Project description:BackgroundMany communities across North America are coming together to develop comprehensive plans to address and respond to the escalating overdose crisis, largely driven by an increasingly toxic unregulated drug supply. As there is a need to build capacity for successful implementation, the objective of our mixed methods study was to identify the current planning and implementation practices, needs, and priority areas of support for community overdose response plans in Ontario, Canada.MethodsWe used a situational assessment methodology to collect data on current planning and implementation practices, needs, and challenges related to community overdose response plans in Ontario, consisting of three components. Between November 2019 to February 2020, we conducted ten semi-structured key informant interviews, three focus groups with 25 participants, and administered an online survey (N = 66). Purposeful sampling was used to identify professionals involved in coordinating, supporting, or partnering on community overdose response plans in jurisdictions with relevant information for Ontario including other Canadian provinces and American states. Key informants included evaluators, representatives involved in centralised supports, as well as coordinators and partners on community overdose response plans. Focus group participants were coordinators or leads of community overdose response plans in Ontario.ResultsSixty-six professionals participated in the study. The current planning and implementation practices of community overdose response plans varied in Ontario. Our analysis generated four overarching areas for needs and support for the planning and implementation of community overdose response plans: 1) data and information; 2) evidence and practice; 3) implementation/operational factors; and 4) partnership, engagement, and collaboration. Addressing stigma and equity within planning and implementation of community overdose response plans was a cross-cutting theme that included meaningful engagement of people with living and lived expertise and meeting the service needs of different populations and communities.ConclusionsThrough exploring the needs and related supports for community overdose response plans in Ontario, we have identified key priority areas for building local capacity building to address overdose-related harms. Ongoing development and refinement, community partnership, and evaluation of our project will highlight the influence of our supports to advance the capacity, motivation, and opportunities of community overdose response plans.

Project description:Introduction: This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals. Methods: COVID-19 cases and locations were curated for geostatistical analyses from March 2020 through June 2021, corresponding to the first, second, and third waves of infections. Daily cases were aggregated according to designated forward sortation area (FSA), and postal codes (PC) in municipal regions Hamilton, Kitchener/Waterloo, London, Ottawa, Toronto, and Windsor/Essex county. Hotspots were identified with area-to-area tests including Getis-Ord Gi*, Global Moran's I spatial autocorrelation, and Local Moran's I asymmetric clustering and outlier analyses. Case counts were also interpolated across geographic regions by Empirical Bayesian Kriging, which localizes high concentrations of COVID-19 positive tests, independent of FSA or PC boundaries. The Geostatistical Disease Epidemiology Toolbox, which is freely-available software, automates the identification of these regions and produces digital maps for public health professionals to assist in pandemic management of contact tracing and distribution of other resources. Results: This study provided indicators in real-time of likely, community-level disease transmission through innovative geospatial analyses of COVID-19 incidence data. Municipal and provincial results were validated by comparisons with known outbreaks at long-term care and other high density residences and on farms. PC-level analyses revealed hotspots at higher geospatial resolution than public reports of FSAs, and often sooner. Results of different tests and kriging were compared to determine consistency among hotspot assignments. Concurrent or consecutive hotspots in close proximity suggested potential community transmission of COVID-19 from cluster and outlier analysis of neighboring PCs and by kriging. Results were also stratified by population based-categories (sex, age, and presence/absence of comorbidities). Conclusions: Earlier recognition of hotspots could reduce public health burdens of COVID-19 and expedite contact tracing.

