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Building upon two previously published research papers exploring Canadian media reporting of childhood in the first wave of the pandemic, this paper investigates how constructions of childhood evolved from the first wave to the fourth wave of the pandemic. This qualitative research is guided by the central research question: Over the span of 2 years, from 2020 to 2022, what changes are evident in discourses reported within media focused on the impact of the COVID-19 global pandemic on Canadians under the age of 18 years? Findings from this study suggest that in the fourth wave young people were constructed as innocent victims of pandemic restrictions framed through an adult-centric lens; noticeably absent were representations of young people under the age of 18 in their voices. A key recommendation emerged from this study: any future research investigating the impact of the pandemic on young people under aged 18 years must include their full participation. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

There has been no shortage of literature that has focused on the role of money in politics. While the majority has focused squarely on the fundraising activities and spending preferences of parties and candidates, far less has paid attention to the spending habits of corporations, unions and interests that often register as non-parties. Yet these actors have gained prominence across general elections and referendum campaigns in the past decade owing to the increase in funds spent to influence election outcomes. Little is known about what the public thinks about the participation of these actors in campaigns. Yet public opinion toward non-party campaign spending is important to the degree that it effects perceptions of electoral integrity and might compel policy change. This paper uses new survey data collected from Canada and the UK to answer questions about how citizens perceive non-party campaign spending and what informs attitudes toward non-parties. We find that the public in both countries have mixed views on the participation of non-parties, but that there is some evidence that core concerns about electoral interiority and perceptions toward the role of money in politics drives opinion. [ABSTRACT FROM AUTHOR]

Stigma of mental illness contributes to silence, denial and delayed help seeking. Existing stigma reduction strategies seldom consider gender and cultural contexts. The Strengths in Unity study was a multi-site Canadian study that engaged Asian men in three stigma reduction interventions (ACT, CEE, psychoeducation) and mobilized them as Community Mental Health Ambassadors. Our participants included both men living with or affected by mental illness (LWA) as well as community leaders (CL). This paper will: (1) describe the baseline characteristics of the Toronto participants including their sociodemographic information, mental illness stigma (CAMI and ISMI), attitudes towards social change (SJS), and intervention-related process variables (AAQ-II, VLQ, FMI, Empowerment); (2) compare the differences among these variables between LWA and CL; and (3) explore factors that may correlate with socio-economic status and mental health stigma. A total of 609 Asian men were recruited in Toronto, Canada. Both CL and LWA had similar scores on measures of external and internalized stigma and social change attitudes, except that LWA had more positive views about the acceptance and integration of those with mental illness into the community on the CAMI, while CL had a higher level of perceived behavioral control on the SJS. Group differences were also observed between LWA and CL in some process-related variables. Exploratory analysis suggests that younger and more educated participants had lower stigma. Our findings underscore the importance of engaging both community leaders and people with lived experience as mental health advocates to address stigma. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of immigrant women with visual impairment in the Greater Toronto and Hamilton Area (GTHA) of Canada. Conceptually, the paper draws from feminist disability theory and critical scholarship on blindness to consider the discursive and material processes shaping women’s experiences across different socio-cultural contexts. Empirically, the paper draws from in-depth interviews with seven women. The analysis is organized around three themes. The first explores women’s understandings of visual impairment. The second examines the ways in which women’s experiences of visual impairment are shaped by meanings and attitudes that circulate within their cultural communities, and the extent to which immigration might challenge or reinforce these meanings. The third examines the shifting barriers and opportunities women face with respect to social and economic participation. We close by identifying the conceptual implications of our research. [ABSTRACT FROM AUTHOR]

In light of recent interest in the theoretical foundations of policy paradigms, this paper aims to specify the qualities that differentiate paradigmatic from non-paradigmatic policy ideas. While the incommensurability thesis that underlies the concept of paradigms has been the target of much criticism, there is something intuitively appealing about the incommensurability of policy alternatives that is not yet fully understood. Hesitant to abandon completely the notion of incommensurability, this paper emphasizes the relative nature of ideational commensurability and provides an account of how the exclusivity of a paradigm may wither in relation to competing perspectives. The empirical section demonstrates this pattern of paradigmatic policy-making by examining solutions advanced to alleviate problems in Canadian trade-industrial policy between 1975 and 1995. Contrary to the popular perception that paradigmatic ideas yield policy stability, the findings suggest that even in areas where clearly articulated paradigms initially exist, strictly paradigmatic thinking is often fleeting. [ABSTRACT FROM AUTHOR]

Healthy eating campaigns that promote unprocessed foods to children using character licensing and fun appeals hope to offset the aggressive marketing of highly processed, unhealthy foods to children. Such campaigns are equally premised on the assumption that fruits, vegetables, and other whole foods are not desirable enough in the current food environment and must be marketed as child friendly to be appealing. This paper examines how children in Canada classify foods and whether they think of whole, unprocessed foods as ‘for them.’ Children aged 7–12 (n = 183) completed a survey asking them to classify various foods (fruit, vegetables, milk, eggs, beef, whole grains) as for ‘kids’, ‘adults’ or ‘both’. Most children classified these foods as for both adults and kids, suggesting that promotional initiatives to convince children that whole foods are uniquely children’s fare may not be necessary. Given the questionable efficacy of marketing whole foods as fun and ‘for kids,’ alongside the ethical stakes of commercializing childhood, we recommend that public health initiatives reject attempts to market whole foods as kids’ foods. Instead a key opportunity exists to emphasize the message that good food is for everyone – which is the most conducive to a building a healthy food environment and positive food habits across a lifetime. [ABSTRACT FROM PUBLISHER]

