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Item Open Access Vaccine Serotypes Continue to Cause Invasive Pneumococcal Disease in the Late PCV Era Especially in Unhoused Adults(Canadian Public Health Association, 2024-11-26) Leah J Ricketson; Shannon N Pyra; James D KellnerVaccine serotypes continue to cause invasive pneumococcal disease in the post-PCV era especially in unhoused adults Introduction: PCV7 vaccine was introduced in 2002 to Calgary, and PCV13 was introduced in 2010 in Calgary. Unhoused people account for about 0.2% of the population of Calgary, but 19% of IPD cases from 2000 to 2016. Methods: The Calgary area Streptococcus pneumoniae research (CASPER) team has been conductin population based surveillance on invasive pneumococcal disease in Calgary, Alberta since 1998. When S. pneumoniae is isolated by culture from a sterile sample, the CASPER team completes a chart review. In addition, antibiotic susceptibility testing, and serotyping through the Quellung reaction are completed by the collaborating laboratory. Results: Following PCV7 introduction we saw a decline in serotype 4 (ST4). However, after PCV13 was introduced in 2010, ST4 began to increase in prevalence again, primarily in adults. From 2020-2022 unhoused adults accounted for over 30% of all IPD cases despite representing a small proportion of the Calgary population. ST4 represented 42% of IPD cases amongst the unhoused population in 2022, and has been a prevalent serotype in unhoused adults since 2014. The second most prevalent were ST3, ST7F, and ST19A, each accounting for 10% of cases in unhoused adults in 2022. All of these serotypes are included in PCV13 and the newly licenced PCV15 and PCV20. However, ST9V and ST4 are not included in the novel unlicenced V116 vaccine, which includes 9 serotypes that are in PCV20 and 11 unique serotypes. Conclusions: Serotypes 4, 3, 7F and 9V are the most prevalent serotypes causing disease in Calgary in 2022/2023 in adults despite high levels of vaccination in children. The newly licenced PCV15 and PCV20 vaccines include all these serotypes, but the novel 21-valent V116 vaccine does not. Over 30% of IPD in the last three years was amongst unhoused or provisionally housed people highlighting the importance of reaching this population with vaccines.Item Open Access Invasive Pneumococcal Disease (IPD) in the Late Years of the COVID-19 Pandemic in Calgary, Canada: 2022-2023(Canadian Public Health Association, 2024-11-26) Leah J Ricketson; Shannon N Pyra; James D KellnerInvasive pneumococcal disease in the later years of the COVID-19 pandemic in Calgary, Canada: 2022-2023 Ricketson, LJ, Kellner, JD Background: Pneumococcal conjugate vaccines were introduced in 2002 (PCV7) and 2010 (PCV13) in Alberta. IPD declined during the COVID-19 pandemic in Calgary then increased following reduction of non-pharmaceutical interventions (NPIs). Methods: The Calgary area Streptococcus pneumoniae Epidemiology Research (CASPER) team conducts population-based surveillance on all IPD cases presenting to Calgary and area health facilities. Here we examine the changes in incidence per 3-month periods (quarters) during the early pandemic years 2020-2021 and the late-pandemic years 2022-2023 for all ages combined. Results: Late 2022 incidence increased to above pre-PCV levels. January to June 2023 had an average incidence of 4 cases per 100,000 people per quarter, which is above the average incidence of 2.5 in the same two quarters of the late-PCV13 years: 2017-2019 (IRR: 1.5, 95%CI: 1.0-2.2, P=0.0382). By Oct-Dec 2023 incidence remained above late PCV13-era levels (IRR: 1.5, 95%CI: 1.02-2.1, P=0.0317). In 2023, PCV serotypes 4 (18.9%), 9V (12.3%), 7F (9.9%), and 3 (9.9%) were most common. The rise of ST9V is notable as this was a relatively uncommon serotype in Calgary after the introduction of PCVs. Childhood vaccine rates in Calgary declined slightly, but not significantly during the COVID-19 era. Conclusions: With the reduction of NPIs, IPD increased in 2022 to above levels seen in the late-PCV era and this continued into 2023. By the end of 2023 IPD incidence remained above late vaccine-era levels. This is likely associated with increases in antecedent viral infections, particularly influenza and RSV, as childhood vaccine rates remained stable. The most common serotypes in 2023 are serotypes found in PCV13, as well as the new PCV15 and PCV20 