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"In light of information concerning the issues of immigration in Quebec, gathered in [the] course of semi-directed interviews, I have identified three overriding viewpoints. The first attributes to the State the role of consolidating a Francophone Quebec, [and] it suggests that the imposition of linguistic and territorial references is the only manner by which one can define a Quebecer and a Quebec nation.... The second viewpoint, by contrast, wants to superimpose linguistic, territorial, cultural and historical references when defining a Quebecer, and by so doing, excludes the immigrants from the nation-State it wants to construct. The third viewpoint, radically opposed to aforementioned approaches, refuses all State intervention imposing a definition of a national collectivity, whether it be based upon language, history or culture; from its perspective, the State has but one role: the protection of liberties and...redistribution." (SUMMARY IN ENG AND SPA)
"Between 1976 and 1981 many pople moved out of Quebec, especially anglophones. To the extent that a person's decision to stay or to move may be related to earnings prospects, earnings comparisons with individuals who lived in Quebec in 1981 may suffer from a selection bias. This paper analyses emigration from Quebec and earnings with a two-equation model, using a sample of men drawn from the from the 1981 [Canadian] census. It is found that a selection bias is indeed present for anglophones and that the returns to learning French may be underestimated when that bias is ignored."
OBJECTIVES: Patients in long-term care institutions (LTCI) are especially at risk for osteoporotic fractures owing to their lack of mobility, poor nutrition, and limited sun exposure. Previous reports have shown that osteoporosis is underdiagnosed and undertreated in LTCI despite the high incidence of osteoporotic fractures in these settings. This document has been developed to assist clinicians practicing in LTCI with the diagnosis and treatment of osteoporosis in their institutionalized patients. These proceedings offer an overview of the particular characteristics of patients at LTCI. Management strategies include both nonpharmacological and pharmacological interventions for the prevention and treatment of osteoporotic fractures in very frail older subjects. PARTICIPANTS: This guide is an edited review of presentations and discussions held by specialists in osteoporosis in the elderly together with physicians and pharmacists practicing in LTCI in the province of Quebec. This symposium was held in Saint-Hyacinthe, Quebec on November 5, 2004. VALUES: The value of a given diagnostic test or treatment option was determined based on the clinical experiences and opinions of the participants and a review of the literature from an evidence-based perspective. RECOMMENDATIONS: All patients located at LTCI are at potential risk for osteoporotic fractures. Global interventions should include vitamin D, calcium, and a comprehensive exercise program. In patients who are at high risk for osteoporotic fractures or with previous fractures, pharmacological treatment should be started. VALIDATION: These recommendations were approved during the final plenary of the symposium. All the prevailing opinions were summarized and included in this article.
OBJECTIVE: To measure the HIV seroprevalence rate in a surrogate sample of the general population in the province of Quebec, using a network of sentinel hospitals. DESIGN: Anonymous unlinked sentinel surveillance study. SETTING: Outpatient surgery units in 19 acute care hospitals throughout Quebec. PARTICIPANTS: All patients attending the outpatient surgery units from November 1990 to October 1992. A total of 61,547 plasma samples were obtained from leftover blood samples collected for cell counts. Fifty samples were excluded because of an insufficient amount of plasma and one because of an indeterminate result. INTERVENTION: HIV antibody testing with enzyme-linked immunosorbent assay; positive results confirmed with radioimmunoprecipitation assay. OUTCOME MEASURES: HIV antibody status, sex, year of birth and area of residence. RESULTS: The crude seroprevalence rate among the subjects aged 15 years or more was 0.4 per 1000 population (95% confidence interval [CI] 0.2 to 0.7) among the women and 3.6 per 1000 population (95% CI 2.8 to 4.4) among the men (p < 0.001). The rate after adjustment for age, sex and geographic distribution of the study population was 2.3 per 1000 population (95% CI 1.9 to 2.7). The seroprevalence rate among the male patients in the City of Montreal was much higher than the rates elsewhere in the province. It increased progressively during each of the four 6-month intervals of the study: 8.1, 8.7, 13.9 and 18.3 per 1000 respectively (chi 2 linear trend = 4.76; p = 0.029). No similar trends were observed outside Montreal for the male patients. There were too few seropositive female patients to draw any solid conclusion. CONCLUSIONS: Despite the possible drawbacks of a nonrandomized sampling scheme, this study suggests that in the male population the HIV seroprevalence rate is increasing in Montreal and is stable in all other areas of the province. The continued surveillance of HIV infection through anonymous unlinked studies is useful to monitor trends.
The incidence and risk factors of intermittent claudication (IC) and its association with coronary heart disease were evaluated in a cohort of 4570 men, aged 35 to 64 in 1973, free of cardiovascular diseases and followed for 12 years. During the follow-up, 188 developed IC, an annual incidence of 41/10,000. The risk of IC increased with age. In comparison to the rest of the cohort, men with IC were older and had a higher prevalence of smoking, elevated blood pressure, and diabetes. Cigarette smoking was the predominant factor, quadrupling the risk of IC compared to those who never smoked, while those who stopped smoking one year before the study had a risk similar to non-smokers. Quintile 5 of systolic blood pressure doubled the risk of IC. Diabetes requiring a pharmacological treatment at entry in the study was significantly more prevalent in men with than in men without IC (7.5% vs 1.5%). There was no significant relationship between IC and serum cholesterol, body weight, or number of years at school. During the follow-up, 84 of the 188 men with IC had a coronary heart disease event, angina being the most frequent manifestation. Furthermore, 11% of men with IC died and in nearly two-thirds of these, death was attributable to coronary heart disease; this was twice the rate observed in the other men. In these Quebec men, IC is a common health problem and is associated with a high rate of coronary heart disease. Since IC is related to modifiable risk factors, primary prevention of these factors appears warrant.
A critique of a 1985 book by Robert Germain, published to commemorate the 25th anniversary of Quebec's professional nursing unions. Recognized as an outstanding document on the emergence and evolution of these unions, the book is resurfacing because of its relevance to today's issues.
The remarkable ice storm that brought life to a standstill in most of Eastern Ontario and Quebec in January had a huge impact on medical services. Hospitals that lost power found themselves serving as shelters not only for patients but also for staff members and nearby residents. Doctors' offices were forced to close and a large number of operations were cancelled. The 2 articles that follow detail the huge impact the "ice storm of the century" had on health care.
Canadian breast cancer researchers and international colleagues met recently to present and discuss their latest data. The conference, which was sponsored by the Canadian Breast Cancer Research Initiative, was held in Quebec City, 3-5 May 2001. The Research Initiative was founded in 1993 and is a unique partnership of groups from the public, private and non-profit sectors committed to funding a broad spectrum of breast cancer research. From this meeting, and others like it, it is becoming increasingly clear that basic research findings are rapidly being translated into tumor subtype and stage-specific therapeutic strategies that have the potential to impact significantly on disease outcome.
The author compares the 1986 population figures obtained through the Canadian census to figures from Quebec's health insurance file. The difference between the two "is very close to the one implied by the estimated rate of undercounting. This paper explains the functioning of the file and how it may be used for demographic purposes, and provides some results by age and sex as well as by region." (SUMMARY IN ENG AND SPA)
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