L'erreur en médecine ambulatoire: comment l'aborder. [Error in ambulatory medicine: how to deal with it?]

Medical errors compromise patient safety in ambulatory practice. These errors must be faced in a framework that reduces to a minimum their consequences for the patients. This approach relies on the implementation of a new culture without stigmatization and where errors are disclosed to the patients; this culture implies the build up of a system for reporting errors associated to an in-depth analysis of the system, looking for root causes and insufficient barriers with the aim to fix them. A useful education tool is the "critical situations" meeting during which physicians are encouraged to openly present adverse events and "near misses". Their analysis, with supportive attitude towards involved staff members, allows to reveal systems failures within the institution or the private practice.

Defining substance use disorders: do we really need more than heavy use?

AIMS: The aim of the study was to explore whether the concept of heavy substance use over time can be used as definition of substance use disorder. METHODS: Narrative review. RESULTS: Heavy use over time clearly underlies the neurobiological changes associated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuum of use may avoid the high level of stigmatization currently associated with substance use disorders. CONCLUSION: 'Heavy substance use over time' seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.

Le stigmate de la "folie": de la fatalité au rétablissement [Stigma of "madness" from fate to recovery].

Stigma is a "natural" social reaction, partly unconscious and automatic towards "different" and "vulnerable" populations. Suspicion of danger, unemployment, excluded from society, locked in hospital, assaulted or killed are the possible consequences of mental disorders' stigma. Despite advances in psychiatric treatments, the stigma of the "madness" remains a barrier to access to recovery. The stigmatization process is more complex than simple labeling, and leads to discrimination and loss of social power. Understanding the mechanisms of stigmatization can determine targets for effective interventions to fight stigma at the individual, institutional and political levels. The roles of patient and family associations, as well as the recovery model for the professionals, are essential. The aim of this article is to review the various aspects of mental disorders' stigma and to examine ways to cope with them.

Santé en milieu pénitentiaire: vulnérabilité partagée entre détenus et professionnels de la santé [Health in prison: shared vulnerability between detainees and health professionals]

In prison, the health professional has to take the sanitary needs of a temporary of chronically vulnerable population. His practice has to meet laws and recommendations, as well as the field reality and its numerous constraints. This puts him in a "shared vulnerability and stigmatization". He attempts to maintain or restore a health status in a deteriorating environment, at least psychologically. He is in the penitentiary world's eye which he depends upon in many ways to achieve his mandate. His activity is scarcely known and recognised by his peers from whom he can be very out of touch. To ensure a humanistic, efficient and equivalent-of-care practice, the health professional must rely on sound knowledge of general healthcare, ethics, deontology and medical laws. Basic and continuous training is a mainspring, like networking and development of federal recommendations.

Mesurer la stigmatisation perçue chez les personnes souffrant de troubles psychiques : traduction française, validation et adaptation de la Stigma Scale [French translation, validation and adaptation of the Stigma Scale].

