Predictors of mental health problems in adolescents living with HIV in Namibia
Gentz, SG.; Calonge R.; , Martínez‐Arias, R.; Ruiz‐Casares, M. (2017)
Background
Little research in sub‐Saharan Africa has looked at factors that predict mental health problems in adolescents living with HIV (ALHIV). This study examines the psychological impact of HIV in adolescents in Namibia, including risk and protective factors associated with mental health.
Methods
Ninety‐nine fully disclosed ALHIV between the ages of 12 and 18 were interviewed at a State Hospital in Windhoek. A structured questionnaire assessed mental health, using the SDQ (Goodman, 1997), sociodemographic factors, poverty, social support, adherence and stigma.
Results
Mean age was 14.3 years, 52.5% were female and most were healthy. Twelve percent scored in the clinical range for total mental health difficulties and 22% for emotional symptoms. Poverty was associated with more total mental health difficulties, t(96) = −2.63, p = .010, and more emotional symptoms, t(96) = −3.45, p = .001, whereas better social support was a protective factor, particularly caregiver support (r = −.337, p = .001). Adherence problems, HIV‐related stigma and disclosing one’s own HIV status to others were also associated with more total mental health difficulties. Poverty (β = −.231, p = .023) and stigma (β = .268, p = .009) were the best predictors for total mental health difficulties, whereas stigma (β = .314, p = .002) predicted emotional symptoms. Social support had a protective effect on peer problems (p = .001, β = −.349).
Conclusions
Several contextual factors associated with poorer mental health in ALHIV are identified.
Key Practitioner Message
- Interventions to improve the mental health of ALHIV should focus on improving the context in which adolescents live, including improvement in food security, creating supportive environments, particularly in the family, and reducing HIV‐related stigma.
- ALHIV require assistance around their decisions to disclose their HIV status to others.
- Early identification of ALHIV with mental health problems is recommended as these adolescents evidenced increased adherence problems.
- Screening tools, such as the SDQ, may be useful in identifying at‐risk adolescents.
Le recours ā l’embauche des travailleurs étrangers temporaires dans les secteurs saisonniers au Québec: Le point de vue des employeurs
Gravel, S.; Bernstein, S.; Villanueva, F.; Hanley, J.; Crespo-Villarreal, D.; Ostiguy, E. (2017)
Résumé:
Pour combler ses besoins de main-d’œuvre peu qualifiée dans les secteurs saisonniers, le Canada embauche des travailleurs étrangers temporaires (TÉT). Dans le cadre d’une étude sur les enjeux de gestion de l’embauche des TÉT, des employeurs et des informateurs-clés ont été interrogés sur les motivations des entreprises à recourir aux TÉT. La principale motivation, contrairement à celle à laquelle on s’attendrait, n’est pas l’économie de coût. L’intérêt d’embaucher des TÉT repose sur des considérations de coûts-utilités, comme celle de bénéficier d’une main-d’œuvre disponible, efficace, loyale, et présente toute la saison, une souplesse permettant aux employeurs de réduire les risques et les incertitudes de production. Les employeurs accordent ainsi leurs préférences aux TÉT plutôt qu’aux travailleurs locaux. Les TÉT répondraient à toutes leurs attentes en matière de souplesse en ce qui a trait au nombre, aux horaires, à la rémunération et aux compétences.
Abstract:
To satisfy its need for seasonal low-skilled labourers, Canada is hiring temporary foreign workers (TFWs). As part of a study on the management issues related to the hiring of TFWs, employers and informants from related NGOs and governmental agencies were interviewed about their motivations to use TFWs. The primary motivation, unlike that which would be expected, is not cost savings. The interest in hiring TFWs would appear to be based on cost-utility considerations, including the benefit of an available, efficient, loyal workforce during the whole season and the flexibility for employers to reduce risk and uncertainties related to the availability of labour. Employers thus give preference to TFWs rather than local workers, because they meet the entirety of their expectations of workforce flexibility, be it numerically or in relation to scheduling, remuneration or skills.
Exister, appartenir et transmettre: ARTCIRCQ comme espace de mieux-être pour les jeunes inuit d’Igloolik
Lemaire, A.; Vachon, M.; Fraser, S. (2017)
Les exemples liés à l’utilisation de l’art comme moyen d’expression et de transformation foisonnent chez les autochtones. Toutefois, nous en connaissons peu sur ce qui se produit en termes de transformations via l’art et la créativité du point de vue de l’expérience des jeunes eux-mêmes. Cette étude, s’insérant dans un devis ethnographique, porte un regard phénoménologique sur un collectif de cirque (Artcirq) dans une communauté inuit et vise à mieux comprendre le vécu des jeunes qui y participent. Nos données de recherche incluent à la fois des entrevues avec les jeunes inuit impliqués dans Artcirq, des notes et observations de terrain et des entretiens complémentaires avec divers acteurs de la communauté. Nos analyses nous amènent à décrire trois dimensions centrales à l’expérience des jeunes, relativement à Artcirq comme espace : 1) où reconnaître et développer ses forces ; 2) où se lier et appartenir et 3) où vivre sa culture inuit et la transmettre. Les implications potentiellement thérapeutiques de tels espaces communautaires au service du mieux-être des jeunes inuit sont évoquées en discussion.
Adapter les mesures préventives de santé et de sécurité pour les travailleurs qui cumulent des précarités : les obligations d’équité
Gravel, S.; Lippel, K.; Vergara, D.; Dubé, J.; Ducharme, J-F.; Legendre, G. (2017)
Cet article rapporte les constats d’une revue de la littérature et d’une consultation d’experts sur la santé de travailleurs cumulant des précarités : ceux embauchés par des agences de location de main-d’œuvre, les petites entreprises non syndiquées et les étrangers temporaires. On constate que : a) il est difficile de dresser un portrait de l’état de santé de ces travailleurs ; b) faute de pouvoir les distinguer au sein des entreprises, ils ne bénéficient d’aucune attention particulière ; c) ils sont souvent embauchés dans des secteurs non prioritaires, où la surveillance n’est pas assidue ; d) ils sont en marge des pratiques de SST parce qu’ils sont de passage dans les entreprises. Ces faits contribuent à les mettre à l’écart, alors qu’il serait possible d’adapter les pratiques préventives aux travailleurs cumulant des précarités en recadrant les obligations scientifiques, administratives, légales et morales de justice sociale des instances de santé et de sécurité au travail (SST).
