Realist review to understand the efficacy of culturally appropriate diabetes education programmes.

Aims: Minority populations often face linguistic, cultural and financial barriers to diabetes education and care. The aim was to understand why culturally appropriate diabetes education interventions work, when they work best and for whom they are most effective.

Methods: This review used a critical realist approach to examine culturally appropriate diabetes interventions.

Ascertainment of chronic diseases using population health data: a comparison of health administrative data and patient self-report.

Background: Health administrative data is increasingly being used for chronic disease surveillance. This study explored agreement between administrative and survey data for ascertainment of seven key chronic diseases, using individually linked data from a large population of individuals in Ontario, Canada.

Methods: All adults who completed any one of three cycles of the Canadian Community Health Survey (2001, 2003 or 2005) and agreed to have their responses linked to provincial health administrative data were included.

Facilitating specialist to primary care transfer with tools for transition: a quality of care improvement initiative for patients with type 2 diabetes.

The epidemic of diabetes has increased pressure on the whole spectrum of the healthcare system including specialist centres. The authors' own specialist centre at The Ottawa Hospital has 20,000 annual visits for diabetes, 80% of which are follow-up visits. Since it is a tertiary facility, managers, administrators and clinicians would like to increase their ability to see newly referred patients and decrease the number of follow-up visits.

Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada.

Background: Immigrants make up one fifth of the Canadian population and this number continues to grow. Adequate access to primary health care is important for this population but it is not clear if this is being achieved. This study explored patient reported access to primary health care of a population of immigrants in Ontario, Canada who were users of the primary care system and compared this with Canadian-born individuals; and by model of primary care practice.

The impact of multiple chronic diseases on ambulatory care use; a population based study in Ontario, Canada.

Background: The prevalence of multiple chronic diseases is increasing and is a common problem for primary health care providers. This study sought to determine the patient and health system burden of multiple chronic diseases among adults in Ontario, Canada, with a focus on the ambulatory health care system (outpatient primary health care and specialist services).

Methods: This population-based study used linked health administrative data from Ontario, Canada.

Influence of ankle plantarflexor fatigue on postural sway, lower limb articular angles, and postural strategies during unipedal quiet standing.

The purpose of this study was to investigate the changes in postural control and in posture induced by ankle plantarflexor fatigue during a unipedal stance task. We also studied the postural strategies in the antero-posterior and medio-lateral planes used by participants to maintain balance. Thirteen young adults were asked to stand barefoot on their preferred leg as still as possible for 30s with vision or without vision.

Attentional demands associated with postural control depend on task difficulty and visual condition.

The authors aimed to assess the effect of vision on variations in attentional resources allocated to postural control during tasks of various levels of difficulty. Test-retest reliability of postural and cognitive parameters was also evaluated. Twenty adults stood quietly on a force platform during 30-s trials (primary task).

Navigating change: how outreach facilitators can help clinicians improve patient outcomes.

Objective: The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care.

Methods: We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program.

Results: Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care.

Age equity in different models of primary care practice in Ontario.

Objective: To assess whether the model of service delivery affects the equity of the care provided across age groups.

Design: Cross-sectional study.

Setting: Ontario.

Comparison of primary care models in the prevention of cardiovascular disease - a cross sectional study.

Background: Primary care providers play an important role in preventing and managing cardiovascular disease. This study compared the quality of preventive cardiovascular care delivery amongst different primary care models.

Methods: This is a secondary analysis of a larger randomized control trial, known as the Improved Delivery of Cardiovascular Care (IDOCC) through Outreach Facilitation.

Improved delivery of cardiovascular care (IDOCC) through outreach facilitation: study protocol and implementation details of a cluster randomized controlled trial in primary care.

Background: There is a need to find innovative approaches for translating best practices for chronic disease care into daily primary care practice routines. Primary care plays a crucial role in the prevention and management of cardiovascular disease. There is, however, a substantive care gap, and many challenges exist in implementing evidence-based care.

Factors that influence disclosure of hearing loss in the workplace.

Objective: The objective of the study was to identify factors that lead individuals to conceal or disclose their hearing loss in the workplace.

Design: A qualitative research paradigm called qualitative description was selected to address this issue.

Study Sample: Twelve people who had an adult onset hearing loss, and were gainfully employed, participated in audio-recorded semi-structured interviews designed to probe issues related to disclosure of hearing loss.

Performance feedback: an exploratory study to examine the acceptability and impact for interdisciplinary primary care teams.

Background: This mixed methods study was designed to explore the acceptability and impact of feedback of team performance data to primary care interdisciplinary teams.

Methods: Seven interdisciplinary teams were offered a one-hour, facilitated performance feedback session presenting data from a comprehensive, previously-conducted evaluation, selecting highlights such as performance on chronic disease management, access, patient satisfaction and team function.

Results: Several recurrent themes emerged from participants' surveys and two rounds of interviews within three months of the feedback session.

Effects of ankle and hip muscle fatigue on postural sway and attentional demands during unipedal stance.

The effect of muscle fatigue on quiet standing is equivocal, including its duration/recovery and whether it leads to an increase in attentional demands. The purpose of this study was to assess the effects of ankle and hip muscle fatigue on postural sway and simple reaction time during a unipedal task. Two groups of 14 young adults (mean age=22.

Acute effects of fatigue of the plantarflexor muscles on different postural tasks.

Although the effect of muscle fatigue on posture is apparent, results are inconsistent across studies and this may be due to differences in the fatigue protocol, postural stance used and/or amount of visual information provided. The purpose of this study was to test the hypothesis that fatigue would have a more pronounced effect for more difficult compared with less difficult postural tasks. Twenty-three young adults (mean age 22 ± 3 years) were asked to perform three different postural tasks on a force-platform: feet together, semi-tandem and single-leg stance, before and immediately after fatiguing the plantarflexor muscles.

Seasonal influenza vaccination campaigns for health care personnel: systematic review.

Background: In Canada, vaccination coverage for seasonal influenza among health care personnel remains below 50%. The objective of this review was to determine which seasonal influenza vaccination campaign or campaign components in health care settings were significantly associated with increases in influenza vaccination among staff.

Methods: We identified articles in eight electronic databases and included randomized controlled trials, controlled before-and-after studies and studies with interrupted time series designs in our review.

Community orientation in primary care practices: Results from the Comparison of Models of Primary Health Care in Ontario Study.

Objective: To determine which of 4 organizational models of primary care in Ontario were more community oriented.

Design: Cross-sectional investigation using practice and provider surveys derived from the Primary Care Assessment Tool, with nested qualitative case studies (2 practices per model).

Setting: Thirty-five fee-for-service family practices (including family health groups), 32 health service organizations, 35 family health networks, and 35 community health centres (CHCs) in Ontario.

Getting it all done. Organizational factors linked with comprehensive primary care.

Background: Comprehensiveness, a defining feature of primary care (PC) is associated with patient satisfaction and improved health status. This paper evaluates comprehensive services in fee-for-service (FFS), Health Service Organizations (HSOs), Family Health Networks (FHNs) and Community Health Centres (CHCs) payment models in Ontario.

Objectives: To assess how organizational models of PC differ in the delivery of comprehensive services and which organizational factors predict comprehensive PC delivery.

The Seniors Health Research Transfer Network Knowledge Network Model: system-wide implementation for health and healthcare of seniors.

The Ontario Seniors Health Research Transfer Network (SHRTN) aims to improve the health of older adults through increasing the knowledge capacity of 850 community care agencies and 620 long-term care homes. The SHRTN includes caregivers, researchers, policy makers, administrators, educators, and organizations. The SHRTN comprises communities of practice, a library service, a network of 7 research institutes, and local implementation teams.

Cost-effectiveness of Anticipatory and Preventive multidisciplinary Team Care for complex patients: evidence from a randomized controlled trial.

Objective: To evaluate the cost-effectiveness of Anticipatory and Preventive Team Care (APTCare).

Design: Analysis of data drawn from a randomized controlled trial.

Setting: A family health network in a rural area near Ottawa, Ont.

Mentoring experiences of aging and disability rehabilitation researchers.

Objectives. To explore research mentoring experiences and perceived mentoring needs of aging and disability researchers at different career stages. Design.