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Background Little has been done to comprehensively study the relationships between multiple well-being constructs at a time. Even less is known about whether child maltreatment and major depressive disorder (MDD) impact different well-being constructs. This study aims to examine whether maltreated or depressed individuals have specific impacts on well-being structures. Methods Data analyzed were from the Montreal South-West Longitudinal Catchment Area Study (N = 1380). The potential confounding of age and sex was controlled by propensity score matching. We used network analysis to assess the impact of maltreatment and MDD on well-being. The centrality of nodes was estimated with the ‘strength’ index and a case-dropping bootstrap procedure was used to test network stability. Differences in the structure and connectivity of networks between different studied groups were also examined. Results Autonomy and daily life and social relations were the most central nodes for the MDD and maltreated groups [MDD group: strength coefficient (SC) autonomy = 1.50; SCdaily life and social relations = 1.34; maltreated group: SCautonomy = 1.69; SCdaily life and social relations = 1.55]. Both maltreatment and MDD groups had statistical differences in terms of the global strength of interconnectivity in their networks. Network invariance differed between with and without MDD groups indicating different structures of their networks. The non-maltreatment and MDD group had the highest level of overall connectivity. Conclusions We discovered distinct connectivity patterns of well-being outcomes in maltreatment and MDD groups. The identified core constructs could serve as potential targets to maximize the effectiveness of clinical management of MDD and also advance prevention to minimize the sequelae of maltreatment.

The physical and social environments are recognized as important therapeutic tools in the care of nursing home residents with dementia, yet little is known about the environments of rural nursing homes. This study was conducted in one rural health authority (16,000 km 2) in the province of Saskatchewan. Long-term institutional care was provided in seven small (15 to 35 beds), publicly funded nursing homes, none of which had separate dementia special care units (SCUs). The Physical Environmental Assessment Protocol (PEAP) was used to evaluate the facilities on nine key dimensions of dementia care environments. Facilities were most supportive in provision of privacy and least supportive on maximizing awareness and orientation. Focus groups were conducted with registered nurses, nursing aides, and activity workers. Staff caregivers identified six special needs of residents with dementia that were difficult to meet in the nursing homes, two of which were related to the physical environment (safety and a calm, quiet environment) and four of which were related to the social environment (meaningful activity and one-to-one contact, opportunity to use remaining abilities, flexible policy, and knowledgeable caregivers who enjoy working with persons with dementia). Staff suggested separate dementia SCUs as one approach to managing dementia care but also identified challenges in creating dementia units in small rural facilities. Results provide support for conceptual models of dementia care settings that emphasize the interaction of organizational, social, and physical factors.

Introduction Excessive use of emergency departments (EDs) for the treatment of mental health complaints (MHCs) suggests alternate interventions are required. Objectives To understand attributes of patients who are high frequent users (HFUs) of EDs for the treatment for MHCs. Aims Suggest realistic changes that would make the health care system more effectively respond to HFUs needs. Methods Administrative data were used to analyze the use of all three emergency departments in Saskatoon Health Region by patients presenting with primary MHCs in 2012. A chart review of HFUs for the years 2011 to 2013 was also undertaken. Results In 2012 approximately 1.2% (3,824) of the Region’s population made the 6,235 visits for a primary MHC. ED visits exhibit a Pareto distribution with most patients (72.8%) making a single visit however Conclusions Action should be taken to identify ‘High Frequency Users’ early in their patient career and develop appropriate interventions taking into account their unique and diverse needs.

SynopsisThis paper examines a comprehensive set of data on the prevalence and correlates of psychological distress in a sample of 1038 adolescent students in a major urban area of a Canadian prairie province. About 27% of the students reported 6 or more symptoms of psychological distress on the GHQ-30. The frequency of symptoms varied with age, grade level and average marks, with sex being the most significant variation. ‘Anxiety’ and ‘social dysfunction’ were the most frequent symptom dimensions reported. More detailed analysis of possible predictors of mental health showed that the nature and quality of family life strongly affected adolescent mental health. Adolescents' positive evaluation of their school atmosphere and peer group life and their locus of control orientation also positively influenced their psychological well-being.