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PubMed1992

Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec.

This report describes the prevalence of non-cavitated and cavitated carious lesions in 911 randomly selected children in grades one through three on the Island of Montreal, Quebec, Canada. The criteria for diagnosis were developed for a longitudinal epidemiological study of restorative treatment decisions by dentists practising under a provincial dental insurance program for children. The intra- and inter-examiner reliability correlation coefficients of the two examiners were excellent (Kappa > or = 0.80). The most frequent carious lesion found in the examined children were non-cavitated carious lesions (incipient) within 1.5 of the gingival line on smooth tooth surfaces, and stained or non-cavitated carious lesions on pits and fissures. Out of 911 children in the study, 19.6% had sealants. Children whose parents completed a university education had a significantly lower prevalence of non-cavitated and cavitated carious lesions and fillings, and a significantly higher mean number of sealants than children whose parents had only primary school education. Education status of the parents was a significant risk marker of children with high caries experience and these children had a significantly higher mean number of non-cavitated carious lesions. This study has found that non-cavitated carious lesions are significantly more prevalent than cavitated carious lesions in children.

Chi-Square Distribution↗

PubMed1979

Clinical measurement in Quebec chrysotile miners: use for future protection of workers.

There is a relationship between dust exposure, on the one hand, and serious disease and death, on the other, in chrysotile asbestos mine and mill workers of Quebec. Studies in current working populations indicate that prevalence of abnormality increases with increasing exposure. However, the relationship is weak and offers only a partial explanation of between-subject variability. In addition, there is no certain way to detect or predict change. Because of the relative nonspecificity of the health measurements examined and their poor relationship to exposure, control should be based on environmental monitoring, with biologic monitoring considered in a complementary role. This leaves the clinician with the dilemma of how best to advise the worker in whom questionable changes have been detected. At present, there appears little doubt that the decision must remain essentially clinical, based, on one hand, on all available information about the man, his job, and the plant or mine in which he works, from which an estimate of likely outcome must be made, and, on the other hand, on the social and human factors concerned, including the fact that removal from exposure does not necessarily prevent the appearance of abnormality.

Asbestos↗

PubMed1978

The distributional effects of national health insurance in Quebec.

In November of 1970 a major change in public health policy occurred in Quebec: the movement from a mixed private-public system to a completely public system of financing health care (known as Medicare). This policy change had important economic effects on the distribution of income, taxation, and health care costs. This paper analyzes these economic effects by focusing on the changes in financial burden of medical care costs between 1969-70 and 1971-72 for eight income classes. The key results that emerge are: the total cost of medical care increases sharply for all of the income groups, and the burden of the cost of medical care becomes more equitable across the income groups. Based on these results, policy considerations for the present debate on national health insurance in the United States are offered.

Financing, Government↗

PubMed1975

The Quebec health care system: its implication for medical education.

Since November 1, 1970, doctors in Quebec have been operating under a government-controlled compulsory and universal "fee-for-service" insurance plan. After a review of some characteristics of the new system, the author describes the impact of this social legislation on physicians' lives, control of health delivery costs, and various policy issues. He examines the implications of these changes for medical education. A qualitatively different kind of physician must be able to deal comfortably and effectively with a reality which includes: (a) the concept of "global medicine" and its social implications, (b) greater external control of costs and increased public concern with quality, (c) a new concept of the role of the hospital and its integration within the system, and (d) the concept of team care. Possible changes associated with the new system include a reevaluation of the criteria for a good clerkship, an acquisition of a new perspective on community health ecology, and a need to become an efficient team-worker.

Community Participation↗

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↗

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↗

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↗

PubMed1979

A serological survey for Brucella canis in dogs in the Province of Quebec.

A serological survey for canine brucellosis has been conducted on 341 dogs from different regions of the province of Quebec. A significant titer was found in six sera (1.6%) with the 2-mercaptoethanol tube agglutination test. Only two dogs presented titers >/= 1:200 which is considered as indicative of active infection.

Agglutination Tests↗

PubMed1978

Ten cases of angiosarcoma of the liver in Shawinigan, Quebec.

Ten cases of angiosarcoma of the liver have been diagnosed in Shawinigan, Quebec since 1955. All have occurred in men who worked in a vinyl chloride polymerizing plant. Cigarettes and alcohol do not seem to be associated with this tumor. The amount of vinyl chloride to which these people were exposed, according to information obtained through questionnaires, appears elevated. Angiosarcoma of the liver is accompanied by a fibrosis of the liver which may precede its appearance. In describing the Canadian cases of angiosarcoma, this study attempts to shed more light upon the causal relationship between vinyl chloride monomer and angiosarcoma of the liver and thus to provide some clues to understanding the pathogenesis of this disease.

