This article introduces a thematic issue of Transcultural Psychiatry with selected papers from the McGill Advanced Study Institute in Cultural Psychiatry on “Pluralism and Polarization: Cultural Contexts and Dynamics of Radicalization,” which took place June 20–22, 2017. The ASI brought together an interdisciplinary group scholars to consider the role of social dynamics, cultural contexts and psychopathology in radicalization to violent extremism. Papers addressed four broad topics: (1) current meanings and uses of the term radicalization; (2) personal and social determinants of violent radicalization, including individual psychology, interpersonal dynamics, and wider social-historical, community and network processes; (3) social and cultural contexts and trajectories of radicalization including the impact of structural and historical forces associated with colonization and globalization as well as contemporary political, economic and security issues faced by youth and disaffected groups; and (4) approaches to community prevention and clinical intervention to reduce the risk of violent radicalization. In this introductory essay, we revisit these themes, define key terms, and outline some of the theoretical and empirical insights in the contributions to this issue. Efforts to prevent violent radicalization face challenges because social media and the Internet allow the rapid spread of polarizing images and ideas. The escalation of security measures and policies also serves to confirm the worldview of conspiracy theory adherents. In addition to addressing the structural inequities that fuel feelings of anger and resentment, we need to promote solidarity among diverse communities by building a pluralistic civil society that offers a meaningful alternative to the violent rhetorics of us and them.

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.

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.

Appliqué aux phénomènes religieux depuis les années 1990, le concept de mobilité permet de saisir la multiplicité des expressions des croyances, des pratiques et des identifications dans un contexte de mondialisation qui régule autant les circulations que les immobilités des acteurs, des objets et des symboles. Si la mobilité est intrinsèque aux fondements mêmes de la plupart des institutions et traditions religieuses, les recompositions, transformations et tensions qui traversent les expériences contemporaines du religieux affichent des variations dont l’approche empirique, plus que toute autre, peut rendre compte. Nous tentons ici de saisir la complexité des parcours religieux actuels en soulignant les conditions de créativité, les possibilités de transgression et les espaces d’indétermination religieux et sociaux qu’elles offrent. Ce dossier rassemble des travaux issus d’une réflexion collective portant sur les migrations et les mobilités religieuses à partir d’études qualitatives menées dans des milieux chrétien et musulman.

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.

Introduction : Le Québec (Canada) fait face à la COVID-19 comme ailleurs dans le monde. Environ 92 % des décès sont survenus chez des personnes de plus de 70 ans et une centaine de centres d’hébergement de soins de longue durée (CHSLD) ont été contaminés. Cette situation alarmante pousse le réseau de la santé à connaître les répercussions socio-économiques de la COVID-19. À notre connaissance, il n’y a pas d’outil valide et fiable pour mesurer les coûts de gestion de la COVID-19 dans les CHSLD. Objectifs : Le présent protocole vise à : i) adapter et valider pour les CHSLD une grille fusionnée, Cout-COVID19-SLD, issue de 2 grilles développées en soins aigus; ii) mettre à l’essai la grille Cout-COVID19-SLD dans les CHSLD afin d’analyser sa faisabilité, résoudre les obstacles à son administration, et procéder à une estimation partielle des coûts causés par la COVID-19. Méthodes : Une étude prospective en 2 volets sera réalisée. Le premier volet utilisera une approche Delphi auprès de 14 à 17 experts pour valider le contenu de la grille. Le second testera la grille via une étude pilote transversale dans deux CHSLD. Discussion et conclusion : Cette étude permettra d’obtenir une grille validée pour systématiser la mesure des coûts associés à la gestion de la COVID-19 (coûts de mesures préventives et de la maladie) dans les CHSLD. Enfin, cette grille servira comme un instrument valide et fiable pour mieux planifier des recherches futures sur les impacts socio-économiques de la COVID-19 dans les CHSLD.