Publications

Complicated grief remains a controversial topic. Although this concept is found in many cultures, few scientific studies address it from a transcultural perspective. This article, through the presentation of a clinical case and a literature review, describes the particularities of grief across cultures and in the context of immigration, offers a transcultural view of complicated grief and discusses limitations of international classifications to diagnose complications of grief across cultures. Culture and religion influence the mourning process, grief’s clinical manifestations and possible complications. Thus, distinction between normal and complicated mourning in an intercultural context can become complex. The concept of complicated grief is discussed by emphasizing the importance of a culturally sensitive approach to enable an appropriate clinical assessment. We highlight the central question of the meaning given to death and the symptoms experienced in times of mourning. We then discuss the relevance of a critique of the risk of medicalization of bereavement and the limits of international classifications (DSM-5 and ICD-11). We argue that future nosographies would benefit from taking into account the characteristics of complicated grief in non-Western cultures, including specific determinants such as belief systems surrounding “bad death” and cultural interpretations of dreams about the deceased.

This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, Indigenous communities, children, and mental health service users; and research with healthcare professionals, frontline workers, and health planners. In the early context of restrictions caused by COVID-19, this commentary highlights our research setbacks and challenges, and the ways in which we are adapting research methodologies, while considering ethical implications related to the pandemic and their impacts on conducting global and public health research. As we learn to become increasingly aware of some of our limitations in the face of the pandemic, some positives are also worth highlighting: we are mobilizing our training and research skills to participate in COVID-19 projects and to disseminate knowledge on COVID-19, including through papers such as this one. However, we do acknowledge that these opportunities have not been equitable. Each thematic section of this commentary concludes with key recommendations related to research in the early and continuing context of the COVID-19 pandemic that we believe to be applicable to early- and not-so-early-career researchers working in the global and public health fields.

• COVID-19 lockdown left parents as the sole respondents for their children’s needs.
• We examine parents’ reports on the response their child received to their needs during the lockdown.
• Parents of older children reported less fulfillment of children’s needs.
• Societies must ensure pandemics do not create context for child neglect.

Adolescence is a critical period of development, when one-in-five psychiatric disorders emerge. Anxiety, depression, and suicide are the most common. However, most children and youth in need of mental health services in Canada do not have access to them. There is limited information about education and support programs for parents of adolescents to promote their children’s mental health, particularly among ethno-cultural populations. Moreover, the quality of studies focused on these programs is variable. An
environmental scan was conducted to identify community-based programs across Canada oriented to assist the parents of adolescents in the promotion of mental health, as well as the challenges and areas for improvement of these interventions. Alongside, a scoping review of the international and Canadian literature on this topic was carried out. This Policy Brief presents the results and recommendations of both studies.

The pandemic has highlighted the complexity of public health measures and their side effects, the intricacy of the underlying health, social and political phenomena at play as well as their specificity for marginalized minority communities. Based on this experience, this commentary suggests that it would be relevant in the future to develop consultation mechanisms that take into account the entire population, including marginalized minority groups, in order to better inform decision-making processes in times of pandemic. In a context of fluid crisis, any consultation process must take into account the limits of what is possible and mourn the comprehensiveness in favour of repeated iterations of dialogue, mediation and decision-making. This means creating conditions favourable to the consideration of the most vulnerable people and groups’ voices by public authorities. In order to prepare for the next crises, it is necessary to develop strong links between public institutions and communities, both of majorities and minorities, in order to define the mechanisms favouring the emergence of truly inclusive public health, taking into account the physical, mental and social health of the population.

En France, les mineurs non accompagnés (mna) rencontrent de multiples obstacles qui peuvent avoir des effets négatifs sur leur santé mentale. Les professionnels de la santé et du social qui participent à leur prise en charge doivent développer et mettre en œuvre des approches et outils adaptés aux réalités des mna et qui leur offrent un espace d’interactions le plus ouvert possible. À partir d’une revue de littérature, nous proposons dans cet article de dresser un état des lieux de la santé mentale des mna et d’identifier les approches ainsi que les outils développés et mis en œuvre par les professionnels qui visent à favoriser la communication et l’expression des mna (notamment l’approche interculturelle, le travail en interdisciplinarité, l’art-thérapie). Nous formulons en conclusion plusieurs pistes de réflexion à l’endroit des professionnels et des pouvoirs publics qui travaillent avec ce jeune public migrant.

Les sentiments xénophobes, la discrimination et les crimes et incidents de haine sont en augmentation à travers le monde. Bien que la relation entre les attitudes et les comportements ne soit pas linéaire, les attitudes de l’ensemble de la population envers la légitimation de certaines formes de violence peuvent représenter un facteur de risque et alimenter la polarisation sociale, ce qui peut à son tour faciliter le recours à la violence au nom d’une idéologie radicale parmi les personnes vulnérables. . Ainsi, comprendre les facteurs de risque et de protection associés aux attitudes positives à l’égard de la radicalisation violente est un point de départ important pour éclairer des programmes de prévention efficaces. Cependant, peu d’études empiriques ont examiné les attitudes positives à l’égard de la radicalisation violente chez les jeunes, qui courent un risque accru de radicalisation violente. En 2015, un échantillon d’étudiants fréquentant 14 collèges au Québec (74% âgés de 16 à 21 ans, 71% de femmes) a participé à un sondage en ligne visant à enquêter sur les attitudes positives envers la radicalisation violente et le risque associé (c.-à-d. Discrimination, exposition violence, dépression, identité collective polarisée) et facteurs de protection (c.-à-d. orientation future positive, soutien social, religiosité). Deux ans plus tard, la même enquête en ligne a été menée dans six collèges, pour examiner à un niveau préliminaire l’évolution du phénomène dans le temps. Le présent article résume les résultats de ce projet de recherche avec l’objectif final d’améliorer notre compréhension de la radicalisation violente chez les adolescents et les jeunes adultes, afin d’identifier des pistes potentielles de prévention et d’intervention. 71% de femmes) ont participé à une enquête en ligne visant à enquêter sur les attitudes positives à l’égard de la radicalisation violente et le risque associé (c.-à-d. Discrimination, exposition à la violence, à la dépression, identité collective polarisée) et les facteurs de protection (c.-à-d. Orientation future positive, soutien social , religiosité).

Objectives: We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake.

Methods: To generate findings for dissemination: (1) the Republic of Côte d’Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led prevention strategy targeting Ebola virus disease; and (2) the Tunisia project used several designs to assess a mental health training’s effectiveness, and a case study design to explore contextual factors that may influence anticipated outcomes.

Results: To share findings with participants, the RCI project relied on workshops and a pamphlet, and the Tunisia project relied on a structured half-day dissemination workshop and research summary. Facilitators that may have encouraged sharing and using findings include involving champions in dissemination activities, ongoing collaboration, and developing/implementing context-specific knowledge sharing strategies. Barriers include omitting to assess strategies, limited consideration of a wider audience, and the exclusion of a knowledge translation training component.

Conclusions: Our experiences might be useful to contexts involved in global and public health research that wish to address the “know-do gap.”

Guide à l’intention du personnel enseignant pour favoriser le développement du bien-être et de la santé mentale en contexte scolaire au vu des nouvelles réalités imposées par la pandémie

The term “second-generation immigrant” remains widely used by researchers to refer to children of immigrant parents. In this paper, we criticize the normalization of this term and its potential for infinite extension from a historical perspective. We analyze the different meanings it can have according to the social and political context, according to the parents’ country of origin, and according to the historical link between the country of birth and the country of origin. In a situation where the identity construction of the children of immigrants is complex and singular, this term can constitute a positive affirmation of identity for some, while for others it can carry a burden of social suffering.

A position statement developed by the Canadian Psychiatric Association’s (CPA) Transcultural Section and approved by the CPA Board of Directors on July 9, 2020

To help primary care teams improve patient-centered care, we elicited health and life goals of immigrants with a chronic disease. We conducted an exploratory study of the (1) acceptability of home visits by volunteers to collect health information and (2) content of health and life goals within a primary care program for immigrants with chronic disease. Pairs of trained community volunteers visited 23 patients in their homes and asked them to identify three life goals and three health goals. We conducted content analyses of written notes. Health goals were related to disease prevention and symptom control, family well-being, own quality of life, own or family members’ work and/or financial situation. Life goals concerned family well-being, their own quality of life, work/financial situation and health. Given the limited time health professionals have with their patients, trained community volunteers could be important members of primary care teams caring for immigrants.

Cet article reprend les intentions de départ des journées d’étude qui entendaient explorer, dans une perspective comparative France-Québec, la pluralité des récits impossibles dans divers champs d’études et de pratiques (intervenants sociaux, formateurs, juristes, psychologues, traducteurs-interprètes). Elles avaient pour ambition de décloisonner les expertises et faire dialoguer les différents acteurs pour mieux comprendre et analyser les expériences et phénomènes en contexte migratoire. Ceci nous a amenés progressivement sur le terrain de l’interculturalité. Nous pensons que les perspectives théoriques et pratiques entourant le recherche et l’intervention en contexte interculturel au XXIe siècle pourraient être actualisées et enrichir ainsi les regards sur les phénomènes sociaux et migratoires. C’est à partir d’une recension des écrits et une reconnaissance des tensions interculturelles, que nous proposons de développer une dimension critique qui permet de tenir compte des rapports de pouvoir, des dimensions structurelles et systémiques qui régissent les rapports sociétaux. Ainsi, nos propos invitent l’univers du politique, de la pratique et la recherche à mieux définir leurs contours pour s’adapter aux enjeux contemporains et promouvoir une perspective interculturelle ancrée dans les réalités et expériences vécues par les premiers concernés, les acteurs eux-mêmes, les citoyens et la société civile.

