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New KUSP articles
What makes a nursing home a home? Insights from family members and friends 
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Abstract: Purpose-The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes. Design/methodology/approach-This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings. Findings-Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships. Research limitations/implications-As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate. Practical implications-Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships. Originality/value-The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.
Classification schemes for knowledge translation interventions: a practical resource for researchers
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BACKGROUND: As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme.
Health of health care workers in Canadian nursing homes and pediatric hospitals: a cross-sectional study
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BACKGROUND: Poor health of health care workers affects quality of care, but research and health data for health care workers are scarce. Our aim was to compare physical/mental health among health care worker groups 1) within nursing homes and pediatric hospitals, 2) between the 2 settings and 3) with the physical/mental health of the Canadian population.
Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis
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IMPORTANCE: Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise.
OBJECTIVE: To assess the potential effectiveness of interventions for preventing falls.
New articles by TREC researchers
A qualitative evidence synthesis to explore healthcare professionals’ experience of prescribing opioids to adults with chronic non-malignant pain
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BACKGROUND: Despite recent guidelines suggesting that patients with chronic non-malignant pain might not benefit, there has been a significant rise in opioid prescription for chronic non-malignant pain. This topic is important because an increasing number of HCPs are prescribing opioids despite very limited evidence for long-term opioid therapy for chronic non-malignant pain outside of end-of-life care. To better understand the challenges of providing effective treatment, we conducted the first qualitative evidence synthesis to explore healthcare professionals’ experience of treating people with chronic non-malignant pain. We report findings that explore healthcare professionals’ experience of prescribing opioids to this group of patients.
The Influence of Context on Utilizing Research Evidence for Pain Management in Jordanian Pediatric Intensive Care Units (PICU)
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PURPOSE: The purpose of this study was to gain a beginning understanding of the contextual factors that influence the use of research for pain management in Jordanian Pediatric Intensive Care Units (PICUs).
Calls for Abstracts
Evidence-Informed Decision Making (EIDM) Casebook Issue 2
The National Collaborating Centre for Methods and Tools (NCCMT) is pleased to announce that we are assembling a second collection of EIDM success stories in public health. Following the success of the first issue of the EIDM Casebook, we invite individuals and organizations from Canada and around the world to submit abstracts describing efforts to achieve EIDM in public health practice, programs and policy. Be a part of this growing collection of selected success stories that illustrate what EIDM looks like across the country and the world.
Grants & Awards
Top Ten Canadian Frailty Priorities
This Catalyst Grant Program supports scalable implementation studies, feasibility studies, translational studies or quality improvement studies that investigate novel and innovative approaches, methodologies and/or technologies, including social innovations and novel approaches to policy change.
Studies must focus on older Canadians living with frailty and/or their families and caregivers and protocols must include frailty assessment of all study participants using a published and validated frailty assessment instrument appropriate for the care setting.
Total budget for this competition is $650,000. This is in addition to the funds allocated for work conducted in the province of New Brunswick (see Program Guidelines for details). Projects with multidisciplinary, multi-institutional teams will be funded for up to 16 months and to a maximum of $100,000. Proposals must include partners who have committed cash or eligible in-kind contributions on a 1:1 basis to CFN funding.
Publications
KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Practice and Methodology
Aging
KT
Scaling up improvements more quickly and effectively
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Abstract: Faster and more widespread implementation could help more patients to benefit more quickly from known effective treatments. So could more effective implementation of better assessment methods, service delivery models, treatments and services. Implementation at scale and ‘descaling’ are ways for hospitals and health systems to respond to rising demands and costs. The paper proposes ways to provide leaders with the information that would help them to decide whether and how to scale up a proven improvement. We draw on our knowledge of the improvement and implementation literature on the subject and on our experience of scale up programs in Kaiser Permanente, in Swedish county health systems, and in international health. We describe a ‘3S’ scale up infrastructure and other ingredients that appear necessary for successful widespread improvement, and list the resources that we have found useful for developing scale up programs. The paper aims to encourage more actionable research into scale up, and shows the opportunities for researchers to both advance implementation and improvement science and contribute to reducing suffering and costs in a more timely and effective way.
