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In 2020–2021, a qualitative study was undertaken using an interpretive description methodology to identify what triggers grief in the first 2 years following the death of a beloved family member, and to gain other helpful insights about grief triggers from bereaved Canadian adult volunteers. In that study, a purposive sampling method was used to select 10 bereaved Canadian adult volunteers for in-depth, semi-structured interviews. This paper reports on the humor findings, as revealed to be a particularly complex grief trigger for many participants, as well as a periodic way for most to manage or live with their grief. Participant quotes and an extended discussion are included to illustrate the importance of these humor findings in relation to grief, and to inform bereaved people, bereavement service providers, and the general public about both helpful aspects and some cautionary considerations about humor. [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]

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]

This article presents data from a mixed-method study on evangelical faith-based organizations in Southern Ontario, Canada. The authors sought to explore the nature and extent of faith-sharing in these organizations by using the Convergent Triangulation Design, which permitted the use of semi-structured interviews, focus groups, surveys, and document review. First, The Great Commission acts as a de facto institutional policy in the evangelical faith-based organizations sampled; The Great Commission is a Biblical injunction, strongly observed by evangelicals, which states that evangelicals are commissioned by Jesus to share and ultimately convert others to their faith. The second theme is that in seeking to realize The Great Commission these organizations tried not to be coercive in sharing their faith. In the discussion, the paper explores briefly some of the potential ethical issues that emerge from faith-sharing in social service settings. [ABSTRACT FROM AUTHOR]

The inclusion of able-bodied athletes within disability sport, a phenomenon known as reverse integration, has sparked significant debate within adapted physical activity. Although researchers and practitioners have taken up positions for or against reverse integration, there is a lack of supporting research on the experiences of athletes who already play in such settings. In this study, we explore how competitive female athletes who have a disability experience reverse integration in Canadian wheelchair basketball. Athletic identity was used as the initial conceptual framework to guide semistructured interviews with nine participants. The results suggest that participation in this context contributed to positive athletic identities. Interviews also pointed to the unexpected theme of "what's the difference?" that this sporting context provided a space for the questioning and creative negotiation of the categories of disability and able-bodiedness. Methodologically, this paper also explores the possibilities and challenges of inter- worldview and insider-outsider research collaboration. [ABSTRACT FROM AUTHOR]

Young bisexual women experience worse mental and sexual health outcomes in comparison to their heterosexual and lesbian peers. These disparities are associated with stigma and devaluation of bisexual identities. The current paper addresses a community-based focus group project in which participants discussed bisexual stigma in regard to bisexual erasure and other stereotypes. Specifically, participants detailed experiences of feeling pressured to provide evidence of their bisexual identity, modifying their relationship or sexual behavior to conform to these expectations, as well as feeling excluded from queer community. Further, participants discussed how these experiences were related to decreased mental and sexual health. Future research should further investigate the relationship between bisexual stigma, pressure to provide evidence of bisexual identity, and negative mental and sexual health outcomes. [ABSTRACT FROM PUBLISHER]

Abstract: This paper reports on a qualitative study examining everyday practices of healthy living (HL). Forty-four semi-structured interviews were undertaken with Canadian and UK citizens, aged 45 – 70, in April–May 2010. The research sits within the now substantial literature concerned with how health information is mediated, both by people and technologies, and employed in the context of ‘good’ health citizenship. Throughout this work, notions of ‘choice’ and ‘empowerment’ have been interrogated, theoretically and empirically, to reveal both the knowledge/power relationships integral to ‘informing’ processes and the shifting relationship between information and care in contemporary health encounters. In this paper, we analyse how people make sense of what it means to live healthily and how they know if they are doing so by focussing on three ways in which study participants become informed about healthy living: through their engagement with universal HL messages, through their own information searches, and through their attempts to measure their ‘healthiness’. Following critique of the “logic of choice” in contemporary healthcare, we understand healthy living as a “situation of choice” where complex problems are framed as simple matters of choice and where information and technologies are understood as neutral aids to decision-making in support of ‘correct’ choices. Our analysis builds on and extends Mol’s work by exploring how participants negotiate between this “logic of choice” and her alternative “logic of care” in their accounts of everyday HL informing practices and how the two logics “interfere” with one another. These accounts show resistance to the logic of choice through ‘calls for care’ but they also show clearly how the disciplining logic of choice works to (re)present such calls for care as failed attempts at healthy living, undermining the very practices the logic of choice seeks to encourage. [Copyright &y& Elsevier]

