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What role do texts play in LGBTQ (lesbian, gay, bisexual, transgender, and queer) parents’ experiences of disability service systems? In interviews with 15 LGBTQ parents of disabled children in Toronto, Canada, participants selected documents to be used as a focus for discussion. Parents considered how LGBTQ identity and other intersectional identities influenced their experiences of institutional texts including adoption certificates, intake forms, and assessments. Findings suggest that documentation practices can operate as forms of systemic gatekeeping. LGBTQ identity was sometimes very significant in parents’ accounts, and sometimes less central than other aspects of their families' identities and experiences. [ABSTRACT FROM PUBLISHER]

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]

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

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]

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

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]

Until 1962, Canada was legally a Eurocentric racial state. After abandoning state-sanctioned racism in 1967, politicians soon realized that institutional entrenchment of racism would need more than laws-based anti-racism. Today, institutional racism, however, remains entrenched in Canadian institutions despite various mitigating processes by all levels of governments since the 1970s. In this qualitative paper, we analyze the marginalizing effects of system anti-Black racism and the dissonances between strategies and attitudes of system professionals and African-Canadian grassroots youth workers. From our findings, we conclude that effective youth workers prioritize behavior-in-time (experience-based) over behavior-in-discourse (text-based) in service provision. [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]

Despite increasing calls for systemic change in the Canadian higher education sector, Indigenous leaders continue to be under-represented, under-funded, and overworked. This qualitative study investigates the purview of senior Indigenous leaders within Canadian higher education, drawing on interviews conducted with four senior Indigenous leaders at Canadian universities. The study, underpinned by emancipatory Indigenist research, draws on the literature predominantly written by Canadian Indigenous scholars. Reporting on Stage Five of a qualitative Australian project – Walan Mayiny: Indigenous Leadership in Higher Education, this paper is the first of four international aspects of the larger project. Findings suggest these Indigenous senior leaders overcome significant barriers to gain senior roles, while the weight of systemic change is carried by individual Indigenous leaders. The question addressed is how senior Indigenous leaders can unsettle systemic barriers so that universities are facing in the direction of where they need to be going, and not where they've been. [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]

Background: Obsessive–Compulsive Disorder (OCD) is a psychiatric illness that can result in debilitating symptoms and functional impairment. Until recently, individuals with severe OCD symptoms have not received appropriate services within the Canadian healthcare system. The Frederick W. Thompson Anxiety Disorders Centre launched an Intensive Services Residential treatment programme for OCD in July 2017 to meet the needs of the Canadian population. This paper sets out to demonstrate the effectiveness of this programme. Methods: This study incorporated quantitative and qualitative data collection. Quantitative data were analysed using paired sample t-tests while qualitative data was transcribed and coded for emerging themes. Results: Beneficial changes in symptomatology were found. Client narrative emphasised the importance of exposure response prevention (ERP), creation of an OCD community as well as enhanced functionality in clients' lives. Clients also commented on why they believed the treatment worked and points of potential improvement for discharge planning and programme organisation. Conclusions: This study adds to the growing body of evidence regarding the importance of intensive services for individuals experiencing severe symptoms of OCD. Enhancing accessibility to services and ensuring ongoing maintenance of gains will be important next steps in ensuring long-term recovery for individuals with severe symptoms of OCD. Intensive services treatment for OCD has been found to be beneficial for clients and this paper demonstrates the first time this has been seen within a Canadian programme. Treatment provided decreased OCD severity and increased functionality and quality of life. Clients cited exposure and response prevention work as a key ingredient in their recovery. Our programme is always in an ongoing state of quality improvement, ensuring client engagement and satisfaction. [ABSTRACT FROM AUTHOR]

