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Biomedical subjects

L Potvin

Publications and source records attributed to L Potvin.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Seizure vs. syncope: measuring serum creatine kinase in the emergency department.

OBJECTIVE: To determine the utility of serum creatine kinase measurement for diagnosing generalized tonic-clonic seizures in patients presenting to an emergency department with transient loss of consciousness. DESIGN: Prospective evaluation of a diagnostic parameter. Retrospective data collection with blinded assignment to diagnostic groups. SETTING: University teaching hospital. PATIENTS: Sequential sample of 205 patients with transient loss of consciousness. The study group consisted of 96 patients who had creatine kinase measurements in the emergency department. MEASUREMENTS AND MAIN RESULTS: An investigator blinded to the results of creatine kinase measurements retrospectively classified events into seizure and nonseizure groups on the basis of clinical presentation, prior history, and follow-up investigations. Mean (+/- SE) creatine kinase level was significantly higher in the seizure group (231.1 +/- 34.8 U/L vs. 70.5 +/- 5.6 U/L, p less than 0.001). Elevated creatine kinase had a test specificity of 0.98 (95% CI 0.90-1.00) and a sensitivity of 0.43 (95% CI 0.28-0.59). The discriminating power of creatine kinase elevation was directly related to the time interval between the event and testing (p less than 0.0001). Among samples taken more than three hours after the event, test sensitivity was 0.80 (0.52-1.00) and specificity was 0.94 (0.71-1.00). CONCLUSION: Creatine kinase may be a useful test for evaluating patients with transient loss of consciousness. The test is highly specific for diagnosing generalized seizures in the emergency department. Test sensitivity improves by sampling serum at least three hours after the event.

Creatine Kinase↗
PubMedDate not supplied

Post-stroke inpatient rehabilitation. I. Predicting length of stay.

This study was undertaken to identify factors predicting stroke inpatient rehabilitation length of stay in an acute inpatient rehabilitation program, including occupational therapy, physical therapy, and speech therapy. A cohort of 152 patients suffering from stroke (76 women and 76 men) voluntarily participated in this study. They were recruited from a general hospital in which they had received physical rehabilitation. The functional status of patients was observed by a physiotherapist, using the Functional Independence Measure(SM). The functional status was observed on patient admission to rehabilitation and at 1 wk from admission. Post-stroke biologic characteristics, including physical, neuropsychological, and clinical characteristics, as well as sociodemographic characteristics were also collected. A path analysis, using successive multiple linear regressions, was adopted to predict length of stay in rehabilitation. Significant predictors of length of stay were age, functional status at 1 wk post-rehabilitation admission, perceptual status, and balance status. These predictors accounted for 43.6% of the total variance in the rehabilitation length of stay. Indirect predictors of length of stay were identified as the following: functional status at admission, rehabilitation program, motor status, communication problems, and medical complications. Functional, biologic, and sociodemographic characteristics should be considered simultaneously in the prediction of length of stay as well as for the better understanding of the stroke rehabilitation process.

Adult↗
PubMedDate not supplied

Post-stroke inpatient rehabilitation. II. Predicting discharge disposition.

This study was undertaken to identify indicators that predict discharge disposition after an acute stroke rehabilitation program. A cohort of 152 incident cases suffering from stroke (76 women and 76 men) voluntarily participated in this study. They were recruited from a general hospital in which they were participating in a rehabilitation program. Post-stroke biologic, sociodemographic, and psychosocial characteristics were considered in our analyses. A polychotomous nominal logistic regression analysis was used to predict inpatient rehabilitation discharge disposition. The three discharge disposition categories were (1) private home, (2) rehabilitation center, and (3) long-term care facility. Significant predictors related to the discharge toward a rehabilitation center were functional status at admission, presence of social support, and gait status. Significant predictors for discharge to a long-term care facility were functional status at admission, presence of social support, gait status, and presence of medical complications. Functional status measured on rehabilitation admission should be considered, in conjunction with the patient's social support, gait status, and presence of medical complications, to be predictive of post-stroke rehabilitation discharge disposition.

Activities of Daily Living↗
PubMedDate not supplied

Determinants of intention to adopt a low-fat diet in men 30 to 60 years old: implications for heart health promotion.

PURPOSE: The purpose of the study was to identify the determinants of intention to have a low-fat diet in 30- to 60-year-old men. DESIGN: The survey design was cross-sectional and consisted of a self-administered questionnaire. The dependent variable was the intention to have a low-fat diet within the next 4 months, and the independent variables were those suggested by the theory of planned behavior. SETTING: The study population was drawn from three districts representing a modal sample of Laval, the second most populous city (N = 314,398) in the province of Quebec. SUBJECTS: The sample comprised 3200 people. Of the 3200 questionnaires sent out, 2583 were received and 2269 were eligible (i.e., were answered by 30- to 60-year-old men), giving a response rate of 70.9%. Of the 2269 questionnaires, 430 were incomplete, resulted in 1839 being usable for analysis. MEASURES: Multiple regression analysis was conducted to determine the influence of the independent variables on the dependent variable, the intention to have a low-fat diet. The independent variables were (1) direct and indirect determinants of intention as suggested in the theory of planned behavior and (2) sociodemographic and concomitant variables and their interactions. Discriminant analysis was used on the significant variables obtained in the regression to establish the cognitive profile of respondents' intention, strong or weak. RESULTS: In the final model, five variables 51% of the total variance. Respondents who had a stronger intention perceived that their important referents would approve them having a low-fat diet. They scored higher in seeing the advantages of adopting the target behavior and had a more positive attitude toward the behavior. They also perceived themselves as having control over the target behavior, and scored higher in terms of recognizing the perceived power of this control factor. CONCLUSIONS: The results suggests that the theory of planned behavior can be an effective tool in the planning of heart health promotion. They indicate that low-fat diet programs for men should target the work site and peer-group organizations, and place emphasis on adapting usual recipes. Though accenting the health and nutritional benefits of a low-fat diet, messages should appeal to emotion as well as reason.

Adult↗
PubMedDate not supplied

Ecological foundations of health promotion.

In this article, human ecology is defined; its historical and intellectual roots are traced through various disciplines to its applications in public health and health promotion today; its strengths and limitations are described; some potential contributions of systems theory are suggested; and some emerging ecological models of health promotion are anticipated.

Ecology↗
PubMedDate not supplied

Assessment of the integration of the ecological approach in health promotion programs.

PURPOSE: This article proposes a model of the ecological approach in health promotion programs. Based on system theory, the model identifies intervention settings and targets as two independent dimensions for assessing the integration of this approach in programs. Additional objectives are to present and pretest an analytical procedure that allows the assessment of integration of the ecological approach in programs. DESIGN: This was a descriptive study of the integration of the ecological approach in a sample of health promotion programs. SUBJECTS: Subjects were 44 health promotion programs drawn from the population of Canadian federally funded programs. MEASURES: Descriptions of programs were obtained by telephone interviews. A coding scheme was applied to the data to identify intervention settings and targets for each program. Using this information, a summative score of the integration of the ecological approach was estimated for each program. RESULTS: Single-setting programs were the dominant pattern in the sample. Individuals whose health was of concern were very frequently the direct targets of the programs. However, organizational and interpersonal environments were also often directly targeted. Single-setting or single-intervention strategy programs outnumbered ecological programs. CONCLUSION: The proposed model and analytical procedure is a useful framework for the assessment of integration of the ecological approach in health promotion programs. The pilot test having been conducted on a convenience sample, future work should replicate the study in a representative sample of programs.

Canada↗
PubMedDate not supplied

The ecological approach in tobacco-control practice: health promotion practitioner characteristics related to using the ecological approach.

