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Biomedical subjects

L McIntyre

Publications and source records attributed to L McIntyre.

At least 19 recordsLinked to original sources
PubMed1995

Technology assessment of nonsurgical closure of patent ductus arteriosus: an evaluation of the clinical effectiveness and costs of a new medical device.

OBJECTIVE: To assess the clinical efficacy and cost impact of a new medical device for the nonsurgical closure of patent ductus arteriosus (PDA). METHODS: This was a before-after study comparing the most recent 20 surgical procedures with the first 20 nonsurgical procedures for PDA using a new medical device. Clinical outcome, hospital stay, device cost, and physician fees were compared. RESULTS: Surgical closure was effective in all 20 patients, with an average cost of $4667. In a similar patient group, nonsurgical closure was achieved in 18 of 20 patients (90%), with an estimated average cost per successful procedure of $4690. A clinically insignificant PDA leak persisted beyond 12 months in four nonsurgically managed patients. CONCLUSION: Nonsurgical closure of PDA can be recommended as an effective new medical technique that is not associated with a measurable increase in direct costs and that provides significant indirect and intangible cost advantages.

Cardiac Catheterization↗
PubMed1994

A model for coordinating school health promotion programs.

This paper presents an empirically developed model for coordinating the planning and implementation of combined health promotion activities for elementary schools. Validity of the model was assessed using results of semi-structured interviews with two individuals who served in the coordinator role. The amended model that was developed in light of the assessment is presented, with suggestions for others who seek to use a coordinated approach for increasing the impact of school health programs.

Algorithms↗
PubMed1994

Trends in the prevalence of congenital heart disease: comprehensive observations over a 24-year period in a defined region of Canada.

OBJECTIVE: To determine the prevalence of congenital heart disease (CHD) in the three Maritime provinces, and to study prevalence differences among provinces and defined regions within these provinces. DESIGN: Each province was divided by counties into regions. All cases of CHD who were born alive in the study area between 1966 and 1989 were entered in a registry. Prevalences were analyzed for each province and for selected regions per year, per 1000 live births, and by diagnosis made by one year of age and by the 16th birthday. Comparison was then made with prevalences of a group who had severe lesions. INTERVENTIONS: Excepting a small number of CHD cases who were diagnosed by autopsy only, diagnosis was made by pediatric cardiologists using appropriate procedures, including cardiac ultrasound and cardiac catheterization. SETTING: The only tertiary care centre for children's heart disease in the provinces of Nova Scotia, New Brunswick and Prince Edward Island, areas of relative geographic isolation (combined population of 1.75 million people). MAIN RESULTS: A statistically significant positive linear trend occurred in these provinces during the study. The recorded prevalence of CHD in New Brunswick was significantly lower. Pooled prevalences by the first and 16th birthdays (8.0 and 12.5 per 1000 live births, respectively) of two regions of highest prevalence for 1980-86 were significantly higher (P < 0.05) than the pooled prevalence rate of all the remaining regions. Prevalence rates of a group with severe lesions were stable for 1976-86 in all regions. CONCLUSIONS: Differences in prevalence of CHD among provinces and regions were related to ascertainment levels. Prevalence of CHD with diagnosis by the first and 16th birthdays were approximately 8.0 and 12.5 per 1000 live births, respectively. The prevalence rate of a severe lesion group was a stable measure.

Adolescent↗
PubMed1992

Exploratory analysis of children's nutrition programs in Canada.

This survey examined the processes by which programs feeding hungry children in Canada are initiated, implemented and sustained. The responses of 32 operators of these programs were obtained by semi-structured telephone interviews and were analysed using qualitative research methods. Concerned citizens within the community and teachers were the major proponents for programs; their primary indicators of need were children's hunger-related behaviours. Programs generally provided the breakfast or lunch meal, were overseen by a board, and were operated by a mix of paid and volunteer staff. A lack of resources, problems with parents and the community, and managerial stresses were the main perceived barriers to program continuance. Programs run by communities generally had more need for resources, expressed lower confidence in their sustainability, and were less likely to cooperate with other groups than school-run programs. While some programs deliberately tried to avoid stigmatization, program operators did hold some prejudicial views about the communities they served and few programs could be considered empowering to users.

Canada↗
PubMed1992

The evolution of health promotion.

This paper describes the evolution of health promotion from its nascent roots which focused upon lifestyle to its global concepts of managing the future. A lifestyle orientation was the focus of approximately the first decade of health promotion efforts which followed the release of the 1974 document, "A New Perspective on the Health of Canadians". This was also a period of national health goal setting in Europe and in the United States. In 1984, the World Health Organization defined health promotion as the process of enabling individuals to take control over and to maintain their health. The focus of health promotion efforts thus changed from an emphasis on the individual to the more structural factors in society which support the types of choices that people ultimately make. Achieving Health for All: A Framework for Health Promotion, released in November 1986, further developed the concept of health promotion, suggesting three strategies for increasing health promotion: fostering public participation, strengthening community health services and healthy public policy. The health promotion movement has had other spin-offs such as the "Healthy Cities Movement" which was begun by another Canadian, Trevor Hancock. The newest evolution of the health promotion movement is a concern for a Healthy Future.

Canada↗
PubMed1991

Lumbar puncture frequency and cerebrospinal fluid analysis in the neonate.

