Enhancing detection of SARS-CoV-2 re-infections using longitudinal sero-monitoring: demonstration of a methodology in a cohort of people experiencing homelessness in Toronto, Canada.

Background: Accurate estimation of SARS-CoV-2 re-infection is crucial to understanding the connection between infection burden and adverse outcomes. However, relying solely on PCR testing results in underreporting. We present a novel approach that includes longitudinal serologic data, and compared it against testing alone among people experiencing homelessness.

Incidence of SARS-CoV-2 Infection Among People Experiencing Homelessness in Toronto, Canada.

Importance: People experiencing homelessness are at high risk of SARS-CoV-2 infection. Incident infection rates have yet to be established in these communities and are needed to inform infection prevention guidance and related interventions.

Objective: To quantify the SARS-CoV-2 incident infection rate among people experiencing homelessness in Toronto, Canada, in 2021 and 2022 and to assess factors associated with incident infection.

Navigator programme for hospitalised adults experiencing homelessness: protocol for a pragmatic randomised controlled trial.

Introduction: People experiencing homelessness suffer from poor outcomes after hospitalisation due to systemic barriers to care, suboptimal transitions of care, and intersecting health and social burdens. Case management programmes have been shown to improve housing stability, but their effects on broad posthospital outcomes in this population have not been rigorously evaluated. The Navigator Programme is a Critical Time Intervention case management programme that was developed to help homeless patients with their postdischarge needs and to link them with community-based health and social services.

Family physician practice patterns during COVID-19 and future intentions: Cross-sectional survey in Ontario, Canada.

Objective: To determine the extent to which family physicians closed their doors altogether or for in-person visits during the pandemic, their future practice intentions, and related factors.

Design: Cross-sectional survey.

Setting: Six geographic areas in Toronto, Ont, aligned with Ontario Health Team regions.

The acceptability of financial incentives to support service engagement of adults experiencing homelessness and mental illness: a qualitative study of key stakeholder perspectives Authorship.

Purpose: Evidence suggests financial incentives may effectively support service engagement among people experiencing homelessness, but literature related to their acceptability in this population is limited. This study used qualitative methods to explore stakeholder perspectives on the acceptability of using financial incentives to promote service engagement among homeless adults with mental illness.

Methods: As part of a larger mixed-methods pragmatic trial of a community-based brief case management program in Toronto, Canada, twenty-two trial participants were purposefully recruited to participate in semi-structured qualitative interviews, and five service providers and seven key informants were purposefully recruited to participate in a focus group and interviews, respectively.

COVID-19 Vaccine Coverage and Sociodemographic, Behavioural and Housing Factors Associated with Vaccination among People Experiencing Homelessness in Toronto, Canada: A Cross-Sectional Study.

People experiencing homelessness were prioritized for COVID-19 vaccination in Toronto, Canada, due to the high risk of infection and associated complications relative to the general population. We aimed to ascertain COVID-19 vaccine coverage in this population and explore factors associated with the receipt of at least one dose. We collected survey and blood sample data from individuals ages 16+ recruited by random selection at 62 shelters, hotels and encampment sites between 16 June 2021 and 9 September 2021.

Exploring COVID-19 vaccine uptake, confidence and hesitancy among people experiencing homelessness in Toronto, Canada: protocol for the qualitative study.

Introduction: People experiencing homelessness are at high risk for COVID-19 and poor outcomes if infected. Vaccination offers protection against serious illness, and people experiencing homelessness have been prioritised in the vaccine roll-out in Toronto, Canada. Yet, current COVID-19 vaccination rates among people experiencing homelessness are lower than the general population.

Using financial incentives to support service engagement of adults experiencing homelessness and mental illness: A qualitative analysis of key stakeholder perspectives.

Introduction: Homelessness and mental illness are associated with poor service engagement, health and health service use outcomes. Existing literature suggests that financial incentives may effectively support service engagement of this population, but studies investigating key stakeholder perspectives are lacking. This study aimed to elicit, using qualitative methods, nuanced service user and provider experiences by using financial incentives to support service engagement among adults experiencing homelessness and mental illness.

Decision conflict and the decision support needs of HIV PrEP-eligible Black patients in Toronto regarding the adoption of PrEP for HIV prevention.

This study examined factors contributing to decision conflict and the decision support needs of PrEP-eligible Black patients. The Ottawa Decision Support Framework (ODSF) was used to guide the development of a key informant guide used for qualitative data collection. Black patients assessed by healthcare providers as meeting the basic criteria for starting PrEP were recruited through the St.

Exploring different methods to evaluate the impact of basic income interventions: a systematic review.

Background: Persistent income inequality, the increase in precarious employment, the inadequacy of many welfare systems, and economic impact of the COVID-19 pandemic have increased interest in Basic Income (BI) interventions. Ensuring that social interventions, such as BI, are evaluated appropriately is key to ensuring their overall effectiveness. This systematic review therefore aims to report on available methods and domains of assessment, which have been used to evaluate BI interventions.

Factors Associated with Readmission Among General Internal Medicine Patients Experiencing Homelessness.

Background: People who are homeless have a higher burden of illness and higher rates of hospital admission and readmission compared to the general population. Identifying the factors associated with hospital readmission could help healthcare providers and policymakers improve post-discharge care for homeless patients.

Objective: To identify factors associated with hospital readmission within 90 days of discharge from a general internal medicine unit among patients experiencing homelessness.

A Web-Based Intervention to Reduce Decision Conflict Regarding HIV Pre-Exposure Prophylaxis: Protocol for a Clinical Trial.

