Why national health research systems matter

Some of the most outstanding problems in Computer Science (e.g. access to heterogeneous information sources, use of different e-commerce standards, ontology translation, etc.) are often approached through the identification of ontology mappings. A manual mapping generation slows down, or even makes unfeasible, the solution of particular cases of the aforementioned problems via ontology mappings. Some algorithms and formal models for partial tasks of automatic generation of mappings have been proposed. However, an integrated system to solve this problem is still missing. In this paper, we present AMON, a platform for automatic ontology mapping generation. First of all, we show the general structure. Then, we describe the current version of the system, including the ontology in which it is based, the similarity measures that it uses, the access to external sources, etc

Improving the Implementation of the Acute Care Nurse Practitioner (ACNP) Role: Development of ACNP Role Implementation Guidelines

With the implementation of the Patient Protection and Affordable Care Act (PPACA) and the Value Based Purchasing (VBP) initiative, hospitals and the health System have rolled out a strategic goals of focusing on meeting the VBP objectives and standardizing care within their hospitals. To help meet these goals and improve patient care, many hospitals have looked toward the implementation of the acute care nurse practitioner (ACNP) role in the hospital setting. There is a lack of guidelines, though, on how to implement the ACNP role. This has led to several barriers, which have created variation in practice and outcomes across the hospital settings. The aim of this project is to improve the implementation of the ACNP role in the hospitals and health system through the development of “ACNP Role Implementation Guidelines” for administrators and nurse practitioners

Linking Psychological Capital, Structural Empowerment and Perceived Staffing Adequacy to New Graduate Nurses\u27 Job Satisfaction

Reports indicate that new graduate nurses (NGNs) are experiencing stressful work environments, affecting job satisfaction and retention in current positions. New nurses are a health human resource that must be retained in order to ensure the replacement of retiring nurses, and to address impending shortages. As a result, creating supportive work environments that promote NGNs’ job satisfaction may play an important role in the retention and recruitment of skilled, satisfied nursing staff. The purpose of this study was to test the relationships between new graduates’ self-reported psychological capital (PsyCap), access to empowerment structures, perceptions of staffing adequacy and job satisfaction. A secondary analysis of data collected using a non-experimental predictive survey design was conducted on a sample of 205 NGN’s working in the province of Ontario. Hierarchical multiple regression was used to test the study hypothesis. Results indicated that PsyCap, structural empowerment and perceptions of adequate nurse staffing were significant independent predictors of NGNs’ job satisfaction (β= .38, β= .50 and β=.17 respectively), explaining 41% of the total variance. Study findings suggest that support for personal and structural resources in the workplace will enhance overall job satisfaction in new nurses

Public Spending on Health Services and Policy Research in Canada: A Reflection on Thakkar and Sullivan; Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

Vidhi Thakkar and Terrence Sullivan have done a careful and thought-provoking job in trying to establish comparable estimates of public spending on health services and policy research (HSPR) in Canada, the United Kingdom and the United States. Their main recommendation is a call for an international collaboration to develop common terms and categories of HSPR. This paper raises two additional questions that have an international comparative dimension: There is little doubt that public spending on HSPR represents more than the “tip of the iceberg,” but how much more? And how do the countries fare on the uptake of HSPR by decision-makers? I have long speculated that probably as much or more is spent by provincial/territorial governments, regional health authorities, hospitals and other agencies on HSPR activities carried out by consultants in Canada than by the federal, provincial/territorial granting agencies. Support for this contention is provided in a paper by Penno and Gauld on spending on external consultancies by New Zealand’s District Health Boards (DHBs). Their estimate of the amount spent on consultancies in 2014/15 represents 80% of the amount spent on research by the Health Research Council of New Zealand in 2015. In terms of the uptake of research Jonathan Lomas pioneered the concept of linking researchers with decisionmakers when he became the founding Chief Executive Officer (CEO) of the Canadian Health Services Research Foundation (CHSRF) in 1997. An early assessment was promising, and it would be interesting to know if other countries have tried this. Most assessments of research uptake and impact are short-term in nature. It might be insightful to assess HSPR developments over the long term, such as prospective reimbursement through diagnosis related groups (DRGs) that has been evolving internationally for more 40+ years. In the short term the prospects for a major infusion of funding in HSPR in Canada are not promising, although there have been welcome investments in the Canadian Foundation for Healthcare Improvement (formerly CHSRF)

