Article scientifique

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

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

Objectives

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

Design

Cross-sectional study.

Setting

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

Participants

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

Primary and secondary outcome measures

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

Results

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

Conclusions

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

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

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

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

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

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

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

À plusieurs égards, la danse peut exprimer et transformer des liens interpersonnels et sociaux. Le présent article explore cette idée en s’appuyant sur un projet de danse mené à Montréal en 2017 dans un quartier pluriethnique faisant face à des enjeux de pauvreté. Ce projet s’appuyait sur l’hypothèse que les liens intergénérationnels et intercommunautaires se font écho et se métamorphosent mutuellement. Le cadre dans lequel le projet a pris forme sera d’abord posé et les défis qu’il a soulevés, notamment sur le plan de l’animation et du processus artistique, seront discutés. Finalement, l’article éclairera la façon dont certaines dynamiques entre centralité et marginalité s’y sont révélées

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

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

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

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

The COVID-19 pandemic led to lockdown measures where congregational faith-based activities were prohibited. With time, the collateral impacts of confinement emerged as priorities, and impositions had to be balanced with the collaboration of the population. In this process, faith-based organizations played a key role in encouraging their congregations to adhere to lockdown measures while fostering their mental wellbeing and resilience. This paper describes the process of establishing a collaborative negotiation among the Montreal Regional Public Health Unit, the police, and the Muslim and Jewish communities, examining the role of mediation in this context. Despite some obstacles, such as communication difficulties and decision-making limitations, the collaborative approach seems to buffer the escalation of intercommunity tension and to promote communities’ commitment to physical distancing measures and should be considered in times of pandemic for a more inclusive public health approach

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

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

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

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

Background

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

Methods

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

Results

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

Conclusion

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Design:
This is a cross-sectional study.

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

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

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

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

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

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

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

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

Background

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

Methods

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

Results

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

Conclusions

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

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

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

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

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

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

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

La façon dont les régimes d’indemnisation des victimes de lésion professionnelle doivent tenir compte des barrières linguistiques est d’une importance capitale à la lumière de la diversification linguistique croissante du Canada. S’appuyant sur des entrevues menées auprès de travailleurs accidentés et d’informateurs clés, cette étude est la première à examiner, de manière empirique, les politiques et les pratiques du retour au travail sous l’angle des barrières linguistiques. En comparant les juridictions du Québec et de l’Ontario, l’étude met en lumière des similitudes et des différences touchant les accommodements linguistiques ainsi que les politiques et les pratiques du retour au travail qui déterminent les expériences des travailleurs accidentés ayant des besoins linguistiques. Elle fait valoir que les lacunes à cet égard, qui sont plus marquées au Québec, contribuent à un faible retour au travail pour ces travailleurs dans les deux provinces.

Objectifs
Selon l’Organisation mondiale de la santé, les écarts dans les statistiques de santé reflètent un accès inégal aux ressources. La Commission de vérité et de réconciliation du Canada appelle à l’accroissement du nombre de travailleurs autochtones dans le domaine des soins de santé et services sociaux. L’implication des travailleurs communautaires locaux est essentielle à la sécurisation culturelle des soins et la décolonisation des services. Cet article décrit le rôle de ces travailleurs dans l’extension des services de santé mentale et des interventions sociales au Nunavik et explore les considérations contextuelles qui influencent leur pratique et leur place au sein des équipes professionnelles.

Méthode
Les résultats ont été obtenus par l’entremise d’une analyse thématique d’entrevues semi-structurées effectuées en 2016 auprès de 60 individus inuit et non-inuit travaillant dans le système de la santé et des services sociaux au Nunavik.

Résultats
L’intégration des travailleurs communautaires locaux est perçue comme apportant plusieurs bénéfices, notamment une amélioration des interventions. Cependant, plusieurs facteurs entravent cette collaboration tels que la clarté dans les mandats, l’accès aux formations et diplômes pré-requis, la reconnaissance du savoir local ainsi que le roulement de personnel. Plus de flexibilité et de soutien après l’embauche permettrait d’adapter la structure des services à la réalité complexe du Nunavik.

