Archive for May 2016

In memoriam for Beatrice (Bea) Ann McDonoughEn mémoire de Beatrice (Bea) Ann McDonough

Beatrice (Bea) Ann McDonough:

We are saddened by the loss of our colleague and friend Beatrice (Bea) McDonough who passed away on February 21, 2015. Bea was a public health clinician with a research background in health promotion, population health, implementation research, knowledge translation and community development. She was an integral part of our research team in the Department of Family Medicine working mainly on the Cardiovascular Health Awareness Program (CHAP) and the Truckers Research for Innovative Health Promotion Programs (TRIHPP). Bea had an innate ability to mentor others, continually provided support and encouragement to her colleagues and trainees, and brought a positive energy to every project. She was a tireless advocate for the needs of marginalized and vulnerable populations and brought these issues to the forefront of her research. Bea was an accomplished researcher and teacher. She completed a Masters in Nursing Science and a Masters in Science and was working towards completing her PhD in health policy and organizational networks at the University of Toronto. She held cross appointments as an adjunct associate professor in the Department of Family Medicine at McMaster University and as a clinical faculty member in the Faculty of Nursing at McMaster University. Bea tutored and supervised undergraduate and graduate students in Nursing and the Masters of Health Promotion programs. Bea was a co-investigator with the CHAP for 13 years. In that time, she provided the health promotion context and chronic disease prevention risk mitigation perspective. She was also responsible for recruiting many of CHAP’s community partners and developing part of the training for the peer volunteer aspect of the program. Bea’s most recent contribution was as a co-lead for the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS); a community based initiative focused on the promotion and prevention of chronic conditions in older adults living in subsidized housing. Bea also co-led the Diffusion of Health Innovation area of work within the Hamilton area Hypertension Collaborative that focused on how the organization of community-based networks foster screening, prevention and management of blood pressure through knowledge transfer and integration of research into practice. Bea was also involved in workplace health and wellness research with vulnerable populations in health promotion focusing on nontraditional occupations, specifically the transportation industry. She was the co-lead of the Canadian Health Institutes of Research (CIHR) funded project Primary Health Care and Truck Drivers, and a CIHR funded dissemination grant that hosted knowledge transfer workshops with stakeholders in the trucking industry. This workplace initiative is the first in Canada to examine male lone workers in the transport sector, both from an individual health risk perspective and an organizational workplace capacity perspective. Bea’s research contributions reflected her focus on population health and primary health issues and the integration of community-based and primary health care approaches to chronic disease prevention and management. Bea breadth of knowledge, depth of commitment and positive energy made her a joy to work with as a research leader within the Department of Family Medicine. Bea will be greatly missed by her colleagues.

Nous sommes attristés par le décès de notre collègue et amie (Bea) McDonough, qui est décédée le 21 février 2015. Bea était une clinicienne en santé publique qui avait une expérience en recherche dans les domaines de promotion de la santé, de la santé de la population, de la recherche sur la mise en œuvre, du transfert des connaissances et du développement communautaire. Elle faisait partie intégrante de notre équipe de recherche au Département de médecine familiale, œuvrant principalement dans le Programme de sensibilisation à la santé cardiovasculaire (PSSC) et les Truckers Research for Innovative Health Promotion Programs (TRIHPP). Bea avait la capacité innée de conseiller les autres, appuyait et encourageait continuellement ses collègues et les stagiaires, et apportait une énergie positive à chaque projet. Elle défendait sans relâche les besoins des populations marginalisées et vulnérables et mettait ces questions au premier plan de sa recherche.

Bea était une chercheuse et professeure chevronnée. Elle avait obtenu une maîtrise en sciences infirmières et une maîtrise en sciences, et suivait des cours en vue d’obtenir un doctorat en politique de la santé et en réseaux organisationnels à l’Université de Toronto. Elle avait été nommée à la fois professeure agrégée adjointe au Département de médecine familiale à l’Université McMaster et membre du corps enseignant de clinique à la Faculté des soins infirmiers à cette même université. Bea offrait des services de tutorat et supervisait les étudiants de premier cycle et des cycles supérieurs dans le cadre des programmes de soins infirmiers et de la maîtrise en promotion de la santé.

Bea a été cochercheuse au PSSC pendant 13 ans. Pendant cette période, elle a fourni le contexte de promotion de la santé et la perspective d’atténuation du risque en matière de prévention des maladies chroniques. Elle était aussi chargée de recruter bon nombre des partenaires communautaires du PSSC et de concevoir une partie de la formation liée au volet de bénévolat des pairs du programme. La plus récente contribution de Bea a été la codirection du Programme d’évaluation de la santé dans la collectivité par les services médicaux d’urgence (CHAPS-EMS), une initiative communautaire axée sur la promotion et la prévention de conditions chroniques chez les adultes âgés habitant dans des logements subventionnés. Bea a aussi codirigé le secteur de travail sur la diffusion des innovations en santé au sein de la Hypertension Collaborative de la région de Hamilton qui portait sur la façon dont l’organisation de réseaux communautaires encourage le dépistage, la prévention et la gestion de la pression artérielle par le transfert des connaissances et l’intégration de la recherche dans la pratique.