Purpose:In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Methods:Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. Results:From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults’ functional capabilities. Professionals’ primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting “rehabilitation” stay was more akin to an extended process of “destination triage” biased towards the promotion of physical safety than optimizing functioning. Conclusions:The resulting reduction of rehabilitation into “destination triage” has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for RehabilitationCurrent trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation.Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation.Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members. [ABSTRACT FROM PUBLISHER]

Acute care social work positions face budgetary scrutiny in the current climate of fiscal restraint in Canadian health care. Managers may be faced with the question of whether a new or vacant medical social work position should be filled by a BSW social worker or an MSW social worker. This question is further complicated when experienced and less costly BSW social workers are available while MSW social workers with medical or hospital experience may be limited in supply. This paper reviews the literature relevant to medical social work practice and hiring. A small scale survey was conducted with inter­professional managers responsible for the hiring of medical social workers. The purpose of this research was to examine the current hiring practices and considerations for hospital medical social workers. [ABSTRACT FROM PUBLISHER]

In this article, we examine how injection drug users who do not attribute their HIV infection to engaging in HIV risk behaviours take up and critique discourses of individual responsibility and citizenship relating to HIV risk and HIV prevention. We draw on data from a study in Vancouver, Canada (2006–2009) in which we interviewed individuals living with HIV who had a history of injection drug use. In this paper, we focus on six cases studies of participants whodid notattribute their HIV infection to engaging in HIV risk behaviours. We found that in striving to present themselves as responsible HIV citizens who did not engage in HIV risk behaviours, these participants drew on individually focused HIV prevention discourses. By identifying themselves in these ways, they were able to present themselves as ‘deserving’ HIV citizens and avoid the blame associated with being HIV positive. However, in rejecting the view that they and their risk behaviours were to blame for their HIV infection and by developing an explanation that drew on broader social, structural and historical factors, these individuals were developing a tentative critique of focus on individual responsibility in HIV transmission as opposed to dangers of infection arising from the socio-economic environment. By framing the risk of infection in environmental rather than individual risk-behaviour terms, these individuals redistributed responsibility to reflect the social-structural realities of their lives. In this article, we reflect on the implications of these findings for public health measures such as risk prevention messages. We argue that it is important that such messages are not restricted to individual risk prevention but also include a focus of broader shared responsibilities of HIV. [ABSTRACT FROM AUTHOR]

Research finds that non-indigenous peoples often hold negative racial attitudes towards indigenous peoples. Contact theory suggests that interpersonal contact can positively influence majority group members' attitudes regarding minority group members, raising the question of whether indigenous population growth in cities will alter non-indigenous peoples' attitudes. Using original 2014 survey data, this paper examines the relationship between interpersonal contact and racial attitudes in Canadian prairie cities. The analysis finds that while personal ties to aboriginal peoples are correlated with lower new and old-fashioned racism scores, general contact with aboriginal peoples only correlates with old-fashioned racism scores. As such, growing urban indigenous populations -- and thus increased aboriginal-non-aboriginal general contact -- alone should not be expected to result in positive racial attitudes. This research advances understanding of contact theory by considering how education interacts with interpersonal contact, and informs on-going dialogue about current racial relations between non-indigenous and indigenous peoples in Canadian prairie cities. [ABSTRACT FROM AUTHOR]

Background: While client-centred practice has received wide support, it remains difficult to apply in many practice settings. Identified barriers include constraints on time, resources, and services imposed by healthcare policies. Healthcare professionals' prioritizing of client safety over (other) interests that clients may name may further restrict the application of client-centred practice. Discharge planning is one area where such considerations can conflict. Aim: This paper presents a secondary analysis of data examining the process of discharge in one Canadian rehabilitation setting. It examines how discourses of client-centred practice and of prioritizing safety were reflected in discharge planning with older adults and considers the implications of potential conflicts between these discourses. Method: Taking a critical bioethics perspective informed by relational autonomy theory, microethnographic case studies were used to examine discharge planning from the perspectives of older adult clients and healthcare professionals. Results: Healthcare professionals interpreted client-centred practice to require abiding by client wishes, as long as this was safe; furthermore prioritizing safety took precedence over other considerations in discharge planning. Conclusion and significance: Client-centred practice was not promoted in discharge planning processes in the research setting. Applying a relational autonomy lens to practice could promote approaches that better facilitate client-centred practice. [ABSTRACT FROM AUTHOR]

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature. [ABSTRACT FROM AUTHOR]

As countries around the globe struggle to find appropriate solutions to the growing migration and refugee crisis, it is essential to better understand attitudes towards refugees. This article explores whether individual differences in personality can help explain anti refugee sentiments. The article takes an expansive approach, integrating both general personality traits (honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness) as well as the Dark Triad (narcissism, Machiavellianism, and psychopathy) into the analysis. While a large literature has explored the relationship between personality and prejudice generally, much less work has studied specific outgroups like refugees. Drawing on survey data from a representative sample of 2,500 Canadians the results reveal the importance of personality for understanding prejudicial attitudes towards refugees, and highlight the importance of studying both general and dark personality traits. [ABSTRACT FROM AUTHOR]

