with an increased risk of being in the upper median of in-hospital delays. CONCLUSIONS: Despite certain improvements, there remain substantial delays between symptom onset and the administration of thrombolysis for patients with acute MI. A large part of the delay is due to the hesitation of patients (particularly women, older patients and patients with diabetes) to seek medical attention. Although the median time for medical decision-making appears reasonable, care must be taken to ensure that all patient groups receive timely evaluation and therapy. The delay associated with having the treatment decision made by a cardiologist probably represents a marker for more difficult, complex cases. Methods should be developed to permit specialty consultation, if needed, while minimizing treatment delays. Community and low-volume hospitals may require special attention.

Aged↗

PubMed1998

Mercury levels in the Cree population of James Bay, Quebec, from 1988 to 1993/94.

BACKGROUND: High levels of mercury in the Cree population of James Bay, Que., have been a cause of concern for several years. This study examines changes in mercury levels within the Cree population between 1988 and 1993/94 and identifies potential determinants of high mercury levels. METHODS: Data on mercury levels among the Cree were obtained through a surveillance program undertaken by the Cree Board of Health and Social Services of James Bay. In 1988 and again in 1993/94 surveys were carried out in all 9 Cree communities of northern Quebec. Hair samples were obtained and analysed for mercury content. Analyses were carried out to determine the proportion of people who had mercury levels in excess of established norms. Changes in mercury levels between 1988 and 1993/94 and determinants of high levels were estimated by means of regression methods. RESULTS: The proportion of the Cree population with mercury levels in excess of 15.0 mg/kg declined from 14.2% in 1988 to 2.7% in 1993/94. Wide variations in mercury levels were observed between communities: 0.6% and 8.3% of the Eastmain and Whapmagoostui communities respectively had mercury levels of 15.0 mg/kg or greater in 1993/94. Logistic regression analyses showed that significantly higher levels of mercury were independently associated with male sex, increasing age and trapper status. There was a correlation between the mercury level of the head of the household and that of the spouse. INTERPRETATION: Mercury levels in the Cree of James Bay have decreased in the recent past. Nevertheless, this decrease in mercury levels may not be permanent and does not necessarily imply that the issue is definitively resolved.

Adolescent↗

PubMedDate not supplied

[Socioeconomic variables and the prevalence of dental caries in second and sixth grade Quebec children in 1989-90].

OBJECTIVES: 1) To determine caries risk factors in second and sixth grade Quebec children; 2)To test multivariate models which identify children as belonging to a high prevalence group. METHODS: For the 1989-90 Santé Dentaire Québec survey, 2,291 second grade and 2,111 sixth grade school children responded to a questionnaire on their personal habits of hygiene and diet and underwent a clinical examination, while their parents answered a questionnaire regarding their family's socio-economic status. RESULTS: Statistics demonstrate a stronger link between socioeconomic variables and caries prevalence than demographic and sanitary factors. Children emerging from a high socioeconomic milieu have better dental health than children with low socioeconomic standing. The most effective model, However, registers a sensitivity of 65% and a specificity of 66%, revealing the inadequacy of statistical models to accurately identify children in the caries high prevalence group.

Child↗

PubMed1998

[Efficacy and complications associated with vasectomies in two clinics in the Quebec region].

OBJECTIVE: To compare the efficacy of, and complications associated with, vasectomies performed in two medical clinics. DESIGN: Retrospective cohort study. SETTING: A private medical clinic and a family planning clinic at a teaching hospital in the Quebec City region, where one doctor performs all surgery. PARTICIPANTS: The 1223 men who underwent a first vasectomy between January 1994 and February 1996. INTERVENTIONS: Isolations of the vas deferens through the scrotum was performed using the no-scalpel technique in both clinics. At the private clinic (n = 775), vasectomy was performed by ligature with tantalum clips. At the family planning clinic (n = 448), a combination of cauterisation of the abdominal end of the vas deferens, leaving the testicular end open, and fascial interposition with a clip was used. MAIN OUTCOME MEASURES: Rate of postoperative complications (painful granuloma; noninfectious inflammation of the vas deferens, epididymis, and testes; hematoma; infection; undiagnosed pain) and rate of recanalization (early and late). RESULTS: At the private clinic, 39 patients (5.0%) consulted for postoperative complications, compared with 55 patients (12.3%) at the family planning clinic (chi (2)1 = 21.0; P < 0.001). Of the patients who underwent semen analysis, 15 (2.8%) at the private clinic and 4 (1.2%) at the family planning clinic experienced early or late recanalization (chi (2)1 = 2.2; P < .14). CONCLUSION: The rate of consultation for postoperative complications was lower at the private clinic than at the family planning clinic, but the efficacy of the procedure appeared to be higher at the family planning clinic. The surgical techniques used at the two clinics might partially explain these differences.

