February 11, 2013


Abstracts
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Publications
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Abstracts

New article by Greta Cummings
Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital.
Non UofA Access
Bernardes A, Cummings G, Evora YD, Gabriel CS.
Revista latino-americana de enfermagem 2012 Nov-Dec;20(6):1142-1151

This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. METHODS: This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. RESULTS: The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. CONCLUSION: Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization.

New article by Hannah O’Rourke
Reexamining the boundaries of the ‘normal’ in ageing.
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O’Rourke HM, Ceci C.
Nursing inquiry 2013 Mar;20(1):51-59

Textbooks and policy documents tend to present the boundary between normal and abnormal ageing as natural and clearly demarcated. In this study, we trouble the notion of natural and clearly demarcated boundaries between normal and abnormal ageing by considering how these boundaries have been established and maintained in present-day Western contexts. We draw on both Canguilhem’s discussion of the normal and the abnormal and Foucault’s emphasis on the role of the sociohistorical context in the social practice of boundary generation. In doing so, we critically examine common conceptualizations of normal and abnormal ageing, including those found in antiageing science, successful ageing and healthy ageing policy discourses and in health education textbooks. We argue that the growing emphasis on ‘healthy’ ageing both reflects and shapes the societal views of those individuals who are not able to remain disease-free and represents a kind of mystification of ageing where ageing without functional or cognitive decline is instituted as the norm. Awareness of the role that the social context plays in shaping definitions of normal and abnormal ageing encourages critical consideration of the effects that Western conceptualizations of normal ageing may have for older adults who continue to age with cognitive or functional decline. © 2011 Blackwell Publishing Ltd.

New article by Janet Squires

Improving physician hand hygiene compliance using behavioural theories: a study protocol.

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Squires JE, Suh KN, Linklater S, Bruce N, Gartke K, Graham ID, et al.
Implementation science : IS 2013 Feb 4;8(1):16

BACKGROUND: Healthcare-associated infections affect 10% of patients in Canadian acute-care hospitals and are significant and preventable causes of morbidity and mortality among hospitalized patients. Hand hygiene is among the simplest and most effective preventive measures to reduce these infections. However, compliance with hand hygiene among healthcare workers, specifically among physicians, is consistently suboptimal. We aim to first identify the barriers and enablers to physician hand hygiene compliance, and then to develop and pilot a theorybased knowledge translation intervention to increase physicians’ compliance with best hand hygiene practice. DESIGN: The study consists of three phases. In Phase 1, we will identify barriers and enablers to hand hygiene compliance by physicians. This will include: key informant interviews with physicians and residents using a structured interview guide, informed by the Theoretical Domains Framework; nonparticipant observation of physician/resident hand hygiene audit sessions; and focus groups with hand hygiene experts. In Phase 2, we will conduct intervention mapping to develop a theory-based knowledge translation intervention to improve physician hand hygiene compliance. Finally, in Phase 3, we will pilot the knowledge translation intervention in four patient care units. DISCUSSION: In this study, we will use a behavioural theory approach to obtain a better understanding of the barriers and enablers to physician hand hygiene compliance. This will provide a comprehensive framework on which to develop knowledge translation interventions that may be more successful in improving hand hygiene practice. Upon completion of this study, we will refine the piloted knowledge translation intervention so it can be tested in a multi-site cluster randomized controlled trial.

CALL FOR ABSTRACTS: Canadian Association on Gerontology 42nd Annual Scientific and Educational Meeting
Halifax, NS October 17-19, 2013
DEADLINE: April 15, 2013

Abstracts are welcomed from all disciplines and all interests in aging, including research, practice, policy and related work. International submissions are encouraged. There will be a Student Poster Competition. Travel assistance grants are available.

CALL FOR ABSTRACTS: 16th International Congress of the International Psychogeriatric Association
1-4 October 2013 Seoul, Republic of Korea
DEADLINE March 31, 2013

Under the theme “Towards Successful Aging: Harmony of Mental, Physical and Social Life,” a wide range of scientific programs will be organized. Advances in the treatment of dementia, depression and other mental disorders in the elderly and the improvement of quality of care will be discussed and explored in a diverse, multidisciplinary and open forum. We are assembling internationally renowned groups of scientists and clinicians (all experts in their field) to contribute to the core program while also providing opportunities for bright, promising young researchers to present their data and new ideas. The program will be comprehensive, stimulating, and informative.

Grants & Awards

KT Canada: STIHR fellowship

Fellowships for graduate students and post-doctoral fellows in KT research, are available for the KT Canada Strategic Training in Health Research (STIHR) Training Program. Available funding per year: Masters and PhD students: $20,000; Post-doctoral fellows: $40,000. If successful applicants hold external funding, they will be eligible for a top up to the amounts above. Applicants holding a fellowship with CIHR will be eligible for $5000. Trainees will be expected to complete the available courses at their home institution and to complete linked courses that are tailored to KT. These courses include: Theories and Models of KT and Targeting KT to various Stakeholder Groups, Systematic Reviews and Meta-Syntheses in KT, Qualitative Research Methods in KT, and Evaluating KT Interventions. Trainees will also secure a mentor from the KT Canada network, develop and revise an annual learning and objectives profile, and participate in the annual KT Canada Summer Institute and monthly research methodology e-seminars.

KT Canada: Student KT-Research Research Project Stipend.

This competition is open to eligible KT Canada Graduate students (Masters and PhDs) and Post-Doctoral Fellows. This funding is to be used for research purposes only and is intended to assist with some of the costs associated with completing thesis-related research.

AIHS: Graduate Studentship
DEADLINE: April 2, 2013

The Graduate Studentship provides opportunities for support for individuals undertaking health-related research areas in pursuit of a Master’s or PhD at an Alberta university.

AIHS: Postgraduate Fellowship
DEADLINE: October 1, 2013

The Postgraduate Fellowship provides opportunities for individuals to pursue postgraduate health-related research at an Alberta university.

