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Homelessness has negative implications for mental well-being and quality of life. This paper identifies the quality of life variables that contribute to positive or negative wellbeing, reporting on a regression analysis from 343 individuals experiencing homelessness in Canada. Results indicate that a lack of sleep duration and quality reduced mental well-being for both genders, not having access to food and/or hygiene facilities decreased men's well-being, and engaging in illegal subsistence strategies, such as selling drugs, negatively impacted women's mental well-being. For persons experiencing homelessness, mental well-being and quality-of-life are gendered outcomes of their limited access to social determinants of health. [ABSTRACT FROM AUTHOR]

Relatively little is yet known about employment readiness and elements that promote access to, and the retention of, employment for adults with autism spectrum disorder (ASD). This paper posits elements within the ecosystem of employment and ASD. The ecosystem approach locates employment among persons with ASD as inextricably linked with broader community resources, family support, workplace capacity building (e.g., employer, co-workers) and policy. Application of the approach is offered through process evaluation data yielded from an ecosystem-informed job readiness program entitled, 'Employment Works Canada'. Findings illustrate job readiness in the context of the broader ecosystem that envelopes salient components in the aim of community engagement and quality of life. Recommendations are offered for community-based applications and for program and research development. [ABSTRACT FROM AUTHOR]

Background: Increased immigration requires successful interaction of different cultures in various life domains, such as health. This study investigates acculturation orientation (AO) of immigrant patients and doctors native to the country, as a potential factor related to perceived medical advice adherence.Data and Methods: N = 171 immigrant patients (M = 54.38 years, SD = 17.94, range = 23-96, 74.3 % female) and their N = 12 doctors (M = 38.88 years, SD = 13.42, range = 27-66, 83 % female) from a hospital in Montreal, Canada, participated in a paper-based survey to assess AOs, patients' perceived expectations of their doctor (regarding adopting the new culture or keeping their previous culture), doctors' actual expectations, perceived quality of care and perceived adherence.Results: AO of patients significantly related to perceived adherence, via a path model involving perceptions of doctors' expectations and perceived quality of care. Integration was positively related to perceived adherence, while Marginalization was negatively related to it. Doctors' AOs were not significant.Conclusion: Patient perceptions seem to be a significant factor to be considered when striving to improve immigrant medical advice adherence. [ABSTRACT FROM AUTHOR]

The social and cultural dimensions of arctic environmental change were explored through Canada's International Polar Year (IPY) research program. Drawing on concepts of vulnerability, resilience and human security, we discuss preliminary results of 15 IPY research projects (of 52) which dealt with the effects and responses of northern communities to issues of ecological variability, natural resource development and climate change. This paper attempts to determine whether the preliminary results of these projects have contributed to the IPY program goal of building knowledge about well-being in the arctic. The projects were diverse in focus and approach but together offer a valuable pan-northern perspective on many themes including land and resource use, food security, poverty and best practices of northern engagement. Case study research using self-reported measures suggests individual views of their own well-being differ from regional and territorial standardized statistics on quality of life. A large body of work was developed around changes in land and resource use. A decline in land and resource use in some areas and consequent concerns for food security, are directly linked to the effects of climate change, particularly in coastal areas where melting sea ice, erratic weather events and changes in the stability of landscapes (e.g., erosion, slumping) are leading to increased risks for land users. Natural resource development, while creating some new economic opportunities, may be compounding rather than offsetting such stresses of environmental change for vulnerable populations. While the IPY program has contributed to our understanding of some aspects of well-being in the arctic, many other issues of social, economic, cultural and political significance, including those unrelated to environmental change, remain poorly understood. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the utilisation of HR-QOL information by US and Canadian federal regulatory bodies, with a focus on pre- and postmarket product review processes. There are a number of challenges facing regulators in using HR-QOL data derived from clinical trials and/or pharmacoeconomic analyses. Some of these challenges are inherent to HR-QOL tools and methodologies, while others relate to their inappropriate application in clinical studies. Regulators also need to take some responsibility for the chasm that exists between the potential and the reality of the contribution of HR-QOL information in decision making. Federal regulators need to develop and promulgate clear guidances that will help improve the quality and validity of studies submitted for review, and greater transparency is needed in terms of how such information is used in the product review process. Advances in technology are sure to increase the volume and complexity of HR-QOL information collected within clinical trials, and regulators need to prepare themselves to address this influx of data. Key actions are proposed to improve both the credibility as well as the uptake of HR-QOL information within the regulatory process so that this important source of information can be used appropriately and to its full potential. [ABSTRACT FROM AUTHOR]

The Health Utilities Index Mark 3 (HUI3) is a multi-dimensional, preference-based measure of health status and health-related quality of life (HRQoL). HUI3 scores correlate strongly with self-ratings of health status and functional disability and vary according to age, gender and occupation. In comparative studies relating to HRQoL, it is necessary to carry out adjusted comparison of the health status of the different groups. taking into account unbalanced distribution of confounding variables. This paper describes a stratification method to adjust the distributions of HUI3 scores. This method provides a graphical representation of adjusted distribution of HUI3, which can also be used to adjust other HRQoL scores. Cross-sectional data from the 1998/1999 National Population Health Survey (NPHS) in Canada were used to verify the proposed method. Male agriculture workers and male construction workers in Canada had quite different age distributions but similar HUI3 distributions. After adjusting the age distribution of the construction group to match the distribution of agriculture group, the mean HUI3 score of the former significantly decreased. [ABSTRACT FROM AUTHOR]