Rural physicians and social capital: the potential and promises of a rural health research capacity building program.

Background: Accessible and contextually relevant healthcare research programs and networks for rural physicians are exceedingly rare, which hinders the development of social capital in an already isolating profession. This study aims to examine the impact of the Rural Health Research Capacity Building (RRCB) Program on enhancing cognitive, structural, and relational social capital through comprehensive research skills training, supported by professional teams and resources.

Methods: This study uses a mixed-methods approach with utilization of qualitative and quantitative data and pre-post quasi-experimental design.

Enhancing seniors' dental care access: Analyzing the impact of government insurance in Canada.

A crucial policy question for the government is whether publicly funded insurance programs effectively improve access to care. Using 2015 and 2018 Canadian Community Health Survey (CCHS) data, we first estimated the effect of government dental insurance for seniors on promoting regular care access and lowering cost barrier. When controlling for individual heterogeneity, we found that having government coverage is associated with significantly lower probability of reporting avoidance of dental care due to cost compared to having no coverage.

Demographic and temporal trends in mental health and substance use services provided by primary care physicians in British Columbia, Canada.

Background: As the demand for mental health and substance use (MHSU) services increases, there will be an even greater need for health human resources to deliver this care. This study investigates how family physicians' (FP) contact volume, and more specifically, MHSU contact volume, is shaped by demographic trends among FPs in British Columbia, Canada.

Methods: We used annual physician-level administrative billing data and demographic information on FPs in British Columbia between 1996 and 2017.

Screening and Treatment of Posttraumatic Stress Disorder in Wildfire Evacuees: A Cost-Utility Analysis.

Unlabelled: Global climate change is resulting in dramatic increases in wildfires. Individuals exposed to wildfires experience a high burden of posttraumatic stress disorder (PTSD), and the cost-effectiveness of the treatment options to address PTSD from wildfires has not been studied. The objective of this study was to conduct a cost-utility analysis comparing screening followed by treatment with paroxetine or trauma-focused cognitive behavioral therapy (TF-CBT) versus no screening in Canadian adult wildfire evacuees.

COVID-19 Pandemic, Physical Distancing Policies, and the Non-Profit Sector Volunteer Force.

Although COVID-19-related physical distancing has had large economic consequences, the impact on volunteerism is unclear. Using volunteer position postings data from Canada's largest volunteer center (Volunteer Toronto) from February 3, 2020, to January 4, 2021, we evaluated the impact of different levels of physical distancing on average views, total views, and total number of posts. There was about a 50% decrease in the total number of posts that was sustained throughout the pandemic.

Child health and its effect on adult social capital accumulation.

Although studies have demonstrated important effects of poor health in childhood on stocks of human and health capital, little research has tested economic theories to investigate the effect of child health on social capital in adulthood. Studies on the influence of child health on adult social capital are mixed and have not used sibling fixed effects models to account for unmeasured family and genetic characteristics, that are likely to be important. Using the Add-Health sample, health in childhood was assessed as self-rated health, the occurrence of a physical health condition or mental health condition, while social capital in adulthood was measured as volunteering, religious service attendance, team sports participation, number of friends, social isolation, and social support.

The impact of team-based primary care on medication-related outcomes in older adults: A comparative analysis of two Canadian provinces.

Objective: To evaluate if access to team-based primary care is related to medication management outcomes for older adults.

Methods: We completed two retrospective cohort studies using administrative health data for older adults (66+) in Ontario (n = 428,852) and Québec (n = 310,198) who were rostered with a family physician (FP) between the 2001/02 and 2017/18 fiscal years. We generated matched comparison groups of older adults rostered to an FP practicing in a team-based model, and older adults rostered to an FP in a non-team model.

Genetic endowments for social capital: An investigation accounting for genetic nurturing effects.

