Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36806
Karen El Hajj
Introduction: The rising cost of healthcare along with the aging demographic requires the attention of policy makers. The United States’ nursing home industry is costly to older adults, requiring many to resort to government funded Medicare to offset these costs. This study aims to understand determinants of nursing home prices in the state of California. Variables included in the analysis are selected based on previous literature on the costs of nursing homes in the US. Methods: The data were analyzed using a multi-variable regression analysis. The analysis sample included 1,121 nursing homes across California, using facility level and governmental data that is publically available for the years of 2016-2017. Data collected included financial indicators (net income), ownership (for-profit, non-profit) represented as a dummy variable, occupancy rates, reimbursement rates (Medicare & Medicaid), staffing, quality and competition variables such as nursing homes per county. Results: The regression analysis indicated that ownership type (for-profit), competition and occupancy rates have a negative significant effect on nursing home prices. Whereas, reimbursement rates of both Medicare and Medicaid, home income and staffing levels have a positive significant effect, driving further nursing home prices. Conclusion: The study aimed to understand the relevant variables that influence nursing home prices in the state of Califronia. The regression analysis yielded significant results for various factors including reimbursement rates, occupancy rates and the number of nursing homes per county. However, a notable limitation to the study is the inability to generalize these factors to the rest of the US due to state specific health policies. Determinants such as reimbursement rates and nursing homes per county vary by governmental decisions, therefore, a comprehensive policy tool could be designed to alter nursing home costs through state health policies.
{"title":"Informing Policy from Prices: An Overview of California Nursing Homes","authors":"Karen El Hajj","doi":"10.33137/utjph.v2i2.36806","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36806","url":null,"abstract":"Introduction: The rising cost of healthcare along with the aging demographic requires the attention of policy makers. The United States’ nursing home industry is costly to older adults, requiring many to resort to government funded Medicare to offset these costs. This study aims to understand determinants of nursing home prices in the state of California. Variables included in the analysis are selected based on previous literature on the costs of nursing homes in the US. \u0000Methods: The data were analyzed using a multi-variable regression analysis. The analysis sample included 1,121 nursing homes across California, using facility level and governmental data that is publically available for the years of 2016-2017. Data collected included financial indicators (net income), ownership (for-profit, non-profit) represented as a dummy variable, occupancy rates, reimbursement rates (Medicare & Medicaid), staffing, quality and competition variables such as nursing homes per county. \u0000Results: The regression analysis indicated that ownership type (for-profit), competition and occupancy rates have a negative significant effect on nursing home prices. Whereas, reimbursement rates of both Medicare and Medicaid, home income and staffing levels have a positive significant effect, driving further nursing home prices. \u0000Conclusion: The study aimed to understand the relevant variables that influence nursing home prices in the state of Califronia. The regression analysis yielded significant results for various factors including reimbursement rates, occupancy rates and the number of nursing homes per county. However, a notable limitation to the study is the inability to generalize these factors to the rest of the US due to state specific health policies. Determinants such as reimbursement rates and nursing homes per county vary by governmental decisions, therefore, a comprehensive policy tool could be designed to alter nursing home costs through state health policies.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120959491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36812
S. H. Fu
Introduction & Objective: Besides age and sex as established risk factors of COVID-19 infection, social factor is found to be a determinant, with people of lower socioeconomic status suffer disproportionately from the disease. The city of Toronto has one of the highest COVID-19 infection rates in Canada. This analysis aims to explore the socioeconomic correlates associated with COVID-19 infection and the temporal trends among different age groups in Toronto using geospatial modeling. Methods: A Bayesian spatio-temporal analysis was conducted using public COVID-19 cases data for Toronto. The case data were modeled using the Besag-York-Mollie (BYM) model, implemented in R-INLA. The model adjusted for age, sex, neighbourhood-level socioeconomic factors, crime rates, and population density. Random effects were included to account for neighbourhood-level variation and for spatial autocorrelation. Temporal trends of COVID-19 cases were modelled using second-order random walks to allow non-parametric estimations. Results: The model estimates showed that men are at higher risk of COVID-19 infection. Among neighbourhood factors, higher home prices, education level, and population density are at lower risks, while belonging to an improvement area showed elevated risks. The temporal trends differed by age, with ages 20-59 showed increased risks over time, compared to the youngest and older age groups. Model predictions showed that northwest Toronto has higher risk compared to the rest of Toronto. Conclusion: The higher COVID-19 infection risks in the Northwest will require increase public health effort to control disease spread in this area. The ecological correlates identified in this analysis will also help to guide the ongoing vaccination plans.
