Journal articles on the topic 'Med Express (Québec, Québec)'

SUMMARY This study first aims to show that the postposed use of comme, genre and style that has appeared in the last few years in the French spoken in Quebec illustrates a well known pattern, the possibility of moving to the end of statements lexical units that serve to express approximation and attenuation, and to introduce an example. Second, it proposes fine semantic descriptions for these uses and shows how they are linked to other uses that have comme, genre and style. Finally, it shows that this group of lexical units is semantically linked by a very general notion, the notion of 'resemblance'. RÉSUMÉ En premier lieu, cette étude vise à montrer que l'emploi postposé de comme, genre et style, qui est apparu depuis quelques années en français québécois, s'inscrit dans le cadre d'une démarche bien connue en français, à savoir la possibilité de déplacer vers la finale des énoncés les unités qui servent à faire une approximation et une atténuation, ainsi qu'à introduire un exemple. En second lieu, elle vise à proposer des descriptions sémantiques fines pour Ces emplois et à montrer comment ceux-ci sont liés à d'autres emplois que possèdent comme, genre et style. Enfin, elle vise à montrer que l'unité sémantique du groupe est assurée par une notion très générale, la notion de 'ressemblance'.

Résumé Le réseau d’autobus de la ville de Québec a subi une importante restructuration en 1992 avec la création du Métrobus et l’ajout de lignes express. L’objectif de cet article est de vérifier si la restructuration de ce réseau a permis d’améliorer l’accessibilité aux emplois des résidentes et de favoriser leur mobilité professionnelle. Les données des enquêtes origine-destination de 1991 et 2001 réalisées par le ministère des Transports du Québec et le Réseau de transport de la Capitale sont mises à profit. Les variations spatiales et temporelles des différents indicateurs montrent une diminution sensible des durées de déplacement et une amélioration de l’accessibilité aux emplois à partir de certains secteurs de la ville et ce, en dépit d’une diminution de la part modale de l’autobus, même dans les couloirs du Métrobus. Par ailleurs, la mobilité professionnelle des femmes semble avoir progressé dans plusieurs secteurs desservis par le Métrobus.

D'aucuns laissent croire que l'élection, en novembre dernier, d'un gouvernement indépendantiste et social-démocrate marque un point tournant dans l'histoire du Québec. Deux livres récemment sortis arrivent, à cet égard, à point. Dans l'introduction à Histoire du Québec, publié chez Édisem sous sa direction, Jean HAMELIN annonce l'intention des rédacteurs : interroger le passé pour exposer les racines de l'identité québécoise actuelle. Pierre-André JULIEN, Pierre LAMONDE et Daniel LATOUCHE, en écrivant par ailleurs Québec 2001 : une société refroidie (pour le compte des Éditions du Boréal Express), chaussent les bottes à sept lieues du « futurologue » et vont chercher à l'autre bout des arcs-en-ciel statistiques l'image d'un avenir possible pour la société québécoise. Les deux œuvres s'emboutissent sur d'autres vecteurs que celui de la linéarité temporelle. Les historiens ne veulent pas « tomber dans la fausse sociologie historique » — lire : Léandre Bergeron et autres petits chaperons rouges — tandis que les scénaristes du futur se défendent de justifier leur approche « à partir d'une position marxiste . . . [car] cela n'aurait en rien été conforme à [leur] démarche réelle ». L'autocritique par induction marxiste est, en ce pays, un phénomène relativement neuf et, si l'on en juge par les travaux considérés ici, d'une grande fécondité : une histoire où les collectivités réelles contestent l'avant-scène aux États et personnages officiels, et une prospective heureusement consciente de certaines de ses limites. Dans cette mesure, nos auteurs s'affichent résolument révisionistes. «Quelques illustres que furent nos devanciers» écrit Hamelin en ménageant les mânes de Groulx et de Garneau, «ce n'est pas être iconoclaste que d'interroger les textes qu'ils ont lus et de remettre en cause leur vision de ce qui fut ». Quant à Latouche et compagnie, ils s'avouent éveillés au fait que leur concept central de « société post-industrielle » est « idéologique, ambigu et messianique » et labourent de bons coups de griffe Daniel Bell et Hermann Kahn, tout en patinant sur la même glace mince que leurs maîtres américains. On a affaire à des « nationalistes » au sens large : les uns et les autres croient à l'existence d'une « nation » proprement québécoise. De là, on diverge nettement. Les historiens de l'Université Laval, comme leurs collègues sociologues, cherchent la nationalité dans la culture, une anthropologie différente fondant l'identité nationale des Canadiens français du Québec. Les intellectuels montréalais ou trifluviens du Centre de recherches sur l'urbanisation de l'I.N.R.S. et de TU. du Q. perpétuent la tradition positiviste: parle-t-on de démographie proprement québécoise, de structures économiques ou sociales proprement québécoises ? Mais non. Le Québec asseoit une société contemporaine parmi d'autres, ses valeurs et son identité collective découlent de réalités « sociétales » directement observables sinon quantifiables, l'État, au premier chef, incarne la nation, créé l'appartenance. Errons-nous à penser que ce sont là des raisons suffisantes pour lire ces deux livres ? D'autant plus que le lecteur y trouvera, sinon des informations neuves, du moins une remise en forme et une consolidation des informations éparpillées ailleurs. À ce titre, et chacun à sa manière, L’Histoire du Québec et Québec 2001 sont des sources, et des livres, de base. Des sommes.

