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This paper examines how children and families of diverse ethnic backgrounds perceive, understand and treat symptoms related to functional gastrointestinal disorders (FGIDs). It is questioned how different ways of dealing with medical uncertainty (symptoms, diagnosis) may influence treatment pathways. Semi-structured interviews were conducted with 43 children of 38 family groups of immigrant and non-immigrant backgrounds. The analysis takes into account (a) the perceived symptoms; (b) the meaning attributed to them; and (c) the actions taken to relieve them. The social and cultural contexts that permeate these symptoms, meanings and actions were also examined. It is found that, in light of diagnostic and therapeutic uncertainty, non-immigrant families are more likely to consult health professionals. Immigrant families more readily rely upon home remedies, family support and, for some, religious beliefs to temper the uncertainty linked to abdominal pain. Furthermore, non-immigrant children lead a greater quest for legitimacy of their pain at home while most immigrant families place stomach aches in the range of normality. Intracultural variations nuance these findings, as well as family dynamics. It is concluded that different courses of action and family dynamics reveal that uncertainty is dealt with in multiple ways. Family support, the network, and trust in a child's expression of distress are key elements in order to tolerate uncertainty. Lastly, the medical encounter is described as a space permeated with relational uncertainty given the different registers of expression inherent within a cosmopolitan milieu. Narrative practices being an essential dynamic of this encounter, it is questioned whether families’ voices are equally heard in these clinical spaces. [ABSTRACT FROM PUBLISHER]

This paper uses interview data from physicians and their spouses to describe the types of spousal support physicians receive when coping with work-related stress and to explore whether they vary by occupational similarity, gender, and parental status. The physicians described receiving different types of spousal support: emotional, informational, and instrumental. Male physicians in this study often reported receiving emotional support from their spouse, consistent with the support gap hypothesis in the literature. An unexpected finding is that from the responses of the physicians’ spouses, the husbands often reportedofferingemotional support to their physician spouse. Physicians who shared similar occupational and work experiences with their spouse (i.e. married to another physician) reported receiving informational support from their spouse, consistent with the theory of homophily. Finally, the findings also suggested that once physicians have children, their wives often reported providing instrumental support by being primarily responsible for childcare and housework. An interesting finding of this study is the discrepancy between the physicians and their spouses in their perceptions of support. [ABSTRACT FROM AUTHOR]

Abstract: This paper addresses the gap in health services and policy research about the implications of everyday weather for health care work. Building on previous research on the weather-related challenges of caregiving in homes and communities, it examines the experiences of ‘seasonal bad weather’ for health care workers in long-term care institutions. It features a hermeneutic phenomenology analysis of six transcripts from interviews with nurses and personal support workers from a qualitative study of institutional long-term care work in rural Canada. Focussing on van Manen's existential themes of lived experience (body, relations, space, time), the analysis reveals important contradictions between the lived experiences of health care workers coping with bad weather and long-term care policies and practices that mitigate weather-related risk and vulnerability. The findings contribute to the growing concern for rural health issues particularly the neglected experiences of rural health providers and, in doing so, offer insight into the recent call for greater attention to the geographies of health care work. [Copyright &y& Elsevier]

Conceiving the construct ‘social-emotional learning climate’ as an embodiment of Illeris’ contemporary learning theory, this paper serves dual purposes. First, it examines recent music education literature, which identifies issues of competence and institutionalised pedagogic practice in secondary school music settings that result in adolescents’ inability to target and develop personal locus of control over learning, and the subsequent rejection of the learning environment. Second, it details findings, discussion and pedagogic implications from the author's dissertation study exploring music teacher formative influence upon and student experience of Illeris’ theory of learning process within three Canadian secondary school learning settings integrating informal learning practices. [ABSTRACT FROM PUBLISHER]