Adult↗

PubMed1977

Health problems and health care for adolescents in residential facilities in Quebec.

The health problems of 160 adolescents in four residential facilities of the Quebec social welfare court were studied. At the time of admission 44% had at least one problem requiring consultation with a specialist and 80% had an average of two problems requiring primary care. The medical records of 106 youngsters in two re-education centres were also reviewed and similar results were noted. The health services available, particularly physical examination and laboratory testing at the time of admission and arrangements for referral and follow-up were judged to be insufficient in most centres. Although society has taken custody of these adolescents, no one is responsible for their health care. Since February 1976 the social welfare court residential facilities and the network involved in the care of socially disturbed youngsters have been undergoing reorganization. Health programs and services ought to be part of this reorganization, and private physicians, hospitals and government each should have a role in the establishment and functioning of these programs.

Adolescent↗

PubMed1976

Escherichia coli strains isolated from diarrheic piglets in the Province of Quebec.

During 1972 to 1974, 112 Escherichia coli strains isolated from diarrheic piglets were recieved from different parts of the Province of Quebec, Canada. Fifty-six strains elicited a positive gut loop response in three week old piglets and were then considered as Moon's class 1 enteropathogens, while four of the 56 remaining strains reacted only in ten day old piglets and were classified as class 2 enteropathogens. Forty-eight strains produced both a heat-labile and a heat-stable enterotoxin, while 12 isolates which included the four class 2 enteropathogens produced only a heat-stable enterotoxin. Fifty-one enterotoxigenic strains could be serogrouped using OK antisera against E. coli strains commonly associated with colibacillosis in piglets. The most common serogroups encountered were O157: K "V17"; 88a,c, O149:K91; 88a.c. O157:K"V1c, O149:K91; 88a.c, O157:K"V17"; 88 a,c or a,b and O45:K"E5"; 88a,c. No significant difference was observed in the fermentation patterns, antibiotic susceptibility, colicin production, production of a filterable hemolysin and transferable tetracycline resistance between the enterotoxigenic and the nonenterotoxigenic strains.

Animals↗

PubMed1976

Medicare in Quebec.

A provincial health insurance system was introduced through Canada more than five years ago. The program and fee schedules for optometric and some ophthalmologic services are presented. Statistics are provided by the government concerning the utilization of optometric and some medical eye services according to the distribution of age and sex in the Quebec population. Relative costs of these services as well as the incomes of health care professionals are compared. It is hoped that this information will aid in the planning and development of the U.S. Medicare program.

Adolescent↗

PubMed1977

Recent time-trends of age-specific death rates for breast cancer: Quebec and other provinces, 1965 through 1974.

For the 10-year period 1965 through 1974 the age-specific death rates for cancer of the breast decreased among middle-aged women, especially at ages 40 to 49 years, in Quebec, the Maritimes and the Prairies but not in Ontario or British Columbia. In women under 35 years of age the mortality generally increased, while in women aged 60 to 64 years there was little change except in the Prairies, where the rate increased. It seems probable that the trends reflect changes in incidence rather than in case-fatality. Some, but not all, of the pattern could be explained by changes in fertility over the past 50 years.

Adolescent↗

PubMed1992

Pilot study for the Quebec Child Mental Health survey: Part I. Measurement of prevalence estimates among six to 14 year olds.

A pilot study for a Quebec Child Mental Health Survey was completed in 1990 with 139 children aged six to 14 years from the general population. Six month prevalence estimates for seven disorders were established using DSM-III-R criteria alone and in combination with an impairment index related to the diagnoses. Prevalence estimates were studied separately for parents and children. Each age group (six to 11, 12 to 14) was also studied separately. The impairment index, working as a severity scale, lowered prevalence estimates and allowed identification of impairing and non impairing diagnoses. Little overlap was found between informants.

Adolescent↗

PubMed1992

Pilot study for the Quebec Child Mental Health Survey: Part II. Correlates of DSM-III-R criteria among six to 14 year olds.

A pilot study for a Quebec Child Mental Health Survey was completed in 1990 with 139 six to 14 year olds from the general population. The following variables, which were correlated with child psychopathology, were studied for each age group (six to 11 years, 12 to 14 years) and informant (parent, child): child's gender and stressful life events, respondent parent's psychiatric illness, family structure, parent-child relationships, parents' relationship, socioeconomic status, respondent parent's social desirability. Correlations obtained are consistent with those found in the literature. Correlations between the parent's mental health, parent-child relationships and the children's mental health are the most important results of the study.

Age Factors↗