AIM: People suffering from mental illness are exposed to stigma. However, only few tools are available to assess stigmatization as perceived from the patient's perspective. The aim of this study is to adapt and validate a French version of the Stigma Scale (King et al., 2007 [8]). This self-report questionnaire has a three-factor structure: discrimination, disclosure and positive aspects of mental illness. Discrimination subscale refers to perceived negative reactions of others. Disclosure subscale refers mainly to managing disclosure to avoid discrimination and finally positive aspects subscale taps into how patients are becoming more accepting, more understanding toward their illness. METHOD: In the first step, internal consistency, convergent validity and test-retest reliability of the French adaptation of the 28-item scale were assessed in a sample of 183 patients. Results of confirmatory factor analyses (CFA) did not confirm the hypothesized structure. In the light of the failed attempts to validate the original version, an alternative 9-item short-form version of the Stigma Scale, maintaining the integrity of the original model, was developed based on results of exploratory factor analyses in the first sample and cross-validated in a new sample of 234 patients. RESULTS: Results of CFA did not confirm that the data fitted well to the three-factor model of the 28-item Stigma Scale (χ(2)/df=2.02, GFI=0.77, AGFI=0.73, RMSEA=0.07, CFI=0.77 and NNFI=0.75). Cronbach's α was excellent for discrimination (0.84) and disclosure (0.83) subscales but poor for potential positive aspects (0.46). External validity was satisfactory. Overall Stigma Scale total score was negatively correlated with the score on Rosenberg's Self-Esteem Scale (r=-0.49), and each subscale was significantly correlated with a visual analogue scale that referred to the specific aspect of stigma (0.43≤|r|≤0.60). Intraclass correlation coefficients between 0.68 and 0.89 indicated good test-retest reliability. The results of the CFA demonstrated that the items chosen for the short version of the Stigma Scale have the expected fit properties (χ(2)/df=1.02, GFI=0.98, AGFI=0.98, RMSEA=0.01, CFI=1.0 and NNFI=1.0). Considering the small number (three) of items in each subscale of the short version of the Stigma Scale, α coefficients for discrimination (0.57), disclosure (0.80) and potential positive aspects subscales (0.62) are considered as good. CONCLUSION: Our results suggest that the 9-item French short version of the Stigma Scale is a useful, reliable and valid self-report questionnaire to assess perceived stigmatization in people suffering from mental illness. The time of completion is really short and questions are well understood and accepted by the patients.

La imagen corporal en la sociedad del siglo XXI

La imagen corporal (IC) representa la forma en la que un individuo se percibe, imagina, siente y actúa respecto a su propio cuerpo. Es un concepto dinámico que puede modificarse a lo largo de la vida. La percepción de nuestro propio cuerpo está influida por factores socioculturales. Desde el punto de vista histórico, el concepto de belleza se ha modificado sustancialmente. En la prehistoria, la belleza se asociaba a la reproducción de la especie, mientras que en la actualidad, se asocia al éxito personal, profesional y social. El estereotipo de belleza femenino de las sociedades contemporáneas se basa en la extrema delgadez y el masculino en cuerpos musculados. La lucha por alcanzar el canon de belleza impuesto por la sociedad ha contribuido a la aparición de diferentes trastornos de la imagen corporal (TIC). Los medios de comunicación son un factor importante en el desarrollo de determinados procesos patológicos, en la insatisfacción con la propia IC y en la estigmatización del individuo. Se consideran los principales impulsores de los patrones estéticos, siendo las mujeres y los adolescentes los más vulnerables. Las diferentes investigaciones indican que los TIC son frecuentes siendo los trastornos de la conducta alimentaria (TCA) los que suponen un mayor número de ingresos y reingresos entre la población femenina. Aunque los TCA afectan principalmente a la población adolescente, los estudios muestran que puede aparecer en la edad adulta e incluso en la infancia. En el sexo masculino, el trastorno dismórfico corporal (TDC) parece ser el más prevalente. La prevención y el tratamiento de este tipo de trastornos es primordial. En este sentido, enfermería tiene un papel fundamental debido al frecuente contacto que mantiene con el paciente. Debido a la importancia concedida en la sociedad actual a la apariencia física y las posibles repercusiones que ello conlleva, el presente trabajo pretende realizar una revisión de la literatura con el objetivo de analizar el valor y la exigencia que otorga la sociedad a la IC. Palabras clave: imagen corporal, desórdenes mentales, estigma social, medios de comunicación, epidemiología, cuidados de enfermería, proceso de atención de enfermería.

