Predicting high quality of participation in adaptive snow-sports for individuals with disabilities: An exploratory study.

OBJECTIVES: This exploratory study aimed to examine the individual, program and environmental (social and physical) characteristics which predict high quality of participation in adaptive snowsports for each dimension of the Quality of Participation in Parasport Framework (QPPF): autonomy, belongingness, mastery, challenge, engagement and meaning. METHODS: A survey was completed by 133 individuals with disabilities or their representatives on each dimension of the QPPF in adaptive snowsports and on the factors impacting the quality of participation. Descriptive statistics were used to describe the study participants, and a multivariate logistic regression model was constructed for each dimension of the QPPF to evaluate the relative contribution of individual, snowsport-related, program and environmental factors to each dimension. RESULTS: Individuals with disabilities in this study reported high quality of participation on all dimensions of the QPPF. The individual characteristics only predicted the QPPF dimension of challenge. However, the program and environmental characteristics such as equipment, number of instructors and barriers were robust predictors of quality of participation. CONCLUSION: Overall, participants experienced high quality participation. Supporting the adaptive snowsports programs while reducing the barriers faced by people with disabilities should be a continued effort to promote quality of participation.

Vasospasm in the feet in workers assessed for HAVS.

BACKGROUND: Previous studies have suggested that the presence of the vascular component of hand-arm vibration syndrome (HAVS) in the hands increases the risk of cold-induced vasospasm in the feet. AIMS: To determine if objectively measured cold-induced vasospasm in the hands is a risk factor for objectively measured cold-induced vasospasm in the feet in workers being assessed for HAVS. METHODS: The subjects were 191 male construction workers who had a standardized assessment for HAVS including cold provocation digital photocell plethysmography of the hands and feet to measure cold-induced vasospasm. Bivariate analysis and multinomial logistic regression were used to examine the association between plethysmographic findings in the feet and predictor variables including years worked in construction, occupation, current smoking, cold intolerance in the feet, the Stockholm vascular stage and plethysmographic findings in the hands. RESULTS: Sixty-one (32%) subjects had non-severe vasospasm and 59 (31%) had severe vasospasm in the right foot with the corresponding values being 57(30%) and 62 (32%) in the left foot. Multinomial logistic regression indicated that the only statistically significant predictor of severe vasospasm in the feet was the presence of severe vasospasm in the hands (OR: 4.11, 95% CI: 1.60-10.6, P < 0.01 on the right side and OR: 4.97, 95% CI: 1.82-13.53, P < 0.01 on the left side). Multinomial logistic regression analysis did not indicate any statistically significant predictors of non-severe vasospasm in the feet. CONCLUSIONS: Workers assessed for HAVS frequently have cold-induced vasospasm of their feet. The main predictor of severe vasospastic foot abnormalities is severe cold-induced vasospasm in the hands.

The skin cancer prevention framework: a comprehensive tool for population-level efforts in skin cancer.

The Skin Cancer Prevention Team (SCPT) required a comprehensive approach for guiding its efforts in population-level skin cancer prevention. After identifying and reviewing several models, it concluded that an appropriate population-level model applicable to the Alberta context did not exist. Thus, the SCPT, under the Alberta Health Services - Cancer Prevention Program, developed and evaluated a model for Alberta. Three inclusion criteria for a comprehensive framework were identified: 1) use an ecological approach to population health; 2) function as a dynamic tool for planning, implementing and evaluating population-level efforts; and 3) address weaknesses in existing theory in population health and health promotion. Theoretical constructs were layered together, on the basis of the criteria, to develop an omnibus framework. The resulting Framework represents a layering of several constructs used in popular health promotion and population health theories. It merges principles of the realist approach to scientific enquiry with principles of ecological theory. The Framework outlines a three-step, dynamic process for planning, implementing and evaluating population-level efforts. It also provides insight into the larger, unifying influences for changes in health outcomes and the complex mechanisms of behaviour change processes at the population level.

Movement of moisture in refrigerated cheese samples transferred to room temperature.

When cheese samples refrigerated at 4 degrees C in 120 mL plastic tubs were transferred to room temperature at 23 degrees C, moisture began to move from the warmer surface to the cooler interior; the difference after 1 h was 0.2-0.4%. Others had observed that moisture moved from the interior of warmer blocks of cheese to the cooler surface during cooling at the end of cheese manufacture. In loosely packed cheese prepared for analysis, part of the moisture movement may have been due to evaporation from the warmer surface and condensation on the cooler cheese. It is recommended that cheese be prepared for analysis immediately before weighing. Cheese samples that have been refrigerated, as in interlaboratory trials, should also be remixed or prepared again.

Variations of moisture measurements in cheese.

Data were accumulated during interlaboratory trials for cheese moisture determination from laboratories using officially recognized methods: AOAC; International Dairy Federation, and Standard Methods for the Examination of Dairy Products (SM). In one trial, ranges of means of 5 cheeses were 0.67, 0.56, and 0.19% for 5, 9, and 8 laboratories, respectively. The lower ranges for the SM method were typical of 3 other interlaboratory trials, with ranges of 0.27, 0.34, and 0.34% for 6, 7, and 5 laboratories, respectively. Within one laboratory, there were no significant differences among the 3 methods, but they all gave about 0.2% lower results than 2 other methods, one using freeze-drying, followed by drying in a vacuum, the other using cheese that was spread on sand and dried in a vacuum oven for 24 h. This finding indicated that none of the officially recognized methods removed all the moisture. Data showed that many laboratories tended to give either higher or lower results than the mean of all of them in a series of 7 interlaboratory trials. Constant results, free of biases or systematic errors, are important in application of formulas for prediction of yield of cheese for purposes of yield control, but are difficult to obtain. It is proposed that results by a laboratory in interlaboratory trials be compared with those obtained by one or more reference laboratories using a method that removes all the moisture from cheese. The difference would be applied as a constant in the predictive yield formula. That difference would likely be best as a running mean of differences in an ongoing series of trials. The reference laboratories would use frozen samples for quality control to ensure uniformity of results among trials. Mean moistures of 36.10 and 36.11% were obtained on subsamples before and after freezing for 7 months.

[Factors associated with convalescence and role reprisal in women after a coronary artery bypass]. / Facteurs associés au rétablissement et à reprise de rôles chez les femmes suite à un pontage aorto-coronarien.

The goal of this study was to describe how psychosocial, cultural, and sociodemographic factors influence the convalescent phase of women who have had an aorto coronary bypass graft (CABG) and to explore the relationship between those factors, the perception of health, and the recovery process. The women participating in this study were recruited during the preoperative period and contacted during the 9th and 12th week post surgery. It was observed that these women had psychosocial difficulties in the preoperative period. The study results demonstrated that some of those factors were influencing their health perception during the preoperative period. There did not appear to be any relation between their health perception and their recovery. Additional analysis demonstrated that their health perception in the postoperative period was better than during the preoperative period, and that their status improved according to the New York Heart Association Classification. Recommendations for future research and nursing practice are proposed.

[An indicator of needs for the regional allocation of public health resources in Quebec]. / Un indicateur de besoins pour l'allocation régionale des ressources en santé publique au Québec.

This paper proposes an indicator of needs for regional resource allocation in public health in Quebec. In the literature, the only reported measure of needs for regional resource allocation in public health has two parameters: size of population and Potential Years of Life Lost for preventable causes of death (APVP-EV). We verified whether APVP-EV were associated with various indices of socioeconomic conditions and lifestyle, preventive behaviours, satisfaction with social life, healthy life expectancy and some clienteles specific to public health. Our analysis indicates that the rate of Potential Years of Life Lost by avoidable causes is significantly related to all variables except satisfaction with social life. We therefore propose using size of population and its rate of APVP-EV to determine regional allocation of resources in public health.

Can bruits distinguish high-grade from moderate symptomatic carotid stenosis? The North American Symptomatic Carotid Endarterectomy Trial.

OBJECTIVE: To determine whether cervical bruits, alone or combined with other clinical characteristics, can distinguish high-grade (70% to 99%) carotid artery stenoses from less severe stenoses in patients with symptoms of cerebrovascular disease. DESIGN: Cross-sectional comparison of clinical observations with contemporaneous angiography. SETTING: The North American Symptomatic Carotid Endarterectomy Trial (NASCET), a multicenter randomized controlled trial of carotid endarterectomy. PATIENTS: All patients enrolled in the NASCET from its inception in 1988 to November 1991. RESULTS: A focal ipsilateral carotid bruit had a sensitivity of 63% and a specificity of 61% for high-grade stenosis and, when absent, only lowered the probability for high-grade stenosis from a pretest value of 52% to a post-test probability of 40%. When combined with four other clinical characteristics (an infarction on computed tomography of the head, a carotid ultrasound scan suggesting more than 90% stenosis, a transient ischemic attack rather than a minor stroke as a qualifying event, and a retinal rather than a hemispheric qualifying event), the predicted probabilities of high-grade stenosis ranged from a low of 18% (when none of the features was present) to a high of 94% (when all the features were present. CONCLUSIONS: Cervical bruits alone were not sufficiently predictive of high-grade symptomatic carotid stenosis to be useful in selecting patients for angiography; they were absent in over one third of patients with high-grade stenosis. When combined with other clinical variables, patients with high or low probabilities of 70% to 99% stenoses could be identified, but this prediction model still missed many individuals with high-grade stenosis, even in this training set of selected patients.

Joshua: A story of individuation.

This article illustrates the value of bringing a psychological perspective to bear on the interpretation of religious stories. Using the story of Joshua's conquest of the promised land recorded in the Hebrew and Christian scriptures, the author applies Jungian themes to the text to elicit psychological truths that are useful for the promotion of mental health and human development.

[Influence of dental amalgams on the concentration of mercury and silver in biological fluids and hair (author's transl)]. / A propos de l'influence des amalgames dentaires sur les taux de mercure et d'argent dans les liquides biologiques et les cheveux.

The influence of the extraction and fixing of dental amalgams on the metallic concentrations of different biological samples was studied by atomic absorption spectrometry on a subject. The levels of mercury obviously increased in urine, saliva and slightly in blood, with a maximum on the second or third day after the intervention; on the other hand, in the hair, the increase was very low even at the end of 40 days. The urinary and salivary kinetics of silver were practically similar to the ones of mercury. The determination of silver in these fluids could reveal with more specificity the part of dental amalgams on the increase of the metallic biological concentrations. A study with 25 other subjects carrying amalgams permitted to put in evidence some factors facilitating a slight increase of the mercury contents of the saliva, urine and blood.