Residents Of Quebec Research Articles

Psychological distress during the COVID-19 pandemic in Canada.

During major pandemics such as COVID-19, the fear of being infected, uncertain prognoses, and the imposition of restrictions may result in greater odds of emotional and psychological distress. Hence, the present study examines the predictors of psychological distress during the COVID-19 pandemic in Canada, and how they differ by gender. Data of 2,756 adults aged 18 years and above from a cross-sectional online survey conducted between July and October 2020 was used for this study. A multivariable logistic regression analysis was carried out. The results were presented as adjusted odds ratio (aOR) with their respective confidence interval (CI). Lower odds of psychological distress were found among males compared to females and among individuals aged 45-64 or 65-84 years compared to those aged 18-44. The odds of psychological distress decreased with a rise in income, with individuals whose annual income was greater than or equal to $100,000 being less likely to experience psychological distress compared to those whose income was less than $20,000. The odds of psychological distress were higher among residents of Ontario compared to residents of Quebec. Similarly, the odds of psychological distress were higher among individuals who reported experiencing COVID-19 symptoms compared to those who did not report any COVID-19 symptoms. The disaggregated results by gender showed that age, province, and self-reported COVID-19 symptoms had significant associations with psychological distress in both males and females, but these effects were more pronounced among females compared to males. In addition, income was negatively associated with psychological distress for both males and females, with this effect being stronger among males. Five exposure variables (gender, age, province, experiencing COVID-19 symptoms, and total annual income in 2019) significantly predicted the likelihood of reporting psychological distress during the COVID-19 pandemic in Canada. Clearly, there is an imminent need to provide mental health support services to vulnerable groups. Additionally, interventions and policies aimed at combating psychological distress during pandemics such as COVID-19 should be gender specific.

Stressors and perceived consequences of the COVID-19 pandemic among older adults: a cross-sectional study using data from the Canadian Longitudinal Study on Aging.

Background:The indirect consequences of the COVID-19 pandemic in older adults, such as stress, are unknown. We sought to describe the stressors and perceived consequences of the COVID-19 pandemic on older adults in Canada and to evaluate differences by socioeconomic factors.Methods:We conducted a cross-sectional study using data from the Canadian Longitudinal Study on Aging COVID-19 Exit Questionnaire (September–December 2020). A 12-item checklist was used to assess stressors (e.g., income loss, separation from family) experienced during the pandemic, and a single question was used to measure perceived consequences. We used a generalized linear model with a binomial distribution and log link to estimate prevalence ratios and 95% confidence intervals (CIs) for the association between socioeconomic factors, stressors and perceived consequences.Results:Among the 23 972 older adults (aged 50–96 yr) included in this study, 17 977 (75.5%) reported at least 1 stressor during the pandemic, with 5796 (24.4%) experiencing 3 or more stressors. The consequences of the pandemic were perceived as negative by 23 020 (63.1%) participants. Females were more likely to report most stressors than males, such as separation from family (adjusted prevalence ratio 1.31, 95% CI 1.28–1.35). The perceived consequences of the pandemic varied by region; residents of Quebec were less likely to perceive the consequences of the pandemic as negative (adjusted prevalence ratio 0.87, 95% CI 0.84–0.91) than those of the Atlantic provinces.Interpretation:These findings suggest that older adults across Canada experienced stressors and perceived the pandemic consequences as negative, though stressors and perceptions of consequences varied by socioeconomic factors and geography, highlighting inequalities. Future research will be needed to estimate the impact of stress during the pandemic on future health outcomes.

Dietary gluten avoidance in Canada: a cross-sectional study using survey data.

