Publications

Québec’s labour market has changed significantly in the past few years, notably with the slower growth of the labour force, an aging population, higher education levels among workers and an increasing proportion of immigrants in the workforce.
In its recent work on occupational rehabilitation, the IRSST has taken a particular interest in workers in vulnerable situations, including immigrant workers. Immigrant workers are considered a more vulnerable population due to, among other things, their proportionately higher-than-average presence in sectors characterized by less favourable working conditions and higher exposure to the risk of occupational injuries. Language and cultural barriers sometimes compound these factors.
The content of this document derives from a study titled The Notion of Ethnocultural Belonging in Rehabilitation Research and Intervention: Knowledge Summaries (published in 2012) and a study (completed in 2017) on the rehabilitation and return-to-work trajectories of immigrant workers with an occupational injury. This study highlighted the role of the health professionals and OHS practitioners involved, their intervention strategies and interactions, and the issues specific to intercultural encounters, while underscoring the impact of the organizational context on these aspects

Pour intervenir auprès des travailleurs immigrants, les professionnels de la santé et les intervenants en santé et en sécurité du travail ont des contacts directs avec eux, soit en personne, soit par téléphone. Ces interlocuteurs étant issus d’horizons culturels variés, leurs rencontres, dites interculturelles, peuvent mettre en relief des perspectives très différentes. Or, on ne peut traiter un travailleur ayant subi une lésion professionnelle sans tenir compte d’une multitude de facteurs qui influencent ses valeurs et la représentation qu’il se fait de lui-même (identité personnelle, organisation sociale, éducation, classe sociale, genre, religion ou idéologie, etc.). Ces variables peuvent présenter d’importants écarts de représentations culturelles entre les individus et être une source de malentendus, d’incompréhension ou de désaccords qui doivent absolument être pris en considération. Pour que ces rencontres favorisent un retour réussi au travail, il importe d’encourager le développement de la compétence interculturelle des intervenants dans les organisations. Ce document a été conçu pour servir d’instrument de réflexion visant à favoriser le développement de telles compétences.

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.

Research has shown that lesbian, gay, bisexual, and transgender (LGBT) children are likely to experience chronic victimization and that these experiences
correlate with numerous mental health problems. However, there is little understanding of the abuse experiences of LGBT children living in countries where rights for sexual and gender minorities are limited or nonexistent. In this chapter, we explore the child abuse experiences that contribute to LGBT individuals’ decision
to flee their countries of origin in search of protection. In addition, we examine the impact of these abuse experiences on their pre-migration mental health. We conducted 26 interviews with individuals who obtained refugee or asylee status in the United States or Canada on the basis of sexual orientation or gender identity.
Participants originated from countries in Asia, Africa, the Caribbean, Eastern Europe, Latin America, and the Middle East. We identified the following themes: abuse by parents and caregivers, abuse by peers and school personnel, having nowhere to turn, and dealing with psychological distress. Findings demonstrate that
participants experienced severe verbal, physical, and sexual abuse throughout childhood and adolescence and that this abuse occurred at home, in school, and in the community. Furthermore, there were no resources or sources of protection available to them. Participants linked their abuse to subjective experiences of depression, anxiety, and traumatic stress, as well as suicidal ideation and suicide attempts. We provide implications for clinical practice as well as international policies that protect the well-being of children

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.

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

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.

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

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

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.

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

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

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

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

Synthèse sur la thérapie par l’approche centrée sur la personne (ACP), développée par le psychologue humaniste américain, Carl Rogers (1902-1987). Elle propose des clés pour comprendre la relation qui se noue entre un patient et son thérapeute à partir d’exemples concrets.

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

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

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

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

Precarious status migrants are a group of persons who are vulnerable, heterogeneous, and often suspicious of research teams. They are underrepresented in population-based research projects, and strategies to recruit them are described exclusively in terms of a single cultural group. We analyzed the recruitment strategies implemented during a research project aimed at understanding precarious status migrants’ health status and healthcare access in Montreal, Canada. The research sample consisted of 854 persons recruited from a variety of ethnocultural communities between June 2016 and September 2017. This article analyzes the strategies implemented by the research team to respond to the challenges of that recruitment, and assess the effectiveness of those strategies. Based on the results, we share the lessons learned with a view to increasing precarious status migrants’ representation in research.

A mixed sequential design was used to combine qualitative data gathered from members of the research team at a reflexive workshop (n = 16) and in individual interviews (n = 15) with qualitative and quantitative data collected using the conceptual mapping method (n = 10).

The research team encountered challenges in implementing the strategies, related to the identification of the target population, the establishment of community partnerships, and suspicion on the part of the individuals approached. The combination of a venue-based sampling method, a communications strategy, and the snowball sampling method was key to the recruitment. Linking people with resources that could help them was useful in obtaining their effective and non-instrumental participation in the study. Creating a diverse and multicultural team helped build trust with participants. However, the strategy of matching the ethnocultural identity of the interviewer with that of the respondent was not systematically effective.

