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This paper explores how one neighbourhood revitalization initiative addresses – or fails to address – intersecting systems of oppression as it seeks to facilitate resident-led change. Unlike many similar initiatives, the Neighbourhood Action Strategy in Hamilton, Ontario, Canada has an explicit focus on grassroots community development and resident leadership, and actors within the strategy have paid significant attention to issues of inclusion. We draw on in-depth interviews with City staff, local service providers, and neighbourhood residents, as well as on observation of neighbourhood meetings and media analysis, to explore how diversity, inclusion, and equity are understood and managed by different actors within the Strategy. We demonstrate that despite a stated mandate of inclusion, the initiative often struggles to engage significant participation from working-class and racialized people. We argue that this is in part due to complex interpersonal and institutional dynamics informed by race and class, which create significant tensions that ultimately limit the initiative's ability to create meaningful transformation. We conclude with some lessons learned about how to disrupt the racist, classist, and other oppressive discourses that can operate even within the most progressive initiatives.

There is a renewed interest in the potential of municipal governments working collaboratively with local communities to address health inequities. A growing body of literature has also highlighted the benefits and limitations of participatory approaches in neighbourhood interventions initiated by municipal governments. However, few studies have investigated how neighbourhood interventions tackling health inequities work in real-time and in context, from the perspectives of Community Developers (CDs) who promote community participation. This study uses a process evaluation approach and semi-structured interviews with CDs to explore the challenges they face in implementing a community development, participatory process in the City of Hamilton's strategy to reduce health inequities – Neighbourhood Action . Findings demonstrate that municipal government can facilitate and suppress community participation in complex ways. CDs serve as significant but conflicted intermediaries as they negotiate and navigate power differentials between city and community actors, while also facing structural challenges. We conclude that community participation is important to bottom-up, resident-led social change, and that CDs are central to this work.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Objective: Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behaviour of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with Functional Memory Disorder (FMD). Methods: In Part 1 of this study, a Diagnostic Scoring Aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features. An optimal cut-off differentiating ND and FMD was established by applying the DSA to 30 initial patient–doctor memory clinic encounters. In Part 2, the DSA was tested prospectively in ten additional cases analysed independently by two Conversation Analysts blinded to medical information. Results: In part one, the median score of the DSA was +5 in ND and -5 in FMD (p

The proliferation of community gardening, and the increasing recognition of its benefits, has led many municipalities to develop community garden policies. Using the process of drafting a community garden policy in the city of Hamilton, Canada, as a case study, this paper illustrates how an environmental justice framework could inform the creation of an effective, inclusive community gardening policy. At the same time, barriers within the policy process could mitigate against the meaningful incorporation of environmental justice concerns. The paper concludes with a discussion of how greater inter-departmental and community collaboration in policy development, as well as the more routine application of an environmental justice lens, could mitigate the ill effects of the inequitable distribution of environmental and other resources.

Emerging forms of social mobilisation are explored, using food initiatives in Canada as an example. Food networks are particularly interesting as a case study: they have holistic goals that include both environmental and social concerns, the number and scope of food initiatives have rapidly increased, and there has recently been a high level of public engagement around food issues. Networks among alternative food initiatives (AFIs) are investigated using a survey and in-depth interviews. Food movement networks exhibit some elements of collective identity, but network members have diverse goals, projects, and tactics that do not always align into a coherent political program. Social network theory and the analytic of complex assemblages are employed to help understand these results. Understanding how these food networks function provides insight not just into food networks, but also more generally into the study and practice of social mobilisation around environmental issues.

PurposeThe purpose of this article was to provide multiple examples of how (central) auditory processing disorder ([C]APD) is being evaluated and treated at various audiology clinics throughout the United States.MethodThe authors present 5 cases highlighting the diagnosis and treatment of (C)APD in children and adults. Similarities and differences between these cases have been showcased through detailed histories, evaluation protocol, and treatment options. When possible, the rationale for evaluation procedures and intervention processes were described and compared with guidelines and findings within the literature.Results and ConclusionsThese cases illustrate the varied processes and clinical protocols by which children and adults are evaluated, diagnosed, counseled, and treated for (C)APD. In addition, similarities and differences between the referral source, evaluation team, developmental history, comorbidities, test battery, recommendations, and remediations were described. The multiple clinic sites, diversity of clinical philosophies, variety of test measures, and diversity of patient populations make these cases ideal for showcasing the assortment of methodologies used with patients who present with histories and characteristics consistent with (C)APD.

