Toronto Metropolitan University Open Journals
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Barriers and facilitators to providing human immunodeficiency virus pre-exposure prophylaxis decision support to black patients in Canada: a cross-sectional study
No full textIntroduction: Healthcare settings can build towards a specific social environment, in which Black patients can make informed health decisions, including those about whether or not to use PrEP. We utilize self-determination theory for guidance to identify the extent to which current HIV pre-exposure prophylaxis (PrEP) decision support practices from healthcare professionals (HCP) are autonomy supportive. This identifies future developments and implementations of interventions for HCP capacity building to enhance the autonomy of Black patients who are considering using PrEP. Methods: Using a cross-sectional design for examining HCPs\u27 perspectives on delivering quality PrEP usage-related decision support. Through a cross-sectional online survey of 24 HCP from 10 community-based health centers serving in Toronto, Canada, descriptive statistics were characterized in close-ended survey data and sample. Open-ended survey responses were analyzed using Q- sorting methodology. Results: Of the HCP, 40% were willing to provide PrEP decision support to Black-identified patients. HCP reported barriers of needing education about PrEP and available resources (96%) There’s a need for more education and resources to facilitate decision support for Black patients to improve decision support and reduce PrEP uptake disparities. Conclusion: It is imperative that cultural humility in healthcare is upheld to provide informed decision support since not only health conditions vary from patient to patient, but life experiences and background are equally crucial to the health status of that individual. Competence development among HCP can take the forms of providing training to increase cultural humility awareness, knowledge, and skills that can build towards an environment in which Black patients are informed about and for their health decisions
Creation of a remote clinical practice curriculum for first year nursing students: Reflections and lessons learned
No full textIntroduction: A problem-based learning approach using intentionally created client profiles and nursing care summaries formed the foundation of a remote clinical experience for first year undergraduate nursing students. Methods: Using carefully designed client scenarios, care summaries and active learning strategies, students were introduced to the nursing profession and provided the opportunity to develop skills in collaboration, critical thinking, clinical reasoning, and clinical judgement. Results: Based on discussion with students, the remote experience assisted in the development of several skills addressing communication, theoretical foundation, and critical thinking. As well, this experience allowed for the integration and application of newly acquired nursing knowledge, and an enhanced understanding of the role of the professional nurse. Implications: Significant lessons learned may serve other nursing programs around the world as we continue to navigate both current and future public health mandates while managing competing demands for in-person clinical practice sites. Conclusion: Face-to-face clinical experiences remain a critical component of comprehensive nursing education, however, given today’s climate and continued restrictions, a hybrid model, utilizing a remote platform, is worthy of further exploration.
Editorial: Media & Social Engagement
No full textFilm and media practitioners and educators have been expanding the use of digital through new experiences with unusual and innovative technical and artistic “approaches.” Likewise, researchers and academics are questioning and analyzing these new practices that increasingly dominate global society, as seen in the past months with the advent of the worldwide pandemic.
In 2013, we created the IFM-Interactive Film and Media Conference to provide an inclusive educational space within the digital theory and interactive studies where researchers and practitioners could discuss and present their research and work in film and media. With this purpose, the IFM has partnered with universities worldwide and established a space for a global integration between academia and the audiovisual production community that aims to forge a valuable exchange between researchers, faculty, students, practitioners, and the community. The goal is to generate a broad debate, emphasizing the need to evaluate the increasing use of digital screens in contemporary society and how people respond artistically, socially, and politically to the challenges of the digital cultural space.
