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Building upon two previously published research papers exploring Canadian media reporting of childhood in the first wave of the pandemic, this paper investigates how constructions of childhood evolved from the first wave to the fourth wave of the pandemic. This qualitative research is guided by the central research question: Over the span of 2 years, from 2020 to 2022, what changes are evident in discourses reported within media focused on the impact of the COVID-19 global pandemic on Canadians under the age of 18 years? Findings from this study suggest that in the fourth wave young people were constructed as innocent victims of pandemic restrictions framed through an adult-centric lens; noticeably absent were representations of young people under the age of 18 in their voices. A key recommendation emerged from this study: any future research investigating the impact of the pandemic on young people under aged 18 years must include their full participation. [ABSTRACT FROM AUTHOR]

There exist ongoing calls among social work scholars and practitioners to cultivate applied knowledge of critical and emancipatory practice. In this paper, I explore the utility of text-based vignettes as instruments that can be used to elicit insight from marginalized service users on critical social work practice. To do this work, I draw on data from interviews with 20 transgender and gender diverse (TGD) social service users, along with 10 social workers, whose responses to a text-based vignette were originally used to build an understanding of the constituents of equitable social work practice with TGD people. Incorporating critical pragmatism as a conceptual framework and constructivist grounded theory as a methodological orientation, I analyze data from this study as an exemplar that substantiates the promise of using text-based vignettes in qualitative social work research to generate knowledge of critical social work practice. Specifically, I demonstrate how text-based vignettes in this study (1) contextualized the meaning, significance, and impact of oppression for service users, (2) built insight on practice that reflects solidarity and allyship, and (3) identified opportunities for social workers' reflexive use of professional power to effect change. Accounting for the tensions between empiricism and critical praxis in social work, I consider the promise of incorporating text-based vignettes to develop empirical social work literature that is rooted in the voices of marginalized service users. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

There has been no shortage of literature that has focused on the role of money in politics. While the majority has focused squarely on the fundraising activities and spending preferences of parties and candidates, far less has paid attention to the spending habits of corporations, unions and interests that often register as non-parties. Yet these actors have gained prominence across general elections and referendum campaigns in the past decade owing to the increase in funds spent to influence election outcomes. Little is known about what the public thinks about the participation of these actors in campaigns. Yet public opinion toward non-party campaign spending is important to the degree that it effects perceptions of electoral integrity and might compel policy change. This paper uses new survey data collected from Canada and the UK to answer questions about how citizens perceive non-party campaign spending and what informs attitudes toward non-parties. We find that the public in both countries have mixed views on the participation of non-parties, but that there is some evidence that core concerns about electoral interiority and perceptions toward the role of money in politics drives opinion. [ABSTRACT FROM AUTHOR]

As part of the response to Canada's worsening overdose crisis driven by a toxic, adulterated drug supply, there has been increased attention to and expansion of drug treatment, options, including injectable opioid agonist treatment (iOAT). iOAT typically involves the, witnessed daily injection of opioids under healthcare provider supervision. There is a robust, evidence base on iOAT; however, there has been less focus on how people engage with this; treatment outside of clinical trials. This paper examines how people engage with iOAT programs, in expanded treatment settings in Canada, focusing on how the broader socio-structural context, shapes patient subjectivities in treatment. This study draws on critical ethnographic and community-based research approaches, conducted with people accessing four iOAT programs in Vancouver's Downtown Eastside; neighbourhood from May 2018 to November 2019. Data included in-depth baseline and followup, interviews and approximately 50 h of observation fieldwork conducted in one iOAT, program and with a subsample of participants in the surrounding neighbourhood. Analysis, leveraged the concepts of biological citizenship and structural vulnerability. This analysis characterized three narrative frames— regular long-term engagers, pain, patients, and sporadic and short-term engagers —through in-depth case presentations of participants with distinct types of engagement with iOAT programs. Participants within these, narrative frames described a dominant form of iOAT citizenship, an autonomous patient who, regularly engages in treatment and avoids pleasure. However, structural vulnerabilities, including, homelessness and housing instability, entrenched poverty, criminal-legal system engagement, and unmanaged pain, shaped the ability of participants to make claims to this normative model of citizenship. This study examined how structural vulnerabilities impact people's construction and ability to make iOAT citizenship claims. Findings point to the need for changes within and outside of iOAT programs, such as lower threshold treatment models, improved social services (e.g., secure housing), and pain management support. • Biological citizenship used to examine how people engage with iOAT. • Narrative frames used to explore patterns of iOAT engagement. • These served as alternate to iOAT citizenship framed by treatment. • Unmanaged pain, housing instability, and poverty impacted treatment engagement. [ABSTRACT FROM AUTHOR]