The Child Protection System from the Perspective of Young People: Messages from 3 Studies

This article reports findings and reflections based on the results of three different research projects conducted between 2008 and 2013 and focusing on the perspective of young care leavers in Spain. The overall aim was to examine these young people’s perceptions and evaluations of how they were treated while in the public care system, mainly residential care. Reviewing these qualitative studies, the most common and relevant issues highlighted by young people were related to the following themes: (a) entering care; (b) stability and emotional bonds in care; (c) education; (d) friends; (e) labelling, stigmatization, rights and opportunities; (f) autonomy and responsibility versus overprotection; (g) contact with parents, siblings and extended family; (h) maltreatment in care; and (i) leaving care. One of the main elements used in their assessments was comparison (i) between their previous situation within their birth family and the quality of care experienced in the residential home; and (ii) between what these young people commonly refer to as “normal children” and children in care. Recommendations deriving from their advice and opinions are also debated

Nuorisorikollisuuden esiintyvyys, taustatekijät ja sovittelu

Tausta Vaikka nuorisorikollisuus on kriminologisen tutkimuksen perinteinen kohde, on edelleen tarvetta pitkittäistutkimuksille, joissa on laaja, koko väestöä edustava otos. Kriminaalipolitiikan alalla puolestaan rikosten sovittelu ja muut restoratiivisen oikeuden muodot ovat nousseet Suomessakin haastamaan perinteiset rikoskontrollin paradigmat, rangaistuksen ja hoidon. Tutkimuskysymykset Tutkimuksen pääkysymyksenä oli, mitkä lapsuudessa (8 v.) ja nuoruudessa (18 v.) mitatut psykososiaaliset tekijät ovat yhteydessä nuorisorikollisuuden (16-20 v.) määrään ja lajiin. Lisäksi yhtenä kysymyksenä oli, miten varusmiespalvelun aikaiset psykiatriset diagnoosit liittyvät nuorisorikollisuuteen. Lisäksi tutkimme nuorisorikollisuuden esiintyvyyttä ja palvelujen käyttöä, ja vertailimme eri informanttien (tutkimushenkilöt itse, vanhemmat ja opettajat) vastausten ennusvoimaa lasten tulevan rikollisuuden suhteen. Rikosten sovittelun osalta kysymyksenä oli, miten suomalainen sovittelukäytäntö vastaa restoratiivisen oikeuden teoriaa ja miten sovittelua pitäisi kehittää. Aineisto ja metodit Pitkittäistutkimuksemme aineistona oli valtakunnallisesti edustava satunnaisotos, joka vastasi 10% vuonna 1981 Suomessa syntyneistä suomenkielisistä pojista. Ensimmäinen tiedonkeruu tapahtui 1989, kun pojat olivat 8-vuotiaita. Tietoa kerättiin lomakekyselyin pojilta itseltään sekä heidän vanhemmiltaan ja opettajiltaan. Tietoja saatiin 2946 pojasta. Lasten lomakkeena oli Children’s Depression Inventory, vanhemman lomakkeena Rutter A2 ja opettajan lomakkeena Rutter B2. Toinen tiedonkeruu järjestettiin, kun pojat osallistuivat kutsuntoihin 1999. Tietoja saatiin 2330 pojasta. Lomakkeena oli Young Adult Self-Report . Puolustusvoimien rekisteristä saatiin tiedot poikien kutsunnoissa ja palvelusaikana (vuosina 1999-04) saamista psykiatrisista diagnooseista, jotka luokiteltiin kuuteen luokkaan: antisosiaalinen persoonallisuushäiriö, päihdehäiriöt, psykoottiset häiriöt, ahdistuneisuushäiriöt, masennustilat ja sopeutumishäiriöt. Tieto mahdollisesta diagnoosista saatiin 2712 pojasta. Rikollisuus operationalisoitiin poliisin ns. RIKI-rekisteriin vuosina 1998-2001 rekisteröityjen tekojen avulla, kun pojat olivat pääasiassa 16-20-vuotiaita. Rikosten määrän mukaan pojat jaettiin neljään ryhmään: ei rikoksia, 1-2 rikosta (satunnainen rikollisuus), 3-5 rikosta (uusintarikollisuus) ja yli 5 rikosta (aktiivinen uusintarikollisuus). Rikoslajeista muodostettiin viisi kategoriaa: huume-, väkivalta-, omaisuus-, liikenne- ja rattijuopumusrikollisuus. Analyysivaiheessa rekisteridatasta poistettiin liikennerikkomukset. Kaikkiaan tiedot mahdollisista poliisikontakteista saatiin 2866 pojasta. Sovitteludata koostui 16 sovittelujutun havainnoinnista Turussa vuosina 2001- 2003. Tulokset Kaikkiaan 23% pojista oli rekisteröity rikoksesta (poissulkien liikennerikkomukset) nelivuotisen