Increasing load carriage and running speed differentially affect the magnitude, variability and coordination patterns of muscle forces.

The study aims to investigate the effects of different loads and speed during running on inter- and intra-individual muscle force amplitudes, variabilities and coordination patterns. Nine healthy participants ran on an instrumentalized treadmill with an empty weight vest at two velocities (2.6 m/s and 3.

Inter-strides variability affects internal foot tissue loadings during running.

Running overuse injuries result from an imbalance between repetitive loadings on the anatomical structures and their ability to adapt to these loadings. Unfortunately, the measure of these in-vivo loadings is not easily accessible. An optimal amount of movement variability is thought to decrease the running overuse injury risk, but the influence of movement variability on local tissue loading is still not known.

Responsiveness of a simple tool for assessing change in behavioral intention after continuing professional development activities.

Background: Continuing professional development (CPD) activities are one way that new knowledge can be translated into changes in practice. However, few tools are available for evaluating the extent to which these activities change health professionals' behavior. We developed a questionnaire called CPD-Reaction for assessing the impact of CPD activities on health professionals' clinical behavioral intentions.

Performance assessment of a portable mass spectrometer using a linear ion trap operated in non-scanning mode.

Rationale: The desire for mass spectrometer portability provides the motivation for simpler, lighter electronics to deliver switched potentials applied to the electrodes of the linear ion trap operated in non-scanning mode. Using a novel method of modelling and theoretical analysis, we simulate the mass analyser performance under these unfavourable operating conditions.

Methods: The electrical fields are simulated using the Charge Particle Optics software which employs the boundary element method.

The majority of accredited continuing professional development activities do not target clinical behavior change.

Purpose: Continually improving patient outcomes requires that physicians start new behaviors, stop old behaviors, or adjust how they practice medicine. Continuing professional development (CPD) is the method most commonly used by physicians to improve their knowledge and skills. However, despite regular physician attendance at these activities, change in clinical behavior is rarely observed.

Development of a simple 12-item theory-based instrument to assess the impact of continuing professional development on clinical behavioral intentions.

Background: Decision-makers in organizations providing continuing professional development (CPD) have identified the need for routine assessment of its impact on practice. We sought to develop a theory-based instrument for evaluating the impact of CPD activities on health professionals' clinical behavioral intentions.

Methods And Findings: Our multipronged study had four phases.

Vestibular lesion-induced developmental plasticity in spinal locomotor networks during Xenopus laevis metamorphosis.

During frog metamorphosis, the vestibular sensory system remains unchanged, while spinal motor networks undergo a massive restructuring associated with the transition from the larval to adult biomechanical system. We investigated in Xenopus laevis the impact of a pre- (tadpole stage) or post-metamorphosis (juvenile stage) unilateral labyrinthectomy (UL) on young adult swimming performance and underlying spinal locomotor circuitry. The acute disruptive effects on locomotion were similar in both tadpoles and juvenile frogs.

Using novel Canadian resources to improve medication reconciliation at discharge: study protocol for a randomized controlled trial.

Background: Adverse drug events are responsible for up to 7% of all admissions to acute care hospitals. At least 58% of these are preventable, resulting from incomplete drug information, prescribing or dispensing errors, and overuse or underuse of medications. Effective implementation of medication reconciliation is considered essential to reduce preventable adverse drug events occurring at transitions between community and hospital care.

Do physician communication skills influence screening mammography utilization?

Background: The quality of physician communication skills influences health-related decisions, including use of cancer screening tests. We assessed whether patient-physician communication examination scores in a national, standardized clinical skills examination predicted future use of screening mammography (SM).

Methods: Cohort study of 413 physicians taking the Medical Council of Canada clinical skills examination between 1993 and 1996, with follow up until 2006.

Educating doctors on evaluation of fitness to drive: impact of a case-based workshop.

Introduction: In 2004, faced with demographic data predicting large increases in the number of older drivers within a relatively short period combined with the realization that screening for driver fitness was largely dependent on health professionals, principally physicians, the Société de l'assurance automobile du Québec (SAAQ) initiated measures to achieve better cooperation with the health professionals performing the screening. A continuing medical education (CME) program was initiated to improve the health professionals' understanding of road safety considerations. This article describes the program and its impact.

Patient, physician, encounter, and billing characteristics predict the accuracy of syndromic surveillance case definitions.

Background: Syndromic surveillance systems are plagued by high false-positive rates. In chronic disease monitoring, investigators have identified several factors that predict the accuracy of case definitions based on diagnoses in administrative data, and some have even incorporated these predictors into novel case detection methods, resulting in a significant improvement in case definition accuracy. Based on findings from these studies, we sought to identify physician, patient, encounter, and billing characteristics associated with the positive predictive value (PPV) of case definitions for 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory (including influenza-like illness)).

Partnerships for knowledge translation and exchange in the context of continuing professional development.

