A Collaborative Response to Addressing Family Violence with Racialized and Diverse Communities During Pandemic Recovery in Peel Region

Family violence is a social issue that impacts families and communities every day in Canada and around the world. As family violence rates continue to increase there is an urgent need for cross-sectoral collaboration to codesign social work and social service systems, in partnership with those experiencing family violence. This article will share learnings from a two-year community-based participatory research study that worked alongside survivors and witnesses of family violence, community partners from diverse social service agencies, and researchers, to understand experiences of family violence in racialized communities in Peel region, Ontario, Canada. An intersectional-trauma-informed approach guided the work that included establishing a community advisory board, hiring peer research assistants, Photovoice, and holding a knowledge exchange event (KEE) with survivors and witnesses of family violence, researchers, and community partners to rapidly generate ideas for intervention areas through a 25/10 crowdsourcing activity and codesign preliminary solutions through a mini hackathon. Key findings from the photovoice highlighted systemic failures and gaps experienced by those facing family violence. As we shifted into ideation, this preliminary focus on systems solidified and top ideas identified included barrier-free, culturally aware provision of services ranging from mental health supports, safe housing, financial independence, and accessing wrap-around services. Our work concluded with the collaborative development of preliminary solutions to these ideas and emphasized the need for cross-sectoral partnerships and lived experience engagement to change systems. Centering the voices of those who have experienced FV in system-level change and advocacy is necessary to ensure services and supports meet the needs of service users

Mucosal Healing in Ulcerative Colitis: A Comprehensive Review

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by periods of remission and periods of relapse. Patients often present with symptoms such as rectal bleeding, diarrhea and weight loss, and may require hospitalization and even colectomy. Long-term complications of UC include decreased quality of life and productivity and an increased risk of colorectal cancer. Mucosal healing (MH) has gained progressive importance in the management of UC patients. In this article, we review the endoscopic findings that define both mucosal injury and MH, and the strengths and limitations of the scoring systems currently available in clinical practice. The basic mechanisms behind colonic injury and MH are covered, highlighting the pathways through which different drugs exert their effect towards reducing inflammation and promoting epithelial repair. A comprehensive review of the evidence for approved drugs for UC to achieve and maintain MH is provided, including a section on the pharmacokinetics of anti-tumor necrosis factor (TNF)-alpha drugs. Currently approved drugs with proven efficacy in achieving MH in UC include salicylates, corticosteroids (induction only), calcineurin inhibitors (induction only), thiopurines, vedolizumab and anti-TNF alpha drugs (infliximab, adalimumab, and golimumab). MH is of crucial relevance in the outcomes of UC, resulting in lower incidences of clinical relapse, the need for hospitalization and surgery, as well as reduced rates of dysplasia and colorectal cancer. Finally, we present recent evidence towards the need for a more strict definition of complete MH as the preferred endpoint for UC patients, using a combination of both endoscopic and histological findings.info:eu-repo/semantics/publishedVersio

Service Provider Perspectives on Exploring Social Determinants of Health Impacting Type 2 Diabetes Management for South Asian Adults in Peel Region, Canada

Background Individuals from South Asian communities are known to have a higher likelihood of developing type 2 diabetes (T2D) which is often attributed to individual lifestyle and behavioral factors. This focus on individual responsibility can position communities as complicit in their illness, compounding stigmatization and systemic discrimination. This manuscript explores the social determinants of health (SDOH) that influence health behaviors among South Asian adults with T2D from a service provider perspective. Methods Using a qualitative descriptive design, we conducted semi-structured interviews with 12 community, social, and healthcare service providers. We used thematic analysis and the analytical concept of intersectionality to explore how different social locations and SDOH impact T2D management for South Asian adults. Results Three themes were identified including: 1) Managing challenges with settlement process, labour policies and job market disparities take priority over T2D management; 2) Poor working conditions and socioeconomic status reduce access to health care and medication; and 3) Social, economic, and cultural barriers to implementing diet and exercise recommendations. Discussion Service providers identified social, economic, and systemic factors as influencing the higher prevalence of T2D among South Asian individuals. They also spoke to their important roles in providing culturally appropriate supports to address SDOH and advocating for changes to policies and practices that reinforce systemic racism. Service providers suggested that more equitable employment policies and practices are needed in order to address the systemic factors that contribute to higher risk of T2D among South Asian adults in Peel

Post-implementation Review of the Himalaya Home Care Project for Home Isolated COVID-19 Patients in Nepal

Background: The emergence of coronavirus disease 2019 (COVID-19) has resulted in a pandemic that has significantly impacted healthcare systems at a global level. Health care facilities in Nepal, as in other low- and middle-income countries, have limited resources for the treatment and management of COVID-19 patients. Only critical cases are admitted to the hospital resulting in most patients in home isolation. Methods: Himalaya Home Care (HHC) was initiated to monitor and provide counseling to home isolated COVID-19 patients for disease prevention, control, and treatment. Counselors included one physician and four nurses. Lists of patients were obtained from district and municipal health facilities. HHC counselors called patients to provide basic counseling services. A follow-up check-in phone call was conducted 10 days later. During this second call, patients were asked about their perceptions of the HHC program. Project objects were: (1) To support treatment of home isolated persons with mild to moderate COVID-19, decrease burden of hospitalizations, and decrease risks for disease transmission; and, (2) To improve the health status of marginalized, remote, and vulnerable populations in Nepal during the COVID-19 pandemic. Results: Data from 5823 and 3988 patients from May 2021-February 2022 were entered in initial and follow-up forms on a REDCap database. The majority of patients who received counseling were satisfied. At follow-up, 98.4% of respondents reported that HHC prevented hospitalization, 76.5% reported they could manage their symptoms at home, and 69.5% reported that counseling helped to limit the spread of COVID-19 in their household. Conclusions: Telehealth can be an essential strategy for providing services while keeping patients and health providers safe during the COVID-19 pandemic

Complete histologic normalisation is associated with reduced risk of relapse among patients with ulcerative colitis in complete endoscopic remission

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153611/1/apt15568.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153611/2/apt15568_am.pd

COVID-19 vaccination up-take in three districts of Nepal

Vaccine hesitancy during the COVID-19 pandemic continues to be an issue in terms of global efforts to decrease transmission rates. Despite high demand for the vaccines in Nepal, the country still contends with challenges related to vaccine accessibility, equitable vaccine distribution, and vaccine hesitancy. Study objectives were to identify: 1) up-take and intention for use of COVID-19 vaccines, 2) factors associated with vaccine up-take, and 3) trusted communication strategies about COVID-19 and the vaccines. A quantitative survey was implemented in August and September 2021 through an initiative at the Nepali Ministry of Health and Population Department of Health Services, Family Welfare Division. Data were collected from 865 respondents in three provinces (Bagmati, Lumbini, and Province 1). Ordinal multivariate logistic regression was utilized to determine relationships between vaccination status and associated factors. Overall, 62% (537) respondents were fully vaccinated and 18% (159) were partially vaccinated. Those respondents with higher education (p \u3c .001) and higher household income (p \u3c .001) were more likely vaccinated. There were also significant differences in vaccine up-take across the three provinces (p \u3c .001). Respondents who were vaccinated were significantly more likely to perceive vaccines as efficacious in terms of preventing COVID-19 (p = .004) and preventing serious outcomes (p = .010). Among both vaccinated and unvaccinated individuals, there was a high level of trust in information about COVID-19 vaccines provided through local health-care workers [e.g. nurses and physicians]. These results are consistent with other findings within the South Asia region. Targeted advocacy and outreach efforts are needed to support ongoing COVID-19 vaccination campaigns throughout Nepal