Les représentations sociales du travail de la personne handicapée physique en territoires fortement urbain et semi-urbain

RÉSUMÉ: Cette étude explore les représentations sociales du travail des personnes handicapées. Le cadre théorique des représentations sociales a permis de préciser le point de vue de personnes handicapées sur le travail en territoire fortement urbain et en territoire semi-urbain. Ces deux territoires opposés dans leur structure et leur organisation connaissent des difficultés relatives à l'intégration au travail des personnes handicapées. En effet, malgré les mesures prises par les gouvernements québécois depuis plusieurs décennies, il existe encore une disparité à l'échelle de l'emploi entre les personnes handicapées et les personnes sans handicap. Nous pourrions penser que le taux d'emploi des personnes handicapées à Montréal est plus élevé que dans la région périphérique du Bas-Saint-Laurent ou encore du Saguenay-Lac-St-Jean, car la présence d'un marché du travail plus fertile offrirait à la population handicapée de plus grandes possibilités, mais ce n'est pas le cas. Donc, notre questionnement de chercheur est le suivant : est-ce que le territoire peut marquer les représentations sociales des personnes handicapées sur la question du travail ? Notre ambition dans cette recherche est de documenter les représentations sociales du travail des personnes handicapées en relation avec leur territoire d'appartenance, fortement urbanisé ou semi-urbain. Notre objectif principal de recherche était d'identifier les représentations sociales des personnes handicapées face au travail dans deux territoires, soit un territoire fortement urbanisé et un territoire semi-urbain. Trois objectifs spécifiques sont venus en quelque sorte se greffer à ce premier, d'ordre plus général. Un premier a été de connaitre les représentations sociales des personnes handicapées à propos du travail en territoire fortement urbanisé, soit dans la région de Montréal et de sa proche périphérie. Le deuxième objectif spécifique a été de connaitre les représentations sociales des personnes handicapées à propos du travail en territoire semi-urbain, soit dans la région du BasSaint-Laurent. Enfin, le troisième objectif spécifique a été d'établir les convergences et divergences en matière de représentations sociales au sujet du travail des personnes handicapées physiques entre la région de Montréal et de sa proche périphérie et la région du Bas-Saint-Laurent. La collecte des données a été réalisée au moyen d'entrevues semistructurées. Deux groupes de personnes handicapées ont été constitués ; un premier groupe cible composé de huit personnes handicapées physiques en territoire fortement urbain, soit dans la région de Montréal et de sa proche périphérie, et un second groupe également composé de huit personnes handicapées physiques en territoire semi-urbain, soit dans la région du BasSaint-Laurent. L'analyse des représentations sociales à propos du travail de ces deux groupes a permis de considérer que celles-ci partagent un tronc commun constitué d'éléments attractifs et d'éléments répulsifs. Parmi les éléments attractifs, le travail constitue un outil favorisant notamment le développement de la personne. De plus, il s'agit d'une activité propre au cours normal de l'existence humaine. Parmi les éléments répulsifs, les préjugés et la discrimination des employeurs à l'endroit des personnes handicapées constituent un des principaux obstacles à leur intégration, mais il y a plus. C'est aussi le rythme accéléré de production du marché du travail pour des personnes déjà limitées physiquement. Le développement dans l'espace n'agit pas sur la structure des représentations sociales à propos du travail des informateurs dans les deux territoires. Néanmoins, le territoire agit en tant que support aux représentations sociales et ainsi peut être déterminant quant à leur nature. Autrement dit, le territoire en regard de son adaptation physique et des possibilités qu'il offre aux répondants aiguillonne la représentation sociale. -- Mot(s) clé(s) en français : personne handicapées physiques - représentation sociale - travail - territoire. -- ABSTRACT: The theoretical concept of social representation makes it possible to bring to light the points of view of disabled people regarding work in diverse territories. Two types of territory, a highly urbanized and a semi-urbanized one, differ widely in their structure and organisation, but both are experiencing difficulties in integrating disabled people into the workplace. Indeed, despite the measures taken by governments over several decades, there is still a disparity in employment rates between people with and without disabilities. One might expect the employment rate of disabled people in Montreal to be higher than in the Lower St. Lawrence or the Saguenay-Lac-Saint-Jean regions of Quebec, as a more active labour market should offer the disabled population greater opportunities, but this is not the case. So, our question as researchers is the following : can the territory mark the social representations of disabled people on the question of work ? The aim of this study was to document the social representation of work among disabled people in relation to the type of territory where they live, specifically bringing out convergences and divergences in this domain between the physically disabled populations of the two types of territory. Our main research objective was to identify the social representations of people with disabilities facing work in two territories : a highly urbanized territory and a semi-urban territory. Three specific objectives have been added to this first, more general objective. The first was to verify the social representations of people with disabilities regarding work in highly urbanized areas, that is, in the Montréal region and its immediate periphery. The second specific objective was to consider the social representations of people with disabilities regarding work in semi-urban areas, namely the BasSaint-Laurent region. Finally, the third specific objective was to establish the convergences and divergences in terms of social representations regarding the work of physically handicapped people between the Montreal region and its close periphery and the Bas-SaintLaurent region. Two target groups were constituted, one composed of eight physically disabled people in the highly urbanized territory of Montreal and its suburbs, and another of eight physically disabled people in a semi-urbanized territory, the Lower St. Lawrence region. Data collection was conducted through semi-structured interviews. The analysis of the social representation of work in the two groups brought out a common core of attractive and repellent elements. Among the attractive elements, work was seen as a tool that promotes personal development and an activity inherent in the normal course of human existence. Among the repellent elements, employer prejudice and discrimination against people with disabilities was seen as one of the main barriers to their integration into the workplace. Furthermore, both groups saw the accelerated pace of production in the labour market as problematic for people who are already physically limited. The difference between the spatial development characteristics in the two territories and the social representation of work by the informants in each territory did not appear to be correlated. Nevertheless, the territory acts as a support for social representations and thus can be decisive as to their nature. In other words, the territory, in terms of its physical adaptation and the possibilities it offers respondents, stimulates social representation

Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia: Antipsychotic Efficacy and Extrapyramidal Safety During the First 24 Hours of Treatment

To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (IM) olanzapine and IM haloperidol during the first 24 hours of treatment of acute schizophrenia. Method: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2: 1) to receive IM olanzapine (10.0 mg, n = 131), IM haloperidol (7.5 mg, n = 126), or IM placebo (n = 54). Results: After the first injection, IM olanzapine was comparable to IM haloperidol and superior to IM placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with IM olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3% olanzapine vs 13.3% haloperidol, P = 0.036), but not akathisia (1.1% olanzapine vs 6.5% haloperidol, P = 0.065), than did patients treated with IM haloperidol; they also required significantly less anticholinergic treatment (4.6% olanzapine vs 20.6% haloperidol, P < 0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during IM olanzapine treatment, compared with a general worsening during IM haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P < 0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P < 0.05). Conclusion: IM olanzapine was comparable to IM haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with IM haloperidol than with IM olanzapine

LINGO1 Variants in the French-Canadian Population

Essential tremor (ET) is a complex genetic disorder for which no causative gene has been found. Recently, a genome-wide association study reported that two variants in the LINGO1 locus were associated to this disease. The aim of the present study was to test if this specific association could be replicated using a French-Canadian cohort of 259 ET patients and 479 ethnically matched controls. Our genotyping results lead us to conclude that no association exists between the key variant rs9652490 and ET (Pcorr = 1.00)

Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

<p>Abstract</p> <p>Background</p> <p>To compare the efficacy and tolerability of paliperidone extended-release (ER) with risperidone immediate-release using propensity score methodology.</p> <p>Methods</p> <p>Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound). Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS) total score and baseline Clinical Global Impressions–Severity (CGI-S) score as factors. The dosage range of paliperidone ER (6-12 mg/day) was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE) reports and weight. AEs with rates ≥5% and with a ≥2% difference between paliperidone ER and risperidone were identified.</p> <p>Results</p> <p>Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95) and risperidone trials (n = 122) groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768). Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179), risperidone 2-4 mg/day (n = 113) or risperidone 4-6 mg/day (n = 129) were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159). PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p < 0.05) and similar to risperidone 4-6 mg/day (0.2; p = 0.927). Placebo-adjusted AEs more common with paliperidone ER were insomnia, sinus tachycardia and tachycardia; more common with risperidone were somnolence, restlessness, nausea, anxiety, salivary hypersecretion, akathisia, dizziness and nasal congestion. Weight changes with paliperidone ER and risperidone were similar (paliperidone ER vs risperidone 2-4 mg/day, p = 0.489; paliperidone ER vs risperidone 4-6 mg/day, p = 0.236).</p> <p>Conclusions</p> <p>This indirect database analysis suggested that paliperidone ER 6-12 mg/day may be more efficacious than risperidone 2-4 mg/day and as efficacious as risperidone 4-6 mg/day. The AE-adjusted incidence rates suggest differences between treatments that may be relevant for individual patients. Additional randomized, direct, head-to-head clinical trials are needed to confirm these findings.</p