The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review
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BACKGROUND: It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors.
A content analysis of dissemination and implementation science resource initiatives: what types of resources do they offer to advance the field?
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BACKGROUND: The recent growth in organized efforts to advance dissemination and implementation (D & I) science suggests a rapidly expanding community focused on the adoption and sustainment of evidence-based practices (EBPs). Although promising for the D & I of EBPs, the proliferation of initiatives is difficult for any one individual to navigate and summarize. Such proliferation may also result in redundant efforts or missed opportunities for participation and advancement. A review of existing D & I science resource initiatives and their unique merits would be a significant step for the field. The present study aimed to describe the global landscape of these organized efforts to advance D & I science.
Knowledge Translation in Rehabilitation: A Shared Vision
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PURPOSE: Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care.
Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care
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BACKGROUND: Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care.
Optimising the value of the evidence generated in implementation science: the use of ontologies to address the challenges
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Abstract: Implementing research findings into healthcare practice and policy is a complex process occurring in diverse contexts; it invariably depends on changing human behaviour in many parts of an intricate implementation system. Questions asked with the aim of improving implementation are multifarious variants of ‘What works, compared with what, how well, with what exposure, with what behaviours (for how long), for whom, in what setting and why?’. Relevant evidence is being published at a high rate, but its quantity, complexity and lack of shared terminologies present challenges. The achievement of efficient, effective and timely synthesis of evidence is facilitated by using ‘ontologies’ to systematically structure and organise the evidence about constructs and their relationships, using a controlled, well-defined vocabulary.
Knowledge translation tools in preventive health care
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Abstract not available.
An ethnographic observation study of the facilitator role in an implementation process
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BACKGROUND: Even though the importance of a facilitator during an implementation process is well described, the facilitator’s role is rarely problematized in relation to the organizational context in terms of power and legitimacy; themes which have recently been brought to the fore when studying change in health care organizations. Therefore, in this article, we present a qualitative study with the aim of identifying key aspects of the experience of being in a facilitator role. The data collection involved ethnographic fieldwork encompassing observations and field notes, as well as two qualitative interviews with the facilitator. The data were analysed using a phenomenological hermeneutical method in order to formulate thematic aspects of the implementation process. The study was conducted in southern Sweden between January 2013 and August 2014.
Studying de-implementation in health: an analysis of funded research grants
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BACKGROUND: Studying de-implementation-defined herein as reducing or stopping the use of a health service or practice provided to patients by healthcare practitioners and systems-has gained traction in recent years. De-implementing ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices is important for mitigating patient harm, improving processes of care, and reducing healthcare costs. A better understanding of the state-of-the-science is needed to guide future objectives and funding initiatives. To this end, we characterized de-implementation research grants funded by the United States (US) National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ).
Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review
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BACKGROUND: One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science.
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Health Care Administration and Organization
Computer and telephone delivered interventions to support caregivers of people with dementia: a systematic review of research output and quality
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BACKGROUND: To assess the scope, volume and quality of research on the acceptability, utilisation and effectiveness of telephone- and computer-delivered interventions for caregivers of people living with dementia.
APRN-Conducted Medication Reviews for Long-Stay Nursing Home Residents
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OBJECTIVE: As part of the Missouri Quality Initiative (MOQI) to reduce hospitalizations for long-stay nursing home residents, this article describes reasons MOQI advanced practice registered nurses (APRNs) recommended medication order changes as part of their medication review process as well as the outcomes of their recommendations.
‘Working away in that Grey Area…’ A qualitative exploration of the challenges general practitioners experience when managing behavioural and psychological symptoms of dementia
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BACKGROUND: General practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they offer to their patients with dementia.
Nursing Home-Hospice Collaboration and End-of-Life Hospitalizations Among Dying Nursing Home Residents
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OBJECTIVES: Nursing homes (NHs) collaboration with hospices appears to improve end-of-life (EOL) care among dying NH residents. However, the potential benefits of NH-hospice collaboration may vary with the patterns of this collaboration. This study examines the relationship between the attributes of NH-hospice collaboration, especially the exclusivity of NH-hospice collaboration (ie, the number of hospice providers in a NH), and EOL hospitalizations among dying NH residents.