The aim of this paper was to propose and test the factor structure of a new self-report questionnaire on leadership. a sample of 373 school principals in the Province of Quebec, Canada completed the initial 46-item version of the questionnaire. In order to obtain a questionnaire of minimal length, a four-step procedure was retained. first, items analysis was performed using classical test Theory. Second, Rasch analysis was used to identify non-fitting or overlapping items. Third, a confirmatory factor analysis (CFA) using structural equation modelling was performed on the 21 remaining items to verify the factor structure of the scale. Results show that the model with a single third-order dimension (leadership), two second-order dimensions (transactional and transformational leadership), and one first-order dimension (laissez-faire leadership) provides a good it to the data. Finally, invariance of factor structure was assessed with a second sample of 222 vice-principals in the Province of Quebec, Canada. this model is in agreement with the theoretical model developed by Bass (1985), upon which the questionnaire is based. [ABSTRACT FROM AUTHOR]

Abstract: An interesting question concerns how large-scale (mental) health services policy initiatives come into being, and the role of evidence within the decision-making process behind their origins. This paper illustrates the process by which motivation to address homelessness, in the context of the upcoming 2010 Vancouver Olympics, was leveraged into a pan-Canadian project including sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton, New Brunswick. The aim of the initiative was to implement and evaluate an intervention, Housing First, to provide housing and support to previously homeless people with mental illness. This qualitative case study was conducted between December 2009 and December 2010, employing grounded theory, and drawing on archival documents and interviews with 19 key informants involved in the conception of the project. Overall, the findings affirm that policy-making does not follow a rational, linear process of knowledge translation/exchange (KTE) and implementation, whereby evidence-based “products” are brought forward to address objectively determined needs and then “placed into decision-making events” (Lomas, 2007, p. 130). Instead, evidence-based policy making should be understood within the much more complex context of “policy entrepreneurship” (Kingdon, 2003; Mintrom & Norman, 2009) which entails taking advantage of windows of opportunity, and helping to bring together the “streams” of problems, politics, and policy ideas (Kingdon, 2003). [Copyright &y& Elsevier]

Currently, 15%, 12.8% and 17.1% of the Canadian, American and European populations, respectively, are 65 years or older. Due to aging-related disabilities, elderly individuals will require support from family members while in the community. Annually, family caregivers save the Canadian and American healthcare systems $25 billion and $350 billion, respectively. However, to maintain the important role they play, caregivers' experiences must be investigated in order to provide appropriate support. Despite the fact that 'caregiver burden' is preponderantly used as an indicator of the caregiving experience, much disagreement remains on what the term entails and how it should be utilized. This paper endeavors to critically discuss the concept of 'caregiver burden', its use in the literature and the implications this has for future research and clinical practice. The vagueness derived from the various 'caregiver burden' definitions limits the term's relevance to policy-making and clinical practice. Additionally, much of the literature on 'caregiver burden' is not theoretically framed, which reduces the conceptual clarity of the term. Quantitative measures are largely used to investigate 'caregiver burden', which can sometimes fail to capture contextual features that are relevant to caregiving outcomes (e.g., culture). Stress theory and role theory are recommended as guiding frameworks for future research that investigates 'caregiver burden'. Future research on 'caregiver burden' would also benefit from integrating qualitative and quantitative approaches into mixed method designs in order to gain a holistic understanding of the concept. [ABSTRACT FROM AUTHOR]

Abstract: The present study was designed to investigate links between dimensions of romantic attachment and relationship functioning in a cross-sectional sample of people in same-sex relationships, with the goals of replicating basic findings from research on heterosexual couples and advancing understanding of unique issues faced by same-sex couples. The sample included 274 female couples, 188 male couples, 34 women whose female partners did not participate, and 39 men whose male partners did not participate. Participants were recruited from geographically diverse regions of the United States and Canada and provided data by responding to pencil-and-paper surveys. Attachment insecurity in both self and partner were linked with poor relationship functioning across a range of variables (satisfaction, commitment, trust, communication, problem intensity). The pattern of results was identical for women and men, but the effects were stronger in male couples for some associations between attachment variables and indices of positive relationship functioning. Monogamy was positively associated with relationship quality only when participants or their partners reported moderate or high levels of attachment anxiety. Contrary to hypothesis, attachment did not moderate links between minority Stressors and relationship functioning. [ABSTRACT FROM AUTHOR]

