The functional resonance analysis method as a health care research methodology: a scoping review protocol.

OBJECTIVE: The objective of this review is to examine and map the literature on the use of the functional resonance analysis method in health care research. INTRODUCTION: Health care systems are highly complex and involve interrelated functions, organizations, individuals, and technologies. Understanding how these elements interact and impact health care processes is difficult because of inherent contextual and human variables. The functional resonance analysis method offers an approach to deconstruct complex systems and examine relationships between individual processes and elements. By using the functional resonance analysis method, researchers can map health care processes and uncover performance variables that can emerge and strengthen, or compromise, intended outcomes. Insight into how the functional resonance analysis method has been operationalized in health care research will help researchers and policy makers understand how the method can be used to strengthen health care systems. INCLUSION CRITERIA: The scoping review will consider research and narrative reports on the application of the functional resonance analysis method in health care research. The concepts of interest are the research questions/aims/objectives, methods used to operationalize the functional resonance analysis method, key concepts and definitions of the functional resonance analysis method, and key findings. Studies that used the functional resonance analysis method in any health care setting will be considered. METHODS: The scoping review will aim to locate published and unpublished literature by employing a three-step search strategy. Only papers published in English will be considered and no limits will be placed on the year of publication. Data extracted will include key concepts and definitions of the functional resonance analysis method, research questions/aims/objectives, methods used to operationalize the functional resonance analysis method, and key findings. Extracted data will be reported in tabular form and presented narratively to express the review question.

Assessment of the benefit of powered exercises for muscular endurance and functional capacity in elderly participants.

BACKGROUND: Aging is accompanied by a significant loss of strength which further contributes to loss of functional ability and a propensity for injury. The purpose of this study was to assess the effectiveness of power assisted exercises on muscle endurance and functional capacity of elderly participants following 12 weeks of supervised training. METHODS: Elderly subjects (N = 53) were randomly assigned to either the experimental or the control group. The experimental group trained for 12 weeks using powered exercise machines incorporating only concentric contractions while attempting to accelerate the preset, moving levers. Training involved 6 separate machines and using both upper- and lower-body musculature. Pre- and posttests consisted of Timed Chair Stand, Up and Go Test, arm curl, bench press, leg extension, triceps extension, and the Berg Balance Scale Assessment. RESULTS: Analysis yielded significant improvements (P < .05) by the experimental group over the control group in all measures of muscle endurance, balance, and functional capacity. An improvement in balance paralleled muscle endurance improvements. CONCLUSIONS: Powered exercise equipment when used actively, will generate both upper- and lower-body muscle endurance in elderly participants in a safe exercise environment and such improvement also generated improvement in balance.

Assessment of the effectiveness of a sublingual, ergogenic spray on muscle strength and power.

Nutrients, chemicals, and drugs may be applied sublingually to provide faster absorption. Sublingual absorption occurs when a substance comes in contact with the buccal mucosa, where it diffuses through a membrane of the dense capillaries. The purpose of this study was to assess the effectiveness of a sublingual, ergogenic product containing vitamins, minerals, amino acids, and a coenzyme on muscle performance. National Collegiate Athletic Association Division I linemen (n = 23) voluntarily participated in the study. All participants (20.11 +/- 1.45 years, 132.1 +/- 9.85 kg, 191.19 +/- 3.85 cm) were tested on 102.1 kg (225 lb) bench press repetitions, vertical jump, and grip strength. One week later, participants were either a placebo or the experimental treatment before they were tested again. Repeated-measures analyses of variance (ANOVAs) yielded a significant (p = 0.046) gain for the bench press. A Newman-Keuls post hoc test revealed a significant change in the treatment group but not in the placebo group. While the treatment group demonstrated greater improvement over the placebo group for each of the remaining variables, none were significant: vertical jump (p = 0.65) and grip strength (p = 0.74). The inconsistency of the results may be due to several factors. First, the spray may not be an ergogenic agent; second, the standardized dose may be too small for those weighing >or=290 lb and should be administered based on weight. Furthermore, the coenzyme and amino acids may not possess the molecular size, solubility, chemical stability, or hydrophilic character to be easily absorbed. Lastly, the data were generated by field tests and may not be sensitive enough to elicit subtle responses.

Assessment of the effectiveness of nontransdermal energy patches on muscle endurance and power.

Claims of recently developed energy patches suggest that organic nanoscale biomolecular "antennas" produced by L and D-stereoisomers resonate at frequencies in unison with molecules in the cells inducing electron flow to assists in recruiting calcium ions, allowing greater muscle fiber recruitment during muscle contraction. The purpose of the study was to assess the efficacy of energy patches in the performance of selected muscle power and endurance measures. After a 5-minute warm-up and stretch, 41 college varsity football players (age, 20.37 +/- 1.24 years; height, 169.91 +/- 7.44 cm; weight, 109.45 +/- 19.85 kg) were pre-tested on 102-kg maximal bench press repetitions, standing vertical jump, grip strength, peak torque, torque to body weight, total work, average power, and average torque as measured by 50 repetitions of leg extensions at 180 degrees .s. The following week, the players were randomly assigned the experimental or placebo patches. After placement of the patches, the participants again completed a 5-minute warm-up, followed by the identical pre-test protocol. Repeated-measures ANOVAs were used to compare resultant data. No significant group interaction effects were found between experimental and placebo patches for maximal bench press repetitions (p = 0.48), vertical jump distance (p = 0.39), grip strength (p = 0.29), total work (p = 0.26), torque to body weight (p = 0.05), average peak torque (p = 0.08), and average power (p = 0.05). A significant increase occurred in the experimental group for peak torque (p = 0.04). It was concluded that the energy patches significantly improved performance over placebo patches in one of the eight variables tested and registered near significance in two additional variables. However, inconsistency in overall results demands further studies to determine the reliability in improvement of performance in the presence of energy patches.

The Alberta Bone and Joint Health Institute: creating sustainable accountability through collaboration, relevant measurement and timely feedback.

A robust accountability strategy is at the core of creating a safe, efficient, effective and sustainable system of healthcare. The commitment to be accountable must extend far beyond the providers of care to include every person involved in the funding, administration, delivery and support of patient care (both directly and indirectly). The Alberta Bone and Joint Health Institute has fostered a new system that will measure, analyze and give valuable feedback to all stakeholders in all three essential domains of system accountability: access, quality and cost. The Institute has employed four key strategies to create system accountability in a hip and knee pilot project: collaboration between stakeholders in defining goals and measures that matter to them; the use of "world's best evidence" to drive decisions and to establish goals and benchmarks to measure against; collection of useful data and its analysis to inform improvement decisions; and timely feedback of relevant data in domains of interest to stakeholders on system outputs in the key domains. While these strategies have not yet been proven to be effective in creating the desired "culture of accountability," they are having a significant clinical impact and do have potential to lead to that outcome.

Counterbalancing patient demands with evidence: results from a pan-Canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus.

OBJECTIVE: To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to standard medical care in reducing psychological distress, medical symptoms, and health care costs and improving quality of life in women with systemic lupus erythematosus (SLE). METHODS: A randomized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada. Clinical and psychosocial measures were taken at baseline, posttreatment, and 6 and 12 months posttreatment. Outcomes assessed were psychological distress, quality of life, disease activity, health service utilization, and diminished productivity. RESULTS: Intention-to-treat analyses revealed that there were no clinically important group differences on any of the outcome measures. CONCLUSION: Although both groups improved over time on several measures (e.g., decreases in psychological distress, stress, and emotion-oriented coping), these changes could not be attributed to the psychotherapeutic intervention. Thus, evidence does not support the referral of these patients to this type of intervention.