Recently in Canada the issue of police encounters among persons living with a mental health issue has received considerable public attention; however, the focus has been primarily on the experiences of adults and not of children and youth. In this paper, we explore police encounters in child and youth mental health by presenting the outcomes of 14 qualitative interviews conducted with seven caregivers and seven siblings and two focus groups conducted with eight caregivers about their experiences of having a child/sibling, 13–21 years old, living with a mental health issue. There were two main themes identified: (1) the need for police support to deescalate a high conflict situation involving a distressed child/sibling, and (2) the stigmatisation and criminalisation of the distressed child, parents and families. Based on these outcomes, a model of support is proposed whereby parents would be provided with crisis intervention training informed by an understanding of the stigma of mental illness as a structural condition of their personal experiences. Such training could provide caregivers with support for identifying and responding to crisis and for developing safety plans that may or may not involve police, but could minimise and/or divert the need for their involvement. [ABSTRACT FROM PUBLISHER]

This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer ( LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to good-quality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse home-care service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, 'provider education' and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives. [ABSTRACT FROM AUTHOR]

The research described herein was a three-year exploratory descriptive study to examine how meaningful involvement (MIPA) is conceptualized and experienced in rural regions of the Maritime provinces of Canada. The focus of this paper is one aspect of the research; i.e., what motivates the clients of AIDS Service Organizations (ASOs) in rural Canada to become meaningfully involved? We interviewed 34 people who were past or current clients of ASOs in Maritime Canada and who self-reported as engaging in at-risk behaviors for HIV or living with HIV. The interviews explored participants' perspectives about their motives for becoming meaningfully involved in an ASO. Three themes regarding motives for MIPA were revealed: (1) meeting personal needs; (2) making a difference to others; and (3) recognizing a fit between their skills, goals, needs and the opportunities and experiences within the ASO and with other ASO clients. Participants generally cited more than one motive. This research study contributed to the field of knowledge about the motives for MIPA in which it reveals (1) that MIPA was conceptualized by the rural ASO clients as whatever participation provided them personal meaning (i.e., by fulfilling a personal need, by making a difference, and by recognizing a fit) and (2) the important role that ASO staff and volunteers have in fostering and sustaining MIPA. The study also highlighted a trajectory of involvements that support the need for ASOs to entertain a wide range of roles that are assumed as MIPA. [ABSTRACT FROM AUTHOR]

The disappointing results of many public health interventions have been attributed in part to the lack of meaningful community engagement in the planning, implementation, and evaluation of these initiatives. Community-based participatory research (CBPR) has emerged as an alternative research paradigm that directly involves community members in all aspects of the research process. Their involvement is often said to be an empowering experience that builds capacity. In this paper, we interrogate these assumptions, drawing on interview data from a qualitative study investigating the experiences of 18 peer researchers (PRs) recruited from nine CBPR studies in Toronto, Canada. These individuals brought to their respective projects experience of homelessness, living with HIV, being an immigrant or refugee, identifying as transgender, and of having a mental illness. The reflections of PRs are compared to those of other research team members collected in separate focus groups. Findings from these interviews are discussed with an attention to Foucault’s concept of ‘governmentality’, and compared against popular community-based research principles developed by Israel and colleagues. While PRs spoke about participating in CBPR initiatives to share their experience and improve conditions for their communities, these emancipatory goals were often subsumed within corporatist research environments that limited participation. Overall, this study offers a much-needed theoretical engagement with this popular research approach and raises critical questions about the limits of community engagement in collaborative public health research. [ABSTRACT FROM PUBLISHER]

