Suchergebnisse

This study used an online questionnaire to explore the relations among different dimensions of religious and cultural Jewish identity in young Canadian adults ( N = 258). We investigated the extent to which three aspects of Jewish identity—religious identity, cultural identity, and identity salience— predicted openness to interfaith relationships and sociopolitical attitudes related to Israel. Results showed that compared to participants who self-identified as cultural Jews, those who self-identified as religious Jews or as both religious and cultural Jews scored higher on measures of cultural and religious identification. Moreover, relative to culturally identified Jews, religious and religious/cultural Jews were less open to interfaith relationships, endorsed more right-wing political attitudes with respect to Israel's foreign policy, and reported that their Jewish identity was more salient than their Canadian identity in identity-relevant situations. Similarly, relative to Jews of other denominations, Orthodox Jews reported higher levels of Jewish identification, greater salience of their Jewish identity, and advocated more right-wing political views.

ObjectivesTo understand changes in prescription patterns over time, and support dental and oral health program planning, Toronto Public Health issued an AHRQ request to collect information on physician-prescribed medications following an oral health-related incident.
ApproachAn algorithm was created to identify oral health-related incidents among children and youth aged up to 17 years old in Ontario and Toronto during fiscal years 2013 to 2022. The algorithm used provincial data on physician visits, emergency department visits, inpatient hospitalizations, or day surgeries to define 'dental-related incidents'. Physician-prescribed medications (e.g., chlorhexidine, opioids, benzodiazepines, antibiotics, NSAIDs and others) within seven days of a dental-related incident were recorded using Ontario Drug Benefit Claims and the Narcotics Monitoring System.
ResultsOf 522,674 dental-related incidents in Ontario between 1 April 2013 and 31 March 2023, 9.2% had physician-prescribed medications (versus 8.6% of 90,810 dental-related incidents in Toronto). The proportion of incidents with prescriptions increased from 6.4% in 2013 to 10.7% in 2022 in Ontario, and from 5.9% to 10.3% in Toronto. The most prescribed medication was antibiotics, followed by immediate-release combination medications and non-long-acting medications.
Conclusions/ImplicationsOver the 10-year period examined, an increasing proportion of dental-related incidents had physician-prescribed medications, which may be attributed to the implementation of Ontario's pharmacare program (OHIP+) in 2018. Early access to routine and preventative dental care could become more accessible as part of Canada's new federal dental program. Results from this AHRQ will inform better resource allocation in dental and oral health program planning, potentially reducing avoidable healthcare costs.

AbstractBackgroundThis study examines newcomers with intellectual and developmental disabilities compared to other adults with intellectual and developmental disabilities in Ontario, Canada.MethodsThis population‐based retrospective cohort study used linked health and social services administrative data to identify adults with intellectual and developmental disabilities as newcomers, or non‐newcomers, and compared their health status and health service outcomes.ResultsAmong those with intellectual and developmental disabilities, compared to non‐newcomers, newcomers generally had lower or similar rates of health issues, except for higher rates of psychosis. Newcomers also had slightly greater use of community‐based health services, but less hospital use.ConclusionTrends among those with the intellectual and developmental disabilities were consistent with general population trends; newcomers had lower rates of many health issues and lower hospital use. It also underscores the value of understanding drivers of heterogeneity within newcomers, such as the circumstances of admission and settlement in their new country.

Background:Recovery education centers (RECs) offer recovery supports through education rather than traditional health services. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Canada, is among the few that are internationally focused on individuals with histories of homelessness. Although research suggests that RECs positively impact participants, there is a paucity of rigorous studies and none address the engagement and impacts on homeless individuals.Aims:This protocol describes a realist-informed evaluation of STAR, specifically examining (1) if STAR participation is more effective in promoting 12-month recovery outcomes than participation in usual services for individuals experiencing housing instability and mental health challenges and (2) how STAR participation promotes recovery and other positive outcomes.Methods:This study uses a quasi-experimental mixed methods design. Personal empowerment (primary outcome) and recovery, housing stability, social functioning, health service use and quality of life (secondary outcomes) data were collected at baseline, and 6 and 12 months. Intervention group participants were recruited at the time of STAR registration while control group participants were recruited from community agencies serving this population after screening for age and histories of housing instability. Interviews and focus groups with service users and providers will identify the key intervention ingredients that support the process of recovery.Results:From January 2017 to July 2018, 92 individuals were recruited to each of the intervention and control groups. The groups were mostly similar at baseline; the intervention group's total empowerment score was slightly higher than the control group's ( M ( SD): 2.94 (0.23) vs 2.84 (0.28), p = .02), and so was the level of education. A subset of STAR participants ( n = 20) and nine service providers participated in the qualitative interviews and focus groups.Conclusion:This study will offer important new insights into the effectiveness of RECs, and expose how key REC ingredients support the process of recovery for people experiencing housing instability.