{"title":"A spatio-temporal modelling of Covid-19 infections in Toronto’s neighbourhoods","authors":"S. H. Fu","doi":"10.33137/utjph.v2i2.36812","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36812","url":null,"abstract":"Introduction & Objective: Besides age and sex as established risk factors of COVID-19 infection, social factor is found to be a determinant, with people of lower socioeconomic status suffer disproportionately from the disease. The city of Toronto has one of the highest COVID-19 infection rates in Canada. This analysis aims to explore the socioeconomic correlates associated with COVID-19 infection and the temporal trends among different age groups in Toronto using geospatial modeling. \u0000Methods: A Bayesian spatio-temporal analysis was conducted using public COVID-19 cases data for Toronto. The case data were modeled using the Besag-York-Mollie (BYM) model, implemented in R-INLA. The model adjusted for age, sex, neighbourhood-level socioeconomic factors, crime rates, and population density. Random effects were included to account for neighbourhood-level variation and for spatial autocorrelation. Temporal trends of COVID-19 cases were modelled using second-order random walks to allow non-parametric estimations. \u0000Results: The model estimates showed that men are at higher risk of COVID-19 infection. Among neighbourhood factors, higher home prices, education level, and population density are at lower risks, while belonging to an improvement area showed elevated risks. The temporal trends differed by age, with ages 20-59 showed increased risks over time, compared to the youngest and older age groups. Model predictions showed that northwest Toronto has higher risk compared to the rest of Toronto. \u0000Conclusion: The higher COVID-19 infection risks in the Northwest will require increase public health effort to control disease spread in this area. The ecological correlates identified in this analysis will also help to guide the ongoing vaccination plans.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132324425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36994
Saba Javaid, M. Derocher
Background: The use of email and secure messaging between physicians and patients is increasing in frequency. P PHowever, residents lack formal training in e-communication, patient privacy and other confidentiality issues associated with it. There is also a paucity of assessment tools and faculty feedback regarding this practice.Objective: The objective is to investigate use of email and secure messaging between patients and residents at St. Michael’s family medicine residency program and analyze educational constructs, facilitators, and barriers relevant to this practice.Methods: Three cross-sectional surveys were conducted at St. Michael’s family medicine residency program in 2018-2020. Each resident in postgraduate year 1 & 2 received an email inviting them to respond. Results: The prevalence of residents using email or secure messaging is increasing (47% in 2018 vs 81% in 2020). Over 86% of FM residents used hospital/clinic computers in 2020 but the proportion of residents using personal computers rose to 60% that year. A prominent barrier appears to be the ‘potential for inappropriate use by patients’, which was cited as ‘fairly’ or ‘very’ important at rates of 85.3%, 86.9%, and 73.68% in 2018, 2019 and 2020, respectively. 76.4% and 56.52% of residents cited lack of consistent advice/guidelines as a barrier in the years 2018 and 2019, respectively. The perception of support has risen (33.3% residents reporting supervisors as ‘very’ or ‘somewhat’ supportive versus 57.8% in 2020). The majority reported ‘rarely’ or ‘never’ getting feedback/guidance from their supervisors.Conclusions: Our study found an increase in the use of email and secure messaging. Residents are increasingly using their personal computers which likely reflects the increase in virtual models of care. Residents have concerns regarding the appropriate use of such messaging by patients. Lack of supervision may pose a risk of patient confidentiality/privacy breach. There is a need for curricular re-design and faculty development around this practice.
