The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.

Background

Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education.

Objectives

The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys.

Method

The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location.

Results

A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health.

Conclusion

Attending school is essential for children’s mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.

Case formulation is used in clinical training to weave together theoretical perspectives and support a shared plan of action. Although a cornerstone of clinical practice, critical social theorists have highlighted the risks of depoliticizing political struggles and of reifying and fixing subjects when using psychopathology and case formulation to address situations of injustice. In the field of violent radicalization, this risk is increased by the extreme affects evoked by terror in practitioners and in societies. This article explores the challenges of training clinicians in the field of violent radicalization. It does so by analyzing a Community of Practice (CoP) that was developed to support practitioners involved in this domain of practice in Quebec, Canada. Four focus groups with CoP participants and participant observation of nine CoP meetings were conducted. Thematic and narrative analyses were used to explore the training potential of the CoP and to identify the discursive processes and group dynamics associated with this modality. Results indicate that the diversity of professional perspectives and social positionalities in the group plays a central role in helping participants become aware of their biases and in developing more complex understandings of cases and of their social embedding. Results also suggest that the collective holding of risk is key to preserve practitioners’ investment in patients involved with violent radicalization. The sensitive issue of partnership between health and social services and security agencies is also addressed. Results suggest that CoPs with strong leadership allow for experiential training to enhance clinical and critical thinking.

Background: Wanting to offer culturally sensitive services to a diverse population, rehabilitation counsellors employed by a workers’ compensation board (WCB) in a Canadian province asked the researchers to provide them with support to develop their intercultural competencies. A collaborative research design was suggested as a potential way to make full use of experiential knowledge. This article presents an action research approach in which study participants were also active in the development of new knowledge and sought to become key players in organizational change. Objective: The objective of this article is to present the steps involved in the co-construction of an intercultural communication support tool and to describe the mechanisms and structure put in place to develop the tool. Methodology: A working group (WG), a steering committee (SC) and a validation group (VG) were created, and each met on a regular basis over approximately 18 months. Several methodological approaches and data collection tools were used: participant observation charts, diaries, an “intercultural situation” workshops. Results: A total of 28 people participated in the project, in addition to the three researchers. The study showed the importance of integrating three dimensions—the individual, collective, and organizational—into the definition of intercultural competence. It soon became evident in our study that a self-reflection process grounded in a collective learning approach was the core component of the entire process of developing intercultural competencies. This finding went well beyond the production of any materials (practical guides, checklists, and supporting documents) that resulted from this process.

Given the increasing value placed on research among social work practitioners, and that field education is primarily responsible for the integration of social work values, knowledge, and practice, it is essential that research skills be incorporated into BSW and MSW field practica. In 2020, a team of faculty co-investigators and students explored the integration of research activities into Canadian BSW and MSW field practica through the review of online field education materials of all accredited programs. We make the argument that not only is it essential for professional social workers to receive training in practice research, but also that there is much room for us to integrate such research into field education. We begin with a review of the literature regarding social work student attitudes toward research, widely known to be hesitant and even hostile, before discussing the limited international literature (English and French) on the experience of integrating research into field education. After describing our methods, we then present our findings in terms of BSW and MSW programs at Canada’s anglophone and francophone universities. We conclude with a discussion of the implications in terms of ways to increase the role of research in field practica.

Accumulation of diverse mutations across the structural and nonstructural genes is leading to rapid evolution of SARS-CoV-2, altering its pathogenicity. We performed whole genome sequencing of 239 SARS-CoV-2 RNA samples collected from both adult and pediatric patients across eastern India (West Bengal), during the second pandemic wave in India (April–May 2021). In addition to several common spike mutations within the Delta variant, a unique constellation of eight co-appearing non-Spike mutations was identified, which revealed a high degree of positive mutual correlation. Our results also demonstrated the dynamics of SARS-CoV-2 variants among unvaccinated pediatric patients. 41.4% of our studied Delta strains harbored this signature set of eight co-appearing non-Spike mutations and phylogenetically out-clustered other Delta sub-lineages like 21J, 21A, or 21I. This is the first report from eastern India that portrayed a landscape of co-appearing mutations in the non-Spike proteins, which might have led to the evolution of a distinct Delta subcluster. Accumulation of such mutations in SARS-CoV-2 may lead to the emergence of “vaccine-evading variants.” Hence, monitoring of such non-Spike mutations will be significant in the formulation of any future vaccines against those SARS-CoV-2 variants that might evade the current vaccine-induced immunity, among both the pediatric and adult populations.

Extract

ABSTRACT

The association of ideologically motivated violence with mental health disorders raises spe-cific challenges for security agencies and clinical services. The aim of this paper is todescribe the clientele of a specialized intervention program based in Montreal, Quebec, interms of type of violent ideology and clinical presentation. We conducted a retrospectivechart review of 156 individuals referred for violent extremism who received clinical servicesbetween 2016 and 2021. Univariate statistics were used to present a description of clientsociodemographic and clinical characteristics. Roughly a third of clients referred for violentextremism presented non-ideologically based violence (32.6%), followed by 31.4% affiliatedwith far-right extremist ideology and over a quarter (25.6%) holding extremist views on gen-der. Over a third of these individuals had a stress-related (35.7%) and/or mood and anxietydisorder (36.9%), followed by 28% with an autism spectrum disorder diagnosis. The majorityhad some previous contact with mental health services. A significant number of clients dis-playing extremist discourses and/or actions needed psychiatric services but often failed toreceive them because of the reluctance of clinicians to work with individuals perceived ashigh risk; in addition, individuals may be reluctant to engage in services perceived to bepart of a socio-political system they reject. Specialized services are important as a means toprovide mental health care to this group and also to develop knowledge and best practicesfor working with this clientele and provide consultation to mainstream mental health serviceproviders.

KEYWORDS

Violent extremism; clinicalservices; mental health care;specialized intervention

Purpose

To elicit stakeholder perspectives on the findings from our scoping review on youth participation in mental health policymaking, we conducted a global consultation with young people and adults directly involved in mental health policymaking.

Method

Forty-four stakeholders from 16 countries, including 15 young people, 9 policymakers and 20 facilitators of youth participation, took part in individual interviews and/or focus groups. They were asked about how the review findings contrasted with their own experiences in mental health policymaking. The transcribed data were thematically analyzed.

Results

All participants viewed lived experience as valuable in identifying policy gaps. Youth pointed out that children and youth with disabilities, diverse sexual orientations, and/or gender identities were often excluded, and spoke about feelings of being an “accessory”, illustrating a lack of power-sharing in a tokenized policymaking process. Adult participants’ accounts highlighted the challenges inherent in policymaking such as the need for political knowledge and institutional time constraints. A range of cultural, socio-economic, and political barriers to youth participation, that were often context-specific, were identified.

Conclusions

The diverse perspectives of stakeholders extended the review results. Based on our findings, we recommend that adults and institutions: (1) recognize lived experience as expertise in shaping mental health policies; (2) include diverse groups; (3) reduce tokenistic relationships through the creation of safer spaces, adult feedback, co-production, and social accountability; and (4) adopt an intersectional approach to address cultural, socio-economic, and political barriers to participation. Methodologically, our work demonstrates why stakeholder consultations are an essential component of scoping reviews.

Introduction : Au Burkina Faso, le manque d’études sur les itinéraires thérapeutiques en santé mentale limite la compréhension des obstacles associés au recours aux soins. Comme dans plusieurs pays d’Afrique subsaharienne, cette situation se traduit par une difficulté des systèmes de santé à adapter l’offre de soins disponible à la réalité des personnes souffrant de troubles mentaux.
But de l’étude : Dans cette étude, des observations participantes ont été faites ; sept groupes de discussion et 25 entretiens individuels ont ainsi été organisés afin d’explorer les représentations sociales et l’utilisation des soins existants en santé mentale. Différents acteurs ont été interrogés : patients, soignants, accompagnants et informateurs clés.
Résultats : Une analyse thématique a révélé la présence de trois systèmes de soins dans la ville de Bobo-Dioulasso : 1) les soins psychiatriques associés à une fonction diagnostique et à la prise en charge de pathologies graves ou déclenchées par des causes « naturelles », 2) les soins traditionnels perçus comme ayant une fonction de guérison pour les pathologies « surnaturelles », mais associés à un risque d’escroquerie, et 3) les soins informels prodigués par la famille identifiés comme représentant le pilier des itinéraires thérapeutiques.
Conclusions : Cette étude révèle qu’à travers la diversité des ressources consultées, l’entourage direct représente le principal pourvoyeur de soins et que les contraintes financières constituent l’obstacle principal aux recours aux soins. Ce constat nous amène à formuler des recommandations relatives à l’élaboration d’éventuelles politiques publiques à l’échelle nationale ainsi qu’à l’organisation des services de santé dans la ville de Bobo-Dioulasso.

