Suchergebnisse

BackgroundPolicy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined. This study developed a new conceptual framework for PA policy analysis - the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework.MethodsThe development of the CAPPA framework was based on: (i) an extensive review of literature; (ii) an open discussion between the authors; (iii) three rounds of a Delphi process; and (iv) two-rounds of consultations with PA policy stakeholders.ResultsThe CAPPA framework specifies 38 elements of a comprehensive analysis of PA policies in the following six categories, which comprise the building blocks of the framework: (i) purpose of analysis (including auditing and assessment of policies); (ii) policy level (including: international; national; subnational; local; and institutional policies); (iii) policy sector (including: health; sport; recreation and leisure; education; transport; environment; urban/rural planning and design; tourism; work and employment; public finance; and research sectors); (iv) type of policy (including: formal written policies; unwritten formal statements; written standards and guidelines; formal procedures; and informal policies); (v) stage of policy cycle (including: agenda setting; formulation; endorsement/legitimisation; implementation; evaluation; maintenance; termination; and succession); and (vi) scope of analysis (including availability; context; processes; actors; political will; content; and effects). Based on the CAPPA framework, we also proposed broad and inclusive definitions of PA policy and PA policy analysis.ConclusionThe CAPPA framework may be used to guide future studies related to PA policy and to provide a context for the analysis of its specific components. The framework could be used in the same way for sedentary behaviour policy research. Future research should examine the extent to which PA policy analysis has covered each of the elements specified in the CAPPA framework and analyse the elements for which evidence is lacking. Future studies should also determine whether the existing tools allow for auditing and assessment of all the CAPPA elements and develop new tools if needed to allow for a more comprehensive PA policy analysis.

BackgroundPolicy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined. This study developed a new conceptual framework for PA policy analysis - the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework.MethodsThe development of the CAPPA framework was based on: (i) an extensive review of literature; (ii) an open discussion between the authors; (iii) three rounds of a Delphi process; and (iv) two-rounds of consultations with PA policy stakeholders.ResultsThe CAPPA framework specifies 38 elements of a comprehensive analysis of PA policies in the following six categories, which comprise the building blocks of the framework: (i) purpose of analysis (including auditing and assessment of policies); (ii) policy level (including: international; national; subnational; local; and institutional policies); (iii) policy sector (including: health; sport; recreation and leisure; education; transport; environment; urban/rural planning and design; tourism; work and employment; public finance; and research sectors); (iv) type of policy (including: formal written policies; unwritten formal statements; written standards and guidelines; formal procedures; and informal policies); (v) stage of policy cycle (including: agenda setting; formulation; endorsement/legitimisation; implementation; evaluation; maintenance; termination; and succession); and (vi) scope of analysis (including availability; context; processes; actors; political will; content; and effects). Based on the CAPPA framework, we also proposed broad and inclusive definitions of PA policy and PA policy analysis.ConclusionThe CAPPA framework may be used to guide future studies related to PA policy and to ...

