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Objective: Some research suggests that suicidal ideation and attempt among adolescents may be contagious – that is adolescents who are exposed to peers' suicidal behaviour are more likely to experience suicidal ideation or attempt suicide themselves. Less is known about the potential contagion effect of non‐suicidal self‐injury (NSSI). Our objective was to determine whether knowledge of a friend's NSSI is associated with adolescent's own non‐suicidal self‐injury and suicidal behaviours. Methods: Data from 1483 youth ages 14–17 years were obtained from the 2014 Ontario Child Health Study, a cross‐sectional population‐based survey of children and adolescents in Ontario, Canada. Logistic regression models were used to examine associations between knowledge of a friend's NSSI and adolescents' own self‐reported self‐injurious and suicidal behaviours. Interactions with gender, age group and presence of a mental disorder were investigated. Results: Knowledge of a friend's non‐suicidal self‐injury was significantly associated with the adolescent's own non‐suicidal self‐injury (OR = 2.03, 95% CI 1.05–3.90), suicidal ideation (OR = 3.08, 95% CI 1.50–6.30) and suicide attempt (OR = 2.87, 95% CI 1.20–6.87). Conclusion: These findings suggest an apparent contagion effect for non‐suicidal self‐injury. Awareness of a friend's self‐injurious behaviours is associated with an adolescent's own self‐injury and suicidality. Interventions aimed at preventing NSSI and suicidality should consider prevention of possible contagion at the school and/or community level. [ABSTRACT FROM AUTHOR]

Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario.Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts.Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89).Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury. [ABSTRACT FROM AUTHOR]

Introduction: To address the challenges and leverage opportunities in obtaining a swift, accurate, and appropriately communicated cancer diagnosis, All. Can Canada embarked on a comprehensive assessment of how well Canada is doing in optimizing entry into cancer care. The purpose was to understand the current state of cancer diagnosis in Canada, including identifying outcomes that matter most to cancer patients, nominated practices in cancer diagnosis to adapt, spread, and scale, and areas of inefficiency that represent opportunities for improvement towards identified outcomes, in order to identify priority areas and concrete actions to inform the work of policymakers and other stakeholders. Aims Objectives Theory or Methods: From June 2020 to March 2021, a consultant with oversight by All. Can Canada's patient-led, multistakeholder Steering Committee conducted research. First was a literature review identifying current Canadian practices which aim to reduce diagnosis inefficiencies; summarize what is known about the impacts of the determinants of health on diagnosis; and identify currently used metrics. Qualitative interviews with cancer survivors across Canada investigated diagnosis from their perspectives, including what matters most as they traverse the diagnosis process. A survey of providers across Canada investigated what they perceive to be inefficiencies in diagnosis and factors essential for a quality diagnosis process. Highlights or Results or Key Findings: Irrespective of cancer type, disease stage, or determinants of health, patients described the diagnosis process as taking place in three phases: Early - when people first try to interact with a provider over a suspicion of cancer until the first referral; Middle - when people undergo diagnostic testing to investigate; and Final - when people arrive at a dedicated cancer facility until they receive their diagnosis. Across all phases, seven outcomes were identified as being critical to the quality of the diagnosis experience: - Swiftness of the process; - Concerns validated by primary care providers; - Excellent patient-provider communication; - Effective provider-provider communication; - Better information; - Integrated psychosocial support; and - Integrated care. Attainment of these outcomes resulted in a more satisfactory diagnosis experience, while failing to attain any of these outcomes had a negative, and oftentimes detrimental, impact. The research resulted in the start of a quality framework for Canadian cancer diagnosis. Conclusions: Findings demonstrate cancer diagnoses' fragmented current state and integrated future state. Workforce capabilities, multi-sectoral collaboration, aligned payments and accountability, a national quality framework, and increased care coordination are required. Digital solutions are vital for rural residents and during pandemics. Anti-fragility means transforming cancer diagnosis systems to absorb shock and improve. Implications for applicability/transferability sustainability and limitations: Findings are not necessarily generalizable to newcomers, racialized people, residents of the Territories, and Indigenous populations. Sample sizes preclude conclusions about jurisdictional disparities. Provider survey results are not necessarily representative of all provider groups across Canada. Provider responses to questions about inefficiencies could have been influenced by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Abstract: The waterfront of historic Kingston, Ontario (pop: 113,000) has been used for industrial activities for over a century. More than 40 industries have existed within the inner harbour, and while many of these industries are no longer present, the properties that they operated on remain as potential sources of persistent contamination to the present day, including mercury. To assess the extent and distribution of total mercury (THg) contamination, 21 sediment cores as well as pore water samples were collected within the inner harbour of Kingston. The spatial distribution of THg in the surface sediment is not homogenous; with concentrations in the surface sediment along the southwestern shoreline, adjacent to the former industrial properties, are significantly greater (p <0.01) than the rest of the inner harbour, and were above the Federal severe effect limit (>2000ug/kg;) guideline for sediment. MeHg was detected in some sediment cores, and was found to have a significant, positive correlation with [THg] in the surface sediment (0–5cm). THg was not found in storm sewer discharges, but was detected in terrestrial soil near the Kingston Rowing Club at a concentration of more than 4000ug/kg. Significant [THg] was detected in runoff draining from contaminated shoreline soils, indicating that erosion from terrestrial sources may be an ongoing source of Hg to the sediment. It can be concluded that there is an increased risk over time to surrounding ecosystems where properties with historical contamination are not remediated until they are developed. [Copyright &y& Elsevier]

This article describes recent trends in the province of Ontario (Canada) and beyond that have begun to create a readiness to bring research to practice in children's mental health. The experience of developing innovative cross-sectoral partnerships in Ontario that facilitate the linkage of research and service is discussed. The Child and Youth Mental Health Information Network is profiled as an emerging collaboration that epitomises such partnerships, and the key knowledge exchange activities of the five partner organisations are described. The article highlights the importance of engaging all levels of the system - clinical, supervisory, management, community, policy and political - in order to create a culture change that truly supports the sharing of information and the process of embedding evidence-based practice in services for children and families. This is a descriptive article that outlines key complementary knowledge exchange activities of each of the partners while highlighting joint initiatives and the value added of the Network. [ABSTRACT FROM AUTHOR]

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT. [ABSTRACT FROM AUTHOR]

This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6–12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14–1.19 for relationships and 1.06–1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations. [ABSTRACT FROM AUTHOR]

Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. [ABSTRACT FROM AUTHOR]