vaccines. PCV13 serotypes persist, especially in adults and some are on the rise despite universal PCV13 use in children. This highlights the need for more effective direct protection for adults through vaccination.Item Open Access Long-Term Cognitive and Neurodevelopmental Outcomes of Pediatric Sepsis: Scoping Review Protocol(2024-09-24) Guderyan, Sydney D.; Thompson, Graham C.The objective of this scoping review is to summarize the evidence surrounding long-term outcomes of sepsis in the pediatric population, specifically outcomes related to neurodevelopment, academic/work performance, and cognitive function. Secondary objectives include evaluation of which etiologies of sepsis more commonly cause long-term neurodevelopmental and cognitive outcomes. Pediatric sepsis is a common presentation to emergency departments worldwide and a major contributor to PICU admissions (1). Long-term complications have been identified in the pediatric population, however, when compared to research in adults, there are significant gaps in characterizing the long-term impacts of sepsis in children, their relationship to different management strategies and potential interventions to optimize these outcomes (2,3). A review of this literature aims to summarize existing knowledge, recognize knowledge gaps and identify critical areas for further research. Literature evaluating long-term outcomes of sepsis on neurodevelopment, cognitive function, academic or work performance, and emotional impacts of pediatric sepsis will be included in the initial search and subsequently categorized into appropriate groupings for analysis. Literature on pediatric populations will be considered, excluding neonatal (≤ 28 days old) and adult (≥ 18 years old) populations due to significant clinical and physiological differences in these groups. Studies that look at long-term impacts of pediatric illness/hospitalization and include sepsis in their population will be included if there is clear division between different conditions but will be excluded if sepsis is analyzed in aggregate. Abstracts reviewed that do not specifically mention sepsis will be excluded unless they describe a presentation specifically consistent with sepsis based on the clinical judgement of reviewers. Information sources searched include: MedLine, EMBase and CINAHL. Searches were conducted on May 14th, 2024. Search limits exclude studies on the neonatal population and studies following participants for less than 12 months. Once all searches are conducted, abstracts will be uploaded into Covidence for abstract and full-text screening by both reviewers. Any disagreement as to which studies should be included will be resolved by a more detailed review and agreement via consensus. Once papers are selected, they will be grouped for analysis. The data will then be summarized in aggregate and presented in the manuscript to address the research objective and sub-objectives. The project aims to summarize existing knowledge on the long-term cognitive and neurodevelopmental impacts of pediatric sepsis and identify gaps which could be addressed by future long-term outcome studies or research on interventions associated with improved outcomes of pediatric sepsis.Item Open Access Protocol: Drug-induced Depression, An Updated Systematic Review to Inform Clinical Practice(2024-09-18) Patten, Scott Burton; McClurg, CaitlinBackground: The etiology of depression is biopsychosocial, with therapeutic drugs often listed as potential risk factors. However, the role of drugs and medications in depression etiology remains unclear. The objective of this review is to summarize existing evidence etiologically linking therapeutic drugs to depression. Methods: A systematic review will be conducted in a series of stages. As the goal of the review is to assess etiological evidence, issues of confounding (e.g. by illness or by illness severity) and temporality are of paramount importance. Therefore, the review will focus on randomized controlled trials (RCTs) and high-quality prospective cohort studies. With guidance from an academic librarian (CM), a literature search will be conducted in three stages. The first search will be a screening review of published review articles combined with a grey-literature search. The stage I search will be used to develop a list of drugs commonly implicated in depression etiology. A stage II search will cross-reference