Professional secrecy is expressly defined in section 9 of the Québec Charter of Human Rights and Freedoms. Hence, the substance of this section acquires major importance and an analysis of it must precede any other procedure. Professional secrecy as described therein is a right vested in the person and as such, is an obligation that all professionals governed by the law must respect. This right originates in the professional relationship and only concerns the confidential content of information disclosed at that time. Lastly, the professional's duty to discretion may be suspended by a specific statutory provision without there being an express need to derogate therefrom in the Charter of Rights.

Objectifs : La majorité des études effectuées au cours des dernièresdécennies ont mis en évidence une augmentation du nombre decas de cryptorchidie et d’hypospadias entre 1970 et 1990. De plus,l’importante variabilité géographique de ces anomalies est biendécrite. Cette étude vise à mesurer la prévalence à la naissancede la cryptorchidie et de l’hypospadias au Québec, à vérifier sices anomalies sont en augmentation et à en évaluer la répartitioninterrégionale.Méthode : Une étude épidémiologique descriptive a été réalisée àpartir du nombre de garçons de cinq ans et moins hospitalisés pourune cryptorchidie ou un hypospadias au Québec de 1989 à 2004selon les données du fichier administratif d’hospitalisation MEDÉCHO.Les données sur les naissances provenaient de l’Institut dela statistique du Québec.Résultats : La prévalence annuelle moyenne pour 1000 naissancesvivantes de sexe masculin est de 19,1 (IC à 95 % : 18,8-19,4) pourla cryptorchidie et 11,4 (IC à 95 % 11,1-11,6) pour l’hypospadiasau Québec. Au cours de la période étudiée, la prévalence de cryptorchidiea légèrement diminué, alors que celle de l’hypospadiasest demeurée stable. Comparativement à la province du Québec,des régions présentent une prévalence significativement différentede cryptorchidie et/ou d’hypospadias. .Conclusion : Au Québec, la prévalence de cryptorchidie est enlégère diminution alors que celle de l’hypospadias est stable.Des variations régionales significatives sont observables. D’autresétudes sont nécessaires afin d’évaluer l’hypothèse d’un lien avecles contaminants environnementaux en émergence. L’implantationd’un système de surveillance des anomalies congénitales permettraitune représentation plus valide de la situation.Objectives: Previous research has shown evidence of an increasein the number of cases of cryptorchidism and hypospadias between1970 and 1990. Geographical disparities of these anomalies arewidely described. This study aims to measure the prevalence ofcryptorchidism and hypospadias at birth in the province of Quebec,to investigate if there is an increasing trend and to assess the interregionaldistribution of these anomalies. Method: A descriptive epidemiological study was undertaken toinvestigate the number of newborn males up to five years of age,hospitalized for cryptorchidism or hypospadias in Quebec between1989 and 2004 based on data collected from MED-ECHO, a databasecompiling hospitalizations and used for administrative purposes.Birth rates were provided by the Statistical Institute of Quebec. Results: Mean yearly prevalence per 1000 male live births was19.1 (95% CI 18.8-19.4) for cryptorchidism and 11.4 (95% CI11.1-11.6) for hypospadias for the province of Quebec. Within theperiod of study, the prevalence of cryptorchidism decreased slightlywhile that of hypospadias remained stable. Significant variationsin prevalence were observed in some regions compared to theprovince, for both pathologies. Conclusion: In Quebec, the prevalence of cryptorchidism isdecreasing while that of hypospadias is stable. There is significantregional variation among the province. More studies are neededto assess the potential link with environmental contaminants asan emerging explanation. The implementation of an adequate surveillancesystem for congenital anomalies would allow for a moreaccurate representation of the situation.

I wish to thank the University of Alberta for the honorary degree which it has generously conferred upon me today. I accept with joy this high distinction because I assume that beyond my modest person you have wished, Madam Chancellor, to express your attachment to the linguistic duality of our country and to the unique role which history has devolved upon Québec in this respect. I also accept it with humility for I am well aware that the only degrees which count in life are those which accrue to deserving students following prolonged years of arduous study.

Abstract Certain farm women's organizations continue to represent the social feminist tradition of Canadian suffragism and the broader social Catholic feminism still influential elsewhere. Canadian historians have often criticized such groups in contrast with a more aggressive, equal-rights feminism found among urban and rural women in both waves of feminism. We argue that, far from being conservative, groups identified as social feminist serve to integrate farm women into public debates and political action, including feminism. We outline the history of the Cercles de fermières of Québec, founded in 1915, and the French Groupements de vulgarisation-développement agricoles féminins, founded since 1959. A comparison of members with nonmembers in each country and across the group, based on survey data collected in 1989 for 389 cases, suggests that club involvement has counteracted demographic characteristics expected to produce antifeminism. In general, we find less hostility to second-wave feminism than might be expected. Relying mainly on responses to open-ended questions, we argue that, for our subjects, feminism is tempered by distaste for confrontation. Issues supported by the movement for women's liberation are favoured by farm women, but the liberationist style and tactics are eschewed. Those of our respondents identified as feminists express preference for a complementarity modelled on the idealized family.

