The authors describe an external crisis intervention service in a general hospital. This service is intended for a clientele presenting acute mental health problems, referred, in the majority of cases, from the emergency department. They present demographic data, diagnostic data, data on the factors precipitating the crises and data which can be used to qualify and quantify the clientele. In addition, they describe the therapeutic approach and the treatment philosophy, the number of follow-up sessions, and the guidance provided to the clientele after follow-up. Finally, the authors suggest prerequisites considered essential to the effective operation of a crisis intervention module in an external psychiatric clinic.
Little attention has been devoted to the effects on children's respiratory health of exposure to sulphur dioxide (SO2) in ambient air from local industrial emissions. Most studies on the effects of SO(2) have assessed its impact as part of the regional ambient air pollutant mix.
To examine the association between exposure to stack emissions of SO(2) from petroleum refineries located in Montreal's (Quebec) east-end industrial complex and the prevalence of active asthma and poor asthma control among children living nearby.
The present cross-sectional study used data from a respiratory health survey of Montreal children six months to 12 years of age conducted in 2006. Of 7964 eligible households that completed the survey, 842 children between six months and 12 years of age lived in an area impacted by refinery emissions. Ambient SO(2) exposure levels were estimated using dispersion modelling. Log-binomial regression models were used to estimate crude and adjusted prevalence ratios (PRs) and 95% CIs for the association between yearly school and residential SO(2) exposure estimates and asthma outcomes. Adjustments were made for child's age, sex, parental history of atopy and tobacco smoke exposure at home.
The adjusted PR for the association between active asthma and SO(2) levels was 1.14 (95% CI 0.94 to 1.39) per interquartile range increase in modelled annual SO(2). The effect on poor asthma control was greater (PR=1.39 per interquartile range increase in modelled SO(2) [95% CI 1.00 to 1.94]).
Results of the present study suggest a relationship between exposure to refinery stack emissions of SO(2) and the prevalence of active and poor asthma control in children who live and attend school in proximity to refineries.
The objective of this cross-sectional study was to compare the activities and participation in the domains of mobility, self-care, domestic life and social functioning in young adults according to osteogenesis imperfecta (OI) type. Fifty-four former OI patients were invited to participate and were sent a structured questionnaire. Twenty-four patients (mean age: 25.0 years, SD: 2.6 years) with OI types I (n=7), III (n=7), IV (n =8) and V (n=2) completed the questionnaire. Participants with OI type I reported full independence, and only few respondents with OI types IV and V reported some limitations in mobility and domestic life activities. Young adults with OI type III had significantly lower activity scores in aspects of mobility and domestic life and lower levels of participation in employment, sporting activities and transportation. Participation in leisure and social interactions were not different across OI types. Young adults with more severe types of osteogenesis imperfecta have greater activity limitations and participation restrictions. Our findings indicate the importance of promoting and facilitating involvement in meaningful activities and roles in young adults with moderate to severe forms of OI.
OBJECTIVES: The Inuit of Nunavik in northern Quebec have a lower risk for ischemic heart disease (IHD) compared to Caucasian populations. Acylation stimulating protein (ASP), which is involved in the storage of dietary fat, may play a role. The objective of the study was to determine plasma concentration of ASP in an Inuit and a southern Quebec Caucasian population. STUDY DESIGN: This is a cross-sectional study evaluating the relationship between ASP and dietary factors, such as retinol, whose intake is higher in the Inuit. As well, concentrations of ASP were evaluated in relationship to components of the metabolic syndrome. METHODS: Medical history was collected via a questionnaire and anthropometric measurements and blood samples were collected. RESULTS: ASP was significantly higher in both the Inuit men and women compared to Caucasian men (66.1 +/- 4.1 nM vs 27.5 +/- 2.5 nM, p
RefSource: Int J Circumpolar Health. 2009 Dec;68(5):419-20
Area-based socio-economic status (SES) measures are frequently used in epidemiology. Such an approach assumes socio-economic homogeneity within an area. To quantify the agreement between area-based SES measures and SES assessed at the individual level, we conducted a cross-sectional study of 943 children who resided in 155 small enumeration areas and 117 census tracts from 18 schools in Montreal, Quebec. We used street address information together with 1986 census data and parental occupation to establish area-based and individual level SES indicators, respectively. As compared with the SES score determined at the level of the individual, 13 different area-based SES indices classified the children within the same quintile 28.7% (+/- 2.8%) of the time. The discrepancy was within one quintile in 35.3% (+/- 2.3%) of cases, two quintiles in 20.6% (+/- 3.6%), three quintiles in 11.3% (+/- 4.2%) and four quintiles in 4.1% (+/- 0.2%). In conclusion, we observed a substantial discrepancy between area- based SES measures and SES assessed at the individual level. Caution should therefore be used in designing or interpreting the results of studies in which area-based SES measures are used to test hypotheses or control for confounding.