In 2019, 30,615 asylum claims were made in Quebec, representing almost half of the claims made in Canada. Asylum-seeking families with young children (0 to 5 years) represent a significant proportion of this population. Canada, as well as Quebec, have a responsibility to protect asylum seekers and to ensure that public policies promote health and well-being, especially among children. However, certain existing public policies exclude asylum seekers and are negatively affecting families. This commentary seeks to raise awareness among all those involved in policymaking, especially decision-makers, regarding asylum-seekers and three policy domains that are contributing to poverty, social isolation, and reduced access to care among asylum-seeking families with young children. These include the lack of eligibility for child benefits, the limited access to affordable daycare, and barriers to accessing family doctors. Consequently, both parents and children suffer impacts to their health and well-being. We are calling on our governments to assume their responsibilities and eliminate these inequities, and to ensure that the health of asylum seekers is considered in all policies.

Le présent ouvrage, en évitant le traditionnel clivage entre méthodes qualitatives et quantitatives, présente 30 devis ou analyses de recherche, dont l’étude de cas, la théorisation ancrée, la revue de littérature systématique, l’essai randomisé, le groupe de discussion focalisée, les analyses multiniveaux, la modélisation par équations structurelles et les approches participatives. Cette nouvelle édition est également enrichie de chapitres portant sur l’examen de la portée, la méta-review des écrits, l’analyse de puissance, l’analyse d’agrégats géographiques, les algorithmes d’apprentissage automatique ou statistique, la modélisation de type Rasch et les enquêtes en ligne.

What factors influence the impact of the crisis associated with COVID-19 on Montreal cultural communities?

Our study indicates that certain groups in cultural communities are made vulnerable by the intersection of multiple economic and social factors, in particular:

• Precarious financial situation;
• Employment in a position at high risk of exposure to COVID ;
• Precarious migration status or lack of status;
• Lack of medical insurance;
• Being allophone;
• Low literacy;
• Being targeted by racism.

These factors may contribute to high levels of infection and psychosocial distress in certain multiethnic, low-income neighbourhoods in Montreal.
Public health policies must take into account the combined impact of these economic, linguistic, sociocultural and migratory factors.

1. Collect data on COVID’s social determinants
2. Facilitate community collaboration and consultation
3. Improve access to health information and guidelines through a multilingual communication
4. Promote access to health and psychosocial services
5. Provide universal access to financial support measures
6. Ensure that COVID-related workplace health and safety measures are respected
7. Guarantee food security
8. Prevent evictions linked to the pandemic
9. Promote family well-being
10. Strengthen intercommunity relations and act against racism

What factors influence the impact of the crisis associated with COVID-19 on  Montreal cultural communities?

Our study indicates that certain groups in cultural communities are made  vulnerable by the intersection of multiple economic and social factors, in  particular :

• Precarious financial situation;
• Employment in a position at high risk of exposure to COVID ;
• Precarious migration status or lack of status;
• Lack of medical insurance;
• Being allophone;
• Low literacy;
• Being targeted by racism.

These factors may contribute to high levels of infection and psychosocial  distress in certain multiethnic, low-income neighbourhoods in Montreal.

Public health policies must take into account the combined impact of these  economic, linguistic, sociocultural and migratory factors.

Background
Migrant families’ transnational ties (i.e., connections to their countries of origin) may contribute to their hardships and/or may be a source of resiliency. A care approach that addresses these transnational ties may foster a positive identity and give coherence to experiences. We conducted an integrative review to determine what is known about transnational ties and the care of migrant families during pregnancy, postpartum and early childhood.

Methods
We searched 15 databases to identify literature reporting on a health or social program, service, or care experience of migrant families during pregnancy up to age five in a Western country (i.e., Canada, US, Australia, New Zealand or a European country). Information regarding if and how the service/program/care considered transnational ties, and care-providers’ perceptions of transnational ties, was extracted, analyzed and synthesized according to transnational ‘ways of belonging’ and ‘ways of being’.

Results
Over 34,000 records were screened; 69 articles were included. Care, programs and services examined included prenatal interventions (a mhealth app, courses, videos, and specialized antenatal care), doula support, maternity care, support groups, primary healthcare and psycho-social early intervention and early childhood programs. The results show that transnational ties in terms of ‘ways of belonging’ (cultural, religious and linguistic identity) are acknowledged and addressed in care, although important gaps remain. Regarding ‘ways of being’, including emotional, social, and economic ties with children and other family members, receipt of advice and support from family, and use of health services abroad, there is very little evidence that these are acknowledged and addressed by care-providers. Perceptions of ‘ways of belonging’ appear to be mixed, with some care-providers being open to and willing to adapt care to accommodate religious, cultural and linguistic differences, while others are not. How care-providers perceive the social, emotional and economic ties and/or the use of services back home, remains relatively unknown.

Conclusion
Significant knowledge gaps remain regarding care-providers’ perceptions of transnational ‘ways of being’ and whether and how they take them into account, which may affect their relationships with migrant families and/or the effectiveness of their interventions. Continued efforts are needed to ensure care is culturally safe for migrants.

This article aims to share key findings from a scoping review of the literature about LGBTQI migrants from a global context. The scoping review methodology allows for rapid assessment of a broad range of literature while also highlighting key knowledge and policy strengths and gaps. Although this review focuses on the Canadian-specific literature, it also compares the Canadian context with the broader global context. Upon presenting a synthesis of the knowledge produced about LGBTQI migrants, implications on Canadian refugee and newcomer settlement policies are critically assessed. This review presents how the Canadian literature has shifted over the past decade from a focus on legal scholarship to broader knowledge from multiple disciplines about the social, political, economic and transnational contexts for LGBTQI migrations to Canada. Although there have been key improvements to Canadian refugee policy, there remains a lack of federal and provincial policies and settlement programs designed to attend to the particular needs of LGBTQI migrants. The relevance of the Canadian knowledge and policies in relation to knowledge emerging from the Global South and elsewhere in the Global North will also enrich the discussion about present and future research and policy directions in this area.

The field of refugee family research and intervention forms a growing field of scientific study, focussing on the refugee family as the central niche of coping with, and giving meaning to, trauma, cultural uprooting, and exile. This important new book develops an understanding of the role of refugee family relationships in post-trauma healing and provides an in-depth analysis of central clinical-therapeutic themes in refugee family psychosocial interventions. Expert contributions from across transcultural psychiatry, psychology, psychotherapy and social work have provided chapters on post-trauma reconstruction in refugee family relationships, trauma care for refugee families, and intersectorial psychosocial interventions with refugee families. This exploration of refugee family systems in both research and clinical practice aims to promote a systemic perspective in health and social services working with families in refugee mental health care.

Canada has no legislation prohibiting forced labour, relying instead on human trafficking penal dispositions; the two are intimately related. However, there was only been one conviction for human trafficking for the purposes of forced labour. Here, we offer an analysis of jurisprudence according to a model of labour trafficking focusing on the intersection of labour exploitation and coercion, particularly among migrant workers. We argue that Canadian human trafficking law remains incomplete and fails to address situations of forced labour. There is a need to think creatively about recourses. Labour and human rights law recourses are more accessible to migrant workers than human trafficking law, given the lighter burden of proof and the unlikelihood that courts will recognize the systemic coercion to which migrant workers are subject. Workers and advocates are understandably drawn to these alternative recourses, yet consequences for employers profiting from forced labour are disappointingly minor.

Selon les intervenants de la Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST), presque 50 % des travailleurs touchés par une lésion professionnelle sur l’île de Montréal seraient issus de l’immigration (ou de groupes ethnoculturels) (CNESST, 2010). Il ne s’agit que d’une estimation, puisque les indicateurs ethnoculturels tels que le pays de naissance, la langue maternelle ou autres ne sont pas des données colligées par la CNESST. Dans le cadre du projet de l’IRSST intitulé Comprendre le processus de réadaptation et de retour au travail dans le contexte des relations interculturelles (Côté et al., 2017), travailleurs, employeurs, cliniciens et intervenants de la CNESST ont été interrogés au sujet des obstacles et des facilitateurs relatifs au retour au travail. Pour le volet clinicien et intervenant de la CNESST, des stratégies ont été identifiées, ainsi que des besoins en matière de développement de compétences interculturelles (CI). Selon les intervenants, l’acquisition de compétences interculturelles peut faciliter la communication interculturelle par les habiletés relationnelles, la capacité d’écoute et de compréhension. La présente recherche a pour objectif le développement du contenu d’un outil d’aide à l’amélioration des compétences interculturelles des intervenants de la CNESST à partir d’une démarche de coconstruction. Cette étude prévoit : la coconstruction d’un outil d’aide à la communication interculturelle pour les intervenants de la CNESST (objectif 1), la documentation du processus de coconstruction de l’outil d’aide à la communication interculturelle (objectif 2) et l’évaluation du développement des compétences interculturelles d’un groupe d’intervenants de la CNESST (objectif 3).Un groupe de travail, composé de dix intervenants (conseillers en réadaptation, agents d’indemnisation) et d’un animateur, un groupe de validation composé de quatorze intervenants (conseillers en réadaptation, agents d’indemnisation) ainsi qu’un comité directeur, se sont réunis sur une base régulière pendant environ dix-huit mois dans la perspective de la recherche collaborative et suivant une approche de coconstruction. Pour atteindre l’objectif général de cette recherche, plusieurs approches méthodologiques et outils de collectes de données ont été utilisés. Tout d’abord, pour répondre à l’objectif 1, a) la recherche collaborative (Desgagné, Chené et Roy, 1997) et b) la méthode des situations en contexte interculturel (Apedaile et Schill, 2008; Mutha, Allen et Welch, 2002; Van Staalduinen, Towle, Godolphin et Laing, 2003; White et Gratton, 2017). Pour répondre à l’objectif 2, c) l’observation participante lors de chacune des rencontres avec le groupe de travail et le comité directeur. Puis, pour répondre à l’objectif 3 sur le développement de la compétence interculturelle, d) l es questionnaires : Intercultural Effectiveness Scale (IES) (Portalla et Chen, 2010) et Intercultural Sensitivity Scale (ISS) (Chen et Starosta, 2000) ont été appliqués aux intervenants et e) un groupe de discussion (avec le comité directeur

L’étude Réactions a pour but de comprendre de façon longitudinale l’expérience des enfants et adolescents d’âge scolaire de la pandémie de la COVID19 ainsi que ses effets sur eux-mêmes et leurs parents. Plus précisément, il s’agit de :1) Dresser un portrait des connaissances et de la compréhension des jeunes de  la pandémie de la COVID19; 2)Explorer les représentations des jeunes des conséquences positives et négatives des mesures de prévention et de protection imposées en réponse à la COVID19; 3) Identifier les facteurs qui contribuent et nuisent au bien-être des enfants, des adolescents et de leur parent en contexte de confinement et de déconfinement; 4) Décrire l’évolution du bien-être, du fonctionnement parental, du fonctionnement familial et du soutien social des familles du Québec au cours de la crise de la COVID19; 5) Générer des connaissances pouvant être mobilisées par les décideurs afin d’être mieux préparés pour soutenir les familles lors de prochaines situations de crise.

