Learning Partnership

Canadian adults are at high risk of chronic diseases from physical inactivity, excessive sedentary behaviour, and poor sleep. Understanding the social-ecological correlates of these behaviours is essential for informing public health interventions. This study examined social-ecological correlates of adherence to the Canadian 24 h Movement Guidelines among parents during the second wave of the COVID-19 pandemic (December 2020). We used baseline data from an online longitudinal survey investigating Canadian parents' adherence to 24 h movement behaviours guidelines. Each guideline was dichotomized as met versus not met for multivariable binary logistic regression models identifying correlates of adherence to sleep, sedentary behaviour, physical activity, and the integrated guidelines (p<0.05). Only 92 (4.0%) of the 2278 participants (64.6% women; 41.14±7.38 years) met the integrated guidelines. Active travel to work compared with working from home or being unemployed increased the odds of meeting the integrated guidelines, odds ratio (OR) = 3.92, p=0.002. While living in the Prairies (OR=0.35, p=0.030), Ontario (OR=0.32, p=0.010), or Quebec (OR=0.26, p=0.004) relative to the Atlantic region, and having one additional adult in the household (OR=0.55, p=0.007), decreased the odds. Participants from households with a COVID-19 diagnosis or isolation were more likely to meet physical activity but not sleep guidelines. Vehicle ownership and COVID-19-related concerns were not significantly associated with adherence. The findings highlight the need for targeted interventions that promote active commuting and expand employment opportunities. Policymakers and practitioners should prioritize measures to support active travel that are sensitive to the needs of parents and families.

Background: The global decline in adolescent reading culture, intensified by digital media proliferation, presents a significant pedagogical challenge. School libraries are posited as vital antidotes, yet their efficacy hinges on access, quality, and guided mediation. This is particularly critical in exam-oriented educational systems like Pakistan's. Objectives: This study aimed to (1) explore how secondary students utilize school library reading materials, (2) determine the quantitative relationship between library use and reading culture development, and (3) investigate the mediating role of English Language Teachers (ELTs) in this process. Methods: A convergent mixed-methods design was employed in a private secondary school in Karachi. Quantitative data from 80 students were collected via a closed-ended survey and analyzed using descriptive statistics, Pearson’s correlation, and linear regression in SPSS (v23). Qualitative data from 25 ELTs were gathered through open-ended questionnaires and analyzed using thematic analysis. Results: Quantitative analysis revealed a significant positive correlation between library use and reading culture (*r* = .421, *p* &lt; .000). Regression confirmed library use as a significant predictor (β = .421, *p* &lt; .000), explaining 17.7% of the variance in reading culture. Students primarily used the library for academic tasks (assignments: 85%, research: 78%). Thematic analysis of teacher responses yielded seven core themes: (1) Teachers as Motivators and Guides, (2) Facilitating Physical Access, (3) Student Perception as an Academic Resource, (4) The Digital Disruption, (5) Systemic Constraints, (6) Collaborative Advocacy with Administration, and (7) Pedagogical Integration of Library Resources. Conclusion: While school library use significantly impacts reading culture, its potential is largely confined to academic reinforcement due to systemic constraints: insufficient library periods, outdated collections, and an exam-centric syllabus. ELTs are active, willing mediators but require structured institutional support. Cultivating a genuine, pleasure-based reading culture necessitates a tripartite strategy: administrative investment in relevant, diverse library stocks and schedule allocation; teacher-led pedagogical innovation; and a conscious effort to balance academic and leisure reading within the school ecosystem.

Psychosis among youth who use drugs in the context of entrenched poverty is often addressed through aggressive forms of psychiatric intervention. Clinicians must carefully consider the benefits and drawbacks of this approach with this population because of how institutionalization and the sedating and numbing effects and affects of antipsychotics may be distinctly constraining. This study aims to increase understanding of the benefits, drawbacks, and socio-material and political contexts of antipsychotic treatment for youth who use drugs. We draw on in-depth, longitudinal qualitative interviews conducted between 2018 and 2021 with 116 youth who used drugs while contending with entrenched poverty in Metro Vancouver, Canada. Our analysis leverages a reflexive thematic approach and ideas from critical psychiatry and mad studies. We begin by outlining a 'psychopolitical landscape' wherein youth could become swept up in mental health certification and antipsychotic treatment with particular and oftentimes negative effects and affects. We then explore how, in the constant shadow of this psychopolitical landscape and socio-material deprivation, youth often sought to balance slippages away from and toward more stable senses of reality engendered by regular stimulant use. Finally, we examine how young people's lived experiences of stimulant use and psychosis shaped their psychiatric treatment trajectories, including through dynamics of refusal, self-management, and performed sanity under the gaze of the psychopolitical landscape. From these findings, we underscore the need to prioritize self-determination - as much as is possible and safe - and equity-focused approaches that address the socio-material conditions of youths' lives in mental health and substance use care. Providers should continually open conversations with youth about lived realities of substance use and psychosis alongside broader desires for the future, finding ways of working with youth within and beyond psychiatric treatment.

ObjectiveUnderstanding differences in outpatient care before and after mental health hospitalization for adolescents from diverse backgrounds is critical to ensuring effective and responsive care. The objective of the current study was to examine outpatient mental health care in the two years before and 30 days after a mental health hospitalization for adolescents from immigrant, refugee and non-immigrant backgrounds.MethodThis retrospective, population-based cohort study, conducted in British Columbia (BC), Canada, analyzed linked health service utilization data (practitioner billings, hospitalizations) and migration records to track outpatient care before and after mental health hospitalization. The study included adolescents (ages 10–18) with an unscheduled/urgent mental health hospitalization between January 1, 2008 and December 31, 2016 (n = 5,314) from a cohort of adolescents in 10 of the largest school districts in BC (between 1996 and 2016). The main analyses examined outpatient mental health visits (e.g., general practitioner/psychiatrist) (i) in the two years before hospitalization and (ii) in the 30 days after discharge. Sub-analyses focused on outpatient visits with psychiatrists.ResultsOverall, 30.4% had no outpatient mental health visit in the two years before hospitalization and 45.1% had none in the 30 days following discharge. First-generation immigrants and refugees and second-generation immigrant adolescents were significantly less likely than non-immigrants to have had an outpatient mental health visit in the two years before mental health hospitalization (aOR1st_gen_immg = 0.79, 95% CI, 0.63 to 0.98; aOR2nd_gen_immg = 0.75, 95% CI, 0.61 to 0.93; aOR1st_gen_ref = 0.40, 95% CI, 0.26 to 0.64). Second-generation immigrant adolescents were significantly more likely than non-immigrants to have had any outpatient mental health visit in the 30 days following hospitalization (aOR2nd_gen_immg = 1.34, 95% CI, 1.09 to 1.65).ConclusionsResults suggest outpatient care before and after mental health hospitalizations is limited for many adolescents in BC and differed by migration background. Implications for meeting standards of care are discussed.Plain Language Summary TitleMental health-related care from a doctor/psychiatrist before and after mental health hospitalization for adolescents from immigrant, refugee, and non-immigrant backgrounds in British Columbia

ABSTRACT:This paper focuses on the development of a viable business model for the PISCES Living Lab, which seeks to address plastic pollution in Indonesia. The overarching aim is to transition it from a project-based initiative to a self-sustaining service enterprise. The paper introduces a new modified engineering design process as a workshop template to guide an interdisciplinary team in creating a business model for a service-oriented living lab. A four-day workshop was conducted in Banyuwangi, Indonesia, involving a diverse group of stakeholders from the project, and the final outcome was the creation of a Business Model Canvas outlining the core components of the PISCES Living Lab’s business model. The findings demonstrate the effectiveness of integrating the engineering design process with business model innovation, offering a structured yet flexible approach to developing self-sustaining Living Labs.