Addressing culture and context in humanitarian response: preparing desk reviews to inform mental health and psychosocial support
Greene, MC.; Jordans M,; Kohrt B,; Ventevogel P,; Kirmayer L,; Hassan G,; Chaument A,; van Ommeren M.; Tol, WA" (2017)
Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners with crucial background information to improve their capacity to work efficiently and with maximum benefit. In this paper, we draw on experience implementing desk review guidance from the World Health Organization (WHO) and UNHCR, the United Nations Refugee Agency (2012) in four diverse humanitarian crises (earthquakes in Haiti and Nepal; forced displacement among Syrians and Congolese). We discuss critical parameters for the design and implementation of desk reviews, and discuss current challenges and future directions to improve mental health care and psychosocial support in humanitarian emergencies.
Provider and Patient Related Determinants ofDiabetes Self-Management Among Recent Immigrants in Toronto: Implications forSystemic Change
Hyman, I.; Patychuk, D.; Zaidi, Q.; Kljujic, D.; Shakya, Y.B.; Rummens, J.A.; Creatore, M.; Vissandjee, B. (2017)
Objective To examine provider- and patient-related factors associated with diabetes self-management among recent immigrants.
Design Demographic and experiential data were collected using an international survey instrument and adapted to the Canadian context. The final questionnaire was pretested and translated into 4 languages: Mandarin, Tamil, Bengali, and Urdu.
Setting Toronto, Ont.
Participants A total of 130 recent immigrants with a self-reported diagnosis of type 2 diabetes mellitus who had resided in Canada for 10 years or less.
Main outcome measures Diabetes self-management practices (based on a composite of 5 diabetes self-management practices, and participants achieved a score for each adopted practice); and the quality of the provider-patient interaction (measured with a 5-point Likert-type scale that consisted of questions addressing participants’ perceptions of discrimination and equitable care).
Results A total of 130 participants in this study were recent immigrants to Canada from 4 countries of origin—Sri Lanka, Bangladesh, Pakistan, and China. Two factors were significant in predicting diabetes self-management among recent immigrants: financial barriers, specifically, not having enough money to manage diabetes expenses (P = .0233), and the quality of the provider-patient relationship (P = .0016). Participants who did not have enough money to manage diabetes were 9% less likely to engage in self-management practices; and participants who rated the quality of their interactions with providers as poor were 16% less likely to engage in self-management practices.
Conclusion Financial barriers can undermine effective diabetes self-management among recent immigrants. Ensuring that patients feel comfortable and respected and that they are treated in culturally sensitive ways is also critical to good diabetes self-management.
The mothering experience of women with female genital cutting raising “uncut” daughters, in Africa and in the West
Koukoui, S.; Hassan, G.; Guzder, J. (2017)
While Female Genital Cutting (FGM/C) is a deeply entrenched cultural practice, there is now mounting evidence for a gradual decline in prevalence in a number of geographical areas in Africa and following migration to non-practicing countries. Consequently, there is now a growing number of women with FGM/C who are raising ‘uncut’ daughters. This study used a qualitative methodology to investigate the experience of women with FGM/C raising daughters who have not been subjected to the ritual. The aim of this study was to shed light on mothers’ perception of the meaning and cultural significance of the practice and to gain insight into their mothering experience of ‘uncut’ girls. To this end, in-depth interviews were conducted with fifteen mothers living in Abidjan, Ivory Coast and in Montreal, Canada (8 and 7, respectively). Thirteen mothers intrinsically refused to perpetuate FGM/C onto their daughters and two diasporic mothers were in favour of FGM/C but forewent the practice for fear of legal repercussions. Whether the eschewing of FGM/C was deliberate or legally imposed, raising ‘uncut’ daughters had significant consequences in terms of women’s mothering experiences. Mothers faced specific challenges pertaining to community and family pressure to have daughters undergo FGM/C, and expressed concerns regarding their daughters’ sexuality. Conversely, women’s narratives were also infused with pride and hope for their daughters, and revealed an accrued dialogue between the mother-daughter dyad about cultural norms and sexuality. Interestingly, women’s mothering experience was also bolstered by the existence of informal networks of support between mothers with FGM/C whose daughters were ‘uncut’. These communities of mothers engaged in open dialogue about the consequences of FGM/C and offered reciprocal solidarity and support in their decision to forego FGM/C for their children. Women with FGM/C who are raising ‘uncut’ daughters in their homeland and in their country of immigration vastly report a positive experience. However, they also face specific challenges related to immigration, psychosocial, and psychosexual considerations, which must be tackled from a multidisciplinary perspectiveBackground
Methods
Results
Conclusion
Postpartum Pain in the Community among Migrant and Non-Migrant Women in Canada
Mahon, A.; Merry, L.; Lu, O.; Gagnon, AJ. (2017)
International migrant women of childbearing age represent a large proportion of immigrants to high-income countries, yet research focusing on their postpartum health is limited. We investigated predictive factors for breast and non-breast pain 1 week post-birth in migrant and non-migrant women in Canada. Among migrant women, difficulty accessing health services; being from a middle-or high-income country; poor functionality in English and French; living with the father of their infant; and having no regular care provider were predictive of breast pain. Among non-migrant women, difficulties accessing health services, multiparity and prenatal education were predictive of breast pain, while receiving an epidural and having no regular care provider were predictive of non-breast pain. Among both groups, difficulties accessing health services and having no regular care provider were predictive of breast pain, while second degree or higher perineal tearing was predictive of non-breast pain. Migration-specific indicators should be considered in postpartum care planning.
KEYWORDS:
Research Handbook on Climate Change, Migration and the Law
Mayer, B.; Crépeau, F. (2017)
Concerns have arisen in recent decades about the impact of climate change on human mobility. Many people affected by climate change are forced or otherwise decide to migrate within or across international borders. Despite its clear importance, many questions remain open regarding the nature of the climate-migration nexus and its implications for laws and institutions. In the face of such uncertainty, this Research Handbook offers a comprehensive picture of laws and institutions relevant to climate migration and the multiple, often contradictory perspectives on the topic.
Carefully edited chapters by leading scholars in the field provide a cross section of the various debates on what laws do, can do and should do in relation to the impacts of climate change on migration. A first part analyses the relations between climate change and migration. A second part explores how existing laws and institutions address the climate-migration nexus. In the final part, the chapters discuss possible ways forward.
This timely Research Handbook provides much-needed insight into this complex issue for graduate and post-graduate students in climate change or migration law. It will also appeal to students and scholars in political science, international relations, environmental studies and migration studies, as well as policymakers and advocates
Everyday ethics of participation: a case study of a CBPR in Nunavik
Fraser, S.; Mickpegak, R. ; Vrakas, G. ; Laliberté, A. (2017)
Introduction:
Multiple reports highlight the need for community-based family-oriented prevention services for Aboriginal peoples in order to address important health and social inequalities. Participatory, empowerment-based approaches are generally favoured for these means. Faced with important social issues, in a context of colonisation and complex power dynamics, we question how community members experience participation, as well as the everyday dynamics that take place when attempting to create community-level change.
