Exploratory study of the use of community treatment orders with clients of an Ontario ACT team

ABSTRACT

Community Treatment Orders (CTOs) have raised questions about coercion, lack of autonomy, and effectiveness in reducing hospitalizations and improving service users’ quality of life. This study examined the experiences of clients and clinicians when CTOs are used in combination with Assertive Community Treatment (ACT) in a recovery oriented approach. Eleven clients who were or had previously been on a CTO and eight ACT clinicians were interviewed. Although most clients had negative feelings about CTOs, some acknowledged their lives had improved. Clinicians reported that the decision to employ a CTO is sometimes debated within the team but they agreed that combining CTOs and ACT resulted in regular access to mental health supports, fewer hospitalizations and overall improvement of quality of life for their clients.     

Navigating healthcare: gateways to cancer screening

This article is the first phase in the Gateways to Cancer Screening project – a user‐driven participatory research project that examines barriers and facilitators to preventive cancer screening for women with physical mobility disabilities. Through a systematic review of the existing literature on this subject we discover that, despite the fact that women with disabilities have the same biological risk of developing cancer as non‐disabled women, women with mobility impairments face systemic, architectural, procedural and attitudinal barriers to preventive cancer screening. Our goals are to identify barriers and facilitators to screening, identify the gaps in the existing literature related to issues of diversity and ultimately set the stage for disabled women to effect change through the telling of their own stories.     

From stress to distress: Conceptualizing the British family farming patriarchal way of life

‘Rural stress’ and ‘farming stress’ are terms that have become commonly appropriated by British health-based academic disciplines, the medical profession and social support networks, especially since the agricultural ‘crises’ of B.S.E. and Foot and Mouth disease. Looking beyond the media headlines, it is apparent that the terms in fact are colloquial catch-alls for visible psychological and physiological outcomes shown by individuals. Seldom have the underlying causes and origins of presentable medical outcomes been probed, particularly within the context of the patriarchal and traditionally patrilineal way of life which family forms of farming business activity in Britain encapsulate. Thus, this paper argues that insufficient attention has been paid to the conceptualization of the terms. They have become both over-used and ill-defined in their application to British family farm individuals and their life situations. A conceptual framework is outlined that attempts to shift the stress research agenda into the unilluminated spaces of the family farming ‘way of life’ and focus instead on ‘distress’. Drawing upon theorization from agricultural and feminist geography together with cultural approaches from rural geography, four distinct clusters of distress originate from the thoughts of individuals and the social practices now required to enact patriarchal family farming gender identities. These are explored using case study evidence from ethnographic repeated life history interviews with members of seven farming families in Powys, Mid Wales, an area dominated by family forms of farming business. Future research agendas need to be based firmly on the distressing reality of patriarchal family farming and also be inclusive of those who, having rejected the associated way of life, now lie beyond the farm gate.     

The mommy wars: on the home front and waged abroad

Anne-Marie Slaughter’s Atlantic article “Why Women Still Can’t Have It All,” published in 2012, generated huge response, well beyond what already has become typical in the intensifying mommy wars in the United States. It also drew considerable attention globally. Within one week of publication, Slaughter’s “lament” attracted a million readers. Slaughter’s explanation of why she quit her high powered job, and then Yahoo’s choice of the then-pregnant Marissa Mayer as its new chief executive, provoked another round of mommy wars. The research reported here on how journalists dealt with the controversy compares the US, with its tradition of heated controversy over working mothers and neoliberal opposition to structural supports for families, and Israel, where attention to Slaughter was somewhat surprising, given the presumption in Israel that mothers will work outside the home. Journalistic discourse in both countries tended to frame the work–home conflict as a women’s issue, to be addressed by women journalists, and not men. Moreover, writers tended to address the issue anecdotally, in terms of personal experience but ignoring structural issues and structural solutions and ignoring how solutions for middle-class professional women or women at the “center” may not work for other kinds of women.     

Strategies for origin-based surveying of international migrants

This paper addresses methodological challenges of investigations of international migration, including difficulties in obtaining information about representative samples of migrants and both their origin and destination location. Our project used an origin-based sample with a destination-focused survey and interviewed 91% of migrants from a community in Nepal to any destination and shares techniques employed. Our procedures and high response rate constitute a significant improvement in survey methods that permit the creation of unbiased data on migrants and allow the study of migration in conjunction with origin communities.     

A historical account of the governance of midwifery education in Australia and the evolution of the Continuity of Care Experience

Background

Midwifery programs leading to registration as a midwife in Australia have undergone significant change over the last 20 years. During this time accreditation and governance around midwifery education has been reviewed and refined, moving from state to national jurisdiction. A major change has been the mandated inclusion of Continuity of Care Experiences as a clinical practice-based learning component.

The role of ‘workplace family’ support on worker health,exhaustion and pain

The goal of this study was to improve understanding of the potential health benefits of social support at work. We utilized 2002 GSS data to examine the relative influence of workplace support on self-reported health, exhaustion and experience of persistent pain in a sample of 1602 workers. Building on previous Demand-Control-Support models, we examined co-worker, supervisor, and organizational safety support (conceptualized as ‘workplace family’) in concert with job demands, job control and work-family conflict as predictors of worker health measures. We further tested the extent to which work-family conflict acted as a mediator between family and work characteristics and worker health outcomes. We found that increased co-worker support in the workplace was associated with better worker self-reported health, lower exhaustion and less pain. In addition, higher levels of perceived organizational safety support were associated with better self-reported health and lowered exhaustion. There is little evidence that work-family conflict mediates between work and family characteristics and worker health, and work-family conflict does not mediate the relationship between workplace family measures and worker health. We discuss results in light of workers’ changing and expanding definitions of family, with implications for changes in the organization of the workplace to improve workers’ health.     

Unlocking the racialized and gendered educational experiences of South Asian females in Hong Kong: the case study of Pakistani girls

Educating South Asians with different language and cultural backgrounds and integrating them into mainstream society have been a challenge for the educational system of Hong Kong. This study documents the educational experiences of a group of Pakistani girls in the contexts of home, community, and school in Hong Kong. Using ethnographic methods, data collection is based on interviews evoking their life stories. These stories recount how Pakistani girls attempt to negotiate with traditional customs, religion and mainstream stereotypes and to construct racialized and gendered schooling experiences. This study highlights the importance of mainstream engagement in regard to critical learning about cultural and linguistic diversity. It is claimed that minorities have an active role as agents in social transformation and change in achieving racial and gender equality, in this case for the most disadvantaged minority females, within the asymmetrical power relationships between local Chinese and South Asian minorities in Hong Kong.