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No description available.

Bakgrund: Snabb kunskapsutveckling, ökade krav på kvalité och kostnadseffektivitet inom hälso- och sjukvården gör det viktigt att sjuksköterskor har god förmåga att söka och använda evidensbaserad kunskap. Idag finns ett glapp mellan forskning och klinik. Sjuksköterskor upplever flera hinder till att arbeta evidensbaserat. Under hösten 2010 och våren 2011 pågick ett projekt på ett sjukhus i en stad i mellansverige. Projektet hette ”Klinisk bibliotekarie”, syftet var att höja vårdkvalitén och patientsäkerheten genom att det dagliga vårdarbetet ska bli mer evidensbaserat och att sjuksköterskorna ska känna större säkerhet i att ta fram vetenskapligt underlag för sitt arbete. Syfte: Belysa sjuksköterskornas erfarenhet av projektet ”Klinisk bibliotekarie”. Metod: Studien har en kvalitativ design. Data samlades in genom fokusgrupper och observationer. Tjugoen sjuksköterskor deltog i projektet ”Klinisk Bibliotekarie” och av dessa har nitton deltagit i föreliggande studie genom fokusgruppdiskussioner. Observationer har skett vid två tillfällen. Data analyserades med manifest och latent innehållsanalys. Resultat: Sjuksköterskorna anser att interventioner för att öka evidensbaserat arbete ska baseras på frivillighet och intresse. Vidare anser sjuksköterskorna att det ska avsättas adekvat med tid för det arbetet. En positiv effekt av projektet är, enligt sjuksköterskorna, att det etablerats en kontakt med bibliotekarien. Konklusion: För att omvårdnaden ska bli mer evidensbaserad behövs intresserade sjuksköterskor och avsatt tid. En klinisk bibliotekarie kan vara ett stöd för sjuksköterskorna. / Background: Rapid development of knowledge, increased demands on quality and cost efficiency within healthcare makes it important that nurses have the ability to seek and use evidence-based knowledge. Today there is a gap between research and clinic. Nurses are experiencing multiple barriers to work evidence based. In autumn 2010 and spring 2011 has a project been going on at a hospital in a town in central Sweden. The project was called "Clinical Librarian" and aimed to raise the quality of care and patient safety by the daily care work to become more evidence based and that nurses should feel more secure in the development of scientific basis for its work. Objective: To highlight nurses' experience of working with the project "Clinical Librarian". Method: The study has a qualitative design. Data has been collected through focus groups and observations. Twenty-one nurses participated in the project “Clinical Librarian” and of these nineteen participated in this study through focus group discussions. Observations have been made on two occasions. Data has been analyzed with manifest and latent content analysis. Results: The nurses feel that interventions to improve evidence-based nursing should be based on voluntary participation and interest. They also believe that it should be allocated adequate time for such work. A positive impact of the project, according to the nurses, is that it established a contact with the librarian. Conclusion: To become more evidens-based tce care needs interestad nurses and time for the purpose. A clinical librarian can be a support for the nurses.

The understanding that Attention Deficit/ Hyperactivity Disorder (ADHD) commonly persists into adulthood has not been widely accepted until recently. Accordingly, less is known about diagnostic and treatment prevalence or health and social outcomes of ADHD in adulthood. The objectives of this study were to: determine lifetime prevalence of ADHD diagnosis and treatment for Manitoba young adults, investigate whether a socioeconomic gradient exists within Manitoba young adults with a lifetime diagnosis of ADHD, and investigate the relationship between ADHD in Manitoba young adults and health service utilization. Using the Manitoba Population Health Research Data Repository, this cross-sectional analysis used 24 years of data (1984/85-2008/09) and included all Manitoba adults aged 18-29 during 2007/08-2008/09 with a lifetime diagnosis of ADHD. Crude prevalence was calculated for ADHD diagnosis and psychostimulant prescriptions, in addition to several demographic variables. The presence of a socioeconomic gradient in lifetime ADHD diagnosis was investigated using Poisson and negative binomial regression. Relationships between young adults with lifetime ADHD diagnosis and health service utilization for several health and social outcome variables were explored using a matched cohort design with two comparison groups and GEE regression models. In relation to previous Manitoba research on childhood ADHD, the socioeconomic gradient for ADHD diagnosis was found to dissipate into young adulthood. However, when region of residence was accounted for, a small inverse gradient in the urban population and a direct gradient in the rural population were evident. Individuals from the highest income quintile were significantly less likely to be diagnosed before age 18 than all other income quintiles. Depression, anxiety, personality disorders, conduct disorder, substance abuse, multiple types of injuries, receipt of income assistance, and reduced high school graduation were significantly correlated with lifetime ADHD diagnosis. Given the high lifetime prevalence of ADHD in Manitoba young adults, significant socioeconomic correlates for diagnosis, and multitude of adverse health and social outcomes in this population, further investigation into the trajectory of this relatively unexplored population is recommended. Furthermore, continued measurement of the provision and success of additional resources will ultimately be necessary for enhancing the health status of all Canadian adults living with ADHD.