Objective
To assess the effect of a free healthcare policy for children under five years old implemented in Burkina Faso since April 2016, on the use of health care of non‐malarial febrile illnesses (NMFI).

Methods
To assess the immediate and long‐term effect of the free healthcare policy in place, we conducted an interrupted time series analysis of routinely collected data on febrile illnesses from three urban primary health centres of Ouagadougou between 1 January 2015 and 31 December 2016.

Results
Of the 39 046 febrile cases reported in the study period, 17 017 NMFI were included in the study. Compared to the period before the intervention, we observed an immediate, non‐statistically significant increase of 7% in the number of NMFI (IRR = 1.07; 95% CI = 0.75, 1.51). Compared to the trend that would have been expected in absence of the intervention, the results showed a small but sustained increase of 6% in the trend of monthly number of NMFI during the intervention period (IRR = 1.06; 95%CI = 1.01, 1.12).

Conclusion
Our study highlighted an increase in the uptake of healthcare services, specifically for NMFI by children under five years of age, after the implementation of a free care policy. This analysis contributes to informing decision makers on the need to strengthen the capacities of healthcare centres and to anticipate the challenges of the sustainability of this policy.

This study used data from the Canadian Community Health Survey (CCHS) (2005–2014) to analyze the relationships between sexual orientation item nonresponse and interview language, conversation language, migration status (migrant-non-migrant), cultural background, sex, age, education level, and marital status in a cross-sectional sample over 18 (n = 351,713 participants). Item nonresponse rates oscillated between 0.87% in 2007 and 1.4% in 2014. Individuals who self-declared as belonging to cultural groups such as Chinese, South Asian, South East Asian, Arab, Indigenous and Other had higher nonresponse odds compared to people who self-identified as Whites. The results showed significant higher nonresponse odds among immigrants. Women had higher nonresponse rates. The likelihood of non-answer increased with age and decreased with education. French interviews, interviews in other languages and speaking both English and French produced less nonresponse. Contrary to common beliefs, sexual orientation questions are not too controversial. Sexual orientation nonresponse is low and stable over time suggesting that research participants are willing to answer sexual orientation questions. These findings highlight that immigrants and people who self-declare as belonging to different cultural groups may interpret the sexual orientation questions differently.

Internationally, human trafficking is usually defined officially as involving a range of exploitative scenarios: forced labor, sexual exploitation, illegal adoption, and organ sales are all commonly included. Each of these phenomena, while having some commonalities, also has many different characteristics. When the state or civil society tries to respond to “human trafficking,” it can be difficult to find an approach that works for all these scenarios. This chapter will discuss the strengths and weaknesses and the advantages and disadvantages of endeavoring to serve the differing populations of people affected by sexual exploitation versus labor trafficking. To substantiate our analysis, we will highlight the experiences of frontline workers by drawing on the findings of 79 interviews conducted in Canada with stakeholders and practitioners in the field. In the context of increased efforts worldwide to counteract trafficking in all its forms, with a notable growing attention to forced labor, this chapter will examine the challenges that arise from tackling diverse forms of trafficking, looking specifically at forced labor and sexual exploitation.

While there is increasing attention to the perspectives of people caught up in human trafficking – attention that has helped illuminate the cloudy nature of consent and agency in situations of human trafficking – the perspectives of children are relatively absent from the debate. Western notions of childhood downplay children’s agency and decision-making. In this chapter, the results of a study that explored the perspectives of over 50 West African children “rescued” by Nigeria’s NAPTIP, a governmental agency mandated to fight human trafficking and protect its victims, are shared. One theme that emerged strongly from the children’s narratives was the centrality of their quest for education, training, and other life opportunities as a factor that led them into situations of human trafficking, a situation likely to exist in other contexts as well. The children’s desire for education was often part of what led them away from home, kept them in their situations of trafficking, and made many of them unwilling to return home after being “rescued” by NAPTIP. These findings suggest a critical need to provide for children’s educational needs if we hope to combat child trafficking, as well as the need to provide meaningful alternatives to children we purport to “rescue.”

Objectives
Growing attention has been given to considering sex and gender in health research. However, this remains a challenge in the context of retrospective studies where self-reported gender measures are often unavailable. This study aimed to create and validate a composite gender index using data from the Canadian Community Health Survey (CCHS).

Methods
According to scientific literature and expert opinion, the GENDER Index was built using several variables available in the CCHS and deemed to be gender-related (e.g., occupation, receiving child support, number of working hours). Among workers aged 18–50 years who had no missing data for our variables of interest (n = 29,470 participants), propensity scores were derived from a logistic regression model that included gender-related variables as covariates and where biological sex served as the dependent variable. Construct validity of propensity scores (GENDER Index scores) were then examined.

Results
When looking at the distribution of the GENDER Index scores in males and females, they appeared related but partly independent. Differences in the proportion of females appeared between groups categorized according to the GENDER Index scores tertiles (p < 0.0001). Construct validity was also examined through associations between the GENDER Index scores and gender-related variables identified a priori such as choosing/avoiding certain foods because of weight concerns (p < 0.0001), caring for children as the most important thing contributing to stress (p = 0.0309), and ability to handle unexpected/difficult problems (p = 0.0375). Conclusion The GENDER Index could be useful to enhance the capacity of researchers using CCHS data to conduct gender-based analysis among populations of workers.

As the global movement of people reaches unprecedented levels, Western governments are increasingly obsessed with border enforcement and migration management. This has resulted in the creation of complex and ever-changing immigration systems, contributing to the proliferation of new and complicated categories of migration status. Increasing numbers of migrants are finding themselves with precarious forms of immigration status and/or no status at all. People in this situation constantly live with the threat of criminalization and deportation – a situation well-documented to have serious economic, social, and health consequences for individuals and communities.

What then of community organizing and community development with people who live under the specter of such threats? Scholarship on community organizing has generally tended to overlook the needs and activism of this population and/or to imply that organizing with precarious and non-status migrants is either practically too difficult or ethically too risky. This chapter challenges the notion that precarious and non-status migrants do not or should not organize and provide insight into the particularities of social work with this community. We begin by looking at how literature describes the risks and challenges associated with organizing this population. We then review the findings of an empirical study conducted in Montreal, shedding light on the forms of individual support, community organizing, and policy advocacy that take place among precarious and non-status migrants. We conclude with a discussion of the importance of organizing with this community and on methods for maximizing their power while minimizing the risk of detention and deportation.

Il s’agit du résumé d’une étude mixte réalisée avec 43 enfants immigrés et réfugiés récemment installés au Québec dans le but de comprendre : 1) Comment les enfants s’adaptent à leur immigration : 2) Comment les enfants perçoivent leur immigration et quels en sont principaux enjeux selon leur point de vue.

Starting from the idea that many social work professors exceed the traditionally defined ‘service’ requirements of their university and are actively involved in social change and justice initiatives, this article aims at critically reflecting upon our own experiences as three social work educators. In the article, we address the question of how social engagement may influence the development of our social work ethical consciousness. If a growing body of literature is available around social work education, teaching and ethical learning and decision-making of social work students, little is yet known about how educators articulate those processes in the context of their work. To achieve this task, we have each undertaken an autoethnographic reflection where we describe one of the most significant situations in the development of our ethical consciousness and examine how they contributed to challenging our pre-existing ethical frameworks in social work. We conclude by discussing how to develop adaptive and pluralistic anti-oppressive ethical frameworks for social work research, teaching, practice and activism.

Purpose: This paper presents the phenomenon of stigmatisation among injured immigrant and ethnocultural minority workers experiencing a long-standing disability. Stigmatisation was one of the main findings of our study, the aim of which was to gain insight into the work rehabilitation process in the context of intercultural relations in Quebec. Various categories of stakeholders took part in the study, which sought to describe their experiences and perspectives and to identify the constraints, barriers, facilitators, and specific needs they encounter in terms of intercultural competencies.

Methods: A purposive sample of 40 individuals was selected and divided into four groups: workers (N = 9), clinicians (N = 15), workers’ compensation board rehabilitation experts (N = 14), and workplace representatives (N = 2). Semi-structured interviews were conducted using the critical incident technique, combined with an “explicitation” interviewing technique. Data collection and analysis procedures were based on grounded theory.

Results: This study shows that immigrant and ethnocultural minority workers may experience stigmatisation as a cumulative process involving different concomitant parts of their “identity”: age, gender, social class, ethnicity, mental health, and occupational injuries. Cumulative stigma may aggravate personal distress and feelings of shame, rejection, and disqualification from full social acceptance. Negative anticipatory judgements made by practitioners may undermine the therapeutic relationship and breach mutual trust and confidence.