A Structured Process Description of a Pragmatic Implementation Project: Improving Integrated Care for Older Persons in Residential Care Homes
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Abstract: Evaluation of the implementation of integrated care can differ from trial-based research due to complexity. Therefore, we examined whether a theory-based method for process description of implementation can contribute to improvement of evidence-based care. MOVIT, a Dutch project aimed at implementing integrated care for older vulnerable persons in residential care homes, was used as a case study. The project activities were defined according to implementation taxonomy and mapped in a matrix of theoretical levels and domains. Project activities mainly targeted professionals (both individual and group). A few activities targeted the organizational level, whereas none targeted the policy level, or the patient, or the “social, political, and legal” domains. However, the resulting changes in care delivery arrangement had consequences for professionals, patients, organizations, and the social, political, and legal domains. A structured process description of a pragmatic implementation project can help assess the fidelity and quality of the implementation, and identify relevant contextual factors for immediate adaptation and future research. The description showed that, in the MOVIT project, there was a discrepancy between the levels and domains targeted by the implementation activities and those influenced by the resulting changes in delivery arrangement. This could have influenced, in particular, the adoption and sustainability of the project.
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Health Care Innovation and Quality Assurance
Care Toward the End of Life in Older Populations and Its Implementation Facilitators and Barriers: A Scoping Review
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PURPOSE: To inform health system improvements for care of elderly populations approaching the end of life (EOL) by identifying important elements of care and implementation barriers and facilitators.
Optimisation of dementia care in care homes: Dementia care framework
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Abstract:There are an increasing number of people living with dementia in care home settings. Recent reports suggest that people who deliver care to residents living with dementia in care homes require specialist support to provide optimum care. To address this need Four Seasons Health Care, the largest provider of care homes within the UK today, sought to design a dementia care framework that enhanced the quality of life for people living with dementia in their care homes. The framework was designed using a robust evidence base, engagement with people living with dementia, their care partners, policy-writers, multidisciplinary professionals and people within the organisation. This paper describes the methodology behind the dementia care framework and outcomes data from the first phase (of 20 care homes that included the care of 451 people living with dementia). The main outcome was a significant improvement in the quality of the lives of residents across biological, psychological, social and spiritual needs.
Resident Vignettes for Assessing Care Quality in Nursing Homes
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OBJECTIVES: Validated process measures that correlate with patient outcomes are needed for research and quality improvement.
Rehabilitation in dementia care
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Abstract: Multidisciplinary rehabilitation is increasingly accepted as valuable in the management of chronic disease. Whereas traditional rehabilitation models focussed on recovery, maintaining independence and delaying functional decline are now considered worthwhile aims even where full recovery is not feasible. Despite this, rehabilitation is notably absent from dementia care literature and practice. People with dementia report frustration with the lack of availability of structured post-diagnosis pathways like those offered for other conditions. Alternative terms such as ‘re-ablement’ are used to refer to rehabilitation-like services, but lack an evidence-base to guide care. This commentary will discuss possible reasons for the resistance to accept multidisciplinary rehabilitation as part of dementia care, and identifies the value of doing so for people with dementia, their families, and for health professionals.
Reliability and Validity of the Care Plan Checklist for Evidence of Person-Centered Approaches for Behavioral and Psychological Symptoms Associated With Dementia
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PURPOSE: The purpose of this study was to test the reliability and validity of the Care Plan Checklist for Evidence of Person-Centered Approaches for Behavioral and Psychological Symptoms Associated with Dementia (BPSD).
Family members’ expectations regarding nurses’ competence in care homes: a qualitative interview study
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BACKGROUND: Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members’ can provide valuable information about competence requirements.
AIM: To explore the expectations of the care home residents’ family members regarding the competence of nurses in care homes for older people.