Adult↗

PubMed1999

One founder/one gene hypothesis in a new expanding population: Saguenay (Quebec, Canada).

High frequencies of some rare inherited recessive disorders can be found in the Saguenay region of Quebec, Canada. Four disorders have a carrier frequency of about 0.04 (in the range 0.035-0.05): pseudovitamin D-dependent rickets, hereditary tyrosinemia type 1, Charlevoix-Saguenay spastic ataxia, and sensorimotor polyneuropathy with or without agenesis of the corpus callosum. Molecular data suggest that only 1 mutation has been introduced into the population since its founding in the 17th century. The carrier frequencies are much higher than one would expect under a theoretical model that includes variance in family size and population growth (Thompson and Neel 1978). I present a methodology called allele dropping to test the hypothesis that only 1 founder introduced a given mutation. This study is based on 891 ascending genealogies and enables one to measure the extent of allele frequency changes resulting from the demographic history of the population. Two scenarios are tested: neutral and lethal alleles. Lethality has a minor effect because the alleles never reach a frequency high enough for selection to be strong. Twenty-five founders have a probability greater than 1% that a lethal mutation they introduced into the population will reach a carrier frequency between 0.035 and 0.05 in the contemporary population. Moreover, 2 founders have a probability greater than 20% that a lethal allele they introduced into the population will reach this target frequency. Therefore the simplest hypothesis that 1 founder introduced 1 disorder into the population is consistent.

Chi-Square Distribution↗

PubMed2005

Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada.

The price elasticity of demand for prescription drugs is a crucial parameter of interest in designing pharmaceutical benefit plans. Estimating the elasticity using micro-data, however, is challenging because insurance coverage that includes deductibles, co-insurance provisions and maximum expenditure limits create a non-linear price schedule, making price endogenous (a function of drug consumption). In this paper we exploit an exogenous change in cost-sharing within the Quebec (Canada) public Pharmacare program to estimate the price elasticity of expenditure for drugs using IV methods. This approach corrects for the endogeneity of price and incorporates the concept of a 'rational' consumer who factors into consumption decisions the price they expect to face at the margin given their expected needs. The IV method is adapted from an approach developed in the public finance literature used to estimate income responses to changes in tax schedules. The instrument is based on the price an individual would face under the new cost-sharing policy if their consumption remained at the pre-policy level. Our preferred specification leads to expenditure elasticities that are in the low range of previous estimates (between -0.12 and -0.16). Naïve OLS estimates are between 1 and 4 times these magnitudes.

Aged↗

PubMed1993

Characterization of monoclonal antibodies to bovine enteric coronavirus and antigenic variability among Quebec isolates.

Twenty monoclonal antibodies (MAbs) were prepared against the Mebus strain of bovine enteric coronavirus, 14 of them reacting with the peplomeric S (gp 100) glycoprotein. Competition binding assays allowed the definition of at least 4 distinct antigenic domains for the S glycoprotein, designated as A, B, C, and D; epitopes associated to neutralizing activity being located in sites A, B, and C. One MAb directed to the hemagglutinin HE (gp 140/gp 65) glycoprotein inhibited the hemagglutinating activity of the virus, but had no neutralizing activity. Comparison of Quebec enteropathogenic BCV isolates using polyclonal antiserum and MAbs directed to the S glycoprotein confirmed their close antigenic relationship, but also revealed the occurrence of at least three distinct antigenic subgroups. Antigenic domain D was highly conserved among BCV isolates, as well as non-neutralizing epitopes assigned to antigenic domains A and C. The Minnesota strain of turkey enteric coronavirus could be distinguished from BCV isolates by MAbs directed to epitopes of antigenic domain C, whereas human coronavirus HCV-OC 43 could be distinguished by MAbs directed to epitopes of antigenic domain A. The porcine hemagglutinating encephalomyelitis virus could be distinguished from the other hemagglutinating coronaviruses by neutralizing epitopes located on antigenic domains A, B, and C.

