Sustaining and spreading quality improvement: Decreasing intrapartum malpractice risk.

Background: Malpractice liability is an ongoing problem in obstetrics. However, developing, sustaining, and spreading effective interventions is challenging. The aim of this study is to examine the spread and sustainability of a multilevel integrated practice and coordinated communication model 66 months after its original implementation.

Mental health problems in people living with HIV: changes in the last two decades: the London experience 1990-2014.

Mental health problems continue to be a significant comorbidity for people with HIV infection, even in the era of effective antiretroviral therapy. Here, we report on the changes in the mental health diagnoses based on clinical case reports amongst people with HIV referred to a specialist psychological medicine department over a 24-year period, which include the relative increase in depressive and anxiety disorders, often of a chronic nature, together with a decline in acute mental health syndromes, mania, and organic brain disorders. In addition, new challenges, like the presence of HIV and Hepatitis C co-infection, and the new problems created by recreational drugs, confirm the need for mental health services to be closely involved with the general medical services.

Documentation of daily sit-to-stands performed by community-dwelling adults.

No information exists about how many sit-to-stands (STSs) are performed daily by community-dwelling adults. We, therefore, examined the feasibility of using a tally counter to document daily STSs, documented the number of daily STSs performed, and determined if the number of STSs was influenced by demographic or health variables. Ninety-eight community-dwelling adults (19-84 years) agreed to participate.

Functional mobility training for individuals admitted to acute care following a stroke: a prospective study.

Purpose: This study describes current stroke care within hospital acute care settings.

Method: Twenty-two acute care hospital sites in Central South Ontario were mailed a survey exploring the prevalence of stroke admissions, use of protocols and policies, staff resources, stroke-specific training, and available equipment. Corresponding site data from the Canadian Institute for Health Information were also analyzed.

Comparing 2 versions of the Chedoke Arm and Hand Activity Inventory with the Action Research Arm Test.

Background And Purpose: The Chedoke Arm and Hand Activity Inventory (CAHAI) is a new, validated upper-limb measure that uses a 7-point quantitative scale in order to assess functional recovery of the arm and hand after a stroke. The purposes of this study were: (1) to determine whether the longitudinal validity of scores on 2 versions of a new upper-limb measure, the CAHAI (CAHAI-9 and CAHAI-13), was greater than that of scores on the Action Research Arm Test (ARAT) and (2) to determine whether the cross-sectional and longitudinal validity of the CAHAI-13 scores was greater than that of the CAHAI-9 scores.

Subjects: One hundred five people with upper-limb dysfunction following a stroke were stratified into 2 impairment groups (mild to moderate and severe), which were expected to change by different amounts.

Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke.

Objectives: To estimate the test-retest reliability and validity of the Chedoke Arm and Hand Activity Inventory (CAHAI) and to test whether the CAHAI was more sensitive to change in upper-limb function than the Impairment Inventory of the Chedoke-McMaster Stroke Assessment (CMSA) and the Action Research Arm Test (ARAT).

Design: Construct validation process.

Setting: Inpatient/outpatient rehabilitation facilities.

Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection.

The Chedoke Arm and Hand Activity Inventory (CAHAI) was developed to address the need for a valid, clinically relevant, responsive functional assessment of the recovering paretic upper limb. The purpose of this article is to describe the development of the measure including its theoretical constructs, item generation, and item selection. From the literature, survivors of stroke, and their caregivers, 751 items were generated.