Context:
The initial steps of this community-based participatory research (CBPR) took place over a two-year period in a community of Nunavik, a large northern region of the province of Quebec. The objective of the CBPR was to develop a community-driven project aimed at supporting families to be able to keep children within their homes or communities, rather than having to be placed under child welfare services.
Method:
We participated in, and documented, various group meetings, community workshops, informal reflexive discussions, and formal interviews with community partners to explore their everyday experiences of participation in community-based change.
Results:
We describe some of the initial actions taken in this project. We describe how certain social and power dynamics infiltrated into the process of participation leading to various tensions, personal and interpersonal experiences and needs.
Discussion:
We discuss how these experiences led to everyday ethical dilemmas regarding participation. We conclude that although participatory approaches towards community change may be effective, they are also ethically challenging and at times disempowering for those who participate. We describe some of the approaches used to work with these ethical challenges.
Écouter les enfants dans la recherche en santé mentale jeunesse (SMJ): une créativité éthique inspirée de la clinique
Caldairou-Bessette, P.; Johnson-Lafleur, J.; Nadeau, L.; Vachon, M.; Rousseau, C. (2017)
Cet article présente quelques réflexions critiques issues de la démarche inductive de deux projets de recherche impliquant des enfants. Ces projets portent sur les services publics en santé mentale jeunesse (SMJ), l’un avec des familles réfugiées et l’autre avec une population générale, tous deux intégrant le jeu et le dessin aux entretiens avec les enfants. Après avoir posé les bases critiques et inductives de la recherche « avec » les enfants, nous présentons quelques éléments de notre approche méthodologique. Cette dernière se situe entre les méthodes projectives de la clinique et les méthodes créatives de la recherche, en proposant un usage narratif, expressif et exploratoire de la projection. La démarche inductive de recherche est présentée à travers l’expérience de l’élaboration méthodologique et de la cueillette de données auprès des enfants. Six exemples sont tirés des projets pour illustrer nos questionnements autour de la directivité des entretiens et de leur exigence pour les enfants, de même que des interrogations autour du degré projectif impliqué, qui change le potentiel interprétatif en le rendant plus complexe, mais aussi plus riche. Nous concluons en proposant une conception créative de la projection en recherche comme un espace de jeu participatif. Cet espace de jeu est également envisagé comme contribuant à l’éthique de la recherche. Finalement, nous proposons, pour des recherches ultérieures, de faire participer les enfants à l’élaboration des méthodologies. Nous terminons en soulignant la pertinence d’une démarche inductive pour développer une réflexion critique en recherche.
Challenges Newly-Arrived Migrant Women in Montreal Face When Needing Maternity Care: Health Care Professionals’ Perspectives
Peláez, S.; Hendricks, K.; N Merry, L.; Gagnon, AJ. (2017)
People who leave their country of origin, or the country of habitual residence, to establish themselves permanently in another country are usually referred to as migrants. Over half of all births in Montreal, Canada are to migrant women. To understand healthcare professionals’ attitudes towards migrants that could influence their delivery of care, our objective was to explore their perspectives of challenges newly-arrived migrant women from non-Western countries face when needing maternity care.
Method
In this qualitative multiple case study, we conducted face-to-face interviews with 63 health care professionals from four teaching hospitals in Montreal, known for providing maternity care to a high volume of migrant women. Interviews were transcribed and thematically analysed.
Results
Physicians, nurses, social workers, and therapists participated; 90% were female; and 17% were themselves migrants from non-Western countries. According to participants, newly-arrived migrant women face challenges at two levels: (a) direct care (e.g., understanding Canadian health care professionals’ expectations, communicating effectively with health care professionals), and (b) organizational (e.g., access to appropriate health care). Challenges women face are strongly influenced by the migrant woman’s background as well as social position (e.g., general education, health literacy, socio-cultural integration) and by how health care professionals balance women’s needs with perceived requirement to adhere to standard procedures and regulations.
Conclusions
Health care professionals across institutions agreed that maternity care-related challenges faced by newly-arrived migrant women often are complex in that they are simultaneously driven by conflicting values: those based on migrant women’s sociocultural backgrounds versus those related to the implementation of Canadian guidelines for maternity care in which consideration of migrant women’s particular needs are not priority.
The gap between coverage and care—what can Canadian paediatricians do about access to health services for refugee claimant children?
Rink, N.; Muttalib, F.; Morantz, G.; Chase, L.; Cleveland, J.; Rousseau, C.; Li, P. (2017)
In June 2012, the government of Canada severely restricted the scope of the Interim Federal Health Program that had hitherto provided coverage for the health care needs of refugee claimants. The Quebec government decided to supplement coverage via the provincial health program. Despite this, we hypothesized that refugee claimant children in Montreal would continue to experience significant difficulties in accessing basic health care.
(1) Report the narrative experiences of refugee claimant families who were denied health care services in Montreal following June 2012, (2) describe the predominant barriers to accessing health care services and understanding their impact using thematic analysis and (3) derive concrete recommendations for child health care providers to improve access to care for refugee claimant children.
Eleven parents recruited from two sites in Montreal participated in semi-structured interviews designed to elicit a narrative account of their experiences seeking health care. Interviews were recorded, transcribed, coded using NVivo software and subjected to thematic analysis.
Thematic analysis of the data revealed five themes concerning barriers to health care access: lack of continuous health coverage, health care administrators/providers’ lack of understanding of Interim Federal Health Program coverage, refusal of services or fees charged, refugee claimants’ lack of understanding about health care rights and services and language barriers, and four themes concerning the impact of denial of care episodes: potential for adverse health outcomes, psychological distress, financial burden and social stigma.
Conclusion
We propose eight action points for advocacy by Canadian paediatricians to improve access to health care for refugee claimant children in their communities and institutions.
Projets identitaires parentaux des couples mixtes au Québec et au Maroc. Similitudes et effets du contexte national
Therrien, C.; Le Gall, J. (2017)
L’article a pour objectif d’examiner l’impact du contexte national sur la mixité conjugale et plus spécifiquement sur les processus de transmission identitaire à travers une comparaison du contexte marocain et du contexte québécois. Il s’appuie sur des travaux ethnographiques qui se sont intéressés aux projets identitaires parentaux d’individus engagés dans des expériences de mixité conjugale. Une telle comparaison entre deux contextes très différents (le Québec étant une société laïque et d’immigration et le Maroc un pays musulman et d’émigration) fait ressortir les différences et les similitudes dans les processus de transmission identitaires des couples mixtes. L’effet du contexte ne concerne pas tant les projets identitaires en tant que tels que leur déploiement. Dans les deux pays, les familles mixtes vivent leur projet familial en non-conformité avec le modèle social majoritaire.