The interviewers’ experience and their understanding of the issue are important factors to take into consideration in future research. More over, the development of a community resource guide tailored to the needs of participants should be major components of any research project targeting migrants. Finally, strategies should be implemented as the result of a continuous reflexive process among all members of the research team.

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

OBJECTIVE:

The overall aim of this article is to examine the self-defined role of romantic relationships, intimacy and sexuality in recovery from severe mental illness.

METHOD:

Semistructured interviews were conducted with 35 people with severe mental illness, accompanied by participant observation. Data were analyzed using thematic analysis.

RESULTS:

The vast majority of participants considered a supportive relationship that was emotionally or sexually intimate to be a key facilitator and indicator of recovery. However, only a small minority of participants were actually in such a relationship. Participants reported numerous barriers to forming and maintaining such relationships such as financial strain and enduring stigma against people with mental illness.

Addressing relational and intimate needs have not been a focus of traditional psychiatric services. As such, some form of « supported dating » within the field of psychosocial rehabilitation may be an essential development to foster an oft-overlooked but important aspect of recovery

Purpose

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

Design/methodology/approach

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

Findings

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

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

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

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

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

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

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

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

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

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

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

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

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

Synthèse du symposium du 28 novembre 2018.

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

Objectives Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes.

Design This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data.

Setting and participants Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014.

Primary outcomes Numerous adverse maternal and perinatal health outcomes.

Results Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers.

Conclusions Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further

We examine patient–provider interactions for Indigenous childbirth evacuees. Our analysis draws on in-depth interviews with 25 Inuit and First Nations women with medically high-risk pregnancies who were transferred or medevacked from northern Quebec to receive maternity care at a tertiary hospital in a southern city in the province. We supplemented the patient data with interviews from eight health care providers. Three themes related to patient–provider interactions are discussed: evacuation-related stress, hospital bureaucracy, and stereotypes. Findings show that the quality of the patient–provider interaction is contingent on individual health care providers’ ability to connect with Indigenous patients and overcome cultural and institutional barriers to communication and trust-building. The findings point to the need for further training of medical professionals in the delivery of culturally safe care and addressing bureaucratic constraints in the health care system to improve patient–provider communication and overall relationship quality.

Despite the importance of adequate supervision to child wellbeing, the academic conversation around this topic is scattered across disciplines and for this reason is difficult to follow. Researchers and decision-makers would benefit from a preliminary overview of conceptualizations, cultural variations, and facilitators and barriers to providing supervision to children in low- and middle-income countries (LMICs). A scoping review was conducted. Two searches of the literature were run within Embase, Medline, PsycInfo, Social SciencesFull Text, ERIC, SocIndex with Full Text, and Academic Search Complete. Additional papers were identified through a call to experts. Out of 2049 publications initially identified, 44 studies met our inclusion criteria, thus reflecting the scarcity of scientific evidence in LMICs. Child supervision was addressed in the literature in terms of links to psychological, health, social and academic outcomes, suggesting a multidisciplinary interest in the topic. However, a vague conceptualization of child supervision emerged across studies. Of importance, cultural and socio-economic influences interacted to shape caregivers’ vision of the family, the child, and the decision-making process regarding supervision practices. Barriers and/or facilitators to adequate child supervision were addressed only in 18 studies. There was substantial variation in how cultural influences on child supervision were taken into account across studies. Our review aims to inform and guide future research and action on child supervision practices in LMICs and calls for a more coherent and comprehensive body of literature on this matter. Programming and policy efforts should take socio-economic and cultural influences into account, as well as be tailored according to the specificities of each child, caregiver(s), and setting.

This pilot study examined psychological, social and cultural risk factors for child insecure attachment in a sample of South Asian immigrant families experiencing high migration stress in Montreal, Canada. Thirty-three participants were recruited through a local Health and Social Service organization. Maternal anxiety and depression, social support, and national and religious sense of belonging were assessed. Child attachment behaviors were coded from a 15 min free play period. Results indicated that maternal depressive symptoms were related to lower child attachment security scores. Lower support from friends was related to greater child ambivalent attachment behaviors. A higher sense of belonging to the country of origin was related to greater child disorganized attachment behaviors. These findings suggest that migration stresses, which include maternal depression, lack of social support and the sense of belonging, are associated with child attachment, and these variables should be considered in the design of appropriate interventions.

Ce merveilleux conte, paru aux éditions Remue Ménage¹, est un ouvrage tout en finesse à travers lequel l’auteur a le courage d’aborder une des tâches les plus délicates qu’un parent ait à faire : parler à son enfant de la violence du monde. Mais puisqu’il le faut, pour le protéger, l’auteur nous fait don de ce conte et nous accompagne avec une délicatesse et une profondeur, qui témoignent d’une réflexion mûrie et d’un grand amour des enfants. Comment  aborder ce sujet sensible avec les petits sans les angoisser, ni les brimer dans leurs élans, dans leurs pulsions de vie ? Sans induire de progression traumatique, comme un fruit devenu mûr trop vite pour avoir été confronté au réel (Ferenczi, 1933) ? Pour ce faire, l’auteur use brillamment de métaphores que le lecteur de tout âge comprendra à l’aulne de son développement. Et c’est là le génie de sa méthode.

Cette puissance d’évocation est décuplée par les créations picturales qui accompagnent le texte. Il s’agit des illustrations d’Albin Christen. La première page, noire, remémore à l’enfant son milieu originel : le ventre de sa mère, lieu des premiers échanges sensoriels, d’où il recevra un premier bain de parole. Puis il y a ces forces invisibles qui jalonnent le parcours de l’enfant et qui sont illustrées de façon magistrale : des tenailles légèrement anthropomorphisées en bras, pour symboliser l’oppression ; les barrières de métal qui représentent les obstacles ; les rouages complexes qui métaphorisent l’appareillage intriqué et pervers qu’est la violence systémique.

Recent changes in U.S. immigration policies and enforcement have precipitated a 300% rise in arrests and planned deportations. Although some family members face deportation, other family members may have state-sanctioned status. Such mixed status puts hundreds of thousands of families at risk of forced separation and associated mental health problems. Building on cross-cultural work with refugee families and other groups and on work with families separated by parental incarceration, the authors provide recommendations to guide clinicians working with families who are separated or who fear separation. Mental health problems among separated families can in part be addressed through identifying the origins of distress, elucidating family structures and roles, strengthening communication practices, linking with legal and economic resources, and facilitating decision making through distress reduction.

Les services en santé mentale jeunesse comprennent des interventions multimodales interdisciplinaires complexes et leur évaluation tire profit des méthodes mixtes, particulièrement auprès de populations caractérisées par leur diversité culturelle.

Ce chapitre présente les résultats d’une étude pilote visant à développer une méthode d’évaluation des soins en collaboration en santé mentale jeunesse à Montréal. La méthode combinait la réalisation d’entrevues semi-dirigées auprès de cinq triades jeune-parent-intervenant et de questionnaires mesurant la satisfaction envers les services et l’amélioration du portrait clinique.

Nous aborderons principalement les forces et les limites de la méthode mixte employée. Les points de convergence et de divergence des données quantitatives et qualitatives sont présentés et l’accent est mis sur l’importance de l’intégration des résultats.

Les résultats mixtes ont permis d’améliorer la rigueur scientifique de la recherche en complétant et en contextualisant les résultats des composantes qualitative et quantitative de l’étude, et en permettant une meilleure adéquation culturelle de la méthode utilisée.

Sur le plan éthique, nous considérons que l’approche qualitative a amélioré la prise en considération de la voix des participants, une question particulièrement importante pour des recherches sur des enjeux de santé pouvant faire l’objet de stigmatisation et menées auprès de populations culturellement minoritaires, marginalisées ou peu représentées dans la littérature scientifique. Les contributions de l’étude pilote au développement d’un devis de recherche mixte longitudinal sont également présentées.

Abstract

Introduction. Despite greater father participation in child care/rearing nowadays and the challenge of involving fathers in nursing interventions, no instrument exists to measure professional attitudes toward father involvement in family interventions. Objectives. The aim of this study was to adapt an existing measure that assesses nurse attitudes regarding the importance of including families in nursing care into a measure that assesses professionals’ attitudes towards the importance of involving fathers in interventions with families. Method. The Professionals’ Attitudes towards Father Involvement (PAFI) scale was adapted from the Families’ Importance in Nursing Care – Nurse Attitudes (FINC-NA) scale. A total of 297 professionals in family care completed the 26 items of the PAFI. Results. Items analysis indicated three items had low variability and abnormal distribution. Principal component analysis was conducted with the 23 remaining items. Results revealed a solution with four factors reproducing the structure of the original scale: Father as conversational partner, Father as resource, Father as burden, and Father as own resource. Most items loaded on their original factor. The four subscales and the global scale showed good internal consistency. Discussion and conclusion. Even though further studies are needed, this adapted scale now enables researchers and practitioners to assess professionals’ attitudes towards the importance of involving fathers in interventions with families.

Résumé

Introduction. Les pères sont de plus en plus engagés auprès de leurs enfants. Plusieurs professionnels, dont les infirmières, peinent à s’adapter à cette nouvelle réalité. Aucune échelle n’existe pour mesurer l’attitude des professionnels par rapport à l’importance d’inclure les pères dans leurs interventions. Objectifs. Le but de cette étude est d’adapter une échelle qui mesure les attitudes des infirmières quant à l’importance d’inclure les familles dans leurs soins pour en faire un instrument permettant de mesurer les attitudes des professionnels envers l’importance d’inclure les pères dans leurs interventions auprès des familles. Méthodes. L’échelle Attitudes des professionnels envers l’inclusion des pères (APIP) a été adaptée à partir de l’échelle Importance des familles dans les soins infirmiers – Attitudes des infirmières. Au total, 297 professionnels ont répondu aux 26 items de l’échelle APIP. Résultats. L’analyse des items révèle que trois d’entre eux présentaient une faible variabilité et une distribution anormale. L’analyse à composantes principales a été effectuée avec les 23 items restants. Les résultats confirment quatre facteurs, reproduisant la structure de l’échelle originale : le père comme partenaire de conversation, le père comme ressource, le père comme fardeau et le père comme ayant ses propres ressources. Les quatre sous-échelles et l’échelle globale ont montré une bonne cohérence interne. Discussion et conclusion. Même si d’autres études sont nécessaires, cette échelle adaptée permet maintenant aux chercheurs et aux praticiens de mesurer les attitudes des professionnels quant à l’importance d’impliquer les pères dans leurs interventions auprès des familles.

The mental health needs of children and adolescents living with HIV (ALHIV) in Namibia are poorly understood, despite the dramatic improvement in their survival. ALHIV in resource poor contexts face particular risk factors, such as poverty, orphanhood, and poor social support. This study examines the mental health of ALHIV in Namibia, and the factors that contribute to mental health problems. A case-control design assessed emotional and behavioural symptoms of distress, risk and protective factors among adolescents aged 12-18 years. Case participants were 99 HIV-positive adolescents. Case controls were 159 adolescents from the same community who were not known to be HIV seropositive at the time of the study. Control group participants were selected from schools using a stratified random sampling. A larger proportion of HIV-positive adolescents were orphaned (62.6% vs. 20.8%, p < .001); the groups showed no differences in poverty factors. HIV-positive adolescents scored lower than the control group on total perceived social support (p < .05) and caregiver support (p < .05), but no differences in perceived friend support and support from a self-selected person were present. HIV-positive adolescents reported significantly more total emotional and behavioural difficulties (p = .027) and conduct problems (p = .025), even after controlling for socio-demographic factors. However, after controlling for the effects of orphanhood, group differences in mental health outcomes were no longer significant. Furthermore, mediation analysis suggested that social support completely mediated the relationship between HIV status and mental health (standardised pathway coefficients = .05, p = .021). Policies and programmes that aim to strengthen social support and take orphanhood status into consideration may improve the mental health of adolescents living with HIV.

In this article, we question the unilateral discourse of benefit of participation in participatory refugee theatre in the context of a growing socio-political climate of polarisation and stigmatisation of refugees in European countries of resettlement. By integrating critical voices from the fields of applied theatre and refugee research, we analyse the micro and macro dramaturgy of a Berlin-based participatory refugee theatre project. Through this analysis, we explore how refugees’ participation entails opportunities for empowerment, agency and giving voice, but also risks disempowerment and silencing in the interconnected relations between the participant, theatre maker, audience and the broader socio-political context.

With the sharp increase of refugees’ arrival and resettlement in western communities, adequate mental health care forms a pivotal dimension in host societies’ responses to those individuals and communities seeking protection within their borders. Here, clinical literature shows a growing interest in the development of family therapy approaches with refugees, in which therapeutic practice engages with the pivotal role of refugee family dynamics in posttrauma reconstruction and adaptation in resettlement and aims at supporting posttrauma reconstruction through strengthening capacities to restore safety, meaning and connectedness within family relationships. In this article, we focus on the narrative restoration of meaning as central mode of posttrauma reparation and explore its specific dynamics and relational complexities in the context of therapeutic practice with refugee families. Hereto, we integrate theoretical and clinical scholarly work on trauma narration and its intersection with empirical findings on trauma communication in refugee families. Furthermore, we develop case reflections to illustrate different processes of engaging with trauma narration in refugee family therapy. This analysis develops an understanding of the multivoiced ways in which refugee families engage with traumatic suffering through different modes of expression that may entail both narration and silence and explores how family therapeutic practices can engage and mobilize voices of narration and silence as relational stories of restoration.

Le contre-transfert culturel est un concept qui souligne la dimension socioculturelle, et donc collective, du contre-transfert. Dans ce texte, nous analysons, au moyen de cinq histoires cliniques présentées dans le cadre de séminaires de discussion de cas transculturels et interinstitutionnels menés à Montréal, Canada, les diverses formes que peut prendre le contre-transfert culturel pour des cliniciens en situation d’impasse thérapeutique face à la prise en charge de familles migrantes. Nous examinons ensuite le rôle éventuel de ces séminaires dans la transformation de ce contre-transfert et dans la formulation de pistes permettant de relancer ou de soutenir le processus thérapeutique. Les résultats indiquent que les séminaires transculturels et interinstitutionnels de discussion de cas facilitent un travail d’élaboration sur les représentations collectives des cliniciens et que ce travail groupal permet de contenir et parfois de dépasser certaines situations d’échec thérapeutique.

Recent changes in U.S. immigration policies and enforcement have precipitated a 300% rise in arrests and planned deportations. Although some family members face deportation, other family members may have state-sanctioned status. Such mixed status puts hundreds of thousands of families at risk of forced separation and associated mental health problems. Building on cross-cultural work with refugee families and other groups and on work with families separated by parental incarceration, the authors provide recommendations to guide clinicians working with families who are separated or who fear separation. Mental health problems among separated families can in part be addressed through identifying the origins of distress, elucidating family structures and roles, strengthening communication practices, linking with legal and economic resources, and facilitating decision making through distress reduction.

Ce manuscrit propose une première description d’un travail clinique spécialisé au regard de la radicalisation menant à la violence au Canada. Une équipe clinique multidisciplinaire rattachée à un programme de santé mentale et de soins de première ligne à Montréal offre depuis juillet 2016 un service de consultation spécialisée pour soutenir des partenaires sur l’ensemble du territoire du Québec. Cet article décrit l’approche de l’équipe, l’organisation de l’offre de service et documente à travers des vignettes cliniques les principales catégories de problèmes sociaux et cliniques pour lesquels l’équipe fut sollicitée durant sa première année de fonctionnement. Nos observations préliminaires confirment la pertinence d’une évaluation pluridisciplinaire fondée sur une approche systémique du phénomène de la radicalisation violente, pour appréhender les différents facteurs sociaux, familiaux et individuels qui influencent les manifestations de ce phénomène, et déterminer la nature des interventions psychosociales et/ou psychiatriques pertinentes. La présentation des cas cliniques propose aux intervenants sociaux, communautaires et en santé mentale des pistes d’intervention et une compréhension du phénomène de radicalisation violente tel qu’il se présente dans les réseaux de la santé, de la protection de la jeunesse et de l’éducation au Québec.

This Working Paper examines the concept of the vulnerability of migrants which has become a key term in the UN’s negotiations for a Global Compact on Safe, Orderly and Regular Migration. The authors argue that the concept must be interpreted inclusively and related to the human rights obligations of states through the UN conventions. All too often migrants are vulnerable because of state action. States must ensure that they deliver on their human rights obligations in ways which reduce the vulnerability of migrants.

The hospital is a place of encounter between health care providers, patients and family members, the healthy and the suffering, migrants and non-migrants, as well as social and cultural minorities, and majorities of various backgrounds. It is also a space where multiple conceptions of care, life, quality of life, and death are enacted, sometimes inhibiting mutual understanding between caregivers and the cared for, a scenario that in turn may provoke conflict. Through the lens of conflict, we explore in this article the theme of Otherness within the clinic, basing analysis on an ethnographic study conducted in recent years in three cosmopolitan Canadian cities. Daily practices and—on a larger scale—the social space of the clinic become material here for reflecting on recognition (and non-recognition) of the Other as actors in the clinical encounter. The examination of structural and situational conditions that contribute to the emergence of conflict offers an understanding of the diversity of values that pervade the clinic. By way of conclusion, we argue that recognition of diversity, at least on the part of practitioners, is a key condition for the emergence of a pluralist normativity in the social space of the clinic.

Stemming from a study with families of migrant & non-migrant backgrounds in Montréal on children’s stomach pains, this paper questions how ways of dealing with medical uncertainty has bearing on pathways to care. These pathways are enacted within and beyond the family space as well as in medical settings. While acknowledging that group practices call for nuance, non-migrant children lead a greater quest for legitimacy of their pain while most migrant families place stomach aches in the range of normality.

Au Canada, le nombre des migrants les plus vulnérables est en augmentation. Alors que les discussions autour des politiques d’immigration tiennent le haut du pavé, la santé et le bien-être des réfugiés, demandeurs d’asile et migrants sans statut passent au second plan, malgré les inégalités sociales et de santé criantes en leur défaveur. Dans ce contexte, la recherche en santé doit s’adjoindre les voix et expériences de ces populations, tant dans la perspective de mieux comprendre leurs réalités, pour des politiques et services appropriés à leurs besoins, que dans une perspective d’empowerment. La recherche-action participative mérite d’être valorisée à ce titre, car elle s’intéresse aux défis réels des populations et reconnaît la complexité des obstacles auxquels sont confrontées les populations migrantes. Fondée sur des processus collaboratifs, la recherche-action participative favorise la co-construction des solutions entre parties prenantes, dont les organismes communautaires, et transforme les « sujets » en acteurs. Or, ce type de recherche est sous-utilisé, faute de financements et de structures permettant la collaboration effective des partenaires. Nous appelons donc à davantage de recherches avec et pour les migrants, particulièrement sous forme de recherche-action participative, et à davantage d’initiatives de financement ciblées et de balises pour favoriser et encadrer ces recherches.

Few studies explore the impact conversion to Islam has on a Western individual’s social identity configuration. This article focuses on six Western Muslim converts—three from Montreal, two from Berlin, and one from Copenhagen—who experienced difficulties relating to their national identities prior to conversion, exploring how it developed afterwards. A qualitative interview guide was adapted in a semi-structured format to the demands of each individual, and interviews were analyzed applying thematic content analysis. The participants reveal how they revised their social identity configuration upon conversion, ultimately reversing their antagonistic relationship to their national identity. Their narratives relate how political realities are embedded in the perception and development of the Western Muslim identity, necessitating a revaluation of their national identity as a form of social critique. Our results demonstrate how socio-political experiences of discrimination and race are all significantly implicated in the process of conversion and Muslim identity development.

