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Background: Events associated with the COVID-19 pandemic, such as physical distancing, closure of community services, postponement of health appointments, and loss of employment can lead to social isolation, financial uncertainty, and interruption of antiretroviral adherence, resulting in additional health-related challenges (disability) experienced among adults living with chronic illness such as HIV. 'Living strategies' is a concept derived from the perspectives of people living with HIV, defined as behaviors, attitudes and beliefs adopted by people living with HIV to help deal with disability associated with HIV and multi-morbidity. Our aim was to describe disability among adults living with HIV and self-care living strategies used during the COVID-19 pandemic. Methods: Adults living with HIV in Toronto, Ontario, Canada, including some with pre-pandemic HIV Disability Questionnaire (HDQ) data, completed a cross-sectional web-based survey between June–August 2020. The survey included the HDQ and questions about self-care living strategy use during the pandemic. We compared disability (HDQ) scores prior to versus during the pandemic using paired t-tests. We reported the proportion of participants who engaged in various living strategies at least 'a few times a week' or 'everyday' during the pandemic. Results: Of the 63 respondents, 84% were men, median age 57 years, and 62% lived alone. During the pandemic the greatest disability severity was in the uncertainty [median 30; Interquartile range (IQR): 16, 43] and mental-emotional (25; IQR: 14, 41) domains. Among the 51 participants with pre-pandemic data, HDQ severity scores were significantly greater (worse) during the pandemic (vs prior) in all domains. Greatest change from prior to during the pandemic was in the mental-emotional domain for presence (17.7; p < 0.001), severity (11.4; p < 0.001), and episodic nature (9.3; p < 0.05) of disability. Most participants (> 60%) reported engaging a 'few times a week' or 'everyday' in self-care strategies associated with maintaining sense of control and adopting positive attitudes and beliefs. Conclusions: People living with HIV reported high levels of uncertainty and mental-emotional health challenges during the pandemic. Disability increased across all HDQ dimensions, with the greatest worsening in the mental-emotional health domain. Results provide an understanding of disability and self-care strategy use during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Many shorebirds rely on small numbers of staging sites during long annual migrations. Numerous shorebird species are declining and understanding the importance of these staging sites is important for successful conservation. We surveyed endangered rufa red knots (Calidris canutus rufa) staging in James Bay, Ontario, Canada, during southbound migration in 2017 and 2018. We used mark‐resight data and count data in an integrated Bayesian analysis to quantify migration phenology, estimate passage population size, and model the age structure of the stopover population. Many adult red knots arrived in James Bay in a single wave in early August in 2017, whereas adult red knots arrived in multiple smaller waves in July and mid‐August in 2018. These waves may correspond with breeding phenology where more red knots bred successfully and arrived in one large event in 2017 and the higher number of earlier arrivals in July 2018 may have been failed breeders. We included a binomial generalized linear model in the integrated analysis to estimate that 20% and 10% of staging red knots were juveniles in 2017 and 2018, respectively. In future applications, this method could provide a metric to assess breeding performance and develop our understanding of its role in population declines. Overall, we estimated that up to 23% of the estimated rufa red knot population staged in southwestern James Bay for an average of 10–12 days. The region is a key staging site for endangered red knots and could be included in conservation planning. © 2021 The Wildlife Society. : We used an integrated Bayesian analysis to estimate passage population size and migration phenology of endangered red knots staging in southwestern James Bay, Ontario, Canada during southbound migration. Our integrated analysis included a method to model the age structure of the population, which could be used as a tool to monitor breeding success. [ABSTRACT FROM AUTHOR]

Background: Healthcare costs are disproportionately incurred by a relatively small group of people often described as high-cost users. Understanding the factors associated with high-cost use of health services among people experiencing homelessness could help guide service planning.Methods: Survey data from a general cohort of adults with a history of homelessness and a cohort of homeless adults with mental illness were linked with administrative healthcare records in Ontario, Canada. Total costs were calculated using a validated costing algorithm and categorized based on population cut points for the top 5%, top 6-10%, top 11-50% and bottom 50% of users in Ontario. Multinomial logistic regression was used to identify the predisposing, enabling, and need factors associated with higher healthcare costs (with bottom 50% as the reference).Results: Sixteen percent of the general homeless cohort and 30% percent of the cohort with a mental illness were in the top 5% of healthcare users in Ontario. Most healthcare costs for the top 5% of users were attributed to emergency department and inpatient service costs, while the costs from other strata were mostly for physician services, hospital outpatient clinics, and medications. The odds of being within the top 5% of users were higher for people who reported female gender, a regular medical doctor, past year acute service use, poor perceived general health and two or more diagnosed chronic conditions, and were lower for Black participants and other racialized groups. Older age was not consistently associated with higher cost use; the odds of being in the top 5% were highest for 35-to-49-year year age group in the cohort with a mental illness and similar for the 35-49 and ≥ 50-year age groups in the general homeless cohort.Conclusions: This study combines survey and administrative data from two cohorts of homeless adults to describe the distribution of healthcare costs and identify factors associated with higher cost use. These findings can inform the development of targeted interventions to improve healthcare delivery and support for people experiencing homelessness. [ABSTRACT FROM AUTHOR]

