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There is an increasing need of gerontological education in social work to enhance the knowledge of aging and interests in senior care among students. This study is conducted based on an experiential-learning strategy with a combination of having an ethnographic interview with an older adult and writing a reflection paper afterward as an assignment embedded in a Gerontology course of the Bachelor of Social Work program in western Canada. Thematic analysis was applied to eight reflection papers in which a consent was obtained from 2020 to 2021 cohorts of social work students. Three key themes emerged: connection between learned knowledge and interview topics, resonation interview content with personal experiences, and a positive perception of aging and a positive attitude toward working with aging populations. The findings support the combination of ethnographic interview and reflection paper as a pedagogical approach in gerontological education not only for improving students’ learning experience and knowledge but also for establishing a positive perception of aging and older adults. The study also reveals the necessity of more interaction between students and older adults to enhance a better understanding of aging-related issues and promote willingness to work with older adults. [ABSTRACT FROM AUTHOR]

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]

This paper uses data from interviews with immigrant youth in Ottawa, Canada, to explore early career-development and employment transition experiences of the youth. Framed by the Community-Interaction Theory of Career Development, the study explores the kind of influences and influencers, which shape career decisions and early on-the-job experiences of young immigrants. Thematic analysis of the qualitative data from face-to-face interviews reveals that some of the key influences on immigrants come from parents, siblings, and members of the ethnic community, in particular from teachers and peers from Sunday language schools, which create a unique climate encouraging students to pursue higher education. [ABSTRACT FROM AUTHOR]

Research shows a positive association between skilled migration and innovation. Related literature however is largely limited to the use of proxies such as patents, and publications. There is also a lack of attention to how innovation is accomplished in practices. This paper addresses these gaps with an examination of the innovative contributions made by immigrant engineers in Canada. Conceptually, informed by practice-based theories, it conceives innovation as a sociocultural and sociomaterial process that leads to the transformation of the object/motives of activities, i.e. the problem space to which actions are directed. Empirically, drawing on a thematic and situational analysis of the career accounts of 32 immigrant engineers, it shows that immigrants expand engineering practices by introducing, inter alias, new technologies, products, processes, policies and standards. It further traces the rise of the problem spaces, and the ways in which engineering objects and other practitioners are knotted into practices of innovation. It argues that while immigrants manage to introduce epistemic objects through continuous learning and knowledge translation, it is through the enrolment of other practitioners, and technologies and tools that relations of differences and power are (re)negotiated, and new ways of doing become amplified as innovation at work. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to add to the research literature and begin to fill the gap in knowledge about shared parenting arrangements for women with young children and who have experienced domestic violence (DV), in three Canadian provinces; Alberta, Manitoba and Ontario. Method: This paper reports on the qualitative findings from a mixed methods study on shared parenting from women with children ages 4 and under. Twenty women participated in one-on-one individual interviews through electronic platform utilizing Zoom. Thematic analysis is used to analyze the data. Results: Despite efforts to not exclusively recruit women who had experienced domestic violence (DV) from their former partner, all participants identified as survivors of DV and ongoing survivors of DV, specifically, coercive controlling behaviours. Five themes describe the women's experiences of shared parenting with young children: 1) walking a tight-rope; 2) navigating post-separation relationships; 3) emotional realities of shared parenting; 4) shared parenting outcomes; and, 5) structural challenges. Conclusions: This paper not only adds to the significant and longstanding gap in knowledge directly from women with children ages 4 and under in shared parenting relationships, and who have experienced DV, and also helps to inform social service and legal actors. It is timely with the amendments to the Divorce Act in Canada which now includes DV as a factor in determining the best interests of the child. [ABSTRACT FROM AUTHOR]

In a series of two papers, the narrative themes of Intergenerational Trauma (IGT) from both the parent and offspring generation in the Chinese diaspora in Canada are examined. This paper focuses on the experiences of parental participants and their perspectives on how trauma transmits to the next generation. Narratives of IGT from three participants were co-constructed using the Collaborative Narrative Method. The narratives were largely situated during pre-migration in China, with most traumatic experiences related to sociopolitical events between the 1950s to 1980s. Themes were developed from the narratives using reflexive thematic analysis. These themes include the following: (a) decimation of social structures; (b) oppression, chaos, and abuse; (c) desperation for survival; (d) personal losses and the denial of education and opportunities; and (e) preservation of values. Themes associated with participant perception of how their traumatic experience transmitted to their offspring, include the following: (a) desire for stability and opportunities; (b) pressure and concern for the future of their offspring; and (c) hope for the future. The study has implications for understanding the linkage between historical events and individual narratives in the Chinese diaspora, as well as the study of IGT among Chinese populations and their narratival understandings. [ABSTRACT FROM AUTHOR]

Young people's voices detailing how they experienced engagement with the criminal justice system following child sexual abuse, what was helpful or unhelpful and how services can be improved to minimise secondary victimisation and maximise the potential for healing are largely absent from the research literature. This paper draws on semi‐structured interviews with a culturally diverse sample (n = 47) of young people aged 14 to 25 across Ireland and Canada about their experiences of disclosure and engagement with systems. Data were collected pertaining to experiences engaging with law enforcement personnel using thematic analysis with a trauma‐informed lens. The research identified three key themes: the importance of feeling safe through kindness, transparency and being believed; the importance of having a say; and the importance of timely court processes. The study builds on the small body of qualitative research illustrating young people's lived experiences of engaging with the criminal justice system and provides empirical support for promoting a trauma‐informed approach in how police engage with young people. Guidance is offered for police professionals on how to engage with adolescents following sexual abuse. [ABSTRACT FROM AUTHOR]

The development of a tool to track participation in activity-based therapy (ABT) for people with spinal cord injury or disease (SCI/D) was identified as a priority of the Canadian ABT Community of Practice. The objective of this study was to understand multi-stakeholder perspectives on tracking ABT participation across the continuum of care. Forty-eight individuals from six stakeholder groups (persons living with SCI/D; hospital therapists; community trainers; administrators; researchers; and funders, advocates and policy experts) were recruited to participate in focus group interviews. Participants were asked open-ended questions concerning the importance of and parameters around tracking ABT. Transcripts were analyzed using conventional content analysis. Themes reflected the Who, What, Where, When, Why and How of tracking ABT. Participants described the importance of involving hospital therapists, community trainers and individuals with SCI/D in tracking ABT to capture both subjective and objective parameters across the continuum of care and injury trajectory. Digital tracking tools were favoured, although paper-based versions were regarded as a necessity in some circumstances. Findings highlighted the importance of tracking ABT participation for individuals with SCI/D. The information may guide the development of ABT practice guidelines and support the implementation of ABT in Canada. Tracking the details of activity-based therapy (ABT) sessions and programs across the continuum of care and injury trajectory may provide important information to support the development of ABT practice guidelines and implementation strategies. Tracking objective and subjective parameters are needed to provide a comprehensive description of an ABT session and program. Clinicians and individuals with spinal cord injury or disease (SCI/D) should both be able to track ABT to accommodate all settings and types of data. Digital tracking tools, such as an app, may provide an accessible, versatile and efficient way of tracking ABT. [ABSTRACT FROM AUTHOR]

In the health professions, altruism is a foundational value upon which professional privilege is built. This imperative towards self-sacrifice for the benefit of others is a key component of what it means to be professional. This paper explores how altruism operates as a coded mechanism of exclusion and oppression for disabled health professionals. Analysis is based on interviews with fifteen Canadian disabled healthcare professionals in medicine, nursing, occupational therapy, and social work about their experiences of inclusion and exclusion. Themes including the disproportionate sacrifice of time, resources, and income emerged, as did the need to manage political disclosure, often embodying the role of the 'super-crip' with patients/clients and colleagues so as to maintain others' faith in their professional competence and their professional privilege. Further discussion includes questions of how to 'crip' altruism as a professional value and the role of altruism as an ableist force within the health professions. Altruism, the idea of helping others even at cost to oneself, is an important value for health professionals. Disabled health professionals sacrifice more than non-disabled healthcare professionals to meet this obligation. Disabled healthcare professionals may work without accommodations, putting in extra time and effort to prove their altruism. Disabled healthcare professionals experience that disclosing disability may mean their colleagues will treat them as patients. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

Since the shift to legalizing recreational cannabis use in Canada in 2018, there has been increased attention on the consequences of cannabis use on women's reproductive and maternal health, with particular attention to the impact of cannabis in utero and through breastfeeding. This has resulted in an intense focus on the behaviors of individuals who consume cannabis during the perinatal period, which raises questions about the impact this has on women and mothers who have historically been under the surveillance of the Canadian public health, health and social care, and legal systems. Grounded in an intersectional feminist framework that acknowledges how race, ability, class, and other social positions impact and differentiate women's experience, this paper presents findings emerging from a participatory arts-based research approach called Photovoice with 23 mothers living throughout Canada. All participants consumed cannabis during pregnancy and breastfeeding and illustrated through photographs and individual and group discussion how their experiences of intersectional stigma and surveillance by health and social care providers resulted in barriers to accessing cannabis-related information and support. Implications arising from our inquiry suggest there is a dire need for public health, perinatal care, and social care responses that run counter to the current context where stigma and fear prevent parents from accessing cannabis information and support. [ABSTRACT FROM AUTHOR]

Background: Parents seek support on behalf of their transgender and gender nonconforming (TGNC) children. Previous qualitative studies explore the types of support parents seek inside and outside of healthcare settings. Healthcare providers often remain unprepared to effectively provide gender-affirming services to TGNC children and their accompanying parents and may benefit from learning about the support seeking experiences of parents with TGNC children. Aims: This paper summarized qualitative research studies that address the topic of parents seeking support on behalf of their TGNC children. We produced this report for healthcare providers to review to enhance gender-affirming services for parents and TGNC children. Methods: This paper outlines a qualitative metasummary of studies from the United States or Canada with data collected from parents of TGNC children. Data collection included the steps of journal runs, database searches, reference checks, and area scans. Data analysis involved the steps of extracting, editing, grouping, abstracting, and calculating the intensity and frequency effect sizes for finding statements from qualitative research study articles. Results: The results of this metasummary yielded two primary themes, six subthemes, and 24 total findings. The first primary theme of seeking guidance had three subthemes: educational resources, community networks, and advocacy efforts. The second primary theme of seeking healthcare had three subthemes: healthcare providers, mental healthcare, and general healthcare. Discussion: These findings provide information healthcare providers can use to inform their practice. These findings also highlight the importance of providers working collaboratively with parents when serving TGNC children. This article concludes with practical tips for providers. [ABSTRACT FROM AUTHOR]

Background: Virtual care quickly became of crucial importance to health systems around the world during the COVID-19 pandemic. Despite the potential of virtual care to enhance access for some communities, the scale and pace at which services were virtualized did not leave many organizations with sufficient time and resources to ensure optimal and equitable delivery of care for everyone. The objective of this paper is to outline the experiences of health care organizations rapidly implementing virtual care during the first wave of the COVID-19 pandemic and examine whether and how health equity was considered. Methods: We used an exploratory, multiple case study approach involving four health and social service organizations providing virtual care services to structurally marginalized communities in the province of Ontario, Canada. We conducted semi-structured qualitative interviews with providers, managers, and patients to understand the challenges experienced by organizations and the strategies put in place to support health equity during the rapid virtualization of care. Thirty-eight interviews were thematically analyzed using rapid analytic techniques. Results: Organizations experienced challenges related to infrastructure availability, digital health literacy, culturally appropriate approaches, capacity for health equity, and virtual care suitability. Strategies to support health equity included the provision of blended models of care, creation of volunteer and staff support teams, participation in community engagement and outreach, and securement of infrastructure for clients. We put our findings into the context of an existing framework conceptualizing access to health care and expand on what this means for equitable access to virtual care for structurally marginalized communities. Conclusion: This paper highlights the need to pay greater attention to the role of health equity in virtual care delivery and situate that conversation around existing inequitable structures in the health care system that are perpetuated when delivering care virtually. An equitable and sustainable approach to virtual care delivery will require applying an intersectionality lens on the strategies and solutions needed to address existing inequities in the system. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic led to major service disruptions in the healthcare sector, especially regarding sexual and reproductive health services. However, the impact of the pandemic on Canadian adolescents is relatively unknown. This study aimed to investigate the impacts of the COVID-19 pandemic and associated public health measures on the sexual and reproductive health (SRH) of adolescents in Alberta, Canada. Methods: A qualitative study using an interpretive description (ID) approach and community-based participatory research principles was conducted to capture the subjective experience and perceptions of adolescents and service providers. With the collaboration of the Adolescent Advisory Group and community partners, 18 adolescents and 15 service providers were recruited for the study through purposive sampling. Findings from the qualitative interviews were analyzed using thematic analysis. Results: Three major themes emerged from the analysis: (1) COVID-19 SRH experience, (2) barriers to SRH, and (3) adolescent SRH strategies. Our findings highlight numerous barriers and challenges that prevented adolescents from accessing SRH education, products, and services. Conclusion: The COVID-19 pandemic had a profound impact on the SRH and the well-being of adolescents. Our study reflects the need for diverse SRH strategies to maintain continued access to SRH resources during disruptive events, such as the pandemic. Plain language summary: Access to sexual and reproductive health (SRH) services is a basic human right. All individuals require access to appropriate SRH services to maintain their optimal sexual and reproductive health. Adolescents require special guidance, support, and youth-friendly services in matters of SRH as they enter puberty and explore their sexual identity. However, during the COVID-19 pandemic, many health and SRH services were suspended. Access to SRH products and services became difficult due to public health restrictions, which has possible negative consequences for adolescents' SRH. The experiences of adolescents during the COVID-19 pandemic regarding their SRH are not reported in Alberta, Canada. Therefore, we explored the impacts of these public health restrictions on adolescents' SRH. We performed qualitative interviews with adolescents and SRH service providers to know their perspectives on how the pandemic influenced the SRH of adolescents. This paper provides insights into the barriers faced by adolescents while accessing SRH services during the pandemic, as well as their perceptions of digital strategies, such as mobile applications, and other recommendations for supporting SRH education and services. Based on the study findings, an adolescent-friendly mobile application will be developed to provide a virtual platform connecting adolescents to SRH educational resources, services, and support. [ABSTRACT FROM AUTHOR]

