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This study examined student experiences participating in a peer-led three-day wilderness canoe excursion in Northern Ontario, Canada. This program is a mandatory outdoor experience program (MOEP) for third-year students and is the final course in a progressive series of outdoor experiences offered at the beginning of the first, second, and third year. Guided by principles of realist evaluation, the written reflections from consenting students in the 2015 MOEP cohort were analyzed to identify the contexts and mechanisms associated with enjoyment or lack of enjoyment of their trip. These findings will help improve the MOEP program and have implications for similar intentionally led outdoor programs offered at other higher education institutions.

Background: Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. Objective: We aimed to understand emergency response systems, services, and training in remote NAN communities. Design: We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multistakeholder roundtable meeting (n=33) in October 2013. Results: Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Conclusions: Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed. [ABSTRACT FROM AUTHOR]

Background: Paramedics are exposed to multiple stressors in the workplace. They are more likely to develop occupational-related stress conditions compared to other occupations. This study focused on understanding the factors affecting QoWL of paramedics in northern Ontario, Canada; a particular focus was on understanding the personal and organizational factors, such as practicing community paramedicine (CP), which may be associated with Quality of Work Life (QoWL)., Methods: Paramedic QoWL was assessed using an online survey that was distributed to approximately 879 paramedics across northern Ontario. The survey included the 23-Item Work- Related Quality of Work Life Scale. Data analysis involved linear regressions with nine predictor variables deemed to be related to QoWL for paramedics with QoWL and its six subscales as dependent variables. Multiple linear regressions were used to assess the personal and organizational factors, such as practicing of CP, which predicted QoWL., Results: One hundred and ninety-seven paramedics completed the questionnaire. Overall, the mean QoWL score of all paramedic participants was 73.99, and this average compared to relevant published norms for other occupations. Factors that were most associated with higher QoWL were, experience practicing CP (p < 0.05), number of sick days/year (p < 0.01), and higher self- rated mental health (p < 0.001)., Conclusions: Higher paramedic QoWL appears to be associated with many factors such as number of sick days per year, self-rated mental health, and participation in CP. EMS organizations should consider establishing necessary workplace health promotion strategies that are targeted at improving QoWL for paramedics.