We sought to determine the association between SES and glycemic control in children with type 1 diabetes (T1D) followed at the Montreal Children’s Hospital (MCH), and whether insulin pump use, processes of care and depression modified the association. Using MCH’s Pediatric Diabetes Database, we conducted a retrospective cohort study of children ages 0 to 18 years diagnosed with T1D for at least a year with a visit between November 2019 and October 2020. Our outcome was mean glycated hemoglobin (HbA1c) in the following year. Our main exposure was socioeconomic status (SES; least deprived, moderately deprived, most deprived) measured by the Material and Social Deprivation Index. We used multivariable linear regression to determine the association between SES and HbA1c, adjusting for age, sex, diabetes duration, insulin pump use and processes of care. Interaction terms for insulin pump, processes of care and depression were included. A total of 306 children were identified. Children in the most deprived quintiles had higher mean HbA1c compared to those in the least deprived quintiles (p<0.01). HbA1c in the most deprived quintiles was 0.5% higher compared to the least deprived quintiles (95% confidence interval, 0.14 to 0.86). Effect modification by insulin pump, processes of care and depression was not significant. Consistent with previous findings, lower SES was associated with higher HbA1c. Our results are important for further research to understand contributing factors to these disparities.

La pandémie de maladie à coronavirus 2019 (COVID-19) a exacerbé les inégalités sociales dans les aspects ethniques, raciaux et socio-économiques, avec d’importantes conséquences nocives pour les enfants. En s’appuyant sur les leçons tirées des initiatives communautaires, le présent commentaire propose une réflexion sur les défis de l’équité, de la diversité et de l’inclusion qui sont intégrés dans les campagnes de vaccination des enfants dans un contexte d’urgence. Nous sommes d’avis que la mise en place de pratiques équitables et inclusives liées à la vaccination des enfants des communautés marginalisées est un défi à multiples facettes. Au-delà des bonnes intentions (vouloir protéger les enfants), les risques et les avantages associés à la mise en évidence de la diversité dans chaque intervention doivent être soigneusement examinés, surtout en ce qui concerne une procédure contestée ou polarisée, comme la vaccination avec un nouveau type de vaccin. Souvent, une approche unique réfute et perpétue les inégalités structurelles. Dans d’autres cas, la mise en évidence de la diversité et des inégalités peut par inadvertance accroître la stigmatisation et la discrimination, et nuire davantage ou infantiliser les collectivités ciblées. En offrant des perspectives multiples, une approche transdisciplinaire peut appuyer la prise de décision dans un contexte de crise.

Mots-clés : santé et médecine des adolescents, services de santé communautaires, santé des minorités, équité et inclusion

Keywords: Quality Lessons Learned (QLLs); Quebec; Hospitals’ Resilience; COVID-19 pandemic project

Background

Refugees, asylum seekers, and migrants without status experience precarious living and working conditions which disproportionately expose them to COVID-19. In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, as well as educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.

Methods

This theory-informed participatory research is co-created with socio-culturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane’s framework on health systems’ responsiveness to guide the 4-phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include, 1) building an inventory of intersectoral initiatives developed during the pandemic, 2) organizing a deliberative workshop with representatives of the study population, community and public sectors respondents to select and validate the intersectoral initiatives, 3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers and employees of philanthropic foundations 4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers.

Discussion

This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach – particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

Introduction

UNICEF estimates that there are as many as 100 million street-involved youth (SIY) globally. Marginalized conditions put SIY at higher risk of HIV and adverse outcomes once HIV-positive. The objective of this analysis was to describe barriers and facilitators of accessing HIV prevention, testing, and treatment services as Phase I of an implementation study evaluating the use of peer navigators to increase access to HIV services.

Methods

Semi-structured interviews, focus group discussions (FGD), and theatre testing were conducted with individuals who identify as SIY, health care providers, and community stakeholders living in Canada (Toronto, Montreal, London) and Kenya (Eldoret, Huruma, Kitale). Data were analyzed using a directed content approach, guided by the socio-ecological model (SEM).

Results

Across the six sites were 195 participants: 64 SIY, 42 healthcare providers, and 97 community-based stakeholders. Barriers were identified at the societal (e.g. intersectional stigma and discrimination), public policy (e.g., inadequate access to basic needs, legal documentation, lack of health insurance, and limited community-based funding), institutional (e.g. lack of inclusive education and training, inadequate HIV educational outreach, and restrictive service provision), interpersonal (e.g., ineffective communication from healthcare providers), and intrapersonal levels (e.g. lack of trust and associated fear, low perception for healthcare, and lack of self-esteem). These contributed to limited HIV services utilization among SIY. Conversely, numerous facilitators were also identified at the public policy (e.g. affordable HIV services and treatment), institutional (e.g. available and accessible HIV prevention tools, HIV education and awareness programs, and holistic models of care), interpersonal level (e.g., systems navigation support, peer support, and personal relationships), and intrapersonal levels (e.g. self-efficacy) as positively supporting SIY access to HIV services.

Conclusion

Intersectional stigma was a critical barrier in all sites, and policies and programs that foster welcoming environments for youth from diverse backgrounds and living circumstances may be better able to respond to the HIV service needs of this high risk population. Social support and navigation services were reported to facilitate access to HIV services in all sites.

This is the protocol for a Campbell systematic review. The main objective of this project is to gather, critically appraise, and synthesize evidence about the appropriateness and utility of tools used to assess the risk of violent radicalization.

Summary

Objectives: The aim of this issue of the journal is to study the way in which “making a family” influences access to rights and the integration of migrant families in Europe (France, Germany), North America (Quebec) and Djibouti, from Yemen, Syria, Tunisia, Mozambique or Brazil. Similarly, and reciprocally, he is interested in the impact of law on family experiences in a migratory context.

Methodology: The ethnographic observation approach, through the cross-referenced collection of life stories and the reconstruction of the life contexts of these migrants (while respecting their words and their anonymity) makes it possible to discover, sometimes in a counter-intuitive way, the effects of the policies on their lives.

Results: It often happens that within the same migrant family the legal status of its members is different, and therefore their rights to be regularised or not. As a result, these families – and more broadly, entire groups of migrants – have to carry out important work in terms of information for access to residence rights, work, access to schooling for their children, health, nationality, etc. Nothing is guaranteed a priori. Nothing is guaranteed a priori.

Conclusion: We can imagine how much migration will continue in the face of climate change and political unrest throughout history. It is likely that a policy evaluation approach, or lack thereof, by those affected, will be increasingly necessary in the future.

Contribution: This thematic issue of the journal Enfances Familles Générations highlights, from a historical and comparative approach, the impact of the legitimacy of being part of the national community to which these men and women have migrated (Destremau, 2022).

The health context surrounding the COVID-19 pandemic has led to significant individual and social upheaval, which has also affected traditional teaching methods. Art therapy training was not spared, notably at the Université du Québec en Abitibi-Témiscamingue (UQAT). UQAT adopts an experiential teaching approach that engages students in a process that promotes the optimal acquisition of the skills inherent to the ethical exercise of the profession, allowing them to take the position of art therapist, in contact with their peers, while emotionally integrating the learning achieved. As the pandemic context forced a rapid shift to distance learning, the authors wanted to put into perspective the potential effects of virtual art therapy teaching on the development of female art therapy students’ sense of self-efficacy (SSE). To do this, they base their reflection on the results of surveys conducted among students and graduates as part of the evaluation of the master’s program in art therapy. Since experiential distance learning implies limitations in terms of emotional experience and actual contact with peers, it is justified to question the effects that these changes will have on trainees’ SSE.

Abstract

Low enrolment in micro-health insurance (MHI) schemes is a recurring issue affecting the viability of such schemes. Beyond the efforts addressing low subscription and retention in these schemes, little is known on how social representations are related to micro-health insurance schemes enrolment and retention. This scoping review aimed at exploring the role of social representations in shaping enrollment and retention in MHI in sub-Saharan Africa. We reviewed qualitative, quantitative and mixed methods studies conducted between 2004 and 2019 in sub-Saharan Africa. We limited our search to peer-reviewed and grey literature in English and French reporting on social representations of MHI. We defined social representations as conventions, cultural and religious beliefs, local rules and norms, local solidarity practices, political landscape and social cohesion. We applied the framework developed by Arksey and O’Malley and modified by Levac et al. to identify and extract data from relevant studies. We extracted information from a total of 78 studies written in English (60%) and in French (40%) of which 56% were conducted in West Africa. More than half of all studies explored either cultural and religious beliefs (56%) or social conventions (55%) whereas only 37% focused on social cohesion (37%). Only six papers (8%) touched upon all six categories of social representation considered in this study whereas 25% of the papers studied more than three categories. We found that all the studied social representations influence enrollment and retention in MHI schemes. Our findings highlight the paucity of evidence on social representations in relation to MHI schemes. This initial attempt to compile evidence on social representations invites more research on the role those social representations play on the viability of MHI schemes. Our findings call for program design and implementation strategies to consider and adjust to local social representations in order to enhance scheme attractiveness.

Cadre de la recherche : La pandémie bouleverse le quotidien des familles depuis plus d’un an. En plus des craintes et des incertitudes liées au virus de la COVID-19, la pandémie a exigé de redéfinir plusieurs routines du quotidien, dont les activités et loisirs, l’accès aux services, le travail, la scolarisation et les relations interpersonnelles. Les enfants, peu susceptibles d’avoir la COVID-19, ont néanmoins vécu les contrecoups des mesures sociosanitaires mises en place pour y faire face.

Objectifs : En se basant sur l’approche centrée sur l’enfant, cet article cherche à comprendre de quelle façon la pandémie de la COVID-19 et les mesures sociosanitaires qui en ont découlées ont bouleversé la vie des familles, principalement la relation grands-parents/petits-enfants.

Méthodologie : Cette étude utilise un devis qualitatif longitudinal en trois temps de mesure en fonction des différents moments clés de la pandémie. Au total, 154 enfants et adolescents ont été rencontrés à trois reprises dans le cadre d’entrevues semi-dirigées via Zoom.

Résultats : Les résultats mettent en lumière les façons dont les petits-enfants et les grands-parents ont su s’adapter pour maintenir leur relation pendant la pandémie. Cette étude nous permet de constater que les petits-enfants s’inquiètent de la santé de leurs grands-parents, mais qu’ils souhaitent quand même avoir des contacts en personne avec eux, malgré les risques.

Conclusions : La relation entre les petits-enfants et leurs grands-parents est une relation affective et durable qui perdure et s’adapte en temps de crise.

Contribution : Cet article rend compte de l’importance des grands-parents dans la vie de leurs petits-enfants, et ce particulièrement en temps de crise. Il permet aussi de mieux comprendre comment les familles ont su s’adapter pendant la pandémie.

Plusieurs systèmes éducatifs dans le monde, comme c’est le cas au Québec, tendent vers l’adoption de politiques d’éducation inclusive qui visent à répondre de façon équitable aux besoins de tous les élèves. Alors que le paradigme d’éducation inclusive concernait initialement les élèves qui présentaient des handicaps, il englobe maintenant d’autres sous-groupes d’élèves, dont les élèves minorisés sur les plans de la diversité ethnoculturelle, religieuse et linguistique. Cet article propose une lecture critique de l’évolution du paradigme de l’éducation inclusive et du concept d’intégration dans deux domaines éducatifs au Québec : celui de l’adaptation scolaire et celui qui concerne la diversité ethnoculturelle, religieuse et linguistique (ERL). L’exploration du chemin parcouru dans les deux domaines éducatifs illustre l’ancrage de l’évolution des concepts dans les débats sociaux, qui eux-mêmes s’articulent selon des courants politiques, des sensibilités particulières de la société, et qui se réflètent dans les pratiques des milieux scolaires. La conclusion invite le milieu de la recherche et les autorités éducatives à contribuer à la clarification des concepts et des paradigmes, en leur rappelant que ces derniers peuvent enfermer les individus et les groupes dans des rapports sociaux parfois teintés de dynamique de domination.

Cette table ronde se penche sur le phénomène du transnationalisme, qui a fait l’objet d’un intérêt important depuis les années  1990 dans diverses disciplines des sciences sociales (Glick Schiller, Basch et Blanc-Szanton, 1992; Green, 2019; Portes, Guarnizo et Landolt, 1999;  Khagram et Levitt, 2008; Mohanty, 2003; Moosa-Mitha et Ross-Sheriff, 2010; Vertovec, 2009). Bien qu’il ne constitue plus une nouveauté, le champ des études transnationales est en évolution constante, ce qui nécessite que l’on continue à s’y intéresser et que l’on tente d’en saisir les contours fluides et changeants. De plus, il appert que les connaissances qui ont été produites en abondance depuis les années 1990 ont été moins mobilisées en travail social (Furman, Negi et Salvador, 2010), et ce, même si les travailleuses sociales partout sur la planète sont de plus en plus confrontées aux réalités de la globalisation et du transnationalisme au quotidien (Moosa-Mitha et Ross-Sheriff, 2010; Vatz Laaroussi et Bolzman, 2010). À noter que le Québec s’avère néanmoins plutôt bien représenté au sein des travaux sur les réseaux transnationaux mobilisés par les personnes immigrantes et réfugiées (Arsenault, 2010; Blain, Rodriguez del Barrio, Caron et al., 2019, 2022; Montgomery, Le Gall et Stoetzel, 2010; Rachédi, Le Gall et Leduc, 2010; Vatz Laaroussi et Bolzman, 2010) ainsi que les militants et militantes œuvrant au sein de réseaux de solidarité transnationaux (Kouri-Towe, 2015; Mahrouse, 2014). Toutefois, s’intéresser aux impacts de ces réalités sur le travail social serait incomplet sans une prise en compte des héritages coloniaux qui existent souvent dans l’ombre du transnationalisme, alors que la globalisation a réellement débuté à l’époque des empires européens à travers les voyages impériaux et l’occupation des territoires par les colons européens dans les Amériques, en Afrique et en Asie (Caron et Lee, 2019; Lee et Ferrer, 2014). Cette articulation critique des approches transnationales et décoloniales au sein des pratiques des panélistes qui la composent est d’ailleurs au cœur de la posture de plusieurs des autrices et auteurs de cette table ronde.

During the pandemic, we undertook, with the authors of this proposal, preliminary research on racism against Asian descendants of migrants (ADMs). Via social media, we contacted a group that mobilized during this period of heightened anti-Asian racism, as the first signs of COVID-19 were identified in China. For this preliminary research, we carried out consultations with women of Asian descent (ADMs) in Quebec. Based on the results, and drawing on previous research on the colonial heritage of Vietnamese ADMs, we will propose a reflection on the effects of racism that existed long before the pandemic, as well as on the self-construction of Asian descendants of migrants in Quebec with a view to decolonizing knowledge on interculturality in social work.

Au Québec, comme ailleurs dans le monde, les décideurs et les formateurs élaborent des encadrements et des programmes de formation et formalisent des compétences qui servent de balises aux établissements d’enseignement pour mettre en œuvre une éducation interculturelle et inclusive (Ministère de l’Éducation du Québec, 1998, 2008; Potvin et al., 2015; UNESCO, 2009). Ces prescriptions orientent et organisent le travail des acteurs scolaires vers des buts et des objectifs précis. Bien que ce travail comprenne une partie normative et commune à tous (Tardif et Lessard, 1999), il implique aussi une manière de faire singulière (Altet, 2002). En effet, le praticien, entre les prescriptions à soutenir et la complexité du contexte à prendre en compte, doit poser des jugements éclairés qui, dans leur souci de cohérence et de justesse par rapport à la situation, témoigneront d’un certain savoir-agir professionnel (Schön, 1983; 1987). Les cinq textes de ce numéro thématique s’intéressent aux pratiques mises en œuvre par des acteurs scolaires en contexte de diversité ethnoculturelle dans deux contextes nationaux : le Québec et la Suisse. Les deux premiers textes découlent du même projet de recherche qui documente, par la reconstruction de récits de pratique, l’intervention pédagogique en contexte de diversité ethnoculturelle, mais abordent les données sous un angle différent. Le texte de Audet, Gosselin-Gagné et Koubeissy, intitulé Une compétence interculturelle et inclusive «en acte» : analyse de récits de pratique d’enseignant.e.s à propos de l’intervention en contexte de diversité ethnoculturelle, propose une analyse de 11 récits de pratique puis la discute à la lumière des prescriptions à cet égard, tout en soulignant la manière dont les pratiques des enseignants témoignent d’un savoiragir professionnel. Rola Koubeissy Université de Montréal (Canada) Geneviève Audet Université du Québec à Montréal (Canada) Introduction au dossier Travailler en contexte scolaire marqué par la diversité ethnoculturelle : des prescriptions au savoir-agir doi: 10.18162/fp.2022.776 ©Auteure. Cette œuvre, disponible à http://dx.doi.org/10.18162/fp.2022.776, est distribuée sous licence Creative Commons Attribution 4.0 International http://creativecommons.org/licences/by/4.0/deed.fr ISSN 2368-9226 2 • Formation et profession 30(1), 2022 Le deuxième texte de Koubeissy et Audet, Gérer les contraintes dans une classe multiethnique : l’angle de l’activité enseignante, se base sur le cadre d’analyse du travail enseignant. À partir d’une sélection de trois récits de pratique, l’article explore les raisons qui poussent les enseignants à prendre des décisions à la lumière des prescriptions et du contexte de leur classe. Dans leur article intitulé Ajoutée, intégrée ou empêchée : quelle place pour la prise en compte de la diversité culturelle en classe ?, Rhadouane et Akkari nous convient à découvrir le contexte suisse. Pour ce faire, ils s’appuient sur des données recueillies auprès de quatorze enseignantes pour analyser les pratiques mises en œuvre dans les classes afin de répondre à l’impératif de prise en compte de la diversité ethnoculturelle. Les deux autres textes nous ramènent au Québec. Dans leur article, intitulé Les conseillers et conseillères d’orientation en contexte scolaire pluriethnique dans le Montréal métropolitain: pratiques et défis déclarés, Bissonnette, Martiny et Provencher analysent les propos recueillis auprès de douze d’entre eux afin de brosser le portrait de leurs pratiques interculturelles et des défis qu’ils rencontrent dans l’exercice de leur rôle. Finalement, dans l’article intitulé Récits de pratiques de directions d’établissement d’enseignement au Québec : illustration d’une compétence pour l’équité, l’inclusion et la justice sociale, Larochelle-Audet, Magnan, Doré et St-Vincent présentent une boite à outils pour illustrer, par des récits de pratique, un modèle de compétence pour l’équité, l’inclusion et la justice sociale.

Abstract

Abstract

Drawing on fieldwork conducted among converts to Islam (France and Quebec), this article focuses on women who are in unions with partners of Muslim background. As these women commit to make a union based on shared religious identity, they face the double challenge of learning to be a Muslim and of transmitting identity to the children. Addressing these issues opens a space of ongoing negotiations within the couple (sometimes involving the in-laws) over the definition of the ‘authentic’ Islam, and the articulation between religion and ethnicity. These conjugal debates create new areas of mixedness through women’s own identification processes as Muslim and French or Quebecois. This negotiation is framed by the social and cultural capital each partner is granted in their specific context of living, including experiences of having minority status, as well as by the specific representations each partner draws on the ethnicity and space of origin of the other. Keywords conversion, identification, Islam, mixed unions, representation, transmission

Purpose: The COVID-19 pandemic may increase risk of intimate partner and sexual violence and make relevant services less accessible. This study explored the perspectives of intimate partner and sexual violence workers across Canada on how the COVID-19 pandemic has affected the survivors with whom they work.

Methods: Using a qualitative descriptive design, we interviewed 17 management and frontline staff of organizations supporting survivors of intimate partner and sexual violence across Canada. Results: We identified 4 themes that describe the impacts of COVID-19 on IPV and SV survivors, from the perspective of service providers: 1) No escape; 2) Isolation; 3) Tough decisions; and 4) Heightened vulnerability. These narrative findings are presented first, followed by an analysis within a social determinants of health framework. Interpreting our findings against such a framework revealed a complex interplay of social determinants, notably social support, access to services, and poverty, that produced several challenges for IPV and SV survivors during COVID-19

Conclusion:  According to service providers, IPV and SV survivors in Canada faced several challenges during the pandemic, including reduced ability to escape their situations, increased isolation, increasingly complex decisions, and heightened vulnerability. Our findings demonstrate the critical need to adopt a broader, more holistic approach in tackling IPV and SV by also addressing socioeconomic issues such as poverty and marginalization. 

Inadequate pregnancy monitoring for pregnant migrant women without medical insurance (PMWMI) exposes them to severe complications during childbirth and consequences for the health of their child (e.g. preterm delivery, low birth weight, etc.). This scoping review aims to identify existing interventions globally to improve access to perinatal care for PMWMI. It will also highlight the strengths, weaknesses as well as the costs of these interventions.

The aim of this article is to shed light on the levers and obstacles of the co-creation process encountered during the first steps of the implementation of a demonstration project in youth mental health in Quebec, in the context of an expansion of youth integrated service networks. Using a qualitative approach, the role of the various stakeholders involved (community partners, service providers, youths) is described in such a way as to highlight the co-creation issues the actors were confronted with between the design and implementation phases. We report on a formative and developmental evaluation, which is still ongoing. In this sense, this article seeks to clarify the lessons learned on the process of co-creation of public action.

This paper contributes to the growing body of work on precarious labor, immigration, and social gerontology by examining the racialization of precarious employment across the life course. In particular, the authors examine the impact of precarious employment and discrimination among racialized older immigrants in Canada. Racialized older immigrants are more likely to be disadvantaged by the effects of lifelong intersections of economic and social discrimination rooted in racialization, gender, ageism, and socio-economic status. Drawing from a narrative-photovoice project that focused on the life stories of older immigrants living in Quebec and British Columbia, this paper presents the in-depth stories and photographs of four participants to highlight how intersections of race, gender, age, immigration status, and ability shape and structure experiences of aging, labor market participation and caregiving relationships.

Social workers play a vital role in helping service users navigate structural barriers and oppressions. Anti-racist social work education trains future social workers to apply critical thinking to the ways in which societal practices of racist exclusion and domination threaten the integrity of racialized individuals and communities. However, inclusion of anti-racist curricula in Schools of Social Work (SSWs) is largely dependent on each individual institution and their course offerings. This study explored the extent to which anti-racist practice is included across social work programs in Quebec through conducting a review of required undergraduate courses. Our results reveal that, among the nine universities that offer Bachelor of Social Work programs across Quebec, only one SSW offered a course that explicitly addressed race. Five out of the nine SSWs include a mandatory course with implicit mention of race under broader terms such as “anti-oppression,” “inequality,” or “intercultural practice.” These findings raise important considerations for social work education in Quebec and the development of anti-racist practitioners across the profession.

Purpose

Social adversity experiences have increased during the pandemic and are potential risk factors for both depression and support for violent radicalization (VR). However, the cumulative and independent effects of various social adversity experiences on support for VR have yet to be explored. This paper examines the cumulative and independent effects of COVID- and non-COVID-related discrimination, exposure to violence, traditional and cyberbullying victimization on support for VR. In addition, we investigate whether depression mediates the relationship between these forms of social adversity and support for VR.

Methods

A total of 6003 young adults (M_age = 27, SD_age = 4.40, range 18–35) living in metropolitan areas in Canada responded to an online survey. We used multivariable regression models, controlling for socio-demographic characteristics, to infer covariate adjusted associations between social adversity measures and support for VR. Additionally, we conducted a formal mediation analysis to estimate the proportion mediated by depression.

Results

There was a cumulative relationship between experiences of social adversity and support for VR (β = 1.52; 95% CI: 1.32, 1.72). COVID-related discrimination and cyberbullying victimization were independently associated with stronger support for VR. Depression partially mediated the effect of cumulative social adversity, COVID-related discrimination and cyberbullying on support for VR.

Conclusion

Prevention programs during the present pandemic should prioritize decreasing discrimination and providing psychosocial support to depressed young adults who experience social adversity. Practitioners should prioritize developing programs that foster digital literacy skills and critical thinking among young adults to address the concerning impact of cyberbullying on support for VR.

In 2010, a group of racialized doctoral students at an elite university in Canada collectively mobilized against institutional racism within their school of social work. They insisted that their school confront the ways in which White supremacy was embedded within various policies and practices. These early initiatives led to the creation of the Racialized Students’ Network (RSN). Although the RSN has ended, it has produced a new generation of scholars who continue to interrogate Whiteness and White supremacy. It has also offered roadmaps through which newer generations of racialized social work scholars can advance anti-racist and decolonial feminist perspectives within postsecondary social work institutions in Canada. In this article, the authors, who are now tenure-track or tenured professors at Canadian universities, demonstrate the ways in which graduate student anti-racist activisms are a central avenue for confronting Whiteness and institutional racism. Through a collaborative autoethnographic methodology, this article draws from the authors’ personal experiences within the RSN, the group’s source documents, and their collective analysis on how the RSN has informed their ongoing activism. They discuss how their everyday experiences align with current anti-racist struggles and movements to shape their actions and responses in academe. The RSN Model of Racialized Students’ Activism is presented to demonstrate the collective processes the student activists explored to reflect and apply their intersecting identities to support racialized students and address systemic racism.

A cross-jurisdictional pan-Canadian environmental scan was conducted to identify provincial, territorial, and federal financial supports available to families with children living with neurodisabilities. In partnership with the organization Childhood Disability LINK, flowchart-styled pathway documents were developed for each financial support identified, mapping out the processes required to access each support. A critical analysis was completed as it relates to structural barriers, accessibility of program information and geographic discrepancies. The results revealed that, despite almost universal availability of programs to support families of children living with neurodisabilities, significant barriers and inequity remain. This included considerable variation in access to financial support based on geographic and jurisdictional discrepancies, absence of adequate and accurate information about programs, and minimal support provided to families in the application process. We argue that the barriers and discrepancies identified were an inherent result of the Canadian federalist fragmentation of the delivery of social care and financial support programs for children living with neurodisabilities. A more unified response by Canadian provincial, territorial, and federal governments is clearly needed to take positive steps to address the consequences of federalist fragmentation and respond to the structural barriers and geographic discrepancies identified by this study. 

Objectives

High mortality rates, anxiety and distress associated with Ebola virus disease (EVD) are risk factors for mood disorders in affected communities. This study aims to document the prevalence and risk factors associated with depressive symptoms among a representative sample of individuals affected by EVD.

Design

Cross-sectional study.

Setting

The current study was conducted 7 months (March 11, 2019 to April 23, 2019) after the end of the ninth outbreak of EVD in the province of Equateur in the Democratic Republic of the Congo (DRC).

Participants

A large population-based sample of 1614 adults (50% women, Mage=34.05; SD=12.55) in health zones affected by the ninth outbreak in DRC.

Primary and secondary outcome measures

Participants completed questionnaires assessing EVD exposure level, stigmatisation related to EVD and depressive symptoms. The ORs associated with sociodemographic data, EVD exposure level and stigmatisation were analysed through logistic regressions.

Results

Overall, 62.03% (95% CI 59.66% to 64.40%) of individuals living in areas affected by EVD were categorised as having severe depressive symptoms. The multivariable logistic regression analyses showed that adults in the two higher score categories of exposure to EVD were at two times higher risk of developing severe depressive symptoms (respectively, OR 1.94 (95% CI 1.22 to 3.09); OR 2.34 (95% CI 1.26 to 4.34)). Individuals in the two higher categories of stigmatisation were two to four times more at risk (respectively, OR 2.42 (95% CI 1.53 to 3.83); OR 4.73 (95% CI 2.34 to 9.56)). Living in rural areas (OR 0.19 (95% CI 0.09 to 0.38)) and being unemployed (OR 0.68 (95% CI 0.50 to 0.93)) increased the likelihood of having severe depressive symptoms.

Conclusions

Results indicate that depressive symptoms in EVD affected populations is a major public health problem that must be addressed through culturally adapted mental health programs.

Ambivalence toward pregnancy is an important predictor of early pregnancy as documented in diverse Western societies. Inuit women from Nunavik, a northern region of Quebec, Canada, experience a high rate of early pregnancy, yet no study has explored their attitudes toward pregnancy. Grounded in a participatory approach, this study aimed to explore ambivalence toward pregnancy, among other pregnancy-related attitudes, and identify themes underlying ambivalence among young Inuit women from Nunavik. We conducted semi-structured interviews with 15 women aged 16 to 20 years, who became pregnant during the year preceding the interview. We used an inductive approach to analyse the data. Eleven participants were identified as ambivalent toward pregnancy while three were characterised as having a favourable attitude, and one as unfavourable. Four themes related to ambivalence were identified: the value of childbearing/motherhood; the use of contraceptives; the likelihood of becoming pregnant; and the ideal age to become pregnant. A better understanding of young women’s attitudes toward pregnancy could contribute to the development of culturally relevant programmes to more effectively support adolescents, pregnant adolescents and young mothers, and to lead to better care.

Purpose

Work disability stakeholders may not share the same understanding and solutions among themselves or with researchers, causing misunderstandings and hindering collaboration regarding solutions for preventing work disability. To reduce such differences, this study sought to build a common vocabulary among stakeholders and researchers, using a transdisciplinary research framework.

Methods

A consensus method based on a constructivist approach was used. A theoretical sampling method was applied to identify researchers or stakeholders representing one of the four systems in the work disability paradigm. A preliminary set of definitions for key terms was assessed using a Web-based questionnaire. It documented participants’ level of agreement with each term’s inclusion and relevance in the field, and the clarity of the definition, while soliciting suggestions for other terms or clearer definitions. Disagreements were discussed at group meetings, yielding consensus on the final terms and definitions.

Results

Eleven stakeholders representing patients, employers, unions, healthcare professionals, and legislative and insurance systems, along with 10 multidisciplinary researchers, participated. The questionnaire yielded initial consensus on the inclusion and definitions of 49 terms, and 109 suggestions mostly for modified definitions (average = 6 suggestions/term). Two preliminary terms were excluded and three terms were added. Ultimately, 80 terms and their definitions yielded consensus.

Conclusions

The process we used to build a common vocabulary was carried out within a transdisciplinary framework. It required a constructivist approach, promoting idea exchanges among participants and co-construction of generally agreed results. The results were rooted in local contexts, thus ensuring the same reference points, regardless of participants’ different understandings.

Unaccompanied minors (UMs) are children under the age of 18 who settle in a foreign country without a legal representative. In France, many UMs are left unprotected from child welfare services because assessment systems evaluate that they are not minors. In Paris, the non-governmental organization Médecins du Monde (MdM) offers unprotected UMs medical, psychological, and social care. In March 2020, the lockdown policy to contain COVID-19 constrained MdM to adapt its care provision model. This case study sought to answer the following question: how did volunteers and employees of MdM respond to the social and health needs of unprotected UMs during the spring 2020 lockdown in Paris? We analyzed a cohort of 58 UMs for eight weeks of lockdown using secondary quantitative data. We further explored the UMs’ needs and the experience of phone consultations, through 15 interviews with MdM’s program volunteers and employees. Time series showed a steady increase in UMs’ needs. The program’s adapted care provision likely contributed to reducing UMs’ feeling of isolation. It also had several negative consequences for unprotected UMs, volunteers, employees, and Médecins du Monde’s institution. This study highlights the role of non-governmental organizations in providing a particularly vulnerable migrant population – unprotected UMs – care and support, despite operational challenges in crisis times.

Le contexte d’interculturalité est le lieu de rapports complexes. Dans le cadre de l’intervention, comment situer et appréhender la posture de la personne intervenante ? Notre article propose une réflexion sur des méthodes de récits basée sur un cadre conceptuel interculturel et de la sociologie clinique appliqués à l’intervention et à la recherche. Nous aborderons spécifiquement le récit de soi à travers le photolangage© et le récit d’expérience pour donner à voir que les postures professionnelles ne peuvent être comprises dans une linéarité mais plutôt dans la transversalité de positions idéal-typiques et de subjectivités.

L’objectif de cet article est d’explorer, à la lumière de l’approche multiculturelle critique (May & Sleeter, 2010 ; May, 2000 ; 2003), la participation des enseignant-es au système de justice sociale scolaire. À partir d’un projet de recherche sur la reconstruction et la théorisation des récits de pratique des enseignant-es (Desgagné, 2005) dans un contexte multiethnique, des données ont été recueillies auprès d’enseignant-es d’écoles primaires hautement multiethniques au Québec. Des enseignant-es ont été invités à raconter un récit lié à un événement ou à un problème qui s’est produit avec l’un-e de leurs élèves immigrant-es ou réfugié-es. Dans cet article, quatre récits narrés et reconstruits par quatre enseignant-es participant-es ont été sélectionnés et analysés. Nous visons à analyser de quelle manière les enseignant-es réagissent culturellement et assument leur rôle dans le soutien de leurs élèves. Notre analyse montre que malgré les efforts déployés pour changer la réalité de leurs élèves, les enseignant-es ne peuvent pas contrôler seuls les normes d’un système scolaire, sociétal et politique qui régit les relations de pouvoir et privilégie les normes et les valeurs dominantes.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

En hématologie-oncologie pédiatrique, les technologies et les avancées médicales génèrent de multiples voies quant aux possibilités thérapeutiques. Ces possibilités et les espoirs qu’elles suscitent s’invitent comme acteurs dans la prise de décision. Parallèlement, les complications inhérentes aux traitements de pointe (greffes hématopoïétiques) sont nombreuses et la mort, une éventualité. À partir d’histoires d’enfants, de parents et de cliniciens, recueillies au cours d’une enquête ethnographique réalisée dans une unité d’hématologie-oncologie dans un hôpital pédiatrique à Montréal, nous discutons du processus de prise de décision lors de pronostics sombres et des défis posés par le passage d’une trajectoire thérapeutique à visée curative à celle ayant une perspective palliative. Nous questionnons la prise de décision partagée (patient/famille/médecin) et le rôle moral des cliniciens dans un contexte où les « morts spontanées » surviennent rarement et où l’option de prolonger la vie à tout prix rivalise avec la médecine palliative.

