Challenges to the Provision of Services for Sexual and Intimate Partner Violence in Canada During the COVID-19 Pandemic: Results of a Nationwide Web-Based Survey.

The COVID-19 pandemic increased women's vulnerability to intimate partner and sexual violence (IPV/SV), as well as challenging organizations' ability to respond. This research is based on a 2021 nationwide survey about the impacts of COVID-19 on IPV/SV services across Canada. Nationwide, organizations adopted several measures to reduce the risk of COVID-19 transmission, including scaling back services, reducing or stopping their volunteers, and reducing the number of in-shelter clients. Organizations detailed several financial challenges including increased costs and cancelation of fundraising events. Organizations also reported many staffing challenges, from increased workloads to staff leaves of absence due to childcare responsibilities, mental health reasons, or contracting COVID-19. Policies ensuring adequate financial support to IPV/SV services in nonemergency times could help minimize disruption to service delivery during crisis situations.

The prevalence and causes of visual impairment among the male homeless population of Montreal, Canada.

CLINICAL RELEVANCE: Homeless populations have lower health indicators, including in eye care. Few data exist on the levels and causes of visual impairment in Canadian homeless populations, and none in Montreal. BACKGROUND: This study aims to characterise the causes and levels of visual impairment, as well as eye care services utilisation among the Montreal homeless. METHODS: Using random sampling, five homeless shelters were selected. In each shelter, 20 participants were randomly selected. After obtaining informed consent, participants completed an ocular examination, which included: presenting visual acuity (pinhole as needed), intraocular pressure, confrontation visual field, dilated fundus examination, post-dilation autorefraction and questionnaire on social determinants of health. RESULTS: A total of 95 participants were examined, of which 97.9% were male. The median age was 49 years old (interquartile range 38-56.5). The age-adjusted prevalence of visual impairment (presenting visual acuity <6/12) was 23.6% (95% CI 15.1-32.9) compared to 6.0% in the Canadian population (Z = 77.9, p < 0.0001). With pinhole correction, the prevalence of visual impairment dropped to 5.8% (95% CI 1.7-11.8). Prevalence was 8.2% (95% CI 3.7-15.9) for cataracts, 11.4% (95% CI 5.9-19.7) for glaucoma or suspects and 4.7% (95% CI 1.7-11.9) for diabetic retinopathy. Lastly, 18.9% of participants had an ocular examination within the last year compared to 41.4% in Canada (Z = -4.5, p < 0.0001) and 13.7% had never had a comprehensive eye examination. CONCLUSIONS: This sample population shows a prevalence of visual impairment which is four times that of the general Canadian population, with highly prevalent uncorrected refractive error, while accessing primary eye care twice less often.

The sociodemographic characteristics and social determinants of visual impairment in a homeless population in the Montreal area.

OBJECTIVE: Homelessness is a serious social and public health concern in Canada. Individuals experiencing homelessness face numerous health problems and barriers in accessing health services. Visual impairment can exacerbate the lower quality of life experienced by people who are homeless, but its incidence among this population has been poorly documented in the literature. Our study aimed to describe health and sociodemographic characteristics and determine their association with visual impairment, ocular pathology and uncorrected refractive errors in a homeless population in Montreal, Canada. METHODS: This cross-sectional study was conducted between May 2019 and September 2020 in eight homeless shelters selected using a stratified random sampling approach on the island of Montreal. An eye examination was performed on all participants, who were also administered a survey on social determinants of health. Descriptive analysis was used to analyze survey data, and logistic regression was used for each of the three study outcomes. RESULTS: A total of 124 individuals experiencing homelessness (93 men, 31 women) were recruited. Participants were mostly Caucasian (> 70%) with an average age of 48 years (standard deviation = 13 years). Our sample reported a high level of education (68% had a high school diploma or higher), a high level of health insurance coverage (77%), social assistance benefits (71%), and social support (over 50%). There was a high prevalence of chronic conditions including diabetes (14%), hypertension (25%), and HIV/AIDS (3%). Results from eye examinations showed a high prevalence of visual impairment (22%), ocular pathology (23%), and uncorrected refractive error (75%). Age was statistically significantly associated with each outcome variable. CONCLUSION: Despite a high level of social and health support, individuals experiencing homelessness in Montreal, Canada, experience high levels of chronic conditions and visual impairment. Our study highlights the unmet need for eye healthcare among homeless populations, and that eye health can be a unique entry point for intervening with homeless populations.

RéSUMé: OBJECTIF: L'itinérance est un problème social et de santé publique important au Canada. Les personnes en situation d'itinérance font face à plusieurs problèmes de santé et d'accès aux soins de santé. La déficience visuelle est un problème de santé moins documenté chez cette population, mais qui peut grandement nuire à la qualité de vie. Notre étude visait à décrire les caractéristiques sanitaires et socio-démographiques et à déterminer leur association avec la déficience visuelle, les pathologies oculaires et les erreurs de réfraction non corrigée, dans une population d'itinérants à Montréal, au Canada. MéTHODOLOGIE: Une étude transversale a été réalisée entre mai 2019 et septembre 2020 auprès de 8 refuges pour itinérants à Montréal, sélectionnés par échantillonnage aléatoire stratifié. Les participants ont tous reçu un examen de la santé oculo-visuelle et il leur a été administré un questionnaire sur les déterminants sociaux de la santé. Une analyse descriptive a été utilisée pour analyser les données de l'enquête et une régression logistique a été utilisée pour chacun des trois variables dépendantes. RéSULTATS: Au total, 124 itinérants (93 hommes, 31 femmes) ont participé à l'étude. Les participants étaient caucasiens (>70 %) avec un âge moyen de 48 ans (±13 ans). Notre échantillon a déclaré un niveau d'éducation élevé (68 % avaient un diplôme d'études secondaires ou plus), un niveau élevé de couverture d'assurance maladie (77 %), d'aide sociale (71 %) et de soutien social (plus de 50 %). La prévalence des maladies chroniques était importante, notamment le diabète (14 %), l'hypertension (25 %) et le VIH/sida (3 %). Il y avait aussi une prévalence élevée de déficience visuelle (22 %), de pathologies oculaires (23 %) et d'erreurs réfractives non corrigées (75 %). L'âge était significativement associé à chacune des 3 variables dépendantes. CONCLUSION: Malgré un niveau élevé de soutien social et de santé, les itinérants de Montréal font face à un niveau élevé de maladies chroniques et de déficience visuelle. Notre étude met en évidence le niveau élevé des besoins non comblés en matière de soins de santé oculaire parmi les populations itinérantes, et le fait que la santé oculaire peut être un point d'entrée unique pour intervenir auprès de ces populations.

Looking at COVID-19 effects on intimate partner and sexual violence organizations in Canada through a feminist political economy lens: a qualitative study.

OBJECTIVES: Intimate partner violence and sexual violence organizations such as women's shelters play a crucial role in advancing gender equality in Canada. COVID-19 has challenged how such organizations operate. This study explored how intimate partner violence and sexual violence organizations in Canada have been affected by COVID-19 and the consequences on service delivery. METHODS: We interviewed 17 frontline and management staff from intimate partner violence and sexual violence organizations and programs across Canada, and analyzed the data using thematic analysis and applying a feminist political economy lens. RESULTS: We identified the following themes: (1) Adapting; (2) Struggling financially; (3) Resourcefulness; (4) Troubles connecting; (5) Narrowing scope of work; and (6) Burden of care. CONCLUSION: A feminist political economy framework considers the gendered impact of the pandemic and related measures on the workforce. Both the pandemic and measures to control it have affected intimate partner violence and sexual violence organizations in Canada, the staff working in these organizations, and the quality of relationships between staff and clients. Intimate partner and sexual violence organizations in Canada have been chronically underfunded and their predominantly female staff underpaid, affecting their ability to meet the needs of women. The onset of COVID-19 not only worsened these issues but converged with a shift in focus to more pandemic-related tasks, further limiting the scope and reach of organizations. Whether the adaptations, innovations, and perseverance demonstrated by such organizations and staff can tip the balance in favour of more equitable policy and outcomes remains to be seen.

RéSUMé: OBJECTIFS: Les organismes de lutte contre la violence conjugale et la violence sexuelle, comme les hébergements pour femmes, jouent un rôle crucial dans la promotion de l'égalité des genres au Canada. La COVID-19 a remis en question le mode de fonctionnement de ces organisations. Cette étude a examiné la manière dont les organismes de lutte contre la violence conjugale et sexuelle au Canada ont été affectés par la COVID-19 et les conséquences sur la prestation de services. MéTHODES: Nous avons mené des entrevues avec 17 intervenantes de première ligne et membres de la direction d'organismes et de programmes de lutte contre la violence conjugale et sexuelle à travers le Canada. Les données ont été analysées à l'aide d'une analyse thématique et en appliquant une optique d'économie politique féministe. RéSULTATS: Nous avons identifié les thèmes suivants : 1) adaptation; 2) difficultés financières; 3) ingéniosité; 4) difficultés à établir des liens; 5) réduction du champ d'action; et 6) charge de travail. CONCLUSION: Un cadre d'économie politique féministe permet d'examiner l'impact genré de la pandémie et des mesures connexes sur le personnel. La pandémie a eu des répercussions sur les organismes de lutte contre la violence conjugale et la violence sexuelle au Canada, sur le personnel qui y travaille et sur la qualité des relations entre le personnel et les clients. Les organisations de lutte contre la violence ont souffert d'un sous-financement chronique et leur personnel, majoritairement féminin, a été sous-payé, ce qui a nui à leur capacité de répondre aux besoins des femmes. L'apparition du COVID-19 a non seulement aggravé ces problèmes, mais a aussi entraîné un changement d'orientation vers des tâches plus liées à la pandémie, ce qui a limité encore davantage le champ d'action des organismes. Il reste à voir si les adaptations, les innovations et la persévérance dont font preuve ces organisations et leur personnel peuvent faire pencher la balance en faveur d'une politique et de résultats plus équitables.