The growing aging population in Canada has multi-faceted psycho-social needs. Social workers are well-positioned to address these needs, despite many challenges. This paper reports findings from the World Café at the Gerontology Symposium in Alberta, Canada, held in 2018. The goal was to learn from social work practitioners, researchers, and educators (N = 49) about current and future needs of gerontological social work in Alberta. There were two research questions: 1) What strategies do social workers need on the micro, mezzo, and macro levels to help better serve the growing older adult population in Alberta? (R1) 2) How can social workers promote the value and contribution of gerontological social work within the interprofessional community? (R2) The data were analyzed using qualitative content analysis. Ten R1-related themes emerged: personal traits of a social worker; professional skills; bio-psycho-social needs of older adults; community connections; access to benefits; gerontological social work education; integrated healthcare; aging policy; ageism; and advocacy to strengthen the voice of older adults. The three R2-related themes include strengthening the status of the social work profession; building trust through demonstrated skills; and interprofessional education and practice. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of the reflections of three mid-career female ESL teachers in Canada through the lens of their participation in a two-year teacher discussion group. Not many studies exist about the mid-career reflections of experienced ESL teachers and their concerns (perceived or otherwise) with the phenomenon known as ‘plateauing’, and so the intent of this paper is to try to shed some light on this topic within the TESOL profession. The results indicate that some ESL teachers in mid-career may encounter some form of plateauing, but if they engage in collaborative group discussions with other teachers either within or outside their institutions, they can learn to better understand, and ultimately learn how to resist it and maintain their commitment and enthusiasm for their work as ESL teachers. [ABSTRACT FROM PUBLISHER]

Age-friendly initiatives often are motivated by a single funding injection from national or sub-national governments, frequently challenging human and financial resources at the community level. To address this problem, this paper examines the challenges and opportunities to sustaining age-friendly programs in the context of a Canadian age-friendly funding program. Based on a qualitative thematic content analysis of interview data with 35 age-friendly committee members drawn from 11 communities, results show that age-friendly sustainability may be conceptualized as an implementation gap between early development stages and long-term viability. Consistent over-dependence on volunteers and on committees' limited capacity may create burnout, limiting sustainability and the extent to which communities can truly become "age-friendly". To close this implementation gap while still remaining true to the grass-roots intention of the global age-friendly agenda, sustainable initiatives should include community champions, multi-disciplinary and cross-sector collaborations, and systemic municipal involvement. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8–10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults. [ABSTRACT FROM AUTHOR]

There has been a growing focus on healthy aging in the political agenda. Discourses contained within policy documents have the potential to shape our notions of healthy aging and well-being. This comprehensive critical document analysis of provincial aging policies in Newfoundland and Labrador (2006–2015) contributes to a larger research study exploring aging women's notions of health and the body in relation to the aging process. The findings highlight how healthy aging discourses focus on the concept of productivity and how a certain type of health is required for ongoing contribution. The paper concludes by arguing that if healthy aging is framed around one's ability to remain productive, notions of health will remain limited to an externalized measure of output versus subjective experience of well-being. [ABSTRACT FROM AUTHOR]

Indigenous Peoples across Turtle Island (North America) experience ongoing health disparities tied to the effects of colonization and persistent racism toward Indigenous Peoples. Educating future clinicians to develop a critical consciousness is an important way to work toward cultural safety and improve the health care experiences of Indigenous patients. The present study evaluated the ability of the KAIROS Blanket Exercise (KBE) to foster critical consciousness. Two hundred thirteen medical students at the University of Toronto participated in the KBE. Subsequently, 174 students completed a paper evaluation, designed to capture concepts of cultural safety and critical consciousness. Data were analyzed using quantitative and qualitative methods to identify shifts in perspectives. The majority of students reported the exercise altered the way they viewed those from backgrounds different from their own, and comments regarding bias, power and privilege were highlighted throughout the responses. Engaging in critical reflection through dialogue and revealing the complex sociopolitical context of Indigenous Peoples' history were emphasized as central to this transformation. Following participation in the KBE, medical students demonstrated a shift in their perspectives. This suggests that creating curricular space for critical pedagogy may be effective in fostering critical consciousness, ultimately encouraging reflexive practice and social action. [ABSTRACT FROM AUTHOR]

