Biomedical subjects

R Renwick

Publications and source records attributed to R Renwick.

10 recordsLinked to original sources

PubMed2006

Histological processing variability in the determination of lateral resection margins in rectal cancer.

BACKGROUND: Involvement of the lateral resection margin (LRM) has been shown to be a reliable predictor of local recurrence of rectal cancer. Accurate determination of the LRM status is crucial in selecting patients for postoperative radiotherapy. However, variability in processing factors may affect the measurement of the LRM. AIM: To investigate how formalin fixation and laboratory processing affects the measurement of the LRM. METHODS: For this study, rectal cancer specimens (n = 9) were fixed in formalin for 4 days and then sectioned transversally, and one half of the specimen was sent for processing. The effacing tumours were placed back in formalin for another 3 days. At day 7, the effacing tumour block (mirror image) was sent for processing. The longest and the shortest perpendicular resection margins for each of the day 4 and day 7 specimens were measured. In a second experiment, control tissue (colon; n = 40), length 10 (0.05) mm, was also processed from a normal sigmoid colon. Specimens were retained in formalin for 24 h (n = 12), 48 h (n = 12), 72 h (n = 9) and 96 h (n = 7). The degree of tissue shrinkage was then recorded. Variations in the recorded LRM and length of colonic tissue are presented as a median (interquartile range) and data were compared using analysis of variance. RESULTS: In the cases of rectal cancer, the variation in measured LRM between day 4 and day 7 specimens was 3.2 (1.5-5) mm. In 30 of the 37 comparisons, the day 7 LRM increased in length, whereas in the remaining 7 it decreased. In the second experiment, control tissue of the original length 10 (0.05) mm increased in length to 10.9 (8.9-13.0) mm, p<0.01. CONCLUSION: These results suggest that the fixation period/laboratory processes result in measurable differences in the reported LRM. This degree of variation has implications for the reliable reporting of the LRM, predicting local recurrence rates and planning subsequent adjuvant radiotherapy.

Formaldehyde↗

PubMed2001

Making the links between community structure and individual well-being: community quality of life in Riverdale, Toronto, Canada.

An inquiry into community quality of life was carried out within a framework that recognizes the complex relationship between community structures and individual well-being. Through use of focus groups and key informant interviews, community members, service providers, and elected representatives in a Toronto community considered aspects of their community that affected quality of life. Community members identified strengths of access to amenities, caring and concerned people, community agencies, low-cost housing, and public transportation. Service providers and elected representatives recognized diversity, community agencies and resources, and presence of culturally relevant food stores and services as strengths. At one level, findings were consistent with emerging concepts of social capital. At another level, threats to the community were considered in relation to the hypothesized role neo-liberalism plays in weakening the welfare state.

Community Networks↗

PubMed1999

Description and validation of a measure of received support specific to HIV.

Validation data are described for the Social Support Inventory for People who are HIV Positive or Have AIDS. This inventory was developed specifically for use with individuals who are HIV-positive to assess three types of received support (instrumental, informational, emotional) for each of four dimensions: whether support is received or wanted, satisfaction with support, and source of the support. It was validated in the context of a larger cross-sectional study of 120 adults with HIV who completed a set of questionnaires. Descriptive statistics, internal consistency coefficients, and evidence of construct validity for the original inventory are presented. An improved, revised version based on the validation data for the original one is also briefly described, but not tested.

Adult↗

PubMed1997

Measuring the quality of life of older persons: a model with implications for community and public health nursing.

Measuring the quality of life (QOL) of older persons can assist health professionals in achieving a number of important objectives. These include assessing the effects of illness and treatment, identifying need for support services, and developing health enhancing environments. Most QOL models focus unduly on illness and disability, define QOL too narrowly, and do not consider aspects of personal control and potential opportunities for change. A new model of QOL with associated instrumentation, the Quality of Life Profile: Seniors Version (QOLPSV), is described. Administration of the QOLPSV to 205 older persons in Ontario, Canada found it to be reliable and valid. Limitations of the instrument are presented and potential uses explored.

Aged↗

PubMed1996

Coping and social support as determinants of quality of life in HIV/AIDS.

