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Background: Improving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population. Methods: We undertook a scoping review using the framework by Arksey and O'Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. Searches were performed in the following bibliographic databases: Medline, EMBASE, PsycINFO via OVID, CINAHL via EBSCOhost, Scopus and Cochrane Library via Wiley. The search strategy was derived from three main concepts: (1) Black people; (2) Canada and Canadian provinces; (3) Palliative, hospice, or end-of-life care. No publication date or language limits were applied. Titles and abstracts were screened for eligibility by one reviewer and full text by two independent reviewers. Results: The search yielded 233 articles. Nineteen articles were selected for full-text review, and 7 articles met the inclusion criteria. These studies were published between 2010 and 2021, and conducted in the provinces of Ontario and Nova Scotia only. Studies used both quantitative and qualitative methods and included cancer decedents, next of kin, family caregivers and religious leaders. Sample sizes in various studies ranged from 6 − 2,606 participants. Included studies reported a general lack of understanding about palliative and end-of-life care, positive and negative experiences, and limited access to palliative and end-of-life care for Blacks, across all care settings. Conclusion: Findings suggest limited knowledge of palliative care and inequities in access to palliative and end-of-life care for Blacks living with life-limiting illnesses in 2 Canadian provinces. There is an urgent need for research to inform tailored and culturally acceptable strategies to improve understanding and access to palliative care and end-of-life care among Blacks in Canada. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine the roles of quality managers at community colleges, their experiences balancing accountability and improvement and their insights into the future of quality assurance. Design/methodology/approach: This phenomenological, qualitative study used semi-structured interviews with eight community college quality managers to investigate their roles, experiences and perspectives. A reflexive thematic approach was used to analyze the interview data. Findings: Four themes were identified from participant responses: quality managers frame and enable program quality, quality managers drive program change, quality managers cultivate a culture of quality and quality managers seek system change. The findings illustrate the roles played by quality managers as they work to improve college education at program, institution and system-wide levels. Research limitations/implications: The decision of participants to accept the recruitment invitation might reflect particular attitudes, perspectives or experiences. Practical implications: Quality assurance has emerged as a key mechanism for ensuring postsecondary programs are current, relevant and meeting the evolving needs of students and employers. This study advances the understanding of how quality assurance processes play out at the operational level and explores the experiences of quality managers as they navigate various quality tensions. Originality/value: Quality managers play key roles in leading, evaluating and influencing quality assurance processes in postsecondary education yet they are underrepresented in the literature. The findings of this study shed new light on the aspirational and influential roles they play in advancing quality assurance. [ABSTRACT FROM AUTHOR]

In this paper, we use intersectionality-based policy analysis (IBPA) to examine how COVID-19 income support policies enacted in Ontario, Canada, affected people living with poverty. We find that the privileging of formal labor market attachment in eligibility requirements systemically excluded constituencies most likely to be living with poverty. More broadly, these exclusions represent a retrenchment of neoliberal logics in social policy, and the rejection of universal social welfare programs. In conclusion, we suggest that the experiences of people living with poverty during the COVID-19 pandemic further highlight the need for comprehensive social welfare programs, including a universal basic income. [ABSTRACT FROM AUTHOR]

The migration literature focusing on understanding interactions between immigrants' integration and transnationalism is replete with mixed findings. However, contemporary consensus among migration scholars suggests that immigrants' integration and transnational connections can occur simultaneously. Focusing on transnational dating—which is understudied—this exploratory study draws on an online qualitative survey with five Ghanaian male immigrants in southwestern Ontario, Canada, to explore how immigrants' attachment to the host society, homeland, and "elsewhere" shape transnational dating behaviour. Transnational dating is conceptualized in this paper as dating partners that live part or most of their life or time detached from each other, yet hold together and create a sense of shared welfare and harmony, namely "datehood" that surpasses national borders. Using the integration‐transnationalism matrix as the theoretical framework, this paper demonstrates that the roles of integration and transnationalism should not be seen as separate influences on participants' transnational dating behaviour given participants' strong attachment to the host society, sending country, and "elsewhere." Importantly, our finding indicates that the motivation for transnational dating is related to transnational connections rather than not feeling integrated into Canadian society. Overall, the finding contributes to discourses on dating, transnational dating, transnationalism, and the conceptual framework of the integration‐transnationalism matrix. Key Messages: The migration literature focusing on understanding interactions between immigrants' integration and transnationalism is replete with mixed findings.This exploratory study has taken a critical step in stimulating a research agenda on transnational dating within the integration‐transnationalism matrix.Our finding indicates that the motivation for transnational dating is related to transnational connections rather than not feeling integrated into Canadian society. [ABSTRACT FROM AUTHOR]

This paper addresses an immediate gap in knowledge about community reintegration of previously incarcerated older adults. It presents an exploratory case study of a community residential facility program in Ontario, Canada, focusing on the experiences and perspectives of older residents, staff members, and community stakeholders on the community reintegration of previously incarcerated older men. Findings provide insights into the aging-related reintegration issues such as the older men's ability to access health and medical services upon community reentry, the challenges and opportunities of the continuum of support (or lack thereof) to help ease the reintegration process, and stigma and other barriers the older men face as they attempt to access long-term care upon release from correctional institutions. Emergent questions for research, policy, and practice are highlighted and discussed to set an agenda for expanding the thread of inquiry into the community reintegration of previously incarcerated older adults. Future research calls for further investigation into the diversity of experiences (e.g., gender, race/ethnicity, geographical locale) to advance the field of study as it relates to aging and social policy. [ABSTRACT FROM AUTHOR]

