{"rowid": 5, "title": "[\"How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial\"]", "DOI": "10.1136/bmjopen-2015-010581", "URL": "http://dx.doi.org/10.1136/bmjopen-2015-010581", "created": "2016-09-13T01:49:12Z", "subject": "[\"General Medicine\"]", "references-count": "0", "is-referenced-by-count": "19", "ISSN": "[\"2044-6055\", \"2044-6055\"]", "container-title": "BMJ Open", "abstract": "<jats:sec><jats:title>Objectives</jats:title><jats:p>We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU). Participants (N=197) had in-person interviews every 3\u2005months for 2\u2005years.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The HF+ACT group spent more time stably housed compared to the TAU group with the mean difference between the groups of 45.8% (95% CI 37.1% to 54.4%, p&lt;0.0001). Accounting for baseline differences, HF+ACT group showed significant improvements over TAU group for community functioning, selected quality-of-life subscales and arrests at some time points during follow-up. No differences between HF+ACT and TAU groups over the follow-up were observed for health service usage, community integration and substance use.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>HF for individuals with high levels of need increased housing stability and selected health and justice outcomes over 2\u2005years in a city with many social and health services.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p>ISRCTN42520374.</jats:p></jats:sec>", "author_number": "10", "orcids": "[]", "names": "[\"Patricia O'Campo\", \"Vicky Stergiopoulos\", \"Pam Nir\", \"Matthew Levy\", \"Vachan Misir\", \"Antony Chum\", \"Bouchra Arbach\", \"Rosane Nisenbaum\", \"Matthew J To\", \"Stephen W Hwang\"]", "award_numbers": "[\"\"]", "funder_names": "[\"\"]", "funder_dois": "[\"\"]"}
{"rowid": 6, "title": "[\"What\\u2019s up doc? A national cross-sectional study of psychological wellbeing of hospital doctors in Ireland\"]", "DOI": "10.1136/bmjopen-2017-018023", "URL": "http://dx.doi.org/10.1136/bmjopen-2017-018023", "created": "2017-10-16T22:16:03Z", "subject": "[]", "references-count": "0", "is-referenced-by-count": "19", "ISSN": "[\"2044-6055\", \"2044-6055\"]", "container-title": "BMJ Open", "abstract": "<jats:sec><jats:title>Objectives</jats:title><jats:p>To measure levels of psychological distress, psychological wellbeing and self-stigma in hospital doctors in Ireland.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>National cross-sectional study of randomised sample of hospital doctors. Participants provided sociodemographic data (age, sex, marital status), work grade (consultant, higher/basic\u2009specialist trainee), specialty and work hours and completed well-being questionnaires (the Depression Anxiety Stress Scale, WHO Well-being Index, General Health Questionnaire) and single-item scales on self-rated health and self-stigma.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Irish publicly funded hospitals and residential institutions.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>1749 doctors (response rate of 55%). All hospital specialties were represented except radiology.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Half of participants were men (50.5%). Mean hours worked per week were 57\u2009hours. Over half (52%) rated their health as very good/excellent, while 50.5% reported positive subjective well-being (WHO-5). Over a third (35%) experienced psychological distress (General Health Questionnaire 12). Severe/extremely\u2009severe symptoms of depression, anxiety and stress were evident in 7.2%, 6.1% and 9.5% of participants (Depression, Anxiety, Stress Scale 21). Symptoms of distress, depression, anxiety and stress were significantly higher and levels of well-being were significantly lower in trainees compared with consultants, and this was not accounted for by differences in sociodemographic variables. Self-stigma was present in 68.4%.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The work hours of doctors working in Irish hospitals were in excess of European Working Time Directive\u2019s requirements. Just over half of hospital doctors in Ireland had positive well-being. Compared with international evidence, they had higher levels of psychological distress but slightly lower symptoms of depression and anxiety. Two-thirds of respondents reported self-stigma, which is likely to be a barrier to accessing care. These findings have implications for the design of support services for doctors, for discussions on quality of patient care and for future research.</jats:p></jats:sec>", "author_number": "5", "orcids": "[]", "names": "[\"Bl\\u00e1naid Hayes\", \"Lucia Prihodova\", \"Gillian Walsh\", \"Frank Doyle\", \"Sally Doherty\"]", "award_numbers": "[\"\"]", "funder_names": "[\"\"]", "funder_dois": "[\"\"]"}