these drugs against methodological search terms to identify relevant RCTs. This stage will enable identification of a subset of drugs etiologically linked to depression. Finally, this subset of drugs will be included in the third stage of the literature search, which will cross-reference these specific drugs with search terms for prospective cohort studies, allowing of clinically salient observations on the course of drug-induced depression. Covidence will be used to organize and summarize eligibility assessment initially in screening for relevance, subsequently in selection of studies for full text review and finally in data extraction. The Cochrane RoB-2 and Robins-E tools will be used for quality assessment of included studies. Meta-analysis will be used, as appropriate, in analysis of the stage II studies whereas narrative description will be the main strategy for data synthesis of the stage III studies. The review will be reported using PRISMA standards. Discussion: This systematic review will identify three subsets of drugs that may be linked to depression: (1) a set of drugs frequently implicated in causing depression, (2) a subset of this list consisting of drugs etiologically linked to depression according to reasonable standards of evidence, and (3) a summarization of evidence concerning diagnosis and clinical management of drug-induced depression. Such evidence will inform clinical practice by supporting risk-benefit decisions in treatment selection and by providing a better understanding of the side-effect profiles of medical drugs.Item Open Access Assessing the Current Layout of Artificial Intelligence Applications in Chronic Elbow Pain Disorders: Scoping Review Protocol(2024-09-11) Perez, Jose Uriel; Bhogal, Mankirat; Jama, Mohamed; Deng, GeorgeReview Question: What AI technologies are available for pain medicine physicians treating adult patients with chronic elbow pain? Introduction: Chronic elbow pain, which includes conditions such as tendinopathies, bursitis, nerve compression syndromes, and osteoarthritis, presents a significant diagnostic challenge due to the complexity of the joint and its surrounding structures. Artificial intelligence (AI) holds great potential in improving the efficiency of diagnosis, prognosis, and treatment in musculoskeletal disorders. However, there is no comprehensive review of the AI applications specifically targeting chronic elbow pain. This scoping review seeks to address this gap by analyzing existing AI technologies relevant to pain medicine. Inclusion Criteria: This review will include peer-reviewed studies involving adult patients with chronic elbow pain, where AI technologies are applied to predict, diagnose, manage, or classify these disorders. Studies on AI applications in musculoskeletal and pain medicine that focus on the elbow will be included. Methods: A comprehensive search will be conducted in MEDLINE and Embase databases. Covidence software will be used to manage the selection process, remove duplicates, and facilitate data extraction. The review will follow the PRISMA-ScR guidelines. Findings will be synthesized through a narrative analysis, highlighting the current state of AI applications in chronic elbow pain and identifying research gaps for future investigation. This review will provide a valuable foundation for understanding AI’s role in pain medicine and its potential impact on the management of chronic elbow pain.Item Open Access Are we Capturing the Socioeconomic Burden of Rare Genetic Disease? A Scoping Review of Economic Evaluation and Cost-of-Illness Studies(PharmacoEconomics, 2023-12) Marshall, Deborah A.; Gerber, Brittany; Lorenzetti, Diane L.; MacDonald, Karen V.; Bohach, Riley J.; Currie, Gillian R.Objectives: Rare diseases have a significant impact on patients, families, the health system, and society. Measuring the socioeconomic burden (SEB) is crucial to valuing interventions for rare diseases. Healthcare system costs are significant, but so are costs to other government sectors, patients, families, and society. To understand the breadth of costs captured in rare disease studies, we examined the cost categories and elements of SEB captured in published studies. Methods: A scoping review was conducted using five electronic databases to identify English language economic evaluations and cost-of-illness studies of interventions for rare diseases (2011-2021). We mapped costs using a previously developed evidence-informed framework of SEB costs for rare disease. Results: Of 4890 studies identified, 48 economic evaluations and 22 cost-of-illness studies were included. While 18/22 cost-of-illness studies utilized a societal perspective, only 7/48 economic evaluations incorporated societal costs. Most reported cost categories related to medical costs, with medication and hospitalizations being the most common elements for both study designs. Costs borne by patients, families, and society were reported less among economic evaluations than cost-of-illness studies. These included: productivity (10% vs 77%), travel/accommodation (6% vs 68%), government benefits (4% vs 18%), and family impacts (0% vs 50%). Conclusions: Contrary to cost-of-illness analyses, most of the included economic evaluations did not account for the hidden burden of rare disease, that is costs borne by patients, families, and societies. Including these types of costs in future studies would provide a more comprehensive picture of the burden of disease, providing empirical data to inform how we value and make decisions regarding rare disease interventions, health policy and resource allocation.Item Open Access Machine learning using multimodal clinical, electroencephalographic, and magnetic resonance imaging data can predict incident depression in adults with epilepsy: A pilot study(Wiley, 2023-07-08) Delgado-García, Guillermo; Engbers, Jordan D. T.; Wiebe, Samuel; Mouches, Pauline; Amador, Kimberly; Forkert, Nils D.; White, James; Sajobi, Tolulope; Klein, Karl Martin; Josephson, Colin B.; Calgary Comprehensive Epilepsy Program CollaboratorsObjective: To develop a multi-modal machine learning (ML) approach for predicting incident depression in adults with epilepsy. Methods: We randomly selected 200 patients from the Calgary Comprehensive Epilepsy Program registry and linked their registry-based clinical data to their first-available clinical electroencephalogram (EEG) and magnetic resonance imaging (MRI) study. We excluded patients with a clinical or Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)-based diagnosis of major depression at baseline. The NDDI-E was used to detect incident depression over a median of 2.4 years follow-up (IQR 1.5-3.3 years). A ReliefF algorithm was applied to clinical as well as quantitative EEG and MRI parameters for feature selection. Six ML algorithms were trained and tested using stratified three-fold cross-validation. Multiple metrics were used to assess model performances. Results: Of 200 patients, 150 had EEG and MRI data of sufficient quality for ML, of which 59 were excluded due to prevalent depression. Therefore, 91 patients (41 women) were included with a median age of 29 (IQR 22-44) years. A total of 42 features were selected by ReliefF, none of which were quantitative MRI or EEG variables. All models had a sensitivity >80% and 5 of 6 had an F1 score ≥0.72. Multilayer perceptron model had the highest F1 score (median 0.74; interquartile range [IQR] 0.71-0.78) and sensitivity (84.3%). Median area under the receiver operating characteristic curve and normalized Matthews correlation coefficient were 0.70 (IQR 0.64-0.78) and 0.57 (IQR 0.50-0.65), respectively. Significance: Multimodal machine learning using baseline features can predict incident depression in this population. Our pilot models demonstrated high accuracy for depression prediction. However, overall performance and calibration can be improved. This model has promise for identifying those at risk for incident depression during follow-up, though efforts to refine it in larger populations along with external validation are required.Item Open Access Feasibility and acceptability of implementing a transdiagnostic cognitive behavioral therapy for children impacted by trauma within a residential treatment facility(Taylor and Francis Child & Youth Services, 2024-04-26) Lindenbach, David; Anderson, Alida; Wang, Emily; Heintz, Madison; Rowbotham, Melissa; Ehrenreich-May, Jill; Arnold, Paul D; Dimitropoulos, GinaThe Unified Protocol (UP) is a flexible, transdiagnostic form of cognitive behavioural therapy that effectively treats diverse psychiatric conditions in children, adolescents and adults. However, the UP has not been rigorously evaluated among children who have experienced severe trauma and may have limited caregiver involvement. The present research project was a single arm, open trial examining the feasibility of utilizing the UP within a residential treatment facility for children involved with child welfare authorities who often have limited caregiver involvement. Children (n = 19; age 9-13) and their caregivers (n = 18; age 32-60) participated in 15 weekly therapy sessions of the UP for Children with minor structural and content modifications. Trauma exposure was high among children, especially physical neglect and emotional abuse (89% exposed to each). Fidelity to the manualized intervention was high (88% for children; 89% for caregivers), indicating the intervention was feasible to deliver and that the adaptations did not interfere with fidelity. All children and caregivers completed the intervention, suggesting high acceptability for recipients. Improvements over time in maladaptive cognitions and behaviours (among children and caregivers) provide preliminary evidence for efficacy. The present study provides support for the notion that the UP for Children can be utilized for children who live in residential care and/or those who have experienced high levels of trauma.Item Open Access Developing a Framework of Cost Elements of Socioeconomic Burden of Rare Disease: A Scoping Review(PharmacoEconomics, 2023-04-07) Currie, Gillian R; Gerber, Brittany; Lorenzetti, Diane; MacDonald, Karen; Benseler, Susanne M; Bernier, Francois P; Boycott, Kym M; Carias, K. Vanessa; Hamelin, Bettina; Hayeems, Robin Z; LeBlanc, Claire; Twilt, Marinka; van Rooijen, Gijs; Wong-Rieger, Durhane; Yeung, Rae S. M.; Marshall, Deborah A.Background and Objective: Rare diseases place a significant burden on patients, families, the healthcare system and society. Evidence on the socioeconomic burden of rare disease is limited and mostly reflects diseases where treatments are available. We developed a framework encompassing recommended cost elements for studies of the socioeconomic burden of rare diseases. Methods: A scoping review, conducted in five databases (Cochrane Library, EconLit, Embase, MEDLINE, and APA PsycINFO), identified English language publications from 2000 and 2021 presenting frameworks developed for determining, measuring or valuing costs for rare or chronic diseases. Cost elements were extracted and used to develop a literature-informed framework. Structured feedback was gathered from experts in rare diseases, health economics/health services and policy research to revise the framework. Results: Of 2990 records identified, eight papers were included and informed our preliminary framework; three focused on rare disease and five on chronic disease. Following expert input, we developed a framework consisting of nine cost categories (inpatient, outpatient, community, healthcare products/goods, productivity/education, travel/accommodation, government benefits, family impacts, and other), with several cost elements within each category. Our framework includes unique costs, added from the expert feedback, including genetic testing to inform treatment, use of private laboratories or out-of-country testing, family involvement in foundations and organizations, and advocacy costs for special access programs. Conclusions: Our work is the first to identify a comprehensive list of cost elements for rare disease for use by researchers and policy makers to fully capture socioeconomic burden. Use of the framework will increase the quality and comparability of future studies. Future work should focus on measuring and valuing these costs through onset, diagnosis, and post-diagnosis.Item Open Access Impacts of the SARS-CoV-2 pandemic on the seasonal pattern of hospitalizations for acute respiratory diseases among children in Alberta, Canada(2024) Lukac, Christine D; Simms, Brett; Kwong, Grace P.S.; Holodinsky, Jessalyn K.; Johnson, David W.; Kellner, James D.Introduction: Acute infectious respiratory diseases (ARD) among children generally have a biennial pattern – peak incidence is highest every other winter. This seasonal pattern of ARD was interrupted in 2020 by SARS-CoV-2 and non-pharmaceutical interventions (NPI). We conducted a population based retrospective cohort study in Alberta, that measured the impact on (i) the weekly incidence of hospitalizations to quantify healthcare use, (ii) the weekly percent of PICU admissions to monitor clinical severity, and (iii) the weekly average age at discharge to characterise