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Biomedical subjects

L W Chambers

Publications and source records attributed to L W Chambers.

At least 55 records · Page 3Linked to original sources
PubMed1977

The development and application of indices of health: general methods and a summary of results.

A multidisciplinary group has developed a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The strategy has been found to be generally applicable, capable of application by lay interviewers, acceptable to interviewees, and amenable to index construction. Furthermore, initial evaluations of the resulting health indices suggest that they are biologically and clinically valid. These health indices have been successfully applied in a randomized trial of innovative primary care services. The comceptualization of individual sections of the health index questionnaire for each of these three functional areas, the generation of the instrument, and the evaluation of questionnaire responses for their biologic and clinical validity are summarized here.

Adolescent↗
PubMed1976

Underreporting of cancer in medical surveys: a source of systematic error in cancer research.

Systematic errors occur in the reports of disease frequency derived from health surveys based on questionnaire interviews. Five hundred and thirty-three persons with clinically and histologically confirmed disease in a case-control study of cancer were interviewed in their homes by carefully trained interviewers using a standardized questionnaire interview schedule. Comparisons of the information obtained by interview about past history of cancer with cancer registry and hospital medical record information about the same people revealed serious underestimates of correct frequency and wide variation in the rates of correct reporting. The findings reported here and elsewhere add support to an essential requirement in medical survey research: the completeness and accuracy of responses in health interview surveys must be verified and the methods of verification must be reported before the results can be interpreted with confidence.

Carcinoma, Squamous Cell↗
PubMed1976

Development and application of an index of social function.

Brief indexes of social function were constructed in a project to develop a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The social function items have been found to be generally applicable, capable of application by lay interviewers, and acceptable to interviewees. Initial evaluations to form composite scores for social function items have demonstrated their validity against concurrent assessments of a health professional. These social function indexes have been successfully applied in two randomized trials of innovative primary care services. The criteria for inclusion of items in the social function index questionnaire, the generation of the instrument, and the evaluation of questionnaire responses for their validity are summarized here.

Attitude to Health↗
PubMed1975

The occupation of fishing as a risk factor in cancer of the lip.

To study the role of commercial fishing and related factors in the development of lip cancer, a project that included a case-control study and a cohort analysis was undertaken in Newfoundland. Household survey data were linked with cancer-registry and census data. In comparison with other males, fishermen had a probability of development of lip cancer that was 1.5 times higher (by the case-control method, P less than 0.05) or 4.4 times higher (by cohort analysis, P less than 0.001). Despite the effect of pipe smoking, "outdoorness" and age on the development of lip cancer in general, the occupation of fishing was an additional, independent contribution to the risk. Unexpectedly, using the mouth as a third hand to handle tar-coated nets seemed to protect fishermen from the disease. It was not possible to attribute the higher risk to a particular work activity, nor was a specific responsible carcinogen identified.

Adult↗
PubMedDate not supplied

Tracking the use and impact of a community social report: where does the information go?

The purpose of this paper is to report on a study evaluating the extent to which a social report (entitled "Hamilton-Wentworth Profile on Children and Youth") was read and used by recipients. Subjects were divided into two groups: an Active Group which had worked on producing the Profile and/or requested copies of it once it had been released, and a Passive Group which had received copies of the Profile through a general mailing list used for other research reports. Approximately one year later, 90% of the Active Group recalled the Profile compared to 21% of the Passive Group. Similarly, 83% of Active Group respondents had read the Profile compared to 8% of Passive Group subjects. 80% of Active Group respondents and 5% of Passive Group respondents used the Profile. The results suggest that if social reports are read by local community agencies and individuals, they will be used to help improve conditions for children and youth. Social reports at the local level are more likely to be read if potential users are engaged in the process of report production and if the reports are disseminated to the appropriate target audience.

Attitude of Health Personnel↗
PubMedDate not supplied

Are child pedestrians at increased risk of injury on one-way compared to two-way streets?

OBJECTIVES: To compare child pedestrian injury rates on one-way versus two-way streets in Hamilton, and examine whether the characteristics of child pedestrian injuries differ across street types. METHODS: The rates of injury per child population, per kilometre, per year were calculated by age, sex and socio-economic status (SES). Child, environment and driver characteristics were investigated by street type. RESULTS: The injury rate was 2.5 times higher on one-way streets than on two-way streets and 3 times higher for children from the poorest neighbourhoods than for those from wealthier neighbourhoods. SES, injury severity, number of lanes, collision location and type of traffic control were also found to be significantly different across street types. CONCLUSIONS: One-way streets have higher rates of child pedestrian injuries than two-way streets in this community. Future risk factor and intervention studies should include the directionality of streets to further investigate its contribution to child pedestrian injuries.

Accidents, Traffic↗
PubMedDate not supplied

Measuring alcohol abuse in the community: consumption, binge-drinking, and alcohol-related consequences ("alcoholism").

This study reported and compared community health indicators for the measurement of alcohol abuse. Using data from the 1989 Hamilton-Wentworth Health Survey, similar rates were found for four differing definitions of alcohol abuse: 1) drinking everyday (5.7%, 95% confidence limit (CL) = 3.8-7.7%), 2) drinking at least 14 drinks in the past seven days (12.1%, 95% CL = 9.2-15.1%), 3) frequent binging on 10 drinks or more (9.4%, 95% CL = 6.9-11.8%), and 4) "alcoholism" as defined by the Michigan Alcoholism Screening Test (MAST) (7.4%, 95% CL = 5.1-9.7%). Binging on five drinks or more occurred frequently (37.0, 95% CL = 32.8-41.1%). All indicators of alcohol abuse from the survey were significantly higher for males as compared to females (p < 0.05), and demonstrated varying distributions by age. Estimates of drinking consumption based on the sale of alcoholic beverages in the community were also examined and found to estimate consumption levels nearly double that of the self-reported survey data. Relevance to public health planning and monitoring is discussed.