The complexities of professional ethics are best understood and interpreted within their sociohistorical context. This paper focuses on the experience of 20 rural psychologists from across Canada, a context rife with demographic and practice characteristics that may instigate ethical issues. Employing hermeneutic phenomenology, these qualitative research results are indicative of professional struggles that impacted the participants' experience of professional ethics and raised key questions about policy and practise. Concerns regarding competition highlight potential professional vulnerability, beget the idea of fostering general psychological practice, and question the role of professional bodies in addressing rural shortages. Dependency on government funding models and decisions highlights the benefits and medical cost-offset effect of psychological services' role in funded medical care. The controversial prescriptive authority debate for psychologists raises myriad concerns that are particularly salient to rural practitioners. These include changes to training and practice, with risks of psychopharmacology gaining prominence over behavioural health interventions. National inconsistencies in level of registration add to the growing shortage of practitioners. Finally, the results illuminate the need for advocacy to move beyond the literature and into public policy to increase public awareness, decrease the stigma of mental illness, and develop rural Canadian psychology. Although limited to this study, these results allowed for a fuller and more robust understanding of rural practice in consideration of professional ethics, which may inform policy, science, or ethical clinical practice. [ABSTRACT FROM AUTHOR]

The science of effective offender rehabilitation remains a very young field: dominated theoretically and empirically by the work of a small group of Canadian psychologists. Their achievements include the 'what works' research literature, and the RNR model of offender rehabilitation. First disseminated in 1990, over the following 20 years, the Risk, Need and Responsivity Principles became the core of the theoretical framework used in those correctional systems around the world that use science as a basis for offender rehabilitation. This paper evaluates the strengths and weaknesses of the RNR model as a Level I rehabilitation framework. It proposes that unrealistic expectations and mistranslations of the model into practice are contributing to concerns about its validity and utility, and stifling needed innovation in the development both of mid-level treatment resources, and of RNR-adherent interventions. It concludes that although the RNR model's empirical validity and practical utility justify its place as the dominant model, it is not the 'last word' on offender rehabilitation; there is much work still to be done. [ABSTRACT FROM AUTHOR]

The Canadian government maintains an international reputation of upholding the rights of its queer citizens. However, its attitude toward the rights of queer migrants remains ambiguous. Queer migration is the movement of individuals within countries or across borders who do not fit into the dominant category of heterosexual migrants. While Canada's treatment of queer migrants has seen significant improvements in the past sixty years, analysis of the migration of same-sex couples and refugee claims based on sexuality demonstrates that immigration policy remains biased against queer migrants. Examination of current events in Canadian migration policy further emphasizes the mixed messages that Citizenship and Immigration Canada is sending to queer migrants. This paper demonstrates that such policies result in queer migrants faced with multiple conflicting identities. Overall, analysis of Canadian immigration policy shows that it remains rooted in heteronormative assumptions. [ABSTRACT FROM AUTHOR]

This paper investigates coverage of cancer in three Canadian newspapers in order to explore how the print media presents issues related to cancer risk and prevention. Six months of newspaper coverage was coded and analysed quantitatively to identify trends in coverage. A small subset of these articles was then analysed qualitatively to identify latent and underlying messages. Results from the analysis suggest that coverage emphasised risk management through individual choice and lifestyle change, privileging a discourse of individual control. Conversely, social and environmental risks related to cancer were minimised, despite the emerging academic consensus around the central importance of social and environmental determinants of health. Lifestyle was the most frequently mentioned source of cancer risk. Social and environmental health links were mentioned sparingly, and when environmental links were presented they were contested in ways that lifestyle risks were not. The coverage reflects the prevalent discourse in Canadian society that responsibility for health management risk lies primarily with the individual. [ABSTRACT FROM AUTHOR]