Breast cancer is as frequent in women with intellectual disabilities as the general population, but the mammography uptake rate for women with intellectual disabilities is almost a third lower. This meta-synthesis aimed to explore physical and psychosocial barriers to mammography access for women with intellectual disabilities from the perspectives of the women themselves, healthcare professionals, paid carers and family members. A systematic search of six databases yielded 12 papers for thematic synthesis review. Three analytic themes were developed: (i) knowing what to expect; (ii) knowing who will assume responsibility and (iii) making adjustments. Mammography screening elicits anxiety from both women with intellectual disabilities and their supporters (whether paid, family or healthcare professional). A formulation-based approach to mammography attendance may help to provide tailored information to women with intellectual disabilities, whilst easing the pressures placed upon their support network and healthcare professionals.

Despite growing attention to child and youth mental health, knowledge gaps exist related to how mental disorders vary for children and youth from diverse backgrounds. The purpose of the present study was to investigate how conduct, attention deficit hyperactivity disorder (ADHD), and mood/anxiety diagnoses varied by immigrant, refugee, and non-immigrant background in British Columbia, Canada. The study utilized population-based, linked administrative data for nearly half a million children and youth (N = 470,464) between 1996 and 2016 (ages 3 to 19) to examine variations in mental disorder diagnosis (defined via administrative health data records) by immigrant generation and admission category (economic, family, refugee) and the predictive/moderating effects of key socio-demographic factors (e.g., sex, socioeconomic status). Findings indicated that first- and second-generation children and youth were less likely to receive a mental disorder diagnosis compared to non-immigrant children and youth. Those in the refugee admission category had higher odds of conduct and mood/anxiety disorder diagnosis and those in the family admission category had higher odds of conduct, ADHD, and mood/anxiety disorder diagnosis (versus the economic admission category). Significant interactions revealed that sex at birth and socioeconomic status differently predicted mental disorder diagnoses for children and youth from immigrant and refugee backgrounds (versus non-immigrant). The findings contribute to a more nuanced understanding of mental disorder diagnoses for children and youth from diverse backgrounds and that well-established predictors of mental disorders for the general population (i.e., sex, SES) differ for children and youth from immigrant and refugee backgrounds.

Illicit drug toxicity is an escalating public health emergency. Usually framed as an adult issue, adolescents are significantly impacted. Little is currently known about the interface between Canadian paediatric physicians and adolescents experiencing severe health events from illicit drug toxicity. (1) To determine the proportion of paediatricians in Canada who care for young people between 12 and 18 years who have managed cases of illicit drug toxicity; (2) to identify the characteristics of paediatricians that provide this care; and (3) to describe respondents' awareness of substance use-oriented services for youth in their home communities. A one-time descriptive cross-sectional study was conducted from May to June 2022. Clinicians self-reported cases of illicit drug toxicity from opioids, stimulants and sedatives for adolescents 12 to 18 years old over the preceding 24-month period. Respondents also self-reported their knowledge of substance use-focussed services for children and adolescents in their communities. A total of 1027/2791 (response rate 37%) physicians completed the survey. Most respondents (n = 934, 91%) reported providing medical care to children and youth 12 years of age and over. 128/934 (13.7%) reported caring for at least one case of illicit drug toxicity. The majority of case reporters were general paediatricians (43%). Overall awareness of substance-related services was limited. A considerable proportion of respondents provided care for illicit drug toxicity over 24 months. This contrasts with a relatively low level of awareness of services for substance use in this population. Further research and education can support patients and physicians alike in the care of adolescent illicit drug toxicity.

In this reflective article, the evaluation team for the NASA-funded SciAct STEM Learning Ecosystems project discusses the process we used to study four exemplar STEM learning ecosystems in regions across the US using culturally responsive evaluation (CRE) methods. We expected to follow a linear path for each of the study’s three inquiry cycles but found that this process needed to be fluid because of the culturally responsive evaluation methods employed. These methods meant we shared control with the project team in ways we had not before and had to rethink study validity and rigor. Beyond the evaluation team, this article shares reflections from the project team as well as the study’s external evaluation advisor about what it was like to participate in a study that used CRE methods.