Background: In Canada, Ontario midwives provide care to sexual and gender minority (SGM) people. Published literature shows how midwives' attitudes shape the experiences of lesbians, but research examining midwives' attitudes toward SGM people is lacking. Our study measured the attitudes of Ontario midwives toward SGM clients, hypothesizing that attitudes would be positive overall and that there would be no difference in attitudes across practice settings. Methods: Paper surveys (n = 926) with an option to respond online were sent to Ontario midwifery practices. We measured midwives' attitudes toward sexual minorities (11 questions, scores ranged from 11 to 55) and gender minorities (9 questions, scores ranged from 9 to 45), with higher scores indicating more positive attitudes. Overall and subgroup analyses were performed. Results: The 268 completed surveys indicated that midwives' attitudes were positive toward both sexual (mean score 49.2, maximum possible score of 55, ie, 89.4%) and gender minorities (mean score 38.9, maximum possible score of 45, ie, 86.4%). Analyses showed that attitudes toward SGM were associated with midwives' sexual identity and route of entry into the profession (ie, university‐based vs bridging programs), but not practice setting. Conclusions: Although attitudes of this subset of midwives toward SGM clients were positive, volunteer bias could account for this finding since 32.6% of respondents identified as sexual minorities. Since the attitudes of midwives who entered the profession through the university‐based education program were significantly more positive than those who entered through international bridging programs, future research should examine how SGM‐related content is integrated into midwifery education and training curricula. [ABSTRACT FROM AUTHOR]

This paper examines how policymakers interpret and deploy cultural economy approaches within municipal economic development strategies and cultural plans. Focusing on the 33 largest municipalities in Ontario, Canada, we conduct a keyword analysis of 63 municipal planning documents, supplemented with key informant interviews with economic development and cultural planning staff. Our analysis reveals that the use of cultural economy approaches in economic development and cultural plans varies depending upon city size, municipal governance structure and municipal organizational structure. However, despite the widespread use of cultural economy ideas in planning documents, we conclude that its uptake in municipal policymaking fails to reflect its professional and scholarly popularity. [ABSTRACT FROM AUTHOR]

Nearly the entire North American and European supply of the bait worm Lumbricus terrestris is hand-picked from southwestern Ontario dairy farms. This "Canadian nightcrawler" industry is largely a cash business that operates 'underground,' with very little information about how the 'worm pickers' engage with dairy farmers and the cash rents they receive. In this paper, I provide a brief background of the industry and how it came to rely on Ontario dairy farms as sites of L. terrestris production. I describe the three prominent arrangements dairy farmers have with pickers that correspond to rental rates that range between $200 and $1500 CND per acre. I then compare these prices with average farmland rental rates in the region and estimated net income from growing field crops typically planted by dairy farmers (corn, soy, alfalfa/hay). By comparing this information, I suggest L. terrestris is the most profitable 'crop' that southwestern Ontario dairy farmers could grow, followed by a discussion of why more farmers decide not to engage with the industry. [ABSTRACT FROM AUTHOR]

In this paper perceptions of inadequate infection control procedures were associated with elevated levels of anxiety symptoms. Educators, school administrators and policy makers should work collaboratively to design school environments that address perceptions of unmet infection control practices, focusing on physical distancing between educators and students and allowing greater compliance with student masking and cohorting. Objective: The aim of this study was to examine the association between the perceived adequacy of infection control practices (ICPs) and symptoms of anxiety among educators in Ontario, Canada. Methods: Data from 4947 educators were collected in December 2020. Modified Poisson models assessed the association between adequacy of ICPs and moderate or severe anxiety symptoms, adjusting for a range of covariates. Results: Approximately 60% of respondents reported moderate or severe anxiety symptoms. Two-thirds (66.5%) of the sample had less than half of their ICP needs met. Respondents with less than half their ICP needs met were more than three times more likely to have moderate or severe anxiety, compared with respondents with their ICP needs met. Conclusion: Findings highlight the importance of adequate administrative and engineering controls in schools, not only to minimize risk of infection, but also for educator's mental health. [ABSTRACT FROM AUTHOR]

This paper provides a theoretical and empirical intervention into housing research by applying the geospatial lens of the rural-urban space (RUS) to the social problem of homelessness, a conceptual linkage absent in the Canadian context. Drawing on original data from 80 surveys, four focus groups, and a community feedback session, we identify and interrogate key local impacts of systemic shifts in the housing market and associated policy responses in Dufferin County, Ontario, a RUS community located 80km northwest of Toronto. We find that for people experiencing homelessness within RUS communities, the intersecting consequences of multiple forms of structural marginalization, such as low wages and social assistance rates and discrimination, can quickly destabilize housing. We emphasize the importance of attending to housing in RUS communities and developing housing policy strategies. [ABSTRACT FROM AUTHOR]

This paper develops a framework for a financial, economic, and stakeholder analysis of a residential rooftop solar net-metering program. The empirical focus of the paper is the net-metering program in Ontario, Canada, but the methodology is applicable to evaluating other public programs. The results highlight that without the Federal Government's subsidy for the initial investment cost, net-metered solar systems are not financially viable for representative households. Moreover, the stakeholder analysis reveals that for each additional net-metered system installed in Ontario, non-net-metered households experience financial losses of six times the benefits to the net-metered households. The net losses to the Federal Government of Canada and the Canadian economy are five and nine times the benefit to the net-metered households, respectively. The only stakeholder who benefits marginally is the Government of Ontario. In terms of environmental benefits, our estimate of the cost of greenhouse gas abatement by residential net-metered solar is 325 CAD per ton of CO 2 , which is significantly higher than the current (65 CAD in 2023) and future (170 CAD by 2030) national carbon price set by the Government of Canada. [ABSTRACT FROM AUTHOR]

This paper examines the political history of the failed struggle to require companies to justify their plant closing decisions in Canada's industrial heartland of Ontario. Demands for the public review of plant closing decisions began, locally, in the auto town of Windsor in the 1950s and 1960s and reached Toronto with the closure of Dunlop Tire in 1970. Another wave of closures struck in 1980, this time reaching deep into rural and small-town Ontario as well as larger industrial towns and cities, generalizing concern. The resulting Select Committee on Plant Shutdowns and Employee Adjustment, created by the Ontario legislature, took it upon itself to conduct the kind of public review of recent closures that was long demanded. Due to the strength of the political opposition to any interference with management rights, it was essential that proponents could point to precedents in Western Europe. Trade unionists also grounded their argument in favour of government regulation in the moral economy idea that long-service workers accrued a proprietary right to their jobs. [ABSTRACT FROM AUTHOR]