This paper presents findings from an investigation of nature-based practices, from the perspectives of 10 academics/educators from six nations. Participants engaged in a focus group exploring the prevalence and inclusion of nature in social work practice and education. While the study focused on individual members' experiences and perspectives, the findings highlight important context-specific factors for including nature within social work to reconnect humans with nature for health, well-being, healing, and justice. An Integrative Environmental Model for social work is proposed to assist future practice and education. [ABSTRACT FROM AUTHOR]

Despite decades of research and education, sexual and gender-based violence remain distressingly prevalent on university and college campuses globally. The taboos associated with sex, gender inequity, and living in a patriarchal world where misogyny is glorified and criminalised are key socio-cultural determinants driving these forms of violence. Less is known about the ways in which sexual slang or terminology impact how students experience and talk about these events. This paper reports on findings from a participatory action study that explored sexual slang use among female and male undergraduate students (n = 23) with the aim of creating more responsive sexual and gender-based violence policies and practices. The terms identified (n = 59) provide a window into the daily lives of these young people, who display remarkable socio-linguistic adaptation and creativity. They also demonstrate how cultural appropriation, the exclusion of queer students, toxic masculinitycontribute to ongoing incidents of sexual and gender-based violence on campus. These findings contribute new insights into sexual terminology among post-secondary students, particularly in the Canadian context where few studies of this nature exist. They also acknowledge the critical role universities can play in making meaningful structural change to prevent traumatic events from occurring. [ABSTRACT FROM AUTHOR]

In a series of two papers, the narrative themes of Intergenerational Trauma (IGT) from both the perspectives of the parent and offspring generation in the Chinese diaspora in Canada are examined. IGT involves parental traumatization, the intergenerational transmission of trauma, and the impact of trauma on subsequent generations. This study focuses on the narratives of the offspring generation and their construction of how their parents' traumas shaped their lives. Narratives of IGT were constructed using a collaborative narrative method. The offspring narratives were centred on their experiences growing up in Canada and how those experiences were influenced by the transmission of their parents' traumas. Narratives were analyzed using Braun and Clarke's (2006) reflexive thematic analysis. The themes developed from the narratives were as follows: (a) silence and disconnection; (b) saving face and conflicting values; (c) discipline and internalization of insecurities; (d) education as necessity; and (e) preservation and reclamation of heritage. The study illustrates how collective and IGT are understood through the mediated narrative lens of subsequent generations. The role of silence and its construction in these narratives is discussed from a cultural standpoint in relation to dominant trauma discourse. The study has implications for understanding Chinese diasporic IGT through narrative and cultural frameworks and invites trauma and IGT discourses as clinical and research considerations for this population. [ABSTRACT FROM AUTHOR]

Background: A limited number of studies have explored religion's role in the intimate lives of adults with intellectual disabilities. This paper illustrates how religion, both of disabled people and those around them (e.g., family members, support workers), can shape the attitudes and experiences of disabled people toward sexuality. Method: This paper draws on in‐depth interviews with adults with intellectual disabilities and support workers from two exploratory projects in Canada. Results: Participants with intellectual disabilities talked about how religion provided a network that served to counter their social isolation and a pool of potential intimate partners, as well as some guidance for maintaining relationships. Support workers discussed the influence of organisational values in their practices related to sexuality. Conclusions: Religion shapes disabled sexualities in various ways, sometimes supporting or constraining sexual expression. This paper invites disability scholars to consider religion when researching the intimate lives of disabled people. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Little is known about how PTSD and dementia in Veterans is identified by health care providers. What the paper adds to existing knowledge?: Healthcare providers identify those behavioural symptoms experienced by older people living with dementia that represent an unmet need associated with PTSD secondary to military service. Once healthcare providers recognize the presence of symptoms relevant to PTSD, they modify their care approach to include focused/tailored non‐pharmacological care interventions that address environmental and situational variables that reflect military action. What are the implications for practice?: Specialized education and training is needed to improve the identification of PTSD when existent with other co‐occurring neurocognitive conditions such as delirium, dementia and depression. Introduction: Co‐occurring PTSD and dementia in Veterans can be difficult to distinguish from dementia‐related responsive behaviours, which may result in inappropriate care management. Improved identification of PTSD and dementia is necessary to inform more appropriate and effective care for Veterans. Aim/Question: The purpose of this study was to understand how Canadian healthcare providers have learned to identify the co‐occurrence of PTSD symptoms in Veterans with dementia. Methods: Eight semi‐structured interviews employing the Critical Incident Technique were conducted with key informant healthcare providers who treat Veterans from across Canada. Framework analysis was used to code, sort and develop themes. Results: Observed differences in Veterans with PTSD and dementia cued healthcare providers to seek our more information, leading to a new understanding of past trauma underlying the symptoms they observed. Healthcare providers then altered their usual care approaches to utilize trust‐based and validation‐oriented strategies resulting in more effective care management. Discussion: Improvement in the identification of co‐occurring PTSD and dementia in Veterans requires specialized education and training for healthcare providers. Implications for Practice: Recognizing the complex needs of older Veterans with co‐occurring PTSD and dementia is necessary for healthcare providers to implement more effective care for this population. Relevance Statement: This paper provides mental health nurses with new understanding of co‐occurring PTSD and dementia in Veterans. With an ageing Veteran population in Canada, mental health nurses need to be knowledgeable about the care for Veteran specific mental health needs. [ABSTRACT FROM AUTHOR]

