Regulating Madness in a Mental Health Court

This article explores the regulation of people with mental illness who are accused of committing minor crimes (e.g. mischief, minor theft, assault, uttering threats, etc.) and viewed as disturbing the public order. The results are drawn from a study of a Mental Health Court (MHC) in Montréal (Canada), illuminating the perceptions and experiences of MHC actors who are involved in its operation. Deploying a multi-method design inspired by institutional ethnographic methods, this study sought to explore the inherent tensions in regulatory penal practices that oscillate at varying degrees between prevention, punishment and therapeutic intentions. It is argued that MHCs symbolize a new form of governmentality, in an eff ort to create disciplined subjects by reigning in madness and controlling marginality.This article explores the regulation of people with mental illness who are accused of committing minor crimes (e.g. mischief, minor theft, assault, uttering threats, etc.) and viewed as disturbing the public order. The results are drawn from a study of a Mental Health Court (MHC) in Montréal (Canada), illuminating the perceptions and experiences of MHC actors who are involved in its operation. Deploying a multi-method design inspired by institutional ethnographic methods, this study sought to explore the inherent tensions in regulatory penal practices that oscillate at varying degrees between prevention, punishment and therapeutic intentions. It is argued that MHCs symbolize a new form of governmentality, in an eff ort to create disciplined subjects by reigning in madness and controlling marginality.This article explores the regulation of people with mental illness who are accused of committing minor crimes (e.g. mischief, minor theft, assault, uttering threats, etc.) and viewed as disturbing the public order. The results are drawn from a study of a Mental Health Court (MHC) in Montréal (Canada), illuminating the perceptions and experiences of MHC actors who are involved in its operation. Deploying a multi-method design inspired by institutional ethnographic methods, this study sought to explore the inherent tensions in regulatory penal practices that oscillate at varying degrees between prevention, punishment and therapeutic intentions. It is argued that MHCs symbolize a new form of governmentality, in an eff ort to create disciplined subjects by reigning in madness and controlling marginality

"Staying Alive" while "Living the Life" : conceptualizations of risk among homeless youth

Le but de cette thèse est de comprendre les représentations du risque chez les jeunes de la rue. Plus précisément, elle s’intéresse à appréhender les constructions du risque que font les jeunes de la rue eux-mêmes, d’autant plus que ces jeunes sont définis comme un groupe à risque. Si le risque est plus souvent défini de manière stricte comme le mal éventuel, dans cette étude, il est défini plus largement intégrant l’idée des opportunités et prises de risque. Ancrée dans une perspective double du constructionnisme social et de l’interactionnisme symbolique, cette recherche a exploré les savoirs des jeunes sur les risques qu’ils vivaient dans les contextes observés et la manière dont ils les appréhendaient. Pour y parvenir, cette recherche s’inscrit dans une approche ethnographique pour mieux comprendre le monde des jeunes de la rue, utilisant des méthodes d'observation participante et dévoilée et des entrevues informelles variées. Cette approche globale permet de saisir comment les jeunes définissent leur capacité à estimer, gérer, éviter ou prendre des risques. L’utilisation d’une perspective longitudinale (de un à deux ans) et les relations de confiance bâties avec ces jeunes, ont permis de suivre comment la construction identitaire des jeunes observés a influencé leurs perception du risque et leurs pratiques de débrouillardise. En outre, les liens établis ont permis de révéler les points de vue singuliers des jeunes mais aussi leurs savoirs expérientiels relatifs aux risques. Il s’agit dans cette étude de montrer à partir des théories générales qui définissent nos sociétés comme des sociétés du risque, comment des individus, identifiés comme appartenant à un groupe à risque, définissent et gèrent leurs risques à partir de leur propre expérience et point de vue afin de révéler la diversité et la complexité des expériences et savoirs des jeunes de la rue à l’endroit du risque. En effet, cette thèse montre qu’un ancrage dans une sociologie du risque permet de sortir de l’image de victime ou de déviance associée généralement aux jeunes de la rue mais qu’elle demeure marquée par la promotion de la sécurité légitimant intervention et régulation de la situation des jeunes de la rue tout en ignorant l’expérience même des jeunes. Les discours sur les risques associés à la rue sont alors inscrits dans une logique d’expertise. Cette étude vise à sortir de ces préconceptions des risques pris par les jeunes de la rue pour au contraire s’attarder à comprendre comment se définit le risque à partir du sens que les jeunes accordent et les expériences qu’ils en ont. Mots clés: jeunes itinérants, jeunes de la rue, le risque, à risque, victimisation, déviance, identité.The goal of this dissertation is to understand conceptualizations of risk among homeless youth. In particular, it strived to examine an identified "at-risk" group's understanding of risk. Risk in this study encompassed all notions of risk, and was not limited to a narrow definition of perceived harm, but also embraced references of opportunities or chances taken. In this light, this study employed an ethnographic approach to better understand the worlds of homeless youth, relying on participant observation and informal interviewing methods. This ontological approach hoped to capture how youth conceptualize their personal power in estimating, managing, and avoiding or embracing risk. Coupling social constructionism with symbolic interactionism, this study explored participant's understandings of risk in the contexts in which they found and understood themselves. Participant's evolving identities greatly impacted their perceptions of risk and subsequently, their management strategies. Utilizing a longitudinal perspective (one to two years) and building relationships with participants allowed for an unfolding of their unique frames of reference and their local knowledges. One of the goals of this study was to disembody grand socio-cultural theories of risk, such as: the risk society, cultural/symbolic, and governmentality approaches, to uncover their cogency for an identified "at-risk" group. Exploring the phenomenological meanings of participant's individual experiences of risk in an identified risk-laden group revealed the heterogeneity of their experiences and understandings. Indeed, this dissertation argues that a sociology of risk has largely subsumed a sociology of victimization and deviance in regards to homeless youth. A sociology of risk has supplanted these earlier underpinnings and rests on this binary of victimization and deviancy to push for intervention and regulation (i.e. normalization) and endorses a "safety at all cost" approach, ignoring the wide array of youth's experiences. However, the insidious risk discourses that are so pervasive in the literature on homeless youth are not deconstructed for the meanings that are imbued, and are presented in a de-contextualized, rational, apolitical fashion; presented in a manner that seems indisputable, as they are nestled in expert logic. This study attempted to re-contextualize conceptualizations of risk by deconstructing such meanings and giving voice to the complexity of youth's experiences that are too frequently portrayed as homogenously victimizing or deviant. Keywords: homeless youth, street youth, risk, at-risk, victimization, deviance, identity

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (&lt;380 AU ml−1). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies