8 research outputs found

    Exercise Prescription for Chronic Disease Management

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    The beneficial role of exercise in chronic disease management is well recognized, but the challenge of effective exercise prescription within primary care persists. Initiatives requesting clinicians to prescribe specific exercises to their patients has left two underlying questions: 1) Who is the most appropriate clinician to prescribe exercise to meet the unique needs of individuals living with more than one disease; 2) How does this clinician ensure appropriate and safe exercise prescriptions are provided? Three studies were completed to begin addressing the aforementioned questions. A nationally distributed survey compared exercise curricula between physiotherapy, nursing, and medical programs, while a systematic literature review showed overlapping physiological and subjective markers that clinicians may use to define safe exercises for individuals living with multiple chronic diseases. Finally a novel approach and a preliminary tool are presented to help guide how exercise prescription could be implemented in primary care. Findings suggest that PTs should lead the exercise prescription movement in primary care with nurses and physicians as exercise advisors or facilitators. Evidence from this thesis supports improving access to PT in primary care. Also, exercise prescription in individuals with multiple chronic diseases from a body-systems perspective is proposed, rather than solely relying on the dominantly available single-disease exercise guidelines. Finally, a newly developed exercise prescription approach is presented, which takes into account the advisors role in exercise prescription, while a preliminary tool is proposed that considers physiological and personal profiles of individuals who have more than one chronic disease, to guide clinicians in developing tailored exercise prescriptions in the primary care context

    Lessons from the business sector for successful knowledge management in health care: A systematic review

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    Abstract Background The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. Methods We searched seven databases using keywords such as "knowledge management", "organizational knowledge", and "business performance". We included articles published between 2000-2009; we excluded non-English articles. Results 83 articles were reviewed and data were extracted to: (1) uncover reasons for initiating knowledge management strategies, (2) identify potential knowledge management strategies/solutions, and (3) describe facilitators and barriers to knowledge management. Conclusions KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate) knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build.</p

    Lessons from the Business Sector for Successful Knowledge Management in Health Care: A Systematic Review

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    BACKGROUND: The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. METHODS: We searched seven databases using keywords such as knowledge management , organizational knowledge , and business performance . We included articles published between 2000-2009; we excluded non-English articles. RESULTS: 83 articles were reviewed and data were extracted to: (1) uncover reasons for initiating knowledge management strategies, (2) identify potential knowledge management strategies/solutions, and (3) describe facilitators and barriers to knowledge management. CONCLUSIONS: KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate) knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build

    Process Evaluation of Implementing Knowledge Management Tools in Public Health

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    Translating formal and informal knowledge into public health (PH) action is essential given that PH professionals rely on up-to-date and context-specific information for effective programme planning, implementation, and evaluation. Knowledge management (KM) provides possible solutions to this challenge. We conducted an evaluation of a pilot implementation of four KM tools: (1) After Action Review; (2) Communities of Practice; (3) Peer Assist and; (4) Organizational Yellow Pages. The evaluation focused on fidelity, feasibility, and acceptability of the tools. Three main messages emerged from the study findings: (1) KM tools can be implemented in a PH context for the sharing of explicit and tacit knowledge, (2) enabling organizational environments were important for implementation, and (3) the provision of a facilitator during the implementation period was also important and appreciated by study participants

    Resistance Training and Older Adults with Type 2 Diabetes Mellitus: Strength of the Evidence

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    Objective. This paper analyzes the effects of resistance training (RT) on metabolic, neuromuscular, and cardiovascular functions in older adults (mean age ≥ 65 years) with type 2 diabetes (T2DM). Research Design and Methods. A systematic review conducted by two reviewers of the published literature produced 3 records based on 2 randomized controlled trials that assessed the effect of RT on disease process measures and musculoskeletal/body composition measures. Statistical, Comprehensive Meta-Analysis (version 2) software was used to compute Hedge’s g, and results were calculated using the random effects model to account for methodological differences amongst studies. Results. Largest effect of RT was seen on muscle strength; especially lower body strength, while the point estimate effect on body composition was small and not statistically significant. The cumulative point estimate for the T2DM disease process measures was moderate and statistically significant. Conclusions. RT generally had a positive effect on musculoskeletal, body composition, and T2DM disease processes measures, with tentative conclusions based on a low number of completed RCTs. Thus, more research is needed on such programs for older adults (≥65 years) with T2DM

    Review Article Resistance Training and Older Adults with Type 2 Diabetes Mellitus: Strength of the Evidence

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    Objective. This paper analyzes the effects of resistance training (RT) on metabolic, neuromuscular, and cardiovascular functions in older adults (mean age ≥ 65 years) with type 2 diabetes (T2DM). Research Design and Methods. A systematic review conducted by two reviewers of the published literature produced 3 records based on 2 randomized controlled trials that assessed the effect of RT on disease process measures and musculoskeletal/body composition measures. Statistical, Comprehensive Meta-Analysis (version 2) software was used to compute Hedge&apos;s g, and results were calculated using the random effects model to account for methodological differences amongst studies. Results. Largest effect of RT was seen on muscle strength; especially lower body strength, while the point estimate effect on body composition was small and not statistically significant. The cumulative point estimate for the T2DM disease process measures was moderate and statistically significant. Conclusions. RT generally had a positive effect on musculoskeletal, body composition, and T2DM disease processes measures, with tentative conclusions based on a low number of completed RCTs. Thus, more research is needed on such programs for older adults (≥65 years) with T2DM
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