Coping, social support and quality of life (QOL) were examined in 120 HIV+ people (mean age = 37). The sample came from ambulatory clinics and drop-in centres in Toronto: 29% had AIDS, 35% were HIV symptomatic, and 35% were asymptomatic. Information was gathered from self-administered questionnaires. Respondents had good levels of social support and used a variety of coping strategies. Their scores on the behavioural and subjective measures of QOL were somewhat below average. The illness-related measure indicated that their diagnosis had an almost neutral effect on QOL and showed several areas where QOL had been positively affected. Data from male subjects only (n = 107) were analysed using a hierarchical block regression for each QOL measure. Income, emotional social support, and problem-oriented and perception-oriented coping were positively related to QOL. Tangible social support and emotion-oriented coping were negatively related and symptom severity was not related at all. Close friends provided most types of support. Although respondents indicated high levels of satisfaction with support generally, they expressed a need for more emotional support. Unemployment was high despite participants being relatively healthy and well-educated.

Adaptation, Psychological↗

PubMed1995

Frailty: constructing a common meaning, definition, and conceptual framework.

The term frailty has been used for many years, both in everyday and academic language. It is a term that appears, on the surface, to be simple enough in its meaning, yet it has been used in a variety of ways to describe both people and a condition that applies to people. Moreover, little conceptual thought has gone into the nature of frailty and the factors that might affect it. This paper presents a definition of frailty: frailty occurs when there is diminished ability to carry out the important practical and social activities of daily living. It also presents a conceptualization of frailty that specifies its basic components, the categories of factors that contribute to it, and its relationship to closely related concepts.

Activities of Daily Living↗

PubMed1990

Crisis in psychosocial occupational therapy: a closer look.

To date, there are no existing data concerning similarities and differences in occupational therapist shortages among the broad areas of clinical practice. Accordingly, this study sought to develop a profile of therapist shortages in Metropolitan Toronto within three broad foci of intervention, namely, physical dysfunction (PD), psychosocial dysfunction (PS), or a combination of both (C). Seventy-seven questionnaires were mailed to occupational therapy managers in Metropolitan Toronto. The 74% response rate from managers supervising a total of 516 therapists provided information which included numbers of existing positions (full- and part-time), numbers of vacancies and vacancy periods, as well as perceptions concerning reasons for vacancies and need for additional positions. Although no significant differences were found among vacancy rates in the three areas there was a perception that the greatest shortage was within the PS area of practice. Implications of these results are discussed in light of the perceived crisis in psychosocial therapy. Recommendations for future research are delineated.

Allied Health Personnel↗

PubMedDate not supplied

Government policies as a threat to health: findings from two Toronto community quality of life studies.

Community members, service providers, and elected representatives in two Toronto communities were asked to identify community factors influencing the health of community members. Many of the identified barriers to health related to government policies and actions. Cutbacks in federal transfers to provinces and provincial cutbacks in funding for agencies, reductions in social assistance, ending of new social housing, and other policy changes were seen as negatively impacting the health of the community and its members. These perceptions were remarkably consistent with emerging findings concerning the determinants of health. Implications for public health practice were considered.

Attitude to Health↗

PubMedDate not supplied

Frailty: a public health perspective.

Traditionally, frailty has been conceptualized as reflecting an inevitable decline in abilities usually associated with physical aspects of aging. More recent thinking now sees frailty as reflecting an interaction among individual factors and a range of environmental elements. These emerging models, however, continue to consider frailty as a condition that resides within the individual rather than a situation that exists for the individual. We present a new model that defines frailty as occurring when there is diminished ability to carry out the important practical and social activities of daily living. Factors related to the occurrence of frailty are considered, as are the theoretical and practice implications of viewing frailty as a social construction.

Activities of Daily Living↗

PubMedDate not supplied

The quality of life of seniors living in the community: a conceptualization with implications for public health practice.

Maintaining and improving the quality of life (QOL) of seniors in the community is an increasingly important goal of public health planning and programming. To provide authentic assessments of seniors' quality of life, a partnership of public health workers and university researchers, working closely with seniors in the community, developed the Quality of Life Profile: Seniors Version (QOLPSV). Administration of the QOLPSV to a wide range of North York, Ontario seniors (n = 205) participating in community-based healthful living programs provided evidence of the instrument's psychometric integrity. Additionally, results indicated specific areas of need among seniors, suggesting shifts in emphasis in program delivery. Additional public health applications of a quality of life perspective are outlined.

Aged↗