To determine the impact of a provincial choking prevention program (CPP) on the incidence of aerodigestive foreign body cases among children.
The CPP, including posters, pamphlets, an informative video, and annual participation in the Parents & Kids Fair, was launched throughout Quebec in October 1999. The incidence rates of aerodigestive foreign body cases prior to implementation (during 1997-1998) and subsequently (2000-2002) within the province and our tertiary care centre (Sainte-Justine Hospital) were compared by estimating incidence rate ratios (IRRs) and associated 95% confidence intervals (95% CIs).
No significant changes in the incidence of aerodigestive foreign body cases after program implementation were observed in our hospital (age-adjusted IRR 0.92, 95% CI 0.79-1.07). The provincial rates were higher after program implementation (age-adjusted IRR 1.15, 95% CI 1.05-1.25).
To influence choking prevention habits, modifications to the campaign are required. Strategies are discussed.
Homelessness is a social condition increasing in frequency and severity across Canada. Interventions to end and prevent homelessness include effective case management in addition to an affordable housing provision. Little standardization exists for service providers to guide their decision making in developing and maintaining effective case management programs. The purpose of this 2-part article is to articulate dimensions of promising practice for case managers working in a "Housing First" context. Part 1 discusses research processes and findings and part-2 articulates the 6 Dimensions of Quality.
Practice settings include community-based organizations that employ and support case managers whose primary role is moving people from homelessness into permanent housing.
Six dimensions of promising practice are critically important to reducing barriers, improving sector collaboration, and ensuring case managers have appropriate and effective training and support. Dimensions of promising practice are: (1) collaboration and cooperation-a true team approach; (2) right matching of services-person-centered; (3) contextual case management-culture and flexibility; (4) the right kind of engagement-relationships and advocacy; (5) coordinated and well managed system-ethics and communication; and (6) evaluation for success-support and training.
Effective, coordinated case management, in addition to permanent affordable housing has the potential to reduce a person or family's homelessness permanently. Organizations and professionals working in this context have the opportunity to improve processes, reduce burnout, collaborate and standardize, and most importantly, efficiently and permanently end someone's homelessness with the help of dimensions of quality for case management.
Research in the context of the dental school has traditionally been focused on institutional/faculty accomplishments and generating new knowledge to benefit the profession. Only recently have significant efforts been made to expand the overall research programming into the formal dental curriculum, to provide students with a baseline exposure to the research and critical thinking processes, encourage evidence-based decision-making, and stimulate interest in academic/research careers. Various approaches to curriculum reform and the establishment of multiple levels of student research opportunities are now part of the educational fabric of many dental schools worldwide. Many of the preliminary reports regarding the success and vitality of these programs have used outcomes measures and metrics that emphasize cultural changes within institutions, student research productivity, and student career preferences after graduation. However, there have not been any reports from long-standing programs (a minimum of 25 years of cumulative data) that describe dental school graduates who have had the benefit of research/training experiences during their dental education. The University of Manitoba Faculty of Dentistry initiated a BSc Dent program in 1980 that awarded a formal degree for significant research experiences taking place within the laboratories of the Faculty-based researchers and has continued to develop and expand this program. The success of the program has been demonstrated by the continued and increasing demands for entry, the academic achievements of the graduates, and the numbers of graduates who have completed advanced education/training programs or returned to the Faculty as instructors. Analysis of our long-term data validates many recent hypotheses and short-term observations regarding the benefits of dental student research programs. This information may be useful in the design and implementation of dental student research programs at other dental schools.
The effect of the 2005 British Columbia (BC) smoking cessation mass media campaign on a panel (N = 1,341) of 20-30-year-old smokers' attitudes is evaluated. The 5-week campaign consisted of posters, television, and radio ads about the health benefits of cessation. Small impacts on the panel's attitudes toward the adverse impacts of smoking were found, with greater impacts found for those who had no plans to quit smoking at the initial interview. As smokers with no plans to quit increasingly recognized the adverse impacts of smoking, they also increasingly agreed that they use smoking as a coping mechanism. Smokers with plans to quit at the initial interview already were well aware of smoking's adverse impacts. Respondents recalling the campaign poster, which presented a healthy alternative to smoking, decreased their perception of smoking as a coping mechanism and devalued their attachment to smoking. Evidence was found that media ad recall mediates unobserved predictors of attitudes toward smoking.
The article presents materials of studying of such important problem of health care as standardization of specialized medical care provided in conditions of hospital and modernization of regional health care. The issues of standardization of specialized medical care are considered in medical, economic and social aspects. The implementation of medical standards was determined as one of main tasks of the regional program of modernization of health care. The program was developed with direct involvement of the authors of article. The comparative analysis of classes of diseases and nosologic forms on main indices of hospitalized morbidity and lethality was used for substantiation of priority of implementing medical standards in the region. The questionnaire survey was carried out on sampling of 510 patients of hospitals. The sociological questionnaire survey was applied to sampling of 8732 patients comprised by system of mandatory medical insurance. Such an approach determined reliability of derived results. The expertise of medical standards was implemented by 124 experienced and competent physicians participating in implementation of medical standards. The results of expertise confirmed expediency of implementation of medical standards. Kepy following shortcomings were established: inadequate financing; lacking of modern equipment and analysis techniques in hospitals, etc. The article presents evidences of effectiveness of process of standardization of specialized of medical care provided in hospital conditions. The basis of such an assumption was reliable increasing of level of satisfaction of quality of its organization and achievement of planned indices of "road map" in the section of increasing of salary of medical workers and decreasing of mortality of population because of controllable causes.
To use the philosophy and methodology of Appreciative Inquiry (AI) in the investigation of unit to unit transfers to determine aspects which are working well and should be incorporated into standard practice.
Handoffs can result in threats to patient safety and an atmosphere of distrust and blaming among staff can be engendered. As the majority of handoffs go well, an alternative is to build on successful handoffs.
The AI methodology was used to discover what was currently working well in unit to unit transfers. The data from semi-structured interviews that were conducted with staff, patients, and family informed structural process improvements.
Themes extracted from the interviews focused on the situational variables necessary for the perfect transfer, the mode and content of transfer-related communication, and important factors in communication with the patient and family.
This project was successful in demonstrating the usefulness of AI as both a quality improvement methodology and a strategy to build trust among key stakeholders.
Giving staff members the opportunity to contribute positively to process improvements and share their ideas for innovation has the potential to highlight expertise and everyday accomplishments enhancing morale and reducing conflict.
Our primary objective was to determine whether a novel 'active school' model--Action Schools! BC--improved the cardiovascular disease (CVD) risk profile in elementary-school children. Our secondary objective was to determine the percentage of children with elevated CVD risk factors.
We undertook a cluster-randomized controlled school-based trial with 8 elementary schools across 1 school year, in British Columbia, Canada, beginning in 2003. Boys and girls (n=268, age 9-11 years) were randomly assigned (by school) to usual practice (UP, 2 schools) or intervention (INT, 6 schools) groups. We assessed change between groups in cardiovascular fitness (20-m Shuttle Run), blood pressure (BP), and body mass index (BMI, wt/ht(2)). We evaluated total cholesterol (TC), total:high-density cholesterol (TC:HDL-C), low-density lipoprotein, apolipoprotein B, C-reactive protein and fibrinogen on a subset of volunteers (n=77).
INT children had a 20% greater increase in fitness and a 5.7% smaller increase in BP compared with children attending UP schools (P