Continuing professional development (CPD) is an important vehicle for knowledge translation (KT); however, selecting CPD strategies that will impact health professionals' behavior and improve patient outcomes is complex. In response, we, KT researchers and CPD knowledge users, have recently formed a partnership known as the National Network for Patient-Centered Evidence-Based Continuing Professional Development. The partnership was initiated in 2006 with a series of CIHR Knowledge Translation: Planning, Meetings and Dissemination grants.

Developing a theory-based instrument to assess the impact of continuing professional development activities on clinical practice: a study protocol.

Background: Continuing professional development (CPD) is one of the principal means by which health professionals (i.e. primary care physicians and specialists) maintain, improve, and broaden the knowledge and skills required for optimal patient care and safety.

Sensitivity and amplitude calibration of a Fourier transform 3D quadrupole ion trap mass spectrometer.

With a three-dimensional (3D) quadrupole ion trap running in a Fourier transform operating mode, the detected signal is an image of the collective motion of the confined ions. Consequently, it is assumed that the image signal is the sum of the axial trajectories of the simultaneously confined ions. The resulting frequency spectrum after Fourier transformation comprises frequency peaks at the axial secular frequencies of the confined species according to their mass/charge ratio.

Accuracy of syndrome definitions based on diagnoses in physician claims.

Background: Community clinics offer potential for timelier outbreak detection and monitoring than emergency departments. However, the accuracy of syndrome definitions used in surveillance has never been evaluated in community settings. This study's objective was to assess the accuracy of syndrome definitions based on diagnostic codes in physician claims for identifying 5 syndromes (fever, gastrointestinal, neurological, rash, and respiratory including influenza-like illness) in community clinics.

Effective continuing professional development for translating shared decision making in primary care: A study protocol.

Background: Shared decision making (SDM) is a process by which a healthcare choice is made jointly by the healthcare professional and the patient. SDM is the essential element of patient-centered care, a core concept of primary care. However, SDM is seldom translated into primary practice.

Poorly performing physicians: does the Script Concordance Test detect bad clinical reasoning?

Introduction: Evaluation of poorly performing physicians is a worldwide concern for licensing bodies. The Collège des Médecins du Québec currently assesses the clinical competence of physicians previously identified with potential clinical competence difficulties through a day-long procedure called the Structured Oral Interview (SOI). Two peer physicians produce a qualitative report.

Influence of physicians' management and communication ability on patients' persistence with antihypertensive medication.

Background: Less than 75% of people prescribed antihypertensive medication are still using treatment after 6 months. Physicians determine treatment, educate patients, manage side effects, and influence patient knowledge and motivation. Although physician communication ability likely influences persistence, little is known about the importance of medical management skills, even though these abilities can be enhanced through educational and practice interventions.

Determining the number of patient charts necessary for a reliable assessment of practicing family physicians' performance.

In many countries, peer assessment programs based on the examination of patient charts are becoming a standard to assess physician's clinical performance. Although data on validity of the process are acceptable, reliability issues need some improvement. This article addresses the rarely studied aspect of optimal number of patient charts for an acceptable reliable assessment.

Doctor scores on national qualifying examinations predict quality of care in future practice.

Objectives: This study aimed to determine if national licensing examinations that measure medical knowledge (QE1) and clinical skills (QE2) predict the quality of care delivered by doctors in future practice.

Methods: Cohorts of doctors who took the Medical Council of Canada Qualifying Examinations Part I (QE1) and Part II (QE2) between 1993 and 1996 and subsequently entered practice in Ontario, Canada (n = 2420) were followed for their first 7-10 years in practice. The 208 of these doctors who were randomly selected for peer assessment of quality of care were studied.

Increasing the detection and response to adherence problems with cardiovascular medication in primary care through computerized drug management systems: a randomized controlled trial.

Background: Adherence with antihypertensive and lipid-lowering therapy is poor, resulting in an almost 2-fold increase in hospitalization. Treatment side effects, cost, and complexity are common reasons for nonadherence, and physicians are often unaware of these potentially modifiable problems.

Objective: To determine if a cardiovascular medication tracking and nonadherence alert system, incorporated into a computerized health record system, would increase drug profile review by primary care physicians, increase the likelihood of therapy change, and improve adherence with antihypertensive and lipid-lowering drugs.

Improving the quality of surgical pathology reports for breast cancer: a centralized audit with feedback.

Context: Good communication of pathologic characteristics of a malignancy is crucial to therapy choices and accurate prognostication. The information must be easily retrieved from a surgical pathology report.

Objectives: To evaluate, first in 1999, the quality of surgical pathology reports for segmental breast resections for cancer in Quebec hospitals.

A randomized trial of the effectiveness of on-demand versus computer-triggered drug decision support in primary care.

Objectives: Prescribing alerts generated by computerized drug decision support (CDDS) may prevent drug-related morbidity. However, the vast majority of alerts are ignored because of clinical irrelevance. The ability to customize commercial alert systems should improve physician acceptance because the physician can select the circumstances and types of drug alerts that are viewed.