Conclusions: The phenomenon of stigmatisation is well documented in the sociological and health literature, but studies tend to focus on only one type of stigma at a time. Future research should focus on the cumulative process of stigmatisation specifically affecting immigrant and ethnocultural minority workers and its potentially damaging impact on self-concept, healthcare delivery, rehabilitation interventions, and the return to work.

Implications for rehabilitation

• The repetition of certain clinical situations with people from certain groups should not lead practitioners to undue generalizations, even if they may sometimes be accurate; these generalizations must always be verified on a case by case basis.

• Ethnicity and culture, along with other social attributions, should serve as working hypotheses or support tools in health communication, not as hindrances to clinical reasoning.

• Practitioners should deepen their understanding of the patient’s treatment expectations and the support available for rehabilitation in his family and community.

• Stigma in the context of care is linked to the idea of conforming to the proposed institutional models of care (including expected beliefs, attitudes, and behaviours). Therefore, practitioners should be aware that alleged differences, misunderstanding or disagreements can highlight an asymmetry in practitioner–patient power relationships.

• Organisations should also promote exchange and reflection on how to adapt their institutional models to avoid asymmetrical power relations.

• Intercultural training should be promoted at the various organisational levels so that managers, decision-makers, and practitioners share a common knowledge of the challenges of intervention in multi-ethnic settings.

In our study, almost half of immigrants without health insurance perceived  their health as negative, much higher than reports of negative self-perceived health in previous Canadian studies (8.5% among recent immigrants, 19.8% among long-term immigrants, and 10.6% among Canadian-born). Our study also suggests a high rate of unmet health care needs among migrants with precarious status, a situation that is correlated with poor self-perceived health. There is a need to put social policies in place to secure access

On les appelle mineurs non accompagnés, mineurs isolés ou encore enfants séparés. Ces dénominations différentes traduisent la difficulté à saisir la complexité et la diversité des situations qu’ils vivent, même s’ils ont en commun le fait d’être âgés de moins de 18 ans et d’avoir migré vers d’autres Etats sans un adulte qui soit responsable d’eux. Cet ouvrage interdisciplinaire réunit et synthétise onze contributions provenant de la sociologie, du droit, de l’anthropologie, de la communication, des sciences de l’éducation, de la psychologie sociale et du travail social.

Objective: The present study examined whether a positive future orientation was linked to lower levels of sympathy for violent radicalization (VR) beyond the contributions of depression among a sample of college students in Quebec, Canada. In addition, we investigated whether these associations varied by gender and levels of depression. Method: A total of 1,680 college students (71% women: 74% aged between 16 and 21 years) were included in this study. Linear mixed-effects models were implemented to test the contributions of future orientation and depression to sympathy for VR, controlling for the relevant sociodemographic variables. Results: A positive future orientation was linked to lower sympathy for VR beyond depressive levels (β = −0.08, 95% confidence interval [CI] [−0.13, −0.04]). This association was stronger among participants with higher depression scores (β = −0.11, 95% CI [−0.20, −0.01]) compared with participants with lower depression scores (β = −0.05, 95% CI [−0.16, 0.05]). The association was also modified by gender with a negative effect observed only in men (β = −0.18, 95% CI [−0.26, −0.10]). Finally, when conducting gender-stratified analyses, higher future orientation was associated with lower sympathy for radicalization among men with higher depression scores (range of estimates: −0.21 to −0.26). Conclusions: Youth who lack positive perspectives of the future may support violence. Fostering a meaningful vision of the future in youth may be a way to counter the attraction of VR. Schools and colleges are in a privileged position to implement preventive interventions to support a positive future orientation. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

While access to healthcare for permanent residents in Canada is well known, this is not the case for migrants without healthcare coverage. This is the first large-scale study that examines the unmet healthcare needs of migrants without healthcare coverage in Montreal. 806 participants were recruited: 436 in the community and 370 at the NGO clinic. Proportions of individuals reporting unmet healthcare needs were similar (68.4% vs. 69.8%). The main reason invoked for these unmet needs was lacking money (80.6%). Situations of not working or studying, not having had enough food in the past 12 months, not having a medical prescription to get medication and having had a workplace injury were all significantly associated with higher odds of having unmet healthcare needs. Unmet healthcare needs were more frequent among migrants without healthcare coverage than among recent immigrants or the citizens with health healthcare coverage (69%, 26%, 16%). Canada must take measures to enable these individuals to have access to healthcare according to their needs in order to reduce the risk of worsening their health status, something that may have an impact on the healthcare system and population health. The Government of Quebec announced that all individuals without any healthcare coverage will have access to COVID-19 related health care. We hope that this right, the application of which is not yet obvious, can continue after the pandemic for all health care.

The worldwide upsurge in social polarizations generates intercommunity  tensions that challenge the social fabric of urban neighborhoods and undermine the relationships between their members. Because community arts can foster the creation of connections between people that would not have been in contact otherwise, they are often perceived as being powerful tools to foster community resilience. Through a multiple case study approach, this article describes how three community arts projects, carried out in two socioeconomically deprived neighborhoods of Montreal (Canada), influenced the social relationships between participants from diverse ethnocultural backgrounds and generations. Using participant observation and arts‐based data collection methods (photography, video, and arts productions), the authors examine how the three projects illustrate (a) the interactive processes at play, (b) the transmission and hybridization of stories and images of adversity and resiliency, and (c) the access to a collective voice.

• Global health can be anywhere as it often focuses on large-scale health inequities that are rooted in transnational determinants.
• Some global health initiatives and actors aim to find solutions to domestic problems.
• King and Koski’s definition of global health may exacerbate inequities by reserving the right to call oneself a global health researcher to those who are privileged and have access to funding that enables them to travel to other settings.
• An inadequate definition of global health based on a ‘here’ vs ‘somewhere else’ dichotomy could result in less funding for a field already characterised by limited resources.
• The decolonisation of global health requires promoting and valuing reflexivity, critical approaches, equitable partnerships and accountability.

Population health intervention research (PHIR) is a particular field of health research that aims to generate knowledge that contributes to the sustainable improvement of population health by enabling the implementation of cross-sectoral solutions adapted to social realities. Despite the ethical issues that necessarily raise its social agenda, the ethics of PHIR is still not very formalized. Unresolved ethical challenges may limit its focus on health equity. This contribution aims to highlight some of these issues and calls on researchers to develop a culture of ethics in PHIR. Three complementary ways are proposed: to build an ethical concept specific to this field, to promote a shared space for critical reflection on PHIR ethics, and to develop the ethical competence in PHIR for which a preliminary framework is proposed.

Objectives
The Ebola virus disease (EVD) is associated with major mental health consequences (e.g., depression, anxiety, PTSD). Studies have shown a need for relevant and effective programs to address mental health consequences associated to EVD. This systematic review aimed to describe programs implemented following EVD outbreaks and to evaluate their effectiveness and relevance in order to provide evidence-based data to improve mental health services.

Methods
We first searched EMBASE, PubMed, PsycINFO, PILOTS, Cochrane Library and MEDLINE for a systematic review on EVD and on MHPSS programs. Then, we searched the grey literature. The search generated 2827 publications. Eleven studies were retained according to the PRISMA statement.

Results
This systematic review revealed that most programs were implemented by international organizations in collaboration with local partners. Many of them were implemented following WHO mhGAP and Psychological First Aid guidelines. Programs were implemented in hospitals, Ebola treatment centres, communities among different categories of individuals exposed to EVD (survivors, health workers and volunteers, other frontline workers, children, adults, etc.). Only two of the identified programs which integrated cultural factors were empirically evaluated. Results from the evaluations showed mental health improvement for both children and adults.

Conclusions
This study provides the first systematic review on MHPSS programs among communities affected by EVD. This study shows the need to increase efforts to systematically document and evaluate the implemented programs. Results also provide preliminary evidence about the value of culturally sensitive MHPSS programs and of the implication of local mental health professionals.

Objective
We aimed to quantify the extent to which country-level trends in HIV incidence in Sub-Saharan Africa (SSA) were influenced by gender inequalities, measured by gender gaps in educational attainment, income, and a Gender Inequality Index (GII).

Study design
We examined the relation between gender inequality and HIV incidence using country-level panel data from 24 SSA countries for the period between 2000 and 2016.

Methods
Our goal was to estimate the relation between within-country changes in gender inequality and HIV incidence. We compared results from fixed effects and random effects models for estimating the effect of gender inequalities on changes in HIV incidence. Based on the results of the Hausman test, the fixed effects model was selected as the preferred approach.

Results
HIV incidence decreased by nearly one-half over the period from 2000 to 2016. We estimated that a one percent increase in the GII was associated with a 1.6 percent increase in HIV incidence (95% confidence interval = [0.21%; 3.00%]), after adjusting by country-level socio-economic and governance variables.

Conclusions
Our study suggests that addressing gender inequalities is a potential strategy to reduce HIV incidence in the SSA region. To control HIV infection, policymakers and public health practitioners should support relevant interventions for promoting gender equality. Further work is needed to identify specific interventions to improve gender inequality and to examine their impacts on changes in HIV incidence.

Evidence about psychological experiences surrounding female genital mutilation/cutting (FGM/C) remains weak and inconclusive. This article is the first of a series that deploys qualitative methods to ascertain the psychological experiences associated with FGM/C through the lifecycle of women. Using the free listing method, 103 girls and women, aged 12 to 68 years from rural and urban Izzi communities in Southeastern Nigeria, produced narratives to articulate their perceptions of FGM/C. Sixty-one of them had undergone FGM/C while 42 had not. Data was analysed using thematic analysis and the emerging themes were related to experiences and disabilities in the psychological, physical, and social health domains. While physical experiences were mostly negative, psychological experiences emerged as both positive and negative. Positive experiences such as happiness, hopefulness, and improved self-esteem were commonly described in response to a rise in social status following FGM/C and relief from the stigma of not having undergone FGM/C. Less commonly reported were negative psychological experiences, e.g., shame when not cut, anxiety in anticipation of the procedure, and regret, sadness, and anger when complications arose from FGM/C. Some participants listed disruption of daily activities, chronic pain, and sleep and sexual difficulties occurring in the aftermath of FGM/C. Most participants did not list FGM/C as having a significant effect on their daily living activities. In light of the association of FGM/C with both positive and negative psychological experiences in the Izzi community, more in-depth study is required to enable policy makers and those campaigning for its complete eradication to rethink strategies and improve interventions.

