Guidance to (Re)integrate Caregivers as Essential Care Partners Into the LTC Setting: A Rapid Review.

OBJECTIVES: This rapid review aimed to identify the strategies used to (re)integrate essential caregivers (ECs) into the LTC setting, particularly pertaining to principles of equity, diversity, and inclusion. In addition, this rapid review aimed to identify the strategies used during prior infectious disease threats, when similar blanket visitor restrictions were implemented in LTC homes. The review was part of a larger effort to support LTC homes in Ontario. DESIGN: A rapid review was conducted in accordance with principles from the Canadian National Collaborating Centre for Methods and Tools. SETTING AND PARTICIPANTS: ECs, residents, staff, and policy decision makers in long-term care home settings. METHODS: Five electronic databases were searched for academic and gray literature using predefined search terms. Selected documents met inclusion criteria if they included policy guidance or an intervention to (re)integrate ECs into LTC homes at the local, national, and/or international level. RESULTS: In total, 15 documents met the inclusion and exclusion criteria. All documents retrieved focused on the context of COVID-19. Documents were either policy guidance (n = 13) or primary research studies (n = 2). Documents differed in these notable ways: Definition of EC; the degree to which an EC is recognized for her or his role in the care of the resident; the degree to which ECs are (re)integrated into the LTC setting is prioritized; response to community spread of COVID-19; visitation during an outbreak or if a resident is symptomatic; the reliance on equity, diversity, and inclusion principles; and lastly, monitoring and improving the process. CONCLUSIONS AND IMPLICATIONS: Using an equity, diversity, and inclusion lens, we posit promising practices for (re)integration. It is clear from the rapid review that more research is needed to understand the efficacy of policies and guidelines to (re)integrate ECs into the LTC setting. Until such evidence is available, expert opinion will drive best care practices.

Recommendations: Will the Tobacco and Vaping Products Act go far enough?

E-cigarette use among adolescents and young adults in Canada is increasing. Potvin's (2016) editorial outlined the need for more evidence on e-cigarettes as a gateway to combustible cigarettes and their toxicity. Since then, new evidence has emerged supporting the gateway effect and establishing toxicity. Health Canada has reviewed the evidence and recently opted to regulate e-cigarettes, including prohibiting brick-and-mortar retail access for youth under 18 years of age. However, many online e-cigarette retailers exist, which increases adolescents' access to e-cigarettes and currently unregulated nicotine-containing refills. Recent evidence on the toxicity of particular compounds in e-cigarette refills has demonstrated how these compounds may be amplified by certain types of e-cigarette devices. The toxicity of e-cigarettes is not only of concern to the user but potentially a concern to the public as well. The message that e-cigarettes have a benign effect on users and the public needs to change and should be reflected in Health Canada's future regulations concerning the Tobacco and Vaping Products Act.