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Background: Youth mental health service organizations continue to rapidly broaden their use of virtual care and digital mental health interventions as well as leverage artificial intelligence and other technologies to inform care decisions. However, many of these digital services have failed to alleviate persistent mental health disparities among equity-seeking populations and in some instances have exacerbated them. Transdisciplinary and intersectional knowledge exchange is greatly needed to address structural barriers to digital mental health engagement, develop and evaluate interventions with historically underserved communities, and ultimately promote more accessible, useful, and equitable care. Methods: To that end, the Digital, Inclusive, Virtual, and Equitable Research Training in Mental Health Platform (DIVERT), the Maritime Strategy for Patient Oriented Research (SPOR) SUPPORT (Support for People and Patient-Oriented Research and Trials) Unit and IWK Mental Health Program invited researchers, policymakers, interprofessional mental health practitioners, trainees, computer scientists, health system administrators, community leaders and youth advocates to participate in a knowledge exchange workshop. The workshop aimed to (a) highlight local research and innovation in youth-focused digital mental health services; (b) learn more about current policy and practice issues in inclusive digital mental health for youth in Canada, (c) participate in generating action recommendations to address challenges to inclusive, diverse and equitable digital mental health services, and (d) to synthesize cross-sector feedback to inform future training curriculum, policy, strategic planning and to stimulate new lines of patient-oriented research. Results: Eleven challenge themes emerged related to white-colonial normativity, lack of cultural humility, inaccessibility and affordability of participating in the digital world, lack of youth and community involvement, risks of too much digital time in youth's lives, and lack of scientific evidence derived from equity-deserving communities. Nine action recommendations focused on diversifying research and development funding, policy and standards, youth and community led promotion, long-term trust-building and collaboration, and needing to callout and advocate against unsafe digital services and processes. Conclusion: Key policy, training and practice implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Care partners are individuals chosen by a person with an illness to support their care during hospitalization. Patients with persistent critical illness have longer than average critical care admission and often other conditions including dysphagia, communication vulnerability, severe physical deconditioning, the need for an artificial airway, and difficulty weaning from invasive mechanical ventilation. Family presence has been identified as important for patients experiencing persistent critical illness in specialized weaning centers. Despite this, the role of care partners in clinical settings for patients with persistent critical illness has not been fully characterized, particularly from the perspectives of patients, care partners, and health care providers. The aim of this study was to gain insights into the roles of care partners during persistent critical illness from the perspectives of patients, care partners, and health care providers. Methods: We used qualitative descriptive methodology including semi-structured interviews and content analysis. Interviews were audio recorded and transcribed verbatim. Included participants (n = 30) were patient survivors (n = 7), care partners of patient survivors (n = 9), and professionally diverse health care providers (n = 14) of adult patients with persistent critical illness from two specialized units in one community academic hospital in Toronto, Canada. Results: Participants across all groups described care partner roles that included physical, mental health, cognitive, social, and spiritual support of the patient, including the perceived role of safeguarding the multiple dimensions of care for the patient who is experiencing persistent critical care in specialized care settings. Discussion: The results of this study are being used to co-design, implement, and evaluate a sustainable care partner program that is acceptable, appropriate, and feasible to implement in clinical settings where the care of patients with persistent critical illness occurs. Reporting method: Consolidated criteria for reporting qualitative studies (COREQ). [ABSTRACT FROM AUTHOR]

AIM The aimof this study was to analyze nursing student level of knowledge and understanding of current experiences of Indigenous people within the Canadian health care system to identify curricular gaps that need to be addressed. BACKGROUND In response to the 2015 Truth and Reconciliation Commission of Canada, nursing schools have begun incorporating Indigenous health content into curricula. However, few studies about the implementation and effectiveness of this education exist. METHOD Students wrote a reflection and engaged with colleagues' reflections after watching a video from the Aboriginal Peoples Television Network. Fifteen reflections were selected using systematic, random sampling to undergo thematic analysis. RESULTS Two themes were identified: 1) students' understanding of barriers Indigenous populations face when accessing the health care system and 2) students' perceptions of strategies to ensure culturally safe care for Indigenous populations. CONCLUSION Analysis of students' learning through a reflection activity can improve the Indigenous health content curriculum. [ABSTRACT FROM AUTHOR]

Aim: To learn from two jurisdictions with mature genomics‐informed nursing policy infrastructure—the United States (US) and the United Kingdom (UK)—to inform policy development for genomics‐informed oncology nursing practice and education in Canada. Design: Comparative document and policy analysis drawing on the 3i + E framework. Methods: We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis. Results: We found several types of policy documents guiding genomics‐informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes. Conclusion: Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education. Implications for the profession: Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics‐informed oncology nursing practice and education within an interprofessional context. Impact: This study informs Canadian policy development for genomics‐informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics. [ABSTRACT FROM AUTHOR]

The article features iCAN, the International Children's Advisory Network, the premier global pediatric platform empowering the patient voice in healthcare, driven by youth for youth. Topics discussed include characteristics of youth members of iCAN, the participation of Dr. Mary Jo Klein in iCAN KIDS in a special Ask the Experts (ATE) session on bioethics in October 2024, and significance of UCB's fundraising success to iCAN.

