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The Physical Activity Neighborhood Environment Scale (PANES) has been used internationally; however, PANES properties have not been assessed in all geographical contexts. Our objectives were to assess the reliability and validity of an online and paper version of the PANES in Canadian adults. Reliability was estimated using intraclass correlation coefficients (ICC), percent of overall agreement (p0) and Cohen's Kappa coefficient (κ). Lower 95% confidence interval (CI) ICC ranged from 0.10 to 0.70. Lower 95%CI for κ statistics ranged from −0.20 to 0.64 and p0 ranged from 80.1% to 95.7%. Cronbach's alpha coefficients (α) estimated internal consistency of the PANES (α = 0.58 for the paper version and α = 0.55 for the online version). Mean scores for the PANES Built Environment Index (BEI) significantly differed by neighborhood street pattern (p <.05). The PANES administrated via paper or online provides reliable overall agreement and valid estimates of the self-reported neighborhood built environment supportiveness of physical activity. [ABSTRACT FROM AUTHOR]

Canada is often viewed as an oasis of multicultural inclusion where racially diverse groups could freely enjoy life in all its forms. Focusing on a group of twenty-five racialized participants working for the public sector in British Columbia (BC), this qualitative study illustrates that workplace racism is alive and prevalent in Canada. Moreover, it aims to demonstrate that this form of racism impacts not only racialized individuals who are targeted, physically and emotionally, but also their families. After presenting an outline of what constitutes racism and racialization, the article will detail and discuss findings with respect to physical, psycho-emotional and familial tolls that experiencing racial discrimination at work had exacted on racialized participants. The paper will then conclude that considering the higher expectations from public servants for not only modeling equity behavior but also upholding the rule of law, opportunities exist to more seriously address systemic racist violence against racialized workers in public sector employment contexts. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

There is limited evidence on the strategies, resources, and tools shown to improve winter mobility and community participation. This paper describes a multifaceted approach taken to develop an mHealth application that provides information, resources, and strategies to facilitate winter mobility for mobility device users, service providers, community organisations, and researchers. The study was conducted in three phases: (1) A scoping review of peer-reviewed and grey literature was completed to identify literature that reported on tools, strategies, resources, and recommendations used to promote winter mobility; (2) Online asynchronous focus groups were conducted to identify the type of content that mobility device users wanted to include in the web-based application; and (3) A prototype mHealth application was developed based on the findings from the previous phases. Using a rapid prototyping process that included stakeholder review through an online survey, four cycles of application design and development were undertaken. The scoping review identified 23 peer-reviewed studies and limited grey literature on winter mobility strategies, resources and recommendations. Twenty-four participants from across Canada engaged in one of five focus groups. Focus group analysis led to the development of the content categories for the mHealth application. The initial prototype application developed was reviewed by; 27 mobility device users, 16 health care providers, and seven consumer organisation representatives identified areas of strength and further refinement in regard to application design. The approach used in this study provided a method to develop an application based on the ideas, needs, and interests of a variety of stakeholders. Once fully developed, the application has the potential to fill the gaps related to the lack of a unified collection of winter mobility strategies and resources, and open the dialogue on methods to improve winter participation among mobility device users. Despite winter conditions being a common challenge among mobility device users, there is an absence of an organised approach towards helping individuals manage their winter mobility needs. As the development and usage of mHealth applications continues to increase, it is valuable to use methods of designing applications based on the ideas, needs, and interests of a variety of stakeholders. Development of a framework for collating information on winter mobility strategies and resources is the first step towards launching an mHealth application. [ABSTRACT FROM AUTHOR]

For many novice teachers, their first year on the job can be a roller coaster experience of 'ups' and 'downs' as they transition from their teacher education programs to teaching in real classrooms. While to 'ups' are always good to experience, the 'downs' can be so traumatic that novice teachers can feel so stressed that their teaching is adversely impacted and burned out to the point that they consider resigning for the profession. For the most part, however, the language teaching profession has not addressed this aspect of a novice ESL (English as a second language) teacher well-being in terms of their personal and emotional investment as they transition from trainee to novice teacher in their first year. This paper attempts to shed light on the emotional experiences of three female novice ESL teachers in a university language school in Canada as they reflected during regular group discussions and journal writing during their first semester (12 weeks) as novice ESL teachers. The results reveal that the group discussions and journal writing provided a platform for the teachers to articulate their mostly negative emotions with three most frequently expressed: frustration, anger and boredom. [ABSTRACT FROM AUTHOR]

Rather than racism targeted toward service users, this paper adds to the sparse corpus of articles that reports on racism and microaggressions experienced by racialized social work practitioners. Based on two qualitative exploratory research studies in Canada, the findings suggest that racism continues to be a significant problem for racialized social workers. In addition to the oft-mentioned category of individual racism, four other "modern" forms of racism are explored: cultural racism, institutional racism, epistemological racism, and aversive racism. The importance of broadening the categories of racism is that these other forms are less familiar and thus are more likely to be unnoticed yet have profound effects on practitioners. [ABSTRACT FROM AUTHOR]

The development of a tool to track participation in activity-based therapy (ABT) for people with spinal cord injury or disease (SCI/D) was identified as a priority of the Canadian ABT Community of Practice. The objective of this study was to understand multi-stakeholder perspectives on tracking ABT participation across the continuum of care. Forty-eight individuals from six stakeholder groups (persons living with SCI/D; hospital therapists; community trainers; administrators; researchers; and funders, advocates and policy experts) were recruited to participate in focus group interviews. Participants were asked open-ended questions concerning the importance of and parameters around tracking ABT. Transcripts were analyzed using conventional content analysis. Themes reflected the Who, What, Where, When, Why and How of tracking ABT. Participants described the importance of involving hospital therapists, community trainers and individuals with SCI/D in tracking ABT to capture both subjective and objective parameters across the continuum of care and injury trajectory. Digital tracking tools were favoured, although paper-based versions were regarded as a necessity in some circumstances. Findings highlighted the importance of tracking ABT participation for individuals with SCI/D. The information may guide the development of ABT practice guidelines and support the implementation of ABT in Canada. Tracking the details of activity-based therapy (ABT) sessions and programs across the continuum of care and injury trajectory may provide important information to support the development of ABT practice guidelines and implementation strategies. Tracking objective and subjective parameters are needed to provide a comprehensive description of an ABT session and program. Clinicians and individuals with spinal cord injury or disease (SCI/D) should both be able to track ABT to accommodate all settings and types of data. Digital tracking tools, such as an app, may provide an accessible, versatile and efficient way of tracking ABT. [ABSTRACT FROM AUTHOR]

