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31.
Sean A. Kidd Lindsey George Maria O’Connell John Sylvestre Helen Kirkpatrick Gina Browne Lehana Thabane 《Community mental health journal》2010,46(4):342-350
There has been increasing commentary about the degree to which Assertive Community Treatment (ACT) teams provide recovery-oriented
services, often centered around the question of the use of coercion. The present study was designed to contribute to this
discussion through an examination of recovery-oriented service provision and ACT fidelity among 67 teams in the province of
Ontario, Canada. The findings indicated a moderate to high degree of recovery orientation in service provision, with no significant
relationship between ACT fidelity and consumer and family/key support ratings of recovery orientation. A significant relationship
was found, however, between the ‘nature of services’ domain of the Dartmouth Assertive Community Treatment Scale (DACTS) and
ratings of recovery orientation provided by staff and ACT coordinators. These findings extend the existing dialogue regarding
the evaluation of ACT intervention process factors and indicate that current measures of fidelity may not be adequately addressing
dimensions of recovery-oriented service provision. 相似文献
32.
Janice Pogue Lehana Thabane PJ Devereaux Salim Yusuf 《BMC medical research methodology》2010,10(1):49
Background
Investigators designing clinical trials often use composite outcomes to overcome many statistical issues. Trialists want to maximize power to show a statistically significant treatment effect and avoid inflation of Type I error rate due to evaluation of multiple individual clinical outcomes. However, if the treatment effect is not similar among the components of this composite outcome, we are left not knowing how to interpret the treatment effect on the composite itself. Given significant heterogeneity among these components, a composite outcome may be judged as being invalid or un-interpretable for estimation of the treatment effect. This paper compares the power of different tests to detect heterogeneity of treatment effect across components of a composite binary outcome. 相似文献33.
Qu Cui Sue Carruthers Andrew McIvor Fiona Smaill Lehana Thabane Marek Smieja 《AIDS research and therapy》2010,7(1):6
Background
Smoking prevalence in human immunodeficiency virus (HIV) positive subjects is about three times of that in the general population. However, whether the extremely high smoking prevalence in HIV-positive subjects affects their lung function is unclear, particularly whether smoking decreases lung function more in HIV-positive subjects, compared to the general population. We conducted this study to determine the association between smoking and lung function, respiratory symptoms and diseases amongst HIV-positive subjects. 相似文献34.
Kaczorowski J Chambers LW Karwalajtys T Dolovich L Farrell B McDonough B Sebaldt R Levitt C Hogg W Thabane L Tu K Goeree R Paterson JM Shubair M Gierman T Sullivan S Carter M 《Preventive medicine》2008,46(6):537-544
OBJECTIVE: High blood pressure is an important and modifiable cardiovascular disease risk factor that remains under-detected and under-treated. Community-level interventions that address high blood pressure and other modifiable risk factors are a promising strategy to improve cardiovascular health in populations. The present study is a community cluster-randomised trial testing the effectiveness of CHAP (Cardiovascular Health Awareness Program) on the cardiovascular health of older adults. METHODS: Thirty-nine mid-sized communities in Ontario, Canada were stratified by geographic location and size of the population aged >or=65 years and randomly allocated to receive CHAP or no intervention. In CHAP communities, residents aged >or=65 years were invited to attend cardiovascular risk assessment sessions held in pharmacies over 10 weeks in Fall, 2006. Sessions included blood pressure measurement and feedback to family physicians. Trained volunteers delivered the program with support from pharmacists, community nurses and local organisations. RESULTS: The primary outcome measure is the relative change in the mean annual rate of hospital admission for acute myocardial infarction, congestive heart failure and stroke (composite end-point) among residents aged >or=65 years in intervention and control communities, using routinely collected, population-based administrative health data. CONCLUSION: This paper highlights considerations in design, implementation and evaluation of a large-scale, community-wide cardiovascular health promotion initiative. 相似文献
35.
Sawka AM Ismaila N Raina P Thabane L Straus S Adachi JD Gafni A Papaioannou A 《Canadian family physician Médecin de famille canadien》2010,56(11):e392-e397
OBJECTIVE
To garner Canadian physicians’ opinions on strategies to reduce hip fractures in long-term care (LTC) facilities, focusing on secondary prevention.DESIGN
A cross-sectional survey using a mailed, self-administered, written questionnaire.SETTING
Canada.PARTICIPANTS
Family physician members of the Ontario Long-Term Care Association (n = 165) and all actively practising geriatricians registered in the Canadian Medical Directory (n = 81).MAIN OUTCOME MEASURES
The strength of recommendations for fracture-reduction strategies in LTC and barriers to implementing these strategies.RESULTS
Of the 246 physicians sent the questionnaire, 25 declined study materials and were excluded. Of the 221 remaining, 120 responded for a response rate of 54%. About two-thirds of respondents were family physicians (78 of 120) and the rest were mostly geriatricians. Most respondents strongly recommended the following secondary prevention strategies for use in LTC after hip fracture: calcium, vitamin D, oral aminobisphosphonates, physical therapy, and environmental modification (such as handrails). Most respondents either did not recommend or recommended limited use of etidronate, intravenous bisphosphonates, calcitonin, raloxifene, testosterone (for hypogonadal men), and teriparatide. Postmenopausal hormone therapy was discouraged or not recommended by most respondents. Support was mixed for the use of hip protectors, B vitamins, and folate. Barriers to implementation identified by most respondents included a lack of strong evidence of hip fracture reduction (for B vitamins and folate, cyclic etidronate, and testosterone), side effects (for postmenopausal hormone therapy), poor compliance (for hip protectors), and expense (for intravenous bisphosphonates and teriparatide). Some respondents cited side effects or poor compliance as barriers to using calcium and potent oral bisphosphonates.CONCLUSION
Canadian physicians favour the use of calcium, vitamin D, potent oral bisphosphonates, physical therapy, and evironmental modifications for LTC residents after hip fracture. Further study at the clinical and administrative levels is required to find ways to overcome the specific barriers to implementation and effectiveness of these interventions. 相似文献36.
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38.
Murray-Davis Beth Grenier Lindsay N. Atkinson Stephanie A. Mottola Michelle F. Wahoush Olive Thabane Lehana Xie Feng Vickers-Manzin Jennifer Moore Caroline Hutton Eileen K. 《Maternal and child health journal》2022,26(9):1861-1870
Maternal and Child Health Journal - Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women... 相似文献
39.
40.
Howell D Marshall D Brazil K Taniguchi A Howard M Foster G Thabane L 《Journal of pain and symptom management》2011,42(1):60-75