Although contraception and abortion are considered medically necessary services, providers in Canada are permitted to deny services and referrals on the basis of their personal beliefs or conscience. Belief-based denial, sometimes referred to as "conscientious objection," remains a controversial issue leading to barriers to access and provision of care. We carried out a scoping review to explore what is currently known about the belief-based denial of contraception and abortion care in Canada. We used a predefined framework to search for relevant sources and found a total of 97 articles including 27 peer-reviewed articles, 47 media articles, and 23 articles from reproductive health organizations, published since 1990. The literature we found shows that policy has been a key area of discussion; sources also focus on conceptually defining belief-based denial and advocacy efforts for reproductive rights. There is a stark lack of peer-reviewed literature documenting and examining the impact of belief-based denial of contraception and abortion care on those denied care in Canada. [ABSTRACT FROM AUTHOR]

Aims: To shed light on the process of advocacy in the context of community health nursing, through a methodology inspired by the epistemologies of the South. Design: We conducted a collaborative ethnography in a community health centre in Canada. Methods: de Sousa Santos' epistemologies of the South, a typology of advocacy and main themes from historic research informed the methodology. Data were collected between 2016 and 2018 through 420 h of fieldwork observations and three group discussions, including a collective process to co‐construct interpretations with participants. Twenty‐one nurses participated in the study. Results: Nurses had sufficient work flexibility to practice advocacy actions focused on individuals and groups. They also engaged in attempts at policy reform in the form of defending access to appropriate care and changing the mode of care organization. However, these were curbed by bureaucracy and administrative rules, resulting in the eventual dismissal of health promotion actions and experiences of moral distress. Conclusion: Despite the political climate of their work environment impeding social justice agendas, nurses' advocacy practices showed a persistence of moral values and ideals in coherence with the regional nursing legacy. Implications for the Profession and/or Patient Care: Acting at the organizational level and involving field nurses in decision making are potential avenues for increasing policy advocacy efficacy. Impact: Examining contexts through another epistemic lens and methods of research drawing on history and anthropology has shed light on a process of advocacy. This research shows that organizations need to equip themselves with mechanisms to promote the sharing of realities between nurses, thereby building collective advocacy. Reporting Method: The research adheres to the EQUATOR guidelines with SRQR and COREQ methods. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

This study aims to understand what is known about the high performing or exceptional learner in medical education. There is a rich literature about learners in difficulty, yet little is known about those performing at the high end, also known as exceptional learners. A qualitative study was undertaken whereby 15 faculty members at the University of Toronto were interviewed to explore their experiences with these learners. Based on the findings, we developed a framework to categorize characteristics of exceptional learners by differentiating them as either 'Being' (a pre-existing attribute or set of values that the learner possesses from the start of training) or 'Doing' (demonstrable characteristics that can be observed or measured). Using this framework, we identified five characteristics in the category of 'Being', five in the category of 'Doing', and two that could be situated in either or both. Utilizing this framework to describe exceptional learners will aid teachers in identifying them early in their training so that their training experience can be enhanced. This novel approach contributes to our knowledge of the exceptional medical learner. The optimization of the training experience will maximize the opportunity to ensure that these learners reach their full potential to contribute to the healthcare system. [ABSTRACT FROM AUTHOR]

Adolescents and young adults (AYAs; 15–39 years) diagnosed with cancer face disparities in outcomes and survival. Patient advocacy organizations can play a pivotal role in advancing outcomes for underserved health conditions, such as AYA cancer. In 2018 a group of AYA patient advocates founded AYA Canada (later renamed to "AYA Can—Canadian Cancer Advocacy"), a peer-led national organization aimed at improving the experiences and outcomes of Canadian AYAs affected by cancer. The aim of this article is to describe the development and impact of AYA Can. AYA Can was incorporated as a not-for-profit organization in 2021 and became a registered charity in 2023. Since 2018, AYA Can has established a thriving community of practice comprising nearly 300 patients, healthcare providers, researchers, and charitable organizations with an interest in advocacy for AYA cancer. Other activities have included advocacy at academic conferences and on scientific committees, collaboration with scientists to advance AYA cancer research, training the next generation of AYA patient advocates through a "patient ambassador program," and developing a national resource hub to centralize knowledge and information on AYA cancer. Through its work to foster collaboration and amplify patient priorities on a national scale, AYA Can has become a leading voice for AYA cancer advocacy in Canada. [ABSTRACT FROM AUTHOR]