Introduction Research in palliative care (PC) is often regarded as challenging due to the vulnerability of the population and other peculiarities. We aim to systematically identify barriers to research in PC in the literature. Methods The electronic databases CINAHL, MEDLINE were searched for papers published in the last 25 years. Citations and then abstracts were screened for inclusion. Original papers were included on first-level analysis. On a second level reviews, reports, and position papers were analyzed. Papers containing a direct patient report were specifically analyzed. Barriers were categorized (ethical considerations, financial and time expenses, study design and methodology, human resources and politics) and results quantified. Results Twenty-one original papers and 65 other papers were included. Five studies involved patients directly, five were systematic reviews, three were study experiences, and seven were surveys or workshop reports. Most papers originated from UK, USA, or Norwegian Universities. Ethics and methods were the most often mentioned categories on both levels. Accrual, attrition, and gatekeeping were frequently named barriers. Complex invasive studies or possible side effects hinder patients' participation, as patients are often willing to participate for altruistic motivations. Discussion Barriers to PC research are ethical concerns and methodological challenges. Possible strategies to overcome methodological barriers include international collaborative efforts to include more patients and improve study designs. Ethical barriers indicate the need for patient involvement in the research development process and tailoring research specifically to the PC population. [ABSTRACT FROM AUTHOR]

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

This paper describes how a study using institutional ethnography (IE) was used as a decolonizing method of inquiry in a rural Indigenous community in Canada. IE honors lived experience, reveals institutional and colonial practices, provides clear empirical evidence, and can offer clear recommendations that can benefit Indigenous communities. At the heart of decolonizing research is the task of shifting whose knowledge is privileged – from those with power (often researchers) to those who are being researched (those subject to the effects of colonization). To highlight how IE can be used as a decolonizing method of inquiry, the authors of this paper (a) point out common pitfalls of academic research and knowledge translation (KT) practices in Indigenous health; (b) highlight decolonizing research principles and how IE can be a decolonizing method of inquiry; and (c) share an example to illustrate how IE was used in a decolonizing health study in a First Nations community context. This paper also outlines critiques of mainstream research and KT practices, highlights principles for conducting research with Indigenous people in Canada, and further discusses how IE is well positioned to facilitate both decolonizing research and strategic KT. [ABSTRACT FROM AUTHOR]

Despite decades of research and education, sexual and gender-based violence remain distressingly prevalent on university and college campuses globally. The taboos associated with sex, gender inequity, and living in a patriarchal world where misogyny is glorified and criminalised are key socio-cultural determinants driving these forms of violence. Less is known about the ways in which sexual slang or terminology impact how students experience and talk about these events. This paper reports on findings from a participatory action study that explored sexual slang use among female and male undergraduate students (n = 23) with the aim of creating more responsive sexual and gender-based violence policies and practices. The terms identified (n = 59) provide a window into the daily lives of these young people, who display remarkable socio-linguistic adaptation and creativity. They also demonstrate how cultural appropriation, the exclusion of queer students, toxic masculinitycontribute to ongoing incidents of sexual and gender-based violence on campus. These findings contribute new insights into sexual terminology among post-secondary students, particularly in the Canadian context where few studies of this nature exist. They also acknowledge the critical role universities can play in making meaningful structural change to prevent traumatic events from occurring. [ABSTRACT FROM AUTHOR]

Intergenerational health and wellness promotion among Métis peoples in Canada is emerging as a priority for Métis communities. Our team is engaged with an intergenerational and lifecourse-oriented program of research on aging well in collaboration with a northern Saskatchewan Métis community (in Canada). We employ a community-engaged participatory action methodology that integrates Métis and Western perspectives through iterative cycles of planning, implementing, and action. Métis perspectives are provided by two Métis community leads and Western perspectives by two non-Métis team leads from the University of Saskatchewan, Canada. Our research program commenced with the development of a program logo which was created by two Métis community youth. We reflect on the intergeneratiaonl health and wellness symbols and significance of this research program logo as our research has progressed. It has become clear that the logo may provide a nascent Métis intergenerational wellness framework that aligns with what we are learning from Métis research participants (young and old). Further, the logo aligns with Indigenous theory and a framework that has informed our original research proposal. In this "advancing the field paper" we introduce the logo and describe its relevance to intergenerational wellbeing among Métis peoples. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary results of a one and a half-year ethnographic study conducted in Victoria, British Columbia, Canada. The research focused on participants' experiences of their bodies in the context of yoga as a health practice—specifically how they conceptualised their musculoskeletal bodies in this practice through ideas of systems, fragments, and materiality. It argues that participants' larger narratives about health and healthy bodies inform how yoga as a health practice is embedded in discourses of body work where yoga, health, and particular notions of bodily-ness become a project for the transformation of the self into a particular idea of what a body is or should be. [ABSTRACT FROM AUTHOR]

