The feasibility of assessing swallowing physiology following prolonged intubation after cardiovascular surgery.

Background: Dysphagia following prolonged intubation after cardiovascular (CV) surgery is common occurring in 67% of patients; however, this population's swallowing physiology has never been prospectively evaluated using standardized methods. Hence, prior to conducting a larger study, our primary objective was to determine the feasibility of assessing swallowing physiology using instrumentation and validated interpretation methods in cardiovascular surgical patients following prolonged intubation.

Method: From July to October 2011, we approached adults undergoing CV surgery at our institution who were intubated > 48 h.

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

Background: Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences.

Facilitated interprofessional implementation of a physical rehabilitation guideline for stroke in inpatient settings: process evaluation of a cluster randomized trial.

Background: The Stroke Canada Optimization of Rehabilitation by Evidence-Implementation Trial (SCORE-IT) showed that a facilitated knowledge translation (KT) approach to implementing a stroke rehabilitation guideline was more likely than passive strategies to improve functional walking capacity, but not gross manual dexterity, among patients in rehabilitation hospitals. This paper presents the results of a planned process evaluation designed to assess whether the type and number of recommended treatments implemented by stroke teams in each group would help to explain the results related to patient outcomes.

Methods: As part of a cluster randomized trial, 20 rehabilitation units were stratified by language and allocated to a facilitated or passive KT intervention group.

Thank you for asking: Exploring patient perceptions of barcode medication administration identification practices in inpatient mental health settings.

Background: Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings.

Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial.

Background: The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extremity function, postural control, and mobility. Twenty rehabilitation centers across Canada were randomly assigned to either the facilitated or passive KT intervention. The objective of the current study was to understand the factors influencing the implementation of the recommended treatments and KT interventions from the perspective of nurses, occupational therapists and physical therapists, and clinical managers following completion of the trial.

"We are all there for the same purpose": Support for an integrated community exercise program for older adults with HF and COPD.

Background: Despite well-established improvements following rehabilitation, functional gains often diminish following discharge.

Objective: To explore the attitudes of older adults with HF and COPD, who have completed rehabilitation, toward community-based exercise maintenance.

Methods: Semi-structured interviews were conducted with 11 individuals with HF or COPD.

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases.

Methods for designing interventions to change healthcare professionals' behaviour: a systematic review.

Background: Systematic reviews consistently indicate that interventions to change healthcare professional (HCP) behaviour are haphazardly designed and poorly specified. Clarity about methods for designing and specifying interventions is needed. The objective of this review was to identify published methods for designing interventions to change HCP behaviour.

AIMD - a validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies.

Background: Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery].

Involving members of vulnerable populations in the development of patient decision aids: a mixed methods sequential explanatory study.

Background: Patient decision aids aim to present evidence relevant to a health decision in understandable ways to support patients through the process of making evidence-informed, values-congruent health decisions. It is recommended that, when developing these tools, teams involve people who may ultimately use them. However, there is little empirical evidence about how best to undertake this involvement, particularly for specific populations of users such as vulnerable populations.

Does the degree of linguistic experience (native versus nonnative) modulate the degree to which listeners can benefit from a delay between the onset of the maskers and the onset of the target speech?

Background noise has a greater adverse effect on word recognition when people are listening in their second language (L2) as opposed to their first language (L1). The present study investigates the extent to which linguistic experience affects the ability of L2 listeners to benefit from a delay between the onset of a masker and the onset of a word. In a previous study (Ben-David, Tse & Schneider, 2012), word recognition thresholds for young L1s were found to improve with the increase in the delay between the onset of a masker (either a stationary noise or a babble of voices) and the onset of a word.

A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation.

Background: Despite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills.

Evaluation of a training program for medicines-oriented policymakers to use a database of systematic reviews.

Background: Suboptimal prescribing and medications use is a problem for health systems globally. Systematic reviews are a comprehensive resource that can help guide evidence-informed decision-making and implementation of interventions addressing such issues; however, a barrier to the use of systematic reviews is their inaccessibility (due to both dispersion across journals and inaccessibility of content). Publicly available databases, such as Rx for Change, provide quick access to summaries of appraised systematic reviews of professional and consumer-oriented interventions to improve prescribing behaviour and appropriate medication use, and may help maximise the use of evidence to inform decisions.

Low-trauma fractures and bone mineral density testing in adults with and without intellectual and developmental disabilities: a population study.

Unlabelled: Individuals with intellectual and developmental disabilities (IDD) are at risk for low-trauma fractures. We investigated the rate of low-trauma fractures and the odds of BMD testing in adults with/without IDD. Adults with IDD were more likely to have a low-trauma fracture, but there was no difference in bone mineral density (BMD) testing rates.

Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

Background: Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g.

Development of training for medicines-oriented policymakers to apply evidence.

Background: Health systems globally promote appropriate prescribing by healthcare providers and safe and effective medicine use by consumers. Rx for Change, a publicly available database, provides access to systematic reviews regarding best practices for prescribing and using medicines. Despite the value of the database for improving prescribing and medicine use, its use remains suboptimal.

Predicting the role of assistive technologies in the lives of people with dementia using objective care recipient factors.

Background: The population of people with dementia is not homogeneous. People with dementia exhibit a wide range of needs, each characterized by diverse factors including age, sex, ethnicity, and place of residence. These needs and characterizing factors may influence the applicability, and ultimately the acceptance, of assistive technologies developed to support the independence of people with dementia.

The Risk of Sleep Disorder Among Persons with Mild Traumatic Brain Injury.

Sleep disorders and mild traumatic brain injury (mTBI) are among the most commonly occurring neurological problems clinicians encounter simultaneously. Each can cause the other, and both share common predisposing factors. An important question that remains to be addressed is whether high-risk groups can be defined.

Meaning of self-management from the perspective of individuals with traumatic spinal cord injury, their caregivers, and acute care and rehabilitation managers: an opportunity for improved care delivery.

Background: The trend of decreasing length of stay in rehabilitation facilities has led to individuals with spinal cord injury (SCI) entering the community with unmet needs and fewer self-care skills to prevent secondary complications. The implementation of a self-management program for individuals with SCI for the management of these complex needs, including secondary complications, may be one option to fill these care gaps. A greater understanding of the meaning of self-management may facilitate the development of a tailored self-management program in this population.

Facilitating Community-Based Exercise for People With Stroke: Cross-Sectional e-Survey of Physical Therapist Practice and Perceived Needs.

Background: Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement.

Objective: The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice.

Design: A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted.

Factors Influencing Physical Therapists' Use of Standardized Measures of Walking Capacity Poststroke Across the Care Continuum.

Background: The use of standardized assessment tools is an element of evidence-informed rehabilitation, but physical therapists report administering these tools inconsistently poststroke. An in-depth understanding of physical therapists' approaches to walking assessment is needed to develop strategies to advance assessment practice.

Objectives: The objective of this study was to explore the methods physical therapists use to evaluate walking poststroke, reasons for selecting these methods, and the use of assessment results in clinical practice.

The effect of prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement on swallowing and swallow-related outcomes in patients undergoing radiotherapy for head and neck cancer: a systematic review.

Patients undergoing radiotherapy for head and neck cancer (HNC) often experience malnutrition and dehydration during treatment. As a result, some centres place PEG tubes prophylactically (pPEG) to prevent these negative consequences. However, recent research has suggested that pPEG use may negatively affect swallowing physiology, function and/or quality of life, especially in the long term.

Visual speech gestures modulate efferent auditory system.

Visual and auditory systems interact at both cortical and subcortical levels. Studies suggest a highly context-specific cross-modal modulation of the auditory system by the visual system. The present study builds on this work by sampling data from 17 young healthy adults to test whether visual speech stimuli evoke different responses in the auditory efferent system compared to visual non-speech stimuli.

Views of people with traumatic spinal cord injury about the components of self-management programs and program delivery: a Canadian pilot study.

Background: Given the increasing emphasis on the community management of spinal cord injury (SCI), strategies that could be developed and implemented in order to empower and engage individuals with SCI in promoting their health and minimizing the risk of health conditions are required. A self-management program could be one approach to address these complex needs, including secondary complications. Thus, the objective of this study was to determine the importance attributed to the components of a self-management program by individuals with traumatic SCI and explore their views/opinions about the delivery of such a program.

Stroke survivors', caregivers', and health care professionals' perspectives on the weekend pass to facilitate transition home.

Objective: To explore stroke survivors', caregivers', and health care professionals' perceptions of weekend passes offered during inpatient rehabilitation and its role in facilitating the transition home.

Design: Qualitative descriptive.

Subjects: Sixteen stroke survivors, 15 caregivers, and 20 health care professionals' from a rehabilitation hospital.