Facteurs socioenvironnementaux associés à la prévalence des limitations d’activités au Québec

Objectifs : Cette thèse porte sur l’association entre les caractéristiques socioenvironnementales des voisinages (milieux locaux) et la prévalence des limitations d’activités (ou handicap) dans la population québécoise. Elle a trois objectifs principaux : (1) clarifier les enjeux conceptuels et méthodologiques relatifs à l’étude des déterminants socioenvironnementaux des limitations d’activités; (2) décrire les contributions respectives de la composition socioéconomique des voisinages et de facteurs contextuels à la variabilité locale de la prévalence des limitations d’activités; (3) évaluer la présence d’interactions entre la santé fonctionnelle des personnes (incapacité) et des caractéristiques des voisinages en lien avec la prévalence des limitations d’activités. Méthodes : Une analyse de la littérature scientifique a été effectuée en lien avec le premier objectif de la thèse. En lien avec le deuxième objectif, des données pour le Québec du recensement canadien de 2001 (échantillon de 20% de la population) ont été utilisées pour estimer l’association entre la prévalence des limitations d’activités et des caractéristiques des voisinages : classification urbain-rural, composition socioéconomique (défavorisation matérielle et sociale) et facteurs contextuels (qualité des habitations, stabilité résidentielle et utilisation des transports actifs et collectifs). En lien avec le troisième objectif, des données pour la population urbaine du Québec issues de l’Enquête sur la santé dans les collectivités canadiennes (2003, 2005 et 2007/2008) ont permis de tester la présence d’interaction entre la santé fonctionnelle des personnes et des caractéristiques des voisinages (défavorisation matérielle et sociale, qualité des habitations, stabilité résidentielle et densité des services). Pour les analyses associées aux deux derniers objectifs, l’analyse des corrélats de la prévalence des limitations d’activités a été effectuée à l’aide de régressions logistiques multiniveaux. Résultats : Différents éléments conceptuels et opérationnels limitent la possibilité de faire une synthèse des analyses épidémiologiques portant sur les influences socioenvironnementales sur les limitations d’activités. Les résultats des analyses empiriques suggèrent que : (1) la variation géographique de la prévalence des limitations d’activités s’explique en grande partie par la composition socioéconomique des voisinages; (2) des facteurs contextuels sont associés à cette variation géographique; (3) les mesures relatives d’inégalités sous-estiment les disparités contextuelles dans la distribution des nombres absolus de personnes ayant une limitation d’activités; et (4) l’association entre la prévalence des limitations d’activités et la défavorisation sociale pourrait varier selon la santé fonctionnelle des personnes. Conclusions : Différentes caractéristiques socioenvironnementales sont potentiellement associées aux variations géographiques des limitations d’activités au Québec. Le développement d’indicateurs socioenvironnementaux favoriserait une connaissance plus précise de l’influence de ces caractéristiques socioenvironnementales sur les limitations d’activités et des mécanismes par lesquels s’exerce cette influence. L’établissement d’un système national de surveillance des aménagements territoriaux est proposé afin de soutenir la recherche et la prise de décision. Des indicateurs locaux d’accessibilité aux transports, aux espaces publics ainsi qu’aux services de proximité devraient être priorisés. Ces aspects de l’aménagement du territoire sont susceptibles de rejoindre plusieurs enjeux de santé publique et ils ont comme autre avantage d’être inclus dans différentes orientations québécoises ciblant le vieillissement en santé et la réduction des limitations d’activités.

Civil applications in the Magistrates Court are often set down for hearing by a judicial registrar, but there is now some uncertainty on the limitation of this practice

The decision of the District Court of Queensland in Mark Treherne & Associates -v- Murray David Hopkins [2010] QDC 36 will have particular relevance for early career lawyers. This decision raises questions about the limits of the jurisdiction of judicial registrars in the Magistrates Court.

Foot pain and functional limitation in healthy adults with hallux valgus : a cross-sectional study

Background Hallux valgus (HV) is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls. Methods Thirty volunteers with HV (radiographic HV angle >15 degrees) and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years). Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion). Mean differences (MD) and 95% confidence intervals (CI) were calculated. Results All self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p < 0.001). Lower pressure-pain threshold was measured at the medial first metatarsophalangeal joint in participants with HV (MD = -133.3 kPa, CI: -251.5 to -15.1). Participants with HV also showed reduced hallux plantarflexion strength (MD = -37.1 N, CI: -55.4 to -18.8) and abduction strength (MD = -9.8 N, CI: -15.6 to -4.0), and increased mediolateral sway when standing with both feet with eyes closed (MD = 0.34 cm, CI: 0.04 to 0.63). Conclusions These findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There was also evidence of impaired hallux muscle strength and increased postural sway in HV subjects compared to controls, although general physical functioning and participation in physical activity were not adversely affected.