Carbon pricing policies face growing threats from populist attacks citing increased costs for consumers. This paper explores the potential for different strategies to protect carbon pricing policies from these attacks through an in-depth analysis of the enactment and subsequent reversal of an economy-wide cap-and-trade programme in Ontario, Canada, from 2015 to 2018. The paper uses process tracing of key government documents, media coverage, and interviews with those involved in the enactment and promotion of the policy, to answer two questions: (1) why did Ontario choose a carbon revenue approach focused on economic development and climate mitigation? and (2) how did that approach make the policy more vulnerable to a populist attack based on higher consumer prices? The analysis tests a central hypothesis grounded in previous research: A failure to focus more on consumer costs in designing and promoting the cap-and-trade progamme is a primary reason for the Ontario policy's startling political failure. In this respect, the paper concludes, Ontario's experience constitutes a warning about the importance of designing and framing carbon pricing policies to defuse the potential power of populist attacks focusing on energy prices for 'working families'. Key policy insights Carbon pricing policies remain vulnerable to populist attacks based on opposition to higher consumer prices. Dedicating carbon revenue to interest groups may undermine the ability to defend the policy against consumer pricing attacks. Carefully explaining a cap-and-trade policy mechanism can be important to building public support for the policy. Neither its complexity nor its integration with international carbon markets protected Ontario's cap-and-trade programme from repeal. Ontario's cap-and-trade policy's repeal can be substantially attributed to the government's approach to allocating carbon revenue. [ABSTRACT FROM AUTHOR]

Background: Homelessness is becoming an international public health issue in most developed countries, including Canada. Homelessness is regarded as both political and socioeconomic problems warranting broad and consistent result-oriented approaches.Methods: This paper represents the qualitative findings of a project that explored risk factors associated with family homelessness and strategies that could mitigate and prevent homelessness among families using a focused ethnographic study guided by the principles of participatory action research (PAR). The sample includes 36 family members residing at a family shelter who participated in focus groups over two years (between April 2016 and December 2017). Most of the participants were single-parent women.Results: The analysis yielded five major themes including, life challenges, lack of understanding of the system, existing power differentials, escaping from hardship, and a theme of proposed solutions for reducing family homelessness in the community.Conclusion: The findings illustrated the complex nature of family homelessness in Ontario; that the interaction of multiple systems can put families at risk of homelessness. Findings from this study underscore the need for urgent housing protocols aimed at educating homeless families on how to navigate and understand the system, enhance their conflict resolution skills, and develop strategies beyond relocation to help them to cope with difficulties with housing. [ABSTRACT FROM AUTHOR]

This paper investigates the certification of insanity through a standardized template called Form K which was used in Ontario between 1873 and 1883. My main thesis is that the introduction of the Form K had profound and long-lasting effects on the determination of insanity. In particular, it created a unique case in the history of certification, it grounded civil confinement on a strategy of consensus, and it informed mental health documentation for more than a century. As the result of a transnational mediation from Victorian England, the Form K prescribed an examination setting which involved a high number of participants, including three physicians and several witnesses. By comparing this case with other jurisdictions of the time, this paper shows how Ontario became a distinctive case worldwide. In order to get a closer look at this medico-legal procedure, I consider the archival records of the Toronto asylum and conclude that the certification of insanity relied on a strategy of consensus. While the Form K proved quite successful in preventing legal actions, it produced financial, logistic, and bureaucratic issues. The Form K was thus discontinued after a decade, yet its structure influenced Ontario's mental health documentation throughout the twentieth century. This paper shows the relevance of the certification of insanity for transnational history and for understanding contemporary issues of involuntary confinement and stigma in mental health. [ABSTRACT FROM AUTHOR]

In an era of rural service decline and population aging, some rural libraries rely on volunteers to keep them open within the community. This paper outlines the challenges of sustaining such volunteer-based rural libraries, drawing on a case study of a volunteer-based library in rural Ontario, Canada. Findings suggest that age of volunteers, volunteer participation, territoriality, branch polarization and the burden of volunteering present challenges in sustaining the volunteer program at the library, yet the library contributes to the community through community engagement, enabling aging in place and through economic development. The paper concludes with recommendations from the case study on how the sustain such a volunteer program. [ABSTRACT FROM AUTHOR]

The research pertaining to racial disparities for Black families in child welfare is relatively limited in Canada. Recent research reveals that the overrepresentation of Black families in Canadian child welfare systems typically begins at the reporting or investigation stage and continues throughout the child welfare service and decision-making continuum. This research is occurring against the backdrop of increasing public acknowledgement of Canada's historic anti-Black policy-making and institutional relationships to Black communities. Though there is increased awareness about anti-Black racism, there has been limited exploration of the connection between anti-Black racism in child welfare legislation and how this policy generates disparities for Black families in both child welfare involvement and outcomes – this paper seeks to fill this gap in knowledge. The objective of this paper is to explore the entrenchment of anti-Black racism within the child welfare system by critically assessing the language and absence of language within the guiding legislative and implementation policies. Utilizing a critical race discourse analysis method, this study explores the entrenchment of anti-Black racism within the Ontario child welfare system by critically assessing the language and absence of language within the guiding legislative policies that shape practice for Black children, youth, and families. The findings revealed that though the legislation does not explicitly address anti-Black racism, there were instances where the legislation indicated that race and culture may be considered in responding to children and families. The lack of specificity, particularly in the Duty to Report, has the potential to contribute to disparate reporting and decision-making for Black families. Policy makers should acknowledge the history of anti-Black racism that informed the development of the legislation in Ontario and move towards tackling systemic injustices that disproportionately affect Black families. More explicit language will shape future policies and practices to ensure that the impact of anti-Black racism is considered across the child welfare continuum. [ABSTRACT FROM AUTHOR]

It has been postulated that field education is the signature pedagogy of social work education. Practicums are paramount in assisting social work students to develop the unique skills and competencies required for professional practice. Traditionally, field education in social work has occurred within the context of social service agencies involving face-to-face interaction with service users and colleagues. The crisis created by the COVID-19 pandemic compelled schools of social work to abandon established placements in favor of virtual or remote learning. This paper describes the experience of the School of Social Work at King's University College, London, Ontario, in moving its undergraduate and graduate social work students to Remote Learning Plans (RLP) to enable the completion of hours required in their professional programs. The transition to remote learning plans not only modeled good social work practice but also reflected a student-centered approach to learning and teaching. In addition, the experience unearthed the possibilities that exist for field education in remote environments while still equipping students with the knowledge, skills, and values required for social work practice. [ABSTRACT FROM AUTHOR]