tutkimusperiodin aikana 16-20-vuotiaana. Satunnaisia rikoksentekijöitä oli 15%, uusijoita 4% ja moninkertaisia uusijoita 4%. Rikokset kasautuivat moninkertaisille uusijoille: tämä 4%:n ryhmä teki 72% kaikista rikoksista . Omaisuus- ja liikennerikollisia oli eniten (kumpiakin 11%), ja huumerikollisia vähiten (4%). Kaikki rikoslajit korreloivat keskenään tilastollisesti merkitsevästi. Nuorisorikollisuuden itsenäisiä ennustekijöitä lapsuudessa olivat rikkinäinen perherakenne, vanhempien alhainen koulutustaso, lapsen käytösongelmat ja hyperaktiivisuus. Kun verrattiin eri informantteja (lapset itse ja heidän vanhempansa ja opettajansa), etenkin opettajien vastaukset ennustivat lasten tulevaa rikollisuutta. Nuoruudessa rikollisuuden itsenäisiä korrelaatteja olivat pienellä paikkakunnalla asuminen, vanhempien ero, seurustelu, itse ilmoitettu antisosiaalisuus ja säännöllinen tupakointi ja humalajuominen. Ennus- ja taustatekijöille oli tyypillistä se, että ne olivat lineaarisessa yhteydessä rikosten määrään (ongelmat ja rikosten määrä lisääntyivät käsi kädessä) ja että ne liittyivät useaan rikoslajiin yhtä aikaa. Huumerikollisuudella oli kuitenkin vähemmän itsenäisiä ennus- ja taustatekijöitä kuin muilla rikoslajeilla. Joka kymmenes poika kärsi psykiatrisista häiriöistä. Tämä ryhmä teki noin puolet kaikista rikoksista, ja lähes joka toinen poika, jolla oli psykiatrinen häiriö, oli rekisteröity rikoksista. Rikolliseen käytökseen liittyivät etenkin antisosiaalinen persoonallisuushäiriö ja päihdehäiriöt. Masennustilat olivat kuitenkin ainoa diagnoosiryhmä, joka ei ollut yhteydessä rikollisuuteen. Myös psykiatristen häiriöiden esiintyvyys kasvoi lineaarisesti rikosten määrän kanssa; aktiivisista uusintarikollisista yli puolella (59%) oli psykiatrinen diagnoosi. Rikollisuuden lisäksi erilaiset psykososiaaliset ongelmat kasautuivat pienelle vähemmistölle. Aktiivisten uusijoiden ryhmään olivat tilastollisesti merkitsevästi yhteydessä lähes kaikki ongelmat mitä tutkimme. Kuitenkin tästä ryhmästä vain alle 3% oli käyttänyt mielenterveyspalveluja viimeisen vuoden aikana. Rikossovittelun havainnointitutkimuksen perusteella sovittelussa monet perusasiat ovat kunnossa, ja toiminta on mielekästä niin asianosaisten kuin yhteiskunnankin kannalta. Useimmiten osapuolet kohtasivat ja saivat aikaan sopimuksen, johon he vaikuttivat tyytyväisiltä. Rikoksentekijät olivat motivoituneita korvaamaan aiheuttamansa vahingot. Osapuolet saivat kertoa tarinansa omin sanoin, heitä kuunneltiin ja he ymmärsivät mitä sovittelussa puhutaan ja sovitaan. Sovittelun kuluessa jännitys väheni ja asiat saatiin loppuunkäsiteltyä. Asianosaiset saivat vaikuttaa prosessiin ja sopimukseen, ja uhrin oikeudet olivat sovittelussa keskeisellä sijalla. Restoratiivisen teorian perusteella sovittelussa havaittiin myös kehittämisen varaa: Etenkin nuoria rikoksentekijöitä oli hankala saada osallistumaan tosissaan, ja aikuiset helposti hallitsivat keskustelua. Etukäteistapaamisia ja tukihenkilöitä ei juuri hyödynnetty. Sovitteluja hallitsi puhe sopimuksesta ja rahasta. Työkorvauksia ei käytetty eikä rehabilitaatiota käsitelty. Sekä sovitteluun pääsy että sovittelumenettely riippuivat yksittäisistä henkilöistä. Johtopäätökset Rikosten tekeminen nuoruudessa on melko yleistä ja monimuotoista. Rikokset ja psykososiaaliset ongelmat kasautuvat pienelle ryhmälle ja kulkevat käsi kädessä. Myös psykiatriset häiriöt ovat lineaarisessa yhteydessä rikosten määrään. Rikosriskiä voidaan ennustaa jo lapsuudessa, ja etenkin opettajat ovat tarkkanäköisiä lasten ongelmien suhteen. Eri rikoslajeilla on varsin samanlaisia taustatekijöitä. Aktiiviset rikoksentekijät vastaavat suuresta osasta kokonaisrikollisuutta, tarvitsevat eniten apua, mutta eivät kuitenkaan hakeudu psykososiaalisten palvelujen piiriin. Rikosten sovittelu tarjoaa keinon puuttua ongelmiin varhaisessa vaiheessa ilman leimaamista. Sovittelun kehitystehtävät liittyvät etenkin dialogiin, valmisteluihin, tukihenkilöihin, työkorvauksiin, palveluunohjaukseen ja sovittelun sovellusalaan. Sovittelua ja muita restoratiivisia menettelyjä on kehitettävä ja laajennettava esimerkiksi niin, että niitä voitaisiin käyttää palveluunohjauksen välineenä.