Context: Engaging with peers is gaining increasing interest from healthcare systems in numerous countries. Peers are people who offer support by drawing on lived experiences of significant challenges or 'insider' knowledge of communities. Growing evidence suggests that peers can serve as a bridge between underserved communities and care providers across sectors, through their ability to build trust and relationships. Peer support is thus seen as an innovative way to address core issues of formal healthcare, particularly fragmentation of care and health inequalities. The wide body of approaches, goals and models of peer support speaks volumes of such interest. Navigating the various labels used to name peers, however, can be daunting. Similar terms often hide critical differences. Objectives/Background: This article seeks to disentangle the conceptual multiplicity of peer support, presenting a conceptual map based on a 3‐year knowledge synthesis project involving peers and programme stakeholders in Canada, and international scientific and grey literature. Synthesis/Main Results: The map introduces six key questions to navigate and situate peer support approaches according to peers' roles, pathways and settings of practice, regardless of the terms used to label them. As a tool, it offers a broad overview of the different ways peers contribute to integrating health and community care. Discussion: We conclude by discussing the map's potential and limitations to establish a common language and bridge models, in support of knowledge exchange among practitioners, policymakers and researchers. Patient or Public Contribution: Our team includes one experienced peer support worker. She contributed to the design of the conceptual map and the production of the manuscript. More than 10 peers working across Canada were also involved during research meetings to validate and refine the conceptual map. [ABSTRACT FROM AUTHOR]

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed. [ABSTRACT FROM AUTHOR]

Objective: To describe the solutions community health nurses (CHNs) identify to address health inequities during the COVID‐19 pandemic and to explore what leadership competencies enable CHNs to enact these solutions. Design: Online survey, distributed to all members of the Community Health Nurses of Canada and associated provincial and territorial networks. Participants: Inclusion criteria included all nurses who were working during the COVID‐19 pandemic in Canada. A total of 245 responses were included in the analysis. Measurement: The survey included 25 open ended and fixed response questions. Descriptive statistics were used to describe the quantitative data. Framework Analysis was used to analyze the qualitative data. Results: Solutions focused on advancing health equity and expanding community relationships and partnerships were identified as priorities. To enact these solutions system transformation, engaging others, and developing coalitions were identified as the main leadership competencies required by CHNs. Conclusion: Participants in this study clearly articulated structural and process solutions to address health inequities among priority populations during the pandemic. CHNs described with practice knowledge and confidence that solutions enacted in system transformation with community partners are necessary to advance health equity. [ABSTRACT FROM AUTHOR]

Medical-legal partnerships bring legal services directly into clinical settings. Policy advocacy is often opportunistic and varies across partnerships. Our objective was to study policy advocacy that emerged from a medical-legal partnership in Toronto over a four-year period. This study consisted of a document review and thematic analysis, triangulated with data from interviews with legal team members and health providers. We defined policy advocacy as actions associated with attempts to change policy or legislation. The medical-legal partnership engaged in seven distinct cases of policy advocacy: disability support form requirements, changing workplace review, challenging barriers to citizenship, housing, publicly funded medication program (pharma care), safe injection sites, and the need for increased social assistance. Actions taken included presentations at conferences and submissions of briefs to government. We found that a medical-legal partnership resulted in policy advocacy with issues arising from both the health and the legal team with impacts likely greater than if each group had acted alone. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Art Therapy is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A growing body of evidence suggests that news media which includes a sympathetic portrayal of a mother bereaved by substance use can increase public support for harm reduction initiatives. However, the extent to which such news media coverage occurs in Canada is unknown, and research has not documented how the news media in Canada covers such stories. We undertook a mixed-method secondary analyses of 5681 Canadian newspaper articles on harm reduction (2000–2016). Quantitative analyses described the volume and content of harm reduction reporting featuring a mother whose child's death was related to substance use while qualitative thematic analysis provided in-depth descriptions of the discourses underlying such news reporting. Newspaper articles featuring a mother whose child's death was related to substance use were rarely published (n = 63; 1.1% of total harm reduction media coverage during the study period). Deductive content analysis of these 63 texts revealed that coverage of naloxone distribution (42.9%) and supervised drug consumption services (28.6%) were prioritized over other harm reduction services. Although harm reduction (services or policies) were advocated by the mother in most (77.8%) of these 63 texts, inductive thematic analysis of a subset (n = 52) of those articles revealed that mothers' advocacy was diminished by newspaper reporting that emphasized their experiences of grief, prioritized individual biographies over structural factors contributing to substance use harms, and created rhetorical divisions between different groups of people who use drugs (PWUD). Bereaved mothers' advocacy in support of harm reduction programs and services may be minimized in the process of reporting their stories for newspaper readers. Finding ways to report bereaved mothers' stories in ways that are inclusive of all PWUD while highlighting the role of broad, structural determinants of substance use has the potential to shift public opinion and government support in favour of these life-saving services. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and health services impacts related to physical distancing posed many challenges for older adults with cancer. The goal of this study was to examine the impact of the pandemic on cancer treatment plans and cancer treatment experiences of older adults (ie, aged 65 years and older) and their caregiver' experiences of caring for older adults during the pandemic to highlight gaps in care experienced. In this multi-centre qualitative study guided by an interpretive descriptive research approach we interviewed older adults diagnosed with cancer and caregivers caring for them. Participants were recruited via cancer treatment centres in the provinces of British Columbia and Ontario (Vancouver and Toronto), Canada, and through an online ad sent out through patient advocacy organization newsletters. Interviews were recorded and transcribed verbatim and data were analyzed using an interpretive thematic analysis approach. A total of 27 individuals (17 older adults, 52.9% female; 10 caregivers, 90% female) participated in interviews lasting on average 45 minutes. Older adults with cancer described many impacts and pressures created by the pandemic on their cancer experiences, though they generally felt that the pandemic did not impact treatment decisions made and access to care. We grouped our findings into two main themes with their accompanying sub-themes, related to: (1) alterations in the individual and dyadic cancer experience; and (2) navigating health and cancer systems during the pandemic. The additional stressors the pandemic placed on older adults during their treatment and decision-making process and their caregivers expose the need to create or avail additional supports for future disruptions in care. [ABSTRACT FROM AUTHOR]