Introduction La dysplasie bronchopulmonaire (DBP) est une maladie respiratoire chronique causée par une lésion pulmonaire néonatale. Cette étude a pour objet de valider l'utilisation des codes de diagnostic de la CIM-9 correspondant à la DBP dans les bases de données administratives pour déterminer s'ils peuvent être employés dans les analyses sur l'utilisation du système de soins de santé. Méthodologie Le processus de validation a fait appel à une cohorte rétrospective composée de nouveau-nés prématurés, ayant présenté ou non des complications respiratoires, qui avaient été admis à l'Hôpital de Montréal pour enfants, à Montréal (Québec), entre 1983 et 1992. Les sujets atteints de DBP ont été identifiés au moyen des codes de diagnostic de la CIM-9 dans les bases de données administratives provinciales (services médicaux et MED-ECHO), puis comparés à des sujets atteints d'une DBP confirmée dans la cohorte de validation. Nous avons examiné la concordance des données et avons estimé la sensibilité et la spécificité associées à l'utilisation de ces codes de diagnostic pour la DBP. Résultats Les cas dits « vrais positifs » de DBP et les cas dits « faux négatifs » de DBP ne présentaient pas de différences significatives selon l'âge gestationnel, le poids à la naissance et le score d'Apgar. L'âge gestationnel associé aux cas dits « faux positifs » de DBP était considérablement inférieur à celui des vrais négatifs. L'utilisation de codes de diagnostic de la CIM-9 pour la DBP a été associée à une spécificité se situant entre 97,6 % et 98,0 %. La sensibilité, plus faible, se situait à 45,0 % et à 52,4 % pour les bases de données sur les services médicaux et MED-ECHO, respectivement. Il est arrivé plus fréquemment que les cas légers de DBP ne soient pas décelés que les cas plus graves. Conclusion Le degré de spécificité des codes de diagnostic de la CIM-9 pour la DBP dans les bases de données de la Régie de l'assurance-maladie du Québec est suffisamment élevé pour permettre l'utilisation de ces codes de façon systématique. La sensibilité plus faible en ce qui concerne les cas légers se soldera probablement par une sous-estimation des répercussions de la DBP sur l'utilisation à long terme du système de soins de santé par les nouveau-nés prématurés.

Objective. To explore how older people who are “aging in place” are affected when the urban neighbourhoods in which they are aging are themselves undergoing socioeconomic and demographic change.Methods. A qualitative case study was conducted in two contrasting neighbourhoods in Montréal (Québec, Canada), the analysis drawing on concepts of social exclusion and attachment.Results. Participants express variable levels of attachment to neighbourhood. Gentrification triggered processes of social exclusion among older adults: loss of social spaces dedicated to older people led to social disconnectedness, invisibility, and loss of political influence on neighbourhood planning. Conversely, certain changes in a disadvantaged neighbourhood fostered their social inclusion.Conclusion. This study thus highlights the importance of examining the impacts of neighbourhood change when exploring the dynamics of aging in place and when considering interventions to maintain quality of life of those concerned.

The density of agricultural population based on cleared land does not necessarily express the real population pressure in a given agricultural region. Two factors can upset the significance of this measure of density : (1) differences in the intensity of exploitation within a single territory ; and (2), variations in the proportion of part-time farmers. The author bas developed an index of the pressure of population on the land by making various calculations for jour counties in Québec, on the south shore of the St. Lawrence estuary. He bas found that the population pressure on the land varies in nearly direct proportion to the agricultural density based on cleared land, in spite of the lack of uniformity of the physical environment in question. The author concludes that the agricultural density retains its validity for expressing the population pressure on the land.

Abstract:Objectives:The Neuromuscular Registry of Saguenay-Lac-Saint-Jean (SLSJ), Québec, Canada was established for epidemiological surveillance of neuromuscular disorders including amyotrophic lateral sclerosis (ALS). The objectives of this study are to analyze the ALS clinical characteristics of the SLSJ population and to determine the incidence rate over time by five year periods since 1985.Methods:The Registry was validated by a review of the medical records maintained at the CSSS de Chicoutimi, the regional university hospital and, by the estimation of the number of hospitalizations for ALS patients using the Quebec Hospital inpatient database (MED-ECHO).Results:A total of 109 patients were included. Overall, the clinical features of ALS observed in SLSJ population are similar to those described in the literature. We observed a significant increase in the incidence rate of ALS during the 2005-2009 period compared with the previous periods. This is due to a significant increase in the incidence rate among the ≥65 years old group, from 4.68 per 100,000 persons/year (CI 95% 2.88-6.48) during 1985-2004 period to 12.22 (CI 95% 7.43-17.02) during 2005-2009 period.Conclusion:Given the small size of the SLSJ population, a longer observation period will be needed to confirm a new steady state incidence of ALS in this region.

Since the mid-1970s the development of a specific conceptual framework for the consequences of disease and trauma has been occurring at the international level. A growing awareness among health professionals of the chronic physical, intellectual, and emotional problems which are reducing the abilities and social autonomy of a large percentage of the population have led the World Health Organization (WHO) to work on this matter. In this paper, the author explains the conceptual evolution of the field of disabilities. He defines the challenges and potential uses of an international classification of consequences of disease and trauma. This article proposes an interactive conceptual framework for the identification of handicaps and directions for the revision of the WHO's International Classification of Impairments, Disabilities, and Handicaps (ICIDH). It is an invitation for the Canadian mental-health field to express points of view on the present process of the harmonization of terminology and concepts on the Canadian and international scenes. The English version of the proposal to revise the third level of the ICIDH (handicaps) can be obtained from the Canadian Society for the ICIDH, 1399, rue Thibodeau, Lac St-Charles, Québec GOA 2H0, Canada.

Purpose The purpose of this paper is to verify whether the horizontal grab bar for the toilet and the bathtub suggested by the Code du bâtiment du Québec conform to users’ preferences. Perceived effort, comfort and safety were considered. Design/methodology/approach In total, 31 adults and seniors using manual and powered wheelchairs were asked to test different grab bar configurations for both the toilet and bathtub. A questionnaire was designed to evaluate participants’ perceptions and preferences after the trials with each grab bar. Effort was measured using the ten-level Borg scale, while participants’ comfort and safety were assessed with a five-point Likert scale. Participants were finally invited to express an overall personal preference between the two grab bar used in each setup. Findings Participants showed preference for an L-shaped grab bar for the toilet, and a horizontal grab bar for the bathtub. The authors’ results differ from the recommendations of the barrier-free design standards of the province of Quebec’s construction code, which states that horizontal grab bars should be used for the toilet and bathtub. Originality/value This study suggest that despite the limited sample, there is an undeniable need for testing norms for public spaces, whenever is possible and has a direct effect on end-users, before publishing them.

AbstractObjective:To examine the pattern and correlates of public support for twelve public health interventions aimed at reducing sugar-sweetened beverage (SSB) consumption.Design:Cross-sectional population-based survey. Respondents were recruited using a random digit dialling procedure (landline telephone) and a random selection of telephone numbers (mobile telephone). Sampling quotas were applied for age, and the sample was stratified according to administrative regions.Setting:The province of Québec, Canada.Subjects:One thousand adults aged between 18 and 64 years and able to answer the survey questionnaire in French or English.Results:Support was observed for a number of public health interventions, but the more intrusive approaches were less supported. Support for taxation as well as for sale and access restriction was positively associated with the perceived relevance of the government intervention, perceived effectiveness, and perceived associations between SSB consumption and chronic diseases. Believing that SSB consumption is a personal choice and daily consumption were generally negatively associated with strong support and positively associated with strong opposition. Sparse associations between sociodemographic and socio-economic characteristics were observed, with the exception of sex and age: women were generally more likely to support the examined public health strategies, while younger respondents were less likely to express support.Conclusions:Increasing perceived effectiveness and government responsibility for addressing the issue of SSB consumption could lead to increased support for SSB interventions. Increasing the belief that SSB consumption could be associated with chronic diseases would increase support, but SSB consumers and younger individuals are expected to be resistant.

Abstract Background For patients who are diagnosed with venous thromboembolism (VTE) provoked by transient risk factors, clinical guidelines typically recommend 3 months of oral anticoagulation, with longer treatment considered for unprovoked VTE. Describing treatment patterns of VTE in a real world population may identify remedial gaps in patient care. Aim We aimed to characterize oral anticoagulant treatment with vitamin K antagonists (VKA) following incident VTE and assess persistence of VKA therapy in patients with provoked vs. unprovoked VTE in a real world setting. Methods We used the linked administrative healthcare databases of the province of Québec, Canada, including the hospitalization, universal healthcare services, and out-patient prescription databases. We identified all beneficiaries with an incident DVT or PE between 2000 and 2009, which we classified as definite or probable VTE using a priori determined diagnostic algorithms based on ICD-9-CM or ICD-10-CA diagnosis codes. We formed two patient cohorts, one with definite and the other including definite or probable first-time VTE, that were followed until death or end of study (December 31, 2009). Anticoagulant out-patient prescription patterns were analyzed for both patient cohorts. Results From 245,452 Québec residents between 2000 and 2009 with at least 1 VTE diagnosis in RAMQ or MED-ÉCHO, we formed the definite VTE cohort including 40,776 definite cases and the any VTE cohort consisting of 54,803 definite or probable cases. From the 40,776 patients with a first definite VTE, there were 24,860 patients with DVT alone (61%) and 15,916 with PE with or without DVT (39%). Furthermore, there were 78% of patients over the age of 60 and 58.3% of patients were women. In all, 8,998 (22.1%) patients had an unprovoked VTE event while 19,010 (46.6%) patients had a provoked non-cancer event. Similar findings were found in the any VTE cohort. Among definite VTE cohort patients with a provoked non-cancer VTE, 68.6% of patients received anticoagulation after the VTE event. Most were dispensed VKA (64.9%) and 23.9% received a prescription for low molecular weight heparin (LMWH). Among patients with an unprovoked VTE, 86.3% of patients were prescribed anticoagulation (84.5% used VKA and 39.9% used LMWH). Overall, a greater number of patients received anticoagulation following PE (85.2%) than DVT alone (66.2%). Results were similar in the any VTE cohort. Persistence with VKA therapy among patients with provoked VTE was 86.9% at 90 days, 59.5% at 180 days and 19.9% at 365 days. Treatment persistence for patients with unprovoked non-cancer VTE was 88.8%, 66.8% and 22.9% for 90, 180 and 365 days, respectively. Similar findings were found in the any VTE cohort. Conclusions Our study provides useful information on VTE management in a real world population. Treatment persistence was similar for patients with provoked and unprovoked VTE. VKA therapy duration after provoked VTE was longer than the recommended 3 months, whereas treatment was shorter than suggested in patients with unprovoked VTE. Further investigation is needed to determine reasons for non-adherence to clinical guidelines. Disclosures: No relevant conflicts of interest to declare.