Background:A gluten-free diet (GFD) is required for the management of some conditions, whereas some Canadians may follow a GFD for discretionary reasons. We sought to estimate the prevalence of Canadians who adhere to a GFD, identify factors associated with adherence to a GFD, and describe and compare the location of food preparation and consumption for those who follow a GFD, those who report no dietary avoidances and those reporting other dietary avoidances.Methods:We used cross-sectional data from the 2015 Canadian Community Health Survey — Nutrition (n = 20 487). Demographic variables included sex, age group, ethnicity, highest level of household education and income adequacy. The relations between respondent characteristics and report of a GFD were estimated using logistic regression. Respondents were further categorized as avoiding dietary gluten, other dietary avoidances and no dietary avoidances.Results:An estimated 1.9% of Canadians follow a GFD. Women had 2 times higher odds (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.32 to 3.27) of reporting a GFD than men. After adjustment for income adequacy, household education, sex, age group and ethnicity, residents of Ontario and Quebec had about half the odds (OR 0.52, 95% CI 0.31 to 0.87, and OR 0.55, 95% CI 0.32 to 0.94, respectively) of reporting a GFD compared with residents of Atlantic Canada. Canadians who followed a GFD consumed significantly fewer calories from foods prepared at restaurants than both Canadians who reported no dietary avoidances and those who reported dietary avoidances other than gluten. Canadians following a GFD reported that 2.0% (95% CI 1.1% to 2.9%) of their daily kilocalories were from foods prepared at restaurants, compared with 6.7% (95% CI 5.4% to 7.9%) for Canadians reporting 1 or more dietary avoidances other than gluten, and 6.4% (95% CI 6.0% to 6.9%) for those reporting no avoidances.Interpretation:The estimated 1.9% prevalence of dietary gluten avoidance likely includes individuals with celiac disease, wheat allergies and nonceliac gluten sensitivity, as well as individuals excluding gluten in the management of irritable bowel syndrome or for reasons related to dietary trends. Canadians eating GFDs consume fewer daily calories from restaurant-prepared foods than other Canadians, which may have social implications.

Is a sense of community belonging associated with problem gambling in Canada?

Despite the increasing demand for public health measures to prevent problem gambling, few studies have examined the association between community characteristics and problem gambling. The aim of this nationally representative cross-sectional study was to investigate the relationship between a sense of community belonging and problem gambling in Canada. We also examined whether this relationship was modified by sex and marital status. Canadian Community Health Survey (2013-2014) data from 38,968 residents of Quebec, Saskatchewan, Manitoba, and British Columbia were analyzed. Problem gambling was assessed using the Canadian Problem Gambling Index. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for problem gambling. The prevalence of problem gambling was 1.4% (1.9% among males; 0.9% among females). We observed an inverse dose-response relationship between a sense of community belonging and problem gambling. Compared with those with a very strong sense of community belonging, the adjusted ORs for problem gambling were 1.07 (95% CI 0.65-1.76) for a somewhat strong sense, 1.27 (95% CI 0.77-2.11) for a somewhat weak sense, and 2.32 (95% CI 1.34-4.02) for a very weak sense of community belonging. The association was more prominent among females (except for those widowed/divorced/separated), whereas no clear association was found among males, irrespective of marital status. When implementing public health measures to reduce problem gambling, it would be useful to account for possible differential impacts of a sense of community belonging by sex and marital status, which may reflect significant social contexts among residents.

Abstract S12-01: High mortality among hospital-acquired COVID-19 infection in patients with cancer: An observational cohort study from Quebec and British Columbia

