Sociodemographic differences in patient experience with primary care during COVID-19: results from a cross-sectional survey in Ontario, Canada.

Purpose: We sought to understand patients' care-seeking behaviours early in the pandemic, their use and views of different virtual care modalities, and whether these differed by sociodemographic factors.

Methods: We conducted a multisite cross-sectional patient experience survey at 13 academic primary care teaching practices between May and June 2020. An anonymised link to an electronic survey was sent to a subset of patients with a valid email address on file; sampling was based on birth month.

Leveraging Innovative Leadership Models within Community and Healthcare Organizations to Support Safe School Reopening during the COVID-19 Pandemic.

Little has been published on successful leadership models within integrated care systems. Within East Toronto Health Partners, there have been considerable efforts at the executive leadership level to empower local leadership, particularly physician leaders, to develop and execute effective solutions across the community. What does distributed leadership look like, and what does it take to implement it? A number of activities demonstrating the impact of a distributed leadership model in East Toronto are outlined in this paper, offering an effective defence against the enormous challenge posed by the COVID-19 pandemic.

Adsorptive Removal of Anionic Azo Dye New Coccine Using Silica and Silica-gel with Surface Modification by Polycation.

In the present work, adsorption of anionic azo dye, new coccine (NCC) on silica and silica-gel in an aquatic environment was discovered. Effective conditions such as adsorption time, pH, the influence of dosage on NCC adsorption using strong polycation, poly-diallyl-dimethylammonium chloride (PDADMAC) modified silica (PMS) and PDADMAC modified silica-gel (PMSG) were systematically studied. The removal of NCC using PMS and PMSG were much higher than that using raw silica and silica-gel without PDADMAC in all pH ranges from 3 to 10.

Patient-centred innovation for multimorbidity care: a mixed-methods, randomised trial and qualitative study of the patients' experience.

Background: Patient-centred interventions to help patients with multimorbidity have had mixed results.

Aim: To assess the effectiveness of a provider-created, patient-centred, multi-provider case conference with follow-up, and understand under what circumstances it worked, and did not work.

Design And Setting: Mixed-methods design with a pragmatic randomised trial and qualitative study, involving nine urban primary care sites in Ontario, Canada.

Mobilizing a Whole Community: Policy and Strategy Implications of an Integrated Local System Response to a Global Health Crisis.

The East Toronto Health Partners (ETHP) include more than 50 organizations working collaboratively to create an integrated system of care in the east end of Toronto. This existing partnership proved invaluable as a platform for a rapid, coordinated local response to the COVID-19 pandemic. Months after the first wave of the pandemic began, with the daily numbers of COVID-19 cases finally starting to decline, leaders from ETHP provided preliminary reflections on two critical questions: (1) How were existing integration efforts leveraged to mobilize a response during the COVID-19 crisis? and (2) How can the response to the initial wave of COVID-19 be leveraged to further accelerate integration and better address subsequent waves and system improvements once the pandemic abates?

Development and clinical application of a preimplantation genetic testing for monogenic disease (PGT-M) for beta thalassemia in Vietnam.

Purpose: The purpose of this research is to study the clinical outcomes using a next-generation sequencing-based protocol allowing for simultaneous testing of mutations in the beta thalassemia (HBB) gene, including single nucleotide polymorphism (SNP) markers for PGT-M along with low-pass whole genome analysis of chromosome aneuploidies for PGT-A.

Methods: A combined PGT-M (thalassemia) plus PGT-A system was developed for patients undergoing IVF in Vietnam. Here we developed a system for testing numerous thalassemia mutations plus SNP-based testing for backup mutation analysis and contamination control using next-generation sequencing (NGS).

Connecting People With Multimorbidity to Interprofessional Teams Using Telemedicine.

Purpose: Most models for managing chronic disease focus on single diseases. Managing patients with multimorbidity is an increasing challenge in family medicine. We evaluated the feasibility of a novel approach to caring for patients with multimorbidity, performing a case study of TIP-Telemedicine IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) Plus-a 1-time interprofessional consultation with primary care physicians (PCPs) and their patients in Toronto, Canada.

Aging at Home: A Portrait of Home-Based Primary Care Across Canada.

Older adults and their families often struggle in navigating an increasingly fragmented healthcare system when it becomes increasingly difficult to receive care beyond their homes in the face of advanced illness, frailty and complex care needs. The provision of integrated home-based primary care has demonstrated improved patient and caregiver experiences and reduced healthcare costs when primary care providers collaborate in delivering care as part of larger interprofessional teams. In this trans-Canada portrait of five urban home-based primary care programs, their core features are highlighted to provide a roadmap on how to integrate this form of care into a Patient's Medical Home in partnership with acute and home-care providers.

Family medicine training in housecalls: Survey of residency program directors across Canada.

Objective: To assess the current landscape of home-based primary care (HBPC) or home visit training for Canadian family medicine residents.

Design: Online survey.

Setting: Canada's 17 family medicine residency programs.

[Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners.

It 'makes you feel more like a person than a patient': patients' experiences receiving home-based primary care (HBPC) in Ontario, Canada.

The lack of effective systems to appropriately manage the health and social care of frail older adults - especially among those who become homebound - is becoming all the more apparent. Home-based primary care (HBPC) is increasingly being promoted as a promising model that takes into account the accessibility needs of frail older adults, ensuring that they receive more appropriate primary and community care. There remains a paucity of literature exploring patients' experiences with HBPC programmes.

"A More Rounded Full Care Model": Interprofessional Team Members' Perceptions of Home-Based Primary Care in Ontario, Canada.

This study explores interprofessional team members' perspectives and experiences providing home-based primary care (HBPC) in Ontario, Canada. Employing an inductive qualitative methodology using procedures informed by grounded theory, themes emerged in the data in relation to the benefits of the HBPC model, and the barriers associated with its provision, as well as the key components that enable or hinder interprofessional collaboration in the HBPC environment. This research deepens our understanding of the key features and processes of interprofessional teams providing high-quality care in the home.

Capturing the experiences of patients across multiple complex interventions: a meta-qualitative approach.

Objectives: The perspectives, needs and preferences of individuals with complex health and social needs can be overlooked in the design of healthcare interventions. This study was designed to provide new insights on patient perspectives drawing from the qualitative evaluation of 5 complex healthcare interventions.

Setting: Patients and their caregivers were recruited from 5 interventions based in primary, hospital and community care in Ontario, Canada.

Optimising water and phosphorus management in the urban environmental sanitation system of Hanoi, Vietnam.

Many areas in the world face clean water scarcity problems and phosphorus reserves are likely to be depleted in the near future. Still, a large amount of clean water is used to transport excreta through sewer systems. Most of the wastewater generated worldwide is discharged untreated into aquatic systems and leads to water pollution and loss of valuable nutrients.