Background: Medical education has traditionally been compartmentalized into basic and clinical sciences, with the latter being viewed as the skillful application of the former. Over time, the relevance of basic sciences has become defined by their role in supporting clinical problem solving rather than being, of themselves, a defining knowledge base of physicians. Methods: As part of the national Future of Medical Education in Canada (FMEC MD) project, a comprehensive empirical environmental scan identified the timing and integration of basic sciences as a key pressing issue for medical education. Using the literature review, key informant interviews, stakeholder meetings, and subsequent consultation forums from the FMEC project, this paper details the empirical basis for focusing on the role of basic science, the evidentiary foundations for current practices, and the implications for medical education. Findings: Despite a dearth of definitive relevant studies, opinions about how best to integrate the sciences remain strong. Resource allocation, political power, educational philosophy, and the shift from a knowledge-based to a problem-solving profession all influence the debate. There was little disagreement that both sciences are important, that many traditional models emphasized deep understanding of limited basic science disciplines at the expense of other relevant content such as social sciences, or that teaching the sciences contemporaneously rather than sequentially has theoretical and practical merit. Innovations in integrated curriculum design have occurred internationally. Less clear are the appropriate balance of the sciences, the best integration model, and solutions to the political and practical challenges of integrated curricula. Discussion: New curricula tend to emphasize integration, development of more diverse physician competencies, and preparation of physicians to adapt to evolving technology and patients' expectations. Refocusing the basic/clinical dichotomy to a foundational/applied model may yield benefits in training widely competent future physicians. [ABSTRACT FROM AUTHOR]

Background Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. Methods This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. Results Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. Conclusions In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit. [ABSTRACT FROM AUTHOR]

This paper deals with the initial steps of the judicial process for persons with intellectual disabilities who are suspected of a minor offense; a stage where plaintiffs, police officers, and crown attorneys make a series of decisions that will have a significant impact on the course of the judicial process. The objective of this study was twofold: (i) to document the criteria that influence dispositions by police officers and crown attorneys about persons with intellectual disabilities in the criminal justice system (CJS), (ii) to report suggested improvements to better support them throughout the judicial process. Fourteen semi-structured interviews were conducted with key informants from the CJS and from service and community organisations working in the field of intellectual disabilities. The results of this qualitative study indicate that decisions made and dispositions taken rely on a series of implicit criteria that influence the course of the subsequent judicial procedures against persons with an intellectual disability. Suggestions for improvement pertain to developing the screening of intellectual disability procedures, the provision of information to key actors about intellectual disabilities, a preference for the use of summons to appear over other types of procedures, and drafting memorandums of understanding between various organisations and police services regarding persons with intellectual disabilities. In conclusion, an emphasis must be put on screening and diversion procedures for persons with intellectual disabilities when appropriate. [ABSTRACT FROM AUTHOR]

kwong e.w.-y., pang s.m.-c., choi p.-p. & wong t.k.-s. (2010) Influenza vaccine preference and uptake among older people in nine countries. Journal of Advanced Nursing 66(10), 2297–2308. Aim. This paper is a report of a study delineating factors that influence older people’s preferences and uptake of the influenza vaccine in nine countries. Background. Vaccination uptake for the aging population in many countries still remains below the World Health Organization recommended rate. Older people who perceive higher susceptibility to and severity of influenza, and more benefits from vaccination and action cues prompting vaccination, tend to accept the vaccine, but those with more perceived barriers to vaccination are less likely to accept it. Method. A total of 208 older people from China, Indonesia, Turkey, Korea, Greece, Canada, the United Kingdom, Brazil and Nigeria were recruited to 14 vaccinated and 12 unvaccinated focus groups. They shared their experiences of influenza, and influenza vaccination, and promotion of influenza vaccination in focus groups. The data were collected in 2007. Findings. We identified five themes and generated a hypothetical framework for in-depth understanding of vaccination behaviour among older people. Participants’ vaccine preferences were determined by their behavioural beliefs in vaccination, which were based on their probability calculation of susceptibility to and severity of influenza and vaccine effectiveness, and their utility calculation of vaccine, healthcare and social costs. Action cues prompting vaccination and vaccine access further affected the vaccine uptake of participants with vaccine preferences. Vaccination coverage was likely to be higher in the countries where normative beliefs in favour of vaccination had formed. Conclusion. The hypothetical framework can be used to guide healthcare providers in developing strategies to foster normative beliefs of older people in vaccination, provide effective action cues and promote vaccine access. [ABSTRACT FROM AUTHOR]