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This introduction to the Special Issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. Current perspectives on resilience, as well as the role of social determinants, and community resilience processes in understanding resilience in Indigenous circumpolar settings are reviewed. The distinctive role for qualitative inquiry in understanding these frameworks is emphasized, as is the uniquely informative lens youth narratives can offer in understanding Indigenous, cultural, and community resilience processes during times of social transition. We then describe key shared cross-site methodological elements of the Circumpolar Indigenous Pathways to Adulthood study, including sampling, research design, procedures, and analytic strategies. The site-specific papers further elaborate on methods, focusing on those elements unique to each site, and describe in considerable detail locally salient stressors and culturally patterned resilience strategies operating in each community. The concluding paper considers these across sites, exploring continuities and discontinuities, and the influence of cross-national social policies. [ABSTRACT FROM AUTHOR]

Persisting high poverty and social exclusion rates remain a key challenge of European welfare states. The socio-economic consequences following the COVID-19 crisis are challenging the protection of social citizenship and social rights of the most vulnerable. We examine the role of the European Union (EU) in supporting the most vulnerable citizens by focusing on the Fund for European Aid to the Most Deprived (FEAD). Our key question is, if and in which ways the EU strengthens social citizenship and social rights through FEAD. We base our analysis on a document analysis of the Regulation, Member States' operational programmes and results of a survey with food aid organizations in Belgium, Lithuania and Portugal. Our findings suggest that FEAD represents a contradictory case of European action in the field of social citizenship and social rights. On the one hand, FEAD is a highly targeted social policy instrument. On the other hand, food aid, as the main provided instrument, is based on charity and not on social rights. Accompanying social inclusion measures could support beneficiaries in the take-up of social rights, but these measures lack clear rules for implementation and monitoring. We conclude that FEAD seems to contribute to the institutionalization of charitable food aid within national welfare systems. [ABSTRACT FROM AUTHOR]

Background: Traditional measures of social status are predicated on position in the labour market. There has been less attention directed to the meanings of social position for people with a long-term condition whose relationship to employment is precarious. Previous research has demonstrated that the MacArthur scale is capable of capturing contextualised aspects of social status, which makes it a useful tool for exploring changes in meaning. Aims: The paper explores the meanings and experiences of social status of people living with a long-term condition with particular reference to employment status. Methods: A sample of 300 participants was drawn from diabetes and chronic heart disease registers of General Practices in North West England. A cross-sectional survey with nested qualitative interviews was used in collecting and analysing the data. Findings: Having financial independence and participating in valued activities are more important for people with chronic illness than power and status mediated through the labour market. Income and the lack and loss of employment were given a central role in respondents’ narratives reflecting the absence of acceptable alternative routes through which social status for those with a long-term condition can realistically be rebuilt outside of participation in the labour market. [ABSTRACT FROM AUTHOR]

This paper explores the contributions of the Cultural Formulation (CF) interview to an overall understanding of patients, and focuses on the narratives of 23 newly referred patients with migrant backgrounds seeking help at a psychiatric outpatient clinic in Stockholm. Through text content analysis methods we identified five themes: displacement in space and time; mental illness as a physical disability; life events as etiological factors; concealing as a coping strategy; and being lost in a fragmented health care system. Findings indicate the need to contextualize symptoms for an in-depth comprehension of patients’ phenomenology. Both clinical and policy implications are discussed. The findings suggest that a section on migration and acculturation should be added to the cultural formulation in the next edition of DSM. [ABSTRACT FROM PUBLISHER]

The importance of appraisal in the stress process is unquestioned. Experience in the social environment that impacts outcomes such as depression are thought to have these effects because they are appraised as a threat to the individual and overwhelm the individual's capacity to cope. In terms of the nature of social experience that is associated with depression, several recent studies have examined the impact of cultural consonance. Cultural consonance is the degree to which individuals, in their own beliefs and behaviors, approximate the prototypes for belief and behavior encoded in shared cultural models. Low cultural consonance is associated with more depressive symptoms both cross-sectionally and longitudinally. In this paper we ask the question: does perceived stress mediate the effects of cultural consonance on depression? Data are drawn from a longitudinal study of depressive symptoms in the urban community of Ribeirão Preto, Brazil. A sample of 210 individuals was followed for 2 years. Cultural consonance was assessed in four cultural domains, using a mixed-methods research design that integrated techniques of cultural domain analysis with social survey research. Perceived stress was measured with Cohen's Perceived Stress Scale. When cultural consonance was examined separately for each domain, perceived stress partially mediated the impact of cultural consonance in family life and cultural consonance in lifestyle on depressive symptoms. When generalized cultural consonance (combining consonance in all four domains) was examined, there was no evidence of mediation. These results raise questions about how culturally salient experience rises to the level of conscious reflection. [ABSTRACT FROM PUBLISHER]

