Innovations in Policy and Practice: Engaging practitioners as scholars.

The Canadian Journal of Public Health is launching a new section entitled Innovations in Policy and Practice, which will be a showcase for and reflection on innovative public health policy and practice in Canada. The section will focus on articles that describe the development and implementation of innovative policies and practices in Canada and/or that reflect on the experience of practitioners in implementation. The section is explicitly intended to attract practitioners as both readers and authors. This will involve a number of innovations for the Journal that will make the role of author easier for practitioners and result in published material that is attractive and useful, while retaining a scholarly approach. In addition, the review process for this section will be oriented to the reality of practice and undertaken by 'practitioner-scholars' in a collegial and non-anonymous manner.

"It's a feel. That's what a lot of our evidence would consist of ": public health practitioners' perspectives on evidence.

This article describes how evidence is defined and used in two British Columbia public health departments during the implementation of a Healthy Living initiative in 2009. Through interviews with 21 public health staff and decision makers, the author sought to investigate how "evidence" was defined by both frontline and management staff and how it was used in decision making. The authors found public health staff, particularly frontline practitioners, to be drawn to grassroots and local "lived experience" evidence. This tacit wisdom, in combination with evidence from academia and clinical evidence accessed through disciplinary or professional networks, offered a knowledge transition opportunity to inform decision making, rather than what can be characterized in the literature as unidirectional knowledge translation. It is often difficult for staff to digest and interpret research as part of their work day because of the volume and density of information that typically counts as evidence. Moreover, there exist challenges to identify and gather indicators as evidence of their work.

Strong and light plaster casts?

Three geometries of volar slab plaster cast for the stabilisation of wrist fractures were investigated. It was found that by moulding reinforcement ridges on the inferior surface of the slab the strength and stiffness could be doubled with only a 20% increase in weight. It was discovered that to provide the same increase in strength with a traditional cast the entire thickness of the cast would have to be doubled, with a 100% increase in weight that would be cumbersome to most users. Bending theory is presented in a simple manner to allow clinicians to understand how reinforcement mouldings can improve the strength and stiffness of plaster casts without adversely influencing weight, or cost.

The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model.

Given the increasing incidence of chronic diseases across the world, the search for more effective strategies to prevent and manage them is essential. The use of the Chronic Care Model (CCM) has assisted healthcare teams to demonstrate effective, relevant solutions to this growing challenge. However, the current CCM is geared to clinically oriented systems, and is difficult to use for prevention and health promotion practitioners. To better integrate aspects of prevention and health promotion into the CCM, an enhanced version called the Expanded Chronic Care Model is introduced. This new model includes elements of the population health promotion field so that broadly based prevention efforts, recognition of the social determinants of health, and enhanced community participation can also be part of the work of health system teams as they work with chronic disease issues.