Editorial

Abstract

I f health systems in Canada are going to tackle the challenges they are facing, for example, growing and aging populations and an increasing burden of chronic disease, new ways of connecting services and service providers need to be found. In Alberta, the establishment of Alberta Health Services (AHS) in May 2008 created an opportunity to review what had been and could be achieved in integrating health services to improve the quality and outcomes of health services delivered within the province. With a renewed focus on the patient and organizational goals of quality, access and sustainability, AHS set out to encapsulate the integration experiences from previous regional/provincial health service organizations within Alberta. Integrating services is a necessary part of improving patient care and efficiently using scarce resources. Integration as a focus of study has been evolving in Canada. By commissioning this special edition, AHS wanted to contribute to a growing body of knowledge regarding integrating health services and integrated care. But how to define integration? While we are challenged by a lack of one common definition, there are relative agreements on what integration is not. Patients' and their families experiences in healthcare are often characterized by fragmentation, duplication and system or care gaps. What readers will see in this special edition is that integration is a framework-a lens that can be systematically applied to better link patients/clients, healthcare providers and services. Informing this framework are a number of foundational tools and progressive approaches: creating an operational definition (Kodner; Suter et al.); critical roles for information management (Protti) and knowledge management (Scott et al.); new roles for healthcare leaders as "change leaders" (Silversin) within modified governance structures (Smyth); and the importance of using rigorous improvement methodologies (Murray). Then, what about the how-how can complex healthcare systems effectively undertake new ways of delivering services that result in a better patient/client experience, improved clinical outcomes and results on investment? Readers will also find in this special edition a wealth of experiential knowledge that demonstrates some of the challenges and successes in integrating health services. Examples are provided related to improving access and organizing the care continuum through a number of initiatives: integrated stroke and cardiac care; exploration of various clinician roles, for example, a pharmacist-managed clinic; a systems approach to chronic disease management and prevention; and a community-based approach to medication reconciliation. Collectively capturing and sharing the key learnings from healthcare leaders and practitioners directly involved in this work not only helped to advance our organizational knowledge about what works and doesn't work. It also helped to break down the "integration silos" that often result from taking on very targeted quality improvement initiatives, thereby preve...

Phylogenetic, ecological and morphological characteristics reveal two new spider-associated genera in Clavicipitaceae

“…are found on the abaxial leaf surfaces of shrubbery, forest floors and shallow soil layers ( Hywel-Jones 1996 ). These entomopathogenic fungi do not spread by airflow diffusion but employ particular strategies, such as producing synnemata and sticky conidia, to accommodate various arthropod activities and facilitate conidial spread ( Abbott 2002 ). In contrast, strains with mononematous conidiophores occur in more open portions of forests and favor dry conidial dispersal ( Chen et al 2020 ).…”