Sigma Theta Tau Capstone International Nursing Book Award
DEADLINE 1 March 2013

PURPOSE: The Capstone International Nursing Book Award recognizes the excellence of one outstanding book published by nurses. ELIGIBILITY: Any nursing books published for the first time from 2 February 2011 through 1 February 2013 are eligible. Book must be in print by close of eligibility period.
NOMINATIONS: Publishers, authors or readers may nominate books for The Capstone International Nursing Book Award.

Publications

KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Methodology
Aging

KT
Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study.
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Mazza D, Chapman A, Michie S.
BMC health services research 2013 Jan 31;13:36-6963-13-36

Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. METHODS: We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. RESULTS: Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations. CONCLUSIONS: Our study has identified some of the barriers and enablers to the delivery and uptake of preconception care guidelines, as perceived by general practitioners. Relating these barriers to a theoretical domain framework provides a clearer understanding of some of the psychological aspects that are involved in the behaviour of general practitioners towards the delivery and uptake of preconception care. Further research prioritising these barriers and the theoretical domains to which they relate to is necessary before a methodologically rigorous intervention can be designed, implemented, and evaluated.

Compliance with clinical practice guidelines for breast cancer treatment: a population-based study of quality-of-care indicators in Italy.
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Sacerdote C, Bordon R, Pitarella S, Mano MP, Baldi I, Casella D, et al.
BMC health services research 2013 Jan 25;13:28-6963-13-28

It has been documented that variations exist in breast cancer treatment despite wide dissemination of clinical practice guidelines. The aim of this population-based study was to evaluate the impact of regional guidelines (Piedmont guidelines, PGL) for breast cancer diagnosis and treatment on quality-of-care indicators in the Northwestern Italian region of Piedmont. METHODS: We included two samples of women aged 50-69 years with incident breast cancer treated in Piedmont before and after the introduction of PGL: 600 in 2002 (pre-PGL) and 621 in 2004 (post-PGL). Patients were randomly selected among all incident breast cancer cases identified through the hospital discharge records database. We extracted clinical data on breast cancer cases from medical charts and ascertained vital status through linkage with town offices. We assessed compliance with 14 quality-of-care indicators from PGL recommendations, before and after their introduction in clinical practice. RESULTS: Among patients with invasive lesions, 77.1% (N = 368) and 77.5% (N = 383) in the pre-PGL and post-PGL groups, respectively, received breast conservative surgery (BCS) as a first-line treatment. Following BCS, 87.7% received radiotherapy in 2002, compared to 87.9% in 2004. Of all patients at medium-to-high risk of distant metastasis, 65.5% (N = 268) and 63.6% (N = 252) received chemotherapy in 2002 and in 2004, respectively. Among the 117 patients with invasive lesions and negative estrogen receptor status in 2002, hormonal therapy was prescribed in 23 of them (19.6%). The incorrect prescription of hormonal therapy decreased to 10.8% (N = 10) among the 92 estrogen receptor-negative patients in 2004 (p < 0.01).Compliance with PGL recommendations was already high in the pre-PGL group, although some quality-of-care indicators did not reach the standard. In the pre/post analysis, 8 out of 14 quality-of-care indicators showed an improvement from 2002 to 2004, but only 4 out of 14 reached statistical significance. We did not find any change in the risk of mortality in the post-PGL versus the pre-PGL group (adjusted hazard ratio 0.94, 95%CI 0.56-1.56). CONCLUSIONS: These results highlight the need to continue to improve breast cancer care and to measure adherence to PGL.

Guest Editorial: Reflections on Research Utilization: Meaning, Measurement, and Impact
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Wilkinson JE.
Worldviews on evidence-based nursing 2013 Feb;10(1):1-2.

This editorial comments about the state of research on research utilization.

Cognitive maturity and readiness for evidence-based nursing practice.
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Nickerson CJ, Thurkettle MA.
The Journal of nursing education 2013 Jan;52(1):17-23

Individual factors are known to influence engagement in research utilization and evidence-based practice (EBP). Cognitive maturity is one factor that may enhance interest in and willingness to engage in clinical inquiry, research utilization, and EBP. Adult cognitive development theory explains why research training alone may not suffice to prepare nurses for EBP. Epistemic assumptions held by pre-reflective and quasireflective thinkers interfere with openness to uncertainty and ambiguity in practice and accurate understanding of the value of research for practice. Nurses may use good formal logic, but they also believe in authority, or revealed truth, as the criterion for knowledge and sometimes fail to perceive the need to evaluate evidence. Developmentally oriented educational efforts informed by the reflective judgment model have the potential to foster the cognitive development required in students of EBP. Further inquiry into the relationship between cognitive maturity and EBP will enhance these educational efforts. Copyright 2012, SLACK Incorporated.

From theoretical model to practical use: an example of knowledge translation.
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Bjork IT, Lomborg K, Nielsen CM, Brynildsen G, Frederiksen AM, Larsen K, et al.
Journal of advanced nursing 2013 Feb 6

To present a case of knowledge translation in nursing education and practice and discusses mechanisms relevant to bringing knowledge into action. BACKGROUND: The process of knowledge translation aspires to close the gap between theory and practice. Knowledge translation is a cyclic process involving both the creation and application of knowledge in several phases. The case presented in this paper is the translation of the Model of Practical Skill Performance into education and practice. Advantages and problems with the use of this model and its adaptation and tailoring to local contexts illustrate the cyclic and iterative process of knowledge translation. DISCUSSION: The cultivation of a three-sided relationship between researchers, educators, and clinical nurses was a major asset in driving the process of knowledge translation. The knowledge translation process gained momentum by replacing passive diffusion strategies with interaction and teamwork between stakeholders. The use of knowledge creates feedback that might have consequences for the refinement and tailoring of that same knowledge itself. With end-users in mind, several heuristics were used by the research group to increase clarity of the model and to tailor the implementation of knowledge to the users. IMPLICATIONS FOR NURSING: This article illustrates the need for enduring collaboration between stakeholders to promote the process of knowledge translation. Translation of research knowledge into practice is a time-consuming process that is enhanced when appropriate support is given by leaders in the involved facilities. CONCLUSION: Knowledge translation is a time-consuming and collaborative endeavour. On the basis of our experience we advocate the implementation and use of a conceptual framework for the entire process of knowledge translation. More descriptions of knowledge translation in the nursing discipline are needed to inspire and advise in this process. © 2013 Blackwell Publishing Ltd.

