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Little research has been carried out on young people transitioning out of care in Canada. The objective of this paper was to describe and comment on the services provided to youth leaving care systems in Canada, with a focus on the four provinces with the largest populations (Ontario, Quebec, British Columbia, and Alberta). The Quebec government offers only one limited-access transition program, which has just been extended to age 25. Ontario, British Columbia, and Alberta offer several transition programs, which include financial, education, and life skills components. In British Columbia, these offer support up to age 29. The 6 remaining provinces and the 3 territories offer support to a maximum age that ranges from 21 to 26. Most offer a general financial allowance, and some offer additional supports that can include a housing allowance, tuition waivers, and job training. British Columbia and Ontario offer the most supports, including medical assistance, tuition waivers, and mental health supports. Research is needed to find out which supports are most beneficial, and under which circumstances. [ABSTRACT FROM AUTHOR]

Team-based care is recognized as a foundational building block of high-performing primary care. The purpose of this study was to identify primary care practice characteristics associated with team functioning and examine whether there is relationship between team composition or size and team functioning. We sought to answer the following research questions: (1) are primary care practice characteristics associated with team functioning; and (2) does team composition or size influence team functioning. This cross-sectional correlational study was conducted in Fraser East, British Columbia, Eastern Ontario Health Unit, Ontario and Central Zone, Nova Scotia in Canada. Data were collected from primary care practices using an organization survey and the Team Climate Inventory (TCI) as a measure team functioning. The independent variables of interest were: physicians' payment model, internal clinic meetings to discuss clinical issues, care coordination through informal and ad hoc exchange, care coordination through electronic medical records and sharing clinic mission, values and objectives among health professionals. Potentially confounding variables were as follows: team size, composition, and practice panel size. A total of 63 practices were included in these analyses. The overall mean score of team climate was 73 (SD: 10.75) out of 100. Regression analyses showed that care coordination through human interaction and sharing the practice's mission, values, and objectives among health professionals were positively associated with higher functioning teams. Care coordination through electronic medical records and larger team size were negatively associated with team climate. This study provides baseline data on what practice characteristics are associated with highly functioning teams in Canada. [ABSTRACT FROM AUTHOR]

Introduction: Improving health services integration through primary health care (PHC) teams for patients with chronic conditions is essential to address their complex health needs and facilitate better health outcomes. The objective of this study was to explore if and how patients, family members, and caregivers were engaged or wanted to be engaged in developing, implementing and evaluating health policies related to PHC teams. This patient‐oriented research was carried out in three provinces across Canada: British Columbia, Alberta and Ontario. Methods: A total of 29 semi‐structured interviews with patients were conducted across the three provinces and data were analysed using thematic analysis. Results: Three key themes were identified: motivation for policy engagement, experiences with policy engagement and barriers to engagement in policy. The majority of participants in the study wanted to be engaged in policy processes and advocate for integrated care through PHC teams. Barriers to patient engagement in policy, such as lack of opportunities for engagement, power imbalances, tokenism, lack of accessibility of engagement opportunities and experiences of racism and discrimination were also identified. Conclusion: This study increases the understanding of patient, family member, and caregiver engagement in policy related to PHC team integration and the barriers that currently exist in this engagement process. This information can be used to guide decision‐makers on how to improve the delivery of integrated health services through PHC teams and enhance patient, family member, and caregiver engagement in PHC policy. Patient or Public Contribution: We would like to acknowledge the contributions of our patient partners, Brenda Jagroop and Judy Birdsell, who assisted with developing and pilot testing the interview guide. Judy Birdsell also assisted with the preparation of this manuscript. This study also engaged patients, family members, and caregivers to share their experiences with engagement in PHC policy. [ABSTRACT FROM AUTHOR]

We explored the experiences of working-age and older adults with acquired vision impairment who pursued braille rehabilitation training, and the facilitators and barriers they encountered throughout this process. Semi-structured interviews of up to 90 min in length were conducted with 14 participants from across Canada who learned braille between the ages of 33 and 67 (Mdn = 46). Transcripts were analyzed by two researchers using interpretive phenomenological analysis. A variety of personal, social and institutional factors characterize the adult braille learning experience. Among these, participants highlight the role of prior identity and experience, the impact of access to resources and the cost of materials and devices needed to maintain braille skills. Findings also emphasize invisible barriers, including the role of societal perceptions towards braille, the level of support provided by family and friends, and the influence of unconscious biases towards braille and aging held by both adult learners and those around them. These findings provide important context to improve policies and practice in adult braille rehabilitation. As the prevalence of age-related vision impairment continues to increase, it will become imperative to understand the unique needs of working-age and older adults with acquired vision impairment who pursue braille. This study is one of the first to explore the experiences of working-age and older adults with acquired visual impairment who pursue braille rehabilitation training. Rehabilitation professionals must take into account prior learning and reading experiences which may shape the braille learning process. Family members require greater access to resources and support during the training process. There is a significant need for public education to address societal misconceptions about braille and blindness that can lead to a reluctance to use braille. Interactions with other braille users foster more empowering definitions of braille that align with the social model understanding of disability. [ABSTRACT FROM AUTHOR]