Abstract Background: Studies suggest that patients with cancer are more likely to experience severe outcomes from COVID-19. Therefore, cancer centers have undertaken efforts to care for patients with cancer in COVID-free zones. Nevertheless, nosocomial transmission of COVID-19 in patients with cancer likely occurs, but the frequency and relevance of these events remain unknown. The goal of this study was to determine the incidence and impact of hospital-acquired COVID-19 in this population and identify prognostic factors for COVID-19 severity in patients with cancer. Methods: Patients with cancer and a laboratory-confirmed or presumed diagnosis of COVID-19 were prospectively identified using provincial registries and hospital databases between March 3rd and May 23rd, 2020, in the provinces of Quebec and British Columbia. Patients’ baseline characteristics including age, sex, comorbidities, cancer type, and type of anticancer treatment were collected. The primary outcome was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalization, supplemental oxygen, intensive-care unit (ICU) admission, and/or mechanical ventilation. Results: A total of 253 patients (N=250 adult and N=3 pediatric) with COVID-19 and cancer were identified, and the majority were residents of Quebec (N=236). Ninety patients (35.6%) received active anticancer treatment in the last 3 months prior to COVID-19 diagnosis. During a median follow-up of 23 days, 209 (82.6%) required hospitalization, 38 (15%) required admission to ICU, and 71 (28%) died. Forty-seven (19%) had a diagnosis of hospital-acquired COVID-19. Median overall survival was shorter in those with hospital-acquired infection, compared to a contemporary community-acquired population (27 days vs. 71 days, HR 2.2, 95% CI 1.2-4.0, p=0.002). Multivariate analysis demonstrated that hospital-acquired COVID-19, age, ECOG status, and advanced stage of cancer were independently associated with death. Conclusion: Our study demonstrates a high rate of nosocomial transmission of COVID-19, associated with increased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importance of treating patients with cancer in COVID-free zones. We also validated that age, poor ECOG, and advanced cancer were negative prognostic factors for COVID-19 in patients with cancer. Citation Format: Arielle Elkrief, Antoine Desilets, Neha Papneja, Lena Cvetkovic, Catherine Groleau, Yahia Abdelali Lakehal, Layla Shbat, Corentin Richard, Julie Malo, Wiam Belkaid, Erin Cook, Stephane Doucet, Thai Hoa Tran, Patrice Savard, Kevin Jao, Nathalie Daaboul, Eric Bhang, Jonathan Loree, Wilson Miller, Donald Vinh, Nathaniel Bouganim, Gerald Batist, Caroline Letendre, Bertrand Routy. High mortality among hospital-acquired COVID-19 infection in patients with cancer: An observational cohort study from Quebec and British Columbia [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S12-01.

High mortality among hospital-acquired COVID-19 infection in patients with cancer: A multicentre observational cohort study

IntroductionStudies suggest that patients with cancer are more likely to experience severe outcomes from COVID-19. Therefore, cancer centres have undertaken efforts to care for patients with cancer in COVID-free units. Nevertheless, the frequency and relevance of nosocomial transmission of COVID-19 in patients with cancer remain unknown. The goal of this study was to determine the incidence and impact of hospital-acquired COVID-19 in this population and identify predictive factors for COVID-19 severity in patients with cancer. MethodsPatients with cancer and a laboratory-confirmed diagnosis of COVID-19 were prospectively identified using provincial registries and hospital databases between March 3rd and May 23rd, 2020 in the provinces of Quebec and British Columbia in Canada. Patient's baseline characteristics including age, sex, comorbidities, cancer type and type of anticancer treatment were collected. The exposure of interest was incidence of hospital-acquired infection defined by diagnosis of SARS-CoV-2 ≥ 5 days after hospital admission for COVID-unrelated cause. Co-primary outcomes were death or composite outcomes of severe illness from COVID-19 such as hospitalisation, supplemental oxygen, intensive-care unit (ICU) admission and/or mechanical ventilation. ResultsA total of 252 patients (N = 249 adult and N = 3 paediatric) with COVID-19 and cancer were identified, and the majority were residents of Quebec (N = 233). One hundred and six patients (42.1%) received active anticancer treatment in the last 3 months before COVID-19 diagnosis. During a median follow-up of 25 days, 33 (13.1%) required admission to the ICU, and 71 (28.2%) died. Forty-seven (19.1%) had a diagnosis of hospital-acquired COVID-19. Median overall survival was shorter in those with hospital-acquired infection than that in a contemporary community-acquired population (27 days versus unreached, hazard ratio (HR) = 2.3, 95% CI: 1.2–4.4, p = 0.0006. Multivariate analysis demonstrated that hospital-acquired COVID-19, age, Eastern Cooperative Oncology Group status and advanced stage of cancer were independently associated with death. InterpretationOur study demonstrates a high rate of nosocomial transmission of COVID-19, associated with increased mortality in both univariate and multivariate analysis in the cancer population, reinforcing the importance of treating patients with cancer in COVID-free units. We also validated that age and advanced cancer were negative predictive factors for COVID-19 severity in patients with cancer.

