Journal articles on the topic 'Community Living Ontario'
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1
Grindrod, Kelly, Niki Sanghera, Israa Rahmaan, Meghna Roy, and Michael Tritt. "Living MedsCheck." Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 146, no. 1 (January 2013): 33–38. http://dx.doi.org/10.1177/1715163512472868.
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Objective: To share the experiences of graduating students as they learn to deliver a new medication review service in community pharmacies in Ontario, Canada. Practice description: Four graduating pharmacy students volunteered in different community pharmacies to learn how to navigate a new provincial program called MedsCheck, which pays pharmacists to do medication reviews. Each student selected his or her own practice site, including 2 independent community pharmacies, a grocery store chain pharmacy and a hospital outpatient pharmacy. Practice innovation: To help the students learn to deliver the new MedsCheck services, a faculty mentor met with them on a weekly basis. To reflect on doing MedsChecks in the “real world” and to elicit feedback from the online community, each student blogged about his or her experiences. Results: All 4 students felt that peer mentoring improved their ability to deliver MedsCheck services. They also identified a number of barriers to delivering the MedsChecks and helped each other try to overcome the barriers. Conclusion: MedsCheck is a new service in Ontario and is not easily implemented in the current pharmacy model of practice. Peer mentoring is a helpful way to share successes and overcome barriers to delivery. Can Pharm J 2013;146:33-38.
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Varatharajan, Thepikaa, Pamela Sabioni, Cayley Russell, Joanna Henderson, Benedikt Fischer, Sarah Miles, and Jürgen Rehm. "Assessing service and treatment needs of young people who use illicit and non-medical prescription drugs living in Northern Ontario, Canada." F1000Research 7 (October 16, 2018): 1644. http://dx.doi.org/10.12688/f1000research.16464.1.
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Background: The use of illicit and prescription drugs for non-medical purposes among youth and young adults living in Northern Ontario communities is a major public health concern. This problem is amplified in that there is insufficient knowledge on the types of services and treatment centers available for and utilized by young people with substance use issues in Northern Ontario. This needs assessment study aims to examine the service and treatment needs of youth and young adults who use drugs in Northern Ontario communities. Methods/Design: A mixed-methods study design will be used to assess the service and treatment needs of youth and young adults (aged 14-25) who have used one or more illicit drug (excluding cannabis) and/or psychoactive prescription drug for non-medical purposes for at least 3 months and on at least 10 days in the last month. Participants will be recruited from approximately ten Northern, remote and rural communities across Northern Ontario using a mobile research lab. Eligible study candidates from each community will be asked to partake in a focus group and questionnaire exploring service and treatment utilization and needs. We will additionally collect basic socio-demographic information as well as examine patterns of problematic drug use. Interviews with service providers and community organizers will also be conducted in each community. Discussion: Findings from our study will highlight the availability, accessibility and utilization of existing services; identify the gaps and barriers in current service provision; and provide insight into the service and treatment needs of youth and young adults who use drugs in Northern Ontario communities. Assessing the needs of young people who use drugs will allow service providers, community organizers and health policymakers to improve addiction-related services and treatment centers in Northern Ontario.
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Varatharajan, Thepikaa, Pamela Sabioni, Cayley Russell, Joanna Henderson, Benedikt Fischer, Sarah Miles, and Jürgen Rehm. "Assessing service and treatment needs of young people who use illicit and non-medical prescription drugs living in Northern Ontario, Canada." F1000Research 7 (October 28, 2019): 1644. http://dx.doi.org/10.12688/f1000research.16464.2.
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Background: The use of illicit and prescription drugs for non-medical purposes among youth and young adults living in Northern Ontario communities is a major public health concern. This problem is amplified in that there is insufficient knowledge on the types of services and treatment centers available for and utilized by young people with substance use issues in Northern Ontario. This needs assessment study aims to examine the service and treatment needs of youth and young adults who use drugs in Northern Ontario communities. Methods/Design: A mixed-methods study design will be used to assess the service and treatment needs of youth and young adults (aged 14-25) who have used one or more illicit drug (excluding cannabis) and/or psychoactive prescription drug for non-medical purposes for at least 3 months and on at least 10 days in the last month. Participants will be recruited from approximately ten Northern, remote and rural communities across Northern Ontario using a mobile research lab. Eligible study candidates from each community will be asked to partake in a focus group and questionnaire exploring service and treatment utilization and needs. We will additionally collect basic socio-demographic information as well as examine patterns of problematic drug use. Interviews with service providers and community organizers will also be conducted in each community. Discussion: Findings from our study will highlight the availability, accessibility and utilization of existing services; identify the gaps and barriers in current service provision; and provide insight into the service and treatment needs of youth and young adults who use drugs in Northern Ontario communities. Assessing the needs of young people who use drugs will allow service providers, community organizers and health policymakers to improve addiction-related services and treatment centers in Northern Ontario.
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Montgomery, Phyllis, Sharolyn Mossey, Parveen Nangia, Darren Jermyn, and Sue Verrilli. "Navigation Service for Community Reintegration: Persons Living with Stroke in Northeastern Ontario." International Journal of Health, Wellness, and Society 10, no. 4 (2020): 47–60. http://dx.doi.org/10.18848/2156-8960/cgp/v10i04/47-60.
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Wright, Heather. "Francophone Theatre in Ontario: On n’est plus loin deToronto." Canadian Theatre Review 46 (March 1986): 42–49. http://dx.doi.org/10.3138/ctr.46.005.
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Like so many of the audience, Helen Stone is attending the production of Michel Tremblay’s Hosanna at Toronto’s Théâtre du P’tit Bonheur for professional reasons: she works in French Services in the provincial government and needs to maintain her French. Hosanna’s process of self-exposure and self-discovery, culminating in his powerful nude scene with his lover, Cuirette, leaves her squirming. But she has no choice: if she wants to go to French theatre, this is the only game in town. Miles from Toronto, a typical spectator at a production by Théâtre du Nouvel-Ontario yields a very different profile. TNO’s Sudbury audience consists largely of members of the community that this theatre has carefully nurtured over the years-retirees, students, unemployed francophones, and their friends and families-all living in the moulin-à-fleur district. Currently these two theatres define the opposite extremes of the Franco-Ontarian theatre community. Contrasting and comparing them, an overview of the issues and opportunities within this community begins to emerge.
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Khan, Amanda Farah, Hsien Seow, Rinku Sutradhar, Stuart Peacock, Kelvin Kar-Wing Chan, Fred Burge, Kim McGrail, Adam Raymakers, Beverley Lawson, and Lisa Barbera. "Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time." Current Oncology 28, no. 6 (November 12, 2021): 4673–85. http://dx.doi.org/10.3390/curroncol28060394.
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This retrospective cohort study of cancer decedents during 2004–2015 examined end-of-life cancer care quality indicators (QIs) in the provinces of British Columbia (BC), Ontario, and Nova Scotia (NS). These included: emergency department use, in-patient hospitalization, intensive care unit admissions, physician house calls, home care visits, and death experienced in hospital. Ontario saw the greatest 12-year decrease in in-hospital deaths from 52.8% to 41.1%. Hospitalization rates within 30 days of death decreased in Ontario, increased in NS, and remained the same in BC. Ontario’s usage of aggressive end-of-life measures changed very little, while BC increased their utilization rates. Supportive care use increased in both NS and Ontario. Those who were male or living in a lower income/smaller community (in Ontario) were associated with a decreased likelihood of receiving supportive care. Despite the shift in focus to providing hospice and home care services, approximately 50% of oncology patients are still dying in hospital and 11.7% of patients overall are subject to aggressive care measures that may be out of line with their desire for comfort care. Supportive care use is increasing, but providers must ensure that Canadians are connected to palliative services, as its utilization improves a wide variety of outcomes.
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Urquhart, Robin, Anik M. C. Giguere, Beverley Lawson, Cynthia Kendell, Jayna M. Holroyd-Leduc, Joseph H. Puyat, Arminee Kazanjian, Sharon Straus, and Grace M. Johnston. "Rules to Identify Persons with Frailty in Administrative Health Databases." Canadian Journal on Aging / La Revue canadienne du vieillissement 36, no. 4 (October 4, 2017): 514–21. http://dx.doi.org/10.1017/s0714980817000393.
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ABSTRACTThis study sought to develop frailty “identification rules” using population-based health administrative data that can be readily applied across jurisdictions for living and deceased persons. Three frailty identification rules were developed based on accepted definitions of frailty, markers of service utilization, and expert consultation, and were limited to variables within two common population-based administrative health databases: hospital discharge abstracts and physician claims data. These rules were used to identify persons with frailty from both decedent and living populations across five Canadian provinces. Participants included persons who had died and were aged 66 years or older at the time of death (British Columbia, Alberta, Ontario, Quebec, and Nova Scotia) and living persons 65 years or older (British Columbia, Alberta, Ontario, and Quebec). Descriptive statistics were computed for persons identified using each rule. The proportion of persons identified as frail ranged from 58.2-78.1 per cent (decedents) and 5.1-14.7 per cent (living persons).
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Fernando, Shanti, Alyson King, and Danielle Loney. "Helping Them Help Themselves: Supported Adult Education for Persons Living with Mental Illness." Canadian Journal for the Study of Adult Education 27, no. 1 (November 15, 2014): 15–28. http://dx.doi.org/10.56105/cjsae.v27i1.3364.
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This case study of the Ontario Shores Supported Education Program (OSSEP) illustrates the importance of a hospital-based education program for adult learners living with mental illness, and its impact on participants’ quality of life and hopes for the future. The findings demonstrate that supported education programs catering to the needs of adults living with mental illness have the potential to not simply provide skills for future employment, but to more broadly improve participants’ ability to manage daily life, increase self-confidence, and improve rehabilitation efforts. With on-going cuts to community-based adult education programs, this research indicates the importance of ensuring specialized supported education programs are introduced and maintained for persons living with mental illness. For hospitals like Ontario Shores Centre for Mental Health Sciences, such programs can be an important part of patients’ recovery and rehabilitation process.
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DePaul, Vincent, Catherine Donnelly, Simone Parniak, and Oasis Study Collaborative. "OASIS STUDY: ACTIVITY PATTERNS OF OLDER ADULTS LIVING IN FIVE AGING IN PLACE COMMUNITIES." Innovation in Aging 3, Supplement_1 (November 2019): S980. http://dx.doi.org/10.1093/geroni/igz038.3551.
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Abstract Background: The Oasis program is a model of aging-in-place that targets social connectedness, physical activity and nutritional wellness through member-driven programming. Oasis, first established in an apartment building in Kingston Ontario, has recently been expanded to 6 new communities across Ontario in a participatory action research study. The purpose of this poster is to describe the physical activity patterns of five unique Oasis communities (Original and 4 new) and explore the impact of personal, environmental, and Oasis program characteristics on these patterns. Methods: Participants were recruited from Oasis communities in 3 market-priced apartiments, 1 subsidized apartment, and 1 mobile-home park. Participants wore the ActivPAL3 activity monitor for 7 days. Mobility was measured using the Timed Up and Go. Programming was described by type (e.g. social, exercise, nutrition), frequency, and timing of programming. Results: Participants included 70 older adults aged 79.8(min 62, max 97), community mean age ranged from 66.2 – 83.5 years. TUG score 11.6(SD 4.9) (community range 10.5 to 13.7 s). Average daily step count was 5800(SD 2835) steps, with communities ranging from 4685 to 6472 steps/day. An average of 604(community range 236 – 1056) of steps were taken at a healthy pace(100 steps/min). Only 27% of participants took the recommended 7000 steps/day (with community rates ranging from 9.5% to 37.5%). Conclusions: Older adults within these aging in place communities demonstrated low to moderate levels of physical activity, with activity patterns differing across communities. Impact of community make up and characteristics on activity patterns will be presented.
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Allen, L., M. Richardson, A. McIntyre, S. Janzen, M. Meyer, D. Ure, D. Willems, and R. Teasell. "Community Stroke Rehabilitation Teams: Providing Home-Based Stroke Rehabilitation in Ontario, Canada." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 41, no. 6 (November 2014): 697–703. http://dx.doi.org/10.1017/cjn.2014.31.
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ABSTRACTBackground: Community stroke rehabilitation teams (CSRTs) provide a community-based, interdisciplinary approach to stroke rehabilitation. Our objective was to assess the effectiveness of these teams with respect to client outcomes. Methods: Functional, psychosocial, and caregiver outcome data. were available at intake, discharge from the program, and six-month follow-up. Repeated measures analysis of covariance was performed to assess patient changes between time points for each outcome measure. Results: A total of 794 clients met the inclusion criteria for analysis (54.4% male, mean age 68.5±13.0 years). Significant changes were found between intake and discharge on the Hospital Anxiety and Depression Scale total score (p=0.017), Hospital Anxiety and Depression Scale Anxiety subscale (p<0.001), Functional Independence Measure (p<0.001), Reintegration to Normal Living Index (p=0.01), Bakas Caregiver Outcomes Scale (p<0.001), and Caregiver Assistance and Confidence Scale assistance subscale (p=0.005). Significant gains were observed on the strength, communication, activities of daily living, social participation, memory, and physical domains of the Stroke Impact Scale (all p<0.001). These improvements were maintained at the 6-month follow-up. No significant improvements were observed upon discharge on the memory and thinking domain of the Stroke Impact Scale; however, there was a significant improvement between admission and follow-up (p=0.002). All significant improvements were maintained at the 6-month follow-up. Conclusions: Results indicate that the community stroke rehabilitation teams were effective at improving the functional and psychosocial recovery of patients after stroke. Importantly, these gains were maintained at 6 months postdischarge from the program. A home-based, stroke-specific multidisciplinary rehabilitation program should be considered when accessibility to outpatient services is limited.
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Aceti Chlebus, Victoria, Jeffrey Dorans, Michelle Courneene, and Sophia Myles. "Healthy Aging in Algoma: Tests of Change Program." International Journal of Integrated Care 23, S1 (December 28, 2023): 511. http://dx.doi.org/10.5334/ijic.icic23533.
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Introduction: In Algoma District, Ontario, Canada, approximately 25% of the population is 65 years of age and older. The Ontario Provincial Geriatrics Leadership Office (2020) predicts that by 2040 this number will increase to 32% and that 29% of older adults will be living with frailty. In February of 2022, Tests of Change (ToC) Program work commenced to bring an integrated care approach to healthy aging in Algoma. Healthcare member organizations of the Algoma Ontario Health Team (AOHT) and community patient, family, and caregiver advisors identified older adults living with frailty as the target population. A driver diagram of change ideas was conceptualized to support improving care for the identified population. To enact the recommended changes, three priority projects - Outpatient Geriatric Rehabilitation Capacity, Coordinated Access to Geriatric Services and Early Frailty Identification - complement each other with the common purpose of improving early frailty intervention and increasing access to the most appropriate care.
Aims: The ToC Program entails:
Embedding a frailty screening tool into electronic medical records for use in primary care;
Initiating coordinated access to geriatric services leveraging eReferral and a common platform for electronic referral management; and
Designing an outpatient geriatric rehabilitation program.
This Program aims to advance the following elements:
Design upstream engagement strategies (e.g., screening, prevention, disease self-management) for the target population;
Increase patient access to the appropriate level of care; and
Transform care coordination, transitions and recovery at home.
Highlights: The AOHT has engaged partners from across the continuum of care who provide services for frail older adults. Partners include: community support services, home and community care support services, primary care, acute care, specialized geriatric services, and patient advisors. These critical partners assume leadership roles in program design, implementation and evaluation.
Conclusions: Early frailty identification can improve quality of life, increase intervention success, and delay the need for specialist care. This program is predicated on the establishment of foundational processes enabled by digital tools to identify frailty early, streamline referrals for access to the most appropriate geriatric services, and provide patients with the opportunity to fully participate in interventions such as outpatient geriatric rehabilitation to increase their ability to live independently in the community. By taking an integrated collaborative approach to program planning and execution, overall patient outcomes will be improved.
Transferability: The WHO Guidelines on Integrated Care for Older People (ICOPE) recommend advancing integrated care through community collaboration, a patient centered approach and supportive leadership. In 2019, the Ontario Health Team (OHT) model was introduced provincially as a way for healthcare providers to partner to deliver coordinated, integrated care. Of significance, several of the 54 approved OHTs have identified older adults living with frailty as a target population. Globally, as older adults are living longer lives, it is anticipated that there will be proportionally more older adults living with frailty. Through collaboration and sharing of the ToC program results, program scalability can be achieved at the OHT level and support the global knowledge base on efforts to strengthen integrated care for older adults.
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Ploeg, Jenny, Marta Canesi, Kimberly D Fraser, Carrie McAiney, Sharon Kaasalainen, Maureen Markle-Reid, Sinead Dufour, Lisa Garland Baird, and Tracey Chambers. "Experiences of community-dwelling older adults living with multiple chronic conditions: a qualitative study." BMJ Open 9, no. 3 (March 2019): e023345. http://dx.doi.org/10.1136/bmjopen-2018-023345.
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ObjectivesThe aim of the study was to understand the experiences of living with multiple chronic conditions (MCC) from the perspective of community-living older adults with MCC.DesignA qualitative study using an interpretive description approach.SettingParticipants were recruited from southern Ontario, Canada.Participants21 community-living, older adults (≥65 years) with an average of 7.4 chronic conditions including one of diabetes, dementia or stroke.MethodsData were collected through digitally-recorded, in-depth, semi-structured in-person interviews. Interview transcripts were analysed and coded using Thorne’s interpretive description approach.ResultsFive themes were identified representing older adults' experiences of living with MCC: (a) trying to stay healthy while living with MCC, (b) depending on family caregivers for support with just about everything, (c) paying the high costs of living with MCC, (d) making healthcare decisions by proxy and (e) receiving healthcare services that do not address the complex needs of persons living with MCC.ConclusionsThe experience of living with MCC in the community was complex and multi-faceted. The need for a person-centred and family-centred approach to care in the community, which includes the coordination of health and social services that are tailored to the needs of older adults and their informal caregivers, was underscored. Such an approach would facilitate improved information-sharing and discussion of care management options between health professionals and their patients, enable older adults with MCC to actively engage in priority-setting and decision-making and may result in improved health and quality of life for older adults with MCC.
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Morrison, Adam, Sabeen Ehsan, Rhonda Schwartz, Sarah Webster, and John Puxty. "Transforming Care for Older Adults Living with Complex Health Conditions in Ontario Post-Covid: Conference Proceedings and Recommendations." Canadian Geriatrics Journal 26, no. 4 (December 1, 2023): 478–85. http://dx.doi.org/10.5770/cgj.26.665.
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The virtual conference ‘Transforming Care: Supporting Older Adults Post-COVID in Ontario’ was held in October 2021. It was organized by Specialized Geriatric Services (SGS) East and held over three half-days. The guiding themes included: The Need, The Innovation, and The Transformation. Over 500 participants heard from ~50 clinicians, researchers, administrators, older adults, care partners, and community partners. The pandemic uncovered and exacerbated existing issues and pushed us to explore new ways to support older adults living with complex health conditions. The following key priorities were identified: older adults and their care partners call for personalized care experiences, and a lifespan approach to care delivery; aging in the community remains the most common preference; an integrated community care system that supports aging at-home should be prioritized; care delivery by SGS interprofessional teams and specialists is paramount to providing comprehensive care; building health human resource capacity should be a system priority; and promising innovations should be scaled and spread. Evidence shows that we cannot return to status-quo; post-pandemic planning of both who we serve and how we serve needs to be anchored in system renewal, not just recovery. Renewal means integrating lessons learned during the pandemic into the redesign of our systems of care. Investments in innovative, upstream strategies that support home and community-based care, and target health promotion and prevention are necessary. The provincial and regional infrastructure of SGS has the expertise and capacity to assist Ontario Health Teams in responding to the evolving health and social needs of this population.
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Fotheringham, John B., Karim Abdo, Hélène Ouellette-Kuntz, and Art Wolfgarth. "Survey of Community Adjustment of Previously Institutionalized Developmentally Disabled Persons." Canadian Journal of Psychiatry 38, no. 10 (December 1993): 641–48. http://dx.doi.org/10.1177/070674379303801004.
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A survey was conducted of the community adjustment of 108 developmentally disabled (mentally retarded) persons who had spent at least three years in an institution in southeastern Ontario. On average, they had resided 3.5 years in the community, were 40 years of age, with a mental age of five years and a median IQ of 41, and most had one or more moderate to severe physical disabilities. During their most recent year living in the community it was found that their daily living skills remained unchanged compared with their skill level in the year prior to community placement. As well, the community staff rated them as average in level of performance and amount of supervision required compared with others of similar ability. About one third were found to have a moderate to severe behavioural/psychiatric problem with aggressive disruptive behaviour being most frequent. Of the two-thirds capable of being interviewed, over three-quarters expressed satisfaction with their present living, work, education and recreation environment and had no desire to return to the institution. Most had few if any meaningful relationships with non developmentally disabled persons other than caregivers. Support agency staff and psychiatric consultants identified additional service needs for those with behavioural/psychiatric problems who may be placed in the community.
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Cornwell, Sarah, and Yasaman Rafat. "Interdental Fricative Production in Dutch Heritage Language Speakers Living in Canada." Ilha do Desterro A Journal of English Language, Literatures in English and Cultural Studies 70, no. 3 (September 22, 2017): 95–116. http://dx.doi.org/10.5007/2175-8026.2017v70n3p95.
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This study investigates the production of / θ / and / ð / by three groups of English speakers in the community of Norwich, Ontario, Canada. English monolinguals, Heritage Dutch speakers, and late-learning Dutch L1 English speakers / θ / and / ð / production was measured in both naturalistic and reading tasks. Heritage Dutch speakers produce [θ] and [ð] at similar levels to Monolingual English speakers, the two groups use different allophone inventories especially in the initial position of / ð / and the medial-position of / θ /. This study suggests that despite having native English accents, Dutch Heritage speakers may manipulate the inherently variable English / θ / and / ð / production to communicate their Dutch cultural identity.
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Solomon, Patricia, Kelly K. O'Brien, Rebecca McGuff, and Michelle Sankey. "Living strategies for disability in men ageing with HIV in Ontario, Canada: a longitudinal qualitative study." BMJ Open 9, no. 8 (August 2019): e031262. http://dx.doi.org/10.1136/bmjopen-2019-031262.
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ObjectivesTo examine the living strategies used by older men living with HIV to deal with the episodic nature of disability and associated uncertainty, over time.DesignQualitative longitudinal study in which men living with HIV were interviewed on four occasions over 20 months.SettingMen were recruited from HIV community organisations in Canada.Participants14 men with a median age of 57.5 years and median time since diagnosis of 21.5 years.ResultsFive themes depict the living strategies used to deal with the episodic nature of disability and uncertainty over time. Actively engaging in problem-solving by prioritising and modifying activities and avoiding stress, advocating for support, being positive and future oriented, engaging in healthy pursuits and providing social support to others helped men to mitigate their disability. By following participants over time, we were able to gather insights into triggers of episodes of disability, and perceptions of the success of implementing their living strategies and avoiding uncertainty.ConclusionsParticipants used living strategies to deal with uncertainty and mitigate episodes of disability over time. This study supports the importance of programmes that promote self-management for older men living with HIV through helping them identify triggers of disability, set realistic goals and problem-solve. These may help build self-efficacy, increase sense of control, and decrease feelings of uncertainty and episodes of disability.
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Leshinsky, Rebecca, and Clare M. Mouat. "Towards better recognising ‘community’ in multi-owned property law and living." International Journal of Housing Markets and Analysis 8, no. 4 (October 5, 2015): 484–501. http://dx.doi.org/10.1108/ijhma-07-2015-0031.
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Purpose – This paper aims to advance best practice by gaining insights into key multi-owned property (MOP) issues challenging policymakers and communities. Ontario (Canada) and Victoria (Australia) are internationally recognised for best practice in MOP living and law. Yet, both jurisdictions struggle with the emerging urbanism related to condominium MOP. Design/methodology/approach – Different ways of recognising community in MOP urbanism will be examined against public policy and political theory perspectives promoting social sustainability. A rich mixed-data and content analysis method is relied upon which synthesises three pillars of MOP community governance: harmonious high-rise living; residential-neighbourhood interface; and metropolitan community engagement. The article cross-examines Canadian policy and law reform documents and Australian dispute case law from the state of Victoria to explore and showcase critical MOP management, residential and policy issues. Findings – A theory-building typology formally recognises “community” as an affective performance across MOP governance contexts: cosmopolitan, civic-citizen and neighbourly. These ideal types differentiate community affects in and beyond (case) law and land-use planning: from determining alternative dispute resolution remedies; addressing neighbourhood and metropolitan NIMBY-ism in urban consolidation to bridging the critical policy and civic gap between the limits and aims of socially sustainable MOP vertical-tenured community affects. Research limitations/implications – Strong cross-jurisdictional MOP community lessons exist, as other cities follow best practice in legal and governance structures to effect change at the frontiers of twenty-first century urbanism. Originality/value – Past studies emphasise classifying dispute issues, single-issue concerns or historical and life cycle evaluations. This theory-building article advances why and how community must be better understood holistically across community contexts to inform cutting-edge governance practices.
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Barry, Arro, Roberta Heale, Anne Marise Lavoie, and Roger Pilon. "The Meaning of Home for Aging Women Living Alone in North Eastern Ontario." Diversity of Research in Health Journal 1 (June 21, 2017): 70–83. http://dx.doi.org/10.28984/drhj.v1i0.13.
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The experience and meaning of home for older, community dwelling women, who live alone was investigated. With the older demographic expanding and resources being directed at keeping older adults in their home, an expanded knowledge base is required. Interviews were conducted with seven home dwelling older women. Semi structured questions targeted the meaning of home for the participants. The theme of precariousness dominated the findings, including precariousness of formal and informal care, precariousness of winter and that home is not precarious. The study confirms that home is the preferred location for aging women. Health policy and services should continue to be implemented to accommodate this preference. Future research is needed to confirm the findings with a larger sample, incorporating additional life circumstances and to investigate the impact of factors such as winter weather and financial vulnerability on women’s ability to remain at home as they age.
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Greene, Saara, Allyson Ion, Gladys Kwaramba, Mary Mwalwanda, Janet Caswell, Esther Guzha, and Adriana Carvalhal. "“Trust Me, It’s Different”: Experiences of Peer Case Management of Women Living with HIV in Ontario, Canada." Canadian Social Work Review 32, no. 1-2 (December 1, 2015): 73–93. http://dx.doi.org/10.7202/1034144ar.
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In response to the dearth of research for delivering women-centred support to women living with HIV, the Women’s HIV Empowerment Through Life Tools for Health (wHEALTH) intervention was developed. This project was grounded in a community-based research framework and aimed to respond to barriers of women living with HIV in accessing appropriate and meaningful social supports. Participants described the benefits of the peer case management intervention including support, mentorship, flexibility in which the intervention was delivered, and the notion of “moving forward” in one’s journey with HIV. Through education, awareness, and advocacy, peer case managers are important partners in addressing HIV-related stigma, and ensuring a multi-level approach to providing care and support to women living with HIV.
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Szpunar, Monika, Matthew Bourke, Leigh M. Vanderloo, Brianne A. Bruijns, Stephanie Truelove, Shauna M. Burke, Jason Gilliland, Jennifer D. Irwin, and Patricia Tucker. "Parent-Reported Changes in Ontario Children’s Physical Activity Levels during the COVID-19 Pandemic." Children 10, no. 2 (January 26, 2023): 221. http://dx.doi.org/10.3390/children10020221.
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The COVID-19 pandemic resulted in closures of physical-activity-supporting environments, including playgrounds, outdoor recreation facilities (e.g., basketball courts), and community centers, which impacted children’s movement opportunities. This study evaluated changes in Ontario children’s physical activity levels during the COVID-19 pandemic and explored the impact of family sociodemographic markers on children’s activity. Parents (n = 243; Mage= 38.8 years) of children aged 12 and under (n = 408; Mage= 6.7 years) living in Ontario, Canada, completed two online surveys between August and December 2020 (survey 1) and August and December 2021 (survey 2). Generalized linear mixed-effects models were used to estimate changes in the proportion of children who accumulated 60 minutes of physical activity per day pre-lockdown, during lockdown, and post-lockdown in Ontario. Results revealed a significant non-linear trajectory whereby the proportion of children achieving 60 minutes of physical activity per day pre-lockdown (63%) declined during lockdown (21%) and then increased post-lockdown (54%). Changes in the proportion of children engaging in 60 minutes of daily physical activity were moderated by several demographic variables. Efforts are needed to provide parents of young children with a wider variety of resources to ensure children are obtaining sufficient levels of physical activity regardless of the presence of community lockdowns.
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Emlet, Charles A., and Lesley Harris. "Giving Back Is Receiving: The Role of Generativity in Successful Aging Among HIV-Positive Older Adults." Journal of Aging and Health 32, no. 1-2 (October 5, 2018): 61–70. http://dx.doi.org/10.1177/0898264318804320.
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Objectives: Successful aging has been identified as an important emphasis for people living with human immunodeficiency virus (HIV). Little is known about how this population conceptualizes aging successfully and how this relates to generativity. This qualitative study examined the importance of generativity among 30 HIV-positive older adults to determine the role of generativity in successful aging. Method: Participants aged 50+ years were recruited in Ontario, Canada, through acquired immunodeficiency syndrome (AIDS) service organizations, clinics, and community agencies. Qualitative interviews were analyzed to explore strategies participants employed to engage in successful aging within their own personal context. Results: Participants saw themselves as pioneers and mentors, helping others to navigate the landscape of aging with HIV. Four themes were identified through consensus including (a) reciprocity, (b) mentoring, (c) pioneerism, and (d) connecting through volunteerism. Discussion: Interventions that promote intergenerational connections, community involvement, and generative acts within the HIV community can facilitate successful aging among older adults living with HIV/AIDS.
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Chan, Justine, Margaret DeMelo, Jacqui Gingras, and Enza Gucciardi. "Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada." International Journal of Endocrinology 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/903468.
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Objective.To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre.Design.Qualitative study comprising of in-depth interviews, using a semistructured interview guide.Setting.Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada.Participants.Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions).Method.Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews.Main Findings.Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience.Conclusion.Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.
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Costa, Idevania G., Kristen McConell, Kaitlin Adduono, Pilar Camargo-Plazas, and Anna Koné. "Exploring diabetes status and social determinants of health influencing diabetes-related complications in a Northwestern community, Ontario, Canada: A mixed method study protocol." PLOS ONE 18, no. 9 (September 28, 2023): e0273953. http://dx.doi.org/10.1371/journal.pone.0273953.
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Diabetes is a common chronic condition affecting the many spheres of individuals’ lives. It can also lead to severe complications without continuous management. Accordingly, this paper describes a study protocol aimed at 1) determining the status and prevalence of diabetes complications in a Northwestern Ontario community; 2) exploring the internal (e.g., demographic and clinical variables) and external factors (e.g., access to services and resources) affecting diabetes outcomes (e.g., complications, emergency room visits, hospitalizations); 3) critically exploring how the social determinants of health affect self-management for individuals living with diabetes; and 4) identifying individuals’ needs, concerns, and challenges to monitor and regulate diabetes. The study uses a cross-sectional design and a social constructivist approach based on qualitative data collection. The proposed study will include patients with type 1 and type 2 diabetes with or without diabetes complications who have been attending the Centre for Complex Diabetes Care (CCDC) in Thunder Bay, Ontario, Canada, since January 2019. Quantitative data related to diabetes complications and other outcomes, diabetes management, and demographic and clinical status will be retrieved from patients’ charts using a data extraction form. Analyses of the quantitative data will include the prevalence of diabetes complications, rate of hospitalizations, and their associations with diabetes management, access to services, and social determinants of health. Additionally, interviews will occur with at least 10 participants with or without diabetes complications to understand their needs, concerns, and struggle to self-manage diabetes daily. The results of this study will generate evidence to support future research and policy on the development and implementation of an educational program to improve self-care management and outcomes for individuals living with diabetes and its complications in Northwestern Ontario.
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Skinner, Ruth, Cindy House, Andrew A. House, Chris McIntyre, Elaine Hayter, Pamela Ireland, Jared McGregor, and Ann Tillmann. "The Renal Community Photo Initiative: A Program Report in Ontario, Canada." Canadian Journal of Kidney Health and Disease 9 (January 2022): 205435812211002. http://dx.doi.org/10.1177/20543581221100292.
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Purpose of Program: We initiated the Renal Community Photo Initiative to better understand why some hemodialysis users express significant capacities for resilience and hope, demonstrating outward-looking perspectives and enjoying a rich quality of life. Sources of Information: “Photovoice” is a participatory research methodology that encourages individuals to develop positive self-perceptions with photography. Photovoice empowers participants as informants within their communities. Visual arts researchers surveyed existing Photovoice studies to identify gaps in knowledge to be addressed in this study, including challenges related to fostering participant agency and social action. Images and logs were collected and reviewed during organized, participant-led substudy groups. These meetings provided researchers with core study values and direction as to how the images and additional information should be used to raise awareness about living with chronic kidney disease. Methods: To address the complexity of the human condition, the Renal Community Photo Initiative offered participants an array of diverse and accessible image-making techniques. No narrative directives for image-making were provided. This qualitative, interdisciplinary, participant-centric study invited adult chronic hemodialysis patients in 4 dialysis units in London and Stratford, Ontario, to participate. The research team designed a selection of different, accessible photo technologies for participant use. Eligible participants were invited to select photographic technologies and given the additional option to write accompanying logs. Researchers organized substudy meetings for participant-led focus groups to discuss core study values and personal encounters with images and image-making. Participants directed how their generated images should be shared with the public and researchers. Key Findings: A total of 40 participants have been recruited to date, producing more than 1600 images and an archive of handwritten logs. Three participant-led focus groups have established priorities for image sharing and a core set of values for subsequent study phases. A series of public presentations of participant images took place. The research team will pursue further public presentation opportunities and the development of a suitable research database. Limitations: Organizing and categorizing images for access in an interdisciplinary research database remains a challenge. Current health and safety protocols related to COVID-19 require the study to pause recruitment and substudy meetings and reassess immediate outputs for visuals. Implications: A qualitative study of this scope offers a new model for participant agency and collaboration. It requires the onboarding of interdisciplinary researchers to effectively engage with its significant image and log archive. Participants should remain involved in directing future steps for disseminating their images. Following substudy directives, researchers are developing visuals for health care and public settings, and determining opportunities for participants to share their experience in both clinic- and public-based settings.
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Proulx, L., S. Stones, J. Coe, D. Richards, L. Wilhelm, N. Robertson, J. Gunderson, A. Sirois, and A. Mckinnon. "OP0196-PARE #ARTHRITISATWORK: USING TWITTER TO ENGAGE THE INTERNATIONAL ARTHRITIS COMMUNITY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 122. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4793.
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Background:In 2019, EULAR launched the #Time2Work campaign [1] to raise awareness of the impact of rheumatic and musculoskeletal diseases on individuals, society, and the economy. Building on this theme, the Canadian Arthritis Patient Alliance (CAPA) developed a social media campaign and Twitter chat in collaboration with international patient advocates and organizations. The Twitter chat built upon CAPA’s successful development of workplace resources for people living with arthritis [2].Objectives:To deliver an international #ArthritisAtWork social media campaign on Twitter, in support of the #Time2Work campaign.Methods:A one-hour Twitter Chat was held on World Arthritis Day (October 12, 2019) on arthritis in the workplace (#ArthritisAtWork) from 18:00 to 19:00 UTC. The chat was hosted by CAPA and co-hosted by Simon Stones, a patient advocate from the United Kingdom (UK) and CreakyJoints, patient-driven arthritis organization in the United States (US). The Twitter Chat questions were co-developed in advance by the hosts, and blog posts were shared from CAPA’s website. Each host also promoted the Twitter Chat through their websites, newsletters and online communities. A social media analytical tool, Symplur, was used to measure audience engagement using the hashtag #ArthritisAtWork. In addition, pertinent Tweets before, during, and after the chat were obtained. The analysis of themes was undertaken to identify common issues and questions.Results:One hundred and ten users participated in the Twitter chat between 17:20 and 19:20 UTC. Participants included people living with arthritis, researchers, patient organizations, health information outlets and academic institutions. During this period, 565 tweets were shared between participants in Australia, Canada, Ireland, Spain, UK and US. There were 3.352 million Twitter impressions. This represents the number of times a tweet appears to users in either their timeline or search results. Emergent themes of the analysis include:common workplace challenges such as employer attitudes and stigma;effective workplace supports such as prioritizing tasks and requesting workplace accommodations; andareas of improvement such as instituting workplace policies, flexible workplace approaches and education for employees and managers.Conclusion:The social media campaign was successful in reaching a diverse audience and supporting the #Time2Work campaign. Social media tools can provide an important social support for people living with arthritis as they navigate workplace challenges. It also offers a more contemporary platform to engage the international community on issues of common interest. Working together, internationally helps expand reach and reduce barriers in communication. Research can be conducted to measure potential behavior change that leverages digital social support for people living with arthritis.References:[1]EULAR (2019). Press release “EULAR launches Time2Work campaign to highlight the importance of keeping people with rheumatic and musculoskeletal diseases in work. Available from:https://www.eular.org/sysModules/obxContent/files/www.eular.2015/1_42291DEB-50E5-49AE-5726D0FAAA83A7D4/time2work_campaign_press_release_final.pdf2. CAPA (2019). Arthritis in the Workplace: Resources for Patients by Patients. Available from:http://arthritispatient.ca/arthritis-in-the-workplace-resources-for-patients-by-patients/Disclosure of Interests:Laurie Proulx Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Speakers bureau: I have provided speaking services to Sanofi and Eli Lilly. These engagements do not relate to this abstract., Simon Stones Consultant of: I have been a paid consultant for Envision Pharma Group and Parexel. This does not relate to this abstract., Speakers bureau: I have been a paid speaker for Actelion and Janssen. These do not relate to this abstract., Joseph Coe: None declared, Dawn Richards Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Consultant of: Dawn has done small consulting projects on patient engagement for companies., Speakers bureau: Dawn has been a paid speaker for several companies., Linda Wilhelm Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Nathalie Robertson Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Janet Gunderson Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Alexandra Sirois Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma., Annette McKinnon Grant/research support from: Sources of grants and support received by the Canadian Arthritis Patient Alliance (including in-kind support) in the last two years include: AbbVie Canada, Alliance for Safe Biologic Medicines, Amgen Canada, Arthritis Alliance of Canada, The Arthritis Society, Best Medicines Coalition, CADTH, Canadian Rheumatology Association, Eli Lilly Canada, European League Against Rheumatism, Janssen Canada, Manulife, Novartis Canada, Ontario Rheumatology Association, Pfizer Canada (including Pfizer Hospira), Purdue Pharma Canada, Sanofi, and UCB Pharma.
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Allen, Laura, Amanda McIntyre, Shannon Janzen, Marina Richardson, Matthew Meyer, David Ure, and Robert Teasell. "Community Stroke Rehabilitation: How Do Rural Residents Fare Compared With Their Urban Counterparts?" Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 43, no. 1 (December 4, 2015): 98–104. http://dx.doi.org/10.1017/cjn.2015.324.
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AbstractBackground: Rural living has been demonstrated to have an effect on a person’s overall health status, and rural residing individuals often have decreased access to health and specialized rehabilitation services. Aim: The aim of this study was to determine if there are differences in recovery from stroke between urban and rural-dwelling stroke survivors accessing an in-home, community-based, interdisciplinary, stroke rehabilitation program. Methods: Data from a cohort of 1222 stroke survivors receiving care from the Community Stroke Rehabilitation Teams between January 2009 and June 2013 was analyzed. This program delivers stroke rehabilitation care directly in a person’s home and community. Functional and psychosocial outcomes were evaluated at baseline, discharge, and six -month follow-up. A series of multiple linear regression analyses was performed to determine if rural versus urban status was a significant predictor of discharge and 6-month health outcomes. Results: The mean age of the rural cohort was 68.8 (±13.1) years (53.6% male), and the urban cohort was 68.4 (±13.0) years (44.8% male). A total of 278 (35.4%) individuals were classified as living in a rural area using the Rurality Index for Ontario. In multivariate linear regression analysis, no significant differences on the Functional Independence Measure, the Stroke Impact Scale, the Hospital Anxiety and Depression Scale, or the Reintegration to Normal Living Index were found between urban and rural cohorts. Conclusions: When provided with access to a home-based, specialized stroke rehabilitation program, rural dwelling stroke survivors make and maintain functional gains comparable to their urban-living counterparts.
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Vanderkruk, Kayla Rachelle, Maria Eberg, Tannaz Mahootchi, Ali Vahit Esensoy, and Dallas Peter Seitz. "Trends of Dementia among Community-Dwelling Adults in Ontario, Canada, 2010–2015." Dementia and Geriatric Cognitive Disorders 49, no. 3 (2020): 286–94. http://dx.doi.org/10.1159/000508687.
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<b><i>Background:</i></b> There are increasing numbers of people living with dementia (PLWD) and most reside in community settings. Characterizing the number of individuals affected with dementia and their transitions are important to understand in order to plan for their healthcare needs. Using administrative health data in Ontario, Canada, we examined recent trends in the prevalence and incidence of dementia among the community-dwelling population, described their characteristics, and investigated admissions to long-term care (LTC) and overall survival. <b><i>Methods:</i></b> Using a validated case ascertainment algorithm, we performed a population-based retrospective cohort study of community-dwelling PLWD aged 40–105 years old between 2010 and 2015. We assessed crude and age- and sex-adjusted prevalence and incidence, cohort characteristics, and time to LTC admission and survival. <b><i>Results:</i></b> Between 2010 and 2015, the adjusted community prevalence increased by 9.5% (<i>p</i> < 0.001), while the incidence decreased by 15.8% (<i>p</i> < 0.001). Demographic and socioeconomic characteristics remained similar over time, while the prevalence of comorbidities increased significantly from 2010 to 2015. There was no difference in the time to LTC admission for individuals diagnosed in 2014 when compared to 2010 (<i>p</i> = 0.06). A lower risk of 2-year mortality was observed for individuals diagnosed in 2015 compared to 2010 (HR 0.93, 95% CI 0.90–0.97, <i>p</i> < 0.001). <b><i>Conclusion:</i></b> There was an increase in the prevalence of dementia despite decreasing incidence among community-dwelling PLWD. Lower rates of mortality indicate that PLWD are surviving longer following diagnosis. Adequate resources and planning are required to support this growing population, considering the changing population size and characteristics.
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Sutherns, Dr Rebecca. "IN PRAISE AND SEARCH OF MIDWIFERY WELL-SUITED To RURAL WOMEN." Canadian Journal of Midwifery Research and Practice 2, no. 2 (May 30, 2024): 13–21. http://dx.doi.org/10.22374/cjmrp.v2i2.183.
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In order to investigate rural maternity care from the perspective of women, narrative interviews were conducted with 36 mothers and 36 health care workers in three small community case study sites in south central Ontario in 2000. Based on the resulting data, this article suggests numerous ways that living rurally affects maternal health. It goes on to explore ways in which midwifery is particularly well-suited to addressing the needs of women living in rural places and identifies sites of resistance to rural midwifery. The research findings indicate that a commitment to the sustained provision of rural midwifery services is well worth the effort and investment required, and this article discusses implications of such a commitment for both practitioners and policy makers.
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Smith-Carrier, Tracy, and Andrea Lawlor. "Realising our (neoliberal) potential? A critical discourse analysis of the Poverty Reduction Strategy in Ontario, Canada." Critical Social Policy 37, no. 1 (September 20, 2016): 105–27. http://dx.doi.org/10.1177/0261018316666251.
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We examine the Poverty Reduction Strategy (PRS) launched in Ontario, Canada’s most populous province. Using corpus linguistics and critical discourse analysis, we explore the dominant discourses that emerge in a genre chain produced by the Government of Ontario, including the initial 2008 PRS, annual reports and the 2014–2019 recontextualised PRS. Six key discourses surfaced: social exclusion, social inclusion, economic benefit or social investment, expert knowledge, community engagement and requisites for the PRS’ success – typically involving investments from the federal government and a favourable economic climate. No discourse of human rights, or of the rights to food, housing and an adequate standard of living is present in the PRS texts, absolving the government from its responsibility to ensure these rights. Without the accountability mechanisms attached to a rights-based approach, the PRS has little chance of ‘breaking the cycle’ of poverty, and will not likely ‘realise its potential’ to do so.
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Finlay & Lauren Akbar, Judy. "Caught Between Two Worlds." Canadian Journal of Children's Rights / Revue canadienne des droits des enfants 3, no. 1 (November 24, 2016): 68–99. http://dx.doi.org/10.22215/cjcr.v3i1.82.
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Mamow Ki-ken-da-ma-win: Everyone Searching for Answers Together (Searching Together) is a partnership-based approach to identifying priorities and issues of importance in remote First Nations in Ontario. The collective goal of this partnership is to learn from one another in the context of northern First Nations lived realities. This community assessment and mobilization process serves as a vehicle for understanding and taking steps to address community wellness. The Searching Together’s southern team is affiliated with faculty, staff and students at Ryerson University. The voices of youth captured herein are from four fly-in communities in northern Ontario and were gathered between 2011 and 2015. Children and youth played a powerful role in shaping the Mamow Ki-ken-da-ma-win process. The conversations with youth were arranged to accommodate their space and time and were built on established, trusting relationships with the youth facilitators on the team. The youth spoke with candour and had valuable insights into the challenges and opportunities they faced while living in their communities. They were thoughtful about how to overcome obstacles that interfered with their wellbeing and they clearly expressed their wishes, hopes and dreams for the future.
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Wister, Andrew V. "Living Arrangement Choices among the Elderly." Canadian Journal on Aging / La Revue canadienne du vieillissement 4, no. 3 (September 1985): 127–44. http://dx.doi.org/10.1017/s0714980800015968.
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ABSTRACTThis research explores factors which differentiate non-institutionalized elderly persons living alone, living only with a spouse, and living with other persons (with or without a spouse present). Special attention is devoted to the measurement and investigation of several social norms and personal preferences. These factors are organized in terms of a decision-making framework developed from micro-economic and demographic theory. Choice of a living arrangement is seen as the product of underlying norms and preferences, a set of socio-demographic factors, and constraints on choice. This research relies on data from 454 personal interviews drawn from a stratified random sample of persons 65 and over living in private households in London, Ontario, Canada.Data analysis indicates that the decision of whom to live with is complex and is influenced by a large group of variables. However, the most important factors are the social norms and personal preferences of the respondents. Of these, a preference for independence and privacy surfaces as the strongest predictor of living arrangements. Being able to do what one wants without outside interference in conjunction with a private living style tends to be viewed by older persons as very important household ‘goods’. The expected separateness of the elderly, age segregation or differentiation, and kinship obligations and ties were found to be influential social norms affecting living arrangement decisions. The analysis also suggests that the constraining effects of domestic competence, physical strength and mobility, and availability of kin for co-residence are also important. In addition, several socio-demographic variables including age, sex and ethnicity arise as significant predictors of living arrangements.
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Cain, Roy, Evan Collins, Tarik Bereket, Clemon George, Randy Jackson, Alan Li, Tracey Prentice, and Robb Travers. "Challenges to the involvement of people living with HIV in community-based HIV/AIDS organizations in Ontario, Canada." AIDS Care 26, no. 2 (June 2, 2013): 263–66. http://dx.doi.org/10.1080/09540121.2013.803015.
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Williams, Peter, Lea Narciso, Gina Browne, Jacqueline Roberts, Robin Weir, and Amiram Gafni. "Characteristics of People Living With HIV Who Use Community-Based Services in Ontario, Canada: Implications for Service Providers." Journal of the Association of Nurses in AIDS Care 16, no. 4 (July 2005): 50–63. http://dx.doi.org/10.1016/j.jana.2005.05.004.
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Cochran, Susie, and Leia Minaker. "The Value in Community Gardens: A Return on Investment Analysis." Canadian Food Studies / La Revue canadienne des études sur l'alimentation 7, no. 1 (August 12, 2020): 154–77. http://dx.doi.org/10.15353/cfs-rcea.v7i1.332.
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Food production in cities is increasingly regarded as one of the building blocks for sustainable urban living, particularly as the agricultural industry faces mounting ecological and economic constraints, and populations continue to concentrate in urban centers. While substantial research exists on the qualitative outcomes of urban agriculture (UA), few studies present these outcomes in monetary terms that align with municipal decision makers economic priorities. In response to this gap, this paper reviews the literature on potential outcomes of one form of UA—community gardens—and identifies where gaps exist which prevent the translation of garden outputs into an economic quantity. The paper then describes a pilot return on investment assessment of a community garden in Ontario, Canada. Substantial data constraints were encountered, however the limited available data indicate that community gardens may represent an ROI-positive government investment. Further local-level research quantifying garden impacts would enable a more robust case for community gardens in cities.
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Offord, David R., Michael H. Boyle, Jan E. Fleming, Heather Munroe Blum, and Naomi I. Rae Grant. "Summary of Selected Results." Canadian Journal of Psychiatry 34, no. 6 (August 1989): 483–91. http://dx.doi.org/10.1177/070674378903400602.
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Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.
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Vafaei, Afshin, William Pickett, Maria Victoria Zunzunegui, and Beatriz E. Alvarado. "Relationships Between Neighborhood Social Capital and The Occurrence of Outdoor Falls in Canadian Older Adults: A Multilevel Analysis." Journal of Aging and Health 30, no. 7 (May 4, 2017): 1108–35. http://dx.doi.org/10.1177/0898264317706236.
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Objective: The aim of this study was to examine whether neighborhood-level social capital is a risk factor for falls outside of the home in older adults. Methods: Health questionnaires were completed by community-dwelling Canadians aged +65 years living in Kingston (Ontario) and St-Hyacinthe (Quebec), supplemented by neighborhood-level census data. Multilevel logistic regression models with random intercepts were fit. Variations in the occurrence of falls across neighborhoods were quantified by median odds ratio and 80% interval odds ratio. Results: Between-neighborhood differences explained 7% of the variance in the occurrence of falls; this variance decreased to 2% after adjustment for neighborhood-level variables. In the fully adjusted models, higher levels of social capital increased the odds of falls by almost 2 times: (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.19, 3.71]). Discussion: Living in neighborhoods with higher levels of social capital was associated with higher risk of falling in older adults, possibly through more involvement in social activities.
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Jacklin, Kristen, Karen Pitawanakwat, Melissa Blind, Andrine M. Lemieux, Adam Sobol, and Wayne Warry. "Peace of mind: A community-industry-academic partnership to adapt dementia technology for Anishinaabe communities on Manitoulin Island." Journal of Rehabilitation and Assistive Technologies Engineering 7 (January 2020): 205566832095832. http://dx.doi.org/10.1177/2055668320958327.
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Introduction Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place. Methods Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions. Results Overall, participants agreed that CareBand would improve caregivers’ peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life. Conclusion All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.
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Gorey, Kevin M., Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, and Eric J. Holowaty. "Breast Cancer Care in California and Ontario: Primary Care Protections Greatest Among the Most Socioeconomically Vulnerable Women Living in the Most Underserved Places." Journal of Primary Care & Community Health 8, no. 3 (January 9, 2017): 127–34. http://dx.doi.org/10.1177/2150131916686284.