Recently, Stewart et al. (2017) investigated the origins of contemporary fisher populations in the Cooking Lake Moraine (CLM) of east-central Alberta, Canada, where fishers (Pekania pennanti) from Ontario and Manitoba, Canada were reintroduced in the early 1990s. To address this objective, Stewart et al. (2017) compared microsatellite alleles from extant fisher populations in the CLM to those from Ontario, Manitoba, and other Alberta populations. They reported that the CLM population clustered with adjacent native Alberta populations, consistent with recolonization, but also that 2 of 109 microsatellite alleles in the CLM occurred only in the source populations from Ontario and Manitoba. Rather than allowing for the possibility that these alleles descended from reintroduced fishers, the authors speculated that they represented random mutations among fishers that recolonized the area naturally from nearby populations in Alberta, and concluded that the reintroduction had failed completely. We disagree with this conclusion for 2 reasons. We contend it is more likely that the 2 alleles represent a genetic signature from the individuals released during the reintroduction, rather than being the result of mutations. We further suggest that, irrespective of the genetic legacy of introduced fishers in the recovered population, the presence of reintroduced fishers in the CLM may have helped facilitate natural recolonization of the area by fishers from surrounding areas. In our view, Stewart et al. 's (2017) findings do not demonstrate conclusively that the reintroduction program failed; on the contrary, we argue that their findings indicate that reintroduced fishers likely contributed to the long-term persistence of fishers in the CLM. The uncertainty surrounding this case underscores the importance of genetic monitoring following reintroductions. [ABSTRACT FROM AUTHOR]

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The Transitional Rehabilitation Housing Pilot (TRHP) was designed to transition hospitalized forensic patients to the community. Twenty clients and their clinicians in two Ontario cities completed measures on functioning, substance use, recovery, social support, and quality of life at admission to the program and then every 6 months until 18 months post-admission. Clients also responded to open-ended questions on the impact of the program and living in the community on their recovery. Three (15%) clients re-offended. Eleven clients (55%) experienced rehospitalization; however, brief rehospitalization was seen as part of the recovery process. Level of community functioning was stable across time and 35% of clients had a decrease in the restrictiveness of their disposition order. Clients described numerous characteristics of community living that contributed to improvements in functioning, such as integration into the community, social contact, and newfound independence. Some aspects of TRHP that encouraged recovery included developing new skills and knowledge, staff support, and the programming that engaged clients in treatment and recovery-oriented activities. Findings suggest that forensic patients can transition successfully into the community with appropriate support and housing. [ABSTRACT FROM PUBLISHER]

The study analyzed the patterns of emergency shelter stays of single persons in three Canadian cities of different sizes (i.e., Toronto, Ottawa, and Guelph). Similar to findings of previous research conducted in large American cities in the early 1990s, cluster analyses defined three clusters with distinct patterns of shelter stays (temporary, episodic, and long stay). A temporary cluster (88-94 per cent) experienced a small number of homeless episodes for relatively short periods of time. An episodic cluster (3-11 per cent) experienced multiple homeless episodes also for short periods of time. A long-stay cluster (2-4 per cent) had a relatively small number of homeless episodes but for long periods of time. Despite their relatively small size, the episodic and long-stay clusters used a disproportionately large number of total shelter beds. The study extends findings from previous American research to a Canadian context and to small- and medium-size cities. Implications of the findings for program and policy development are discussed. [ABSTRACT FROM AUTHOR]

Objective: The current study evaluated the demographic, clinical, and social support and service use predictors of alcohol and drug use disorders among a population of consumers of community mental health programs. Methods: The methodology is a secondary analysis of data collected from two randomized controlled trials that were part of the Community Mental Health Evaluation Initiative completed in Ontario, Canada. Participants included an inner-city population of persons with severe and persistent mental illness who had experienced housing instability. Participants were either randomly selected to receive Assertive Community Treatment or Intensive Case Management (Toronto) or Intensive Case Management or Standard Community Care (Ottawa). Data were collected from consumers at three time points (baseline, 9 months, and 18 months), and prospective and cross-sectional predictors of alcohol use disorders and drug use disorders at 9- and 18-month follow-up were examined. There were 232 participants at baseline, 203 at 9 months, and 179 at 18 months. Results: Approximately 32% of consumers had problematic substance use at 9 months and 28% of consumers had problematic substance use at 18 months. A sequential logistic regression analysis uncovered several significant predictors, which differed across the type of substance used and the two time points considered. The most salient and common predictors included nonadherence to medication and a decreased level of community functioning. Conclusions: Implications for treatment planning in community mental health programs to better address concurrent mental illness and substance use disorders are discussed. [ABSTRACT FROM PUBLISHER]