Since the mid-1990s, the reuse of brownfield properties for urban intensification has emerged as a core strategy in government efforts to remediate pollution and support renewal, regeneration, and retrofitting. While upper levels of government in Canada engaged in early efforts to devise policies, programs, and funding strategies to support redevelopment, the job of overseeing it has fallen mainly to local governments. This paper investigates the role of municipalities in Ontario, Canada's most populous and industrialized province, in managing and facilitating brownfields redevelopment. Survey data from 43 municipalities, coupled with information gathered from six site visitations and provincial information, reveal that despite common goals, tools, and approaches put forward by Ontario municipalities in their Community Improvement Plans, the management of planning, funding, and redevelopment issues continues to be a challenge for many, resulting in some very proficient municipalities and numerous hopeful ones with limited capacity to address this demanding issue. [ABSTRACT FROM AUTHOR]

While there is a growing body of literature on Black people's access to HIV services in Canada, the question of how this access varies across Canada's urban jurisdictions has hitherto never arisen in research and policy. This paper assesses HIV healthcare needs among heterosexual Black men in four Ontario cities of Windsor, London, Toronto and Ottawa. Multivariate results show that heterosexual Black men in Windsor (OR = 3.2; p <.01), London (OR = 2.5; p <.05), and Toronto (OR = 2.2; p <.05) were significantly more likely to experience difficulties getting HIV healthcare compared with those living in the nation's capital—Ottawa. Also, experiences of discrimination (OR = 1.08; p <.001), not having a family doctor (OR = 1.7; p <.01) and difficulty with the English language (OR = 2.4; p <.01) predicted higher odds of difficulty accessing HIV health needs. These findings suggest that contextually sensitive policies within Canadian cities are needed to help marginalized populations meet their healthcare needs. [ABSTRACT FROM AUTHOR]

Background: In Ontario, Canada, Indigenous communities experience some of the province's worst drinking water, with issues ranging from deteriorating water quality to regulatory problems and lack of support. When water is known, or suspected, to be unsafe for human consumption, communities are placed under a Drinking Water Advisory. Between 2004 and 2013, approximately 70% of all on-reserve communities in Ontario were under at least one Drinking Water Advisory. Despite the widespread impact of Drinking Water Advisories on health and wellbeing, little is known about First Nation individuals' perceptions and experiences living with a Drinking Water Advisory. This study presents information shared by members of a community who have lived with Boil Water Advisories on and off for many years, and a long-term Boil Water Advisory since 2017. The goal of this paper is to unpack and explore the Boil Water Advisories from the perspective of community members and provide considerations for current and future Boil Water Advisory management. Methods: Methodological choices were driven by the principles of community-based participatory research. Two data collection methodologies were employed: hard copy surveys and interviews. Results: Forty-four individuals (19.5%) completed a survey. Eight Elders and 16 key informants participated in 20 interviews. Respondents expressed varying degrees of uncertainty regarding protective actions to take while under a Boil Water Advisory. Further, 79% of men but only 46% of women indicated they always adhere to the Boil Water Advisory. Knowledge gaps that could lead to risky behaviours were also identified. Finally, Boil Water Advisories were demonstrated to have physical, financial, and time impacts on the majority of respondents. Conclusions: A direct outcome was the identification of a critical need to reinforce best practices for health protection through community education and outreach. More broadly, Chief and Council were able to use the findings to successfully advocate for improved drinking water for the community. Additionally, benefits of participatory research and community ownership include enhanced local research capacity, and increased awareness of, and desire for, research to inform decisions. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of substance use disorders among incarcerated individuals in Canada is substantially higher than in the general population. Many incarcerated individuals with opioid use disorder remain untreated due to inadequate access to opioid agonist therapy (OAT). A considerable proportion of overdose-related deaths in the province of Ontario are individuals who have recently been released from prison. The purpose of this paper is to highlight that discontinuation of OAT as a disciplinary measure remains an active concern within prisons in Canada and places individuals with opioid use disorder at increased risk of relapse and resultant overdose death.Design/methodology/approach: This case report describes an incarcerated client with opioid use disorder who was initially stable on OAT, but was forcibly tapered off OAT as a disciplinary measure and subsequently relapsed to illicit opioid use while in custody.Findings: This case calls attention to concerns regarding treatment of opioid use disorder during incarceration, as forcible detoxification from OAT as a disciplinary measure is a highly dangerous practice. The authors discuss concerns regarding diversion and ways in which prison-based OAT programs can be improved to increase their safety and acceptability among correctional staff. Ongoing advocacy is required on the part of health-care workers and policymakers to ensure that individuals are able to appropriately access this life-saving therapy while incarcerated.Originality/value: To the best of the authors' knowledge, this is the first case report to describe forcible tapering of OAT as a disciplinary measure during incarceration. Despite existing evidence emphasizing the significant risk of overdose associated with detoxification from opioids, this case highlights the need for further research into the causes and prevalence of this practice. [ABSTRACT FROM AUTHOR]

For at least the past 20 years, the Province of Ontario – as well as other advanced economic regions – has experienced a period of transition, with traditional manufacturing declining and advanced manufacturing firms and sectors emerging. Concurrently, there has been a concerted policy effort emphasising the development of industry clusters within the province, though key issues of governance and where and how to invest public funds remain. This paper presents research on the spatial configuration of firms in 26 manufacturing sub‐sectors, using point density analysis of the basis for determining the presence and spatial configuration of firms. This allows for the comparison of patterns observed in traditional, advanced, and evolving sub‐sectors. The findings show that there are patterns of clustering in all sub‐sectors, though different spatial configurations are apparent between traditional, advanced, and evolving sub‐sectors. These differences have implications for both investment and governance. Based on the findings, investment needs to be directed towards areas with locational advantages, while regional perspectives and initiatives on cluster governance are needed. [ABSTRACT FROM AUTHOR]