Background: Health navigators are healthcare professionals who specialize in care coordination, case management, navigating transitions, and reducing barriers to care. There is limited literature on the impact of health navigators on community-based palliative care for people experiencing homelessness. Aim: We devised key performance indicators in nine categories with the aim to quantify the impact of a health navigator on the delivery of palliative care to patients experiencing homelessness. Design: Data were collected prospectively for all patient encounters involving a health navigator from July 2020 to 2021 and reviewed to determine the distribution of the health navigator's role and the ways in which patient care was impacted. Setting and participants: This study was conducted in Toronto, Ontario with the Palliative Education and Care for the Homeless (PEACH) Program. At any one time, the PEACH health navigator served a total of 50 patients. Results: We identified five key areas of the health navigator role including (1) facilitating access (2) coordinating care (3) addressing social determinants of health (4) advocating for patients, and (5) counselling patients and loved ones. The health navigator role was split evenly between activities pertaining to palliative care for structurally vulnerable populations and community-based palliative care for the general population. To achieve high impact outcomes, a considerable investment of time and energy was required of the health navigator, speaking to the importance of adequate and sustainable funding. Conclusions: These findings underscore the potential for health navigators to add value to community-based palliative care teams, especially those caring for structurally vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic caused disruptions across healthcare systems globally exposing the precarious state of patient engagement across all levels of healthcare. While evidence is emerging to describe how engagement was affected across various settings, insights about how some organizations at the policy and practice level of healthcare were able to sustain or adapt patient engagement activities is lacking. Objective: This paper addresses the following research question: "How were healthcare, government, and patient partner organizations able to sustain or adapt patient engagement activities during the COVID-19 pandemic?" Methods: A qualitative descriptive study was conducted to understand how patient engagement activities were maintained or adapted in a variety of healthcare, government, and patient partner organizations in Canada throughout the pandemic. This analysis was part of a larger qualitative, multiple case study where one-to-one interviews were conducted with organizational leaders, managers and patient partners. Results: The following themes were identified as key aspects of maintaining or adapting patient engagement activities: 1) having an embedded organizational culture of patient engagement; 2) adapting patient engagement activities to focus on COVID-19 response efforts; 3) having patient partners who exercised leadership and advocacy to support patient care and experiences during the pandemic; and 4) leveraging virtual technology as a communication tool to engage patient partners. Conclusion: This paper highlights important insights that may be useful to other health care organizations on how to sustain or adapt patient engagement activities during a healthcare crisis. Having patient engagement embedded within an organization's culture supported by, but not limited to, infrastructure, resources, investments in dedicated staff and patient partner leadership, and communication strategies and tools enabled continued patient engagement activities during the pandemic. [ABSTRACT FROM AUTHOR]

The Canadian Music Therapy Podcast celebrated two years of episodes in February 2023. Hosted by music therapist Adrienne Pringle (AP) and business leader Cathy Thompson (CT), the bi-weekly podcast shines a bright light on the impact and work of music therapists across Canada. This reflective article features Adrienne's and Cathy's personal explorations of themes and ideas that emerged from a close examination of the podcast transcripts from the first 40 interview-based episodes. [ABSTRACT FROM AUTHOR]

Gaps in health-care services for women with polycystic ovary syndrome (PCOS) are not isolated incidents. They are systemic and disadvantage women. In this study, we explored the juxtaposition of power and agency in diagnosis narratives collected from 72 Canadian women diagnosed with PCOS. Using Braun and Clarke's inductive codebook thematic analysis, three themes of power were constructed: physicians as gatekeepers, oppression as intersectional, and antagonistic provider communications, leading to emotional and cognitive impacts. Themes of agency centered on education, active resistance strategies, and collective action. Implications for these findings are discussed in relation to women's health equity. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Current literature is lacking in describing families' experiences in being involved in children's pain management. This study sought to understand children and their parents' experiences with pain management at a tertiary care children's hospital. Twelve child–parent dyads were recruited to participate in the study from January to August 2022. Children and their parents chose whether to be interviewed together or separately. Transcripts were analyzed using inductive, data-driven codes. Codes and themes were developed using a codebook and member-checking. Three main themes were identified: a. Painful experiences can have a significant positive or negative effect on families' lives and healthcare trajectories; b. There can be a mismatch between families' expectations of pain management and how they perceive the pain was managed; c. Families feel that they must advocate for better pain care, but often feel too intimidated to do so, or worry that their concerns will be dismissed by healthcare professionals. Families want healthcare professionals to proactively manage their children's pain, supporting the shaping of early positive memories of the child's healthcare interactions. Healthcare providers must further recognize that poorly treated pain can significantly impact families' lives and should both seek and be receptive to child and parent input for better pain care. [ABSTRACT FROM AUTHOR]

To describe the experiences and outcomes of participants who enrolled in a randomized controlled trial testing implementation of the Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis. Fifty-six persons with MS who enrolled in the trial participated in the current study which involved a semi-structured interview at 16-week follow-up. Interview data were analyzed using thematic analysis. Of the 56 participants, 26 ended up enrolling in a community-based exercise program specialized for persons with multiple sclerosis (MS), 7 joined another gym, 4 trained at home, and 17 took part in no specific program. Across all study participants, positive outcomes were reported across a number of domains including mental function, knowledge about the physical activity (PA) and MS, physical function, advocacy of PA to peers, daily participation, and body awareness. For those who enrolled in the community-based program, having a supportive and inclusive environment was critical to their PA experiences. Furthermore, environmental supports, particularly knowledgeable and supportive trainers and similar peers, contributed largely to the positive mental changes and increased knowledge gained. Our study provides support for the promotion of PA in persons with MS and the development of community-based programs adapted for people with MS. Engaging in regular physical activity is associated with many positive benefits and outcomes for people with MS. Supportive elements such as a community of peers who also have MS, adaptive equipment, and trainers who are knowledgeable about MS are especially important for creating positive experiences including enjoyment from and desire to engage in regular physical activity. This study provides support for further advocacy (e.g., by persons with MS directly) and referral to community-based exercise programs adapted for people with MS. [ABSTRACT FROM AUTHOR]

The article emphasizes the Canadian Urological Association's (CUA) commitment to being the leading voice for urology in Canada, particularly focusing on advocacy as a key responsibility. Topics discussed include the development of the CUA's surgical wait times document, ongoing government engagement through a Urology Awareness campaign, and efforts to increase collaboration with primary care providers to enhance awareness of common urologic conditions.

The author offers perspectives on the two different worlds of medicine. He provides an overview of his residency training in a medical school in a West African country where the cost of computed tomography (CT) scan is out-of-pocket and confirmation of acute appendicitis without CT scan is commonplace. He cites disparity in healthcare access and provision upon transitioning to Canada where advanced diagnostic tools like CT scans and magnetic resonance imaging machines are readily available.

Although there is an increasing awareness of the critical role of gender within pediatric rehabilitation, little is known about the strategies that clinicians use to provide such care. The purpose of this study was to explore clinicians' strategies for providing gender-sensitive care within a pediatric rehabilitation hospital. We used a qualitative needs assessment design and a convenience sampling strategy to recruit clinicians from a pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation health care providers from various disciplines. We applied a thematic analysis to the interview transcripts. Our analysis revealed the following themes regarding clinicians' strategies in providing gender-sensitive care: (1) awareness of gender biases and not making assumptions; (2) recognizing gender-based vulnerabilities; (3) respecting patient values, preferences and needs; and (4) advocacy. Health care providers working within pediatric rehabilitation have several strategies for providing a gender-sensitive care approach to clients. Clinicians should seek training (i.e., appropriate terminology, creating inclusive spaces) in how to recognize gender-based health vulnerabilities, especially among patients who identify as non-binary or transgender. Clinicians should make an effort to try to be aware of their own biases and not make gender-based assumptions. Advocacy, respecting patient values, preferences and needs are important aspects of providing gender-sensitive care. [ABSTRACT FROM AUTHOR]

People with dementia have typically been treated as homogenous groups with little recognition of unique aspects of identities, including age and gender. The purpose of this paper is to illuminate the experiences of women living with young onset dementia which led them to take up advocacy roles as a result of their experiences. Five women from Canada who were diagnosed with young onset dementia and had then taken on advocacy roles were interviewed. Two main themes emerged–Moving In (the challenges of a diagnosis) and Moving On (into a new life). They described the challenges of a diagnosis as stopping work, being taken seriously, fighting for support, failing to meet requirements for programs and services, and changing relationships with friends. The challenges led them to move into a new life, accepting their diagnosis, and moving into new roles of advocacy and supporting others with dementia in their journey. Further research should seek to explore diversity, rather than treating people with dementia as the same. The experience of dementia is different for everyone. From getting a diagnosis to living a life with dementia, these experiences are unique. Based on interviews with five women living with dementia diagnosed before age 65, it was found that the challenges of getting a diagnosis led the women to become advocates for supporting others with dementia in their journey. The challenges of a diagnosis included stopping work, being taken seriously, fighting for support, not meeting requirements for programs and services, and changing relationships with friends. As a result of their experiences, the women moved on into a new life, accepting their diagnoses, and taking on advocacy roles to create change for others living with dementia. The advocacy roles undertaken by these women demonstrate the need to recognize the unique aspects of people with dementia, in particular women with young onset dementia, without making assumptions that the experience of dementia is the same for everyone. [ABSTRACT FROM AUTHOR]

