Gastrocolic fistula due to benign disease.
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Aged↗
Biomedical subjects
L Richard
Publications and source records attributed to L Richard.
Correlates of the sustainability of community-based heart health promotion interventions.
OBJECTIVES: This study investigated factors related to the perceived sustainability of 189 heart health promotion interventions initiated by a public health department or research initiative and implemented in a variety of organizations across Canada. METHODS: Data were collected in a telephone survey of key informants from schools, restaurants, grocery stores, health care facilities, and sports facilities that had implemented a heart health promotion intervention (risk factor screening, courses for smoking cessation, healthy eating or physical activity, support groups to promote healthy lifestyles, environmental modification, dissemination of information) in the past 8 years. RESULTS: Overall, 43.6% of 189 interventions were perceived to be very permanent, 34.8% were somewhat permanent, and 21.5% were not permanent. Independent correlates of perceived sustainability included intervention used no paid staff (odds ratio (OR) 95% confidence interval (95% Cl) = 3.7 (1.8, 7.5)), intervention was modified during implementation (OR (95% Cl) = 2.7 (1.4, 5.0)), there was a good fit between the local provider and the intervention (OR (95% Cl) = 2.4 (1.2, 5.0)), and there was the presence of a program champion (OR (95% Cl) = 2.3 (1.2, 4.4)). CONCLUSION: Consideration of these factors by health promotion program planners could increase the potential for sustainability of health promotion interventions implemented in the community.
Adult↗
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↗
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↗
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↗
Formative and effectiveness evaluation of a worksite program promoting healthy alcohol consumption.
PURPOSE: This project involved the formative and effectiveness evaluation of a program aiming to enable working, nondependent drinkers to consume alcohol in a healthy and socially responsible fashion. DESIGN: A baseline survey (n=387) of employee needs and interests was followed by a formative evaluation testing accessibility, interest/resistance, and potential effectiveness. The formative evaluation used successive iterations of focus groups. The subsequent effectiveness evaluation (n=268) used a randomized pre-post design with three conditions: alcohol program, placebo (nutrition) program, or no program. SETTINGS AND SUBJECTS: The program was implemented in a multi-branch, blue-collar, shiftworking organization (n=813) in four Quebec cities with many mobile workers. INTERVENTION: The worksite alcohol program consisted of two, half-hour sessions delivered one week apart by a health professional during paid time. The program provided information on the social and personal costs of alcohol, on strategies for promoting socially responsible drinking, and for the prevention of negative consequences of intoxication for oneself and one's family and friends. MEASURES: Constructs measured using self-administered questionnaires were: alcohol knowledge, socially responsible attitudes, perceived self-efficacy for drinking management, and self-reported drinking behavior. RESULTS: Despite the lack of interest in the topic (as found in the needs and interests survey), the program was effective in promoting socially responsible attitudes and reducing self-reported weekly consumption among participants. Some placebo effects were also present. Participants were not completely representative of all employees. CONCLUSION: Worksite alcohol health promotion programs can be effective especially when promoting socially responsible attitudes.
Alcohol Drinking↗
[Public health professionals' perceptions regarding two dimensions of health promotion: the ecological approach and community participation].
The aim of this paper is to explore public health professionals' perceptions regarding two dimensions of the new health promotion movement: the ecological approach and the principle of community participation. Data were collected by focus-groups of public health professionals (n = 22) in one Public Health Directorate in Québec. Results indicate a fair degree of integration of these two dimensions into the respondents' professional practice. However, limitations related to the work environment and to the theoretical underpinnings of these two components might impede the respondents' ability to integrate them into their practice.
Ecology↗
Chemical sterilization with peracetic acid: permeation risks inside parenteral infusion fluid.
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Chromatography, High Pressure Liquid↗
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↗
[Determinants of satisfaction with medical prenatal care in Quebec women].
This study aims at identifying determinants of satisfaction with medical care during pregnancy, a topic little explored until now. 937 women from the Montreal area answered a mailed questionnaire 4 to 7 months after giving birth. Results show a high level of satisfaction with prenatal care among respondents. Multiple regression analysis reveals that information variables emerge as the main determinants of satisfaction. In fact, not having received desired information appears as the strongest predictor; information pertaining to the delivery process is most often cited by women. The other predictors are events happening during the delivery process. Contrary to findings from other studies, sociodemographic data and characteristics of the physicians do not predict satisfaction. The discussion suggests some guidelines for the measurement of satisfaction with prenatal care as well as implications for practice.