Afestschrift is a collection of essays written to honour the contributions of a colleague during his or her career. These essays are not about the colleague, but about the science. A theme is often chosen to align with the interests of the honoree. In June 2017, several colleagues of Dr. Roger Keith will gather in Saskatoon, Sask., to discuss topics regarding the past and future of surgery and its subspecialties, particularly surgical education and hepatopancreatobiliary surgery. The Canadian Journal of Surgery is pleased to collaborate in the production of this festschrift for its former editor, Dr. Keith. Roger Keith was born in Calgary in August 1940. After completing his medical doctorate at the University of Alberta and general surgery residency at the University of Toronto, Dr. Keith went to Toulouse (Professor Jean Escat), London (Sir Rodney Smith), Los Angeles (Dr. William Longmire) and Seattle (Dr. Thomas T. White) to gain the best training in liver and pancreatic surgery (known today as HPB surgery). Hepatopancreatobiliary surgery, including endoscopic retrograde cholangiopancreatography, became Dr. Keith's specialty, and he led its development in Canada over the next 40 years. In 1990 he moved back west and became the professor and head of surgery at the University of Saskatchewan. He contributed to the rapid development of surgical education through leadership roles, many of which continue today, at the Royal College of Physicians and Surgeons of Canada, the American College of Surgeons, the Canadian Association of General Surgeons, the American Surgical Association and the James IV Association of Surgeons. Dr. Keith was editor-in-chief of the Canadian Journal of Surgery from 1992 to 1998.1 Vivian McAlister, MB Accepted Dec. 21, 2016 Correspondence to: V. McAlister Department of Surgery Western University London ON N6A 5A5 vmcalist@uwo.ca DOI:10.1503/cjs.016816 The festschrift in honour of Dr. Roger Keith, past editor of the Canadian Journal of Surgery, includes essays (available at canjsurg.ca), written from a personal perspective, on the development of specialty surgery in Canada (Richard Nason, Michael Marcaccio, Michael Kelly and Lissa Peeling), evolution of the certification examination (Ward Davies), building of a megahospital (Gerald Fried) and on the changes in surgical education (Grant Miller, Anees Chagpar, Christopher DeGara, E. Christopher Ellison, Richard Prinz and William Pollett), as well as personal reflections (Andrew Warshaw, Stewart Hamilton). Summary Dr. Roger Keith, editor-in-chief of the Canadian Journal of Surgery from 1992 to 1998. COMMENTARY Can J Surg, Vol. 60, No. 1, February 2017 7 This festschrift is opened by a description of challenges facing medical schools in the 21st century (Dr. Grant Miller, University of Saskatchewan) and continues with essays on the development surgery in Canada: neurosurgery in Saskatchewan (Drs. Michael Kelly and Lissa Peeling, University of Saskatchewan); HPB surgery, including transplantation (Dr. William Wall, University of Western Ontario); head and neck surgery (Dr. Richard Nason, University of Manitoba) and endoscopy (Dr. Michael Marcaccio, McMaster University) as well as a personal account of participation in Canada's military hospital in Kandahar, Afghanistan, as a civilian surgeon (Dr. Stewart Hamilton, University of Alberta). Essays on surgical education include the topics of undergraduate education (Dr. Christopher DeGara, University of Alberta), postgraduate education (Dr. E. Christopher Ellison, Ohio State University; Dr. Anees Chagpar, Yale University School of Medicine), academic surgery (Dr. Richard Prinz, University of Chicago) and continuing education (Dr. William Pollett, Memorial University of Newfoundland). Chief examiner Dr. Ward Davies (University of Western Ontario) reflects on the evolution of the certification examinations of the Royal College. Dr. Gerald Fried (McGill University) describes the development of Canada's latest megahospital in Montreal. These essays are written from a personal perspective by surgical colleagues of Dr. Keith who also have a lifetime of contributions to the science. As Dr. Andrew Warshaw (Harvard Medical School) remarked referring to his idol of outcome research in surgery, Dr. Ernest Codman (1869–1940), that Dr. Keith's career would have met with praise and approval from Dr. Codman, a sentiment echoed in the essays of this festschrift.

BACKGROUND: Small studies suggest an association between ANCA-associated vasculitis (AAV) incidence and rurality, seasonality and socioeconomic deprivation. We examined the incidence of kidney biopsy-proven AAV and its relationship with these factors in the adult Scottish population. METHODS: Using the Scottish Renal Biopsy Registry, all adult native kidney biopsies performed between 2014 and 2018 with a diagnosis of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) were identified. The Scottish Government Urban Rural Classification was used for rurality analysis. Seasons were defined as autumn (September–November), winter (December–February), spring (March–May) and summer (June–August). Patients were separated into quintiles of socioeconomic deprivation using the validated Scottish Index of Multiple Deprivation and incidence standardised to age. Estimated glomerular filtration rate and urine protein:creatinine ratio at time of biopsy were used to assess disease severity. RESULTS: 339 cases of renal AAV were identified, of which 62% had MPA and 38% had GPA diagnosis. AAV incidence was 15.1 per million population per year (pmp/year). Mean age was 66 years and 54% were female. Incidence of GPA (but not MPA) was positively associated with rurality (5.2, 8.4 and 9.1 pmp/year in 'urban', 'accessible remote' and 'rural remote' areas, respectively; p=0.04). The age-standardised incidence ratio was similar across all quintiles of deprivation (p=ns). CONCLUSIONS: Seasonality and disease severity did not vary across AAV study groups. In this complete national cohort study, we observed a positive association between kidney biopsy-proven GPA and rurality.

Background: Small studies suggest an association between ANCA-associated vasculitis (AAV) incidence and rurality, seasonality and socioeconomic deprivation. We examined the incidence of kidney biopsy-proven AAV and its relationship with these factors in the adult Scottish population. Methods: Using the Scottish Renal Biopsy Registry, all adult native kidney biopsies performed between 2014 and 2018 with a diagnosis of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) were identified. The Scottish Government Urban Rural Classification was used for rurality analysis. Seasons were defined as autumn (September–November), winter (December–February), spring (March–May) and summer (June–August). Patients were separated into quintiles of socioeconomic deprivation using the validated Scottish Index of Multiple Deprivation and incidence standardised to age. Estimated glomerular filtration rate and urine protein:creatinine ratio at time of biopsy were used to assess disease severity. Results: 339 cases of renal AAV were identified, of which 62% had MPA and 38% had GPA diagnosis. AAV incidence was 15.1 per million population per year (pmp/year). Mean age was 66 years and 54% were female. Incidence of GPA (but not MPA) was positively associated with rurality (5.2, 8.4 and 9.1 pmp/year in 'urban', 'accessible remote' and 'rural remote' areas, respectively; p=0.04). The age-standardised incidence ratio was similar across all quintiles of deprivation (p=ns). Conclusions: Seasonality and disease severity did not vary across AAV study groups. In this complete national cohort study, we observed a positive association between kidney biopsy-proven GPA and rurality.