Despite social capital having been shown to be important for health and well-being, relatively little research has examined genetic determinants. Genetic endowments for education have been shown to influence human, financial, and health capital, but few studies have examined social capital, and those conducted have yet to account for genetic nurturing. We used the Add-Health data to study the effect of genetic endowments on individual social capital using the education polygenic score (PGS).

Referring and Specialist Physician Gender and Specialist Billing.

Importance: While a gender pay gap in medicine has been well documented, relatively little research has addressed mechanisms that mediate gender differences in referral income for specialists.

Objective: To examine gender-based disparities in medical and surgical specialist referrals in Ontario, Canada.

Design, Setting, And Participants: This cross-sectional study included referrals for specialist care ascertained from Ontario Health Insurance Plan physician billings for fiscal year 2018 to 2019.

The Impact of Dental Care Programs on Individuals and Their Families: A Scoping Review.

Background: Despite significant global improvements in oral health, inequities persist. Targeted dental care programs are perceived as a viable approach to both improving oral health and to address inequities. However, the impacts of dental care programs on individual and family oral health outcomes remain unclear.

Public-private partnership alternative for a national pharmacare program in Canada.

Background: Recently, the government and an opposition party cut a deal that involved a promise to consider implementing a single-payer pharmacare scheme in Canada in exchange for supporting the current minority government. There have been political headwinds from the private extended health insurance industry, the provinces of Ontario and Quebec, as well as the pharmaceutical industry. We suggest a new multiple-payer of mixed-resort framework that achieves both the goal of universal coverage and preserves the private extended health insurance industry through a scheme based on the current coordination of benefits between private payers in this sector.

Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada.

Background: Uptake of virtual care increased substantially during the first year of the COVID-19 pandemic. The aim of this study was to evaluate whether a shift from in-person to virtual visits by primary care physicians was associated with increased use of emergency departments among their enrolled patients.

Methods: We conducted an observational study of monthly virtual visits and emergency department visits from Apr.

Family health conditions and parental occupational status modify the relationship between pediatric-onset multiple sclerosis and parental health-related quality of life.

Background: The health-related quality of life (HRQoL) of children with multiple sclerosis (MS) is mediated by the HRQoL of their parents. Understanding factors that modify the relationship between the child's MS diagnosis and parental HRQoL would inform interventions to improve the HRQoL of both parents and children living with MS.

Objective: We evaluated whether the association between an MS diagnosis during childhood and parental HRQoL is modified by the presence of a family health condition or low socioeconomic position (SEP).

The Disadvantaged Home Care Personal Support Worker: Differences in Job Characteristics, Unionization, Pensions, Participation, and Wages by Care Sector in Canada.

Personal Support Worker (PSW) supply is struggling to match the rising demand within many countries, particularly in the home and community (HC) sector. Although care demand projections are often sector-specific, our understanding of sector discrepancies on the PSW labour supply side is limited. This paper compares PSW job characteristics by means, proportions, and tests of significance across HC, nursing and long-term care home (LTC), and hospital sectors utilizing a sample of Canadian PSWs (1996-2010).

Collaborating neuroscience online: The case of the Human Brain Project forum.

This paper analyzes user interactions on the public-access online forum of the Human Brain Project (HBP), a major European Union-funded neuroscience research initiative, to understand the utility of the Forum for collaborative problem solving. We construct novel data using discussion forum posts and detailed user profiles on the HBP Forum. We find that HBP Forum utilization is comparable to that of a leading general-interest coding platform, and that online usage metrics quickly recovered after an initial Covid-19-related dip.

Personal Support Worker Socio-Demographic Differences Across Care Sectors in Canada.

With the growing reliance on Personal Support Workers (PSWs) in health care delivery for older adults across hospital, nursing and long-term care home, and home and community (HC) sectors, understanding the PSW labor market is critical for healthcare human resource capacity to care for an aging population. This study utilizes a longitudinal, cross-provincial, individual-level dataset of PSWs in Canada from 1996-2010 to provide socio-demographic characteristics of PSWs by sector. Means, proportions, and multivariate tests of significance showed that PSWs differed significantly by care sector across many factors-including sex, health, family, and education characteristics.

Public drug insurance, moral hazard and children's use of mental health medication: Latent mental health risk-specific responses to lower out-of-pocket treatment costs.

Studies have shown that reducing out-of-pocket costs can lead to higher medication initiation rates in childhood. Whether the cost of such initiatives is inflated by moral hazard issues remains a question of concern. This paper looks to the implementation of a public drug insurance program in Québec, Canada, to investigate potential low-benefit consumption in children.

A Tale of Two Countries: Changes to Canadian and U.S. Senior Population Projections due to the Pandemic-Implications for Health Care Planning in Canada and Other Western Countries.

To examine COVID-19 mortality demographics to determine if there will be any substantive shifts in population forecasts that will impact health and long-term care planning for seniors in both countries. Demographic data from Statistics Canada and the U.S.

Impact of the COVID-19 pandemic upon self-reported physician burnout in Ontario, Canada: evidence from a repeated cross-sectional survey.

Objectives: To estimate the impact of the SARS-CoV-2 (COVID-19) pandemic on levels of burnout among physicians in Ontario, Canada, and to understand physician perceptions of the contributors and solutions to burnout.

Design: Repeated cross-sectional survey.

Setting: Active and retired physicians, residents and medical students in Canada's largest province were invited to participate in an online survey via an email newsletter.

Global drug diffusion and innovation with the medicines patent pool.

This paper studies the impact of the first joint licensing platform for patented drugs, the Medicines Patent Pool, on global drug diffusion and innovation. The pool allows generic firms worldwide to license drug bundles cheaply and conveniently for sales in a set of developing countries. I construct a novel dataset from licensing contracts, public procurement, clinical trials, and drug approvals.

Forecasting Staffing Needs for Ontario's Long-Term Care Sector.

This paper presents a forecasting model for personal support workers (PSWs) and nurses (registered nurses [RNs] and registered practical nurses [RPNs]) for Ontario's long-term care (LTC) sector. In the base-case scenario, the model projects a shortfall in the supply of full-time equivalent (FTE) workers required to meet the expected demand for care for all workers by 2035, which would require an estimated increase of 11,632 FTE PSWs, 6,031 FTE RNs and 10,178 FTE RPNs entering the market by 2035. The results of this paper may have important implications for health human resources policy planning in Ontario's LTC sector.

COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis.

The COVID-19 crisis in long-term care in Canada has been characterized as a crisis upon a crisis. This study examines recent documents on the crisis in long-term care in Ontario, using document and thematic analysis to synthesize issues and recommendations from the perspectives of different groups and organizations. Thirty-three documents from 20 organizations were analysed and six thematic areas were identified: resident care; human resources; governance, leadership and management; financing; physical infrastructure and supplies; and training and preparation.

Exemplars in Long-Term Care during COVID-19: The Importance of Leadership.

Early in the pandemic, many long-term care (LTC) homes struggled to manage resources and care for vulnerable residents. Using an appreciative inquiry approach, we analyzed exemplar homes in Ontario that remained free of COVID-19 in wave one and interviewed executive directors, directors of care and staff. Findings demonstrate the importance of leadership styles; clear, consistent communication; focusing on staff and resident safety; using a team-based approach; and adapting staff roles to meet care needs.

COVID-19 and Long-Term Care: What Have We Learned?

The COVID-19 pandemic has led to thousands of deaths; of these, a disproportionate number has occurred in long-term care settings. The papers presented here deal with a number of issues highlighted by this crisis in several jurisdictions, including Ontario, Quebec and the Netherlands. Analyzing these may give us some insight into what is necessary to prevent this disaster from happening again.

U.S. State approaches to cannabis licensing.

U.S. states have taken varied approaches to licensing cannabis businesses under federal prohibition, but up to now there is limited research on cross-state licensing approaches.