List Distinguishing Parameters of Trees

A coloring of the vertices of a graph G is said to be distinguishing} provided no nontrivial automorphism of G preserves all of the vertex colors. The distinguishing number of G, D(G), is the minimum number of colors in a distinguishing coloring of G. The distinguishing chromatic number of G, chi_D(G), is the minimum number of colors in a distinguishing coloring of G that is also a proper coloring. Recently the notion of a distinguishing coloring was extended to that of a list distinguishing coloring. Given an assignment L= {L(v) : v in V(G)} of lists of available colors to the vertices of G, we say that G is (properly) L-distinguishable if there is a (proper) distinguishing coloring f of G such that f(v) is in L(v) for all v. The list distinguishing number of G, D_l(G), is the minimum integer k such that G is L-distinguishable for any list assignment L with |L(v)| = k for all v. Similarly, the list distinguishing chromatic number of G, denoted chi_{D_l}(G) is the minimum integer k such that G is properly L-distinguishable for any list assignment L with |L(v)| = k for all v. In this paper, we study these distinguishing parameters for trees, and in particular extend an enumerative technique of Cheng to show that for any tree T, D_l(T) = D(T), chi_D(T)=chi_{D_l}(T), and chi_D(T) <= D(T) + 1.Comment: 10 page

Mentoring Experiences of Aging and Disability Rehabilitation Researchers

Objectives. To explore research mentoring experiences and perceived mentoring needs of aging and disability researchers at different career stages. Design. Focus group and individual interviews with rehabilitation researchers at various career stages based in hospitals, universities, and hospital-based research institutes in Ontario, Canada. Results. The overall theme was mentoring for transition. Participants across career stages referred to helpful mentoring experiences as those that assisted them to move from their previous stage into the present stage or from the present stage into their next career progression. Unhelpful mentoring experiences were characterized by mentor actions that were potentially detrimental to transition. Subsumed under this theme were three categories. The first, “hidden information” referred to practical information that was difficult to access. The second “delicate issues” referred to helping the participant work through issues related to sensitive matters, the discussion of which could put the participants or their colleagues in a vulnerable position. The third category was “special challenges of clinician-researchers”. Conclusions. Helpful mentoring for rehabilitation researchers working on concerns related to aging and disability appears to be characterized by interaction with more experienced individuals who aid the researcher work through issues related to career transition

Reliability of Standardized Assessment for Adults who are Deafblind

This study assessed the reliability of the interRAI Community Health Assessment (interRAI CHA) and Deafblind Supplement (DbS). The interRAI CHA and DbS represents a multidimensional, standardized assessment instrument for use with adults (18 and older) who are deafblind. The interrater reliability of the instrument was tested through the completion of dual assessments with 44 individuals who were deafblind in the province of Ontario, Canada. Overall, nearly 50% of items had a kappa value of at least 0.60, indicating fair to substantial agreement for these items. Several items related to psychosocial well-being, mood, and sense of involvement had kappa scores of less than 0.40. However, among these items with low kappa values, most (78%) showed at least 70% agreement between the two assessors. The internal consistency of several health subscales, embedded within the assessment, was also very good and ranged from 0.63 to 0.93. The interRAI was also very good and ranged from 0.63 to 0.93. The interRAI CHA and DbS represents a reliable instrument for assessing adults with deafblindness to better understand their needs, abilities, and preferences

Review of the Canadian Association of Optometrists Frequency of Eye Examinations Guideline – Summary

Review of the Canadian Association of Optometrists Frequency of Eye Examinations Guideline – Summar

Care transitions for older patients with musculoskeletal disorders: continuity from the providers’ perspective

<p><strong>Introduction</strong>: Care transitions are a common and frequently adverse aspect of health care, resulting in a high-risk period for both care quality and patient safety. Patients who have complex care needs and undergo treatment in multiple care settings, such as older patients with musculoskeletal disorders, may be at higher risk for poor care transitions.</p><p><strong>Methods: </strong>Key informant interviews were used to gather in-depth information on transitional care issues, particularly those which impact informational continuity, from the perspective of a range of health professionals (η=17) in care settings relevant to the care continuum of older patients with hip fractures.</p><p><strong>Results:</strong> Three transitional care themes were identified; medical complexity impacts care trajectories, larger circles of care can be both beneficial and challenging, and a variety of channels and modes are required for meaningful information exchange. Many issues cut across each care setting, and address challenges to informational continuity among and between health care providers, patients, and caregivers.</p><p><strong>Conclusions:</strong> Medical complexity enlarges the circle of care which challenges care continuity. There may be fundamental elements which, regardless of care setting, strengthen transitional care quality. Standardized transitional care processes might help to offset informational discontinuity across care settings as a result of this population's larger circles of care.</p

Examining the Hospital Elder Life Program in a rehabilitation setting: a pilot feasibility study

