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Masselot P, Chebana F, Campagna C, Lavigne É, Ouarda TBMJ, Gosselin P. Constrained groupwise additive index models. Biostatistics 2023; 24:1066-1084. [PMID: 35791751 PMCID: PMC10583725 DOI: 10.1093/biostatistics/kxac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/28/2022] [Accepted: 06/06/2022] [Indexed: 10/19/2023] Open
Abstract
In environmental epidemiology, there is wide interest in creating and using comprehensive indices that can summarize information from different environmental exposures while retaining strong predictive power on a target health outcome. In this context, the present article proposes a model called the constrained groupwise additive index model (CGAIM) to create easy-to-interpret indices predictive of a response variable, from a potentially large list of variables. The CGAIM considers groups of predictors that naturally belong together to yield meaningful indices. It also allows the addition of linear constraints on both the index weights and the form of their relationship with the response variable to represent prior assumptions or operational requirements. We propose an efficient algorithm to estimate the CGAIM, along with index selection and inference procedures. A simulation study shows that the proposed algorithm has good estimation performances, with low bias and variance and is applicable in complex situations with many correlated predictors. It also demonstrates important sensitivity and specificity in index selection, but non-negligible coverage error on constructed confidence intervals. The CGAIM is then illustrated in the construction of heat indices in a health warning system context. We believe the CGAIM could become useful in a wide variety of situations, such as warning systems establishment, and multipollutant or exposome studies.
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Affiliation(s)
- Pierre Masselot
- Department of Public Health, Environment and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Fateh Chebana
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada
| | - Céline Campagna
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada and Institut National de Santé Publique du Québec, 945, avenue Wolfe Québec (Québec) G1V 5B3 Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada and Air Health Science Division, Health Canada, 269 Laurier Avenue West, Mail Stop 4903B, Ottawa, Ontario K1A0K9 Canada
| | - Taha B M J Ouarda
- Centre Eau-Terre-Environnement, Institut National de la Recherche Scientifique, 490, rue de la Couronne, Québec (Québec), G1K 9A9, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada, Institut National de Santé Publique du Québec, Québec, Canada, and Ouranos, Montréal, 550 Sherbrooke Ouest, Tour Ouest, 19eme Étage, Montréal (Québec), H3A 1B9, Canada
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Hebbern C, Gosselin P, Chen K, Chen H, Cakmak S, MacDonald M, Chagnon J, Dion P, Martel L, Lavigne E. Future temperature-related excess mortality under climate change and population aging scenarios in Canada. Can J Public Health 2023; 114:726-736. [PMID: 37308698 PMCID: PMC10484859 DOI: 10.17269/s41997-023-00782-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/27/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Climate change is expected to increase global temperatures. How temperature-related mortality risk will change is not completely understood, and how future demographic changes will affect temperature-related mortality needs to be clarified. We evaluate temperature-related mortality across Canada until 2099, accounting for age groups and scenarios of population growth. METHODS We used daily counts of non-accidental mortality for 2000 to 2015 for all 111 health regions across Canada, incorporating in the study both urban and rural areas. A two-part time series analysis was used to estimate associations between mean daily temperatures and mortality. First, current and future daily mean temperature time series simulations were developed from Coupled Model Inter-Comparison Project 6 (CMIP6) climate model ensembles from past and projected climate change scenarios under Shared Socioeconomic Pathways (SSPs). Next, excess mortality due to heat and cold and the net difference were projected to 2099, also accounting for different regional and population aging scenarios. RESULTS For 2000 to 2015, we identified 3,343,311 non-accidental deaths. On average, a net increase of 17.31% (95% eCI: 13.99, 20.62) in temperature-related excess mortality under a higher greenhouse gas emission scenario is expected for Canada in 2090-2099, which represents a greater burden than a scenario that assumed strong levels of greenhouse gas mitigation policies (net increase of 3.29%; 95% eCI: 1.41, 5.17). The highest net increase was observed among people aged 65 and over, and the largest increases in both net and heat- and cold-related mortality were observed in population scenarios that incorporated the highest rates of aging. CONCLUSION Canada may expect net increases in temperature-related mortality under a higher emissions climate change scenario, compared to one assuming sustainable development. Urgent action is needed to mitigate future climate change impacts.
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Affiliation(s)
| | - Pierre Gosselin
- Institut National de La Recherche Scientifique (Centre Eau-Terre-Environnement), Québec, QC, Canada
- Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center On Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Hong Chen
- Population Studies Division, Health Canada, Ottawa, ON, Canada
| | - Sabit Cakmak
- Population Studies Division, Health Canada, Ottawa, ON, Canada
| | - Melissa MacDonald
- Meteorological Service of Canada, Environment and Climate Change Canada, Gatineau, QC, Canada
| | | | - Patrice Dion
- Centre for Demography, Statistics Canada, Ottawa, ON, Canada
| | - Laurent Martel
- Centre for Demography, Statistics Canada, Ottawa, ON, Canada
| | - Eric Lavigne
- Population Studies Division, Health Canada, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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3
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Mehiriz K, Gosselin P. The Effect of Perceived Threats and Response Efficacy on Adaptation to Smog: An Instrumental Variables Design. Risk Anal 2022; 42:1042-1055. [PMID: 34424564 DOI: 10.1111/risa.13814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/19/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
Threats and response efficacyperceptions are core conceptsof the protection motivationtheory, and recent years have witnessed a considerable growth of research on the effect of thesefactors on adaptation to air pollution. However, few studies use appropriate designs to deal with endogeneity issues, a situation that raises serious questions on the validity of their findings. To overcome this problem, this study uses the instrumental variables method to test the effect of perceived threats and response efficacy on adaptation to smog episodes. The results of this study show that the conjunction of a moderate to high perception of threats with a high perception of response efficacy is positively associated with the adoption of the recommended behavior. The increase of perceived threats does not seem to have an effect on the behavior of individuals with low response efficacy perception. Moreover, change in perceived response efficacy does not lead to any change in the behavior of individuals with low threat perceptions. Concerning policy implications, this study suggests that smog warnings and health communication campaigns could be more effective if they provide accurate information simultaneously on air pollution level, its adverse effects, and advice on how to mitigate these effects.
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Affiliation(s)
- Kaddour Mehiriz
- Doha Institute for Graduate Studies, School of Public Administration and Development Economics, Doha, Qatar
| | - Pierre Gosselin
- Institut National de Santé Publique du Québec, Québec, Canada
- Université Laval, Québec, Canada
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Yan B, Chebana F, Masselot P, Campagna C, Gosselin P, Ouarda TBMJ, Lavigne É. A cold-health watch and warning system, applied to the province of Quebec (Canada). Sci Total Environ 2020; 741:140188. [PMID: 32886981 DOI: 10.1016/j.scitotenv.2020.140188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
CONTEXT A number of studies have shown that cold has an important impact on human health. However, almost no studies focused on cold warning systems to prevent those health effects. For Nordic regions, like the province of Quebec in Canada, winter is long and usually very cold with an observed increase in mortality and hospitalizations throughout the season. However, there is no existing system specifically designed to follow in real-time this mortality increase throughout the season and to alert public health authorities prior to cold waves. OBJECTIVE The aim is to establish a watch and warning system specifically for health impacts of cold, applied to different climatic regions of the province of Quebec. METHODOLOGY A methodology previously used to establish the health-heat warning system in Quebec is adapted to cold. The approach identifies cold weather indicators and establishes thresholds related to extreme over-mortality or over-hospitalization events in the province of Quebec, Canada. RESULTS AND CONCLUSION The final health-related thresholds proposed are between (-15 °C, -23 °C) and (-20 °C, -29 °C) according to the climatic region for excesses of mortality, and between (-13 °C, -23 °C) and (-17 °C, -30 °C) for excesses of hospitalization. These results suggest that the system model has a high sensitivity and an acceptable number of false alarms. This could lead to the establishment of a cold-health watch and warning system with valid indicators and thresholds for each climatic region of Quebec. It can be seen as a complementary system to the existing one for heat warnings, in order to help the public health authorities to be well prepared during an extreme cold event.
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Affiliation(s)
- Bixun Yan
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada
| | - Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada
| | - Céline Campagna
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada; Institut National de Santé Publique du Québec, 945 av Wolfe, Québec G1V 5B3, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada; Institut National de Santé Publique du Québec, 945 av Wolfe, Québec G1V 5B3, Canada
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490 Couronne St, Québec G1K 9A9, Canada
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa K1G 5Z3, Canada; Air Health Science Division, Health Canada, 269 Laurier Ave West, Ottawa K1A 0K9, Canada
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Meade RD, Akerman AP, Notley SR, McGinn R, Poirier P, Gosselin P, Kenny GP. Physiological factors characterizing heat-vulnerable older adults: A narrative review. Environ Int 2020; 144:105909. [PMID: 32919284 DOI: 10.1016/j.envint.2020.105909] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/24/2020] [Accepted: 06/17/2020] [Indexed: 05/26/2023]
Abstract
More frequent and intense periods of extreme heat (heatwaves) represent the most direct challenge to human health posed by climate change. Older adults are particularly vulnerable, especially those with common age-associated chronic health conditions (e.g., cardiovascular disease, hypertension, obesity, type 2 diabetes, chronic kidney disease). In parallel, the global population is aging and age-associated disease rates are on the rise. Impairments in the physiological responses tasked with maintaining homeostasis during heat exposure have long been thought to contribute to increased risk of health disorders in older adults during heatwaves. As such, a comprehensive overview of the provisional links between age-related physiological dysfunction and elevated risk of heat-related injury in older adults would be of great value to healthcare officials and policy makers concerned with protecting heat-vulnerable sectors of the population from the adverse health impacts of heatwaves. In this narrative review, we therefore summarize our current understanding of the physiological mechanisms by which aging impairs the regulation of body temperature, hemodynamic stability and hydration status. We then examine how these impairments may contribute to acute pathophysiological events common during heatwaves (e.g., heatstroke, major adverse cardiovascular events, acute kidney injury) and discuss how age-associated chronic health conditions may exacerbate those impairments. Finally, we briefly consider the importance of physiological research in the development of climate-health programs aimed at protecting heat-vulnerable individuals.
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Affiliation(s)
- Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ryan McGinn
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Pierre Gosselin
- Institut National de Santé Publique du Québec and Université Laval, Québec, Québec, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
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Can G, Şahin Ü, Sayılı U, Dubé M, Kara B, Acar HC, İnan B, Aksu Sayman Ö, Lebel G, Bustinza R, Küçükali H, Güven U, Gosselin P. Excess Mortality in Istanbul during Extreme Heat Waves between 2013 and 2017. Int J Environ Res Public Health 2019; 16:ijerph16224348. [PMID: 31703402 PMCID: PMC6887774 DOI: 10.3390/ijerph16224348] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 01/03/2023]
Abstract
Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.
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Affiliation(s)
- Günay Can
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Ümit Şahin
- Sabanci University Istanbul Policy Center, Bankalar Caddesi, No:2 Karaköy Minerva Han, 34420 Istanbul, Turkey
| | - Uğurcan Sayılı
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Marjolaine Dubé
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada
| | - Beril Kara
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Hazal Cansu Acar
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
- Correspondence: ; Tel.: +90-5368283447
| | - Barış İnan
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Özden Aksu Sayman
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Germain Lebel
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada
| | - Ray Bustinza
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada
| | - Hüseyin Küçükali
- Department of Public Health, Istanbul Medipol University School of Medicine, Kavacık mah. Ekinciler cad. No:19 Kavacık Kavşağı, Beykoz, 34810 Istanbul, Turkey
| | - Umur Güven
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098 Istanbul, Turkey
| | - Pierre Gosselin
- Institut national de santé publique du Québec and Université Laval, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada
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Masselot P, Chebana F, Lavigne É, Campagna C, Gosselin P, Ouarda TBMJ. Toward an Improved Air Pollution Warning System in Quebec. Int J Environ Res Public Health 2019; 16:ijerph16122095. [PMID: 31200502 PMCID: PMC6617323 DOI: 10.3390/ijerph16122095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 11/16/2022]
Abstract
The nature of pollutants involved in smog episodes can vary significantly in various cities and contexts and will impact local populations differently due to actual exposure and pre-existing sensitivities for cardiovascular or respiratory diseases. While regulated standards and guidance remain important, it is relevant for cities to have local warning systems related to air pollution. The present paper proposes indicators and thresholds for an air pollution warning system in the metropolitan areas of Montreal and Quebec City (Canada). It takes into account past and current local health impacts to launch its public health warnings for short-term episodes. This warning system considers fine particulate matter (PM2.5) as well as the combined oxidant capacity of ozone and nitrogen dioxide (Ox) as environmental exposures. The methodology used to determine indicators and thresholds consists in identifying extreme excess mortality episodes in the data and then choosing the indicators and thresholds to optimize the detection of these episodes. The thresholds found for the summer were 31 μg/m3 for PM2.5 and 43 ppb for Ox in Montreal, and 32 μg/m3 and 23 ppb in Quebec City. In winter, thresholds found were 25 μg/m3 and 26 ppb in Montreal, and 33 μg/m3 and 21 ppb in Quebec City. These results are in line with different guidelines existing concerning air quality, but more adapted to the cities examined. In addition, a sensitivity analysis is conducted which suggests that Ox is more determinant than PM2.5 in detecting excess mortality episodes.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada.
- Air health Science Division, Health Canada, 269 Laurier Ave West, Ottawa, ON K1A 0K9, Canada.
| | - Céline Campagna
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
- Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
- Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
- Ouranos, 550 Rue Sherbrooke Ouest, Montréal, QC H3A 1B9, Canada.
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
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Mehiriz K, Gosselin P. Evaluation of the Impacts of a Phone Warning and Advising System for Individuals Vulnerable to Smog. Evidence from a Randomized Controlled Trial Study in Canada. Int J Environ Res Public Health 2019; 16:ijerph16101817. [PMID: 31121903 PMCID: PMC6571566 DOI: 10.3390/ijerph16101817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 12/11/2022]
Abstract
Smog warning systems are components of adaptation strategies that are adopted by governments around the world to protect their citizens from extreme episodes of air pollution. As part of a growing research stream on the effectiveness of these systems, this article presents the results of a study on the impacts of an automated phone warning and advising system for individuals vulnerable to air pollution. A sample of 1328 individuals were recruited and randomly assigned to treatment and control groups. The treatment group received smog warning while the control group did not. Data were collected via three phone surveys, two before and one after issuing the smog warning. The comparison between treatment and control groups indicates that exposure to a smog warning improved information on the occurrence of smog episodes (n = 484, OR = 5.58, p = 0.00), and knowledge on protective behaviors. Furthermore, members of treatment group were more likely to avoid exposure to smog episodes by spending more time inside with the windows closed than usual (n = 474, OR = 2.03, p = 0.00). Members of treatment group who take medication in the form of aerosol pumps also kept these devices on themselves more frequently than those of control group (n= 109, OR = 2.15, p = 0.03). The system however had no discernible effects on the awareness of air pollution risks, reduction of health symptoms related to smog and the use of health system services. The absence of health benefits could be related to the lower actual exposure to air pollution of such vulnerable groups during winter.
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Affiliation(s)
- Kaddour Mehiriz
- Doha Institute for Graduate Studies, School of Public Administration and Development Economics, P.O. Box: 200592, Zone 70, Al Tarfa Street Al-Daayen, Doha, Qatar.
| | - Pierre Gosselin
- Institut National de la Santé Publique and Ouranos, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
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Abstract
Pollen allergies are a major source of seasonal allergic rhinitis in North America. This type of rhinitis affects 17% of adults in Quebec, a marked increase in the last 30 years. Ragweed (Ambrosia artemisiifolia L.) pollens are responsible for 50% to 90% of rhinitis cases. Climate change has played a significant role in the increased prevalence of seasonal allergic rhinitis over the last few decades. In 2015, the Quebec government put in place a strategy to tackle this problem, the Stratégie québécoise de réduction de l'herbe à poux et des autres pollens allergènes [Quebec strategy to reduce ragweed and other allergenic pollens]. Based on solid evidence, the Strategy advocates for co-operation between stakeholders and the integration of control measures into the maintenance practices of municipalities and other large public and private landowners. This article presents the scientific data underpinning the Strategy and initial successes of the action taken under the Strategy.
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Affiliation(s)
- Isabelle Demers
- Ministère de la santé et des services sociaux du Québec, Québec, Quebec, Canada
| | - Pierre Gosselin
- Institut national de santé publique du Québec and Ouranos, Québec, Quebec, Canada
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Ouellet C, Langlois F, Provencher M, Gosselin P. Intolerance of uncertainty and difficulties in emotion regulation: Proposal for an integrative model of generalized anxiety disorder. European Review of Applied Psychology 2019. [DOI: 10.1016/j.erap.2019.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Masselot P, Chebana F, Ouarda TBMJ, Bélanger D, St-Hilaire A, Gosselin P. A new look at weather-related health impacts through functional regression. Sci Rep 2018; 8:15241. [PMID: 30323248 PMCID: PMC6189063 DOI: 10.1038/s41598-018-33626-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
A major challenge of climate change adaptation is to assess the effect of changing weather on human health. In spite of an increasing literature on the weather-related health subject, many aspect of the relationship are not known, limiting the predictive power of epidemiologic models. The present paper proposes new models to improve the performances of the currently used ones. The proposed models are based on functional data analysis (FDA), a statistical framework dealing with continuous curves instead of scalar time series. The models are applied to the temperature-related cardiovascular mortality issue in Montreal. By making use of the whole information available, the proposed models improve the prediction of cardiovascular mortality according to temperature. In addition, results shed new lights on the relationship by quantifying physiological adaptation effects. These results, not found with classical model, illustrate the potential of FDA approaches.