It has long been recognised that cancer is an extraordinarily culturally charged disease. However, while studies have provided valuable insights into the embodied experience of cancer, far less research exists on cancer patients' and survivors' perceptions of the treatments they receive and the meanings they assign to these treatments. This paper focuses specifically on chemotherapy – a highly feared form of treatment that is often popularly depicted to be worse than the experience of cancer itself. Drawing on ethnographic fieldwork over an 8-month period at a cancer support group in western Canada, this article explores patient perceptions of adjuvant chemotherapy. I argue that a widespread cultural model of chemotherapy exists that emphasises the value of suffering as a means of tracking treatment effectiveness and the possibility of cure. However, this framework diverges from biomedical understandings of treatment in important respects, with implications for patient anxiety levels during treatment and their subjective assessments of the future risk of recurrence. Overall, research findings highlight the need to pay closer attention to the meanings patients assign to cancer treatments and call for further research in this area. [Copyright &y& Elsevier]

Using 1996/1997 to 2000/2001 data from the Canadian National Longitudinal Survey of Children and Youth, this paper examines the effects of harassment on self-rated and mental health status among Canadian adolescents aged 16–17 years. Forty-six percent of the children experienced harassment and victimization (verbal aggression, threat, and physical harm/assault) at school and 40% outside of school. Harassment at school, rather than otherwise, was associated with poor health status and higher levels of depression even when previous health conditions and socio-demographic variables were held constant. The relationship between harassment and mental health is particularly pronounced among girls, immigrant children and those living in single-parent households. Given the sizable proportion of adolescents as victims of harassment at school and its significant relationship with both health status and depression, the issue warrants serious public health attention through school-based intervention programs. [Copyright &y& Elsevier]

In this paper we examined discourses of mothers who use substances. Focus groups were conducted at two different treatment programmes with diverse women who identified as mothers challenged by substance use. Real scenarios were presented to the participants and feedback was sought about how the women within the scenarios managed their situations and the actions taken by legal, media, and health authorities. Through the use of three lenses - rights, risks, and evidence - we identified four major discourses in the participants' talk. The 'good mother', 'bad mother', 'thwarted mother' and 'addicted mother' discourses revealed the multiple and at times contradictory ways the women made sense of their lives. Within all of the discourses the mother-child bond and the importance of providing necessary supports to mothers with substance-use problems were central. The women's discourses highlighted the challenges of negotiating the prevailing attitudes, practices and stigmas of being a substance-using mother while trying to do the right thing for their children. [ABSTRACT FROM AUTHOR]

Background: There is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider. However, the data show that SDM has not been broadly adopted yet. Consequently, the main goal of this proposal is to bring together the resources and the expertise needed to develop an interdisciplinary and international research team on the implementation of SDM in clinical practice using a theory-based dyadic perspective. Methods: Participants include researchers from Canada, US, UK, and Netherlands, representing medicine, nursing, psychology, community health and epidemiology. In order to develop a collaborative research network that takes advantage of the expertise of the team members, the following research activities are planned: 1) establish networking and on-going communication through internet-based forum, conference calls, and a bi-weekly e-bulletin; 2) hold a two-day workshop with two key experts (one in theoretical underpinnings of behavioral change, and a second in dyadic data analysis), and invite all investigators to present their views on the challenges related to the implementation of SDM in clinical practices; 3) conduct a secondary analyses of existing dyadic datasets to ensure that discussion among team members is grounded in empirical data; 4) build capacity with involvement of graduate students in the workshop and online forum; and 5) elaborate a position paper and an international multi-site study protocol. Discussion: This study protocol aims to inform researchers, educators, and clinicians interested in improving their understanding of effective strategies to implement shared decision-making in clinical practice using a theory-based dyadic perspective. [ABSTRACT FROM AUTHOR]

Since 2000, Canada has mandated the use of a set of 16 rotating graphic warning labels that cover the top 50 percent of the front and back of each cigarette package. This paper examines the issue of tobacco warning labels within the context of the Protection Motivation Model. Based on this psychological model, we provide recommendations as to how tobacco warning labels could be revised to include specific recommendations and coping advice that would outline the benefits of quitting (response efficacy) and offer encouragement (self-efficacy). [ABSTRACT FROM AUTHOR]

