Publications scientifiques

Cette contribution présente des résultats issus d’un projet de recherche sur le climat interculturel et sur la réussite éducative des élèves issus de l’immigration en contexte québécois. Dans ce sens, le climat interculturel de huit établissements secondaires publics a été documenté du point de vue de différents acteurs scolaires et communautaires, d’élèves et de parents. Le présent article se centre plus particulièrement sur la dimension liée à l’engagement en faveur d’une culture d’équité, appréhendée à partir des processus et pratiques à effet d’exclusion et des pratiques mises en œuvre pour les contrer, par le biais d’entretiens auprès d’acteurs ciblés Les résultats permettent d’identifier cinq zones de vulnérabilité à l’égard de certains groupes minorisés : la transition accueil-régulier des élèves en apprentissage du français ; l’évaluation et le soutien aux difficultés d’apprentissage ou comportementales vécues par les élèves issus de l’immigration ; l’orientation de ces élèves vers la formation générale des adultes ou les parcours de formation axés sur l’emploi ; leur participation aux activités parascolaires et leur accès aux projets particuliers offerts au sein des établissements. En outre, diverses pratiques d’équité en réponse à ces processus et pratiques à effet d’exclusion ont été déclarées au sein des écoles. Toutefois, ces dernières sont souvent ponctuelles, volontaires et liées à des interactions entre individus. Ces constats permettent de discuter de l’importance d’initiatives systémiques et concertées afin de tendre vers l’équité.

Minorities and marginalized groups have increasingly become the target of discriminatory actions related to the COVID-19 pandemic. Detailed information about the manifestation of COVID-related discrimination is required to develop preventive actions that are not stigmatizing for such groups. The present study investigates experiences of perceived discrimination related to COVID-19 and its socio-cultural correlates in a culturally diverse sample of adults in Quebec (Canada). An online survey was completed by 3273 Quebec residents (49 % 18−39 years old; 57 % female; 49 % White). We used multivariate binomial logistic regression models to assess prevalence of COVID-related discrimination and to investigate socio-cultural correlates of reasons and contexts of discrimination. COVID-related discrimination was reported by 16.58 % of participants. Non-white participants, health-care workers and younger participants were more likely to experience discrimination than White, unemployed and older participants, respectively. Discrimination was reported primarily in association with participants’ ethno-cultural group, age, occupation and physical health and in the context of public spaces. Participants of East-Asian descent and essential workers were more likely to report discrimination because of their ethnicity and occupation, respectively. Although young people experienced discrimination across more contexts, older participants were primarily discriminated in the context of grocery stores and because of their age. Our findings indicate that health communication actions informed by a social pedagogy approach should target public beliefs related to the association of COVID-19 with ethnicity, age and occupation, to minimize pandemic-related discrimination. Visible minorities, health-care workers and seniors should be protected and supported, especially in public spaces.

The ‘Developmental Origins of Health and Disease’ hypothesis suggests that a healthy trajectory of growth and development in pregnancy and early childhood is necessary for optimal health, development and lifetime well-being. The purpose of this paper is to present the protocol for a randomised controlled trial evaluating a preconception-early childhood telephone-based intervention with tailored e-health resources for women and their partners to optimise growth and development among children in Canada: a Healthy Life Trajectory Initiative (HeLTI Canada). The primary objective of HeLTI Canada is to determine whether a 4-phase ‘preconception to early childhood’ lifecourse intervention can reduce the rate of child overweight and obesity. Secondary objectives include improved child: (1) growth trajectories; (2) cardiometabolic risk factors; (3) health behaviours, including nutrition, physical activity, sedentary behaviour and sleep; and (4) development and school readiness at age 5 years.

La télésanté connait un essor fulgurant en ce contexte de pandémie. Or, en cette période d’insécurité mondiale, la santé préventive reprend ses droits. En période de déconfinement, la discipline et la cohésion sociale peuvent se relâcher. Cette enquête sociale vise à décrire un programme d’intervention à distance, réalisé en partenariat avec des locataires de logement communautaire, des infirmières et des étudiantes pour soutenir la littératie en santé au temps de la COVID-19. Le Programme de déconfinement en toute sécurité vise à renforcer les mesures préventives et de soutien avec des groupes en contexte de vulnérabilités économiques et sociales à l’aide de la télésanté. Les infirmières ont développé des pratiques cliniques et psychosociales et renforcé la littératie en santé, soutenant les mesures de santé publique post-COVID-19, surveillant l’éclosion de nouveaux foyers et apaisant les souffrances issues du confinement. À l’aide de cibles de performance des systèmes de santé et d’une perspective de justice sociale, nous avons documenté les défis, les leviers et les menaces à l’usage des pratiques à distance en prévention. Vecteur d’une approche intégrée, la télésanté préventive peut cibler simultanément, la lutte contre les maladies non transmissibles et transmissibles et les inégalités. La pandémie de COVID-19 renvoie à un nouvel équilibre des enjeux qui exige un accompagnement et des pratiques de santé communautaire engagées et critiques.

This brief report explored trends of cigarette smoking among Syrian newcomers in the first two years of resettlement in Canada. 1794 adult Syrian refugees were surveyed about their physical and mental health, and smoking behaviours. Results were analyzed using descriptive statistics, Wilcoxon signed-rank tests, and logistic regressions. Almost 27% of the sample reported cigarette smoking (50% light smokers and 50% moderate/heavy smokers). Light smokers increased and moderate/heavy smokers decreased in the number of cigarettes smoked from year 1 to year 2. Moderate/heavy smokers were more likely to be male and reported higher post-traumatic stress scores, while light smokers reported higher depression scores. Only 14.3% of smokers recalled receiving advice from health care providers in Canada regarding their smoking habits. Healthcare providers should provide tailored advice to everyone who is an active smoker with a specific emphasis on those who have concurrent health issues.