La vie et la mort sont étroitement liées en milieux de soins où les questions nombreuses en regard (notamment) de la qualité de vie et de mort, de la poursuite ou de l’arrêt du traitement et de la légitimité des personnes qui prennent part aux décisions façonneront ces moments cruciaux. Devant de nombreux possibles thérapeutiques, quand s’arrêter ou encore quand tendre vers une perspective palliative n’est jamais donné d’emblée. Les frontières entre les catégorisations sociales séparant le curable de l’incurable, le malade du mourant et la compréhension de l’imminence de la mort restent parfois incertaines ou à reconstruire selon les cas. À partir de deux études ethnographiques (observations en unités de soins, entretiens avec soignants, patients et leurs familles), l’une menée en contexte pédiatrique hospitalier (unité d’hématologie-oncologie-greffe de moelle osseuse) et l’autre auprès de personnes de grand âge en milieu hospitalier et en centre d’hébergement et de soins de longue durée à Montréal, les auteures discutent de la diversité des trajectoires de fin de vie. Quand peut-on s’arrêter ? Qui peut répondre ? Ces questions sont récurrentes sans être nouvelles. Elles demeurent néanmoins le quotidien de la « grande maladie ». Les auteures puiseront à même le « prendre soin » et le « devoir de non-abandon » pour dégager quelques éléments de réponse tout en s’interrogeant sur le statut contemporain de la (bio)médecine (entre espoirs et tensions) et les ambigüités conceptuelles et empiriques entre le « curatif » et le « palliatif ».

In a number of ways, dance can express and transform interpersonal and social bonds. This article explores this idea, drawing on a dance project conducted in Montreal in 2017 in a multi-ethnic neighborhood facing issues of poverty. The project was based on the premise that intergenerational and intercommunity ties both echo and transform each other. This article will describe the framework in which the project took place and discuss the challenges it raised, particularly in terms of animation and artistic process. Finally, we will reflect on the way that the dynamics between centrality and marginality were revealed in the project.

Background: Migrants commonly maintain transnational ties as they relocate and settle in a new country. There is a growing body of research examining transnationalism and health. We sought to identify how transnationalism has been defined and operationalized in migrant health research in high income countries and to document which populations and health and well-being outcomes have been studied in relation to this concept.

Methods: We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute (JBI). We searched nine electronic databases; no time restrictions were applied. Studies published in English or French in peer-reviewed journals were considered. Studies were eligible if they included a measure of transnationalism (or one of its dimensions; social, cultural, economic, political and identity ties and/or healthcare use) and examined health or well-being.

Results: Forty-seven studies, mainly cross-sectional designs (81%), were included; almost half were conducted in the United States. The majority studied immigrants, broadly defined; 23% included refugees and/or asylum-seekers while 36% included undocumented migrants. Definitions of transnationalism varied according to the focus of the study and just over half provided explicit definitions. Most often, transnationalism was defined in terms of social connections to the home country. Studies and measures mainly focused on contacts and visits with family and remittance sending, and only about one third of studies examined and measured more than two dimensions of transnationalism. The operationalization of transnationalism was not consistent and reliability and validity data, and details on language translation, were limited. Almost half of the studies examined mental health outcomes, such as emotional well-being, or symptoms of depression. Other commonly studied outcomes included self-rated health, life satisfaction and perceived discrimination.

Conclusion: To enhance comparability in this field, researchers should provide a clear, explicit definition of transnationalism based on the scope of their study, and for its measurement, they should draw from validated items/questions and be consistent in its operationalization across studies. To enhance the quality of findings, more complex approaches for operationalizing transnationalism (e.g., latent variable modelling) and longitudinal designs should be used. Further research examining a range of transnationalism dimensions and health and well-being outcomes, and with a diversity of migrant populations, is also warranted.

This article presents a preliminary evaluation of training sessions promoting a systemic approach to violent radicalization (VR) offered to first-line health and education professionals in Quebec. We describe the rationale and content for the training program, its general principles and implementation modalities. The mixed-method evaluation indicated that the participants felt the training increased their level of confidence in dealing with VR in their work. It appeared that training also shifted participants’ attitudes significantly on four items with decreases: (1) worry about the extent of VR of young people in Quebec; (2) belief that VR should automatically be reported to the police; (3) thinking that Islam favors VR; and (4) assumption that enhanced security measures would have a deterrent effect on VR. The conclusion discusses the challenges associated with violent radicalization training programs, emphasizing the delicate ethical and political questions related to the provision of training on this socially divisive topic.

Mixed methods research is well-suited to grapple with questions of what counts as valid knowledge across different contexts and perspectives. This article introduces Weight of Evidence as a transformative procedure for stakeholders to interpret, expand on and prioritize evidence from
evidence syntheses, with a focus on engaging populations historically excluded from planning and decision making. This article presents the procedure’s five steps using pilot data on perinatal care of immigrant women in Canada, engaging family physicians and birth companions. Fuzzy cognitive mapping offers an accessible and systematic way to generate priors to update published literature with stakeholder priorities. Weight of Evidence is a transparent procedure to broaden what counts as expertise, contributing to a more comprehensive, context-specific, and
actionable understanding.

The present study examines the moderating role of total, intrinsic, and extrinsic religiosity in the relation between perceived discrimination and sympathy for violent radicalization (VR) among college students in Quebec, Canada. A total of 931 students responded to an online questionnaire and were included in this study. Linear mixed-effects models were conducted to account for the clustered nature of the data, and moderation was assessed via interaction analysis using cross-product terms in the models. Findings indicated that both intrinsic and extrinsic religiosity had a protective role in the link between perceived discrimination and sympathy for VR and buffered the effects of sadness in response to discrimination on sympathy for VR, but not the effects of anger in response to discrimination. These results provide evidence of the protective role of religiosity in Canada, a social context characterized by an increase in religious discrimination, but which also supports religious diversity.

Background

International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens.

Methods

We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens.

Results

One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a ‘foreign-born male nurse’, and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services’ personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex.

Conclusion

Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students’ contexts.

Health care personnel attitudes toward refugee claimant entitlement to health care are influenced by multilevel factors including institutional and societal culture. Although individual attitudes may be modified through training, macro- and meso-issues require system-level interventions. This paper analyzes the role of individual-, institutional-, and city-level factors in shaping attitudes toward refugee claimants’ access to health care among Canadian health care personnel. A total of 4207 health care personnel in 16 institutions located in Montreal and Toronto completed an online survey on attitudes regarding health care access for refugee claimants. We used multilevel logistic regression analysis to identify individual-, institutional-, and city-level predictors of endorsing access to care. Participants who had prior contact with refugee claimants had greater odds of endorsing access to care than those who did not (OR 1.13; 95% CI 1.05, 1.21). Attitudes varied with occupation: social workers had the highest probability of endorsing equal access to health care (.83; 95% CI .77, .89) followed by physicians (.77; 95% CI .71, .82). An estimated 7.97% of the individual variation in endorsement of equal access to health care was attributable to differences between institutions, but this association was no longer statistically significant after adjusting for city residence. Results indicate that the contexts in which health care professionals live and work are important when understanding opinions on access to health care for vulnerable populations. They suggest that institutional interventions promoting a collective mission to care for vulnerable populations may improve access to health care for precarious status migrants.

Highlights
Poor Ebola virus disease (EVD) knowledge is associated to risky rumors, misconceptions, and inappropriate practices.

A large proportion of participants did not have sufficient knowledge on EVD transmission, prevention and treatment methods.

More than half of participants had misconceptions about EVD and were not aware of appropriate practices.

Results will facilitate the development of education programs that should equip them to prevent the spread of the EVD.

Objectives
This study explored the perspectives of mental health practitioners serving LGBTQ+ forced migrants, LGBTQ+ individuals, and forced migrants not identifying as LGBTQ+ to understand the clinical frameworks guiding their practice and how they approached clients whose identities were similar to or different than their own.
Methods
Twenty-eight mental health practitioners from three Canadian cities participated in qualitative interviews. The sample comprised practitioners serving LGBTQ+ forced migrants (n=11); forced migrants not identifying as LGBTQ+ (n=9); and non-migrant LGBTQ+ clients (n=8). Thirteen providers identified as white; 3 as Middle-Eastern/North African, 3 as Latinx, 1 as West African, 1 as Indigenous, 1 as West Asian, and 1 as Other. Data were analyzed using constructivist grounded theory.
Results
Practitioners across all three 3 sample groups used similar approaches, whether or not they worked with clients whose sexual orientations, gender identities, racial/ethnic backgrounds, or migration status were different than their own. Practitioners described using an
eclectic approach, incorporating cultural competence, cultural humility, and LGBTQ+- affirmative and anti-oppressive practices in their work. Practitioners also noted that lack of training for ancillary providers could lead to discrimination that negatively impacts clients, making establishing a therapeutic relationship challenging.
Conclusions
Findings suggest that the concepts of cultural humility, cultural competence, and affirmative practice may not be mutually exclusive. The similarities in practice approaches across provider samples point to the salience of integrating these clinical practice concepts and frameworks when working with LGBTQ+ forced migrants, LGBTQ+ individuals with diverse cultural backgrounds, and forced migrants who do not identity as LGBTQ+.