the affected population. Methods: From Apr 2003-Dec 2023, all hospital discharges and PICU admissions for ARD (i.e. bronchiolitis, pneumonia, influenza-like-illness, and croup) among children < 18 years old were identified in the provincial hospital Discharge Abstract Database. Weekly incidence of hospital discharge was calculated using population denominators. Weekly percent PICU admissions was calculated using all hospital discharges as the denominator. Weekly average age at discharge was calculated from birth to discharge in months. Seasonal autoregressive-integrated-moving-average (SARIMA) models predicted the expected weekly outcomes from Apr 2020 onward. Incidence ratios and percent change compared observed versus expected outcomes. Analyses were conducted in R version 4.2.2 (2022-10-31) and R studio build 2022.12.0+353. Results: There were 63,776 hospitalizations for ARD among children from Apr 2003-Dec 2023: 22,963 (36.01%) for bronchiolitis, 23,977 (37.44%) for pneumonia, 10,833 (16.97%) for influenza-like-illness, and 4,984 (7.81%) for croup. Of the hospitalizations, 4,167 (6.53%) included a PICU admission. The average weekly incidence of hospitalization for ARD per 100,000 children decreased 12.71-fold during Dec 2020-Feb 2021 (0.82 observed vs. 10.42 [95%CI 5.11, 15.73] expected) and increased 1.51-fold during Dec 2022-Feb 2023 (16.28 observed vs. 10.77 [95%CI 4.71, 16.83] expected). The average percentage of PICU admissions steadily increased from 4.07% (95%CI 1.22%, 6.91%) in Dec 2003-Feb 2004 to 10.48% (95%CI 8.36%, 12.60%) in Dec 2019-Feb 2020. There was no significant change in the percentage of PICU admissions in Dec 2020-Feb 2021 and Dec 2022-Feb 2023, 11.17% (95%CI 0.00%, 26.32%) and 11.86% (95%CI 9.33%, 14.39%) respectively. During each winter season, the average age at discharge decreased to 25 months (95%CI 17.85, 33.74) annually. Similar patterns for incidence of hospitalizations, percent PICU admissions, and average age at discharge were observed for bronchiolitis, pneumonia, influenza-like-illness, and croup. Discussion: SARS-CoV-2 and NPI had significant impacts on provincial hospitalization for ARD among children. Initially hospitalizations for ARD decreased 12.71-fold during Dec 2020-Feb 2021. With SARS-CoV-2 vaccine availability, increased population immunity, and relaxation of NPI, hospitalizations for ARD increased 1.51-fold during Dec 2022-Feb 2023. However, there was no change in clinical severity based on percent PICU admissions, and no change in affected population based on average age at discharge.Item Metadata only The Cost of Cystic Fibrosis Care in Canada: A Scoping Review(2024) Desai, Leena; Bomersback, Taryn; Galante, Gary; Bjornson, Candice; Hirota, SimonBackground: Cystic fibrosis (CF) contributes a significant economic burden on individuals, health systems and society. This economic impact is highly relevant in a single-payer, publicly funded health system such as Canada. CFTR modulator therapy has been shown in large clinical trials to reduce the burden of disease in the pediatric population. Currently 17% of patients at the Alberta Children’s Hospital in Calgary, AB do not qualify for any CFTR modulator therapy, presumably resulting in an incremental cost to the system. Precision medicine tools such as organoid models may offer an opportunity for n-of-1 trials for individual patients who are currently not approved for therapy. Rationale: In order to better understand the health and economic impact of cystic fibrosis in Canada, we wish to identify direct, indirect and intangible costs of cystic fibrosis care in Alberta and Canada, and highlight the higher rate of heterogeneity amongst our southern Alberta CF population which predisposes to higher cost of care due to lack of approval to currently available therapies. Aim and Objective: This protocol describes the purpose of a scoping review which is to identify the most accurate estimation of the cost of cystic fibrosis care in Canada, and gather comprehensive data on how the costs of CF care (including direct, indirect and intangible costs) are defined and measured in Canada. Methodology: The protocol is developed using the JBI (Joanna Briggs Institute) guidance for scoping reviews and based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist, both of which will also guide its reporting. We will search PUBMED and OVID/MEDLINE for peer-reviewed English-language publications and grey literature search of relevant databases (ProQuest Dissertation and Theses, Canadian Health Research Collection) and organizational websites (Health Canada, Government of Canada, Cystic Fibrosis Foundation of Canda, Canadian Agency for Drugs and Technology in Health (CADTH)).Item Open Access Evaluating the Impact of Community-Driven Grassroots Vaping Interventions on Changing the Attitudes, Perceptions, and Knowledge of Adolescents in Grade 7 and 8 Classrooms(None, 2023-11-14) Beg, Mirza; Dawood, Yahya; Patten, ScottThis is a protocol for a randomized control study design evaluating the effectiveness of a video designed to increase knowledge and improve attitudes towards vaping in a student population attending a middle school.Item Open Access 2SLGBTQQIA+ Experiences of Intimate Partner Abuse and Help-Seeking: An Intersectional Scoping Review(2023-08-08) Kurbatfinski, Stefan; Whitehead, Jessica; Hodge, Lee; Ulicki, Noah; Madaan, Ridham; Henry, Richard S.; Parente, Isi; Kumbah, Ophilia; Pino, Fritz; Krentz, Hartmut B.; Morris, Martin; Santinele Martino, Alan; Maurer, Katherine; Marshall, ZackBackground Intimate partner abuse (IPA) encompasses various forms of abuse between intimate partners, including physical, sexual, emotional, financial, legal, cultural, spiritual, religious, and other types of violence. Recent studies challenge cisgender heteronormative representations of IPA by revealing that the prevalence of IPA between Two-Spirit, lesbian, gay, bisexual, trans, queer, questioning, intersex, asexual, and other sexual or gender minority (2SLGBTQQIA+) partners is similar to heterosexual IPA. However, discriminatory beliefs enacted through homophobia, transphobia, racism, sexism, and colonialism uniquely influence 2SLGBTQQIA+ experiences of IPA. Moreover, the lack of service availability and diversity specifically tailored to 2SLGBTQQIA+ communities further complicate efforts to address IPA, exacerbating inequities and impacting well-being. Objectives This scoping review aimed to achieve three main objectives: 1. Identify knowledge strengths and gaps related to IPA among 2SLGBTQQIA+ people; 2. Describe the help-seeking efforts and experiences of 2SLGBTQQIA+ people who have encountered IPA, including interactions with informal supports (e.g., friends, family members) and formal services (e.g., police, counsellors); and 3. Provide evidence-based recommendations to enhance service responsiveness to 2SLGBTQQIA+ communities. Methodology The review protocol was registered on PROSPERO (#CRD42020139639) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. We included qualitative, quantitative, and mixed-method studies that examined help-seeking patterns and outcomes of 2SLGBTQQIA+ people who experience and/or use IPA against partners. A comprehensive search was conducted across multiple databases, including Medline, Embase, PsycInfo, Scopus, CINAHL, Genderwatch, and Social Science Abstracts. From the 5,827 initial results, 1,790 references were screened on full text. A total of 703 peer-reviewed studies focused on 2SLGBTQQIA+ IPA, and of those, 142 specifically examined help-seeking and 2SLGBTQQIA+ IPA. Each reference was screened by at least two members of the review team and data extraction was supported by four authors. Findings were categorized by sexual and gender identity group when possible, with further consideration of intersectionality. Results Most studies examined mixed sexual and gender minority (SGM) samples without providing stratified results. Community-specific studies on IPA were more likely to focus on lesbians, and trans people, followed by studies with bisexual participants, gay men, and Two-Spirit people. Notably, no studies included intersex participants, and there were no specific results available for individuals questioning their sexual and/or gender identity or those who identified as asexual. Emotional abuse or violence was commonly reported as the most prevalent form of IPA among LGBT individuals. Bisexual men and women seemed to experience a higher prevalence of IPA compared to lesbians or gay men. Many studies revealed that 2SLGBTQQIA+ individuals were often unaware that the control, violence, or manipulation they experienced in their intimate relationships could be classified as abuse, acting as a barrier to seeking support or leaving abusive relationships. This lack of