Stigma of mental illness contributes to silence, denial and delayed help seeking. Existing stigma reduction strategies seldom consider gender and cultural contexts. The Strengths in Unity study was a multi-site Canadian study that engaged Asian men in three stigma reduction interventions (ACT, CEE, psychoeducation) and mobilized them as Community Mental Health Ambassadors. Our participants included both men living with or affected by mental illness (LWA) as well as community leaders (CL). This paper will: (1) describe the baseline characteristics of the Toronto participants including their sociodemographic information, mental illness stigma (CAMI and ISMI), attitudes towards social change (SJS), and intervention-related process variables (AAQ-II, VLQ, FMI, Empowerment); (2) compare the differences among these variables between LWA and CL; and (3) explore factors that may correlate with socio-economic status and mental health stigma. A total of 609 Asian men were recruited in Toronto, Canada. Both CL and LWA had similar scores on measures of external and internalized stigma and social change attitudes, except that LWA had more positive views about the acceptance and integration of those with mental illness into the community on the CAMI, while CL had a higher level of perceived behavioral control on the SJS. Group differences were also observed between LWA and CL in some process-related variables. Exploratory analysis suggests that younger and more educated participants had lower stigma. Our findings underscore the importance of engaging both community leaders and people with lived experience as mental health advocates to address stigma. [ABSTRACT FROM AUTHOR]

Introduction: Students from low‐income backgrounds (LIB) have been under‐represented in Canadian medical schools for over fifty years. Despite our awareness of this problem, little is known about the experiences of aspiring physicians from LIB in Canada who are working towards medical school admission. Consequently, we have little insight into the barriers and facilitators that may be used to increase the representation of students from LIB in Canadian medical schools. Methods: This paper describes a qualitative description interview study aimed at understanding the experiences of aspiring physicians from LIB as they attempt to gain entry to medical school. We conducted semi‐structured interviews with 21 participants at different stages of their undergraduate, master's, and non‐medical professional education, and used the theories of intersectionality and identity capital as a theoretical framework for identifying barriers and facilitators to a career in medicine. Results: Participants experienced social, identity‐related, economic, structural and informational barriers to a career in medicine. Intrinsic facilitators included motivation, self‐confidence, attitude, strategy, information‐seeking and sorting, and financial literacy and increasing income. Extrinsic facilitators were social, informational, financial and institutional in nature. Conclusion: This study fills existing knowledge gaps in the literature by identifying the pre‐admissions barriers and facilitators encountered by aspiring physicians from LIB in Canada. The barriers and facilitators outlined in this study offer a framework for identifying target areas in developing support for admitting medical students from LIB. Given that medical students from LIB are more likely to serve underserved populations, our study is relevant to Canadian medical schools' social accountability commitment to producing physicians that meet the health needs of marginalised and vulnerable patients. Out of concern for socioeconomic diversity, the authors apply an intersectional approach to examine the barriers and facilitators faced by aspiring physicians from low‐income backgrounds. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of immigrant women with visual impairment in the Greater Toronto and Hamilton Area (GTHA) of Canada. Conceptually, the paper draws from feminist disability theory and critical scholarship on blindness to consider the discursive and material processes shaping women’s experiences across different socio-cultural contexts. Empirically, the paper draws from in-depth interviews with seven women. The analysis is organized around three themes. The first explores women’s understandings of visual impairment. The second examines the ways in which women’s experiences of visual impairment are shaped by meanings and attitudes that circulate within their cultural communities, and the extent to which immigration might challenge or reinforce these meanings. The third examines the shifting barriers and opportunities women face with respect to social and economic participation. We close by identifying the conceptual implications of our research. [ABSTRACT FROM AUTHOR]