The Tele.TAnDem Intervention: Telephone-based CBT for Family Caregivers of People With Dementia
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BACKGROUND AND OBJECTIVES: This study evaluated the effectiveness of a telephone-based cognitive-behavioral therapy for family caregivers of people with dementia in existing health care provision structures.
Quality nursing care in dementia specific care units: A scoping review
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Background: The concept of quality nursing care in a dementia specific unit is perceived as being subject to the interpretation of individuals, nurses and healthcare organisations. As the number of dementia diagnoses increases, understanding what constitutes quality nursing care within dementia specific care units is vital to inform policy makers and healthcare organisations globally. Efforts to identify quality nursing care and improve dementia care within dementia specific care units, may significantly reduce the financial and emotional burden of care-giving and improve the quality of life for individuals living with dementia. This scoping review aimed to examine current literature to gain an understanding of what constitutes quality nursing care in a dementia specific care unit. Design and methods Five electronic databases (CINAHL, MEDLINE, ProQuest, Social Sciences Citation Index and Ovid) were used to search for articles published in English between 2011 and 2016 focusing on a definition of quality nursing care within dementia specific care units.
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Research Practice and Methodology
Consensus Approaches to Identify Incident Dementia in Cohort Studies: Systematic Review and Approach in the Successful Aging after Elective Surgery Study
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OBJECTIVES: To survey the current methods used to ascertain dementia and mild cognitive impairment (MCI) in longitudinal cohort studies, to categorize differences in approaches and to identify key components of expert panel methodology in current use.
Measuring nurses’ perception of work environment: a scoping review of questionnaires
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BACKGROUND: Nurses’ work environment has been shown to be associated with quality of care and organizational outcomes. In order to monitor the work environment, it is useful for all stakeholders to know the questionnaires that assess or evaluate conditions for delivering nursing care. The aim of this article is: to review the literature for assessed survey questionnaires that measure nurses’ perception of their work environment, make a brief assessment, and map the content domains included in a selection of questionnaires.
Toward a comprehensive evidence map of overview of systematic review methods: paper 1-purpose, eligibility, search and data extraction
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BACKGROUND: Overviews of systematic reviews attempt to systematically retrieve and summarise the results of multiple systematic reviews. Methods for conducting, interpreting and reporting overviews are in their infancy. To date, there has been no evidence map of the methods used in overviews, thus making it difficult to determine the gaps and priorities for methods research. Our objectives were to develop and populate a comprehensive framework of methods for conducting, interpreting and reporting overviews (stage I) and to create an evidence map by mapping studies that have evaluated overview methods to the framework (stage II).
Review of methodologies of cohort studies of older people
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Abstract: This paper describes a cohort study in terms of its design, the research questions answered by cohort studies, common analytic techniques and the strengths and limitations of this type of study. We also describe the main cohort studies of older populations, many of which are available for secondary data analysis.
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Aging
Utilization of Antibiotics in Long-Term Care Facilities in British Columbia, Canada
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BACKGROUND: Antibiotic use is highly prevalent in long-term care facilities (LTCFs); a resident’s annual exposure to at least 1 course of antibiotic is approximately 50% to 80%. The objective of this study was to understand the extent of antibiotic use in the population of residents in British Columbia’s (BC) LTCFs from 2007 to 2014.
JAMDA’s New Editors-in-Chief Present a Vision for the Journal of Post-Acute and Long-Term Care Medicine
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Editorial note: During JAMDA’s first 15 years of publication, it was the Journal of the American Medical Directors Association. In 2014, JAMDA was renamed the Journal of Post-Acute and Long-Term Care Medicine, better reflecting the breadth of the long-term care spectrum and the involvement of nurse practitioners, physician assistants, and other members of the interdisciplinary care team. 1 As the new editors-in-chief of JAMDA, we heartily endorse this evolution to a broader perspective of post-acute and long-term care (PA/LTC) medicine.