Internationally Educated Nurses in Canada: Predictors of Workforce Integration
Covell, C. L., Primeau, M.-D., Kilpatrick, K., & St-Pierre (2017)
BACKGROUND:
Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs’ workforce integration.
METHODS:
A cross-sectional, descriptive, correlational survey design was used. Eligible IENs were immigrants, registered and employed as regulated nurses in Canada. Data were collected in 2014 via online and paper questionnaires. Descriptive statistics were used to examine the data by year of immigration. Logistic regression modeling was employed to identify predictors of IENs’ workforce integration measured as passing the licensure exam to acquire professional recertification and securing employment.
RESULTS:
The sample consisted of 2280 IENs, representative of all Canadian provincial jurisdictions. Since changes to the immigrant selection process in 2002, the IEN population in Canada has become more racially diverse with greater numbers emigrating from developing countries. Recent arrivals (after 2002) had high levels of human capital (knowledge, professional experience, language proficiency). Some, but not all, benefited from the formal and informal assistance available to facilitate their workforce integration. Professional experience and help studying significantly predicted if IENs passed the licensure exam on their first attempt. Bridging program participation and assistance from social networks in Canada were significant predictors if IENs had difficulty securing employment.
CONCLUSIONS:
Nurses will continue to migrate from a wide variety of countries throughout the world that have dissimilar nursing education and health systems. Thus, IENs are not a homogenous group, and a “one size fits all” model may not be effective for facilitating their professional recertification and employment in the destination country. Canada, as well as other countries, could consider using a case management approach to develop and tailor education and forms of assistance to meet the individual needs of IENs. Using technology to reach IENs who have not yet immigrated or have settled outside of urban centers are other potential strategies that may facilitate their timely entrance into the destination countries’ nursing workforce.
Promoting the wellbeing of lesbian, gay, bisexual and transgender forced migrants in Canada: providers’ perspectives.
Kahn, S., Alessi, E,, Woolner, L.,Kim, H., Olivieri C. (2017)
Researchers are beginning to document the experiences of lesbian, gay, bisexual and transgender (LGBT) forced migrants in settlement. However, studies exploring the perceptions of service providers working with this vulnerable population are limited. These may shed light on the challenges of meeting the needs of LGBT forced migrants, especially mental health issues and problems.
This qualitative study elicited the views of 22 Canadian service providers, including advocates, lawyers and mental health practitioners, who serve LGBT forced migrants. Grounded theory analysis revealed the following four themes: facilitating safety, buffering rejection; tracking avoidance patterns; interpreting mental health; and negotiating identity paradigms.
Participants’ accounts suggest that LGBT forced migrants may be best served by providers who understand the exigencies of establishing trust and safety for their clients; recognise their clients’ nuanced social support needs; facilitate the refugee claims process; grasp the complexity of their clients’ mental health challenges; and interrogate their own cultural biases regarding sexual orientations and gender identities.
The state of knowledge about LGBTQI migrants living in Canada in relation to the global LGBTQI rights agenda
E. Ou Jin Lee, T. Hafford-Letchfield, A. Pullen Sansfaçon, O. Kamgain, H. Gleeson et F. Luu (2017)
Scoping review methodology was used to rapidly assess a broad range of literature while at the same time identify key knowledge strengths and gaps. A total of 241 publications included in this scoping review, with 56 from Canada, 74 from the US, 50 from elsewhere in the Global North and 61 from the Global South. LGBTQI people living in the Global South: Homophobic and transphobic violence faced by LGBTQI people living in the Global South is always situated within particular geo-political and regional contexts that are shaped by neo-liberalism, gender inequalities, colonial legacies, nationalisms, armed conflict, police violence, corruption, religious extremism, etc. LGBTQI migrants living in Canada: Most focused on LGBTQI refugees. Since 2014 there has been a shift in focus from refugee to precarious status, newcomers and immigrants and exploring how LGBTQI migrants navigated community belonging and structural barriers. LGBTQI migrants living in the US: Exploration of well-being especially with respect to HIV risk and prevention. For LGBTQI migrants, chosen families broke social isolation and fostered belonging. LGBTQI migrants also encounter multiple identity-based discriminations that blocked access to housing and health and social services, along with a fear, especially for those undocumented, of being profiled and detained by immigration officials. LGBTQI migrants living elsewhere in the Global North: Two areas of focus include SOGIE-based refugee claims and multiple discriminations by LGBTQI migrants, such as family / community rejection and barriers to access housing, employment, health and social services. Detention centres have a detrimental impact on the mental health of LGBTQI refugees, and increases their exposure to homophobic and transphobic violence. Key research methodologies and theories used: Qualitative research methods used include semi-structured interviews, focus groups, mixed methods and refugee case decisions. Some applied intervention, community-based and/or participatory research methodologies. Theories applied include ecological systems theory, minority stress model, multicultural feminist framework, the social determinants of health and especially intersectionality. Knowledge strengths and gaps: Researcher use of critical and participatory research methodologies as well as intersectionality theory are knowledge strengths. The IRB has implemented SOGIE-based guidelines for decision makers. There remains little knowledge about the realities of LGBTQI immigrants and migrants with precarious status. Need to develop anti-racist, anti-heterosexist and anti-cissexist service delivery and specialized services for LGBTQI migrants. Service providers should engage in trauma-informed and anti-oppressive practice that attends to the intersectional realities of LGBTQI migrants. Policy makers involved in developing Canada’s international role in LGBTQI human rights, should consider the complexities of LGBTQI realities in the Global South.
Souffrance sociale et radicalisation : redéfinir la prévention
Journée d’étude Les tensions manifestes entre majorités et minorités, à l’échelle locale, nationale comme internationale, s’aggravent dans un contexte d’inégalités sociales croissantes qui cristallisent des enjeux identitaires. Nourrie par ces polarisations et par la manière dont on s’y adresse, la radicalisation violente pose des défis au champ social. Comment la comprendre en tenant compte de […]
Ethnopsychiatrie
Mekki-Berrada, A. (2017)
Refugees, Asylum-seekers, Undocumented Migrants and the Experience of Parenthood
Merry, L.; Pelaez, S.; Edwards, N. C. (2017)
Objective
To synthesize the recent qualitative literature and identify the integrative themes describing the parenthood experiences of refugees, asylum-seekers and undocumented migrants.
Methods
We searched seven online databases for the period January 2006 to February 2017. We included English and French published peer-reviewed articles and graduate-level dissertations, which qualitatively examined the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We summarized study characteristics and performed a thematic analysis across the studies.