Internet non-use among the Canadian older adult population: General Social Survey (GSS)

Benefits of Internet use for older adults include the ability to access informational resources, facilitate social connections and use online communication resources. Further research on identifying the characteristics of older adult Internet non-users is warranted. The present study aims to examine the prevalence and characteristics of Internet non-use among Canada’s older adult populations. The analysis was based on the 2016 General Social Survey (GSS)– Canadians at Work and Home. Analysis was restricted to Canadians of 65 years of age or older. The outcome was Internet non-use, which was defined as having not used the Internet in the 30-day period prior to survey data collection. Demographic, socio-economic, health related, and social support and relationship factors were considered for a multivariable logistic regression analysis.
 Overall, the prevalence of Internet non-use among Canadian older adults was 31.9%. Characteristics significantly associated with Internet non-use included: lower educational achievement, decreased socioeconomic status, poor mental and physical health, having a partner / significant other, and being a cigarette smoker. The province of residence was significantly associated with non-internet use with residents of Quebec being at increased odds of non-internet use compared to residents of British Columbia (OR =2.09, 95% CI= 1.51-2.88). Additionally, increased age among older adults was associated with increased likelihood of not using the Internet. The findings from this study can be used as the basis for future research and to aid in the development of effective policies and programs directed towards the needs of this unique population.

Factors associated with the blood and urinary selenium concentrations in the Canadian population: Results of the Canadian Health Measures Survey (2007-2011).

The objective of the present work is to assess the factors associated with whole blood and urinary selenium (Se) concentrations in Canadians aged 6-79 years old, and to interpret the data in the context of exposure guidance values. Whole blood Se concentrations data collected from 10740 participants as part of the Canadian Health Measures Survey (CHMS) Cycle 1 (2007-09) and Cycle 2 (2010-11) were analyzed for associations with the demographic and dietary characteristics of the Canadian population; whereas the urinary Se concentrations were only assessed for their association with the demographic variables. Whole blood and urinary Se concentrations were compared to biomonitoring equivalents established for exposure guidance values. The geometric means of whole blood Se concentrations (μg/L) were 197.42 (95% CI: 194.79, 200.08) and 192.35 (95% CI: 189.68, 195.06) for males and females, respectively. The corresponding urinary Se concentrations (μg/L) were 56.91 (95% CI: 54.81, 59.10) and 44.10 (95% CI: 41.89, 46.43) respectively. Males, participants born in Asia, older individuals, and participants who frequently consumed nuts and vegetables had higher whole blood Se, whereas current smokers, residents of Quebec and Ontario, participants who frequently consumed meat, fruits or dairy products were associated with lower whole blood Se. Sociodemographic factors were also significantly associated with urinary Se although the direction of association sometimes differed from those observed with blood Se. More than 99.9% of the Canadian population covered by the survey had whole blood Se concentrations within the range from the lower (100 μg/L) and higher (400 μg/L) biomonitoring equivalents set for the protection from deficiency and selenosis, respectively. The CHMS data provide a baseline for Se exposure among Canadians and indicated that the population is generally not at risk of deficiency or toxicity.

Significant disparities in eyeglass insurance coverage in Canada

ObjectiveTo describe patterns of access to eyeglass insurance by Canadians. DesignA population-based, cross-sectional survey. ParticipantsA total of 134 072 respondents to the Canadian Community Health Survey 2003 who were aged ≥12 years. MethodsWe compared self-reported insurance coverage for eyeglasses or contact lenses provided by private, government, or employer-paid plans. ResultsOverall, 55.0% of Canadians aged ≥12 years had insurance that covers all or part of the costs of optical correction. School-age children (63.3%) and individuals aged 20–39 years (55.9%) and 40–64 years (59.5%) had higher coverage rates than seniors (aged ≥65 years) (33.8%, p < 0.05). Canadians residing in the 3 territories had the highest coverage (76.9%), while those in Quebec had the lowest coverage (39.1%, p < 0.05). Lower coverage was reported among immigrants (47.3%) versus nonimmigrants (57.4%, p < 0.05), nonwhites (49.2%) versus whites (56.4%, p < 0.05) and aboriginals (70.7%), and the self-employed (38.5%) versus employees (63.8%). Among Canadians in the 20–64 years age group, individuals in the lower or middle income bracket were 40% (prevalence ratio [PR] 0.60, p < 0.05) less likely to have insurance than those in the upper-middle or higher income bracket after adjusting for ethnicity, immigrant status, and education. Compared to those with university or college education, individuals with less than secondary school education were 13% (adjusted PR 0.87, p < 0.05) less likely to have insurance. ConclusionsSignificant disparities exist in eyeglass insurance coverage in Canada. Individuals with low levels of income and education, and the self-employed, seniors, immigrants, nonwhites, and residents of Quebec had less coverage. Studies are needed to understand whether these disparities contribute to the visual impairment burden in Canada.

