Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canad... more Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canada. Method: Questionnaires were mailed to acute-care community hospitals (institutions with >100 inpatient beds, excluding psychiatric, mental health, paediatric, rehabilitation, tertiary, and long-term care facilities) across Canada from January to April 2010. The questionnaire collected information on patient referral criteria, staffing, workload, and compensation for weekend physiotherapy services and on the availability of other rehabilitation health professionals. Results: Of 146 community hospitals deemed eligible, 104 (71%) responded. Weekend physiotherapy was offered at 69% of hospitals across Canada, but this rate varied: ≥75% in all regions except Quebec (30%). Hospitals with a high proportion of acute-care beds were more likely to offer weekend physiotherapy services (logistic regression, p=0.021). Services differed among Saturdays, Sundays, and holidays in terms of the numb...
Scientific inquiry is one of four domains at the centre of the Curriculum Content Framework of th... more Scientific inquiry is one of four domains at the centre of the Curriculum Content Framework of the content guidelines for the Entry-to-Practice Physiotherapy Curriculum in Canadian university programmes;2 the role of scholarly practitioner is one of the seven essential competencies required of physiotherapists in Canada.3 Therefore, teaching key skills required to use, create, and disseminate research knowledge is an important part of physiotherapy education. To illustrate the dissemination of research findings made in the course of the MScPT curriculum at the University of Toronto, Salbach and colleagues1 present rates of presentation and publication by MScPT student research groups from 2003 through 2009. In this retrospective study, the authors found that dissemination efforts by 113 student groups totalled at least 43 presentations at scientific conferences and 32 publications, which, they conclude, represents a “moderate rate” of dissemination. Their study makes an important contribution by presenting the first published rates of scientific dissemination by physiotherapy students—indeed, the only published dissemination rates for health professional trainees other than medical students and residents. Salbach and colleagues used comprehensive methods to identify dissemination events and achieved an excellent response rate, particularly in the later years of their study period. As response rates were lower (<80%) in the early years of the study period, it is possible that the dissemination rates presented for those years (2003, 2004) may be slightly overestimated, if non-responding groups tended to be those that did not publish their findings. In contrast, as the authors note, the dissemination rates presented (particularly for publications) for the later years (2008, 2009) may be underestimated because of the limited follow-up time available. Taken together, a rise in dissemination over time appears likely, particularly from 2006 onward. To verify this rise, and to extend the timeline slightly, I undertook an informal search to estimate the publication rate to date of my own graduating class at the University of Toronto, MScPT 2010. This cohort totalled 19 research groups, including one from the Advanced Standing programme. A Facebook request to members of the graduating class of 2010 identified 10 peer-reviewed publications from 10 research groups.4–13 Further bibliographic searching of the class list via Ovid AMED (Allied and Complementary Medicine) and MEDLINE yielded no further publications. Thus, at approximately 2 years' follow-up, the publication rate for the class of 2010 appears to be 52.6%; 50% of these publications appeared in Physiotherapy Canada. Like Salbach and colleagues' estimates for 2008 and 2009, this dissemination rate may be expected to increase with longer follow-up. I believe that the level of dissemination achieved by the scholarly efforts of physiotherapy students is commendable and that it represents an important, and possibly growing, contribution to the base of evidence in our evidence-based/evidence-informed profession. As a relatively recent MScPT graduate, I have found that the first-hand experience of creating and disseminating new research knowledge provided opportunities to learn lessons far beyond the focus of my own group's study. In addition to the role of scholarly practitioner, at least three of the other essential competencies of physiotherapists in Canada can arguably be developed in important ways by participation in research: those of expert, collaborator, and communicator. As a clinician, I find that the experience of creating research, from study design through analysis and publication, has affected the way I treat patients/clients. Key activities in a research endeavour—defining a clear question, finding the appropriate measuring tools to answer that question, distinguishing real effects from potential confounding variables and the expected variation in a system—are thought processes I try to bring to each treatment session. I consistently ask myself, How can I tell if my treatments are effective? and What do I need to measure (and when) to be sure that this is working? In a way, each treatment session is a mini-study in itself. Selecting appropriate assessment measures, analyzing findings, and evaluating the effectiveness of interventions are key components of the role of expert. To ensure that my skills and practice continue to develop, I find I frequently need to check the published literature for evidence-based guidance on patient conditions that are less familiar to me. While developing the research ethics proposal for my student group's study, I learned efficient ways to access peer-reviewed primary literature, sources for meta-analyses, and other expert sites that synthesize health information; these skills now serve me well in my time-strapped practice. Having helped to analyze and write a research manuscript, I find I now have an internal point of…
International Journal of Injury Control and Safety Promotion, 2013
Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study ... more Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study objectives were to identify and estimate current factors associated with seat-belt use and levels of potentially unsafe driving behaviours in Kuwait. In 2010, 741 adults were surveyed regarding driving habits and history. Only 41.6% of drivers reported always using a seat belt. Front seat passenger belt use was more common (30.5%) than rear seat belt use (6.5%). Distracted driving behaviours were common, including mobile phone use (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;always&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;almost always&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;: 51.1%) and texting/SMS (32.4%). Logistic regression indicated that drivers who were young (18-19 years), male, Kuwaiti nationals or non-Kuwaiti Arabs, drove over the speed limit, had traffic violation tickets or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1 car crashes in the last year, were less likely to use seat belts. Targeted initiatives to increase public awareness and to enforce car-safety legislation, including use of seat belts, are necessary to decrease the health burden of car crashes in Kuwait.
To describe and compare patient demographics, inpatient lengths of stay (LOS), and walking-relate... more To describe and compare patient demographics, inpatient lengths of stay (LOS), and walking-related functional outcomes of individuals with spinal cord injuries (SCIs) of traumatic (TSCI) and non-traumatic (NTSCI) etiologies. To contrast these features between individuals who walked from those who did not walk at discharge from inpatient rehabilitation. Prospective observational study; comparisons between TSCI and NTSCI, walkers and non-walkers. Information collected as a pilot project within a provincial SCI informatics strategy. Rehabilitation hospital specialized for SCIs. Adults with NTSCI (n = 31) or TSCI (n = 59) admitted to inpatient rehabilitation, 2007-2009. Lower-extremity motor scores (LEMS), spinal cord independence measure version III (SCIM-III) total and mobility subscores, functional independence measure (FIM), Length of Stay (LOS) at inpatient facilities. Groups (NTSCI vs. TSCI) did not differ in the proportion of individuals that achieved "walker" status (S...
Proceedings of the Royal Society B: Biological Sciences, 2005
Leatherback sea turtles, Dermochelys coriacea, undertake broad oceanic movements. While satellite... more Leatherback sea turtles, Dermochelys coriacea, undertake broad oceanic movements. While satellite telemetry has been used to investigate the post-nesting behaviour of female turtles tagged on tropical nesting beaches, long-term behavioural patterns of turtles of different sexes and sizes have not been described. Here we investigate behaviour for 25 subadult and adult male and female turtles satellite-tagged in temperate waters off Nova Scotia, Canada. Although sex and reproductive condition contributed to variation in migratory patterns, the migratory cycle of all turtles included movement between temperate and tropical waters. Marked changes in rates of travel, and diving and surfacing behaviour, accompanied southward movement away from northern foraging areas. As turtles approached higher latitudes the following spring and summer, they assumed behaviours consistent with regular foraging activity and eventually settled in coastal areas off Canada and the northeastern USA. Behavioural patterns corresponding to various phases of the migratory cycle were consistent across multiple animals and were repeated within individuals that completed return movements to northern waters. We consider the potential biological significance of these patterns, including how turtle behaviour relates to predator avoidance, thermoregulation and prey distribution.
Research into surgeon and pathologist knowledge of guidelines for lymph node (LN) assessment in g... more Research into surgeon and pathologist knowledge of guidelines for lymph node (LN) assessment in gastric cancer demonstrated a knowledge deficit. To understand factors affecting optimal assessment we surveyed pathologists to identify external barriers. Pathologists were identified using two Ontario physician databases and surveyed online or by mail, with a 40% response rate. The majority (56%) of pathologists stated assessing an additional five LNs would not be a burden. Most (80%) pathologists disagreed with pay for performance for achieving quality standards. Qualitative analysis determined the majority of pathologists believed achieving quality standards was inherent to their profession and should not require incentives. Poor surgical specimen was identified as a barrier and underscores the importance of aiming quality improvement initiatives at the multidisciplinary team. In addition to education, tailoring an intervention to address all barriers, including laboratory constraints may be an effective means of improving gastric cancer care.
