Care trajectories for musculoskeletal disorders following a new episode of low back pain.

This study explored diverse care trajectories (CTs) for low back pain (LBP) and other musculoskeletal disorders (MSDs), over a 5-year period following a first episode of LBP. Based on Quebec's administrative health data from 2007 to 2011, this longitudinal cohort study involved 12,608 adults seeking health care for LBP. Using a new multidimensional state sequence analysis, we identified 6 distinct types of CTs.

Minimal influence of milling technique in contrast to sourdough on the nutritional and organoleptic quality of bread.

A number of studies have shown the effect of cereals and sourdough on bread nutritional and organoleptic quality, but the impact of the milling technique remains little studied. There are two main types of milling technic depending on the bread-making food chain. Industrial bakeries mainly use roller mills while artisanal bakeries may also use stone mill.

Multidimensional analysis of adult patients' care trajectories before a first diagnosis of schizophrenia.

For patients at high-risk for developing schizophrenia, a delayed diagnosis could be affected, among many reasons, by their patterns of healthcare use. This study aims to describe and generate a typology of patients' care trajectories (CTs) in the 2 years preceding a first diagnosis of schizophrenia, over a medico-administrative database of 3712 adults with a first diagnosis between April 2014 and March 2015 in Quebec, Canada. This study applied a multidimensional approach of State Sequence Analysis, considering together sequences of patients' diagnoses, care settings and care providers.

Comparative effectiveness and safety of antipsychotic drugs in patients with schizophrenia initiating or reinitiating treatment: A Real-World Observational Study.

Objective: To compare the effectiveness and safety of various second-generation antipsychotics (SGAs), newer oral and long-acting injectable (LAI) SGAs, and first-generation antipsychotics (FGAs) treatments in patients with schizophrenia or schizoaffective disorder (SCZ).

Methods: This retrospective cohort study included medical administrative information for patients with a diagnosis of SCZ living in Quebec (Canada), initiating or reinitiating at least one antipsychotic (AP) drug (with a clearance baseline period of 12 months without any APs). Effectiveness was defined by a reduced risk of hospitalization for mental disorder and discontinuation, and safety by a reduced risk of all-cause death and hospitalization for non-mental disorder, 2 years after AP initiation or reinitiation.

Antipsychotic utilization trajectories three years after initiating or reinitiating treatment of schizophrenia: A state sequence analysis approach.

Objective: This study aims to describe the utilization patterns of antipsychotic (AP) medication in patients with schizophrenia (SCZ), three years after initiating or reinitiating a given AP.

Methods: Based on medico-administrative information on patients living in Quebec (Canada), this retrospective cohort study included 6444 patients with a previous diagnosis of SCZ initiating or reinitiating AP medication between January 1, 2012, and December 31, 2014, with continuous coverage by public drug insurance. For each day of follow-up (1092 days), patient was either exposed to one of the chosen categories of APs, or to none.

Association between previous and future antipsychotic adherence in patients initiating clozapine: real-world observational study.

Background: Although recognised as the most effective antipsychotic for treatment-resistant schizophrenia, clozapine remains underused. One reason is the widespread concern about non-adherence to clozapine because of poor adherence before initiating clozapine.

Aims: To determine if prior poor out-patient adherence to treatmentbefore initiating clozapine predisposes to poor out-patient adherence to clozapine or to any antipsychotics (including clozapine) after its initiation.

The validity of diagnostic algorithms to identify asthma patients in healthcare administrative databases: a systematic literature review.

To review the available evidence supporting the validity of algorithms to identify asthma patients in healthcare administrative databases. A systematic literature search was conducted on multiple databases from inception to March 2020 to identify studies that reported the validity of case-finding asthma algorithms applied to healthcare administrative data. Following an initial screening of abstracts, two investigators independently assessed the full text of studies which met the pre-determined eligibility criteria.

Healthcare utilization after a first hospitalization for COPD: a new approach of State Sequence Analysis based on the '6W' multidimensional model of care trajectories.

Background: Published methods to describe and visualize Care Trajectories (CTs) as patterns of healthcare use are very sparse, often incomplete, and not intuitive for non-experts. Our objectives are to propose a typology of CTs one year after a first hospitalization for Chronic Obstructive Pulmonary Disease (COPD), and describe CT types and compare patients' characteristics for each CT type.

Methods: This is an observational cohort study extracted from Quebec's medico-administrative data of patients aged 40 to 84 years hospitalized for COPD in 2013 (index date).

The '6W' multidimensional model of care trajectories for patients with chronic ambulatory care sensitive conditions and hospital readmissions.

Objectives: To synthesize concepts and approaches related to the analysis of patterns or processes of care and patient's outcomes into a comprehensive model of care trajectories, focusing on hospital readmissions for patients with chronic ambulatory care sensitive conditions (ACSCs).

Study Design: Narrative literature review.

Methods: Published studies between January 2000 and November 2017, using the concepts of 'continuity', 'pathway', 'episode', and 'trajectory', and focused on readmissions and chronic ACSCs, were collected in electronic databases.

Noise-induced hearing loss and combined noise and vibration exposure.

Background: While there is a wide body of literature addressing noise-induced hearing loss (NIHL) and hand-arm vibration syndrome (HAVS) independently, relatively few studies have considered the combined effects of noise and vibration. These studies have suggested an increased risk of NIHL in workers with vibration white finger (VWF), though the relationship remains poorly understood.

Aims: To determine whether hearing impairment is worse in noise-exposed workers with VWF than in workers with similar noise exposures but without VWF.

The IVAIRE project--a randomized controlled study of the impact of ventilation on indoor air quality and the respiratory symptoms of asthmatic children in single family homes.

Unlabelled: A randomized controlled trial was carried out to measure the impact of an intervention on ventilation, indoor air contaminants, and asthma symptoms of children. Eighty-three asthmatic children living in low-ventilated homes were followed over 2 years. Several environmental parameters were measured during the summer, fall, and winter.

Cardiovascular disease mortality among retired workers chronically exposed to intense occupational noise.

Objective: The aim of this study, conducted among retired workers (≥65 years), is to estimate the association between long-term risk of cardiovascular disease (CVD) death and (1) duration of occupational noise exposure in career and (2) noise-induced hearing loss (NIHL), the latter being used as an indicator of adverse effects for long-term exposure to occupational noise.

Methods: Data from screening activities of occupational NIHL were paired to data from death records and were used for this study. A nested case-control analysis was performed.

Occupational noise exposure and noise-induced hearing loss are associated with work-related injuries leading to admission to hospital.

Objective: This study focuses on work-related injuries that required admission to hospital in a population of male workers exposed to occupational noise (≥80 dBA) which some displayed a hearing loss due to their exposure.

Methods: The study population count 46 550 male workers, 1670 (3.6%) of whom incurred at least one work-related injury requiring admission to hospital within a period of 5 years following hearing tests conducted between 1987 and 2005.

Falls risk and hospitalization among retired workers with occupational noise-induced hearing loss.

This study sought to ascertain whether occupational noise-induced hearing loss (NIHL) increased the risk of falls requiring hospitalization among retired workers. The study population consisted of males (age ≥ 65) with an average occupational noise exposure of 30.6 years and whose mean bilateral hearing loss was 42.

Biomarkers of arsenic exposure and effects in a Canadian rural population exposed through groundwater consumption.

Drinking water intake of arsenic (As) from private wells may represent a significant exposure pathway and induce oxidative DNA damage. We measured total As concentrations in hair and nails, and concentrations of the different species of As and its metabolites as well as 8-OHdG in urine of 110 non-smoking adults living in a rural region of the Province of Quebec, Canada. Significant differences in exposure biomarker levels were observed between individuals consuming drinking water with As levels of≤1.

Relation between dietary acrylamide exposure and biomarkers of internal dose in Canadian teenagers.

Acrylamide (AA) is a probable human carcinogen found in several foods. Little information is available regarding exposure of adolescents, a subgroup potentially consuming more AA-rich foods. We investigated the relationship between dietary AA intake and levels of biomarkers of exposure (urinary metabolites and hemoglobin adducts) in 195 non-smoking teenagers of Montreal Island aged 10-17 years.

Dietary exposure to acrylamide in adolescents from a Canadian urban center.

The distribution of acrylamide in food items frequently consumed by Canadian adolescents was determined along with estimates of their contribution to the overall dietary intake of acrylamide. A total of 196 non-smoking adolescents (10-17 years old) were recruited in Montreal Island population, Canada. Participants were invited to fill out a 2-day food diary and a food frequency questionnaire over the last month.

The impact of drinking water, indoor dust and paint on blood lead levels of children aged 1-5 years in Montréal (Québec, Canada).

Lead is neurotoxic at very low dose and there is a need to better characterize the impact of domestic sources of lead on the biological exposure of young children. A cross-sectional survey evaluated the contribution of drinking water, house dust and paint to blood lead levels (BLLs) of young children living in old boroughs of Montréal (Canada). Three hundred and six children aged 1 to 5 years and currently drinking tap water participated in the study.

The interactive atlas on health inequalities.

In order to translate specialized scientific information into available, relevant and useful knowledge for decision-makers in public health, the PRIMUS group has developed the on-line Interactive Atlas on Health Inequalities (IAHI), based on user's needs assessments and data availability. Built on multidimensional tables, the IAHI is an health information system which has the power to allow users, especially those concerned by health inequalities, to query rapidly and interactively large volumes of health data (in aggregated format) at different spatial and population levels and to produce meaningful results displayed as tables, graphs or maps almost instantly. Designed explicitly to reveal inequalities in health, the IAHI offers relevant information for understanding social and geographical health inequalities observed for myocardial infarction, osteoporotic fractures, diabetes, chronic pain, schizophrenia, and mood disorders.

Could driving safety be compromised by noise exposure at work and noise-induced hearing loss?

Objective: A study was conducted to verify if there is an association between occupational noise exposure, noise-induced hearing loss and driving safety expanding on previous findings by Picard, et al. (2008) that the two factors did increase accident risk in the workplace.

Methods: This study was made possible when driving records of all Quebec drivers were made available by the Societe de l'assurance automobile du Quebec (SAAQ is the state monopoly responsible for the provision of motor vehicle insurance and the compensation of victims of traffic accidents).

Detection of renal artery stenosis: prospective comparison of captopril-enhanced Doppler sonography, captopril-enhanced scintigraphy, and MR angiography.

Objective: The objective of our study was to compare the value of captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, and gadolinium-enhanced MR angiography for detecting renal artery stenosis.

Subjects And Methods: Forty-one patients with suspected renovascular hypertension were prospectively examined with captopril-enhanced Doppler sonography, captopril-enhanced renal scintigraphy, gadolinium-enhanced MR angiography, and catheter angiography. The sensitivity and specificity of each technique for detecting renal artery stenosis measuring 50% or greater and 70% or greater were compared using the McNemar test.

Percutaneous revascularization of the renal arteries: predictors of outcome.

Purpose: To identify predictors of clinical outcome after percutaneous revascularization of the renal arteries.

Materials And Methods: In 63 patients, the therapeutic response was retrospectively assessed after percutaneous revascularization of the renal arteries indicated for hypertension (41.3%), renal failure (4.