Background: Over the last three decades, there has been worldwide recognition of peer support contributions to improve mental healthcare provision. However, in the current literature, little attention has been paid to exploring perspectives of peer supporters on their involvement in mental health services provision. The purpose of the present study was to examine peer supporters' perspectives on the implementation of a transitional discharge model (TDM), an intervention for the community integration of people with mental illness. Methods: This paper represents ethnographic qualitative data collected as part of a study that used mixed methods to evaluate the implementation of TDM across nine hospitals from the Province of Ontario, in Canada. The study involved a sample of 66 peer supporters, who were recruited from participating Consumer/Survivor Initiative Organizations and Peer Support Programs. The study collected data using two sets of focus groups, which were held at 6 months and 1-year post implementation. Data analysis used an ethnography model of qualitative analysis. Results: Peer supporters expressed that their involvement in mental healthcare enhanced clients' autonomy and hope about their recovery, as well as established a safety net and reduced hospital readmissions. Peer supporters articulated that they assumed several roles to facilitate clients' transition from hospital to the community. These roles included: assisting clients in building their capacity and developing healthy routines; attending regular on-ward and community meetings; accompanying clients to their appointments; and working with clients to set goals for their recovery. The study showed hindrances to effective implementation of peer support programs, such as a lack of understanding and appreciation of peer supporter roles, lack of careful allocation of peer supporters to clients, and an absence of appropriate protocols for ensuring the safety and supervision of the peer supporters. Conclusions: Results of the TDM implementation demonstrated that involving peer supporters in mental healthcare delivery may benefit clients by enhancing autonomy and hope about their recovery, as well as establishing a safety net and reducing hospital readmissions. Results from the study have the potential to inform healthcare professionals and managers of strategies for developing effective peer support programs. [ABSTRACT FROM AUTHOR]

Set within the framework of the birthplace effect literature and the seminal work of Curtis and Birch, this paper draws information from the publicly available database www.hockeydb.com and from the Census to examine the hometowns of Canadian National Hockey League (NHL) players from 1970 to 2015. It found that from a regional perspective, the distribution of players' hometowns remained fairly stable over the 46-year period with Ontario and the three Prairie provinces being prominent. Players from small centres have been well represented in the NHL. While larger urban areas have historically produced the most players, there has been a marked increase in 'big city' players while the odds of making it are low. However, when the analysis is adjusted according to the population aged 10-19, boys growing up in small and mid-sized centres were at advantage in reaching the NHL until 2009. Finally, we discuss whether the growing presence of big city players in the NHL will affect the image of hockey as a national sport, as for many, small-town hockey remains at the heart of Canadian sporting culture. [ABSTRACT FROM AUTHOR]

Background: Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care. Methods: Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases. Discussion: Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population. [ABSTRACT FROM AUTHOR]

This paper examines the role of in-migrants in the functional transformation of amenity-rich places. Its overarching goal is to determine if and how internal migrants arriving from larger settlement areas (i.e., counterurbanites) are contributing to the creation of functionally diverse (hybrid), or functionally limited (pure) commercial landscapes in places endowed with heritage assets. We focus on Paris, an historic town situated at the confluence of the Grand and Nith Rivers in southern Ontario. Three objectives guide the research: (1) to determine which commercial landscape form (hybrid or pure) and landscape generating process (creative enhancement or destruction) best characterizes the downtown; (2) to establish counterurbanite presence in this commercial core; and (3) to assess their role in the downtown's recent evolution. Evidence gleaned from secondary sources, and local fieldwork reveals that creative enhancement (functional addition), rather than creative destruction (functional displacement) is the dominant process. This has given rise to a hybrid landscape, where quotidian businesses (i.e., those selling ordinary goods and services) accompany five non-quotidian (i.e., distinctive) product types (i.e., authentic heritage, infused heritage, heritage-enhanced, faux-authentic heritage, and non-heritage boutique), each relying in different ways on the town's heritage assets. Information gathered from 35 proprietors finds that counterurbanites, and other inmigrants, dominate the downtown core, with only six non-migrant proprietors represented. In-comers, including counterurbanites, sell both quotidian and nonquotidian products, with non-migrant vendors offering only ordinary goods and services. These findings reveal that by selling both product types, counterurbanites are contributing to the creation of a hybrid landscape in the city's countryside. Their attraction is thus an important ingredient for facilitating diversity and economic viability in small settlement areas. [ABSTRACT FROM AUTHOR]

Floating Catchment Area (FCA) methods are a popular tool to investigate accessibility to public facilities, in particular health care services. FCA approaches are attractive because, unlike other accessibility measures, they take into account the potential for congestion of facilities. This is done by 1) considering the population within the catchment area of a facility to calculate a variable that measures level of service, and then 2) aggregating the level of service by population centers subject to catchment area constraints. In this paper we discuss an effect of FCA approaches, an artifact that we term demand and level of service inflation. These artifacts are present in previous implementations of FCA methods. We argue that inflation makes interpretation of estimates of accessibility difficult, which has possible deleterious consequences for decision making. Next, we propose a simple and intuitive approach to proportionally allocate demandand and level of service in FCA calculations. The approach is based on a standardization of the impedance matrix, similar to approaches popular in the spatial statistics and econometrics literature. The result is a more intiuitive measure of accessibility that 1) provides a local version of the provider-to-population ratio; and 2) preserves the level of demand and the level of supply in a system. We illustrate the relevant issues with some examples, and then empirically by means of a case study of accessibility to family physicians in the Hamilton Census Metropolitan Area (CMA), in Ontario, Canada. Results indicate that demand and supply inflation/deflation affect the interpretation of accessibility analysis using existing FCA methods, and that the proposed adjustment can lead to more intuitive results. [ABSTRACT FROM AUTHOR]

Background: This study reports on physicians’ experiences with chronic pain management. For over a decade prescription opioids have been a primary treatment for chronic pain in North America. However, the current opioid epidemic has complicated long-standing practices for chronic pain management which historically involved prescribing pain medication. Caring for patients with chronic pain occurs within a context in which a growing proportion of patients suffer from chronic rather than acute conditions alongside rising social inequities. Methods: Our team undertook an ethnographic approach known as institutional ethnography in the province of Ontario, Canada in order to explore the social organization of chronic pain management from the standpoint of primary care physicians. This paper reports on a subset of this study data, specifically interviews with 19 primary care clinicians and 8 nurses supplemented by 40 hours of observations. The clinicians in our sample were largely primary care physicians and nurses working in urban, rural and Northern settings. Findings: In their reflections on providing care for patients with chronic pain, many providers describe being most challenged by the work involved in helping patients who also struggled with poverty, mental health and addiction. These frustrations were often complicated by concerns that they could lose their license for inappropriate prescribing, thus shifting their work from providing treatment and care to policing their patients for malingering and opioid abuse. Interpretation: Our findings show that care providers find the treatment of patients with chronic pain–especially those patients also experiencing poverty–to be challenging at best, and at worst frustrating and overwhelming. In many instances, their narratives suggested experiences of depersonalization, loss of job satisfaction and emotional exhaustion in relation to providing care for these patients, key dimensions of burnout. In essence, the work that they performed in relation to their patients’ social rather than medical needs seems to contribute to these experiences. Their experiences were further exacerbated by the fact that restricting and reducing opioid dosing in patients with chronic pain has become a major focus of care provision. [ABSTRACT FROM AUTHOR]

