PHYSICAL ACTIVITY GUIDELINE ADHERENCE AMONG CANADIAN IMMIGRANT YOUTH: A QUALITATIVE EXPLORATORY STUDY

The Canadian Society for Exercise Physiology (CSEP) Youth Physical Activity Guidelines are the national criterion standard for youth physical activity. Minimal research exists regarding CSEP Guideline adherence in immigrant youth despite this population’s significance in Canada. The purpose of this study was to foster an understanding of physical activity guideline adherence in Canadian immigrant youth. The study objectives were to determine Canadian immigrant youth’s adherence levels, barriers to adherence, recommendations to improve adherence, and the impact of the COVID-19 pandemic on adherence. A qualitative exploratory design was used. Purposive sampling from Edmonton community-agencies occurred to generate a sample of 6 community service-workers who have experience with Canadian immigrant youth and physical activity. Data collection occurred through virtual semi-structured interviews. Data analysis occurred via Braun and Clarke’s Six Thematic Analysis Steps. Three primary themes emerged: (1) Multiple Barriers to CSEP Guideline Adherence including low familiarity with physical activity, inaccessibility, finances, and competing responsibilities, (2) Low Adherence Level to CSEP Guidelines indicating significant under-adherence that was worsened by the pandemic, and (3) Recommendations to improve CSEP Guideline Adherence include increase accessibility to physical activities, increase education, and promote mentorship. This study’s findings can optimize nursing health promotion efforts and organizational policies, inform health promotion protocols in nursing education, and guide further research that would enhance the breadth of current literature. Collectively, this study helps provide a foundation for promoting the health of Canadian immigrant youth

Barriers and facilitators in providing oral health care to nursing home residents, from the perspective of care aides—a systematic review protocol

PRISMA-P checklist. The checklist is composed of recommended items to address in a systematic review protocol. (PDF 218 kb

Older high-cost patients in Norwegian somatic hospitals: A register-based study of patient characteristics

Objective Two-thirds of the economic resources in Norwegian hospitals are used on 10% of the patients. Most of these high-cost patients are older adults, which experience more unplanned hospital admissions, longer hospital stays and higher readmission rates than other patients. This study aims to examine the individual and clinical characteristics of older patients with unplanned admissions to Norwegian somatic hospitals and how these characteristics differ between high-cost and low-cost older patients. Design Observational cross-sectional study. Setting Norwegian somatic hospitals. Participants National registry data of older Norwegian patients (≥65 years) with ≥1 unplanned contact with somatic hospitals in 2019 (n=2 11 738). Primary outcome measure High-cost older patients were defined as those within the 10% of the highest diagnosis-related group weights in 2019 (n=21 179). We compared high-cost to low-cost older patients using bivariate analyses and logistic regression analysis. Results Men were more likely to be high-cost older patients than women (OR=1.25, 95% CI 1.21 to 1.29) and the oldest (90+ years) compared with the youngest older adults (65–69 years) were less likely to cause high costs (OR=0.47, 95%CI 0.43 to 0.51). Those with the highest level of education were less likely to cause high costs than those with primary school degrees (OR=0.74, 95%CI 0.69 to 0.80). Main diagnosis group (OR=3.50, 95%CI 3.37 to 3.63) and dying (OR=4.13, 95%CI 3.96 to 4.30) were the clinical characteristics most strongly associated with the likelihood of being a high-cost older patient. Conclusion Several of the observed patient characteristics in this study may warrant further investigation as they might contribute to high healthcare costs. For example, MDGs, reflecting comprehensive healthcare needs and lower education, which is associated with poorer health status, increase the likelihood of being high-cost older patients. Our results indicate that Norwegian hospitals function according to the intentions of those having the highest needs receiving most services

Prioritizing supports and services to help older adults age in place: A Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders

Aging in place (AIP) is a policy strategy designed to help older adults remain in their community. While planners internationally have modified aspects of the older adult care continuum (e.g., home care, assisted living, nursing homes) to facilitate AIP, further improvements to community-based supports and services are also required. This study compared and constrasted the community-based factors (e.g., supports, services and personal strategies or characteristics) that family/friend care partners and healthcare stakeholders (i.e., planners/providers) view as most important to help older adults successfully AIP.; An initial list of factors shown to influence AIP was created from the academic literature. These factors were used to develop a Delphi survey implemented separately on care partners and healthcare stakeholders. Respondents rated the importance of each factor using a 10-point Likert Scale (1 = not important; 10 = absolutely critical). Consensus in each group was defined when at least 80% of participants scored a factor ≥8 ("very important"), with an interquartile range ≤2. Respondents suggested additional factors during Delphi round one.; Care partners (N = 25) and healthcare stakeholders (N = 36) completed two and three Delphi rounds, respectively. These groups independently agreed that the following 3 (out of 27) factors were very important to help older adults age in place: keeping one's home safe, maintaining strong inter-personal relationships, and coordinating care across formal providers. While healthcare stakeholders did not reach consensus on other factors, care partners agreed that 7 additional factors (e.g., access to affordable housing, having mental health programs) were important for AIP.; Compared to healthcare stakeholders, care partners felt that more and diverse community-based factors are important to support older adults to successfully AIP. Future research should replicate these findings in other jurisdictions, examine the availability and accessibility of the priority factors, and develop sustainable solutions to enhance their effectiveness

German translation of the Alberta context tool and two measures of research use: methods, challenges and lessons learned

Background: Understanding the relationship between organizational context and research utilization is key to reducing the research-practice gap in health care. This is particularly true in the residential long term care (LTC) setting where relatively little work has examined the influence of context on research implementation. Reliable, valid measures and tools are a prerequisite for studying organizational context and research utilization. Few such tools exist in German. We thus translated three such tools (the Alberta Context Tool and two measures of research use) into German for use in German residential LTC. We point out challenges and strategies for their solution unique to German residential LTC, and demonstrate how resolving specific challenges in the translation of the health care aide instrument version streamlined the translation process of versions for registered nurses, allied health providers, practice specialists, and managers. Methods: Our translation methods were based on best practices and included two independent forward translations, reconciliation of the forward translations, expert panel discussions, two independent back translations, reconciliation of the back translations, back translation review, and cognitive debriefing. Results: We categorized the challenges in this translation process into seven categories: (1) differing professional education of Canadian and German care providers, (2) risk that German translations would become grammatically complex, (3) wordings at risk of being misunderstood, (4) phrases/idioms non-existent in German, (5) lack of corresponding German words, (6) limited comprehensibility of corresponding German words, and (7) target persons’ unfamiliarity with activities detailed in survey items. Examples of each challenge are described with strategies that we used to manage the challenge. Conclusion: Translating an existing instrument is complex and time-consuming, but a rigorous approach is necessary to obtain instrument equivalence. Essential components were (1) involvement of and co-operation with the instrument developers and (2) expert panel discussions, including both target group and content experts. Equivalent translated instruments help researchers from different cultures to find a common language and undertake comparative research. As acceptable psychometric properties are a prerequisite for that, we are currently carrying out a study with that focus

Ceci n’est pas une ville

Treballs Finals de Grau de Belles Arts. Facultat de Belles Arts. Universitat de Barcelona, Curs: 2015-16, Tutor: Bibiana Crespo[cat] El títol de l’obra d’aquest Treball Final de Grau, Ceci n’est pas une ville, fa al·lusió a la paradoxa proposada per René Magritte al quadre La Trahison des images (La traïció de les imatges), atès que la incapacitat de distingir realitat i ficció ha sobrepassat el territori de la mera representació, convertint-se en un dels dilemes més presents a la nostra contemporaneïtat, fent-se evident tant en les imatges i la informació que ens envolta com en els paisatges que habitem.La peça és un dibuix en el que es representa un paisatge de gran format, introduint l’espectador dins la vivència d’un lloc fictici, simulat. En el dibuix es presenta el carrer principal de La Roca Village, un centre comercial construït imitant l’arquitectura catalana del segle XIX i dedicat a la venda de grans marques de roba i altres complements. Amb més de 4 milions de visitants a l’any aquest “no-poble” ja és el més visitat de Catalunya. Mitjançant el suport d’un material transparent, pintura blanca i una il·luminació dirigida, es crea una projecció d’ombra del grafisme del dibuix a la paret que domina la visió, fet que suscita una confusió a l’espectador, ja que no sap si està veient el dibuix mateix o l’ombra que genera aquest. L’ obra constitueix una crítica al capitalisme cultural i convida a l’espectador a reflexionar sobre el paisatge que habita, tot considerant que els carrers de La Roca Village, habitats per marques i transitats per consumidors, podrien ser un model per una societat en potència, que amaga les seves diferències sota un espectacle dedicat exclusivament a vendre productes lluents i experiències fictícies.[eng] The work’s title of this Final Degree Dissertation project, Ceci n’est pas une ville, refers to René Magritte’s paradox proposed in his painting La Trahison des images (The image betrayal), since the inability to distinguish reality and fiction has exceeded the territory of the mere representation, becoming one of our most noticeable contemporary dilemmas, making itself evident both in images and information that surround us, as in the landscapes that we inhabit. This piece is a drawing representing a large landscape, aiming to introduce the viewer into the experience of a fictitious and simulated place. The drawing shows the main street of La Roca Village, a shopping center built imitating the Catalan architecture of the 19th Century, devoted to selling big clothing brands. With more than 4 million of visitors per year, this “no-village” is already the most visited one in Catalonia. Through a transparent material support, white painting and a directed light, the shadow of the graphism is projected onto the wall and dominates the vision, this fact causes a confusion to the viewer as he/she doesn’t know if is watching the drawing itself or the shadow that it generates. The work constitutes a critic to cultural capitalism and invites the viewers to think about the landscapes they inhabit. Considering that La Roca Village streets, inhabited by brands and crowded by consumers, could be a potential model for a society that hides its differences under a performance exclusively dedicated to sell shiny products and fictitious experiences