The complexities of developing and disclosing multiple, marginalized, minority identities is theoretically recognized by Minority Stress Theory and the concept of intersectionality; however, the experiences of people living at these intersections, such as Asian transgender youth, are under-examined. Consequently, they remain a largely erased community, often excluded from the research and services that are assumed to include them. The present study attempted to ameliorate this erasure by examining the coming out experiences of eight Asian-Canadian transgender youth. Interpretative phenomenological analysis (IPA) was utilized from Minority Stress Theory and intersectional perspectives to advance understanding of their coming out experiences and the contexts that maintain their marginalization. Semi-structured individual interviews elicited three themes: (a) Maintaining Family Cohesion; (b) Experiencing Adultism; and (c) Creating Community. Implications for service provision and future research are discussed with emphasis on attending to their whole personhood, which necessarily includes the individual, their community, and the systemic structures that perpetuate oppression. [ABSTRACT FROM AUTHOR]

We conceptualize infection prevention and control (IPAC) as a form of risk communication in the hospital and examine how doctors and nurses interpret and adopt IPAC measures in the wards. We conducted a 20-week ethnography in a Canadian hospital in which we observed doctors' and nurses' routines, infection prevention practices, and barriers they encountered when following IPAC guidelines. After the observation period, we conducted interviews with doctors and nurses to gauge their perceptions of risk and how they make IPAC decisions while working in the wards. Doctors and nurses perceive the hospital as a site of risk, and expressed this anxiety in disinfection routines and cleansing rituals. This risk prevention behaviour is mediated by situational and lived experience, and not expressed consistently. Doctors and nurses negotiate IPAC protocols with individual perceptions of risk, material limitations, and more pressing needs. IPAC behaviour could be reinforced by improving risk communication in the hospital, first, by involving workers as stakeholders in managing the risk of infection, and second, by acknowledging various forms of risk knowledge, including embodied and situated experience, as well as material constraints. We recommend developing participatory models of risk communication that engage stakeholders in long-term dialogue, considering their risk perceptions, risk tolerance, and challenges to comply with guidelines; communicating IPAC measures as a way to protect patients and emphasizing personal risk for hospital workers; and conducting regular in-person training sessions to ensure that any concerns can be voiced. [ABSTRACT FROM AUTHOR]

The overall goal was to synthesize knowledge on actions that need to be taken to promote health equity and the mental health of Black refugees in Canada. Group concept mapping systems were applied to generate and organize action-oriented statements related to the different social determinants of health. A total of 174 participants from the cities of Calgary and Edmonton with experience working with Black Canadians participated in four focus groups: (a) 2 focus groups that engaged 123 participants in brainstorming 84 statements guided by the following focus prompt: 'A specific action that would improve the mental health equity of Black refugees living in Canada is ... ' and (b) 2 focus groups of 51 participants who sorted the generated statements and rated them by order of 'importance' and 'ideas seen in action.' Data was further computed and analysed by the research team and a select advisory group from the participants. A 10-cluster map generated included the following clusters: (1) promoting cultural identity, (2) promoting ways of knowing, (3) addressing discrimination and racism, (4) addressing the criminalization of Black Canadians, (5) investing in employment for equity, (6) promoting equity in housing, (7) facilitating self-determination, (8) improving (public) services, (9) promoting appropriate and culturally relevant mental health services, and (10) working with and addressing faith and belief related issues. Clusters 4 and 9 ranked as the most important clusters in promoting health equity and the mental health of Black Canadians. Addressing the criminalization of Black Canadians through a range of rehumanizing interventions at institutional levels will provide a platform from which they can participate and engage others in developing appropriate and culturally relevant mental health services. [ABSTRACT FROM AUTHOR]

Migration is stressful and potentially detrimental to the mental health of immigrant children. However, they may draw tremendous mental health benefits by participating in group-based arts programs. In this literature review, we aimed to answer the question: how does participation in group-based arts programs impact the mental health of immigrant children in Canada? Findings indicated that factors at personal, interpersonal, and structural levels affect the mental health of these populations. Arts classes and programs at schools or communities would promote these children's mental health through both the direct impact of artworks and the facilitation of social support within groups. [ABSTRACT FROM AUTHOR]

This study explored social service providers' perceptions of risk and resilience while caring for their vulnerable clients during COVID-19. Participants (N = 68) from two agencies completed an online survey. Over half of participants had shifted to virtual service delivery; about 30% continued to have direct contact with clients. Using regression modeling, we found that age, gender, confidence in providing COVID-related care, worries about spreading SARS-CoV-2, and information and supports explained 36% of variance (Adjusted R2 =.357) in provider resilience. Social service agencies need to address provider worries, which may contribute more to resilience than providing information. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic significantly changed the lives of a majority of the world's population. People have been encouraged to implement social distancing behaviors enforced by governments, and have experienced loss of employment or changes to their usual working environment. In the mental health sector, psychologists and psychiatrists have been forced to alter the standard care of patients without compromising safety. This article documents the experiences of the authors – mental health professionals in four countries, Canada, Russia, Australia and Japan – at the time of the COVID-19 pandemic, and offers recommendations on how clinical, training, and research practices may need to be adjusted to deal with lockdown situations. Clinicians adapted their usual best practices by learning new skills and updating their knowledge base. Mental health clinicians noticed that the pandemic led to symptomatic changes in some of their patients. Most clinicians moved towards providing telemental health services, such as conducting assessments and treatments remotely. Those who continued seeing patients in person employed personal protective equipment with various impacts on the clinician–patient relationship. The dilemmas of mass quarantines need to be carefully examined, as their effects on numerous health and psychosocial variables appear to be far-reaching. [ABSTRACT FROM AUTHOR]

