Background The annual Scientific Meeting of the Canadian Association on Gerontology was held on O... more Background The annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop. Methods Discussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors. Results Workshop presenters moved from the neuromuscular, biomechanics, and neurology of gait impairments, and falls through the role of cognition and mood on mobility regulation to the whole person in the environment. Research gaps were identified. Conclusions Despite a consensus that mobility and cognition are increasingly correlated as people age, several gaps in our understanding of mechanisms and how to assess the interaction were recognized. The gaps originally identified in 2008 are still pertinent today. Common and standardized assessments ...
Canadian Journal on Aging / La Revue canadienne du vieillissement, 2015
RÉSUMÉLes octogénaires qui habitent aux communautés sont la caractéristique la plus croissante da... more RÉSUMÉLes octogénaires qui habitent aux communautés sont la caractéristique la plus croissante dans la démographie du Canada. Au même temps, ils ont la plus forte prévalence des chutes et neuf fois plus de risques de blessures dues à une chute [par rapport a qui]? Une approche systématique est essentielle pour améliorer la sécurité des octogenaires qui vieillissent en place (chez soi). Comprendre comment les facteurs sociaux interagissent et affectent les aînés peuvent aider à identifier et éliminer les carences en matière de sécurité qui provoquent des chutes. Le but de cette étude était d'identifier les facteurs dans l'ensemble du système qui contribuent aux chutes chez les octogénaires qui habitent aux communautés. Huit chutes ont été étudiées en utilisant une méthode systématique d'examiner les chutes (MSEC). Les participants étaient âgés de 83 à 90 ans. Les analyses à travers des cas ont identifiées 247 facteurs contributifs, regroupés au sein de quatre thèmes disti...
American journal of Alzheimer's disease and other dementias, Jan 18, 2015
While much of the literature on caregiver burden has focused on caregiving for people living with... more While much of the literature on caregiver burden has focused on caregiving for people living with Alzheimer's disease (AD) there is little information on the experience of caring for a loved one living with amnestic Mild Cognitive Impairment (aMCI), the group most likely to convert to AD. A hermeneutic phenomenological approach was used to understand the organizing principles that give experiences of being form and meaning in the lifeworld. Study findings highlight the precarious nature of caregiver role acquisition and the heterogeneity that is present among informal care providers. Specifically, the findings suggest that the wearing of multiple situational masks is required by the carer to cope with accumulated progressive losses suffered as they continually adjust to their new and evolving carer identity. Support groups specific to the carers of those living with aMCI are needed in an effort to remove these masks and to validate this unique caregiving experience.
Background: The increasing number of falls in hospitals precipitates the need to collect and anal... more Background: The increasing number of falls in hospitals precipitates the need to collect and analyze falls data. Hospital falls data have been captured through staff documentation and incident reporting systems. Objective: The purpose of this study was to identify the variables associated with falls and injurious falls in an acute care hospital over the five years from the implementation of the Adverse Event Management System (AEMS). A secondary purpose was to identify problems associated with the AEMS.Methods: Falls data recorded in the AEMS system from February 2009 to February 2014 were analyzed to observe trends of falls and contributing factors occurring in various hospital units.Results: A total of 7,721 falls occurred during the study period. The highest frequency of the falls (901) occurred between 10:00 a.m. and 12:00 p.m. There were 2,275 falls which resulted in an injury. Both total fall and injurious fall rates were highest in Medicine inpatient units and lowest in Ambul...
A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcar... more A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures. Specific objectives of this literature review include: summarising definitions of safety culture and safety climate, identifying theories, dimensions and measures of safety culture in healthcare, and reviewing progress in improving safety culture. Peer-reviewed, English-language articles published from 1980 to 2009 pertaining to safety culture in healthcare were reviewed. One hundred and thirty-nine studies were included in this review. Results suggest that there is disagreement among researchers as to how safety culture should be defined, as well as whether or not safety culture is intrinsically diverse from the concept of safety climate. This variance extends into the dimensions and measurement of safety culture, and interventions to influence culture change. Most studies utilise quantitative surveys to measure safety culture, and propose improvements in safety by implementing multifaceted interventions targeting several dimensions. Conversely, very few studies made their theoretical underpinnings explicit. Moving forward, a common set of definitions and dimensions will enable researchers to better share information and strategies to improve safety culture in healthcare, building momentum in this rapidly expanding field. Advancing the measurement of safety culture to include both quantitative and qualitative methods should be further explored. Using the expertise of traditional culture experts, anthropologists, more in-depth observational and longitudinal research is needed to move research in this area forward.
The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique, 2005
Buspirone, a 5HT-agonist and D2-dopamine antagonist/agonist, has modest beneficial effects in you... more Buspirone, a 5HT-agonist and D2-dopamine antagonist/agonist, has modest beneficial effects in younger individuals with cerebellar ataxia. However, it is unclear whether it is beneficial and tolerable in older ataxic individuals. To determine if an older individual with cerebellar ataxia would benefit from and tolerate buspirone. We performed a single-subject, double-blinded, placebo-controlled randomized-phase study. The 80 year-old subject was to undergo six 4-week testing periods, divided randomly into three treatment and three placebo arms with a 2-week washout period between each arm. Treatment consisted of buspirone hydrochloride. Outcomes were clinical gait and balance testing, posturography testing, and subjective measurement of balance confidence. There were no statistically significant objective improvements with buspirone. The subject experienced a subjective improvement in balance confidence and tolerated treatment. Single-subject studies can help when it is unclear wheth...
Attempts to increase dive height by introducing a period of flight in the final approach step pre... more Attempts to increase dive height by introducing a period of flight in the final approach step preceding the hurdle of dives from forward and reverse groups were investigated. One study involved 11 collegiate-level divers experienced in both traditional and hurdle preflight techniques. In a second study, dives executed by 9 national-level women were compared. Dives with a hurdle preflight had shorter final approach steps and greater hurdle flight durations. Flight time differences in favor of hurdle preflight techniques diminished from final approach step through hurdle flight to dive flight. Although the collegiate-level divers had longer dive flight times when using a hurdle preflight, it was suggested that the costs of these techniques may outweigh their potential benefits.
To compare the original and reduced versions of the Berg Balance Scale (BBS) and the Western Onta... more To compare the original and reduced versions of the Berg Balance Scale (BBS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as completed by patients following total hip arthroplasty (THA) or total knee arthroplasty (TKA), with respect to their potential utility in clinical and research settings. Patients with THA (n=26) or TKA (n=28) were evaluated before and after 5 to 7 weeks' participation in a home-based exercise programme. They were assessed using the original versions of the BBS and the WOMAC; scores for the reduced versions of the BBS and the WOMAC were extracted from the original versions. Good to excellent correlations (r≥0.80) were observed between the original and the reduced versions of the BBS and the WOMAC. The index of responsiveness, evaluated using standardized response means (SRM), was similar for the original and the reduced versions of the BBS and the WOMAC function sub-scale. The reduced versions of the BBS and the WOMAC provided similar information to the original versions and were equally responsive. These reduced versions comprise fewer questions and may be completed in considerably less time, which suggests that they may be advantageous for clinical and research use.
Background The annual Scientific Meeting of the Canadian Association on Gerontology was held on O... more Background The annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop. Methods Discussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors. Results Workshop presenters moved from the neuromuscular, biomechanics, and neurology of gait impairments, and falls through the role of cognition and mood on mobility regulation to the whole person in the environment. Research gaps were identified. Conclusions Despite a consensus that mobility and cognition are increasingly correlated as people age, several gaps in our understanding of mechanisms and how to assess the interaction were recognized. The gaps originally identified in 2008 are still pertinent today. Common and standardized assessments ...
Canadian Journal on Aging / La Revue canadienne du vieillissement, 2015
RÉSUMÉLes octogénaires qui habitent aux communautés sont la caractéristique la plus croissante da... more RÉSUMÉLes octogénaires qui habitent aux communautés sont la caractéristique la plus croissante dans la démographie du Canada. Au même temps, ils ont la plus forte prévalence des chutes et neuf fois plus de risques de blessures dues à une chute [par rapport a qui]? Une approche systématique est essentielle pour améliorer la sécurité des octogenaires qui vieillissent en place (chez soi). Comprendre comment les facteurs sociaux interagissent et affectent les aînés peuvent aider à identifier et éliminer les carences en matière de sécurité qui provoquent des chutes. Le but de cette étude était d'identifier les facteurs dans l'ensemble du système qui contribuent aux chutes chez les octogénaires qui habitent aux communautés. Huit chutes ont été étudiées en utilisant une méthode systématique d'examiner les chutes (MSEC). Les participants étaient âgés de 83 à 90 ans. Les analyses à travers des cas ont identifiées 247 facteurs contributifs, regroupés au sein de quatre thèmes disti...
American journal of Alzheimer's disease and other dementias, Jan 18, 2015
While much of the literature on caregiver burden has focused on caregiving for people living with... more While much of the literature on caregiver burden has focused on caregiving for people living with Alzheimer's disease (AD) there is little information on the experience of caring for a loved one living with amnestic Mild Cognitive Impairment (aMCI), the group most likely to convert to AD. A hermeneutic phenomenological approach was used to understand the organizing principles that give experiences of being form and meaning in the lifeworld. Study findings highlight the precarious nature of caregiver role acquisition and the heterogeneity that is present among informal care providers. Specifically, the findings suggest that the wearing of multiple situational masks is required by the carer to cope with accumulated progressive losses suffered as they continually adjust to their new and evolving carer identity. Support groups specific to the carers of those living with aMCI are needed in an effort to remove these masks and to validate this unique caregiving experience.
Background: The increasing number of falls in hospitals precipitates the need to collect and anal... more Background: The increasing number of falls in hospitals precipitates the need to collect and analyze falls data. Hospital falls data have been captured through staff documentation and incident reporting systems. Objective: The purpose of this study was to identify the variables associated with falls and injurious falls in an acute care hospital over the five years from the implementation of the Adverse Event Management System (AEMS). A secondary purpose was to identify problems associated with the AEMS.Methods: Falls data recorded in the AEMS system from February 2009 to February 2014 were analyzed to observe trends of falls and contributing factors occurring in various hospital units.Results: A total of 7,721 falls occurred during the study period. The highest frequency of the falls (901) occurred between 10:00 a.m. and 12:00 p.m. There were 2,275 falls which resulted in an injury. Both total fall and injurious fall rates were highest in Medicine inpatient units and lowest in Ambul...
A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcar... more A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures. Specific objectives of this literature review include: summarising definitions of safety culture and safety climate, identifying theories, dimensions and measures of safety culture in healthcare, and reviewing progress in improving safety culture. Peer-reviewed, English-language articles published from 1980 to 2009 pertaining to safety culture in healthcare were reviewed. One hundred and thirty-nine studies were included in this review. Results suggest that there is disagreement among researchers as to how safety culture should be defined, as well as whether or not safety culture is intrinsically diverse from the concept of safety climate. This variance extends into the dimensions and measurement of safety culture, and interventions to influence culture change. Most studies utilise quantitative surveys to measure safety culture, and propose improvements in safety by implementing multifaceted interventions targeting several dimensions. Conversely, very few studies made their theoretical underpinnings explicit. Moving forward, a common set of definitions and dimensions will enable researchers to better share information and strategies to improve safety culture in healthcare, building momentum in this rapidly expanding field. Advancing the measurement of safety culture to include both quantitative and qualitative methods should be further explored. Using the expertise of traditional culture experts, anthropologists, more in-depth observational and longitudinal research is needed to move research in this area forward.
The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique, 2005
Buspirone, a 5HT-agonist and D2-dopamine antagonist/agonist, has modest beneficial effects in you... more Buspirone, a 5HT-agonist and D2-dopamine antagonist/agonist, has modest beneficial effects in younger individuals with cerebellar ataxia. However, it is unclear whether it is beneficial and tolerable in older ataxic individuals. To determine if an older individual with cerebellar ataxia would benefit from and tolerate buspirone. We performed a single-subject, double-blinded, placebo-controlled randomized-phase study. The 80 year-old subject was to undergo six 4-week testing periods, divided randomly into three treatment and three placebo arms with a 2-week washout period between each arm. Treatment consisted of buspirone hydrochloride. Outcomes were clinical gait and balance testing, posturography testing, and subjective measurement of balance confidence. There were no statistically significant objective improvements with buspirone. The subject experienced a subjective improvement in balance confidence and tolerated treatment. Single-subject studies can help when it is unclear wheth...
Attempts to increase dive height by introducing a period of flight in the final approach step pre... more Attempts to increase dive height by introducing a period of flight in the final approach step preceding the hurdle of dives from forward and reverse groups were investigated. One study involved 11 collegiate-level divers experienced in both traditional and hurdle preflight techniques. In a second study, dives executed by 9 national-level women were compared. Dives with a hurdle preflight had shorter final approach steps and greater hurdle flight durations. Flight time differences in favor of hurdle preflight techniques diminished from final approach step through hurdle flight to dive flight. Although the collegiate-level divers had longer dive flight times when using a hurdle preflight, it was suggested that the costs of these techniques may outweigh their potential benefits.
To compare the original and reduced versions of the Berg Balance Scale (BBS) and the Western Onta... more To compare the original and reduced versions of the Berg Balance Scale (BBS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as completed by patients following total hip arthroplasty (THA) or total knee arthroplasty (TKA), with respect to their potential utility in clinical and research settings. Patients with THA (n=26) or TKA (n=28) were evaluated before and after 5 to 7 weeks' participation in a home-based exercise programme. They were assessed using the original versions of the BBS and the WOMAC; scores for the reduced versions of the BBS and the WOMAC were extracted from the original versions. Good to excellent correlations (r≥0.80) were observed between the original and the reduced versions of the BBS and the WOMAC. The index of responsiveness, evaluated using standardized response means (SRM), was similar for the original and the reduced versions of the BBS and the WOMAC function sub-scale. The reduced versions of the BBS and the WOMAC provided similar information to the original versions and were equally responsive. These reduced versions comprise fewer questions and may be completed in considerably less time, which suggests that they may be advantageous for clinical and research use.
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