Results
One hundred thirty eight studies met inclusion criteria. All but three were conducted in high-income countries, mainly in the US. Migrants studied were mostly undocumented from Latin America and refugees from Sub-Saharan Africa. Almost all studies (93%) included mothers; about half (47%) included fathers; very few (5%) included extended family members. We identified three integrative themes: 1) experiencing hardship and/or loss in the context of precarious migration and past traumas; 2) building resilience and strength by bridging language, norms and expectations; and 3) living transnationally: obligations, challenges and resources. Each theme contributed to shaping the parenthood experience; the transnationalism theme intersected with the themes on hardship and loss and resilience and strength.
Conclusion
More research is needed with fathers, extended family members, asylum-seekers and in the LMIC context. A transnational lens needs to be applied to programs, policies and future research for refugee, asylum-seeker and undocumented migrant parents. Addressing transnational concerns (family separation and reunification), acknowledging transnational resources, fostering a transnational family identity and conducting transnational and longitudinal studies are potentially pivotal approaches for this sub-population of parents.
Responses of international migrant women to abuse associated with pregnancy
Mehta, P.; Gagnon, AJ. (2016)
The current study aims to identify what newly arrived migrant women do, in the early months post-birth, to respond to abuse associated with pregnancy. Textual data from 59 migrant women were analyzed thematically to identify common responses to abuses. The most common response was to physically leave their countries of origin and move to Canada, or to move out of the shared dwelling. Other responses included taking legal action, remaining silent, reporting the abuse, seeking counseling, isolating themselves, and supporting anger management for the abuser. These results enhance our understanding of the decisions, including inaction, made by migrant women.
They cut your wings over here . . . you can’t do nothing’: Voices of children and parents held in immigration detention in Canada
Kronick, R.; Rousseau, C.; Cleveland, J.Rachel Kronick, Cécile Rousseau, Janet Cleveland (2016)
Prevalence, continuation, and identification of postpartum depressive symptomatology among refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women: results from a prospective cohort study
Dennis, C-L.; Merry, L.; Stewart, D.; Gagnon, AJ. (2016)
This study assessed the prevalence, continuation, and identification of maternal depressive symptomatology over the first 16 weeks postpartum among refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women. A sample of 1125 women (143 refugees, 369 asylum-seekers, 303 non-refugee immigrant, and 310 Canadian-born) completed the Edinburgh Postnatal Depression Scale (EPDS) at 1 and 16 weeks postpartum. The sensitivity, specificity, and predictive power of the 1-week EPDS to identify women with elevated EPDS scores at 16 weeks were determined. The total number of women with EPDS scores >9 for each group at 1 and 16 weeks, respectively, was 26.6 and 18.2 % for refugees; 25.2 and 24.1 % for asylum-seekers; 22.4 and 14.2 % for non-refugee immigrants, and 14.8 and 7.4 % for Canadian-born. Using the cut-off score of 9/10, the 1-week EPDS accurately classified 77.6 % refugee, 73.4 % asylum-seeking, 76.6 % non-refugee immigrant, and 85.5 % Canadian-born women at 16 weeks with or without postpartum depressive symptomatology. The 1-week EPDS was significantly correlated to the 16-week EPDS (r = 0.46, p < 0.01). All groups were significantly more likely to exhibit depressive symptomatology at 16 weeks if they had EPDS scores >9 at 1 week postpartum: refugees (OR = 6.9, 95 % CI = 2.8–17.3), asylum-seekers (OR = 4.0, 95 % CI = 2.4–6.7), non-refugee immigrants (OR = 3.8, 95 % CI = 2.0–7.6), and Canadian-born women (OR = 8.0, 95 % CI = 3.3–19.8). Our findings suggest that refugee, asylum-seeking, non-refugee immigrant, and Canadian-born women at risk of postpartum depression may be identified early in the postpartum period such that secondary preventive interventions may be implemented.
Des pictogrammes pour surmonter la barrière de la langue. Une étude de cas dans une ressource intermédiaire
Alvarez, J. (2016)
Lorsqu’on donne des soins et que la personne que l’on tente d’aider ne parle pas la même langue que nous, il est parfois difficile de comprendre l’autre et de se faire comprendre. Et si on pouvait utiliser des images pour s’aider? C’est le pari qu’a fait Juliana Alvarez, designer industrielle et cofondatrice d’IDE3S. Avec l’aide des professionnels de la santé et des services sociaux travaillant dans une ressource intermédiaire hébergeant des personnes âgées, elle a conçu une gamme d’outils visuels ayant pour but de faciliter la communication entre les intervenants et les personnes âgées allophones
Accueillir les réfugiés: pratiques et politiques
L’arrivée des réfugiés syriens au Canada et au Québec a mis en évidence un enthousiasme certain au sein de la société hôte pour l’accueil des réfugiés et une multiplication d’initiatives citoyennes pour leur venir en aide. Mais alors qu’il y a eu une mobilisation sans précédent dans des communautés pour accueillir des réfugiés, nous devons […]
Communicating power and resistance: exploring interactions between aboriginal youth and non-aboriginal staff members in a residential child welfare facility
Fraser, S.; Vachon, M.; Hassan, G.; Parent, V. (2016)
Reproductive health research of women migrants to Western countries: A systematic review for refining the clinical lens
Gagnon, AJ.; Redden, KL. (2016)
Highlights
- •Many migrant reproductive health reports are inadequate to inform clinical practice.
- •Comparative migrant reproductive health reports are concentrated in the USA, Spain, and Italy.
- •Recommended migration indicators related to reproductive health remain underreported.
- •Quality studies to inform clinical practice are available for some pregnancy-related care.
- •Non-pregnancy-related reproductive health outcomes in migrant women warrant further investigation.
Global Migration Governance: Avoiding Commitments on Human Rights, Yet Tracing a Course for Cooperation
Crépeau, F.; Atak, I. (2016)
This article maps the global governance processes on migration and assesses whether the human rights of migrants are effectively included and mainstreamed therein. It is argued that the lack of a comprehensive framework for migration governance and the insufficient focus on the human rights dimension in migration management have led to serious human rights violations in the treatment of migrants and asylum seekers, and to a lack of oversight and accountability when these violations occur. The article commences with an examination of the legal and normative framework related to the three areas that have been the main objects of global migration governance: the refugee regime, international labour standards and transnational criminal law regarding human trafficking. It goes on to explore the complex institutional framework of global migration governance and how it has been mostly informal, ad hoc, non-binding and State-led. The article concludes with a discussion on the future perspectives for a human rights-centred approach in global migration governance. It is contended that there is a need to bring the migration dialogue inside the United Nations, as it already plays a key role in international cooperation, with human rights as one of its pillars.
Facilitating Mobility and Fostering Diversity: Getting EU Migration Governance to Respect the Human Rights of Migrants
Crépeau, F,; Purkey, AL. (2016, mai)
Migration towards Europe has surged over the past few years, overwhelming government authorities at the national and EU levels, and fuelling a xenophobic, nationalist, populist discourse linking migrants to security threats. Despite positive advances in the courts and worthy national initiatives (such as Italy’s Operation Mare Nostrum), the EU’s governance of migration and borders has had disastrous effects on the human rights of migrants. These effects stem from the criminalisation of migrants, which pushes them towards more precarious migration routes, the widespread use of administrative detention and the processing of asylum claims under the Dublin system, and now the EU–Turkey agreement. Yet, this paper finds that with the right political leadership, the EU could adopt different policies in order to develop and implement a human rights-based approach to migration that would seek to reconcile security concerns with the human rights of migrants. Such an approach would enable member states to fully reap the rewards of a stable, cohesive, long-term migration plan that facilitates and governs mobility rather than restricts it at immense cost to the EU, the member states and individual migrants.
Foreword: Banking on mobility over a generation
Créeau, F. (2016)
Judaïsme et éducation : enjeux et défis pédagogiques
Hirsh, S.; Mc Andrew, M.; Audet, G.; J. Ipgrave. (2016)
La question des rapports entre groupes ethniques définis par différents marqueurs, dont celui de la religion, s’impose aujourd’hui plus que jamais au sein de nos sociétés plurielles. Cet ouvrage original s’intéresse au rôle de l’éducation dans la dynamique des relations entre la communauté juive et leurs concitoyens de toutes origines au Québec, au Canada et dans d’autres pays. En effet, alors que les communautés juives sont souvent bien implantées dans leurs sociétés d’accueil, elles demeurent souvent mal connues de la population et plus particulièrement des groupes majoritaires.
Les auteurs se penchent sur trois enjeux susceptibles d’interpeller les intervenants des milieux scolaire et communautaire, mais aussi le grand public intéressé au « vivre ensemble » et à ses défis :
– L’enseignement sur les communautés juives à l’école publique
– L’éducation sur l’Holocauste et les pratiques novatrices à cet égard
– Le vécu des écoles juives et leur impact.
Use of reproductive health care services among urban migrant women in Bangladesh
Islam, MM.; Gagnon, AJ. (2016)
Recent internal migration flows from rural to urban areas pose challenges to women using reproductive health care services in their migratory destinations. No studies were found which examined the relationship between migration, migration-associated indicators and reproductive health care services in Bangladesh.
Methods
We analyzed the 2006 Bangladesh Urban Health Survey (data made publically available in June 2013) of 14,191 ever-married women aged 10–59 years. Cross tabulations and logistic regression were conducted.
Results
Migrants and non-migrants did not differ significantly in their use of modern contraceptives and treatment for STI but were less likely to receive ANC even after controlling for a range of variables. Compared to non-migrants, more migrants had home births, did not take vitamin A after delivery, and had no medical exam post-birth. Migrant women being village-born (rather than urban-born) were associated with risk of diminished: use of ANC; treatment for STI; medical exam post-birth; vitamin A post-birth. Migrating for work or education (rather than other reasons) was associated with risk of diminished: use of ANC; use of modern facilities for birth; and medical exam post-birth. Each additional year lived in urban areas was associated with a greater likelihood of receiving ANC.
Conclusions
Women who migrated to urban areas in Bangladesh were significantly less likely than non-migrants to use reproductive health care services related to pregnancy care. Pro-actively identifying migrant women, especially those who originated from villages or migrated for work or education may be warranted to ensure optimal use of pregnancy-related services.
Migrant Live-In Caregivers: Control, Consensus and Resistance in the Workplace and the Community
Koo, JH.; Hanley, J. (2016)
La diversité ethnoculturelle et les rapports ethniques au Québec : le contexte historique et social
Mc Andrew, M.; Audet, G. (2016)
Predictors of Unplanned Cesareans among Low‐Risk Migrant Women from Low‐and Middle‐Income Countries Living in Montreal, Canada
Merry, L.; Semenic, S.; Gyorkos, TW.; Fraser, W.; Gagnon, AJ. (2016)
Background
Research has yielded little understanding of factors associated with high cesarean rates among migrant women (i.e., women born abroad). The objective of this study was to identify medical, migration, social, and health service predictors of unplanned cesareans among low‐risk migrant women from low‐ and middle‐income countries (LMICs).
Methods
We used a case–control research design. The sampling frame included migrant women from LMICs living in Canada less than 8 years, who gave birth at one of three Montreal hospitals between March 2014 and January 2015. Data were collected from medical records and by interview‐administration of the Migrant‐Friendly Maternity Care Questionnaire. We performed multi‐variable logistic regression for low‐risk women (i.e., vertex, singleton, term pregnancies) who delivered vaginally (1,615 controls) and by unplanned cesarean indicated by failure to progress, fetal distress, or cephalopelvic disproportion (233 cases).
Results
Predictors of unplanned cesarean included being from sub‐Saharan Africa/Caribbean (OR 2.37 [95% CI 1.02–5.51]) and admission for delivery during early labor (OR 5.43 [95% CI 3.17–9.29]). Among women living in Canada less than 2 years predictors were having a humanitarian migration classification (OR 4.24 [95% CI 1.16–15.46]) and admission for delivery during early labor (OR 7.68 [95% CI 3.12–18.88]).
Conclusion
Migrant women from sub‐Saharan Africa/Caribbean and recently arrived migrant women with a humanitarian classification are at greater risk for unplanned cesareans compared with other low‐risk migrant women from LMICs after controlling for medical factors. Strategies to prevent cesareans should consider the circumstances of migrant women that may be contributing to the use of unplanned cesareans in this population.
Mental Health and Psychosocial Wellbeing of Syrians Affected by Armed Conflict
Hassan, G.; Ventevogel, P,; Jefee-Bahloul, H,; Barkil-Oteo, A.; Kirmayer, LJ. (2016)
AIMS:
This paper is based on a report commissioned by the United Nations High Commissioner for Refugees, which aims to provide information on cultural aspects of mental health and psychosocial wellbeing relevant to care and support for Syrians affected by the crisis. This paper aims to inform mental health and psychosocial support (MHPSS) staff of the mental health and psychosocial wellbeing issues facing Syrians who are internally displaced and Syrian refugees.
METHODS:
We conducted a systematic literature search designed to capture clinical, social science and general literature examining the mental health of the Syrian population. The main medical, psychological and social sciences databases (e.g. Medline, PubMed, PsycInfo) were searched (until July 2015) in Arabic, English and French language sources. This search was supplemented with web-based searches in Arabic, English and French media, and in assessment reports and evaluations, by nongovernmental organisations, intergovernmental organisations and agencies of the United Nations. This search strategy should not be taken as a comprehensive review of all issues related to MHPSS of Syrians as some unpublished reports and evaluations were not reviewed.