Attachment style and filial obligation in the burden of caregivers of dementia patients
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Abstract: Insecure attachment styles have been known to predict greater burden in caregivers of dementia patients. However, it has not been tested how filial obligation, which refers to one’s sense of duty on helping elderly parents and is especially pronounced in Asian cultures, is involved in that relationship. We sought to identify whether the association between attachment style and caregiver burden differs according to the degree of filial obligation in caregivers of dementia patients. To assess filial obligation in Korean participants, a Korean filial obligation measure was developed. Ninety-eight Korean female caregivers of dementia patients reported their attachment style, filial obligation, burden, and patient behavioral symptoms. Patients’ cognitive abilities, daily activity levels, and global dementia severities were obtained from hospital records. When adjusting for caregiver and patient characteristics, greater attachment anxiety predicted higher burden, corroborating literature findings. However, the association of attachment avoidance with burden was contingent on filial obligation: When obligation was high, greater avoidance associated with lower burden, which contrasts with previous negative implications of attachment insecurity. This implies a buffering role of attachment avoidance among those highly obligated. In addition, obligation positively predicted burden among those low in avoidance. This study is the first one to investigate and find conditional associations between attachment style, filial obligation, and caregiver burden. Given that filial obligation tends to be higher in caregivers of Eastern countries, this study provides quantitative evidence that the caregiving process may be different for them.
Associations of Neuropsychiatric Symptoms and Antidepressant Prescription with Survival in Alzheimer’s Disease
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OBJECTIVE: Depression is associated with increased mortality in community samples. The use of antidepressant medication may also increase mortality, however, it is still unclear whether taking antidepressants before or after a diagnosis of dementia influences survival.
“The Lesser of Two Evils” Versus “Medicines not Smarties”: Constructing Antipsychotics in Dementia
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BACKGROUND AND OBJECTIVES: Because antipsychotics are associated with an increased risk of morbidity and mortality, they should only be prescribed in dementia in limited circumstances. But antipsychotics are prescribed to a large proportion of residents in formal care settings despite guidance and warnings to the contrary, justifying a study into how professionals define and in turn create realities about antipsychotic usage in dementia.
Associations between skin barrier characteristics, skin conditions and health of aged nursing home residents: a multi-center prevalence and correlational study
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BACKGROUND: Geriatric patients are affected by a range of skin conditions and dermatological diseases, functional limitations and chronic diseases. Skin problems are highly prevalent in elderly populations. Aim of this study was to investigate possible associations between health, functional and cutaneous variables in aged long-term care residents.
Physical status and frailty index in nursing home residents: Results from the INCUR study
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AIM: The Short Physical Performance Battery (SPPB) is a widely used instrument for measuring physical performance, consisting of 3 sub-tests: a hierarchical test of balance, a gait speed test, and a chair stand test. Although equally considered in the computation of the SPPB score, each of the components may present a specific and different weight in clinical practice. The aim of this study was to estimate the relationship between SPPB and its component of an age-related deficit accumulation index (the so-called Frailty Index [FI] proposed by Rockwood).
Prevalence and predictors of potentially inappropriate prescribing of central nervous system and psychotropic drugs among elderly patients: A national population study in Korea
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OBJECTIVES: To investigate the prevalence of potentially inappropriate prescribing (PIP) of central nervous system and psychotropic (CNS-PS) drugs to the Korean elderly population, and to identify PIP-associated factors.
Tube feeding decreases pneumonia rate in patients with severe dementia: comparison between pre- and post-intervention
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BACKGROUND: It is widely supposed that there is no benefit, including extended survival and decreased rate of pneumonia, in patients with severe dementia receiving enteral tube feeding (TF). However, there have been few studies comparing the frequency of pneumonia before and after TF in severe dementia.
Social and clinical determinants of preferences and their achievement at the end of life: prospective cohort study of older adults receiving palliative care in three countries
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BACKGROUND: Achieving choice is proposed as a quality marker. But little is known about what influences preferences especially among older adults. We aimed to determine and compare, across three countries, factors associated with preferences for place of death and treatment, and actual site of death.