In this article, I argue that satisfaction with multiculturalism and support for discrimination in the immigration system are conceptually linked but distinct in the Canadian public's mind. Following a large literature, I make the case that despite a normative assumption of nondiscrimination in the intellectual framework and policy rhetoric of multiculturalism, the public can support discrimination while also supporting multiculturalism. To support this, I present the results of a 2017 survey of Canadians. I show that slightly less than half of respondents are willing to explicitly support discrimination. Next, I show that, when faced with a more complex decision that offers the chance to discriminate, many do so. Finally, I compare experimental results to a nearly identical experiment in the United States, which reveals that Canadian and American respondents discriminate at similar rates. [ABSTRACT FROM AUTHOR]

Over the past several decades, societal responses to juvenile crime has evolved from harsh sentences (including death) to more lenient punishments in congruence with our greater understanding of adolescent development. However, some groups of young offenders, such as those convicted of sexual offenses, appear to have fallen victim to a more punitive zeitgeist, where the mitigating effect of age may be diminished. In a 3 × (2) design, participants were randomly assigned to one of three vignette conditions and completed several measures regarding both juveniles and adults adjudicated for sexual offenses, including attitudes, moral outrage, and recommendations for sentence length and registration. Results indicated that adjudicated juveniles are viewed more favourably than their adult counterparts, although both received relatively long sentences. Further, over 90% of participants endorsed some form of registration for juvenile offenders. Implications for offender reintegration and public policy are discussed below. [ABSTRACT FROM AUTHOR]

This study's aim was to explore the complexities of how power tilt use is integrated within the context of daily life. Other studies have used mobility-type metrics of frequency, duration, and amplitude as measures of power tilt use in the context of daily life but results lack depth in explaining the complex interplay of participating in daily activities and power tilt use. This grounded theory study explored how power tilt was used in daily life from the perspectives of people experienced with using power tilt and therapists experienced with prescribing power tilt. Data collected from 22 in-depth interviews and five 3-day journals were analysed using a constant comparative approach. The resultant substantive theory offers an avenue for examining the complex, iterative relationships of person, environment, technology and occupation that comprise daily life, influencing how power tilt is used at any point during the course of the day. The knowledge generated from this research contributes to the advancement of understanding of how the decision to use tilt is integrated in daily life occupations. The theory can inform clinical practice related to individualizing power tilt use within the context of the person's own reality of daily life. The decision to use tilt or not use tilt at any point during the day, is made contingent on the iterative transaction between environmental, functional and personal contexts at that point in time. Feedback from each experience where power tilt was used generates learning and knowledge about the context of power tilt use, informing subsequent occurrences where tilt use may be an option. The substantive theory generated in this study can provide an avenue to explore how and why context influences the decision-making process to foster an in-depth understanding of why tilt is chosen or not chosen to affect problems/issues/situations occurring in day-to-day life. [ABSTRACT FROM AUTHOR]

Adolescent suicide is a preventable health problem; however, warning signs are often missed. In this study we developed a grounded theory to explore the process of how adolescent girl suicide attempters escape suicide in a sample of 12 young female adults ages 18-25. Using grounded theory methods of constant comparison, memo-writing, axial, and theoretical coding, searching for a sense of place emerged as the core process encompassing social process stages of: (1) existing in a toxic environment; (2) seeing suicide as the only way out; (3) seeing new ways to escape. Implications for nursing practice, education, and research are discussed. [ABSTRACT FROM AUTHOR]

A political party is keen to jettison anyone who could plunge it into crisis, cost it votes, harm its reputation and damage its brand. Association with election candidates is particularly high risk because of the high stakes of an election campaign. As part of their reputation and brand management, party officials can screen aspiring candidates before local party members do so. Little is known about these pre-selection methods. We examine the lengthy, invasive screening questionnaires and secretive processes that Canadian political parties use to assess potential candidates. We show that parties probe for edgy remarks, controversial activities, intolerant attitudes and unlawful conduct. Vetting pays special attention to social media. We explain that the phenomenon responds to the growth of digital content, media interest in controversy and the turmoil sparked by opposition research. We then consider normative implications associated with media and democracy. [ABSTRACT FROM AUTHOR]

We administered a questionnaire to 78 counselling psychologists who were members of the Section for Counselling Psychology of the Canadian Psychological Association (CPA), achieving a 35.4% response rate. There was high satisfaction with the profession and no evidence of gender differences in satisfaction. The sampled counselling psychologists tended to see counselling psychology as moderately different from allied professions with academics and older counselling psychologists reporting the strongest distinctiveness. Respondents were concerned about other professions' increasingly overlapping scope of practice, and thought that the most important next step was advocacy for the profession and its core values. The results of this study can be used to better address training and professional identity issues adversely impacting the field (e.g. counselling psychologists with graduate degrees in subjects other than counselling psychology, trained counselling psychologists who license as other types of professionals), promote the profession, and prepare for future challenges to the field. The results also are relevant for those seeking to increase their knowledge of the profession in other countries to learn ways to better expand and promote the profession in their own country and for those looking to create country-specific surveys to better elucidate the profession in their own country. [ABSTRACT FROM AUTHOR]