PURPOSE: To identify cognitive factors and personal characteristics related to the integration of the ecological approach in the everyday practice of health promotion practitioners. DESIGN: Sociodemographic, cognitive, and behavior data were collected using a cross-sectional mail survey. SETTING: Information was collected from regional public health organizations (n = 129) in the 10 Canadian provinces. SUBJECTS: Health promotion practitioners involved in tobacco-control programming for youth (n = 524) comprised of 81% women with a mean age of 39 years. MEASURES: Attempts to integrate ecological strategies (i.e., interpersonal, organizational, and policy change) into tobacco-control practice were based on three self-report items. Six scales assessed knowledge, values, and normative beliefs about the ecological approach as well as perceived need for, effectiveness of, and competency regarding using the ecological approach. RESULTS: The survey response rate was 80%. Stepwise discriminant analyses revealed four predictors (p < .001) contributing to the function solution concerning practitioner attempts to target the interpersonal environment: perceived competency, training discipline, years doing health promotion, and gender. Three predictors (p < .001) contributed to each of the function solutions concerning practitioner attempts to target the organizational environment (perceived competency, perceived effectiveness, and normative beliefs) and practitioner attempts at policy change (perceived competency, knowledge, and normative beliefs). CONCLUSIONS: Tobacco-control practitioners who perceive themselves as having the skills to develop and/or implement interventions targeting a person's environment are more likely to target the environment for change.

Adult↗
PubMedDate not supplied

[Structuring action from using a model for planning health promotion programs].

The aim of this paper is to present results which illustrate the role of the PRECEDE-PROCEED model in the program planning process. Based on the results of an implementation evaluation of the EMPOWER software which supports health programming efforts, we have developed a metaphor to illustrate the use of the model. The following four functions of the model were identified: direction, coordination, articulation and transmission. Analysis of these functions demonstrated the structuring action of the model on planning. It would be interesting to further study how these four functions operate with or without the support of the software, to explore the influence of other health promotion models in their natural settings and to see in which way the same or other functions might be identified.

Community Health Services↗
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Collective lifestyles as the target for health promotion.

The last five years have witnessed intense debate among health researchers in Canada regarding the overlap of the health promotion and population health discourses. Meanwhile, strong currents within health promotion have attempted to move the field beyond a focus on individual behaviour towards the influence of social environments on health, although the tendency is often to fall back on individual behaviour modification as the primary lever for change. The Population Health research agenda bypasses behavioural determinants of health and explores instead social determinants. This body of knowledge provides useful insight for addressing some of the tensions in the health promotion discourse. This paper explores two of these tensions: whether individuals at risk or general populations should be targeted for change; and whether lifestyle is an individual or a collective attribute. We propose the notion of collective lifestyles as a heuristic for understanding the interaction between social conditions and behaviour in shaping health.

Canada↗
PubMedDate not supplied

Organizational and professional characteristics predicting external communications in Canadian public health units.

This study is a survey of administrative divisions involved in tobacco programs in Canadian public health units. It aims to identify correlates of public health units' contacts and collaborations with external agencies, as predisposing factors in their capacity to innovate. Heads of 124 divisions involved in tobacco control completed a questionnaire about their budgets, staff, and management practices. In each of these divisions, professionals involved in tobacco programs also completed a questionnaire about their characteristics and experience. Results showed a high level of contacts and collaborations with external agencies. Four variables emerged as correlates of external communications: professionals' degree of access to public health information sources, the diversity of disciplines within the administrative division, the decentralization of authority, and the level of professionals' participation in decision-making. Because of the potential relationship between innovation and external communication, public health units should consider fostering external communication by management practices and policies, such as favouring professional diversity, increasing access to sources of information, and adopting more decentralized, participatory management.

Canada↗
PubMedDate not supplied

A supermarket cardiovascular screening program: analysis of participants' solicitation of follow-up care.

We conducted a cardiovascular screening program in 54 supermarkets in the province of Québec, Canada to determine cardiovascular risk factors, including total cholesterol, blood pressure, tobacco use, height, weight, and physical activity levels. A 10-minute debriefing counseling session followed. Of the 3,432 screening participants 18-74 years of age, 2,420 participated in a nutrition study, consisting of answering a brief questionnaire before the screening. Three months after the screening, 1,293 individuals returned the posttest nutrition questionnaire sent to them by mail. We report follow-up care activity for low-risk and high-risk individuals for respondents of the posttest nutrition questionnaire. Overall, 53% of respondents reported seeing a physician within three months after the screening to discuss their blood cholesterol or blood pressure results, and the percentage ranged from 25% for individuals with normal cholesterol (< or = 199 mg/dL) and normal blood pressure (< 140/90 mm Hg) to 83% for individuals with high cholesterol (> or = 240 mg/dL) and high blood pressure (> or = 140/90 mm Hg). Respondents who saw a physician following the screening were more likely to be (1) those on medication at the time of the screening for high blood cholesterol and high blood pressure, (2) older individuals, (3) those found to have high blood cholesterol and high blood pressure values during the screening, (4) women, and (5) individuals with a lower level of education. Seventy-nine percent identified as having high blood cholesterol during the screening reported that their blood cholesterol was remeasured. The majority of high-risk participants and their physicians took appropriate follow-up action.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[The effects of a nutritional information program on the contents of grocery carts].

In 1988, a chain of supermarkets in Quebec organized and sponsored a campaign to promote healthy eating habits and regular physical activity. Over a six-week period, comprehensive articles were published in a free home-delivered flyer. This study aimed to determine the effectiveness of the program in changing the buying habits of customers, as reflected by the content of their grocery carts. Data were collected at four points in time in one supermarket. Four independent samples of customers (N = 465) answered a brief questionnaire and the grocery receipt was used to analyze the food items in their shopping carts. The major dependent variables were the portions of various food groups, and fiber and lipid densities per dollar. Results show that, over time, customers lowered the lipid content and increased the fiber content of their purchases. This suggests that the food industry can play an effective role in improving the well-being of their clients.

Adolescent↗
PubMedDate not supplied

Changes in knowledge and food behaviour following a screening program held in a supermarket.

We examined the relationship between knowledge, health beliefs and dietary behaviours of participants in a supermarket cardiovascular screening program, the conceptual framework for which was the Health Belief Model. 3,432 individuals aged 18-74 participated in the screening program conducted in 54 supermarkets in Montreal and Quebec. This program identified participants' risk for cardiovascular disease by measuring total serum cholesterol, blood pressure, height, weight, level of physical activity, and tobacco use. A ten-minute debriefing counselling session interpreted risk factors and recommended follow-up. 70% (n = 2,420) also completed a nutrition questionnaire on knowledge, health beliefs, and frequency of consumption of high fat foods. Respondents increased their knowledge and reduced the frequency of consumption of high-fat foods following the screening program (p < or = 0.05), particularly individuals with higher blood cholesterol levels, high blood pressure, and women.

Adolescent↗
PubMedDate not supplied

[Social support network evolution after the birth of their first baby: comparison between lower and middle class mothers].

The social support networks of a group of low socio-economic status (S.E.S.) mothers (n = 87) and a group of higher S.E.S. mothers (n = 44) are described and compared at the 30th week of pregnancy and at the third week after the birth of their first baby. The evolution of the support networks for these two groups of mothers during this period is also examined. A modified form of the ASSIS from Barrera has been used to measure the social support network. Results show that, during pregnancy, the social support network of low-S.E.S. mothers is more restricted than that of higher S.E.S. mothers. Although the actual number of people around them after the birth of the baby did not increase, low-S.E.S. mothers said they felt a slight increase in the number of people available to give support in some way. They also reported that conflicts were more frequent with some of them. For higher S.E.S. mothers, all social network variables remained stable from pregnancy through the first postpartum month.

Adult↗
PubMedDate not supplied

Methodological challenges in evaluation of dissemination programs.

Several authors have suggested that the purpose of evaluating programs in their dissemination phase is to show that the conditions necessary to produce the expected outcomes are implemented. The need for outcome evaluation should thus decrease when a program goes from the demonstration to the dissemination phase. Disputing such a proposition, this paper argues that: 1) the evaluation agenda should be broad and open in all phases of program development; 2) the need for outcome assessment should be present during the entire cycle of any program's life, and 3) there is a need to develop creative methodological approaches to address issues relevent to the evaluation of dissemination programs. Finally, eight research strategies are presented for addressing two such issues: the relationship between the researcher and the program and the equivocality of the causal inference present during the dissemination phase.

Community Participation↗