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BackgroundPhysical activity (PA) is beneficial for all people; however, people affected by multiple sclerosis (MS) find regular PA challenging. These people may include individuals with advanced disabilities and their care partners. ObjectiveThe objective of this study is to determine the feasibility of a dyadic PA intervention for people with advanced MS and their care partners. MethodsThis study is a randomized controlled feasibility trial of a 12-week intervention, with 1:1 allocation into an immediate intervention condition or delayed control condition. A target of 20 people with MS–care partner dyads will be included. The outcomes will be indicators of process, resources, management, and scientific feasibility. Participant satisfaction with the intervention components will be evaluated using a satisfaction survey. The subjective experience of participation in the study will be explored using semistructured interviews. ResultsThe project is funded by the Consortium of Multiple Sclerosis Centers. This protocol was approved by the Ottawa Hospital Research Ethics Board (20190329-01H) and the University of Ottawa Research Ethics Board (H-09-19-4886). The study protocol was registered with ClinicalTrials.gov in February 2020. The findings of this feasibility trial will be disseminated through presentations at community events to engage the MS population in the interpretation of our results and in the next steps. The results will also be published in peer-reviewed journals and presented to the scientific community at national and international MS conferences. ConclusionsThe data collected from this feasibility trial will be used to refine the intervention and materials in preparation for a pilot randomized controlled trial. Trial RegistrationClinicalTrials.gov NCT04267185; https://clinicaltrials.gov/ct2/show/NCT04267185. International Registered Report Identifier (IRRID)PRR1-10.2196/18410

Objective: To describe the creation of an educational podcast with 'living cases' of older adults to support students' learning on a gerontology course and report on students' evaluation of the project. Setting: Gerontology course in a graduate programme. Method: We developed a podcast series based on interviews with older adults in the community following recent guidelines for creating educational podcasts. The podcast episodes were used in a case-based group assignment to work on during the course and to present findings at the end. Evaluation: Student experiences were evaluated using a mixed-methods survey. Results: From November 2019 to January 2021, case-based podcasts, averaging 17 minutes in length, were created and evaluated. Most students found the content of the podcasts relevant to working with older adults and increased their understanding of the issues facing members of that population. Qualitative analysis of the survey findings found that the overall strengths of the podcasts were that they were well structured, provided an authentic, real-world experience, allowed listeners to experience an innovative teaching strategy, promoted reflection, and encouraged students to consider a future career working with older adults. Students also recommended ways to improve the podcasts. Conclusion: Delivering living case studies using podcasts is a feasible, inexpensive and effective teaching method for improving physiotherapy students' attitudes towards caring for older adults. Students enjoyed learning via the podcasts and found them a valuable way to better understand the issues facing older adults. The living case podcasts could have broad applicability to other aging and health courses.

An understanding of the prevalence and risk factors of parental mental health problems is important for early intervention and prevention measures and shaping services for parents and their children. However, large representative surveys of parental mental health problems and associated risk factors are lacking. The aim of this study was to estimate prevalence rates of parental mental health problems using a standardised measure of psychiatric morbidity (General Health Questionnaire; GHQ‐12), in a representative sample of parents and caregivers of children and young people (2–19 years) in Northern Ireland. Further, this study explored associated risk factors of parental mental health problems. A random household survey of parents and children was conducted between June 2019 and March 2020. Parental responses on demographic, economic, familial and psychological measures were collected (N = 2815) and 22% of parents and caregivers screened positive for mental health problems. The STROBE checklist for observational research was adhered to. Multivariate logistic regression indicated that being in receipt of benefits, having poor family support, a history of adverse childhood experiences, a history of exposure to politically motivated violence (the Troubles), and a child with conduct problems and poor health were all independent risk factors of increased parental mental health problems. Findings will help to inform future commissioning and development of services and broaden understanding of the correlates of parental mental health problems. [ABSTRACT FROM AUTHOR]

Introduction: The benefits of physical activity for mental health and well-being and the associations between parental mental health and children's mental health have been well established. These important issues tend to be examined separately however, and there is limited research on the associations between parent and child physical activity and mental health when all considered together. While family focused practice is recommended to provide support for parents who have mental health problems and their families and includes various components (such as psychoeducation, support for mental health and parenting), promoting physical activity for parents and children is not usually a core component of these interventions. Methods: The Northern Ireland Youth Wellbeing Survey aimed to provide estimates of the prevalence of mental health problems among children and young people. The survey also included questions about parental physical activity, parental mental health, and children's physical activity (for those aged 11-19 years). The main aim of the analysis reported in this article was to explore possible bivariate associations between parent and child physical activity and mental health and also explore these associations when all considered together. Participants were included in the analysis where there were completed interviews for the young person and one of their parents, and both young person and parent provided responses in relation to questions on weekly physical activity (n = 882). Results: The findings highlight the positive associations between parental physical activity and parental mental health, and between children's physical activity and children's mental health. They also explore some of the more complex interactions between these four variables, which suggest that gender may also be an important consideration. There were significant associations between father's physical activity and son's mental health, and son's physical activity and father's mental health. Discussions: These findings suggest that including support for parental physical activity and children's physical activity should be a routine component of family focused mental health interventions. It is important to acknowledge that there may be additional barriers to engaging in physical activity for families where a parent is experiencing mental health problems, and these should also be explored and addressed. [ABSTRACT FROM AUTHOR]