Recently, the planning profession in North America has begun to recognize the importance of integrating food considerations into planning. However, the field of food system planning is still in its infancy, and its proponents seek a more thorough understanding of the applied role of planning practitioners in this emerging field. This exploratory investigation included interviews with a small sample of self-identified "food system planners" in Canada and the United States whose work is quietly nurturing this emerging subfield in the planning profession. Based on the views of this sample of planners, we offer several considerations on how the professional planning establishment can enhance the ability of planners to contribute to the development of holistic, sustainable, and equitable food systems. The lessons learned here may be applicable to other fields and disciplines where food system work is an emerging focus.

Objectives: In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on ‘timely diagnosis’ aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints.\ud \ud Method: This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group.\ud \ud Results: Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences.\ud \ud Conclusion: The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

In the last two decades, emergency food provision (e.g., food banks, meal programmes) has become an increasingly institutionalized form of hunger relief. Critiques of the emergency food system, as articulated by Poppendieck’s 1998 book Sweet Charity?, suggest that such programmes are unable to cope with growing hunger in a meaningful, stable, efficient, or culturally appropriate way, and that they may facilitate government retrenchment. Meanwhile, popular attention has increasingly focused on the environmental and social costs of our globalized industrial food system, and efforts to challenge it (e.g., urban fruit gleaning, chicken rearing) are becoming widespread. These efforts have drawn new kinds of organizations into the world of food (in)security. Drawing on organizational documents and key informant interviews, this paper examines how emergency food provision is changing because of the rise of ‘community food security’ discourse and practice in the period since Sweet Charity? Findings suggest that emergency food providers have responded to critiques in partial and incongruent ways. Organizations face structural constraints that curtail their ability to reorganize, while new kinds of organizations are engaging in community food security projects, both challenging and reinforcing the charity food model in ways that have relevance for progressive (food) organizing more generally.

Purpose – Sustainability initiatives typically operate for a limited time period, but it is often unclear whether they have lasting effects. The purpose of this paper is to examine a laboratory fume hood campaign, in order to identify factors that might contribute or detract from long‐term change persistence.Design/methodology/approach – The University of Toronto Sustainability Office ran a fume hood sash‐closing campaign in one building for a four‐month period. The campaign had two components: awareness‐raising, where the safety and energy benefits of sash‐closing were explained through posters, presentations, and a website; and a competition where participants received raffle tickets when their sashes were in compliance during unannounced inspections. Sash heights were recorded six and a half months before the campaign, throughout the campaign itself, and eight months after the campaign. Surveys and focus groups were used to assess participant attitudes and experiences.Findings – The campaign was effect...

Food security is a fundamental element of community health. Informal house-lot food growing, by providing convenient access to diverse varieties of affordable and nutritious produce, can provide an important support for community food security. In this exploratory assessment of the contribution home food gardening makes to community food security, in-depth interviews were conducted with gardeners in two contrasting neighborhoods in Toronto, Canada. A typology of food gardeners was developed, and this qualitative understanding of residential food production was then assessed from a community food security perspective. It was found that growing food contributes to food security at all income levels by encouraging a more nutritious diet. The sustainability of household food sourcing and gardeners’ overall health and well-being also increased with food production. Secure access to suitable land to grow food and gardening skills were the most significant barriers found to residential food production.

This paper investigates coverage of cancer in three Canadian newspapers in order to explore how the print media presents issues related to cancer risk and prevention. Six months of newspaper coverage was coded and analysed quantitatively to identify trends in coverage. A small subset of these articles was then analysed qualitatively to identify latent and underlying messages. Results from the analysis suggest that coverage emphasised risk management through individual choice and lifestyle change, privileging a discourse of individual control. Conversely, social and environmental risks related to cancer were minimised, despite the emerging academic consensus around the central importance of social and environmental determinants of health. Lifestyle was the most frequently mentioned source of cancer risk. Social and environmental health links were mentioned sparingly, and when environmental links were presented they were contested in ways that lifestyle risks were not. The coverage reflects the prevalent di...

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Objective: This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases. Methods: Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging. Results: Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses. Conclusion: Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD. Practical implications: Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care.

This article explores individual and community action taken in response to perceived environmental risks by investigating the determinants of environmental action across a range of action types. A conceptual framework is first presented, which provides a foundation for investigating the role of local compositional (i.e., individual characteristics), contextual (i.e., neighborhood environment), and collective (i.e., social networks) factors in environmental action. To test the utility of the conceptual framework, a quantitative survey was administered to a random sample of households (n = 512) in Hamilton, Canada. The results suggest that the predictors of environmental action vary by action type (i.e., personal change, individual civic action, and cooperative civic action), and that factors related to perceived environmental exposure and social capital generally play a stronger, more consistent role in civic environmental action than sociodemographic or neighborhood factors. The results underscore the role of social connection in responses to perceived environmental risks.