The purpose of this paper is threefold: firstly, to provide a brief overview of current practice in workplace mental health and introduce an emerging role for occupational therapy in this field (i.e., practicing at the organizational level where "clients" are workplaces or organizations, and not individual workers); secondly, to present the findings from a small qualitative study which describes this emerging role from the perspectives of occupational therapists who have worked in this area; and thirdly, to provide suggestions for future work which could advance this emerging role for occupational therapy world-wide. Previous research suggests that there is an increasing interest among employers to address workplace mental health through organizational initiatives and that occupational therapists are beginning to consult on the topic. Occupational therapists in our small qualitative study described their role in organizational workplace mental health as one which involves adopting a business lens, practicing in an organization-centred manner, and focusing on population health promotion. Suggestions for future work to advance this emerging role include identifying the fundamental elements of the business lens, investigating models and frameworks to guide organization-centred practice, evaluating the short-, medium-, and long-term outcomes of interventions, exploring the fit between an occupational perspective and workplace mental health, and examining the impact of COVID-19 on current practice. [ABSTRACT FROM AUTHOR]

This article presents data from a mixed-method study on evangelical faith-based organizations in Southern Ontario, Canada. The authors sought to explore the nature and extent of faith-sharing in these organizations by using the Convergent Triangulation Design, which permitted the use of semi-structured interviews, focus groups, surveys, and document review. First, The Great Commission acts as a de facto institutional policy in the evangelical faith-based organizations sampled; The Great Commission is a Biblical injunction, strongly observed by evangelicals, which states that evangelicals are commissioned by Jesus to share and ultimately convert others to their faith. The second theme is that in seeking to realize The Great Commission these organizations tried not to be coercive in sharing their faith. In the discussion, the paper explores briefly some of the potential ethical issues that emerge from faith-sharing in social service settings. [ABSTRACT FROM AUTHOR]

This paper describes findings from an institutional ethnography that arose out of the concerns of women living with HIV in Ontario, Canada, regarding the disclosure of their HIV status while accessing perinatal care. The enquiry traces the connections between women's experiences of perinatal care, the activities of healthcare providers delivering such care and the ruling relations that organise women's experiences and healthcare providers' activities. Focusing on HIV disclosure as a concern expressed by women, the findings make visible the day-to-day, routinised practices of healthcare providers working in perinatal care for women living with HIV, as well as the ideological discourses of 'fear of contagion' and 'AIDS hysteria' that contributed to producing the kinds of care experiences that were articulated by women. Opportunities to strengthen perinatal care policies and practices for women living with HIV are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Weather is a key source of marine risk, but relationships between fishing activity, safety, and weather remain poorly understood. Critically, the fit between available marine forecast products, fish harvesters' needs, and harvester's decision-making processes has not been rigorously assessed. This paper addresses these gaps by documenting a) weather-related decision-making by harvesters, and its relationship to forecasts across multiple regions and fisheries on Canada's East coast (Newfoundland) and b) the dynamics of forecast production priorities. Methods: A multi-disciplinary, community-engaged research approach, conducted in partnership with the Newfoundland and Labrador Fish Harvesting Safety Association (NL-FHSA). Data consist of semi-structured interviews with fish harvesters and weather forecasters, focused on marine forecast production and use. Results: Results emphasize that there is a subjective "art" to both production and use of marine forecasts. Forecasters and harvesters share several common values regarding forecasts, but different emphases: forecasters favor some combination of accuracy, consistency, and utility, while harvesters are largely concerned with utility. Finally, harvesters' decision-making is based on nuanced and contextual interpretations of a few key hazards (winds and, to a lesser extent, waves). Conclusion: This community-engaged research has triggered experimentation with forecasts tailored to fisheries utility within Environment and Climate Change Canada (ECCC). It lays the groundwork for ongoing, mutually beneficial dialogue between forecasters and harvesters, engaging harvesters with the forecasting process while familiarizing forecasters with harvester's decision-making processes. Ongoing industry partnerships (NL-FHSA) continue to sustain momentum from this study towards further enhancing the utility of future marine forecasts for small-scale harvesters. [ABSTRACT FROM AUTHOR]

Developing the Canadian initial attack (IA) wildland fire fighter (WFF) physical employment standard (WFX-FIT) began in a previous investigation with a physical demands analysis in which hand and back carrying a 28.5 kg pump, back carrying a 25 kg hose pack and advancing charged hose were identified as the critical IA emergency tasks. In the present study, a circuit was created incorporating simulations of the critical tasks with faster completion times required for provinces with more arduous terrains. The oxygen cost (mean ± SD VO2 mL∙kg−1∙min−1) of performing IA WFF tasks sequentially on the job was 37 ± 6 compared to 37 ± 4 when performing the WFX-FIT, indicating strong construct validity. Content validation ratings comparing the likeness of on-the-job tasks to simulated tasks in the WFX-FIT provided strong agreement. These validations confirm that the physical demands involved in performing the WFX-FIT are the same as IA wildland fire fighting. Practitioner Summary: This paper details the process used to develop and validate the physical employment standard for jurisdictional employment and national exchange of IA WFF. The range of cut-scores reflects the differences in jurisdictional physical demands due to terrain difficulty, fire management policy on fire risk and forest value index. [ABSTRACT FROM AUTHOR]

Ethics education is the cornerstone of professional practice, fostering knowledge and respect for core ethical values among healthcare professionals. Ethics is also a subject well-suited for interprofessional education and collaboration. However, there are few initiatives to gather experiences and share resources among ethics educators in rehabilitation. We thus undertook a knowledge exchange project to: 1) share knowledge about ethics training across Canadian occupational and physical therapy programs, and 2) build a community of educators dedicated to improving ethics education. The objectives of this paper are to describe this interprofessional knowledge exchange project involving ethics educators (with a diversity of professional and disciplinary backgrounds) from Canadian occupational and physical therapy programs as well as analyze its outcomes based on participants’ experiences/perceptions. Two knowledge exchange strategies were employed: an interactive one-day workshop and a wiki platform. An immediate post-workshop questionnaire evaluated the degree to which participants’ expectations were met. Structured telephone interviews 9-10 months after the workshop collected participants’ perceptions on whether (and if so, how) the project influenced their teaching or led to further interprofessional collaborations. Open-ended questions from the post-workshop questionnaires and individual interviews were analyzed using qualitative methods. Of 40 ethics educators contacted, 23 participated in the workshop and 17 in the follow-up interview. Only 6 participants logged into the wiki from its launch to the end of data collection. Five themes emerged from the qualitative analysis: 1) belonging and networking; 2) sharing and collaborating; 3) changing (or not) ways of teaching ethics; 4) sustaining the network; and 5) envisioning the future of ethics education. The project attained many of its goals, despite encountering some challenges. While the wiki platform proved to be of limited benefit in advancing the project goals, the interactive format and collaborative nature of the one-day workshop were described as rewarding and effective in bringing together occupational therapy and physical therapy educators to meet, network, and share knowledge. [ABSTRACT FROM AUTHOR]