The number of people with dementia worldwide will reach 115.4 million by 2050. This accelerating crisis has sparked research on how to design neighbourhoods for those with early dementia, and how to empower them through built environment changes to remain in their community for as long as possible. There are numerous benefits for persons with dementia who continue access to their neighbourhood: physical activity, sense of dignity, social interaction, autonomy and psychological wellbeing. In this paper, I examine 17 recommendations (urban design and land use strategies) identified as ‘dementia-friendly’, within dementia design and planning literature. Each is then examined against the planning frameworks for a mid-size suburban municipality in Ontario and assessed for its financial impact on a base case subdivision using pro forma analysis. The effect on the financial return for a developer was minimal, demonstrating that establishing these recommendations as policy is viable, through regulation and incentives. [ABSTRACT FROM AUTHOR]

While a growing body of research is examining the impacts of prolonged occupational sitting on cardiovascular and other health risk factors, relatively little work has examined the effects of occupational standing. The objectives of this paper were to examine the relationship between occupations that require predominantly sitting and those that require predominantly standing and incident heart disease. A prospective cohort study combining responses to a population health survey with administrative health-care records, linked at the individual level, was conducted in Ontario, Canada. The sample included 7,320 employed labor-market participants (50% male) working 15 hours a week or more and free of heart disease at baseline. Incident heart disease was assessed using administrative records over an approximately 12-year follow-up period (2003-2015). Models adjusted for a wide range of potential confounding factors. Occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting. This association was robust to adjustment for other health, sociodemographic, and work variables. Cardiovascular risk associated with occupations that involve combinations of sitting, standing, and walking differed for men and women, with these occupations associated with lower cardiovascular risk estimates among men but elevated risk estimates among women. [ABSTRACT FROM AUTHOR]

The consequences of parallel paper and electronic medical records (EMR) and their impact on informational continuity are examined. An interdisciplinary team conducted a multi-site, ethnographic field study and retrospective documentation review from January 2010 to December 2010. Three case studies from the sample of older patients with hip fractures who were transitioning across care settings were selected for examination. Analysis of data from interviews with care providers in each setting, field observation notes, and reviews of medical records yielded two themes. First, the lack of interoperability between electronic information systems has complicated, not eased providers’ ability to communicate with others. Second, rather than transforming the system, digital records have sustained health care’s ‘culture of documentation’. While some information is more accessible and communications streamlined, parallel paper and electronic systems have added to front line providers’ burden, not lessened it. Implementation of truly interoperable electronic health information systems need to be expedited to improve care continuity for patients with complex health-care needs, such as older patients with hip fractures. [ABSTRACT FROM AUTHOR]

This paper employs a descriptive case study method to analyze and critically review the emergence of the provincial poverty reduction strategy in Ontario, Canada which was implemented in 2008 and renewed in 2014. The purpose of this study is two-fold: first, it defines the principles of neoliberalism and explores the historical growth of neoliberal thought in Canada, and specifically within Ontario, beginning in the 1980s to the present-day. Drawing on a combination of primary, secondary and grey literature, this paper discusses the ways in which neoliberal ideologies and rhetoric became deeply rooted in political thought and discourse within the province. Employing a critical theory framework, the paper highlights the contrasting ways in which neoliberal values were adopted by the different political parties in power and the detrimental impact this espousal had on individuals living in poverty within Ontario. Second, the paper illustrates the powerful ways in which anti-poverty grassroots movements and social advocacy groups assembled to push for the creation of a provincial poverty reduction strategy. The analysis ends with a critique of the neoliberal influences on the strategy's recommendations and the future outlook of the poverty reduction strategy based on the current political climate within the province. [ABSTRACT FROM AUTHOR]

Background: In the 1920s, eight of nine Canadian provinces legalized alcohol sales, ending prohibition in favor of government control. Much has been written about the rise and fall of Prohibition in North America, but there is little work examining these events in the light of current drug policy debates. This paper attempts to fill some of these gaps.Methods: The aims of this paper are primarily exploratory and descriptive. Following a literature review, it draws from secondary and some primary sources to explore the debate around ending alcohol prohibition (i.e. legalizing its distribution) in Ontario between 1920 and 1927. It then uses material drawn from a comprehensive search of the Canadian House of Commons debates on cannabis legalization between 2016 and 2018 to draw parallels with the debates around alcohol legalization in Ontario about 90 years earlier.Results: While alcohol and cannabis legalization occurred in very different social and political contexts, there are similarities in both the arguments in favor of ending prohibition (ineffectiveness at preventing consumption and collateral social harms) and post-legalization debates around regulation (most notably the optimal way to replace the illicit market).Conclusion: The Canadian cannabis legalization debates of the 2010s echo the alcohol legalization debates of the 1920s in remarkable and relevant ways. Ultimately the most striking parallel may be the extent to which the political leaders advocating for legalization emphasized that their policy was not liberalization, but more effective control. [ABSTRACT FROM AUTHOR]

This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare. [ABSTRACT FROM AUTHOR]