Following the 6th Conference of the International Society for Child Indicators  Montreal, 2017), this Special Issue was compiled to advance an interdisciplinary understanding of the complexity of conceptualizations, determinants, consequences, and measurement of child neglect around the world and to highlight the need for reforms in child protection systems. The most common type of child maltreatment with long term damaging consequences for children, families, and societies child neglect continues to receive limited scientific and public attention, particularly in resource low settings and in the field of child indicators. Lack of clarity in definition and measures, weak multi-sectoral coordination, and unclear accountability lines, are among the factors that contribute to the insufficient attention to neglect in research and action. Adopting an eco-systemic perspective of child neglect allows us to incorporate the perspectives of families and to question the role and responsibility of the State and the broader conditions within which parents operate. Sound statistical and qualitative indicators of child wellbeing in cases of neglect are urgently needed across geographic areas and over time. Combining child-centredness and attention to socio-economic, cultural, and political context issues will be important in advancing the field.

L’immigration constitue une transition ayant des répercussions considérables sur la santé et le bien-être des personnes immigrantes pouvant donner lieu à des virages dans une trajectoire de vie. Le contexte dans lequel ces expériences sont vécues requiert une sensibilité aux dynamiques, aux interactions, aux trajectoires, aux situations de vulnérabilité et aux capacités de résilience qui modulent le recours et l’accès aux services de santé ainsi qu’à la justice. Il est proposé de prendre ancrage dans les expériences des femmes avec divers angles d’analyse. Il s’agira d’illustrer par le biais de trois perspectives les risques auxquels sont exposées les femmes ayant subi l’excision et l’infibulation. Le statut identitaire, notamment une identité de victime, un détachement entre le corps et le vécu seront mis en exergue comme expériences rapportées vers le développement de pratiques sensibles à la complexité des expériences, des approches se voulant réflexives, de qualité et équitables. Des illustrations sur les divergences perçues entre des pratiques et discours professionnels, et l’expérience effective des femmes, issus des communautés de pratique contribueront aux discussions.

The number of refugee youth worldwide receives international attention and is a top priority in both academic and political agendas. This article adopts a critical eye in summarizing current epidemiological knowledge of refugee youth mental health as well as interventions aimed to prevent or reduce mental health problems among children and adolescents in both high- and low-to-middle-income countries. We highlight current challenges and limitations of extant literature and present potential opportunities and recommendations in refugee child psychiatric epidemiology and mental health services research for moving forward. In light of the mounting xenophobic sentiments we are presently witnessing across societies, we argue that, as a first step, all epidemiological and intervention research should advocate for social justice to guarantee the safety of and respect for the basic human rights of all refugee populations during their journey and resettlement. A constructive dialogue between scholars and policy makers is warranted.

The upsurge in violent radicalization is associated with a global increase in social inequalities and conflicts related to different markers of identity. To date, literature on the factors associated with legitimizing violence toward others is cross-sectional and does not provide information on the possible change of this phenomenon over time. Such information is necessary to design primary prevention programs that are adapted to and address a rapidly evolving social context. We use a repeated cross-sectional study design to explore the association between sociodemographic characteristics and scores on the Sympathy for Violent Radicalization Scale (SVR) in Quebec (Canada) college students at 2 times points. Results from an online survey completed by students of 6 colleges in 2015 (n = 854) and 2017 (n = 702) indicate that although overall scores on the SVR scale remained stable, there were changes in the association between age, identity, and the outcome at the two time points. Specifically, scores on the SVR were significantly higher among younger students in 2017 than in 2015. In addition, in 2017 we observed a relationship between collective identity and SVR that was not present in 2015. These results align with other recent studies in Canada and the U.S. documenting the emergence of new forms of youth politicized bullying associated with race, ethnicity, and religion. A close monitoring of the phenomenon is warranted to both better understand the impact of populist policies on the increase in hate incidents and crimes and develop programs to address these forms of violence from a public health perspective. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Forced migration and extended time spent migrating may lead to prolonged marginalization and increased risk of HIV. We conducted a population-based cohort study to examine whether secondary migration status, where secondary migrants resided in a transition country prior to arrival in Ontario, Canada and primary migrants arrived directly from their country of birth, modified the relationship between refugee status and HIV. Unadjusted and adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated using log-binomial regression. In sensitivity analysis, refugees with secondary migration were matched to the other three groups on country of birth, age and year of arrival (+/− 5 years) and analyzed using conditional logistic regression. Unmatched and matched models were adjusted for age and education. HIV prevalence among secondary and primary refugees and non-refugees was 1.47% (24/1629), 0.82% (112/13,640), 0.06% (7/11,571) and 0.04% (49/114,935), respectively. Secondary migration was a significant effect modifier (p-value = .02). Refugees with secondary migration were 68% more likely to have HIV than refugees with primary migration (PR = 1.68, 95% CI 1.06, 2.68; APR = 1.68, 95% 1.04, 2.71) with a stronger effect in the matched model. There was no difference among non-refugee immigrants. Secondary migration may amplify HIV risk among refugee but not non-refugee immigrant mothers.

L’école occupe une place centrale dans le développement du bienêtre psychologique des enfants traumatisés et endeuillés. Une recherche-action nous a permis d’évaluer positivement les retombées de la mise en place de groupes de parole dans les classes accueillant des élèves réfugiés.

This article is based on life stories collected between 2014 and 2018 among a population of baby boomers of French Canadian descent, whose personal path echoes the social and political history of the province. Following their socialization in a Catholic context, this generation has known a rapid phase of secularization, modernization and diversification that, since the end of the 1960s, have impacted the local social and political landscape of the province. The entanglement between individual and collective experiences shapes a particular rhetoric on the « laïc » (secularist) project in Quebec that hinges on memories of Catholicism, concern for gender equity and pluralist ethics. Drawing on Maclure and Taylor’s model of open and closed secularism, the author discuss the means and ends of the moral principles underlying baby boomers’ narratives.

While a series of changes in the approaches to FGM/C health research and intervention have historically taken place, there has been an increased implementation of sexual health interventions for women with FGM/C over more than a decade. These interventions derive from health research data, but their epistemology and praxis are also informed by cultural representations of the clitoris and what it means to be ‘healthy’. This is the case, notably, for genital reconstructive surgeries, which are performed globally in spite of a lingering inconclusiveness regarding their general efficacy, Summary drawing from research in Ivory Coast and Canada, from the results of the Quebec Ministry of Health and Social Services- commission ED training module on FGM/C, as well as from the author’s clinical practice in mental health working with women with FGM/C, this presentation aims to illuminate the multifarious ethical underpinnings of such sexual health interventions. The overarching goal of this presentation is to share best practices in sexual health interventions in order to afford compassionate care, grounded in a reflexive and ethical professional practice.

International migration to North America continues to rise, and with it the meeting of different cultural norms surrounding child caregiving and supervision. Previous research shows that high rates of reporting of supervisory neglect involving migrant families may partly result from these different norms and challenges particular to the migrant context. In this study, five focus groups were conducted with migrant caregivers (n = 19) and children aged 12–17 years (n = 25) to explore their experiences surrounding caregiving changes in migration as well as factors that help and hinder child supervision in migrant communities in Montreal, Canada. Results following thematic analysis indicate that family roles change in migration, but that caregivers and children perceive these changes differently. Families perceive and experience discrimination and judgment of their parenting practices from community members and fear that those will be labelled neglectful. Change in families’ social support, especially at the neighbourhood level, has an important influence on caregiving practices. Results also show that parents’ preparation of children to provide care for siblings and others is often not recognised as a strength by service providers in direct contact with families. Directions for future research and implications for practice are discussed.

To date the literature on religion and mental health has focused upon Christianity. We cannot assume that these findings can be transposed onto other faith groups. In this paper I focus upon Islam, Judaism and Hinduism and discuss understandings of mental illness and the relationships between central beliefs and mental health. I discuss implications for clinical work and psychotherapy.

• Opening up dialogue with children and youth can add to research and support participation.
• Young people’s advisory groups contribute a valuable ethical dimension to research practice.
• Institutional ethics requirements can create challenges for ethical practice with children and youth.
• Young people and adults may have differing expectations of the role and process of advisory groups.
• Virtual communications can facilitate dialogue, but have limitations in the Global South.

Dans le contexte d’arrivées importantes de demandeurs d’asile au Québec depuis l’été 2017, le CERDA, en collaboration avec le Centre de recherche SHERPA, a développé une trousse d’outils afin de :

1. Sensibiliser les professionnels aux réalités vécues par les demandeurs d’asile et aux particularités de l’intervention auprès de cette clientèle ;
2. Faciliter le travail des professionnels en rendant accessible des informations sur les ressources d’accueil et d’intégration auxquelles les demandeurs d’asile ont accès

La trousse inclut un guide, 7 capsules vidéos et des fiches synthèses

Ce symposium fut l’occasion de poser un regard
critique sur diverses questions autour du processus de transfert de connaissances, incluant les
notions de valorisation des savoirs, d’innovation
sociale ou technologique, de “meilleures pratiques“,
de gestion ou de mode d’intervention par données
probantes. Les réflexions sur la nature du partenariat entre l’Université, les chercheurs, les établissements et les divers acteurs impliqués dans
l’intervention furent également au cœur de cette
journée

There is a gap in research regarding transnational family support (emotional, practical, spiritual, informational and financial) as a resource for migrant families with children. From the perspective of migrant families and their family back home, the objectives of this study are to (1) identify the types and ways that transnational family support is provided to migrant families in Canada; (2) assess for patterns in the data that may suggest variations in the nature of this support (eg, by migration status, time in Canada, children’s ages, family circumstances) and over time and (3) explore the impact (positive and negative) in receiving and providing transnational support, respectively.

