Ontario Community Research Articles

Life With HIV in a Canadian Suburban Community: A Qualitative Inquiry of Health Care and Social Services Access.

HIV has been examined in urban and rural contexts, but the suburban gradient has not been sufficiently described, despite the fact that many Canadians live in suburbia. Using qualitative description, we investigated how people living with HIV in a suburban community in Ontario, Canada, accessed health care and social services. Posters at the regional AIDS Service Organization and snowball sampling were used to recruit and interview 13 adult participants with various experiences and perspectives. A content analysis identified three meta-themes in the interviews: (a) transportation cost and time: barriers to access, (b) isolation, and (c) defective primary care: unmet and deflected needs. The findings have implications for the (a) development of community-based groups, (b) the role of transportation in health care and social services utilization, (c) community-based, interprofessional health and social care services, and (d) aging with HIV.

Mistreated older adults with dementia in the home: practitioner experience and unattainable professional agency

ABSTRACT The experience of practitioners who encounter mistreatment of an older adult with dementia by a caregiver in the home has received little attention in the literature. A critical research methodology aimed to understand the experience of professional agency, the ability to control outcomes and act in a meaningful way, of health and social service practitioners when encountering these cases in the home. Fifty-one practitioners from urban, rural and Northeastern communities in Ontario participated in semi-structured interviews, reflective journals, as well as focus group discussions. Theoretical thematic analysis of data led to the discovery of five themes: weathering the storm to realization; cognitive uncertainty; emotional upheaval; one’s inability to resolve the mistreatment; and the double-edge sword of self-reflection. Understanding this experience is an essential step toward improving practice and policy, and achieving positive outcomes for the mistreated older adult with dementia and their caregiver within the home.

Kurdish-Canadian Identity and the Intricacies of Acculturation

This paper studies the process of acculturation of the Iraqi Kurdish community in Ontario, Canada. It explores factors such as ethno-cultural identities and the socio-cultural circumstances that impact the adaptation of a dual identity. The study explores components of the Kurdish participants’ ethnic and national identities, such as their self-identification and their sense of belonging and participation in aspects of life. It also elaborates on the ways in which members of the Iraqi Kurdish community in Canada understand and construe their life experiences, and what it means to live as Kurdish immigrants in a multicultural society.

Wartime Propaganda in the Gazette van Detroit (1914-1918)

ABSTRACTThe Gazette van Detroit was one of many immigrant newspapers started up in the United States shortly after the outbreak of the First World War. During the war, it kept the Belgian community of Detroit, wider Michigan and Southwestern Ontario (Canada) abreast of the developments in their former homeland, while also reporting on the hostilities elsewhere in Europe from a typically Belgian, and particularly Flemish perspective. It published to that end a variety of pieces under the scrutiny of the Belgian and later also the American government: (1) pieces submitted byregular contributors; (2) letters of Belgian soldiers; (3) articles gleaned from other news sources; and (4) pieces reproducing official information provided by the exiled Belgian government in Le Havre (France). Caught like most other media outlets in a powerful tide of national solidarity, much of this wartime reporting can be considered as propaganda, since it aimed to standardize public opinion by mobilizing the animosity of an entire community against a thoroughly evil enemy engaged in the victimization of an intrinsically good, heroic and unflinching opponent: the Belgian civilian population and army. To achieve this effect, the Gazette employed rhetorical strategies, such as over-lexicalisation, stereotyping and the kinship metaphor.

Prevalence of chronic kidney disease and cardiovascular comorbidities in adults in First Nations communities in northwest Ontario: a retrospective observational study.

