La pratique outreach auprès des personnes itinérantes souffrant de troubles mentaux graves et persistants : observations, réalités et contraintes

L'équipe itinérance a pour mandat de favoriser l'accessibilité des soins et des services sociaux aux personnes itinérantes de tous âges. Elle a aussi développé des services spécifiques outreach adaptés à la réalité du phénomène de l'itinérance à Montréal. Le principe fondamental qui sous-tend la pratique de l'équipe est l'universalité des soins, tant l'accès que la qualité ; tous les citoyens ont droit à la même attention de la part du réseau de la santé et c'est dans cette optique que les services sont offerts aux personnes itinérantes. Cet article se limite à un seul aspect des activités de l'équipe : la pratique outreach auprès des personnes souffrant de troubles mentaux graves et persistants. Nous décrivons notre environnement outreach, notre clientèle, une trajectoire outreach — illustrée par quelques exemples cliniques — les obstacles rencontrés et, enfin, nous partageons nos observations et suggestions.The outreach practice with homeless people suffering from severe and chronic mental illness: observations, reality and obstacles The team working with homeless people has the mandate to favor access to care and social services for all homeless people regardless of age. It has also developed specific outreach services adapted to the reality of homelessness in Montréal. The fundamental principle underlying our practice is universality, be it access or quality of services; all citizens have the right to the same attention from the health system. It's in this perspective that services are offered to homeless people. This article is limited to one aspect of the team's work : the outreach practice with homeless people suffering from severe and chronic mental illness. The authors describe their outreach environment, their clientele and an example of outreach—llustrated with a few cases—as well as the obstacles met. Finally, the authors share their observations and suggestions.La práctica outreach con las personas itinerantes que sufren de desórdenes mentales graves y persistentes: observaciones, realidades e impedimentos El equipo itinerancia tiene el mandato de favorecer el acceso a los cuidados ofrecidos por los servicios sociales a las personas itinerantes de todas las edades. Igualmente, el equipo ha desarrollado los servicios específicos outreach adaptados a la realidad del fenómeno de la itinerancia en Montreal. El fundamento principal que sostiene la práctica del equipo, es la universalidad de los cuidados, tanto el acceso como la calidad; todos los ciudadanos tienen derecho a la misma atención por parte de la red de salud y es en esta óptica que son ofrecidos los servicios a las personas itinerantes. Este artículo se limita a un solo aspecto de las actividades del equipo: la practica outreach con las personas que sufren de desórdenes mentales graves y persistentes. Describimos nuestro ambiente outreach, nuestra clientela, una trajectoria outreach — ilustrada por algunos ejemplos clínicos — los obstáculos que hemos encontrado y, finalmente, compartimos nuestras observaciones y sugerencias

Support: The Keystone of Distance Education

TÉLUQ University is the only French-language university in North America that is entirely dedicated to distance education. It has been in existence for 50 years and all courses are delivered asynchronously. As in most open or distance learning universities, the majority of students are adults who are returning to school and trying to balance their studies with their family or professional life. Students are attracted by the possibility of enrolling at any time and completing available courses at their own pace. However, as research in the field has demonstrated, the downside of such freedom is a higher dropout rate in distance learning than in traditional in-person courses. Thus, support seems to play a key role in improving student perseverance. But what type of support do students need? In this paper, we highlight some of the ways in which we support distance students at our university. First, coordinators and professors support and guide students in their choice of programme courses and pathway. Second, follow-up is provided in each course by professors, tutors or supervisors who support the students in their learning. Finally, while the opportunity to communicate with other students is rare within the courses, the system called “Ensemble à distance” allows students to communicate in forums in asynchronous mode or in synchronous mode during virtual cafés. In addition, other special support mechanisms are available for certain categories of students, such as those with disabilities or those taking their first distance learning course. Moreover, during the COVID-19 pandemic, TÉLUQ University played a major role in supporting all teachers in Quebec (and beyond) by creating the J’enseigne à distance (I teach at a distance) training programme at the request of the Ministry of Education. This programme was created in four months and includes four microprograms (support, dissemination, adaptation and evaluation) for the different levels of education (preschool-primary/secondary/college-university). The modules were made available online as soon as each one was created and they were a great success, with more than 300,000 people consulting the training worldwide (connections from 191 countries). Although the majority (79%) of participants were in Canada, the reach of this training is a reminder of the extent of the need for assistance in the transition to distance learning. It is also interesting to note that among the students registered for a certificate, the microprogram on support was the most widely taken. In fact, as highlighted by the difficulties in interaction and the isolation experienced by distance education students during the lockdown, support remains the main challenge and the keystone of distance education

Architecture et bibliothèque

En 2012, l’enssib a saisi l’opportunité de ses vingt ans pour publier dans ses Presses un ouvrage hors collection : "Architecture et bibliothèque, 20 ans de constructions", lequel proposait un tour d’horizon des questions posées par la place du bâtiment dans nos problématiques professionnelles. C’est à partir de points de vue parfois divergents, souvent complémentaires, des architectes, conservateurs de bibliothèques, élus, journaliste et programmiste, que s’ouvrait la réflexion. Dans le prolongement de cet ouvrage, et parce que la question est loin d’être épuisée, la journée « Architecture et bibliothèque » a fait entendre la parole d’architectes bâtisseurs de bibliothèques. Comment penser et bâtir ensemble la bibliothèque de demain, tel fut le fil rouge de cette journée. Afin de mieux comprendre les spécificités de la construction d’établissements publics et plus particulièrement des bibliothèques comparativement aux autres lieux de culture. Afin de s’interroger sur le statut emblématique ou non de la bibliothèque du futur, dans un univers culturel qui tend à devenir immatériel. Afin de se situer dans la cité, tant symboliquement, démocratiquement que du point de vue de l’urbanisme. Afin de repenser la place de l’usager, du lecteur, et sans doute aussi du professionnel au sein de la bibliothèque en construction. Pour toutes ces raisons, la question de l’architecture se place au coeur du métier de bibliothécaire

Mucolipidosis II : a single causal mutation in the N-acetylglucosamine-1-phosphotransferase gene (GNPTAB) in a French Canadian founder population

Mucolipidosis (ML) II (I-cell disease) is a lysosomal storage disorder caused by a deficiency of UDP-N-acetylglucosamine:lysosomal enzyme N-acetylglucosamine-1-phosphotransferase. MLII is an autosomal recessive disease with a carrier rate estimated at 1/39 in Saguenay-Lac-Saint-Jean (SLSJ) (Quebec, Canada), which is the highest frequency documented worldwide. To identify the causing mutation, we sequenced GNPTAB exons in 27 parents of 16 MLII-deceased children from the SLSJ region as obligatory and potential carriers. We also performed a genealogical reconstruction for each parent to evaluate consanguinity levels and genetic contribution of ancestors. Our goal was to identify which parameters could explain the high MLII frequency observed in the SLSJ population. A single mutation (c.3503_3504delTC) was found in all obligatory carriers. In addition, 11 apparent polymorphisms were identified. The mutation was not detected in genomic DNA of 50 unrelated controls. Genealogical data show six founders (three couples) with a higher probability of having introduced the mutation in the population. The frequency of the mutation was increased as a consequence of this founder effect and of the resulting population structure. We suggest that c.3503_3504delTC is the allele causing MLII in the SLSJ population, and its high carrier rate is most likely explained by a founder effect

Molecular and genealogical characterization of the R1443X BRCA1 mutation in high-risk French-Canadian breast/ovarian cancer families

The Quebec population contains about six-million French Canadians, descended from the French settlers who colonized “Nouvelle-France” between 1608 and 1765. Although the relative genetic contribution of each of these founders is highly variable, altogether they account for the major part of the contemporary French-Canadian gene pool. This study was designed to analyze the role of this founder effect in the introduction and diffusion of the BRCA1 recurrent R1443X mutant allele. A highly conserved haplotype, observed in 18 French-Canadian families and generated using 17 microsatellite markers surrounding the BRCA1 locus, supports the fact that the R1443X mutation is a founder mutation in the Quebec population. We also performed haplotyping analysis of R1443X carriers on 19 other families from seven different nationalities; although the same alleles are shared for three markers surrounding the BRCA1 gene, distinct haplotypes were obtained in four families, suggesting multiple origins for the R1443X mutation. Ascending genealogies of the 18 French Canadian families and of controls were reconstructed on an average depth of 10 generations. We identified the founder couple with the highest probability of having introduced the mutation in the population. Based on the descending genealogy of this couple, we detected the presence of geographical concentration in the diffusion pattern of the mutation. This study demonstrates how molecular genetics and demogenetic analyses can complement each other to provide findings that could have an impact on public health. Moreover, this approach is certainly not unique to breast cancer genetics and could be used to understand other complex traits

Partnering in oncogenetic research – the INHERIT BRCAs experience : opportunities and challenges

Today it is common to conduct research in collaboration with colleagues from different disciplines and institutions. The INterdisciplinary HEalth Research International Team on BReast CAncer susceptibility (INHERIT BRCAs), involves Canadian and international experts from diverse fields working with health service providers, patients and collaborators from the World Health Organization and other European networks. Evidence-based information and knowledge transfer drive our efforts to advance genomic research to understand the genetic basis of cancer susceptibility and treatment response. Several goals reveal the interdisciplinary team approach: (a) to estimate the prevalence and penetrance of BRCA1 and BRCA2 mutations and their deleterious impact upon different populations; (b) to pinpoint novel breast cancer susceptibility loci; (c) to assess the efficacy of clinical interventions; (d) to address changes in quality of life and health-related behaviour from the decision to undergo genetics testing and during follow-up; (e) to evaluate legal, social and ethical implications; and, finally; (f) to promote professional and public education by facilitating the transfer of research findings to clinical practice and informing policy makers. The lessons learned by the INHERIT research team and future challenges are presented

La colonisation agricole au Viêt Nam : contribution à l’étude de la construction d’un État moderne, du bouleversement à l’intégration des Plateaux centraux

L’ouvrage recensé présente les fondements et les manifestations de la colonisation agricole au Viêt Nam en tant qu’un des éléments du processus de déforestation qui a contribué à la conversion des territoires forestiers vers un autre usage. L’expansion des terres cultivées aux dépens des forêts constitue un phénomène qui a affecté, à divers degrés, toutes les grandes régions du monde au cours de l’histoire. Depuis quelques décennies, l’Asie du Sud-Est connaît des transformations territoriales..