Methods and analysis:
A focused ethnography is planned. We will recruit 25–35 migrant families with children with different migration histories (eg, economic or forced migration from a mix of countries) and family circumstances (eg, single parenthood, families living with extended family, families with children in the home country) living in Montreal, Canada. Families will be recruited through community organisations. Data will be gathered via semistructured interviews. To capture the
perspective of those providing support, family members in the home country for each migrant family will also be recruited and interviewed through communication technology (eg, WhatsApp). Data collection will also involve observation of ‘transnational interactions’ between family members in Montreal and those back home. Data will be
thematically analysed and results reported in a narrative form with an in-depth description of each theme.

Ethics and dissemination :
Ethical approval was obtained from the sciences and health research ethics committee at the University of Montreal. Study results will be shared through traditional forums (publication, conference presentations) and via other knowledge dissemination/ exchange activities (eg, ‘lunch and learn conferences’ and seminars) through the research team’s research centres and networks to reach front-line care-pro.

Youth mental health (YMH) services are greatly underutilized, particularly for migrant youth. Collaborative models of care offer promising avenues, but research on these treatment modalities is still scarce, particularly for migrants. The goal of this exploratory study is to better understand quality of care including factors improving access to care and collaborative YMH services use, efficacy and satisfaction, for this vulnerable population. This qualitative study relies on a multi-informants (youth, parents, clinicians) and multiple case study design to explore YMH collaborative services for migrant youth living in an urban setting (Montreal, Canada). Participants are five young patients (12–15 years old), one of their parents and their primary care therapist (N = 15). They come from migrant families, have a psychiatric diagnosis and have been receiving mental health services in a collaborative care setting for at least 6 months. Transcripts of semi-structured interviews for the five triads were thematically analyzed to draw similarities and contrasts between actors, across and within case-studies. Based on these findings, four themes emerged concerning the optimal care setting for collaborative YMH services for migrant families: (1) providing an equilibrium between communication, collaboration and privacy/confidentiality, (2) special attention to ensuring the continuity of care and the creation of a welcoming environment where trusting relationships can develop, (3) the inclusion of family intervention, and (4) the provision of collaborative decision-making pathways to care, addressing interprofessional and interinstitutional collaboration as well as cultural differences in explanatory models and values.

This article examines how the Canadian immigration regime socially organizes the everyday lives of queer and trans migrants with precarious status. Drawing from key findings from an institutional ethnographic study, this article maps out the disjuncture between the actual experiences of queer and trans migrants with precarious status and the ideological and textual production of precarious status by the Canadian state. Making explicit this disjuncture reveals how the Canadian immigration regime enacts structural violence upon queer and trans migrants. This article also engages with the response-based approach to violence in order to understand how queer and trans migrants actively respond to this violence. In doing so, this article highlights the ways in which queer and trans migrants respond and resist the structural violence integral to the Canadian state’s production of precarious status.

Introduction : La « démence » est généralement vue comme un syndrome caractérisé par le déclin d’une ou de plusieurs capacités cognitives, comme la perte de mémoire. Toutefois, perte de mémoire ne signifie pas pour autant démence. La plus fréquente des démences est la maladie d’Alzheimer dont la fréquence augmente avec le grand âge. En anthropologie de la santé, les maladies et leur expression représentent des construits socio-culturels qui ne sont pas reconnus et interprétés de la même façon par tout le monde. Par ailleurs, le contexte migratoire est source de difficultés dans le domaine de la démence. Cet article vise à discuter les liens entre vieillesse, démence et recherche d’aide dans ce contexte.
Méthode : Nous nous appuyons sur une étude qualitative exploratoire. Dix entrevues semi-structurées ont été réalisées avec des femmes et des hommes nés en Haïti et qui ont ensuite immigré au Québec. Ces entrevues nous ont permis de discuter du statut des aînés, du sens donné à la perte de mémoire et de la recherche d’aide.
Résultats : Les entrevues révèlent une pluralité des représentations à propos des pertes de mémoire et de la maladie d’Alzheimer. Elles mettent en lumière une diversité de croyances, d’attitudes et de valeurs traduisant une variabilité culturelle et sociale au sein d’une même communauté. La prise en compte du contexte permet de comprendre tantôt la transformation, tantôt la continuité des représentations et des conduites vis-à-vis des pertes de mémoire.
Conclusion : La démence ne semble pas être un phénomène qui est abordé facilement au sein de la communauté haïtienne du Québec. Au final, cette étude révèle un manque d’information à ce propos.

Les débats autour du projet de loi 21 sur la laïcité de l’État reflètent l’ampleur de ses enjeux sociétaux. Beaucoup d’opinions et d’analyses théoriques, historiques et philosophiques ont été exprimées pour ou contre le projet de loi, mais peu ou pas de données empiriques ont été présentées pour éclairer les choix politiques délicats qui s’imposent. L’objectif du présent avis est d’amorcer une analyse des bénéfices et des risques du projet de loi 21, en termes de conséquences pour la santé publique. Cette analyse préliminaire se base sur les données probantes québécoises disponibles, pour la période 1990-2019. Elle a été produite par des chercheurs en sciences humaines, sociales et médicales, appartenant à l’Institut Universitaire SHERPA du CIUSSS-CODIM et à l’Équipe de Recherche et Action sur les Polarisations Sociales.

Les débats autour du projet de loi 21 sur la laïcité de l’État reflètent l’ampleur de ses enjeux sociétaux. Beaucoup d’opinions et d’analyses théoriques, historiques et philosophiques ont été exprimées pour ou contre le projet de loi, mais peu ou pas de données empiriques ont été présentées pour éclairer les choix politiques délicats qui s’imposent. L’objectif du présent avis est d’amorcer une analyse des bénéfices et des risques du projet de loi 21, en termes de conséquences pour la santé publique. Cette analyse préliminaire se base sur les données probantes québécoises disponibles, pour la période 1990-2019. Elle a été produite par des chercheurs en sciences humaines, sociales et médicales, appartenant à l’Institut Universitaire SHERPA du CIUSSS-CODIM et à l’Équipe de Recherche et Action sur les Polarisations Sociales.

La Maison Bleue is a community-based perinatal health and social centre in Montreal that provides services during pregnancy up to age five to families living in vulnerable contexts. The study aimed to describe: 1) the challenges and protective factors that affect the well-being of migrant families receiving care at La Maison Bleue; and 2) how La Maison Bleue strengthens resilience among these families.

Climate change is one of today’s major challenges, among the causes of population movements and international migration. Climate migrants impact health systems and how they respond and adapt to their needs and patterns. But to date, the resilience of health systems in the context of climate change has been little explored.

The purpose of this article is to show the importance of studying, from an interdisciplinary perspective, the relationships between climate change, migration, and the resilience of health systems.
Resilience is an old concept, notably in the field of psychology, and is increasingly applied to the study of health systems. Yet, no research has analysed the resilience of health systems in the context of climate change.

While universal health coverage is a major international goal, little research has to date focused on the existing links between climate, migration, health systems and resilience.

We propose an interdisciplinary approach relying on the concept of health system resilience to study adaptive and transformative strategies to articulate climate change, migration and health systems

Les croisements entre trauma et violence sont souvent pensés sous l’angle de la violence subie, le premier s’inscrivant dans le sillage de la seconde. Les effets de la violence se traduisent alors en symptômes, mais aussi en agir, dans des cycles de répétition traumatique où la personne traumatisée peut se remettre dans des situations de risque. Qu’ils empruntent le vocabulaire de la psychanalyse ou celui d’approches biomédicales, de nombreux écrits en psychologie mettent ainsi de l’avant le caractère déstructurant de la violence traumatique.

Introduction Every year, up to 1 billion children are victims of violence worldwide. Most child abuse takes place in the context of punishment. The Families First Programme, an adaptation of the Positive Discipline in Everyday Parenting Programme to the West Java context, is a parenting support programme anchored on children’s rights that gives parents guidance on child development, parenting and positive discipline practices. This trial will evaluate the effectiveness of the Families First Programme compared with a waitlist control group.

Methods and analysis This is a pragmatic, parallel-group, stratified, cluster-randomised controlled trial. Twenty rural and urban villages in the Cianjur District, Indonesia, involving 720 caregivers of children up to 7 years of age, will be randomised. Villages will receive either a parenting programme consisting of 10 group sessions and four home visits over 3 months and standard community health and social services or just the latter. After completion of the trial period, the programme will be offered to those in the delayed group. Outcome data will be collected before randomisation (baseline), immediately postintervention (3 months postrandomisation) and 6 months later (9 months postrandomisation). The primary outcome will be frequency of physical and emotional punishment as measured by a weighted sum from three self-report items. Primary outcome analysis will use Poisson regression with generalised estimating equations and assess the interaction between intervention and time over baseline and 3 and 9 months postrandomisation assessments. Concurrent process evaluation will be conducted to assess programme satisfaction and facilitators and barriers to the implementation of the programme generalisable to other settings.

Ethics and dissemination Ethics approval was obtained from McGill University and Universitas Katolik Indonesia Atma Jaya. Results will be published in peer-reviewed journals and presented at scientific conferences and events for decision-makers, including in the participating communities.