The current paper presents the results of a national survey of 190 full-time members of Canadian sociology departments to examine the state of the discipline in 2014-15. The paper focuses on the extent of epistemological diversity in an effort to answer two key questions. First, what intellectual perspectives prevail among Canadian sociologists and, along these lines, does any particular perspective hold greater prominence? Second, what might explain the variation in the epistemological stances most commonly endorsed? The evidence reveals a preponderance of critical and feminist scholars, which can be explained in large measure by considering the social locations of sociological practitioners. The results of a logistic regression model confirm that gender, generation, geography, and disciplinary genre are significant predictors of critical and critical-feminist orientations. A discussion of qualitative responses fleshes out the dominant themes that Canadian scholars expressed in their survey responses. [ABSTRACT FROM AUTHOR]

With the human papillomavirus (HPV) vaccine positioned as the "right tool" to protect girls' health and sexual health, public discourse positions parents as "responsible" if they vaccinate, "irresponsible" if they do not. The problem with this binary, however, is that it cannot account for the full spectrum of responsibilities and social norms that parents enact in vaccine decisions. In this paper, and in the context of low HPV vaccination rates, I confront this binary and encourage a fuller view of adolescent health and sexual health. Using data from qualitative semi‐structured interviews with 28 Canadian mothers tasked with consenting to the HPV vaccine, I examine the complexity of this responsibility. I find HPV vaccine‐consenting mothers have normative conceptualisations of responsibility aligned with dominant interpretations of public health. Rather than expressing irresponsibility, some non‐HPV vaccine‐consenting mothers articulated alternate responsibilities, aligned with broad efforts to manage their teens' sexual health and sexuality. They extend responsibility beyond cancer protection vis‐à‐vis vaccines to a general responsibility for daughters' sexual health and self‐esteem. In conclusion, I recommend the need for a broader public health approach to HPV, which includes, and goes beyond vaccination. Moreover, I suggest that some of these alternate responsibilities be viewed as complementary to vaccination. [ABSTRACT FROM AUTHOR]

Background: HPV vaccine has been described as a very efficacious and safe vaccine, making it highly acceptable for the prevention of potential cervical cancer. However, rejection of vaccine use is on the rise. This paper aims to showcase the benefit of educational intervention as an avenue to increase the rate of vaccination among the high-risk population. Hypothesis: Parental education on HPV vaccine will improve the rate of vaccination acceptance. Methods: Databases including PubMed, Google Scholar, Science-Direct and Web of Science were searched for studies pertaining to the effects of educational intervention on HPV vaccine receipt. Results: A total of 11 articles were included in this review. Eight studies targeted high-risk minors of recommended ages for the HPV vaccine. The parents of these minors were then assessed pre- and post-intervention to study the effect of educational intervention on intent to vaccinate against HPV. Three studies focused on the effect of educational intervention targeted to adolescents and young adults ages 18-22 on intent to vaccinate against HPV. Results compared the intent to vaccinate in groups exposed to the educational intervention versus groups without intervention. Percentage increase in the intent to vaccinate was reported for all groups exposed to educational intervention versus groups without intervention. Conclusion: The increase in the percentage of participants with intent to vaccinate reflects the importance of individual knowledge. Future studies should focus on methods that improve dialogue and acceptance with groups of different ethnicity and cultures. [ABSTRACT FROM AUTHOR]

Aim: To explore the views and practices of paediatric occupational therapists and physical therapists in Canada and the USA regarding the implementation of power mobility for children with mobility limitations.Method: This descriptive study utilized a web-based survey that included questions pertaining to therapists' decisions to trial and use power mobility, agreement or disagreement with statements developed from published practice considerations regarding power mobility, and the frequency of performing tasks related to power mobility prescription and training.Results: Most respondents reported that child characteristics (e.g. cognition, safety awareness) were important factors in decision-making about power mobility, whereas other child characteristics (e.g. communication abilities, age) were not as important. Family resources and home accessibility were also not considered important. The average age at which respondents considered power mobility for children was 2 years 3 months. The majority of respondents agreed with statements developed from published practice considerations and most frequently performed various power mobility tasks twice a year or less.Interpretation: Although most respondents appeared to have positive views regarding power mobility, few appeared to actively perform power mobility tasks in their practice. Resources to support therapists in the early introduction of power mobility may be beneficial.What This Paper Adds: Occupational and physical therapists positively view early introduction of power mobility for children with mobility limitations. Few therapists actively provide early power mobility experiences. Power mobility training and monitoring power mobility devices are important therapist roles. [ABSTRACT FROM AUTHOR]

In light of recent interest in the theoretical foundations of policy paradigms, this paper aims to specify the qualities that differentiate paradigmatic from non-paradigmatic policy ideas. While the incommensurability thesis that underlies the concept of paradigms has been the target of much criticism, there is something intuitively appealing about the incommensurability of policy alternatives that is not yet fully understood. Hesitant to abandon completely the notion of incommensurability, this paper emphasizes the relative nature of ideational commensurability and provides an account of how the exclusivity of a paradigm may wither in relation to competing perspectives. The empirical section demonstrates this pattern of paradigmatic policy-making by examining solutions advanced to alleviate problems in Canadian trade-industrial policy between 1975 and 1995. Contrary to the popular perception that paradigmatic ideas yield policy stability, the findings suggest that even in areas where clearly articulated paradigms initially exist, strictly paradigmatic thinking is often fleeting. [ABSTRACT FROM AUTHOR]

Abstract: Using theory syllabi and departmental data collected for three academic years, this paper investigates the institutional practice of theory in sociology departments across Canada. In particular, it examines the position of theory within the sociological curriculum, and how this varies among universities. Taken together, our analyses indicate that theory remains deeply institutionalized at the core of sociological education and Canadian sociologists’ self‐understanding; that theorists as a whole show some coherence in how they define themselves, but differ in various ways, especially along lines of region, intellectual background, and gender; that despite these differences, the classical versus contemporary heuristic largely cuts across these divides, as does the strongly ingrained position of a small group of European authors as classics of the discipline as a whole. Nevertheless, who is a classic remains an unsettled question, alternatives to the “classical versus contemporary” heuristic do exist, and theorists’ syllabi reveal diverse “others” as potential candidates. Our findings show that the field of sociology is neither marked by universal agreement nor by absolute division when it comes to its theoretical underpinnings. To the extent that they reveal a unified field, the findings suggest that unity lies more in a distinctive form than in a distinctive content, which defines the space and structure of the field of sociology. [ABSTRACT FROM AUTHOR]

Healthy eating campaigns that promote unprocessed foods to children using character licensing and fun appeals hope to offset the aggressive marketing of highly processed, unhealthy foods to children. Such campaigns are equally premised on the assumption that fruits, vegetables, and other whole foods are not desirable enough in the current food environment and must be marketed as child friendly to be appealing. This paper examines how children in Canada classify foods and whether they think of whole, unprocessed foods as ‘for them.’ Children aged 7–12 (n = 183) completed a survey asking them to classify various foods (fruit, vegetables, milk, eggs, beef, whole grains) as for ‘kids’, ‘adults’ or ‘both’. Most children classified these foods as for both adults and kids, suggesting that promotional initiatives to convince children that whole foods are uniquely children’s fare may not be necessary. Given the questionable efficacy of marketing whole foods as fun and ‘for kids,’ alongside the ethical stakes of commercializing childhood, we recommend that public health initiatives reject attempts to market whole foods as kids’ foods. Instead a key opportunity exists to emphasize the message that good food is for everyone – which is the most conducive to a building a healthy food environment and positive food habits across a lifetime. [ABSTRACT FROM PUBLISHER]