Social capital has been the focus of considerable academic and policy interest in recent years. Despite this interest, the concept remains undertheorized: there is an urgent need for a critical engagement with this literature that goes beyond summary. This paper lays a foundation for a critical dialogue between social capital and health promotion, by examining problematics in the conceptualization and practice of social capital building and linking these to models of community development, a cornerstone health promotion strategy. In so doing, the paper contributes to the existing literature by providing a theoretical exposition and critique of various threads in social capital discourse, and linking these threads explicitly to community development practice. Distinctions between communitarian, institutional and critical approaches to social capital are elaborated, and the relationships between these three approaches and three models of community development-social planning, locality development, and social action-are discussed. The existing social capital literature is then critically examined in relation to three key themes common to both literatures: community integration, public participation, and power relations. This examination suggests that social capital cannot be conceived in isolation from economic and political structures, since social connections are contingent on, and structured by, access to material resources. This runs counter to many current policy discourses, which focus on the importance of connection and cohesion without addressing fundamental inequities in access to resources. This paper posits that approaches to community development and social capital should emphasise the importance of a conscious concern with social justice. A construction of social capital which explicitly endorses the importance of transformative social engagement, while at the same time recognising the potential negative consequences of social capital development, could help community organizers build communities in ways that truly promote health.

This article examines the degree to which relationships between social capital and health are embedded in local geographical contexts and influenced by demographic factors, socio-economic status, health behaviours and coping skills. Using data from a telephone survey of a random sample of adults (N=1504 respondents, response rate=60%), the article determines if relationships between involvement in voluntary associations and various measures of individual health are associated with neighbourhood of residence in the mid-sized city of Hamilton, Canada. Associational involvement and overweight status (assessed by body-mass score) were weakly but significantly related after controlling for the other variables; involvement had relationships with self-rated health and emotional distress before but not after controlling for socio-economic status, health behaviours and coping skills. Relationships between neighbourhood of residence and two health outcomes, self-rated health and overweight status, were statistically significant before and after controlling for the other characteristics of respondents; neighbourhood of residence was not a significant predictor of number of chronic conditions and emotional distress in multivariate models. The neighbourhood and associational involvement relationships with health were not dependent upon one another, suggesting that neighbourhood of residence did not help to explain the positive health effects of this particular measure of social capital.

This paper reports the results of a comparative analysis of the psychosocial impacts of municipal solid waste disposal facilities (both landfills and incinerators) in six communities in the provinces of Ontario and British Columbia, Canada. Telephone surveys were administered to random samples of residents living around each facility between 1990 and 1995 (total n=1203). The results of logistic regression analyses show that type of facility was the strongest predictor of residents' awareness, concern, and actions taken in response to site concerns. Essentially, residents living in close proximity to a landfill had a higher probability of reporting awareness, concern or actions than residents living around an incinerator site. There was little evidence of differences in reactions between Ontario and British Columbia (BC) residents, despite variations in provincial policies on waste disposal. The effects of other predictors, with the exception of involvement in the local community, were not consistent, supp...

Effective risk communication is central to good environmental risk management. While studies have shown that newspapers are the primary source of information to the public regarding environmental issues, little is known about how environmental news is used as a risk-communication tool. This article explores the role of local information systems in risk communication, using newspaper content analysis as well as in-depth interviews with journalists and community residents to develop a case study of an environmental assessment process for a nonhazardous industrial-waste landfill. Results indicate that risk messages were chosen and shaped by journalists on the basis of their own exigencies. In addition, while newspapers were a major source of risk information, their impact was mitigated by resident distrust and access to other information sources, most notably their own personal information networks. These results have implications for environmental policy, as decision makers often use—either passive...

with a mean of 12.6 years of education (8-17). The mean number of professional fights was 45.2 and years of professional fighting, 14.3. Impairments on cognitive tests were frequent, with 43% failing a psychomotor speed test, 57% failing a processing speed test and 28.6% failing a memory test. The memory test was failed by a similar proportion of active fighters, while less active fighters failed the tests involving speed. . When corrected for age and other relevant variables, thalamic volume did not differ between active and retired fighters, but a greater fight exposure was associated with smaller volumes (p1⁄4.0.031). Conclusions: Cognitive dysfunction is common in retired fighters, and may be associated with specific changes in the brain. Timed tasks are particularly vulnerable, whereas impairment in memory is seen similarly in younger, active fighters. Analysis of larger groups of fighters will further elucidate this relationship.