Developing communities of practice to support the implementation of research into clinical practice
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Thomson L, Schneider J, Wright N.
Leadership in Health Services 2013;26(1):20-33

Purpose: The purpose of this paper is to review the role of social networks in the translation of research into practice, propose a broader model of communities of practice (CoPs) involving practitioners, researchers and service users, and describe a case report which adopts this broader model. Design/methodology/approach: Using the evidence on both knowledge transfer and the use of CoPs to share practice, this work presents an approach to supporting and developing CoPs around the specific context of an applied research programme in health and social care. Findings: The development of CoPs across the professional and organisational boundaries of researchers, practitioners, and service users has the potential to enhance the translation of evidence into practice. It requires bringing together the right people and providing a supportive infrastructure to facilitate exchanges. Methods of engaging and involving the different stakeholder groups vary according to the specific context and pre-existing networks, but developing closer working relationships and sharing common values is an important step in this process. Within the applied health research partnership of the Collaboration for Leadership in Applied Health Research and Care for Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC-NDL), the role of Diffusion Fellows, Engagement Fellows and CLAHRC Associates provides a way of engaging with its diverse stakeholders. Originality/value: This paper builds on existing evidence about CoPs and the role of social networks in knowledge transfer. © Emerald Group Publishing Limited

Patterns of research utilization among Certified Hand Therapists.
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Groth GN, Farrar-Edwards D.
Journal of hand therapy 2013 Feb 4

STUDY DESIGN: Mixed methods, cross-sectional. INTRODUCTION: Nearly 30% of Certified Hand Therapists rarely or never use research findings when treating carpal tunnel syndrome. PURPOSE OF THE STUDY: To identify groups of CHTs with common research utilization patterns. METHODS: National randomized mail survey of 600 CHTs (n = 308, RR = 55%). Latent class and thematic analysis of eight questions assessing research use and beliefs. RESULTS: Four groups of CHT research users were identified: Analytic (n = 135, 45%); Skeptic (n = 65, 22%); Pragmatic (n = 53, 18%); and Traditional (n = 46, 15%). Highest research use was reported among Analytics and Pragmatics although Skeptics willingly relied on research evidence when it contradicted other sources of knowledge. Age, not experience or population density, was a significant covariate of group membership. CONCLUSIONS: Empowering CHTs to use research findings by increased understanding of their group membership, and understanding others’ groups, may increase progress toward evidence-based practice. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Health Care Administration & Organization
Paid caregiver motivation, work conditions, and falls among senior clients.
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Lindquist LA, Tam K, Friesema E, Martin GJ.
Archives of Gerontology and Geriatrics 2012 Sep-Oct;55(2):442-445

The purpose of this study was to determine the motivation of paid non-familial caregivers of seniors, understand more about their work conditions, and identify any links to negative outcomes among their senior clients. Ninety-eight paid caregivers (eighty-five female and thirteen male), recruited from multiple sites (i.e. senior centers, shopping malls, local parks, lobbies of senior apartments, caregiver agency meetings) completed face-to-face questionnaires and semi-structured interviews. We found that 60.7% of participants chose to become a caregiver because they enjoyed being with seniors while 31.7% were unable to obtain other work, and 8.2% stated it was a prerequisite to a different health related occupation. Caregivers stated that the most challenging conditions of their work were physical lifting (24.5%), behavioral and psychological symptoms of dementia (24.5%), senior depression/mood changes (18.4%), attachment with impending death (8.2%), missing injuries to client (5.1%), lack of sleep (4.1%), and lack of connection with outside world (3.1%). Caregivers who reported that the best part of their job was the salary, flexible hours, and ease of work were significantly more likely to have clients who fell and fractured a bone than those who enjoyed being with seniors (job characteristics, 62.5% vs. senior enjoyment, 25.6%; p<0.004). We concluded that in pursuing their occupation, paid caregivers are motivated commonly by their love of seniors and also by their lack of other job opportunities. Paid caregivers frequently face challenging work conditions. When seeking a caregiver for a senior, motivation of the caregiver should be considered when hiring. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Health Care Innovation and Quality Assurance
A mixed methods descriptive investigation of readiness to change in rural hospitals participating in a tele-critical care intervention.
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Zapka J, Simpson K, Hiott L, Langston L, Fakhry S, Ford D.
BMC health services research 2013 Jan 29;13:33-6963-13-33

Telemedicine technology can improve care to patients in rural and medically underserved communities yet adoption has been slow. The objective of this study was to study organizational readiness to participate in an academic-community hospital partnership including clinician education and telemedicine outreach focused on sepsis and trauma care in underserved, rural hospitals. METHODS: This is a multi-method, observational case study. Participants included staff from 4 participating rural South Carolina hospitals. Using a readiness-for-change model, we evaluated 5 general domains and the related factors or topics of organizational context via key informant interviews (n=23) with hospital leadership and staff, compared these to data from hospital staff surveys (n=86) and triangulated data with investigators’ observational reports. Survey items were grouped into 4 categories (based on content and fit with conceptual model) and scored, allowing regression analyses for inferential comparisons to assess factors related to receptivity toward the telemedicine innovation. RESULTS: General agreement existed on the need for the intervention and feasibility of implementation. Previous experience with a telemedicine program appeared pivotal to enthusiasm. Perception of need, task demands and resource need explained nearly 50% of variation in receptivity. Little correlation emerged with hospital or ED leadership culture and support. However qualitative data and investigator observations about communication and differing support among disciplines and between staff and leadership could be important to actual implementation. CONCLUSIONS: A mixed methods approach proved useful in assessing organizational readiness for change in small organizations. Further research on variable operational definitions, potential influential factors, appropriate and feasible methods and valid instruments for such research are needed.