Team-Based Integrated Knowledge Translation for Enhancing Quality of Life in Long-term Care Settings: A Multi-method, Multi-sectoral Research Design

Multi-sectoral, interdisciplinary health research is increasingly recognizing integrated knowledge translation (iKT) as essential. It is characterized by diverse research partnerships, and iterative knowledge engagement, translation processes and democratized knowledge production. This paper reviews the methodological complexity and decision-making of a large iKT project called Seniors - Adding Life to Years (SALTY), designed to generate evidence to improve late life in long-term care (LTC) settings across Canada. We discuss our approach to iKT by reviewing iterative processes of team development and knowledge engagement within the LTC sector. We conclude with a brief discussion of the important opportunities, challenges, and implications these processes have for LTC research, and the sector more broadly

Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial

Background Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers. The study aims are to a) systematically feed back TREC research data to nursing home care units, and b) compare the effectiveness of three different theory-based feedback strategies in improving performance within care units. Methods INFORM (Improving Nursing Home Care through Feedback On PerfoRMance Data) is a 3.5-year pragmatic, three-arm, parallel, cluster-randomized trial. We will randomize 67 Western Canadian nursing homes with 203 care units to the three study arms, a standard feedback strategy and two assisted and goal-directed feedback strategies. Interventions will target care unit managerial teams. They are based on theory and evidence related to audit and feedback, goal setting, complex adaptive systems, and empirical work on feeding back research results. The primary outcome is the increased number of formal interactions (e.g., resident rounds or family conferences) involving care aides – non-registered caregivers providing up to 80% of direct care. Secondary outcomes are a) other modifiable features of care unit context (improved feedback, social capital, slack time) b) care aides’ quality of worklife (improved psychological empowerment, job satisfaction), c) more use of best practices, and d) resident outcomes based on the Resident Assessment Instrument – Minimum Data Set 2.0. Outcomes will be assessed at baseline, immediately after the 12-month intervention period, and 18 months post intervention. Discussion INFORM is the first study to systematically assess the effectiveness of different strategies to feed back research data to nursing home care units in order to improve their performance. Results of this study will enable development of a practical, sustainable, effective, and cost-effective feedback strategy for routine use by managers, policy makers and researchers. The results may also be generalizable to care settings other than nursing homes. Trial registration ClinicalTrials.gov Identifier: NCT02695836 . Date of registration: 24 February 201

Factor structure, reliability and measurement invariance of the Alberta Context Tool and the Conceptual Research Utilization Scale, for German residential long term care

We translated the Canadian residential long term care versions of the Alberta Context Tool (ACT) and the Conceptual Research Utilization (CRU) Scale into German, to study the association between organizational context factors and research utilization in German nursing homes. The rigorous translation process was based on best practice guidelines for tool translation, and we previously published methods and results of this process in two papers. Both instruments are self-report questionnaires used with care providers working in nursing homes. The aim of this study was to assess the factor structure, reliability, and measurement invariance (MI) between care provider groups responding to these instruments. In a stratified random sample of 38 nursing homes in one German region (Metropolregion Rhein-Neckar), we collected questionnaires from 273 care aides, 196 regulated nurses, 152 allied health providers, 6 quality improvement specialists, 129 clinical leaders, and 65 nursing students. The factor structure was assessed using confirmatory factor models. The first model included all ten ACT concepts. We also decided a priori to run two separate models for the scale-based and the count-based ACT concepts as suggested by the instrument developers. The fourth model included the five CRU Scale items. Reliability scores were calculated based on the parameters of the best-fitting factor models. Multiple-group confirmatory factor models were used to assess MI between provider groups. Rather than the hypothesized ten-factor structure of the ACT, confirmatory factor models suggested thirteen factors. The one-factor solution of the CRU Scale was confirmed. The reliability was acceptable (> .7 in the entire sample and in all provider groups) for 10 of 13 ACT concepts, and high (.90–.96) for the CRU Scale. We could demonstrate partial strong MI for both ACT models and partial strict MI for the CRU Scale. Our results suggest that the scores of the German ACT and the CRU Scale for nursing homes are acceptably reliable and valid. However, as the ACT lacked strict MI, observed variables (or scale scores based on them) cannot be compared between provider groups. Rather, group comparisons should be based on latent variable models, which consider the different residual variances of each group