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Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

The article provides information about the "Workshop on Policies for Distributed Systems and Networks" which was held at the University of Western Ontario, Ontario, Canada in June 2006. The papers in the workshop explored the use of policies in databases and the use of policies to support autonomic computing n DiffServ routing.

This paper investigates how to best compare algorithms for predicting chronic homelessness for the purpose of identifying good candidates for housing programs. Predictive methods can rapidly refer potentially chronic shelter users to housing but also sometimes incorrectly identify individuals who will not become chronic (false positives). We use shelter access histories to demonstrate that these false positives are often still good candidates for housing. Using this approach, we compare a simple threshold method for predicting chronic homelessness to the more complex logistic regression and neural network algorithms. While traditional binary classification performance metrics show that the machine learning algorithms perform better than the threshold technique, an examination of the shelter access histories of the cohorts identified by the three algorithms show that they select groups with very similar characteristics. This has important implications for resource constrained not-for-profit organizations since the threshold technique can be implemented using much simpler information technology infrastructure than the machine learning algorithms. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to document the operationalization of the OCAP® principles in the context of the work of a medical anthropologist and Whapmagoostui First Nation (FN). The authors describe their recent collaboration with Whapmagoostui FN to digitize and transfer the research data archive to the community. Design/methodology/approach: Beginning with a description of the data collection process from the late 1980s to early 1990s, this study describes recent efforts to digitize the research data archive and work with Whapmagoostui FN to develop a plan for access and safekeeping. The authors focus on the work required to implement the OCAP® principles locally, including the need to address questions of ownership rights/transfer, information technology systems and community capacity. Findings: This study describes the necessary work that is required to operationalize the OCAP® principles on a local level, including obstacles to this work. This study also underscores how the process of OCAP® implementation is distinct for each community and research context. Based on these considerations, the authors calls for increased resources and new legal mechanisms in support of achieving indigenous data sovereignty (IDSov) in FNs, Inuit and Métis communities across Canada. Originality/value: To the best of the authors' knowledge, this study makes an original contribution to the literature on IDSov. This study provides a valuable case study, illustrating how the OCAP® principles can be operationalized in the context of a longstanding partnership between an academic researcher and an indigenous community. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to provide a concept analysis of 'pandemic influenza'. Background Pandemic influenza can have a devastating impact as individuals have little to no immunity towards the newly encountered virus. It is a persistent societal threat due to the advancement of multiple technological processes. Nurses work in multiple roles in pandemics. As such, a thorough understanding of the concept and its implications from a nursing perspective is required. Design Rodgers' Evolutionary Method was used to conduct the concept analysis of the term 'pandemic influenza'. Data sources Forty-nine papers were examined from the disciplines of public health, medicine, law, bioethics and healthcare policy. Papers were found from the PubMed, CINAHL and Google Scholar databases all dates up to December 2013. Limits were set to include peer-reviewed, English language articles. Methods Identified papers were critically analyzed to explore the concept's antecedents, attributes and consequences. Surrogate and related terms, and an exemplar, were identified. Results Attributes of pandemic include original viral structure, increased human susceptibility, younger vulnerable populations and unpredictable time frames. Antecedents include processes that enable the increased geographical transmission of a newly created influenza. Consequences include higher morbidity and mortality rates and the need for an efficient pandemic response. Conclusions This analysis identified the attributes of pandemic influenza through a synthesis of the current pandemic literature. However, no articles were identified as specifically nursing in nature. Therefore, more research is required to examine the impact of a pandemic declaration on the nursing profession. [ABSTRACT FROM AUTHOR]