Service provider perspectives on how COVID-19 and pandemic restrictions have affected intimate partner and sexual violence survivors in Canada: a qualitative study.

BACKGROUND: The COVID-19 pandemic may increase risk of intimate partner and sexual violence and make relevant services less accessible. This study explored the perspectives of intimate partner and sexual violence workers across Canada on how the COVID-19 pandemic has affected the survivors with whom they work. METHODS: Using a qualitative descriptive design, we interviewed 17 management and frontline staff of organizations supporting survivors of intimate partner and sexual violence across Canada. RESULTS: We identified 4 themes that describe the impacts of COVID-19 on intimate partner and sexual violence survivors, from the perspective of service providers: (1) No escape; (2) Isolation; (3) Tough decisions; and (4) Heightened vulnerability. These narrative findings are presented first, followed by an analysis within a social determinants of health framework. Interpreting our findings against such a framework revealed a complex interplay of social determinants, notably social support, access to services, and poverty, that produced several challenges for intimate partner and sexual violence survivors during COVID-19. CONCLUSION: According to service providers, intimate partner and sexual violence survivors in Canada faced several challenges during the pandemic, including reduced ability to escape their situations, increased isolation, increasingly complex decisions, and heightened vulnerability. Our findings demonstrate the critical need to adopt a broader, more holistic approach in tackling  intimate partner and sexual violence by also addressing socioeconomic issues such as poverty and marginalization.

War and reintegration for girls and young women in northern Uganda: A scoping review.

BACKGROUND: During the civil war in northern Uganda (1986-2006), thousands of girls were abducted into rebel and government forces. Most of the females who were not abducted lived in abhorrent conditions in camps for internally displaced people (IDP). As the war was drawing to a close, reintegration programs emerged and some continue today. OBJECTIVE: Using a feminist lens, we conducted a scoping review to examine the literature written about these girls and young women. The impetus for this research was to determine the breadth of literature available; compare how this population is represented in the academic, practitioner and popular literature and to analyse how this representation may be impacting reintegration programming. METHODS: Key words were entered into 14 academic databases, search engines and practitioner websites. Articles were included if they covered the recruitment, retention, return, and/or reintegration of formerly abducted and/or war-affected girls and women and if they were published between 2005 and 2019. A total of 112 articles were categorized and coded according to topics, themes and theoretical approaches. RESULTS: Based on the findings of this scoping review, it appears that many articles describe formerly abducted and war-affected young women from a deficit-based perspective, while relatively fewer articles are written with a strength-based, resiliency-focused lens. CONCLUSION: Based on our analysis, we argue for a more nuanced representation of women formerly engaged with armed groups, and argue for a gendered, inclusive approach to reintegration programming.

School-based sleep promotion programs: effectiveness, feasibility and insights for future research.

Adolescent sleep restriction is prevalent in today's society and is associated with major negative consequences for adolescent development and well-being. In the present review, we examine efforts to reduce adolescent sleep restriction via school-based sleep promotion programs. Such programs effectively enhance sleep knowledge but usually do not succeed in maintaining sleep behavioral changes. This may be because insufficient consideration is given to the importance of integrating motivational components into the programs. We suggest that future interventions should consider the use of individually tailored approaches to sleep promotion. We recommend the use of motivational interviewing, which can detect individual differences in the degree of willingness to change, thus allowing motivational barriers to be adequately addressed on an individual basis. Furthermore, we suggest that individually tailored sleep promotion strategies could be delivered to a significant proportion of adolescents via internet-based communication.

Short sleep duration is associated with teacher-reported inattention and cognitive problems in healthy school-aged children.

PURPOSE: Pediatric, clinical, and research data suggest that insufficient sleep causes tiredness and daytime difficulties in terms of attention-focusing, learning, and impulse modulation in children with attention deficit hyperactivity disorder (ADHD) or in those with ADHD and primary sleep disorders. The aim of the present study was to examine whether sleep duration was associated with ADHD-like symptoms in healthy, well-developing school-aged children. PATIENTS AND METHODS: Thirty-five healthy children (20 boys, 15 girls), aged 7-11 years participated in the present study. Each child wore an actigraphic device on their nondominant wrist for two nights prior to use of polysomnography to assess their typical sleep periods. On the third night, sleep was recorded via ambulatory assessment of sleep architecture in the child's natural sleep environment employing portable polysomnography equipment. Teachers were asked to report symptoms of inattention and hyperactivity/impulsivity on the revised Conners Teacher Rating Scale. RESULTS: Shorter sleep duration was associated with higher levels of teacher-reported ADHD-like symptoms in the domains of cognitive problems and inattention. No significant association between sleep duration and hyperactivity symptoms was evident. CONCLUSION: Short sleep duration was found to be related to teacher-derived reports of ADHD-like symptoms of inattention and cognitive functioning in healthy children.