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Affiliation(s)
- Pierre Masselot
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada.
| | - Fateh Chebana
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Taha B M J Ouarda
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Diane Bélanger
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Pierre Gosselin
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
- Institut national de santé publique du Québec (INSPQ), Québec, Canada
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Masselot P, Chebana F, Bélanger D, St-Hilaire A, Abdous B, Gosselin P, Ouarda TBMJ. Aggregating the response in time series regression models, applied to weather-related cardiovascular mortality. Sci Total Environ 2018; 628-629:217-225. [PMID: 29438931 DOI: 10.1016/j.scitotenv.2018.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/04/2018] [Accepted: 02/02/2018] [Indexed: 06/08/2023]
Abstract
In environmental epidemiology studies, health response data (e.g. hospitalization or mortality) are often noisy because of hospital organization and other social factors. The noise in the data can hide the true signal related to the exposure. The signal can be unveiled by performing a temporal aggregation on health data and then using it as the response in regression analysis. From aggregated series, a general methodology is introduced to account for the particularities of an aggregated response in a regression setting. This methodology can be used with usually applied regression models in weather-related health studies, such as generalized additive models (GAM) and distributed lag nonlinear models (DLNM). In particular, the residuals are modelled using an autoregressive-moving average (ARMA) model to account for the temporal dependence. The proposed methodology is illustrated by modelling the influence of temperature on cardiovascular mortality in Canada. A comparison with classical DLNMs is provided and several aggregation methods are compared. Results show that there is an increase in the fit quality when the response is aggregated, and that the estimated relationship focuses more on the outcome over several days than the classical DLNM. More precisely, among various investigated aggregation schemes, it was found that an aggregation with an asymmetric Epanechnikov kernel is more suited for studying the temperature-mortality relationship.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Diane Bélanger
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Belkacem Abdous
- Université Laval, Département de Médecine Sociale et Préventive, Québec, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada; Institut National de Santé Publique du Québec (INSPQ), Québec, Canada
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
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Masselot P, Chebana F, Bélanger D, St-Hilaire A, Abdous B, Gosselin P, Ouarda TBMJ. EMD-regression for modelling multi-scale relationships, and application to weather-related cardiovascular mortality. Sci Total Environ 2018; 612:1018-1029. [PMID: 28892843 DOI: 10.1016/j.scitotenv.2017.08.276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/31/2017] [Accepted: 08/28/2017] [Indexed: 06/07/2023]
Abstract
In a number of environmental studies, relationships between nat4ural processes are often assessed through regression analyses, using time series data. Such data are often multi-scale and non-stationary, leading to a poor accuracy of the resulting regression models and therefore to results with moderate reliability. To deal with this issue, the present paper introduces the EMD-regression methodology consisting in applying the empirical mode decomposition (EMD) algorithm on data series and then using the resulting components in regression models. The proposed methodology presents a number of advantages. First, it accounts of the issues of non-stationarity associated to the data series. Second, this approach acts as a scan for the relationship between a response variable and the predictors at different time scales, providing new insights about this relationship. To illustrate the proposed methodology it is applied to study the relationship between weather and cardiovascular mortality in Montreal, Canada. The results shed new knowledge concerning the studied relationship. For instance, they show that the humidity can cause excess mortality at the monthly time scale, which is a scale not visible in classical models. A comparison is also conducted with state of the art methods which are the generalized additive models and distributed lag models, both widely used in weather-related health studies. The comparison shows that EMD-regression achieves better prediction performances and provides more details than classical models concerning the relationship.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Diane Bélanger
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Belkacem Abdous
- Université Laval, Département de médecine sociale et préventive, Québec, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Québec, Canada
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
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Hongoh V, Gosselin P, Michel P, Ravel A, Waaub JP, Campagna C, Samoura K. Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec. PLoS One 2017; 12:e0190049. [PMID: 29281726 PMCID: PMC5744945 DOI: 10.1371/journal.pone.0190049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 12/07/2017] [Indexed: 12/03/2022] Open
Abstract
Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to research, surveillance, and prevention and control interventions in a context of climate change. Multi-stakeholder engagement in prioritization can help broaden the range of criteria taken into account, offer opportunities for early identification of potential challenges and may facilitate acceptability of any resulting decisions.
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Affiliation(s)
- Valerie Hongoh
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Pierre Gosselin
- Institut national de santé publique Québec (INSPQ), Québec, Canada
- Ouranos, Consortium on Regional Climatology and Adaptation to Climate Change, Montreal, Canada
| | - Pascal Michel
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- National Microbiology Laboratory at Saint-Hyacinthe, Public Health Agency of Canada, Saint-Hyacinthe, Canada
| | - André Ravel
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Jean-Philippe Waaub
- Group for Research in Decision Analysis (GERAD, HEC Montréal, Polytechnique Montréal, McGill, UQAM), Montreal, Canada
| | - Céline Campagna
- Institut national de santé publique Québec (INSPQ), Québec, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec, Canada
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Vanasse A, Talbot D, Chebana F, Bélanger D, Blais C, Gamache P, Giroux JX, Dault R, Gosselin P. Effects of climate and fine particulate matter on hospitalizations and deaths for heart failure in elderly: A population-based cohort study. Environ Int 2017; 106:257-266. [PMID: 28709636 DOI: 10.1016/j.envint.2017.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND There are limited data on the effects of climate and air pollutant exposure on heart failure (HF) within taking into account individual and contextual variables. OBJECTIVES We measured the lag effects of temperature, relative humidity, atmospheric pressure and fine particulate matter (PM2.5) on hospitalizations and deaths for HF in elderly diagnosed with this disease on a 10-year period in the province of Quebec, Canada. METHODS Our population-based cohort study included 112,793 elderly diagnosed with HF between 2001 and 2011. Time dependent Cox regression models approximated with pooled logistic regressions were used to evaluate the 3- and 7-day lag effects of daily temperature, relative humidity, atmospheric pressure and PM2.5 exposure on HF morbidity and mortality controlling for several individual and contextual covariates. RESULTS Overall, 18,309 elderly were hospitalized and 4297 died for the main cause of HF. We observed an increased risk of hospitalizations and deaths for HF with a decrease in the average temperature of the 3 and 7days before the event. An increase in atmospheric pressure in the previous 7days was also associated with a higher risk of having a HF negative outcome, but no effect was observed in the 3-day lag model. No association was found with relative humidity and with PM2.5 regardless of the lag period. CONCLUSIONS Lag effects of temperature and other meteorological parameters on HF events were limited but present. Nonetheless, preventive measures should be issued for elderly diagnosed with HF considering the burden and the expensive costs associated with the management of this disease.
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Affiliation(s)
- Alain Vanasse
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada; Research Center of the Centre hospitalier universitaire de Sherbrooke - Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada.
| | - Denis Talbot
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
| | - Fateh Chebana
- The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Diane Bélanger
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Claudia Blais
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
| | - Philippe Gamache
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada.
| | - Jean-Xavier Giroux
- The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Roxanne Dault
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada.
| | - Pierre Gosselin
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada; Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
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Bouzar L, Müller MM, Gosselin P, Kulić IM, Mohrbach H. Squeezed helical elastica. Eur Phys J E Soft Matter 2016; 39:114. [PMID: 27888445 DOI: 10.1140/epje/i2016-16114-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
We theoretically study the conformations of a helical semi-flexible filament confined to a flat surface. This squeezed helix exhibits a variety of unexpected shapes resembling circles, waves or spirals depending on the material parameters. We explore the conformation space in detail and show that the shapes can be understood as the mutual elastic interaction of conformational quasi-particles. Our theoretical results are potentially useful to determine the material parameters of such helical filaments in an experimental setting.
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Affiliation(s)
- Lila Bouzar
- Département de Physique Théorique, Faculté de Physique, USTHB, El-Alia Bab-Ezzouar, BP 32, 16111, Alger, Algeria
- Laboratoire de Physique et Chimie Quantique, Université Mouloud Mammeri, BP 17, 15000, Tizi-Ouzou, Algeria
| | - Martin Michael Müller
- Equipe BioPhysStat, ICPMB-FR CNRS 2843, Université de Lorraine, 1 boulevard Arago, 57070, Metz, France.
- Institut Charles Sadron, CNRS-UdS, 23 rue du Loess, BP 84047, 67034, Strasbourg cedex 2, France.
| | - Pierre Gosselin
- Institut Fourier, UMR 5582 CNRS-UJF, Université Grenoble I, BP74, 38402, Saint-Martin d'Hères, France
| | - Igor M Kulić
- Institut Charles Sadron, CNRS-UdS, 23 rue du Loess, BP 84047, 67034, Strasbourg cedex 2, France
| | - Hervé Mohrbach
- Equipe BioPhysStat, ICPMB-FR CNRS 2843, Université de Lorraine, 1 boulevard Arago, 57070, Metz, France
- Institut Charles Sadron, CNRS-UdS, 23 rue du Loess, BP 84047, 67034, Strasbourg cedex 2, France
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Abstract
The study of the management of weather-related disaster risks by municipalities has attracted little attention even though these organizations play a key role in protecting the population from extreme meteorological conditions. This article contributes to filling this gap with new evidence on the level and determinants of Quebec municipalities’ preparedness for weather hazards and response to related weather warnings. Using survey data from municipal emergency management coordinators and secondary data on the financial and demographic characteristics of municipalities, the study shows that most Quebec municipalities are sufficiently prepared for weather hazards and undertake measures to protect the population when informed of imminent extreme weather events. Significant differences between municipalities were noted though. Specifically, the level of preparedness was positively correlated with the municipalities’ capacity and population support for weather-related disaster management policies. In addition, the risk of weather-related disasters increases the preparedness level through its effect on population support. We also found that the response to weather warnings depended on the risk of weather-related disasters, the preparedness level and the quality of weather warnings. These results highlight areas for improvement in the context of increasing frequency and/or severity of such events with current climate change.