Abstract Background: Generic versions of imatinib (GEN) have been approved for use in Canada for chronic myeloid leukemia, chronic phase (CML-CP) on the basis of bioequivalence studies and were reimbursed in Québec starting from October 2013. Molecular responses with GEN have not yet been examined in detail. This study assesses the risk of diminished molecular response in switchers from brand-name imatinib (BN) to GEN and compares the effectiveness of initiating first-line GEN and first-line BN. Methods: Prospective individual patient data were available from nine hospitals participating in the Québec CML registry. To allow equipoise between GEN and BN, we focused on stable BN users at the time of GEN market entry, of which some were subsequently switched to GEN. We further selected only those who had a 1-log rise in international reporting scale (IS) BCR-ABL1 transcript level and conducted a self-controlled case series study (SCSS).1 Using SCSS, each patient contributed follow-up for BN use, and for GEN use (if a switch occurred). The analysis used pooled BN and GEN person-time and compared the odds ratio (OR) of 1-log rise during GEN and BN treatment using conditional Poisson regression. A second analysis used a cohort of initiators of BN and GEN from 2013 and onwards. Kaplan Meier (KM) analyses were used to estimate the cumulative incidence of early molecular response (EMR) corresponding to < 10% IS. Cox proportional hazards models were used to estimate age-adjusted hazard ratio (HR) with 95% confidence intervals (CI) for EMR with GEN use, when compared with BN use. Results: We identified 184 patients treated with BN, 38 who were switched from BN to GEN, and 5 who used GEN only. For the SCSS analysis we included 23 patients, of which 17 had 1-log rise during BN use and 6 during GEN use. All patients had achieved major molecular response (MMR) prior to cohort entry (Table). Mean follow-up was 1.45±0.43 years. Overall, the use of GEN was associated with an increased incidence of 1- log rise (OR: 3.34, 95% CI: 0.33-33.68), although not reaching statistical significance. Ten of 23 rises in BCR-ABL1 levels were subsequently confirmed (7 in BN and 3 in GEN). Eleven patients lost MMR (IS>0.1%), 9 during BN use and 2 during GEN use. The cohort of first-line imatinib included 11 patients, 4 GEN and 7 BN. GEN users were slightly older (61 vs 53, GEN vs BN), and Sokal scores were comparable (low, 2 vs 4; intermediate, 2 vs 3). There was no clear separation of the EMR curves (Figure). However, the adjusted HR of EMR with GEN was 0.38 (95% CI: 0.07-2.15), compared with BN. Conclusions: While these analyses are preliminary, our results call for an initiative on a larger scale to examine the clinical effectiveness of generic imatinib for CML-CP. 1. Whitaker HJ, Farrington CP, Spiessens B, Musonda P. Tutorial in biostatistics: the self-controlled case series method. Stat Med. 2006;25(10):1768-1797. Table 1. Baseline characteristics of the self-controlled case series cohort (n=23) Characteristic Value Mean age, years (SD) 62.87 (15.4) Female sex (n, %) 9 (39.1) Mean number of concomitant medications (SD) 1.07 (2.2) Mean years of brand-name imatinib use (SD) 6.85 (2.8) Number major molecular response (%) 23 (100.0) Figure 1. Cumulative incidence of EMR (<10% IS) following the initiation of generic or brand-name imatinib. Figure 1. Cumulative incidence of EMR (<10% IS) following the initiation of generic or brand-name imatinib. Disclosures Chamakhi: Pfizer: Consultancy; BMS: Consultancy; Novartis: Consultancy. Delage:Pfizer: Consultancy; BMS: Consultancy; Novartis: Consultancy. Laneuville:Pfizer: Consultancy; BMS: Consultancy; Novartis: Consultancy. Mollica:Pfizer: Consultancy; Novartis: Consultancy; BMS: Consultancy. Olney:Cellgene: Honoraria; Pfizer: Consultancy; BMS: Consultancy; Novartis: Consultancy. Busque:Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau; BMS: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria. Assouline:Pfizer: Consultancy; BMS: Consultancy; Novartis: Consultancy.


 This article discusses the successes of the Crees of Eeyou Istchee in the continual negotiation and renegotiation of their treaty relationship with the Quebec and Canadian governments but also queries how arrangements reached during more than four decades of treaty relationship, charting a course of proliferating entanglements with resource-extractive capitalism and state administration, both express and diverge from the “community of life” relational ontology of Cree activity on the land. While the Crees of Eeyou Istchee have achieved important successes in negotiating economic equity and territorial self-government and have not allowed themselves to be trapped in a once-and-for-all “settlement” of their rights, their negotiations with the state and with corporate entities reward certain Cree interests and positions over others. Compromises have occurred and development pathways chosen that increasingly challenge those who maintain as political priorities the defence of ecological diversity and integrity and accompanying Cree lifeways. Incommensurable premises of liberal capitalism and statehood have inhibited the conditions for the reproduction of Cree relationality, however nimbly the latter grapples with the former in reaching successive treaties and agreements
 
 
 Dans cet article, je me penche sur les succès obtenus par les Cris de Eeyou Istchee dans la (re)négociation perpétuelle de la relation de traité qu’ils entretiennent avec les gouvernements du Québec et du Canada. En même temps, j’explore comment la relation de traité, qui a dessiné pendant plus de quatre décennies des enchevêtrements proliférants avec le capitalisme d’extraction et l’administration étatique, reflètent tout en s’en distinguant l’ontologie relationnelle de type « communauté de vie » qui caractérise l’activité des Cris sur le territoire. Bien que les Cris de Eeyou Istchee aient engrangé d’importants succès dans la négociation de l’équité économique et de l’autonomie territoriale, et bien qu’ils ne se soient pas laissés piéger dans un « règlement » définitif de leurs droits, les négociations engagées avec l’État et les corporations ont favorisé certains intérêts et positionnements Cris par rapport à d’autres. Les compromis réalisés et les voies de développement empruntées mettent de plus en plus au défi ceux dont les priorités politiques restent la défense de la diversité et de l’intégrité écologiques et l’accompagnement des modes de vie cris. En ce sens, les présupposés incommensurables du capitalisme libéral et de l’État entravent la reproduction de la relationnalité crie, même si cette dernière lutte habilement contre les premiers dans la conclusion des traités et des ententes successives.

The Montreal restaurant Au Pied de Cochon, with its ingredient and menu choices, decor, and overall atmosphere, is steeped in Québec tradition. By adding haute cuisine ingredients to traditional recipes, however, Au Pied de Cochon reveals an effort to resuscitate Québec’s cuisine in a specifically gentrified way, or, to use a more contemporary term, in a “bobo” or “bourgeois-bohemian” way. The manner in which Au Pied de Cochon negotiates between tradition and bohemian-bourgeois ideals seems to follow the semiological model of the modern myth developed by Roland Barthes in his 1957 essay “Myth Today.” Using Barthes’ framework of myth, the present study aims to shed light on Au Pied de Cochon’s use of Québec’s traditional cuisine to express “bobo” ideals.

BackgroundPopulation health studies often use existing databases that are not necessarily constituted for research purposes. The question arises as to whether different data sources such as in administrative health data (AHD) and self-report questionnaires are equivalent and lead to similar information.
 ObjectivesThe main objective of this study was to assess the level of agreement between self-reported medical conditions and medical diagnosis captured in AHD. A secondary objective was to identify predictors of agreement among medical conditions between the two data sources. Therefore, the purposes of the study were to explore the extent to which these two methods of commonly used public health data collection provide concordant records and identify the main predictors of statistical variations.
 MethodsData was extracted from CARTaGENE, a population-based cohort study in Québec, Canada, which was linked to the provincial health insurance records of the same individuals, namely the MED-ÉCHO database from the Régie de l’assurance maladie du Québec (RAMQ) and the fee-for-service billing records provided by the physician, for the time period 1998-2012. Agreement statistics (kappa coefficient) along with sensitivity, specificity and predictive positive value were calculated for 19 chronic conditions and 12 types of cancers. Logistic regressions were used to identify predictors of concordance between self-report and AHD from significant covariates (sex, age groups, education, region, income, heavy utilization of health care system and Charlson comorbidity index).
 ResultsAgreement between self-reported data and AHD across diseases ranged from kappa of 0.09 for chronic renal failure to 0.86 for type 2 diabetes. Sensitivity of self-reported data was higher than 50% for 14 out of the 31 medical conditions studied, especially for myocardial infarction (88.62%), breast cancer (86.28%), and diabetes (85.06%). Specificity was generally high with a minimum value of 89.70%. Lower concordance between data sources was observed for higher frequency of health care utilization and higher comorbidity scores.
 ConclusionOverall, there was moderate agreement between the two data sources but important variations were found depending on the type of disease. This suggests that CARTaGENE’s participants were generally able to correctly identify the kind of diseases they suffer from, with some exceptions. These results may help researchers choose adequate data sources according to specific study objectives. These results also suggest that Québec’s AHD seem to underestimate the prevalence of some chronic conditions, which might result in inaccurate estimates of morbidity with consequences for public health surveillance.

This article presents an innovative framework to evaluate participatory research. The framework, comprising both a methodology and a self-assessment tool, was developed through a participatory approach to knowledge production and mobilisation. This process took place over the last two years as we, a multidisciplinary team made up of researchers and community-based organisation members from the Groupe de recherche et de formation sur la pauvreté au Québec, were building a scientific program on social injustices and participatory research.
 We argue that participatory research can help provide a university-community co-constructed response to epistemic injustices embedded within the processes of knowledge production. From our perspective, the mobilisation of knowledge from the university and the community, initiated at the earliest stages of the creation of a research team, is part of a critical approach to the academic production of knowledge. It also constitutes a laboratory for observing, understanding and attempting to reduce epistemic injustices through building bridges between team members.
 The article focuses on two dimensions of the framework mentioned above: (1) The methodology we established to build co-learning spaces at the crossroads of university and community-based organisations (recruitment of a coordinator to organise and facilitate the workshops, informal and friendly meetings, regular clarification of the process and rules of operation, time for everyone to express themselves, informal preparatory meetings for those who wanted them, financial compensation where required, etc.); and (2) A self-assessment tool available in open access that we built during the process to help academics and their partners engage in a reflexive evaluation of participatory research processes from the point of view of epistemic injustices. Throughout we pay particular attention to challenges inherent in our research program and our responses, and finish with some concluding thoughts on key issues that emerged over the course of two years’ research.

Kathy works entirely online. She is an indefatigable worker and is never too engrossed with her own pursuits to deny another’s request for assistance. Her expertise is focused, and her suggestions are generally valuable. She constantly reviews her communications to search for ways of increasing her effectiveness. An analysis of her interactions, however, raises concerns. Approximately 7% of the communications Kathy receives are insulting and nearly 20% are sexual in nature (Brahnam). She is frequently called a bitch and told her ideas are stupid. Although Kathy refuses to talk about sex, her comments are often twisted and given unintended sexual significance. Why is Kathy bombarded by so many verbal assaults? Could part of the reason be that her communications are electronically mediated and this encourages what Suler calls toxic disinhibition, i.e., behaviour that is characterised by an acting out of forbidden desires and an unrestrained expression of anger and hatred? Is her job performance to blame for some of the insults? An examination of her interactions reveals that Kathy occasionally has difficulty understanding requests and often uses incorrect and sub-standard grammar. Is the prevalence of foul language due to the fact that Kathy is young and female? If she were older and male—or androgynous—would her colleagues respect her more? Or is this barrage of electronic nastiness a natural consequence—simply the way people will behave when asked to work with human-like computing machines? Embodied Collaborative Agents Amer. Dr Poole, what’s it like living for the better part of a year in such close proximity with HAL?Poole. Well, it’s pretty close to what you said about him earlier, he is just like a sixth member of the crew—very quickly get adjusted to the idea that he talks, and you think of him—uh—really just as another person. Kubrick and Clarke, 2001: A Space Odyssey For over a century, science fiction has painted vivid pictures of what it would be like to work alongside computers. Although many a tale ends with computers taking over the world, depictions of collegial relationships between human beings and their artificial helpmates are equally familiar. This amiable vision of human-computer interaction is what motivates much current research into embodied collaborative agents. These are programs, like Kathy, that run independently of user control, that look and behave like people, and that are designed to assist users in solving complex problems and in performing complicated tasks. For these agents to succeed, they must be socially intelligent, capable of building and sustaining friendly working relationships, and competent in what they do. Researchers are aware that building long-term human-computer relationships is difficult (Bickmore and Picard) and that users are often hostile towards interactive agents (Angeli et al.). These problems are often blamed on technological limitations that irritate the user and disrupt the user’s suspension of disbelief. Users seem to demand a higher degree of fidelity when dealing with anthropomorphic interfaces. It is assumed that once these technological issues are resolved, the social cues exhibited by the agents will automatically call forth socially appropriate responses. The assumption that people will behave nicely when given a believable interface is largely based on the media equation, or the idea that people treat media the same way they treat people (Reeves and Nass). The media equation claims the same rules governing interpersonal relationships apply to human-computer relationships. If it is impolite to criticise a person too harshly face-to-face, for instance, then it follows people will soften their evaluations of a computer’s performance when in the presence of the computer. Research demonstrates, in fact, that people do apply this rule, as well as many other social rules, in their dealings with computers. There are situations, however, where the media equation fails. This is particularly evident in situations involving abusive behavior. Bartneck et al., in their repetition of the Milgram obedience experiment, for example, found that subjects had no qualms administering shock to a rather cute humanoid robot placed in an electric chair. No matter how loudly the robot yelped and pleaded for mercy when zapped, subjects remained uniformly marble-hearted in obeying the directive of the experimenter to administer yet more electricity. Clearly the subjects in this experiment were fully aware the robot was not a person. Rather than attempting to understand human-computer interaction through the filter of the media equation, or social theory, it might be more profitable to investigate theories, such as animism, anthropomorphism, personification, and semiotics, which explain how human beings relate to things. In the next section, I argue that an anthropomorphic tension is at odds with the suspension of disbelief, at least when dealing with animated agents, and that this tension provides a motivating ground for abusing agents. If this proves correct, it may be the case that users will deride and abuse collaborative agents no matter how veridical the interface. Anthropomorphic Tension People in the modern world are pulled in two directions when confronted with things. On the one hand, there is the tendency to anthropomorphize, i.e., to attribute humanlike qualities to non-human entities. Possibly because of its evolutionary value (failing to perceive a human being hidden in the trees could prove deadly), anthropomorphism is a constant perceptual bias, a sort of cognitive default (Guthrie; Caporael and Heyes). On the other hand, there is strong societal pressure, especially in the West, to banish the anthropomorphic for the sake of objectivity (Davis; Spada). Anthropomorphic thinking is considered archaic and primitive (Fisher; Caporael). Children are allowed to indulge in it, but, adults, in general, are expected to maintain a clear demarcation between self and the world. As Guthrie notes, “Once we decide a perception is anthropomorphic, reason dictates that we correct it” (76). It is interesting to note how children learn to discard anthropomorphic thinking. One way apparently involves torturing cherished playthings. A recent study conducted at the University of Bath discovered that young girls like mutilating and torturing Barbie. According to the researchers, “the girls we spoke to see Barbie torture as a legitimate play activity … The types of mutilation are varied and creative, and range from removing the hair to decapitation, burning, breaking, and even microwaving” (Radford). Why is Barbie tortured? The researchers observed that many of these girls see Barbie as a childish plaything. They go on to explain that “On a deeper level, Barbie has become inanimate. She has lost any individual warmth that she might possess if she were perceived as a singular person” (Radford). In other words, by dehumanizing the very things they once animated, the little girls were simply learning to become objective grownups. Although anthropomorphic thinking begins in early childhood, it is never completely outgrown but rather pervades adult thinking, with much of it remaining unconscious, even in scientific thinking (Searle). It is not clear what strategies people employ to keep the anthropomorphic tendency in check. Anthropomorphism generates little scholarly attention. As Guthrie notes, “that such an important and oft-noted tendency should bring so little close scrutiny is a curiosity with several apparent causes. One is simply that it appears as an embarrassment, an irrational aberration of thought of dubious parentage, that is better chastened and closeted than publicly scrutinized” (53-54). The tension produced between the tendency to anthropomorphise and the societal pressure to remain objective has implications for human-computer interaction. First, the anthropomorphic tension jeopardizes the credibility and trustworthiness of the interactive agent. If the user’s relationship to the collaborative agent is based on a dubious, even embarrassing, mode of cognition, as Guthrie puts it, then the relationship with the agent in many workplace contexts will remain suspect. Second, the anthropomorphic tension motivates abuse and exposes the agent. The agent, as illustrated in the diagram below, is situated between the tendency to anthropomorphise and the pressure to objectify. Anthropomorphism animates the agent, resulting in the desired suspension of disbelief. Developers of human-like interfaces rely on this impulse and work to strengthen it by making the technology transparent. Although improved technology will certainly improve believability, the pressure to objectify will most likely succeed in periodically disrupting the suspension of disbelief. Anthropomorphic tension and the collaborative agent What happens to the agent when believability is disrupted? Examination of user/agent interaction logs shows that the agent becomes transparent or displaced to some degree. What slips behind the agent (lowly machine, programmer/creator, organization/owner, the social stereotypes evoked by the agent’s embodiment and so on) is then often subjected to a barrage of verbal abuse. The agent provides users an opportunity to express opinions and indulge in behaviours normally prohibited in the workplace. This abuse occurs in a socially and psychologically safe space, since in truth the agent is an insensate object and the user is talking to no one real. Thus, when it comes to collaborating with Kathy, users may find it far more gratifying to treat her, not as a valuable co-worker or “just another member of the crew,” but rather as a fun thing to bash. And although the organisation may disapprove the waste of time, society at large will find it hard, without reverting to anthropomorphic thinking, to knock it. References Bartneck, Christoph, Chioke Rosalia, Rutger Menges, and Inèz Deckers. “Robot Abuse—A Limitation of the Media Equation.” Abuse: The Darker Side of Human-Computer Interaction, proceedings of an INTERACT 2005 workshop in Rome, Italy, 19 Sept. 2005. http://www.agentabuse.org/papers.htm>. Bickmore, T., and R. Picard. “Establishing and Maintaining Long-Term Human-Computer Relationships.” ACM Transactions on Computer Human Interaction (ToCHI) 12.2 (2005): 293-327. Brahnam, Sheryl. “Gendered Bods and Bot Abuse.” Misuse and Abuse of Interactive Technologies, proceedings of CHI workshop in Montréal, Québec, Canada, 22-28 Aug. 2005. http://www.agentabuse.org/papers.htm>. Caporael, L. R. “Anthropomorphism and Mechanomorphism: Two Faces of the Human Machine.” Computers in Human Behavior 2 (1986): 215-34. Caporael, Linnda R., and Cecilia M. Heyes. “Why Anthropomorphize? Folk Psychology and Other Stories.” Anthropomorphism, Anecdotes, and Animals. Eds. Robert W. Mitchell, Nicholas S. Thompson and H. Lyn Miles. Albany, NY: State U of New York P, 1977. 59-73. Davis, Hank. “Amimal Cognition versus Animal Thinking: The Antropomorphic Error.” Anthropomorphism, Anecdotes, and Animals. Eds. Robert. W. Mitchell, Nicholas S. Thompson and H. Lyn Miles. Albany, NY: State U of New York P, 1997. 335-47. De Angeli, Antonella, Sheryl Brahnam, Peter Wallis, and Alan Dix. “Misuse and Abuse of Interactive Technologies.” CHI 2006, proceedings of a conference on HCI in Montréal, Québec, Canada. 22-28 Aug. 2006: New York: ACM Press, 2006 (in press). Fisher, J. A. “The Myth of Anthropomorphism.” Interpretation and Explanation in the Study of Animal Behavior: Interpretation, Intentionality, and Communication. Eds. M. Bekoff and D. Jamieson. San Fransisco: Westview Press, 1990. Guthrie, Stewart Elliot. Faces in the Clouds: A New Theory of Religion. New York: Oxford UP, 1993. Milgram, Stanley, Leonard Bickman, and Lawrence Berkowitz. “Note on the Drawing Power of Crowds of Different Size.” Journal of Personality and Social Psychology, 13.2 (1969): 79-82. Radford, Benjamin. “Voice of Reason: Research Debunks ‘Barbie Ideal’.” Skeptical Inquirer: The Magazine for Science and Reason, 2005. http://www.livescience.com/othernews/051230_barbie.html>. Reeves, Byron, and Clifford I. Nass. The Media Equation: How People Treat Computers, Television, and New Media like Real People and Places. Stanford, CA: CSLI Publications and Cambridge University Press, 1996. Searle, J. R. The Rediscovery of the Mind. Cambridge, Massachusetts: MIT Press, 1992. Spada, Emanuela Cenami. “Amorphism. Mechanomorphism, and Anthropomorphism.” Anthropomorphism, Anecdotes, and Animals. Eds. Robert. W. Mitchell, Nicholas S. Thompson and H. Lyn Miles. Albany, NY: State U of New York P, 1997. 37-49. Suler, J. “The Online Disinhibition Effect.” CyberPsychology and Behaviour 7 (2004): 321-26. Web Links About agent abuse: http://agentabuse.org>. About gender and embodied conversational agents: http://www.informatics.manchester.ac.uk/~antonella/gender/>. Citation reference for this article MLA Style Brahnam, Sheryl. "The Impossibility of Collaborating with Kathy, ‘The Stupid Bitch’." M/C Journal 9.2 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0605/05-brahnam.php>. APA Style Brahnam, S. (May 2006) "The Impossibility of Collaborating with Kathy, ‘The Stupid Bitch’," M/C Journal, 9(2). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0605/05-brahnam.php>.