Predictors of primary health care utilization by former residents of institutions in Ontario

For years institutionalization has been the primary method of service delivery for persons with developmental disabilities (DD). However, in Ontario the last institution was closed on March 31, 2009 with former residents now residing in small, communitybased homes. This study investigated potential predictors of primary health care utilization by former residents. Several indirect measures were employed to gather information from 60 participants on their age, health status, adaptive functioning level, problem behaviour, mental health status and, total psychotropic medication use. A direct measure was used to gather primary health care utilization information, which served as the dependent variable. A stepwise linear regression failed to reveal significant predictors of health care utilization. The data were subsequently dichotomized and the outcomes of a logistic regression analysis indicated that mental health status, psychotropic medication use and, an interaction between mental health status and health status significantly predicted higher primary health care usage.

Educational issues perceived by expectant lesbian couples /

Despite the increasing public profile of lesbian childbearing, public health resources for expectant women often bear heterosexist assumptions and create barriers to accessing information relevant to lesbian mothering experiences. This descriptive, exploratory study examined one lesbian couple's perceived educational needs for effective support, barriers to access, strategies for locating care, and the impact of childbearing on their lives, as well as their reflections on inviting ways to offer supportive practices in a public health context. A case study approach used feminist ethnographic methodology and purposeful convenience sampling. A prenatal and a postnatal open-ended interview were completed with 1 white, middle-class, able, lesbian childbearing couple, each ofwhom has birthed as coparent and biological mother in this couple relationship. Despite this couple's immense situated privilege, they struggled to locate the support they sought for childbearing in a way that offered optimal emotional and physical care from the preconceptual to postpartum stages and which maintained confidentiality or anonymity as desired. They created meaningful care through personal networks. The findings were framed using invitational and feminist theories: how people, places, programs, processes, policies, and politics contributed to educational support. A three part conceptual framework emerged which identified components of access to support: perceived safety of resources, disclosure status, situated privilege, and public or private availability of information. The consequences of lack of public access to comprehensive childbearing care for lesbian women and their communities are described. Educational possibilities addressed systemic heterosexism through the development of sensitive educators, meaningful curriculum, program planning, explicit policies, community partnerships, and political leadership with respect to both institutional and research venues.