Community intervention strategies to reduce the impact of financial strain and promote financial well-being: a comprehensive rapid review.

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May-September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.

The lived experience of paroled offenders with fetal alcohol spectrum disorder and comorbid psychiatric disorder.

This case study presents the life history and postincarceration experiences of two forensic psychiatric patients diagnosed with comorbid mental illness and fetal alcohol spectrum disorder (FASD). The men first met in prison and a few years after their release became roommates at the suggestion of their community support worker and parole officer. With shared and coordinated clinical and mentorship supports, the men were able to establish stability in their lives and manage their mental illness. However, changes in support and gaps within the continuum of care contributed to a sudden breakdown in their stability. The life history and experiences of the two men illustrate the importance in establishing and maintaining positive social networks and coordinated supports for the postincarceration success of offenders living with FASD and comorbid mental illness. The findings highlight areas of patient and system vulnerability that should be addressed to reduce recidivism and strengthen the stability in the lives of these individuals.

Sleep tight: exploring the relationship between sleep and attachment style across the life span.

Based on early life experiences in which developmental, genetic, and environmental components interact, humans learn to trust themselves and others and connect emotionally in consistent ways that are broadly defined as "attachment styles." These relatively stable patterns of interpersonal interaction are associated with either vulnerability to various health risks or resilience. Similarly, the mechanisms involved in sleep regulation undergo developmental changes that overlap temporally with attachment formation and remain sensitive to a series of biological, environmental and psychological influences. Interestingly, while sleep has been conceptualized as a fundamental attachment behavior given its dyadic context, few studies have explored its relationship with attachment style in various ages. We present the first systematic review of the published literature examining the relationship between attachment style and sleep in humans across the life span. While levels of evidence and methods of assessment vary significantly, the results suggest a possible life-long relationship between individual attachment style and sleep. These findings are particularly useful in understanding relatively ingrained psychological mechanisms that can affect and be affected by sleep. Clinical and research implications are discussed.

Gleaning signals about the past from cemetery data.

Cemetery headstones provide an easily accessible source of demographic data in human populations. In common with other sources of demographic data, such as skeletal samples, cemetery data may not be representative of the populations from which they were derived. In some circumstances they can be reasonably representative, however, and in such cases they may provide signals about demographic changes in the population that contributed to the cemetery. We present here analyses of burials occurring between 1900 and 1990 at the Columbia Cemetery in Columbia, Missouri. Our analyses, in combination with archival materials relating to infrastructure improvements in Columbia and data on infectious disease mortality in the state of Missouri, show that patterns of death observed in the cemetery data provide evidence for the timing of changes in the health of Columbia's residents. At the time that major improvements in sanitation and hygiene were implemented, burials of individuals dying under age 45 decreased significantly while burials of individuals older than 45 remained relatively high. Furthermore, data on infectious disease mortality indicate significant declines in deaths from water- and milk-borne infections, but no change in mortality from respiratory illnesses. These data also indicate that observed changes occurred about a decade later in Columbia than in large cities and more densely populated states elsewhere in the United States. Thus, this study illustrates the value of cemetery data in helping to fill gaps about how and when different events known to affect patterns of birth and death may have played out across time and space.