Conclusion
Cet article s’ajoute au corpus de littérature qui met de l’avant l’importance de la collaboration avec les travailleurs locaux. La décolonisation des services passe nécessairement par le remaniement des structures afin de reconnaitre l’apport des travailleurs locaux.

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

This paper addresses the well-being of children in Switzerland, Canada and Estonia, as they experienced the lockdown imposed by governments after the state of international public health emergency, declared by the World Health Organization on 30 January 2020. Suspension of school or starting with distance learning, cessation of extracurricular activities, closure of playgrounds, parks, shopping centres and loss of daily contacts with friends completely transformed children’s lives. The surveys conducted by the authors in individual ways, were all inspired by their membership to the Children’s Understandings of Well-Being network and involved the participation of 403 children aged 7–17 years old (229 girls and 174 boys). They present the emerging trends from the children’s narratives focusing on their experience of the lockdown in relation to family life, school life, contacts with friends, and in relation to space, time and self. During the lockdown leisure activities and hobbies, followed by life with friends and school life challenged relational well-being the most, while family life opened up new perspectives and generational solidarity. Staying at home and decreased physical activity impacted on the physical health of children, missing direct contacts with friends and teachers put social relations to test, fear of the virus decreased feeling safe and secure, and the lockdown restricted participation in society. The findings underline the relational nature of their well-being. More in-depth studies are needed to highlight the widening of inequalities and the balance between protection and participation of children.

The perception of epidemic risk has been associated with the production of narratives in which figures such as villains and heroes emerge. This article critically analyzes social media users’ construction of heroic figures during the 2013–2016 Ebola epidemic. We used international Twitter and Facebook comments as our raw material, collected by key word extraction. A thematic analysis resulted in a descriptive typology of three heroic figures: the martyr, the warrior, and the saviour. Our analysis showed that heroic status (highly associated with willingness to take high risks on behalf of others) was mostly conferred on common individuals and ‘insiders’ living in the Ebola-afflicted communities – often deemed ‘unsung’ – rather than the foreigners frequently heroised in previous crises. We deconstruct this heroisation dynamic, showing that it is a socially strategic move because it is embedded in a potential instrumentalization of heroes. First, this production of ‘everyday heroes’ may encourage the involvement of lay people in the epidemic response, by conveying that anyone can become a health hero. Second, we show that this heroisation process maintains the status quo by encouraging adherence to biomedical discourses, and by individualising the narrative and neglecting the structural changes needed to address the epidemic. Finally, we caution against discourses that seem socially ‘progressive’ but may be used as a smokescreen to hide discriminatory dynamics, and we recommend changes in communication strategies.

Ce numéro montre que la mise en œuvre d’une éducation inclusive constitue un défi de taille inachevé, tant au plan systémique que du travail sur soi. Cette démarche de changement des pratiques, questionnant de manière continue la responsabilité de l’école à l’égard de la (re)production des inégalités, de l’exclusion et de rapports sociaux inégaux, est parsemée d’obstacles, de situations non prévisibles et d’émotions fortes. Les chercheurs soulignent notamment que de nombreux mécanismes systémiques de la culture scolaire contribuent à reproduire et à réifier des expériences scolaires hiérarchisées et à exacerber des processus de discrimination institutionnelle en défaveur des élèves issus de l’immigration et/ou racisés. Les recherches empiriques présentées mettent également en exergue la pensée déficitaire (deficit thinking) du personnel scolaire vis-à-vis des élèves issus de l’immigration et de leurs parents. Les résultats montrent que des intervenants tendent à utiliser les écarts linguistiques et culturels entre les élèves et le système scolaire pour expliciter l’échec scolaire. Quoi qu’il en soit, les chercheurs ainsi que les acteurs scolaires et les élèves interrogés dans les articles du numéro suggèrent des pistes fécondes pour améliorer l’inclusion en contexte scolaire, soulignant l’importance de donner la voix aux divers acteurs pour tendre vers des transformations institutionnelles.