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Affiliation(s)
- Kaddour Mehiriz
- Centre Eau, Terre et Environnement, Institut National de la Recherche Scientifique, Québec, Québec, Canada
- * E-mail:
| | - Pierre Gosselin
- Institut National de la Santé Publique du Québec, Québec, Québec, Canada
- OURANOS, Montréal, Québec, Canada
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18
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Barcellos C, Roux E, Ceccato P, Gosselin P, Monteiro AM, de Matos VP, Xavier DR. An observatory to gather and disseminate information on the health-related effects of environmental and climate change. Rev Panam Salud Publica 2016; 40:167-173. [PMID: 27991974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/31/2016] [Indexed: 06/06/2023] Open
Abstract
This report sought to critically examine proposals, potentials, and challenges of environmental health observatories with an emphasis on climate change processes. A critical review of existing environmental health observatories was performed, examining their purposes, potential audiences, and technological platforms. The implementation of the Brazilian Climate and Health Observatory (C&HO) is described, and two stages are defined: (i) the requirement analysis and negotiation stage that identified the national and regional institutional players and their roles as data producers/users; and (ii) thematic health-related workshops that reviewed water-related diseases, vector-borne diseases, extreme climate events, and health problems derived from forest fires. The C&HO is an example of making information on climate and health available through an Internet site where data from different origins can be accessed on a common platform. Complex queries are made by users and can be executed over multiple sites, geographically distributed, with all technical details hidden from the end user. At this stage of the C&HO prototype, alongside the queries, users can also produce semi-qualitative graphs and maps. A multi-scale approach was developed using the platform by setting up sentinel sites. Building a successful observatory is a participatory process that involves choosing indicators, data sources, information technology, and languages to best reach different audiences, such as researchers, citizens, public health professionals, and decisionmakers.
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Affiliation(s)
- Christovam Barcellos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT/Fiocruz), Rio de Janeiro, Brazil
| | - Emmanuel Roux
- Unité Mixte de Recherche Espace pour le développement, Institut de Recherche pour le Développement, Montpellier, Languedoc-Roussillon, France
| | - Pietro Ceccato
- International Research Institute for Climate and Society, Columbia University, New York, United States of America
| | - Pierre Gosselin
- Institut national de santé publique du Québec, Health and Environmental Group, Québec, Canada
| | | | - Vanderlei Pascoal de Matos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT/Fiocruz), Rio de Janeiro, Brazil
| | - Diego Ricardo Xavier
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT/Fiocruz), Rio de Janeiro, Brazil
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Chiu Y, Chebana F, Abdous B, Bélanger D, Gosselin P. Mortality and morbidity peaks modeling: An extreme value theory approach. Stat Methods Med Res 2016; 27:1498-1512. [DOI: 10.1177/0962280216662494] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hospitalizations and deaths belong to the most studied health variables in public health. Those variables are usually analyzed through mean events and trends, based on the whole dataset. However, this approach is not appropriate to comprehend health outcome peaks which are unusual events that strongly impact the health care network (e.g. overflow in hospital emergency rooms). Peaks can also be of interest in etiological research, for instance when analyzing relationships with extreme exposures (meteorological conditions, air pollution, social stress, etc.). Therefore, this paper aims at modeling health variables exclusively through the peaks, which is rarely done except over short periods. Establishing a rigorous and general methodology to identify peaks is another goal of this study. To this end, the extreme value theory appears adequate with statistical tools for selecting and modeling peaks. Selection and analysis for deaths and hospitalizations peaks using extreme value theory have not been applied in public health yet. Therefore, this study also has an exploratory goal. A declustering procedure is applied to the raw data in order to meet extreme value theory requirements. The application is done on hospitalization and death peaks for cardiovascular diseases, in the Montreal and Quebec metropolitan communities (Canada) for the period 1981–2011. The peak return levels are obtained from the modeling and can be useful in hospital management or planning future capacity needs for health care facilities, for example. This paper focuses on one class of diseases in two cities, but the methodology can be applied to any other health peaks series anywhere, as it is data driven.
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Affiliation(s)
- Y Chiu
- Institut national de la recherche scientifique, centre ETE, Québec, Canada
| | - F Chebana
- Institut national de la recherche scientifique, centre ETE, Québec, Canada
| | - B Abdous
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
| | - D Bélanger
- Institut national de la recherche scientifique, centre ETE, Québec, Canada
- Centre de recherche du centre hospitalier universitaire de Québec, Québec, Canada
| | - P Gosselin
- Institut national de la recherche scientifique, centre ETE, Québec, Canada
- Institut national de santé publique du Québec, Québec, Canada
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20
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Beaudoin M, Gosselin P. An effective public health program to reduce urban heat islands in Québec, Canada. Rev Panam Salud Publica 2016; 40:160-166. [PMID: 27991973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/10/2016] [Indexed: 06/06/2023] Open
Abstract
In 2005, the Government of the Province of Québec, Canada, adopted the Climate Change Action Plan for 2006 - 2012. The Institut national de santé publique du Québec (National Institute of Public Health of Québec), charged with implementing the health adaptation component of the Plan, worked to mitigate urban heat islands (UHI) by funding and evaluating 40 pilot projects. These projects explored different methods of fighting UHIs by greening cities in a participative and mobilizing approach led mainly by non-governmental organizations and municipalities. An assessment of temperatures before and after implementing various methods demonstrated that some actions enabled significant gains of coolness and more efficiently mitigated heat (reduction of concrete/asphalt surfaces, increasing vegetation, etc.). An assessment of quality of life showed that projects were positively received by users, especially by those living in vulnerable situations. A lifecycle analysis showed that from the environmental perspective, UHI mitigation measures that do not require fertilization or maintenance are preferable. Finally, communication efforts that raise awareness of UHI and mitigation are of significant importance to program success.
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21
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Hongoh V, Campagna C, Panic M, Samuel O, Gosselin P, Waaub JP, Ravel A, Samoura K, Michel P. Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios. PLoS One 2016; 11:e0160651. [PMID: 27494136 PMCID: PMC4975439 DOI: 10.1371/journal.pone.0160651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/23/2016] [Indexed: 11/25/2022] Open
Abstract
The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk.
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Affiliation(s)
- Valerie Hongoh
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- * E-mail:
| | - Céline Campagna
- Institut national de santé publique du Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
| | - Mirna Panic
- Institut national de santé publique du Québec, Québec, Canada
- Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Onil Samuel
- Institut national de santé publique du Québec, Québec, Canada
| | - Pierre Gosselin
- Institut national de santé publique du Québec, Québec, Canada
- Ouranos, Consortium on regional climatology and adaptation to climate change, Montreal, Quebec, Canada
| | | | - André Ravel
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Karim Samoura
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Université Aube Nouvelle, Ouagadougou, Burkina Faso
| | - Pascal Michel
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- National Microbiology Laboratory at Saint-Hyacinthe, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
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Ngom R, Gosselin P, Blais C, Rochette L. Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes--A Cross-Sectional Study for Quebec, Canada. Int J Environ Res Public Health 2016; 13:423. [PMID: 27089356 PMCID: PMC4847085 DOI: 10.3390/ijerph13040423] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/24/2016] [Accepted: 04/12/2016] [Indexed: 12/22/2022]
Abstract
This study aimed at determining the role of proximity to specific types of green spaces (GSes) as well as their spatial location in the relationship with the most morbid cardiovascular diseases (CVD) and diabetes. We measured the accessibility to various types of GS and used a cross-sectional approach at census Dissemination Area (DA) levels in the Montreal and Quebec City metropolitan zones for the period 2006–2011. Poisson and negative binomial regression models were fitted to quantify the relationship between distances to specific types of GS and CVD morbidity as well as some risk factors (diabetes and hypertension) while controlling for several social and environmental confounders. GSes that have sports facilities showed a significant relationship to cerebrovascular diseases: the most distant population had an 11% higher prevalence rate ratio (PRR) compared to the nearest, as well as higher diabetes risk (PRR 9%) than the nearest. However, the overall model performance and the understanding of the role of GSes with sport facilities may be substantially achieved with lifestyle factors. Significantly higher prevalence of diabetes and cerebrovascular diseases as well as lower access to GSes equipped with sports facilities were found in suburban areas. GSes can advantageously be used to prevent some CVDs and their risk factors, but there may be a need to reconsider their types and location.
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Affiliation(s)
- Roland Ngom
- Geoimpacts Consulting, 111 Rue de la Chasse Galerie, Québec, QC G1B 1Y2, Canada.
| | - Pierre Gosselin
- Institut National de la Santé Publique du Québec, 945, Avenue Wolfe, QC G1V 5B3, Canada.
- Institut National de la Recherche Scientifique, 490, Rue de la Couronne, Québec, QC G1K 9A9, Canada.
| | - Claudia Blais
- Institut National de la Santé Publique du Québec, 945, Avenue Wolfe, QC G1V 5B3, Canada.
- Faculty of Medicine, Université Laval, 1050 Avenue de la Médécine, Québec, QC G1V 0A6, Canada.
| | - Louis Rochette
- Institut National de la Santé Publique du Québec, 945, Avenue Wolfe, QC G1V 5B3, Canada.
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Hongoh V, Michel P, Gosselin P, Samoura K, Ravel A, Campagna C, Cissé HD, Waaub JP. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases. Int J Environ Res Public Health 2016; 13:419. [PMID: 27077875 PMCID: PMC4847081 DOI: 10.3390/ijerph13040419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 01/08/2023]
Abstract
The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.
