Objectives: (1) To describe body composition of the frail elderly, (2) To relate lean body mass to muscle strength and functional ability, and (3) To assess temporal stability of strength measures and index of functional ability. Design: Cross-sectional study. Setting: Community-dwelling. Subjects: Thirty frail elderly women (81.5 AE 7 y) recruited from residences or out-patient facilities. Methods: Total body fat and fat-free mass (FFM) were determined using multi-frequency bioelectrical impedance analysis and predicted from anthropometry. Handgrip strength, biceps and quadriceps strength, functional capacities (Timed`Up & Go') as well as self-perceived health and functional status were measured. Reliability was assessed using two separate observations made one week apart by the same examiner. Results: Mean height, weight and body mass index were 1.52 AE 0.04 m, 60.4 AE 10.7 kg and 26.0 AE 4.8 kg/m 2 respectively. FFM (34.1 AE 4.6 kg) was lower than previous reports for autonomous elderly females and associated with all measures of muscle strength (Pearson's r 0.42±0.62, P 0.02), but not with performance on the Timed`Up & Go' or self-perceived health and functional status. Strength measures correlated signi®cantly with different subscales of self-perceived functional capacities and were signi®cantly lower among women with a low %FFM (n 19) and those reporting pain (n 11) as compared to other women. Excellent temporal stability for muscle and functional measures was observed (ICC 0.80±0.90). Conclusions: Muscle strength was strongly related to FFM in free-living frail elderly women especially in the absence of pain.

Background : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures. Objective: To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model. Methods: Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability. Results: PCA based scales showed generally excellent internal consistency (Cronbach's a = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted k(k w ) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (r s = 0.14-0.45, p,0.05). Conclusions: This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems.

No abstract

In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study -a repeat census of all public health organizations in Canada -we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country. RésuméDans le domaine de la prévention des maladies chroniques (PMC), la collaboration interorganisationnelle est un processus fondamental pour l' action intersectorielle ainsi que pour l'échange de connaissances, d' expertise et de ressources. Cependant, peu de connaissances existent sur les liens entre la structure de ces réseaux de collaboration et la capacité d' action ainsi qu' avec les résultats de la PMC. En nous appuyant sur des données tirées du Public Health Organizational Capacity Study -un recensement de tous les organismes canadiens de santé publique -nous avons utilisé des méthodes dérivées de l' analyse des réseaux sociaux pour cartographier et examiner les relations de collaboration interorganisationnelle dans le domaine de la PMC. Les résultats de notre étude montrent que les frontières provinciales demeurent un facteur d'influence important sur les schémas de collaboration. Non seulement les relations sont-elles rares au niveau interprovincial, mais elles se limitent presque exclusivement à des liens entre les organisations fédérales et multiprovinciales. À la lumière de ces résultats, les organisations fédérales et multiprovinciales qui occupent une position centrale dans la structure canadienne de collaboration pour la PMC devraient agir comme joueurs clés dans l'élaboration des pratiques de PMC au pays.

These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.