Navigating Emerging Adulthood: Exploring Current Challenges Experienced in the Community

Background: Despite experiencing challenges, many young people resist seeking formal mental health support services (McGorry & Mei, 2018). One possible reason for this underutilization is that outreach and current service frameworks might not meet the evolving needs of this group, especially among young people with marginalized identities (Robards et al., 2018). In collaboration with Hôtel-Dieu Grace Healthcare, a lead agency engaged with local community mental health services, this project seeks to contribute to initiatives specific to transitional-aged youth’s mental health, possible trauma symptoms, and help-seeking.Method: This study invites undergraduate students and transitional-aged youth (18–24 years old) residing in Windsor-Essex County, Ontario, to participate in a mixed-method project with two phases. The first phase is ongoing and consists of a quantitative online survey. The next phase of this project will involve adopting a narrative inquiry approach and interviewing a subsample of participants from community and university settings.Results: Preliminary analyses will be presented. Descriptive and correlational findings will reveal how local transitional-aged youth are coping with mental health challenges and engaging in help-seeking behaviours within the context of the COVID-19 pandemic and related restrictions and disruptions.Conclusion: The expected implications of this mixed-method study include gaining valuable insights into understanding the unique challenges experienced by a traditionally hard-to-reach population during the COVID-19 pandemic. The resulting insights may be leveraged to inform and refine existing support services. This project aims to accomplish these objectives by conceptualizing the problem at the local level from the youth perspective

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Risk for Re-Enrollment to Cardiac Rehabilitation: A Retrospective Study of Ontario-Based Cardiac Rehabilitation Programs

Cardiac rehabilitation (CR) reduces recurrent cardiac events, and cardiovascular disease-related mortality, and increases overall quality of life among individuals with heart disease. Some participants have recurrent cardiac events and require re-referral to CR; however, it is not known whether the risk for recurrent events can be predicted and possibly mitigated. Thus, the purpose of this study was to describe CR re-referral and subsequent re-enrollment rates and understand the impact of risk factors on the risk of re-enrollment. In this study, data from individuals who were referred to CR (n = 1602) in 2008 and individuals who enrolled (n = 930) at two Southwestern Ontario CR programs over a five-year period were used. CR re-referral was defined as a second event within five years of initial discharge in 2008 that may or may not have resulted in re-enrollment, whereas re-enrollment was defined as a second admission to CR. Time to re-referral and re-enrollment by hospital site was described using the Kaplan Meier method and log-rank test. Of the 930 participants who enrolled (58% of individuals referred to CR), 27 (2.9%) participated in CR a second time. The time of re-enrollment was not influenced significantly by program site (Mean (M)=4.89 years, 95% CI 4.84 - 4.95, p =.75 and M=4.92 years, 95% CI 4.87 - 4.97). Findings suggest that individuals who participate in CR the first time have a low rate of re-enrollment and that Ontario CR programs have a consistent model of care

ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: American College of Cardiology Foundation Appropriate Use Criteria Task Force Society for Cardiovascular Angiography and Interventions American Association for Thoracic Surgery American Heart Association, American Society of Echocardiography American Society of Nuclear Cardiology Heart Failure Society of America Heart Rhythm Society, Society of Critical Care Medicine Society of C

The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. © 2012 Wiley Periodicals, Inc