Health Care in Rural Communities: Exploring the Development of Informal and Voluntary Care

Nation-state restructuring has resulted in significant political, economic and social change in rural communities. One manifestation of this transformation has been the changing nature of local governance, characterised by the re-working of central-local relations and public- private responsibilities, such that local informal and voluntary sectors now play an active and direct role in the organisation and delivery of health care services. This paper investigates the relationship between the changing nature of local governance and the provision of health care services, and places it within the context of rural communities and population aging in Canada. In particular, it considers the ascendancy of informal and voluntary sectors with respect to homecare in rural Ontario, and features an analysis of data from the National Population Health Survey and the National Survey of Giving, Volunteering and Participating, representing user (demand) and provider (supply) perspectives respectively. The results provide a cross-section of informal and voluntary home care in the late 1990s, which indicates that informal and voluntary sectors are major players in the local organisation and delivery of health care services in rural communities. This suggests that the current state of health care provision in rural communities of Ontario is affected very much by the changing nature of local governance associated with restructuring. The 'snap-shot' of health care in rural communities presented in this paper highlights the need to examine further the relationship between governance and health care services at the local level. It also points to the need for more detailed data sets that integrate health, informal and voluntary care data at meaningful geographical and administrative scales to reflect clearly rural communities in Canada.health care; rural communities

Public Spending on Health Services and Policy Research in Canada: A Reflection on Thakkar and Sullivan Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”

Abstract Vidhi Thakkar and Terrence Sullivan have done a careful and thought-provoking job in trying to establish comparable estimates of public spending on health services and policy research (HSPR) in Canada, the United Kingdom and the United States. Their main recommendation is a call for an international collaboration to develop common terms and categories of HSPR. This paper raises two additional questions that have an international comparative dimension: There is little doubt that public spending on HSPR represents more than the “tip of the iceberg,” but how much more? And how do the countries fare on the uptake of HSPR by decision-makers? I have long speculated that probably as much or more is spent by provincial/territorial governments, regional health authorities, hospitals and other agencies on HSPR activities carried out by consultants in Canada than by the federal, provincial/territorial granting agencies. Support for this contention is provided in a paper by Penno and Gauld on spending on external consultancies by New Zealand’s District Health Boards (DHBs). Their estimate of the amount spent on consultancies in 2014/15 represents 80% of the amount spent on research by the Health Research Council of New Zealand in 2015. In terms of the uptake of research Jonathan Lomas pioneered the concept of linking researchers with decisionmakers when he became the founding Chief Executive Officer (CEO) of the Canadian Health Services Research Foundation (CHSRF) in 1997. An early assessment was promising, and it would be interesting to know if other countries have tried this. Most assessments of research uptake and impact are short-term in nature. It might be insightful to assess HSPR developments over the long term, such as prospective reimbursement through diagnosis related groups (DRGs) that has been evolving internationally for more 40+ years. In the short term the prospects for a major infusion of funding in HSPR in Canada are not promising, although there have been welcome investments in the Canadian Foundation for Healthcare Improvement (formerly CHSRF)

Hypertension control: results from the Diabetes Care Program of Nova Scotia registry and impact of changing clinical practice guidelines

BACKGROUND: The objective of this study was to determine the rate of blood pressure control according to 4 sets of Canadian guidelines published over a decade in patients with diabetes mellitus attending Diabetes Centres in the province of Nova Scotia. METHODS: One hundred randomly selected charts from each of 13 Diabetes Centres audited between 1997 and 2001 were extracted from the Diabetes Care Program of Nova Scotia Registry. Multivariate logistic regression analyses examined the relationship between individual characteristics and self-reported antihypertensive use. Included were 1132 adults, mean age 63 years (48% male), with 9 years mean time since diagnosis of diabetes. RESULTS: According to the 1992 guidelines, 63% of the patients and according to the 2003 guidelines, 84% of patients were above target blood pressure or receiving antihypertensive medications. Forty-seven percent of patients are considered to be hypertensive and not on treatment according to 2003 guidelines. The results of the multivariate analyses showed that the only factors independently associated with anti-hypertensive use was oral anti-hyperglycemic use. CONCLUSION: Hypertension is an additional risk factor in those with diabetes mellitus for macrovascular and microvascular complications. The health and budgetary impacts of addressing the treatment gap need to be further explored