The prevalence of adult chronic kidney disease and cardiovascular comorbidities in Canadian Indigenous communities is largely unknown. We conducted a study to document the prevalence of chronic kidney disease and concurrent diabetes mellitus, hypertension and dyslipidemia in a First Nations population in northwest Ontario. In this observational study, we used retrospective data collected from regional electronic medical records of 16 170 adults (age ≥ 18 yr) from 26 First Nations communities in northwest Ontario from May 2014 to May 2017. Demographic and laboratory data included age, gender, prescribed medications, estimated glomerular filtration rate, urine albumin:creatinine ratio, low-density lipoprotein cholesterol (LDL-C) level and glycated hemoglobin (HbA1c) concentration. We identified patients with diabetes by an HbA1c concentration of 6.5% or higher, or the use of a diabetic medication, those with dyslipidemia by an elevated LDL-C level (≥ 2.0 mmol/L) or use of lipid-lowering medication, and those with hypertension by use of antihypertensive medication. Of the 16 170 adults residing in the communities, 5224 unique patients (32.3%) had renal testing (albumin:creatinine ratio and/or estimated glomerular filtration rate). The age-adjusted prevalence of chronic kidney disease was 14.5%, and the prevalence of stage 3-5 chronic kidney disease (estimated glomerular filtration rate < 60 mL/min) was 7.0%. Most patients with chronic kidney disease (1487 [80.0%]) had at least 1 cardiovascular comorbidity. A total of 1332 patients (71.6%) had diabetes, 1313 (70.6%) had dyslipidemia, and 1098 (59.1%) had hypertension; all 3 comorbidities were present in 716 patients (38.5%). We document a high prevalence of advanced chronic kidney disease in this First Nations population, 7.0%, double the rate in the general population. High rates of cardiovascular comorbidities were also common in these patients with chronic kidney disease, which places them at increased risk for cardiovascular disease.

A cost analysis comparing telepsychiatry to in-person psychiatric outreach and patient travel reimbursement in Northern Ontario communities

Introduction Residents of Northern Ontario have limited access to local psychiatric care. To address this, three program models exist: (1) telepsychiatry; (2) psychiatrists traveling to underserved areas; and (3) reimbursing patients for travel to a psychiatrist. Evidence shows that telepsychiatry has comparable outcomes to in-person consultations. The objective of this study was to determine the cost difference between programs. Methods A cost-minimization analysis estimating cost per visit from a public healthcare payer economic costing perspective was conducted. Data on fixed and variable costs were obtained. Evidence-based assumptions were made where relevant. Base-case scenarios and a break-even analysis were completed, as well as deterministic and probabilistic sensitivity analyses, to explore the effects of parameter variability on program costs. Results Costs per visit were lowest in telepsychiatry (CAD$360) followed by traveling physicians (CAD$558) and patient reimbursement (CAD$620). Among the 100,000 Monte Carlo simulations, results showed telepsychiatry was the least costly program in 71.2% of the simulations, while the reimbursement and outreach programs were least costly in 15.1% and 13.7% of simulations, respectively. The break-even analysis found telepsychiatry was the least costly program after an annual patient visit threshold of approximately 76 visits (compared to traveling psychiatrists) and 126 visits (compared to reimbursed patients). Discussion Our analyses support telepsychiatry as the least costly program. These results have important implications for program planning, including the prioritization of telepsychiatry, increased integration of telepsychiatry with other modalities of outreach psychiatry, and limiting use of the patient remuneration program to where medically necessary, to reduce overall cost.

Probabilistic depth–damage curves for assessment of flood-induced building losses

The most common and internationally accepted method of assessing building damage due to flooding is through the application of a depth–damage curve (DDC). A DDC relates the percent damage or estimated economic loss to a buildings’ structural integrity and/or contents directly to a given water level (depth). The DDC generally represents an average structure within a given building category, e.g. one-storey single-family residence. Given the great variability across any given structural category, the variation in building materials, construction quality across communities and the singular focus on depth for estimation of losses, it is important to communicate the uncertainty and potential variability of the expected losses in any assessment. In this paper, probabilistic depth–damage curves (PDDCs) are developed based on synthetically derived DDCs from communities in southern Ontario. The generated PDDCs are based on assumed loss thresholds for minor and major loss levels, as spent in Canadian dollars. The economic loss estimates obtained in this way and their likelihood of being exceeded at any given flood depth express more transparently the potential building losses. An applied example of this method is included for both aggregate and building-by-building loss estimation.

The rationale for developing a programme of services by and for Indigenous men in a First Nations community

While mental well-being is recognized as a significant public health priority in numerous Indigenous communities, little work has focused on the mental health needs of Indigenous men. In this article, we describe results from the mixed-methods research used to inform the development of mental wellness programming for boys and men. Quantitative and qualitative data from two studies conducted in Kettle &amp; Stony Point First Nation, an Indigenous community in southern Ontario, Canada, were used to (a) understand factors that contributed to issues of mental health, substance use and violence for men, (b) understand men’s experiences accessing and seeking supports and services, and (c) identify ways to address mental health, substance use and violence among boys and men in the community. We show how results from two studies ignited a group of men to develop a culturally strong and strengths-based programme of services as well as a wellness strategy for boys and men in the community.