Cannabis-impaired driving (CID) is associated with an increased risk of motor vehicle accidents. A number of studies have reported on the prevalence of CID and/or riding in a vehicle with a cannabis-impaired driver (RCID), which appears to have increased in certain jurisdictions. However, there is little evidence on beliefs and perceptions of risk associated with CID vs. alcohol-impaired driving (AID). This study examined perceptions of CID and AID, prevalence of CID, and associations with cannabis use status. Respondents aged 16–30 years in Canada (n = 870) were recruited via a commercial panel and completed an online survey in October 2017. Perceptions of risk for CID were significantly lower than those for AID (p <.001). Cannabis use status predicted past CID, RCID, and low perceived risk of motor vehicle accidents (p ≤.01). CID behaviors were prevalent among young people in Canada: over 40% of respondents reported RCID, and 17% reported CID – including over a third of past-year cannabis users. Respondents also reported a lower willingness to intervene (p <.001) and reduced likelihood of legal consequences (p <.001) of CID compared to AID. These perceptions may be important barriers to reducing CID and should be prioritized in public education campaigns targeting both youth and young adults. [ABSTRACT FROM AUTHOR]

Bowen's Family of Origin training is extended to supervisory training in a Western Canada children's mental health setting with new team leaders. The training focused on worker life experiences and how they bring those experiences to the supervisory relationship to influence work with children, youth and families. Participant vulnerability, inherent in the training, provides significant insight for them in their leadership role to reveal awareness of self and other; how awareness of family of origin patterns can reduce stress and increase relationships across the organisation supporting therapeutic alliance. One-on-one interviews were audio recorded and transcribed. Inductive thematic analysis identifies three emerging themes that speak to the awareness of self and other, shifting understandings of the supervisory role, and a parallel process of peer support. Findings are presented using participant quotes, followed by a discussion of implications for supervision within children's mental health. [ABSTRACT FROM AUTHOR]

In this article I discuss the ways in which writing poetry and reflecting on its meanings may be a valuable tool for promoting an educator's reflexivity surrounding issues of reconciliation. As Canada embarks on the work of healing the difficulties its colonial past has caused its original inhabitants (i.e. Indigenous peoples), educators must explore ways in which they can contribute to a more socially just, democratic, and healthy society. By utilising the theoretical framework of Dialogical Self Theory (DST) to describe and explore identity and the writing of poetry as an exploration of self, it becomes possible for myself, as an educator, to unearth my own biases and begin to create safe spaces for identity exploration, learning, and healing. [ABSTRACT FROM AUTHOR]

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Efforts to improve cultural competence in pediatric hearing loss services should be informed by evidence of how culture can affect services, yet there is a paucity of research in the field of audiology. The aim of this study was to gain insight into practitioners' experiences with offering early hearing loss services to minority culture families. Specifically, the objective was to examine possible barriers and facilitators to improving cultural competence in early hearing loss services by exploring the perspectives of the providers of care from across Canada. A survey, informed by our previous studies, was disseminated to practitioners providing hearing loss services. Responses to all survey questions were analyzed descriptively. Open-ended questions were analyzed with simple content analysis. Results indicate practitioners reported barriers at each stage of service delivery: during diagnoses, amplification discussions, language assessments, and interventions. Practitioners also described various strategies used to facilitate culturally competent care. Findings stemming from this study can be used to inform practitioners seeking to provide culturally competent care. [ABSTRACT FROM AUTHOR]

The criminalization of HIV nondisclosure is reshaping the landscape of support and care for people living with HIV/AIDS (PLWHA). Focusing on Canada, this article examines how criminalization is reshaping the relationships between frontline AIDS Service Organization (ASO) workers and their HIV-positive service users. Using data gleaned through semi-structured interviews with N = 62 frontline ASO staff members across Canada that were coded using thematic analysis, we describe how ASO workers are rethinking and altering their notetaking practices in light of fears about criminalization and how their charts may be used by legal actors. Specifically, we identified three main themes. First, awareness that their notes can be subpoenaed and used against their clients in criminal proceedings is leading ASO staff to keep less detailed records of their conversations with PLWHA, although there were variations by the type of position held. Participants with professional obligations (doctors, nurses, social workers) reported that they continue to keep more detailed charting records than other frontline ASO staff (peer counselors, educators, etc.). Second, participants acknowledged that criminalization threatens the trust dynamic in the therapeutic relationship and that by taking less detailed notes they risk the quality of care provided. Third, we found that evolving knowledge about risk and responsibility in light of criminalization is impacting the type of counsel ASO workers offer to PLWHA regarding how to document disclosure. The article concludes by reflecting on the challenges associated with navigating the "medico-legal borderland", as ASO staff balance their commitments to serving PLWHA with the realities created by the harsh climate of criminalization. Greater political attention should be paid to the risks that criminalization poses to frontline HIV support work and efforts to support PLWHA, who already face significant stigma, without the additional stigma of the criminal label. [ABSTRACT FROM AUTHOR]

