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Peer moderation has been used as a beneficial strategy in asynchronous online discussions to assist student learning performance. However, most studies in peer-moderated asynchronous online discussions (PMAOD) have focused only on learning effectiveness and perceptions of students rather than on students’ knowledge dimensions and cognitive processing patterns. This study combined quantitative content analysis (QCA) and lag sequential analysis (LSA) to explore student knowledge dimensions and cognitive processing patterns in PMAOD. The participants were 84 students in an undergraduate blended course from University Putra Malaysia (UPM), Malaysia. The Revised Bloom Taxonomy (RBT) was used as the codification scheme to code the discussion transcripts of participants assigned the role of peer moderators in a reciprocal manner over seven weeks. Behavioural distributions and patterns of high- and low-quality discussion groups were compared. Results showed that students were primarily sharing knowledge dimensions and cognitive processes of metacognition and understanding, respectively. Additionally, it was found that there was a modest proportion of off-topic discussions. Nonetheless, by means of LSA, it was found that PMAOD exhibited a certain degree of self-sustainability in knowledge and cognitive process behaviours, with the exceptions of procedural knowledge and the cognitive process of applyingand, in terms of diversity in knowledge dimension and cognitive processing, high-quality discussion groups outperformed low-quality groups.

Because of its increasing incidence, breast cancer is a significant burden for women worldwide. In industrialized countries, breast cancer is the second-leading cause of cancer-related deaths among women, and it is estimated that 1 in every 8 women will develop the disease during her lifetime. Sufficient evidence indicates that a number of genetic, environmental and lifestyle risk exposures during life may play important roles in the etiology of this disease. The purpose of this paper is to review some etiologic factors and underlying mechanisms in relation to breast cancer risk. Based on the published literature, there is sufficient evidence that some established factors are associated with breast cancer risk. Age, early age at menarche, late menopause, height, post-menopausal obesity, family history of breast cancer, ionizing radiation, oral contraceptives, hormonal replacement therapy, mammographic density, some gene mutations and clinical conditions, such as benign breast disease, are associated with an increased risk of breast cancer. The risk decreases with early childbearing, high parity and physical activity, and breastfeeding. Alcohol increases the risk, while caloric restriction may confer protection from breast cancer. Epidemiological evidence for other nutritional factors is insufficient. These results suggest that breast cancer is a multifactorial disease where genetic susceptibility, environment, nutrition and other lifestyle risk factors interact. Better identification of modifiable risk factors and risk reduction of breast cancer may allow implementation of useful strategies for prevention.

Over recent years, there appears to have been an explosion of public interest in facial rejuvenation. With the recent development of short-pulsed high-peak power and rapidly scanned carbon dioxide (CO2) lasers, it is now possible to remove photo-damaged skin precisely and reproducibly, while leaving behind a narrow zone of thermal damage. This development has generated tremendous interest in laser skin resurfacing as a technique to reverse photoaging. However, the overall review of the existing literature, except for very few publications, reveals several major methodological problems. The use of CO2 laser for cosmetic purposes is very recent and therefore requires further justification, standardization and regulation based on well designed studies. Most of the recent published data correspond to case reports, rather than well-designed scientific studies. For these reasons, this field needs more clinical trials and epidemiological investigations such as prospective cohorts or case-control studies, to provide new knowledge in this field.

Basing our views on recent works of an Ontarian research group, we analyze the profiles of incidence of the main types of cancers observed in the province of Québec for the periods 1984-1986 and 1989-1991. Using the Québec Tumors Registry, we have calculated standardized incidence rates according to sex for each of the 32 departments of community health in the province. A geographical analysis of cancers was conducted via two methods of spatial autocorrelation (SA). Many cancer sites (i.e., breast, lung, stomach) show a positive SA (p < 0.05), indicating an aggregation of cases. Several aggregation schemes observed in Québec resemble those observed in Ontario. In women, the highest incidence rate increases are in leukemia and lung cancer; in men, prostate cancer and leukemia show the highest increase of rates (p < 0.01). The consistency of our observations with those of the Ontario group is discussed.

This study describes the geographical variations in the incidence of, and mortality due to, the most frequent cancers in Quebec. They are breast, colon and tracheal, bronchial, and lung cancers in women and prostate, colon and trachea, bronchial and lung cancers in men. Data for the periods 1984 to 1986 and 1989 to 1991 for the whole of the Quebec Community Health Department are reviewed. A direct method of standardization, with the world population as the reference population, was used to allow comparison of geographical units. The ranking correlation method was used to test correlations for the various cancer sites. There were significant coefficients between the two periods only for lung cancer for both sexes, for both incidence and mortality. The spatial autocorrelation method was used to determine the presence or absence of a geographical configuration from the estimated rates. Moran I values were positive and significant for the two periods for lung cancer associated mortality and for the incidence of breast cancer. This implicates local factors (probably associated with lifestyle). The results for the incidence of lung cancer among men and women were similar for the period 1989 to 1991. The advantages and limitations of the methods used and also the data available are considered.

