Conceptual differences between prevention and health promotion: research implications for community health programs.

We review recent publications on the concepts of health promotion and prevention. These concepts are based on various paradigms which are defined here. A brief history of the evolution in the meaning of health is presented. Attention is turned to the research implications of the new trend of public health programs which focus on health promotion. In Canada, Achieving Health for All: a framework for health promotion is under examination in order to establish objectives and strategies for the development of health promotion programs. However, a well-articulated research strategy is urgently needed to enhance health promotion activities in this country. Disease prevention and health promotion could continue as distinct entities only if clear operational criteria, characteristics and definitions exist for each of them.

[Early screening using a direct test for genital chlamydiosis in women]. / Dépistage précoce à l'aide d'un test direct de la chlamydiose génitale chez la femme.

Elevated prevalence of asymptomatic genital tract Chlamydia infection in women, complications of this infection and introduction on the market of simple and accurate diagnostic tests at low cost are the major reasons to suggest screening programs for genital tract Chlamydia infection in women. Case finding should be the adopted approach. Diagnostic tests, including culture considered to be the gold standard, are reviewed. Accuracy and usefulness of these laboratory techniques are discussed in the context of the proposed case-finding approach.

Hospital practices and breastfeeding duration: a meta-analysis of controlled trials.

Controlled clinical trials studying the influence of hospital practices on breastfeeding duration were combined using meta-analysis. Nine studies were selected. Supplementation demonstrated a negative clinical effect on breastfeeding duration that was not significant. Nursing support demonstrated a positive clinical effect on breastfeeding duration that was not statistically significant if there was no telephone follow-up, but was significant if there was telephone follow-up. Early contact revealed a positive clinical effect that was significant. We conclude that early contact and nursing support with telephone follow-up appear as enhancing factors of breastfeeding duration.

[Hospital practices and duration of breast feeding: meta-analysis]. / Pratiques hospitalières et durée de l'allaitement maternel: méta-analyse.

Clinical trials studying the influence of hospital practices on breast-feeding duration were combined in a meta-analysis. Nine studies were selected. The global quality score was poor, and varied between 11.6 and 71.5 (Chalmers' scale). The results of each study were pooled using Peto's method and showed the following findings. Supplementation demonstrated a negative clinical effect on breast-feeding duration which was not significant (OR: 0.77, 95% CI[0.59, 1.02] p greater than 0.05). Nursing support demonstrated a positive clinical effect on breast-feeding duration which was not statistically significant if there was no telephone follow-up (OR : 2.29, 95% CI [0.87, 6.02] p greater than 0.05), but was significant if there was telephone follow-up (OR : 2.01, 95% CI [1.37, 2.94] p less than 0.05). Early contact revealed a positive clinical effect which was significant (OR : 2.96, 95% CI [1.6, 5.22] p less than 0.05). In conclusion, early contact and nursing support with telephone follow-up appear as enhancing factors of breast-feeding duration.