An etiologic paradigm of hearing loss for industrial workers is introduced as having two major components, one being occupational and the other extra-occupational. The extra-occupational factors include age, noise exposure outside the work place, trauma, ear disease and ototoxic drugs. The work-related factors include occupational noise, whole body vibration, work-related diseases and toxic exposures. Within this framework, a review of the epidemiology of hearing loss examines the possible relationships between hearing loss and these factors.
It has been suggested that a reduced HDL particle size could be another feature of the atherogenic dyslipidemia found among viscerally obese subjects.
To investigate, in women, the relationship between HDL particle size and coronary artery disease (CAD).
Average HDL particle size was measured in a sample of 239 women on whom CAD was assessed by angiography.
Overall, women who had CAD were characterized by a deteriorated fasting metabolic risk profile, which was accompanied by smaller HDL particles compared to women without CAD (80.4???2.2?? vs. 81.5???2.7??, p?
To examine the distribution of contextual risk factors for antenatal depression according to immigrant status and the length of stay in Canada, to assess the association between these risk factors and antenatal depression (AD) for Canadian-born and immigrant women, and to compare the vulnerability of Canadian-born and immigrant women to risk factors in relation to antenatal depression.
Women were recruited at routine ultrasound examinations (16-20 weeks), at antenatal blood sampling (8-12 weeks), or in antenatal care clinics. Cross-sectional analysis was performed on the baseline sample consisting of 5,162 pregnant women. CES-D scale was used to investigate depression. Levels of exposure to the selected risk factors according to immigrant status and length of stay were assessed using Chi-square-test or the t test. All measures of association were assessed using logistic regression. Multiplicative interaction terms were constructed between each of the risk factors and immigrant status to reveal differential vulnerability between Canadian-born and immigrant women.
Prevalence of AD (CES-D =16 points) was higher in immigrants (32% [29.6-34.4]) than in Canadian-born women (22.8% IC 95% [21.4-24.1]). Immigrant women were significantly more exposed than Canadian-born women to adverse contextual risk factors such as high marital strain, lack of social support, poverty, and crowding. At the same level of exposure to risk factors, Canadian-born women presented higher vulnerability to AD when lacking social support (OR = 4.14 IC 95% [2.69; 6.37]) while immigrant women presented higher vulnerability to AD when lacking money for basic needs (OR = 2.98 IC 95% [2.06; 4.32]).
Important risk factor exposure inequalities exist between Canadian-born and immigrant pregnant women. Interventions should target poverty and social isolation. The observed high frequency of AD highlights the need to evaluate the effectiveness of preventive interventions of antenatal depression.
We prospectively tested the extent to which witnessing school violence predicts psychosocial and school adjustment in students while accounting for their prior psychosocial characteristics and peer victimization. We also explored the role of feelings of insecurity in explaining this relationship.
Questionnaires were administered to 1104 students (52% boys) from five high schools from the Montreal area (Quebec, Canada) at the beginning, middle, and end of seventh grade. Self report measures included sociodemographic characteristics, victimization, witnessing violence, feelings of insecurity, internalizing and externalizing behavior problems, and measures of engagement, achievement, and truancy as indicators of school adjustment.
Witnessing school violence was a comparatively better predictor of subsequent externalizing problems and school adjustment than actual victimization. Conversely, relative to having experienced violence as a witness, actual victimization more reliably estimated later internalizing problems. Feelings of insecurity partially explained the development of school engagement and truancy.
Our findings underscore the implications of school violence as a public health and safety issue, the consideration of witnessing as important in estimating its impact, and a comprehensive approach when developing and implementing strategies that aim to prevent this form of community violence.
Although related to inflammatory markers in adults, little is known about the association between cigarette smoking and C-reactive protein (CRP) in adolescent smokers. We examined the association between high-sensitivity CRP (hs-CRP) concentrations and smoking in youth. We used data from a cross-sectional, province-wide survey of a representative sample of youth conducted in Quebec, Canada, in 1999. Data were collected in self-report questionnaires completed by participants and their parents. Participants provided a fasting blood sample, and anthropometric measures were undertaken by trained technicians. The present analysis pertains to 1,501 adolescents aged 13 and 16 years who completed questionnaires and for whom blood samples were available. The independent association between a six-category indicator of smoking status and elevated hs-CRP, defined as a value at least in the 90th percentile of the age- and sex-specific CRP distribution, was assessed in multiple logistic regression analyses controlling for potential confounders. Relative to never-smokers, the odds ratios (95% confidence intervals) for puffers (i.e., never smoked a whole cigarette), those who smoked but not in the past month, light past-month smokers, moderate past-month smokers, and heavy past-month smokers were 1.04 (0.55-1.98), 1.76 (1.06-2.94), 1.39 (0.70-2.76), 2.07 (0.96-4.42), and 2.40 (1.18-4.88), respectively. Our data suggest a positive association between smoking status and elevated CRP in adolescents, and in particular among heavier past-month smokers. Damage related to cigarette smoking may begin soon after tobacco use initiation, reinforcing the preventive message that no level of smoking is safe in youth.