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Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation therapy. Results: Women in Ontario received more optimal care in communities well supplied by primary care physicians. They were particularly advantaged in the most disadvantaged places: high poverty neighborhoods (rate ratio = 1.65) and communities lacking specialist physicians (rate ratio = 1.33). Canadian advantages were explained by better health insurance coverage and greater primary care access. Conclusions: Policy makers ought to ensure that the newly insured are adequately insured. The Medicaid program should be expanded, as intended, across all 50 states. Strengthening America’s system of primary care will probably be the best way to ensure that the Affordable Care Act’s full benefits are realized.
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Gladstone, James W. "Identifying the Living Arrangements of Elderly Married Couples in Long-term Care Institutions." Canadian Journal on Aging / La Revue canadienne du vieillissement 11, no. 2 (1992): 184–96. http://dx.doi.org/10.1017/s0714980800011715.
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RÉSUMÉCet article se consacre essentiellement aux couples mariés et aux individus âgés mariés résident dans des foyers pour personnes âgées et dans des centres d'accueil en Ontario. Les données ont été recueillies à partir de réponses d'administrateurs à des questionnaires envoyés par la poste (331 administrateurs d'établissement en 1988 et 395 en 1989). Les résultats montraient que 12 pour cent des lits, dans ces deux sortes d'établissements, sont occupés par des personnes mariées. En outre, il a également été démontré qu'il y a plus de couples âgés dans les foyers de personnes âgées que dans les centres d'accueil, qu'ils habitent ou non dans la même chambre. Enfin, les résultats ont laissé entendre qu'il y aurait, dans les centres d'accueil, davantage d'individus mariés vivant seuls (leur époux vivant ailleurs) que dans les foyers de personnes âgées. De nouvelles perspectives de recherche sont envisagées.
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Beauchamp, Marla K., Brenda Vrkljan, Renata Kirkwood, Elisabeth Vesnaver, Luciana G. Macedo, Heather Keller, Janie Astephen-Wilson, et al. "Impact of COVID-19 on mobility and participation of older adults living in Hamilton, Ontario, Canada: a multimethod cohort design protocol." BMJ Open 11, no. 12 (December 2021): e053758. http://dx.doi.org/10.1136/bmjopen-2021-053758.
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IntroductionThe novel COVID-19 required many countries to impose public health measures that likely impacted the participation and mobility of community-dwelling older adults. This protocol details a multimethod cohort design undertaken to describe short-term and medium-term changes to the mobility and participation of older Canadians living in the community rather than retirement facilities during the COVID-19 pandemic.Methods and analysisA longitudinal telephone (or online)-administered survey is being conducted with a random sample of older adults living within 20 km of McMaster University, Hamilton, Ontario, Canada, identified from census dissemination areas. Baseline data collection of community-dwelling older adults aged 65 years and over began in May 2020 with follow-ups at 3, 6, 9 and 12 months. The Late-Life Function and Disability Instrument and global rating of change anchors are the primary outcomes of interest. A subsample of respondents will participate in open-ended, semistructured interviews conducted over the telephone or through video-conference, to explore participants’ lived experiences with respect to their mobility and participation during the pandemic. Descriptive statistics and quantitative approaches will be used to determine changes in mobility and social and personal participation, and associated personal and environmental factors. For the interviews, qualitative data will be analysed using descriptive phenomenology.Ethics and disseminationApproval was obtained from the Hamilton Integrated Research Ethics Board of McMaster University (2020-10814-GRA). This study may inform the design of programmes that can support community-dwelling older adults during and after the COVID-19 pandemic. Findings will be disseminated through peer-reviewed publications and conferences focused on ageing.
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Belanger, Christopher, Cayden Peixoto, Sara Francoeur, and Lise M. Bjerre. "Patient and Provider Satisfaction With a Geomapping Tool for Finding Community Family Physicians in Ontario, Canada: Cross-Sectional Online Survey Study." JMIR Formative Research 8 (July 9, 2024): e56716. http://dx.doi.org/10.2196/56716.
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Background Language-concordant health care, or health care in a patient’s language of choice, is an important element of health accessibility that improves patient safety and comfort and facilitates an increased quality of care. However, prior research has found that linguistic minorities often face higher travel burdens to access language-concordant care compared to the general population. Objective This study intended to assess patient experiences and satisfaction with an online interactive physician map that allows patients to find family physicians who speak their preferred language in and around Ottawa, Ontario, Canada, as a means of identifying areas of improvement. Methods This study used an online survey with questions related to user satisfaction. Responses to Likert-scale questions were compiled as summary statistics and short-answer responses underwent thematic analysis. The study setting was Ottawa and Renfrew County, Ontario, and the surrounding region, including the province of Quebec. Results A total of 93 respondents completed the survey and self-identified as living in Ontario or Quebec. Overall, 57 (61%) respondents were “very satisfied” or “somewhat satisfied” with the map, 16 (17%) were “neither satisfied nor dissatisfied,” and 20 (22%) were “very dissatisfied” or “somewhat dissatisfied.” We found no significant differences in satisfaction by preferred language, age group, physician attachment, or intended beneficiary. A total of 56 respondents provided short-answer responses to an open-ended question about map improvements. The most common specific suggestion was to show which physicians are accepting new patients (n=20). Other suggestions included data refreshes (n=6), user interface adjustments (n=23), and additional languages (n=2). Some participants also provided positive feedback (n=5) or expressed concern with their inability to find a family physician (n=5). Several comments included multiple suggestions. Conclusions While most patients were satisfied with the online map, a significant minority expressed dissatisfaction that the map did not show which family physicians were accepting new patients. This suggests that there may be public interest in an accessible database of which family physicians in Ontario are currently accepting new patients.
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Daiski, Isolde, Nancy Viva Davis Halifax, Gail J. Mitchell, and Andre Lyn. "Homelessness in the Suburbs: Engulfment in the Grotto of Poverty." Studies in Social Justice 6, no. 1 (November 1, 2012): 103–23. http://dx.doi.org/10.26522/ssj.v6i1.1071.
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This paper describes findings of a research inquiry into the lived experience of homelessness in Peel, a suburban region located in the Greater Toronto Area in Ontario, Canada. It is based on the data from a collaborative project undertaken by members of the Faculties of Health and Education of York University with two local community organizations. The dominant theme of the narratives was that suburban homelessness is similar to being engulfed in a grotto of poverty, isolated from the rest of the community and invisible to it. Once entrapped in the grotto, it is almost impossible to escape from it. There were four sub-themes: (a) falling into the grotto, (b) living/struggling in the grotto, (c) envisioning escape routes from the grotto, and (d) beauty, community and hope in the grotto. Following a discussion of the findings, researchers describe strategies to address homelessness through promotion of social justice for all.
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HERRON, RACHEL V., and MARK W. ROSENBERG. "Dementia in rural settings: examining the experiences of former partners in care." Ageing and Society 39, no. 2 (September 11, 2017): 340–57. http://dx.doi.org/10.1017/s0144686x17000952.
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ABSTRACTInformal carers, also referred to as partners in care, provide the bulk of care to people living with dementia across a range of community settings; however, the changing experiences and contexts of providing informal care for people with dementia in rural settings are under-studied. Drawing on 27 semi-structured interviews with former partners in care in Southwestern and Northern Ontario, Canada, we examine experiences of providing and accessing care over the course of the condition and across various settings. Our findings illustrate the challenges associated with navigating the system of care, finding people who understand dementia in the surrounding community, negotiating hours of home support, facing resistance to respite from the person with dementia, and feeling pressured into long-term care. We argue that partners' time, bodies and choices are spatially constrained within rural and small-town settings and the current systems of home, community and long-term care.
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Ploeg, Jenny, Anna Garnett, Kimberly D. Fraser, Lisa Garland Baird, Sharon Kaasalainen, Carrie McAiney, Maureen Markle-Reid, and Sinéad Dufour. "The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study." Journal of Comorbidity 10 (January 1, 2020): 2235042X2098119. http://dx.doi.org/10.1177/2235042x20981190.
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Background: Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC. Methods: This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne’s interpretive description approach. Results: Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers’ experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving. Conclusions: Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.
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Edwards, Beth, Lydia-Joi Marshall, Ghazaleh Ahmadzadeh, Ranie Ahmed, Lydia Angarso, Shilpa Balaji, Princess Okoh, et al. "Exploring barriers to living donor kidney transplant for African, Caribbean and Black communities in the Greater Toronto Area, Ontario: a qualitative study protocol." BMJ Open 13, no. 8 (August 2023): e073176. http://dx.doi.org/10.1136/bmjopen-2023-073176.