The aim of this mixed-method study was to explore the trajectories of leaving home, and views and experiences among children and youth in the Kagera region in Tanzania, who have lived on the streets or been domestic workers. The main results showed that orphanhood and mistreatment were the main reasons for leaving home: few children lived with their parents before they left, and leaving home was a complex process over several years where three trajectories were identified. The children who had left home showed strong agency and competency but lived in vulnerable conditions, especially young children living on the streets. [ABSTRACT FROM AUTHOR]

Objectives Diabetes-specific family behaviors are associated with self-care and glycemic control among adults with type 2 diabetes. Formative research is needed to inform assessment of these behaviors and interventions to address obstructive family behaviors (sabotaging and nagging/arguing), particularly among racial/ethnic minorities and low-income adults who struggle most with self-care adherence. Methods We conducted a mixed-methods study with adults with type 2 diabetes at a Federally Qualified Health Center to better understand experiences with diabetes-specific family behaviors and willingness to engage family members in diabetes interventions. Participants completed a phone survey (N = 53) and/or attended a focus group (n = 15). Results Participants were 70% African American and had low socioeconomic status (96% annual income

Objective: To explore the impact of footwear, bandaging and hosiery interventions in the everyday lives of women and men undergoing treatment for chronic, complex wounds in a city in England, UK. Methods: This study draws on data generated in semi-structured interviews with patients exploring outcomes and impacts of undergoing treatment for leg and foot ulcers undertaken as part of a UK National Institute for Health Research funded study. Footwear, bandaging and hosiery are explored here as aspects of material culture, not only in functional terms as a treatment supporting or hindering healing but also as part of the means by which people receiving treatment for two of the most common complex, chronic wounds, leg ulcers and foot ulcers, negotiate and understand their embodied selves in everyday life. Findings: Physical and social discomfort associated with interventions can lead to ambivalence about effectiveness. Not being able to dress appropriately impacts on the ability of people to feel comfortable and take part in special occasions and everyday events. In this context, the removal of bandaging or refusal to wear support hosiery which may be viewed as ‘non-compliance’ by a health professional may feel like a strategy of self-care or self-preservation from a patient perspective. Discussion: The study of material culture explores how inanimate objects work and how they are worked with in carrying out social functions, regulating social relations and giving symbolic meaning to human activity. The interviews show some of the ways in which footwear, hosiery and bandaging play a role in controlling the boundaries between the private (wounded and potentially socially unacceptable smelly, leaky, embodied), self and the public presentation of self. [ABSTRACT FROM AUTHOR]

Aims: The public health coordinator (PHC) is a municipal-government position in Norway whose role is to organise and oversee municipal policies and functions to support national public health goals. This cross-sectional study investigates conditions associated with use of PHCs by Norwegian municipalities in the period immediately before the new Public Health Act came into effect in 2012, decentralising responsibility for citizen health to the municipal level. This study provides descriptive baseline data regarding Norwegian municipalities’ use of PHCs in this time – a marker for municipal engagement with inter-sectorial collaboration – before this policy was nationally mandated, and explores whether municipal characteristics such as structure, socio-economic status and extent of Health in All Policies (HiAP) implementation were associated factors. Methods: All Norway’s municipalities (N=428) were included. We combined Norwegian register data with survey data. Descriptive analyses and bi- and multivariate logistic regression analyses were performed. Results: A total of 76% of Norwegian municipalities employed a PHC in the period just before 2012. Of the PHCs employed, 22% were employed full time and 28% were located within the staff of the chief executive office. Our study indicates that partnership for health promotion with county councils (OR=7.78), development of a health overview (OR=3.53), collaboration with non-government sectors (OR=2.85) and low socio-economic status (OR=0.46) are significantly associated with Norwegian municipalities having a PHC. Conclusions: This study suggests that the municipality’s implementation of HiAP, as well as lower socio-economic indicators, is associated with the use of PHCs in Norway, but not factors related to municipal structure. [ABSTRACT FROM AUTHOR]