A cross-lake comparison of crustacean zooplankton communities in the Laurentian Great Lakes, 1997–2016

Spring and summer open-water crustacean zooplankton communities were examined across all five Laurentian Great Lakes from 1997 to 2016. Spring communities were dominated by calanoid (lakes Superior, Huron and Michigan) or cyclopoid (lakes Erie and Ontario) copepods. Volumetric biomass of summer communities increased along an assumed trophic gradient (Superior, Huron, Michigan, Ontario; eastern, central and western Erie), as did dominance by cyclopoids and cladocerans. Over the time series of the study, summer communities in lakes Michigan, Huron and Ontario shifted towards greater dominance by calanoids and greater similarity with Lake Superior. Trajectories of changes were different; however, reductions in cladocerans accounted for most of the change in lakes Michigan and Huron while reductions in cyclopoids and increases in Leptodiaptomus sicilis were behind the changes in Lake Ontario. Shifts in the predatory cladoceran community in Lake Ontario from Cercopagis pengoi to occasional dominance by Bythotrephes longimanus, a species much more vulnerable to planktivory, as well as the appearance of Daphnia mendotae in a daphnid community previously consisting almost exclusively of the smaller Daphnia retrocurva, suggest impacts of reduced vertebrate predation. In contrast, strong correlations between cladocerans and chlorophyll in lakes Michigan and Huron point to the possible importance of bottom-up forces in those lakes. Large interannual shifts in cladoceran community structure in the central and eastern basins of Lake Erie suggest intense but variable vertebrate predation pressure. The zooplankton communities of lakes Huron, Michigan and Ontario may be approaching a historic community structure represented by Lake Superior.

Examining Indigenous food sovereignty as a conceptual framework for health in two urban communities in Northern Ontario, Canada.

While land is a nexus for culture, identity, governance, and health, as a concept land is rarely addressed in conversations and policy decisions about Indigenous health and well-being. Indigenous food sovereignty, a concept which embodies Indigenous peoples' ability to control their food systems, including markets, production modes, cultures and environments, has received little attention as a framework to approach Indigenous health especially for Indigenous people living in urban spaces. Instead, discussions about Indigenous food sovereignty have largely focused on global and remote and rural communities. Addressing this gap in the literature, this article presents exploratory work conducted with Waasegiizhig Nanaandawe'iyewigamig and Shkagamik-Kwe Health Centre, two Indigenous-led Aboriginal Health Access Centres in urban service centers located in Northern Ontario, Canada.

Breaking Point: Violence Against Long-Term Care Staff.

Direct resident care in long-term care facilities is carried out predominantly by personal support workers and registered practical nurses, the majority of whom are women. They experience physical, verbal, and sexual violence from residents on a regular basis. To explore this widespread problem, fifty-six staff in seven communities in Ontario, Canada, were consulted. They identified such immediate causes of violence as resident fear, confusion, and agitation and such underlying causes as task-driven organization of work, understaffing, inappropriate resident placement, and inadequate time for relational care. They saw violence as symptomatic of an institution that undervalues both its staff and residents. They described how violence affects their own health and well-being-causing injuries, unaddressed emotional trauma, job dissatisfaction, and burnout. They outlined barriers to preventing violence, such as insufficient training and resources, systemic underfunding, lack of recognition of the severity and ubiquity of the phenomenon, and limited public awareness.

Keeping kids safe: caregivers' perspectives on the determinants of physical activity in rural Indigenous communities.

Physical activity is one way to ameliorate the disproportionately high obesity rates among Indigenous children yet little is known about the determinants of physical activity in First Nation communities. A socioecological approach was used to explore the determinants that influence physical activity among Indigenous children in six First Nation communities in north-eastern Ontario, Canada. A thematic analysis of eight focus groups with 33 caregivers of Indigenous children was conducted. Caregivers reported that the present patterns of physical activity among children are different from previous generations, who were physically active through walking, outside play and physically demanding chores. Changes in lifestyles, influenced by the consequences of colonization, have resulted in reduced physical activity. Three themes emerged as present day impediments to physical activity: recreational technology, caregivers' safety concerns, and barriers to community activation. There is a dynamic interrelationship among the proximal, intermediate and distal determinants of children's physical activity with colonial policies continuing to have impacts in the participating First Nation communities. Community generated research and strategies are important ways to ameliorate physical inactivity and obesity among First Nation children.