A prospective study was performed to assess the frequency and diagnostic utility of lumbar punctures in neonates both during their first week of life and thereafter. During the two 6-month periods from January 1, 1985 to June 30, 1985, and February 1, 1986 to July 31, 1986, 712 neonates underwent 728 lumbar punctures during their first week of life primarily as part of the evaluation for suspected infection, either congenital or postnatal. There were eight patients with positive spinal fluid cultures in the first week of life, but only one patient simultaneously had a positive blood culture and a clinical course consistent with meningitis. In contrast, a considerably higher yield, approximating five times that of the first week of life, was obtained in patients undergoing a lumbar puncture after the first week of life.

Bacterial Infections↗
PubMed1991

Breast-feeding patterns of Montserratian women.

This article describes the breast-feeding patterns found on Montserrat by a survey that interviewed 69 mothers who delivered infants over a 13-month period, from March 1989 through March 1990. The results indicated that 94% of the women breast-fed these children for at least two weeks after delivery; that 70% were still breast-feeding at the time of the interview in March or April 1990; and that principal factors influencing early termination of breast-feeding were the age at which supplementary feeding was commenced and lack of maternal information about why babies appear to reject the breast.

Age Factors↗
PubMed1990

An epidemiological study on increased length of stay.

The epidemiologic triad of causation states that all illness results from a disequilibrium between host, agent and environmental factors. The "illness" investigated in this report--increased LOS--resulted from a combination of: patient factors--the increased prevalence of chronic diseases in childhood, a revolution in neonatal survival and an increase in survivorship in general for severe diseases, such as congenital anomalies and genetic diseases; agent factors--the transition from agents of infectious disease to agents of chronic disease as well as iatrogenesis; and health care environmental factors--equity issues involving the ethics of treatment, changes in medical technology and patterns of medical practice. The use of preadmission testing, increased participation by parents in the care of their children, an investigation of the appropriate venue for care of chronically ill children and the back transfer of recovering children to their home hospitals were recommended and considered by the hospital's administration and board of governors.

Child↗
PubMed1989

Characterization of wound cytokines in the sponge matrix model.

Although different populations of inflammatory cells infiltrate the healing wound, the mechanisms by which they influence the healing process in vivo are poorly defined. In vitro studies suggest that these cells may mediate wound healing by releasing various cytokines within the wound. We measured the levels of interleukin (IL) 1, IL-2, IL-3, IL-4, IL-6, tumor necrosis factor, and macrophage colony-stimulating factor within a subcutaneously implanted polyurethane sponge on various days after injury. Significantly higher levels of IL-1, IL-6, tumor necrosis factor, and macrophage colony-stimulating factor were detected in the wound fluid compared with basal serum levels in nonwounded mice. Tumor necrosis factor, macrophage colony-stimulating factor, and IL-6 peaked earlier than IL-1; however, the levels of these cytokines had fallen by the 13th day after wounding. Interleukin 2, IL-3, and IL-4 could not be detected in the wound fluid, and the wound fluid inhibited the proliferation of the IL-2-dependent cell lines CTLL-2 and HT-2 in response to recombinant IL-2. We hypothesize that tumor necrosis factor, macrophage colony-stimulating factor, IL-1, and IL-6, which are secreted at the site of injury, interact to promote tissue remodeling. The decrease in the levels of these cytokines by the 13th day after wounding may be the result of a regulatory process by the healed wound.

Animals↗
PubMed1989

Pharmacy dispensing practices for Sudanese children with diarrhoea.

In order to study the dispensing practices of Khartoum and Khartoum North pharmacies with respect to the management of infantile diarrhoea, a Sudanese woman presented pharmacists with a brief description of an infant with acute diarrhoea. Sixty-three pharmacies were visited; only 3 (5%) recommended oral rehydration salts (ORS) alone. An additional 4 pharmacies (6%) recommended ORS plus either an antimicrobial agent or a physician visit. 39 pharmacies (62%) recommended antimicrobial therapy alone, 9 (14%) recommended a physician visit alone and 7 pharmacies (11%) had no available treatment. On average, antimicrobials cost four times more than two packets of ORS. In order to increase pharmacists' recommendation of ORS, health professional training may be required, perhaps in association with dispensing subsidies. Increased public awareness of ORS should also be encouraged.

Adult↗
PubMed1989

Professional attitudes toward the autopsy. A survey of clinicians and pathologists.

One hundred six clinicians and 20 pathologists at a pediatric hospital and an adult general hospital in Halifax, Nova Scotia, were surveyed by way of a mailed questionnaire on their attitudes toward the autopsy. Approximately two-thirds of both groups rated the overall usefulness of the autopsy as high, but most limited its benefits to ascertaining the cause of death and as a tool for medical education. The autopsy was rated more highly by pathologists; those who worked in the pediatric hospital; medical rather than surgical specialists; and medical staff rather than housestaff. Personal attitudes toward authorization of an autopsy on a member of the respondent's family or on his or her own body did not differ from declared professional attitudes. It is unclear whether clinicians' and pathologists' negative attitudes toward the autopsy are related to lack of knowledge, lack of hospital and community support of the autopsy, or barriers to the practice of autopsy pathology.

Attitude of Health Personnel↗
PubMed1989

Pediatric pathology and the autopsy.

The damaging effects of low and declining autopsy rates on the discipline of pediatric pathology are discussed. A survey of autopsy rates in 25 children's hospitals indicates that current rates are about 51%. Strategies for improving autopsy rates are presented.

Adolescent↗