Conceptions of mathematics teacher education : thoughts among teacher educators in Tanzania

This study addresses the question of teacher educators’ conceptions of mathematics teacher education (MTE) in teacher colleges in Tanzania, and their thoughts on how to further develop it. The tension between exponents of content as opposed to pedagogy has continued to cause challenging conceptual differences, which also influences what teacher educators conceive as desirable in the development of this domain. This tension is connected to the dissatisfaction of parents and teachers with the failure of school mathematics. From this point of view, the overall aim was to identify and describe teacher educators’ various conceptions of MTE. Inspired by the debate among teacher educators about what the balance should be between subject matter and pedagogical knowledge, it was important to look at the theoretical faces of MTE. The theoretical background involved the review of what is visible in MTE, what is yet to be known and the challenges within the practice. This task revealed meanings, perspectives in MTE, professional development and assessment. To do this, two questions were asked, to which no clear solutions satisfactorily existed. The questions to guide the investigation were, firstly, what are teacher educators’ conceptions of MTE, and secondly, what are teacher educators’ thoughts on the development of MTE? The two questions led to the choice of phenomenography as the methodological approach. Against the guiding questions, 27 mathematics teacher educators were interviewed in relation to the first question, while 32 responded to an open-ended questionnaire regarding question two. The interview statements as well as the questionnaire responses were coded and analysed (classified). The process of classification generated patterns of qualitatively different ways of seeing MTE. The results indicate that MTE is conceived as a process of learning through investigation, fostering inspiration, an approach to learning with an emphasis on problem solving, and a focus on pedagogical knowledge and skills in the process of teaching and learning. In addition, the teaching and learning of mathematics is seen as subject didactics with a focus on subject matter and as an organized integration of subject matter, pedagogical knowledge and some school practice; and also as academic content knowledge in which assessment is inherent. The respondents also saw the need to build learner-educator relationships. Finally, they emphasized taking advantage of teacher educators’ neighbourhood learning groups, networking and collaboration as sustainable knowledge and skills sharing strategies in professional development. Regarding desirable development, teacher educators’ thoughts emphasised enhancing pedagogical knowledge and subject matter, and to be determined by them as opposed to conventional top-down seminars and workshops. This study has revealed various conceptions and thoughts about MTE based on teacher educators´ diverse history of professional development in mathematics. It has been reasonably substantiated that some teacher educators teach school mathematics in the name of MTE, hardly distinguishing between the role and purpose of the two in developing a mathematics teacher. What teacher educators conceive as MTE and what they do regarding the education of teachers of mathematics revealed variations in terms of seeing the phenomenon of interest. Within limits, desirable thoughts shed light on solutions to phobias, and in the same way low self-esteem and stigmatization call for the building of teacher educator-student teacher relationships.