Drawing upon a discourse analysis of public-use policy documents and qualitative interview data, this paper explores how mothers on social assistance in three Canadian provinces balance actual or expected policy expectations of their employability (e.g., participation in welfare-to-work programming) with their caregiving responsibilities. The results suggest that mothers’ experiences of a time crunch, overload, and interference varied depending on their employability status and that they often experienced work-family conflict in ways similar to that experienced by working mothers not on assistance. The policy implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Stress is one byproduct of hectic and busy lives. Therefore, examining active living and leisure in relation to stress and coping offers an important area of study. This paper presents key findings from a multi-year qualitative study of stress and coping. A series of focus groups were conducted with diverse residents of a western Canadian city including: (a) Aboriginal individuals with diabetes, (b) individuals with disabilities, and (c) people who identified as gay or lesbian. The findings emphasized that active leisure is more than physical activity, and that less physical forms of leisure should not be undervalued in the conceptualization of active living and leisure. Coping with stress using active leisure encompassed a wide range of meanings (e.g., spiritual, social, cultural, altruistic, empowerment). [ABSTRACT FROM AUTHOR]

This paper describes four studies on self-reported problems in 2,243 adolescent males and females, 12 to 17 years of age. In Study 1, principal-axis factoring of 102 items covering 11 problem domains revealed six factors comprising 49.5% of the variance. Study 2 used confirmatory factor analysis of a 64-item reduced set on a new sample of 408 adolescents. Goodness-of-fit indicators suggested that the six-factor model had excellent fit to the data. Study 3 used data from the 2,157 adolescents used in the first two studies. Coefficient alphas ranged from .83 to .92. Median test-retest reliability for the six factors was .86. There was a consistent structure of the correlation matrix across age and gender. Study 4 was a study of criterion validity, using an additional sample of 86 children with attention-deficit hyperactivity disorder (ADHD). Sensitivity and specificity were high, with an overall diagnostic efficiency of 83%. This new self-report scale, the Conners/Wells Adolescent Self-Report of Symptoms (CASS), may provide a useful component of a multimodal assessment of adolescent psychopathology. [ABSTRACT FROM AUTHOR]

In 1974, the Liberal government of Pierre Trudeau released a "green paper" known as the Lalonde Report, after the health minister at that time. The report formulated perspectives on health and the main concepts and ideas developed in it, particularly the concept of "lifestyle," which became the foundation of public health policies in many different European countries and the United States. The concept of "lifestyle" connected personal behaviour and habits to the individual health condition; people were not dying due to a lack of access to medical care but because they lived a life prone to personal risk taking. Furthermore, what is seldom discussed is that this report not only propagated the (neo)liberal view of citizens as autonomous rational actors (homo oeconomicus), with personal responsibility for their health, but it was a first step in the transformation of Medicare and went far beyond the question of health promotion. Health was no longer something that happened to a person but was created through personal choice and, therefore, one had to assume responsibility for one's behaviour. Using Foucault's definition of government as the "conduct of conduct," we will demonstrate that the Lalonde report must be understood as a specific "technology of government" and contributed to a neoliberal transformation of health care despite the fact that the Canadian system of Medicare was based on the idea of universality, meaning citizens had equal access to health care independent of their socio‐economic situation. As we will demonstrate, the Lalonde report undermined this foundation and initiated a profound reorientation, not only of the healthcare system, but even more importantly, it radically changed the way we think about our behaviour around health‐related issues. We will also discuss how the making of the report contributed to the redefinition of politics and demonstrated a lack of concern with liberal‐democratic decision‐making processes. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which discusses various papers published within the issue, including one on adolescent distress following a separation period from their fathers, one on the effects of bullying on adolescent victims, and another on the prevalence of attention-deficit hyperactivity disorder (ADHD) in young adults.

Presents an abstract of the paper `Parents' work overload and problem behaviour in young adolescents,' by N. Galambos, H. Sears et al published in the `Journal of Research on Adolescence' about the relationship between parental work overload and problem behavior in young Canadian teenagers.