Background: Papua New Guinea is a developing country with limited resources for specialist mental health services. Little is known about the mental health and treatment services of Papua New Guinea. Aim: The aim of this study was to clarify the presenting mental health problems encountered by Papua New Guinean health workers and the common treatment approaches used. Methods: A total of 203 Papua New Guinean health workers completed a retrospective quantitative survey about their three most recent mental health patients. The survey asked about presenting symptomatology, diagnoses (including culture-bound diagnoses) and treatment approaches. Results: The major presenting mental health problems for males included schizophrenia, substance use disorder, sorcery and spirit possession. Depression was the most common diagnoses for women, followed by sorcery and somatisation. Over 65% of patients were prescribed psychotropic medication, over 50% received some form of psychological intervention and 28% were receiving traditional treatments. Conclusions: Somatic symptoms are common among both male and female Papua New Guineans; however, males may be more likely to present with psychotic symptoms and females with mood-related problems. Schizophrenia and depression are commonly identified with substance use disorder more problematic among males. Culture-specific explanations and treatment are commonly used. [ABSTRACT FROM AUTHOR]

The health benefits associated with marriage are disproportionately large in older adulthood, due in part to the powerful role spouses play in promoting each other’s well-being. What remains unclear is what motivates this caretaking. To determine whether compassionate love plays a role, the current study used an Actor–Partner Interdependence Model to examine how 64 older couples’ compassionate love is linked to their health. Feeling compassionate love was linked to better health for wives. The partner effects, however, painted a more complicated picture, with the receipt of compassionate love appearing to undermine health. Given the unprecedented growth in the number of older adults in the United States, we have a vested interest in determining how compassionate love may help or hinder well-being in later-life marriages. [ABSTRACT FROM PUBLISHER]

The article discusses a study to examine the preferences and concerns of New Zealand patients waiting for kidney transplantation. Topics discussed include the positive attitudes towards living donor kidney transplantation, the importance for patients to understand risks and benefits of various renal replacement therapy options to themselves and the need to integrate a range of initiatives in practice and policy for an effective strategy to increase rates of living donor transplantation.

In light of the challenges involved in leading a health care organization, it is important that the executives and managers charged with doing so are competent in a variety of areas. However, leading at all organizational levels does not necessarily require the same levels and types of competencies. The purpose of this research is to determine how well competency training works in health care organizations, and to obtain a better understanding of the competencies needed for leaders at different points of their careers and at various organizational levels. Ten health care management competency domains thought to positively influence job performance for health care executives are presented. The study seeks to answer four hypotheses related to self-perceptions of competencies and training opportunities at various hierarchical levels. A survey method was used to sample a subset of the healthcare executive population in the USA, based on three variables of interest, competency training opportunities, self-reported level of competency and hierarchical level. A series of Kruskal-Wallis and Mann-Whitney U tests were conducted to identify perceived differences in both competency level and training opportunities among respondents of various hierarchical levels. The most significant result of our research is that competency training is effective in health care organizations. The implications and need for additional research are discussed. [ABSTRACT FROM AUTHOR]

Objectives:We sought to examine patients’ and providers’ views on the treatment of gout to better understand why management is suboptimal. Methods: In-depth telephone interviews were conducted with gout patients (n¼26) who initiated treatment with a urate-lowering drug (ULD) in the previous 6 months and with providers who care for gout patients (n¼15). The interviews were audiotaped and transcribed verbatim. Using qualitative methods, results were analysed and themes were identified. Interviews focused on the acute management, chronic management and prevention and improvement strategies. Results: Providers viewed the majority of patients as having excellent relief with non-steroidal anti-inflammatories, colchicine and glucocorticoids, while some patients felt these medications were ineffective. Providers felt that most patients had a good understanding of the rationale for ULD therapy and that patients responded well. Some patients felt ULDs triggered, worsened or had no impact on their disease. Most providers thought medication adherence was relatively good. Some patients reported discontinuing medications. Discontinuations were largely purposeful and due to clinical or financial concerns. Most providers thought they had adequate skills to teach disease self management behaviours. Patients requested more information and longer visit times. Conclusions: Providers view gout as easily managed, while patients report challenges and purposeful non-adherence. [ABSTRACT FROM AUTHOR]