Aims and objectives. This discursive paper explores issues of abuse during smoking cessation counselling. Background. During a training session for a smoking cessation intervention pilot study, nurses expressed concerns about issues of abuse that had previously surfaced during cessation counselling in their practice. Abused women are more likely to smoke. As guidelines recommend integrating cessation interventions into practice, issues of abuse are likely to surface. Methods. A literature review and synthesis of abuse and smoking cessation was undertaken to arrive at recommendations for practice. Results. There are a few suggestions about how to manage abuse within cessation counselling, but none have been studied: (1) integrate stress-management strategies, (2) assess for abuse, (3) provide separate interventions for partners to create a safe environment, and (4) develop interventions that consider the relationship couples have with tobacco. However, coping strategies alone do not address abuse, screening without treatment is not helpful, and partner interventions assume both partners are open to quitting/counselling. In contrast, as with all clinical practice, abuse and cessation would be considered separate but intertwined problems, and following best practice guidelines for abuse would provide the guidance on how to proceed. After care has been taken to address abuse, it is the patient's decision whether to continue with cessation counselling. Conclusion. Guidelines addresses both care planning and the ethical/legal issues associated with the disclosure of abuse and provide a practical tool for addressing abuse that obviates the need to tailor cessation interventions to abuse. Relevance to clinical practice. This paper clarifies a relationship between smoking and abuse and the subsequent implications for smoking cessation interventions and highlights the importance of addressing abuse and smoking cessation separately, even though they are interrelated problems. It provides nurses with appropriate initial responses when abuse is disclosed during an unexpected encounter such as during a smoking cessation intervention. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to analyze the relationship among measures of resource and service usage and other features of academic libraries in the USA and Canada. Design/methodology/approach – Through the use of a self-organizing map, academic library data were clustered and visualized. Analysis of the library data was conducted through the computation of a "library performance metric" that was applied to the resulting map. Findings – Two areas of high-performing academic libraries emerged on the map. One area included libraries with large numbers of resources, while another area included libraries that had low resources but gave greater numbers of presentations to groups, offered greater numbers of public service hours, and had greater numbers of staffed service points. Research limitations/implications – The metrics chosen as a measure of library performance offer only a partial picture of how libraries are being used. Future research might involve the use of a self-organizing map to cluster library data within certain parameters and the identification of high-performing libraries within these clusters. Practical implications – This study suggests that libraries can improve their performance not only by acquiring greater resources but also by putting greater emphasis on the services that they provide to their users. Originality/value – This paper demonstrates how a self-organizing map can be used in the analysis of large data sets to facilitate library comparisons. [ABSTRACT FROM AUTHOR]

Purpose: Social isolation and loneliness are global issues experienced by many seniors, especially immigrant and refugee seniors. Guided by the five-stage methodological framework proposed by Arksey and O'Malley and more recently Levac, Colquhoun and O'Brien, the purpose of this paper is to explore the existing literature on social isolation and loneliness among immigrant and refugee seniors in Canada. Design/methodology/approach: The authors conducted a literature search of several databases including: PubMed; MEDLINE; CINAHL; Web of Science; HealthStar Ovid; PschyInfo Ovid; Social Services Abstracts; AgeLine; Public Health Database, Google Scholar and Cochrane Library. In total, 17 articles met the inclusion criteria. Findings: Based on the current literature five themes related to social isolation and loneliness emerged: loss; living arrangements; dependency; barriers and challenges; and family conflict. Research limitations/implications: Given the increasing demographic of aging immigrants in Canada, it is useful to highlight existing knowledge on social isolation and loneliness to facilitate research, policy and programs to support this growing population. Practical implications: The population is aging around the world and it is also becoming increasingly diverse particularly in the high-income country context. Understanding and addressing social isolation is important for immigrant and refugee seniors, given the sociocultural and other differences. Social implications: Social isolation is a waste of human resource and value created by seniors in the communities. Originality/value: The paper makes a unique contribution by focusing on immigrant and refugee seniors. [ABSTRACT FROM AUTHOR]

In this paper, we explore the evolution of modelling practices used to develop three significant Heritage Building Information Models (HBIM) on Canada's Parliament Hill National Historic Site – West Block, Centre Block, and The Library of Parliament. The unique scope, objective, and timeline for each model required an in-depth analysis to select the appropriate classification for Level of Detail (LOD) and Level of Accuracy (LOA). With each project, the refinement of modelling practices and workflows evolved, culminating in one of our most complex and challenging projects – the Library of Parliament BIM. The purpose of this paper is to share ideas and lessons learned for the intricate challenges that emerge when using LOD and LOA classifications including trade-offs between model performance, tolerances, and anticipated BIM use. In addition, we will evaluate how these decisions effected managing the digitization, data processing, data synthesis, and visualisation of the models. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to provide an overview of the state of clinical governance practices globally as well as a more detailed examination of the clinical governance landscape in Canada. The paper explores the concept that established clinical governance practices are more important than ever as healthcare systems are increasingly under pressure to reduce costs while dealing with the challenges of ageing populations. Additionally, it suggests that healthcare could benefit by studying and adopting some of the successful governance policies that exist in other jurisdictions or sectors where quality and safety are an integral part of their governance mandate, such as the airline or nuclear energy sectors. Design/methodology/approach - This paper explores the status of clinical governance practices in Canada. This is achieved through a combination of author experience in addition to the review of existing literature and assessments on clinical governance practices and patient safety. Findings - While individual success stories can be found, standardized clinical governance practices across the range of healthcare providers remain largely absent. By focussing on standardized processes, and by placing an emphasis on improved clinical governance, healthcare providers can control and in some cases lower costs while improving efficiency and increasing patient safety. While progress has been slow for many years, the authors speculate that healthcare has reached a tipping point. As information systems develop and become more reliable and robust, and systems move to a patient-centric collaborative approach to care, there is a tremendous opportunity for healthcare and life sciences organizations to exploit and capitalize on both their growing information repositories, and the big data trends that have been embraced and leveraged by other sectors in recent years. Practical implications - Managing costs and delivering safe, efficient care to patients remain top considerations for healthcare boards and healthcare systems alike. As healthcare systems grapple with the increasing costs and risk associated with ageing populations and a more complex healthcare delivery model, effective clinical governance policies focussed on quality outcomes are essential. Originality/value - This paper highlights the responsibility of healthcare boards to learn lessons from other safety-critical industries and develop their own capacity to evaluate progress toward the goals identified above. It also provides insight into the role that leaders on both the corporate and clinical sides of the industry have to play, and the need for meaningful measures that will drive a quality agenda. The paper also emphases the link between established clinical governance practices and greater efficiency, reduced costs and improved patient safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the current state of knowledge about the use of the sit‐to‐stand intervention with older people and to identify implications for further research. Background: Many older people experience mobility challenges which can negatively affect their well‐being. Physical activities are vital to improving or maintaining mobility. Although there is evidence that mobility challenged older people benefit from the sit‐to‐stand intervention, there is a need to systematically examine the state of knowledge about this intervention. Design: Scoping review using Arksey and O'Malley's methodological framework. Methods: A systematic search of three databases was completed. Abstracts were evaluated for relevance using predetermined inclusion criteria. Studies that met the inclusion criteria had data extracted and were appraised for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. Results: Of 3,041 papers, six studies met the inclusion criteria. Publications provided a range of sit‐to‐stand interventions with durations varying from four weeks to six months. The frequency of each intervention fluctuated from three to seven times/week with a duration of 15–45 min. Different professionals prompted the activity. Three themes were identified the following: (a) sit‐to‐stand activity as an intervention; (b) generalisability of findings; and (c) sustainability. Conclusions: Most of the studies reviewed indicated improvements in performance of the sit‐to‐stand activity and in motor function. However, issues with studies rigour do not allow us to make generalisations. Further research is needed to confirm the effectiveness of the intervention. Implications for practice: Healthcare providers are expected to offer evidence‐based patient care. This review details current knowledge about the sit‐to‐stand intervention with older people. [ABSTRACT FROM AUTHOR]