Objectives: (1) To calculate rates for maxillofacial (MF) injury-related visits in emergency departments (EDs) and hospitals in Ontario; (2) To investigate socio-demographic distribution of MF injuries; (3) To identify common causes for MF injuries. Methods: An 8-year retrospective study design was implemented. Two datasets were used: Discharge Abstract Database and National Ambulatory Care Reporting System. Color-coded maps were created using ArcGIS. Results: From 2004 to 2012 in Ontario, 1,457,990 ED visits and 41,057 hospitalizations due to MF injuries were registered. MF injuries are most frequent in males and occur mainly in evenings (7:00 to 9:00 pm) and weekends. Higher rates of MF injury are seen in rural areas and low-income neighborhoods. The leading cause of MF injuries is falls. Conclusion: 3 out of 100 ED visits and 1 out of 200 hospitalizations were caused by MF injury. Male youth and female older people suffered high rates of MF injury.

Objectives: (1) To calculate rates for maxillofacial (MF) injury-related visits in emergency departments (EDs) and hospitals in Ontario; (2) To investigate socio-demographic distribution of MF injuries; (3) To identify common causes for MF injuries. Methods: An 8-year retrospective study design was implemented. Two datasets were used: Discharge Abstract Database and National Ambulatory Care Reporting System. Color-coded maps were created using ArcGIS. Results: From 2004 to 2012 in Ontario, 1,457,990 ED visits and 41,057 hospitalizations due to MF injuries were registered. MF injuries are most frequent in males and occur mainly in evenings (7:00 to 9:00 pm) and weekends. Higher rates of MF injury are seen in rural areas and low-income neighborhoods. The leading cause of MF injuries is falls. Conclusion: 3 out of 100 ED visits and 1 out of 200 hospitalizations were caused by MF injury. Male youth and female older people suffered high rates of MF injury.

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This study examined the effect of interdisciplinary discharge planning rounds on timing of social work intervention, length of stay (LOS), and readmission for patients aged 65 and over. Data sources were the medical charts of 449 patients discharged during two corresponding 28 day periods (one before end one after the implementation of rounds) supplemented by Discharge Planning Committee minutes (DPCM) and interviews with four key informants. No significant differences in the timing of social work intervention, LOS, or readmissions were found between the two samples. Qualitative research revealed that essential components were either missing (physician participation), or not uniformly included (family participation) in rounds, and that staff felt that rounds improved communication among the disciplines and contributed to improved efficiency in planning hospital and posthospital services. These findings highlight the need to further study all aspects of the complex discharge planning process to identify factors that would reduce LOS and readmissions.

Model Forests were developed to bridge the gap between the emerging policy and the practice of sustainable forest management (SFM) in the early 1990s and, as such, to facilitate uptake of research findings into practice. The purpose of this study was to explore mechanisms that may explain why some research results are used in the policy and practice of SFM and others are not. Based on interviews in three Model Forests in Canada, the most prominent factors influencing research utilization identified were (1) relevance of the research findings to users’ needs, (2) effective research design and scientific credibility, and (3) user involvement in the research process. However, it was evident that there is no one factor that influences uptake, but rather a combination dependent upon the circumstances of each situation. This study also deepens understanding of the science–practice/policy interface by exploring the notion of Model Forests as boundary organizations.