Health and Social Services
Health and Social Services
Shankar S.,University of British Columbia |
Mortenson W.B.,University of British Columbia |
Mortenson W.B.,Vancouver Coastal Health Research Institute |
Wallace J.,Health and Social Services
American Journal of Occupational Therapy | Year: 2015
Tilt-in-space (TIS) wheelchairs are common in residential care, but little empirical evidence exists regarding how they are used by residents and staff in these settings. As part of a larger study exploring the use of wheeled mobility in these facilities, we conducted a substudy to examine how TIS wheelchairs are used in practice and to explore the experiences of the residents who use them. We conducted a series of three participant observations and interviews with 6 residents or their family members and interviewed 10 staff. Our analysis identified taking control as the main overarching theme, subsuming two subthemes: promoting comfort and mobilizing to participate. Findings suggest that power TIS wheelchairs enable user control, whereas manual TIS wheelchairs promote staff control. These findings illustrate how TIS wheelchairs may enable or inhibit occupational engagement and suggest that vigilance is necessary to prevent their use as a restraint. © 2015, American Occupational Therapy Association, Inc. All rights reserved.
Osteras N.,Diakonhjemmet Hospital |
van Bodegom-Vos L.,Leiden University |
Dziedzic K.,Keele University |
Moseng T.,Diakonhjemmet Hospital |
And 8 more authors.
Implementation Science | Year: 2015
Background: Previous research indicates that people with osteoarthritis (OA) are not receiving the recommended and optimal treatment. Based on international treatment recommendations for hip and knee OA and previous research, the SAMBA model for integrated OA care in Norwegian primary health care has been developed. The model includes physiotherapist (PT) led patient OA education sessions and an exercise programme lasting 8-12 weeks. This study aims to assess the effectiveness, feasibility, and costs of a tailored strategy to implement the SAMBA model. Methods/design: A cluster randomized controlled trial with stepped wedge design including an effect, process, and cost evaluation will be conducted in six municipalities (clusters) in Norway. The municipalities will be randomized for time of crossover from current usual care to the implementation of the SAMBA model by a tailored strategy. The tailored strategy includes interactive workshops for general practitioners (GPs) and PTs in primary care covering the SAMBA model for integrated OA care, educational material, educational outreach visits, feedback, and reminder material. Outcomes will be measured at the patient, GP, and PT levels using self-report, semi-structured interviews, and register based data. The primary outcome measure is patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire) at 6-month follow-up. Secondary outcomes include referrals to PT, imaging, and referrals to the orthopaedic surgeon as well as participants' treatment satisfaction, symptoms, physical activity level, body weight, and self-reported and measured lower limb function. The actual exposure to the tailor made implementation strategy and user experiences will be measured in a process evaluation. In the economic evaluation, the difference in costs of usual OA care and the SAMBA model for integrated OA care will be compared with the difference in health outcomes and reported by the incremental cost-effectiveness ratio (ICER). Discussion: The results from the present study will add to the current knowledge on tailored strategies, which aims to improve the uptake of evidence-based OA care recommendations and improve the quality of OA care in primary health care. The new knowledge can be used in national and international initiatives designed to improve the quality of OA care. Trial registration: ClinicalTrials.gov NCT02333656 © 2015 Østerås et al.
Do M.T.,Public Health Agency of Canada |
Frechette M.,Public Health Agency of Canada |
McFaull S.,Public Health Agency of Canada |
Ruta M.,Health and Social Services |
Thompson W.,Public Health Agency of Canada
International Journal of Circumpolar Health | Year: 2013
Background. Injury is a major public health concern, particularly for Canadians living in Arctic regions where the harsh physical and social conditions pose additional challenges. Surveillance data collected over the past 2 decades through the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) provide insights into the burden of injuries in certain parts of Canada. Objectives. This study aims to summarize and compare patterns of injuries in the Northwest Territories (NWT) and Nunavut to other southern communities across Canada. Methods. Analysis was based on CHIRPP data covering the period 1991-2010. Proportionate injury ratio (PIR) and its 95% confidence interval were used to summarize and compare the injury experience of Canadians living in the Arctic regions to other CHIRPP sites across Canada. Results. Between 1991 and 2010, there were 65,116 reported injuries. Approximately 83% of the cases were unintentional in nature; however, significantly higher proportions were observed for assaults and maltreatment (PIR=2.80, 95% CI: 2.72-2.88) among Canadians living in northern communities. Significantly higher proportions were also observed for crushing/amputations (PIR=2.28, 95% CI: 2.14-2.44), poison/toxic effects (PIR=1.21, 95% CI: 1.15-1.28), drowning/asphyxiations (PIR=1.52, 95% CI: 1.33-1.74) and frostbites (PIR=7.39, 95% CI: 6.60-8.28). The use of all-terrain vehicles or snowmobiles also resulted in significantly higher proportions of injuries (PIR=1.93, 95% CI: 1.79-2.09). Conclusions. This study contributes to the limited literature describing injuries in northern communities where the harsh physical and social climates pose additional challenges. Excesses in the proportions identified in this study could be useful in identifying strategies needed to minimize injury risks in northern communities within Canada. © 2013 Minh T. Do et al.