Risk factors associated with women's reproductive life and sexual growth do not adequately predict cancer incidence of the breast, uterus and ovary. The heterogeneous worldwide distribution of these cancers could imply that some environmental and cultural risk factors are involved in their cancerogenesis. The few attempts made so far to unravel their spatial structures at a geographic scale facilitating the search for exogenous risk factors have proved inconclusive. This study reports the results of a spatial analysis of the cancer incidence rates for breast, cervix, endometrium and ovary among Community Health Departments (CHD) in Quebec using a spatial autocorrelation method. Correlograms built according to four definitions of the inter-CHDs distance indicate that breast and ovary incidence rates follow quite similar spatial gradients attesting to their etiologic affinity. They also suggest that the spatial distribution of endometrial cancer follows a gradient divergent from that of breast and ovary cancers, and that the CHDs' spatial scale does not suitably describe the distribution of cervical cancer. The demonstration of a structured spatial distribution for breast, endometrium and ovary cancers in Québec strengthen the hypothesis that cultural or environmental risk factors are involved in their etiology. But, the observed disparities in the spatial structure of these cancers imply that their etiologic specificity may be greater than their biologic bond would suggest.

In a population-based case-control study of dietary risk factors in French Canadians in Montreal, a total of 179 cases and 239 controls were interviewed between 1984 and 1988. It was found that the frequency of diabetes was almost three times higher in cases of pancreatic cancer (16%) than in the controls (6%), with an Odds Ratio (OR) of 2.52 and a Confidence Interval (CI) of 1.04-6.11. Fifty per cent of the pancreatic cancer cases had this disease before the cancer was diagnosed, compared with 71% of the controls at the time of the study. Those aged 50 years and over accounted for 75% of the cases and 71% of the controls (diabetic subjects); 68% of the cases were treated with a combination of diet and oral hypoglycemic agents compared with 86% of the controls. Insulin was used by 32% of the cases and 14% of the controls. These results suggest that diabetes may play a major role in the etiopathogenesis of pancreatic cancer in this urban population. A lot of controversy remains about the precise role of diabetes, and further studies are needed for a better assessment and understanding of the mechanisms of this association.

Driving ability is controlled by specific regulations. Therefore disabled individuals or those with certain chronic diseases may be affected by these regulations. These latter are based on assumption that the existence and the nature of certain diseases may cause particular hazard; and this could be prevented by introducing certain driving regulations. This hypothesis has not been tested properly, considering the proposed and suspected risk factors. Diabetes mellitus is a good example of the interested medical condition in this field. Review of the literature do not provide adequate information to allow us to conclude whether the insulin treated diabetic person is at higher risk to develop traffic accident, compared with non diabetic individual; and there is no definite explanation whether hypoglycaemia play a causative role in the etiology of traffic accident among insulin treated diabetics. Perhaps the lack of knowledge in this field is due to use of non-standardized methodologies and small sample size studies which make the comparisons difficult. The existing regulations in different countries are based on empirical knowledge and common sense. This often leads to conflictual situations and apparently discriminatory decisions regarding diabetics. Further comparative and prospective studies are needed.

This is a review of the literature dealing with exposure to the risk of traffic accidents. We present the principal definitions of this concept, the different measures of risk exposure, indicators of the risk of traffic accidents, and the advantages and disadvantages of the methods used for the collection of data. The validity of the measure of exposure to risk is analyzed as well. We conclude that while distance travelled is the principal measure of exposure to risk accepted by the research community, it is necessary to use a composite measure which also takes into account the risk associated with the driver.

Since 1981, the Quebec Tumor Registry (FTQ) is using form AH-101P which is filled out for all patients seeking care in Quebec hospitals. From a list of 8,000 names in 1981-82, we have found that 4.8% was constituted of cases reported 2, 3 and 4 times. In two major hospitals, we have checked 71 medical records of patients reported more than once to FTQ using the AH-101P form with what was found in the hospital records. Only 6 multiple cancers (8.5%) were found. All other cases were constituted of invasions, infiltrations or metastasis. It is concluded that, despite the new procedure, cancer incidence is still overestimated in FTQ in 1981-82 but this problem should disappear in the near future.

A review of available data on the epidemiology of oesophageal cancer from different parts of the world as well as an analysis of new findings, suggests the following conclusions: 1. A peculiar incidence pattern of the disease exists worldwide with roughly 500-fold differences in rates (truncated) between the highest and lowest risk areas. 2. Males are generally affected more than females, with a few exceptions such as the very high risk regions of northern Iran. The highest male: female sex ratios (based on truncated incidence rates) have been reported from Normandy and Brittany (25:1) and the lowest ratios from South Gorgan in northern Iran (0.5:1). 3. There is evidence that the frequency of oesophageal cancer is rising over time in many regions, particularly among the black population of the United States and in England and France. 4. Most of the areas reflecting a very high incidence of this disease are located in poorer parts of the world. 5. The frequency of this disease varies among the native and migrated population in different countries.

This study concerns the geographical relationships between alcohol consumption per capita; smoking and death from cirrhosis of the liver and cancer of the oesophagus in persons of 15 years old and over in Quebec. First, the geographical distribution of variables is analysed. Secondly, we have used methods of correlation and regression in order to evaluate their relation to each other. In the latest case we have chosen the logistic regression model to investigate the simultaneous effects of alcohol and tobacco. The results show that alcohol consumption is closely related to mortality from cirrhosis of the liver. Moreover, there was no significant relation found between total alcohol consumption and oesophageal cancer. These findings can be applied to cases of consumption of wine and spirits.