Public transportation systems play a significant role in emergency evacuation. Therefore, this paper is geared towards harnessing subway and bus transit to alleviate congestion pressure during evacuation of busy urban areas. Routing and scheduling of transit vehicles and subway operation is envisioned as a new variant of the well-established vehicle routing problem. The model presented in this paper combines multiple variants of the traditional vehicle routing problem while reflecting on the operational characteristics during emergency evacuation, to include (1) multiple depots to better distribute the transit fleet, (2) time constraints to account for the evacuation time window, and (3) constraints for pick-up and delivery locations of evacuees. The evacuation problem is hereafter defined as a multi-depot time-constrained pick-up delivery vehicle route problem. A framework, using constraint programming and local search methods, was developed to model and solve the problem. An optimal spatio-temporal evacuation model was performed first to optimize evacuation of background vehicular traffic, generating transit travel cost (i.e., link travel times) as an input to the evacuation problem. The methodology was applied to evacuate the entire city of Toronto. The results show that the Toronto Transit Commission fleet is capable of evacuating the transit-dependent population (1.34 million) within 2 h on average. The four subway lines of the city of Toronto carry approximately 0.62 million people and can evacuate these people in less than 3 h on average. Toronto Transit Commission shuttle buses (1,320 vehicles) can evacuate the remainder of the transit-dependent population (0.72 million) in approximately 1.5 h on average. [ABSTRACT FROM AUTHOR]

In 1823, the Ontario House, a hotel and tavern, was built near Niagara Falls, Canada. In addition to providing a location for travelers and tourists to drink and lodge, Ontario House, like many other establishments, billeted soldiers when the need arose. The 2012 excavation of the midden and features of the Ontario House produced a large assemblage of artifacts including ceramics, buttons, numismatics, and military accoutrements. Of particular interest is an East Indian coin, found in the natural topsoil, which can be associated with the 67th Regiment of Foot's brief occupation of Ontario House in 1841. This paper addresses the significance of this coin and associated finds in regards to the global movement of the regiment and the socio-political context of Ontario House within regional history. [ABSTRACT FROM AUTHOR]

Reconciling diverse forest values within policy and decision-making processes is an ongoing challenge in forestry. The use of environmental impact assessment (EIA) provides potential for improving forest management and making it more responsive to diverse interests. This paper examines EIA in Canadian and Finnish forest planning. In Finland there has been a reluctance to see EIA as a tool for forest planning while in Canada some provinces have long applied EIA to forest management. Ontario, Canada, provides one example of applying EIA to forest planning at a range of scales in order to advance integrated planning and help conflict management. The paper provides a brief analysis of the Finnish forest planning system, an illustration of the Ontario EIA forest management experience, and then considers the application of EIA to Finnish forest management. The paper concludes that EIA may be workable for Finnish state forests and would likely enhance planning and management, but given the existing institutional frameworks EIA would be difficult to apply to private forests. [ABSTRACT FROM AUTHOR]

Abstract: Social expectations surrounding sickness have undergone a transformation in Western welfare states. Emerging discourses about patients’ roles and responsibilities do not however always map neatly onto patients’ actions, experiences or desires. This paper emerges from a study in Ontario, Canada. Drawing on in-depth interviews with 5 women diagnosed with breast cancer we explore the activity and effort prompted for patients by the routine professional practice of outlining treatment options and encouraging patients to choose between them. We highlight research participants’ complex responses to their responsibility for treatment decisions: their accepting, deflecting and reframing and their active negotiation of responsibility with professionals. The literature on treatment decision making typically characterizes people who resist taking an active role as overwhelmed, misinformed about the nature of treatment decisions, or more generally lacking capacity to participate. In this paper we suggest that patients’ expressions of ambivalence about making treatment choices can be understood otherwise: as efforts to recast the identities and positions they and their physicians are assigned in the organization of cancer care. We also begin to map key features of this organization, particularly discourses of patient empowerment, and evidence-based medicine. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines the provision of mobility options being one of the important policy areas vital to addressing transportation accessibility of the elderly. A provincial analysis, taking the case of the Province of Ontario in Canada, is warranted given that the country’s highly decentralized system puts provincial policies at the forefront in meeting this challenge. The paper evaluates the important progress made in this policy area and stressed the need to go beyond the traditional policy focus on the less able-bodied elderly and consider the increased heterogeneity of the elderly population with respect to lifestyle, preferences, resources, health and physical abilities. While significant efforts have been made, a more explicit recognition of population aging in Ontario’s transport policy motivation that could strongly influence transport strategies and investments attuned to the mobility concerns in an aging society remains to be seen. The paper summarizes the general concerns in the literature, policy developments, and the challenges in crafting solutions in terms of policy and research for Ontario and other regions with similar institutional setup. [ABSTRACT FROM AUTHOR]

Abstract: Utilizing the empirical study of four ‘New Urbanist’ housing schemes, this paper seeks to unpack the emergence, legitimisation, contestation and subsequent hybridisation of New Urbanism in urban and suburban Toronto. Conceptually, the paper builds on the observation that in order to understand the circulation of New Urbanism as a global movement, it is necessary to first de-universalize the processes; to view it as a globally circulated idea that crucially is co-constituted by the practices of situated interpretative communities of development and planning actors. The situated complexities of New Urbanist production in Greater Toronto are used as a critical lens to understand the constrained dynamism of the regional development and building culture which is relationally assembled through regulatory, industry and ideological practices. New Urbanism is re-positioned as a localized and politicized housing response to suburban growth management and urban intensification agendas that is unevenly supported in terms of market acceptance, historical precedence, technocratic planning and product design flexibility. [Copyright &y& Elsevier]

Mode choice models used for travel demand forecasting generally include “major” transportation modes of driving, ridesharing, walking, and riding public transit. In the Toronto Area, these make up 96% of all trips. This paper describes the challenge of realistically modeling “minor” modes, while maintaining behavioral realism in the rest of the model. This is critical to public policy since increasing the mode share of bicycling, commuter rail, and school bus has the potential to reduce emissions, save on expensive auto infrastructure, encourage healthier lifestyles, reduce congestion, and support liveable communities. The tour-based model presented in this paper simulates household interactions as part of the mode choice process. Model parameters are estimated using a choice-based sample of tours in the Toronto Area and a genetic algorithm. The model shows very good results for commuter rail and school bus modes, but limited success for the drive access subway, taxi, and bicycle modes. Representation of niche markets through restricted choice sets allows for a parsimonious utility function that includes level of service, land-use, activity, and socioeconomic variables. [ABSTRACT FROM AUTHOR]

Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population. [ABSTRACT FROM AUTHOR]