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

Background: The increased scrutiny on public health brought upon by the ongoing COVID-19 pandemic provides a strong impetus for a renewal of public health systems. This paper seeks to understand priorities of public health decision-makers for reforms to public health financing, organization, interventions, and workforce. Methods: We used an online 3-round real-time Delphi method of reaching consensus on priorities for public health systems reform. Participants were recruited among individuals holding senior roles in Canadian public health institutions, ministries of health and regional health authorities. In Round 1, participants were asked to rate 9 propositions related to public health financing, organization, workforce, and interventions. Participants were also asked to contribute up to three further ideas in relation to these topics in open-ended format. In Rounds 2 and 3, participants re-appraised their ratings in the view of the group's ratings in the previous round. Results: Eighty-six public health senior decision-makers from various public health organizations across Canada were invited to participate. Of these, 25/86 completed Round 1 (29% response rate), 19/25 completed Round 2 (76% retention rate) and 18/19 completed Round 3 (95% retention rate). Consensus (defined as more than 70% of importance rating) was achieved for 6 out of 9 propositions at the end of the third round. In only one case, the consensus was that the proposition was not important. Proposition rated consensually important relate to targeted public health budget, time frame for spending this budget, and the specialization of public health structures. Both interventions related and not related to the COVID-19 pandemic were judged important. Open-ended comments further highlighted priorities for renewal in public health governance and public health information management systems. Conclusion: Consensus emerged rapidly among Canadian public health decision-makers on prioritizing public health budget and time frame for spending. Ensuring that public health services beyond COVID-19 and communicable disease are maintained and enhanced is also of central importance. Future research shall explore potential trade-offs between these priorities. [ABSTRACT FROM AUTHOR]

This paper discusses the experiences during COVID-19 of mothers who have young children, are survivors of domestic violence and who share parenting to highlight the further unsafe situations survivors of violence and their children were placed in during the pandemic. Part of a larger mixed methods study, these participants (n = 19) from three Canadian provinces, Alberta, Manitoba and Ontario, engaged in virtual individual one-on-one interviews via zoom. Using thematic analysis, four themes emerged from the data: 1) increased use of coercive controlling behaviors; 2) fear of the unknown; 3) lack of supports; and, 4) finding balance. Direct quotes are used to highlight the meaning of each theme. We outline the challenges these women have that are in addition to those experienced by many during COVID-19 times (increased stress, isolation, disconnect from supports, financial challenges). These include managing the shared parenting arrangements with a former abusive partner who used the pandemic as a further opportunity for coercive controlling behaviors under the guise of the public health order. The mothers were left to manage the difficult exchanges with a former abusive partner and unknown circumstances of the pandemic without guidance and support from legal actors. There will need to be a prioritization of the safety of mothers and their children in post-divorce parenting arrangements both during times of a community lockdown such as during the pandemic and also during non-pandemic times. [ABSTRACT FROM AUTHOR]

Trans and non-binary youth (TNBY) face high levels of interpersonal and social adversity as well as disproportionate rates of mental health issues such as depression, self-harm and suicidal ideation. Among protective factors, context plays a key role. In addition to parental support, access to gender-affirming medical care begins to emerge as crucial for young people needed them. This paper compares, through thematic analysis, the experiences of TNBY with regard to access and experiences to care in Canada, Switzerland, England, and Australia. It identifies similarities and differences in barriers to access to care, as well as impacts of gender affirming care on young people and their well-being. The article concludes with a discussion on the importance of prompt and easier access to gender-affirming medical care, of training of professionals, and a hypothesis about the role of context in TNBY well-being. [ABSTRACT FROM AUTHOR]

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

Jean Raspail's controversial 1973 novel The camp of the saints predicts mass migration to Europe that will destroy European civilization. Decades later, the book has accurately predicted the hundreds of thousands of refugees arriving in Europe annually, prompting a continent-wide crisis. From Lesbos and Lampedusa to the Canary Islands and Calais, no one seems to know how to stem the flow of humanity. Borders are being resurrected, despite Schengen and European Union (EU) agreements, in an effort to control the movement of populations. European governments disagree on how to proceed and some are suggesting that the EU could be torn apart by differing approaches to the problem. But does this have to be the response to the migration crisis? This paper compares the predictions of The camp of the saints to events in Europe today and critiques the book's conclusions with regard to what is an ancient phenomenon: movements of migrants from surplus to deficit labor settings. The paper will also evaluate the response to migrants in the United States under its populist president, Donald Trump, and will review related issues in other parts of the world: Turkey, Russia, and Canada. Contrary to Raspail's predictions, world leaders will need to accept what has already become a de facto reality: large scale admission of migrants and refugees to the EU and North America, as full citizens, will be the only realistic way to preserve prosperity in the years to come. [ABSTRACT FROM AUTHOR]

Objective: In the past few years, increasing numbers of Indigenous doula collectives have been forming across Canada. Indigenous doulas provide continuous, culturally appropriate support to Indigenous women during pregnancy, birth, and the post-partum period. This support is critical to counter systemic medical racism and socioeconomic barriers that Indigenous families disproportionately face. This paper analyzes interviews with members of five Indigenous doula collectives to demonstrate their shared challenges, strategies, and missions. Methods: Qualitative interviews were conducted with members of five Indigenous doula collectives across Canada in 2020. Interviews were transcribed and returned to participants for their approval. Approved transcripts were then coded by all members of the research team to ascertain the dominant themes emerging across the interviews. Results: Two prominent themes emerged in the interviews. The first theme is "Indigenous doulas responding to community needs." Participants indicated that responding to community needs involves harm reduction and trauma-informed care, supporting cultural aspects of birthing and family, and helping clients navigate socioeconomic barriers. The second theme is "Indigenous doulas building connections with mothers." Participants' comments on providing care to mothers emphasize the importance of advocacy in healthcare systems, boosting their clients' confidence and skills, and being the "right" doula for their clients. These two inter-related themes stem from Indigenous doulas' efforts to counter dynamics in healthcare and social services that can be harmful to Indigenous families, while also integrating cultural teachings and practices. Conclusion: This paper illustrates that Indigenous doula care responds to a wide range of issues that affect Indigenous women's experiences of pregnancy, birth, and the post-partum period. Through building strong, trusting, and non-judgemental connections with mothers and responding to community needs, Indigenous doulas play a critical role in countering medical racism in hospital settings and advancing the resurgence of Indigenous birthing sovereignty. [ABSTRACT FROM AUTHOR]