Project description:BackgroundTo support AIDS service organisations and other community-based organisations' use of research evidence to inform HIV-related programmes, services and policies, the Ontario HIV Treatment Network (OHTN) developed a Rapid Response Service. The final product of the rapid response process at the OHTN, which is more streamlined than that of traditional systematic reviews, consists of a detailed report answering questions regarding an HIV-specific issue and how the findings apply within the local context. In 2016, the OHTN conducted an evaluation to assess the effectiveness of its Rapid Response Service. This article reports on the development of this service as well as the results of the evaluation.MethodsAll rapid responses published between January 1, 2009, and September 30, 2016, by the OHTN (n = 102) were analysed using univariate analyses. Frequency distributions were determined for the following variables for each rapid response: populations observed, topics covered, requestor affiliations and number of downloads from the OHTN's website. Requestors of rapid responses were also interviewed regarding perceived helpfulness and utility of the service and final products, and suggestions for changes to the service. Six-month follow-up interviews were conducted to determine how affiliated organisations used the evidence from the rapid response they requested.ResultsThe 102 rapid responses published covered 14 different populations of interest. Topics covered included the HIV prevention, engagement and care cascade, determinants of health, syndemics, and comorbidities. Requestor affiliations consisted of AIDS service organisations, government agencies and policy-makers, non-HIV-focused community-based organisations, and hospitals, universities or health centres. Requestors perceived most aspects of the Rapid Response Service as very helpful and most frequently suggested that the rapid responses should provide recommendations. Follow-up interviews regarding the impact of rapid responses show that rapid responses have been used to assist organisations in numerous activities.ConclusionsOrganisations that have used the OHTN's Rapid Response Service describe it as a valuable service useful for the development of programmes and policies. Improvements in capacity-building efforts may increase its utility. Describing the findings of this evaluation may serve as a reference for similar programmes to increase the use of research evidence among public health decision-makers.

Project description:Volunteers are critical to supporting health care systems worldwide. For organisations that rely on volunteers, service to clients can be disrupted when volunteers leave their roles. Volunteer retention is a multi-layered phenomenon. In this mixed methods case-control study, we compared two naturally-occurring volunteer groups supporting a complex primary care-based programme for older adults in the community: volunteers retained by the programme, and volunteers that left. Our objectives were to describe differences between the groups and also understand how compassion changed over time for those that stayed. We collected quantitative data on demographics, the UCLA Geriatric Attitudes Scale, the Professional Quality of Life Index, the Basic Empathy Scale, the Reasons for Volunteering subscale of the Volunteerism Questionnaire and the 5-level EQ-5D. Qualitative data were collected through focus groups/interviews. Overall, 78 volunteers completed surveys and 23 participated in focus groups/interviews. Volunteers that stayed were more likely to be a little older and were a slightly higher proportion male than those who left. They also had significantly less positive attitudes towards older adults, descriptively lower Cognitive Empathy and descriptively higher Secondary Traumatic Stress. Compared to volunteers who left, volunteers retained were more likely to have said they were volunteering for Enhancement or Social purposes; however, these differences were non-significant. Over time, Compassion Satisfaction decreased with a medium effect size for those that stayed, and Burnout decreased with a small effect size. Volunteers that stayed described more logistical and client-related aspects of the programme were working well. We recommend that volunteer programmes communicate positive programme impacts that could enhance volunteers' development, communicate any client impacts to volunteers to reinforce volunteers' purposes for volunteering (thus reinforcing that their work is meaningful), and ensure logistical aspects of volunteer role work well.