Accessible summary What Is Known on the Subject? Psychiatric day hospital (DH) treatment has been offered since the 1930s and is appropriate for individuals experiencing intense psychiatric symptoms without requiring 24-hour inpatient care., No empirical research has examined the specific purpose of DH treatment from the perspectives of healthcare providers within these programs., What This Paper Adds To Existing Knowledge? This study was the first to address the question of the purpose and function of DH treatment from the outlook of frontline workers within this setting, and confirmed anecdotal observations that DH treatment provides an alternative to intensive psychiatric care, and also operates as 'bridge' between these intensive services and purely outpatient treatment., Additional information emerged, such as the importance of the name of DH programs avoiding connotations of illness, the benefits and skills that draw patients to these programs, and challenges that staff and patients experience within DH programs (e.g. short length of treatment, barriers to treatment access)., What Are the Implications for Practice? This information can enhance curriculum development within these settings. For example, given the importance of skill building, it is essential to integrate the provision of skill building and coping strategies within these settings., In addition, given that the name of the setting can impact staff (and perhaps service users as well), ensuring that the name of such program highlight wellness and recovery may enable a different type of therapeutic community to develop within these settings., Abstract Introduction Despite the benefits of psychiatric day hospitals ( DH), research has not addressed staff perspectives of these programs' effectiveness and barriers. Aim To elucidate staff perceptions of Adult Mental Health DH programs at two hospitals in Canada, allowing for improved programming, enhanced structure and increased understanding of DH settings within the continuum of care. Method Twenty-five DH staff members completed semi-structured qualitative interviews. Two independent coders applied content analysis to achieve data saturation. Results Four major themes emerged: (1) program purpose and function, (2) what is in a name, (3) perceived patient motivation, and (4) room for improvement. Discussion Findings highlighted the importance of a multidisciplinary team delivering education and skill-focused interventions. Services were cited as 'bridging' different mental health settings. Challenges included barriers to treatment access and inadequate length of treatment. Implications for Practice Understanding the function and purpose of this treatment service may enhance service delivery by enabling programs to integrate identified key ingredients. Providers can also note treatment duration and consider how to best use that time. Finally, language used within a DH setting appears to impact staff delivering services, and may also alter patients' understanding of the services they will receive and purpose of the program. [ABSTRACT FROM AUTHOR]

This paper explores Canada's accelerated expansion of international university enrollments from the perspective of 72 international students and graduates from 29 countries, who participated in semi-structured interviews conducted in the four provincial capitals of Canada's Atlantic region. Addressing the emerging campus diversity and incoming students' immigration potential, this research illustrates that students encounter campus dynamics and immigration policy landscapes shaped by long-spanning histories of race and ethnic relations, by current multi-scalar iterations of economic development, and by regional reorganizations of immigration and higher education in Canada. In turn, the ways students experience and negotiate their positions within these contexts is directed by multigenerational projects of geographic and social mobility, to include key lessons learned about the possibility of long-term settlement in Canada. Set in less populous urban centers in Canada's Atlantic provinces, the outcomes reported here also provide an opportunity to explore international students' experiences outside Canada's large metropolitan areas and more predictable sites of education internationalization. [ABSTRACT FROM AUTHOR]

Purpose:In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Methods:Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. Results:From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults’ functional capabilities. Professionals’ primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting “rehabilitation” stay was more akin to an extended process of “destination triage” biased towards the promotion of physical safety than optimizing functioning. Conclusions:The resulting reduction of rehabilitation into “destination triage” has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for RehabilitationCurrent trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation.Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation.Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members. [ABSTRACT FROM PUBLISHER]

Background: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs.Methods: We conducted in-depth case studies in three primary care medical practices in Canada where physicians had been using EMR systems for 3 years or more. A total of 37 semi-structured interviews were conducted with key informants: family physicians (about half of the interviews), nurses, secretaries, and administrative managers. Additional information was obtained through notes taken during observations of users interacting with their EMR systems and consultation of relevant documents at each site. We used abductive reasoning to infer explanations of the observed phenomenon by going back and forth between the case data and conceptual insights.Results: Our analysis shows that a ceiling effect has taken place in the three clinics. We identified a set of conditions preventing the users from overcoming the ceiling. In adopting an EMR system, all three clinics essentially sought improved operational efficiency. This had an influence on the criteria used to assess the systems available on the market and eventually led to the adoption of a system that met the specified criteria without being optimal. Later, training sessions focussed on basic functionalities that minimally disturbed physicians' habits while helping their medical practices become more efficient. Satisfied with the outcome of their system use, physicians were likely to ignore more advanced EMR system functionalities. This was because their knowledge about EMR systems came almost exclusively from a single source of information: their EMR system vendors. This knowledge took the form of interpretations of what the innovation was (know-what), with little consideration of the rationales for innovation adoption (know-why) or hands-on strategies for adopting, implementing and assimilating the innovation in the organization (know-how).Conclusions: This paper provides a holistic view of the technological innovation process in primary care and contends that limited learning, satisficing behaviours and organizational inertia are important factors leading to the ceiling effect frequently experienced in the EMR system assimilation phase. [ABSTRACT FROM AUTHOR]

Acute care social work positions face budgetary scrutiny in the current climate of fiscal restraint in Canadian health care. Managers may be faced with the question of whether a new or vacant medical social work position should be filled by a BSW social worker or an MSW social worker. This question is further complicated when experienced and less costly BSW social workers are available while MSW social workers with medical or hospital experience may be limited in supply. This paper reviews the literature relevant to medical social work practice and hiring. A small scale survey was conducted with inter­professional managers responsible for the hiring of medical social workers. The purpose of this research was to examine the current hiring practices and considerations for hospital medical social workers. [ABSTRACT FROM PUBLISHER]

In this article, we examine how injection drug users who do not attribute their HIV infection to engaging in HIV risk behaviours take up and critique discourses of individual responsibility and citizenship relating to HIV risk and HIV prevention. We draw on data from a study in Vancouver, Canada (2006–2009) in which we interviewed individuals living with HIV who had a history of injection drug use. In this paper, we focus on six cases studies of participants whodid notattribute their HIV infection to engaging in HIV risk behaviours. We found that in striving to present themselves as responsible HIV citizens who did not engage in HIV risk behaviours, these participants drew on individually focused HIV prevention discourses. By identifying themselves in these ways, they were able to present themselves as ‘deserving’ HIV citizens and avoid the blame associated with being HIV positive. However, in rejecting the view that they and their risk behaviours were to blame for their HIV infection and by developing an explanation that drew on broader social, structural and historical factors, these individuals were developing a tentative critique of focus on individual responsibility in HIV transmission as opposed to dangers of infection arising from the socio-economic environment. By framing the risk of infection in environmental rather than individual risk-behaviour terms, these individuals redistributed responsibility to reflect the social-structural realities of their lives. In this article, we reflect on the implications of these findings for public health measures such as risk prevention messages. We argue that it is important that such messages are not restricted to individual risk prevention but also include a focus of broader shared responsibilities of HIV. [ABSTRACT FROM AUTHOR]

As a first-year doctoral student, I experience challenges of confronting conflicts between my secular education, my Islamic beliefs, my past in Guyana, and my present and presence in Canada, while simultaneously contemplating my future. In this paper, I share my struggles with identity and epistemology through the contours of clarity, confusion, and twilight as I think about my doctoral research. I will present a brief synopsis of my professional and educational background, as well as my identity as a Muslim immigrant, and examine what emerged from this as a personal epistemology that will guide my qualitative research. [ABSTRACT FROM AUTHOR]

In 2010, Castleden and colleagues published a paper in this journal using the concept of 'place' as an analytic tool to understand the nature of palliative care provision in a rural region in British Columbia, Canada. This publication was based upon pilot data collected for a larger research project that has since been completed. With the addition of 40 semi-structured interviews with users and providers of palliative care in four other rural communities located across Canada, we revisit Castleden and colleagues' (2010) original framework. Applying the concept of place to the full dataset confirmed the previously published findings, but also revealed two new place-based dimensions related to experiences of rural palliative care in Canada: (1) borders and boundaries; and (2) 'making' place for palliative care progress. These new findings offer a refined understanding of the complex interconnections between various dimensions of place and palliative care in rural Canada. [ABSTRACT FROM AUTHOR]

Background Participating in everyday life is essential to the healthy development and emotional well-being of children. However, little is known about siblings of children with complex care needs (CCN), and their perspectives and experiences of participating in everyday life. The aim of this paper is to present research findings that add to our understanding of how siblings of children with CCN view and experience participation in everyday life. Methods To arrive at a detailed and accurate understanding of the siblings' perspectives and experiences, we used the qualitative research design of ethnography. Sixteen siblings (seven brothers, nine sisters) of children with CCN were recruited. The siblings ranged in age between 7 and 25 years, with a mean age of 14 years. All siblings took part in opened-ended interviews and completed ecomaps to describe how they participate. Five siblings also took part in the photovoice method. Analysis involved several iterative steps, congruent with ethnography. Results Four main themes emerged as follows: (1) participation is about being part of a group; (2) it feels good; (3) I love my sibling but...; and (4) promoting participation. Siblings of children with CCN identified challenges to participation and also described ways that they participate that relate to the care of their sibling. Conclusions Siblings prioritized the relationship with their sisters and brothers with CCN in their life, and a great deal of their participation was chosen with their sibling in mind. Sibling-to-sibling relationships were distinct and meaningful and, as a result, participation was always done mindfully and with the family needs at the forefront. Nonetheless, clinicians caring for children with CCN must keep in mind the challenges that siblings of children with CCN experience and provide strategies to siblings that will help to promote their participation in everyday life. [ABSTRACT FROM AUTHOR]

Research finds that non-indigenous peoples often hold negative racial attitudes towards indigenous peoples. Contact theory suggests that interpersonal contact can positively influence majority group members' attitudes regarding minority group members, raising the question of whether indigenous population growth in cities will alter non-indigenous peoples' attitudes. Using original 2014 survey data, this paper examines the relationship between interpersonal contact and racial attitudes in Canadian prairie cities. The analysis finds that while personal ties to aboriginal peoples are correlated with lower new and old-fashioned racism scores, general contact with aboriginal peoples only correlates with old-fashioned racism scores. As such, growing urban indigenous populations -- and thus increased aboriginal-non-aboriginal general contact -- alone should not be expected to result in positive racial attitudes. This research advances understanding of contact theory by considering how education interacts with interpersonal contact, and informs on-going dialogue about current racial relations between non-indigenous and indigenous peoples in Canadian prairie cities. [ABSTRACT FROM AUTHOR]

Ethno-cultural disparities in blood and tissue donation patterns have been described as an emergent challenge in the context of the transfusion medicine literature (Boulware et al. in Med Care 40(2):85-95, ; Molzahn et al. in Nephrol Nurs J 30(1):17-26, , Can J Nurs Res 36(4):110-128, ). In the North American context, much has been written about blood and tissue donation patterns among different religious and cultural groups within the United States. However, there are few available statistics or descriptive research that discusses blood donation decisions among Aboriginal Canadians. In 2001, Aboriginal Canadians represented approximately 4.1 % of the total Canadian population, or 1.1 million persons (Birn et al., in Textbook of international health: global health in a dynamic world. Oxford University Press, New York, NY, ). Comparatively, Canada Blood Services reports that Aboriginal Canadians represent only 0.9% of registered donors (Canadian Blood Services ). These low donation patterns suggest that blood donation choice among Aboriginal Canadians requires better understanding. This paper discusses several factors that may influence Aboriginal health choices, specifically those associated with blood donation decision-making. Several influential factors will be discussed, including: the meaning of the body and its parts in relationship to the interconnectedness of all things (religio-cultural), the reflexivity of choice and control (political), and relationships with others (social). [ABSTRACT FROM AUTHOR]

Background: While client-centred practice has received wide support, it remains difficult to apply in many practice settings. Identified barriers include constraints on time, resources, and services imposed by healthcare policies. Healthcare professionals' prioritizing of client safety over (other) interests that clients may name may further restrict the application of client-centred practice. Discharge planning is one area where such considerations can conflict. Aim: This paper presents a secondary analysis of data examining the process of discharge in one Canadian rehabilitation setting. It examines how discourses of client-centred practice and of prioritizing safety were reflected in discharge planning with older adults and considers the implications of potential conflicts between these discourses. Method: Taking a critical bioethics perspective informed by relational autonomy theory, microethnographic case studies were used to examine discharge planning from the perspectives of older adult clients and healthcare professionals. Results: Healthcare professionals interpreted client-centred practice to require abiding by client wishes, as long as this was safe; furthermore prioritizing safety took precedence over other considerations in discharge planning. Conclusion and significance: Client-centred practice was not promoted in discharge planning processes in the research setting. Applying a relational autonomy lens to practice could promote approaches that better facilitate client-centred practice. [ABSTRACT FROM AUTHOR]