The concept of vulnerability is frequently used in public health policies to develop tailored interventions or dedicate proportionately more resources to certain sub-populations. However, once segments of the population are identified as vulnerable, they are rarely consulted regarding whether this label is acceptable before instituting interventions. Instead, it is implicitly assumed that the targeted individuals identify themselves as vulnerable and experience an unambiguous and consistent need for public health assistance. In this paper, using public health interventions during heat waves as a case study, we question such assumptions. A qualitative study was conducted in Montreal, Canada involving two focus groups among populations specifically targeted by the heat action plan as vulnerable: one composed of individuals diagnosed with schizophrenia, and one composed of individuals who have alcohol or drug addictions. Findings revealed significant heterogeneity in the definition and experience of vulnerability as it is used in the context of a heat action plan in Montreal. We found differences between the two focus groups in several areas including sources of information they had access to within the heat action plan measures and their perspectives regarding the appropriateness of specific measures in the heat action plan. We then observed differences within each of the focus groups in several areas including their social networks relationships. The concept of vulnerability is often used in public health policies. Yet, while this concept may be convenient for shaping policies to reduce inequalities in health, the heterogeneity of populations defined as vulnerable should not be underestimated. [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]

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This paper explores the experiences of, and thoughts on, interprofessional learning and care of first year health science students at a large Canadian university within a broad socioeconomic context. We apply discourse analysis to survey data collected to evaluate an introductory interprofessional event involving first year students from a variety of health professions. Follow-up focus-group interviews were conducted to gain greater understanding of student issues and concerns emerging from the survey, providing a second source of data. A significant paper entitled, 'Education, enterprise culture and the entrepreneurial self: A Foucauldian perspective' by Peters (2001) provides an historical and theoretical framework for this paper. Peters notes the changing nature of professionalism and global crises in public institutions under neoliberalism as governments divest themselves of social responsibility, shifting it onto individuals through increased privatization and focus on entrepreneurialism. In exploring the thoughts and experiences of students through the historical lens of a shifting professional discourse and changing cultural and political environment, a unique view of professionalism and this interprofessional project comes to light. Reflective of the paradigm shift that Peters documents, there was evidence of students 'internalizing' responsibility for a sustainable health care system through acquisition of interprofessional knowledge and behaviours. [ABSTRACT FROM AUTHOR]

This paper draws on in-depth interviews undertaken eight years apart to provide a reflection upon the nature of transnational relationships and settlement over time. It follows the lives of five immigrant families between 1999 and 2007, and focuses in particular on the accounts provided by the women. These individuals migrated to Canada from Hong Kong or Taiwan during the 1990s, and then 'stuck it out', when most of their friends, in contrast, had returned home. The paper uncovers changes in their familial and personal circumstances as a consequence of migration to Canada and their subsequent experiences of transnationalism, and provides insights into the longevity and durability of transnational relationships. It contributes to debates around the persistence of transnationalism over time and the relationship between transnationalism and integration for migrants, whilst also making a methodological point about the need for more longitudinal qualitative accounts of immigrants' lives. [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]

This paper presents the findings of a study designed to extend and develop a previous study conducted by the authors on the management of visitor impacts at visitor attractions in Scotland. This follow-up study sets out to discover the extent to which attractions in other countries experience similar impacts, with comparable management challenges to those already identified in the Scottish visitor attraction sector. In order to provide a direct comparison to the Scottish study, a replication of the research methodology employed in that study was considered necessary. Aself-completion survey was thus mailed to managers of paid-admission attractions in Canada, Australia and New Zealand: three ‘leading-edge’ destinations selected for comparison. Findings suggest that although many impacts are perceived to be similar across the four countries, a number of important differences are evident. Given that the reasons for such differences vary, the paper concludes that the development of a generic strategy for the management of visitor impacts internationally remains something for the future. In the meantime, the sector should rely on the identification and adoption of best practice on a case-by-case basis. The sector's diversity and fragmentation suggest that qualitative research holds the key to identifying appropriate techniques for managing visitor impacts. [ABSTRACT FROM AUTHOR]

Health Canada (the federal government department in Canada responsible for health issues) commissioned a research team to conduct an environmental scan and research report in order to understand interprofessional education and collaborative patient-centred practice (IECPCP). This paper presents the findings from semi-structured telephone interviews with key informants conducted as part of the environmental scan. Grounded theory analysis was employed in order to identify factors associated with interprofessional education and collaborative practice initiatives. These factors were grouped according the following themes: lack of consensus regarding terminology; the need for both champions and external support; sensitization to the effects of professional culture, and logistics of implementation. Findings are discussed related to the literature and to the other papers included in this supplement to the Journal of Interprofessional Care . [ABSTRACT FROM AUTHOR]