Let Go and Remember. How Finnish Communities Experienced and Memorialized School Shootings

This study examines the aftermath of mass violence in local communities. Two rampage school shootings that occurred in Finland are analyzed and compared to examine the ways in which communities experience, make sense of, and recover from sudden acts of mass violence. The studied cases took place at Jokela High School, in southern Finland, and at a polytechnic university in Kauhajoki, in western Finland, in 2007 and 2008 respectively. Including the perpetrators, 20 people lost their lives in these shootings. These incidents are part of the global school shooting phenomenon with increasing numbers of incidents occurring in the last two decades, mostly in North America and Europe. The dynamic of solidarity and conflict is one of the main themes of this study. It builds upon previous research on mass violence and disasters which suggests that solidarity increases after a crisis, and that this increase is often followed by conflict in the affected communities. This dissertation also draws from theoretical discussions on remembering, narrating, and commemorating traumatic incidents, as well as the idea of a cultural trauma process in which the origins and consequences of traumas are negotiated alongside collective identities. Memorialization practices and narratives about what happened are vital parts of the social memory of crises and disasters, and their inclusive and exclusive characteristics are discussed in this study. The data include two types of qualitative interviews; focused interviews with 11 crisis workers, and focused, narrative interviews with 21 residents of Jokela and 22 residents of Kauhajoki. A quantitative mail survey of the Jokela population (N=330) provided data used in one of the research articles. The results indicate that both communities experienced a process of simultaneous solidarity and conflict after the shootings. In Jokela, the community was constructed as a victim, and public expressions of solidarity and memorialization were promoted as part of the recovery process. In Kauhajoki, the community was portrayed as an incidental site of mass violence, and public expressions of solidarity by distant witnesses were labeled as unnecessary and often criticized. However, after the shooting, the community was somewhat united in its desire to avoid victimization and a prolonged liminal period. This can be understood as a more modest and invisible process of “silent solidarity”. The processes of enforced solidarity were partly made possible by exclusion. In some accounts, the family of the perpetrator in Jokela was excluded from the community. In Kauhajoki, the whole incident was externalized. In both communities, this exclusion included associating the shooting events, certain places, and certain individuals with the concept of evil, which helped to understand and explain the inconceivable incidents. Differences concerning appropriate emotional orientations, memorialization practices and the pace of the recovery created conflict in both communities. In Jokela, attitudes towards the perpetrator and his family were also a source of friction. Traditional gender roles regarding the expression of emotions remained fairly stable after the school shootings, but in an exceptional situation, conflicting interpretations arose concerning how men and women should express emotion. The results from the Jokela community also suggest that while increased solidarity was seen as important part of the recovery process, some negative effects such as collective guilt, group divisions, and stigmatization also emerged. Based on the results, two simultaneous strategies that took place after mass violence were identified; one was a process of fast-paced normalization, and the other was that of memorialization. Both strategies are ways to restore the feeling of security shattered by violent incidents. The Jokela community emphasized remembering while the Kauhajoki community turned more to the normalization strategy. Both strategies have positive and negative consequences. It is important to note that the tendency to memorialize is not the only way of expressing solidarity, as fast normalization includes its own kind of solidarity and helps prevent the negative consequences of intense solidarity.