Adolescent↗
[Roy's adaptation model].
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Adaptation, Psychological↗
[Thyroid hormones and the metabolism of lipoproteins].
Variations, generally not very marked, observed in triglycerides levels during thyroid affections are the result of the action of thyroid hormones on very low density lipoprotein (VLDL) metabolism. Hepatic synthesis of VLDL is increased in hyperparathyroidism due to elevation of circulating fatty acids levels, and in hypothyroidism only in obese patients. Catabolism of VLDL is accelerated in hyperthyroidism and slowed in hypothyroidism. The variations are probably related to changes in activity of lipoprotein lipase and/or hepatic triglyceride lipase, as well as structural modifications in VLDL. Variations in cholesterolemia observed during thyroid affections result mainly from alterations in low density lipoprotein (LDL) metabolism, parallel variations occurring in apoprotein B levels. Thyroid hormones increase cholesterol synthesis, and accelerate LDL catabolism by increasing the number of apoprotein B receptor in peripheral tissues and probably by other mechanisms independent of these receptors. Significant variations in cholesterol levels carried by high density lipoproteins (HDL) are not observed during hypothyroidism, an inconstant reduction being noted in hyperthyroidism. Apoprotein A2 levels are unchanged in thyroid disorders, those of apoproteins A1 being reduced in hyperthyroidism and normal in hypothyroidism, though they diminish transiently during substitutive treatment of the latter condition.
Animals↗
[Transurethral incision of the prostate. 5 years of follow-up. Apropos of 57 patients].
Fifty-seven bladder neck incisions were studied with a minimum follow-up of 5 years. The results published after one year were very satisfactory, but became more disappointing after 5 years, with a 38.7 reoperation rate. The weight of the prostate appears to be the determining factor. The indications, 5 years ago, were much wider than they are today, with prostate weights of up to 45 g on digital rectal examination. This type of operation should now be reserved for young subjects wishing to retain antegrade ejaculation with a prostate not exceeding 20 to 30 g and in high surgical risk patients unsuitable for transurethral resection.
Adult↗
[Frequency and severity of viral hepatitis C after liver transplantation. Study in 28 patients].
OBJECTIVES AND METHODS: HCV cirrhosis is one of the major indications for liver transplantation. HCV recurrence rate is high but long term development to cirrhosis seems to be rare. This study included 28 patients with HCV infection (HCV RNA in blood, histologic lesions highly suggestive or compatible with HCV infection). RESULTS: Twenty-one out of the 28 patients were transplanted for hepatic chronic liver disease associated with HCV infection (reinfection), whereas only 7 out of 94 transplanted patients (7.4%) without pre-transplant HCV infection ("de novo" infection). Patients were followed clinically and histologically for a mean period of 26.8 months (range: 3-56). Of 26 patients with a good histological evaluation, 24 (92.3%) had chronic hepatitis: 7 with mild activity, 17 with moderate activity, 7 of whom had bridging fibrosis. Two patients had unusual features with associated lesions (necrotic hepatitis and chronic rejection in one case, acute hepatitis associated with CMV infection in the other). CONCLUSION: This study confirms the high prevalence of HCV recurrence, as well as the "de novo" infection risk, and suggests caution concerning long term prognosis.
Adult↗
One year outcome evaluation of an alcohol and drug abuse prevention program in a Québec high school.
This article presents the results of a one-year outcome evaluation of a school-based alcohol- and drug-abuse prevention program targeting adolescents in Quebec. This evaluation concerns the school component of the program and includes the first seven classroom interventions. The design is a pre- and post-intervention assessment of both the experimental (n = 145 students) and the control school (n = 179 students). Results obtained do not reveal any significant effect of the program on knowledge and beliefs regarding the use of alcohol and drugs, or any modification in self-efficacy with respect to decision making and ability to resist external pressure concerning the decision to use marijuana/hashish. The results do show, however, a decrease among the exposed students in self-efficacy within the context of alcohol use. Such a result may be a consequence of the program's capacity to raise the students' level of awareness of their susceptibility to social influences. It is plausible that in order to have positive effects, classroom interventions such as the present one need to be supplemented by additional activities targeting youths' environment.
Adolescent↗
[Different procedures for the isolation of DNA from blood samples].
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DNA↗