{"title":"The Use of Email and Secure Messaging between Residents and Patients at St. Michael’s Family Medicine Residency Program","authors":"Saba Javaid, M. Derocher","doi":"10.33137/utjph.v2i2.36994","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36994","url":null,"abstract":"Background: The use of email and secure messaging between physicians and patients is increasing in frequency. P PHowever, residents lack formal training in e-communication, patient privacy and other confidentiality issues associated with it. There is also a paucity of assessment tools and faculty feedback regarding this practice.Objective: The objective is to investigate use of email and secure messaging between patients and residents at St. Michael’s family medicine residency program and analyze educational constructs, facilitators, and barriers relevant to this practice.Methods: Three cross-sectional surveys were conducted at St. Michael’s family medicine residency program in 2018-2020. Each resident in postgraduate year 1 & 2 received an email inviting them to respond. \u0000Results: The prevalence of residents using email or secure messaging is increasing (47% in 2018 vs 81% in 2020). Over 86% of FM residents used hospital/clinic computers in 2020 but the proportion of residents using personal computers rose to 60% that year. A prominent barrier appears to be the ‘potential for inappropriate use by patients’, which was cited as ‘fairly’ or ‘very’ important at rates of 85.3%, 86.9%, and 73.68% in 2018, 2019 and 2020, respectively. 76.4% and 56.52% of residents cited lack of consistent advice/guidelines as a barrier in the years 2018 and 2019, respectively. The perception of support has risen (33.3% residents reporting supervisors as ‘very’ or ‘somewhat’ supportive versus 57.8% in 2020). The majority reported ‘rarely’ or ‘never’ getting feedback/guidance from their supervisors.Conclusions: Our study found an increase in the use of email and secure messaging. Residents are increasingly using their personal computers which likely reflects the increase in virtual models of care. Residents have concerns regarding the appropriate use of such messaging by patients. Lack of supervision may pose a risk of patient confidentiality/privacy breach. There is a need for curricular re-design and faculty development around this practice.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122055329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36894
Ronaz Remtulla, A. Mohamed, Jason Liu, A. Thayaparan, Areez Remtulla, Cora Clearwater, Mim Harder, Jeya Thayaparan
Objective: To gather informal evidence on the Canadian community’s knowledge of the history and matters of Indigenous Peoples of Canada and identify gaps in education and awareness. Methods: A cross-sectional study was performed through a structured and anonymous questionnaire that was completed on a voluntary basis. Knowledge gained from partnering with Indigenous members of the community and participating in a blanket exercise was used to produce questions surrounding current and historical matters of Indigenous peoples of Canada. The blanket exercise is an Indigenous-led educational program that tells the story of Canadian history from an Indigenous lens. The inclusion criteria for the study was individuals enrolled in a primary and/or secondary Canadian educational institution and non-Indigenous self-identification. The survey sample most closely represents individuals between 18 to 24 years old in the population. Results: The target demographic scored an average of 54.4% on knowledge-based survey questions. Most individuals answered questions more accurately on topics relating to historical facts, such as the content of the Indian Act, than they did on topics relating to current Indigenous issues, like percent of land mass occupied by Indigenous peoples. Despite indicating primary and secondary schooling as the main source of education on Indigenous history, 86% of participants found their education “limited” and “inadequate”. Results of the survey do not definitively represent the Canadian population, as this was an informal study completed on a voluntary basis. Conclusion: Survey results highlighted gaps in the Canadian population’s knowledge on challenges faced by Indigenous members of Canada. Many respondents recognized an inadequate primary and/or secondary education on Indigenous issues, suggesting a need for educational reform. Increasing awareness on Indigenous matters can potentially reduce discrimination and systemic racism, which can improve social determinants of health. This data can serve as an informal basis of knowledge until further research is conducted.