This paper outlines the research methodology, conceptual framework, and initial research results for a holistic and longitudinal study of the impact and management of information technology in two governments considered to be in the forefront of its application, the federal Government of Canada and the Province of Ontario. The methodology involves close observation and interviewing of public servants, questionnaires of politicians and public servants, and ongoing tracking of government and party Websites. The conceptual framework uses economic analysis to identify and describe demand, supply, and competition in a number of related markets that comprise the IT sector in government. We also examine the use of IT in political processes and political control over the management of IT by public servants. [ABSTRACT FROM PUBLISHER]

Purpose:In Canada, two counseling services are offered to facilitate physical activity participation among persons with physical disabilities, yet both have encountered concerns related to the recruitment and retainment of clients. The purpose of this paper is to explore factors related to service adoption among nonusers, and the barriers and facilitators to maintaining service participation among adopters. Methods:Individuals who had never enrolled in the services (nonusers,n = 13) as well as current/previous service clients (adopters,n = 26) participated in interviews based on the Theoretical Domains Framework. Transcripts were subjected to deductive thematic analysis according to participant group. Results:Fifteen themes relating to service adoption within 10 of the 12 theoretical domains were identified for nonusers, while 23 themes relating to maintenence of service participation were identified across all 12 theoretical domains for adopters. Conclusions:The findings provide strategies to improve recruitment, adoption, and retention of clients in counseling services and to enhance the experiences of targeted service users. Implications for RehabiliationPeer support and education for equipment use should be built into physical activity programs to encourage participation among persons with physical disabilities.Programs that encourage physical activity among individuals with disabilities should be designed by practitioners to be responsive to a variety of needs, which are addressed in the program’s advertisements and offerings.The Theoretical Domains Framework is a useful framework for providing valuable insight about clients’ experiences of adoption and maintenance of a behavior change service, suggesting merit in other rehabilitation settings. [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]

Young bisexual women experience worse mental and sexual health outcomes in comparison to their heterosexual and lesbian peers. These disparities are associated with stigma and devaluation of bisexual identities. The current paper addresses a community-based focus group project in which participants discussed bisexual stigma in regard to bisexual erasure and other stereotypes. Specifically, participants detailed experiences of feeling pressured to provide evidence of their bisexual identity, modifying their relationship or sexual behavior to conform to these expectations, as well as feeling excluded from queer community. Further, participants discussed how these experiences were related to decreased mental and sexual health. Future research should further investigate the relationship between bisexual stigma, pressure to provide evidence of bisexual identity, and negative mental and sexual health outcomes. [ABSTRACT FROM PUBLISHER]

Preparing for the future is a major developmental task during adolescence and early adulthood. However, youth experiencing homelessness face additional challenges relating to economic instability, housing insecurity, and a lack of social support. Semi-structured interviews were conducted with 38 youth, from Ottawa and Toronto, who were experiencing homelessness and participating in a randomized controlled trial of Housing First for Youth (HF4Y). This qualitative study explores youths' visions for the future, including their goals, aspirations, plans, and barriers to achieving them. Overall, findings demonstrated that youth had positive visions of the future and strove to reach developmentally appropriate goals and responsibilities. Compared to youth receiving HF4Y, the future expectations of those receiving treatment as usual (TAU) were characterized by uncertainty and lacked clear direction. Additionally, they emphasized self-reliance and autonomy, while HF4Y prioritized forming relationships and reconnection. Findings highlight the importance of stable housing intervention, and social, community, and financial support in planning for the future and transitioning out of homelessness. Implications for intervention, directions for future research, and limitations are provided. [ABSTRACT FROM AUTHOR]

Aims: This study provides an examination of normalization trends associated with the use of cannabis and tobacco, and whether and to what extent health concerns and legal contexts appear to modify the tolerance displayed to users.Methods: Data for this paper are drawn from a mixed methods interview study involving 202 respondents who reported being regular users of cannabis (alonen = 100 or in conjunction with tobaccon = 67) or tobacco only users (n = 35), in four Canadian cities (Halifax, Montreal, Toronto and Vancouver).Findings: While participants commonly attributed serious health risks to the use of tobacco, cannabis was viewed as relatively low risk. All groups described cannabis laws as too punitive, while most agreed with the regulatory controls for tobacco. Drawing on norms around appropriate context for use, cannabis users illustrate the expansion of normalization, with varying degrees of acceptability in different spaces. In contrast, tobacco users’ heightened awareness of the dangers of smoking leads them to engage in a reflexive process-limiting appropriate venues and contexts for use.Conclusions: These findings suggest that perceptions of health risk shape users’ experience of normalization (and denormalization) and help to contextualize the larger societal processes where both drugs are in a stage of societal re-evaluation. Much can be learned about the cannabis future from the tobacco past. [ABSTRACT FROM PUBLISHER]