Temporal trends in outpatient management of incident pulmonary embolism and associated mortality

IntroductionIn clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. MethodsAll residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion. Comparing the years 2005–9 with 2000–4, we assessed the odds ratio (OR) for outpatient management, and relative risk (RR) for all-cause mortality, readmissions for PE, and major bleeding in 30days. We adjusted the RR for a mortality risk score. ResultsOf 15,217 patients included, 7583 were outpatients (7.5% confirmed PE) and 7634 were inpatients (60.6% confirmed PE). In all, 10.9% of patients with confirmed PE were outpatients, but outpatient management of confirmed PE was more likely in the latter study period (OR 1.73, 95%CI 1.44–2.09). Among outpatients with confirmed PE, mortality (RR 0.84, 95%CI 0.15–4.61) and readmission (RR 1.25, 95%CI 0.45–3.48) rates were stable, and only 3 major bleeding events were noted. Inpatients with confirmed PE had stable mortality rates (RR 0.95, 95%CI 0.72–1.24). ConclusionOutpatient PE management increased over 10years while remaining fairly uncommon. Nevertheless, stable mortality and readmission rates indicate this practice is safe in routine care, and add to the growing evidence in support of outpatient PE management.

Identifying potential exposure reduction priorities using regional rankings based on emissions of known and suspected carcinogens to outdoor air in Canada.

BackgroundEmissions inventories aid in understanding the sources of hazardous air pollutants and how these vary regionally, supporting targeted reduction actions. Integrating information on the relative toxicity of emitted pollutants with respect to cancer in humans helps to further refine reduction actions or recommendations, but few national programs exist in North America that use emissions estimates in this way. The CAREX Canada Emissions Mapping Project provides key regional indicators of emissions (total annual and total annual toxic equivalent, circa 2011) of 21 selected known and suspected carcinogens.MethodsThe indicators were calculated from industrial emissions reported to the National Pollutant Release Inventory (NPRI) and estimates of emissions from transportation (airports, trains, and car and truck traffic) and residential heating (oil, gas and wood), in conjunction with human toxicity potential factors. We also include substance-specific annual emissions in toxic equivalent kilograms and annual emissions in kilograms, to allow for ranking substances within any region.ResultsFor provinces and territories in Canada, the indicators suggest the top five substances contributing to the total toxic equivalent emissions in any region could be prioritized for further investigation. Residents of Quebec and New Brunswick may be more at risk of exposure to industrial emissions than those in other regions, suggesting that a more detailed study of exposure to industrial emissions in these provinces is warranted. Residential wood smoke may be an important emission to control, particularly in the north and eastern regions of Canada. Residential oil and gas heating, along with rail emissions contribute little to regional emissions and therefore may not be an immediate regional priority.ConclusionsThe developed indicators support the identification of pollutants and sources for additional investigation when planning exposure reduction actions among Canadian provinces and territories, but have important limitations similar to other emissions inventory-based tools. Additional research is required to evaluate how the Emissions Mapping Project is used by different groups and organizations with respect to informing actions aimed at reducing Canadians’ potential exposure to harmful air pollutants.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0055-2) contains supplementary material, which is available to authorized users.

The Supreme Court of Canada Long-Gun Registry Decision: The Constitutional Question Behind an Intergovernmental Relations Failure

In 2012, Parliament repealed the federal law that had established a mandatory long-gun registry. The law to repeal the long-gun registry also provided for the destruction of the data contained therein. Quebec, however, expressed its intention to establish its own gun-control scheme and asked the federal government for its data on long-guns owned by residents of Quebec. When the federal government refused to turn over the data from the long-gun registry, despite the fact that Quebec government offi cials had access to the data while the long-gun registry was in operation, Quebec challenged the constitutionality of the federal law providing for the destruction of the data and sought an order requiring the federal government to turn over the data to Quebec. Th e federal government’s refusal to participate in an act of intergovernmental cooperation began a three-year round of constitutional litigation that concluded in March of 2015 with a split decision of the Supreme Court of Canada.