Drawing on semi‐structured interviews with larger bodied patients (n = 20) and their healthcare practitioners (n = 22) in Canada, this paper combines micro and macro approaches in outlining a social justice approach to caring for larger patients in healthcare practice. Theoretically, we draw upon structural competency and critical consciousness to address the question of how social justice is enacted, experienced, and understood in interactions between clinicians and larger patients. Our findings highlight four key themes that provide a framework for integrating social justice into healthcare practice: (1) an awareness of one's simultaneous experience of marginalisation and privilege in the clinical interaction; (2) navigating between additive and interactive understandings of intersectionality; (3) micro and macro approaches to change; and (4) straddling the line between equity and equality. The synergies in participants' perspectives across social identities suggests that the cultivation of social justice awareness potentially mitigates some blinders of privilege. Furthermore, practitioners' social justice orientation positively impacted patient experience, with most patients expressing appreciation for having their various histories of trauma and social challenges handled compassionately during appointments. [ABSTRACT FROM AUTHOR]

A social accountability mandate for Canadian medical schools formally emerged in Canada with changes to accreditation standards in 2015. However, how social accountability is defined and operationalized within medical schools has transpired independently. Key enablers of social accountability in Canadian medical schools have been largely unexplored. This paper is the first of a two part series that seeks to explore drivers of social accountability in a sample of Canadian medical schools. Nine key drivers of social accountability emerged from the data including a unified vision, committed leadership, accreditation standards, champions of social accountability, authentic community engagement, community-based learning opportunities, a supportive organizational and governance structure, diversity within medical schools, and measurement of progress and outcomes. This is the first study of its kind to examine what is driving social accountability across Canadian medical schools. An appreciative inquiry approach highlights areas of progress for future work to focus and build upon. This paper presents the findings from part one of the study – exploring the themes emerging from key informant interviews with senior leaders. A second paper will dive into the broader perspectives of faculty, staff and students, to explore more fully the varying perspectives of social accountability within colleges. [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]

Accessible Summary: What is known on the subject?: Involuntary treatment orders are increasingly being used around the world to allow the treatment of individuals living with a mental illness deemed incapable of giving consent and who are actively refusing treatment.The use of involuntary treatment orders can impact the nurse–patient therapeutic relationship, which is essential to offer quality care and promote recovery. What the paper adds to existing knowledge?: Nurses and patients do not agree on the possibility to develop a therapeutic relationship, with nurses believing they can build a bond with the patients despite the challenges imposed by the involuntary treatment order, and patients rejecting this possibility.Nurses caring for patients on involuntary treatment orders feel obligated to apply the conditions of this measure, even if it damages the relationship with their patients. This difficult aspect of their work leads them to question their role in relation to the management of involuntary treatment orders. What are the implications for practice?: Nurses need to be aware of the reasons why patients on involuntary treatment orders do not believe in the possibility of building a therapeutic relationship.Nurses need to reflect on and express their concerns about the damaging effects that managing involuntary treatment orders conditions can have on the nurse–patient therapeutic relationship. Introduction: Involuntary treatment orders (ITO) can impact the nurse–patient therapeutic relationship (TR) negatively. Despite the increasing use of ITOs around the world, few studies have explored their influence on the TR from the perspectives of nurses and patients. Aim: To describe the TR in the context of ITOs as reported by nurses and individuals living with a mental illness. Method: Secondary data analysis of qualitative interviews with nurses (n = 9) and patients (n = 6) was performed using content analysis. Results: Participants described the TR as fundamentally embedded in a power imbalance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relation between the ITO and the TR, and the influence of mental healthcare settings' context. Discussion: Nurses and patients' views were opposed, questioning the authenticity of the relationship. Implications for Practice: Nurses should be aware of the patients' lack of faith in the TR to ensure that they are sensitive to patients' behaviours that may falsely suggest that a relationship is established. Further studies should explore ways to alleviate the burden of the management of ITOs on nurses and allow for a trusting relationship to be build. [ABSTRACT FROM AUTHOR]

Age-friendly initiatives often are motivated by a single funding injection from national or sub-national governments, frequently challenging human and financial resources at the community level. To address this problem, this paper examines the challenges and opportunities to sustaining age-friendly programs in the context of a Canadian age-friendly funding program. Based on a qualitative thematic content analysis of interview data with 35 age-friendly committee members drawn from 11 communities, results show that age-friendly sustainability may be conceptualized as an implementation gap between early development stages and long-term viability. Consistent over-dependence on volunteers and on committees' limited capacity may create burnout, limiting sustainability and the extent to which communities can truly become "age-friendly". To close this implementation gap while still remaining true to the grass-roots intention of the global age-friendly agenda, sustainable initiatives should include community champions, multi-disciplinary and cross-sector collaborations, and systemic municipal involvement. [ABSTRACT FROM AUTHOR]

This paper demonstrates how a qualitative methodology can be used to gain novel insights into the demands of wheelchair racing and the impact of particular racing chair configurations on optimal sport performance via engagement with expert users (wheelchair racers, coaches, and manufacturers). We specifically explore how expert users understand how wheels, tires, and bearings impact sport performance and how they engage, implement, or reject evidence-based research pertaining to these components. We identify areas where participants perceive there to be an immediate need for more research especially pertaining to the ability to make individualized recommendations for athletes. The findings from this project speak to the value of a qualitative research design for capturing the embodied knowledge of expert users and also make suggestions for "next step" projects pertaining to wheels, tires, and bearings drawn directly from the comments of participants. [ABSTRACT FROM AUTHOR]