Understanding the Parent Experience in Child Custody Decision-Making: How Social Workers Can Help

Parent perspective and experience is largely absent from the research literature in child custody decision-making, making it challenging for social workers to understand the parent experience. Research often focuses on outcome studies regarding children’s adjustment and well-being, with little attention to the parent voice. This article addresses this gap using a phenomenological approach. Eighteen participants were recruited from a mid-sized community in Ontario through the mandatory information program (MIP). In-depth interviews and thematic analysis reveal five themes: (a) redefining role, (b) the importance of agency, (c) shared decision-making, (d) the battleground—barriers to shared decision-making, and (e) complexities involved in shared decision-making. These findings illuminate shared parenting challenges, highlighting the need for family supports and services in navigating challenging post-separation realities.

Building the Future: Rural Infrastructure and Regional Economic Development

Communities of all sizes must balance fiscal realities, changing economies, aging infrastructure, changing demographics, and a challenging climate as they work to manage their core infrastructure assets and accommodate and/or address new infrastructure and service demands. Given these challenges, are rural Ontario communities capable of responding to infrastructure pressures and opportunities? How does that capacity – or lack thereof – affect a community’s current and future long-term economic development? Funded by the Ontario Ministry of Agriculture, Food and Rural Affairs through the University of Guelph-OMAFRA Research Partnership, this research initiative will examine the capacity of different communities in rural Ontario to respond to infrastructure pressures and how these response impact their short and long-term economic well-being. Running from 2018-2021, the research team will use surveys, workshops, content analysis, and case studies, to develop recommendations for addressing these issues through both immediate and long-term policy alternatives. This research initiative will directly support rural Ontario’s economic vitality by providing three key benefits: enhanced understanding of the diversity and varying levels of rural community capacities, improved and more nuanced public policy, and enhanced rural infrastructure development programming.

Impact of land composition and configuration on the functional trait assembly of forest communities in southern Ontario

AbstractThe conversion of natural lands to agricultural and urban areas is the leading cause of biodiversity loss worldwide, and an understanding of functional trait assembly pattern can help to mitigate the ecological implications of this loss. We use plant functional traits—characteristics of the plant that determine how they react to and interact with the surrounding ecosystem—to assess the impacts of landscape composition and configuration on plant community assembly patterns in the multiple‐use Credit River watershed, Southern Ontario. We examine functional patterns in metacommunities to uncover how eight landscape variables (including both agricultural and urban uses) affect community assembly patterns and which traits explain these assembly patterns. We find that landscape variables result in significant trait‐divergence assembly patterns at two spatial scales (1 and 10 km), which means that these forest communities are more functionally diverse than would be expected by chance. Additionally, the optimal functional traits that maximize divergence in the community are dependent on landscape variables. We discuss three mechanisms—limiting similarity, niche availability, disturbance—that might be responsible for the trait divergence observed. First, we propose that limiting similarity could lead to trait divergence through niche differentiation and thus coexistence of more traits. Second, we argue that mosaic landscapes provide multiple and diverse habitats in which more species, likely with differing functional traits, can occur. Finally, we discuss how disturbances could prevent dominant species from competitively excluding others, thus favoring coexistence of functional traits.

Alternate funding plans have made their mark on academic departments of paediatrics in Canada.

An Alternate Funding Plan (AFP) was introduced at the Hospital for Sick Children in 1990 as the fee-for-service model was incapable of meeting the academic mandate of the Department of Pediatrics. The plan was challenged by some members of the Ontario Medical Association and community paediatricians as inefficient, too costly, and possibly a challenge to the fee-for-service system. At present, 28 years later, there are nine productive Department of Pediatrics AFPs across Canada. The current state of the AFPs and possible future direction of the program are discussed.