Outdoor learning offers clear physical, cognitive, social-emotional and academic benefits for children and yet, it is considered a grassroots approach to teaching and learning in elementary schools. We examined teachers' perspectives on barriers and supports for outdoor learning in public elementary schools. Thirty-six teachers in (urban and rural) British Columbia, Alberta, and Ontario (all female; Mean age = 43.84, SD = 10) participated in one of five virtually administered, semi-structured focus groups. Questions/prompts facilitated a discussion on teachers' experiences with barriers and supports for outdoor learning. Thematic analysis was used to identify main themes. Four interrelated themes and further sub-themes were found: 1) Teacher characteristics: interest/motivation to teach outdoors, preparedness, confidence in handling risks; 2) Systemic factors: principal support, school/district policies, funding/resources, curriculum, school schedule; 3) Culture: school culture, societal beliefs about education, family backgrounds; 4) Environmental factors: weather, built/natural environment, hazards. Systemic support is needed to integrate outdoor learning in schools. The findings in this study are relevant to health education specialists particularly focused on elementary school education. [ABSTRACT FROM AUTHOR]

Antimicrobials are among the most prescribed medications in Canada, with over 90% of antibiotics prescribed in outpatient settings. Seniors prescribed antimicrobials are particularly vulnerable to adverse drug events and antimicrobial resistance. The extent of inappropriate antibiotic prescribing in outpatient Canadian medical practice, and the potential long-term trends in this practice, are unknown. This study is the first in Canada to examine prescribing quality across two large-scale provincial healthcare systems to compare both quantity and quality of outpatient antibiotic use in seniors. Population-based analyses using administrative health databases were conducted in British Columbia (BC) and Ontario (ON), and all outpatient, oral antimicrobials dispensed to seniors (≥65 years) from 1 January 2000 to 31 December 2018 were identified. Antimicrobials were linked to an indication using a 3-tiered hierarchy. Tier 1 indications, which always require antibiotics, were given priority, followed by Tier 2 indications that sometimes require antibiotics, then Tier 3, which never require antibiotics. Prescription rates were calculated per 1000 population, and trends were examined overall, by drug class, and by patient demographics. Prescribing remained steady in both provinces, with 11,166,401 prescriptions dispensed overall in BC, and 27,656,014 overall in ON. BC prescribed at slightly elevated rates (range: 790 to 930 per 1000 residents), in comparison to ON (range: 745 to 785 per 1000 residents), throughout the study period. For both provinces, a Tier 3 diagnosis was the most common reason for antibiotic use, accounting for 50% of all indication-associated antibiotic prescribing. Although Tier 3 indications remained the most prescribed-for diagnoses throughout the study period, a declining trend over time is encouraging, with much room for improvement remaining. Elevated prescribing to seniors continues across Canadian outpatient settings, and prescribing quality is of high concern, with 50% of all antimicrobials prescribed inappropriately for common infections that do not require antimicrobials. [ABSTRACT FROM AUTHOR]

Introduction: Although data on new graduates are available and typically included in the health workforce planning (HWP) model, information on their interprovincial migration pattern is less known. This paper aims to understand the mobility pattern of recent healthcare graduates - family physicians and regulated nurses - across the different Canadian jurisdictions., Methodology: Health workforce data from the Canadian Institute for Health Information (CIHI) were used to identify recent family physician and regulated nurse graduates. We identified new graduates (between 2015 and 2019) in a particular province and distributed them according to the province/territory in which they registered to practise., Results: The jurisdiction where they are trained is a key factor in determining their migration rates. For both professions, Ontario and British Columbia have the lowest rates of new graduate out-migration and the highest rates of in-migration, leaving them with a positive net interprovincial migration., Discussion: This analysis can be used to inform better HWP at the jurisdictional level in these professions., Conclusion: Working and community conditions matter to keep and attract new graduates., (Copyright © 2023 Longwoods Publishing.)