Research

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  • A systematic literature review of diabetes self-management education features to improve diabetes education in women of Black African/Caribbean and Hispanic/Latin American ethnicity, Patient Education and Counseling
    A systematic literature review of diabetes self-management education features to improve diabetes education in women of Black African/Caribbean and Hispanic/Latin American ethnicity, Patient Education and Counseling
    Abstract: Objective This systematic literature review aims to identify diabetes self-management education (DSME) features to improve diabetes education for Black African/Caribbean and Hispanic/Latin American women with Type 2 diabetes mellitus. Methods We conducted a literature search in six health databases for randomized controlled trials and comparative studies. Success rates of intervention features were calculated based on effectiveness in improving glycosolated hemoglobin (HbA1c), anthropometrics, physical activity, or diet outcomes. Calculations of rate differences assessed whether an intervention feature positively or negatively affected an outcome. Results From 13 studies included in our analysis, we identified 38 intervention features in relation to their success with an outcome. Five intervention features had positive rate differences across at least three outcomes: hospital-based interventions, group interventions, the use of situational problem-solving, frequent sessions, and incorporating dietitians as interventionists. Six intervention features had high positive rate differences (i.e. ≥50%) on specific outcomes. Conclusion Different DSME intervention features may influence broad and specific self-management outcomes for women of African/Caribbean and Hispanic/Latin ethnicity. Practical implications With the emphasis on patient-centered care, patients and care providers can consider options based on DSME intervention features for its broad and specific impact on outcomes to potentially make programming more effective., Gucciardi, E., Chan, V., Manuel, L. and Sidani, S. (2013). A systematic literature review of diabetes self-management education features to improve diabetes education in women of Black African/Caribbean and Hispanic/Latin American ethnicity. Patient Education and Counseling, 92(2), pp.235-245.
    A systematic review of the effectiveness of advanced practice nurses in long-term care
    A systematic review of the effectiveness of advanced practice nurses in long-term care
    To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long-term care residential settings. Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted. Quantitative systematic review. Twelve electronic databases were searched (1966-2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group. Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria. Four prospective studies conducted in the USA and reported in 15 papers were included. Long-term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services. Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff., Donald, F., Martin‐Misener, R., Carter, N., Donald, E. E., Kaasalainen, S., Wickson‐Griffiths, A.. . DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long‐term care. Journal of Advanced Nursing, 69(10), 2148-2161. doi:10.1111/jan.12140
    A systematic review of web-based educational interventions
    A systematic review of web-based educational interventions
    A complement to in-hospital educational interventions is web-based patient education accessed during the home recovery period. While findings demonstrate the effectiveness of web-based patient education interventions on patient outcomes, they fall short of identifying the characteristics that are associated with desired outcomes. The purpose of this systematic review was to determine the characteristics of web-based patient education interventions that are associated with producing changes in self-care behaviours. A systematic review involving 19 studies was conducted to determine the most effective components of a web-based intervention. Findings suggest that the most effective form of web-based patient education is one that is interactive and allows patients to navigate the online system on their own. The findings from this systematic review allow for the design of a web-based educational intervention that will promote increased performance of self-care behaviours during the home recovery period., Fredericks, S., Martorella, G., & Catallo, C. (2015). A systematic review of web-based educational interventions. Clinical Nursing Research, 24(1), 91-113.
    A thematic analysis of nursing students’ end-of-life knowledge
    A thematic analysis of nursing students’ end-of-life knowledge
    Background: Nursing Associations recommend that undergraduate nursing programs integrate end-of-life content throughout their nursing curricula to address the needs of those requiring such care. Objective: To determine the extent of nursing students' knowledge about end-of-life care in the final year of an undergraduate nursing program in Ontario, Canada. Method: The content of reflective exercises written by 24 nursing students enrolled in an end-of-life elective were thematically analyzed, both at the beginning and end of a 12 week course. Results: Results indicate that undergraduate nursing students’ end-of-life knowledge and experiences vary greatly. The overarching theme Duty of Care indicated that the students were motivated to take the course to fulfill a sense of professional responsibility. The sub-themes Assumptions and Experience (subdivided as Limited, Personal, and Professional) depicted students' initial and variable understanding of end-of-life care. Under the theme of Transferable Skills, the students’ range of knowledge and the competencies they gained from their clinical placements and the course were illustrated. Conclusion: The study is expected to aid in curriculum review of a university's undergraduate nursing program.