The Patient-Centered Medical Home: A Systematic Review
Jackson GL, Powers BJ, Chatterjee R, Prvu Bettger J, Kemper AR, Hasselblad V, et al.
Annals of Internal Medicine 2013 February 5;158(3):169-178

Background: The patient-centered medical home (PCMH) describes mechanisms for organizing primary care to provide high-quality care across the full range of individuals’ health care needs. It is being widely implemented by provider organizations and third-party payers. Purpose: To describe approaches for PCMH implementation and summarize evidence for effects on patient and staff experiences, process of care, and clinical and economic outcomes. Conclusion: The PCMH holds promise for improving the experiences of patients and staff and potentially for improving care processes, but current evidence is insufficient to determine effects on clinical and most economic outcomes.

How big does the effect of an intervention have to be? Application of two novel methods to determine the smallest worthwhile effect of a fall prevention programme: a study protocol.
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Franco MR, Ferreira ML, Howard K, Sherrington C, Rose J, Haines TP, et al.
BMJ open 2013 Feb 5;3(2):10.1136/bmjopen-2012-002355.

This project concerns the identification of the smallest worthwhile effect (SWE) of exercise-based programmes to prevent falls in older people. The SWE is the smallest effect that justifies the costs, risks and inconveniences of an intervention and is used to inform the design and interpretation of systematic reviews and randomised clinical trials. METHODS AND ANALYSIS: This study will comprise two different methodological approaches: the benefit-harm trade-off method and the discrete choice experiment to estimate the SWE of exercise interventions to prevent falls in older people. In the benefit-harm trade-off method, hypothetical scenarios with the benefits, costs, risks and inconveniences associated with the intervention will be presented to each participant. Then, assuming a treatment effect of certain magnitude, the participant will be asked if he or she would choose to have the intervention. The size of the hypothetical benefit will be varied up and down until it is possible to identify the SWE for which the participant would choose to have the intervention. In the discrete choice experiment, the same attributes (benefits, costs, risks and inconveniences) with varying levels will be presented as choice sets, and participants will be asked to choose between these choice sets. With this approach, we will determine the probability that a person will consider the effects of an intervention to be worthwhile, given the particular costs, risks and inconveniences. For each of the two approaches, participants will be interviewed in person and on different occasions. A subsample of the total cohort will participate in both interviews.

Prevalence and measures of nutritional compromise among nursing home patients: weight loss, low body mass index, malnutrition, and feeding dependency, a systematic review of the literature.
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Bell CL, Tamura BK, Masaki KH, Amella EJ.
Journal of the American Medical Directors Association 2013 Feb;14(2):94-100

Weight loss and poor nutrition have been important considerations in measuring quality of nursing home care since 1987. Our purpose was to examine, synthesize, and provide a systematic review of the current literature on the prevalence and definitions of nutritional problems in nursing home residents. In the fall of 2011, we performed MEDLINE searches of English-language articles published after January 1, 1990. Articles were systematically selected for inclusion if they presented prevalence data for general nursing home populations on at least one of the following: weight loss, low body mass index, Mini-Nutritional Assessment or other measure of malnutrition, poor oral intake, or dependency for feeding. Data on each study, including study author, year, setting, population, type of study (study design), measures, and results, were systematically extracted onto standard matrix tables by consensus by a team of two fellowship-trained medical school faculty geriatrician clinician-researchers with significant experience in long term care. The MEDLINE search yielded 672 studies plus 229 studies identified through related citations and reference lists. Of the 77 studies included, 11 articles provided prevalence data from the baseline data of an intervention study, and 66 articles provided prevalence data in the context of an observational study of nutrition. There is a wide range of prevalence of low body mass index, poor appetite, malnutrition, and eating disability reported among nursing home residents. Studies demonstrate a lack of standardized definitions and great variability among countries. Of all the measures, the Minimum Data Set (MDS) weight loss definition of ≥5% in 1 month or ≥10% in 6 months had the narrowest range of prevalence rate: 6% to 15%. Weight loss, as measured by the MDS, may be the most easily replicated indicator of nutritional problems in nursing home residents for medical directors to follow for quality-improvement purposes. Additional studies are needed, reporting the prevalence of the MDS weight loss definition among international nursing home residents. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

A Multicentric Individually-Tailored Controlled Trial of Education and Professional Support to Nursing Home Staff: Research Protocol and Baseline Data of the IQUARE Study.
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de Souto Barreto P, Lapeyre-Mestre M, Mathieu C, Piau C, Bouget C, Cayla F, et al.
The journal of nutrition, health & aging 2013;17(2):173-178

Background: Whilst the number of people living in nursing homes (NH) is expected to rise, research on NH quality is scarce. The purpose of this article is to describe the research protocol of the IQUARE study and to present its baseline data. Methods and design: IQUARE is a 18-month multicentric individually-tailored controlled trial of education and professional support to NH staff. The main purposes of IQUARE are to improve the quality of the health care provided in NHs and to reduce the risk of functional decline among residents. Data on internal organisation and residents’ health for the 175 participating NHs were recorded by NH staff at baseline. NHs were allocated to either a light intervention group (LIG, n = 90 NHs, totalising 3 258 participants) or a strong intervention group (SIG, n = 85 NHs, totalising 3 017 participants). Intervention for LIG consisted at delivering to NH staff descriptive statistics on indicators of quality regarding their NH and the NHs from their sub-region of health and region; whereas for SIG, NH staff received the same information that LIG, but quality indicators were discussed by a cooperative work (two half-day meetings) between a hospital geriatrician and NH staff. Strategies for overcoming NH’s weaknesses were then traced; the efficacy of strategies is evaluated at a 6-month period. Results: Baseline data showed high levels of dependence, comorbidities, psychological disturbances and medication’s consumption among NH residents. Large discrepancies among NHs were observed. Conclusions: IQUARE is one of the largest controlled trials in NHs developed in France. Results from IQUARE may constitute the basis for the development of new work modalities within the French health system, and serve as a model of a feasible research approach in NHs.

Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare.
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Andersson AC, Elg M, Perseius KI, Idvall E.
BMC health services research 2013 Feb 7;13(1):48

BACKGROUND: Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. METHODS: A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted.
RESULTS: The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. CONCLUSIONS: The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

The Health Foundation: Leading networks in healthcare
January 2013

In autumn 2011, an improvement programme to support networks in healthcare was launched. Selected networks were linked with a faculty of experts, and with each other, to provide an exchange of ideas, advice, support and training in network leadership and development. The aim was to see what could be achieved by combining the experiences of those who are building and running networks with the theory and knowledge from a range of sectors about what makes a network succeed. This report captures the experiences of the programme participants as they began working together, highlights key learning and early insights, and examines how all this relates to what the research evidence tells us about running networks. The report includes the voices of many of the network leaders who took part in this programme. It also provides an informal overview of the literature on networks and a glossary of commonly used network terms.

Health Quality Council of Alberta: Satisfaction and Experience with Healthcare Services: A Survey of Albertans 2012
January 2013

64% of Albertans were satisfied with the healthcare services they received, compared to 62% in 2010. Respondents in Alberta Health Services North zone were significantly less likely to be satisfied
with healthcare services (56%) as compared to the overall rating for Alberta (64%). Albertans in good health were most likely to be satisfied with healthcare services received (71%), and respondents considered the least healthy were less likely to be satisfied (56%) – both ratings differed significantly from the overall satisfaction rating of 64%.

CIHI: When a Nursing Home Is Home: How Do Canadian Nursing Homes Measure Up on Quality?
January 29, 2013

The purpose of this report is to establish a baseline for tracking the quality of care provided to some of our most frail and vulnerable citizens–residents of nursing homes. It profiles eight quality indicators derived form the RAI-MIDS collected through the Continuing Care Reporting System at CIHI. The report defines the indicators, describes the importance of each indicator, presents results across jurisdictions and showcases how some facilities used quality indicator information to improve the quality of care for their residents.

Research Methodology
Methods to improve recruitment to randomised controlled trials: Cochrane systematic review and meta-analysis
Treweek S, Lockhart P, Pitkethly M, Cook JA, Kjeldstrøm M, Johansen M, et al.
BMJ Open 2013 January 01;3(2)

Objective To identify interventions designed to improve recruitment to randomised controlled trials, and to quantify their effect on trial participation.Design Systematic review. Results 45 trials with over 43 000 participants were included. Some interventions were effective in increasing recruitment: telephone reminders to non-respondents (risk ratio (RR) 1.66, 95% CI 1.03 to 2.46; two studies, 1058 participants), use of opt-out rather than opt-in procedures for contacting potential participants (RR 1.39, 95% CI 1.06 to 1.84; one study, 152 participants) and open designs where participants know which treatment they are receiving in the trial (RR 1.22, 95% CI 1.09 to 1.36; two studies, 4833 participants). However, the effect of many other strategies is less clear, including the use of video to provide trial information and interventions aimed at recruiters. Conclusions There are promising strategies for increasing recruitment to trials, but some methods, such as open-trial designs and opt-out strategies, must be considered carefully as their use may also present methodological or ethical challenges. Questions remain as to the applicability of results originating from hypothetical trials, including those relating to the use of monetary incentives, and there is a clear knowledge gap with regard to effective strategies aimed at recruiters.

What is the role and authority of gatekeepers in cluster randomized trials in health research?
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Gallo A, Weijer C, White A, Grimshaw JM, Boruch R, Brehaut JC, et al.
Trials 2012 Jul 26;13:116-6215-13-116

ABSTRACT: This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the sixth of the questions posed, namely, what is the role and authority of gatekeepers in CRTs in health research? ‘Gatekeepers’ are individuals or bodies that represent the interests of cluster members, clusters, or organizations. The need for gatekeepers arose in response to the difficulties in obtaining informed consent because of cluster randomization, cluster-level interventions, and cluster size. In this paper, we call for a more restrictive understanding of the role and authority of gatekeepers.Previous papers in this series have provided solutions to the challenges posed by informed consent in CRTs without the need to invoke gatekeepers. We considered that consent to randomization is not required when cluster members are approached for consent at the earliest opportunity and before any study interventions or data-collection procedures have started. Further, when cluster-level interventions or cluster size means that obtaining informed consent is not possible, a waiver of consent may be appropriate. In this paper, we suggest that the role of gatekeepers in protecting individual interests in CRTs should be limited. Generally, gatekeepers do not have the authority to provide proxy consent for cluster members. When a municipality or other community has a legitimate political authority that is empowered to make such decisions, cluster permission may be appropriate; however, gatekeepers may usefully protect cluster interests in other ways. Cluster consultation may ensure that the CRT addresses local health needs, and is conducted in accord with local values and customs. Gatekeepers may also play an important role in protecting the interests of organizations, such as hospitals, nursing homes, general practices, and schools. In these settings, permission to access the organization relies on resource implications and adherence to institutional policies.

RAMESES publication standards: meta-narrative reviews.
Non UofA Access
Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R.
BMC medicine 2013 Jan 29;11:20-7015-11-20

Meta-narrative review is one of an emerging menu of new approaches to qualitative and mixed-method systematic review. A meta-narrative review seeks to illuminate a heterogeneous topic area by highlighting the contrasting and complementary ways in which researchers have studied the same or a similar topic. No previous publication standards exist for the reporting of meta-narrative reviews. This publication standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project’s aim is to produce preliminary publication standards for meta-narrative reviews. METHODS: We (a) collated and summarized existing literature on the principles of good practice in meta-narrative reviews; (b) considered the extent to which these principles had been followed by published reviews, thereby identifying how rigor may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, meta-narrative reviews, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing meta-narrative reviews and the open-access RAMESES online discussion list so as to capture problems and questions as they arose; and (e) synthesized expert input, evidence review and real-time problem analysis into a definitive set of standards. RESULTS: We identified nine published meta-narrative reviews, provided real-time support to four ongoing reviews and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature, and common questions and challenges into briefing materials for the Delphi panel, comprising 33 members. Within three rounds this panel had reached consensus on 20 key publication standards, with an overall response rate of 90%. CONCLUSION: This project used multiple sources to draw together evidence and expertise in meta-narrative reviews. For each item we have included an explanation for why it is important and guidance on how it might be reported. Meta-narrative review is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further theoretical and methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of meta-narrative reviews.

RAMESES publication standards: realist syntheses.
Non UofA Access
Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R.
BMC medicine 2013 Jan 29;11:21-7015-11-21

There is growing interest in realist synthesis as an alternative systematic review method. This approach offers the potential to expand the knowledge base in policy-relevant areas – for example, by explaining the success, failure or mixed fortunes of complex interventions. No previous publication standards exist for reporting realist syntheses. This standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project’s aim is to produce preliminary publication standards for realist systematic reviews. METHODS: We (a) collated and summarized existing literature on the principles of good practice in realist syntheses; (b) considered the extent to which these principles had been followed by published syntheses, thereby identifying how rigor may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, realist research, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing realist syntheses and the open-access RAMESES online discussion list so as to capture problems and questions as they arose; and (e) synthesized expert input, evidence syntheses and real-time problem analysis into a definitive set of standards. RESULTS: We identified 35 published realist syntheses, provided real-time support to 9 on-going syntheses and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature and common questions and challenges into briefing materials for the Delphi panel, comprising 37 members. Within three rounds this panel had reached consensus on 19 key publication standards, with an overall response rate of 91%. CONCLUSION: This project used multiple sources to develop and draw together evidence and expertise in realist synthesis. For each item we have included an explanation for why it is important and guidance on how it might be reported. Realist synthesis is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of realist syntheses.

Aging
Reviewing the definition of crisis in dementia care.
Non UofA Access
Vroomen JM, Bosmans JE, van Hout HP, de Rooij SE.
BMC geriatrics 2013 Feb 1;13(1):10

BACKGROUND: Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. METHODS: We systematically searched for articles containing definitions of crisis in the context of dementia care. We created an operational framework of crisis based on retrieved definitions. Recommendations to address crisis situations were reviewed and classified according to care settings. RESULTS: Abstracts and titles of 1,113 articles, screened from PubMed and EMBASE, were narrowed down to 27 articles. After review, crisis in dementia was defined as a process where a stressor causes an imbalance requiring an immediate decision to be made which leads to a desired outcome and therefore a resolution of the crisis. If the crisis is not resolved, the cycle continues. Recommendations for resolving crisis involving persons with dementia and their caregivers include awareness therapy after diagnosis and increased contact with general practitioners, case manager consultations, caregiver support and education. Furthermore, nursing home staff should be attuned to the environmental, physical and psychological needs of persons with dementia. CONCLUSIONS: This is the first article to review the definition of crisis in the context of dementia care. A review of the literature indicated that the definition of a crisis is idiosyncratic. Therefore, it is difficult to prevent or plan for all crises. We used an operational framework to compile types of crisis stressors and recommendations from the crisis literature based on three different perspectives; the person with the dementia, the caregiver and the healthcare providers.

Pain Characteristics and Pain Control in European Nursing Homes: Cross-sectional and Longitudinal Results From the Services and Health for Elderly in Long TERm care (SHELTER) Study.
Non UofA Access
Lukas A, Mayer B, Fialova D, Topinkova E, Gindin J, Onder G, et al.
Journal of the American Medical Directors Association 2013 Jan 31

Few studies have compared cross-national characteristics of residents with pain in European long term care facilities. The SHELTER project, a cross-national European study on nursing home residents, provides the opportunity to examine this issue. The present study aimed to evaluate key figures about pain and compare them with seven European countries and Israel. SETTING, PARTICIPANTS, AND MEASUREMENTS: A total of 3926 nursing home residents were assessed by the interRAI instrument for Long Term Care Facilities (interRAI LTCF). Prevalence of pain, frequency, intensity, consistency, and control were estimated and compared cross-nationally. Correlates between patient-related characteristics and inadequate pain management were tested using bivariate and multivariate logistic regression models. RESULTS: Overall, 1900 (48.4%) residents suffered from pain. Pain prevalence varied significantly among countries, ranging from 19.8% in Israel to 73.0% in Finland. Pain was positively associated with female gender, fractures, falls, pressure ulcers, sleeping disorders, unstable health conditions, cancer, depression, and number of drugs. It was negatively associated with dementia. In a multivariate logistic regression model, all associations remained except for sleeping disorders. Clinical correlations varied considerably among countries. Although in 88.1% of cases, pain was self-rated by the residents as sufficiently controlled, in only 56.8% of cases was pain intensity self-rated as absent or mild. Pain control and intensity improved within 1 year. CONCLUSION: Pain prevalence is high and varies considerably across Europe. Although most residents considered pain as adequately controlled, a closer look confirmed that many still suffer from high pain intensities. Analyzing the reasons behind these differences may help to improve pain management. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

A Hospital-to-Nursing Home Transfer Process Associated With Low Hospital Readmission Rates While Targeting Quality of Care, Patient Safety, and Convenience: A 20-Year Perspective.
Non UofA Access
Sandvik D, Bade P, Dunham A, Hendrickson S.
Journal of the American Medical Directors Association 2013 Jan 31

BACKGROUND: Safe patient transfer from hospitals to skilled nursing facilities (SNFs) is one of the most logistically challenging safety problems in the US medical system. PROBLEM: The authors describe a community that experienced inefficient transfers in the 1990s, spurring development of continuous quality improvement (CQI) methods to develop transfer forms and processes to improve efficiency. METHODS: The community established a Geriatric Forum for educational and process improvement purposes. Attendees consist of anyone involved with care of older patients in the community. Over the years, minor environmental changes forced periodic adjustments to transfer processes. The need for adjustment is identified by asking the simple question, “Have any problems occurred with transfers lately?” When problems are identified, forum attendees make process changes. The current forms and processes are discussed in detail. RESULTS: Initial improvement in efficiency of transfers also produced improvements in patient safety and quality of medical care according to periodic internal surveys. During 2009, this community’s 30-day rehospitalization rate of patients discharged to a SNF was 14.75%, lower than any national or state average reported rate. CONCLUSIONS: Developing hospital-to-SNF transfer methods focusing on the traditional CQI goals of efficiency, patient safety, and quality of care also yields lower hospital readmission rates. Because the methodology is that of CQI, a widely taught skill, similar programs could be established between any hospital and the SNFs to which it discharges patients. The particular examples of transfer forms and processes described might be helpful to other programs. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved

Alzheimer disease in the United States (2010-2050) estimated using the 2010 census.
Non UofA Access
Hebert LE, Weuve J, Scherr PA, Evans DA.
Neurology 2013 Feb 6

To provide updated estimates of Alzheimer disease (AD) dementia prevalence in the United States from 2010 through 2050. METHODS: Probabilities of AD dementia incidence were calculated from a longitudinal, population-based study including substantial numbers of both black and white participants. Incidence probabilities for single year of age, race, and level of education were calculated using weighted logistic regression and AD dementia diagnosis from 2,577 detailed clinical evaluations of 1,913 people obtained from stratified random samples of previously disease-free individuals in a population of 10,800. These were combined with US mortality, education, and new US Census Bureau estimates of current and future population to estimate current and future numbers of people with AD dementia in the United States. RESULTS: We estimated that in 2010, there were 4.7 million individuals aged 65 years or older with AD dementia (95% confidence interval [CI] = 4.0-5.5). Of these, 0.7 million (95% CI = 0.4-0.9) were between 65 and 74 years, 2.3 million were between 75 and 84 years (95% CI = 1.7-2.9), and 1.8 million were 85 years or older (95% CI = 1.4-2.2). The total number of people with AD dementia in 2050 is projected to be 13.8 million, with 7.0 million aged 85 years or older. CONCLUSION: The number of people in the United States with AD dementia will increase dramatically in the next 40 years unless preventive measures are developed.

Geriatrician input into nursing homes reduces emergency hospital admissions.
Non UofA Access
Lisk R, Yeong K, Nasim A, Baxter M, Mandal B, Nari R, et al.
Archives of Gerontology and Geriatrics 2012 Sep-Oct;55(2):331-337

Nursing home residents are often very dependent, very frail and have complex care needs. Effective partnerships between primary and secondary care will be of benefit to these residents. We looked at 1954 admission episodes to our Trust from April 2006 to March 2009 inclusive. 3 nursing homes had the highest number of multiple admissions (≥ 4). Four strategies to reduce hospital admissions were used at these nursing homes for 3 months. An alert was also sent to the geriatrician if one of the residents was admitted so that their discharge from hospital could be expedited. The project was then extended for another 4 months with 6 nursing homes. The results showed that geriatrician input into nursing homes had a significant impact on admissions from nursing homes (χ(2)(2)=6.261, p < 0.05). The second part of the project also showed significant impact on admissions (χ(2)(2) = 12.552, p < 0.05). Furthermore, in both parts of the project the length of stay in hospital for the residents was reduced. Geriatricians working together with co-ordinated multidisciplinary teams are well placed to manage the care needs of frail, elderly care home residents. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

WHO: Home Care Across Europe: Current structure and future challenges
2012

This text outlines the current home care situation in Europe.

Courses
KT Canada: 2013 Summer Institute
Hamilton from June 17-19, 2013.

The theme of the 2013 Summer Institute is “Challenges in the Science and Practice of Knowledge Translation”. This competition is open to graduate students, post-doctoral fellows and junior faculty in the field of Knowledge translation. The purpose of this Summer Institute is to provide participants with the opportunity to increase their understanding of knowledge translation research, as well as a chance to network with colleagues including national and international KT experts.

Canadian Centre for Evidence-Based Nursing: Workshop on Evidence-Informed Decision Making
May 6th to May 10th, 2013 McMaster University, Hamilton, ON

Decisions about practice, program development, and policy making confront those involved with health care on a daily bases. Such decisions may include interpreting diagnostic tests, identifying the harm associated with a particular treatment, understanding the course of a disease in a specific patient, determining the effectiveness of interventions, or establishing the cost and consequences many other clinical decision. The EIDM Workshop focuses on helping participants to engage in decision making that is informed by the purposeful and systematic use of the best available evidence.

Online
KT Canada Seminar: Respiratory Guidelines: Update, Dissemination and Implementation
Thursday February 14, 2013, 10:00-11:00 MT ECHA Rm 3-001

Presented by Louis-Philippe Boulet, Université Laval
Learning Objectives:
Report on current status of respiratory guidelines production in Canada.
Discuss the main barriers to their use in primary care.
Discuss current initiatives to promote their dissemination and implementation into care.

KT Canada Seminar: Perils of Publication: Temptations I have Faced and Some that I Haven’t
Thursday February 21, 2013 10:00-11:00 MT ECHA Rm 3-001

Presented by Dr. Ann McKibbon
Learning Objectives:
• Describe publishing temptations with respect to authorship, review and inclusion of already published studies, and salami slicing.
• Describe other publishing slips or challenges that also exist – such as plagiarism; forgetting to get ethics approval or register a trial; mistakes, fabrication of data, and fraud; manipulation of images; funding and influence; and publishing data from others such as graduate students and post docs.
• Describe situations where poor publishing practices have affected jobs and lives as well as the reputation of individuals, journals, and institutions.

CPSI: Learning from the Delirium Collaborative
February 25, 2013 10:00-11:00

Speaker: Dr. Yoanna Skrobik
Objectives:
To share learnings and results from the Delirium Med Rec Collaborative
To hear improvement Teams share how they implemented knowledge into practice

News
Tri-Agency Harmonization of the Canada Graduate Scholarships

Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC) and the Social Sciences and Humanities Research Council of Canada (SSHRC) have formed a Tri-Agency Harmonization Team to redesign the Canadian Graduate Scholarship (CGS) Master’s and Doctoral components. This project is an opportunity for graduate students and post-secondary institutions to take full advantage of simpler application and adjudication procedures and processes.

Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR) launches new website

The site features a dynamic web design available through a variety of devices including tablets and smart phones. The site is also designed to maximize accessibility.

NY Times post: Measuring the ‘Quality’ of Health Care

A wise thing to say in casual conversation is that “outcome” is all that matters in measuring the quality of health care. Presumably, “outcome” includes clinical outcome and patient satisfaction. Experts in quality measurement agree in principle. In practice, however, they warn that “outcome” is a complex metric.

Banff Centre partners artists with big thinkers

The Banff Centre announced a collaboration with the Canadian Institute for Advanced Research (CIFAR), a virtual think-tank that includes some of the finest scientific minds around the world. The two institutions are teaming up to create a physical home for the Canadian Institute for Advanced Research, with the hope being that their big brains will cross-pollinate with some of 4,000 artists and innumerable business leaders who spend time each year at the Banff Centre to find innovative approaches to the 21st century and all of the challenges it presents.

Report slams U.K. health service for ‘appalling and unnecessary suffering’

Britain’s National Health Service was a pioneer in public health care for the world, but it now faces disturbing charges that standards of care have sunk so low that thirsty and untended patients at one hospital were reduced to drinking water from flower vases.

AHRQ Director Stepping Down Later this Year

AHRQ Director Carolyn Clancy, M.D., is planning to step down later this year after a decade of leading the Agency.

The Long-Term Care (LTC) Task Force (Ontario) releases its first progress report.

This progress report represents the first of six semi-annual progress reports that will be issued over the next three years. This report follows up on the implementation of 18 multi-faceted actions contained in the original report Action Plan to Address Abuse and Neglect in Long-Term Care Homes, released in May 2012. Stories about implementation are also provided.

Resources
BetterEvaluation

BetterEvaluation guides you through the rapidly expanding range of choices available to you when planning and designing evaluation activities. With BetterEvaluation you can find and discover options and useful resources, share your experiences and learn with peers.

EndNote for iPad now available
Special introductory price $0.99 until Feb 11th then it’s $9.99

The EndNote® for iPad app enables users to easily view, edit, organize, and share bibliographic research material and PDFs on iPad. And it syncs with DropBox!!!

Presentations from Eisenberg Center Conference Series 2012 Supporting Informed Decision Making When Clinical Evidence and Conventional Wisdom Collide now available online

This conference took place on September 13, 2012, in Gaithersburg, Maryland. Presenters and discussants examined, using examples from their professional experiences, where evidence and conventional wisdom collide and what has been learned that can inform communication strategies for the translation, dissemination and integration of evidence in support of clinical decisionmaking.

sense about science

This site helps the public make sense of scientific reports that show up in the media. An example of this is the recent news reports that diet soft drinks caused depression. Experts associated with the site took a closer look at the evidence reported in this study and broke it down. In summary, the experts didn’t recommend drinking diet soft drinks in excess, but they didn’t think the link between depression and diet drinks was that strong. So don’t feel guilty about sipping on your diet coke once in a while. Just keep your consumption reasonable. They didn’t give solid numbers but I’d say if you’re chugging back less than a 6-pack a day, you’re probably OK.

AHRQ Patient Safety Education and Training Catalog

The Patient Safety Education and Training Catalog consists of 333 patient safety programs available in the United States as of November 28, 2011. Developed by the American Institutes for Research (AIR) from internet searches in 2010 and 2011, the catalog captures a snapshot of available programs at the time. Because new programs are continually being developed, old ones retired, and others revised and improved, interested readers should check the relevant websites for up-to-date information.

Opportunities
UofT: CIHR Strategic Training Program in Public Health Policy Fellowship Award
DEADLINE: March 22, 2013

The CIHR Strategic Training Program in Public Health Policy has funds to support graduate students and post-doctoral fellows. Successful candidates are recognized as CIHR Fellows in Public Health Policy, and become part of a dynamic public health policy training and research community.
Masters level Fellowships: stipends up to $17,850, with possible renewable for up to one additional year
Doctoral level Fellowships: stipends up to $17,850, with possible renewable for up to three additional years
Post doctoral Fellowships: stipends up to $36,850, with possible renewable for up to one additional year

CLIR/DLF Postdoctoral Fellowship in the Curation of Confidential Health Data
Please circulate to anyone who may be interested

University of Alberta Libraries (UAL) seeks a postdoctoral fellow to engage with and contribute to its innovative services in research data curation and digital preservation. Working with professional staff within UAL, the University of Alberta Research Ethics Office, and the University of Alberta Health Law Institute, this fellowship position will be responsible for investigating data management practices, norms, policies, and infrastructure in health research that would improve methods for sharing sensitive, private, or proprietary data.

NCCMT Knowledge Broker (continuing subject to funding)
DEADLINE February 20, 2013

Responsible for bridging the gap between research and decision making to promote evidence based practice and policy decisions. Initiates, develops, and implements knowledge translation strategies to make research evidence available and accessible for practice, planning and policy making.

NCCMT Knowledge Broker (limited term appointment- 14 mos)
DEADLINE February 20, 2013

Responsible for bridging the gap between research and decision making to promote evidence based practice and policy decisions. Initiates, develops, and implements knowledge translation strategies to make research evidence available and accessible for practice, planning and policy making.

Michael Smith Foundation: Evaluation Lead (one-year maternity leave)
DEADLINE February 20, 2013

We are seeking to fill the position of Evaluation Lead for a one-year maternity leave. The Evaluation Lead works as a member of the impact analysis team to design and implement evaluations of MSFHR programs, projects and functions, measure the impact of MSFHR’s organizational performance, and undertake evaluation initiatives related to other health research topics. The role also contributes to building organizational capacity for research and evaluation.

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