Ryerson University

About: Ryerson University is a education organization based out in Toronto, Ontario, Canada. It is known for research contribution in the topics: Computer science & Population. The organization has 7671 authors who have published 20164 publications receiving 394976 citations. The organization is also known as: Ryerson Polytechnical Institute & Ryerson Institute of Technology.

The social determinants of the incidence and management of type 2 diabetes mellitus: are we prepared to rethink our questions and redirect our research activities?

Abstract: This paper discusses the role played by social determinants of health in the incidence and management of type 2 diabetes mellitus (diabetes) among vulnerable populations. This issue is especially important in light of recent data from Statistics Canada indicating that mortality rates from diabetes have been increasing among Canadians since the mid‐1980s, with increases being especially great among those living in low‐income communities. Diabetes therefore appears – like cardiovascular disease – to be an affliction more common among the poor and excluded. It also appears to be especially likely to afflict poor women. Yet we know little about how these social determinants of health influence diabetes incidence and management. What evidence is available is provided and the case is made that the crisis in diabetes requires new ways of thinking about this disease, its causes, and its management.

“Transnationalizing Families: Canadian Immigration Policy and the Spatial Fragmentation of Care-Giving among Latin American Newcomers”

Abstract: Complex factors associated with migration and immigration policies contribute to the dispersion of families across space. We draw on interviews with 40 Latin American women in Toronto who experienced separation from children as a result of migration and argue that Canadian immigration policy and elements of the women’s context of departure lead to the systemic production of transnational family arrangements. Once in Canada, the women dealt with unexpected lengths of separation, the spatial dispersal of social reproduction, and post-reunification problems. The absence of a normative framework that could help the mothers make sense of family dispersal meant that their experiences of migration, family separation, reunification and settlement were marked by tension, guilt, isolation and shame.

The clinical effectiveness and cost-effectiveness of clinical nurse specialist-led hospital to home transitional care: a systematic review.

Abstract: Rationale, aims and objectives Clinical nurse specialists (CNSs) are major providers of transitional care. This paper describes a systematic review of randomized controlled trials (RCTs) evaluating the clinical effectiveness and cost-effectiveness of CNS transitional care. Methods We searched 10 electronic databases, 1980 to July 2013, and hand-searched reference lists and key journals for RCTs that evaluated health system outcomes of CNS transitional care. Study quality was assessed using the Cochrane Risk of Bias and Quality of Health Economic Studies tools. The quality of evidence for individual outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We pooled data for similar outcomes. Results Thirteen RCTs of CNS transitional care were identified (n = 2463 participants). The studies had low (n = 3), moderate (n = 8) and high (n = 2) risk of bias and weak economic analyses. Post-cancer surgery, CNS care was superior in reducing patient mortality. For patients with heart failure, CNS care delayed time to and reduced death or re-hospitalization, improved treatment adherence and patient satisfaction, and reduced costs and length of re-hospitalization stay. For elderly patients and caregivers, CNS care improved caregiver depression and reduced re-hospitalization, re-hospitalization length of stay and costs. For high-risk pregnant women and very low birthweight infants, CNS care improved infant immunization rates and maternal satisfaction with care and reduced maternal and infant length of hospital stay and costs. Conclusions There is low-quality evidence that CNS transitional care improves patient health outcomes, delays re-hospitalization and reduces hospital length of stay, re-hospitalization rates and costs. Further research incorporating robust economic evaluation is needed.