Hyejin Park, Blake Linthwaite, Camille Dussault, Alexandros Halavrezos, Sylvie Chalifoux, Jessica Sherman, Lina Del Balso, Jane A. Buxton, Joseph Cox and Nadine Kronfli
People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among…
Abstract
Purpose
People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.
Design/methodology/approach
The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.
Findings
A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.
Originality/value
The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.
Details
Keywords
Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…
Abstract
Purpose
The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.
Design/methodology/approach
Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.
Findings
The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.
Practical implications
A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.
Originality/value
Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.
Details
Keywords
Hassan Vatanparast, Mustafa Koc, Marwa Farag, Joseph Garcea, Rachel Engler-Stringer, Tamer Qarmout, Carol Henry, Louise Racine, Judy White, Romaina Iqbal, Mahasti Khakpour, Sindhuja Dasarathi and Sonia D'Angelo
This study aims to provide a qualitative in-depth account of the status and experience of food insecurity for Syrian refugee households in Toronto and Saskatoon, Canada. The study…
Abstract
Purpose
This study aims to provide a qualitative in-depth account of the status and experience of food insecurity for Syrian refugee households in Toronto and Saskatoon, Canada. The study considers the range of geographic, socio-economic, cultural and gendered components shaping and determining the barriers and management of food insecurity.
Design/methodology/approach
The study included 54 semi-structured interviews with refugee families in Toronto and Saskatoon who resettled in Canada after November 2015. In addition, 15 semi-structured in-person or telephone interviews were conducted with settlement and support agencies to measure their capacity to respond to issues of food insecurity for Syrian refugees.
Findings
Syrian refugees reported experiencing food insecurity as part of the broader resettlement journey, including in the transitional phase of refuge and in each settlement context in Canada. Income status in Canada was reported as a key barrier to food security. Low-income barriers to food security were experienced and shaped by factors including food affordability, physical access and availability and the extent of familial or other support networks including sponsorship relationships. Participants also reported how managing food insecurity contributed to the intensification of gender expectations.
Originality/value
The analysis reveals food insecurity as both an income and non-income based concern for refugees during the process of resettlement. The study also highlights the importance of considering variations between primary barriers to food security identified by Syrian families and key informants as critical to the development of strategies designed to mitigate the impacts of resettlement on food security.
Details
Keywords
Cassandre Dion Larivière, Quintan Crough, Funmilola Ogunseye, Paul Mitton and Joseph Eastwood
Suspect interviewing in North America has evolved from coercive tactics to guilt-presumptive methods and, more recently, to information seeking dialogue-based (ISDB) approaches…
Abstract
Purpose
Suspect interviewing in North America has evolved from coercive tactics to guilt-presumptive methods and, more recently, to information seeking dialogue-based (ISDB) approaches such as the PEACE model. Such approaches prioritize open dialogue and comprehensive suspect accounts over confession-driven strategies. These methods have been shown to reduce the risk of false confessions and enhance the quality of investigative information, though they are sometimes criticized for being “too soft” or insufficiently tested in real-world settings. This paper aims to explore the real-world application of an ISDB approach in the high-stakes interview of Adam Strong, who was ultimately convicted of first-degree murder and manslaughter.
Design/methodology/approach
Using PEACE as a framework, the authors detail how Detective Paul Mitton skillfully used rapport-building, strategic evidence presentation and open dialogue to elicit admissions without coercion or confrontation.
Findings
Although Strong did not confess to the homicides or discuss how the victims died, the admissions he provided during the 12-h interview were central to the court’s guilty rulings.
Research limitations/implications
Though a single-case analysis, this paper underscores the necessity for further empirical research on ISDB approaches across diverse real-world scenarios.
Practical implications
This case highlights how an ISDB approach can generate critical evidence while meeting both investigative and legal standards. The authors believe it underscores that the future of suspect interviewing lies in the continued adoption and refinement of approaches that prioritize rapport-building and open, free-flowing dialogue while incorporating safeguards to ensure the admissibility of the interview.
Originality/value
This paper presents a unique and practical application of an ISDB approach, contributing valuable insights for practitioners and researchers into advancing ethical and effective suspect interviewing practices.
Details
Keywords
Chi-Ling Joanna Sinn, Zain Pasat, Lindsay Klea, Sophie Hogeveen, Ceara Holditch, Carrie Beltzner and Andrew Costa
Remote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies…
Abstract
Purpose
Remote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies contribute to integrated care. Since maturity models are useful frameworks for understanding current performance and motivating progress, the authors developed a model describing the features of RPM that can advance integrated care.
Design/methodology/approach
This work was led by St. Joseph's Health System Centre for Integrated Care in collaboration with clinical and programme leads and frontline staff offering RPM services as part of Connected Health Hamilton in Ontario, Canada. Development of the maturity model was informed by a review of existing telehealth maturity models, online stakeholder meetings, and online interviews with clinical leads, programme leads, and staff.
Findings
The maturity model comprises 4 maturity levels and 17 sub-domains organised into 5 domains: Technology, Team Organisation, Programme Support, Integrated Information Systems, and Performance and Quality. An implementation pillars checklist identifies additional considerations for sustaining programmes at any maturity level. Finally, the authors apply one of Connected Health Hamilton's RPM programmes to the Team Organisation domain as an example of the maturity model in action.
Originality/value
This work extends previous telehealth maturity models by focussing on the arrangement of resources, teams, and processes needed to support the delivery of integrated care. Although the model is inspired by local programmes, the model is highly transferable to other RPM programmes.