Civil litigation limitation periods : submission to the Royal Commission into institutional responses to child sexual abuse

This submission makes one simple yet powerful recommendation for law reform to promote justice for survivors of child sexual abuse. It is informed by extensive analyses of the phenomenon of child sexual abuse and its psychological sequelae, legislative time limits and case law across Australia and internationally, the policy reasons underpinning statutory time limits generally, and the need for fairness, certainty and practicability in the legal system. The recommendation is that legislative reform is required in all Australian States and Territories to remove time limitations for civil claims for injuries caused by child sexual abuse.

Herbivores and nutrients control grassland plant diversity via light limitation

Human alterations to nutrient cycles1, 2 and herbivore communities3, 4, 5, 6, 7 are affecting global biodiversity dramatically2. Ecological theory predicts these changes should be strongly counteractive: nutrient addition drives plant species loss through intensified competition for light, whereas herbivores prevent competitive exclusion by increasing ground-level light, particularly in productive systems8, 9. Here we use experimental data spanning a globally relevant range of conditions to test the hypothesis that herbaceous plant species losses caused by eutrophication may be offset by increased light availability due to herbivory. This experiment, replicated in 40 grasslands on 6 continents, demonstrates that nutrients and herbivores can serve as counteracting forces to control local plant diversity through light limitation, independent of site productivity, soil nitrogen, herbivore type and climate. Nutrient addition consistently reduced local diversity through light limitation, and herbivory rescued diversity at sites where it alleviated light limitation. Thus, species loss from anthropogenic eutrophication can be ameliorated in grasslands where herbivory increases ground-level light.

Limitation of actions - medical negligence

In Christensen v Salter [2002] QDC 082 the District Court of Queensland considered some issues on the limitation period applying to claims arising out of a failed sterilisation procedure

Motor Accident Insurance Act 1994 s45 - whether obligation to co-operate may authorise order requiring commencement of proceedings by minor prior to expiration of limitation period

In Australian Associated Motor Insurers Ltd v McPaul; Council of the City of Gold Coast v McPaul [2005] QSC 278 the applicant insurer sought an order requiring a claimant who had been injured in a motor vehicle accident some years earlier when he was five years old to commence a proceeding to determine the question of the applicant's liability to him. The applicant's interest in seeking the order was to avoid the prejudice which could follow from further delay, particularly delay until the respondent became obliged to commence proceedings to avoid a limitations bar.

Limitation of Actions - effect of admission of liability

The decision in Simpson v Lenton [2002] QDC 214 applied the decisions of the Court of Appeal in Lindsay v Smith [2002] 1 Qd R 610 and Morris v FAI General Insurance Co Ltd [1996] 1 QDR 495 in finding the second defendant, having admitted liability, was estopped from relying on the expiration of the limitation period.

Limitation of actions - Workcover Queensland Act 1996 s 308(2)

In Narayan v S-Pak Pty Ltd [2002] QSC 373 the court concluded that proceedings to which the Workcover (Queensland) Act 1996 applies must be commenced within 60 days after the compulsory conference required by s308(2) of the Act and there is no power in the court to extend the time for compliance.

Limitation of Actions - incorrect date of accident advised to solicitor

The decision of the Queensland Court of Appeal in Cormie v Orchard [2003] QCA 236 involved consideration of whether the respondent solicitor was liable in negligence for failing to commence proceedings within the applicable limitation period in circumstances where the solicitor had relied on the advice as to the date of injury nominated incorrectly but unequivocally by the client.

Disclosure of documents and limitation of actions

This article considers the decisions in Stephan v NRMA Insurance Limited [2001]QDC 002 and Bertha v Dragut [2001] QDC 003

Submission on NSW Attorney-General's Discussion Paper on Amendment of Limitation of Actions Act 1969 to remove time limit for civil claims for child abuse

The New South Wales Attorney-General and Justice Policy Division released a Discussion Paper about reform of the Limitation of Actions Act 1969. The key question was whether and how to amend the statute to better provide access to justice for civil claimants in child abuse cases. This submission draws on published literature and multidisciplinary research to support the Discussion Paper's Option A, namely, to abolish the time limit for civil claims for injuries in criminal child abuse cases, and for this to be made retrospective.

Defamation proceedings - Limitation of Actions Act 1974

In Noonan v MacLennan [2010] QCA 50 the Queensland Court of Appeal considered for the first time the provision permitting extension of the limitation period for a defamation action under s32A of the Limitation of Actions Act 1974.