Search

Copyright of Canadian Review of Sociology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this paper, we present evidence on the concentration of hospital-based medical spending in Canada. We use longitudinal administrative data from the province of Quebec to document how medical spending is concentrated cross-sectionally, over time and near the end of life when death occurs in hospital. Average expenditures rise rapidly with age, starting around the age of 50, and are concentrated in a small fraction of high-cost users. For example, the top 1 per cent of men and women in terms of hospital spending account for 52.9 per cent and 49.8 per cent of total spending respectively. Persistence among high users is quite low. Fewer than 19.7 per cent of those in the top quintile of hospital spending stay in the same quintile the following year. Finally, hospital spending among those in their last year of life and who die in hospital can account for 11.3 per cent of total hospital spending in the population. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has affected cancer care worldwide. This study aimed to estimate the long‐term impacts of cancer care disruptions on cancer mortality in Canada using a microsimulation model. The model simulates cancer incidence and survival using cancer incidence, stage at diagnosis and survival data from the Canadian Cancer Registry. We modeled reported declines in cancer diagnoses and treatments recorded in provincial administrative datasets in March 2020 to June 2021. Based on the literature, we assumed that diagnostic and treatment delays lead to a 6% higher rate of cancer death per 4‐week delay. After June 2021, we assessed scenarios where cancer treatment capacity returned to prepandemic levels, or to 10% higher or lower than prepandemic levels. Results are the median predictions of 10 stochastic simulations. The model predicts that cancer care disruptions during the COVID‐19 pandemic could lead to 21 247 (2.0%) more cancer deaths in Canada in 2020 to 2030, assuming treatment capacity is recovered to 2019 prepandemic levels in 2021. This represents 355 172 life years lost expected due to pandemic‐related diagnostic and treatment delays. The largest number of expected excess cancer deaths was predicted for breast, lung and colorectal cancers, and in the provinces of Ontario, Québec and British Columbia. Diagnostic and treatment capacity in 2021 onward highly influenced the number of cancer deaths over the next decade. Cancer care disruptions during the COVID‐19 pandemic could lead to significant life loss; however, most of these could be mitigated by increasing diagnostic and treatment capacity in the short‐term to address the service backlog. [ABSTRACT FROM AUTHOR]

In 2014, Québec became the first province in Canada to allow medical assistance in dying (MAID) by adopting the Act Respecting End‐of‐Life Care. This was, and still is, an important policy change. It involves a singular and highly moral issue that generated debates spanning over a longer period than that specific to the law's development and adoption. Using French and English newspapers' renderings of these debates in Québec between 2005 and 2015, this study deconstructs MAID's journey in the province into four periods, each characterized by a specific narrative: flexible precaution, legal hypocrisy, accountability imperative, and ineluctable adaptation. These four narratives allow us to better understand MAID's framing process as they reveal the underlying rationales of three overarching frames covering the 2005–2015 period: the legal frame, the social progress frame, and the service provision frame. [ABSTRACT FROM AUTHOR]

Background: There is inconsistency across child development and care literature in operationalizing serious play‐related injury and also a lack of understanding of how mothers and fathers conceptualize serious play‐related injury. The current study explores parents' perspectives of their 2‐ to 7‐year‐old children's serious play‐related injuries in urban and rural areas of British Columbia and Québec, Canada, and provides an urban/rural and gender analysis of the results. Methods: We conducted semistructured interviews with 41 mothers and 63 fathers from 57 families, a total of 104 participants, in urban and rural locations in British Columbia and Québec, Canada. We used a social constructionist approach to the research and reflexive thematic analysis to construct themes from participant responses and to inform the consequent categorizations of serious play‐related injury. Results: The results indicate four categories of parents' conceptualizations of serious play‐related injury: (a) injury requiring medical intervention, (b) injury resulting in head trauma, (c) injury resulting in debilitation, and (d) broken bones. Conclusions: Child development and care advocates can use these categories to strengthen their communications with parents and to improve understanding of parents' conceptualizations of children's serious play‐related injury. [ABSTRACT FROM AUTHOR]

Marginal structural models (MSMs) allow estimating the causal effect of a time-varying exposure on an outcome in the presence of time-dependent confounding. The parameters of MSMs can be estimated utilizing an inverse probability of treatment weight estimator under certain assumptions. One of these assumptions is that the proposed causal model relating the outcome to exposure history is correctly specified. However, in practice, the true model is unknown. We propose a test that employs the observed data to attempt validating the assumption that the model is correctly specified. The performance of the proposed test is investigated with a simulation study. We illustrate our approach by estimating the effect of repeated exposure to psychosocial stressors at work on ambulatory blood pressure in a large cohort of white-collar workers in Québec City, Canada. Code examples in SAS and R are provided to facilitate the implementation of the test. [ABSTRACT FROM AUTHOR]

Over the last years, many actions have been implemented in the Canadian province of Quebec to prevent health issues related to diet, physical activity and obesity. As a new public health programme is being launched, the 'How can we do better?' project aimed to identify priority areas for further action. An exhaustive search led to identify 166 interventions rolled out in Quebec between 2006 and 2014. We compared it with evidence-based recommendations. Findings were challenged during a 2-d deliberative forum gathering 25 key stakeholders. At the crossroads of these analyses, 50 proposals emerged to sustain/bolster current efforts or to implement new initiatives. Specific improvements were recommended, e.g. about food supply quality monitoring, healthy food accessibility and affordability, physical activity promotion through land use policies, schools and childcare facilities retrofit and urban planning. Crosscutting proposals stress the importance to implement a new governmental prevention strategy and to reinforce evaluation at all levels. This call for action takes place at a critical period for political commitment and should be maintained until and after curbing the prevalence of obesity and related diseases. Although Quebec-focused, 'How can we do better?' project outcomes may be informative for other jurisdictions, and the methods may be inspiring for those interested in combining knowledge syntheses and deliberative processes to inform decision makers in a limited time frame. [ABSTRACT FROM AUTHOR]

This article challenges the conventional interpretation of the transition from French to British rule in Quebec, which has emphasised the increasing marginalisation of women in the colonial economy. Using hitherto unexplored criminal and civil court records and newspaper advertisements, reveals that women and in particular married women, both French and English speaking, were active in all facets of business life. Given the importance of imported British luxury items in the colonial economy following the American Revolution, this article argues that women occupied a particularly dynamic segment of business life in Quebec, and were especially prominent in the critical textile and fashion trades. A major theme of this article is to show the significance of informal trade networks in expanding economic development in the late eighteenth century, where women were demonstrably key players. The presence of women in both formal and formal economies goes far to locating Quebec in a burgeoning Atlantic economy, and to explaining the nature of consumer society in this new British colony. [ABSTRACT FROM AUTHOR]

Copyright of Antipode is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In many ways, male farmers can be considered to be a vulnerable group in relation to mental health, experiencing high rates of suicide, psychological distress and low use of health services. This study highlights important connections between rurality, farming and masculinities in the context of men's mental health. In-depth interviews with 32 male farmers from Quebec, Canada were completed focusing on stress and coping strategies. Findings include informal and formal strategies. Many participants had previous positive experience of formal help and would be willing to use such help again and to recommend it to others in need. Those without such experience are sceptical about services but recognise the courage it requires to seek help. Pride and lack of knowledge about services are the main barriers to help-seeking, but it can be legitimated in certain contexts, such as divorce or other psychosocial crisis, and by alignment with particular male ideals. Role models at national or local levels can also help farmers prioritise their own and their family's wellbeing over stigmas and rigid, traditional masculine ideals. Furthermore, gender-based strengths and recommendations for practice are also discussed. [ABSTRACT FROM AUTHOR]