L’enfer préasilaire à la fin du XIXe siècle et au début du XXe : perceptions, interprétations et discours masculins sur la folie des femmes mariées

L’enquête de l’auteure dans les archives de l’hôpital Saint-Jean-de-Dieu lui a permis de découvrir, dans les dossiers médicaux des femmes mariées, des documents relatifs aux demandes d’internement rédigées par leur époux et leur médecin de famille. Ces traces du discours masculin révèlent les difficultés et les problèmes familiaux occasionnés par l’impossibilité de contrôler les comportements insanes de l’aliénée, épouse et mère de famille, avant son admission asilaire. Loin de faire de cette analyse de genre un plaidoyer fondé sur une croyance populaire, selon laquelle les femmes internées pour aliénation mentale n’étaient pas folles ou abandonnées par leur mari, l’auteure veut plutôt illustrer les perceptions et les interprétations des hommes concernant la folie des femmes mariées, interprétations incontestablement influencées par l’idéologie victorienne.Research in the archives of the Montréal asylum Hôpital Saint-Jean-de-Dieu has revealed very interesting documents, especially letters written by the spouses of the patient women before they were admitted to the institution. Those letters show the difficulty of the husbands in dealing with a mental ill spouse. This article analyses the masculine discourses from the admission forms, and how the men perceived their wife behaviors as madness, and also the physician’s explanation of the madness of women. This gender analysis does not suggest that women were institutionalized for the wrong reasons or simply abandoned by their husbands in the asylum. The interest is to explore the perceptions and the interpretations of men about women’s madness and how their discourses were influenced by the Victorian ideology

Sentiments et correspondance dans les dossiers médicaux des femmes internées à l’hôpital Saint-Jean-de-Dieu, de la fin du XIXe au début du XXe

Au cœur de cette étude des mentalités, l'auteure examine les sentiments partagés entre les femmes internées pour folie à l'hôpital Saint-Jean-de-Dieu pendant la période 1873-1921 et les membres de leur famille. S'il est question d'attachement, d'espoir et d'assistance à l'égard des femmes internées, c'est bien parce que la récurrence de telles manifestations attentionnées repérées dans les dossiers médicaux de Saint-Jean-de-Dieu a surpris l'auteure. Ces lettres, principalement rédigées par un ou une membre de la famille de l'aliénée, se sont avérées suffisamment nombreuses pour reconnaître qu'effectivement la famille garde contact avec sa malade pendant l'internement et pour repérer les principales préoccupations de l'époux, de la mère ou des enfants à l'égard de leur malade, confinée derrière les murs de pierre de l'asile.This paper examines the relationship between the women admitted for mental illness and their families during their institutionalization in Montreal asylum, Hôpital Saint-Jean-de-Dieu, in the late 19th and in the early 20th century. The documents we have found in the archives, especially letters written by the families' members of the patients, show evidence of affection, tenderness and feeling, hope and love. These letters were found in sufficient number with in medical records to let us glimpse the preoccupations of families for their sick members and their true concerns for a spouse, a sister or a daughter who had been sent to the asylum

Sur quelques visages de la folie à Saint-Jean-de-Dieu au tournant du siècle dernier

Saint-Jean-de-Dieu Hospital, at the far east end of Montreal, is presented as the ideal site for uncovering the lives of men and women institutionalized for madness in Quebec. Recognized as the largest asylum for the insane in Canada, it housed a clientele not only from Montreal but also from all corners of the province of Quebec, a characteristic that offers, under the same roof, a sample population representative of the entire province. As part of a project involving the history of marginalized populations of Montreal, the authors undertook a systematic, quantitative retrieval of information from almost 10,000 files of patients committed to Saint-Jean-de-Dieu. The quantitative data allowed them to reveal profiles of those institutionalized from the establishment of the asylum in 1873 up to 1921. The correspondence contained in the medical files of about 300 patients, however, made it possible to trace the “faces” of madness. Six broad categories emerged repeatedly: broken relationships, conjugal violence, those considered undesirable, the forgotten, the persecuted, and those committed unjustly.L’Hôpital Saint-Jean-de-Dieu, situé à l’extrémité est de Montréal, s’est présenté comme étant le premier et le meilleur choix pour découvrir la vie des femmes et des hommes enfermés pour folie au Québec. Cet asile, reconnu comme étant le plus grand asile d’aliénés au Canada, dessert une clientèle montréalaise, mais également originaire de tous les coins de la province de Québec, une particularité qui offre le privilège d’avoir sous le même toit un échantillon de population représentatif du Québec tout entier. Dans le cadre d’un projet d’histoire des populations marginalisées de Montréal, les auteurs ont entrepris une saisie quantitative systématique de presque 10 000 dossiers de patients internés à Saint-Jean-de-Dieu. Ces banques de données quantitatives leur ont permis de révéler les profils des personnes internées de la fondation de l’asile en 1873 jusqu’à 1921. Mais c’est à partir de la correspondance répertoriée dans les dossiers médicaux d’environ 300 cas qu’il a été possible de tracer des « visages » de la folie. Six grandes catégories sont ressorties avec récurrence : les amours brisés, la violence conjugale, les indésirables, les oubliés, les persécutés et les injustement internés