    A theory of sharecropping: the role of price behavior and imperfect competition
    A theory of sharecropping: the role of price behavior and imperfect competition
    Also available for download here: http://mpra.ub.uni-muenchen.de/14898/
    AMP-Activated Protein Kinase Regulates the Cell Surface Proteome and Integrin Membrane Traffic
    AMP-Activated Protein Kinase Regulates the Cell Surface Proteome and Integrin Membrane Traffic
    The cell surface proteome controls numerous cellular functions including cell migration and adhesion, intercellular communication and nutrient uptake. Cell surface proteins are controlled by acute changes in protein abundance at the plasma membrane through regulation of endocytosis and recycling (endomembrane traffic). Many cellular signals regulate endomembrane traffic, including metabolic signaling; however, the extent to which the cell surface proteome is controlled by acute regulation of endomembrane traffic under various conditions remains incompletely understood. AMP-activated protein kinase (AMPK) is a key metabolic sensor that is activated upon reduced cellular energy availability. AMPK activation alters the endomembrane traffic of a few specific proteins, as part of an adaptive response to increase energy intake and reduce energy expenditure. How increased AMPK activity during energy stress may globally regulate the cell surface proteome is not well understood. To study how AMPK may regulate the cell surface proteome, we used cell-impermeable biotinylation to selectively purify cell surface proteins under various conditions. Using ESI-MS/MS, we found that acute (90 min) treatment with the AMPK activator A-769662 elicits broad control of the cell surface abundance of diverse proteins. In particular, A-769662 treatment depleted from the cell surface proteins with functions in cell migration and adhesion. To complement our mass spectrometry results, we used other methods to show that A-769662 treatment results in impaired cell migration. Further, A-769662 treatment reduced the cell surface abundance of β1-integrin, a key cell migration protein, and AMPK gene silencing prevented this effect. While the control of the cell surface abundance of various proteins by A-769662 treatment was broad, it was also selective, as this treatment did not change the cell surface abundance of the transferrin receptor. Hence, the cell surface proteome is subject to acute regulation by treatment with A-769662, at least some of which is mediated by the metabolic sensor AMPK., Ross E, Ata R, Thavarajah T, Medvedev S, Bowden P, Marshall JG, et al. (2015) AMP-Activated Protein Kinase Regulates the Cell Surface Proteome and Integrin Membrane Traffic. PLoS ONE 10(5): e0128013.
    Absence of Evidence and Evidence of Absence
    Absence of Evidence and Evidence of Absence
    This paper appears in Faith and Philosophy 24 (2007): 203-228.
    Academic Librarianship: A Crisis or an Opportunity?
    Academic Librarianship: A Crisis or an Opportunity?
    Partnership: the Canadian Journal of Library and Information Practice and Research, vol. 6, no. 2 (2011). Also available online at: http://journal.lib.uoguelph.ca/index.php/perj/article/view/1678
    Accelerated Compressed Sensing Based CT Image Reconstruction
    Accelerated Compressed Sensing Based CT Image Reconstruction
    In X-ray computed tomography (CT) an important objective is to reduce the radiation dose without significantly degrading the image quality. Compressed sensing (CS) enables the radiation dose to be reduced by producing diagnostic images from a limited number of projections. However, conventional CS-based algorithms are computationally intensive and time-consuming. We propose a new algorithm that accelerates the CS-based reconstruction by using a fast pseudopolar Fourier based Radon transform and rebinning the diverging fan beams to parallel beams. The reconstruction process is analyzed using a maximum-a-posterior approach, which is transformed into a weighted CS problem. The weights involved in the proposed model are calculated based on the statistical characteristics of the reconstruction process, which is formulated in terms of the measurement noise and rebinning interpolation error .Therefore, the proposed method not only accelerates the reconstruction, but also removes the rebinning and interpolation errors. Simulation results are shown for phantoms and a patient. For example, a 512 × 512 Shepp-Logan phantom when reconstructed from 128 rebinned projections using a conventional CS method had 10% error, whereas with the proposed method the reconstruction error was less than 1%.Moreover, computation times of less than 30 sec were obtained using a standard desktop computer without numerical optimization., Hashemi, S., Beheshti, S., Gill, P. R., Paul, N. S., & Cobbold, R. S. C. (2015). Accelerated compressed sensing based CT image reconstruction. Computational and Mathematical Methods in Medicine, 2015, 1-16. doi:10.1155/2015/161797
    Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents
    Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents
    Background Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Methods Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. Data The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Results Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns. Conclusions The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes., Paez, A., Mercado, R. G., Farber, S., Morency, C., & Roorda, M. (2010). Accessibility to health care facilities in montreal island: An application of relative accessibility indicators from the perspective of senior and non-senior residents. International Journal of Health Geographics, 9(1), 52-52. doi:10.1186/1476-072X-9-52