Objectif
Évaluer les stratégies d’interventions dans la lutte contre le choléra à Uvira dans la perspective de les
renforcer
Matériel et méthodes.
L’étude a été évaluative recourant à des entrevues avec des acteurs impliqués dans la lutte contre le choléra et à la revue documentaire. Elle concerne la période de 2013 à 2016. Les données quantitatives relatives aux nombres de nouveaux cas et des décès ont été analysées à l’aide d’Excel. L’analyse des données qualitatives a été faite par thème en fonction des questions de recherche et au regard de la stratégie nationale de lutte contre le choléra en RDC.

Résultats
La corrélation entre les stratégies de lutte contre le choléra mises en place par les acteurs et les stratégies nationales de lutte contre le choléra reste relativement très faible dans la zone de santé. Des inadéquations entre ces deux groupes de stratégies sont ainsi relevées au cours de l’étude. Les effets positifs des différentes interventions mises en œuvre se traduisent par la diminution du nombre des nouveaux cas de choléra de 28% entre 2014 (1839 cas) et 2015 (1316 cas) et une certaine stagnation depuis 2016 autour de 1392 cas par an. L’efficacité des interventions est perçue efficace par seulement par 25% des membres de la  communauté contre 62% des agents des organisations; les effets des interventions sont estimés durables par 38% des membres de la communauté contre 68 % des agents des organisations et 34% des membres de la communauté (68% des agents des organisations) pensent que la participation communautaire est sollicitée lors des interventions de lutte contre le choléra. Par contre, la grande majorité des membres de la communauté (87%) et des agents des organisations (99%) jugent pertinentes les interventions de lutte contre le choléra au cours de l’étude. La faible implication de la communauté dans les actions de lutte contre le choléra et le caractère urgentiste des interventions sont fortement fustigés.

Conclusion
L’élimination du choléra en tant que problème de santé publique fait face à plusieurs défis dont le plus important semble être l’accès durable à plus de ressources par tous les acteurs, principalement l’État. L’implication plus visible des autorités politico-administratives est souhaitée.

Purpose

This paper presents an analysis of how health intersects with the experience of housing insecurity and homelessness, specifically for migrant women. The authors argue that it is important to understand the specificities of the interplay of these different factors to continue the advancement of our understanding and practice as advocates for health and housing security.

Design/methodology/approach

An exploratory, qualitative, methodological approach was adopted, using a broad definition of housing insecurity: from absolute homelessness (e.g. residing rough) to invisible homelessness (e.g. couch surfing) to those at risk of homelessness. In total, 26 newcomer (foreign-born women who came to live in Canada during the previous ten years, regardless of their immigration status) women were recruited in Montreal, Canada. Participants were recruited directly through advertisements in public places and in collaboration with community organizations (women’s centers, homeless shelters, crisis centers, domestic violence shelters, immigrant settlement agencies and ethnic associations) and they self-identified as having experienced housing insecurity. Efforts were made to include a diversity of immigrant statuses as well as diversity in ethnicity, race, country of origin, family composition, sexual orientation, age and range of physical and mental ability. Women were engaged in semi-structured, open-ended interviews lasting approximately 1 h. Interviews were conducted in English or French in a location and time of participants’ choosing.

Findings

The findings are presented around three themes: how health problems instigate and maintain migrant women’s housing insecurity and homelessness; ways in which women’s immigration trajectories and legal status may influence their health experiences; and particular coping strategies that migrant women employ in efforts to maintain or manage their health. The authors conclude with implications of these findings for both policy and practice in relation to migrant women who experience or are at risk of housing insecurity and homelessness.

Originality/value

Intersections of women experiencing migration and housing insecurity in Canadian contexts have rarely been examined. This paper addresses a gap in the literature in terms of topic and context, but also in terms of sharing the voices of migrant women with direct experience with housing insecurity.

The Immigration and Refugee Protection Act (IRPA) in Canada has set the stage for inclusive policy. Health literacy, language spoken, and gender are among the selected differential resettlement determinants of refugees’ access to health resources and opportunities. Gender-based analysis (GBA) is a priority for IRPA for promoting inclusive settlement policies. However, these legislative structures do not reflect language and health literacy as important intersections for immigrant integration. The objective of this chapter is to demonstrate that intersectionality as a policy tool can help structural and political processes to promote social justice and integration commitments to settlement and health care policy.

Objectives :Violence committed by extremists has serious violent and non-violent public health consequences. Researchers have hypothesized an association between experiencing discrimination and support for radicalization. This study examines the relationship between perceived discrimination and support for violent extremism among youth and young adults in Belgium.

Methods:  A total of 2037 young adults between the ages of 16 and 30 participated in the study. We used multivariate linear regression to determine the association between sociodemographic characteristics, experiences of perceived discrimination, and scores on the Radical Intention Scale (RIS).

Results:  Sex, religion, generation status, and language were associated with experiencing discrimination. Sex and language were associated with scores on the RIS. Discrimination based on language and political views was independently associated with scores on the RIS. Discrimination experienced during interactions with the police/justice system was also associated with RIS scores.

Conclusions : Public health primary prevention programs and policies that target the relationship between discrimination and sympathy for violent radicalization need to be situated on micro- to macro-levels. Of primary importance is the development of partnerships between stakeholders in public health, legal, political, and educational sectors to develop strategies to diminish discrimination and promote positive civic engagement among youth.

Ce numéro d’Alterstice s’inscrit dans le contexte actuel, où les rencontres interculturelles sont multipliées. La  diversification des société fait naître différentes problématiques, notamment celles liées à l’intégration sociale et  professionnelle des immigrants et de leurs familles, en particulier dans les grands centres urbains, où ils ont  davantage tendance à s’établir. Mais c’est à l’école, dans les établissements scolaires et leurs environnements, lieux  privilégiés de rencontres, de maillage et de métissage, que cet enjeu prend forme, dans des dynamiques de  socialisation aux codes du vivre ensemble.

Nous interrogeons ici les expériences et relations interculturelles au sein  de la communauté éducative, ce qui implique de porter attention à une multiplicité d’acteurs : enseignants, élèves,  professionnels (orthopédagogues, éducateurs spécialisés, etc.), équipe de direction, employés de soutien  (secrétaire, concierge, etc.), familles, organismes communautaires, etc. Divers éclairages théoriques et empiriques  sont proposés pour appréhender les processus d’ajustements continus et réciproques dans la négociation de cette  diversité à l’école, au travers des interactions quotidiennes.

Sont regroupés d’abord les textes qui rapportent  spécifiquement la perspective des enseignants formés à l’étranger à propos de leurs expériences d’intégration dans  le nouveau milieu professionnel, au Québec et en Ontario. Sont ensuite proposés des textes qui croisent les regards  de différents acteurs sur la diversité ethnoculturelle au sein de l’école et les défis qu’elle soulève, mais aussi les  ressources qu’elle constitue pour les relations au sein de l’écologie professionnelle.

Although structural violence and social inequality affect youth physical and mental health throughout the world, the problem of violent radicalization (VR) has more recently emerged as an area of concern for professionals working with youth. Radicalization is a dynamic, complex process that is generated and fueled by intercommunity frictions and conflicting political, social, and economic discourses and interests. It takes the form of a shift away from a moderate point of view to a rigid one that rejects the status quo and demands drastic societal change, although not necessarily through violence.² Violent radicalization is when radicalization includes the support of or the plan to use violent measures, including hate crimes and incidents and/or mass killings, often targeting a group characteristic (race, religion, gender orientation and identity, or political views), to achieve one’s goals of social change.

This study aimed to analyze main groups accused on social media of causing or spreading the 2014–2016 Ebola epidemic in West Africa. In this analysis, blame is construed as a vehicle of meaning through which the lay public makes sense of an epidemic, and through which certain classes of people become “figures of blame”. Data was collected from Twitter and Facebook using key word extraction, then categorized thematically. Our findings indicate an overall proximate blame tendency: blame was typically cast on “near-by” figures, namely national governments, and less so on “distant” figures, such as generalized figures of otherness (“Africans”, global health authorities, global elites). Our results also suggest an evolution of online blame. In the early stage of the epidemic, blame directed at the affected populations was more prominent. However, during the peak of the outbreak, the increasingly perceived threat of inter-continental spread was accompanied by a progressively proximal blame tendency, directed at figures with whom the social media users had pre-existing biopolitical frustrations. Our study proposes that pro-active and on-going analysis of blame circulating in social media can usefully help to guide communications strategies, making them more responsive to public perceptions.

Around the world, armed conflicts force people to leave their homes, families, and communities in search of protection from collective violence, and seek to regain a meaningful perspective on their lives within the borders of their Western host societies. As the dynamics of organized violence and forced displacement continue to impact and disrupt relationships in refugee communities, scholars in the field of refugee trauma care have increasingly argued for the need to understand spaces that are able to restore safety, meaning, and connectedness in the process of post-trauma reconstruction within those disrupted communities. This is reflected in the growing interest in community-based psychosocial interventions. In this article, we focus on applied theatre interventions with refugee communities. In doing so, we aim to understand the restorative role of within-group interactions in applied theatre. We performed a case study of a community-based applied theatre project with Syrian refugees who were recently resettled in Belgium. The qualitative analysis that was the result of this case study allows us to develop an understanding of the various processes of coping with trauma and exile that are at play in within-group interactions between Syrian community members in applied theatre, against a background of authoritarian rule, collective violence, and forced displacement.

Highlights
Within-group interactions in applied theatre can play a r5restorative role in coping with trauma and exile in refugee communities.
The group in applied theatre provides participants a temporary safe haven.
Within-group interactions reinstall a sense of personal continuity.
Within-group interactions install a sense of hope for political and social change.
Within-group interactions enable participants to reshape cultural belonging.

Although collaborative care was adopted in several countries, including Canada, to improve the health and social services system, partnerships are often experienced as challenging. In many cases, transformative partnership remains a political rhetoric rather than a practical reality. This article presents an analysis of partnership relationships in youth mental health (YMH) using insights from game theory and a qualitative analysis of interactions during transcultural interinstitutional and interdisciplinary case discussion seminars (TIICDSs).