Animals↗

PubMed1986

Seasonal variations in egg passage of Fasciola hepatica in dairy cows in Quebec.

Seasonal changes in Fasciola hepatica egg passage were documented in 17 dairy herds in Portneuf County, Quebec (Canada). Egg passage was low or absent in spring and summer but rose in autumn to reach a peak in winter, then subsequently returned to low levels. This study suggests that there are two periods of transmission to the bovine host during the grazing season: a minor period in the spring, due to overwintered snails, and a major period in August and September due to snails that acquired the infection in May or June.

Animals↗

PubMed1990

Monoclonal antibodies to Quebec strain (Q17) of bovine rotavirus.

Fourteen monoclonal antibodies (MAbs) against "Quebec" strain (Q17) of bovine rotavirus were isolated and characterized. Four were specific for viral protein Vp7 and ten were specific for viral protein Vp6. Five different isotypes were represented by this group of antibodies. All of the anti-Vp6 and none of the anti-Vp7 antibodies were sensitive to the effects of periodate on their antigen. The antibodies could be separated into three groups based on their relative resistance to the dissociation of their antigen-antibody complex by thiocyanate. The MAbs cross-reacted with the proteins of porcine and human rotaviruses both by immunoprecipitation and immunoblot analyses. These techniques revealed the differences in Mw of the viral proteins from different serotypes.

Animals↗

PubMed1996

The Quebec Back Pain Disability Scale: conceptualization and development.

The Quebec Back Pain Disability Scale is a new measure of functional disability for patients with back pain. Functional disability was operationalized in terms of perceived difficulty associated with simple physical activities. The content of the scale was developed in several stages, including a literature review, two studies seeking the opinions of patients and experts, pilot testing, and a large, longitudinal study of back pain patients. Forty-eight disability items were extensively studied using standard methods such as test-retest reliability, item-total correlations, and factor analysis, as well as modern techniques based on item response theory. Items that were highly effective in discriminating between different levels of disability were selected for the final, reduced scale. The scale has 20 items, representing six empirically derived categories of activities affected by back pain. Measurement properties of this instrument have been previously discussed.

Activities of Daily Living↗

PubMed2001

Applying the Quebec Task Force criteria as a frame of reference for studies of whiplash injuries.

Research prior to 1995 showed a diversity of either inclusion or exclusion criteria (or both) for diagnosing whiplash injury. As a consequence, the Quebec Task Force (QTF) developed expert-based criteria, which may be considered as a the 'new' gold standard. Here, we examined the inclusion criteria and exclusion criteria used in research populations from the major 82 research studies performed during the period 1980-1998, comparing their similarities and dissimilarities to the QTF standard. None of the articles satisfied the QTF definitions completely, either before or after their introduction in 1995. Nevertheless, the QTF still seems to have had some impact on either the published inclusion or exclusion criteria. We observed that both sets of criteria showed a qualitative shift following the QTF publication in 1995. For the inclusion criteria, we found both a statistically significant increase in use of the QTF definition (acceleration-deceleration mechanism, rear-end collision, motor vehicle collision or other mishaps) and in the criterion 'neck pain'. We also observed some smaller changes in both inclusion and exclusion criteria but none of these was significant statistically.

Cervical Vertebrae↗

PubMed1998

The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: the implementation of a standard assessment protocol.

OBJECTIVE: There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples. METHOD: A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers. RESULTS: The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support. CONCLUSION: The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.

Canada↗

PubMed2004

White birch (Betula papyrifera Marshall) foliar litter decomposition in relation to trace metal atmospheric inputs at metal-contaminated and uncontaminated sites near Sudbury, Ontario and Rouyn-Noranda, Quebec, Canada.