{"title":"The Canadian Community’s Knowledge on the History and Matters of Indigenous Peoples of Canada","authors":"Ronaz Remtulla, A. Mohamed, Jason Liu, A. Thayaparan, Areez Remtulla, Cora Clearwater, Mim Harder, Jeya Thayaparan","doi":"10.33137/utjph.v2i2.36894","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36894","url":null,"abstract":"Objective: To gather informal evidence on the Canadian community’s knowledge of the history and matters of Indigenous Peoples of Canada and identify gaps in education and awareness. \u0000Methods: A cross-sectional study was performed through a structured and anonymous questionnaire that was completed on a voluntary basis. Knowledge gained from partnering with Indigenous members of the community and participating in a blanket exercise was used to produce questions surrounding current and historical matters of Indigenous peoples of Canada. The blanket exercise is an Indigenous-led educational program that tells the story of Canadian history from an Indigenous lens. The inclusion criteria for the study was individuals enrolled in a primary and/or secondary Canadian educational institution and non-Indigenous self-identification. The survey sample most closely represents individuals between 18 to 24 years old in the population. \u0000Results: The target demographic scored an average of 54.4% on knowledge-based survey questions. Most individuals answered questions more accurately on topics relating to historical facts, such as the content of the Indian Act, than they did on topics relating to current Indigenous issues, like percent of land mass occupied by Indigenous peoples. Despite indicating primary and secondary schooling as the main source of education on Indigenous history, 86% of participants found their education “limited” and “inadequate”. Results of the survey do not definitively represent the Canadian population, as this was an informal study completed on a voluntary basis. \u0000Conclusion: Survey results highlighted gaps in the Canadian population’s knowledge on challenges faced by Indigenous members of Canada. Many respondents recognized an inadequate primary and/or secondary education on Indigenous issues, suggesting a need for educational reform. Increasing awareness on Indigenous matters can potentially reduce discrimination and systemic racism, which can improve social determinants of health. This data can serve as an informal basis of knowledge until further research is conducted.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121582957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36763
Xu Li, P. Hu
Introduction & Objective: Ulcerative colitis is an intestinal disorder with an erratic progression in which the patients suffer from capricious remissions and changeful severities. Lacking prognosis to the UC progression can lead to irrational treatments that adversely affect the patients’ quality of life. Existing studies have stated a connection between gut microbiomes and UC progression. We aim to construct Long Short-Term Memory (LSTM) networks to predict UC progression (remission & severity) from longitudinal gut microbiome data. Methods: Using one-step and two-step modelling strategies, we develop a standard LSTM network, an encoder-decoder LSTM network, a convolutional LSTM network, and several benchmarking classifiers such as random forests. For high-dimensional data, we also implement auto-encoder to select variables in addition to baseline procedures like principal component analysis. We train each model using a longitudinal microbiome data, and validate them via a 10-round set splitting approach. Results: Each proposed model shows the potential to predict UC progression, but they do not reach an optimal level for medical utilizations. The encoder-decoder LSTM demonstrates superiority over the other classifiers while the auto-encoder outperformed the baseline variable selectors. Conclusion: We support the capacity of Long Short-Term Memory (LSTM) networks to predict UC progression from longitudinal microbiome data, and verify the strength of autoencoder networks in selecting features from high dimensional data.
{"title":"Constructing Long Short-Term Memory Networks to Predict Ulcerative Colitis Progression from Longitudinal Gut Microbiome Profiles","authors":"Xu Li, P. Hu","doi":"10.33137/utjph.v2i2.36763","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36763","url":null,"abstract":"Introduction & Objective: Ulcerative colitis is an intestinal disorder with an erratic progression in which the patients suffer from capricious remissions and changeful severities. Lacking prognosis to the UC progression can lead to irrational treatments that adversely affect the patients’ quality of life. Existing studies have stated a connection between gut microbiomes and UC progression. We aim to construct Long Short-Term Memory (LSTM) networks to predict UC progression (remission & severity) from longitudinal gut microbiome data. \u0000Methods: Using one-step and two-step modelling strategies, we develop a standard LSTM network, an encoder-decoder LSTM network, a convolutional LSTM network, and several benchmarking classifiers such as random forests. For high-dimensional data, we also implement auto-encoder to select variables in addition to baseline procedures like principal component analysis. We train each model using a longitudinal microbiome data, and validate them via a 10-round set splitting approach. \u0000Results: Each proposed model shows the potential to predict UC progression, but they do not reach an optimal level for medical utilizations. The encoder-decoder LSTM demonstrates superiority over the other classifiers while the auto-encoder outperformed the baseline variable selectors. \u0000Conclusion: We support the capacity of Long Short-Term Memory (LSTM) networks to predict UC progression from longitudinal microbiome data, and verify the strength of autoencoder networks in selecting features from high dimensional data.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114004317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.37002
D. Toccalino, Amy Moore, Sophia Chuon Gutierrez, A. Colantonio, Christine M. Wickens, H. Haag
Introduction: One in four Canadian women experience intimate partner violence (IPV) in their lifetime. The COVID-19 pandemic has significantly increased rates of IPV globally and the level of violence encountered, exposing IPV survivors to greater risk of physical injury, including traumatic brain injury (TBI). Up to 75% of survivors are suspected of sustaining a TBI and 50-75% experience mental health or substance use challenges (MHSU) as a result of IPV, resulting in extensive personal, social, and economic implications. Objective: The objective of this scoping review was to synthesize what is currently known in the literature about MHSU and TBI among survivors of IPV and identify gaps. Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science were searched for relevant articles using a search strategy including text words and subject headings related to TBI, IPV, and MHSU. Two reviewers independently assessed articles for inclusion. Results: The search identified 399 unique articles, 34 of which were included in this study. Of these, 11 articles reported on MHSU in IPV-related TBI and 9 articles reported on both TBI and MHSU in IPV but did not discuss the groups together. The remainder were reviews or theses that noted MHSU in IPV-related TBI. Included articles predominantly focused on cis-gendered women in heterosexual relationships and were conducted in the United States. Only three articles focused on the experiences of Black or Indigenous women and none of the included studies discussed implications of co-occurring TBI and MHSU on survivor’s healthcare-related needs or access to care. Conclusions: Despite the high rates of co-occurring TBI and MHSU among survivors of IPV, there is little research on this intersection and no investigation of the impacts on the health system. Future research should focus on identifying the healthcare-related needs of survivors and identifying and mitigating barriers to access.
四分之一的加拿大妇女在其一生中经历过亲密伴侣暴力(IPV)。2019冠状病毒病大流行大大增加了全球IPV发病率和暴力程度，使IPV幸存者面临更大的身体伤害风险，包括创伤性脑损伤(TBI)。多达75%的幸存者被怀疑患有创伤性脑损伤，50-75%的幸存者因IPV经历精神健康或物质使用挑战(MHSU)，造成广泛的个人、社会和经济影响。目的:本综述的目的是综合目前已知的关于IPV幸存者中MHSU和TBI的文献，并确定差距。方法:使用包含TBI、IPV和MHSU相关文本词和主题标题的搜索策略，对MEDLINE、EMBASE、PsycINFO、CINAHL、Cochrane、Scopus和Web of Science等相关文章进行检索。两名审稿人独立评估文章是否纳入。结果:检索到399篇独特的文章，其中34篇被纳入本研究。其中，11篇文章报道了ipvv相关TBI中的MHSU, 9篇文章同时报道了ipvv中的TBI和MHSU，但没有一起讨论这两组。其余的是在ipvv相关的TBI中注意到MHSU的综述或论文。纳入的文章主要集中在异性恋关系中的顺性女性，并在美国进行。只有三篇文章关注黑人或土著妇女的经历，而且纳入的研究中没有一篇讨论同时发生的创伤性脑损伤和MHSU对幸存者医疗保健相关需求或获得医疗保健的影响。结论:尽管IPV幸存者中同时发生TBI和MHSU的比例很高，但关于这一交叉点的研究很少，也没有对卫生系统影响的调查。未来的研究应侧重于确定幸存者的卫生保健相关需求，并确定和减轻获得卫生保健的障碍。
{"title":"Exploring the intersection of traumatic brain injury and mental health in survivors of intimate partner violence","authors":"D. Toccalino, Amy Moore, Sophia Chuon Gutierrez, A. Colantonio, Christine M. Wickens, H. Haag","doi":"10.33137/utjph.v2i2.37002","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.37002","url":null,"abstract":"Introduction: One in four Canadian women experience intimate partner violence (IPV) in their lifetime. The COVID-19 pandemic has significantly increased rates of IPV globally and the level of violence encountered, exposing IPV survivors to greater risk of physical injury, including traumatic brain injury (TBI). Up to 75% of survivors are suspected of sustaining a TBI and 50-75% experience mental health or substance use challenges (MHSU) as a result of IPV, resulting in extensive personal, social, and economic implications. \u0000Objective: The objective of this scoping review was to synthesize what is currently known in the literature about MHSU and TBI among survivors of IPV and identify gaps. \u0000Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science were searched for relevant articles using a search strategy including text words and subject headings related to TBI, IPV, and MHSU. Two reviewers independently assessed articles for inclusion. \u0000Results: The search identified 399 unique articles, 34 of which were included in this study. Of these, 11 articles reported on MHSU in IPV-related TBI and 9 articles reported on both TBI and MHSU in IPV but did not discuss the groups together. The remainder were reviews or theses that noted MHSU in IPV-related TBI. Included articles predominantly focused on cis-gendered women in heterosexual relationships and were conducted in the United States. Only three articles focused on the experiences of Black or Indigenous women and none of the included studies discussed implications of co-occurring TBI and MHSU on survivor’s healthcare-related needs or access to care. \u0000Conclusions: Despite the high rates of co-occurring TBI and MHSU among survivors of IPV, there is little research on this intersection and no investigation of the impacts on the health system. Future research should focus on identifying the healthcare-related needs of survivors and identifying and mitigating barriers to access.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129765892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36997
Tianru Wang, Safa Ahmad, R. Schwartz, M. Chaiton, S. Bondy
Background: The prevalence of electronic cigarette use has doubled among Canadian youth and young adults in recent years. However, little is known about the predictors of greater vaping nicotine dependence. This study identifies variables associated with greater Penn-State Electronic Cigarette Dependence Index (PS-ECDI) scores and higher vaping sessions per month (SPM) among this population. Methods: Data were drawn from a longitudinal study that recruited 1048 Canadian participants aged 16-26 in 2018. Quota sampling was used to ensure enough regular e-cigarette users were recruited. The current study restricted analyses to the 459 participants who were baseline vapers and have completed both the baseline and 12-month follow-up surveys. Linear regression analyses were employed, with the use of the best subset modelling strategy to obtain reduced models. Results: Baseline vapers who were ≥ 18 and married or cohabiting, had used other tobacco products, had 30 or more puffs per vaping session, started vaping at an earlier age, vaped to quit/reduce smoking, and had used a disposable cigarette-like vaping device and/or an advanced box or tubular device and/or a pod vape in the last 6-month were associated with greater PS-ECDI scores compared to their respective counterparts. Additionally, baseline vapers who were ≥18 and married or cohabiting, had used cannabis, had 30 or more puffs per vaping session; vaped to reduce/quit smoking and/or because friends vape; had used a pod vape in the last 6-month were more likely to have higher SPM at the 12-month follow-up compared to their respective counterparts. Conclusion: 11% of the participants were classified as high vaping nicotine dependence and 42% of the participants had increased their SPM over 1 year. The findings provide targets for vaping reduce or cessation programs and potential policy change in the regulation and sales of pod vape.
{"title":"Predictors of Greater Vaping Dependence and Higher Vaping Frequencies among Canadian Youth and Young Adults over 12-Month","authors":"Tianru Wang, Safa Ahmad, R. Schwartz, M. Chaiton, S. Bondy","doi":"10.33137/utjph.v2i2.36997","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36997","url":null,"abstract":"Background: The prevalence of electronic cigarette use has doubled among Canadian youth and young adults in recent years. However, little is known about the predictors of greater vaping nicotine dependence. This study identifies variables associated with greater Penn-State Electronic Cigarette Dependence Index (PS-ECDI) scores and higher vaping sessions per month (SPM) among this population. \u0000Methods: Data were drawn from a longitudinal study that recruited 1048 Canadian participants aged 16-26 in 2018. Quota sampling was used to ensure enough regular e-cigarette users were recruited. The current study restricted analyses to the 459 participants who were baseline vapers and have completed both the baseline and 12-month follow-up surveys. Linear regression analyses were employed, with the use of the best subset modelling strategy to obtain reduced models. \u0000Results: Baseline vapers who were ≥ 18 and married or cohabiting, had used other tobacco products, had 30 or more puffs per vaping session, started vaping at an earlier age, vaped to quit/reduce smoking, and had used a disposable cigarette-like vaping device and/or an advanced box or tubular device and/or a pod vape in the last 6-month were associated with greater PS-ECDI scores compared to their respective counterparts. Additionally, baseline vapers who were ≥18 and married or cohabiting, had used cannabis, had 30 or more puffs per vaping session; vaped to reduce/quit smoking and/or because friends vape; had used a pod vape in the last 6-month were more likely to have higher SPM at the 12-month follow-up compared to their respective counterparts. \u0000Conclusion: 11% of the participants were classified as high vaping nicotine dependence and 42% of the participants had increased their SPM over 1 year. The findings provide targets for vaping reduce or cessation programs and potential policy change in the regulation and sales of pod vape.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131191536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.37001
R. Field, Gul-e-Naghma Saeed, Mariana Villada Rivera, S. Campanella, Lauren S Tailor
Introduction: The COVID-19 pandemic has revealed critical gaps in the public’s knowledge of infectious diseases. Experts, including the World Health Organization, acknowledge that an “infodemic” of misinformation is spreading at the same time as the pandemic. Furthermore, 13% of Canadians age 50 and younger reported using social media as their primary source of information about COVID-19. Thus, in January 2020, the Infectious Disease Working Group (IDWG) was formed by a group of students at the Dalla Lana School of Public Health, University of Toronto. The IDWG’s Media Messaging Team (MMT) uses Knowledge Translation (KT) strategies to increase access to evidence-based information related to public health and COVID-19. Specifically, MMT uses virtual platforms, including Twitter and Instagram (@infectious_info), to disseminate information to a wide audience. Objectives: The MMT aims to produce content to dispel pervasive and harmful myths about COVID-19, raise public awareness, and advocate for health equity. Methods: The team creates 2-4 pieces of original content per week on topics such as Ontario Government legislation updates, myth-busting series, and “Wednesday Series” (summaries of novel research findings). The IDWG employs an equity lens to ensure that the content takes into account the experiences and needs of diverse groups, and that graphics are representative of a diverse audience. Health communication strategies are used to promote audience engagement through compelling and bold content design. Results: The Instagram account has over 4,400 followers, with some posts surpassing 50,000 views. Qualitative feedback from social media followers indicates that this project is addressing an emerging gap in knowledge resulting from unclear messaging from official bodies, the spread of mis/disinformation, and disparities in health literacy levels. Conclusions: The findings can inform the development and implementation of KT strategies to reach a wide audience and increase the uptake of public health information.
导言:2019冠状病毒病大流行暴露了公众对传染病知识的严重空白。包括世界卫生组织(World Health Organization)在内的专家承认，在疫情蔓延的同时，一场错误信息的“信息大流行”正在蔓延。此外，13%的50岁及以下的加拿大人报告使用社交媒体作为他们关于COVID-19的主要信息来源。因此，2020年1月，传染病工作组(IDWG)由多伦多大学达拉拉纳公共卫生学院的一群学生组成。IDWG的媒体消息小组(MMT)使用知识翻译(KT)战略来增加获得与公共卫生和COVID-19相关的循证信息的机会。具体来说，MMT使用虚拟平台，包括Twitter和Instagram(@传染性ous_info)，向广泛的受众传播信息。目标:MMT旨在制作内容，消除关于COVID-19的普遍和有害的神话，提高公众意识，倡导卫生公平。方法:团队每周创建2-4篇原创内容，主题包括安大略省政府立法更新，神话打破系列和“周三系列”(新颖研究成果摘要)。IDWG采用公平视角来确保内容考虑到不同群体的经验和需求，并且图像能够代表不同的受众。健康传播策略通过引人注目和大胆的内容设计来促进受众的参与。结果:这个Instagram账号有超过4400名粉丝，一些帖子的浏览量超过了5万。来自社交媒体关注者的定性反馈表明，该项目正在解决由于官方机构的信息不明确、错误信息/虚假信息的传播以及卫生知识普及水平的差异而导致的新出现的知识差距。结论:研究结果可以为KT战略的制定和实施提供信息，以达到广泛的受众并增加对公共卫生信息的吸收。
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Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36748
Rachel Fields
For my practicum, I worked with the Health Equity Integration Team (HEIT) to improve the application of Sex- and Gender-Based Analysis + (SGBA+) at The Public Health Agency of Canada (PHAC). SGBA+ is an analytical tool used in the federal government to ensure the consideration of diversity and intersectionality in programs and policies. One of the training resources on SGBA+ at PHAC is called Toward Health Equity: The SGBA+ Guide. This guide provides an overview of SGBA+, associated concepts, and a case study. I was part of a team tasked with updating this document to make the guide more applicable to current agency priorities. However, in revising the guide it became clear that there was a significant gap in understanding what document users needed. To make this guide as user-friendly and relevant as possible, I suggested that we conduct interviews with key informants throughout the agency to gather feedback and identify barriers to SGBA+ application. This project was part of a Knowledge Translation (KT) process that involved employees from many different roles and divisions at PHAC. The interviews allowed readers to identify the guide’s strengths, weaknesses, and gaps in clarity and content. Improving SGBA+ application at the federal public health level is important, because it is the agency’s way of applying a health equity lens to the work that they do. This project was also significant because it interrupted the standard process of KT, which follows a linear path and only integrates user feedback at the end. Instead, this project promoted an iterative process, involving document users throughout the development and revision of the guide to create a final product that is more tailored to their needs. Clear and effective communication is crucial to public health practice; this project is an example of how to achieve that by incorporating constructive feedback.
{"title":"Toward Health Equity Guide Interview Project:","authors":"Rachel Fields","doi":"10.33137/utjph.v2i2.36748","DOIUrl":"https://doi.org/10.33137/utjph.v2i2.36748","url":null,"abstract":"For my practicum, I worked with the Health Equity Integration Team (HEIT) to improve the application of Sex- and Gender-Based Analysis + (SGBA+) at The Public Health Agency of Canada (PHAC). SGBA+ is an analytical tool used in the federal government to ensure the consideration of diversity and intersectionality in programs and policies. One of the training resources on SGBA+ at PHAC is called Toward Health Equity: The SGBA+ Guide. This guide provides an overview of SGBA+, associated concepts, and a case study. I was part of a team tasked with updating this document to make the guide more applicable to current agency priorities. However, in revising the guide it became clear that there was a significant gap in understanding what document users needed. To make this guide as user-friendly and relevant as possible, I suggested that we conduct interviews with key informants throughout the agency to gather feedback and identify barriers to SGBA+ application. This project was part of a Knowledge Translation (KT) process that involved employees from many different roles and divisions at PHAC. The interviews allowed readers to identify the guide’s strengths, weaknesses, and gaps in clarity and content. Improving SGBA+ application at the federal public health level is important, because it is the agency’s way of applying a health equity lens to the work that they do. This project was also significant because it interrupted the standard process of KT, which follows a linear path and only integrates user feedback at the end. Instead, this project promoted an iterative process, involving document users throughout the development and revision of the guide to create a final product that is more tailored to their needs. Clear and effective communication is crucial to public health practice; this project is an example of how to achieve that by incorporating constructive feedback.","PeriodicalId":265882,"journal":{"name":"University of Toronto Journal of Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125479042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.33137/utjph.v2i2.36809
Yining Shi, S. Bull
Introduction & Objective: Rare variants with allele frequency smaller than 1% are postulated to be associated with disease susceptibility. Since allele frequencies vary globally, the use of population control data that does not match the study population can produce bias. The research question is to identify factors that explain variation in allele frequency across populations. The secondary question is to evaluate the potential bias in using population as control data when studying variants. We use data from gnomAD (Genome Aggregation Database) to answer these questions. Methods: We apply each of three model formulations: Linear, Logistic, and Poisson to explain how the frequency or count of variants depends on population subgroup/ancestry, functional annotation, sex, and disease status. We also evaluate interactions between population subgroups and functional annotation. Results: For very rare variants (allele frequency < 0.1%), likelihood ratio testing (LRT) provides evidence that allele frequencies vary with functional annotation and population in all three model formulations. By LRT, interactions of population and functional annotation are significant in the Logistic model and the Poisson model. The goodness-of-fit statistics show a better fit in the linear model compared to low frequency variants. Conclusion: We observe that population & functional annotation affect variant frequencies, and conclude that detection of differences across populations and annotations is model scale-dependent, especially for different degrees of rareness. Therefore, statisticians need to carefully consider the potential for bias when using gnomAD as control data. Moreover, gnomAD is a great resource for studies dealing with rare variants.
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