Background: Obsessive–Compulsive Disorder (OCD) is a psychiatric illness that can result in debilitating symptoms and functional impairment. Until recently, individuals with severe OCD symptoms have not received appropriate services within the Canadian healthcare system. The Frederick W. Thompson Anxiety Disorders Centre launched an Intensive Services Residential treatment programme for OCD in July 2017 to meet the needs of the Canadian population. This paper sets out to demonstrate the effectiveness of this programme. Methods: This study incorporated quantitative and qualitative data collection. Quantitative data were analysed using paired sample t-tests while qualitative data was transcribed and coded for emerging themes. Results: Beneficial changes in symptomatology were found. Client narrative emphasised the importance of exposure response prevention (ERP), creation of an OCD community as well as enhanced functionality in clients' lives. Clients also commented on why they believed the treatment worked and points of potential improvement for discharge planning and programme organisation. Conclusions: This study adds to the growing body of evidence regarding the importance of intensive services for individuals experiencing severe symptoms of OCD. Enhancing accessibility to services and ensuring ongoing maintenance of gains will be important next steps in ensuring long-term recovery for individuals with severe symptoms of OCD. Intensive services treatment for OCD has been found to be beneficial for clients and this paper demonstrates the first time this has been seen within a Canadian programme. Treatment provided decreased OCD severity and increased functionality and quality of life. Clients cited exposure and response prevention work as a key ingredient in their recovery. Our programme is always in an ongoing state of quality improvement, ensuring client engagement and satisfaction. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has significant impact on long-term care (LTC) residents and staff. The purpose of this paper is to report the data gathered during a COVID-19 outbreak in a Canadian LTC home regarding staff experiences, challenges, and needs, to offer lessons learned and implications. Methods: A total of 30 staff from multiple disciplines participated in the study, including nurses, care workers, recreational staff, and a unit clerk. Focus groups (n = 20) and one-on-one interviews (n = 10) were conducted as part of a larger participatory action research (PAR) study in a Canadian LTC home. All data collection was conducted virtually via Zoom, and thematic analysis was performed to identify themes. Results: Four main themes were identified: We are Proud, We Felt Anxious, We Grew Closer to Residents and Staff Members, and The Vaccines Help. Conclusions: This research details the resilience that characterizes staff in LTC, while highlighting the emotional toll of the pandemic, particularly during an outbreak. LTC staff in this study found innovative ways to connect and support residents and this resulted in stronger connections and relationships. Leadership and organizational support are pivotal for supporting team resilience to manage crisis and adapt positively in times of COVID-19 pandemic, especially during the period of outbreak. [ABSTRACT FROM AUTHOR]

There has been a growing focus on healthy aging in the political agenda. Discourses contained within policy documents have the potential to shape our notions of healthy aging and well-being. This comprehensive critical document analysis of provincial aging policies in Newfoundland and Labrador (2006–2015) contributes to a larger research study exploring aging women's notions of health and the body in relation to the aging process. The findings highlight how healthy aging discourses focus on the concept of productivity and how a certain type of health is required for ongoing contribution. The paper concludes by arguing that if healthy aging is framed around one's ability to remain productive, notions of health will remain limited to an externalized measure of output versus subjective experience of well-being. [ABSTRACT FROM AUTHOR]

Background: Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is critically important as modern healthcare provides persons with different options at end-of-life to relieve suffering. The purpose of this paper is to present findings specific to the understanding and application of suffering in the context of MAID from nurses' perspectives. Methods: A longitudinal qualitative descriptive study using semi-structured telephone interviews. Inductive analysis was used to construct a thematic account. The study received ethical approval and all participants provided written consent. Results: Fifty nurses and nurse practitioners from across Canada were interviewed. Participants described the suffering of dying and provided insights into the difficulties of treating existential suffering and the iatrogenic suffering patients experienced from long contact with the healthcare system. They shared perceptions of the suffering that leads to a request for MAID that included the unknown of dying, a desire for predictability, and the loss of dignity. Eliciting the suffering story was an essential part of nursing practice. Knowledge of the story allowed participants to find the balance between believing that suffering is whatever the persons says it is, while making sure that the MAID procedure was for the right person, for the right reason, at the right time. Participants perceived that the MAID process itself caused suffering that resulted from the complexity of decision-making, the chances of being deemed ineligible, and the heighted work of the tasks of dying. Conclusions: Healthcare providers involved in MAID must be critically reflective about the suffering histories they bring to the clinical encounter, particularly iatrogenic suffering. Further, eliciting the suffering stories of persons requesting MAID requires a high degree of skill; those involved in the assessment process must have the time and competency to do this important role well. The nature of suffering that patients and family encounter as they enter the contemplation, assessment, and provision of MAID requires further research to understand it better and develop best practices. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary results of a one and a half-year ethnographic study conducted in Victoria, British Columbia, Canada. The research focused on participants' experiences of their bodies in the context of yoga as a health practice—specifically how they conceptualised their musculoskeletal bodies in this practice through ideas of systems, fragments, and materiality. It argues that participants' larger narratives about health and healthy bodies inform how yoga as a health practice is embedded in discourses of body work where yoga, health, and particular notions of bodily-ness become a project for the transformation of the self into a particular idea of what a body is or should be. [ABSTRACT FROM AUTHOR]

Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded in feminist political economy approaches, to evaluate the gendered effects of the COVID-19 pandemic and response in four case studies: China, Hong Kong, Canada, and the UK. Through a rapid scoping of documentation of the gendered effects of the outbreak, it applies the matrix framework to analyse findings, identifying common themes across the case studies: financial discrimination, crisis in care, and unequal risks and secondary effects. Results point to transnational structural conditions which put women on the front lines of the pandemic at work and at home while denying them health, economic and personal security – effects that are exacerbated where racism and other forms of discrimination intersect with gender inequities. Given that women and people living at the intersections of multiple inequities are made additionally vulnerable by pandemic responses, intersectional feminist responses should be prioritised at the beginning of any crises. [ABSTRACT FROM AUTHOR]

The purpose of this paper is threefold: firstly, to provide a brief overview of current practice in workplace mental health and introduce an emerging role for occupational therapy in this field (i.e., practicing at the organizational level where "clients" are workplaces or organizations, and not individual workers); secondly, to present the findings from a small qualitative study which describes this emerging role from the perspectives of occupational therapists who have worked in this area; and thirdly, to provide suggestions for future work which could advance this emerging role for occupational therapy world-wide. Previous research suggests that there is an increasing interest among employers to address workplace mental health through organizational initiatives and that occupational therapists are beginning to consult on the topic. Occupational therapists in our small qualitative study described their role in organizational workplace mental health as one which involves adopting a business lens, practicing in an organization-centred manner, and focusing on population health promotion. Suggestions for future work to advance this emerging role include identifying the fundamental elements of the business lens, investigating models and frameworks to guide organization-centred practice, evaluating the short-, medium-, and long-term outcomes of interventions, exploring the fit between an occupational perspective and workplace mental health, and examining the impact of COVID-19 on current practice. [ABSTRACT FROM AUTHOR]