The work of professors, researchers, and practitioners (artists, filmmakers, and videomakers) from various areas and several countries, including Italy, Brazil, England, Spain, Canada, New Zealand, Portugal, Scotland, Germany, and the United States, constitutes this special issue with selected articles and audiovisuals from the #IFM2014. The aim is to launch IFM Journal first issues while archiving our preliminary works
An application of the ADAPT-ITT model to an evidence-based behavioral HIV prevention intervention for men who have sex with men in Ghana
No full textDespite constituting only about 1% of Ghana’s population, men who have sex with men (MSM) carry a disproportionate burden of HIV infections, constituting 18% of the population of people living with HIV in the country. Scholars have associated the disproportionate infection rates of HIV among MSM with existing structural factors (such as criminalization and stigma against MSM), and individual-level factors (such as sex without a condom, and transactional sex). Nonetheless, limited scholars consider intervention as an approach to reducing HIV and STI risk among MSM in the country. As such, in collaboration with community partners, we engaged MSM through the use of the ADAPT-ITT model to adapt the Many Men Many Voices (3MV) to address the needs of MSM. We addressed HIV/STD risk factors and ways to reduce HIV/STD infections. In this paper, we describe the use of the ADAPT-ITT model in the adoption and adaptation of the 3MV with MSM in Ghana. Whereas the 3MV was a good fit for our target population, we made modifications to fit the Ghanaian cultural setting by examining HIV and STD risk in the context of bisexuality, emphasizing on secrecy in location choice, and incorporating historical colonial setting in contextualizing sexuality and stigma in the Ghanaian sociocultural context. Our implementation process shows the efficacy of collaboration with community partners to implement culturally relevant interventions in HIV and STD prevention efforts in highly stigmatized environments
Invisible diaspora: A scoping review of migrant caregivers’ social integration trajectory
No full textBackground: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequate public policy and programs on child and elder care in Canada. Consequently, migrant caregivers have become an invisible diaspora filling a domestic labour gap with few protections.
Aim and Methods: This scoping review aims to identify the systemic barriers that undermine social integration of migrant caregivers. We searched ten publication index databases from 2001-2020. We retrieved 1,624 articles, after accounting for exclusion criteria, 22 peer-reviewed articles were selected for this review representing migrant women across Canada who are and/or were part of the program.
Results: Four key barriers were identified: economic exploitation, deskilling and downward occupational mobility, asymmetrical accountability, and social isolation.
Conclusion: Discriminatory policies and hidden exploitative employment practices of the Canadian Caregiver program perpetuate a cycle of marginalization. This review also found that community support groups and alliances function to promote resilience among migrant caregivers through community advocacy
Mental health Apps to address inequitable access to care in specific regions of the global North and South: A scoping review
No full textIntroduction: There is a recent growth in the development of mental health applications (MHAPPs) to reduce stigma, improve knowledge and facilitate access to care especially in the area of common mood disorders. Yet, it remains unclear whether such interventions can address the access to care gap equitably in the global North and South. Such understanding could provide insights for mental health innovations during the COVID-19 pandemic as well. Methods: Using Arksey and O’Malley’s methodical framework, a scoping review was conducted on academic and grey literature published during 2015 and 2019. The countries of India and China were selected as exemplar for the global South and Canada and US for the global North. The reviewed literature was synthesized through thematic analysis and employed the social determinants of health lens. Results: 20 articles were selected for full-text review. The results reveal that MHAPPs for depression and anxiety are efficacious in improving symptoms across the examined regions. Outcome scores (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, flourishing scale, social interaction anxiety scale) improved in 13 studies. Yet, public awareness in the global North and logistical barriers (mental health stigma/discrimination, financial and social challenges, usability of apps, and cultural barriers to self-care) in the global South inhibit uptake. Conclusion: Awareness of MHAPPs and logistical barriers must be addressed to make MHAPPs more accessible. Policy makers should be cautious in implementing MHAPPs in disadvantaged communities given several challenges. A broader policy level emphasis is needed to address the logistical capabilities and cultural sensitivity of MHAPPs. The findings are also discussed in relation to the digital innovations for mental health in the pandemic. Given the focus of the presented review on specific regions, the transferability of findings warrant caution
Mental health seeking behaviour of women university students: An intersectional analysis
No full textThis research study explored the mental health seeking behaviour of racialized and non-racialized female students at a large size public university located in Ontario, Canada. A sample consisting of 570 students participated in the cross-sectional survey. The majority (n = 413, 84.1%) were identified as Canadian racialized female students. The remainder (n = 78, 15.9%) were Canadian non-racialized female students, identifying with dominant Canadian culture. We contended that intersectionality, an emergent theoretical and methodological public health framework, provides a powerful tool for understanding these complex interlocking experiences in the context of mental health. High levels of depression and anxiety symptoms were reported by both the racialized non-racialized female students. The proportion of students with CES-D scores > 16 (indicating that may suffer from depression) was higher among the female racialized students (n = 265, 64.2%) than the non-racialized female students (n = 39, 50.0%). Approximately, half of the racialized students (n = 202, 48.9%) had BAS scores > 10 indicating that they may suffer from anxiety. About half (n = 38, 48.7%) of the non-racialized students also had BAS scores > 10 indicating that they may suffer from anxiety. The findings of this research study advocate university governance, healthcare professionals, and counsellors need to improve their services to address the specific needs and concerns of racialized students. Future research should focus on how findings can be translated into practice by designing culturally adaptive treatment modalities, that focus on resolving mental health problems in racialized and non-racialized female students especially in times of crisis similar to the Corvid-19 pandemic
Tackling pain after cardiac surgery: It takes a village!
No full textThere is increasing concern regarding the risk to develop chronic pain after cardiac surgery with potential detrimental effects on recovery and quality of life. With shortened hospital stays after cardiac surgery, there needs to be more emphasis placed on self-management skills and the support provided to patients and their informal caregivers during the subacute phase. A paradigm shift needs to occur on multiple levels to prevent chronic pain and opioid misuse after surgery. Initiating this change means redefining the timing, recipients, and content and format of interventions. Several avenues can be examined and translated in practice to promote a successful transition after cardiac surgery
Emerging Forms of Citizen Video Activism: Challenges in Documentary Storytelling & Sustainability
No full textGilles Deleuze\u27s early reflections on assemblage identify the idea of the diagram or possibility space as a framework to suggest the ways in which the assembling of technology and human practices merge to create distinctive and innovative new assemblages. Yet routinely it is the technological advances of the 21st century that receive the most revered credit for shifts within citizen-based video activism. Essential to the new and often undefined waves of digital documentary birthed in scattered alcoves of social activism and human rights movements are the relationships between the components of these assemblages. Particularly influential are the facilitating agents spearheading the means to digital video literacy that allow these narratives to be shared. Conducted over three years, my Ph.D. research has examined very specific emerging video practices rooted in social activism in a number of global settings. My fieldwork has sought out citizen media makers in order to discuss how these practitioners have approached their nascent video activism with the goal of identifying properties that might allow these surfacing video practices to become sustainable over time. This paper examines and critiques specific elements that these particular forms of video activism confront in their own unique global possibility spaces. Moreover, as traditional methods of video distribution and video recording continue to change even further through online platforms and mobile technology, how might we begin to identify emerging forms of citizen-based video activism and documentary media
Streams of the Self: The Instagram Feed as Narrative Autobiography
No full textThis article offers a working draft of a larger qualitative analysis of the popular smartphone application Instagram. It offers a reading of the ubiquitous contemporary form of self-portraiture, the selfie, locating its origin in the longer evolution of digital photography into a form of social media. Though its function as a basic self-portrait and signifier for our various social profiles appears straightforward, it has somehow become the ‘face’ of online sociality and subjectivity, a portrait of the promise and peril of our online existence. And yet, a closer look at the various feeds and streams in which the selfie appears reveals that it is one genre amongst many, no more or less common than a variety of landscapes, still-lifes, and other modes of photographic observation. Taken together, these various views of the world reveal an emplaced mode of image-driven autobiography, one far more complex and nuanced than a straightforward meme would appear to be.
Image Credit: Jeremy Bishop on Unsplas