Premières initiatives d’intégration sociale des malades mentaux dans une phase de pré-désinstitutionnalisation. L’exemple de Saint-Jean-de-Dieu, 1910–1950

Cet article sur les premières initiatives d’intégration sociale des malades mentaux, dans l’exemple de l’Hôpital Saint-Jean-de-Dieu, présente la mise en place d’une phase de désinstitutionnalisation au cours des premières décennies du XXe siècle. Notre étude s’inscrit dans le courant historiographique récent qui propose une relecture de la période pré-Révolution tranquille au Québec. Nous entendons y contribuer en démontrant que les politiques, les stratégies et les pratiques des Soeurs de la Providence et des psychiatres ont mis en place un système de désinstitutionnalisation et de réintégration des patients dans leur famille dès les années 1910, soit un demi-siècle avant que ne s’amorce la première vague de désinstitutionnalisation des années 1960 orchestrée par les auteurs du rapport Bédard. This article on the first initiatives of social integration of the mentally ill, using the example of the Hôpital St-Jean-de-Dieu, explores the implementation of a period of deinstitutionalization in the early decades of the 20th century. Our study is situated in the recent historiography that offers a rereading of the period just prior to the Quiet Revolution in Quebec. We intend to contribute by demonstrating that the policies, strategies and practices of the Sisters of Providence and the psychiatrists of St-Jean-de-Dieu developed a system of deinstitutionalization that reintegrated patients into their family as early as the 1910s, half a century before the first wave of deinstitutionalization of the 1960s was orchestrated by the authors of the Bédard report

Differences in metabolomic and transcriptomic profiles between responders and non-responders to an n-3 polyunsaturated fatty acids (PUFAs) supplementation

Studies have demonstrated large within-population heterogeneity in plasma triacylglycerol (TG) response to n-3 PUFA supplementation. The objective of the study was to compare metabolomic and transcriptomic profiles of responders and non-responders of an n-3 PUFA supplementation. Thirty subjects completed a 2-week run-in period followed by a 6-week supplementation with n-3 PUFA (3 g/d). Six subjects did not lower their plasma TG (+9 %) levels (non-responders) and were matched to 6 subjects who lowered TG (−41 %) concentrations (responders) after the n-3 PUFA supplementation. Pre-n-3 PUFA supplementation characteristics did not differ between the non-responders and responders except for plasma glucose concentrations. In responders, changes were observed for plasma hexose concentrations, docosahexaenoic acid, stearoyl-CoA-desaturase-18 ratio, and the extent of saturation of glycerophosphatidylcholine after n-3 PUFA supplementation; however, no change in these parameters was observed in non-responders. Transcriptomic profiles after n-3 PUFA supplementation indicate changes in glycerophospholipid metabolism in both subgroups and sphingolipid metabolism in non-responders. Six key genes in lipid metabolism: fatty acid desaturase 2, phospholipase A2 group IVA, arachidonate 15-lipoxygenase, phosphatidylethanolamine N-methyltransferase, monoglyceride lipase, and glycerol-3-phosphate acyltransferase, were expressed in opposing direction between subgroups. In sum, results highlight key differences in lipid metabolism of non-responders compared to responders after an n-3 PUFA supplementation, which may explain the inter-individual variability in plasma TG response

Effects of age, sex, body mass index and APOE genotype on cardiovascular biomarker response to an n-3 polyunsaturated fatty acid supplementation

Objectives: To test whether age, sex, body mass index (BMI), and the apolipoprotein E (APOE) genotype are associated with the metabolic response to an n-3 polyunsaturated fatty acid (PUFA) supplementation. Methods: 210 subjects followed a 2-week run-in period based on Canada’s Food Guide and underwent a 6-week 5 g/day fish oil supplementation (1.9 g of eicosapentaenoic acid and 1.1 g of docosahexaenoic acid). Cardiovascular disease risk factors were measured. Results: n-3 PUFA supplementation was associated with a decrease of plasma triglyceride levels (p = 0.0002) as well as with an increase of fasting glucose (FG) levels (p = 0.02). Age was associated with post-intervention plasma total cholesterol (p = 0.01), low-density lipoprotein cholesterol (p = 0.007), apolipoprotein B (p = 0.04), and insulin (p = 0.002) levels. Sex was associated with post-intervention plasma high-density lipoprotein cholesterol levels (p = 0.02). BMI was associated with plasma FG (p = 0.02) and insulin levels (p < 0.0001) after the supplementation. APOE genotype was associated with FG (p = 0.001) and C-reactive protein levels (p = 0.03) after the supplementation. Conclusion: Results suggest that age, sex, BMI, and the APOE genotype contribute to the inter-individual variability observed in the metabolic response to an n-3 PUFA supplementation

Supporting work practices through telehealth: impact on nurses in peripheral regions

<p>Abstract</p> <p>Background</p> <p>In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs) are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions.</p> <p>Methods/Design</p> <p>First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately fifty semi-structured interviews with key stakeholders.</p> <p>Discussion</p> <p>Data from both parts of this research project will be jointly analysed using triangulation of researchers, theoretical approaches, methods, and results. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the nursing recruitment and retention.</p