The Process Overview Measure is a query-based measure developed to assess operator situation awareness (SA) from monitoring process plants. A companion paper describes how the measure has been developed according to process plant properties and operator cognitive work. The Process Overview Measure demonstrated practicality, sensitivity, validity and reliability in two full-scope simulator experiments investigating dramatically different operational concepts. Practicality was assessed based on qualitative feedback of participants and researchers. The Process Overview Measure demonstrated sensitivity and validity by revealing significant effects of experimental manipulations that corroborated with other empirical results. The measure also demonstrated adequate inter-rater reliability and practicality for measuring SA in full-scope simulator settings based on data collected on process experts. Thus, full-scope simulator studies can employ the Process Overview Measure to reveal the impact of new control room technology and operational concepts on monitoring process plants. Practitioner Summary: The Process Overview Measure is a query-based measure that demonstrated practicality, sensitivity, validity and reliability for assessing operator situation awareness (SA) from monitoring process plants in representative settings. [ABSTRACT FROM AUTHOR]

Background There is a lack of evidence in Canada surrounding the costs to parents and society to raise a child with intellectual disability. Knowledge of these costs is necessary to ensure appropriate governmental support to families and to assess the financial impact of new diagnostic tests and treatments. Method We adapted 2 paper-based cost diaries into an online retrospective survey and evaluated it using a small pilot study of individuals with Down syndrome. Results Parents completed the survey with apparent ease, giving answers requiring little clarification; they used comment fields to add data that elaborated on both financial and emotional costs. Costs appeared concordant with those reported in other countries. Conclusion The survey successfully documents care time required, impact on employment, and other expenses. Minor modifications were made as a result of this pilot, and the survey is now available for wider use. [ABSTRACT FROM AUTHOR]

This paper presents a case study that explored and reflected on the relationship between the beliefs and classroom practices of four English as a Second Language (ESL) teachers in a university language school in Canada related to teacher questions. Data gathered consisted of interviews and classroom observations of all four teachers. The findings revealed that although for the most part the teachers implemented their classroom questioning practices in convergence with their stated beliefs, there were some instances of divergence observed for all teachers. Potential factors contributing to the patterns of convergence and divergence are further explored. In addition, this study found that through the reflective process whereby the teachers articulated and reflected on their beliefs about their use of questions, they became more aware of the meaning and impact of these beliefs on their classroom practices. [ABSTRACT FROM PUBLISHER]

Recently in Canada the issue of police encounters among persons living with a mental health issue has received considerable public attention; however, the focus has been primarily on the experiences of adults and not of children and youth. In this paper, we explore police encounters in child and youth mental health by presenting the outcomes of 14 qualitative interviews conducted with seven caregivers and seven siblings and two focus groups conducted with eight caregivers about their experiences of having a child/sibling, 13–21 years old, living with a mental health issue. There were two main themes identified: (1) the need for police support to deescalate a high conflict situation involving a distressed child/sibling, and (2) the stigmatisation and criminalisation of the distressed child, parents and families. Based on these outcomes, a model of support is proposed whereby parents would be provided with crisis intervention training informed by an understanding of the stigma of mental illness as a structural condition of their personal experiences. Such training could provide caregivers with support for identifying and responding to crisis and for developing safety plans that may or may not involve police, but could minimise and/or divert the need for their involvement. [ABSTRACT FROM PUBLISHER]

In Canada, there has been a rise in criminal HIV non-disclosure cases where public health records have been subpoenaed for use in police investigations and criminal court proceedings. In particular, public health nurses’ written counseling notes, originally collected for the purposes of creating a record of treatment and a plan of care, have been used as evidence against their clients. This article engages sociologically with this issue by analyzing whether and how this criminal law development has affected public health nurses’ reasoning and documentary practices in settings of HIV post-test counseling sessions. The paper argues that variations in nurses’ inscription styles result in part from considerations about the criminal law, which indicates the influence of ‘medico-legal’ relations that connect health care and the criminal justice system. Implications for nursing practice and the broader goals of HIV prevention are discussed. Data are drawn from interviews with thirty nurses working at four public health units in Ontario. [ABSTRACT FROM PUBLISHER]

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]

Child care, conceptualized as one area of social policy, is a good example of a population health intervention (PHI) that operates outside of the health sector. Exploration of child care as a PHI could help to clarify the scope of the PHI field, and contribute to a credible base from which to advocate for PHIs, yet such exploration is not yet prominent in the population health research literature. The purpose of this paper is to consider child care through the lens of PHI, and in particular, to consider whether a strong case can be made for a universal approach to child care in Canada and perhaps other liberal welfare regimes where targeted approaches are more commonly accepted. We first examine the peer-reviewed evidence on the impact of universal and targeted child care for later outcomes. We then interrogate other issues that are pertinent to making a strong case for universal child care in Canada as one example of a liberal regime; namely, (1) limitations and challenges of research on the impact of universal child care; (2) the intuitive appeal of targeting; (3) the fundamental differences between targeted and universal approaches; and (4) the values inherent in judgments about the equity of universal interventions. Notably, some of these issues do not lend themselves to empirical resolution, which raises interesting questions about the acceptable balance of ideology and empiricism in population health. [ABSTRACT FROM AUTHOR]

Background: Throughout their careers, doctors and other healthcare professionals experience numerous transitions. When supporting transitions, opportunities for development and learning should be maximized, while stressors having negative impacts on well-being should be minimized. Building on our international data, this study aimed to develop a conceptual model of the trainee-trained transition (i.e. the significant transitions experienced by doctors as they complete postgraduate training moving from trainee/resident status to medical specialist roles). Methods: Employing Multiple and Multidimensional Transitions (MMT) theory and current conceptualizations of clinical context, this study undertook secondary analysis of 55 interviews with doctors from three countries (Netherlands, Cananda and the UK) undergoing trainee-trained transitions. Results: Through this analysis, the Transition-To-Trained-Doctor (T3D) conceptual model has been developed. This model takes into consideration the multiple contexts and multiple domains in which transitions take place. Discussion: This model is significant in that it has several uses and is applicable across countries: to remind doctors, managers and medical educators of the complexity of transitions; to frame and facilitate supportive conversations; and as a basis to teach about transitions. [ABSTRACT FROM AUTHOR]

Background: Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. Aim: This paper showcases a more practice-grounded needs assessment approach. Methods: A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. Results: Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2's practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. Conclusions: This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs. [ABSTRACT FROM AUTHOR]

