Migrants’ wellbeing and use of information and communication technologies.

The number of migrants is increasing worldwide coupled with an ever-expanding entrenchment of information and communication technologies (ICTs) in the fabric of daily life. There has been little attention in the health disciplines to the unique ways migrants adopt and are influenced by ICTs across multiple local and transnational social spaces. This scoping review explores the current evidence on migrants’ ICT-mediated transnational social activities and related influences on wellbeing. The review was conducted using Arksey and O'Malley’s (2005) methodological framework and a total of 37 articles were included for the final study. Key findings highlight barriers and facilitators of ICT use in transnational contexts, types of ICT-mediated transnational social activities; and reported influences on migrants’ wellbeing. Migrants’ ICT use facilitates reciprocal channels of social support and continuation of valued social roles. Social role disruption, unequal exchange of social support, and mismatch between migrants’ expectations around ICT use and that of left-behind communities are some of the negative processes with psychological, social, and emotional consequences identified in the review. Main review conclusions emphasize the need to further explore the quality and intensity of ICT-mediated social influences on migrants’ wellbeing and to incorporate a transnational lens in the design of digital learning interventions targeting vulnerable migrant populations.

Tackling pain after cardiac surgery: It takes a village!

There 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.

Mental health crisis and spatial accessibility to mental health services in the city of Toronto: A geographic study

Mental illness includes a wide range of disorders that affect mood, thinking, behaviour and overall wellbeing. One in five Canadians has mental health care needs, many of which are unmet. Within the City of Toronto, the provision of specialized mental health care is delivered by over 100 public and private community service organisations and over 700 physicians with a psychiatric specialization - each providing community-based general or specialised care to residents in need. Research has shown that travel distance is an enabling factor of health service utilisation, thus equitable spatial access to services remains a key priority. Using spatial quantitative methods, this study examines potential spatial accessibility to both general and specialized mental health services within the City of Toronto, and levels of statistical association between access to care and prevalence of mental health crisis events. The main datasets analyzed including geo-referenced Census data and occurrence data on mental health crisis (represented by apprehensions under the Mental Health Act undertaken by the Toronto Police Service). The enhanced two-step floating catchment area (E2SFCA) method is used to model spatial accessibility to mental health services based four modes of transportation: driving, walking, cycling and public transit. Areas that are underserved by mental health specialists and mental health community services are identified and shown to have different socioeconomic characteristics. The study reveals spatially explicit patterns of access to various mental health services in Toronto, providing detailed data to inform the planning of and policy on mental health care delivery concerning severe mental health crisis.

Mental health seeking behaviour of women university students: An intersectional analysis

This 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.

Illuminating five possible dimensions of self-care during the COVID-19 pandemic

Introduction: Self-care is about taking care of yourself. It is a proactive action involving steps to develop, protect, maintain and improve health, wellbeing or wellness. Self-care can be seen as a repertoire of practices – different things you do that help you care for you, no matter how small. It is an act of treating yourself like you would a close friend. The importance of valuing self-care has not changed in light of the COVID-19 pandemic, in fact more awareness and appreciation for what one can do to empower yourself may indeed be valued more. Methods: In this paper, I draw on data from 53 participants aged over 18 years who responded to an online qualitative questionnaire between the months of May to June in 2020. Poetry derived from all the participants has been generated to both represent their voice and to provide a provocation that ignites our heart and mind to consider what is good in life. Results: To further conceptualise self-care, five possible dimensions of self-care (mindfulness, self-compassion, habits, time and agency) are suggested and the aspects within these dimensions are described juxtaposed with poetic representation that illuminates practices and mindsets engaged with during a pandemic. Conclusions: When thinking about self-care across five possible dimensions, this framework becomes useful for capturing a holistic and authentic view of both proactive actions and the variety of practices that can be engaged with. Empowerment is possible in partnership with self-compassion and awareness, where a self-kindness supports proactive decisions to be made on a daily basis that support wellbeing. Central is that no matter one’s situation, difficulty and suffering during a pandemic, gratitude and awareness for oneself is possible.