Bea participait aussi à la recherche sur la santé et le mieux-être au travail avec les populations vulnérables en promotion de la santé axée sur les professions non traditionnelles, plus particulièrement l’industrie des transports. Elle codirigeait le projet Primary Health Care and Truck Drivers [Soins de santé primaires et camionneurs] financé par les Instituts de recherche en santé du Canada (IRSC), de même qu’une subvention de diffusion financée par les IRSC qui permettait d’organiser des ateliers de transfert des connaissances à l’intention des intervenants de l’industrie du transport routier.

Cette initiative en milieu de travail constitue la première initiative d’étude de la situation des travailleurs masculins solitaires œuvrant dans le secteur des transports, tant sur le plan du risque pour la santé personnelle que sur le plan de la capacité organisationnelle en milieu de travail.

Les travaux de recherche de Bea témoignaient de l’attention qu’elle portait aux questions de santé de la population et des soins primaires, et à l’intégration d’approches communautaires et de soins de santé primaires à l’égard de la prévention et de la gestion des maladies chroniques. L’étendue des connaissances de Bea ainsi que son degré d’engagement et son énergie positive en faisaient un chef de recherche très agréable au Département de médecine familiale. Bea manquera beaucoup à ses collègues.

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CHAP has been selected as one of the Ten most notable family medicine research studies in Canada by CFPC/SORLe PSSC sélectionné comme l’une des 10 études les plus notables en recherche de médecine familiale au Canada par le CMFC

The top 10 most noteworthy family medicine research studies are presented in this article and illustrate the unique contribution that Canadian family medicine research brings to health care in Canada. They have helped advance the quality of health care and improve care delivery, beneficially influencing health care practices, health care policy, and patient experiences. These Canadian studies in family medicine have contributed to improving the delivery of family medicine in Canada and throughout the world.

  • A primary care pragmatic cluster randomized trial of the use of home blood pressure monitoring on blood pressure levels in hypertensive patients with above target blood pressure. In this award-winning paper by Dr Marshall Godwin and colleagues, it was demonstrated that home blood pressure (BP) monitoring did not improve BP compared with usual care at 12 months’ follow-up, but that it might improve BP monitoring in men. Further studies are needed.
  • Does episiotomy prevent perineal trauma and pelvic floor relaxation? First North American trial of episiotomy.Dr Michael Klein questioned the use of episiotomy in childbirth, which was being widely used, because he suspected that it caused many of the problems it was supposed to prevent. He and his colleagues carried out the first North American trial of episiotomy in childbirth. The work of Dr Klein and colleagues is often credited for the dramatic reduction in the use of episiotomy.
  • The impact of patient-centred care on outcomes. Published in 2000 by a team of family medicine researchers at Western University, this study was one of the first to demonstrate that the patient-centred clinical method improved health outcomes. Since the publication of this study, patient-centredness has become a foundation of the practice of family medicine.
  • The Kahnawake Schools Diabetes Prevention Project: intervention, evaluation, and baseline results of a diabetes primary prevention program with a Native community in Canada. Published in 1997 by Dr Ann Macaulay and colleagues, this study demonstrated the feasibility of implementing a community-based diabetes prevention program in an aboriginal community through the use of participatory research.
  • Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP). This very large, well designed study, which involved 39 communities in 2 Canadian provinces, demonstrated how, at the community level with the support of family doctors, a simple BP test in older adults could be taken in a setting like a pharmacy by trained volunteers and could decrease death and hospitalization from heart disease.
  • The impact of not having a primary care physician among people with chronic conditions. Carried out by researchers at the Institute for Clinical Evaluative Sciences, this 2008 study shows how important having a family doctor can be in avoiding emergency department visits, reducing health care costs, and reducing demands on the health care system.
  • Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward.This study demonstrated the feasibility of the development of a pan-Canadian primary care research network that would help researchers collect longitudinal data from practices across Canada to assess the primary care epidemiology and management of 5 chronic diseases: hypertension, diabetes, depression, chronic obstructive pulmonary disease, and osteoarthritis.
  • Principles for the justification of public health intervention.This study by Dr Ross Upshur focuses on the intersection of primary care and public health, particularly with respect to the interrelationship between ethics and evidence. These principles are colloquially and widely referred to as the Upshur principles.
  • Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care. Ontario has been on the leading edge of primary care reform with its family health teams, aiming to demonstrate how teams of caregivers can improve performance and health outcomes in primary care. This rigorously designed study demonstrated the effectiveness of an intervention delivered by nurse facilitators in improving preventive care procedures in primary care settings.
  • Prevalence of multimorbidity among adults seen in family practice. This study was the first in Canada to examine multimorbidity in the adult population receiving primary care from family physicians. It demonstrates the complexity of problems common in the Canadian population that confront family physicians daily.