The research described herein was a three-year exploratory descriptive study to examine how meaningful involvement (MIPA) is conceptualized and experienced in rural regions of the Maritime provinces of Canada. The focus of this paper is one aspect of the research; i.e., what motivates the clients of AIDS Service Organizations (ASOs) in rural Canada to become meaningfully involved? We interviewed 34 people who were past or current clients of ASOs in Maritime Canada and who self-reported as engaging in at-risk behaviors for HIV or living with HIV. The interviews explored participants' perspectives about their motives for becoming meaningfully involved in an ASO. Three themes regarding motives for MIPA were revealed: (1) meeting personal needs; (2) making a difference to others; and (3) recognizing a fit between their skills, goals, needs and the opportunities and experiences within the ASO and with other ASO clients. Participants generally cited more than one motive. This research study contributed to the field of knowledge about the motives for MIPA in which it reveals (1) that MIPA was conceptualized by the rural ASO clients as whatever participation provided them personal meaning (i.e., by fulfilling a personal need, by making a difference, and by recognizing a fit) and (2) the important role that ASO staff and volunteers have in fostering and sustaining MIPA. The study also highlighted a trajectory of involvements that support the need for ASOs to entertain a wide range of roles that are assumed as MIPA. [ABSTRACT FROM AUTHOR]

This paper examines how children and families of diverse ethnic backgrounds perceive, understand and treat symptoms related to functional gastrointestinal disorders (FGIDs). It is questioned how different ways of dealing with medical uncertainty (symptoms, diagnosis) may influence treatment pathways. Semi-structured interviews were conducted with 43 children of 38 family groups of immigrant and non-immigrant backgrounds. The analysis takes into account (a) the perceived symptoms; (b) the meaning attributed to them; and (c) the actions taken to relieve them. The social and cultural contexts that permeate these symptoms, meanings and actions were also examined. It is found that, in light of diagnostic and therapeutic uncertainty, non-immigrant families are more likely to consult health professionals. Immigrant families more readily rely upon home remedies, family support and, for some, religious beliefs to temper the uncertainty linked to abdominal pain. Furthermore, non-immigrant children lead a greater quest for legitimacy of their pain at home while most immigrant families place stomach aches in the range of normality. Intracultural variations nuance these findings, as well as family dynamics. It is concluded that different courses of action and family dynamics reveal that uncertainty is dealt with in multiple ways. Family support, the network, and trust in a child's expression of distress are key elements in order to tolerate uncertainty. Lastly, the medical encounter is described as a space permeated with relational uncertainty given the different registers of expression inherent within a cosmopolitan milieu. Narrative practices being an essential dynamic of this encounter, it is questioned whether families’ voices are equally heard in these clinical spaces. [ABSTRACT FROM PUBLISHER]

The disappointing results of many public health interventions have been attributed in part to the lack of meaningful community engagement in the planning, implementation, and evaluation of these initiatives. Community-based participatory research (CBPR) has emerged as an alternative research paradigm that directly involves community members in all aspects of the research process. Their involvement is often said to be an empowering experience that builds capacity. In this paper, we interrogate these assumptions, drawing on interview data from a qualitative study investigating the experiences of 18 peer researchers (PRs) recruited from nine CBPR studies in Toronto, Canada. These individuals brought to their respective projects experience of homelessness, living with HIV, being an immigrant or refugee, identifying as transgender, and of having a mental illness. The reflections of PRs are compared to those of other research team members collected in separate focus groups. Findings from these interviews are discussed with an attention to Foucault’s concept of ‘governmentality’, and compared against popular community-based research principles developed by Israel and colleagues. While PRs spoke about participating in CBPR initiatives to share their experience and improve conditions for their communities, these emancipatory goals were often subsumed within corporatist research environments that limited participation. Overall, this study offers a much-needed theoretical engagement with this popular research approach and raises critical questions about the limits of community engagement in collaborative public health research. [ABSTRACT FROM PUBLISHER]

This paper uses interview data from physicians and their spouses to describe the types of spousal support physicians receive when coping with work-related stress and to explore whether they vary by occupational similarity, gender, and parental status. The physicians described receiving different types of spousal support: emotional, informational, and instrumental. Male physicians in this study often reported receiving emotional support from their spouse, consistent with the support gap hypothesis in the literature. An unexpected finding is that from the responses of the physicians’ spouses, the husbands often reportedofferingemotional support to their physician spouse. Physicians who shared similar occupational and work experiences with their spouse (i.e. married to another physician) reported receiving informational support from their spouse, consistent with the theory of homophily. Finally, the findings also suggested that once physicians have children, their wives often reported providing instrumental support by being primarily responsible for childcare and housework. An interesting finding of this study is the discrepancy between the physicians and their spouses in their perceptions of support. [ABSTRACT FROM AUTHOR]

Background: Medical education has traditionally been compartmentalized into basic and clinical sciences, with the latter being viewed as the skillful application of the former. Over time, the relevance of basic sciences has become defined by their role in supporting clinical problem solving rather than being, of themselves, a defining knowledge base of physicians. Methods: As part of the national Future of Medical Education in Canada (FMEC MD) project, a comprehensive empirical environmental scan identified the timing and integration of basic sciences as a key pressing issue for medical education. Using the literature review, key informant interviews, stakeholder meetings, and subsequent consultation forums from the FMEC project, this paper details the empirical basis for focusing on the role of basic science, the evidentiary foundations for current practices, and the implications for medical education. Findings: Despite a dearth of definitive relevant studies, opinions about how best to integrate the sciences remain strong. Resource allocation, political power, educational philosophy, and the shift from a knowledge-based to a problem-solving profession all influence the debate. There was little disagreement that both sciences are important, that many traditional models emphasized deep understanding of limited basic science disciplines at the expense of other relevant content such as social sciences, or that teaching the sciences contemporaneously rather than sequentially has theoretical and practical merit. Innovations in integrated curriculum design have occurred internationally. Less clear are the appropriate balance of the sciences, the best integration model, and solutions to the political and practical challenges of integrated curricula. Discussion: New curricula tend to emphasize integration, development of more diverse physician competencies, and preparation of physicians to adapt to evolving technology and patients' expectations. Refocusing the basic/clinical dichotomy to a foundational/applied model may yield benefits in training widely competent future physicians. [ABSTRACT FROM AUTHOR]