Objectives. This paper will explore the social history of the transnational migration of foreign-trained doctors to western countries in the post-WWII era, by examining, as a case study, South Asian-trained doctors who were first licensed in the Canadian province of Nova Scotia between 1961 and 1971.Design. This article draws on both quantitative and qualitative primary sources. First, we analyzed the 1966 and 1971 copies of the Canadian Medical Directories (CMD), the annual compendium of all licensed practitioners in the country (over 20,000 practitioners). These CMD entries were supplemented by the annual returns of ‘intended occupation’ (those designated as ‘physician’ or ‘surgeon’) of landed immigrants to Canada, as compiled by the federal Department of Manpower and Immigration. Secondly, we analyzed testimony of 26 oral histories and narrative accounts of foreign-trained doctors being compiled as part of an ongoing multiyear program of research on the immigration of foreign-trained doctors to Canada. We have interviewed 14 doctors who, at one point in their career, practiced in Nova Scotia, 8 of whom were South Asian-trained medical practitioners. These oral interviews provide personal reflections on the process of professional and social acculturation that occurred as these foreign doctors settled in Canada.Results.The results of this paper indicate that the social history of the immigration of South Asian-trained doctors to Canada in the 1960s must be seen within a larger and more complicated pattern of the international migration of health care professionals. Indeed, the demand for foreign-trained doctors in Britain was in part a reflection of the out-migration of British-born doctors who were leaving the National Health Service for Canada, the USA, and Australia. And the demand in Canada for doctors was itself a reaction to the drift of a certain number of Canadian-trained doctors for advanced training in the USA.Conclusions. In this way, this article sheds important historical perspectives on the globalization of health human resources and the complicated, multiple migrations that continue to animate international health human resources today. [ABSTRACT FROM AUTHOR]

Police officers are increasingly tasked with responding to people in crisis (PIC), often resulting in transfers to emergency departments (EDs) where they can encounter challenges like long wait times, safety concerns, and conflicting perspectives between the medical and legal systems. This qualitative study explores the experiences of police officers during the transfer of PIC to ED nurses and staff. Eleven police officers were recruited and interviewed, providing contextual information about ED transfers in the greater Montreal area. The findings revealed that police officers face varied challenges in transferring PIC to different EDs, influenced by each hospital's unique characteristics, staffing, security, and organizational issues. Relationships with nurses significantly impact these experiences, ranging from positive interactions to tension and conflict influenced by staff biases and differing perceptions of the PIC. Effective communication between police and ED nurses is critical for accurate clinical evaluation and decision-making, yet often hindered by inconsistent information transfer and procedural gaps. Role confusion, divergent philosophies between police officers and ED nurses, and 'grey zones' further complicate transfers, emphasizing the need for clear communication and mutual understanding to ensure safe and effective care. The results underscore the need to ameliorate ED transfers through enhanced joint training for police officers and nurses, establishing hospital-precinct committees, and other intersectoral initiatives to promote collaboration. Such measures are essential to ensure effective and compassionate care of people in crisis while prioritizing safety for all involved. [ABSTRACT FROM AUTHOR]

Trans and non-binary youth (TNBY) face high levels of interpersonal and social adversity as well as disproportionate rates of mental health issues such as depression, self-harm and suicidal ideation. Among protective factors, context plays a key role. In addition to parental support, access to gender-affirming medical care begins to emerge as crucial for young people needed them. This paper compares, through thematic analysis, the experiences of TNBY with regard to access and experiences to care in Canada, Switzerland, England, and Australia. It identifies similarities and differences in barriers to access to care, as well as impacts of gender affirming care on young people and their well-being. The article concludes with a discussion on the importance of prompt and easier access to gender-affirming medical care, of training of professionals, and a hypothesis about the role of context in TNBY well-being. [ABSTRACT FROM AUTHOR]

