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J Légaré

Publications and source records attributed to J Légaré.

13 recordsLinked to original sources
PubMed2000

Living at home or in an institution: what makes the difference for seniors?

OBJECTIVES: This article examines some of the health and socio-demographic factors associated with living in long-term health care facilities rather than in private households, for elderly people with various levels of disability. DATA SOURCE: The data are from the 1996/97 National Population Health Survey conducted by Statistics Canada. Data from a sample of 1,711 people aged 65 or older living in long-term health care facilities and 13,363 in private households were weighted to represent about 185,100 and 3.4 million seniors, respectively. ANALYTICAL TECHNIQUES: Descriptive data were produced using bivariate frequencies. Multiple logistic regression models were used to examine associations between living in long-term health care facilities and selected health and socio-demographic characteristics for seniors with self-reported severe, moderate or no disability. MAIN RESULTS: While health status was strongly associated with residence in a long-term health care facility, the absence of a spouse, low income, low education, and advanced age were also significant.

Aged↗
PubMed1999

Practice guidelines for clinical prevention: do patients, physicians and experts share common ground?

BACKGROUND: Clinical practice guidelines, such as those of the Canadian Task Force on Preventive Health Care, although based on sound evidence, may conflict with the perceived needs and expectations of patients and physicians. This may jeopardize the implementation of such guidelines. This study was undertaken to explore patients' and family physicians' acceptance of the task force's recommendations and the values and criteria upon which the opinions of these 2 groups are based. METHODS: Focus groups were used to collect study data. In total, 35 physicians (in 7 groups) and 75 patient representatives (in 9 groups) participated in the focus groups. An inductive approach was used to develop coding grids and to generate themes from the transcripts of the interviews. RESULTS: Physicians expressed resistance to discontinuing the annual check-up, which they viewed as an organizational strategy to counteract the many barriers to preventive care that they encounter. They reported difficulties in explaining to their patients the recommendations of the Canadian Task Force on Preventive Health Care, which they found complex and inconsistent with popular wisdom. Both patients and physicians attributed high value to the detection of insidious diseases, even in the absence of proof of the effectiveness of such activity. INTERPRETATION: The patients and family physicians who participated in this study shared many opinions on the value of preventive activities that depart from the values used by "prevention experts" such as the Canadian Task Force on Preventive Health Care in establishing their recommendations. A better understanding of the values of patients and physicians would help guideline developers to create better targeted communication strategies to take these discrepancies into account.

Adult↗
PubMed1999

Human sex ratio at birth and mother's birth season: multivariate analysis.

We used a population-based historical French Canadian database to examine the effects of mother's birth season on sex ratio at birth. Non-first births in the database (n = 127,658) were analyzed for their sex, parish size (2 large parishes of Montreal and Quebec or the other smaller parishes), time period (births up to 1719 or those from 1720), maternal age (< or = 24, 25-29, 30-34, 35+ years), sex of the preceding sibling (male or female), and birth seasons of the child and his or her parents (February-April, May-July, August-October, November-January). Season of child's birth significantly affected the sex ratio (chi 2 = 11.507, d.f. = 3, p = 0.009), with the births in February-April or May-July showing a lower sex ratio. Season of mother's birth also contributed highly significantly to the variation of sex ratio (chi 2 = 15.196, d.f. = 3, p = 0.002); mothers born in February-April had a low sex ratio among their children (sex ratio = 1.013). In contrast, season of father's birth did not affect the sex ratio (chi 2 = 0.618, d.f. = 3, p = 0.892). When a multiple logistic model was applied to the data, mother's birth season was the single most significant factor. The lower sex ratio from mothers born in February-April was observed consistently for every maternal age and delivery season. Seasonal influences on female fetuses seem to have changed their future reproductive characteristics.

Canada↗
PubMed1998

Marriage season, promptness of successful pregnancy and first-born sex ratio in a historical natural fertility population--evidence for sex-dependent early pregnancy loss?

We investigated population-based vital records of the seventeenth and eighteenth century French Canadian population to assess the effects of marriage season on the outcome of the first births under natural fertility conditions (n = 21,698 marriages). Promptness of the first successful conception after marriage differed according to marriage season; the proportion of marriages with a marriage-first birth interval of 8.0-10.0 months was lowest (34%) for marriages in August-October (P = 0.001). Although the male/female sex ratio of the babies born with an interval of 8.0-10.0 months was generally higher (1.10) than those with an interval of 10.0-24.0 months (1.05), the marriages in August-October resulted in a significantly reduced sex ratio (0.96) among only the prompt conceptions (P = 0.026). We discuss whether this seasonal reduction of the sex ratio could be partly explained by a clustered pregnancy loss of male zygotes in early pregnancy.

Adult↗
PubMed1995

Slow twin conception at first birth and subsequent maternal twin proneness in a natural fertility population.

To study whether apparently more fecund women having delivered twins at first birth have traits of higher twin-proneness, we performed a retrospective cohort study on population-based historical vital records of the 17-18th century French Canadian immigrants and their descendants under natural fertility conditions. Among 24896 mothers who had at least one child, 248 had twin maternities at their first birth (twinning rate = 1.0%). Among 21508 mothers with a valid marriage-first birth interval, twinning rate was 0.97% among prompt conceptions (7.0-11.0 months), with a particularly high rate at the interval of 7.0-8.0 months (2.2%). Marriages in August-October resulted in a higher twinning rate particularly for the slow conceptions than those in the other seasons. Promptly-conceived mothers of twins at the first delivery may seem to have higher fecundity, but subsequent births from these mothers (n = 88) show a lower twinning rate (1.7%) particularly at younger maternal age than from the other mothers who had slowly conceived twins at their first birth (n = 112). The latter show a 4.5% twinning rate as a whole among their second or later births. So-called twin-proneness of a mother, whether genetic or acquired, was not connected to higher conception rate of twin's mothers immediately after marriage. Reduced fecundity, which may have been imposed by some environmental factors, could raise the chance of twinning.

Adult↗
PubMed1990

Effects of maternal birth season on birth seasonality in the Canadian population during the seventeenth and eighteenth centuries.

Birth records of the French-Canadian population for the period 1621-1765 were analyzed retrospectively to examine the effect of maternal birth season on the seasonal distribution of births. Preliminary examination indicated that there was a bimodal pattern in birth seasonality: a major peak in early spring, a trough in early summer, a minor peak in autumn, and a trough around December. Because this seasonality was strongly biased at the level of the first birth by the month of marriage, which was concentrated in November, the seasonality of nonfirst births (n = 32,926) was examined in relation to the four seasons of maternal birth. Mothers born in May-July showed a flatter monthly distribution of nonfirst births at a maternal age of 28 years or more. Analysis of marriage-first birth intervals indicated that mothers who married in August-October showed a lower percentage of immediate conception (intervals of 8-10 months), whereas those mothers born in May-July had a higher percentage of immediate conception. This difference in birth seasonality shown by mothers born in May-July is similar to results from early twentieth-century Japan. Some seasonal infertility factors could have affected the embryos at the earliest stage of pregnancy, modifying a part of the seasonal variation in birth rate.

Birth Intervals↗
PubMed1979

[Not Available].

Explore the source record for details and available documents.

Demography↗
PubMedDate not supplied

A cohort approach to tobacco use and mortality: the case of Quebec.

BACKGROUND: Cigarette smoking is the No. 1 cause of premature death among Canadians. However, tobacco consumption dropped by 35% in Canada during the 1980s. METHODS: Using data collected during a Quebec health survey, we evaluated the prevalences of tobacco use by birth cohort. Since mortality has been decreasing for both sexes, we computed gender-specific cohort mortality indices for tobacco-related causes of death. In the analysis, we took into account the inevitable time lag between adopting the behavior and becoming the victim of a smoking-attributable disease. RESULTS: Results indicate a systematic decrease in tobacco use from older male cohorts to younger ones across all ages; however, for females an increase in tobacco use has been observed from one cohort to the next but there seems to be hope for a future trend toward breaking the habit. While a decline in tobacco-related mortality has been observed among men (e.g., death from ischemic heart disease), female lung cancer mortality increased considerably. Finally, we present an indicator measuring the years of potential life lost for some tobacco-related causes of death. CONCLUSIONS: The cohort approach allows us to observe birth-cohort-specific trends, thereby more easily relating past behavior to current mortality levels. In terms of prevention, increasing female mortality from lung cancer should become a major concern and a motivator in the fight against tobacco use.

Adult↗
PubMedDate not supplied

Reproductive life of French-Canadians in the 17-18th centuries: a search for a trade-off between early fecundity and longevity.

One of the predictions derived from Williams' (1957) evolutionary theory of senescence is the existence of a trade-off between early fecundity and longevity. The population register of the French immigrants to Québec in the 17th century and of the first Canadians in the 17th and 18th centuries was used to detect such a trade-off in a noncontraceptive human population living at a time when longevity had not been prolonged by medical care and was not artificially shortened by wars, epidemics, or other external causes. No evidence for such a trade-off could be detected in these populations which had not yet reached the demographic transition phase (i.e., the historical period when longevity began to be extended and the progeny began to be reduced). Results are discussed in connection with the various studies aiming to test the Williams' theory.

Canada↗