Factors Influencing Initial Rehabilitation Type After Hip Fracture Surgery: A Retrospective Cohort Study.

Objective: To describe and compare the factors that impact initial rehabilitation type after hip fracture surgery.

Design: Retrospective population-based cohort study.

Setting And Participants: People aged between 50 and 105 with a hip fracture who had a surgical repair in Ontario, Canada, between January 1, 2015, and December 31, 2021.

Impact of quality improvement strategies on the quality of life of individuals post-stroke: a systematic review.

The purpose of this systematic review was to synthesize and appraise the evidence regarding the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. Studies were identified by searching MEDLINE (OVID interface, 2000 onwards), CINAHL (EBSCO interface, 2000 onwards), EMBASE (OVID interface, 2000 to present), and PsycINFO (OVID interface, 2000 onwards). The Effective Practice and Organization of Care Risk of Bias Tool was applied.

Rehabilitation service models for people with physical and/or mental disability living in low- and middle-income countries: A systematic review.

Objective: To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries.

Data Sources: CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed.

Study Selection: Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language.

Discharge destination following hip fracture: comparative effectiveness and cost analyses.

Unlabelled: This study determines outcomes and costs of similar hip fracture patients that were discharged from hospital to a rehabilitation facility or to the community within 1 year. Community patients had worse outcomes and lower costs compared to rehabilitation facility patients. This study contributes to understanding hip fracture quality of care.

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

Background: While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke.

Scoping review of potential quality indicators for hip fracture patient care.

Objective: The purpose of this study is to identify existing or potential quality of care indicators (ie, current indicators as well as process and outcome measures) in the acute or postacute period, or across the continuum of care for older adults with hip fracture.

Design: Scoping review.

Setting: All care settings.

Post-acute pathways among hip fracture patients: a system-level analysis.

Background: Hip fractures among older adults are one of the leading causes of hospitalization and result in significant morbidity, mortality, and health care use. Guidelines suggest that rehabilitation after surgery is imperative to return patients to pre-morbid function. However, post-acute care (which encompasses rehabilitation) is currently delivered in a multitude of settings, and there is a lack of evidence with regards to which hip fracture patients should use which post-acute settings.

Role of context in care transition interventions for medically complex older adults: a realist synthesis protocol.

Introduction: Approximately 30-50% of older adults have two or more conditions and are referred to as multimorbid or complex patients. These patients often require visits to various healthcare providers in a number of settings and are therefore susceptible to fragmented healthcare delivery while transitioning to receive care. Care transition interventions have been implemented to improve continuity of care, however, current evidence suggests that some interventions or components of interventions are only effective within certain contexts.

Hospital costs associated with laparoscopic and open inguinal herniorrhaphy.

Purpose: The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy.

Methods: A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative.

Quality indicators for hip fracture patients: a scoping review protocol.

Introduction: Hip fractures are a significant cause of morbidity and mortality and care of hip fracture patients places a heavy burden on healthcare systems due to prolonged recovery time. Measuring quality of care delivered to hip fracture patients is important to help target efforts to improve care for patients and efficiency of the health system. The purpose of this study is to synthesise the evidence surrounding quality of care indicators for patients who have sustained a hip fracture.

Development of a Chronic Care Model for Neurological Conditions (CCM-NC).

Background: Persons with neurological conditions and their families face a number of challenges with the provision of health and community-based services. The purpose of this study was to understand the existing health and community service needs and gaps in care and to use this information to develop a model to specify factors and processes that may improve the quality of care and health and well-being for persons with neurological conditions.

Methods: We conducted semi-structured interviews with health care professionals, community-based non-health care professionals working with individuals with neurological conditions, and policy makers -from the Ministries of Health, Community and Social Services, Transportation and Education- across Canada.

Evaluating communities of practice and knowledge networks: a systematic scoping review of evaluation frameworks.

Communities of Practice (CoPs) are increasingly considered a part of ecohealth and other sectors such as health care, education, and business. However, there is little agreement on approaches to evaluate the influence and effectiveness of CoPs. The purpose of this review was to understand what frameworks and methods have been proposed or used to evaluate CoPs and/or knowledge networks.

A qualitative study to understand the barriers and enablers in implementing an enhanced recovery after surgery program.

Objective: Explore the barriers and enablers to adoption of an Enhanced Recovery after Surgery (ERAS) program by the multidisciplinary perioperative team responsible for the care of elective colorectal surgical patients.