Mobility care in nursing homes: development and psychometric evaluation of the kinaesthetics competence self-evaluation (KCSE) scale
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BACKGROUND: Impaired mobility is a prevalent condition among care-dependent persons living in nursing homes. Therefore, competence development of nursing staff in mobility care is important. This study aimed to develop and initially test the Kinaesthetics Competence Self-Evaluation (KCSE) scale for assessing nursing staff’s competence in mobility care.
Patient safety culture in care homes for older people: a scoping review
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BACKGROUND: In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes.
End-of-life care of elderly patients with dementia: A cross-sectional study of family carer decision-making
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BACKGROUND: Dementia syndromes pose a major worldwide challenge to public health. In terminal stage of dementia, carers are responsible for decision making in end-of-life treatment and there may be multiple factors that contribute to the choice of a palliative or invasive treatment.
Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study
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BACKGROUND: Negative effects of restraint use have been well-documented. However, the prevalence of restraints use has been high in long-term care facilities in Hong Kong compared with other countries and this goes against the basic principles of ethical and compassionate care for older people. The present study aimed to review the change in the prevalence of physical and chemical restraint use in long-term care facilities (LTCFs) over a period of 11 years in Hong Kong and to identify the major factors associated with their use.
Examining Differences in Oral Health Status Based on Assessments Conducted by Long-term Care Staff Versus a Dentist
Potentially inappropriate prescriptions for elderly people taking antidepressant: comparative tools
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BACKGROUND: The use of psychotropic drugs by elderly people is widely spread around the world, given that prevalence of inappropriate medication is frequent. Strictly speaking, in Brazil, the vulnerable population of elderly people is more likely to use Potentially Inappropriate Psychotropic (PIP) due to the impact of social-economic characteristics, to the Brazilian Public Health System, and to the lack of patient monitoring. However, neither the use pattern nor the prevalence rate of PIP have been studied in Brazil so far. The objectives of this study were to determine the prevalence of PIP in elderly outpatients taking antidepressants, and to compare the performance of two different tools (Beers, STOPP).
Key stakeholders’ experiences of respite services for people with dementia and their perspectives on respite service development: a qualitative systematic review
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BACKGROUND: Respite services provide a break in the caregiving relationship for people with dementia and their carers, however they are often under-used and service acceptability can be low. This study aims to understand key stakeholders’ experiences of respite services for people with dementia, with a view to informing respite service development.
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Events
UofA
Join us to hear from two University of Alberta researchers who reviewed grant applications for the CIHR Fall 2017 Project Competition: Dr. Kathy Hegadoren (Chair, Gender Sex & Health Panel) and Dr. Michael Schultz (Scientific Officer, Biochemistry & Molecular Biology B Panel). They will discuss problems with and strategies for: -selecting an appropriate peer review committee -ensuring that your registration abstract demonstrates why your application is appropriate for the peer review committee selected along with the grant -assignment process at CIHR meeting sex and gender requirements -providing key words and shaping summaries to best fit their important roles in the peer review process.
Q&A Session with Fall 2017 Project Competition CIHR Peer Reviewers
Join us to hear from Drs. Emmanuelle Cordat (Reviewer, Hematology, Digestive & Kidney Diseases Panel), Michelle Graham (Chair, Clinical Investigation D Panel), and Rachel Wevrick (Reviewer, Genetics Panel), all of whom participated in the review of CIHR Fall 2017 Project Competition grants. They will spend a few minutes summarizing their experiences reviewing Project grants this fall, and outline what we can expect for the review of Spring 2018 Project submissions. This will be followed by our opportunity to ask questions as we prepare Spring 2018 Project applications.
Preparing your CIHR Project Budget
Join us to hear from Drs. Hanne Ostergaard (CIHR Project Reviewer [Spring 2016, Fall 2016 & Fall 2017] and OOGP and Planning grant awardee) and Adrian Wagg (CIHR Project, OOGP, PHSI, and Team grant awardee). They will share their insights into preparing budgets for the project competition. We will also hear from the Research Services Office Research Facilitators, who will share their observations on more common errors made and difficulties encountered when preparing CIHR grant budgets.