Objective: Mental health promotion and primary prevention have been evident in government policies in recent decades and this focus may also be visible in response to the COVID-19 pandemic. However, there has yet to be a review of promotion and prevention in current mental health plans in relatively high-income countries with small populations. The objective of this review was to analyse recent government mental health plans in relatively high-income countries with small populations in order to compare and contrast their plans on promotion and prevention. Method: The review focussed on mental health policies, strategies or action plans published in English between 2017 and 2020 in Finland, New Zealand, the Republic of Ireland, Scotland and Wales. The research team developed an analytical framework for the review based on online interviews with policy and mental health experts and WHO guidance. Individual plans were then reviewed against the policy framework to produce an analysis in table form which provided the basis for a narrative discussion of developments. Results: There is evidence of attention in current mental health plans to 'whole of population' mental health and prevention which suggests a consensus on the need for action at this end of the spectrum. The extent of commitments to prevention and to reducing inequalities in mental health varies and is evidenced by commitments to cross-departmental structures for action on mental health and dedicated actions to reduce inequalities. Discussion: The results of this review can help to inform the development of national mental health policies. [ABSTRACT FROM AUTHOR]

Over the past few years, levels of mental health problems among children and adolescents have risen alongside an increased demand for services, which has driven the demand for a transformative systems change in how child and adolescent mental health services are delivered. Theory of change methodology is a valuable approach for advancing systems change. This article describes the theory of change process to evaluate a strategic partnership approach to advancing systems change improvements in child and adolescent's mental health. This article describes the development and application of a theory of change methodology for these strategic partnerships, discussing the benefits derived from developing the theory of change and its use by the programme staff and evaluation team. This article also discusses the challenges and limitations of using this approach and recommendations for use more widely. [ABSTRACT FROM AUTHOR]

Nora Foster Stovel. Divining Margaret Laurence: A Study of Her Complete Writings. Montreal and Kingston: McGill-Queen's University Press, 2008.406 pp.; $29.95 ISBN 9780773534377 In Divining Margaret Laurence: A Study of [...]

Actress Jodie Foster is showing a great talent for directing on the film 'Little Man Tate.' The film's story is about a child prodigy, a subject Foster is very familiar with.

Background: The move from inpatient to community services in mental health has sparked debate internationally but the evidence base for successful service models is sparse. Aim: To evaluate the impact of bed reduction on quality of services when accompanied by redesign of community services. Methods: Qualitative and quantitative data were collected 6 months before and 6 months after the redesign was implemented. Results: Bed numbers reduced by 35%. Number of admissions and occupied bed days (OBD) reduced; bed occupancy and proportion of detained patients increased. Access to community services improved but quality of assessments did not. Transitions across pathways were rated as difficult by clinicians. There was an overall reduction in staff numbers; staff sickness levels and dissatisfaction with working conditions increased. Service users were generally positive about the redesign but GPs and staff were not. Conclusions: Multi-faceted evaluation of change in cost-pressured services is feasible and should guide developments to minimise negative effects on quality of care. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the level of theory application and use of behaviour change techniques (BCTs) in dyadic health interventions for persons with chronic neurological conditions (CNCs) and their caregivers.Methods: A systematic review of five databases was conducted to locate articles published before January 2019. Methodological quality was assessed, study characteristics, theory application and BCTs were narratively summarized.Results: More than half of the studies identified (59% [16/27]) did not mention theory, and only 22% (6/27) were explicitly theory-based. Across the 27 studies, two to 17 BCTs (mean = 6.8 ± 4.02) were used. Common BCTs were related to intervention implementation (e.g., credible source), knowledge (e.g., instruction on how to perform behaviour) and skill development (e.g., behavioural practice/rehearsal).Conclusions: Researchers need to incorporate theory-based dyadic techniques that target both people with CNCs and their caregivers into the design and implementation of future health interventions.Practice Implications: Health professionals require explicitly theory-based interventions to provide dyads with CNCs techniques that they can apply in their daily life to the benefit of each individual and the partnership. [ABSTRACT FROM AUTHOR]