Data from focus groups held in Montréal (Canada) with 13 women born in Cameroon, Colombia, and Democratic Republic of Congo were used to explore cancer knowledge among immigrant grandmothers and mothers-in-law and their influence over family cancer-preventative practices. Thematic analysis identified the following leading themes: cancer literacy and influence over family cancer preventative and early detection practices, cancer literacy in relation to family health behaviors, and barriers to accessing health services. Perceived external causes of cancer and its prevention are countered by healthy eating and exercises. Cancer literacy was contextualized by the development of women’s ways of being and doing.

Les imams pourraient-ils, sans compromettre leur islamité, se faire les complices-promoteurs de l’équité de genre dans leur communauté et, si oui, comment et à quelles conditions? C’est ici la question de fond que les auteurs taquinent dans cet article. A l’aide d’une méthode mixte, qualitative et quantitative, nous explorons cette (im)possible <<complicité>> à Mumbai, en Inde. Il s’agit de l’un des volets d’un programme de recherche plus large portant sur la santé sexuelle et les comportements sexuels à risque dans des quartiers pauvres de Mumbai. Ce programme implique une diversité d’acteurs sociaux, dont des résidentes et résidents, des tradipraticiens, des leaders religieux et des intervenants communautaires d’un quartier oø la population est majoritairement musulmane. Considérant l’islam comme une tradition discursive, nous explorons la portée et les limites du volet impliquant les imams dans une recherche-action participative oø les résultats préliminaires de la phase recherche, soulignant l’importance de l’équité de genre, ont été soumis, durant la phase action, aux imams qui ont identifié avec les chercheurs des extraits issus des textes canoniques de l’islam qui soient conciliables avec ces résultats. Les messages issus de cette collaboration ont été transmis à la communauté par les imams à travers différents canaux, dont essentiellement les prêches du vendredi rassemblant plusieurs milliers de fidèles masculins. L’article souligne que plusieurs imams ont fait évoluer certains de leurs savoirs et attitudes initialement misogynes (violence conjugale, sexualité maritale pour la satisfaction exclusive des maris) à la suite de leur implication dans la recherche-action participative; d’autres éléments fortement ancrés dans la culture locale les rendent cependant rétifs au changement. Il n’est pas clair si cette réticence se traduit chez les femmes musulmanes de la communauté en subordination ou en résistance.

Morocco has become a permanent transit country for tens of thousands of sub-Saharan migrants heading to Europe. Many of these migrants are women who have a precarious legal status and can no longer reach Europe, whose borders have been considerably securitized since September 11, 2001. They also have no wish to risk their lives again returning south across the Sahara Desert. This paper discusses the results of an exploratory research project conducted in Morocco on the relationships between the sub-Saharan migrant women’s traumatic experiences, social invisibility, and emotional distress in the context of a massive securitization of Euro-Mediterranean borders.

Abstract: The main objective of this systematic review is to synthesize the empirical evidence on how the Internet and social media may, or may not, constitute spaces for exchange that can be favorable to violent extremism. Of the 5,182 studies generated from the searches, 11 studies were eligible for inclusion in this review. We considered empirical studies with qualitative, quantitative, and mixed designs, but did not conduct meta-analysis due to the heterogeneous and at times incomparable nature of the data. The reviewed studies provide tentative evidence that exposure to radical violent online material is associated with extremist online and offline attitudes, as well as the risk of committing political violence among white supremacist, neo-Nazi, and radical Islamist groups. Active seekers of violent radical material also seem to be at higher risk of engaging in political violence as compared to passive seekers. The Internet’s role thus seems to be one of decision-shaping, which, in association with offline factors, can be associated to decision-making. The methodological limitations of the reviewed studies are discussed, and recommendations are made for future research

Throughout history, refugees have alternatively been seen as entitled victims of adversity or as threats or abusers of host countries scarce resources. Within the present globalized context, ambivalent public perceptions of refugees are shattering the protective nature of the post migratory environment in refugee receiving countries. This raises new challenges for refugees’ mental health and calls for systemic responses to address both pre-migratory trauma and losses and post migratory adversities. Recent evidence on the effectiveness of mental health treatment for refugees confirms the utility of trauma-focused psychotherapy and the limits of psychopharmacology for stress related disorders in this group. Training of mental health professionals may improve the quality of care for refugees by deconstructing prevalent prejudices about them and promoting empathic understanding. Mental health professionals may also advocate by providing information about social determinants refugee mental health to policy makers and promoting psychosocial interventions and protective social policies.