Project description:BACKGROUND:Aedes japonicus was first documented in Ontario, Canada, in 2001. The objective of this study was to determine the effect of Ae. japonicus establishment on the abundance of other mosquitoes in the Greater Golden Horseshoe (GGH) region of Ontario. METHODS:Adult mosquito data from the Ontario West Nile virus surveillance program were used. Descriptive analyses, linear trends and distribution maps of average trap count per month for six mosquito species of interest were produced. Multivariable negative binomial regression models were constructed to 1) test whether the invasion of Ae. japonicus affected the abundance of other mosquitoes by comparing the time period before Ae. japonicus was identified in an area (pre-detection), to after it was first identified (detection), and subsequently (establishment), and 2) identify the variables that explain the abundance of the various mosquito species. RESULTS:The monthly seasonal average (May-October) of Ae. japonicus per trap night increased from 2002 to 2016, peaking in September, when the average of most other mosquitoes decrease. There were increased numbers of Ae. triseriatus/hendersoni (Odds Ratio (OR): 1.40, 95% Confidence Interval (CI): 1.02-1.94) and decreased numbers of Coquillettidia perturbans (OR: 0.43, 95% CI: 0.26-0.73) in the detection period, compared to the pre-detection period. Additionally, there was a decrease in Cx. pipiens/restuans (OR: 0.87, 95% CI: 0.76-0.99) and Cq. perturbans (OR: 0.68, 95% CI: 0.49-0.94) in the establishment period, compared to the pre-detection period. None of the most parsimonious explanatory models included the period of the establishment of Ae. japonicus. CONCLUSIONS:There is no evidence that the introduction of Ae. japonicus significantly reduced populations of Ae. triseriatus/hendersoni, Cx. pipiens/restuans or An. punctipennis in the GGH. While further research is needed to understand the impact of the Ae. japonicus invasion on other mosquito species, our work indicates that, on a regional scale, little impact has been noted.

Project description:ImportanceScreening for amblyopia in primary care visits is recommended for young children, yet screening rates are poor. Although the prevalence of amblyopia is low (3%-5%) among young children, universal screening in schools and mandatory optometric examinations may improve vision care, but the cost-effectiveness of these vision testing strategies compared with the standard in primary care is unknown.ObjectiveTo evaluate the relative cost-effectiveness of universal school screening and mandated optometric examinations compared with standard care vision screening in primary care visits in Toronto, Canada, with the aim of detecting and facilitating treatment of amblyopia and amblyopia risk factors from the Ontario government's perspective.Design, setting, and participantsAn economic evaluation was conducted from July 2019 to May 2021 using a Markov model to compare 15-year costs and quality-adjusted life-years (QALYs) between school screening and optometric examination compared with primary care screening in Toronto, Canada. Parameters were derived from published literature, the Ontario Schedule of Benefits and Fees, and the Kindergarten Vision Testing Program. A hypothetical cohort of 25 000 children aged 3 to 5 years was simulated. It was assumed that children in the cohort had irreversible vision impairment if not diagnosed by an optometrist. In addition, incremental costs and outcomes of 0 were adjusted to favor the reference strategy. Vision testing programs were designed to detect amblyopia and amblyopia risk factors.Main outcomes and measuresFor each strategy, the mean costs per child included the costs of screening, optometric examinations, and treatment. The mean health benefits (QALYs) gained were informed by the presence of vision impairment and the benefits of treatment. Incremental cost-effectiveness ratios were calculated for each alternative strategy relative to the standard primary care screening strategy as the additional cost required to achieve an additional QALY at a willingness-to-pay threshold of $50 000 Canadian dollars (CAD) ($37 690) per QALY gained.ResultsSchool screening relative to primary care screening yielded cost savings of CAD $84.09 (95% CI, CAD $82.22-$85.95) (US $63.38 [95% CI, US $61.97-$64.78]) per child and an incremental gain of 0.0004 (95% CI, -0.0047 to 0.0055) QALYs per child. Optometric examinations relative to primary care screening yielded cost savings of CAD $74.47 (95% CI, CAD $72.90-$76.03) (US $56.13 [95% CI, $54.95-$57.30]) per child and an incremental gain of 0.0508 (95% CI, 0.0455-0.0561) QALYs per child. At a willingness-to-pay threshold of CAD $50 000 (US $37 690) per QALY gained, school screening and optometric examinations were cost-effective relative to primary care screening in only 20% and 29% of iterations, respectively.Conclusions and relevanceIn this study, because amblyopia prevalence is low among young children and most children in the hypothetical cohort had healthy vision, universal school screening and optometric examinations were not cost-effective relative to primary care screening for detecting amblyopia in young children in Toronto, Canada. The mean added health benefits of school screening and optometric examinations compared with primary care screening did not warrant the resources used.

Dataset Information

Isolation of Candida dubliniensis in an aboriginal community in Ontario, Canada.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets