George Tolomiczenko | University of Southern California (original) (raw)

Papers by George Tolomiczenko

2021 ASEE Virtual Annual Conference Content Access, Jul 26, 2021

Journal of Advanced Nursing, Apr 1, 2005

Journal of Advanced Nursing 50(1), 101-110 SARS: coping with the impact at a community hospital A... more Journal of Advanced Nursing 50(1), 101-110 SARS: coping with the impact at a community hospital Aim. This paper presents the findings of a staff survey conducted at a 350-bed acute care facility located on the periphery of Toronto, Canada. Background. Toronto's severe acute respiratory syndrome (SARS) crisis resulted in trauma-like effects at hospitals hardest hit by the disease. A systematic examination of the impact on staff working in hospitals that saw relatively few cases, while maintaining the precautions associated with elevated alert levels, has not been undertaken. Methods. A questionnaire was distributed for 1 month commencing 17 April 2003 and 300 completed responses were obtained (approximately one in six staff members). The data collected included demographic and occupational information, in addition to perceptions of SARS' impact on patient care, factors contributing to adverse impacts on patient care, working conditions, decision-making, communication and relations, sources of support, and the impact on workers' lives outside work. Items for these sections were developed by a multidisciplinary team of health care workers and hospital administrators.

Cancer Epidemiology, Biomarkers & Prevention, Sep 1, 2020

Since the mid-1990s, a significant scientific literature has evolved regarding the mental/physica... more Since the mid-1990s, a significant scientific literature has evolved regarding the mental/physical health outcomes from the use of what we now refer to as Clinical Virtual Reality (VR). While the preponderance of clinical work with VR has focused on building immersive virtual worlds for treating anxiety disorders with exposure therapy, providing distracting immersive experiences for acute pain management, and supporting physical rehabilitation with game-based interactive content, there are other emerging areas that have extended the impact of VR in healthcare. One such area involves the recent technological advances that have led to the evolution of intelligent virtual human (VH) agents. VH representations can now be designed to perceive and act in a 3D virtual world, engage in face-to-face spoken dialogues with real users, and in some cases, can exhibit human-like emotional reactions. We have reported positive outcomes from studies using VHs in the role of virtual patients for training novice clinicians, as job interview/social skill trainers for persons on the autism spectrum, and as online health care support agents with university students and military veterans. The computational capacity now exists to deliver similar VH interactions by way of mobile device technology. This capability can support the “anywhere/anytime” availability of VH characters as agents for engaging users with clinical care information and could provide opportunities for improving access to care and emotional support for childhood cancer survivors (CCS). With a survivorship rate of over 83%, CCS are living longer, with estimates indicating that there will be over 500,000 CCS in the United States by 2020. However, CCS are at high risk for late effects of treatment, including recurring or secondary cancers, unhealthy lifestyle, disengagement from care, and the lack of the social support that has been shown to be vital for health and well-being. The majority of CCS will have at least one chronic condition by age 40. Moreover, existing initiatives to serve the needs of CCS have had limited success as these populations can be hard to reach and difficult to engage. We conducted two preliminary studies to inform development and evaluate the usefulness of a mobile app that included VH interaction and guidance to help CCS navigate survivorship and maintain health. In Study 1, two rounds of focus group interviews were conducted with 15 CCS aged 13-30 years. In Study 2, a pilot VH-driven app was developed using the information collected in Study 1. The app was downloaded, tested, and evaluated for one week by 60 CCS between the ages of 13-29 years. The results indicated that dynamic, accessible, engaging and survivor-focused VH approaches could address the needs of young, “digitally native” CCS. We will present a brief introduction to the clinical use of VHs within the VR context (Rizzo), followed by a discussion of a new mobile-enabled VH project designed to promote access to health care information and emotional support in young adult CCS (Spruijt-Metz). Citation Format: Skip Rizzo, Donna Spruijt-Metz, Arno Hartholt, Bill Swartout, Kayla de la Haye, Joel Milam, David Freyer, Kimberly Miller, Anamara Ritt-Olson, Stacy Schepens-Niemiec, Shinyi Wu, Maryalice Jordan-Marsh, Amie Hwang, Anya Samek, Dennis Wixon, George Tolomiczenko, Kenneth Hayashida, Marientina Gotsis, Stefan Schneider, Swaroop Samek, Yaniv Bar-Cohen. Mobile virtual human health care guides for young adult childhood cancer survivors [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr IA15.

Journal of Personality Disorders, Jun 1, 2000

The psychiatric status of homeless adults has been described primarily in terms of Axis I disorde... more The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibil ity and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups character ized by distinct profiles. Two of these were characterized by ex treme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and dif fered primarily on the dimension of suicidality. The third re flected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The valid ity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assess ment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interper sonal dimensions that will likely affect service provision. The prevalence of mental illness among homeless persons has been stud ied in a variety of urban settings (Fischer, Drake, &Breakey, 1992; Smith, North, & Spitznagel, 1992) using standardized diagnostic interviews fo cusing primarily on Axis I diagnoses (Dennis, Buckner, Lipton, & Levine, 1991). Only rarely, however; are Axis II disorders included, and when they are, these assessments are limited to determining the presence or ab sence of antisocial personality disorder (Koegel, Burnam,

Psychiatric Rehabilitation Journal, 2000

PubMed, 2004

Background: Rooming houses are an important source of housing for low-income Canadians. Little in... more Background: Rooming houses are an important source of housing for low-income Canadians. Little information is available on the relationship between housing conditions and health status in this vulnerable population. Methods: Interviews were conducted with a representative sample of 295 residents in 171 rooming houses in Toronto. Health status was assessed using the SF-36. The physical attractiveness of each rooming house was rated using the Multiphasic Environmental Assessment Procedure. Associations between the health status of residents and the physical attractiveness and organizational characteristics of rooming houses were examined. Results: Rooming house residents aged 35 years and older had significantly poorer health status than their counterparts in the Canadian general population. Eight of the ten dimensions of individual health status assessed by the SF-36 were significantly correlated with the physical attractiveness of the rooming house in which the individual lived. However, there was no significant association between residents' health status and the rooming house's non-profit status, provision of meals, or the presence of an on-site landlord. Conclusions: Rooming house residents suffer from a high prevalence of ill health. Residents reporting worst health are concentrated in rooming houses in the poorest physical condition. This relationship may be mediated by selection processes that place the sickest individuals in the lowest-quality rooming houses, and/or by a direct effect of adverse housing conditions on health status. Further research is needed to elucidate these processes and to improve the health of this vulnerable population.

The Canadian Journal of Psychiatry, Apr 1, 2001

Ob jec tive: To de ter mine whether the view ing of a video de pict ing the suc cess ful strug gl... more Ob jec tive: To de ter mine whether the view ing of a video de pict ing the suc cess ful strug gles of home less per sons with men tal ill ness in find ing and main tain ing hous ing can have a posi tive im pact on at ti tudes to ward home less per sons with men tal ill ness. Method: Five hun dred and seventy-five high school stu dents at tend ing a brief edu ca tional ses sion on men tal ill ness par tici pated in 1 of 3 com pari son ver sions of the 2-hour pro gram (con trol, video, video plus dis cus sion). All com pleted an "At ti tudes to ward Home less ness and Men tal Ill ness Ques tion naire." Demo graphic and prior ex po sure vari ables were en tered as co vari ates in between-group analy ses of vari ance. Re sults: Fe males and sub jects who had more prior en coun ters with home less per sons were found to have the most posi tive at titudes. Af ter con trol ling for these ef fects, the video alone had a nega tive im pact on at ti tudes rela tive to the other groups, while the video fol lowed by a dis cus sion with one of the peo ple fea tured in it had a largely posi tive im pact. Con clu sions: The ap par ent im me di acy and the evoca tive power of video pres en ta tions can not sub sti tute for di rect con tact for the pur pose of pro mot ing posi tive at ti tude change. The find ings are con sis tent with prior re s earch em pha siz ing the im por tance of direct in ter ac tion with mem bers of stig ma tized groups to re duce nega tive at ti tudes. Edu ca tion pro grams try ing to des tig ma tize men tal ill ness and home less ness us ing vid eos should pro ceed with cau tion.

Journal of Urban Health-bulletin of The New York Academy of Medicine, Jul 23, 2009

Homeless individuals often suffer from serious health problems. It has been argued that the homel... more Homeless individuals often suffer from serious health problems. It has been argued that the homeless are socially isolated, with low levels of social support and social functioning, and that this lack of social resources contributes to their ill health. These observations suggest the need to further explore the relationship between social networks, social support, and health among persons who are homeless. The purpose of this study was to examine the association between multidimensional (cognitive/ perceived and behavioral/received) social support and health outcomes, including physical health status, mental health status, and recent victimization, among a representative sample of homeless individuals in Toronto, Canada. Multivariate regression analyses were performed on social support and health outcome data from a subsample of 544 homeless adults, recruited from shelters and meal programs through multistage cluster sampling procedures. Results indicated that participants perceived moderately high levels of access to financial, emotional, and instrumental social support in their social networks. These types of perceived social supports were related to better physical and mental health status and lower likelihood of victimization. These findings highlight a need for more services that encourage the integration of homeless individuals into social networks and the building of specific types of social support within networks, in addition to more research into social support and other social contextual factors (e.g., social capital) and their influence on the health of homeless individuals.

IEEE Pulse, Nov 1, 2015

Training people seeking to develop the diverse skill set needed to create, test, and commercializ... more Training people seeking to develop the diverse skill set needed to create, test, and commercialize health care solutions, predictably, Learning each time you iterate can be enhanced through interdisciplinarity. linking engineering and Medical Training

Community Mental Health Journal, Jun 1, 1996

Although placement in community housing is a frequent intervention with populations of seriously ... more Although placement in community housing is a frequent intervention with populations of seriously mentally ill homeless individuals, there has been little formal investigation of the criteria used by clinicians in screening individuals for such placement. In this paper, we describe screening a population of 303 homeless people with severe mental illness for placement in independent apartments. We assess subjects' level of risk along multiple dimensions and determine the contribution of each risk dimension to the final safety decision. In addition, we evaluate the validity of the risk measures with other measures of clinical condition. Two-thirds of the sample were judged as safe for independent living. Assaultiveness was the most frequent risk identified, followed by self-destructiveness, substance abuse, and medication non-compliance. The final safety decision was associated most strongly with assaultiveness, selfdestructiveness, and medication non-compliance. We conclude that it is possible to assess risk with measures that are available from shelter and medical records, and call for more research on the role of medication non-compliance in safety decisions and for longitudinal research to validate risk assessments.

BMC Public Health, Feb 24, 2010

Background: Drug use is believed to be an important factor contributing to the poor health and in... more Background: Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods: Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Results: Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI-6.5 to-3.2) but not with poorer physical health status (-0.03 points, 95% CI-1.3 to 1.3)). Conclusions: Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

Rooming houses are an important source of housing for low-income Canadians. Little information is... more Rooming houses are an important source of housing for low-income Canadians. Little information is available on the relationship between housing conditions and health status in this vulnerable population. Interviews were conducted with a representative sample of 295 residents in 171 rooming houses in Toronto. Health status was assessed using the SF-36. The physical attractiveness of each rooming house was rated using the Multiphasic Environmental Assessment Procedure. Associations between the health status of residents and the physical attractiveness and organizational characteristics of rooming houses were examined. Rooming house residents aged 35 years and older had significantly poorer health status than their counterparts in the Canadian general population. Eight of the ten dimensions of individual health status assessed by the SF-36 were significantly correlated with the physical attractiveness of the rooming house in which the individual lived. However, there was no significant association between residents' health status and the rooming house's non-profit status, provision of meals, or the presence of an on-site landlord. Rooming house residents suffer from a high prevalence of ill health. Residents reporting worst health are concentrated in rooming houses in the poorest physical condition. This relationship may be mediated by selection processes that place the sickest individuals in the lowest-quality rooming houses, and/or by a direct effect of adverse housing conditions on health status. Further research is needed to elucidate these processes and to improve the health of this vulnerable population.

The Canadian journal of gastroenterology, 2009

The organizers thank AstraZeneca Canada Inc, the CIHR-Institutes of Nutrition, Metabolism and Dia... more The organizers thank AstraZeneca Canada Inc, the CIHR-Institutes of Nutrition, Metabolism and Diabetes, and the CCFC for their generous support of this meeting, the ninth of its kind. In addition, we thank the invited faculty, Drs

Journal of Psychology & Psychotherapy, Nov 9, 2017

The Canadian journal of gastroenterology, 2010

IBD anD the mIcroBIome Understanding the microbiome Advances in genome sequencing technologies an... more IBD anD the mIcroBIome Understanding the microbiome Advances in genome sequencing technologies and bioinformatics have created a new field of research-metagenomicsthat enables comprehensive analysis of entire microbial communities, even those that cannot be cultured. The Human Microbiome Project (HMP) and the associated Canadian Microbiome Initiative are examining the composition of human microbial communities. Genetic and environmental factors such as geography, diet, age and lifestyle, influence an individual's microbiota. Although more than 500 bacterial species are represented in the human microbiome, most belong to only three phyla: Firmicutes, Bacteroidetes and Proteobacteria. Associations have already been made between colonizing microbes and some chronic diseases (7). It is anticipated that this tremendous undertaking will clarify the relationship between innate microbial communities and human health and disease.

Journal of health & medical informatics, Nov 22, 2016

and relation to health status

Journal of Psychology & Psychotherapy, Nov 9, 2017

2021 ASEE Virtual Annual Conference Content Access, Jul 26, 2021

Journal of Advanced Nursing, Apr 1, 2005

Journal of Advanced Nursing 50(1), 101-110 SARS: coping with the impact at a community hospital A... more Journal of Advanced Nursing 50(1), 101-110 SARS: coping with the impact at a community hospital Aim. This paper presents the findings of a staff survey conducted at a 350-bed acute care facility located on the periphery of Toronto, Canada. Background. Toronto's severe acute respiratory syndrome (SARS) crisis resulted in trauma-like effects at hospitals hardest hit by the disease. A systematic examination of the impact on staff working in hospitals that saw relatively few cases, while maintaining the precautions associated with elevated alert levels, has not been undertaken. Methods. A questionnaire was distributed for 1 month commencing 17 April 2003 and 300 completed responses were obtained (approximately one in six staff members). The data collected included demographic and occupational information, in addition to perceptions of SARS' impact on patient care, factors contributing to adverse impacts on patient care, working conditions, decision-making, communication and relations, sources of support, and the impact on workers' lives outside work. Items for these sections were developed by a multidisciplinary team of health care workers and hospital administrators.

Cancer Epidemiology, Biomarkers & Prevention, Sep 1, 2020

Since the mid-1990s, a significant scientific literature has evolved regarding the mental/physica... more Since the mid-1990s, a significant scientific literature has evolved regarding the mental/physical health outcomes from the use of what we now refer to as Clinical Virtual Reality (VR). While the preponderance of clinical work with VR has focused on building immersive virtual worlds for treating anxiety disorders with exposure therapy, providing distracting immersive experiences for acute pain management, and supporting physical rehabilitation with game-based interactive content, there are other emerging areas that have extended the impact of VR in healthcare. One such area involves the recent technological advances that have led to the evolution of intelligent virtual human (VH) agents. VH representations can now be designed to perceive and act in a 3D virtual world, engage in face-to-face spoken dialogues with real users, and in some cases, can exhibit human-like emotional reactions. We have reported positive outcomes from studies using VHs in the role of virtual patients for training novice clinicians, as job interview/social skill trainers for persons on the autism spectrum, and as online health care support agents with university students and military veterans. The computational capacity now exists to deliver similar VH interactions by way of mobile device technology. This capability can support the “anywhere/anytime” availability of VH characters as agents for engaging users with clinical care information and could provide opportunities for improving access to care and emotional support for childhood cancer survivors (CCS). With a survivorship rate of over 83%, CCS are living longer, with estimates indicating that there will be over 500,000 CCS in the United States by 2020. However, CCS are at high risk for late effects of treatment, including recurring or secondary cancers, unhealthy lifestyle, disengagement from care, and the lack of the social support that has been shown to be vital for health and well-being. The majority of CCS will have at least one chronic condition by age 40. Moreover, existing initiatives to serve the needs of CCS have had limited success as these populations can be hard to reach and difficult to engage. We conducted two preliminary studies to inform development and evaluate the usefulness of a mobile app that included VH interaction and guidance to help CCS navigate survivorship and maintain health. In Study 1, two rounds of focus group interviews were conducted with 15 CCS aged 13-30 years. In Study 2, a pilot VH-driven app was developed using the information collected in Study 1. The app was downloaded, tested, and evaluated for one week by 60 CCS between the ages of 13-29 years. The results indicated that dynamic, accessible, engaging and survivor-focused VH approaches could address the needs of young, “digitally native” CCS. We will present a brief introduction to the clinical use of VHs within the VR context (Rizzo), followed by a discussion of a new mobile-enabled VH project designed to promote access to health care information and emotional support in young adult CCS (Spruijt-Metz). Citation Format: Skip Rizzo, Donna Spruijt-Metz, Arno Hartholt, Bill Swartout, Kayla de la Haye, Joel Milam, David Freyer, Kimberly Miller, Anamara Ritt-Olson, Stacy Schepens-Niemiec, Shinyi Wu, Maryalice Jordan-Marsh, Amie Hwang, Anya Samek, Dennis Wixon, George Tolomiczenko, Kenneth Hayashida, Marientina Gotsis, Stefan Schneider, Swaroop Samek, Yaniv Bar-Cohen. Mobile virtual human health care guides for young adult childhood cancer survivors [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr IA15.

Journal of Personality Disorders, Jun 1, 2000

The psychiatric status of homeless adults has been described primarily in terms of Axis I disorde... more The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibil ity and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups character ized by distinct profiles. Two of these were characterized by ex treme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and dif fered primarily on the dimension of suicidality. The third re flected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The valid ity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assess ment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interper sonal dimensions that will likely affect service provision. The prevalence of mental illness among homeless persons has been stud ied in a variety of urban settings (Fischer, Drake, &Breakey, 1992; Smith, North, & Spitznagel, 1992) using standardized diagnostic interviews fo cusing primarily on Axis I diagnoses (Dennis, Buckner, Lipton, & Levine, 1991). Only rarely, however; are Axis II disorders included, and when they are, these assessments are limited to determining the presence or ab sence of antisocial personality disorder (Koegel, Burnam,