Prior to 1997, ovarian cancer (OC) was a 'poor target' for patient advocacy. At that time, there were only three OC researchers in Canada, little information available for women diagnosed, and no community of survivors existed. The Corinne Boyer Fund to advance OC was founded in 1997 (later renamed the National Ovarian Cancer Association (NOCA) and subsequently Ovarian Cancer Canada (OCC)), and a Blueprint for Action was established. NOCA developed training programs for public education, partnered with clinicians and scientists, established a Tissue Banking Network across Canada In 2015, the Ladyballs awareness campaign was launched nationally, giving the community a presence and voice. Strategic planning by the organization put advocacy for research funding as a top priority and, working with patients and researchers across the country, petitioned the government for C$10 million in research funding. In 2019, OCC received the funding. In 2020, the OvCAN project was launched with the aim to improve the outcomes of women diagnosed with OC. In the first three years of OvCAN, a pan-Canadian team of 25 Patient Partners was established, and 41 projects to date on research models, pre-clinical and clinical trials covering a wide spectrum of OC types have been funded. [ABSTRACT FROM AUTHOR]

Introduction: The legalization of recreational cannabis in Canada in 2018 has led to many patients being curious about the benefits of taking cannabis in conjunction with their cancer treatment. We investigated the perceptions among genitourinary (GU) cancer patients regarding cannabis use as part of their care plans. Methods: A survey was created to explore current cannabis use behaviors, reasons for cannabis use, and the beliefs of cannabis usefulness towards cancer-related care, including cancer treatment, among GU cancer patients. The survey was distributed across Canada online via RedCAP through social media platforms, email, and patient advocacy groups. The survey was active from August to December 2020. Results: Of eighty-five responses, 52 met inclusion for analysis. Participants included 11 bladder, 26 kidney, and 15 prostate cancer patients. Many (48.1%) participants used cannabis daily and 75% had been using it for more than one year. Cannabis was consumed through oil-based products, edibles, and smoking. The most common reasons for using cannabis were cancerrelated anxiety, to prevent cancer progression, cancer-related pain, recreational use, and other, non-cancer-related illness or symptoms. Participants believed cannabis improved their sleep (70.2%), anxiety (65.9%), and overall mood (72.3%). Most participants were either unsure (38.3%) or neutral (31.9%) in the belief that cannabis might decrease their cancer progression. Conclusions: GU cancer patients use cannabis for a variety of cancer- and non-cancer-related symptoms. Many patients believe cannabis has benefited their cancer-related symptoms. These findings highlight the importance of healthcare providers remaining familiar with current evidence on cannabis to support patient conversations about cannabis use. [ABSTRACT FROM AUTHOR]

Background: Midlife and older women who experience intimate partner violence (IPV) often have less access to supports and services than younger women. There is far less focus on research and supports for midlife and older women compared to younger women experiencing IPV, and often, neither elder abuse nor IPV services meet their needs. Few interventions are available to meet the needs of midlife and older women., Objective: The goal of this randomized controlled trial is to test the effectiveness of an advocacy intervention for midlife and older women who experience IPV and to learn from the experiences of those who implement and participate in the program., Methods: This trial is a 2-arm, unblinded, parallel, pragmatic randomized controlled trial with a qualitative component. Eligible participants will be women who live in the Maritime provinces of Canada (New Brunswick, Nova Scotia, and Prince Edward Island), who are in midlife and older (aged approximately ≥50 years), and who are currently in a relationship with an abusive partner or have recently left an abusive partner. Facilitators will be trained to deliver the intervention. The intervention will be entirely virtual and will consist of 2 components: (1) an empowerment component, which will involve sharing resources and information with the women; and (2) a social support component, which will include providing support and encouragement to women for 12 weeks. Quantitative effectiveness data will be collected from all trial participants at baseline, 3 months after the intervention, and 9 months after the intervention about the incidence and severity of IPV, physical and mental health, and safety behaviors and strategies. Qualitative interviews will be conducted with the facilitators and intervention group participants. Control group participants will receive a static, nontailored version of the advocacy intervention for midlife and older women (AIM) intervention materials after baseline data collection., Results: A total of 12 facilitators have been trained to deliver the AIM intervention to trial participants. Participant recruitment and data collection will be completed in January 2025. Data analysis will continue throughout the data collection period, and the results will be disseminated by December 2025., Conclusions: This research will result in the adaptation and testing of a program to support and empower midlife and older women in the Maritime provinces of Canada who experience IPV., Trial Registration: International Standard Randomized Controlled Trial Registry ISRCTN30646991; https://doi.org/10.1186/ISRCTN30646991., International Registered Report Identifier (irrid): DERR1-10.2196/57886., (©Lori Weeks, Kathleen Allen, Catherine Holtmann, Joni Leger, Suzanne Dupuis-Blanchard, Colleen MacQuarrie, Marilyn Macdonald, Elaine Moody, Christie Stilwell, Heather Helpard, Danie Gagnon. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 30.10.2024.)