Introduction Conversation Analysis (CA) can help with the differential diagnosis of seizure disorders. We investigated if CA could be used in the memory clinic to distinguish neurodegenerative (NDD) from functional memory disorders (FMD). Methods We recruited consecutive, patients newly referred to the Neurology-led memory Clinic. Consultations were video & audio recorded. All participants underwent detailed Neuropsychology testing and MRI. Results 111 patients of 178 approached were recruited (20 ND, 24 FMD, 87 other). We identified profiles of 14 interactional features that can distinguish NDD from FMD consultations based on encounters with 15 patients with NDD and 15 with FMD. Features of NDD included an inability to answer compound questions fully, inability to give detailed examples of memory failures, shorter length of turn and reduced complexity of replies. Prospective analysis of an additional 10 encounters proved that Conversation Analysts could use these features to predict the diagnoses of FMD and ND with high sensitivity and specificity. Conclusions Simple differences in the communication behaviour of patients can help to distinguish between ND and FMD, suggesting that a targeted observation of interactional features could improve screening for ND in primary or secondary or care settings.

SUMMARY This article describes results from an investigation of the health impacts of community gardening, using Toronto, Ontario as a case study. According to community members and local service organizations, these gardens have a number of positive health benefits. However, few studies have explicitly focused on the health impacts of community gardens, and many of those did not ask community gardeners directly about their experiences in community gardening. This article sets out to fill this gap by describing the results of a community-based research project that collected data on the perceived health impacts of community gardening through participant observation, focus groups and in-depth interviews. Results suggest that community gardens were perceived by gardeners to provide numerous health benefits, including improved access to food, improved nutrition, increased physical activity and improved mental health. Community gardens were also seen to promote social health and community cohesion. These benefits were set against a backdrop of insecure land tenure and access, bureaucratic resistance, concerns about soil contamination and a lack of awareness and understanding by community members and decisionmakers. Results also highlight the need for ongoing resources to support gardens in these many roles.

The 2009 Dementia strategy promoted a ‘memory clinic in every town’. We investigated the patient mix seen in a neurology-led memory clinic. Retrospective review (2004, 2006, 2012) attendees to memory clinic. Prospective review memory clinic from October 2012–Dec 2013. Survey to neurologists in Specialist Interest Group in Cognition (ABN). Survey of local GPs. Results Percentage of attendees with benign memory complaints increased from 30% & 32% in 2004 and 2006 to 55% in 2012. Oct 2012–Dec 2013 >50% attendees do not have dementia or MCI. 9 responders: A mean of 27% of attendees of neurology-led memory clinics in the UK have ‘benign memory complaints’. The following terms were used: ▸ Attentional amnestic disorder, ▸ Attentional cognitive complaints, ▸ Worried well, ▸ Subjective memory complaints, ▸ Subjective memory impairment, ▸ Normal cognitive ageing, ▸ Hypocondrial, ▸ ‘Stress related.’ 4. GPs used; ‘worried well’, ‘benign senescent forgetfulness’, ‘Possible dementia’, ‘mild neurocognitive disorder’ and ‘late life forgetfulness’ & treated with antidepressants but also referred to psychology or memory clinic. People attending memory clinic frequently do not have dementia and currently there is no consensus for diagnostic label or treatment.

This paper explores the links between (perceived) environmental risk and community (re) action in an urban industrial neighbourhood in Hamilton, Ontario, Canada. In-depth interviews were conducted with residents of an area with a documented history of adverse air quality, in order to determine the relative influence of social capital (networks, norms, and social trust) and place attachment (sense of belonging in a neighbourhood) in deciding to take civic action around this particular environmental issue. The interviews illustrate the complexity of lay understandings of air pollution, and indicate that social capital is a primary contributor to the decision to take certain kinds of action, while attachment to place plays a lesser role.

In the context of siting (environmentally) noxious land uses, recent research suggests that the well-being of individuals and communities is impacted as much by the decision-making process as the outcome itself. The study results presented in this paper stem from an ongoing, two-stage quantitative/qualitative investigation of impacts on individual and community well-being associated with the environmental assessment process in Ontario, Canada. This research uses a parallel case-study design to investigate two proposed landfill sites in southern Ontario. Qualitative in-depth interviews (n=36), conducted across a variety of stakeholder groups, were used to address the following objectives: to explore the nature of concerns experienced by individuals faced with a local landfill site proposal; to explore the effects of the siting process on individuals and communities; and to examine the coping strategies employed by individuals in response to impacts experienced. The work attempts to apply theories of risk society (as conceptualised by Beck and Giddens) at a community scale. In so doing, we build on the work of health geographers attempting to link the social and contextual with the medical. Overall, substantial impacts on individual and community well-being were reported across all stakeholder groups interviewed: these included stress, disempowerment, hostility and divisions within the community. The experience of psychosocial impacts and effectiveness of coping strategies is shaped by certain factors associated with the site and the siting process (including uncertainty and the perceived lack of meaningful participation). The links between risk, process and impacts are theorized using a conceptual framework which incorporates site and process factors, effects on daily life (e.g. feelings of losing control, mistrust), and Gidden's conception of ‘ontological security’. These findings have implications for environmental decision-making, as they suggest a need to locate the delicate balance point between community involvement and an expedient decision-making process within variable community contexts.