Whereas the autism prevalence rate has been very closely monitored in the United States, the same has not been observed in many other countries. This may be attributed to the fact that each culture views and defines autism differently. Using field notes and semi-structured interviews with family members with an individual with autism, teachers, and professionals in Canada, Nicaragua, and Korea, this paper illustrates how autism is socially differently constructed in these distinctively different cultures. Observing and experiencing what autism means in different cultures urge us to accept and appreciate individual differences or ‘differ-bilities’ in the diverse twenty-first century. [ABSTRACT FROM AUTHOR]

An interprofessional team of maternity care providers and academics developed a pilot interprofessional education (IPE) program in maternity care for undergraduate students in nursing, midwifery and medicine. There are few published studies examining IPE programs in maternity care, particularly at the undergraduate level, that examine long-term outcomes. This paper outlines findings from a case study that explored how participation in an IPE program in maternity care may enhance student knowledge, skills/attitudes, and may promote their collaborative behavior in the practice setting. The program was launched at a Canadian urban teaching hospital and consisted of six workshops and two clinical shadowing experiences. Twenty-five semi-structured, in-depth interviews were completed with nine participants at various time points up to 20 months post-program. Qualitative analysis of transcripts revealed the emergence of four themes: relationship-building, confident communication, willingness to collaborate and woman/family-centered care. Participant statements about their intentions to continue practicing interprofessional collaboration more than a year post-program lend support to its sustained effectiveness. The provision of a safe learning environment, the use of small group learning techniques with mixed teaching strategies, augmented by exposure to an interprofessional faculty, contributed to the program's perceived success. [ABSTRACT FROM AUTHOR]

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The paucity of literature in the field of visitor attractions, combined with the virtual vacuum of literature on international comparative research methodologies in tourism generally, and more specifically within the visitor attractions sector, together serve as the catalytic focus for this paper. Where studies have been completed on visitor attractions in the international arena, they have often been practitioner-led and lack the depth of analysis and rigour required for academic scrutiny. This paper will begin to fill this gap, by evaluating the methodological options available to academics when researching visitor attractions in different countries. Reference will be made throughout the paper to an international comparative Study undertaken by the authors at visitor attractions in Scotland, Canada, Australia and New Zealand. The paper concludes with a synthesis of those methodological issues deemed to be of benefit to future researchers wishing to advance their understanding of the management of-visitor attractions in different countries around the world. [ABSTRACT FROM AUTHOR]

This study investigated the psychometric properties of the 12-item proxy-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in young children with chronic physical illness in Canada. Data come from the Multimorbidity in Youth across the Life-course, a longitudinal study of Canadian youth with physical illnesses (n = 263). Baseline parent-reported data from children (2–9 years, n = 143) and adolescents (10–16 years, n = 117) were analyzed. Wilcoxon's tests examined differences in WHODAS 2.0 scores between subgroups. Internal consistency was estimated, and confirmatory factor analysis modeled the WHODAS 2.0 factor structure. Regression modeling examined if the WHODAS 2.0 could discriminate between children with vs. without mental comorbidity. Differences were found between children and adolescents regarding self-care and getting along, and for the item on emotional affect. Inter-item correlations were similar between subgroups and internal consistency was strong for children (α = 0.90) and adolescents (α = 0.93). The factor structure of the WHODAS 2.0 was confirmed; parameter estimates were similar between subgroups. The association between mental comorbidity and disability did not differ by age – comorbidity was associated with greater disability (β = 5.87, p < 0.01). The 12-item proxy-administered WHODAS 2.0 appears valid and reliable in young children with physical illness and can be used in this population. The 12-item proxy-administered WHODAS 2.0 has acceptable inter-item correlations and internal consistency in young Canadian children with chronic physical illness, and its factor structure is consistent with previous reports Expansion of its use in measuring disability in young children provides the opportunity to use the WHODAS 2.0 across the life-course, facilitating the interpretation of changes in disability over time or in response to treatment Additional research is needed to determine responsiveness to change and the minimal clinically important difference of the WHODAS 2.0 in this population [ABSTRACT FROM AUTHOR]

The objectives of this study were to translate the Pain Self-Efficacy Questionnaire (PSEQ) into Canadian French (PSEQ-F) and to evaluate its validity, reliability and responsiveness in a French-Canadian sample of patients with persistent rotator cuff related shoulder pain (RCRSP). Translation and cross-cultural adaptation of the original English version of the PSEQ into Canadian French were performed according to standard procedures. Thereafter, 78 adults with RCRSP completed the PSEQ-F on three occasions: baseline, 2 days later to evaluate the reliability and 6 weeks later to evaluate responsiveness. Cross-cultural adaptation was performed without problems with content or language. The PSEQ-F was found to be reliable (Intraclass Correlation Coefficient = 0.96; Minimal Detectable Change = 3 points [5%]), valid (moderate correlations with an abbreviated version of Disability of the Arm, Shoulder and Hand [QuickDASH] and Brief Pain Inventory [BPI] Questionnaires) and responsive (Standardized Response Mean = 0.96; Effect Size = 0.81; Minimal Clinically Important Difference = 6 points [10%]). The PSEQ-F is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP. Further studies should use a self-efficacy-specific Global Rating of Change scale to estimate its responsiveness more thoroughly. Higher levels of pain self-efficacy have been associated with increased odds of symptom resolution in those with persistent rotator cuff related shoulder pain (RCRSP). The Pain Self-Efficacy Questionnaire (PSEQ) has been identified as the most frequently used tool by clinicians to assess pain self-efficacy in patients at risk of developing persistent musculoskeletal pain. The Canadian French version of the PSEQ (PSEQ-F) is a reliable, valid and responsive questionnaire that can be used to assess pain self-efficacy in French-speaking individuals with RCRSP. [ABSTRACT FROM AUTHOR]

A proportion of youth who experience concussion develop persistent or prolonged post-concussion symptoms (PPCS). Owing to the complex clinical presentation of PPCS, an interprofessional approach to care is increasingly recommended. Despite increased research in this area, there remains a dearth of evidence from the perspective of the recipients of interprofessional concussion care. The objective of this qualitative descriptive study was to explore the experiences of youth with PPCS and their parents who participated in an interdisciplinary team-based assessment (ITA) at a children's rehabilitation hospital in Ontario, Canada. Semi-structured interviews were conducted with fifteen individuals (eight youth [8–17 years] and seven parents). Results suggest that the ITA serves as a context for meaningful therapeutic interactions whereby youth, their parents, and the interprofessional team establish and build therapeutic relationships, engage in dialogue emphasizing collaboration, prioritize the young person rather than the injury, and co-create an individualized treatment plan. Results are discussed within the broader literature in the areas of client and family-centered care, interdisciplinary assessment, and concussion management. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the perceptions of antisocial behaviour on the use of the social media platform Twitter. We extend the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Perception of Antisocial Behaviour as a risk factor, and two supporting constructs: Strategic Self-Presentation and Protective Self-Presentation. We call this extended model Technology Acceptance and Use under Risk (TAUR). We investigate two groups via an online questionnaire, contrasting Anglophone countries (the UK, USA, and Canada, 200 responses), with Saudi Arabia (540 responses). In both cases the data shows that the Perception of Antisocial Behaviour impacts Twitter use, but not directly, rather it negatively impacts the influence of other factors such as Behavioural Intention – it also shows that this affects Anglophones more than Saudis. This indicates that future work should differentiate between different cultural groups, and different solutions may be needed to assuage users' fears in different parts of the world. [ABSTRACT FROM AUTHOR]

Dystonia is a neurological disorder characterised by involuntary muscle contractions. Pain is the primary non-motor symptom, and limited studies have investigated how dystonic pain is experienced. This study aimed to investigate how people with isolated dystonia describe their pain and compare across subgroups of dystonia. Anonymous online survey via social media asking participants to describe their pain in their own words, complete the McGill Pain Questionnaire (MPQ), and answer demographic questions. Thematic analysis identified common themes and frequencies were calculated for demographic and MPQ data. One-hundred and sixty-five respondents were included (mean age 51 years, 85% female). Thematic analysis identified four major themes "Physical sensations", "Temporal features", "Destruction", "Impact on life" with several sub-themes. The most chosen MPQ descriptor was "exhausting" followed by "tight," "sharp," "pulling," and "aching". The most common descriptors showed similar prevalence across subgroups of dystonia. As no objective tests for pain exist, pain sufferers must use language to describe their pain experience. People with isolated dystonia used sensory words combined with metaphorical language to detail temporal features of pain, as well as destructive internal battles or feelings of external forces acting upon them, and the significant toll pain has on everyday life. Pain is a common and debilitating non-motor symptom for people living with dystonia and should be discussed in a persons treatment plan. Pain sufferers use language to discuss their pain experience with others and report they don't feel well understood by others including health professionals. People with dystonic pain commonly described physical sensations, temporal features, destructive forces, and the impact on life caused by their pain. Findings suggest the experience of pain with dystonia is varied and better pain management options for people with dystonia are needed. [ABSTRACT FROM AUTHOR]

This study aimed to describe how occupational therapists evaluate older adults with cognitive impairments. A descriptive qualitative study design was used. Four focus groups were conducted with 16 occupational therapists working with cognitively impaired older adults in institutional and community care settings. An inductive thematic analysis of the content of the interviews was applied. Occupational therapists described a three-stage assessment process that was predominantly occupation-based, linear and iterative: (a) gathering information from the older adult, their care network and family members to plan the assessment, (b) assessing cognitive impairment and occupational performance using non-standardized observations and standardized tests, and (c) applying clinical reasoning to predict further performance issues and safety. Despite using a predominantly occupation-based assessment process, occupational therapists reported a lack confidence to predict safety. Occupational therapists may require additional knowledge, skills and tools to support them in assessing older adults with cognitive impairments. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were to determine the effects of hearing disability on employment rates; examine how various factors are associated with employment; and identify workplace accommodations available to persons with hearing disabilities in Canada. Material and methods: A population-based analysis was done using the data collected through the 2017 Canadian Survey on Disability (CSD), representing 6 million (n = 6 246 640) Canadians. A subset of the complete dataset was created focusing on individuals with a hearing disability (n = 1 334 520). Weighted descriptive and multivariate logistic regression analyses were performed. Results: In 2017, the employment rates for working-age adults with a hearing disability were 55%. Excellent general health status (OR: 3.37; 95% CI: 2.29–4.96) and daily use of the internet (OR: 2.70; 95% CI: 1.78–4.10) had the highest positive effect on the employment rates. The top three needed but least available accommodations were communication aids (16%), technical aids (19%), and accessible parking/elevator (21%). Conclusion: Employment rates for persons with a hearing disability are lower than the general population in Canada. Employment outcomes are closely associated with one's general health and digital skills. Lack of certain workplace accommodations may disadvantage individuals with a hearing disability in their employment. People with severe hearing disabilities and those with additional disabilities may need additional and more rigorous services and supports to achieve competitive employment. It is important for the government to improve efforts toward inclusive education and develop strategies that promote digital literacy for job seekers with hearing disabilities. Officials concerned with implementing employment equity policies in Canada should focus on finding strategies that enable employees to have supportive conversations with their employers regarding disability disclosure and obtaining required accommodations. [ABSTRACT FROM AUTHOR]