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Affiliation(s)
- Valerie Hongoh
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
| | - Pascal Michel
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
- National Microbiology Laboratory at Saint-Hyacinthe, Public Health Agency of Canada, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
| | - Pierre Gosselin
- Institut National de Santé Publique du Québec (INSPQ), 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
- Ouranos, Consortium on Regional Climatology and Adaptation to Climate Change, Montreal, QC H3A 1B9, Canada.
| | - Karim Samoura
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
- Université Aube Nouvelle, Quartier 1200 Logement, 06 B.P.: 9283, Ouagadougou, Burkina Faso.
| | - André Ravel
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada.
| | - Céline Campagna
- Institut National de Santé Publique du Québec (INSPQ), 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
- Department of Social And Preventive Medicine, Université Laval, 2325 Rue de l'Université, Québec, QC G1V 0A6, Canada.
| | - Hassane Djibrilla Cissé
- Urban Safety and Sustainable Development, Bureau of Environmental Evaluation and Impact Studies of the Ministry of Environment, Niamey B.P.: 578, Niger.
| | - Jean-Philippe Waaub
- Group for Research in Decision Analysis (GERAD), 3000, Côte-Sainte-Catherine Rd., Montreal, QC H3T 2A7, Canada.
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Gosselin P, Chabot K, Béland M, Goulet-Gervais L, Morin AJS. [Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms]. Encephale 2016; 42:191-6. [PMID: 26924001 DOI: 10.1016/j.encep.2016.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/02/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. METHOD Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). RESULTS Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role in the link between fear of childbirth and PPD. CONCLUSIONS These results support the relevance of taking into account the fear of childbirth and perception of pain in connection with symptoms of PTS and PPD in nulliparous women. The unplanned caesarean section (including emergency caesarean) also appears to be important in the study of the relationship between fear and symptoms of PTS. Fear of childbirth could render the experience of childbearing more negative and predispose to PTS and PPD. Enabling psychological vulnerabilities could also be an interesting avenue for understanding these links. Limitations are discussed.
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Affiliation(s)
- P Gosselin
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada.
| | - K Chabot
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - M Béland
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - L Goulet-Gervais
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - A J S Morin
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australie
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Bélanger D, Abdous B, Valois P, Gosselin P, Sidi EAL. A multilevel analysis to explain self-reported adverse health effects and adaptation to urban heat: a cross-sectional survey in the deprived areas of 9 Canadian cities. BMC Public Health 2016; 16:144. [PMID: 26872840 PMCID: PMC4751716 DOI: 10.1186/s12889-016-2749-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background This study identifies the characteristics and perceptions related to the individual, the dwelling and the neighbourhood of residence associated with the prevalence of self-reported adverse health impacts and an adaptation index when it is very hot and humid in summer in the most disadvantaged sectors of the nine most populous cities of Québec, Canada, in 2011. Methods The study uses a cross-sectional design and a stratified representative sample; 3485 people (individual-level) were interviewed in their residence. They lived in 1647 buildings (building-level) in 87 most materially and socially disadvantaged census dissemination areas (DA-level). Multilevel analysis was used to perform 3-level models nested one in the other to examine individual impacts as well as the adaptation index. Results For the prevalence of impacts, which is 46 %, the logistic model includes 13 individual-level indicators (including air conditioning and the adaptation index) and 1 building-level indicator. For the adaptation index, with values ranging from -3 to +3, the linear model has 10 individual-level indicators, 1 building-level indicator and 2 DA-level indicators. Of all these indicators, 9 were associated to the prevalence of impacts only and 8 to the adaptation index only. Conclusion This 3-level analysis shows the differential importance of the characteristics of residents, buildings and their surroundings on self-reported adverse health impacts and on adaptation (other than air conditioning) under hot and humid summer conditions. It also identifies indicators specific to impacts or adaptation. People with negative health impacts from heat rely more on adaptation strategies while low physical activity and good dwelling/building insulation lead to lower adaptation. Better neighbourhood walkability favors adaptations other than air conditioning. Thus, adaptation to heat in these neighbourhoods seems reactive rather than preventive. These first multi-level insights pave the way for the development of a theoretical framework of the process from heat exposure to impacts and adaptation for research, surveillance and public health interventions at all relevant levels. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2749-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Diane Bélanger
- Institut national de la recherche scientifique (INRS) Centre Eau Terre Environnement, 490, rue de la Couronne, Québec, Québec, G1K 9A9, Canada.,Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada
| | - Belkacem Abdous
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada.,Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Pierre Valois
- Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Pierre Gosselin
- Institut national de la recherche scientifique (INRS) Centre Eau Terre Environnement, 490, rue de la Couronne, Québec, Québec, G1K 9A9, Canada. .,Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada. .,Institut national de santé publique du Québec (INSPQ), 945, avenue Wolfe, Québec, Québec, G1V 5B3, Canada. .,Ouranos, 550, Sherbrooke Ouest, Tour Ouest, 19e étage, Montréal, Québec, H3A 1B9, Canada.
| | - Elhadji A Laouan Sidi
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, 2705, boulevard Laurier, Québec, Québec, G1V 4G2, Canada
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Vanasse A, Cohen A, Courteau J, Bergeron P, Dault R, Gosselin P, Blais C, Bélanger D, Rochette L, Chebana F. Association between Floods and Acute Cardiovascular Diseases: A Population-Based Cohort Study Using a Geographic Information System Approach. Int J Environ Res Public Health 2016; 13:168. [PMID: 26828511 PMCID: PMC4772188 DOI: 10.3390/ijerph13020168] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 12/18/2022]
Abstract
Background: Floods represent a serious threat to human health beyond the immediate risk of drowning. There is few data on the potential link between floods and direct consequences on health such as on cardiovascular health. This study aimed to explore the impact of one of the worst floods in the history of Quebec, Canada on acute cardiovascular diseases (CVD). Methods: A cohort study with a time series design with multiple control groups was built with the adult population identified in the Quebec Integrated Chronic Disease Surveillance System. A geographic information system approach was used to define the study areas. Logistic regressions were performed to compare the occurrence of CVD between groups. Results: The results showed a 25%–27% increase in the odds in the flooded population in spring 2011 when compared with the population in the same area in springs 2010 and 2012. Besides, an increase up to 69% was observed in individuals with a medical history of CVD. Conclusion: Despite interesting results, the association was not statistically significant. A possible explanation to this result can be that the population affected by the flood was probably too small to provide the statistical power to answer the question, and leaves open a substantial possibility for a real and large effect.
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Affiliation(s)
- Alain Vanasse
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
- Research center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS), 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
| | - Alan Cohen
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
- Research center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS), 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
| | - Josiane Courteau
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
| | - Patrick Bergeron
- Department of Biological Sciences, Bishop's University, 2600 College Street, Sherbrooke (Québec), QC J1M, Canada.
| | - Roxanne Dault
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke (Québec), QC J1H 5N4, Canada.
| | - Pierre Gosselin
- Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada.
- Research center of the Centre Hospitalier Universitaire de Québec (CHUQ), Delta II building, 6th floor, 2875 Laurier Boulevard, Québec (Québec), QC G1V 2M2, Canada.
| | - Claudia Blais
- Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada.
- Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec (Québec), QC G1V 0A6, Canada.
| | - Diane Bélanger
- Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada.
- Research center of the Centre Hospitalier Universitaire de Québec (CHUQ), Delta II building, 6th floor, 2875 Laurier Boulevard, Québec (Québec), QC G1V 2M2, Canada.
- The Eau Terre Environment Research center, Institute National de la Recherche Scientifique (INRS), 490 Couronne Street, Québec (Québec), QC G1K 9A9, Canada.
| | - Louis Rochette
- Institute National de Santé Publique du Québec (INSPQ), 945 Wolf Avenue, Québec (Québec), QC G1V 5B3, Canada.
| | - Fateh Chebana
- The Eau Terre Environment Research center, Institute National de la Recherche Scientifique (INRS), 490 Couronne Street, Québec (Québec), QC G1K 9A9, Canada.
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Valois P, Blouin P, Ouellet C, Renaud JS, Bélanger D, Gosselin P. The Health Impacts of Climate Change: A Continuing Medical Education Needs Assessment Framework. J Contin Educ Health Prof 2016; 36:218-225. [PMID: 27583999 DOI: 10.1097/ceh.0000000000000084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION As the health consequences of climate change (CC) will likely become more manifest in the future, family physicians have to be knowledgeable about these impacts and the ways in which they can affect their patients. The main aim of this study was to propose a competency framework and questionnaire used to conduct a needs analysis to identify and prioritize family physicians' real educational needs regarding the health impacts of CC. METHODS A mixed method combining a qualitative interview and a quantitative online questionnaire was used (n = 24 physicians). The interview assessed key beliefs related to participating in an online continuing medical education (eCME) activity on the health impacts of climate change, and the perception of the key factors or conditions required to ensure the family physicians' satisfaction with this eCME activity. The questionnaire assessed the current and desired levels of competency on five general training themes: general knowledge about CC; heat-related illnesses; CC, extreme weather events and modification of vector-borne and zoonotic diseases; CC, extreme weather events and modification of water-borne diseases; and mental health impacts of natural disasters. RESULTS Results revealed the need for improved medical education on climate change and health. Results also add to the literature by showing that a 3-hour eCME activity covering these topics would be useful and would allow family physicians to use this knowledge in their daily practice, notably through prevention and counseling. DISCUSSION Introducing a CME needs assessment framework and a generic instrument that reflects family physicians' needs regarding the health impacts of CC has the added advantage of standardizing the assessment procedure.
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Affiliation(s)
- Pierre Valois
- Dr. Valois: Faculté des sciences de l'éducation, Université Laval, Québec, Canada. Mr. Blouin: Faculté des sciences de l'éducation, Université Laval, Québec, Canada. Ms. Ouellet: Faculté des sciences de l'éducation, Université Laval, Québec, Canada. Dr. Renaud: Faculté de médecine, Université Laval, Québec, Canada. Dr. Bélanger: Centre de recherche du Centre hospitalier universitaire de Québec, Québec, Canada, and Institut national de la recherche scientifique-Centre eau, terre et environnement, Québec, Canada. Dr. Gosselin: Faculté de médecine, Université Laval, Québec, Canada, and Direction de la santé environnementale et de la toxicologie, Institut national de la santé publique, Québec, Canada
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Gerber A, Saini C, Curie T, Emmenegger Y, Rando G, Gosselin P, Gotic I, Gos P, Franken P, Schibler U. The systemic control of circadian gene expression. Diabetes Obes Metab 2015; 17 Suppl 1:23-32. [PMID: 26332965 DOI: 10.1111/dom.12512] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 05/25/2015] [Indexed: 11/28/2022]
Abstract
The mammalian circadian timing system consists of a central pacemaker in the brain's suprachiasmatic nucleus (SCN) and subsidiary oscillators in nearly all body cells. The SCN clock, which is adjusted to geophysical time by the photoperiod, synchronizes peripheral clocks through a wide variety of systemic cues. The latter include signals depending on feeding cycles, glucocorticoid hormones, rhythmic blood-borne signals eliciting daily changes in actin dynamics and serum response factor (SRF) activity, and sensors of body temperature rhythms, such as heat shock transcription factors and the cold-inducible RNA-binding protein CIRP. To study these systemic signalling pathways, we designed and engineered a novel, highly photosensitive apparatus, dubbed RT-Biolumicorder. This device enables us to record circadian luciferase reporter gene expression in the liver and other organs of freely moving mice over months in real time. Owing to the multitude of systemic signalling pathway involved in the phase resetting of peripheral clocks the disruption of any particular one has only minor effects on the steady state phase of circadian gene expression in organs such as the liver. Nonetheless, the implication of specific pathways in the synchronization of clock gene expression can readily be assessed by monitoring the phase-shifting kinetics using the RT-Biolumicorder.
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Affiliation(s)
- A Gerber
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
- Laboratory of Biochemistry and Molecular Biology, Rockefeller University, New York, NY, USA
| | - C Saini
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
- Laboratory of Circadian Endocrinology, Geneva University Hospitals, Geneva, Switzerland
| | - T Curie
- Center of Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Y Emmenegger
- Center of Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - G Rando
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
| | - P Gosselin
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
| | - I Gotic
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
| | - P Gos
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
| | - P Franken
- Center of Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - U Schibler
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland
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Kokin J, Younger A, Gosselin P, Vaillancourt T. Biased Facial Expression Interpretation in Shy Children. Inf Child Dev 2015. [DOI: 10.1002/icd.1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Jessica Kokin
- University of Ottawa; School of Psychology; Ottawa Ontario Canada
| | - Alastair Younger
- University of Ottawa; School of Psychology; Ottawa Ontario Canada
| | - Pierre Gosselin
- University of Ottawa; School of Psychology; Ottawa Ontario Canada
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Abstract
The authors investigated children's ability to recognize emotions from the information available in the lower, middle, or upper face. School-age children were shown partial or complete facial expressions and asked to say whether they corresponded to a given emotion (anger, fear, surprise, or disgust). The results indicate that 5-year-olds were able to recognize fear, anger, and surprise from partial facial expressions. Fear was better recognized from the information located in the upper face than those located in the lower face. A similar pattern of results was found for anger, but only in girls. Recognition improved between 5 and 10 years old for surprise and anger, but not for fear and disgust.
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Bélanger D, Gosselin P, Valois P, Abdous B. Neighbourhood and dwelling characteristics associated with the self-reported adverse health effects of heat in most deprived urban areas: A cross-sectional study in 9 cities. Health Place 2015; 32:8-18. [DOI: 10.1016/j.healthplace.2014.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 12/16/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022]
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Théberge-Lapointe N, Marchand A, Langlois F, Gosselin P, Watts S. Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder. European Review of Applied Psychology 2015. [DOI: 10.1016/j.erap.2014.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Masse J, Filali A, Nigeon O, Van Grunderbeeck N, Gosselin P, Tronchon L, Mallat J, Thevenin D. Surviving Sepsis Campaign 2012 3-hour bundle in the emergency department: compliance and impact of pathway of care before and after implementation. Crit Care 2014. [PMCID: PMC4273733 DOI: 10.1186/cc14020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bélanger D, Gosselin P, Valois P, Abdous B. Perceived adverse health effects of heat and their determinants in deprived neighbourhoods: a cross-sectional survey of nine cities in Canada. Int J Environ Res Public Health 2014; 11:11028-53. [PMID: 25347192 PMCID: PMC4245598 DOI: 10.3390/ijerph111111028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/26/2014] [Accepted: 10/07/2014] [Indexed: 11/17/2022]
Abstract
This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada). The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people <65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having ≥2 diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR<65 = 5.6; OR≥65 = 4.2), and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially.
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Affiliation(s)
- Diane Bélanger
- Institut National de la Recherche Scientifique Centre Eau Terre Environnement, 490, rue de la Couronne, QC G1K 9A9, Canada.
| | - Pierre Gosselin
- Institut National de Santé Publique du Québec, 945, Avenue Wolfe, QC G1V 5B3, Canada.
| | - Pierre Valois
- Université Laval, 2325 rue de l'Université, QC G1V 0A6, Canada.
| | - Belkacem Abdous
- Centre de Recherche du Centre Hospitalier Universitaire de Québec, 2705, Boulevard Laurier, QC G1V 4G2, Canada.
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Sbidian E, Eftekahri P, Viguier M, Laroche L, Chosidow O, Gosselin P, Trouche F, Bonnet N, Arfi C, Tubach F, Bachelez H. National Survey of Psoriasis Flares after 2009 Monovalent H1N1/Seasonal Vaccines. Dermatology 2014; 229:130-5. [DOI: 10.1159/000362808] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 04/03/2014] [Indexed: 11/19/2022] Open
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Canuel M, Abdous B, Bélanger D, Gosselin P. Development of composite indices to measure the adoption of pro-environmental behaviours across Canadian provinces. PLoS One 2014; 9:e101569. [PMID: 25013929 PMCID: PMC4094473 DOI: 10.1371/journal.pone.0101569] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/08/2014] [Indexed: 11/18/2022] Open
Abstract
Objective The adoption of pro-environmental behaviours reduces anthropogenic environmental impacts and subsequent human health effects. This study developed composite indices measuring adoption of pro-environmental behaviours at the household level in Canada. Methods The 2007 Households and the Environment Survey conducted by Statistics Canada collected data on Canadian environmental behaviours at households' level. A subset of 55 retained questions from this survey was analyzed by Multiple Correspondence Analysis (MCA) to develop the index. Weights attributed by MCA were used to compute scores for each Canadian province as well as for socio-demographic strata. Scores were classified into four categories reflecting different levels of adoption of pro-environmental behaviours. Results Two indices were finally created: one based on 23 questions related to behaviours done inside the dwelling and a second based on 16 questions measuring behaviours done outside of the dwelling. British Columbia, Quebec, Prince-Edward-Island and Nova-Scotia appeared in one of the two top categories of adoption of pro-environmental behaviours for both indices. Alberta, Saskatchewan, Manitoba and Newfoundland-and-Labrador were classified in one of the two last categories of pro-environmental behaviours adoption for both indices. Households with a higher income, educational attainment, or greater number of persons adopted more indoor pro-environmental behaviours, while on the outdoor index, they adopted fewer such behaviours. Households with low-income fared better on the adoption of outdoors pro-environmental behaviours. Conclusion MCA was successfully applied in creating Indoor and Outdoor composite Indices of pro-environmental behaviours. The Indices cover a good range of environmental themes and the analysis could be applied to similar surveys worldwide (as baseline weights) enabling temporal trend comparison for recurring themes. Much more than voluntary measures, the study shows that existing regulations, dwelling type, households composition and income as well as climate are the major factors determining pro-environmental behaviours.