In recent years, health promotion has come under critique for being framed according to the contexts and priorities of Western communities, with the notion of 'control' underpinning much of its theoretical and practical development. Ceding space to Indigenous voices and knowledge is one way forward to overcoming this limitation and decolonizing the field. This paper reports on insights gained from a participatory digital storytelling project focused on Indigenous health promotion that took place at M'Wikwedong Indigenous Friendship Centre in the city of Owen Sound, Canada. The research team was formed by M'Wikwedong's Executive Director, five Indigenous youth and two university researchers. We co-created data through an 8-month digital storytelling process that involved 13 weekly research meetings, the creation of 4 digital stories and video screenings. We analysed data from seven group interview transcriptions, field notes and video transcripts through qualitative coding and theme building. The four themes we identified speak to the ways M'Wikwedong reinforced connections to youth, their sense of self, place in the city and Indigenous cultures. From our findings, we theorize that egalitarianism of knowledge, restoring balance in relationships and Indigenous leadership are core components of an 'ethos of connection' that underlies Indigenous health promotion. The 'ethos of connection' challenges Western notions of 'control' and brings attention to the unique expertise and practices of urban Indigenous communities and organizations as a primary basis for health promotion. [ABSTRACT FROM AUTHOR]

The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Although the seminal work of McCormack et al. (International Practice Development Journal, 2015, 5, 1) and Nolan, Davies, Brown, Keady, and Nolan () provides useful conceptual frameworks in person‐centred care, research is needed to understand how theoretical concepts can be applied into practice to support dementia care. Also, evidence is needed to demonstrate the impacts of implementing person‐centred care and staff experiences. What does this paper add to existing knowledge?: This paper adds to the emerging work that is providing a greater understanding of how team education in practice can make a difference in building capacity to improve dementia care.We offer timely evidence and useful insights into how an education programme, Gentle Persuasive Approaches (GPA), was implemented ("what worked" and "how") in a large Canadian hospital to improve knowledge and skills among staff in dementia care.The GPA education helped hospital staff enact person‐centred care by cultivating shared values and a learning environment to change attitudes, practices and conditions for continuous practice development. What are the implications for practice?: Mental health nurses in advance practice are well positioned to lead dementia education and advocate for person‐centred care in hospitals.Hospital leaders are responsible for providing resources to cultivate a supportive environment for continuous learning to ensure the workforce gains the capacity to meet the changing demands and needs of the ageing population. System support is essential for creating conditions to enable person‐centred care. Introduction: Hospital staff lacks knowledge and skills in dementia care. There is a need to understand how person‐centred care theory can be operationalized in staff's practices to improve dementia care. Aims: To describe the staff's experiences of learning and applying the Gentle Persuasive Approaches (GPA) to enact person‐centred care in a hospital. Methods: Mixed methods, including posteducation survey and focus groups, were used. Thematic analysis was conducted to identify themes that describe participants' experiences. Results: Three hundred and ten staff and leaders in a hospital participated in the GPA education and completed a posteducation survey (n = 297). After 1 year, two follow‐up focus groups were conducted with interdisciplinary staff (n = 24) across medicine and mental health programmes. Our analysis identified three themes to enable person‐centred care: (a) changing attitudes, (b) changing practices and (c) changing conditions. Discussion: This study contributes to the literature by providing evidence of how an education programme was implemented in a large Canadian hospital to build capacity for dementia care. Joint education for interprofessional staff offers value in enabling person‐centred care. Implication: Mental health nurses are in position to lead dementia education and advocate for person‐centred care in hospitals. Staff need structural support to engage in team learning for practice improvement. [ABSTRACT FROM AUTHOR]

Discourses on later-life housing and care are polarised. Ageing in place – typically in one's long-term dwelling – is often presented as the most desirable living arrangement, while moving to a congregate environment tends to be regarded as a last resort. Such polarised discourses obscure older people's experiences as they contemplate needs for housing, health and social care. To expand current understandings of mobility intentions, this paper examines 'time work' – or actions undertaken to exert some agency over time – as older people with chronic health conditions and disabilities navigate present and future support arrangements. Based on an interpretive analysis of qualitative interviews with 22 older persons receiving home care in Ontario, Canada, I identify three themes that highlight the temporal aspects of mobility intentions: (a) maintaining continuity with the past and present, (b) constructing alternative futures and (c) facing precarity. Focusing on time work shows how people make sense of ageing in place and/or relocating not only in relation to their physical, social and psychological capacities, but also in relation to perceptions of the past, present and future. Time work, moreover, has implications for feelings of security in the present and a sense of control over the future. Based on these findings, I make suggestions for developing a comprehensive continuum of supports, so all older people can make meaningful choices concerning housing and care. [ABSTRACT FROM AUTHOR]

Introduction: With governments worldwide reducing their involvement in the provision of institutional long‐term elder care, community‐based family caregivers (FCs) have become a key element in policies aimed at improving the quality of healthcare systems and maintaining their financial sustainability. This paper uses data from focus groups with FCs providing care to older adults to describe their approaches to and priorities for achieving care quality and sustainability as they work with formal health and social care systems. It describes FCs' views on information and communications technology (ICT) as potential supports for achieving these care quality and sustainability goals. Methods: We held 10 focus groups from May 2017 to August 2018 and recruited 25 FCs through a mix of convenience and snowball sampling strategies. We employed an inductive approach and used qualitative thematic content analysis methods to examine and interpret the resulting data. We used NVIVO 12 software for data analysis. Results: Quality of care – as delivered by both FCs themselves, and formal health and social care systems – was a major preoccupation for our participants. They saw communications quality as a key aspect of the broader concept of care quality. Our data analysis produced a typology of communications quality from the FC perspective. Analysis of our data also revealed ICT development opportunities and available products in key areas. Conclusions: Our findings suggest that the formal care system providers could be more caregiver‐oriented in their communications by engaging FCs in the decision‐making process and allowing them to express their own concerns and goals. The implication of our findings for those seeking to develop policies and ICT products in support of FCs is that these should focus on human relationships and seek to expand facilitative communications. [ABSTRACT FROM AUTHOR]