For the last three decades, Western host countries have been implementing restrictive immigration measures toward asylum seekers aiming to keep them out, to contain them in their country of origin or to toughen their living conditions in the host country. These measures have deeply affected the civil and political rights of asylum seekers as well as their social and economic well-being. Using an exploratory approach, this study explored how social workers dealt with situations of social and economic human rights violations experienced by asylum seekers in Canada. Findings revealed that many factors shaped social workers’ conceptions of human rights and their decisions to engage in human rights–based practice. These factors were academic training, social workers’ personal stance toward human rights, and social workers’ approach to structural disadvantage carried out in public institutions toward asylum seekers. Findings suggested social workers developed different understanding of inland immigration measures and the effect of structural disadvantages in asylum seekers’ host countries. Findings also illustrated interventions centered around human rights that followed from empowerment, such as consciousness-raising, critical thinking and actions of mobilization.

In the context of migration, different perspectives of child agency can influence childcare practices and may create tensions within families and in the host society. This study explores the individual, relational, environmental, and cultural factors that influence how child agency is understood and exercised within immigrant households. Focus group discussions were conducted with first- and second-generation immigrant children (12- to 17-year-old) (N = 46) and parents (N = 19) from South-Asia, Latin-America and the Caribbean in Montreal. Our findings suggest that children exercise agency by taking actions to ensure their own safety and contributing to their families’ needs. Moreover, we found that negotiating children’s agency is influenced by the nature of the parent–child relationship, the material and social resources available to the family, and the perceived and lived experiences of authority and safety in the host society. This study advances our understanding of how immigrant children contribute to their families and the role that contextual factors play in shaping, promoting and hindering child agency. Policy makers and service providers in host societies should consider the perspectives of immigrant children and parents in order to develop a more culturally responsive understanding of the elements and processes that influence childcare and supervision practices of immigrant families.

Using a retrospective sample, the authors sought to determine whether Black patients with first-episode psychosis (FEP) in Canada were at a higher risk for coercive referral and coercive intervention than non-Black patients with FEP. Methods: Retrospective data from patients referred to an FEP program in 2008?2018 were collected via chart review (N=208). The authors used chi-square and logistic regression analyses to explore the relationships among race-ethnicity, diagnosis of psychosis, and coercive referral and intervention. Results: Results showed that Black persons of Caribbean or African descent with FEP were significantly more likely to be coercively referred (?2=9.24, df=2, p=0.010) and coercively treated (?2=9.21, df=2, p=0.010) than were non-Black individuals with FEP. Age and violent or threatening behavior were predictors of coercive referral. Ethnoracial status, age, and violent or threatening behavior were predictors of coercive intervention. Conclusions: This study contributes to the dearth of research on Black Canadians and offers insight into factors that may place patients with FEP at risk for coercive treatment. More research is needed to explore the role that ethnoracial status may play in hospital admissions and to uncover the role of racial prejudices in the assessment of danger.

Bien qu’il y ait un intérêt grandissant dans la recherche en sciences sociales sur la réalité des personnes migrantes marginalisées, telle que celles appartenant à la population LGBTQ+, on dispose de très peu d’études dans la littérature québécoise sur les meilleures stratégies d’implication des personnes concernées dans la construction des savoirs. Cet article vise à contribuer à la diffusion de la connaissance empirique et autoréflexive sur l’inclusion des personnes LGBTQ+ migrantes dans les espaces de délibération et de co-construction des savoirs. Pour ce faire, plusieurs pistes sont proposées pour dépasser les limites systémiques ainsi que résoudre les défis méthodologiques et éthiques liés à l’inclusion des personnes LGBTQ+ migrantes au sein des espaces de réflexion et de construction des connaissances autour des enjeux qui les concernent directement. D’un point de vue empirique, notre démarche s’appuie sur l’autoreflexivité de différents acteurs et actrices concernés (membres soutenus, membres du conseil d’administration, membres de l’équipe de soutien et employés) dans une recherche communautaire menée en collaboration avec l’organisme communautaire AGIR (Action LGBTQ avec les immigrant.e.s et les réfugié.e.s).

Dans cet article nous interrogeons la prise de décision qui jalonne la grande maladie chez les enfants. En milieu hospitalier pédiatrique montréalais (et en particulier ici à l’unité de greffe de moelle osseuse) la mort et la vie se côtoient de près et appellent souvent des décisions délicates qui transformeront un projet thérapeutique d’une vision curative (et de guérison) à un accompagnement (et soins palliatifs). Lors de pronostics sombres, une relation complexe s’installe entre la science, les soignants et les soignés donnant lieu à des trajectoires où prime l’action même lorsque la mort se dessine.

Abstract

Introduction: As elsewhere in the world, Quebec (Canada) is currently facing the COVID-19 pandemic. Approximately 92% of deaths have occurred among people aged over 70, and approximately 100 long-term care (LTC) centers (termed CHSLDs in Quebec) were contaminated. This alarming situation is prompting stakeholders from healthcare networks to investigate the socio-economic repercussions of COVID-19. To the best of our knowledge, there is no valid and reliable tool to measure the costs associated with the management of COVID-19 in CHSLDs. Objectives: This research protocol aims to: i) adapt and validate for use in CHSLDs a combined guide, Cout-COVID19-SLD, developed from 2 guides used in acute care; ii) pilot the Cout-COVID19-SLD guide in CHSLDs and test its feasibility and afterwards resolve any barriers to its administration, and to conduct a partial estimate of costs brought about by COVID-19. Methods: A two-part prospective study will be conducted. Phase 1 will use a Delphi approach with 14 to 17 experts to validate the content of the Cout-COVID19-SLD guide. Phase 2 will pilot test the guide in a cross-sectional study in two CHSLDs. Discussion and conclusion: This study will provide a validated guide for the systematic measurement of costs associated with the management of COVID-19 (costs of preventive measures and costs of illness) in CHSLDs. Finally, this guide will serve as a valid and reliable instrument with which to better plan future research surrounding the socio-economic impacts of COVID-19 in CHSLDs.

Purpose:
The objective of this study is to identify the relationship between COVID-19 experiences, perceived COVID-19 behavioral control, social norms and attitudes, and future intention to follow social distancing guidelines.

Design:
This is a cross-sectional study.

Setting:
Participants responded to an on-line survey in June 2020.

Subjects:
The study included 3,183 residents within Quebec, Canada aged 18 and over.

Measures:
Measures include perceived COVID-19 related discrimination, fear of COVID-19 infection, prior exposure to COVID-19, and prior social distancing behavior. Participants self-reported attitudes, perceived behavioral control, and perceived norms related to social distancing. Finally, we measured social distancing behavioral intention.

Analysis:
We evaluated a theory of planned behavior (TPB) measurement model of social distancing using confirmatory factor analysis (CFA). The association between COVID-19 perceived discrimination, fear of infection, previous social distancing behavior, exposure to COVID-19, TPB constructs and behavioral intentions to social distance were estimated using SEM path analysis.

Results:
TPB constructs were positively associated with intention to follow social distancing guidelines. Fear of COVID-19 infection and prior social distancing behavior were positively associated with behavioral intentions. In contrast, perceived discrimination was negatively associated with the outcome. Associations between fear of COVID-19, perceived COVID-19 discrimination and behavioral intentions were partially mediated by constructs of TPB.

Conclusions:
COVID-19 prevention efforts designed to emphasize positive attitudes, perceived control, and social norms around social distancing should carefully balance campaigns that heighten fear of infection along with anti- discrimination messaging.

Background
Children exposed to violence are at risk of a range of adverse outcomes. Given the unique cultural and social context, understanding what fosters children’s resilience in resource-limited areas such as sub-Saharan Africa, is vital.
Objectives
Using data from the International Survey of Children’s Well-Being (ISCWeB), this paper explores individual-, family-, and school-level factors associated with positive outcomes for children who have experienced some form of violence in Khomas region, Namibia.
Method and participants
Using a cross-sectional survey design, the ISCWeB questionnaire, assessing cognitive, affective, and psychological dimensions of well-being, child protection factors and violence exposure was administered to 2124 Grade four and six children.
Results
Our sample had a mean age of 11.2 years. Overall, 56.8 % of children reported at least one incident of violence from an adult caregiver at home and 86.0 % of children reported some form of peer violence at school. Materially deprived children experienced higher incidence of both family and peer violence. The quality of children’s relationships at home (β = 0.17, p < 0.001), and school (β = 0.07, p < 0.001) emerged as important protective factors for children’s well-being for both types of violence, suggesting that supportive family and school relationships may be more important to the subjective well-being of children who experienced violence than material wellbeing, violence severity, and individual child factors.
Conclusions
Providing positive social interaction and emotional security in contextually and culturally appropriate ways within children’s proximal systems should be prioritized while challenging norms that support violence in Namibian families and schools.
Keywords: Children; Family violence; Bullying; Subjective well-being; Namibia

This article presents an analysis of the lived experiences of youth mental health practitioners taking part in Transcultural Interinstitutional and Interdisciplinary Case Discussion Seminars (TIICDS), an intercultural training initiative developed in Montréal (Québec, Canada), while considering the current context of increasing social polarizations. Using insights from the community of practice (CoP) framework and drawing on the analysis of 21 seminar sessions and 26 semi-structured individual interviews, this article examines the relation between the local sociopolitical context, the participants’ verbalization about their identities, and the affect and cognition evoked by the training. Results indicate that TIICDSs present several features of a CoP and that intercultural training needs to build on both theoretical and experiential knowledge, while considering local contextual elements. These include historical and contemporary social representations and power differentials between groups, the cultural identities of trainees, and the institutions and sociopolitical structures in which clinical practices take place. These elements, we argue, are sensitive and potentially conflictual but can be addressed through supportive and reflexive group-based initiatives such as CoPs that bring together practitioners on a regular basis and provide them with a ‘culturally safe enough’ space in which they can learn to complexify their understanding of clinical situations.