Purpose - To set up a protocol for electronic thesis and dissertation (ETD) submission for the electronic thesis initiative pilot project at McGill University in Montreal, Canada. Design/methodology/approach - An electronic thesis and dissertation submission protocol was implemented and tested. To test authoring tools, we had 50 students submit their theses or dissertations using one of four style sheets. Word-processed files were converted to PDF and XML formats. The pilot project team evaluated DigiTool's effectiveness in digital conversion, capture of metadata and cataloguing, digital content harvesting, digital preservation, and integration with the student information system. Findings - All theses experienced some degree of information loss during the conversion. DigiTool is still being tested for storage, cataloguing, and dissemination capability. For full implementation, three major issues need to be addresed further: conversion; metadata; and file formats. Practical implications - Most of the issues that have arisen during the McGill pilot project will be mirrored in other academic institutions that are considering electronic thesis submission. Originality/value - This paper provides insights into the procedures that will arise as institutions go through the process of introducing electronic thesis and dissertation submission. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact and cost associated with mental illness. Methods: A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results: A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions: Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic?: Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add?: This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only limited information is available on the impact of attention deficit hyperactivity disorder, anxiety, cognitive function, conduct disorder, eating disorder and psychological distress. There was also a dearth of evidence on the intangible elements of pain and suffering of people and their families with depressive disorders. More research is required to better understand the full extent of the impact of mental illness and strategies that may be implemented to minimise this harm. What are the implications for practitioners?: Knowing the current and future impact of mental illness highlights the imperative to develop an effective policy response. [ABSTRACT FROM AUTHOR]

A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically relevant to current treatments, but typically, there is no seamless method for a clinical user to access longitudinal DI results for their patient. Radiologists, and other specialists that are intensive users of image data, require seamless ingestion of foreign exams into the picture archiving and communication system (PACS) to achieve full clinical value. Most commonly, a clinical user will depend on the patient to bring in a CD that contains imaging from another location. However, a number of issues can arise when using this type of solution. Firstly, a CD will not provide the clinical user with the full longitudinal record of the patient. Secondly, a CD often will not contain the report associated with the images. Finally, a CD is not seamless, due to the need to manually import the contents of the CD into the local PACS. In order to overcome these limitations, and provide clinical users with a greater benefit related to a patient's longitudinal DI history, the implementation of foreign exam management (FEM) at the local site level is required. This paper presents the experiences of FEM in practice. By leveraging industry standards and edge devices to support FEM, multiple sites with disparate PACS and radiology information system (RIS) vendors are able to seamlessly ingest foreign exams within their local PACS as if they are local exams. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Geographer is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