This paper compares the founding of the elementary school systems of Ireland and Ontario in the nineteenth century. The systems shared a common set of textbooks that had originated in Ireland. Using examples from a number of these books, which were part of a series that had been specially prepared for the Irish national school system, founded in 1831, and information from archive sources on policy and administration in both countries, the paper argues that there was a common, 'universalist', imperialist ideology being promulgated in both systems. The article focuses on these 'universalist' principles rather than undertaking a detailed analysis of the textbooks. [ABSTRACT FROM AUTHOR]

The City of Edmonton’s Drainage Operations branch oversees the inspection, maintenance, and repair of the city’s drainage network. This network covers an area of 700.6 km2 to serve the city’s growing population of nearly 1 million people. The activities performed by this division consume a large amount of funding and are, therefore, receptive to improvements in productivity. The study presented in this paper was conducted to develop improved work methods and engineered productivity standards for the various drainage operations. The study focused on six crews, which accounted for over 25% of the total drainage operations budget. The six crews were divided based on their respective duties: (1) cleaning mains by low pressure flushing (LPF); (2) cleaning mains by high pressure flushing; (3) scheduled mechanical cleaning of catch basins (CBC); (4) inspecting mains by televising; (5) commercial establishment investigation; and (6) service-line rodding and televising. The study utilized the concept of work simplification and focused on two crew activities—LPF and CBC work tasks—to improve crew work methods, to develop an established work standard, and to verify the proposed improvements based on the simulation model’s output. These activities are described in greater detail in two case studies. The work measurement concept was implemented to develop engineered productivity standards for the remaining crews in order to improve their productivity as well. This paper describes the application of an industrial engineering philosophy of work measurement—lean production theory—and the technique of simulation analysis to capture current work methods, generate and test alternative methods, and develop new productivity standards for drainage maintenance operations crews. [ABSTRACT FROM AUTHOR]

The objective of this paper is to explore the ways in which diversity is taken into account in the conceptualization, definition and role of the voluntary sector as well as policy debates around the recasting of relations between the state and the voluntary sectors. The paper is based on a study of voluntary sector organizing among lesbian, gay, bisexual and transgender (LGBT) citizens in the city of Toronto. It presents an overview of LGBT voluntary sector organizing in the city, demonstrating the rich network of non-profit organizations that serve the LGBT community in the city of Toronto, Canada's largest city. The paper argues that the dominant cross-national and cross-time definitions of the voluntary sector do not account for some of the specific features of LGBT organizing and result in the marginalization of such organizing from the very concept of the voluntary sector. The paper discusses the implications of this mapping for policy discussions of the state–voluntary sector relationship. Drawing on the Canadian experience of government consultation with voluntary sector organizations, the paper demonstrates that such initiatives define certain forms of diversity in voluntary sector organizing out of the policy-making process. Traditional policy-making around voluntary sector issues is organized in ways that exclude urban and local identity-based organizing. [ABSTRACT FROM AUTHOR]

After the election of a neo-liberal provincial government in 1995, Ontario was at the forefront of work-based welfare reform in Canada. Many of the sweeping reforms carried out under the banner of the“Common Sense Revolution” received widespread coverage: for example, reductions in welfare rates, the introduction of the Ontario Works programme, the adoption of a zero-tolerance policy for so-called welfare fraud, and changes to the rules relating to common-law spousal relationships. However, much less attention has focused upon significant changes to the ways welfare is delivered. This paper critically interrogates a number of key changes to the Service Delivery Model in Ontario. After the passage of federal legislation in 1995, national entitlements to welfare have been terminated, replaced with local responsibility; this decentralization is changing not only the hierarchy of the regulation of poor people, but also the form and function of provision. In particular, there is evidence of the reinvention of administration towards the micro-regulation of job search and personal behaviour and the deterrence of welfare receipt as applicants and recipients are bureaucratically disentitled. Although administrative practices have historically acted as a secondary barrier to welfare receipt, the paper suggests that the current incarnation of work-enforcing reforms could be especially significant as the worlds of welfare and work continue to change. [ABSTRACT FROM AUTHOR]

Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental health. [ABSTRACT FROM AUTHOR]

Canadian studies have examined patterns of sexual behaviour and health based on age, gender, and geographical regions, but typically ignored the increasing ethnic diversity in Canada's population. In large part this is because sampling techniques tend to produce insufficient numbers of youth in specific ethnic groups for detailed analysis. This paper presents a profile of the sexual experiences of African, Caribbean, and Black (ACB) youth using data collected in a survey (n = 510) with ACB youth age 16-25 years living in the Windsor/Essex County region of Ontario, Canada. Data were examined for differences among the three ethno-racial groups in combination with differences between Muslims and Christiana, and males and females. In this predominantly heterosexual sample (95%), nearly 3/4 of the Black and Caribbean youth reported sexual intercourse experience compared to well under 1/2 of the African youth. Overall, African were less experienced than Caribbean and Black youth and, within the African group, Muslim less than Christian youth. This included age of initiating various sexual activities, number of partners, use of condoms, and experiences of either non-volitional or non-relational sex. Alcohol in connection with sexual activity and multiple partners within a single month were rare. The Black and Caribbean participants reported sexual experiences and had a sexual profile that was closest to that of Canadian youth. Given the increasingly multicultural profile of Canada, these findings support the importance of research on distinct ethno-racial groups in Canada to inform the delivery of sexual education and health policy and programming. [ABSTRACT FROM AUTHOR]

Background This paper reviews what is currently known about mortality among Canadians with intellectual and developmental disabilities and describes opportunities for ongoing monitoring. Methods In-hospital mortality among adults with intellectual and developmental disabilities in Ontario was examined using hospital data. Mortality was compared between age-, sex- and residence area-matched groups of Manitobans with and without intellectual and developmental disabilities using linked administrative data. A retrospective cohort study of mortality among individuals with intellectual and developmental disabilities in a region of Ontario focused on measuring excess mortality and risk factors. Findings There is evidence of excess mortality in persons with intellectual and developmental disabilities in Canada. Some of the excess is attributable to comorbidities that are more common in this population. Women may have a greater risk of death than men. Excess mortality occurs at all ages but is more pronounced in early life. Discussion High-quality ongoing monitoring of mortality among individuals with intellectual and developmental disabilities is possible in Canada. Examination of sex differences should be a priority. [ABSTRACT FROM AUTHOR]