Objective: The overall aim of the present paper is to elicit the subjective perceptions and experiences of people with Severe Mental Illness (SMI) involved in a Participatory Video project, with a focus on self-reported impact on recovery. There are 2 subobjectives, namely (a) to document which specific aspects (if any) of Participatory Video project participation are reported to positively influence recovery; and (b) to assess the impact of project involvement on specific dimensions of recovery. Method: In this project, 3 workgroups of people with Severe Mental Illness met approximately twice per week over a 2-year period to make and disseminate educational videos about mental illness. Workgroup participants (n = 20) took part in an in-depth semistructured qualitative interview at project end to understand their experience in the project, especially impact on recovery. Data was analyzed using thematic analysis techniques. Results: At completion, participants had made 26 videos and organized 49 community screenings reaching over 1,500 people. Participants reported that regular involvement in this project fostered their recovery in a variety of ways, imparting multiple psychosocial benefits, which are summarized in 5 themes: (a) skill-acquisition, (b) platform and voice, (c) connectedness, (d) a meaningful focus, and (e) personal development. Conclusions and Implications for Practice: Participatory Video is a powerful group intervention which positively benefits workgroup participants. Importantly, results overlap with other research indicating that grassroots-produced mental health themed videos can educate viewers and reduce public stigma. As such, psychiatric rehabilitation organizations should consider initiating similar projects in their own locales. Impact and Implications: Participatory Video is an innovative group program where marginalized people get together to produce documentary-type videos about their lives, which are then screened at community venues. This study found that regular involvement in a successful Participatory Video program helped foster the recovery of participants with severe mental illness. This suggests that Participatory Video is a recovery-oriented intervention, which could be initiated by mental health services and peer support organizations elsewhere. [ABSTRACT FROM AUTHOR]

Between 2015 and 2019, over 100 Indigenous women from six provinces and two territories have come forward to say that they were forced or coerced to undergo a sterilization procedure in Canada. Despite this, government action is lacking. Through this paper, the research team aims to collect and synthesize the recommendations that have been made in response to the recent cases of forced or coerced sterilization of Indigenous women in Canada. Through a secondary analysis of data, we outline the findings of a thematic analysis of 162 recommendations from four selected sources: (a) Tubal Ligation in the Saskatoon Health Region: The Lived Experience of Aboriginal Women, an external review by Senator Yvonne Boyer and Dr. Judith Bartlett, July 22, 2017; (b) a meeting of the Senate Committee on Human Rights, April 3, 2019; (c) meetings of the House of Commons Standing Committee on Health, June 13 and 18, 2019; and (d) a letter from Bill Casey, Member of Parliament and Chair of the House of Commons Standing Committee on Health, to three federal ministers, August 2, 2019. Seven themes emerged following the thematic analysis of the 162 recommendations: (a) Services and Supports, (b)Accountability, (c) Training and Education, (d) Legislation and Policy, (e) Criminalization, (f) Data Collection, and g) Investigation. These themes represent seven areas where immediate government action is required to meaningfully and appropriately respond to the recent cases of forced or coerced sterilization of First Nations, Inuit, and Metis women in Canada. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of primary care practitioners in refugee resettlement countries are providing care to refugees. Access to trained interpreters is a priority for these practitioners, but there are many barriers to the implementation of interpreted consultations in routine care. There is a lack of international, theoretically informed research. The purpose of this paper is to understand barriers to interpreter use in primary care consultations in four resettlement countries using Normalisation Process Theory. Method: We conducted a cross-sectional online survey with networks of primary care practitioners (PCPs) who care for refugees in Australia, Canada, Ireland and the US (n = 314). We analysed qualitative data from the survey about barriers to interpreter use (n = 178). We completed an inductive thematic analysis, iteratively developed a Normalisation Process Theory (NPT)-informed coding frame and then mapped the emergent findings onto the theory's construct about enacting interpreted consultations. Results: In all four countries, the use of an interpreter presented communication and interaction challenges between providers and patients, which can impede the goals of primary care consultations. Primary care practitioners did not always have confidence in interpreted consultations and described poor professional practice by some interpreters. There was variation across countries, and inconsistency within countries, in the availability of trained interpreters and funding sources. Conclusion: There are shared and differential barriers to implementation of interpreted consultations in a consistent and sustained way in the four countries studied. These findings can be used to inform country-specific and international level policies and interventions focusing on improving skills and resources for interpreted consultations to improve implementation of interpreted primary care consultations. [ABSTRACT FROM AUTHOR]

In this paper, we put forward a proposal for a critical geography of physical activity that attunes to experience while centring on the socio‐spatial processes and power structures enabling and constraining physical activity participation. Drawing on our research that explored women's and men's emotional geographies of an everyday exercise environment – the gym – in a Canadian city, we show how this approach can identify otherwise invisible environmental influences on physical activity participation. Our thematic analysis reveals that the gym environment is generative of three place‐based emotive processes of dislocation, evaluation, and sexualisation that collectively configure an unevenly gendered emotional architecture of place. Through this interstitial structure, the boundaries of localised hierarchies of masculinities and femininities become felt in ways that create tensions and anxieties, which in turn reinforce gendered boundaries on physical activity participation. Two additional themes reveal how gendered motivation and individual factors mediate negative emotional experiences. Our findings indicate that emotional geographies are one way in which gender disparities in physical activity are naturalised at the scale of the everyday exercise environment. Interventions for gender equity in physical activity would benefit from being empathetically attuned to the subtleties of place‐based experiences. More widely, bringing emotions into geographies of physical activity sheds light on the larger question of the role of place in (re)producing gendered health inequities, with implications for geographical research on health and social justice. Future critical geographical inquiry is necessary to ensure that public health interventions are grounded in the experiential realities of practising physical activity in particular places. [ABSTRACT FROM AUTHOR]

For children and their families who have experienced success in middle years mental health interventions, adolescence represents a developmental period when additional challenges can emerge and potentially threaten positive gains. For youth who have a history of disruptive behaviors, addressing risks and balancing interventions with a focus on skill development, leadership, and resiliency can serve to support these youth in reaching their potential. This paper will present the development of the Canadian SNAP-Boys Youth Leadership Services, a continuing-care component for youth who have had previous involvement in children's mental health services, designed to enhance protective factors or developmental assets. This exploratory qualitative study was conducted in 2017 and examined 12 youths' perspectives on what they have gained from participation in the program, and why they consider this program to be of value. We used thematic analysis to analyse interview transcripts. We identified themes of motivation, "second home", and personal growth. What youth value and their investment in the program can be linked to key positive youth development components of a skills focus, explicit leadership and employment opportunities, program structure, supportive relationships and a sense that they matter. Implications for practice, research, and policy are shared. [ABSTRACT FROM AUTHOR]