Background: ERAS programs include perioperative interventions that when used together have led to decreased length of stay while increasing patient recovery and satisfaction. Despite the known benefits of ERAS programs, uptake remains slow.

Comparative analysis of open and laparoscopic colectomy for malignancy in a developing country.

Aim: To compare the short-term, including oncologic, outcomes of open vs laparoscopic colectomy for cancer in a developing country.

Methods: The records of patients who underwent elective open and laparoscopic colectomies for cancer at the University Hospital of the West Indies between January 2005 and December 2010 were retrospectively reviewed. Demographic (age, gender, Charlson comorbidity index score), peri-operative, post-operative and oncologic data were collected for each patient.

A cost comparison of laparoscopic and open colon surgery in a publicly funded academic institution.

Background: The objective of this study was to compare the total hospital cost of laparoscopic (lap) and open colon surgery at a publicly funded academic institution.

Methods: Patients undergoing elective laparoscopic or open colon surgery for all indications at the University Health Network, Toronto, Canada, from April 2004 to March 2009 were included. Patient demographic, operative, and outcome data were reviewed retrospectively.

Understanding disposition after referral for bariatric surgery: when and why patients referred do not undergo surgery.

Background: Bariatric surgery is an effective long-term solution for weight loss in the severely obese. Prevalence of bariatric surgery has increased over the recent years; however, the attrition rate of those referred who actually undergo surgery is high. The purpose of this study was to examine patients' attrition rates after referral for bariatric surgery at an academic tertiary care institution.

Feasibility of remote administration of the Fundamentals of Laparoscopic Surgery (FLS) skills test.

Background: Fundamentals of Laparoscopic Surgery (FLS) certification testing currently is offered at accredited test centers or at select surgical conferences. Maintaining these test centers requires considerable investment in human and financial resources. Additionally, it can be challenging for individuals outside North America to become FLS certified.

Linear-stapled gastrojejunostomy with transverse hand-sewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y gastric bypass.

Background: Gastrojejunostomy (GJ) stricture is a common complication after Roux-en-Y gastric bypass (RYGB) for morbid obesity, and the optimal anastomotic technique remains uncertain. The objective of this study was to use cumulative summation (CUSUM) analysis to compare rates of gastrojejunostomy strictures after linear stapling with longitudinal versus transverse enterotomy closure in gastric bypass patients.

Methods: Charts of all consecutive patients with at least 60 days of post-operative follow-up after laparoscopic RYGB (LRYGB) at our tertiary care institution from Nov 2009 to Dec, 2011 were retrospectively reviewed.

The JNK- and AKT/GSK3β- signaling pathways converge to regulate Puma induction and neuronal apoptosis induced by trophic factor deprivation.

The AKT, GSK3 and JNK family kinases have been implicated in neuronal apoptosis associated with neuronal development and several neurodegenerative conditions. However, the mechanisms by which these kinase pathways regulate apoptosis remain unclear. In this study we have investigated the role of these kinases in neuronal cell death using an established model of trophic factor deprivation induced apoptosis in cerebellar granule neurons.

Validation of three virtual reality Fundamentals of Laparoscopic Surgery (FLS) modules.

The Fundamentals of Laparoscopic Surgery (FLS) box trainer is the gold standard for development of laparoscopic technical skills however the scoring metrics require a trained proctor and do not allow for immediate feedback. The Lap Mentor™ virtual-reality (LMVR) FLS tasks, with automated scoring metrics and haptic feedback, may be a suitable alternative. We determined the construct and concurrent validity of LMVR-FLS.

Clinical and economic comparison of laparoscopic to open liver resections using a 2-to-1 matched pair analysis: an institutional experience.

Background: Surgical resection of hepatic lesions is associated with intraoperative and postoperative morbidity and mortality. Our center has introduced a laparoscopic liver resection (LLR) program over the past 3 years. Our objective is to describe the initial clinical experience with LLR, including a detailed cost analysis.

Comparison of outcomes and costs between laparoscopic distal pancreatectomy and open resection at a single center.

Background: The cost implications of laparoscopic distal pancreatectomy (LDP) and a detailed breakdown of hospital expenditures has not been presented in the literature to date. This study aimed to compare hospital costs and short-term clinical outcomes between LDP and open distal pancreatectomy (ODP).

Methods: The authors evaluated all the distal pancreatic resections performed at their center between January 2004 and March 2010.

Monitoring gender equity in health using gender-sensitive indicators: a cross-national study.

Background: As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries.

Methods: Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country.