Background

This article reports the results of a rapid scoping review of the literature on COVID-19 transmission risk to workers in essential sectors such as retail, health care, manufacturing, and agriculture, and more particularly the experiences of workers in precarious employment and social situations.

Methods

Following scoping review methods, we included 30 studies that varied in terms of methodology and theoretical approaches. The search included peer-reviewed articles and grey literature published between March and September 2020.

Results

Based on the studies reviewed, we found that COVID-19 infection and death rates increased not only with age and comorbidities, but also with discrimination and structural inequities based on racism and sexism. Racial and ethnic minority workers, including migrant workers, are concentrated in high-risk occupations and this concentration is correlated to lower socioeconomic conditions. The COVID-19 pandemic appears in the occupational health and safety spotlight as an exacerbator of already existing socioeconomic inequalities and social inequalities in health, especially in light of the intersection of issues related to racism, ethnic minority status, and sexism.

Conclusions

This review provides early evidence about the limitations of institutions’ responses to the pandemic, and their capacity to provide a safe and decent working environment for all workers, regardless of their employment status or the social protections they may enjoy under normal circumstances. It is also important to think about these issues in the postpandemic context, when conditions of precariousness and vulnerability persist and possibly worsen.

On the basis of ethnographic fieldwork carried out among youths living in Montreal(Canada) who are interested in Islam and adopt some elements of a Muslim lifestyle, I show how affinities with Islam arise from sociability practices with friends of Muslim background and relate to the cultural diversification of secular societies. By combining network analysis with narrative analysis, I examine how youths interpret and make sense of these interactions and propose a critical view of their cosmopolitan discourses. While the latter is grounded in a universalist rhetoric, I argue it also unfolds within the intimacy of sociability experiences and share demotions. Youth’s cosmopolitanism draws on cultural repertoires that stem from public education programs and local strategies to promote peaceable cohabitation in secular contexts. Consequently, youth competencies for cosmopolitanism lead to on going conversations that make differences and divergences within sociability spaces new sites to negotiate intercultural encounters in highly diversified localities.

In the past decade there has been an increase in focus on the concept of deservingness and how it plays out in debates around health care for migrant populations with precarious legal status. This study uses latent class analysis to identify subtypes of attitudes regarding asylum seeker access to health care and endorsement of support for asylum seeker access to care among 4066 employees of health care institutions in Montreal and Toronto, Canada. Authors identified four classes of attitudes towards asylum seeker access to care named ‘Favorable,’ ‘Opposed,’ ‘Ambivalent/Reactive,’ and ‘Unconcerned/Status quo’. The odds of endorsing access to health care depended on the individual’s class membership of asylum seeker attitude. Although there are segments of the population that overwhelmingly endorse, or reject, asylum seeker access to care, there are important variants in opinions and beliefs. Interventions are needed to engage professionals more ambivalent or opposed to asylum seeker access to care.

Nous proposons une réflexion analytique basée sur les résultats de deux recherches qualitatives antérieures réalisées au Québec (Canada) portant sur des personnes descendantes de migrants. Dans le cadre d’interventions en contexte d’interculturalité, on doit rester à l’écoute parfois d’un silence des personnes racisées. Que signifie ce silence ? Nous montrons ici que le silence de ces personnes face à des micro-agressions récurrentes est une forme de résistance à l’exclusion qui conduit à la fois à renforcer des liens d’appartenance et à fragiliser un lien social global, cela dans un contexte macrosocial inscrit dans un processus sociohistorique. Dans cette perspective, il s’agira d’articuler les plans subjectif et social en faisant usage d’une approche théorique interdisciplinaire ainsi que d’une épistémologie et d’une méthodologie spécifique.

Le programme de Services intégrés en périnatalité et pour la petite enfance (SIPPE) offre une intervention précoce et intensive qui cible les facteurs de risque et promeut les facteurs de protection chez les enfants d’âge préscolaire et leurs familles. À ce jour, aucune étude n’a évalué la pertinence des critères d’admissibilité au programme pour la clientèle immigrante. La présente étude explore donc la capacité des critères d’admissibilité à identifier les mères réfugiées ou immigrantes vulnérables du point de vue d’intervenantes SIPPE. Les intervenantes identifient certains problèmes soulevés dans le cadre du processus décisionnel actuel. Des recommandations sont émises pour favoriser un processus décisionnel qui tienne compte des besoins spécifiques de la clientèle desservie.

Hairstyles have always been important to Black Africans and their descendants and are important in expressing identity. The transatlantic slave trade made it difficult to maintain these hairstyles, mostly due to separation from familial and other ties. Since Black phenotypes were viewed as inferior, Black hair and styles were seen as ugly and unacceptable. The American Civil Rights Movement (ACRM) ushered in a resurgence in ‘natural’ hairstyles, supporting a collective identity and a counterhegemonic movement. However, the success of this movement did not propel Black hairstyles on to the same plane as those that maintained the imperial aesthetic of the white ideal. The constant diminution of the Black identity through the disparagement of Black hairstyles has been used as a synonym for racism and can lead to psychological distress and mental instability. Although Black people have resided in Canada and Quebec since the 17th century, there is very little in Canadian academic literature addressing these issues. This theoretical paper presents a discourse on the importance of hair to the identity of Black people and will add to the limited literature by providing Canadian and Québécois institutions with a greater appreciation of the prominence of Black hair and hairstyles to the identity and well-being of Black people.

Vaccination is a common painful procedure for children. Parents’ concern regarding vaccination pain is a significant driver of vaccine hesitancy. Despite the wealth of evidence-based practices available for managing vaccination pain, parents lack knowledge of, and access to, these strategies. Knowledge translation (KT) tools can communicate evidence-based information to parents, however little is known about what factors influence parents’ use of these tools. A two-page, electronic KT tool on psychological, physical, and pharmacological vaccination pain management strategies for children, was shared with parents as part of a larger mixed methods study, using explanatory sequential design, exploring factors related to uptake of this KT tool. The aim of this qualitative study was to understand what influenced parents’ perceptions of the relevance of the KT tool, as well as their decision as to whether to use the tool.

The question of how workers’ compensation systems should account for language barriers is of increasing importance given Canada’s growing linguistic diversity. This study is the first to empirically examine, based on interviews with injured workers and key informants, return-to-work policies and practices through the lens of language barriers. By comparing two jurisdictions, Quebec and Ontario, the study highlights similarities and differences in language accommodation and return-to-work policies and practices that shape the experiences of injured workers with language needs. It argues that gaps in this regard, which are more pronounced in Quebec, contribute to poor return-to-work outcomes for these workers in both provinces.

Objectives
According to the World Health Organization, discrepancies in health statistics reflect unequal access to resources. The Truth and Reconciliation Commission of Canada calls for an increase in the number of Indigenous workers within health and social services. The involvement of local community workers is essential to ensure the cultural security of care and the decolonization of services. This article presents the role played by these workers in the expansion of mental health services and social interventions in Nunavik, the contextual considerations that influence their practice and their place within professional teams.

Methods
A thematic analysis was conducted on semi-structured interviews done in 2016 with 60 Inuit and non-Inuit individuals working in the broad field of health and social services in Nunavik.

Results
The integration of local community workers is perceived to bring several benefits, including the improvement of interventions and unique learning opportunities. However, several factors hinder this collaboration, such as clarity of mandates, access to pre-requisite training and diplomas, recognition of local knowledge, and staff turnover. More flexibility and support after hiring would allow for the service structure to be adapted to the complex reality of Nunavik.

Conclusion
This article adds to the body of literature highlighting the importance of collaboration with local community workers. The decolonization of services necessarily involves redesigning structures in order to recognize their contribution and to give a place to local knowledge.

This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change.