Public Perceptions of Expert Credibility on Policy Issues: The Role of Expert Framing and Political Worldviews

How do individuals assess the credibility of experts in various policy domains? Under what conditions does the public interpret particular scientific knowledge claims as being trustworthy and credible? Using data collected from an online survey experiment, administered to 1,507 adult residents of Quebec, this paper seeks answers to these questions. Specifically, we examine variation in the way members of the public perceive the credibility of scientific experts in the areas of climate change, shale gas extraction, cell phones, and wind farms. Our results contribute to the existing literatures on public perceptions of policy experts, framing, and cultural theory. We find that individuals evaluate expert credibility based on the way in which experts frame issues, and on the congruity/dissonance between these expert communication frames and one's underlying worldview. However, we also identify limits to these framing effects. Our findings shed light on the interaction of framing and political worldviews in shaping public perceptions of expert credibility in various policymaking contexts.

Gender differences in the relationship between anxiety symptoms and physical inactivity in a community-based sample of adults with type 2 diabetes.

To examine the association between physical inactivity and anxiety symptoms in a community-based sample of men and women with type 2 diabetes mellitus. Eligibility criteria included residents of Quebec, Canada aged between 40 and 75 years, having a diagnosis of type 2 diabetes (≤10 years), being insulin-naive and having participated in a previous telephone-based survey of diabetes treatments. Of the 2028 eligible respondents, 1953 (96.3%) provided information on anxiety symptoms and were included in this analysis. Participants were interviewed and provided information on diabetes-related clinical and sociodemographic factors. A total of 27.3% of participants reported being physically inactive. The prevalence of mild to severe anxiety symptoms was 22.9%. Persons with mild anxiety symptoms and moderate to severe anxiety symptoms were 1.4 times and 1.7 times more likely to report being inactive than persons without anxiety symptoms, respectively. Subgroup analyses according to gender revealed that women who had mild anxiety symptoms were 1.5 times more likely to report being inactive compared with women who did not have anxiety symptoms, whereas men who had moderate to severe anxiety symptoms were 2.5times more likely to be inactive than men who did not have anxiety symptoms. Anxiety symptoms in the mild and moderate to severe range are a relevant clinical comorbidity in persons with type 2 diabetes, and men may represent a particularly vulnerable subgroup. Future research is recommended to further assess the relationship between anxiety symptoms and diabetes-related health behaviours.

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec

Objectives. The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec.Study design and methods. In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193), we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal) and by community type (predominantly First Nations, Inuit or non-Aboriginal).Results. From 1991–1995 to 1996–2000, there was a trend of increasing rates of preterm birth for all 6 study groups. In all rural and northern areas, low birth weight rates increased significantly only for the Inuit mother tongue group [RR1.45 (95% CI 1.05–2.01)]. Stillbirth rates showed a non-significant increase for the Inuit mother tongue group [RR1.76 (0.64–4.83)]. Neonatal mortality rates decreased significantly in the predominantly non-Aboriginal communities and in the non-Aboriginal mother tongue group [RR0.78 (0.66–0.92)], and increased non-significantly for the First Nations mother tongue group [RR2.17 (0.71–6.62)]. Perinatal death rates increased for the First Nations mother tongue grouping in northern areas [RR2.19 (0.99–4.85)].Conclusion. There was a disconcerting rise of some mortality outcomes for births to First Nations and Inuit mother tongue women and to women in predominantly First Nations and Inuit communities, in contrast to some improvements for births to non-Aboriginal mother tongue women and to women in predominantly non-Aboriginal communities in rural or northern Quebec, indicating a need for improving perinatal and neonatal health for Aboriginal populations in rural and northern regions.