One overall objective of Electronic Patient Records (EPRs) is to improve patient education and to enhance the patient experience through the use of information technology (IT) so as to facilitate the sharing of information between providers and their patients. The research project reported on herein took place at University Health Network (UHN) in Toronto (Canada), which is a large academic health science center with multiple hospital sites in the city. As a first step in this process, we examined the literature to investigate the human factors issues related to healthcare as well as other settings. Subsequently, we interviewed a number of interested stakeholders from two groups: the physicians (both family and attending) and the patients themselves. Finally, using a simulation environment, we explored the content that UHN lung-transplant patients would be interested in having within their own EPRs. In this paper, we report on the research, the methodology and the findings pertaining to the both the content and the design of an electronic patient record. [ABSTRACT FROM AUTHOR]

Background: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs.Methods: We conducted in-depth case studies in three primary care medical practices in Canada where physicians had been using EMR systems for 3 years or more. A total of 37 semi-structured interviews were conducted with key informants: family physicians (about half of the interviews), nurses, secretaries, and administrative managers. Additional information was obtained through notes taken during observations of users interacting with their EMR systems and consultation of relevant documents at each site. We used abductive reasoning to infer explanations of the observed phenomenon by going back and forth between the case data and conceptual insights.Results: Our analysis shows that a ceiling effect has taken place in the three clinics. We identified a set of conditions preventing the users from overcoming the ceiling. In adopting an EMR system, all three clinics essentially sought improved operational efficiency. This had an influence on the criteria used to assess the systems available on the market and eventually led to the adoption of a system that met the specified criteria without being optimal. Later, training sessions focussed on basic functionalities that minimally disturbed physicians' habits while helping their medical practices become more efficient. Satisfied with the outcome of their system use, physicians were likely to ignore more advanced EMR system functionalities. This was because their knowledge about EMR systems came almost exclusively from a single source of information: their EMR system vendors. This knowledge took the form of interpretations of what the innovation was (know-what), with little consideration of the rationales for innovation adoption (know-why) or hands-on strategies for adopting, implementing and assimilating the innovation in the organization (know-how).Conclusions: This paper provides a holistic view of the technological innovation process in primary care and contends that limited learning, satisficing behaviours and organizational inertia are important factors leading to the ceiling effect frequently experienced in the EMR system assimilation phase. [ABSTRACT FROM AUTHOR]

Objective. The aim of the present study was to review the contribution of mobile health applications (‘apps’) to consumers’ self-management of chronic health conditions, and the potential for this practice to inform health policy, procedures and guidelines. Methods. A search was performed on the MEDLINE, Cochrane Library, ProQuest and Global Health (Ovid) databases using the search terms ‘mobile app*’, ‘self-care’, ‘self-monitoring’, ‘trial’, ‘intervention*’ and various medical conditions. The search was supplemented with manual location of emerging literature and government reports. Mapping review methods identified relevant titles and abstracts, followed by review of content to determine extant research, reports addressing the key questions, and gaps suggesting areas for future research. Available studies were organised by disease state, and presented in a narrative analysis. Results. Four studies describing the results of clinical trials were identified from Canada, England, Taiwan and Australia; all but the Australian study used custom-made apps. The available studies examined the effect of apps in health monitoring, reporting positive but not robust findings. Australian public policy and government reports acknowledge and support self-management, but do not address the potential contribution of mobile interventions. Conclusions. There are limited controlled trials testing the contribution of health apps to consumers’ self-management. Further evidence in this field is required to inform health policy and practice relating to self-management. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Joule Inc.) is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Performance reporting in primary health care in Canada is challenging because of the dearth of concise and synthesized information. The paucity of information occurs, in part, because the majority of primary health care in Canada is delivered through a multitude of privately owned small businesses with no mechanism or incentives to provide information about their performance. The purpose of this paper is to report the methods used to recruit family physicians and their patients across 10 provinces to provide self-reported information about primary care and how this information could be used in recruitment and data collection for future large scale pan-Canadian and other cross-country studies. Methods: Canada participated in an international large scale study-the QUALICO-PC (Quality and Costs of Primary Care) study. A set of four surveys, designed to collect in-depth information regarding primary care activities was collected from: practices, providers, and patients (experiences and values). Invitations (telephone, electronic or mailed) were sent to family physicians. Eligible participants were sent a package of surveys. Provincial teams kept records on the number of: invitation emails/letters sent, physicians who registered, practices that were sent surveys, and practices returning completed surveys. Response and cooperation rates were calculated. Results: Invitations to participate were sent to approximately 23,000 family physicians across Canada. A total of 792 physicians and 8,332 patients from 772 primary care practices completed the surveys, including 1,160 participants completing a Patient Values survey and 7,172 participants completing a Patient Experience survey. Overall, the response rate was very low ranging from 2% (British Columbia) to 21% (Nova Scotia). However, the participation rate was high, ranging from 72% (Ontario) to 100% (New Brunswick/Prince Edward Island and Newfoundland & Labrador). Conclusions: The difficulties obtaining acceptable response rates by family physicians for survey participation is a universal challenge. This response rate for the QUALICO-PC arm in Canada was similar to rates found in other countries such as Australia and New Zealand. Even though most family physicians operate as self-employed small businesses, they could be supported to routinely submit data through a collective effort and provincial mandate. The groundwork in setting up pan-Canadian collaboration in primary care has been established through this study. [ABSTRACT FROM AUTHOR]

Background: Managing toenail onychomycosis with topical treatments is challenging. It is difficult for topical medication to penetrate the nail plate, and this is reflected in lower cure rates with topical treatment than with oral treatment. However, oral medications may not be suitable for some patients, because of drug interactions; therefore, topical treatments are critical in managing the disease in certain patient populations. Objective: This paper reviews the quality and content of the scientific literature on topical treatments for toenail onychomycosis. Methods: PubMed, Ovid (Medline and Embase), Scopus, Cochrane library, and clinicaltrials.gov databases were searched for original clinical reports of topical monotherapy for microscopy and/or culture-confirmed toenail onychomycosis in adults. Studies were evaluated using an onychomycosis study quality scale, which was based on the CONSORT guidelines. Results: Twenty-five publications (28 studies) were identified and met the inclusion criteria. Thirteen studies scored high ratings on the quality scale. These were randomized controlled trials or randomized comparative trials. Low-quality studies were nonrandomized, open studies that prevented statistical analysis. Most studies reported clinical and mycological cure. The most variation was observed with reporting outcomes of clinical improvement. Amorolfine, ciclopirox, tavaborole, and efinaconazole produced clinical and mycological cure in patients with mild to moderate toenail onychomycosis (<50-65 % nail involvement), with efinaconazole showing the highest rates. Treatments were generally applied daily for 24-48 weeks, with longer treatment and follow-up showing better outcomes. Conclusion: Topical treatment with amorolfine, ciclopirox, tavaborole, or efinaconazole is appropriate for cases of mild to moderate toenail onychomycosis due to dermatophyte or mixed dermatophyte/ Candida infection. [ABSTRACT FROM AUTHOR]

Introduction: This review explores a pertinent issue for healthcare professionals and recruiters alike: which factors are most important in the recruitment and retention of these professionals in rural practice in Canada. Existing research concentrates on specific factors or focused populations. This review was created to explore multiple factors and a wider population of healthcare professionals, including chiropractors, osteopaths, dentists and physiotherapists. Methods: A literature search was carried out on four databases. Data from included studies were extracted, and thematic analysis was conducted on relevant findings. The quality of individual studies was assessed, and then themes were evaluated for overall confidence based on four components, using the Confidence in the Evidence for Reviews of Qualitative Research. Results: One quantitative and four qualitative articles were identified, all of which targeted physicians. Five themes -- Personal/family matters, Community factors, Professional practice factors, Professional education factors and Economic factors -- were generated in two domains, recruitment and retention. Forty major codes were generated through axial coding of open codes. Codes included attraction to rural lifestyle, recreational activities, Scope of practice, rural training and incentives. Scope of practice was deemed very important as a factor of recruitment, as was attraction to rural lifestyle. Incentives were found to be of little importance in influencing the recruitment of healthcare professionals, and even less important for retention. Conclusion: Wide scope of practice and attraction to the rural lifestyle were considered the most important for recruitment and to a lesser extent, retention, among the five papers studied. A lack of research was determined in the realm of factors influencing the recruitment and retention in healthcare professionals other than medical doctors in Canada. Therefore, it is recommended that further such studies investigate specific healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Increasing laboratory test utilization is a major challenge facing clinical laboratories. However, in most instances we lack population level information on the patient groups to which increased testing is directed. Much recent work has been published on the sociodemographic correlates of 25-hydroxyvitamin D deficiency. An unanswered question, however, is whether testing is preferentially directed towards individuals with a higher likelihood of deficiency. In this paper we examine this question by combining laboratory information system data on testing rates with Census Canada data. Methods: We examined 1,436 census dissemination areas within the city of Calgary, Alberta, Canada. For each census dissemination area we determined age and sex-specific 25-hydroxyvitamin D testing rates over a one year period. We then compared these testing rates with the following sociodemographic variables obtained from Census Canada: first nations status, education level, household income, visible minority status, and recent immigrant status. Results: Overall, 6.9% of males in the city of Calgary were tested during the study period. Females were 1.7 times more likely to be tested than males. Testing rate increased with increasing age, with 16.8% of individuals 66 years and over tested during the one-year study period. Individuals having at least some university education were less likely to be tested (RR = 0.60; p < 0.0001). Interestingly, although visible minorities were over twice as likely to be tested as compared to non-visual minorities (RR = 2.25; p < 0.0001), recent immigrants, a group known to exhibit low 25 hydroxyvitamin D levels, were significantly less likely to be tested than non-recent immigrants (RR = 0.72; p = 0.0174). While median household income was modestly associated with increased testing (RR = 1.02; p < 0.0001), First Nations status and non-English speaking were not significant predictors of 25-hydroxyvitamin D testing. Conclusions: Testing for 25-hydroxyvitamin D is in part directed toward populations at higher risk of deficiency (visible minorities) and at higher risk of osteoporosis (older females), but a particularly high risk group (recent immigrants) is being tested at a lower rate than other patient groups. [ABSTRACT FROM AUTHOR]