Engaging in a newspaper cartoon thematic analysis to understand the socioeconomic, health, political, and environmental impact of COVID-19 in Sri Lanka

Introduction: Newspaper cartoons are viewed as an effective means of communicating important social concerns. Method:An exploratory content analysis of newspaper cartoons was done during the COVID-19 outbreak in Sri Lanka . Cartoons from eight daily online newspapers published from 15th of March to 15th of April 2020 were included. “corona”, “COVID-19”, or “Sri Lanka” were used as keywords. Thematic analysis was used to identify the different perspectives of cartoons. Results: Background of COVID-19 pandemic, health, social, economic, political, and environmental aspects emerged within a sample of 87 cartoons. Thirteen common themes were identified as COVID-19 as a pandemic, COVID-19 has become a crisis for Sri Lanka, prevention is the priority, knowledge deficit leads to breaking health advice, efforts to control virus outbreak, shifting socio-cultural practices, effects of lockdown, rich man’s virus – poor suffer the most bringing the global economy to its knee, coronavirus is driving the black market for essential stuff, seeking strategies to hold the election, applying health precautions in election activities and other political involvements. Conclusion: Cartoons were effectively used to give broad health and other messages to the public during the COVID-19 outbreak in Sri Lanka. Newspaper cartoons can be used as an effective mode of disseminating information during a crisis.

Mental health Apps to address inequitable access to care in specific regions of the global North and South: A scoping review

Introduction: 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.

Perspectives of service agencies on factors influencing immigrants’ mental health in Alberta, Canada

Newcomers to Canada experience resettlement challenges that affect their mental well-being. Guided by an intersectionality theoretical framework, we sought the perspectives of immigrant service agencies on factors influencing immigrants’ mental health in Alberta, Canada. Data were collected by means of qualitative interviews and focus groups with immigrant service providers. Our data analysis identified seven themes – precarious immigration status, employment discrimination, social isolation, socioeconomic pressures, sociocultural stress, gender and age-related vulnerabilities, and lack of appropriate mental health supports – reflecting the major intersecting determinants of immigrants’ mental health. We propose policy interventions for addressing the mental health vulnerabilities of immigrants.

Considerations for the design of a perinatal mindfulness intervention for adolescents based on a systematic review of the literature

Objectives: This systematic review of the literature was conducted to determine the best way to design mindfulness interventions for perinatal adolescent mothers to support mental health during the transition to parenthood and beyond. Perinatal adolescents face unique challenges compared to adults due to their developmental stage and difficulties accessing social determinants of health. Mindfulness educational interventions may be an ideal addition to perinatal supports to foster resilience and teach skills to reduce stress, anxiety, and depression. Methods: A search strategy was developed to identify articles from 6 electronic databases including PsycInfo, ProQuest, PubMed, Cochrane Library, Ovid, and CINAHL. Qualitative analysis was done to identify mindfulness interventions which significantly decrease anxiety, depression or stress and to determine the components and designs of these interventions. Participants’ satisfaction with the interventions were analyzed, when available. Best practices for designing interventions for adolescents were used to recommend adaptations to the mindfulness interventions to tailor them to the perinatal adolescent population. Results: Of the 561 studies retrieved from the search, 16 met the inclusion criteria. All included studies found at last one significant decrease in mental health outcomes (stress 9 of 13, anxiety 9 of 9; depression 9 of 14). The majority of the interventions began in the perinatal period, were delivered face-to-face, included homework, multiple sessions and by a trained professional. Conclusion: Mindfulness interventions are feasible, acceptable and effective in adult perinatal populations. Components and design of these interventions could be adapted for perinatal adolescents to increase resilience to cope with unique parenthood challenges.

“The little lights in this dark tunnel”: Emotional support of nurses working in COVID-19 acute care hospital environments

Background: Working on the frontlines of hospitals during the COVID-19 pandemic has been challenging and distressing for nurses. The troublesome nature of these emotions have surfaced because of uncharted territory related to this virus, compromised work conditions, unfavourable patient outcomes, and the witnessing of suffering and loss. Although there has been renewed emphasis on how to emotionally support nurses, the nature of support needed is somewhat unknown considering that healthcare professionals have not experienced a pandemic of this magnitude in their lifetime. Aim: We explored how nurses were emotionally supported and how they can be better supported while working in COVID-19 acute care hospital environments. Methods: In this narrative study, semi-structured interviews were conducted with 20 registered nurses working in hospitals in the Greater Toronto Area and working on units caring for COVID-19+ patients. Results and Conclusions: Our findings reflected the organic emergence of support, intentional forms of support, and the social justice nature of support. It is important for hospital and government leaders to employ a multifold approach to emotionally support nurses. These supports include information transparency, visible presence of leadership, and recognition of nurses’ contributions. While emotionally supporting nurses, these types of resources can act as “little lights in this dark tunnel” of COVID-19 and illuminate a path forward. Implications: Some strategies relevant to clinical practice include regular rounding of units by leaders, and transparent communication about information and resources. Other strategies are on-site psychological support and legitimate support of mental health sick days as well as lobbying governments for financial compensation for the risky work involved in being a frontline provider and appropriate provision of personal protective equipment.