Non UofA
Global Conference on Integrated Care 2018
The Global Conference on Integrated Care (GCIC) 2018 is an international conference that will bring together clinicians, health and social care professionals and practitioners, and policymakers from around the world to share knowledge, experiences, ideas and innovations in integrated care delivery.
The conference will be used as a platform to look beyond the immediate horizon, future-proof healthcare delivery, and strengthen relationships between policymakers and public users to enable successful care integration.
A world-class programme of keynote lectures, plenary sessions and symposia has been designed to facilitate impactful knowledge exchange and foster fruitful dialogues with internationally renowned experts. It will cover the three key themes of:
– Care Integration in Practice
– Enabling Care Integration
– Transcending Boundaries in Integrated Care
Hear from Dr Catherine Calderwood, Chief Medical Officer of Scotland and plenary speakers such as Dr Bruce (B.J.) Miller from the United States of America (USA), Dr Christina Maw from Hong Kong, Mr Chai Chuah from New Zealand and more!
Online
Knowledge Translation in Canada – Today and Tomorrow
Dr. Sharon Straus, director of the Knowledge Translation Program of St. Michael’s Hospital and of Geriatric Medicine at the University of Toronto, will present a webcast, Knowledge Translation in Canada – Today and Tomorrow. Dr. Straus will discuss the current status of KT activities in Canada, with a focus on the KT Canada Network and the KT program at St. Michael’s, and will describe KT plans that are under development.
Courses
Online
Introductory course on Systematic Reviews and Meta-Analyses
This is an introductory course on systematic reviews and meta-analyses and will be delivered online. It is co-taught by Andrea Tricco (MSc, PhD) and Sharon Straus (MD, MSc). The overall course objective is to teach about systematic reviews in general, as well as how to go about doing a systematic review. This information will be used by the students to prepare a protocol for a systematic review on the topic of their choice, with guidance from the course instructors.
News
Canada’s lack of long-term care space is forcing seniors as far as 200 km from home
A dearth of nursing homes and an aging population is creating a growing backlog that’s putting pressure on families across Canada.
Hospice Workers Who Care For The Dying Don’t Plan Ahead Themselves
Hospice workers may witness terminal illness and death almost daily, but that doesn’t mean they’ve documented their own end-of-life wishes, a new report finds.
Grey Matters: Seniors shouldn’t quietly take their medicine
When it comes to pharmaceuticals, seniors tend to be super users. Two-thirds of those in long-term care facilities take 10 or more medications, according to a 2012 Canadian Institute for Health Information (CIHI) report. These medications can improve our quality of life or extend our days, but they can also bring side-effects and harmful drug interactions. Should we just quietly take our medicine?
Are You Missing Opportunities to Improve Care for Older Adults?
It should be great news. The US knows what kind of care to provide for older adults. We have PACE (Programs of All-Inclusive Care for the Elderly) programs in hospitals and communities, ACE (Acute Care of the Elderly) units in hospitals, and GRACE (Geriatric Resources for Assessment and Care of Elders) in hospitals, for example.
The problem is that even though we know what care to provide for older adults, we meet less than 10 percent of the total need in our country with the best evidence-based models of care available. This means that the majority of older adults in the US could be getting care that is unnecessary, ineffective, or harmful.
Demand for Long-Term Care Beds in Canada Could Nearly Double in Little More Than 15 Years
Canada could need to build 42,000 new long-term care beds in just the next five years to meet the needs of an aging population without changes to how health care for seniors is being delivered. By 2035, this number could increase to 199,000—nearly double the 255,000 beds available in 2016, according to a new Conference Board of Canada report.
Relatives of murdered seniors set to ask to take part in public inquiry
Relatives of murdered seniors, along with advocacy and health-care groups, are among four dozen applicants seeking to participate in a public inquiry sparked by a nurse who killed eight elderly long-term-care residents in Ontario.
The other big drug problem: Older people taking too many pills
For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders.
Unlike the overuse of opioid painkillers, the polypharmacy problem has attracted little attention, even though its hazards are well documented. But some doctors are working to reverse the trend.