Drawing on the analysis of 40 seminar sessions and six focus groups with seminar participants conducted in Montréal (Canada) between October 2013 and April 2015, this article interrogates the conditions and processes present in TIICDSs that contribute to building and strengthening YMH partnerships, examining how tensions among TIICDS participants are attended to.

Research results indicate that TIICDSs can be seen as a game operating under different rules than real-life clinical work. They are characterized by the establishment of a climate of trust and respect, a high value placed on diversity and creativity, a concern for affects and power dynamics, a process of inclusive dialogue and negotiation, and a consideration for continuity. The game rules allow participants to safely apprehend a situation from a different perspective, a key competence in intercultural and collaborative YMH care. Results also indicate that participants complexify their representations by playing with divergent perceptions of people and situations and that enhanced case formulations are collective game outcomes. In light of our findings, tensions in collaborations can be seen as constituting both obstacles that can be counterproductive if not attended to, as well as powerful and useful learning tools that, under certain conditions, can support the clinical process and contribute to partnership building. Some clinical and partnership impasses may be overcome through clinical case discussions that allow partners to address these tensions and negotiate power relationships.

À la suite de l’arrivée de nombreux réfugiés syriens en 2015-2016 et dans le but de les accueillir, plusieurs mesures  extraordinaires et ressources supplémentaires ont été déployées par le gouvernement du Canada. En considérant  que près de la moitié des nouveaux arrivants étaient mineurs, l’école québécoise s’est retrouvée devant de  nombreux défis relatifs à l’accueil et à l’organisation des pratiques scolaires. Dans ce contexte, nous avons mené  une recherche-action visant à évaluer une intervention mise en place en contexte scolaire pour favoriser le bienêtre et le sentiment d’appartenance des élèves réfugiés syriens.

L’action comportait deux volets distincts : des  groupes de parole menés en classe sur des sujets sensibles (ex. : la migration, les deuils et les pertes, la famille) et  un accompagnement psychosocial proposé à des élèves identifiés par les acteurs scolaires comme étant  potentiellement en mal-être. Cinq classes, provenant de deux écoles secondaires et une école primaire, ont  participé à la recherche.

Cet article reprend des données secondaires collectées dans ce cadre pour mettre en  lumière des résultats de recherche qui soulignent l’importance de la compréhension et de la prise en compte de  l’expérience pré-, péri- et post-migratoire des élèves réfugiés en vue de favoriser leur accueil et leur expérience  socioscolaire. Nous discutons, entre autres, de l’écart important entre la perception des acteurs scolaires du  parcours migratoire et du vécu de leurs élèves réfugiés d’une part et de l’expérience réelle de ceux-ci d’autre part.

Le climat d’une école résulte des relations continues entre les individus qui la composent. Dans les milieux où la  diversité ethnoculturelle est très présente, ces relations entre les acteurs contribuent donc nécessairement à la  construction du climat. Il n’existe toutefois aucune définition claire du climat scolaire interculturel. Une telle  définition est pourtant nécessaire, tant pour mieux comprendre les normes, les valeurs, les croyances et les  échanges qui existent entre les acteurs issus de la diversité au sein d’un milieu que pour identifier les pratiques qui  sont ou qui devraient être mises en place par l’école pour soutenir la réussite de tous les élèves.

S’inscrivant dans  une perspective interculturelle et inclusive, nous visons dans un premier temps à combler les limites actuelles des  écrits scientifiques en proposant une définition théorique du climat scolaire interculturel qui prévaut dans les  écoles. Cette définition comporte cinq dimensions, soit 1) l’engagement de l’école en faveur d’une culture d’équité  et d’ouverture à la diversité dans les rapports avec les élèves, les familles et la collectivité, 2) le statut et la  légitimité des cultures et des langues d’origine dans les pratiques en classe et dans les normes et les règlements  des établissements, 3) les attitudes du personnel à l’égard des élèves et des familles d’origines diverses et de la  diversité en général, 4) la qualité des relations interculturelles entre les élèves et le personnel d’origines diverses  et, enfin, 5) le soutien de l’école à la construction identitaire des jeunes issus de la diversité.

Dans un second temps,  nous présentons un portrait des rares liens documentés entre ces différentes facettes du climat scolaire  interculturel et la réussite éducative des élèves.

Nunavimmiut (people of the land) are the Indigenous peoples of the northern peninsula of the province of Quebec. Communities of Nunavik and its regional organizations have been making concerted efforts in implementing community-based strategies to support family wellbeing. These community strategies are grounded in many of the values underpinning community psychology: favoring empowerment-oriented approaches, fostering community capacity, and transforming organizational cultures to allow for new modes of interaction, as well as new policies and practices that are grounded in community and culture. Despite the growing support and expectation for community mobilization, there is still very little research on the processes and challenges to such mobilization.

In this study, we explored the unique challenges and facilitators to community endeavors in northern Quebec in order to better understand the complex dynamics and the strengths that Inuit build upon. We first used a focused ethnographic approach in the context of a 5-year community mobilization project in Nunavik. We then conducted 12 individual interviews and two small group interviews with Inuit working on community-based wellbeing-oriented mobilization projects in four additional communities.

Results expose how sociogeographical realities and colonialism influence the process of community mobilization. They also highlight the values and motivational factors that lead community members to move beyond these influences

Background: Many Canadian adolescents and young adults with mental health problems face delayed detection, long waiting lists, poorly accessible services, care of inconsistent quality and abrupt or absent inter-service transitions. To address these issues, ACCESS Open Minds, a multi-stakeholder network, is implementing and systematically evaluating a transformation of mental health services for youth aged 11 to 25 at 14 sites across Canada. The transformation plan has five key foci: early identification, rapid access, appropriate care, the elimination of age-based transitions between services, and the engagement of youth and families.

Methods: The ACCESS Open Minds Research Protocol has multiple components including a minimum evaluation protocol and a stepped-wedge cluster randomized trial, that are detailed in this paper. Additional components include qualitative methods and cost-effectiveness analyses. The services transformation is being evaluated at all sites via a minimum evaluation protocol. Six sites are participating in the stepped-wedge trial whereby the intervention (a service transformation along the key foci) was rolled out in three waves, each commencing six months apart. Two sites, one high-population and one low-population, were randomly assigned to each of the three waves, i.e., randomization was stratified by population size. Our primary hypotheses pertain to increased referral numbers, and reduced wait times to initial assessment and to the commencement of appropriate care. Secondary hypotheses pertain to simplified pathways to care; improved clinical, functional and subjective outcomes; and increased satisfaction among youth and families. Quantitative measures addressing these hypotheses are being used to determine the effectiveness of the intervention

Camp Cosmos was founded in 1971 in Montreal to provide children from diverse social, economic and cultural backgrounds with a safe and fun environment to play, learn and grow. The summer camp is grounded on an anti-oppression philosophy that drives its enriching intercultural, accessibility, environmental, youth leadership and athletic programs. After 47 summers of empowering children, building communities with families, and fostering support networks with partner organizations, Camp Cosmos continues to be a vehicle of social transformation in Montreal. Since 1971, more than 2000 children have participated in the Camp Cosmos summer camp program. In response to the Syrian refugee crises, Camp Cosmos expanded in 2016 to create a second camp on Montreal’s West Island. That year, 23 Syrian children were welcomed at both the West Island and Downtown locations. In summer 2017, numbers rose, with 28 Syrian children and 12 children whose families had recently crossed the Canadian/USA border for a total of 40 (camp fees waived). The total number of campers in 2017 was 121 (up from 50 in 2014). In addition to welcoming Syrian campers, there were also 3 young Syrian counselors-in- training who had their first Canadian job experience. In 2018, with the aim to continue adapting to the Montreal society’s needs, Camp Cosmos welcomed 158 campers from diverse backgrounds, introduced a sliding scale payment system to welcome a greater diversity of campers, and extended the hours of care to improve access to camp. The camp adapted their 5-day staff training to include a greater focus on their anti- oppression mandate and a focus on accessibility by collaborating with Montreal-based organizations. For the first time, the camp welcomed 12 and 13-year-old campers, filling the previously existing age gap, to participate in a new program that included both activities with the whole camp as well as volunteer opportunities at community organizations.

Immigration status and unemployment may intersect on the health outcomes of men and women. This study aimed to identify intersections between unemployment and immigration in inflammatory, metabolic and nutritional blood markers and assess gender differences.

Methods
We used Canadian Health Measures Survey data on 2493 participants aged 18 to 65. Outcomes were chronic inflammation (high-sensitivity C-reactive protein (hsCRP) and fibrinogen), nutritional (albumin and hemoglobin), and metabolic blood markers (glycosylated hemoglobin, blood glucose, total and high density lipoprotein (HDL) cholesterol). Multivariate linear regressions were used to assess the associations between each biomarker, unemployment and immigrant status, controlling for age, education, province, smoking, physical inactivity and body mass index and testing for multiplicative interactions between unemployment, immigrant status and gender.

Results
Unemployment was associated with higher inflammation (hsCRP and fibrinogen) in Canadian born men; Canadian born employed women showed higher hsCRP values compared with corresponding employed men. Unemployed immigrant women presented the highest values of hsCRP while employed immigrant women had the lowest hsCRP. Unemployment was associated with higher glucose; immigrant status was associated with higher glucose and glycosylated hemoglobin. Unemployed immigrants had significantly lower levels of hemoglobin and albumin than employed immigrants, and Canadian-born citizens regardless of their employment status. Some of these associations were attenuated after adjustment by body mass index, physical inactivity and smoking.

Conclusion
Blood biomarkers unveil intersections among unemployment, immigration and gender. This study provides evidence on biological pathways of unemployment on the likelihood of common chronic diseases, inflammation and potential malnutrition with some increased vulnerabilities in unemployed immigrants, and particularly in unemployed immigrant women.