As the medical cannabis industry in Canada moved from a single government producer to an open market model in 2014, this paper provides insight into how entrepreneurs from illegal medical cannabis dispensaries, as well as legal licensed producers, protect their position and reputation in this 'emerging' market. On the one hand, MCDs are illegal, niche-filling entities that have historically been 'boxed out' by the legal framework, trying to survive untouched by enforcement and supported by faithful clientele. Licensed producers (LPs), on the other hand, are new legal entities that follow a strict government regulated framework, and are essentially stepping on their illegal predecessor's territory. This project draws on 63 in-depth qualitative interviews, when medical cannabis access transitioned to an open market model. In this context, we see that rather than attempts to construct a credible shared identity for legitimacy, the emphasis is on building a distinct identity narrative in the face of market competition. The emergence of legal cannabis markets and the future of cannabis legalization in Canada presents a fruitful avenue for continuing the study of both the micro and macro processes in emerging markets, organizations, and entrepreneurial activities. [ABSTRACT FROM AUTHOR]

Substance use among marginalized populations has historically been constructed as a social problem to be managed, cured, and eliminated. Much social science research concerning drug use among marginalized populations focuses on risks and harms, with little attention to positive aspects of substance use. In this paper we explore positive roles of drugs/drug use among marginalized people who use drugs. We draw on in-depth qualitative interviews conducted with 50 people who use drugs in Vancouver's Downtown Eastside neighbourhood. Forty-three participants reported positive aspects of drug use. Participant narratives revealed four main themes regarding the role and function of drugs and drug use in their lives: (1) pain relief and management; (2) alleviating mental health issues; (3) fostering social experiences; (4) pleasurable embodied experiences. Our findings show that despite known negative consequences of substance use, in many ways drug use was beneficial for these individuals. Our study demonstrates that given the opportunity, meaningful and useful conversations that shed light on why people take drugs is possible. By understanding why marginalized individuals choose to consume the drugs they do we can begin to engage in truly helpful conversations about how to reduce drug-related harm. [ABSTRACT FROM AUTHOR]

Research suggests that food insecurity exacerbates the harms experienced by people who use drugs (PWUD). Therefore, improving the food security status can help PWUD reduce drug-related harms. This paper identifies a knowledge gap in public health and harm reduction literatures regarding the relationship between food and harm reduction. We argue that there needs to be a more comprehensive and systematic model of food provision in harm reduction services. Our argument is based on a qualitative case study of 42 people who currently use, or have used drugs in Vancouver, Canada and of staff of 27 programs that provide harm reduction services in the city. The research demonstrates how PWUD experience the effects of drug use on their food consumption, how they access food, and how they practice self-care. It also shows how harm reduction services, while they often provide food, are unable to systematically address the dietary-related harms associated with drug use. This presents an opportunity and a challenge for these organizations and for harm reduction as a public health approach. We call for more research to be done on food as harm reduction and for stable publically funded food provision in harm reduction-oriented services. [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]

Though Canadian universities are legally required to accommodate disabled employees, disabled faculty still experience difficulties navigating neoliberal performance standards and medicalized conceptualizations of disability. Drawing on data from a qualitative study with Canadian university faculty, this paper explores the experiences of five disabled academics. Our analysis draws on post-structural understandings of neoliberalism, discourse, disciplinary power, and governmentality, as well as Rosemarie Garland-Thomson's concepts of the fit and misfit. Though the sample is small, this analysis suggests universities pose disabling contexts for academics. Disability is cast as individual responsibility, leaving disabled academics navigating accommodations without institutional support. The normative academic constructed through a discourse of efficiency and productivity is the measure against which disabled academics are evaluated, requiring self-governance to produce themselves as 'good enough' academics. Although higher education environments are increasingly diverse, disabled academics are still having to prove their right to exist in academia, hindering their abilities to participate fully. [ABSTRACT FROM AUTHOR]

Purpose: Explore occupational therapists' (OTs) and speech language pathologists' (SLPs) process of selecting and applying motor learning strategies (MLS) in their interventions for children with acquired brain injury (ABI), and identify similarities and differences between OTs and SLPs in MLS selection and application. Methods: This qualitative descriptive study involved individual semi-structured interviews with OTs and SLPs from the ABI program at Holland Bloorview Kids Rehabilitation Hospital (Toronto, Canada). Interviews were analyzed using thematic analysis. A modified constant comparison method permitted comparison within and between professions. Results: Four OTs and three SLPs were interviewed. Four themes were developed: aligning MLS application with the child's cognitive ability, using MLS to promote success within a single session, adjusting MLS across treatment sessions, and promoting generalization and transfer of motor skills beyond the therapy session. MLS application was predominately based on child-specific factors with task-specific considerations. OTs and SLPs used similar clinical reasoning processes for selecting and applying MLS. Conclusions: This study provides a greater understanding of OTs' and SLPs' clinical reasoning process when applying MLS in pediatric ABI interventions. The similarities in MLS selection and application between disciplines suggest that an interprofessional approach to MLS is suitable for pediatric ABI rehabilitation. IMPLICATIONS FOR REHABILITATION: Pediatric occupational therapists and speech language pathologists use a similar process for selecting and applying motor learning strategies (MLS) in their interventions Clinicians continually reflect upon and adapt their use of MLS based on each child's performance, progress, and goals Adopting an interprofessional approach to MLS selection and application, including the use of a common MLS language, has the potential to optimize motor outcomes in pediatric acquired brain injury rehabilitation [ABSTRACT FROM AUTHOR]

Background and objectives: The global shift towards competency-based medical education (CBME) has led to the development of national guidelines for CBME implementation (CBME Guides). The characteristics of CBME Guides from CBME-developed countries were analysed to inform the revision process for the CBME Guide in Japan, a CBME-developing country. Methods: Document analysis of CBME Guides from Canada, Singapore, the Netherlands, the United Kingdom, and the United States was conducted by six Japanese medical education experts. The process of analysing the CBME Guides was also reviewed. Results: While the CBME Guides contain many commonalities in structure and content, there is variation in terminology and forms of expression. The characteristics vary according to national systems, culture, and customs. The content of the Guides may have changed depending on the publication date, in line with changes in medical technology, medical needs, and advances in the understanding of CBME. Conclusions: Analysing CBME Guides from CBME-developed countries may lead to more meaningful revisions to a CBME-developing country's guide, enabling it to be better aligned with the local, social, cultural, and historical context of the country now and in the future. [ABSTRACT FROM AUTHOR]

In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]

This paper uses qualitative interview analysis conducted online with adults to examine links between self-injury and creative writing. It concentrates on why an individual who self-injures may write creatively and what this could mean for professional practice. The research shows that writing about self-injury and associated trauma can be helpful for controlling 'internal chaos' and allowing the individual to communicate their experiences in different ways, as controlled by the writer. This creates the potential for an escape from their 'encaptive conflict', facilitating a move from pseudo-independence to forming containing relationships with professionals and others. [ABSTRACT FROM AUTHOR]

The deployment of civilian police in UN peacekeeping operations represents a significant commitment for many police organisations, especially in decentralised political systems such as Canada where municipal and provincial police services are involved. While these missions attract large numbers of highly motivated officers, their selection, deployment and return are fraught with organisational challenges that are underestimated or ignored by the contributing agencies. In this paper, we will examine these challenges as they are experienced and resolved by three large Canadian police organisations, through a number of qualitative interviews conducted with former police peacekeepers and their managers. We argue in this paper that the deployment and reintegration stages of a police peacekeeping mission should be included in the assessment of its success, and that unless contributing police organisations find ways to improve the experience of their returning officers, the sustainability of UN police peacekeeping deployments could become problematic. [ABSTRACT FROM AUTHOR]

There is scant research literature on the interconnection between spirituality and anti-oppressive pedagogy in the higher-education classroom. In this paper, based on a broader qualitative study that examined spiritually-minded activist scholars in the Canadian university context, I focus on how four such scholars integrate spirituality into their teaching practices. Two themes are presented in this paper: (1) toward a pedagogy of hope; and (2) affirming different ways of knowing. I conclude with the argument that teaching from a spiritual paradigm is fraught with challenges and risks yet has positive implications for developing anti-oppressive pedagogy in higher education. [ABSTRACT FROM AUTHOR]