The combined forces of economic globalization and international migration have resulted in specific challenges to palliative care systems. The COVID-19 pandemic has and is still greatly affecting elder populations as well as those across the age continuum living with long-standing chronic conditions or with pre-existing diverse unmet needs. While health promotion and palliative care may appear to be conceptually opposing fields, we argue that palliative care can and should fit under the umbrella of the health promotion continuum. This commentary seeks to discuss the importance of linguistic literacy and communication imperatives in the context of access to palliative care, given the broad, diversified and sensitive scope of care. While the pandemic has demonstrated that the public health responses of migrant host societies are deeply intertwined with policies as well as local rules and constraints, the promotion and provision of safe, timely and appropriate palliative care can be achieved through a sensitive assessment of differential contexts of diversity. The pandemic has painfully illustrated the need for a strong, respectful and equitable working partnership within the professions as well as with the civic society in order for the palliative needs of those exposed to a sustained risk not to be forgotten.

Objectifs:
Cet article vise à combler certaines lacunes dans la littérature concernant les conditions propices à des soins en collaboration de qualité en santé mentale jeunesse (SMJ) pour les jeunes migrants et leurs familles, dans les services de première ligne. Il examine les facteurs susceptibles de favoriser l’engagement des familles migrantes dans les services, en tenant compte des dimensions liées à la rencontre clinique, aux enjeux systémiques et aux questions institutionnelles/sociopolitiques.

Méthode:
Utilisant un devis multiphase en méthodes mixtes, l’article présente séquentiellement les résultats qualitatifs et quantitatifs spécifiques aux familles migrantes, d’un vaste programme de recherche sur les soins en collaboration en SMJ dans des quartiers culturellement et socioéconomiquement diversifiés. Ces résultats proviennent de données collectées à Montréal au cours de la dernière décennie par le biais de questionnaires, d’entrevues semi-structurées, de groupes de discussion, d’observation participante et de documentation. Les participants à la recherche étaient des enfants, des adolescents et des parents de familles migrantes, des cliniciens et des gestionnaires.

Résultats:
Les résultats suggèrent que le macrosystème sociopolitique et institutionnel structure l’espace de la clinique et influence le processus de soins. En particulier, les réformes successives du système de santé posent des défis de taille aux institutions et aux équipes en SMJ quant à leur capacité à créer un environnement favorable à la continuité des soins et au partenariat interinstitutionnel et à la collaboration interprofessionnelle, des facteurs associés à l’engagement des familles dans les soins. Cet engagement est également tributaire des représentations que les familles migrantes se font de la santé mentale et des services. Ces représentations sont façonnées par leur expérience des soins, mais aussi par ce que leur environnement socioculturel et les discours publics leur permettent d’imaginer de ces services. Cela invite à considérer une intégration de dimensions culturelles et sociopolitiques dans le concept d’engagement. Enfin, les résultats suggèrent également que les écoles jouent un rôle important pour favoriser l’engagement dans les soins de santé mentale.

Conclusion:
La qualité des soins de santé mentale pour les enfants et adolescents migrants dépend de l’engagement des familles dans les services, et aussi de l’engagement réciproque des cliniciens et des institutions. Les contextes politiques où des tensions entre les groupes majoritaires et minoritaires sont présentes peuvent également faire obstacle aux soins. Étant donné que les familles migrantes s’engagent moins dans les services par rapport aux familles non migrantes, ces considérations appellent à un examen important des moyens pour faciliter l’engagement des familles migrantes dans les soins en collaboration en SMJ. L’article propose certaines avenues pour favoriser cet engagement.

Introduction:
L’Interprétation de Service Public (ISP) s’intègre graduellement à la société québécoise. Les mécanismes institutionnels et organisationnels destinés à encadrer cette pratique interprétative ne sont pas généralisés à l’ensemble des services publics de la province, et là où ils le sont, de nombreux défis demeurent.

Objectif:
L’étude avait pour objectif de fournir à l’intervenant oeuvrant dans le secteur de la santé mentale des stratégies concrètes pour favoriser la collaboration avec l’interprète de service public.

Méthode:
Une lecture critique de la littérature (narrative overview) a été effectuée afin d’offrir un regard neuf sur l’objet d’étude, déjà existant. Parce qu’elle offre une synthèse critique d’informations clés du domaine, cette méthode répond particulièrement bien aux besoins du lecteur qui n’est pas à jour dans les avancées du domaine.

Résultats:
La lecture critique a d’abord permis de circonscrire 2 défis généraux concernant l’intervenant appelé à collaborer avec l’interprète de service public, soit la reconnaissance du rôle de celui-ci et la reconnaissance de la diversité des situations de communication aptes à favoriser leur collaboration. Sept stratégies de collaboration interprofessionnelle à la disposition de l’intervenant ont été formalisées pour répondre à ces défis : 1) utilisation des vocabulaires tirés de la Typologie des positionnements de l’interprète de service public (René de Cotret et coll., en cours de publication) et de la Typologie des postures de l’interprète de service public (Leanza, 2005) ; 2) obtention des informations à transmettre dans la demande de service ; 3) allocation de temps pour le briefing avec l’interprète ; 4) et pour le débriefing ; 5) appui à la présentation de l’interprète ; 6) encadrement du small et du big talk ; 7) promotion de la continuité des soins.

Discussion:
La présente étude offre un regard neuf sur certaines lignes de tension caractéristiques du domaine de l’ISP. Les 7 stratégies de collaboration proposées constituent une réponse à celles-ci et visent à améliorer la qualité de la communication interculturelle et des services offerts à l’usager en favorisant le transfert de connaissances. Elles sont spécifiquement adressées aux utilisateurs des connaissances, tiennent comptent de leur pratique et sont articulées dans un langage familier.

Le besoin des services d’un interprète dans le domaine de la santé pour traiter des patients allophones est, de nos jours, indiscutable. La littérature scientifique fait la démonstration de ce besoin dans toutes les spécialités médicales. En santé mentale, la situation est particulièrement sensible lorsqu’une évaluation psychologique nécessite les services d’un interprète.

Objectifs:
Explorer les meilleures pratiques mises en évidence par la littérature précédente pour le travail avec un interprète en santé mentale et les appliquer au contexte particulier des évaluations psychologiques.

Méthodes:
Une synthèse des principales recommandations fournies par la recherche pour communiquer par l’intermédiaire d’un interprète a été effectuée.

Résultats:
Une compilation des meilleures pratiques pour garantir une évaluation psychologique de qualité lors du travail en partenariat avec un interprète est fournie, en se concentrant sur les principales questions à prendre en compte lors de l’évaluation de patients linguistiquement et culturellement divers. Cette compilation est organisée en 3 phases : avant, pendant et après la consultation. Par exemple, la nécessité de préparer la rencontre avec l’interprète (briefing), l’impossibilité de demander une interprétation « mot à mot » (sauf dans des cas très particuliers) et la nécessité d’un débriefing avec l’interprète pour compléter l’évaluation.

Discussion:
Les professionnels de la santé mentale peuvent optimiser leur collaboration avec les interprètes dans l’évaluation psychologique en appliquant ce modèle en 3 phases, ce qui améliorera la communication interculturelle.

La grossesse est un moment de remaniements psychiques et identitaires fragile, où l’ambivalence de la mère est nécessaire et structurante pour l’enfant à venir. Mais qu’en est-il de l’ambivalence lorsque la mère est aux prises avec des traumatismes ? Quel est le rôle de la migration et de l’exil dans le fait de donner naissance dans un monde nouveau ? Quels impacts pour l’enfant et pour sa « continuité d’exister » ? C’est à la lumière de situations cliniques issues d’une recherche portant sur la transmission transgénérationnelle du trauma de la mère à l’enfant auprès de mères migrantes que ces questionnements ont surgi et que leur approfondissement s’est imposé comme une réponse à une réalité clinique souvent rencontrée en périnatalité auprès des populations immigrantes et réfugiées. L’acte de transmettre la vie prend racine dans l’histoire des mères et vient questionner leurs identités, leurs filiations et leurs affiliations mises à l’épreuve par l’adversité rencontrée. L’arrivée des enfants est à la fois fragilisante et source de « résilience » exceptionnelle. Il est donc essentiel de penser la question de l’accueil de ces dyades mère-bébé pour des soins adaptés et culturellement sensibles.

Objectif L’objectif central de cet article consiste à explorer les interactions
dynamiques entre 5 ensembles de variables, à savoir les « caractéristiques
sociodémographiques », la « satisfaction à l’égard de la vie », la
« discrimination perçue », la « religiosité » et la « détresse émotionnelle » au
sein de la Tariqa Qadiriya Boudchichiya de Montréal, voie soufie musulmane
dont les origines sont marocaines et remontent au 18e
siècle.
Méthode Pour ce qui est de la méthode utilisée, en considérant la « détresse
psychologique » comme variable dépendante, nous avons procédé à des
analyses statistiques descriptives univariées, des analyses de corrélation
bivariées (Corrélation de Pearson), des analyses ANOVA à un facteur et des
analyses multivariées (régressions linéaires).
Résultats Nos résultats, même si préliminaires en raison d’un échantillon
relativement mince (n = 56), nous permettent d’avancer une nouvelle
hypothèse voulant que la pratique spirituelle intense qui caractérise la Tariqa,
autoriserait « un travail de soi sur soi » par l’entremise d’un ensemble de
« techniques de soi » (Foucault) contribuant, sinon à la santé mentale, du moins
à un certain bien-être émotionnel.
Conclusion Notre conclusion souligne l’importance d’investiguer plus en
profondeur la possible contribution de la « religiosité » à la capacité du s

Background
Recent advances in immunology, genomics, and cellular therapy have opened numerous therapeutic possibilities in pediatric hematology-oncology, generating new hope in poor prognosis situations. How decisions are made when it comes to treatments and aims needs to be explored in this new technological context. In particular, their impact on the gold standard of early referral to palliative care must be assessed.
Materials and methods
Stemming from an ethnographic study combining semistructured interviews and observations carried out in a hematopoietic stem cell transplant unit in a Montréal Pediatric Hospital, we discuss the decision-making process when a patient faces poor prognosis.
Results and discussion
Although health care providers individually envisioned that palliative care may be the best course of action for patients receiving emergent therapy, they remained collectively in the curative mode. The intricate relationship between science, hope, caregiver, and care receiver sustains this perspective even when (near) death is the probable outcome. When proven treatment fails, emerging therapeutic possibilities offer new hope that can delay the referral to the palliative care team.

Unaccompanied minors (UMs) are children under 18 who arrive on the territory  of a foreign country without the care of a guardian. In many countries their access to social and health care services depends on their legal recognition as minors. For instance, in France, high rejection rates of minor status place unprotected UMs in social precarity, such that in Paris, civil society organizations (CSOs) have stepped in to offer social, medical, and psychological care to unprotected UMs. In the context of the COVID-19 pandemic however, CSOs had to adapt their care provision.

We review promising CSO-led initiatives to ensure continuity of care for this population. In doing so, we highlight how, by promoting UMs’ healthy behaviors in the context of the pandemic, continued social interactions between CSO members and unprotected UMs may have contributed to disease prevention among UMs. In addition, CSOs have continued to advocate for sheltering unprotected UMs, calling on public authorities to take action.

L’article vise à présenter une synthèse de la littérature sur l’intervention sociale en contexte de deuil et de pandémie afin d’analyser sa pertinence dans le contexte québécois. À partir de cette littérature, nous soulignons la manière dont ces connaissances pourraient être mobilisées dans le but de développer et d’implanter des outils d’intervention et des pratiques innovantes, notamment dans la grande région de Montréal. Parmi ces pratiques émergentes, nous mettons en lumière un projet récemment mis en place qui a pour but d’implanter une communauté de pratique virtuelle, un guide de pratique destiné aux intervenants et des outils d’intervention adaptés au contexte montréalais et québécois

Ces dernières années, un nombre important d’enfants immigrants ont été accueillis dans des classes d’accueil au Québec. Or, en raison d’une hausse globale de la polarisation et de la xénophobie qui ont des répercussions jusque dans les classes, l’adaptation psychosociale de ces jeunes pourrait être compromise, notamment leur lien social. Dans un contexte de classe d’accueil, créer des liens sociaux pourrait être plus complexe, puisque la création de relations positives significatives dépend des capacités empathiques de l’enseignant et des enfants. Par contre, partager une expérience commune d’immigration pourrait faciliter l’expression de l’empathie et la création de liens. Ainsi, l’intégration en classe d’un programme d’expression créatrice pourrait faciliter la prise de conscience émotionnelle et contribuer au développement du lien social au sein du groupe. Ce texte vise donc à explorer comment la participation au programme Art et Contes, conçu par l’Institut Universitaire Sherpa, a influencé la reconstruction d’un lien social dans le contexte interculturel des classes d’accueil au Québec. Pour ce faire, il s’appuiera sur des données de recherche qualitatives recueillies par des moyens ludiques et artistiques (ex. dessin) ainsi que sur des données issues d’entrevues avec l’enseignant, de groupes de parole avec les enfants et de notes d’observation des art-thérapeutes.

There has been much talk about decolonizing global health lately. The movement, which has arisen in various communities around the world, suggests an interesting critique of the Western dominant model of representations. Building upon the ‘decolonial thinking’ movement from the perspective of Francophone African philosophers, we comment on its potential for inspiring the field of global healthinterventions. Using existing literature and personal reflections, we reflect on two widely known illustrations of global health interventions implemented in sub-Saharan Africa – distribution of contraceptives and dissemination of Ebola virus prevention and treatment devices – featuring different temporal backdrops. We show how these solutions have most often targeted the superficial dimensions of global health problems, sidestepping the structures and mental models that shape the actions and reactions of African populations. Lastly, we question the ways through which the decolonial approach might indeed offer a credible positioning for rethinking global health interventions.

In January 2010, Haiti was hit by a terrible earthquake that pushed thousands of people to migrate. Many of them chose to settle in Quebec, Canada. Years after the earthquake, many Haitians continue to migrate to the Quebec province. Several studies however have shown that this population’s socioeconomic status is lower than the provincial average. Given the potential multiple stressors that affect Haitian migrants in Quebec, there are concerns about their health status.

Located at the intersection of international migration studies and global health, this paper offers an in-depth qualitative investigation of Haitian migrants’ representations of both their situation and self-perceived health in Montreal, Quebec. Our perspective on migrant health was inspired by the World Health Organisation’s framework on the social determinants of health and recent studies in the field of migrant health. We collected and analysed qualitative data from 23 key informants (i.e., 12 women and 11 men, aged 21-76 years old) from diverse socioeconomic backgrounds. The analysis of the data from these people’s narratives revealed the importance of structural determinants such as social position, and intermediate determinants such as living and working conditions. Our analysis also highlighted several interrelations between those determinants. Specifically, participants reported coping with issues related to migrant status, income, occupation, language, and racism, and challenging living and working conditions, and stress. This study underscored the importance of social support brought by relatives, friends, as well as community-based organisations and religious practices.

Our findings were coherent with available literature looking at the determinants of health of racialized and migrant minorities in other high-income regions of the world. Our conclusive remarks featured reflections on three cross-cutting issues and their practical implications for policy and practices.

Introduction : Une grossesse sur cinq ne se rend pas à terme au Canada et ce type de perte est une expérience douloureuse pour les parents. Les chercheurs qui se sont intéressés au vécu de ces familles endeuillées décrivent des interventions à privilégier, mais en les généralisant à
l’ensemble des populations touchées par ce phénomène. Or, l’expérience spécifique des parents immigrants est peu étudiée. Par conséquent, leurs besoins sont méconnus et les interventions de soutien et d’accompagnement à leur endroit sont peu développées et personnalisées.

Objectifs : Cette étude vise à décrire l’expérience, à travers le parcours de soins, de parents immigrants ayant vécu un décès périnatal. En deuxième lieu, elle vise à décrire leurs besoins.

Méthode : Une recherche de type qualitative descriptive, par l’entremise d’entretiens semidirigés, a permis de rencontrer 18 parents immigrants ayant vécu un décès périnatal dans les 5 dernières années et vivant dans 3 régions différentes du Québec (Canada).

Résultats: L’analyse de leur expérience fait émerger 3 thèmes : une méconnaissance du réseau de la santé, l’importance des soins personnalisés et un isolement teinté par le parcours migratoire.

Discussion et conclusion : L’expérience d’avoir vécu un décès périnatal comporte des spécificités propres à la communauté immigrante. Les parents issus de cette communauté vivent des défis plus marqués considérant le contexte d’immigration. Des recommandations cliniques simples
pourraient permettre de reconnaître leur expérience particulière liée à leur vécu de parent immigrant. Il incombe de personnaliser les soins qui leur seront offerts.

Dans nos sociétés contemporaines où l’individu est confronté à des exigences de performance et d’adaptabilité, et où l’idéal démocratique perdure, qu’en est-il des personnes faisant l’objet de racisme en milieu de travail ? Quelle parole leur donne-t-on ou comment cette parole se donne-t-elle ? Les milieux  organisés se doivent de montrer des positions d’équité envers leurs employés, soutenant ainsi un idéal démocratique où chacun aurait les mêmes droits et libertés. Pour autant, les rapports de domination et d’oppression persistent. Parallèlement, dans ces milieux, le sujet affronte l’injonction implicite d’être efficace et autonome pour rester productif. Le sujet devient responsable de son intégration au sein du collectif et a la responsabilité de vivre « bien » ensemble au sein du milieu de travail. Notre article interroge l’autocensure des personnes faisant l’objet de racisme et ne pouvant le dire au risque de paraître improductives. Notre méthodologie de recherche révèle une clinique de l’interculturalité comme approche d’intervention interculturelle.

In this article, we feature photographs and cellphilms produced by 13 girls and  young women (aged 13 to 19) from urban, rural, and Indigenous areas of   Quebec, Canada during the COVID-19 pandemic. Framed within girls’ studies, we present girls’ and young women’s creations and co-analysis about wellbeing during a period of lockdown. We explore how girls and young women restructured their routines at home as well as negotiated motivation and the pressure to be productive. We note that girls had more time than usual for creative activities and self-discovery and that they engaged with the politics of the pandemic and advocated for collective forms of wellbeing. Importantly, girls reported that participating in this research improved their wellbeing during this lockdown.

Immigration affects children and teenagers in particular – there are  approximately ten million of them immigrating to new countries every year. The significant amount of stress endured during this transition both directly and indirectly influences the development and well-being of immigrant children. The child’s point of view on migration is, however, largely absent from studies on the subject. This mixed-method study seeks to understand how children adapt to and perceive their immigration. Forty-three recently immigrated children participated in the study. The qualitative and quantitative results highlighted a better adaptation of refugee children than children with economic immigrant status, while the qualitative results revealed differences in migration experiences for these two groups of children, which were rooted in their representations of the motives for immigration, the support they received during the transition, and their feelings related to the migration transition. These results point to the usefulness of interventions with newcomer families to support children’s adaptation to immigration.

Globally, the COVID-19 pandemic is causing extensive morbidity and mortality and is fueling psychological distress across populations. Early evidence has shown an increase in anxiety, depression and sleep problems in the general population.1
,2
Although pandemics shatter the functioning of communities and families globally, there is a paucity of studies targeting the effects of pandemics on youth mental health.
As mental health professionals, our fields have become aware of how the COVID-19 outbreak represents an extraordinarily stressful experience for youths, including how necessary public health measures may also threaten personal and collective meaning-making, and disrupt family dynamics and youths’ usual social environment. Because of the COVID-19−related school closures and social distancing measures, millions of children have been confined at home. Although families, communities, and schools have attempted to adapt, at times successfully, many children and youth have been deprived of structured support, trapped in dysfunctional family settings, and are relying largely on peer relations through the unsupervised use of social media.3
In the absence of much needed evidence, clinical experience and available evidence on stress-related disorders in emergency settings is provisionally informing clinical practice and defining the role of child mental health services during a pandemic. Although it is impossible and premature to address all aspects of pediatric mental health during the COVID-19 pandemic, it is important to begin conceptualizing what this pandemic has meant for our practice and where and how we can promote pediatric mental health during a global emergency that is not currently remitting.

Le deuil compliqué demeure un sujet à controverse. Bien que ce concept se retrouve dans de nombreuses cultures, peu d’études scientifiques abordent les complications du deuil dans une perspective transculturelle. Cet article, qui repose sur la présentation d’un cas clinique et une revue de la littérature, décrit les particularités du deuil selon les cultures et en contexte d’immigration. Il offre un regard transculturel sur le deuil dit compliqué et discute les limites des classifications internationales pour diagnostiquer les complications d’un deuil selon les cultures. En influençant le processus même du deuil, ses manifestations cliniques et ses complications éventuelles, la culture et la religion peuvent rendre complexe la distinction entre un deuil normal et un deuil compliqué en contexte interculturel. Le concept de deuil compliqué est discuté en mettant en avant l’importance d’une approche culturellement sensible pour en permettre une évaluation clinique appropriée. Nous soulignons la question centrale du sens donné à la mort et aux symptômes vécus en période de deuil, et la pertinence d’un regard critique sur le risque de médicalisation du deuil et les limites des classifications internationales, DSM-5 et CIM-11. Les nouvelles nosographies devraient bénéficier d’une plus grande précision concernant les complications du deuil selon les cultures non occidentales, en incluant des déterminants spécifiques liés à la culture, comme les systèmes de croyances entourant une « mauvaise mort » et les interprétations culturelles des rêves où figure une personne défunte.

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

La pandémie a mis en lumière la complexité des mesures de santé publique et de leurs effets collatéraux, l’intrication des phénomènes sanitaires, sociaux et politiques sous-jacents, ainsi que leur spécificité pour des communautés minoritaires marginalisées. Fort de cette expérience, le présent commentaire souligne la pertinence d’élaborer des mécanismes de consultation qui tiennent compte de l’ensemble de la population en incluant les groupes minoritaires marginalisés, pour mieux informer les processus décisionnels en temps de pandémie. Dans un contexte de crise fluide, tout processus de consultation doit tenir compte des limites du possible et faire le deuil de l’exhaustivité au profit d’itérations répétées de dialogue, de médiation et de prises de décision au sujet de l’action. Il s’agit de créer des conditions propices à ce que les voix des personnes et groupes plus vulnérables soient entendus par les autorités publiques. Afin de nous préparer aux prochaines crises, il est nécessaire d’ores et déjà de développer des liens forts entre institutions publiques et communautés, tant majoritaires que minoritaires, afin de définir les mécanismes favorisant l’émergence d’une santé publique réellement inclusive, qui tienne compte de la santé physique, mentale et sociale de la population.

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

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

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

Une déclaration de principe préparée par la section de psychiatrie transculturelle de l’Association des psychiatres du Canada (APC) et approuvée par le Conseil d’administration de l’APC le 9 juillet 2020

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

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

En 2019, 30 615 demandes d’asile ont été traitées au Québec, ce qui représente presque la moitié des demandes au Canada. Les familles avec des enfants de 0 à 5 ans représentent un pourcentage important de cette population. Le Canada ainsi que le Québec ont l’obligation de protéger les demandeurs d’asile et d’assurer que les politiques publiques soient favorables à la santé, surtout chez les enfants. Toutefois, certaines politiques publiques actuelles excluent les demandeurs d’asile et affectent négativement les familles. Ce commentaire vise à sensibiliser l’ensemble des acteurs impliqués dans l’élaboration des politiques publiques, surtout les décideurs politiques, sur des enjeux concernant trois domaines de politiques publiques qui contribuent à l’isolement social, à l’appauvrissement et à un accès réduit aux services de soins pour les familles demandeuses d’asile avec de jeunes enfants. Ceux-ci incluent la non-éligibilité aux allocations familiales, l’accès difficile aux garderies à prix abordables et les difficultés à obtenir des services d’un médecin de famille. En conséquence, les parents et les enfants subissent des impacts sur leur santé et leur bien-être. Nous demandons à nos gouvernements d’assumer leurs responsabilités et d’éliminer ces inégalités, et d’assurer que la santé des demandeurs d’asile soit prise en compte dans toutes les politiques.

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

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

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

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

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

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

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

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

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

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

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

Objectifs
Dans le domaine de la recherche en santé, une attention grandissante est portée à l’importance de tenir compte à la fois du sexe et du genre. Toutefois, ceci représente un défi quand on travaille avec des données existantes qui ne contiennent pas toujours de mesure autoraportée de genre. L’objectif de cette étude était donc de développer et valider un indice composite de genre grâce aux données de l’Enquête sur la santé dans les collectivités canadiennes (ESCC).

Méthodologie
Basé sur la littérature et l’opinion d’experts, le GENDER Index a été développé grâce à plusieurs variables contenues dans l’ESCC et potentiellement liées au genre (ex. occupation, recevoir une pension alimentaire, nombre d’heures travaillées). Chez les travailleurs de 18 à 50 ans n’ayant pas de données manquantes sur le plan des variables sélectionnées (n = 29 470 participants), des scores de propension ont été dérivés d’un modèle de régression logistique dans lequel les variables potentiellement liées au genre ont été incorporées comme covariables et le sexe biologique a été considéré comme variable dépendante. La validité conceptuelle des scores de propension obtenus (scores du GENDER Index) a ensuite été explorée.

Résultats
Sur le plan de la distribution des scores du GENDER index selon le sexe, les deux concepts se sont avérés semblables, mais indépendants. La proportion de femmes était différente selon les différents sous-groupes formés grâce aux tertiles du GENDER index (p < 0,0001). La validité conceptuelle a aussi été examinée en mesurant les associations entre les scores du GENDER Index et différentes variables liées au genre et identifiées à priori telles que le fait de choisir certains aliments en raison d’une préoccupation pour son poids corporel (p < 0,0001), le fait que les soins à donner aux enfants soient identifiés comme principale source de stress (p = 0,0309), ou la capacité à faire face à des problèmes inattendus et difficiles (p = 0.0375). Conclusion Le GENDER Index pourrait être utile pour renforcer la capacité des chercheurs à effectuer une analyse fondée sur le genre dans des populations de travailleurs grâce aux données de l’ESCC.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Implications for rehabilitation

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

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

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

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

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

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

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

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

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

Les politiques d’immigration du Québec et du Canada visent à attirer des candidats très qualifiés. Pourtant, ces migrants font face à de nombreuses barrières sur le marché du travail local. L’expérience des médecins diplômés à l’étranger ayant immigré au Québec est particulière en raison de la complexité du processus de reconnaissance professionnelle. Basé sur une recherche qualitative menée auprès de diplômés internationaux en médecine (DIM) et d’acteurs clés, cet article traite du caractère dynamique et relationnel de ce processus de reconnaissance, influencé par des rapports sociaux témoignant des relations inégalitaires entre certaines populations. Comme les trajectoires d’intégration professionnelle sont différenciées et que certains DIM semblent devoir surmonter plus d’obstacles que d’autres, nous discutons des aspects souvent invisibilisés de mécanismes qui influencent la reconnaissance sociale et professionnelle de médecins tentant de faire carrière au Québec, au-delà des qualités individuelles des DIM concernés.

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

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

Cet article s’appuie sur des récits de vie collectés entre 2014 et 2018 auprès d’une population de baby-boomers d’ascendance française canadienne, dont la trajectoire personnelle reflète l’histoire sociale et politique de la province. Après avoir été socialisée dans un contexte catholique, cette génération a en effet connu la phase de sécularisation, de modernisation et de diversification précipitées qui a marqué le paysage social et politique local à partir de la fin des années 1960. L’entremêlement des expériences individuelles et collectives façonne un discours particulier sur le projet laïc au Québec qui articule mémoire catholique, souci de l’égalité des genres et éthique pluraliste. En s’inspirant du modèle de laïcité ouverte et fermée proposé par Maclure et Taylor, l’autrice discute les principes moraux et modes opératoires sous-jacents ces discours.

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

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

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

Background: Considering the growing number of asylum-seeking children worldwide, research
on interventions which may buffer the effects of early resettlement conditions on asylum-seeking
children’s adjustment is warranted. In Canada, creative expressive workshops for asylum-seeking
children and adolescents were implemented as a Psychological First Aid (PFA) intervention in
temporary shelters. The present exploratory study aims to describe the implementation of
these workshops to assess whether the intervention met core elements of PFA and explore its
potential in supporting the diverse needs of asylum-seeking youth in temporary shelters, adopting
a process-evaluation research approach.
Method: The intervention was evaluated via a qualitative thematic analysis of extensive field and
supervision notes and focus groups with facilitators.
Results: Preliminary results suggest that the intervention contributed to fostering emotional safety
and a sense of normalcy in children and supported the creation of connections among both children
and parents. Children’s expression of past and present experiences during the workshops was seen
as a way to promote self-efficacy in children and was reported as a potential way to provide some
comfort and hope in a time of high instability. However, the high needs of children and the lack of
resources in the temporary shelters represented significant challenges and barriers.
Conclusions: PFA using creative expression may be a promising youth mental health prevention
intervention in temporary shelters

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

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

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

Malgré le nombre important d’immigrants de sexe masculin accueillis au Québec chaque année, il existe peu  d’études québécoises portant sur les enjeux rencontrés par les pères immigrants ou sur les services qui leur sont  offerts. Depuis dix ans, certains travaux ont tenté de combler cette lacune. Parmi eux, l’un porte sur un programme  de soutien aux pères immigrants offert par un organisme montréalais d’accueil et d’intégration des nouveaux  arrivants, un autre sur la relation père-enfant, la relation conjugale, l’identité paternelle et l’exercice de la  discipline, avec une attention particulière accordée à la période périnatale.

Cet article propose une synthèse de ces  travaux, inspirée par le modèle bioécologique du développement humain, avec comme objectif de faire ressortir  les convergences à propos des enjeux auxquels font face les pères immigrants dans leurs relations avec leur enfant,  leur conjointe et leur travail, puis de dégager quelques pistes pour l’amélioration des services offerts dans les  milieux institutionnels et communautaires.

Pendant la transition à la parentalité, les pères sont confrontés à deux principaux défis, soit le développement de leur identité paternelle et de leur engagement paternel. Pour les pères immigrants, des défis particuliers s’ajoutent en termes de construction de leur identité paternelle, que l’on connaît encore peu.

Objectif. Cette comparaison des résultats de deux études qualitatives a pour objectif de décrire l’engagement paternel et le processus de construction de l’identité paternelle de pères originaires du Maghreb. Méthodologie. Les données ont été recueillies lors d’entretiens semi-dirigés auprès de six pères maghrébins de première génération immigrés au Québec et six pères maghrébins de deuxième génération résidant en Belgique.

Résultats. Les pères des deux groupes s’impliquent auprès de leur enfant et partagent des facteurs facilitants ou faisant obstacle à la construction de leur identité paternelle. Des recommandations pour la pratique clinique, pour la formation et pour la recherche sont formulées.

Researchers are beginning to document the experiences of lesbian, gay, bisexual and transgender (LGBT) forced migrants in settlement. However, studies exploring the perceptions of service providers working with this vulnerable population are limited. These may shed light on the challenges of meeting the needs of LGBT forced migrants, especially mental health issues and problems.

This qualitative study elicited the views of 22 Canadian service providers, including advocates, lawyers and mental health practitioners, who serve LGBT forced migrants. Grounded theory analysis revealed the following four themes: facilitating safety, buffering rejection; tracking avoidance patterns; interpreting mental health; and negotiating identity paradigms.

Participants’ accounts suggest that LGBT forced migrants may be best served by providers who understand the exigencies of establishing trust and safety for their clients; recognise their clients’ nuanced social support needs; facilitate the refugee claims process; grasp the complexity of their clients’ mental health challenges; and interrogate their own cultural biases regarding sexual orientations and gender identities.

This chapter brings to the forefront various challenges of engaging in both critical and participatory forms of knowledge building, in particular with queer and trans migrants with precarious status. Two scholars trace their previous experiences of engaging in participatory and critical research as well as their shift toward reflexive ways of knowing. This shift elicits the ways in which Critical Participatory Action Research (CPAR) may be used to build reflexive knowledge with and about queer and trans migrant communities, and in particular, LGBTQ refugees and MSM Latino migrants.

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

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

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

La problématique de la radicalisation violente interpelle de plus en plus le champ politique qui y répond par des plans d’action consistant souvent en une multiplication de programmes, visant à la prévenir et/ou à la traiter et la mise en place de formations s’adressant aux services de sécurité ou aux acteurs du champ social. Au Québec, le gouvernement s’est doté d’un plan d’action (Gouvernement du Québec 2015) qui comprenait notamment le développement de formations sur la prévention de la radicalisation violente, destinées aux intervenants des milieux de la santé et de l’éducation, un volet qui a été confié au centre de recherche SHERPA (Montréal, Québec) par le ministère de la santé et des services sociaux ainsi que le ministère de l’éducation.

À notre connaissance, bien que la pertinence d’offrir de la formation en matière de prévention de la radicalisation violente aux acteurs des milieux de la santé et de l’éducation soit relevée par plusieurs études (Ranstorp & al. 2016, Robinson & al. 2017), peu s’attardent sur les contenus de ces formations et encore plus rares sont les écrits qui en évaluent l’impact. Les formations portant sur la prévention de la radicalisation violente sont ainsi prônées mais peu évaluées : cette faiblesse concerne la plupart des programmes de prévention de la radicalisation violente, dont l’efficacité reste à démontrer (Bossong 2012, Lum & al. 2006, Horgan & al. 2010, Ris & al. 2017).

Dans le cadre de cet article, la portée des formations menées par le centre de recherche SHERPA sera discutée. L’évaluation de ces formations, que nous décrirons ci-après, suggère que celles-ci deviennent un lieu où se jouent différents mouvements de polarisation au sein du groupe de participants autour de certains sujets. Le travail d’accompagnement du groupe par les formateurs devient alors un enjeu de premier plan pour éviter les clivages, la circulation de blâmes démobilisants et pour promouvoir un sentiment de compétence chez les participants.

D’une part, cet article décrit les processus groupaux documentés par le biais de l’observation participante. D’autre part, il examine les déclencheurs et analyse les stratégies qui permettent aux participants et aux formateurs de contenir les affects et de transformer les tensions en occasion d’apprentissage. Finalement, les résultats qualitatifs de l’observation participante servent d’amorce à une réflexion qui, en croisant les notions d’incertitude et d’angoisse, donne matière à penser aussi bien le phénomène de la radicalisation violente que celui de sa construction en objet de savoir.

There is little longitudinal research that directly compares the effectiveness of Canada’s Government-Assisted Refugee
(GAR) and Privately Sponsored Refugee (PSR) Programs that takes into account possible socio-demographic differences between them. This article reports findings from 1,921
newly arrived adult Syrian refugees in British Columbia, Ontario, and Quebec. GARs and PSRs differed widely on several demographic characteristics, including length of time displaced. Furthermore, PSRs sponsored by Groups of 5 resembled GARs more than other PSR sponsorship types on
many of these characteristics. PSRs also had broader social networks than GARs. Sociodemographic differences and city of residence influenced integration outcomes, emphasizing the importance of considering differences between refugee groups when comparing the impact of these programs.

Il existe peu de recherches longitudinales comparant directement l’efficacité des programmes gouvernemental (RPG) et privé (PPR) de parrainage des réfugiés au Canada qui tiennent compte de possibles différences socio-démographique
entre eux. Cet article rend compte des résultats de 1921 nouveaux arrivants syriens adultes en Colombie-Britannique, en Ontario et au Québec. Les RPG et PPR diffèrent largement sur plusieurs caractéristiques démographiques, dont le temps du déplacement. De plus, les PPR parrainés par
groupes de cinq ressemblaient davantage aux RPG que les autres types de parrainage PPR sur plusieurs de ces caractéristiques. Les PPR avaient aussi des réseaux sociaux plus
larges que les RPG. Les différences sociodémographiques et la ville de résidence influent sur l’intégration, ce qui fait ressortir l’importance de tenir compte des différences entre les groupes de réfugiés dans la comparaison de l’impact de ces programmes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Identity issues have been at the forefront in studies on determinants of youth violent radicalization. Identity uncertainty and identity fusion appear to be associated with quests for meaning, which may find some answers in extremist discourses and radical engagements. This process has been considered to be particularly important for second-generation migrants who have to negotiate multiple identities, sometimes in situations of social adversity. T

his paper aims to understand the relations between collective identity, social adversity (discrimination and exposure to violence), and sympathy for violent radicalization in College students in Quebec. This mixed-method study consisted of a large online survey conducted at eight colleges in Quebec. Multilevel analysis accounted for the clustered nature of data while generalized additive mixed models were used to study nonlinear relations.

Results highlight the complex associations between collective identity and youth sympathy for violent radicalization. They confirm that negative public representations of minority communities may lead to more sympathy for violent radicalization. Although results suggest that strong enough identities can act as protective anchorages for youth, they also indicate that when collective identity becomes too central in personal identity this may accentuate othering processes and legitimize violence toward the out-group.

These results have implications for prevention programs. They indicate that improving the public image of minority communities through mainstream media or the social media may increase youth public self-esteem and decrease their sympathy for violent radicalization. They also invite the education field to foster the development of strong plural identities