Pyrethroid Pediculicide Resistance of Head Lice in Canada Evaluated by Serial Invasive Signal Amplification Reaction

Most people in the United States and Canada with pediculosis will be treated with neurotoxic pediculicides containing pyrethrins or pyrethroids. Their widespread use led to significant resistance reported from various countries. Although treatment failures are frequently observed in Canada, the resistance frequency to pyrethroid pediculicide of human head lice (Pediculus humanus capitis) has not been determined. To determine the knockdown resistance (kdr) allele frequency in human head louse populations in Canada. Patients infested with Pediculus humanus capitis, aged 4 to 65 years, residents of Ontario, Quebec, and British Columbia, were participants. Head lice were collected by combing and picking the enrolled subjects' hair. Lice were analyzed by serial invasive signal amplification reaction (SISAR) for genotyping the T917I mutation of lice indicating permethrin resistance. The permethrin-resistant kdr allele (R allele) frequency could then be evaluated in the head lice collected in Canada. Of the head louse populations analyzed, 133 of 137 (97.1%) had a resistant (R) allele frequency, whereas only 4 of 137 (2.9%) had a susceptible (S) allele frequency. The 97.1% resistant (R) allele frequency in head lice from Canada could explain the treatment failures encountered with pyrethrin and pyrethroid pediculicide treatments in Canadian populations infested with Pediculus humanus capitis as the latter will not be eliminated by those pediculicides.

Blood and Boundaries: Virginia Backcountry Violence and the Origins of the Quebec Act, 1758-1775

The intent of the Quebec Act was, first and foremost, to provide a permanent civil government for the French Canadian residents of Quebec. Secondarily, however, Frederick, Lord North, the king’s prime minister and the secretary of state for the colonies, George Legge, Earl of Dartmouth, wanted to resolve an issue that had vexed imperial authorities ever since the end of the Seven Years’ War: the enforcement of an Anglo-Indian backcountry boundary. 4 MATTHEW L. RHOADES / BLOOD AND BOUNDARIES

Profile of Tim Keith, Ph.D.

BioTechniquesVol. 41, No. 5 ScientistsOpen AccessProfile of Tim Keith, Ph.D.Vice President and Chief Scientific Officer, Genizon BioSciences, St. Laurent, QC, Canada and Waltham, MALynne LedermanLynne LedermanSearch for more papers by this authorPublished Online:21 May 2018https://doi.org/10.2144/000112301AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit In Love with GeneticsI've been in the biotechnology industry for more than 20 years and believe that now is the time for genetics to realize its full potential in the identification of disease genes and their translation into novel therapeutics.I have been privileged to have had the opportunity to work with some very influential people, key leaders, and top intellects in field of genetics, and to learn from them as much as possible. Much of my enthusiasm for science derives from the mentors that I have had. I fell in love with genetics during the first genetics course I ever took, at Tufts University where I did my undergraduate education, and decided at that time that's where I wanted to make a contribution to science.I received my Ph.D. at Harvard, where I worked with one of the preeminent population geneticists in the field, Richard Lewontin, and continued my postdoctoral studies with him. There were not many women at Harvard in the sciences when I began there, but by the time I completed my Ph.D. and postdoctoral fellowship, this was starting to change. I decided to transition from a pure academic focus into industry, where I could work on more practical applications. This took me from strict population genetics research using model organisms to human genetics with a real focus on human health.In 1986, I joined Collaborative Research, one of the first biotechnology organizations focused on developing the tools to make genetics a force in the future. A key mentor at Collaborative Research was Helen Donis-Keller, who was lead author on a 1987 Cell paper titled “A genetic linkage map of the human genome.” I was very fortunate to be in the right place at the right time, during an exciting period of rapid progress in human genetics, which solidified my commitment to this field.Over the past 20 years, Collaborative Research became Genome Therapeutics, and then Oscient Pharmaceuticals. During my tenure there, we forged several alliances with pharmaceutical companies to translate our disease gene discoveries into novel therapeutics. These programs were quite successful but somewhat limited in scope, because the tools needed to perform a comprehensive analysis of the genome in complex disorders were not available until very recently.As a continuation of my focus on identifying susceptibility genes for common diseases, I was enthusiastic to join Genizon BioSciences 2 years ago as their Chief Scientific Officer. Genizon utilizes a unique resource in its discovery efforts, the Quebec founder population, which descended from a few thousand French immigrants who arrived in Quebec between the early 1600s and the mid-1700s. Importantly, the population grew very rapidly in the next 300 years, but remained very homogeneous due to little intermarriage with the other residents of Quebec. As a result, this population is excellent for genetic studies, especially for complex diseases.Genizon is performing discovery research in more than 20 disease areas and has more than 36,000 DNA samples in its biobank. We've recently conducted genome-wide association studies in seven of our disease programs. Key to the success of these studies has been the unique resource of the Quebec founder population. I believe that we were the first company to complete a genome-wide association study for a complex disease and have partnered the results of this study on Crohn's disease with Genentech, which will be translating our studies into the development of novel therapeutics and companion diagnostics.While there were a lot of promises delivered by researchers in human genetics 5 to 10 years ago regarding the identification of disease genes to improve therapeutics and much progress was made, the scope of what we were able to do was quite limited. I am very enthusiastic about where the field is today. The completion of the human genome sequence and the HapMap project has facilitated the development of dense linkage disequilibrium-based genetic maps. These, combined with high-throughput low cost genotyping technology, have enabled cost-effective and comprehensive genome-wide studies to identify susceptibility genes for complex human diseases. There are still challenges to face in managing and analyzing vast amounts of data and selecting the best targets for therapeutic development, but we now have the tools and expertise to be successful.FiguresReferencesRelatedDetails Vol. 41, No. 5 Follow us on social media for the latest updates Metrics History Published online 21 May 2018 Published in print November 2006 Information© 2006 Author(s)PDF download