Linking multiple databases to create longitudinal data is an important research problem with multiple applications. Longitudinal data allows analysts to perform studies that would be unfeasible otherwise. We have linked historical census databases to create longitudinal data that allow tracking people over time. These longitudinal data have already been used by social scientists and historians to investigate historical trends and to address questions about society, history and economy, and this comparative, systematic research would not be possible without the linked data. The goal of the linking is to identify the same person in multiple census collections. Data imprecision in historical census data and the lack of unique personal identifiers make this task a challenging one. In this paper we design and employ a record linkage system that incorporates a supervised learning module for classifying pairs of records as matches and non-matches. We show that our system performs large scale linkage producing high quality links and generating sufficient longitudinal data to allow meaningful social science studies. We demonstrate the impact of the longitudinal data through a study of the economic changes in 19th century Canada. [ABSTRACT FROM AUTHOR]

Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently in the analysis as a high-level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health-care providers in spaces called 'wait times', where it is systematically rendered 'unknowable'. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. [ABSTRACT FROM AUTHOR]

Background/context Unnecessary laboratory testing leads to considerable healthcare costs. Aspartate aminotransferase (AST), commonly ordered with alanine aminotransferase (ALT) and blood urea nitrogen (BUN), commonly ordered with creatinine (Cr), often add little value to patient management at significant cost. We undertook a choosing wisely based quality improvement initiative to reduce the frequency of testing. Objectives To reduce the ratio of AST/ALT and BUN/Cr to less than 5% for all inpatient and outpatient test orders. Measures Absolute number and ratio of AST/ALT and BUN/Cr; AST, ALT, BUN and Cr tests per 100 hospital days; projected annualised cost savings and monthly acute inpatient bed days. Improvements We created guidelines for appropriate indications of AST and BUN testing, provided education with audit and feedback and removed AST and BUN from institutional order sets. Impact/results The ratios of AST/ALT and BUN/Cr decreased significantly over the study period (0.37 to 0.14, 0.57 to 0.14, respectively), although the goal of 0.05 was not achieved due to a delay in adopting the choosing wisely strategies during the study time period by some inpatient units. The number of tests per 100 hospital days decreased from 20 to 7 AST (95% CI 19 to 20.5, 5.6 to 8.7, p<0.001) and from 72 to 17 BUN (95% CI 70 to 73.4, 16.6 to 22.9, p<0.001). The initiative resulted in a projected annualised cost savings of C$221 749. Discussion A significant decrease in the AST/ALT and BUN/Cr ratios can be achieved with a multimodal approach and will result in substantial healthcare savings. [ABSTRACT FROM AUTHOR]

The Government of Canada's Atlas of Canada has, for over 100 years, produced maps of Canada's geography and history reflecting its social, environmental and economic diversity. The current online 6th Edition offers interactive and static thematic, reference and topographic maps. Initial interactive mapping user interfaces contained tools that were based on the developers' GIS experience. Users had, however, difficulty using these tools. To resolve this, the Atlas undertook considerable user and usability research initiatives and adopted and integrated a User Centred Design (UCD) process. This paper will look specifically at the methods used by the Atlas, the issues encountered and solutions achieved. [ABSTRACT FROM AUTHOR]

Background: The System of Observing Play and Leisure Activity in Youth (SOPLAY) has assisted in providing valid and reliable data of youth physical activity and characteristics specific to environmental contexts. The review aimed to examine empirical research that employed the SOPLAY instrument to measure physical activity in leisure‐based activity environments in North American countries. Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. A systematic search was conducted with an exhaustive process using 10 electronic databases to locate peer‐reviewed studies implementing SOPLAY that were published between 2000 and 2021. Results: A total of 60 studies were included in the review. Most studies (n = 35) reported physical activity findings related to contextual characteristics measured using SOPLAY. Interestingly, a few of the studies (n = 8) found the provision of equipment and supervision, particularly adult supervision, significantly increased child physical activity observed. Conclusions: This review provides information relative to the group‐level physical activity observed across multiple contexts (ie, playgrounds, parks, recreation centers) using a validated direct observation instrument. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of INFOR is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Growth of neonatal intensive care units in number and size has raised questions towards ability to maintain continuity and quality of care. Structural organization of intensive care units is known as a key element for maintaining the quality of care of these fragile patients. The reconstruction of megaunits of intensive care to smaller care units within a single operational service might help with provision of safe and effective care.Methods/design: The clinical team and patient distribution lay out, admission and discharge criteria and interdisciplinary round model was reorganized to follow the microstructure philosophy. A working group met weekly to formulate the implementation planning, to review the adaptation and adjustment process and to ascertain the quality of implementation following the initiation of the microsystem model.Discussion: In depth examination of microsystem model of care in this study, provides systematic evaluation of this model on variable aspects of health care. The individual projects of this trial can be source of solid evidence for guidance of future decisions on optimized model of care for the critically ill newborns.Trial Registration: ClinicalTrial.gov, NCT02912780 . Retrospectively registered on 22 September 2016. [ABSTRACT FROM AUTHOR]