recognition was often attributed to gendered discourses that centre cisheteronormative relationships and overlook 2SLGBTQQIA+ specific forms of abuse. Other significant barriers across all groups included a lack of knowledge about available services, the absence of 2SLGBTQQIA+-specific services (and services providers), and anticipated or enacted discrimination from service providers. Negative experiences with accessing police services were commonly reported by many identity groups, while LGBT individuals also expressed dissatisfaction with legal services, indicating limited opportunities for seeking justice. Counsellors and friends were often regarded as positive sources of support. Key Messages Based on this review, the following areas require attention: 1. Critical changes are needed to gender-based violence services, particularly violence shelters, to properly respond to 2SLGBTQQIA+ communities. Many services perpetuate gender norms and engage in discriminatory actions that impede adequate support, including a significant service gap for both cis and trans male-identified individuals. 2. Ensuring justice for 2SLGBTQQIA+ people who experience violence is essential, necessitating attention to formal legal systems, policing, and transformative justice. 3. Counselling services are a strength and a valuable resource for 2SLGBTQQIA+ people in relation to IPA. It is crucial to support this sector, including measures to reduce individual costs and increase accessibility. 4. Increased education and training are needed for service providers working in formal services to reduce stigma and misconceptions and improve service interactions. 5. Educational curricula in schools should be adapted to include 2SLGBTQQIA+ IPA, enabling individuals to recognize experiences of abuse and support one another. 6. Informal support from friends is a crucial resource, and its effectiveness could be enhanced by establishing stronger connections to collective care initiatives. 7. Research and service design need to meaningfully integrate intersectional frameworks that better respond to the full diversity of 2SLGBTQQIA+ communities. 8. There is an urgent need for a collective impact model that addresses abuse prevention, coordinated service navigation pathways, evaluation of informal and formal supports, shared values (intersectional and trauma-informed care), and increased funding. By implementing these recommendations, progress can be made in addressing the gaps and challenges identified in this review leading to improved IPA supports and services for 2SLGBTQQIA+ communities.Item Open Access From knowledge to action : contributions from the social sciences to the One Health approach and its evaluation(Université de Montréal, 2019-08-22) Rock, Melanie J.Item Open Access The Grievance Hoax, critical scholarship, and healthy cities as multi-species spaces(2023-11-13) ROCK, Melanie J.; BLUE, GwendolynItem Open Access The British Columbia Farmers' Market Nutrition Coupon Program reduces short-term household food insecurity among adults with low incomes: a pragmatic randomized controlled trial.(ELSEVIER, 2023-10-06T06:00:00Z) Aktary, Michelle L; Dunn, Sharlette; Sajobi, Tolulope; O'Hara, Heather; Leblanc, Peter; McCormack, Gavin R; Caron-Roy, Stephanie; Lee, Yun Yun; Reimer, Raylene A; Minaker, Leia M; Raine, Kim D; Godley, Jenny; Downs, Shauna; Nykiforuk, Candace I J; Olstad, Dana LeeThe British Columbia Farmers' Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers' markets.Item Open Access Vivo Play Project: How to Let Loose as a Play Ambassador(Vivo for Healthier Generations, 2023) Vivo for Healthier GenerationsItem Open Access Validating the Brief Resilience Scale (BRS) in Undergraduate Students: A mixed methods study(2023-08-04) Hews-Girard, Julia; Patten, Scott; Dimitropoulos, Gina; Szeto, Andrew; Thannhauser, Jennifer; King, Nathan; Duffy, Anne; Cunningham, SimoneItem Open Access Examining the impact of missing data in an undergraduate mental health survey(2023-08-04) Hews-Girard, Julia; Patten, Scott; Dimitropoulos, Gina; Szeto, Andrew; Thannhauser, Jennifer; Duffy, Anne; Rivera, Daniel; King, NathanItem Open Access Exploring Perceptions, Experiences, Acceptability and Validity of Mental Health Screening and Diagnosis among Undergraduate Students: A mixed methods study(2023-08-04) Hews-Girard, Julia; Patten, Scott; Dimitropoulos, Gina; Szeto, Andrew; Thannhauser, Jennifer