Collins S.A.,University of British Columbia |
Sinclair G.,University of British Columbia |
McIntosh S.,University of British Columbia |
Bamforth F.,University of Alberta |
And 7 more authors.
Molecular Genetics and Metabolism | Year: 2010
Carnitine palmitoyltransferase 1A (CPT1A), encoded by the gene CPT1A, is the hepatic isoform of CPT1 and is a major regulatory point in long-chain fatty acid oxidation. CPT1A deficiency confers risk for hypoketotic hypoglycaemia, hepatic encephalopathy, seizures, and sudden unexpected death in infancy (SUDI). It remains controversial whether the CPT1A gene variant, c.1436C>T (p.P479L), identified in Inuit, First Nations, and Alaska Native infants, causes susceptibility to decompensation, in particular during times of fever and intercurrent illness. Although newborn screening for the P479L variant occurs in some jurisdictions, background knowledge about the presence of the variant in Canadian Aboriginal populations is lacking. In an effort to understand the population implications of the variant in northern Canada, overall frequencies of the variant were assessed. Further studies are underway to determine associated risk. Ethics approval was obtained from university REBs, local research institutes, and with consultation with territorial Aboriginal groups. Newborn screening blood spots from all infants born in 2006 in the three territories were genotyped for the p.P479L variant. p.P479L (c.1436C>T) allele frequencies in the three territories were 0.02, 0.08, and 0.77 in Yukon (n= 325), Northwest Territories (n= 564), and Nunavut (n= 695), respectively. Homozygosity rates were 0%, 3%, and 64%. Aboriginal status was available only in NWT, with allele frequencies of 0.04, 0.44, 0.00, and 0.01 for First Nations, Inuvialuit/Inuit, Métis, and non-Aboriginal populations. Although individual blood spots were not identified for Aboriginal ethnicity in Nunavut infants, ~. 90% of infants in Nunavut are born to Inuit women. The allele frequency and rate of homozygosity for the CPT1A P479L variant were high in Inuit and Inuvialuit who reside in northern coastal regions. The variant is present at a low frequency in First Nations populations, who reside in areas less coastal than the Inuit or Inuvialuit in the two western territories. The significance of the population and geographic distribution remains unclear, but the high population frequencies of the variant suggest a historically low penetrance for adverse outcomes. Further evidence is needed to determine if there is an increased risk for infant mortality and morbidity and whether newborn screening will be indicated on a population basis. © 2010 Elsevier Inc.
PubMed | Health and Social Services, Diakonhjemmet Hospital, University of Oslo, Leiden University and 2 more.
Type: | Journal: Implementation science : IS | Year: 2015
Previous research indicates that people with osteoarthritis (OA) are not receiving the recommended and optimal treatment. Based on international treatment recommendations for hip and knee OA and previous research, the SAMBA model for integrated OA care in Norwegian primary health care has been developed. The model includes physiotherapist (PT) led patient OA education sessions and an exercise programme lasting 8-12weeks. This study aims to assess the effectiveness, feasibility, and costs of a tailored strategy to implement the SAMBA model.A cluster randomized controlled trial with stepped wedge design including an effect, process, and cost evaluation will be conducted in six municipalities (clusters) in Norway. The municipalities will be randomized for time of crossover from current usual care to the implementation of the SAMBA model by a tailored strategy. The tailored strategy includes interactive workshops for general practitioners (GPs) and PTs in primary care covering the SAMBA model for integrated OA care, educational material, educational outreach visits, feedback, and reminder material. Outcomes will be measured at the patient, GP, and PT levels using self-report, semi-structured interviews, and register based data. The primary outcome measure is patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire) at 6-month follow-up. Secondary outcomes include referrals to PT, imaging, and referrals to the orthopaedic surgeon as well as participants treatment satisfaction, symptoms, physical activity level, body weight, and self-reported and measured lower limb function. The actual exposure to the tailor made implementation strategy and user experiences will be measured in a process evaluation. In the economic evaluation, the difference in costs of usual OA care and the SAMBA model for integrated OA care will be compared with the difference in health outcomes and reported by the incremental cost-effectiveness ratio (ICER).The results from the present study will add to the current knowledge on tailored strategies, which aims to improve the uptake of evidence-based OA care recommendations and improve the quality of OA care in primary health care. The new knowledge can be used in national and international initiatives designed to improve the quality of OA care.ClinicalTrials.gov NCT02333656.
News Article | November 29, 2016
The International Nurses Association is pleased to welcome MaryJane Johnson, RN, to their prestigious organization with her upcoming publication in the Worldwide Leaders in Healthcare. MaryJane Johnson is a Palliative Care Nurse currently serving patients at Health and Social Services, Yukon Government, Whitehorse, Yukon, Canada. MaryJane holds over 33 years of experience and an extensive expertise in all facets of nursing, especially palliative care and dementia care. MaryJane Johnson graduated with her Nursing Degree from the University of Alberta in Edmonton, Canada in 1983, and remains associated with the University’s hospital to this day. To keep up to date with the latest advances in her field, MaryJane maintains a professional membership with the Registered Nurses Association of the Yukon, the College of Nurses of Ontario, and the Canadian Hospice Palliative Care Association. MaryJane says that her great success is due to her passion for palliative care, based upon her belief that people should leave the world with the same care and love that they enter it. Learn more about MaryJane Johnson here and read her upcoming publication in Worldwide Leaders in Healthcare.
News Article | November 1, 2016
Hospital for Special Surgery (HSS), which has an Outpatient Center in Stamford, plans to increase outreach and educational programs to meet the needs of surrounding communities. To that end, the hospital recently conducted a survey to assess the muscle, bone and joint health needs of people living in lower Fairfield and Upper Westchester Counties. Efforts were made to ensure input from residents in all socioeconomic groups, including underserved communities. HSS researchers found that arthritis and osteoporosis were the most common diagnosed musculoskeletal conditions affecting survey participants. Falls were also a significant problem in the community: 25% of respondents said they had fallen in the past year, and 9% had sustained a fracture when they fell. Back and shoulder pain were the most common musculoskeletal ailments among the underserved population. HSS presented the study at the annual meeting of the American Public Health Association in Denver on November 1. "We currently offer free monthly lectures on different health topics at the Stamford Outpatient Center, as well as health education newsletters. In the interest of enhancing our programs that serve the community, it was important for us to learn more about their needs and any potential barriers to care," said Pamela Sanchez-Villagomez, manager, Stamford Education Initiative at Hospital for Special Surgery. "Musculoskeletal diseases are among the most prevalent health conditions in the U.S., resulting in financial and social burdens, especially in underserved communities," said Titilayo Ologhobo, associate director of Outcomes in the Public & Patient Education Department at HSS. "We collaborated with many community-based organizations in lower Fairfield County, and they played an essential role in the development and implementation of our survey." The AmeriCares Free Clinics, the Stamford Department of Health and Social Services, various senior centers in the region, and several additional public and private organizations were instrumental in gathering information. A Community Health Needs Assessment questionnaire, available in both English and Spanish, was distributed by email, standard mail and in person. Researchers also conducted limited outreach via social media. Target communities included Stamford, Greenwich, Darien, Norwalk, Westport and New Canaan. Additional surveys were sent to residents of Upper Westchester County. Questions focused on health status and quality of life; health behaviors and lifestyle; health education; use of and access to care; and children's health. As a follow-up to the questionnaire, interviews were conducted with 25 Spanish-speaking members of community-based organizations to obtain additional information about the underserved population. A total of 357 people responded to the survey, ranging in age from 20 to 89. More than half (57%) of respondents were age 60 or older, and 73% were female. Osteoarthritis was the most common diagnosed musculoskeletal condition overall. The most frequent barriers to care were a lack of health insurance or the cost of insurance. In addition to the monthly community health seminars at its Stamford Outpatient Center, HSS currently offers a Tai Chi class at the Over 60 Senior Neighborhood center in Stamford. A bilingual instructor speaks both English and Spanish. Armed with the information gleaned from the survey, HSS educators plan to expand wellness programs to meet the diverse needs of the community. "With what we learned from the survey, the Stamford Outpatient Center, which opened in 2015, is now well positioned to develop additional programs to promote good health and enhance mobility in local communities, particularly in underserved areas," said Sandra Goldsmith, assistant vice president, Education & Academic Affairs at Hospital for Special Surgery. Lectures, small group workshops, and exercise classes will be among the offerings. Study title: "Assessing Musculoskeletal Health Needs and Barriers to Care: A Community Based Participatory Approach" Authors: Pamela Sanchez-Villagomez; Sandra Goldsmith, MA, MS, RDS; Titilayo Ologhobo, MPH; Minlun (Demi) Wu, MPA; and Laura Robbins, DSW, all from Hospital for Special Surgery. Hospital for Special Surgery (HSS) is the world's largest academic medical center focused on musculoskeletal health. HSS is nationally ranked No. 1 in orthopedics and No. 2 in rheumatology by U.S. News & World Report (2016-2017), and is the first hospital in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. HSS has one of the lowest infection rates in the country. HSS is an affiliate of Weill Cornell Medical College and as such all Hospital for Special Surgery medical staff are faculty of Weill Cornell. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at http://www. .
Journeaux M.,Health and Social Services
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2013
This article explores whether there are adverse surgical outcomes for patients who experience hypothermia in the peri-operative period. Findings of this literature review highlight the need to establish a standard definition of hypothermia. Furthermore, the literature supports the full implementation of the National Institute for Health and Care Excellence guidance on The Management of Lnadvertent Perioperative Hypothermia in Adults. A total of 18 studies were critically appraised to determine their rigour, reliability and validity. A discussion of the findings from the studies has taken into account the inferences drawn from the appraisal. Evaluation of the quality of the evidence has been used to evaluate which findings could apply to clinical practice. While there were variations in study quality, the evidence supports developing an effective strategy for preventing hypothermia in the peri-operative period.