The article offers information on the formation of the Canadian Association for Information Science/L'Association Canadienne des Sciences de L'Information (CAIS-ACSI) and its activities. It states that CAIS-ACSI was established in 1971 to foster the enhancement of information science in Canada and to facilitate information exchange concerning the use, access, retrieval, management and dissemination of information. CAIS-ACSI communicates with its members through the "Canadian Journal of Information and Library Science" (CJILS). The association conducts its conference every year in late May or early June.

Background: Pharmacy students can help protect the public from vaccine-preventable diseases by participating in immunization initiatives, which currently exist in some Canadian and American jurisdictions. The objective of this article is to critically review evidence of student impact on public health through their participation in vaccination efforts. Methods: PubMed, CINAHL, Cochrane Database, EMBASE, International Pharmaceutical Abstracts, Scopus and Web of Science electronic databases were searched for peer-reviewed literature on pharmacy student involvement in vaccination programs and their impact on public health. Papers were included up to November 17, 2015. Two reviewers independently screened titles and abstracts and extracted data from eligible full-text articles. Results: Eighteen titles met all inclusion criteria. All studies were published between 2000 and 2015, with the majority conducted in the United States (n = 12). The number of vaccine doses administered by students in community-based clinics ranged from 109 to 15,000. Increases in vaccination rates in inpatient facilities ranged from 18.5% to 68%. Across studies, student-led educational interventions improved patient knowledge of vaccines and vaccine-preventable diseases. Patient satisfaction with student immunization services was consistently very high. Discussion: Methodology varied considerably across studies. The literature suggests that pharmacy students can improve public health by 1) increasing the number of vaccine doses administered, 2) increasing vaccination rates, 3) increasing capacity of existing vaccination efforts, 4) providing education about vaccines and vaccine-preventable diseases and 5) providing positive immunization experiences. Conclusion: Opportunities exist across Canada to increase pharmacy student involvement in immunization efforts and to assess the impact of their participation. Greater student involvement in immunization initiatives could boost immunization rates and help protect Canadians from vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

Entropy applications in hydrometric network design problems have been extensively studied in the most recent decade. Although many studies have successfully found the optimal networks, there have been assumptions which could not be logically integrated into their methodology. One of the major assumptions is the uncertainty that can arise from data processing, such as time series simulation for the potential stations, and the necessary data quantization in entropy calculations. This paper introduces a methodology called ensemble-based dual entropy and multiobjective optimization (EnDEMO), which considers uncertainty from the ensemble generation of the input data. The suggested methodology was applied to design hydrometric networks in the Nelson-Churchill River Basin in central Canada. First, the current network was evaluated by transinformation analysis. Then, the optimal networks were explored using the traditional deterministic network design method and the newly proposed ensemble-based method. Result comparison showed that the most frequently selected stations by EnDEMO were fewer and appeared more reliable for practical use. The maps of station selection frequency from both DEMO and EnDEMO allowed us to identify preferential locations for additional stations; however, EnDEMO provided a more robust outcome than the traditional approach. [ABSTRACT FROM AUTHOR]

This article reports findings from a national survey of Research Ethics Board (REB) personnel across Canada on the satisfaction and use of information systems that support the review and administration of research ethics protocols. Findings indicate that though a wide variety of REB systems are utilized, the majority fall short of desired characteristics. Despite these shortcomings, most respondents are satisfied with their current REB systems. Satisfaction is dependent on the volume of protocols processed in relation to the robustness of the system. Boards with higher volumes are more satisfied with full-fledged systems; however, the satisfaction of REBs with lower volumes is not affected by the robustness of the REB system used. Recommendations are provided. [ABSTRACT FROM AUTHOR]

Global ballast water management aims to reduce the transport and introduction of non-indigenous species through practices such as ballast water exchange and ballast water treatment. Comprehensive enforcement to ensure vessels are meeting ballast water management requirements are a key part of success, but such activities are limited by available resources. Targeted and/or stratified enforcement activities are one option to make best use of available resources. International vessels are required to submit ballast water reporting forms prior to arrival at many ports around the world, declaring quantities, geographic sources, management undertaken and expected discharge location. These data are essential for risk assessment and trends analysis, but the inflow of data can be overwhelming for daily operations, particularly for jurisdictions with many ports and/or high vessel traffic. Having near real-time access to ballast water data enhances opportunities for data validation and verification and facilitates customized reports such as mapping of exchange coordinates and ballast water discharge statistics. Customized software enables seamless application of best-available science through integration of decision-support tools. The Ballast Water Information System (BWIS) was developed to support daily ballast water enforcement activities and scientific research in Canada. The BWIS increases accessibility of ballast water report data and streamlines data processing to support decision-making using an on-line platform. [ABSTRACT FROM AUTHOR]

Screening mammograms are important to detect breast cancer at earlier and more treatable stages. Immigrant and minority women report low participation rates due to barriers related to cultural beliefs and norms, privacy/modesty, and language. This review examines whether screening mammogram interventions in Canada and other countries with comparable health-care systems have addressed the needs of these women. Our systematic literature search identified studies that focused on increasing screening mammogram participation among immigrant and/or minority women. We used the Health Belief Model and the PRECEDE-PROCEED Model to guide our critical synthesis of the reviewed interventions and the recommendations for the future. Eight studies met the search criteria. Overall, interventions showed some increase in mammogram participation rates. The barriers targeted were relatively similar across studies and there was a focus on increasing cues to screening. This review illustrates that it is essential to develop and implement programs to overcome the unique barriers to screening mammography if we are to increase participation among immigrants and minority women. We suggest other potentially effective health promotion strategies as a starting point for discussion and future research. [ABSTRACT FROM AUTHOR]

A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN).This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. [ABSTRACT FROM AUTHOR]

sutcliffe k., caird j., kavanagh j., rees r., oliver k., dickson k., woodman j., barnett-paIge e. & thomas j. (2012) Comparing midwife-led and doctor-led maternity care: a systematic review of reviews. Journal of Advanced Nursing 68(11), 2376-2386. Abstract Aims. A report of a systematic review of reviews which examines the impact of having midwives-led maternity care for low-risk women, rather than physicians. Background. A rising birth rate, increasing complexity of births, and economic constraints pose difficulties for maternity services in the UK. Evidence about the most effective, cost-effective, and efficient ways to give maternity services is needed. Data sources. Searches were carried out in August-September 2009 of ten electronic databases, 16 key nursing and research websites, and reference lists of 56 relevant reviews. We also contacted 38 experts for information. No date restrictions were employed. Review methods. A narrative review of systematic reviews or 'meta review' was conducted using transparent and systematic procedures to limit bias at all stages. Systematic reviews that compared midwife-led care during pregnancy and birth with physician-led care were eligible for inclusion. Results. Three meta-analytic reviews were included. Midwife-led care for low-risk women was found to be better for a range of maternal outcomes, reduced the number of procedures in labour, and increased satisfaction with care. For some maternal, foetal, and neonatal outcomes reviews found no evidence that care led by midwives is different to that led by physicians. No adverse outcomes associated with midwife-led care were identified. Conclusions. For low-risk women, health and other benefits can result from having their maternity care led by midwives rather than physicians. Moreover, there appear to be no negative impacts on mothers and infants receiving midwife-led care. [ABSTRACT FROM AUTHOR]

brereton l., gardiner c., gott m., ingleton c., barnes s. & carroll c. (2011) The hospital environment for end of life care of older adults and their families: an integrative review. Journal of Advanced Nursing 68(5), 981-993. Abstract Aim. This article is a report of an integrative review to identify key elements of the physical hospital environment for end of life care of older adults and their families as reported by patients, relatives, staff and policy makers. Background. Globally ageing populations and increases in long-term illness mean that more people will need palliative care in the future. Despite policy initiatives to increase end of life care in the community, many older adults prefer, and will require, end of life care in hospital. Providing an appropriate physical environment for older adults requiring end of life care is important given concerns about hospital environments for this group. Data sources. Thirteen databases from 1966 to 2010 were searched including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index, the Science Citation Index, HMIC and the National Research Register. Reference and citation tracking was performed on included publications. Review methods. An integrative review was conducted. Two reviewers independently screened titles and abstracts for inclusion and completed data extraction. Study quality is not reported as this poses methodological difficulties in integrative reviews. Data synthesis involved thematic analysis informed by the findings of included literature. Results. Ten articles were included. Four themes were identified: privacy as needed; proximity (physically and emotionally) to loved ones, home and nature; satisfaction with the physical environment; and deficiencies in physical environment. Conclusion. Little evidence exists about physical hospital environments for end of life care of older adults and their families. More research is required in this field. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Administrative Sciences (John Wiley & Sons, Inc.) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)