Resources
Public Engagement: A Practical Guide
Sense About Science, work with researchers on many of the most sensitive subjects – some fraught with misunderstanding – to improve the communication of their research findings. They only undertake such partnerships where there are high stakes for the public and communication is difficult. Communicating the survival statistics of children’s heart surgery at different treatment centres in 2016 was among the toughest of these, with potentially major consequences for all involved. It is a using this experience as a case study, funded by the National Institute for Health Research, that has been used as the basis of this new practical guide. The guide sets out a five-step guide to involve the public in communicating research.
Communicating Your Research – A Toolkit
This toolkit is for researchers to help increase influence and impact in health and health care.
Knowledge Translation Planning: NIDILRR Grantee Benchmarks and KTDRR Resources
KT Planning to Implementation to Outcomes
Knowledge Translation Planning Template
Developing the KT Plan to Build Research Impact
Guide to Knowledge Translation Planning at CIHR: Integrated and End-of-Grant Approaches
Development of a Planning Tool to Guide Research Dissemination
Communication: a Practical Resource
This practical resource was created in 2017, primarily for improvement and implementation researchers who are carrying out projects that aim to improve health services, or change practice in line with research results. The resource may also be useful to health and social care professionals, patients, service users and others who are involved in improvement or implementation projects. The contents of the resource may not be as relevant for improvement and implementation researchers who are developing theories, carrying out systematic reviews or observing change.
Social Systems Evidence (beta)
With a growing international focus on evidence-informed policymaking across government and on achieving the UN’s Sustainable Development Goals, Forum+ has launched the beta version of Social Systems Evidence to better support policymakers, stakeholders and researchers who want to access the best available research evidence in a timely manner. Social Systems Evidence will soon be the world’s most comprehensive, continuously updated repository of research evidence about the programs, services and products available in 16 government sectors and program areas (i.e., community and social services, culture and gender, economic development and growth, education, transportation), as well as the governance, financial and delivery arrangements within which these programs and services are provided, and the implementation strategies that can help to ensure that these programs and services get to those who need them.
The experiences of participants in care home research – final report
Aim: To summarise the findings for an eight-week project exploring the experiences of care home participants, putting forward possible benefits, challenges, and recommendations for future practice.
Opportunities
This new post is funded by Marie Curie to support capacity building in palliative care and end of life research, particularly at the interface with primary care. It is ideally suited to an experienced post-doctoral researcher interested in health services innovation and quality, who enjoys the challenge and stimulation from working on a portfolio of activities in an exciting clinical and academic environment. The post offers an ideal platform for developing experience and building your CV, and encouragement will be given towards applying for a personal NIHR, research council or charity-funded fellowship.
You will be involved in delivery of a portfolio of research projects, and also have the opportunity to lead the development of new research proposals and funding applications. Your work will fit within the overall research strategies of the Warwick UAPC and Marie Curie, and there will be considerable opportunity to develop your research skills and co-author papers.
This new post is funded by Marie Curie to support capacity building in palliative care and end of life research, particularly at the interface with primary care. It is ideally suited to a post-doctoral researcher interested in health services innovation and quality, who enjoys the challenge and stimulation from working on a portfolio of activities in an exciting clinical and academic environment. The post offers an ideal platform for developing experience and building your CV, and encouragement will be given towards applying for a personal NIHR, research council or charity-funded fellowship.
You will be involved in delivery of a portfolio of research projects, and also have the opportunity to contribute to or lead the development of new research proposals and funding applications. Your work will fit within the overall research strategies of the Warwick UAPC and Marie Curie, and there will be considerable opportunity to develop your research skills and co-author papers.
IMPACT (IMPlementation to Achieve Clinical Transformation) is a 2-year postdoctoral research career development (K12) pro-gram based at the University of Colorado, School of Medicine and supported by a grant from the National Heart, Lung, and Blood Institute (NHLBI). Mentors lead scholars to independence in T4 population-based (implementation science) translational work, merging clinical, public health research and practice in cardiovascular, pulmonary, hematologic, and sleep disorders. The program offers innovative, didactic training and mentored research experience in diverse, cutting-edge health care systems.