Experiencing Difficulties Accessing First-Contact Health Services in Canada

In this study, we identify the significant factors associated with having difficulties accessing first-contact healthcare services. Population-based data from two national health surveys, the Health Services Access Survey and the Canadian Community Health Survey, were used to identify respondents who required first-contact services for themselves or for a family member during 2003. Fifteen percent of Canadians reported difficulty accessing routine care, and 23% reported difficulties with immediate care. Physician/service availability was the chief reason cited for difficulties accessing routine care, while for urgent care, it was long wait times. Women, younger respondents and residents of eastern Canada and Quebec were consistently more likely to report difficulties accessing both types of these first-contact services, whereas less educated Canadians were less likely to report problems. Canadians without a regular family doctor were more than twice as likely to report difficulties accessing routine care compared to those who had a regular doctor. New immigrants were almost two and a half times more likely to report difficulties accessing immediate care than were Canadian-born respondents. Household income was not associated with difficulties accessing either type of care. The relatively low level of reporting of difficulties by older and less educated Canadians may be related, in part, to more modest expectations about the healthcare system.

Preliminary Findings for Pleural Mesothelioma among Women in the Quebec Chrysotile Mining Regions

Introduction. We conducted a descriptive study to compare cases of pleural mesothelioma among female residents of Quebec’s asbestos mining regions to matched controls for residential, domestic and occupational asbestos exposures. Methods. We visited hospitals throughout the province of Quebec to identify women aged ≥50 yr whose hospital records mentioned any possible mesothelioma between 1970 and 1989. Hospital records and biological materials were reviewed by three expert pathologists to identify individuals who had lived in a mining region in Quebec at the time of diagnosis. For each case, 15 controls matched for year (±2) of birth and area of residence were selected from a previously interviewed sample of 817 female asbestos mining area residents alive in 1989. Relatives of the cases were similarly interviewed regarding lifetime occupational and residential histories and cohabitation with asbestos worker(s). Cumulative exposure from each source was estimated in fibers/ml-yr from indirect data. Results. We identified six ‘definite or probable’ and four ‘possible’ pleural mesothelioma cases. All resided in Thetford Mines (none in the town of Asbestos) and were born before 1935. Five cases (50%) worked in the asbestos industry (versus 2.7% of controls; relative risk = 53.8). Nine (90%) had lived with one or more asbestos workers (versus 65% of controls); six (60%) with two or more workers (versus 36% of controls). Mean cumulative exposure (residential, domestic, and occupational combined) was estimated as 226.1 fibers/ml-yr (range 84–525) for cases and 84.1 fibers/ml-yr (range 0–189) for controls, with a plausible 5-fold error on either side.