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Affiliation(s)
- Magalie Canuel
- Institut national de santé publique du Québec (INSPQ), Québec City, Canada
- * E-mail:
| | - Belkacem Abdous
- Centre de recherche du Centre hospitalier universitaire de Québec, Québec City, Canada
- Département de médecine sociale et préventive de l′Université Laval, Québec City, Canada
| | - Diane Bélanger
- Centre de recherche du Centre hospitalier universitaire de Québec, Québec City, Canada
- Institut national de la recherche scientifique, Centre Eau Terre Environnement, Québec City, Canada
| | - Pierre Gosselin
- Institut national de santé publique du Québec (INSPQ), Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec, Québec City, Canada
- Institut national de la recherche scientifique, Centre Eau Terre Environnement, Québec City, Canada
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Modarres R, Ouarda TBMJ, Vanasse A, Orzanco MG, Gosselin P. Modeling climate effects on hip fracture rate by the multivariate GARCH model in Montreal region, Canada. Int J Biometeorol 2014; 58:921-930. [PMID: 23722925 DOI: 10.1007/s00484-013-0675-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/23/2013] [Accepted: 04/26/2013] [Indexed: 06/02/2023]
Abstract
Changes in extreme meteorological variables and the demographic shift towards an older population have made it important to investigate the association of climate variables and hip fracture by advanced methods in order to determine the climate variables that most affect hip fracture incidence. The nonlinear autoregressive moving average with exogenous variable-generalized autoregressive conditional heteroscedasticity (ARMAX-GARCH) and multivariate GARCH (MGARCH) time series approaches were applied to investigate the nonlinear association between hip fracture rate in female and male patients aged 40-74 and 75+ years and climate variables in the period of 1993-2004, in Montreal, Canada. The models describe 50-56% of daily variation in hip fracture rate and identify snow depth, air temperature, day length and air pressure as the influencing variables on the time-varying mean and variance of the hip fracture rate. The conditional covariance between climate variables and hip fracture rate is increasing exponentially, showing that the effect of climate variables on hip fracture rate is most acute when rates are high and climate conditions are at their worst. In Montreal, climate variables, particularly snow depth and air temperature, appear to be important predictors of hip fracture incidence. The association of climate variables and hip fracture does not seem to change linearly with time, but increases exponentially under harsh climate conditions. The results of this study can be used to provide an adaptive climate-related public health program and ti guide allocation of services for avoiding hip fracture risk.
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Affiliation(s)
- Reza Modarres
- Hydroclimate modeling group, INRS-ETE, 490 de la Couronne, Quebec, Qc, Canada, G1K 9A9,
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Maassarani R, Gosselin P, Montembeault P, Gagnon M. French-speaking children's freely produced labels for facial expressions. Front Psychol 2014; 5:555. [PMID: 24926281 PMCID: PMC4044975 DOI: 10.3389/fpsyg.2014.00555] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 05/19/2014] [Indexed: 11/17/2022] Open
Abstract
In this study, we investigated the labeling of facial expressions in French-speaking children. The participants were 137 French-speaking children, between the ages of 5 and 11 years, recruited from three elementary schools in Ottawa, Ontario, Canada. The facial expressions included expressions of happiness, sadness, fear, surprise, anger, and disgust. Participants were shown one facial expression at a time, and asked to say what the stimulus person was feeling. Participants’ responses were coded by two raters who made judgments concerning the specific emotion category in which the responses belonged. 5- and 6-year-olds were quite accurate in labeling facial expressions of happiness, anger, and sadness but far less accurate for facial expressions of fear, surprise, and disgust. An improvement in accuracy as a function of age was found for fear and surprise only. Labeling facial expressions of disgust proved to be very difficult for the children, even for the 11-year-olds. In order to examine the fit between the model proposed by Widen and Russell (2003) and our data, we looked at the number of participants who had the predicted response patterns. Overall, 88.52% of the participants did. Most of the participants used between 3 and 5 labels, with correspondence percentages varying between 80.00% and 100.00%. Our results suggest that the model proposed by Widen and Russell (2003) is not limited to English-speaking children, but also accounts for the sequence of emotion labeling in French-Canadian children.
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Affiliation(s)
- Reem Maassarani
- School of Psychology, University of Ottawa Ottawa, ON, Canada
| | - Pierre Gosselin
- School of Psychology, University of Ottawa Ottawa, ON, Canada
| | | | - Mathieu Gagnon
- School of Psychology, University of Ottawa Ottawa, ON, Canada
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Chebana F, Martel B, Gosselin P, Giroux JX, Ouarda TBMJ. A general and flexible methodology to define thresholds for heat health watch and warning systems, applied to the province of Québec (Canada). Int J Biometeorol 2013; 57:631-44. [PMID: 23100100 DOI: 10.1007/s00484-012-0590-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 08/27/2012] [Accepted: 08/27/2012] [Indexed: 05/22/2023]
Abstract
Several watch and warning systems have been established in the world in recent years to prevent the effects of heat waves. However, many of these approaches can be applied only in regions with perfect conditions (e.g., enough data, stationary series or homogeneous regions). Furthermore, a number of these approaches do not account for possible trend in mortality and/or temperature series, whereas others are generally not adapted to regions with low population densities or low daily mortality levels. In addition, prediction based on multiple days preceding the event can be less accurate if it attributes the same importance to each of these days, since the forecasting accuracy actually decreases with the period. The aim of the present study was to identify appropriate indicators as well as flexible and general thresholds that can be applied to a variety of regions and conditions. From a practical point of view, the province of Québec constitutes a typical case where a number of the above-mentioned constraints are present. On the other hand, until recently, the province's watch and warning system was based on a study conducted in 2005, covering only the city of Montreal and applied to the whole province. The proposed approach is applied to each one of the other health regions of the province often experiencing low daily counts of mortality and presenting trends. The first constraint led to grouping meteorologically homogeneous regions across the province in which the number of deaths is sufficient to carry out the appropriate data analyses. In each region, mortality trends are taken into account. In addition, the proposed indicators are defined by a 3-day weighted mean of maximal and minimal temperatures. The sensitivity of the results to the inclusion of traumatic deaths is also checked. The application shows that the proposed method improved the results in terms of sensitivity, specificity and number of yearly false alarms, compared to those of the existing and other classical approaches. An additional criterion based on the Humidex is applied in a second step and a local validation is applied to historical observations at reference forecasting stations. An integrated heat health watch and warning system with thresholds that are adapted to the regional climate has thus been established for each sub-region of the province of Quebec and became operational in June 2010.
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Affiliation(s)
- Fateh Chebana
- Institut National de la Recherche Scientifique/INRS-ETE, 490 de la Couronne, Québec, QC, Canada, G1K 9A9.
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Arsenault J, Michel P, Berke O, Ravel A, Gosselin P. How to choose geographical units in ecological studies: proposal and application to campylobacteriosis. Spat Spatiotemporal Epidemiol 2013; 7:11-24. [PMID: 24238078 DOI: 10.1016/j.sste.2013.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 02/20/2013] [Accepted: 04/17/2013] [Indexed: 11/19/2022]
Abstract
In spatial epidemiology, the choice of an appropriate geographical unit of analysis is a key decision that will influence most aspects of the study. In this study, we proposed and applied a set of measurable criteria applicable for orienting the choice of geographical unit. Nine criteria were selected, covering many aspects such as biological relevance, communicability of results, ease of data access, distribution of exposure variables, cases and population, and shape of unit. These criteria were then applied to compare various geographical units derived from administrative, health services, and natural frameworks that could be used for the study of the spatial distribution of campylobacteriosis in the province of Quebec, Canada. In this study, municipality was the geographical unit that performed the best according to our assessment and given the specific objectives and time period of the study. Future research areas for optimizing the choice of geographical unit are discussed.
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Affiliation(s)
- Julie Arsenault
- Faculté de médecine vétérinaire, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Québec, Canada J2S 7C6; Groupe de recherche en épidémiologie des zoonoses et santé publique, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, Canada J2S 7C6.
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Campagne G, Cuny J, Gosselin P, Goldstein P, Assez N, Wiel E. Prehospital management of COPD patients in respiratory failure and short-term outcome. Crit Care 2013. [PMCID: PMC3642437 DOI: 10.1186/cc12070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cuny J, Campagne G, Gosselin P, Goldstein P, Assez N, Wiel E. Analysis of management of non-invasive ventilation support in prehospital care for COPD patients and short-term outcome. Crit Care 2013. [PMCID: PMC3642460 DOI: 10.1186/cc12082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bustinza R, Lebel G, Gosselin P, Bélanger D, Chebana F. Health impacts of the July 2010 heat wave in Québec, Canada. BMC Public Health 2013; 13:56. [PMID: 23336593 PMCID: PMC3554487 DOI: 10.1186/1471-2458-13-56] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 01/16/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND One of the consequences of climate change is the increased frequency and intensity of heat waves which can cause serious health impacts. In Québec, July 2010 was marked by an unprecedented heat wave in recent history. The purpose of this study is to estimate certain health impacts of this heat wave. METHODS The crude daily death and emergency department admission rates during the heat wave were analyzed in relation to comparison periods using 95% confidence intervals. RESULTS During the heat wave, the crude daily rates showed a significant increase of 33% for deaths and 4% for emergency department admissions in relation to comparison periods. No displacement of mortality was observed over a 60-day horizon. CONCLUSIONS The all-cause death indicator seems to be sufficiently sensitive and specific for surveillance of exceedences of critical temperature thresholds, which makes it useful for a heat health-watch system. Many public health actions combined with the increased use of air conditioning in recent decades have contributed to a marked reduction in mortality during heat waves. However, an important residual risk remains, which needs to be more vigorously addressed by public health authorities in light of the expected increase in the frequency and severity of heat waves and the aging of the population.