For more information visit: http://www.cfp.ca/content/61/6/523.full

En novembre 2014, à l’occasion du dixième anniversaire du jour de la recherche en médecine familiale de la section des chercheurs du Collège des médecins de famille du Canada, des représentants de cette section ont voulu identifier 10 études de recherche particulièrement notables qui ont été effectuées au Canada et qui ont influencé la pratique et amélioré les soins des patients.

  • A primary care pragmatic cluster randomized trial of the use of home blood pressure monitoring on blood pressure levels in hypertensive patients with above target blood pressure.In this award-winning paper by Dr Marshall Godwin and colleagues, it was demonstrated that home blood pressure (BP) monitoring did not improve BP compared with usual care at 12 months’ follow-up, but that it might improve BP monitoring in men. Further studies are needed.
  • Does episiotomy prevent perineal trauma and pelvic floor relaxation? First North American trial of episiotomy.Dr Michael Klein questioned the use of episiotomy in childbirth, which was being widely used, because he suspected that it caused many of the problems it was supposed to prevent. He and his colleagues carried out the first North American trial of episiotomy in childbirth. The work of Dr Klein and colleagues is often credited for the dramatic reduction in the use of episiotomy.
  • The impact of patient-centred care on outcomes.Published in 2000 by a team of family medicine researchers at Western University, this study was one of the first to demonstrate that the patient-centred clinical method improved health outcomes. Since the publication of this study, patient-centredness has become a foundation of the practice of family medicine.
  • The Kahnawake Schools Diabetes Prevention Project: intervention, evaluation, and baseline results of a diabetes primary prevention program with a Native community in Canada.Published in 1997 by Dr Ann Macaulay and colleagues, this study demonstrated the feasibility of implementing a community-based diabetes prevention program in an aboriginal community through the use of participatory research.
  • Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP).This very large, well designed study, which involved 39 communities in 2 Canadian provinces, demonstrated how, at the community level with the support of family doctors, a simple BP test in older adults could be taken in a setting like a pharmacy by trained volunteers and could decrease death and hospitalization from heart disease.
  • The impact of not having a primary care physician among people with chronic conditions.Carried out by researchers at the Institute for Clinical Evaluative Sciences, this 2008 study shows how important having a family doctor can be in avoiding emergency department visits, reducing health care costs, and reducing demands on the health care system.
  • Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward.This study demonstrated the feasibility of the development of a pan-Canadian primary care research network that would help researchers collect longitudinal data from practices across Canada to assess the primary care epidemiology and management of 5 chronic diseases: hypertension, diabetes, depression, chronic obstructive pulmonary disease, and osteoarthritis.
  • Principles for the justification of public health intervention.This study by Dr Ross Upshur focuses on the intersection of primary care and public health, particularly with respect to the interrelationship between ethics and evidence. These principles are colloquially and widely referred to as the Upshur principles.
  • Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care.Ontario has been on the leading edge of primary care reform with its family health teams, aiming to demonstrate how teams of caregivers can improve performance and health outcomes in primary care. This rigorously designed study demonstrated the effectiveness of an intervention delivered by nurse facilitators in improving preventive care procedures in primary care settings.
  • Prevalence of multimorbidity among adults seen in family practice. This study was the first in Canada to examine multimorbidity in the adult population receiving primary care from family physicians. It demonstrates the complexity of problems common in the Canadian population that confront family physicians daily.

Pour plus d’information, visitez: http://www.cfp.ca/content/61/6/523.full

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C-CHAP was selected by BMJ as one of the Twenty top papers to mark: The BMJ’s two digital decadesLe PSSC sélectionné par la revue BMJ dans son palmarès des 20 articles les plus marquants de ses 20 ans de parution en ligne


To mark the 20th anniversary of The BMJ’s website, the journal asked 20 UK and international readers, authors, friends, and former colleagues to name an outstanding article published since the mid-1990s. The result is an extraordinary mix of editorials, research papers, analysis, and comment, including an investigation, on topics as wide ranging as the MMR vaccine scare, death, evidence based medicine, and the use of stirrups for pelvic examinations. Some represent seminal moments in recent medical history, others are pieces of research that, for their sheer simplicity and focus on patient experience, have inspired our readers to think and work differently.

So here is The BMJ’s top 20 and why, according to our 20 chosen readers, they are the best.

Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP), Januz Kaczorowski, Larry W Chambers, Lisa Dolovich, et al (Research, BMJ 2011;342:d442, doi:10.1136/bmj.d442)

“This article will have enormous influence over the coming years because it tests, with positive, patient important results, an intervention aimed at harnessing ‘volunteer power’ in the community.” Brian Haynes, professor of clinical epidemiology and medicine, McMaster University Faculty of Health Sciences, Canada.

For more information visit: http://www.bmj.com/content/351/bmj.h3660

Voici un lien vers le Top 20 du BMJ et pourquoi, selon les 20 lecteurs sélectionnés, ils sont les meilleurs.

Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP), Januz Kaczorowski, Larry W Chambers, Lisa Dolovich, et al (Research, BMJ 2011;342:d442, doi:10.1136/bmj.d442)

Pour plus d’information, visitez: http://www.bmj.com/content/351/bmj.h3660

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