Adolescent↗
PubMedDate not supplied

Healthy communications: producing a health report (Infowatch) for monitoring and promoting health in local communities.

In order to bridge the gap between producers and users of community health data, we have developed a standardized format to provide a simple, comprehensive approach to the communication of epidemiologic data at the local level. Infowatch follows a series of format and style rules selected to enhance readability. The four-page format is divided into six sections: introduction and scope; "results" presented as charts, figures and text; policy implications (through consultation with community groups); methodological summary; references for self-study; and, invitation for reader feedback. An editorial committee comprising experts and representatives from local interest groups ensures that the data presented are relevant and of high quality. The content of each Infowatch issue varies depending on community priorities. Infowatch is distributed to 3,000 people, including representatives from health-related, academic, governmental and non-governmental agencies. Five areas assess qualitatively the impact of Infowatch: reader, media, policy, education, and solicited responses. Overall, response from all categories has been favourable with evidence of infiltration into policy.

Community Health Services↗
PubMedDate not supplied

Follow-up of participants in a preschool hearing screening program in child care centres.

As part of its response to the Ontario Ministry of Health recommendation that communication disorders in preschool children be identified, the Hamilton-Wentworth Department of Public Health Services performed hearing screening tests on all preschool children in child care centres. Parents of children who had failed the hearing screening test were recommended to take their child to their family physician for further assessment. Out of 1,844 children tested between September 1990 and February 1991, 35 children failed the pure-tone audiometry test administered by nurses. A telephone follow-up interview determined that 26 children with screening test failures had received some medical follow-up. Eight children had a confirmed hearing problem; of these, five were newly diagnosed with a hearing problem, all resulting from fluid build-up in the middle ear. Three children were treated, with two having improved hearing. Of the two children not treated, one was reported to have improved hearing. As with other recently reported preschool hearing screening programs, this study raises doubts about the usefulness of such programs.

Audiometry, Pure-Tone↗
PubMedDate not supplied

How can local health agencies improve health knowledge and skills of child care centre operators?

As the number of child care centres increases across Canada, local health agencies are increasingly involved in health issues within these facilities. 90% of operators of the 98 child care centres in an Ontario community responded to a mail survey distributed by the local health unit to determine health needs in these facilities. Infectious disease was reported to be the major health problem of the children. 76% of operators requested information about infectious diseases, in particular through use of written materials made available to their centre. The level of education of operators was high with 79% having completed community college courses. Over 70% of operators had attended continuing education sessions or workshops on child abuse, growth and development and nutrition; fewer operators reported attending sessions on infectious diseases, child safety, parent-child relationships and dental health. As a result of the needs assessment, a health unit multidisciplinary team has met and initiated a number of activities including meeting with child care centre operators, publication of newsletter for operators, and development of educational materials.

Child↗
PubMedDate not supplied

New approaches to addressing information needs in local public health agencies.

For local Public Health agencies to be fully responsive to community needs, staff must have ready access to up-to-date and accurate information. During the last several years, the Hamilton-Wentworth Department of Public Health Services (DPHS), a Teaching Health Unit affiliated with McMaster University, has been developing new information services including establishment of a specialized library on site; education sessions on the use of information stored in this library and in the Hamilton-Wentworth Health Library Network; innovative approaches to tailoring information services to staff needs including on-site access to on-line literature databases; and establishment of a group to retrieve and report community health data. In the initial three years of operation, surveys of Hamilton-Wentworth staff and a comparison health unit (Niagara) revealed that staff most frequently sought information from managers and support staff, as well as from personal books, articles and journals. Over half (57%) of the Hamilton-Wentworth staff reported use of the DPHS library, whereas 28% of Niagara Regional Health Unit staff reported use of their library. Other information services, for example, bibliographic indexes on population health, were less frequently used. Plans to increase their use are discussed.

Canada↗
PubMedDate not supplied

AIDS seminars for senior grades in secondary schools.

AIDS seminars lasting 70 minutes, consisting of an oral presentation, a videotape and time for discussion, were offered to students in grades 11, 12 and 13 in secondary schools in the Hamilton Board of Education. Specially chosen teacher and public health nurse facilitators were assigned to sessions. 19 secondary school principals and 1,898 students in 10 schools completed questionnaires about the usefulness of the seminars. Students and principals viewed the seminars. Students and principals viewed the seminar as highly valuable for obtaining new information in sessions with either public health nurse or teacher facilitators. The oral presentation was rated most valuable but students rated the videotape and the discussion components highly as well. The students strongly agreed that the seminar assisted in understanding how STDs could be prevented, and made them aware of the community groups or agencies they could go to for help. A substantially greater number of females than males indicated they wished to attend other seminars.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Estimating the burden of illness in an Ontario community with untreated drinking water and sewage disposal problems.

The Hamilton-Wentworth regional health department was asked by one of its municipalities to determine whether the present water supply and sewage disposal methods used in a community without piped water and regional sewage disposal posed a threat to the health of its residents. Three approaches were used: assessments by public health inspectors of all households; bacteriological and chemical analyses of water samples; and completion of a specially designed questionnaire by residents in the target community and a control community. 89% of the 227 residences in the target community were found to have a drinking water supply that, according to the Ministry of Environment guidelines, was unsafe and/or unsatisfactory. According to on-site inspections, 32% of households had sewage disposal problems. Responses to the questionnaire revealed that the target community residents reported more symptoms associated with enteric infections due to the water supply. Two of these symptoms, diarrhea and stomach cramps, had a relative risk of 2.2 when compared to the control community (p less than 0.05). The study was successfully used by the municipality to argue for provincial funding of piped water.

Diarrhea↗