In 2010 Prime Minister Stephen Harper quietly created a system of Minister's Caucus Advisory Committees (MCACs), requiring ministers to consult with their backbench colleagues before taking policy proposals to cabinet. Based on interviews with Conservative MPs, ministers, political staffers and public servants, the paper argues that MCACs increase MPs' influence over government policy and enhance cohesion within the government's parliamentary caucus. By constraining ministers' policy freedom and providing the prime minister with regular political intelligence concerning policy proposals, MCACs reinforce his pre-eminence within cabinet and represent a significant innovation in the relationship between the executive and government caucus. [ABSTRACT FROM AUTHOR]

Everyday cultural resources that originate outside school offer possibilities for multimodal creativity and identity play, as children consume, transform and produce multimodal texts. In this study, Kyle, a boy in elementary school, fluidly performed social identities and engaged in playful and parodic rescripting of identities and resources from everyday culture, such as professional wrestling and rap music. In this paper, I posit that (1) Kyle and his family understood and experienced professional wrestling in contradictory ways as both taboo and appealing, (2) Kyle’s deep knowledge of the genre of professional wrestling as performative text allowed him to use it in playful and parodic ways, (3) this playful approach to wrestling and other masculine identities, made available through Kyle’s culture, constitutes a form of improvisation and can be explained as a form of masculine melodrama and (4) the role of audiences is key in the reflexive performance of masculine identities. [ABSTRACT FROM PUBLISHER]

Students’ increasing use of text messaging language has prompted concern that textisms (e.g., 2 for to, dont for don’t, ☺) will intrude into their formal written work. Eighty-six Australian and 150 Canadian undergraduates were asked to rate the appropriateness of textism use in various situations. Students distinguished between the appropriateness of using textisms in different writing modalities and to different recipients, rating textism use as inappropriate in formal exams and assignments, but appropriate in text messages, online chat and emails with friends and siblings. In a second study, we checked the examination papers of a separate sample of 153 Australian undergraduates for the presence of textisms. Only a negligible number were found. We conclude that, overall, university students recognise the different requirements of different recipients and modalities when considering textism use and that students are able to avoid textism use in exams despite media reports to the contrary. [ABSTRACT FROM PUBLISHER]

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature. [ABSTRACT FROM AUTHOR]

Background: Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. Methods: A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care. Results: The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East. Conclusions: This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran. [ABSTRACT FROM AUTHOR]

Background: The health care sector has a significant role to play in fostering equity in the context of widening global social and health inequities. The purpose of this paper is to illustrate the process and impacts of implementing an organizational-level health equity intervention aimed at enhancing capacity to provide equity-oriented health care. Methods: The theoretically-informed and evidence-based intervention known as 'EQUIP' included educational components for staff, and the integration of three key dimensions of equity-oriented care: cultural safety, trauma- and violence-informed care, and tailoring to context. The intervention was implemented at four Canadian primary health care clinics committed to serving marginalized populations including people living in poverty, those facing homelessness, and people living with high levels of trauma, including Indigenous peoples, recent immigrants and refugees. A mixed methods design was used to examine the impacts of the intervention on the clinics' organizational processes and priorities, and on staff. Results: Engagement with the EQUIP intervention prompted increased awareness and confidence related to equity-oriented health care among staff. Importantly, the EQUIP intervention surfaced tensions that mirrored those in the wider community, including those related to racism, the impacts of violence and trauma, and substance use issues. Surfacing these tensions was disruptive but led to focused organizational strategies, for example: working to address structural and interpersonal racism; improving waiting room environments; and changing organizational policies and practices to support harm reduction. The impact of the intervention was enhanced by involving staff from all job categories, developing narratives about the socio-historical context of the communities and populations served, and feeding data back to the clinics about key health issues in the patient population (e.g., levels of depression, trauma symptoms, and chronic pain). However, in line with critiques of complex interventions, EQUIP may not have been maximally disruptive. Organizational characteristics (e.g., funding and leadership) and characteristics of intervention delivery (e.g., timeframe and who delivered the intervention components) shaped the process and impact. Conclusions: This analysis suggests that organizations should anticipate and plan for various types of disruptions, while maximizing opportunities for ownership of the intervention by those within the organization. Our findings further suggest that equity-oriented interventions be paced for intense delivery over a relatively short time frame, be evaluated, particularly with data that can be made available on an ongoing basis, and explicitly include a harm reduction lens. [ABSTRACT FROM AUTHOR]