Background: HIV pre-exposure prophylaxis (PrEP) is recommended for populations at high ongoing risk for infection. There are noted racial disparities in the incidence of HIV and other sexually transmitted infections (STIs) for African, Caribbean, and Canadian Black (ACB, black) populations in Ontario, Canada. Although blacks represent only 4.

Shrinking the language accessibility gap: a mixed methods evaluation of telephone interpretation services in a large, diverse urban health care system.

Introduction: Language interpretation services for patients who are not proficient in a country's official language(s) are essential for improving health equity across diverse populations, and achieving clinical safety and quality for both patients and providers. Nevertheless, overall use of these services remains low, regardless of how they are delivered. In Toronto, Ontario, one of the most ethnically diverse urban centres, the regional local health integration network which oversees the highest concentration of health care organizations servicing 1.

Pathways and trajectories linking housing instability and poor health among low-income women experiencing intimate partner violence (IPV): Toward a conceptual framework.

We used grounded theory to understand pathways and trajectories to housing instability (HI) and poor health among low-income women with experiences of intimate partner violence (IPV). We conducted in-depth interviews during 2010-11 with forty-one women (ages 18-45 years) living in Ontario, Canada. All women reported depressive symptoms in combination with other health problems.

Where Did She Go? The Transformation of Self-Esteem, Self-Identity, and Mental Well-Being among Women Who Have Experienced Intimate Partner Violence.

Background: Discussions on intimate partner violence (IPV) often focus on physical abuse, ignoring psychological and sexual abuse and controlling behaviors. The damage of varied forms of IPV on mental well-being in its broader form have been far less explored, especially among low-income women. Our aim was to improve our understanding of self-perceptions of mental well-being among low-income women who have experienced IPV by considering a broader definition of mental well-being that includes self-esteem and self-identity as core components.

Home mechanical ventilation in Canada: a national survey.

Background: No comprehensive Canadian national data describe the prevalence of and service provision for ventilator-assisted individuals living at home, data critical to health-care system planning for appropriate resourcing. Our objective was to generate national data profiling service providers, users, types of services, criteria for initiation and monitoring, ventilator servicing arrangements, education, and barriers to home transition.

Methods: Eligible providers delivering services to ventilator-assisted individuals (adult and pediatric) living at home were identified by our national provider inventory and referrals from other providers.

Prolonged mechanical ventilation in Canadian intensive care units: a national survey.

Background: We sought to describe prevalence and care practices for patients experiencing prolonged mechanical ventilation (PMV), defined as ventilation for 21 or more consecutive days and medical stability.

Methods: We provided the survey to eligible units via secure Web link to a nominated unit champion from April to November 2012. Weekly telephone and e-mail reminders were sent for 6 weeks.

Institutional care for long-term mechanical ventilation in Canada: A national survey.

Introduction: No national Canadian data define resource requirements and care delivery for ventilator-assisted individuals (VAIs) requiring long-term institutional care. Such data will assist in planning health care services to this population.

Objective: To describe institutional and patient characteristics, prevalence, equipment used, care elements and admission barriers for VAIs requiring long-term institutional care.

Patient transitions relevant to individuals requiring ongoing ventilatory assistance: a Delphi study.

Background: Various terms, including 'prolonged mechanical ventilation' (PMV) and 'long-term mechanical ventilation' (LTMV), are used interchangeably to distinguish patient cohorts requiring ventilation, making comparisons and timing of clinical decision making problematic.

Objective: To develop expert, consensus-based criteria associated with care transitions to distinguish cohorts of ventilated patients.

Methods: A four-round (R), web-based Delphi study with consensus defined as >70% was performed.

Prevalence of gambling problems among the clients of a toronto homeless shelter.

Few studies have examined the prevalence of problem and pathological gambling among clients of homeless service agencies. The objective of this study was to estimate the prevalence of problem gambling among these clients. We collected primary data on gambling using the NORC diagnostic screen for disorders.

Linking childhood and adult criminality: using a life course framework to examine childhood abuse and neglect, substance use and adult partner violence.

Child abuse and neglect, considered criminal acts under the Criminal Code of Canada, play an important role in substance use, violence, and other criminal behaviour in adulthood. We adopted the life course perspective to identify modifiable contextual influences and co-occurring individual, social, and familial determinants associated with adult criminality. Using in-depth interview data, a sub-sample of 13 women who had recently experienced intimate partner violence, recounted their experiences of childhood abuse, their own substance use or criminality, as well as implications of these factors on their children's life trajectories.

Going blank: factors contributing to interruptions to nurses' work and related outcomes.

Aim: To examine interruptions to nurses' work, the systems issues related to these and the associated outcomes.

Background: While some research has described the role interruptions play in medication errors, work is needed to examine specific factors in the nursing work environment that cause interruptions and to assess the impact of these on nurses' work and patient outcomes.

Methods: The present study utilized a mixed method design that involved work observation to detect nursing interruptions in the workplace followed by focus groups with a subsample of nurses.

Interruptions and pediatric patient safety.

This study explored interruptions in pediatric nurses' work and the systems issues related to interruptions in nursing work environments. A total of 5,325 interruptions were observed in this study, providing information on sources, types, and causes of interruptions. The nursing work being performed when interrupted and the outcomes of these interruptions are described.

Losing the moment: understanding interruptions to nurses' work.

Interruptions in the nursing work environment can have significant, detrimental effects on patient safety. This mixed-method study used work observation and focus groups to explore interruptions in nursing work. A large number of interruptions were reported.