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At least 19 recordsLinked to original sources
PubMed1989

The role of the professional nurse. A report from the Task Force of the Department of Nursing at the Montreal General Hospital, Montreal, Quebec.

In order to deal with the nursing shortage the Department of Nursing at the Montreal General Hospital commissioned a series of task forces to study recruitment and retention issues and to develop recommendations for the department. Welcoming the involvement of nurses at all levels in the organization, the task forces became a method of developing objectives and strategies to foster decentralized decision-making and professional practice, to organize care efficiently and effectively and to market nursing. This article examines the work of the Task Force on the Professional Role of the nurse. Background information on the development of the task forces, a description of current behaviours of nurses, a vision of the future role and recommendations for the support required to develop the role are included.

Hospitals, General↗
PubMed1995

Mortality in two Jewish populations--Montreal and Israel: environmental determinants of differences.

BACKGROUND: Mortality was compared in the Jewish populations of Montreal and Israel and the overall Canadian population, to investigate whether the Israeli pattern of low male mortality and relatively high female mortality is replicated among Jews living elsewhere. METHODS: In Montreal, death certificates were obtained from Jewish funeral homes (where all Jewish deaths are believed to be handled) for 1986-1990 and coded. RESULTS: All-cause cumulative mortality for ages 35-74 (CM), was exceedingly low in Montreal Jews, both in males (CM = 0.312, 95% confidence interval [CI]: 0.274-0.350) and females (CM = 0.202, 95% CI: 0.172-0.232), compared to all Canadians (CM = 0.425; 95% CI: 0.414-0.435 and 0.251; 95% CI: 0.243-0.253) and Israeli Jews (CM = 0.406; 95% CI: 0.379-0.434, and 0.299; 95% CI: 0.276-0.322), for males and females. Sex ratios (male:female) were 1.36, 1.54, and 1.69 for Israeli Jews, Montreal Jews, and Canadians, respectively. Differences were due mainly to substantially lower cumulative mortality from circulatory diseases in Montreal Jews (CM = 0.139, 0.043 versus 0.203, 0.125 in Israeli Jews and 0.199, 0.081 in Canadians, in males and females, respectively); these differences were all highly significant. Sex ratios for circulatory deaths were lowest in Israel (1.63), highest in Montreal (3.23) and intermediate in Canadians (2.47). Among men, the circulatory diseases mortality ratio for Canadians versus Montreal Jews was 1.43, and 1.46 between Israeli and Montreal Jews; in women, these ratios were 1.87 and 2.90, respectively. CONCLUSIONS: These findings suggest that the mortality pattern characteristic of Israeli Jews is not a universal Jewish phenomenon and may be affected by modifiable environmental factors. Similar studies conducted in other Jewish communities would aid in confirming these observations.

Adult↗
PubMed1997

Prognostic classification for esophageal atresia and tracheoesophageal fistula: Waterston versus Montreal.

Since 1962, the Waterston classification has been used to stratify neonates who have esophageal atresia (EA) and/or tracheoesophageal fistula (TEF) into prognostic categories based on birth weight, the presence of pneumonia, and the identification of other congenital anomalies. In response to advances in neonatal care, the surgeons from the Montreal Children's Hospital proposed a new categorization system in 1993 in an attempt to define the current risk factors for patients who have EA/TEF. In the Montreal experience only two characteristics independently affected survival: preoperative ventilator dependence and associated major anomalies. The goal of this study was to determine which system had the greatest validity for the evaluation of prognosis in our patients with EA/TEF. The charts of 94 patients who had EA/TEF treated between 1972 and 1991 were reviewed. Patients were classified using both the Waterston and Montreal systems. Groups were compared with Fisher's Exact test using a 95% confidence level for statistical significance. Eleven infants were ventilator dependent preoperatively; 62 children had major associated anomalies, 8 of which were considered life threatening. Sixteen children died within 4 years, eight during their initial hospital stay. Five of the eight early postoperative deaths occurred in the highest-risk patients (Waterston C or Montreal II). Analysis was performed for multiple risk factors and mortality. As in the Montreal study, the presence of life-threatening and major congenital anomalies represented significant risk factors for death. Pulmonary disease as delineated by ventilator dependence appeared to be more accurate than pneumonia. This study confirms the accuracy of the Montreal classification in defining prognosis for EA/TEF. The Montreal system more accurately identifies children at highest risk than the Waterston classification.

Abnormalities, Multiple↗
PubMed1998

Epidemiology of tuberculosis in Montreal.

OBJECTIVE: To identify the epidemiologic characteristics of tuberculosis (TB) in Montreal and the patterns of resistance to antituberculous drugs in order to improve TB control in the region. DESIGN: Descriptive analysis of surveillance data for TB cases reported in Montreal by physicians and laboratories between 1992 and 1995. SETTING: Region of Montreal, population 1,775,889. PARTICIPANTS: All cases of active TB among Montreal residents reported to the Department of Public Health between Jan. 1, 1992, and Dec. 31, 1995. OUTCOME MEASURES: Epidemiologic characteristics, proportion of cases resistant to antituberculous drugs and types of resistance. RESULTS: A total of 798 cases of TB (mean annual incidence 11.2 per 100,000) were reported in Montreal during the study period. Of these patients, 617 (77.3%) were born outside Canada. The annual incidence of TB in the foreign-born population (37.5 per 100,000) was 10 times the rate in the Canadian-born population, and the highest rate among foreign-born residents (62.8 per 100,000) occurred in those 15-29 years of age. In general, annual incidence in Montreal's foreign-born population reflected the reported incidence of TB in their regions of birth. In 8.7% of all cases, the disease was resistant to isoniazid, and the proportion of cases resistant to this drug was greater than 4% in almost all age groups, among both foreign-born and Canadian-born patients. CONCLUSIONS: TB remains a major problem in Montreal, as in other large cities. Surveillance data give opportunities to public health agencies to adapt their prevention and control strategies to local situations and can also help clinicians in their clinical decision-making.