Psychiatric Rehabilitation Journal, 2000

PubMed, 2004

Background: Rooming houses are an important source of housing for low-income Canadians. Little in... more Background: Rooming houses are an important source of housing for low-income Canadians. Little information is available on the relationship between housing conditions and health status in this vulnerable population. Methods: Interviews were conducted with a representative sample of 295 residents in 171 rooming houses in Toronto. Health status was assessed using the SF-36. The physical attractiveness of each rooming house was rated using the Multiphasic Environmental Assessment Procedure. Associations between the health status of residents and the physical attractiveness and organizational characteristics of rooming houses were examined. Results: Rooming house residents aged 35 years and older had significantly poorer health status than their counterparts in the Canadian general population. Eight of the ten dimensions of individual health status assessed by the SF-36 were significantly correlated with the physical attractiveness of the rooming house in which the individual lived. However, there was no significant association between residents' health status and the rooming house's non-profit status, provision of meals, or the presence of an on-site landlord. Conclusions: Rooming house residents suffer from a high prevalence of ill health. Residents reporting worst health are concentrated in rooming houses in the poorest physical condition. This relationship may be mediated by selection processes that place the sickest individuals in the lowest-quality rooming houses, and/or by a direct effect of adverse housing conditions on health status. Further research is needed to elucidate these processes and to improve the health of this vulnerable population.

The Canadian Journal of Psychiatry, Apr 1, 2001

Ob jec tive: To de ter mine whether the view ing of a video de pict ing the suc cess ful strug gl... more Ob jec tive: To de ter mine whether the view ing of a video de pict ing the suc cess ful strug gles of home less per sons with men tal ill ness in find ing and main tain ing hous ing can have a posi tive im pact on at ti tudes to ward home less per sons with men tal ill ness. Method: Five hun dred and seventy-five high school stu dents at tend ing a brief edu ca tional ses sion on men tal ill ness par tici pated in 1 of 3 com pari son ver sions of the 2-hour pro gram (con trol, video, video plus dis cus sion). All com pleted an "At ti tudes to ward Home less ness and Men tal Ill ness Ques tion naire." Demo graphic and prior ex po sure vari ables were en tered as co vari ates in between-group analy ses of vari ance. Re sults: Fe males and sub jects who had more prior en coun ters with home less per sons were found to have the most posi tive at titudes. Af ter con trol ling for these ef fects, the video alone had a nega tive im pact on at ti tudes rela tive to the other groups, while the video fol lowed by a dis cus sion with one of the peo ple fea tured in it had a largely posi tive im pact. Con clu sions: The ap par ent im me di acy and the evoca tive power of video pres en ta tions can not sub sti tute for di rect con tact for the pur pose of pro mot ing posi tive at ti tude change. The find ings are con sis tent with prior re s earch em pha siz ing the im por tance of direct in ter ac tion with mem bers of stig ma tized groups to re duce nega tive at ti tudes. Edu ca tion pro grams try ing to des tig ma tize men tal ill ness and home less ness us ing vid eos should pro ceed with cau tion.

Journal of Urban Health-bulletin of The New York Academy of Medicine, Jul 23, 2009

Homeless individuals often suffer from serious health problems. It has been argued that the homel... more Homeless individuals often suffer from serious health problems. It has been argued that the homeless are socially isolated, with low levels of social support and social functioning, and that this lack of social resources contributes to their ill health. These observations suggest the need to further explore the relationship between social networks, social support, and health among persons who are homeless. The purpose of this study was to examine the association between multidimensional (cognitive/ perceived and behavioral/received) social support and health outcomes, including physical health status, mental health status, and recent victimization, among a representative sample of homeless individuals in Toronto, Canada. Multivariate regression analyses were performed on social support and health outcome data from a subsample of 544 homeless adults, recruited from shelters and meal programs through multistage cluster sampling procedures. Results indicated that participants perceived moderately high levels of access to financial, emotional, and instrumental social support in their social networks. These types of perceived social supports were related to better physical and mental health status and lower likelihood of victimization. These findings highlight a need for more services that encourage the integration of homeless individuals into social networks and the building of specific types of social support within networks, in addition to more research into social support and other social contextual factors (e.g., social capital) and their influence on the health of homeless individuals.

IEEE Pulse, Nov 1, 2015

Training people seeking to develop the diverse skill set needed to create, test, and commercializ... more Training people seeking to develop the diverse skill set needed to create, test, and commercialize health care solutions, predictably, Learning each time you iterate can be enhanced through interdisciplinarity. linking engineering and Medical Training

Community Mental Health Journal, Jun 1, 1996

Although placement in community housing is a frequent intervention with populations of seriously ... more Although placement in community housing is a frequent intervention with populations of seriously mentally ill homeless individuals, there has been little formal investigation of the criteria used by clinicians in screening individuals for such placement. In this paper, we describe screening a population of 303 homeless people with severe mental illness for placement in independent apartments. We assess subjects' level of risk along multiple dimensions and determine the contribution of each risk dimension to the final safety decision. In addition, we evaluate the validity of the risk measures with other measures of clinical condition. Two-thirds of the sample were judged as safe for independent living. Assaultiveness was the most frequent risk identified, followed by self-destructiveness, substance abuse, and medication non-compliance. The final safety decision was associated most strongly with assaultiveness, selfdestructiveness, and medication non-compliance. We conclude that it is possible to assess risk with measures that are available from shelter and medical records, and call for more research on the role of medication non-compliance in safety decisions and for longitudinal research to validate risk assessments.

BMC Public Health, Feb 24, 2010

Background: Drug use is believed to be an important factor contributing to the poor health and in... more Background: Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods: Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Results: Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI-6.5 to-3.2) but not with poorer physical health status (-0.03 points, 95% CI-1.3 to 1.3)). Conclusions: Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

Rooming houses are an important source of housing for low-income Canadians. Little information is... more Rooming houses are an important source of housing for low-income Canadians. Little information is available on the relationship between housing conditions and health status in this vulnerable population. Interviews were conducted with a representative sample of 295 residents in 171 rooming houses in Toronto. Health status was assessed using the SF-36. The physical attractiveness of each rooming house was rated using the Multiphasic Environmental Assessment Procedure. Associations between the health status of residents and the physical attractiveness and organizational characteristics of rooming houses were examined. Rooming house residents aged 35 years and older had significantly poorer health status than their counterparts in the Canadian general population. Eight of the ten dimensions of individual health status assessed by the SF-36 were significantly correlated with the physical attractiveness of the rooming house in which the individual lived. However, there was no significant association between residents' health status and the rooming house's non-profit status, provision of meals, or the presence of an on-site landlord. Rooming house residents suffer from a high prevalence of ill health. Residents reporting worst health are concentrated in rooming houses in the poorest physical condition. This relationship may be mediated by selection processes that place the sickest individuals in the lowest-quality rooming houses, and/or by a direct effect of adverse housing conditions on health status. Further research is needed to elucidate these processes and to improve the health of this vulnerable population.

The Canadian journal of gastroenterology, 2009

The organizers thank AstraZeneca Canada Inc, the CIHR-Institutes of Nutrition, Metabolism and Dia... more The organizers thank AstraZeneca Canada Inc, the CIHR-Institutes of Nutrition, Metabolism and Diabetes, and the CCFC for their generous support of this meeting, the ninth of its kind. In addition, we thank the invited faculty, Drs

Journal of Psychology & Psychotherapy, Nov 9, 2017

The Canadian journal of gastroenterology, 2010

IBD anD the mIcroBIome Understanding the microbiome Advances in genome sequencing technologies an... more IBD anD the mIcroBIome Understanding the microbiome Advances in genome sequencing technologies and bioinformatics have created a new field of research-metagenomicsthat enables comprehensive analysis of entire microbial communities, even those that cannot be cultured. The Human Microbiome Project (HMP) and the associated Canadian Microbiome Initiative are examining the composition of human microbial communities. Genetic and environmental factors such as geography, diet, age and lifestyle, influence an individual's microbiota. Although more than 500 bacterial species are represented in the human microbiome, most belong to only three phyla: Firmicutes, Bacteroidetes and Proteobacteria. Associations have already been made between colonizing microbes and some chronic diseases (7). It is anticipated that this tremendous undertaking will clarify the relationship between innate microbial communities and human health and disease.

Journal of health & medical informatics, Nov 22, 2016

and relation to health status

Journal of Psychology & Psychotherapy, Nov 9, 2017