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Affiliation(s)
- Ray Bustinza
- Institut national de santé publique du Québec, Direction de la santé environnementale et de la toxicologie, Québec, Canada
- Université Laval, Québec, Canada
| | - Germain Lebel
- Institut national de santé publique du Québec, Direction de la santé environnementale et de la toxicologie, Québec, Canada
| | - Pierre Gosselin
- Institut national de santé publique du Québec, Direction de la santé environnementale et de la toxicologie, Québec, Canada
- Université Laval, Québec, Canada
- Centre hospitalier universitaire de Québec, Centre de recherche, Québec, Canada
- Institut national de la recherche scientifique, Centre eau-terre-environnement, Québec, Canada
| | - Diane Bélanger
- Centre hospitalier universitaire de Québec, Centre de recherche, Québec, Canada
- Institut national de la recherche scientifique, Centre eau-terre-environnement, Québec, Canada
| | - Fateh Chebana
- Institut national de la recherche scientifique, Centre eau-terre-environnement, Québec, Canada
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Arsenault J, Berke O, Michel P, Ravel A, Gosselin P. Environmental and demographic risk factors for campylobacteriosis: do various geographical scales tell the same story? BMC Infect Dis 2012; 12:318. [PMID: 23173982 PMCID: PMC3570353 DOI: 10.1186/1471-2334-12-318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/15/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Campylobacter is a common cause of bacterial gastro-enteritis characterized by multiple environmental sources and transmission pathways. Ecological studies can be used to reveal important regional characteristics linked to campylobacteriosis risk, but their results can be influenced by the choice of geographical units of analysis. This study was undertaken to compare the associations between the incidence of campylobacteriosis in Quebec, Canada and various environmental characteristics using seven different sets of geographical units. METHODS For each set of geographical unit, a conditional autoregressive model was used to model the incidence of reported cases of campylobacteriosis according to environmental (poultry density, ruminant density, slaughterhouse presence, temperature, and precipitation) and demographic (population density, level of education) characteristics. Models were compared in terms of number of significant predictors, differences in direction and magnitude of predictors, and fit of the models. RESULTS In general, the number of significant predictors was reduced as the aggregation level increased. More aggregated scales tend to show larger but less precise estimates for all variables, with the exception of slaughterhouse presence. Regional characteristics associated with an increased regional risk of campylobacteriosis, for at least some geographical units, were high ruminant density, high poultry density, high population density, and presence of a large poultry slaughterhouse, whereas a reduction in risk was associated with a lower percentage of people with diplomas, a lower level of precipitation, and warmer temperature. Two clusters of elevated residual risk were observed, with different location and size depending on the geographical unit used. CONCLUSIONS Overall, our results suggest that the use of municipality or census consolidated subdivision were the most optimal scales for studying environmental determinants of campylobacteriosis at a regional level. This study highlights the need for careful selection and analysis of geographical units when using ecological study designs.
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Affiliation(s)
- Julie Arsenault
- Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada.
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Vida S, Durocher M, Ouarda TBMJ, Gosselin P. Relationship between ambient temperature and humidity and visits to mental health emergency departments in Québec. Psychiatr Serv 2012; 63:1150-3. [PMID: 23117515 DOI: 10.1176/appi.ps.201100485] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examined whether the number of emergency department visits for "mental and psychosocial problems" varies with temperature or humidity. METHODS The number of visits in three geographic areas of Québec were examined as a function of temperature and humidity by using routinely collected May-September data for 1995-2007 (N=347,552 visits). Data for two age groups (under age 65 and age 65 and older) were examined. Incidence rate ratios for mean temperature and humidity were estimated by using Poisson regression and generalized additive models. RESULTS The number of visits tended to increase with increasing mean temperature. At 22.5 °C (72.5 °F) and 25 °C (77.0 °F), the number was usually significantly higher than average. Visits increased with humidity in the younger age group. CONCLUSIONS Results suggest increased use of emergency departments for mental and psychosocial problems with higher mean temperature and humidity, especially in metropolitan areas and in southern Québec. Climate change may make this effect increasingly important.
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Affiliation(s)
- Stephen Vida
- Department of Psychiatry, McGill University and McGill University Health Centre, B6-160, 1650 Cedar Ave, Montréal, Québec H3G 1A4, Canada.
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Béland M, Chabot K, Goulet Gervais L, Morin A, Gosselin P. Évaluation de la peur de l’accouchement. Validation et adaptation française d’une échelle mesurant la peur de l’accouchement. Encephale 2012; 38:336-44. [DOI: 10.1016/j.encep.2011.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 06/16/2011] [Indexed: 10/15/2022]
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Vanasse A, Orzanco MG, Dagenais P, Ouarda T, Courteau J, Asghari S, Chebana F, Martel B, Gosselin P. Secular trends of hip fractures in Québec, Canada. Osteoporos Int 2012; 23:1665-72. [PMID: 21877202 DOI: 10.1007/s00198-011-1749-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 08/05/2011] [Indexed: 11/28/2022]
Abstract
UNLABELLED This study examined the secular trends of hip fracture incidence among individuals 50 years and older in Québec between 1993 and 2004. Age-standardized rates decreased at both the provincial and regional levels. The largest relative decrease was observed among younger females, and rates declined more slowly in the elderly. INTRODUCTION The population of the province of Québec is among the oldest in North America. Before the trend rupture reported in the late 1990s in several countries, hip fracture (HF) incidence rates did not show a secular trend (between 1981 and 1992). This study examined the secular trends of HF incidence at the provincial level and in two of the most important urban areas of the province, Montréal and Québec City, between 1993 and 2004. METHODS All hospitalisations of individuals 50 years and older living in the province of Québec between 1993 and 2004 with a main diagnosis of HF were included. Standardized rates of HF incidence were calculated for females and males, 50-74 years and 75 years and older. RESULTS The Québec City area showed a strong decreasing trend in HF rates for younger females, but the other groups did not show an obvious trend. Although our models did not support the existence of significant differences in trends between both areas, the rates of HF of younger males and, to a lesser extent, of older women in the Montréal area were significantly higher than in the Québec City area. CONCLUSIONS Differences observed in hip fracture rates as well as in secular trends between age groups and gender emphasise the need for decision makers to rely on results based on age-specific and sex-specific analyses.
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Affiliation(s)
- A Vanasse
- Groupe de recherche Primus, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e avenue nord, Sherbrooke, QC, J1H 5N4, Canada.
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Hrudey SE, Naeth MA, Therrien R, Van Der Kraak G, Gosselin P, Plourde A, Xu Z. Response to Timoney critique of Royal Society of Canada expert panel on oil sands. Environ Sci Technol 2012; 46:4257-4258. [PMID: 22471897 DOI: 10.1021/es300858k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Modarres R, Ouarda TBMJ, Vanasse A, Orzanco MG, Gosselin P. Modeling seasonal variation of hip fracture in Montreal, Canada. Bone 2012; 50:909-16. [PMID: 22270055 DOI: 10.1016/j.bone.2012.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 01/04/2012] [Accepted: 01/09/2012] [Indexed: 11/23/2022]
Abstract
The investigation of the association of the climate variables with hip fracture incidences is important in social health issues. This study examined and modeled the seasonal variation of monthly population based hip fracture rate (HFr) time series. The seasonal ARIMA time series modeling approach is used to model monthly HFr incidences time series of female and male patients of the ages 40-74 and 75+ of Montreal, Québec province, Canada, in the period of 1993-2004. The correlation coefficients between meteorological variables such as temperature, snow depth, rainfall depth and day length and HFr are significant. The nonparametric Mann-Kendall test for trend assessment and the nonparametric Levene's test and Wilcoxon's test for checking the difference of HFr before and after change point are also used. The seasonality in HFr indicated sharp difference between winter and summer time. The trend assessment showed decreasing trends in HFr of female and male groups. The nonparametric test also indicated a significant change of the mean HFr. A seasonal ARIMA model was applied for HFr time series without trend and a time trend ARIMA model (TT-ARIMA) was developed and fitted to HFr time series with a significant trend. The multi criteria evaluation showed the adequacy of SARIMA and TT-ARIMA models for modeling seasonal hip fracture time series with and without significant trend. In the time series analysis of HFr of the Montreal region, the effects of the seasonal variation of climate variables on hip fracture are clear. The Seasonal ARIMA model is useful for modeling HFr time series without trend. However, for time series with significant trend, the TT-ARIMA model should be applied for modeling HFr time series.
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Affiliation(s)
- Reza Modarres
- Canada Research Chair on the Estimation of Hydrometeorological Variables, INRS-ETE, 490 de la Couronne, Quebec, Qc, Canada, G1K 9A9.
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Abstract
The Duchenne marker has been proposed as a universal marker of smile authenticity. However, Elfenbein, Beaupré, Levesque, and Hess (2007 ) found that, whereas Canadians typically show the Duchenne marker when posing happiness, Gabonese do not. We therefore investigated whether the Duchenne marker is perceived as a marker of smile authenticity by Gabonese and by Mainland Chinese living in Quebec, Canada. The results show that Gabonese do not use the Duchenne marker to assess smile authenticity at all. Mainland Chinese immigrants to Quebec showed sensitivity to the Duchenne marker only when judging smiles by French-Canadian encoders, suggesting learning of the use of this cultural dialect through cultural exposure. In sum, the use of Duchenne marker is not universal, but rather limited to certain cultures.
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