Adolescent↗
PubMed1990

Cancer incidence and risk factors among Montreal residents of Italian origin.

Cancer risks associated with Italian ethnicity were investigated using data from a large case-control study on the aetiology of several cancer sites in the male population of Montreal. Two approaches were taken. First, incidence rates were computed for Italians and for others in the Montreal area using our ascertained cases as numerators and census-derived denominators. Secondly, for respondents to the case-control study, an analysis was carried out with Italian ethnicity as the risk factor and a number of covariates as potential confounders. Out of 4553 incident cases in men aged 35-69, 301 were of Italian origin. As compared with other Montreal males, those of Italian origin had higher incidence rates for cancers of the stomach (p = 0.016, based on 31 cases) and of the colon and rectum (p = 0.102, based on 75 cases) and lower rates for cancer of the lung (p = 0.006) and prostate (p = 0.102, based on 24 cases). For other sites the differences between Montrealers of Italian and non-Italian origins were small. Montreal Italians manifested risks similar to those of the country of origin for cancer of the prostate and similar to the host country for cancers of the colon, rectum and liver. For other sites it was difficult to characterize the pattern because of wide variations among Italian registries. Over 80% of the study subjects in Montreal were interviewed and odds ratios (OR) for Italian ethnicity were estimated for each cancer site using all other sites as controls, adjusting for five potential confounders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 1. Nonaccidental mortality.

This study was undertaken to determine whether variations in concentrations of particles in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in nonaccidental mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particulates and gaseous pollutants. Total sulfates were also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We estimated associations for PM(2.5), PM(10), total suspended particles, coefficient of haze (COH), extinction coefficient, and sulfates. We used coefficient of haze, extinction coefficient, and Sutton sulfates to predict fine particles and sulfates for days that were missing. To estimate the associations between nonaccidental mortality and ambient air particles, we regressed the logarithm of daily counts of nonaccidental mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. There were 140,939 residents of Montreal who died during the study period. We found evidence of associations between daily nonaccidental deaths and most measures of particulate air pollution. For example, the mean percentage increase (MPC) for an increase of total suspended particles of 28.57 microg/m(3) (interquartile range, IQ), evaluated at lag 0 days, was 1.86% (95% confidence interval (CI): 0.00-3.76%), and for an increase of coefficient of haze (IQ=18.5 COH units per 327.8 linear m) the MPC was 1.44% (95% CI: 0.75-2.14%). These results are similar to findings from other studies (the mean percentage increase in nonaccidental deaths for a 100 microg/m(3) increase in daily total suspended particles was 6.7%). We also found increases for fine particles and for inhalable particles, but the confidence intervals included unity. All measures of sulfates showed increased daily mortality; e.g., the MPC for sulfates from fine particles (IQ=3.51 microg/m(3)) was 1.86% (95% CI: 0.40-3.35%). We generally found higher excesses in daily mortality for persons 65 years of age and for exposures averaged across lags 0, 1, and 2 days. The slope of the association between daily mortality and ambient air particles in Montreal, which has lower levels of pollution than most major urban centers, is similar to that reported in most other industrialized cities. This study therefore provides further evidence that the association is linear and that any threshold effect, should it exist, would be found at lower levels of air pollution than those found in Montreal.

Aged↗
PubMed2003

Total suspended particulate manganese in ambient air in Montreal 1981-2000.

Our research group previously established the time variation of atmospheric Mn in Montreal for the period 1981-1992. The results indicated stable Mn concentrations between 1981 and 1990 followed by a decrease of almost 50% attributed to the closing of a ferromanganese plant located approximately 25 km from Montreal. The aim of this study is to assess the atmospheric concentrations of Mn in Montreal between 1993 and 2000, to compare these data to those for the period 1981-1992, and to evaluate the presence of any trend. Three sampling stations belonging to the Montreal Urban Community (MUC) air quality surveillance network were selected. Filters from 1993 to 2000 were obtained from the MUC archives. The first sample of each month was selected and chemical analysis was performed by neutron activation analysis. The mean annual atmospheric Mn concentrations in Montreal from 1993 to 2000 were found to be very stable. The mean Mn concentration calculated for this time period was 0.01 microg/m(3) for station 99 (characterized by a low traffic density), which was significantly different (P<0.05) from the mean of 0.03 microg/m(3) for stations 13 and 68 which had higher traffic densities. Even though Mn represented a small percentage of the TSP (varying between 0.02% and 0.14%), the comparison between Mn and TSP is interesting since the stable temporal profile of Mn since 1993 contrasts with the continuously decreasing atmospheric TSP concentrations. This observation suggests that the combustion of MMT used in gasoline could be contributing to maintaining stable atmospheric Mn levels.

Journal Article↗