Aim: In Québec, Canada, the prevalence of children using powered mobility (PM) is not reflective of evidence supporting its use and for achieving developmental milestones. The aim of this study was to explore the perceptions of four key stakeholder groups in a metropolitan area regarding daily use, barriers, facilitators, and clinical practice associated with use of PM. Methods: Using convenience sampling, semi-structured qualitative interviews were conducted with children (n = 6), parents (n = 2), rehabilitation center occupational therapists (OTs; n = 4), and special needs school-based OTs (n = 6). Drawings were used as a supplemental data collection strategy with children. Interviews were audio recorded and transcribed verbatim to conduct thematic analysis. Results: Three overarching themes were identified: (1) "A sense of liberty, except...", highlighting environmental obstacles reducing social participation; (2) "A necessity, for better or for worse," covering benefits and drawbacks of PM; and (3) "First choice versus last resort," raising clinical differences related to provision, assessment, and training. Conclusions: Stakeholders' perceptions illustrated benefits of PM, yet use is contingent on the physical, institutional, and societal environments, leading stakeholders to feel both powerful and powerless as users, parents, or clinicians. [ABSTRACT FROM AUTHOR]

This study highlights the process of undertaking a social innovation-informed evaluative approach, with the aim of piloting a preformative stage developmental evaluation framework. The evaluative method was applied in a concurrent disorder treatment program, a settlement program, and a youth and young adult homeless shelter, in Toronto, Canada. Conceptual models were developed and operationalized based on staff and service user perceptions of the relationships between program characteristics, service user social outcomes, and intended program goals. This evaluative approach can help human service organizations to develop similar models with their own service user groups, to inform their socially innovative efforts. [ABSTRACT FROM AUTHOR]

Background: Hemineglect, defined as a failure to attend to the contralesional side of space, is a prevalent and disabling post-stroke deficit. Conventional hemineglect assessments lack sensitivity as they contain mainly non-functional tasks performed in near-extrapersonal space, using static, two-dimensional methods. This is of concern given that hemineglect is a strong predictor for functional deterioration, limited post-stroke recovery, and difficulty in community reintegration. With the emerging field of virtual reality, several virtual tools have been proposed and have reported better sensitivity in neglect-related deficits detection than conventional methods. However, these and future virtual reality-based tools are yet to be implemented in clinical practice. Objectives: The present study aimed to explore the barriers/facilitators perceived by clinicians in the use of virtual reality for hemineglect assessment; and to identify features of an optimal virtual assessment. Methods: A qualitative descriptive process, in the form of focus groups, self-administered questionnaire and individual interviews was used. Results: Two focus groups (n = 11 clinicians) were conducted and experts in the field (n = 3) were individually interviewed. Several barriers and facilitators, including personal, institutional, client suitability, and equipment factors, were identified. Clinicians and experts in the field reported numerous features for the virtual tool optimization. Conclusion: Factors identified through this study lay the foundation for the development of a knowledge translation initiative towards an implementation of a virtual assessment for hemineglect. Addressing the identified barriers/facilitators during implementation and incorporating the optimal features in the design of the virtual assessment could assist and promote its eventual adoption in clinical settings. Implications for rehabilitation: A multimodal and active knowledge translation intervention built on the presently identified modifiable factors is suggested to be implemented to support the clinical integration of a virtual reality-based assessment for post-stroke hemineglect. To amplify application and usefulness of a virtual-reality based tool in the assessment of post-stroke hemineglect, optimal features identified in the present study should be incorporated in the design of such technology. [ABSTRACT FROM AUTHOR]

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining CTOs and ACT resulted in regular access to mental health supports, fewer hospitalizations and overall improvement of quality of life for their clients. [ABSTRACT FROM AUTHOR]

Objective: The present study explores the content of abortion provider stigma. Background: Abortion stigma extends beyond women who have abortions to abortion providers. Previous analyses of anti-abortion bills and rhetoric have revealed stereotypes of abortion providers as dangerous and less trustworthy than other health professionals. Methods: We present a thematic analysis of one-on-one interviews about attitudes toward abortion providers with Canadian individuals (N = 21) holding an anti-abortion stance. Results: We found participants held two kinds of beliefs about abortion providers: (1) providers are agentic and intentional actors and (2) providers are non-agentic victims of a larger system. While the former subtype of provider was viewed with hostility and disgust, the latter was viewed with pity, with participants suggesting that restriction of abortion would be beneficial for provider well-being. Conclusion: We document a new component of abortion provider stigma: the belief that abortion providers are harmed by abortion and that they are to be pitied for this. This ‘abortion harms providers’ attitude parallels recent anti-abortion arguments that abortion harms women. These stigmatising attitudes both construct the provider as untrustworthy and unable to properly care for women. [ABSTRACT FROM AUTHOR]

HPV-associated anal cancer is one of the most prevalent non-AIDS defining cancers affecting gay men living with HIV. Drawing on interviews with 25 HIV-positive gay men living in Toronto in 2017, we explored their responses to anal cancer as a comorbidity risk and the necessity of preventative screening. These participants had previously been screened for anal cancer through a clinical trial. The majority of our sample did not initially consider anal cancer a health priority. They relied on narratives of living with HIV - that is, on their HIV biographies - to make sense of anal cancer’s significance given their self-described lack of knowledge. This included references to personal-level narratives of the biographical disruption and revision associated with a HIV diagnosis, as well as reflections on community-level and socio-historical trends in the HIV epidemic. Drawing on these narratives, some started to accept anal cancer as a significant comorbidity risk, while others remained ambivalent. Those who began to accept anal cancer as significant integrated it into their HIV biographies to present anal cancer as a threat to the ontological security they have gained managing HIV in an era of effective treatment and to position themselves as pragmatic, responsible health-seekers. Others drew on their HIV biographies to vocalise resistance to chronic risk and medicalisation. Our analysis points to the fundamental role narratives play on everyday risk perception practices, health decision-making and, for those managing a chronic illness, on securing ontological security and presenting a coherent self-identity under conditions of expanding risks and prevention possibilities. [ABSTRACT FROM AUTHOR]

Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers’ perspectives, behaviours, and interactions of interprofessional collaboration in a medical surgical ICU in a community teaching hospital in Canada. Approximately 160 hours of observations were undertaken and 24 semi-structured interviews with healthcare workers were conducted over a period of 6 months. Data were analysed using a directed content approach where two national competency frameworks were used to help generate an understanding of the practice of interprofessional collaboration. Healthcare professionals demonstrated numerous instances of interprofessional communication, role understandings, and teamwork in the ICU setting, which supported a number of key collaborative competencies. However, organisational factors such as pressures for discharge and patient flow, staffing, and lack of prioritisation for interprofessional learning undermined competencies designed to improve collaboration and teamwork. The findings demonstrate that interprofessional competencies can play an important role in promoting knowledge, attitudes, skills, and behaviours needed. However, competencies that promote interprofessional collaboration are dependent on a range of contextual factors that enable (or impede) individuals to actually enact these competencies. [ABSTRACT FROM AUTHOR]

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members’ perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU. [ABSTRACT FROM AUTHOR]

The present study was designed to explore experiences and constructions of fertility and fertility control among new migrant and refugee women in Sydney, Australia and Vancouver, Canada. Seventy-eight individual interviews and 15 focus groups (n = 82) were conducted with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. Participants positioned having children as a cultural and religious mandate and as central to a woman’s identity. Many women had limited knowledge about contraception, positioned contraception as forbidden or dangerous, and described negative experiences with its use. These findings are interpreted in relation to the provision of culturally safe medical practice and sexual and reproductive health education. [ABSTRACT FROM AUTHOR]

Comprehensive agri-food policy includes food waste reduction as an important policy goal. Food bank donor indemnification is codified in law in several countries to support the charitable food sector. Other policy instruments to address waste reduction have emerged recently, among them tax measures to incentivize private sector action. These have been increasingly linked to the discourse on hunger in many jurisdictions. We asked 17 Canadian food insecurity policy entrepreneurs to comment on a vignette scenario featuring a hypothetical proposal for food waste diversion as a policy response to household food insecurity; the polarization in responses – ‘Not human garburators,’ vs. ‘everyone wins’ – was remarkable. This case of an unexpected divergence in the response to a policy idea in the food insecurity realm provides an opportunity to understand fundamental differences in societal perspectives that might be relevant to public health more generally. In particular we address the parallel humanist and ecological imperatives at work in contemporary public health practice. It appears that objections to food waste diversion for human consumption could be crystallized in terms of Mary Douglas’s theory of morality within particular worldviews. From a humanist viewpoint, the proposal was an indignity; for those with an ecological worldview, it was sensible and pragmatic. Public health has embraced ecosystem thinking and takes for granted that its ecological approach is sensitive to humanist perspectives but the two worldviews may differ and humanist ideals of dignity may raise moral rancor when considered in the context of ecological good. [ABSTRACT FROM PUBLISHER]

Family-centered approaches offer significant promise regarding the enhancement of child and family safety. Child protection workers find value in working alongside families, whereas families appreciate having a voice in decision-making processes. The introduction of Family Group Conferencing (FGC) in New Zealand in 1989 prompted the exploration of family partnership options internationally. This study, focusing on Ontario, Canada, examines the expansion of FGC from a local pilot in 1998 to a current province-wide initiative. The internal and external factors that have promoted and inhibited change were investigated. Interviews and a focus group were used to elicit the perspectives of Alternative Dispute managers and key informants. Participants concluded that the FGC program has been successful as a result of multilevel and multipronged change efforts. However, the long-term viability remains in question, primarily because of unstable funding and uneven buy-in, on provincial levels and within child welfare agencies. To ensure sustainability current strengths should be built upon, employing the same intentional, strategic planning that characterized the introduction of FGC into the province. The Ontario experience provides pointers for interested parties wishing to embed FGC and other family-centered approaches in daily child welfare practice. [ABSTRACT FROM PUBLISHER]

A research-to-practice gap was identified in a study on knowledge sharing regarding future cardiovascular disease (CVD) risk associated with a previous diagnosis of pre-eclampsia (PE) during pregnancy, where 41% of healthcare practitioners did not inform patients of increased risk more than 50% of the time. Employing an empirical, sociological lens, we conducted interviews with women and healthcare providers from the same sample as that study. In this article, we analyse participants' perceptions of and attitudes towards the relationship between PE and CVD risk, assessing how relationships between research findings, risk, pregnancy, and women's health are understood and acted upon in Canadian healthcare. Relating empirical observations to larger debates surrounding knowledge sharing practices, we argue that structural, practical, and ideological barriers impede knowledge sharing between healthcare practitioners and patients. Patient perceptions and experiences of the knowledge sharing gap must be addressed in practical and structural changes to healthcare. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the face validity of a measure of therapeutic alliance for paediatric speech–language pathology and to determine whether a difference exists in therapeutic alliance reported by speech–language pathologists (SLPs) conducting face-to-face sessions, compared with telepractice SLPs or in their ratings of confidence with technology. Method: SLPs conducting telepractice (n = 14) or face-to-face therapy (n = 18) completed an online survey which included the Therapeutic Alliance Scales for Children – Revised (TASC-r) (Therapist Form) to rate clinicians’ perceptions of rapport with up to three clients. Participants also reported their overall perception of rapport with each client and their comfort with technology. Result: There was a strong correlation between TASC-r total scores and overall ratings of rapport, providing preliminary evidence of TASC-r face validity. There was no significant difference between TASC-r scores for telepractice and face-to-face therapy (p = 0.961), nor face-to-face and telepractice SLPs’ confidence with familiar (p = 0.414) or unfamiliar technology (p = 0.780). Conclusion: The TASC-r may be a promising tool for measuring therapeutic alliance in speech–language pathology. Telepractice does not appear to have a negative effect on rapport between SLPs and paediatric clients. Future research is required to identify how SLPs develop rapport in telepractice. [ABSTRACT FROM PUBLISHER]

