Home care utilization and outcomes among Asian and other Canadian patients with heart failure

Article deposited according to publisher policy posted on SHERPA/RoMEO, 16/08/2010.YesFunding provided by the Open Access Authors Fund

Data enhancement for co-morbidity measurement among patients referred for sleep diagnostic testing: an observational study

<p>Abstract</p> <p>Background</p> <p>Observational outcome studies of patients with obstructive sleep apnea (OSA) require adjustment for co-morbidity to produce valid results. The aim of this study was to evaluate whether the combination of administrative data and self-reported data provided a more complete estimate of co-morbidity among patients referred for sleep diagnostic testing.</p> <p>Methods</p> <p>A retrospective observational study of 2149 patients referred for sleep diagnostic testing in Calgary, Canada. Self-reported co-morbidity was obtained with a questionnaire; administrative data and validated algorithms (when available) were also used to define the presence of these co-morbid conditions within a two-year period prior to sleep testing.</p> <p>Results</p> <p>Patient self-report of co-morbid conditions had varying levels of agreement with those derived from administrative data, ranging from substantial agreement for diabetes (κ = 0.79) to poor agreement for cardiac arrhythmia (κ = 0.14). The enhanced measure of co-morbidity using either self-report or administrative data had face validity, and provided clinically meaningful trends in the prevalence of co-morbidity among this population.</p> <p>Conclusion</p> <p>An enhanced measure of co-morbidity using self-report and administrative data can provide a more complete measure of the co-morbidity among patients with OSA when agreement between the two sources is poor. This methodology will aid in the adjustment of these coexisting conditions in observational studies in this area.</p

Translating research in elder care: an introduction to a study protocol series

<p>Abstract</p> <p>Background</p> <p>The knowledge translation field is undermined by two interrelated gaps – underdevelopment of the science and limited use of research in health services and health systems decision making. The importance of context in theory development and successful translation of knowledge has been identified in past research. Additionally, examination of knowledge translation in the long-term care (LTC) sector has been seriously neglected, despite the fact that aging is increasingly identified as a priority area in health and health services research.</p> <p>Aims</p> <p>The aims of this study are: to build knowledge translation theory about the role of organizational context in influencing knowledge use in LTC settings and among regulated and unregulated caregivers, to pilot knowledge translation interventions, and to contribute to enhanced use of new knowledge in LTC.</p> <p>Design</p> <p>This is a multi-level and longitudinal program of research comprising two main interrelated projects and a series of pilot studies. An integrated mixed method design will be used, including sequential and simultaneous phases to enable the projects to complement and inform one another. Inferences drawn from the quantitative and qualitative analyses will be merged to create meta-inferences.</p> <p>Outcomes</p> <p>Outcomes will include contributions to (knowledge translation) theory development, progress toward resolution of major conceptual issues in the field, progress toward resolution of methodological problems in the field, and advances in the design of effective knowledge translation strategies. Importantly, a better understanding of the contextual influences on knowledge use in LTC will contribute to improving outcomes for residents and providers in LTC settings.</p

In vivo imaging of enamel by reflectance confocal microscopy (RCM): non-invasive analysis of dental surface

The aim is to establish the feasibility to image in vivo microscopic dental surface by non-invasive, real-time, en face Reflectance Confocal Microscopy (RCM). Fifteen healthy volunteers referred at the Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy, were enrolled. A commercially available hand-held RCM (Vivascope(®)3000, Lucid, Rochester, NY, USA) was used to image in vivo the dental surface of the upper right and left central incisors of each volunteer. Totally, thirty vestibular surfaces of upper central incisors were imaged in vivo by RCM to preliminary image the dental surface and assess the feasibility of a more extended study on teeth. In vivo RCM was able to image the dental surface within the enamel, at a maximum depth imaging of 300 μm, with images good in quality and the capability to detect enamel structures such as enamel lamellae and enamel damages, such as unevenness and cracks. In conclusion, enamel "optical biopsy", gained by RCM imaging, revealed to be a non-invasive real-time tool valid to obtain architectural details of the dental surface with no need for extraction or processing the samples. RCM appears to be an optimum auxiliary device for investigating the architectural pattern of superficial enamel, therefore inviting further experiments aimed to define our knowledge about damages after etching treatments or bracket removal and the responsiveness to fluoride seals and the morphology of the tooth/restoration interface. Moreover, this device could also be used to detect relevant diseases like caries, or to assess surface properties to evaluate lesion activity