An interview with Chrissy Pearson, BMT, RP, MTA, FAMI is presented. Topics include talks about to become interested in music therapy as a profession; and considered the training and schooling that has led to current roles which undergraduate degree at the University of Windsor, back when they still had a music therapy program, and then went from Windsor to Toronto to do an internship at Sunnybrook in Veterans' Care program.

Intracommunity support and knowledge sharing is used in transgender ("trans") communities as they navigate systems of oppression. Even for individuals with access to accepting families and service providers, connecting with other trans individuals can provide useful insight and resources. Conducted between December 2018 and April 2019, this scoping literature review examines the extent, range and nature of research activity regarding intracommunity knowledge and support sharing within trans communities. Drawing from Weeks' framework regarding sexual communities and the concepts of positive in‐group identity and group‐level coping, this review specifically addresses the guiding questions of what, how and why knowledge and support are shared within trans communities. Empirical studies conducted between 2004 and 2019 in the United States and Canada that were published in English and had a discernible trans sample or subsample were included. Thirty‐one studies met the criteria. Key themes from this literature are (a) sharing information related to advocacy & education, identity/expression and personal stories/experience while (b) utilising an array of both online and/or in‐person methods in order to (c) build community/support and navigate identity development and transition. Implications from the review, including impacts on both clients and students in social work and care programs, are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The legalization of recreational cannabis in Canada in 2018 has led to many patients being curious about the benefits of taking cannabis in conjunction with their cancer treatment. We investigated the perceptions among genitourinary cancer (GUC) patients regarding cannabis use as part of their care plans. Methods: A survey was created to explore current cannabis use behaviors, reasons for cannabis use, and the beliefs of cannabis usefulness towards cancer-related care, including cancer treatment, among GUC patients. The survey was distributed across Canada online via RedCAP through social media platforms, email, and patient advocacy groups. The survey was active from August to December 2020. Results: Of eighty-five responses, fifty-two met inclusion for analysis. Participants included 11 bladder, 26 kidney, and 15 prostate cancer patients. Many (48.1%) participants used cannabis daily and 75% had been using it for more than one year. Cannabis was consumed through oilbased products, edibles, and smoking. The most common reasons for using cannabis were cancer-related anxiety, to prevent cancer progression, cancer-related pain, recreational use, and other non-cancer-related illness or symptoms. Participants believed cannabis improved their sleep (70.2%), anxiety (65.9%), and overall mood (72.3%). Most participants were either unsure (38.3%) or neutral (31.9%) in the belief that cannabis might decrease their cancer progression. Conclusions: GUC patients use cannabis for a variety of cancer- and non-cancer-related symptoms. Many patients believe cannabis has benefited their cancer-related symptoms. These findings highlight the importance of healthcare providers remaining familiar with current evidence on cannabis to support patient conversations about cannabis use. [ABSTRACT FROM AUTHOR]

A common problem faced by social workers working in long-term care is that they are not given the opportunity to tell how they understand their roles and thus their roles are neither understood nor recognized by other professionals. There is a need for social workers to tell how they understand their roles so that their roles can be better understood and recognized. A research study was conducted in the province of British Columbia in Canada to explore how social workers working in long-term care understand their roles. Fourteen semi-structured interviews were conducted. Five themes were identified, including advocating for the most vulnerable, humanizing long-term care, balancing between self-determination and safety, dancing with the systems, and facilitating collaboration. The results reiterated but also supplemented the existing literature. This research study also proposes future research studies on the roles of social workers working in long-term care. [ABSTRACT FROM AUTHOR]

This commentary addresses barriers to care among older adults living with neurodiversity (ND), and their aging family carers in the context of the COVID-19 pandemic in Canada. Factors contributing to inequities are described and the significant negative consequences of current policy decisions on the social and mental health of older adults with ND and their aging family carers are highlighted. The commentary calls for a collective social work response that highlights the critical role of support and advocacy necessary to redress social exclusion. [ABSTRACT FROM AUTHOR]