AbstractBackgroundRates of death and avoidable deaths are reportedly higher among people with intellectual and developmental disabilities. This study contributes to our understanding of how mortality and intellectual and development disabilities are associated.MethodGeneral population and intellectual and developmental disabilities adult cohorts were defined using linked administrative data. All‐cause and amenable deaths between 2010 and 2015 were reported for these cohorts and subcohorts with and without Down syndrome. Cox proportional hazards models evaluated the impact of potential contributors to amenable deaths.ResultsAdults with intellectual and developmental disabilities had higher all‐cause (6.1 vs. 1.6%) and amenable death percentages (21.4 vs. 14.1%) than general population comparators. Within intellectual and developmental disabilities, those with Down syndrome had higher all‐cause (12.0 vs. 6.0%) but lower amenable death percentages (19.2 vs. 21.8%) than those without.ConclusionsResults suggest that interventions to reduce amenable deaths target provider‐care‐recipient interactions and coordination across care and support sectors.

AbstractBackgroundData on the prevalence of developmental disabilities in people who experience imprisonment and on their characteristics are lacking.MethodsThe present authors identified adults with developmental disabilities who were released from Ontario provincial prisons in 2010 and a general population comparator group using administrative data. The present authors examined demographic characteristics, morbidity and healthcare use.ResultsThe prevalence of developmental disabilities was 2.2% in the prison group (N = 52,302) and 0.7% in the general population (N = 10,466,847). The prevalence of psychotic illness, substance‐related disorder and self‐harm was higher among people in the prison group with developmental disabilities. People with developmental disabilities were more likely to have emergency department visits and hospitalizations in prison and in the year after release.ConclusionsPeople with developmental disabilities are overrepresented in provincial prisons and have a high burden of disease. Strategies are indicated to prevent incarceration and to improve health.

AbstractBackgroundTo address the growing concerns over poor mental health experienced by adults with intellectual disabilities due to the COVID‐19 pandemic, a national virtual mental health course was delivered and evaluated.MethodsThis mixed methods study utilized both qualitative and quantitative assessments. Participants were 27 adults with intellectual disabilities who participated in the 6‐week course. Participants completed measures of self‐efficacy and well‐being at three time points and qualitative satisfaction measures at post and follow‐up.ResultsAttendance was high and the course was feasible and acceptable to participants. Positive changes related to mental health self‐efficacy were detected (p = .01), though mental well‐being did not improve.ConclusionThe study provided evidence for the feasibility and value of the course for this population. Future research should examine how virtual courses could support the population in terms of pandemic recovery and how courses may work for individuals who are less independent.

AbstractBackgroundAdults with intellectual and developmental disabilities (IDD) have high rates of homelessness. This observational study evaluates Bridges to Housing, a cross‐sector intervention offering immediate access to housing and supports to this population in Toronto, Canada.MethodsTwenty‐six participants, enrolled between April 2016 and December 2017, were assessed at baseline, six and 12 months post‐enrolment. Descriptive statistics and generalized linear modelling evaluated quality of life (QOL) and service needs outcomes. Twenty‐one service users and providers participated in semi‐structured interviews between August 2017 and June 2018 to elicit their experiences of the intervention, which were analysed thematically.ResultsTwelve months post‐enrolment, 24 participants were successfully housed and reported increased QOL scores (F(2,43) = 13.73, p = <.001) and decreased perceived unmet service needs (Wald χ2(2) = 12.93, p = .002). Individual‐, intervention‐ and system‐level characteristics facilitated housing stability in this population.ConclusionsCross‐sector approaches can improve outcomes for homeless adults with IDD and may have an important role in supporting this marginalized population.

AbstractBackgroundThere is little research with people who experience intellectual/developmental disabilities and imprisonment.MethodsThe study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n = 9278) and two non‐incarcerated groups (n = 10,086,802).ResultsThe prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non‐incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post‐incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non‐incarcerated groups.ConclusionsPeople with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post‐incarceration.