RESULTS:
Conflict affected Syrians may experience a wide range of mental health problems including (1) exacerbations of pre-existing mental disorders; (2) new problems caused by conflict related violence, displacement and multiple losses; as well as (3) issues related to adaptation to the post-emergency context, for example living conditions in the countries of refuge. Some populations are particularly vulnerable such as men and women survivors of sexual or gender based violence, children who have experienced violence and exploitation and Syrians who are lesbian, gay, bisexual, transgender or intersex. Several factors influence access to MHPSS services including language barriers, stigma associated with seeking mental health care and the power dynamics of the helping relationship. Trust and collaboration can be maximised by ensuring a culturally safe environment, respectful of diversity and based on mutual respect, in which the perspectives of clients and their families can be carefully explored.
CONCLUSIONS:
Sociocultural knowledge and cultural competency can improve the design and delivery of interventions to promote mental health and psychosocial wellbeing of Syrians affected by armed conflict and displacement, both within Syria and in countries hosting refugees from Syria.
Immigration and diversity in Quebec’s schools: An assessment
Mc Andrew, M.; Audet, G.; Bakhshaei, M. (2016)
An Exploratory Study Assessing Psychological Distress of Indigents in Burkina Faso: A Step Forward in Understanding Mental Health Needs in West Africa.
Pigeon-Gagné, É.; Hassan, G.; Yaogo, M.; Ridde, V. (2016)
Background
Poverty is known as an important determinant of health, but empirical data are still missing on the relationships between poverty, other adverse living conditions, and psychological distress, particularly in low-income countries.
This study aimed to assess mental health needs and psychological distress among the poorest in rural settings in Burkina Faso where food security and access to water, electricity, schooling, and healthcare are limited.
Methods
We randomly selected 2000 individuals previously identified as indigents by a community-targeting process. Interviewers visited participants (n = 1652) in their homes and completed a questionnaire on mental health variables that included presence and intensity of anxious, depressive, psychotic, and aggressive symptoms, as well as level of psychological distress. Descriptive statistics, Spearman correlations, and logistic regressions were performed.
Results
In all, 40.2% of the sample reported 10 or more anxious/depressive symptoms in the past 30 days, and 25.5% reported having experienced at least one psychotic symptom over their lifetime, 65.6% of whom had had those symptoms for many years. The number of anxious and depressive symptoms was significantly associated with the level of psychological distress (r = 0.423, p < .001). Predictors of distress level included: poor health condition (F(1) = 23.743, p <. 001), being a woman (F(1) = 43.926, p < .001), not having any income (F(1) = 16.185, p < .001), having begged for food in the past 30 days (F(1) = 12.387, p < .001), being illiterate, and being older (F(1) = 21.487, p < .001). Approximately one third of respondents reporting anxious/depressive or psychotic symptoms (28.2 and 30.0%, respectively) had not talked about their symptoms to anyone in their social network.
Conclusions
These results suggest alarmingly high levels of psychological distress and reported symptoms among the poorest in rural settings in Burkina Faso, which can be explained by their difficult living conditions. However, these results must be interpreted from a transcultural perspective to avoid decontextualized misinterpretations. Ethnographic works are needed to document the larger context within which these distress results can be analyzed.
Caring for a Newly Arrived Syrian Refugee Family
Pottie, K.; Greenaway, C.; Hassan, G.; Hui, C.; Kirmayer, LJ. (2016)
Comment perçois-tu l’arrivée de nouveaux immigrants?
Institut du Nouveau Monde, IU SHERPA (2016)
Vox pop réalisé en décembre 2015 par Györgyi Kizer, Faïçal Lounis et Simon Massicotte. Ce vox pop s’inscrit dans le cadre d’un projet pilote portant sur le vivre ensemble. Les jeunes sont accompagnés dans leur démarche par l’Institut du Nouveau Monde et le centre de recherche SHERPA.
Perceptions des hommes québécois de leurs besoins psychosociaux et de santé
Tremblay, G. Roy, B. Bizot, D. deMontigny, F. Houle, J. Le Gall, J. Cazale, L. Beaudet, L. Chamberland, L. Paré, L. Séguin, M. Villeneuve, P. Lajeunesse, S. Dupéré, S. Léveillé, S. Roy, V. (2016)
Reconfigurations familiales et relations intergénérationnelles dans les réseaux transnationaux : Familles en recomposition, Familles Alternatives
Vatz Laaroussi, M.; Le Gall, J.; Bolzman, C.; Rachédi, L. (2016)
The Canadian government’s recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April-June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada’s socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as “deserving” of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as “underserving” of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a “privilege”, that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.
Collaborative youth mental health service users, immigration, poverty, and family environment
Nadeau, L.; Lecompte, V.; Johnson-Lafleur, J.; Pontbriand, A.; Rousseau, C. (2016)
Background
This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood.
Method
Participants in this study were 140 parent–child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area. Measures included in this study were collected at the initial phase of the longitudinal project (Time 0). Parents completed a sociodemographic questionnaire and the Family Environment Scale (FES), and both parents and children completed the Strength and Difficulties questionnaire (SDQ).
Results
Results suggest that the family environment, especially family conflicts, has a significant role in the MH problems of children seeking help in collaborative MH services. In this specific population, results also show a trend, but not a statistically significant association, between poverty or immigration and emotional and behavioral problems. They suggest as well that boys show more MH problems, although this could be a contamination effect (parents’ perspective).
Conclusions
The results support the importance of interventions that not only target the child symptomatology but also address family dynamics, especially conflicts. Collaborative care models may be particularly well suited to allow for a coherent consideration of family environmental factors in youth mental health and to support primary care settings in addressing these issues.
L’équité en santé mondiale : qu’en est-il de la fabrique, de la circulation et des conséquences des stéréotypes sur les populations ?
Cloos, P.; Belaid, L. (2016)
La santé mondiale est un vaste champ de savoirs et d’interventions dont l’intérêt porte sur des grands enjeux comme les inégalités sociales transnationales qui affectent toutes les populations dans le monde. La constitution d’un savoir issu de pratiques comparatives entre groupes sociodémographiques est un moyen d’informer l’intervention destinée à ce qui est communément qualifié de communautés. Selon une certaine littérature, les disparités raciales et ethniques sanitaires sont un problème de santé mondiale. Malgré la controverse qui entoure l’usage de la catégorie de race, à laquelle sont souvent associées voire préférées celles d’ethnicité ou encore de culture, certains auteurs jugent que leur mobilisation comme cadre d’analyse reste pertinente pour discuter et rendre compte des iniquités sociales dans le monde. En d’autres mots, ces catégories permettraient d’identifier des groupes et des individus désavantagés sur le plan médico-sanitaire.
