On multivariate analysis, a positive T-SPOT.TB test was associated with a history of active tuberculosis, radiographic markers of previous infection, and birth in an endemic country, whereas a physician panel diagnosis also was associated with a history of previous tuberculosis contact. The TST is insensitive in hemodialysis patients and is not recommended to be used in isolation to diagnose latent tuberculosis infection. It is suggested that a combination of T-SPOT.TB testing and medical assessment may be the most accurate screening method.

Patients with AS perceive the benefits of exercise, with average EBBS benefits scores comparable to historical controls with similar conditions. Despite positive perceptions, the majority of patients with AS did not report participating in exercise on a frequent basis.

Background: Timely access to publicly funded health services has emerged as a priority policy issue across the continuum of care from hospitals to the home and community sector. The purpose of this study was to examine wait lists and wait times for publicly funded outpatient and community occupational therapy (OT) and physical therapy (PT) services. Methods: A mailed self-administered questionnaire was sent in December 2005 to all publicly funded sites across Ontario that deliver outpatient or community OT or PT services (N ¼ 374). Descriptive statistics were used to describe the study sample and to examine wait lists and wait times by setting and client condition. Results: Overall response rate was 57.2% (n ¼ 214). More than 10,000 people were reported to be waiting for OT or PT services across Ontario. Of these, 16% (n ¼ 1,664) were waiting for OT and 84% (n ¼ 8,842) for PT. Of those waiting for OT, 59% had chronic conditions and half were waiting for home care rehabilitation services. Of those waiting for PT, 73% had chronic conditions and 81% were waiting at hospital outpatient departments. Conclusions: Individuals with chronic conditions experience excessive wait times for outpatient and community OT and PT services in Ontario, particularly if they are waiting for services in hospital outpatient departments.

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Purpose: The purpose of this study was to examine barriers to accessing physical therapy (PT) services in Ontario primary health care with respect to funding sources and wait times. Methods: A stratified random sample of 1100 registered Ontario PTs and 3000 Ontario family physicians were surveyed by mail in 2004. Relationships were examined between PT wait times, funding source, geographical region and caseload composition. Results: Physicians identified the cost of private rehabilitation and long wait times as the most common barriers to referring patients to rehabilitation. Wait times for PT were longer in publicly funded settings than in privately funded practice settings (p, 0.001) and in the North (p, 0.001) and East (p 5 0.010) regions of Ontario compared with the most urban region of Ontario. Patients with chronic musculoskeletal conditions, cardiopulmonary conditions and general debility were at least three times more likely to receive PT services at publicly funded than privately funded practice settings. Furthermore, patients with acute musculoskeletal conditions were less likely to receive PT services in publicly funded practice settings (odds ratio 5 0.11, 95% confidence interval 5 0.05-0.23). Conclusions: Current Ontario health-care structures may affect access to PT services for vulnerable populations such as those with chronic conditions, those lacking private health insurance and those living in less urban regions of Ontario.

A review of recently published articles has resulted in a number of studies that support the body of literature describing physiotherapy as an effective form of intervention for AS. In order to continue to build on the existing research, further examination into physiotherapy modalities, beyond exercise-based intervention, needs to be explored.

GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.