This longitudinal study examined physical integration, defined as becoming re-housed, of women who were homeless at the study's outset. Participants (N = 101) were recruited at homeless shelters in Ottawa and participated in two in-person interviews, approximately two years apart. A predictive model identifying factors associated with becoming rehoused and achieving housing stability was developed from previous empirical research and tested. Being accompanied by dependent children and having access to subsidized housing predicted being re-housed at follow-up. This research represents the first longitudinal study examining exits from homelessness in a sample of Canadian women. The findings suggest that providing financial resources is essential to helping women who have experienced homelessness to become physically integrated in their communities. In addition, it is suggested women who are unaccompanied by children would benefit from more intensive services. [ABSTRACT FROM AUTHOR]

Abstract: The following study evaluates the complex association between legal involvement and mental illness. It describes a population of consumers of community mental health programs, comparing those with legal involvement to those without legal involvement, on a number of demographic, clinical and social indicators. It is a secondary analysis of data collected in studies making up the Community Mental Health Evaluation Initiative (CMHEI) in the province of Ontario, Canada. Legal involvement was a significant issue among community mental health program consumers; about one in five consumers had at least some contact with the legal system in the preceding nine months. Legally involved consumers were more likely to be in receipt of social assistance and be unstably housed than those legally uninvolved. However, there were no significant differences between legally involved and uninvolved consumers with respect to severity of symptomatology, current medication use or number of hospitalization days in the past 9 months. A predictive model compared the differential impact of clinical and social determinants upon legal involvement. Analyses failed to uncover a significant relationship between severity of psychiatric symptomatology and legal involvement. Significant predictors of legal involvement included gender, race, drug use as well as housing instability, and receipt of social assistance. Legal involvement was attributable to factors other than the severity of mental illness; these results challenge assumptions that the most symptomatically severe consumers are most at risk of legal involvement. Accordingly, the rate of legal involvement in a sample of community mental health program users must be considered in a broad context, with particular emphasis on social disadvantage. [Copyright &y& Elsevier]

Evaluates the use of a sliding-fee scale at a training clinic (TC) for doctoral students in Ottawa, Ontario. Influence of fees on the delivery of psychological services; Consequences of fee charging in TC; Reactions of participants to the fees charged; Comparisons of the use of sliding scale.s to other forms of fee-charging arrangements.

Abstract: We conducted a randomized effectiveness trial to test the hypothesis that foster children of primary-school age who were exposed to an individualized direct-instruction tutoring intervention delivered by their foster parents would experience significantly greater pre-test to post-test gains in reading and math than would foster children in a wait-list control group. The sample consisted of 77 foster children in 9 local Children''s Aid Societies in Ontario, Canada. At the pre-test, the foster children were aged 6 to 13years (M =10.7years, SD =1.6) and were in primary-school grades 2 through 7. Forty-two foster children were randomly assigned to the experimental (tutoring) group and 35 to the wait-list control group. The sub-tests of the Wide Range Achievement Test—Fourth edition (WRAT4; Wilkinson & Robertson, 2006) served as the outcome measures. At the post-test, the foster children in the experimental group had made statistically and practically greater gains than those in the control group on the WRAT4 sub-tests of Sentence Comprehension (Hedges'' g =0.38, p <.05), Reading Composite (g =0.29, p <.10), and Math Computation (g =0.46, p <.01) but not on Word Reading (g =0.19, ns) or Spelling (g =−0.08, ns). The implications of the results for improving foster children''s educational achievement were discussed. [Copyright &y& Elsevier]

Abstract: Community mental health services benefit from measuring clinical outcomes relevant to a community-based context in contrast to medically modeled outcomes. The Multnomah Community Ability Scale (MCAS) addresses broad dimensions of community functioning and was developed for clinical and evaluation purposes. We assessed the structural consistency and fit of the scale as a measure of community functioning through confirmatory factor analysis using a longitudinal sample of individuals (n =408) with severe and persistent mental illness receiving services from community mental health programs. None of the previously hypothesised factor solutions achieved a good fit and a high degree of invariance over time was observed. Through exploratory factor analysis, the possibility of alternative solutions was explored. After exclusion of two of the 17 items, four models – including four-, three-, two- and one-factor solutions - were tested for fit and invariance with no improvement. We discuss our findings of poor fit under the assumption that the MCAS should psychometrically behave as a scale. Alternative interpretations for the tool and suggestions for the use of its items as an index that measures aspects of disability are proposed. [Copyright &y& Elsevier]

Abstract: This article describes the planning of a multi-agency and multi-stakeholder evaluation of the implementation of supportive housing. The Ottawa HousingPlus Collaborative Communities project is a collaboration between university-based evaluators and members of a local network of supportive housing providers. The objectives of the initiative are (1) to develop tools and methods for evaluating the implementation of supportive housing by network members, (2) to evaluate program implementation, and (3) to use evaluation findings to assist network members to collaborate in finding solutions to shared implementation challenges. This article examines the early planning of the project. It describes the process used to engage stakeholders in the conception and planning of the project, the challenges and successes in the early planning efforts, and the issues that will need to be addressed over the course of the 3-year project term. These challenges and successes of engaging stakeholders are discussed in the context of adapting educational concepts to the evaluation of social services and in engaging multiple agencies, at multiple levels, in a collaborative evaluation. [Copyright &y& Elsevier]