Objectifs
Cahier REALISME n°11 : L’équité en santé mondiale : qu’en est-il de la fabrique, de la circulation et des conséquences des stéréotypes sur les populations ? vise à discuter la manière dont ces trois catégories sont instrumentalisées par les pratiques sanitaires qui constituent, ensemble, comme cela avait déjà été proposé dans un autre contexte, un système d’opposition et de différence. En d’autres mots, la construction de cette forme de savoir relève de pratiques dans le champ sanitaire qui en viennent à reproduire, renforcer et donner un nouveau sens à la différence dans l’opposition. C’est un ensemble d’opérations qui aboutissent éventuellement à la constitution de stéréotypes à connotation raciale, ethnique voire culturelle.
Méthodes
Nos propos s’appuient sur deux recherches ayant été menées aux États-Unis et au Burkina Faso. La première a procédé à une déconstruction du discours de la santé publique américaine et plus précisément des pratiques et des représentations à propos de la catégorie de race. Elle la situe dans son contexte historique et politique. La seconde a observé la circulation de stéréotypes à propos de certaines populations locales au sein des discours de professionnels de santé au Burkina Faso. Elle a aussi permis de discuter des conséquences potentielles de ces stéréotypes sur une politique sanitaire.
Résultats
Plus globalement, dans ce commentaire, nous discutons des conséquences potentielles des stéréotypes sur la santé des populations visées et sur leurs conduites. Enfin, nous cherchons à dégager des moyens de sortir d’un discours qui a tendance à naturaliser la différence et à donner beaucoup de place à la question de la diversité tout en omettant, dans une certaine mesure, la question du racisme et des inégalités sociales et économiques partout présentes.
Building Intercultural Competences in Monocultural Organisations : Issues and Perspectives in Planning Rehabilitation Services in Montréal
CÔTÉ D.; GRATTON D.; DUBÉ J.; GRAVEL S. (2016)
L’anthropologie et la clinique : épistémologies et pratiques
Fortin, S.; Dorval, G. (2016)
Les rumeurs du blâme en temps d’épidémie
Atlani-Duault, L,; Mercier, A,; Rousseau, C,; Guyot, P,; Moatti, J.P. (2016)
Aujourd’hui comme hier, dans la vie publique comme dans la vie privée, le mensonge et son contraire, la vérité, occupent une place ambivalente.
En politique, le rêve d’une société transparente a abouti au cauchemar totalitaire. Le mensonge est à première vue incompatible avec l’idéal démocratique, qu’il pervertit. Pourtant, il semble devenu inhérent à l’activité politique, même s’il est rendu plus difficile qu’avant avec les technologies nouvelles de communication qui, elles-mêmes, favorisent le succès des théories du complot.
Le mensonge et le secret sont associés parfois à des valeurs supérieures : ne faut-il pas accepter l’existence de secrets d’État, ou de secrets de familles, pour rendre possible le vivre ensemble ? Mensonges et secrets permettent aussi de résister à un pouvoir ou une domination, ménagent l’espace privé, toujours menacé d’intrusion.
Cet ouvrage offre une réflexion sur les conditions qui permettraient de renforcer la démocratie, le vivre ensemble en réduisant la part du mensonge (et celle du secret) à ce qui serait un strict minimum. Mais lequel ?
Discrimination et double appartenance culturelle: la négociation identitaire des adolescents adoptés à l’international
Boivin, M.; Hassan, G.Ghayda Hassan (2015)
À l’adolescence, les enfants adoptés à l’international sont confrontés à un double défi identitaire : celui de l’adoption et celui de la négociation du statut minoritaire. S’ajoute à cette tâche complexe la possibilité que certains d’entre eux soient victimes de discrimination. Le but de la présente étude est de documenter les processus en jeu dans la négociation identitaire des adolescents adoptés à l’international en portant une attention particulière aux enjeux culturels et de discrimination. Des entrevues semi-structurées ont été menées auprès de 13 participants âgés entre 12 et 17 ans et adoptés de pays d’Asie. Une analyse par théorisation ancrée révèle l’existence d’une variation dans les stratégies identitaires bien que la majorité privilégie l’assimilation. Les expériences de discrimination poussent certains à surinvestir leur culture d’accueil au détriment de leurs origines ou, à l’inverse, rend impossible leur intégration. Les implications cliniques sont discutées en lien avec les bénéfices possibles de la socialisation culturelle.
Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians
Hassan, G.; Kirmayer, LJ.; Mekki-Berrada A.; Quosh, C.,; Chammay, R.; Deville-Stoetzel, J.B.; Youssef, A.; Jefee-Bahloul, H.; Barkeel-Oteo, A. Coutts, A.; Song, S.; Ventevogel, P. (2015)
Migrant Friendly Maternity Care in a Western Urban Centre
Gagnon, A.; Pelaez, S.; Merry, L.; Amiri, A.; Hendricks, K. (2015)
Background and Purpose
Migrant-sensitive care provision has been identified as a priority in the World Health Assembly Resolution, ‘Health of Migrants’. Little research has been done on the extent to which migrant-sensitive (‘friendly’) maternity care (MFMC) is currently being provided, factors that support or inhibit provision of such care, and whether specific components of MFMC may be more important than others. We sought to determine: (1) to what extent recommended components of MFMC are being provided to recently-arrived international migrant women giving birth in an urban Canadian city; and (2) what contextual factors support the implementation of MFMC.
Methodology
We conducted a mixed quantitative-qualitative study of 2400 women recently giving birth, speaking any language, in Canada <8 years, and from non-Western countries; and 63 health professionals. Medical records and unit documents were reviewed. The Migrant Friendly Maternity Care Questionnaire was administered and open-ended interviews were completed.
Results
Women from over 97 countries, speaking any of 79 languages reported on their perceptions of how the health system responded to their needs including communication facilitation, promotion of social support, education for healthy weight, treatment of pre-pregnancy/perinatal/maternal illnesses, early access to prenatal care, and responsiveness to preferences for care, among other indicators of MFMC. A range of professionals reported on challenges to care provision and how these were met.
Conclusions and Discussion
Empirical data on migrant-sensitive maternity care, contextual factors supportive of that care, and associated reproductive health outcomes offer baseline data for programming and to permit benchmarking nationally and internationally.
Key messages
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Empirical data on migrant-sensitive maternity care offer baseline data for health programming
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Migrant-friendly maternity care data allow for benchmarking for the future