Models representing the assimilation of post-Second World War immigrants to North America use the academic achievement of children of first-generation immigrants as a benchmark of social mobility. Filipino youths in Canada fall short of this benchmark – they neither meet nor exceed their parents’ academic achievements. While concern with outcomes is a useful starting point, I suggest that there is a need to interrogate how and where students are produced as different. To do this, I attend to the geographies in the narratives of youths gathered from Filipino high school students in Vancouver (unceded Coast Salish Territories). I examine how they negotiate the spaces of transnational migration, their lives as students and spaces where their educational trajectories are deferred and delayed. I argue that the geographies of transnational migration and family should be held together with spaces of the school and education when considering academic outcomes. [ABSTRACT FROM PUBLISHER]

Teachers are key players in creating inclusive dance education environments. Guided by a conceptual framework of relational ethics, this qualitative study explored the perceptions and practices of four elementary school dance teachers teaching in public schools in two large school districts in Western Canada. Data collection involved interviews, observation, and researcher field notes. Thematic analysis guided data analysis procedures. Analysis revealed six themes connected to teacher perceptions: (a) valuing uniqueness; (b) establishing supportive relationships; (c) becoming pedagogically aware; (d) regarding children’s needs; (e) teaching students about responsibility; and (f) having high expectations. Dance teachers valued inclusion and dance as a means for enabling student movement exploration and discovery of their unique style and ability. By acknowledging and respecting difference, the practice of accommodating diverse learning needs contributed to the learning of all students. [ABSTRACT FROM AUTHOR]

Progressive public health authorities in high-income countries have advocated supervised consumption facilities, where people who use illicit drugs can consume them in a hygienic, supervised environment, as a way of reducing drug-related risks to both people who use drugs and communities. However, the planning of such facilities has often met with strong reactions from the local community. ‘Not in my backyard’ (NIMBY) type reactions are frequently encountered and public opinion polling is limited in its ability to provide detailed insights into the reasons why people support or oppose these facilities in Toronto and Ottawa. We explore perceptions of residents and business representatives to the proposed implementation of supervised consumption facilities, and examine their perceptions of risks from these facilities. We collected qualitative data from 2008–2010 using focus groups and interviews with 38 residents and 17 business representatives in these two large Canadian cities lacking supervised consumption facilities. We used thematic analysis to examine expressed benefits and risks regarding supervised consumption facilities amongst community members. These participants saw these facilities as potentially risk-reducing, but recognised that the facilities could also create risks for their communities. While community members accepted that facilities could have positive health effects, they expressed a level of concern regarding the risk of public nuisance associated with supervised consumption facilities that seemed unwarranted based on the existing evidence. Discussions on the risks involved in the establishment of supervised consumption facilities should move beyond a focus on the benefits to facility users, to exploring community-level benefits and risks, and integrate evidence regarding actual risk experiences from other locations. Similar approaches may apply to NIMBY concerns related to other contentious issues. [ABSTRACT FROM AUTHOR]

This literature review describes the impact of health professional schools with a social accountability mandate by identifying characteristics of medical education found to impact positively on medical students, health workforce, and health outcomes of disadvantaged communities. A critical appraisal tool was used to identify the strengths and weaknesses of the published articles. Data are presented as a narrative synthesis due to the variety of methodologies in the studies, and characterized using a logic model. Health professional schools aiming to improve health outcomes for their disadvantaged local communities described collaborative partnerships with communities, equitable selection criteria, and community-engaged placements in underserved areas as positively impacting the learning and attitudes of students. Students of socially accountable schools were more likely to stay in rural areas and serve disadvantaged communities, and were often more skilled than students from more traditional schools to meet the needs of underserved communities. However, published literature on the impact of socially accountable health professional education on communities and health outcomes is limited, with only one study investigating health outcomes. The findings of this literature review guide schools on the inputs likely to maximize their socially accountability outputs and increase their impact on students, local health workforce and local communities. [ABSTRACT FROM PUBLISHER]

This article focuses on the forgotten voices of marginalized feminist mothers—those active in welfare rights groups. These activists were primarily poor single mothers who understood motherhood differently from more mainstream feminists. Whilst they echoed mainstream feminist demands for childcare, they also supported women's right to stay at home with their children, emphasizing the role of the state. This presented a serious class-based critique in a society that increasingly saw stay-at-home motherhood as a middle-class option. This article focuses upon working-class mothers' groups, thus problematizing dominant feminist discourses and developing a more diverse history of second wave feminism in Canada. [ABSTRACT FROM AUTHOR]