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IntroductionLiving donor (LD) kidney transplant (KT) is the best treatment option for many patients with kidney failure as it improves quality of life and survival compared with dialysis and deceased donor KT. Unfortunately, LDKT is underused, especially among groups marginalised by race and ethnicity. African, Caribbean and Black (ACB) patients are 60%–70% less likely to receive LDKT in Canada compared with white patients. Research from the USA and the UK suggests that mistrust, cultural and generational norms, access, and affordability may contribute to inequities. To date, no Canadian studies have explored the beliefs and behaviours related to LDKT in ACB communities. Research approaches that use a critical, community-based approach can help illuminate broader structural factors that may shape individual beliefs and behaviours. In this qualitative study, we will investigate barriers to accessing LDKT in ACB communities in the Greater Toronto Area, to enhance our understanding of the perspectives and experiences of ACB community members, both with and without lived experience of chronic kidney disease (CKD).Methods and analysisHospital-based and community-based recruitment strategies will be used to recruit participants for focus groups and individual interviews. Participants will include self-identified ACB individuals with and without experiences of CKD and nephrology professionals. Collaboration with ACB community partners will facilitate a community-based research approach. Data will be analysed using reflexive thematic analysis and critical race theory. Findings will be revised based on feedback from ACB community partners.Ethics and disseminationThis study has been approved by the University Health Network Research Ethics Board UHN REB file #15-9775. Study findings will contribute to the codevelopment of culturally safe and responsive educational materials to raise awareness about CKD and its treatments and to improve equitable access to high-quality kidney care, including LDKT, for ACB patients.
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Kokorelias, Kristina M., Tin-Suet Joan Lee, Mark Bayley, Emily Seto, Alene Toulany, Michelle L. A. Nelson, Gina Dimitropoulos, Melanie Penner, Robert Simpson, and Sarah E. P. Munce. "“I Have Eight Different Files at Eight Different Places”: Perspectives of Youths and Their Family Caregivers on Transitioning from Pediatric to Adult Rehabilitation and Community Services." Journal of Clinical Medicine 12, no. 4 (February 20, 2023): 1693. http://dx.doi.org/10.3390/jcm12041693.
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Introduction: The number of young adults (youth) living with childhood-onset disabilities, and requiring transitional support to adult community and rehabilitation services, is increasing. We explored facilitators and barriers to accessing and sustaining community and rehabilitation services during the transition from pediatric to adult care. Methods: A qualitative descriptive study was conducted in Ontario, Canada. Data were collected through interviews with youth (n = 11) and family caregivers (n = 7). The data were coded and analyzed using thematic analysis. Results: Youth and caregivers face many types of transitions from pediatric to adult community and rehabilitation services, e.g., those related to education, living arrangements, and employment. This transition is marked by feelings of isolation. Supportive social networks, continuity of care (i.e., same care providers), and advocacy all contribute to positive experiences. Lack of knowledge about resources, changing parental involvement without preparation, and a lack of system responses to evolving needs were barriers to positive transitions. Financial circumstances were described as either a barrier or facilitator to service access. Conclusions: This study demonstrated that continuity of care, support from providers, and social networks all contribute markedly to the positive experience of transitioning from pediatric to adult services for individuals with childhood-onset disabilities and family caregivers. Future transitional interventions should incorporate these considerations.
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Phillips, Susan P., and Lisa F. Carver. "Greatest Risk Factor for Death from COVID-19: Older Age, Chronic Disease Burden, or Place of Residence? Descriptive Analysis of Population-Level Canadian Data." International Journal of Environmental Research and Public Health 20, no. 24 (December 15, 2023): 7181. http://dx.doi.org/10.3390/ijerph20247181.
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During the first wave of COVID-19, three-quarters of Canadian deaths were among those age 80 and older. We examined whether age, chronic disease load, sex, or place was the strongest predictor of such deaths. A cross-sectional analysis of administrative data from 1 January 2020 to 30 October 2020 for the population of Ontario (n = 15,023,174) was performed. Using logistic regression analysis, we determined whether place of residence (community dwelling, community dwelling with formal home care, or long-term care facility), age group, sex, or chronic disease burden was most strongly associated with the outcome of death within 60 days of a positive SARS-CoV-2 PCR test. Overall, there were 2766 deaths attributed to COVID-19. The age-related odds of dying increased from 6.1 (age 65–74) to 13.4 (age 85 or older) relative to those aged <65 years. This age effect was dwarfed by an odds ratio of 117.1 for those living in long-term care versus independently in the community, adjusted for age, sex, and chronic disease burden. The risk of death from COVID-19 aligned much more with social realities than individual risks. The disproportionate mortality arising specifically from institutional residence demands action to identify sources and ameliorate the harms of living in such facilities.
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Yous, Marie-Lee, Rebecca Ganann, Jenny Ploeg, Maureen Markle-Reid, Melissa Northwood, Kathryn Fisher, Ruta Valaitis, et al. "Older adults’ experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study." BMJ Open 13, no. 4 (April 2023): e068694. http://dx.doi.org/10.1136/bmjopen-2022-068694.
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ObjectivesTo assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions. The ACHRU-CPP is a complex 6-month self-management evidence-based intervention for community-living older adults aged 65 years or older with type 1 or type 2 diabetes and at least one other chronic condition. It includes home and phone visits, care coordination, system navigation support, caregiver support and group wellness sessions delivered by a nurse, dietitian or nutritionist, and community programme coordinator.DesignQualitative descriptive design embedded within a randomised controlled trial was used.SettingSix trial sites offering primary care services from three Canadian provinces (ie, Ontario, Quebec and Prince Edward Island) were included.ParticipantsThe sample was 45 community-living older adults aged 65 years or older with diabetes and at least one other chronic condition.MethodsParticipants completed semistructured postintervention interviews by phone in English or French. The analytical process followed Braun and Clarke’s experiential thematic analysis framework. Patient partners informed study design and interpretation.ResultsThe mean age of older adults was 71.7 years, and the mean length of time living with diabetes was 18.8 years. Older adults reported positive experiences with the ACHRU-CPP that supported diabetes self-management, such as improved knowledge in managing diabetes and other chronic conditions, enhanced physical activity and function, improved eating habits, and opportunities for socialisation. They reported being connected to community resources by the intervention team to address social determinants of health and support self-management.ConclusionsOlder adults perceived that a 6-month person-centred intervention collaboratively delivered by a team of health and social care providers helped support chronic disease self-management. There is a need for providers to help older adults connect with available health and social services in the community.Trial registration numberClinicalTrials.gov ID:NCT03664583; Results.
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Vader, Kyle, Soo Chan Carusone, Rachel Aubry, Puja Ahluwalia, Carolann Murray, Larry Baxter, Gregory Robinson, et al. "Strengths and Challenges of Implementing Physiotherapy in an HIV Community-Based Care Setting: A Qualitative Study of Perspectives of People Living with HIV and Healthcare Providers." Journal of the International Association of Providers of AIDS Care (JIAPAC) 20 (January 1, 2021): 232595822110056. http://dx.doi.org/10.1177/23259582211005628.
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The needs of people living with HIV (PLWH) who have access to antiretroviral therapy have shifted from hospital to community care; however, little is known about physiotherapy within HIV community-based care. Our aim was to understand strengths and challenges of implementing physiotherapy within an interprofessional HIV day health program in Toronto, Ontario, Canada. We conducted a qualitative descriptive study using semi-structured interviews. Data were analyzed using inductive content analysis. Fifteen PLWH and 5 healthcare providers participated. Strengths included improved access to physiotherapy and fulfilling an unmet need for rehabilitation; a tailored approach to physiotherapy; co-location improved communication, coordination, and engagement in care; and improved health outcomes for PLWH (i.e. function, psychosocial outcomes, and quality of life). Challenges related to managing expectations; variable attendance at visits; and managing complex and diverse needs of PLWH. Results may be transferable to other community-based care settings that provide care for PLWH and complex multi-morbidity.
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McKenzie, Katherine, Hélène Ouellette-Kuntz, and Lynn Martin. "Frailty as a Predictor of Institutionalization Among Adults With Intellectual and Developmental Disabilities." Intellectual and Developmental Disabilities 54, no. 2 (April 1, 2016): 123–35. http://dx.doi.org/10.1352/1934-9556-54.2.123.
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Abstract Adults with intellectual and developmental disabilities (IDD) frequently become frail earlier than the general population, resulting in higher care needs. This population is at risk for institutionalization, or re-institutionalization, into long-term care (LTC). Using a retrospective cohort design to follow 3,034 individuals (18-99 years) living in Ontario, Canada, and assessed with the Resident Assessment Instrument–Home Care, individuals were characterized with a frailty index (FI) for persons with IDD. Survival analyses determined differences in rates of admission to LTC and survival in the community. Frail individuals had greater rates of admission than non-frail individuals, adjusted HR = 2.19, 95% CI [1.81, 2.64]. The FI predicts institutionalization.