High caesarean birth rates among migrant women living in high-income countries are of concern. Women from sub-Saharan Africa and South Asia consistently show overall higher rates compared with non-migrant women, whereas women from Latin America and North Africa/Middle East consistently show higher rates of emergency caesarean. Higher rates are more common with emergency caesareans than with planned caesareans. Evidence regarding risk factors among migrant women for undergoing a caesarean birth is lacking. Research suggests that pathways leading to caesarean births in migrants are complex, and they are likely to involve a combination of factors related to migrant women’s physical and psychological health, their social and cultural context and the quality of their maternity care. Migration factors, including length of time in receiving country and migration classification, have an influence on delivery outcome; however, their effects appear to differ by women’s country/region of origin.

Background

The high number of caesareans performed in High Income Countries (HICs) is of concern due to associated risks. Recommendations to reduce caesarean rates include preventing emergency caesareans among low-risk women (i.e., vertex, singleton, term pregnancies). Pregnant migrant women from low or middle income countries (LMICs) may face conditions that exacerbate childbearing and delivery health risks. The objective of this study was to identify medical, migration, social and health service predictors associated with emergency caesareans in low-risk migrant women from LMICs.

Methods

Using a case-control research design, migrant women from LMICs, and living in Canada ≤ 8 years were recruited from the postpartum units of three hospitals in a major urban Canadian city between March 2014 and January 2015. Data were collected from medical records and by administration of the Migrant-Friendly Maternity Care questionnaire (available in 8 languages). Low risk women who delivered by emergency caesarean for discretionary indications (cases) or vaginally (controls) were included in analyses. Multi-variable logistic regression was performed to identify predictors of emergency caesarean.

Results

233 cases and 1615 controls were analyzed. Predictors of emergency caesarean were: pre-pregnancy BMI ≥ 25 and/or excessive pregnancy weight gain (OR = 1.49, 95% CI 1.02-2.13), poor maternal health (OR = 1.38, 95% CI 0.95-1.98), admission to birthing centre < 4 cm dilated (OR = 6.48, 95% CI 3.50-12.01), maternal region of birth Sub-Saharan African/Caribbean (OR = 2.39, 95% CI 0.95-5.99), and length of time in Canada < 2 years (OR = 2.04, 95% CI 1.04-4.03). Among women < 2 years in Canada, gestational diabetes and/or hypertension (OR = 2.07, 95% CI 0.98-4.35), having a humanitarian migration classification (OR = 4.48, 95%CI 1.21-16.49), and admission to the birthing centre < 4 cm dilated (OR = 7.43, 95% CI 3.04-18.18) were important predictors.

Conclusion

There are important migration, medical, and health service predictors of emergency caesareans to migrant women from LMICs.

Abstract
Resettling refugee women may be at greater risk than
other women for several harmful reproductive health outcomes as a result of their migration experience. The objective of this study was to determine differences in reproductive health status between refugee women in
countries of resettlement and non-refugee counterparts. A systematic review of the literature culled from five electronic databases and web searching of international agencies and academic centres focusing on refugees was
conducted. Of the forty-one high quality studies identified, fourteen looked at refugees exclusively; only nine of the fourteen focused on the reproductive health of refugees; six of the nine directly compared refugee to non-refugee women’s health. There is a paucity of populationbased data to support or refute claims of greater reproductive health risks for resettling refugee women.

Résumé
Les femmes réfugiées en situation de réétablissement
pourraient bien être plus susceptibles que d’autres femmes
de souffrir d’un certain nombre de conséquences néfastes en
matière de santé génésique suite à l’expérience de la migration.
Le but de cette étude était de cerner les différences entre le niveau de santé génésique des femmes réfugiées dans les pays de réétablissement et leurs congénères non-réfugiées. Pour ce faire, un examen systématique de la littérature provenant de cinq bases de données électroniques a
été entrepris, ainsi que des recherches sur le Web d’agences et de centres académiques internationaux. Des 41 études de haut niveau identifiées, seules 9 de ces études se concentraient sur la santé génésique des réfugiées ; 6 de ces 9 études effectuaient une comparaison directe entre la santé des réfugiées et celle des non-réfugiées. Il existe en fait un manque de données démographiques qui permettraient de soutenir ou de rejeter l’affirmation selon laquelle les risques sont accrus en matière de santé génésique chez les femmes réfugiées en cours de réétablissement.

This article focuses on the implications of administrative ‘undocumentedness’, arguing that a lack of legal recognition across jurisdictional boundaries has parallels whether international or inter-municipal. In Canada and China, migrant workers only began receiving significant public attention in the past 20 years. Canada has had a boom in the use of the Temporary Foreign Worker Program, yet tightening immigration procedures overall has led to a rise in the number of undocumented workers. While in China, most rural-to-urban migrants move without transferring their hukou residency registration. The authors argue that there are surprising parallels in the policy frameworks governing access to social rights for undocumented migrants in Quebec and in Shanghai, parallels that create social exclusion. Mutual lessons for addressing the social rights of irregular migrants are discussed.