Adherence to guidelines for adequate gastric cancer specimen assessment is poor in North America.... more Adherence to guidelines for adequate gastric cancer specimen assessment is poor in North America. Inadequate staging and poor prognosis were noted in some series when these guidelines are not met. Recent advances have been made in standardizing cancer pathology reports in Canada; however, the uptake of these reporting systems is unknown for gastric cancer. A survey of pathologists in Ontario was performed to outline the processing techniques and practices for assessing gastric cancer specimens. A survey was designed through a collaboration of surgical oncologists, general surgeons, pathologists, and research staff. Pathologists were identified using the College of Physicians and Surgeons of Ontario and MD Select databases. Participants were surveyed online or by mail-out. The response rate was 40.2% (147/366). Vascular invasion, perineural invasion, and signet ring cells were all reported as being examined for by the majority of pathologists. Fat clearing solution and keratin immunohistochemical techniques were not reported as being consistently utilized. Less than 70% of pathologists indicated using a form of synoptic report. Variations in practice and technique were observed. This may or may not reflect differences in quality of care or simply preferences for achieving equivalent results in the absence of standardized procedures. Education, evidence-based procedural guidelines and further research are required to provide infrastructure and support for pathologists and surgeons involved in the care of gastric cancer patients.
... Yet, while behavioural studies of the short-finned pilot whale, Globicephala macrorhyn-chus, ... more ... Yet, while behavioural studies of the short-finned pilot whale, Globicephala macrorhyn-chus, have been and are being conducted (eg, Shane and McSweeney 1990; Heimlich-Boran 1993), the genetic rela-tionships of individuals have not been studied in detail. ...
Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canad... more Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canada. Method: Questionnaires were mailed to acute-care community hospitals (institutions with >100 inpatient beds, excluding psychiatric, mental health, paediatric, rehabilitation, tertiary, and long-term care facilities) across Canada from January to April 2010. The questionnaire collected information on patient referral criteria, staffing, workload, and compensation for weekend physiotherapy services and on the availability of other rehabilitation health professionals. Results: Of 146 community hospitals deemed eligible, 104 (71%) responded. Weekend physiotherapy was offered at 69% of hospitals across Canada, but this rate varied: ≥75% in all regions except Quebec (30%). Hospitals with a high proportion of acute-care beds were more likely to offer weekend physiotherapy services (logistic regression, p=0.021). Services differed among Saturdays, Sundays, and holidays in terms of the numb...
Scientific inquiry is one of four domains at the centre of the Curriculum Content Framework of th... more Scientific inquiry is one of four domains at the centre of the Curriculum Content Framework of the content guidelines for the Entry-to-Practice Physiotherapy Curriculum in Canadian university programmes;2 the role of scholarly practitioner is one of the seven essential competencies required of physiotherapists in Canada.3 Therefore, teaching key skills required to use, create, and disseminate research knowledge is an important part of physiotherapy education. To illustrate the dissemination of research findings made in the course of the MScPT curriculum at the University of Toronto, Salbach and colleagues1 present rates of presentation and publication by MScPT student research groups from 2003 through 2009. In this retrospective study, the authors found that dissemination efforts by 113 student groups totalled at least 43 presentations at scientific conferences and 32 publications, which, they conclude, represents a “moderate rate” of dissemination. Their study makes an important contribution by presenting the first published rates of scientific dissemination by physiotherapy students—indeed, the only published dissemination rates for health professional trainees other than medical students and residents. Salbach and colleagues used comprehensive methods to identify dissemination events and achieved an excellent response rate, particularly in the later years of their study period. As response rates were lower (<80%) in the early years of the study period, it is possible that the dissemination rates presented for those years (2003, 2004) may be slightly overestimated, if non-responding groups tended to be those that did not publish their findings. In contrast, as the authors note, the dissemination rates presented (particularly for publications) for the later years (2008, 2009) may be underestimated because of the limited follow-up time available. Taken together, a rise in dissemination over time appears likely, particularly from 2006 onward. To verify this rise, and to extend the timeline slightly, I undertook an informal search to estimate the publication rate to date of my own graduating class at the University of Toronto, MScPT 2010. This cohort totalled 19 research groups, including one from the Advanced Standing programme. A Facebook request to members of the graduating class of 2010 identified 10 peer-reviewed publications from 10 research groups.4–13 Further bibliographic searching of the class list via Ovid AMED (Allied and Complementary Medicine) and MEDLINE yielded no further publications. Thus, at approximately 2 years' follow-up, the publication rate for the class of 2010 appears to be 52.6%; 50% of these publications appeared in Physiotherapy Canada. Like Salbach and colleagues' estimates for 2008 and 2009, this dissemination rate may be expected to increase with longer follow-up. I believe that the level of dissemination achieved by the scholarly efforts of physiotherapy students is commendable and that it represents an important, and possibly growing, contribution to the base of evidence in our evidence-based/evidence-informed profession. As a relatively recent MScPT graduate, I have found that the first-hand experience of creating and disseminating new research knowledge provided opportunities to learn lessons far beyond the focus of my own group's study. In addition to the role of scholarly practitioner, at least three of the other essential competencies of physiotherapists in Canada can arguably be developed in important ways by participation in research: those of expert, collaborator, and communicator. As a clinician, I find that the experience of creating research, from study design through analysis and publication, has affected the way I treat patients/clients. Key activities in a research endeavour—defining a clear question, finding the appropriate measuring tools to answer that question, distinguishing real effects from potential confounding variables and the expected variation in a system—are thought processes I try to bring to each treatment session. I consistently ask myself, How can I tell if my treatments are effective? and What do I need to measure (and when) to be sure that this is working? In a way, each treatment session is a mini-study in itself. Selecting appropriate assessment measures, analyzing findings, and evaluating the effectiveness of interventions are key components of the role of expert. To ensure that my skills and practice continue to develop, I find I frequently need to check the published literature for evidence-based guidance on patient conditions that are less familiar to me. While developing the research ethics proposal for my student group's study, I learned efficient ways to access peer-reviewed primary literature, sources for meta-analyses, and other expert sites that synthesize health information; these skills now serve me well in my time-strapped practice. Having helped to analyze and write a research manuscript, I find I now have an internal point of…
International Journal of Injury Control and Safety Promotion, 2013
Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study ... more Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study objectives were to identify and estimate current factors associated with seat-belt use and levels of potentially unsafe driving behaviours in Kuwait. In 2010, 741 adults were surveyed regarding driving habits and history. Only 41.6% of drivers reported always using a seat belt. Front seat passenger belt use was more common (30.5%) than rear seat belt use (6.5%). Distracted driving behaviours were common, including mobile phone use (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;always&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;almost always&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;: 51.1%) and texting/SMS (32.4%). Logistic regression indicated that drivers who were young (18-19 years), male, Kuwaiti nationals or non-Kuwaiti Arabs, drove over the speed limit, had traffic violation tickets or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1 car crashes in the last year, were less likely to use seat belts. Targeted initiatives to increase public awareness and to enforce car-safety legislation, including use of seat belts, are necessary to decrease the health burden of car crashes in Kuwait.
To describe and compare patient demographics, inpatient lengths of stay (LOS), and walking-relate... more To describe and compare patient demographics, inpatient lengths of stay (LOS), and walking-related functional outcomes of individuals with spinal cord injuries (SCIs) of traumatic (TSCI) and non-traumatic (NTSCI) etiologies. To contrast these features between individuals who walked from those who did not walk at discharge from inpatient rehabilitation. Prospective observational study; comparisons between TSCI and NTSCI, walkers and non-walkers. Information collected as a pilot project within a provincial SCI informatics strategy. Rehabilitation hospital specialized for SCIs. Adults with NTSCI (n = 31) or TSCI (n = 59) admitted to inpatient rehabilitation, 2007-2009. Lower-extremity motor scores (LEMS), spinal cord independence measure version III (SCIM-III) total and mobility subscores, functional independence measure (FIM), Length of Stay (LOS) at inpatient facilities. Groups (NTSCI vs. TSCI) did not differ in the proportion of individuals that achieved "walker" status (S...
Proceedings of the Royal Society B: Biological Sciences, 2005
Leatherback sea turtles, Dermochelys coriacea, undertake broad oceanic movements. While satellite... more Leatherback sea turtles, Dermochelys coriacea, undertake broad oceanic movements. While satellite telemetry has been used to investigate the post-nesting behaviour of female turtles tagged on tropical nesting beaches, long-term behavioural patterns of turtles of different sexes and sizes have not been described. Here we investigate behaviour for 25 subadult and adult male and female turtles satellite-tagged in temperate waters off Nova Scotia, Canada. Although sex and reproductive condition contributed to variation in migratory patterns, the migratory cycle of all turtles included movement between temperate and tropical waters. Marked changes in rates of travel, and diving and surfacing behaviour, accompanied southward movement away from northern foraging areas. As turtles approached higher latitudes the following spring and summer, they assumed behaviours consistent with regular foraging activity and eventually settled in coastal areas off Canada and the northeastern USA. Behavioural patterns corresponding to various phases of the migratory cycle were consistent across multiple animals and were repeated within individuals that completed return movements to northern waters. We consider the potential biological significance of these patterns, including how turtle behaviour relates to predator avoidance, thermoregulation and prey distribution.
Research into surgeon and pathologist knowledge of guidelines for lymph node (LN) assessment in g... more Research into surgeon and pathologist knowledge of guidelines for lymph node (LN) assessment in gastric cancer demonstrated a knowledge deficit. To understand factors affecting optimal assessment we surveyed pathologists to identify external barriers. Pathologists were identified using two Ontario physician databases and surveyed online or by mail, with a 40% response rate. The majority (56%) of pathologists stated assessing an additional five LNs would not be a burden. Most (80%) pathologists disagreed with pay for performance for achieving quality standards. Qualitative analysis determined the majority of pathologists believed achieving quality standards was inherent to their profession and should not require incentives. Poor surgical specimen was identified as a barrier and underscores the importance of aiming quality improvement initiatives at the multidisciplinary team. In addition to education, tailoring an intervention to address all barriers, including laboratory constraints may be an effective means of improving gastric cancer care.
Adherence to guidelines for adequate gastric cancer specimen assessment is poor in North America.... more Adherence to guidelines for adequate gastric cancer specimen assessment is poor in North America. Inadequate staging and poor prognosis were noted in some series when these guidelines are not met. Recent advances have been made in standardizing cancer pathology reports in Canada; however, the uptake of these reporting systems is unknown for gastric cancer. A survey of pathologists in Ontario was performed to outline the processing techniques and practices for assessing gastric cancer specimens. A survey was designed through a collaboration of surgical oncologists, general surgeons, pathologists, and research staff. Pathologists were identified using the College of Physicians and Surgeons of Ontario and MD Select databases. Participants were surveyed online or by mail-out. The response rate was 40.2% (147/366). Vascular invasion, perineural invasion, and signet ring cells were all reported as being examined for by the majority of pathologists. Fat clearing solution and keratin immunohistochemical techniques were not reported as being consistently utilized. Less than 70% of pathologists indicated using a form of synoptic report. Variations in practice and technique were observed. This may or may not reflect differences in quality of care or simply preferences for achieving equivalent results in the absence of standardized procedures. Education, evidence-based procedural guidelines and further research are required to provide infrastructure and support for pathologists and surgeons involved in the care of gastric cancer patients.
... Yet, while behavioural studies of the short-finned pilot whale, Globicephala macrorhyn-chus, ... more ... Yet, while behavioural studies of the short-finned pilot whale, Globicephala macrorhyn-chus, have been and are being conducted (eg, Shane and McSweeney 1990; Heimlich-Boran 1993), the genetic rela-tionships of individuals have not been studied in detail. ...
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Papers by Andrea Ottensmeyer