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Understanding how informal care impacts formal care utilisation for home‐based end‐of‐life patients is an important policy‐ and practice‐relevant question. This paper aims to assess the relationship between informal and formal home care among home‐based end‐of‐life patients and how this relationship has changed over the last decade and over the end‐of‐life trajectory. We focus on informal care provided by family members or friends, and three types of home‐based formal care services: care by personal support workers, physician visits, and nurse visits. Using survey data collected in a home‐based end‐of‐life care programme in Ontario, Canada from 2005 to 2016, we build a two‐part utilisation model analysing both the propensity to use each type of formal care and the amount of formal care received by patients. The results suggest that informal care is a substitute for care by personal support workers, but a complement to physician visits and nurse visits. In the case of nurse visits, an increased complementary effect is observed in more recent years. For home‐based physician and nurse visits, the complementary effect grows with patient's proximity to death. These results highlight the complexity of the relationship between informal and formal care among home‐based end‐of‐life patients. Decision‐makers need to take into account the relationship between informal care and different types of formal services when introducing future policies. [ABSTRACT FROM AUTHOR]

This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare. [ABSTRACT FROM AUTHOR]

Objectives: Aging is associated with deterioration in health and well-being, but previous research suggests that this can be attenuated by maintaining group memberships and the valued social identities associated with them. In this regard, religious identification may be especially beneficial in helping individuals withstand the challenges of aging, partly because religious identity serves as a basis for a wider social network of other group memberships. This paper aims to examine relationships between religion (identification and group membership) and well-being among older adults. The contribution of having and maintaining multiple group memberships in mediating these relationships is assessed, and also compared to patterns associated with other group memberships (social and exercise). Method: Study 1 (N = 42) surveyed older adults living in residential care homes in Canada, who completed measures of religious identity, other group memberships, and depression. Study 2 (N = 7021) longitudinally assessed older adults in the UK on similar measures, but with the addition of perceived physical health. Results: In Study 1, religious identification was associated with fewer depressive symptoms, and membership in multiple groups mediated that relationship. However, no relationships between social or exercise groups and mental health were evident. Study 2 replicated these patterns, but additionally, maintaining multiple group memberships over time partially mediated the relationship between religious group membership and physical health. Conclusion: Together these findings suggest that religious social networks are an especially valuable source of social capital among older adults, supporting well-being directly and by promoting additional group memberships (including those that are non-religious). [ABSTRACT FROM AUTHOR]

BACKGROUND: The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity‐related school policies and programs on youths' BMI trajectories. METHODS: Obesity‐related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012‐2013) and year 2 (2013‐2014) of the COMPASS study. Self‐reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity‐related school policies and programs on youths' BMI trajectories. RESULTS: Between Y1 and Y2, 26 of the 41 schools implemented distinct new obesity‐related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. CONCLUSIONS: Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors. [ABSTRACT FROM AUTHOR]

Internationally, mental health care systems have identified recovery as the underlying philosophy for practice and policy in mental health care, although establishing a specific definition of recovery is still work in progress. This mixed-methods study explored the meaning and scope of recovery from the perspective of people diagnosed with mental illnesses. Sixty-five individuals self-identifying as diagnosed with schizophrenia completed measures of recovery, symptom level, insight into illness, hopelessness and internalised stigma. In addition, twenty people participated in a semi-structured interview focused on how diagnosis affected their personal and social experiences. Regression analyses based on the quantitative data and thematic analysis of the qualitative data indicated stigma is a major barrier to recovery. However, recovery can be promoted by integrated biomedical, psychological, social and political processes. Qualitative findings suggested that an important component of recovery is feeling empowered and entitled to full participation in social environments. This study suggests that recovery-oriented social work interventions should be directed at promoting social citizenship for people diagnosed with mental illness, combating stigma, and creating the psychological and social environments for finding meaning and hope after receiving a diagnosis. [ABSTRACT FROM AUTHOR]

Aims To describe the relationship between nursing staff turnover in long-term care ( LTC) homes and organisational factors consisting of leadership practices and behaviours, supervisory support, burnout, job satisfaction and work environment satisfaction. Background The turnover of regulated nursing staff [ Registered Nurses ( RNs) and Registered Practical Nurses ( RPNs)] in LTC facilities is a pervasive problem, but there is a scarcity of research examining this issue in Canada. Methods The study was conceptualized using a Stress Process model. Distinct surveys were distributed to administrators to measure organisational factors and to regulated nurses to measure personal and job-related sources of stress and workplace support. In total, 324 surveys were used in the linear regression analysis to examine factors associated with high turnover rates. Results Higher leadership practice scores were associated with lower nursing turnover; a one score increase in leadership correlated with a 49% decrease in nursing turnover. A significant inverse relationship between leadership turnover and nurse turnover was found: the higher the administrator turnover the lower the nurse turnover rate. Conclusion Leadership practices and administrator turnover are significant in influencing regulated nurse turnover in LTC. Implications for Nursing Management Long-term care facilities may want to focus on building good leadership and communication as an upstream method to minimize nurse turnover. [ABSTRACT FROM AUTHOR]