For newcomers to Canada, placement agencies (or temp agencies) are a common path into a labour market that is difficult to access. It is widely documented that temp agencies are linked to precarious work conditions, dangerous occupational health conditions, racialized and gendered division of labour, and the exploitation of precarious immigration statuses. Our study shows that gender plays out strongly in (im)migrants’ experiences of temp agency work. Regardless of their previous education or experiences it is their immigration status, race and gender that seemed to dictate the types of work available to them. We discuss five elements of workers’ experiences that were strongly shaped by gender: their sectors of work; their tasks within the workplace; gender-normative bullying;
sexual harassment and assault; and their management of work-life balance.

Pour les nouveaux arrivants au Canada, les agences de placement (ou les agences de placement temporaire) sont une voie commune vers un marché du travail difficile d’accès. Il est largement documenté que les agences de placement temporaire sont liées à des conditions de travail précaires, à des conditions de santé professionnelles dangereuses, à la division du travail racialisée et sexuée et à l’exploitation de statuts d’immigration précaires. Notre étude montre que le genre joue un rôle important dans les expériences des (im)migrants dans le travail temporaire. Indépendamment de leurs études antérieures ou de leurs expériences, c’est leur statut d’immigration,
leur race et leur sexe qui ont dicté les types de travail disponibles. Nous discutons de cinq éléments de l’expérience des travailleurs qui ont été fortement façonnés par le genre: secteurs de travail, tâches sur le lieu de travail, intimidation sexiste, harcèlement sexuel et voies de fait, et gestion de l’équilibre entre vie professionnelle et vie privée

Abstract:

Domestic and caregiving work have been part of the Canadian fabric since our colonial founding and have long represented one of the most easily accessible routes for migration open to women. Until very recently the Live-In Caregiver Program (LCP) operated as the primary program in Canada facilitating this labour migration. While the LCP has been replaced by the Caregiver Program (CP), it has yet to be determined how these changes will impact migrant caregivers. We suggest that many lessons can be drawn from our knowledge of migrant caregivers’ experiences under the LCP that can help us understand the dynamics of new immigration policies. Using the global care chain framework, we consider here whether Canada’s caregiver migration policy demonstrates a concern for the wellbeing of migrant caregivers as workers, as family members and as citizens. Our analysis suggests that the CP does not adequately address the concerns raised through the global care chain critique. Rather, the CP continues and deepens the trend of using immigration policy to hold people in substandard employment, with very little care for migrant caregivers whether in terms of their labour rights, their family relationships or their sense of belonging and citizenship.

Résumé:

Le travail domestique et le travail d’aide-soignant font partie de la réalité canadienne depuis nos débuts coloniaux et représentent depuis longtemps l’une des voies migratoires les plus accessibles aux femmes. Le Programme des aides familiales résidentes (PAFR) est le principal programme facilitant l’entrée de ce type de main-d’œuvre au Canada. Récemment, ce programme a été remplacé par le Programme des aides familiales (PAF), mais la façon dont ce remplacement va affecter les aides familiales reste indéterminée. Aussi nous recourons à notre connaissance des expériences des aides familiales sous l’ancien programme afin de tirer des leçons susceptibles de faciliter la compréhension des dynamiques se rapportant à la nouvelle politique d’immigration. En faisant appel au cadre de la chaîne globale des soins, nous examinons ici si la politique canadienne relative aux aides-soignants démontre une préoccupation pour le bien-être de ces migrants, en tant que travailleurs, membres d’une famille et citoyens. Notre analyse suggère que le PAF ne répond pas adéquatement aux critiques émises en lien à la chaîne globale des soins. En fait, le PAF pour-suit et approfondit la tendance consistant à voir dans la politique d’immigration un outil confinant les aides-soignants dans des emplois précaires, sans égard pour leurs droits du travail, leurs relations familiales et leurs sentiments d’appartenance et de citoyenneté.

Cet article présente les résultats d’une étude exploratoire sur l’accès aux services de santé des migrants à statut précaire. Une enquête a été menée auprès de 211 hommes et femmes migrants, et parmi ceux-ci, 31 ont été retenus pour un entretien en profondeur. Pour cet article, nous présentons les résultats concernant 78 travailleurs comprenant ceux recrutés en tant que travailleurs (travailleurs étrangers temporaires) ou qui n’ont pas d’accès au filet de sécurité sociale et doivent habituellement travailler (les sans-papiers). Une revue de la littérature est présentée, reliant le statut migratoire à l’accès aux soins de santé et aux problèmes de santé au travail. Nous présentons la méthodologie et ensuite les résultats qui décrivent les réseaux sociaux auxquels les travailleurs migrants ont recours pour répondre à leurs préoccupations en matière de santé, comprenant notamment les professionnels du Québec, et des ressources transnationales en santé. Ces résultats pourront être utiles aux professionnels de la SST pour comprendre certains obstacles auxquels font face les travailleurs migrants ayant subi un accident du travail ou une maladie professionnelle. Les difficultés d’accès aux soins de santé peuvent-elles compromettre le recours des travailleurs migrants victimes de lésions professionnelles ?