Objective: A growing body of research has established that specific elements of suicide-related news reporting can be associated with increased or decreased subsequent suicide rates. This has not been systematically investigated for social media. The aim of this study was to identify associations between specific social media content and suicide deaths. Methods: Suicide-related tweets (n = 787) geolocated to Toronto, Canada and originating from the highest level influencers over a 1-year period (July 2015 to June 2016) were coded for general, putatively harmful and putatively protective content. Multivariable logistic regression was used to examine whether tweet characteristics were associated with increases or decreases in suicide deaths in Toronto in the 7 days after posting, compared with a 7-day control window. Results: Elements independently associated with increased subsequent suicide counts were tweets about the suicide of a local newspaper reporter (OR = 5.27, 95% CI = [1.27, 21.99]), 'other' social causes of suicide (e.g. cultural, relational, legal problems; OR = 2.39, 95% CI = [1.17, 4.86]), advocacy efforts (OR = 2.34, 95% CI = [1.48, 3.70]) and suicide death (OR = 1.52, 95% CI = [1.07, 2.15]). Elements most strongly independently associated with decreased subsequent suicides were tweets about murder suicides (OR = 0.02, 95% CI = [0.002, 0.17]) and suicide in first responders (OR = 0.17, 95% CI = [0.05, 0.52]). Conclusions: These findings largely comport with the theory of suicide contagion and associations observed with traditional news media. They specifically suggest that tweets describing suicide deaths and/or sensationalized news stories may be harmful while those that present suicide as undesirable, tragic and/or preventable may be helpful. These results suggest that social media is both an important exposure and potential avenue for intervention. [ABSTRACT FROM AUTHOR]

Engaging patients-defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them-as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process. [ABSTRACT FROM AUTHOR]

Background: A multi-phase Canadian study was conducted as part of a large-scale community and academic research partnership focused on understanding and improving the employment experiences of people with intellectual disabilities., Method: This multi-method study utilized a sequential approach, using findings from qualitative interviews (n = 28) to inform an online survey (n = 149). Participants were invited to share their experiences with paid employment or with persons with intellectual disabilities., Results: Thematic analysis of data across interview and survey findings resulted in six themes: (1) assumptions and attitudes, (2) knowledge and awareness, (3) accessibility of processes, (4) use of accommodations, (5) workplace relationships, and (6) supports and resources., Conclusions: A holistic and systemic approach has the potential to improve inclusive employment experiences of people with intellectual disabilities. Action is needed mainly at the policy and employer level to reduce barriers and improve on facilitating measures reinforced by the themes shared in this study., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

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At the Canadian Testis Cancer Workshop, the rationale and feasibility of regionalization of testis cancer care were discussed. The two-day workshop involved urologists, medical and radiation oncologists, pathologists, radiologists, physician's assistants, residents and fellows, and nurses, as well as patients and patient advocacy groups. This review summarizes the discussion and recommendations of one of the central topics of the workshop -- the centralization of testis cancer in Canada. It was acknowledged that non-guideline-concordant care in testis cancer occurs frequently, in the range of 18-30%. The National Health Service in the U.K. stipulates various testis cancer care modalities be delivered through supra-regional network. All cases are reviewed at a multidisciplinary team meeting and aspects of care can be delivered locally through the network. In Germany, no such network exists, but an insurance-supported online second opinion network was developed that currently achieves expert case review in over 30% of cases. There are clear benefits to regionalization in terms of survival, treatment morbidity, and cost. There was agreement at the workshop that a structured pathway for diagnosis and treatment of testis cancer patients is required. Regionalization may be challenging in Canada because of geography; independent administration of healthcare by each province; physicians fearing loss of autonomy and revenue; patient unwillingness to travel long distances from home; and the inability of the larger centers to handle the ensuing increase in volume. We feel the first step is to identify the key performance indicators and quality metrics to track the quality of care received. After identifying these metrics, implementation of a "networks of excellence" model, similar to that seen in sarcoma care in Ontario, could be effective, coupled with increased use of health technology, such as virtual clinics and telemedicine. [ABSTRACT FROM AUTHOR]

Canada's universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services. A nationally coordinated approach to remodel the primary health care system was incited at the turn of the 21st century yet, twenty years later, evidence of widespread meaningful improvement remains underwhelming. As a provincial/territorial responsibility, the organization and provision of primary care remains discordant across the country. Canadian pharmacists are, now more than ever, poised and primed to provide care integrated with the rest of the primary health care system. However, the self-regulation of the profession of pharmacy is also a provincial/territorial mandate, making progress toward integration of pharmacists into the primary care system incongruent across jurisdictions. Among 11,000 pharmacies, Canada's 28,000 community pharmacists possess varying authority to prescribe, administer, and monitor drug therapies as an extension to their traditional dispensing role. Expanded professional services offered at most community pharmacies include medication reviews, minor/common ailment management, pharmacist prescribing for existing prescriptions, smoking cessation counselling, and administration of injectable drugs and vaccinations. Barriers to widely offering these services include uncertainties around remuneration, perceived skepticism from other providers about pharmacists' skills, and slow digital modernization including limited access by pharmacists to patient health records held by other professionals. Each province/territory enables pharmacists to offer these services under specific legislation, practice standards, and remuneration models unique to their jurisdiction. There is also a small, but growing, number of pharmacists across the country working within interdisciplinary primary care teams. To achieve meaningful, consistent, and seamless integration into the interdisciplinary model of Canadian primary health care reform, pharmacy advocacy groups across the country must coordinate and collaborate on a harmonized vision for innovation in primary care integration, and move toward implementing that vision with ongoing collaboration on primary health care initiatives, strategic plans, and policies. Canadians deserve to receive timely, equitable, and safe interdisciplinary care within a coordinated primary health care system, including from their pharmacy team. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)