Review of Weber, Urias. 2018. &lt;em&gt;New Beginnings: A History of the Old Order Mennonites of Ontario&lt;/em&gt;. Wallenstein, ON: Vineyard Publications.

Old Order Mennonites do not write many books so when they do it is worth paying attention. Urias Weber’s first book makes a significant contribution by providing details of the growth and expansion of new Old Order Mennonite communities in Ontario. Urias grew up in the established Waterloo district, where pioneering Mennonites have lived since the early 1800s and Old Orders were founded in the division of 1889. However, in 1968, the young Weber family was one of several founding families to begin a new Old Order community in Mount Forest. At the time, this was a contentious and risky venture, far from the mother community (about 65kms/40 miles). The concern about new communities was probably due in part to the history of the past seven decades, when virtually all Old Order communities in Ontario had become extinct except for the flourishing Waterloo district. [First paragraph]

The Gaataa’aabing Visual Research Method: A Culturally Safe Anishinaabek Transformation of Photovoice

Photovoice is a community-based participatory visual research method often described as accessible to vulnerable or marginalized groups and culturally appropriate for research with Indigenous peoples. Academic researchers report adapting the photovoice method to the sociocultural context of Indigenous participants and communities with whom they are working. However, detailed descriptions on cultural frameworks for transforming photovoice in order for it to better reflect Indigenous methodologies are lacking, and descriptions of outcomes that occur as a result of photovoice are rare. We address the paucity of published methodological details on the participant-directed Indigenization of photovoice. We conducted 13 visual research group sessions with participants from three First Nations communities in Northern Ontario, Canada. Our intent was to privilege the voice of participants in a mindful exploration aimed at cocreating a transformation of the photovoice method, in order to meet participants’ cultural values. Gaataa’aabing is the Indigenized, culturally safe visual research method created through this process. Gaataa’aabing represents an Indigenous approach to visual research methods and a renewed commitment to engage Indigenous participants in meaningful and productive ways, from the design of research questions and the Indigenization of research methods, to knowledge translation and relevant policy change. Although Gaataa’aabing was developed in collaboration with Anishinaabek people in Ontario, Canada, its principles will, we hope, resonate with many Indigenous groups due to the method’s focus on (1) integration of cultural values of the respective Indigenous community(ies) with whom researchers are collaborating and (2) placing focus on concrete community outcomes as a requirement of the research process.

The Emerging Indigenous Language Economy: Labour Market Demand for Indigenous Language Skills in the Upper Great Lakes

Language revitalization is necessarily intertwined with economic spheres, as Grenoble and Whaley have expressed that the economic wellbeing of a community influences its ability to engage in such efforts (2006, p. 44). Conversely, health researchers assert that cultural continuity, in which language is inextricably linked, is a prerequisite to self-sufficiency and community sustainability (Oster, Grier, Lightning, Mayan, &amp; Troth, 2014). Nonetheless, the place of Indigenous language(s) within labour market research has often focused on the need for greater access to dominant-language education (MacIsaac &amp; Patrinos, 1995) or the impact on wage differentials (Chiswick, Patrinos, &amp; Hurst, 2000) while research on Indigenous language revitalization in Canada has been largely silent on the relationship to economic spheres, and community economic development literature has engaged with notions of culture more broadly. Drawing on interviews and focus groups from a selection of Anishinaabe communities in Northern Ontario, Canada, this research identifies existing needs for Anishinaabe language speakers within the regional labour market, showcasing the oft-overlooked economic demand for Indigenous language skills. Support for this project was provided by the Ontario Human Capital Research and Innovation Fund from the Ministry of Training, Colleges and Universities.

Dioctophyme Renale in the Canine Patient

Some northern Ontario communities do not have access to veterinarians. As a result, many dogs in this area are not spayed or neutered. This deficit leads to over breeding and an increased number of strays. This results in harsh living conditions where dogs are forced to scavenge for food leading to an increased risk of contracting a parasitic infection. Dioctophyme renale, commonly referred to as “giant kidney worm” is a parasitic roundworm found in mammals. Animal rescue groups traveling to Northern Ontario communities are bringing back stray dogs for veterinary care and for adoption. The case study presented describes this rare parasitic infection. The prognosis if left untreated is fatal. Ultrasound is a useful diagnostic modality for diagnosing giant kidney worms as it has no adverse effects.