Background: The Hospital Elder Life Program (HELP) has been shown to effectively prevent delirium and functional decline in older patients in acute care, but has not been examined in a rehabilitation setting. This pilot study examined potential successes and implementation factors of the HELP in a post-acute rehabilitation hospital setting. Methods: A mixed methods (quantitative and qualitative) evaluation, incorporating a repeated measures design, was used. A total of 100 patients were enrolled; 58 on the pilot intervention unit and 42 on a usual care unit. Group comparisons were made using change scores (pre-post intervention) on outcome measures between pilot unit patients and usual care patients (separate analyses compared usual care patients with pilot unit patients who did or did not receive the HELP). Qualitative data were collected using focus group and individual interviews, and analyzed using emergent coding procedures. Results: Delirium prevalence reduced from 10.9 % (n = 6) to 2.5 % (n = 1) in the intervention group, while remaining the same in the usual care group (2.5 % at both measurement points). Those who received the HELP showed greater improvement on cognitive and functional outcomes, particularly short-term memory and recall, and a shorter average length of stay than patients who did not. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP in a rehabilitation setting. Conclusions: This study adds to the limited research on delirium and the effectiveness of the HELP in post-acute rehabilitation settings. The HELP was found to be feasible and have potential benefits for reduced delirium and improved outcomes among rehabilitation patients.Funded in part by an Emerging Team Grant (ETG 92249) from the Canadian Institutes of Health Researc

Engaging older adults in healthcare research and planning: a realist synthesis

Background The importance of engaging the community in healthcare research and planning has been widely recognized. Currently however, there is a limited focus on older adults, Canada’s fastest growing segment of the population and biggest users of the healthcare system. Objective This project aimed to develop an understanding of engagement of older adults and their caregivers in healthcare research and planning. Method A realist synthesis was conducted of the available knowledge on engagement in healthcare research and planning. The search methodology was informed by a framework for realist syntheses following five phases, including consultations with older adults. The synthesis included theoretical frameworks, and both peer-reviewed and grey literature. Results The search generated 15,683 articles, with 562 focusing on healthcare research and planning. The review lead to the development of a framework to engage older adults and their caregivers in healthcare research and planning. The 5 stages environment, plan, establish, build, and transition are accompanied with example context, mechanism, and outcomes to guide the use of this framework. Conclusion We have identified a framework that promotes meaningful engagement of older adults and their caregivers. We are continuing to collaborate with our community partners to further develop and evaluate engagement strategies that align with the presented framework.This work was supported by a Knowledge Synthesis Grant from the Technology Evaluation for the Elderly Network (TVN), grant # KS2013-08, which is funded by the Government of Canada’s Networks of Centres of Excellence (NCE) Program

Knowledge brokers in a knowledge network: the case of Seniors Health Research Transfer Network knowledge brokers

Background The purpose of this paper is to describe and reflect on the role of knowledge brokers (KBs) in the Seniors Health Research Transfer Network (SHRTN). The paper reviews the relevant literature on knowledge brokering, and then describes the evolving role of knowledge brokering in this knowledge network. Methods The description of knowledge brokering provided here is based on a developmental evaluation program and on the experiences of the authors. Data were gathered through qualitative and quantitative methods, analyzed by the evaluators, and interpreted by network members who participated in sensemaking forums. The results were fed back to the network each year in the form of formal written reports that were widely distributed to network members, as well as through presentations to the network’s members. Results The SHRTN evaluation and our experiences as evaluators and KBs suggest that a SHRTN KB facilitates processes of learning whereby people are connected with tacit or explicit knowledge sources that will help them to resolve work-related challenges. To make this happen, KBs engage in a set of relational, technical, and analytical activities that help communities of practice (CoPs) to develop and operate, facilitate exchanges among people with similar concerns and interests, and help groups and individuals to create, explore, and apply knowledge in their practice. We also suggest that the role is difficult to define, emergent, abstract, episodic, and not fully understood. Conclusions The KB role within this knowledge network has developed and matured over time. The KB adapts to the social and technical affordances of each situation, and fashions a unique and relevant process to create relationships and promote learning and change. The ability to work with teams and to develop relevant models and feasible approaches are critical KB skills. The KB is a leader who wields influence rather than power, and who is prepared to adopt whatever roles and approaches are needed to bring about a valuable result

Choosing Healthcare Options by Involving Canada's Elderly: a protocol for the CHOICE realist synthesis project on engaging older persons in healthcare decision-making

Introduction: While patient and citizen engagement has been recognised as a crucial element in healthcare reform, limited attention has been paid to how best to engage seniors-the fastest growing segment of the population and the largest users of the healthcare system. To improve the healthcare services for this population, seniors and their families need to be engaged as active partners in healthcare decision-making, research and planning. This synthesis aims to understand the underlying context and mechanisms needed to achieve meaningful engagement of older adults in healthcare decision-making, research and planning. Methods and analysis: The CHOICE Knowledge Synthesis Project: Choosing Healthcare Options by Involving Canada's Elderly aims to address this issue by synthesising current knowledge on patient, family, and caregiver engagement. A realist synthesis will support us to learn from other patient and citizen engagement initiatives, from previous research, and from seniors, families and caregivers themselves. The synthesis will guide development or adaptation of a framework, leading to the development of best practice guidelines and recommendations for engagement of older people and their families and caregivers in clinical decision-making, healthcare delivery, planning and research. Ethics and dissemination: The components of this protocol involving consultation with patients or caregivers have received ethics clearance from the University of Waterloo, Office of Research Ethics (ORE# 19094). After completion of the project, we will amalgamate the information collected into a knowledge synthesis report which will include best practice guidelines and recommendations for patient, family and caregiver engagement in clinical and health system planning and research contexts. Results: Will be further disseminated to citizens, clinicians, researchers and policymakers with the help of our partners.Technology Evaluation in the Elderly Network (TVN, grant # KS2013-08), which is funded by the Government of Canada's Networks of Centres of Excellence (NCE) Progra