Decomposition of white birch (Betula papyrifera Marshall) foliar litter was examined at metal-contaminated and uncontaminated sites established along gradients of soil Cu, Ni, Pb and Zn concentrations near Sudbury, Ontario and Rouyn-Noranda, Quebec. Over an 18-month study period, a significantly lower rate of litter mass loss was observed at the Sudbury contaminated site (S1) than at the uncontaminated site (S2). This result was not duplicated at corresponding sites (RN1, RN2) in Rouyn-Noranda, despite similar levels of soil metal contaminants and atmospheric inputs. Concentrations of metals in litter increased at all sites with time. However, the greatest litter Cu and Ni concentrations were observed at S1 (188 and 192 microg/g, respectively), a result of substantial net gains of these elements from atmospheric inputs. On a per hectare basis, Cu accumulation in litter at S1 approached recommended application rates of Cu as copper sulphate for control of fungal diseases in agricultural operations, indicating that the current rate of Cu smelter emissions in Sudbury may cause the observed impairment of decomposition.

Air Pollutants↗

PubMed1988

Parental age and birth order in Alzheimer's disease: a case-control study in the Saguenay-Lac-St-Jean area (Quebec, Canada).

Parental age at the time of birth of 133 clinically diagnosed Alzheimer patients from the Saguenay-Lac-St-Jean area (Quebec, Canada) were compared with those of 6 control groups formed out a population registry. The birth order of the Alzheimer patients was also analyzed. The results did not show any parental age or birth order effect, which is in agreement with previous reports. The importance of control selection in such studies is stressed.

Adult↗

PubMed1984

The neuropathology of "typical" Friedreich's ataxia in Quebec.

We present the pathological data from the autopsies performed on 6 Friedreich's disease patients since the start of the Quebec Cooperative Study. All patients met the strict diagnostic criteria of the QCSFA. The anatomical lesions found in the peripheral and central nervous system were similar in all 6 cases and do not differ from those described in the literature. The clinical findings correlate closely with the histological lesions found in the peripheral nervous system and spinal cord. The evidence of segmental demyelination and remyelination in the spinal ganglia and posterior roots further supports the dying-back axonopathy hypothesis.

Adolescent↗

PubMed1984

The Quebec Cooperative Study of Friedreich's Ataxia: 1974-1984--10 years of research.

In this paper the author reviews the progress accomplished in the understanding of Friedreich's disease since the start of the "Quebec Cooperative Study of Friedreich's Ataxia" in 1974. The last ten years have indeed seen important strides taken in the definition and nosography of the hereditary ataxias and the characterization of a number of new entities. Biochemically, the principal leads uncovered during the initial prospective survey, have been pursued to great detail. Unfortunately no clear-cut constant and severe enzyme block in the principal metabolic pathways has yet been identified, despite intensive studies. It is postulated that the defect may instead be a regulatory one and involve a decreased availability or utilization of one of the vitamin cofactors that are known experimentally, or clinically, to produce central nervous system damage with ataxia: Vitamin E, Biotin or Pantothenic Acid. Studies in that direction and in molecular genetics to localize the Friedreich's disease gene are being undertaken for the next phase of the Cooperative Study.

Amino Acids↗

PubMed1996

Epidemiological study of reptured intracranial aneurysms in the Saguenay-Lac-Saint-Jean region (Quebec, Canada).

BACKGROUND: Using a population-based register of the Saguenay-Lac-Saint-Jean region (Quebec, Canada), the genealogical reconstruction of 533 individuals with intracranial aneurysm (IA) showed a familial aggregation (the presence of aneurysm in two or more first- to third-degree relatives) for 159 (29.8%) of them; this proportion is much higher than reported elsewhere. OBJECTIVE: As part of an ongoing project to assess a genetic predisposition to intracranial aneurysms in the Saguenay-Lac-Saint-Jean population, the objective of the present study was to determine whether age-specific rates of reputed cerebral aneurysms were higher than in other populations. DESIGN: A retrospective study of cases of proven ruptured IAs which were hospitalized during the 1973 to 1992 period was conducted. Age-adjusted rates were computed and compared to those reported in the Helsinki population. RESULTS: We identified 412 cases of ruptured aneurysms. The age-adjusted incidence rate was 7.2/100,000/year (6.2 for men, 8.1 for women), which is similar to the incidence rates reported in other studies. Although the mean age at time of rupture was younger (46.6 years +/- 13.8) than usually reported, no increase in age-specific incidence rates was detected. CONCLUSIONS: The results of this epidemiological study neither support nor reject the hypothesis of a genetic predisposition to intracranial aneurysms in the Saguenay-Lac-Saint-Jean population.

Adolescent↗