Université du Québec en Outaouais

Suicidality frequently leads to emergency department (ED) visits, yet few interventions are offered in EDs to mitigate suicide risk. This study uses a descriptive interpretative design to evaluate the key components for a successful use of such an intervention, the Stanley-Brown safety plan, in EDs. Semi-structured interviews were conducted with patients and ED clinicians and were analyzed using a thematic analysis approach. Participants’ perspectives revealed 6 key recommendations for a successful use of the safety plan in EDs: (1) personalize the content of the safety plan, (2) offer a variety of formats, (3) avoid periods of high emotional intensity, (4) engage a broad range of professionals in safety planning, (5) use limited time to make meaningful interventions, (6) propose alternative interventions. A change in the ED culture is needed to ensure that the management of suicidal patients in EDs includes brief therapeutic interventions like safety planning, to mitigate suicide risk.

Despite several existing outpatient services, individuals with dual disorders make extensive use of the emergency department to try to meet their needs. The objectives of this study were to: (1) describe the outpatient services provided to individuals with dual disorders, and (2) compare these services according to the most frequent discharge diagnoses after leaving the emergency department. The frequent discharge diagnoses have been classified into five groups: suicide attempts, psychotic/agitation symptoms, anxiety/depressive symptoms, suicidal ideation, and substance intoxication or withdrawal symptoms. This retrospective cross-sectional descriptive study took place in four emergency department settings in Québec, Canada. Data from emergency department visits and referrals to outpatient services between May 2015 and April 2016 were collected from the medical records of 150 adults with dual disorders. Results showed a low proportion of referrals to primary care or specialized substance use outpatient services; mention of dual disorder in referrals was also rare. Only 19% of individuals received referrals for both mental health and substance use services, suggesting a potential under-recognition of dual disorders. The distribution of services and referrals differed among the five groups, with individuals presenting for suicide attempts and those expressing suicidal ideations accounting for the lowest and highest proportions, respectively.

This qualitative meta-synthesis was conducted with the aim to understand fathers’ experiences and involvement when their child has a chronic condition within family context. Family nurse researchers from five countries identified 19 studies through a systematic search. Inclusion criteria were: (a) fathers as primary informant; (b) children (<19 years) with a chronic condition; (c) written in English, Spanish, French, or Portuguese. Data were synthesized using thematic analysis. Four themes reflected fathers’ journey: “Juggling multiple roles” included protector, provider, and supporter; “Managing control” included relinquishing and regaining control; “Creating a new normal” addressed recovery; “Maintaining wellbeing” reflected multiple emotional responses and support found through partners, family, spirituality, and health care communities. Fathers desire to be involved in caring for their child with a chronic condition, yet involvement and experience are continually evolving due to various family needs. Health care providers should consider unconscious assumptions regarding fathers’ role in child care and encourage fathers’ involvement to facilitate family wellbeing.

In physics, we construct idealized mathematical models in order to explain various phenomena which we observe or create in our laboratories. In this article, I recall how sophisticated mathematical models evolved from the concept of a number created thousands of years ago, and I discuss some challenges and open questions in quantum foundations and in the Standard Model. We liberated nuclear energy, landed on the Moon and built ‘quantum computers’. Encouraged by these successes, many believe that when we reconcile general relativity with quantum theory we will have the correct theory of everything. Perhaps we should be much humbler. Our perceptions of reality are biased by our senses and by our brain, bending them to meet our priors and expectations. Our abstract mathematical models describe only in an approximate way different layers of physical reality. To describe the motion of a meteorite, we can use a concept of a material point, but the point-like approximation breaks completely when the meteorite hits the Earth. Similarly, thermodynamic, chemical, molecular, atomic, nuclear and elementary particle layers of physical reality are described using specific abstract mathematical models and approximations. In my opinion, the theory of everything does not exist.

Context Intensive agriculture increases crop yields, but harms biodiversity and associated ecosystem services such as pollination. To sustain wild-bee pollination in intensive agricultural landscapes, a minimum of (semi-) natural habitat is needed in the vicinity of crop fields. However, restoration of (semi-) natural habitat is a challenge, especially when most land is allocated to commodity production. Objectives To evaluate the restoration potential of marginal lands to enhance pollination in intensive agricultural landscapes. Methods We simulated restoration scenarios in marginal agricultural lands (abandoned and degraded fields, and field edges) in La Vallée-du-Richelieu (Quebec, Canada), aimed at enhancing pollination provision and increasing (semi-) natural habitat coverage by at least 20% within 1 km from crop fields, the estimated minimum amount required to sustain wild-bee populations. We then evaluated the extent to which restoration targets were reached in our scenarios. Results More than half of the agricultural region studied remained with less than 20% (semi-) natural area coverage, and wild-bee pollination provision could not be ensured across the whole agricultural region after restoration. However, our results show that there is still an important potential for increasing natural habitat coverage by restoring marginal agricultural lands alone. Conclusion Restoration of marginal lands has a key role to play in the transition towards multifunctionality of production landscapes but might not be sufficient to achieve goals such as those adopted at the COP15 (e.g., restoring 30% of degraded land). Our framework can assist landscape planners in evaluating the restoration potential of agricultural landscapes, as well as its limitations.

Polyamory is a relationship style that allows individuals to develop multiple romantic relationships simultaneously. Although studies show that many polyamorous people have children, very little is known about the experiences of children growing up in such a family context. Based on 18 semi-structured interviews with Canadian children living with polyamorous parents, we examined the level of emotional closeness they felt towards their parents’ romantic partners, and what these adults meant to them. We found that these children generally appreciated their parents’ partners. These adults were seen by our participants as someone who contributed positively to their lives. More specifically, the participating children —especially pre-teens and younger children— described their parents’ romantic partners as adults: 1) to have fun with, 2) who contributed to their material well-being, 3) who took care of them, and 4) who, through their own children, contributed to expanding their circle of friends. Finally, some children — mainly teenagers and pre-teens— talked about these adults primarily as people who contributed positively to their parents' lives. Overall, this study makes an important contribution to the literature on family diversity.

Background Time-driven activity-based costing (TDABC) and activity-based costing (ABC) are methods used in the healthcare sector to assess the costs of patient care pathways. These methods help identify opportunities for optimizing and reducing activity times without compromising the quality of care. TDABC is recommended in the Value-Based Healthcare (VBHC) model to assess the outcomes of care pathways in relation to their associated costs. By focusing on the creation of value for patients, TDABC helps identify the interventions and processes that provide the most value in terms of clinical outcomes and patient satisfaction. This enables healthcare organizations to make informed decisions on improvements that will maximize value for patients. The aim of the study is to evaluate the cost of the oncology thoracic surgery care pathway prior to and following the implementation of digital health solution. Methods We have chosen to use the TDABC and ABC methods to calculate the costs of care pathway for oncology patients undergoing thoracic surgery in two healthcare establishments prior to and following the implementation of a digital health solution. By using these methods, we were able to calculate the costs associated with each stage of the patients’ care pathway. This has given us a clearer picture of the costs associated with each activity and a better understanding of the sources of expenditure. Results The results show that implementing the digital health solution and applying the principles of the VBHC model have provided tangible benefits in terms of reviewing processes and the roles of the various players involved, eliminating unnecessary or non-value-added activities, automating administrative or repetitive tasks, and improving coordination between the two healthcare establishments and between healthcare professionals. These improvements have contributed to better patient care. Conclusions Given the success observed in this pilot project, decision-makers chose to persistently implement this digital health solution for specific care pathways over the long term. Additionally, there is a commitment to further enhance the platform to align closely with the needs and the expectations of healthcare professionals. This proactive approach aims to ensure optimal utilization of resources, ultimately providing the best care to patients.

Bullying is associated with psychological, physical, academic, and interpersonal problems that can persist into emerging adulthood, a developmental phase marked by changes and exploration in academic, professional, and romantic domains. While weight is known to be a leading cause of bullying, no study has explored how weight-related bullying during adolescence and emerging adulthood might influence the life trajectories of emerging adults. This study examines the academic, professional, and romantic pathways of emerging adults based on the chronicity of the weight-related bullying they experienced. Using a longitudinal design, data was collected from 104 emerging adults aged 24 to 29. Four groups were compared: those who had never been bullied, those who had experienced weight-related bullying during one, two, or three periods (adolescence, early and/or late emerging adulthood). ANCOVA analyses and chi-squared tests were conducted to examine the differences between the four groups. Results show that despite objective pathways that are broadly comparable to those of their peers, chronic victims report lower academic, professional, and romantic satisfaction. This study highlights the importance of considering the chronicity of weight-related bullying when designing interventions to identify individuals in particular need of support and promote the positive development of emerging adults.

The concept of misleading information categorized as misinformation, disinformation, and mal-information among others is receiving much attention, as it is seen to have detrimental consequences on the organizations’ reputation and going concerns. Corporations face more challenges in honing responses to combat these cyber threats as there are still significant differences in the proposed governance solutions and a lack of empirical research investigating the most prevalent ones to fight these growing risks. Grounded on protection motivation theory, empirical evidence, and the data collected from the Statistics Canada Open Sources Database, this paper investigates the appropriateness of governance solutions that corporations contemplate in managing these cybersecurity risks. Our results show that governance solutions related to increasing online presence and customer outreach explained 52% of overall solutions contemplated by corporations to fight these cyber threats. The results also revealed that organizations ranked governance solutions associated with employee training, new increase cybersecurity measures, marketing campaigns, legal action, political advocacy, and reporting to external parties as the most adopted solutions to combat false or misleading information. Overall, our paper contributes to a growing disinformation, misinformation, and mal-information literature in business environments by providing empirical evidence on key governance solutions favored by corporations to combat misleading information.

Background Social anxiety disorder (SAD) is a long-term and overwhelming fear of social situations that can affect work, school, and other daily activities. Although cognitive behavioral therapy is effective, few seek treatment, and many who do start often drop out. This may be due to the component of exposure inherent to cognitive behavioral therapy, where the patient confronts feared stimuli outside the therapist’s office, which they otherwise try to avoid. As an alternative, research has explored the effectiveness of virtual reality (VR)–based exposure therapy with promising results. However, few studies have investigated the feasibility of VR tools using mixed methodologies before assessing their efficacy. Objective This study aims to assess the usability, feasibility, and presence of four 360° virtual environments and whether these were able to evoke anxiety in patients with SAD. Methods A total of 10 adult participants with SAD and 10 healthy controls were recruited for 1 experimental session (age range 21-32 y; 12/20, 60% male participants). Questionnaire and interview data were collected and analyzed. A mixed methods triangulation design was applied to analyze and compare the data. Results Participants with SAD experienced increased anxiety when exposed to VR, and environments were considered relevant and useful as an exposure tool. Participants with SAD reported significantly higher average anxiety levels (P=.01) and peak anxiety levels (P=.01) compared with controls during exposure; however, significant differences in anxiety when accounting for baseline anxiety levels were only found in 2 of 4 environments (P=.01, P=.01, P=.07, and P=.06). While presence scores were acceptable in both groups, participants with SAD scored significantly lower than controls. Qualitative analyses highlight this finding within the SAD group, where some participants experienced presence reduction due to being observed while in VR and in situations with reduced interaction in VR. Conclusions VR exposure with 360° videos seems to be useful as a first step of exposure therapy for patients with SAD. Future exploration in the clinical application of VR-based exposure for SAD, as well as means of increasing presence within the virtual environments, may be useful.

Résumé Comme tous les grands transporteurs aériens, l’entreprise Air Canada a été très durement frappée par la Grande récession survenue à l’échelle mondiale en 2008. Ses activités et ses revenus ont chuté dramatiquement et, outre des mises à pied et des licenciements collectifs, l’entreprise a cherché à limiter ses coûts de main-d’œuvre en réduisant les avantages des régimes de retraite en vigueur. La présente étude s’inscrit dans le cadre d’une vaste recherche sur la grande entreprise au Canada et le déclin de la citoyenneté au travail. Elle s’intéresse plus particulièrement à l’impact de la crise financière de 2008 sur la dynamique des relations de travail et l’évolution de la citoyenneté au travail chez Air Canada : nous entendons vérifier en particulier si nos hypothèses d’une médiation des interactions entre économie et droit par le politique, d’une part, par les relations industrielles (autonomie collective), d’autre part, se confirment ou non.

The aim of this study was to explore whether National Football League (NFL) coaches show variation in their decision-making on fourth down when traveling through time zones. Data from visiting teams in games from 20 seasons (2000–2020) of the NFL were retrieved from online sources (n = 5360 games). Decision-making was measured with the percentage of offensive plays on fourth down. A factorial ANCOVA was done to verify whether travel direction had an impact on fourth downs in evening games, while controlling for the seasons. A moderation analysis was computed to verify whether the time of game moderates the relationship between longitudinal distance traveled and decisions on fourth downs. Results showed that in evening games, coaches in teams traveling westward called more offensive plays on fourth down, compared to when they traveled in any other direction. Results from the moderation analysis showed that only in evening games, further westward longitudinal degrees traveled predict more fourth downs. For the first time, this study offers insight that circadian misalignment may not only affect player performance but also influence coaching decisions in professional sports. These results beg the question whether other aspects of coaching or staff decisions show circadian variations in professional sports.

Introduction As parental mental illness is a global public health concern, rigorous qualitative research is central to understanding families' experiences, needs and outcomes to inform optimal service provision in adult mental health and children's social services. Methods The current review identified, appraised and synthesized international qualitative research exploring Families and Parent Mental Illness (FaPMI) research to determine the focus, findings and outcomes and to summarize the recommendations made about the direction of future research. Findings are classified according to outcomes for children, parents, and families. Results While some children experienced positive outcomes from a parent's illness, most faced impacts on their social-emotional wellbeing, school performance, increased caregiving responsibilities, strained parent relationships, and lack of understanding about parental mental illness. Some family members endured abuse and struggled to adapt to an ill parent's unpredictable needs, with reluctance to discuss the situation. Parents found parenting challenging yet viewed having children as a protective factor. Future research should gather diverse perspectives, explore within-family factors and social environments, develop and test interventions, and address methodological issues like sampling. Discussion This review highlights the centrality of qualitative data in comprehensively understanding and evaluating outcomes of parental mental illness on families and provides clear recommendations regarding future research.

The aim of this chapter is to examine the potential effects of the minimum wage on three strands (jobs and incomes, poverty and inequality, and health and well-being) in the literature while focusing on recent studies to integrate the changes caused by Covid-19 in the wage structure. In general, the effects of the minimum wage can be seen as mixed with respect to employment. Some studies find negative results that can be considered small or modest. In addition, the use of certain methodologies may influence the results obtained. The decline in youth employment, as predicted by the economic theory, does not seem to be confirmed in the studies used. As for the impacts on poverty and inequality, they are not clear-cut. The minimum wage in some circumstances would be an inadequate tool for income redistribution, which does not target poor households. As for the effect on health and well-being, there is a growing consensus that minimum wage laws can influence employers’ decisions to offer health insurance and improve the self-reported health and well-being of individuals in general.

In this chapter, we aim to provide a comparative analysis of the different measures taken by selected OECD countries. In adopting the various policies put in place, the countries selected were keen to adopt concerted labour market policies. Policy coordination has been particularly important in countries such as France and Germany. Others, such as Canada and the United States, had to create new mechanisms to support jobs during the pandemic. However, most OECD countries were able to build on existing mechanisms to support job retention in the labour market. The results of these mechanisms and measures also point to differentiated effects on the labour market for different categories of workers. The data show that significant gaps are now appearing on the labour market to the detriment of less-educated workers. Vulnerable groups, such as young people and women, have also seen their situation on the labour market deteriorate considerably during the pandemic.