The aim of this paper is to examine how members of the public define the legitimacy of cognitive and behavioural enhancement. Our study involved a two-step multimedia-based deliberative intervention in which participants of different age groups pondered the desirability of a fictional enhancement technology: a sweater made of ‘smart’ textiles that provide ‘bio-psycho-feedback’ (PBF) to its user. A 3-min video clip presenting the fictional technology was used to stimulate deliberations in four face-to-face workshops (n = 38). A larger group of participants (n = 57) then discussed, in an online forum, two short stories illustrating dilemmas raised by the PBF sweater. Qualitative analysis of transcripts of the workshops and the forum identified patterns of moral argumentation in the reasoning processes by which participants challenge the PBF sweater’s legitimacy: (1) when a shift in purpose occurs – from therapeutic to enhancement – and (2) when it engenders a shift in the user’s sense of self – from an autonomous self to a socially coerced individual. These findings add nuance to current knowledge on public perceptions of cognitive and behavioural enhancement, providing insight into the ways that people conceive of the tension between autonomy and social coercion. [ABSTRACT FROM PUBLISHER]

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Positive psychology has made significant advances in our understanding of well-being, yet agreement about the definition and nature of well-being remains elusive. This study explores theexperience of well-beingfrom a bottom-up, naturalistic point of view and compares these inductive notions with existing a priori theories. Using a qualitative-focused case study methodology, this paper explores how everyday people describe well-being in the context of job loss among a sample of 20 workers from the Ottawa, Canada technology sector. Findings support integrated conceptualizations of hedonia and eudaimonia while also potentially identifying new notions of well-being. Identified themes include (a) life evaluation, (b) transitory experiencing, (c) growth and grounding, (d) environmental mastery/stability, (e) mental ill-being/ill-health, and (f) motivational mindsets/conditions. This study shows well-being to be a rich, pluralistic construct which includes the non-dualistic notions of both subjectivity and objectivity as well as encompassing notions related to the ‘what’ and ‘how’ of well-being. [ABSTRACT FROM AUTHOR]

Purpose: To understand how persons with non-dysvascular lower limb amputation (LLA) use occupations to contextualize their quality of life (QoL). Methods: A qualitative study using an interpretative description approach was conducted. Analysis of the interviews was guided by an occupational perspective, which considers the day-to-day activities that are important to an individual. Results: Twenty adults with an adult-acquired non-dysvascular amputation (e.g., trauma, cancer or infection) were interviewed. Following thematic analysis, two main themes were developed: (1) sense of self expressed through occupations; and (2) sense of belonging with others influenced by occupations. Participants expressed the way they felt about themselves through their activities and placed high value on whether they could participate in certain occupations. Participants also described how their sense of belonging was changed through the context of their changing occupations. Conclusion: The findings from this work can be leveraged by clinicians and researchers alike to improve care for this population. Rehabilitation programs should consider interventions and programming that help to restore occupations or develop new ones given the importance placed on occupations by persons with non-dysvascular LLA. IMPLICATIONS FOR REHABILITATION: Quality of life is affected following non-dysvascular lower limb amputation due to physical, mental and psychosocial changes. Occupations (or day-to-day activities) are important components of quality of life for persons with lower limb amputation. Rehabilitation professionals should take into account the influence that occupations have on how persons with lower limb amputation perceive themselves when developing interventions and programming for this population. The influence occupations have on sense of belonging should also be considered by rehabilitation professionals when developing these interventions and programs for persons with non-dysvascular lower limb amputation. [ABSTRACT FROM AUTHOR]

There is an urgent need to develop an international competency and capability framework to support standardization of education and roles in advanced practice physiotherapy (APP). This need arose due to the rapid growth of the APP model of care, implemented out of necessity in the absence of agreement as to the competencies and capabilities or formal education required for the roles. This study explores the views and perceptions of practitioners and key stakeholders on a draft competency and capability framework for advanced practice physiotherapists. The purpose of this study was to: 1) gather feedback from key stakeholders (advanced practice physiotherapists, researchers, and leaders) on a draft competency and capability framework and 2) use that feedback to revise and improve the draft framework. Qualitative study using a series of four multi-national online focus groups. Thematic analysis was conducted according to Braun and Clarke. Sixteen participants from the United Kingdom, Ireland, Canada, Australia, and New Zealand participated in the study. Five themes were generated after data analysis: clinical expert, experienced communicator, strong leader, collaborator, and knowledge creator). A modified competency and capability framework was developed based on feedback from the focus groups and input from subject matter experts (SMEs). This study provides a modified core competency and capability framework comprising 24 competencies grouped under six domains. This study is a step toward international standardization of advanced practice physiotherapy based on a commonly agreed framework for the education and training of advanced practice physiotherapists. [ABSTRACT FROM AUTHOR]

To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs) We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective. Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments. HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs' also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation. Non-pharmacological strategies in combination with pain medication may be a more effective strategy to support recovery than pain medication alone but should be informed by fracture acuity and patient symptoms. To improve access to physiotherapy and other non-pharmacological treatment options during the acute or chronic management of vertebral fractures, it may be worthwhile to explore the effectiveness and feasibility of virtual-care. [ABSTRACT FROM AUTHOR]

Social work is a practice-based profession with social justice as a core value and ethical principle. Social work programs incorporate social justice into both the explicit and implicit curricula. However, there has been a longstanding divide in how to address social justice at systemic levels while fostering socially just and competent practice. The aim of this qualitative study was to examine how MSW students describe their learning about social justice and social work practice. To explore this area of inquiry, we conducted three focus groups (N = 16) with current MSW students or recent MSW graduates from Canadian social work programs. Participants described the following five themes that either facilitated or created barriers in their learning about social justice and social work practice: 1) reflection on practice, 2) negotiating discomfort, uncertainty, and safety, 3) learning from lived experiences, 4) learning how to embody social justice in practice, and 5) receiving support, supervision, and coaching. We discuss the implications for social work education and practice. [ABSTRACT FROM AUTHOR]

The evolving virtual health care experience highlights the potential of technology to serve as a way to enhance care. Having virtual options for assessment, consultation and intervention were essential during the coronavirus (COVID-19) pandemic, especially for children with disabilities and their families. The purpose of our study was to describe the benefits and challenges of outpatient virtual care during the pandemic within pediatric rehabilitation. This qualitative study, part of a larger mixed methods project, involved in-depth interviews with 17 participants (10 parents, 2 youth, 5 clinicians) from a Canadian pediatric rehabilitation hospital. We analyzed the data using a thematic approach. Our findings demonstrated three main themes: (1) benefits of virtual care (e.g., continuity of care, convenience, stress reduction and flexibility, and comfort within the home environment and enhanced rapport); (2) challenges related to virtual care (e.g., technical difficulties and lack of technology, environmental distractions and constraints, communication difficulty, and health impacts); and (3) advice for the future of virtual care (i.e., offering choice to families, enhanced communication and addressing health equity issues). Clinicians and hospital leaders should consider addressing the modifiable barriers in accessing and delivering virtual care to optimize its effectiveness. Families are invested in access to virtual care appointments and can benefit from clear communication about choices regarding appointment options and supports in how to access and use technology for equitable access to care. Hospitals should aim to provide clinicians with an appropriate workspace (i.e., private, quiet with adequate room to demonstrate what they need to do), equipment and technology to have virtual care appointments. Current understanding of virtual care delivery suggests a tailored approach, with some types of appointments, such as follow-ups or check-ins, more suited to this modality than other more hands-on therapy. [ABSTRACT FROM AUTHOR]

Mistreatment negatively impacts the wellbeing of medical learners and is related to worse patient outcomes and team functioning. Resident perspectives on improving mistreatment reporting structures and investigations have not been explored. We aimed to understand residents' views on safe reporting structures, investigations, and resolution processes. We conducted an exploratory sequential mixed method study beginning with a series of qualitative interviews to inform an anonymous online survey to all Dalhousie University residents (N = 645). When interviewed, residents (N = 10) discussed personal experiences with mistreatment, barriers to reporting, and how these processes could better serve them. Themes from the interviews were imbedded in an anonymous online survey to explore their prevalence among a larger group. Residents (N = 120; 19%) completed the online survey and revealed that mistreatment was very common yet underreported. Barriers to reporting included confidentiality concerns, perceptions that reporting would not change anything, and fear of retaliation. Desired outcomes for perpetrators depended on the perpetrator's position and incident severity, and most prefer a remedial approach. Resident mistreatment remains prevalent and current processes of dealing with reports may be inadequate. Residents have thoughtful insights for improving institutional policies and procedures and should be meaningfully engaged. [ABSTRACT FROM AUTHOR]