Disabled legislators : disability and Irish colonial pathology in James Joyce's Ulysses

Why are there so many disabled characters in James Joyce's Ulysses? "Disabled Legislators" seeks to answer this question by exploring the variety and depth of disability's presence in Joyce's novel. This consideration also recognizes the unique place disability finds within what Lennard Davis calls "the roster of the disenfranchised" in order to define Joyce as possessing a "disability consciousness;" that is, an empathetic understanding (given his own eye troubles) of the damaged lives of the disabled, the stigmatization of the disabled condition, and the appropriation of disabled representations by literary works reinforcing normalcy. The analysis of four characters (Gerty MacDowell, the blind stripling, the onelegged sailor, and Stephen Dedalus) treats disability as a singular self-concept, while still making necessary associations to comparably created marginal identities-predominantly the colonial Other. This effort reevaluates how Ulysses operates in opposition to liberal Victorian paradigms, highlighting disability's connections to issues of gender, intolerance, self-identification and definition.

A black-focused school : black Canadian youth and the mainstream curriculum

ABSTRACT When asked about the proposal for a black-focused school, black youth from the Greater Toronto Area (GTA) voiced their agreement with elements of the proposal, but resisted the idea of implementing the proposal by creating a separate school. Although media representations and Dei (1996, 2006) provide insight into what Torontonians' reactions are to the proposed blackfocused school there has been no such information documented on what black youth in the GTA think about the project. This is the first known study that attempts to fill that gap by providing a representation of black youths' voices obtained via focus groups. The study examines what black youth know and think about the proposal, and why they largely disagree with the blackfocused school proposal. While the findings of this study indicate that the participants saw many positive elements of the proposal, they did not support the implementation of a black-focused school as they saw the creation of a separate space for the school as a negative thing. The youth had trouble conceptualizing 'black-focused schooling' as an alternative approach to mainstream education, which had an impact on whether they choose to, or could, respond to questions that precisely related to the black-focused school project. The study concludes that the youth could not visualize what the school would look like and how it would operate because they draw on liberal racist discourses (e.g. colour-blindness, blaming the victim, and equal opportunity) when thinking about their educational experiences; however, there was a clear contradiction in the way the youths' voices reflected an awareness of the role of race in education experiences. It was evident when they talked about fear of stigmatization, but when using liberal discourses the youth discounted the role of race, and seemed not to be aware of its role in educational experiences. These findings pose important implications for educators, would-be educators, administrators, the TDSB and proponents of the black-focused school.

Mental Health and Becoming a Teacher: A Narrative on the Experiences and Identities of Teacher Candidates

This study used narrative inquiry to shed light on the identity development of teacher candidates who experienced mental health issues during teacher education programs. The study sought to examine (a) stories that teacher candidates tell about being in a teacher education program while experiencing mental health issues; (b) identity development of teachers who have experienced mental health issues; and (c) how narratives of teacher candidates and beginning teachers challenge stereotyping and stigmatization. Through discussion and letter correspondence, the participants and I shared stories that represented our lived experiences. The study explored our stories using the 3 commonplaces of temporality, sociality, and place from a theoretical framework of narrative inquiry. Four themes emerged from the data analysis: the stigmatization of mental health issues; dealing with conflict; the need for a safe and supportive environment; and the complexity of mental health issues. This study contributes to the literature by exploring the lived experiences of teacher candidates and beginning teachers with mental health issues. The narratives inform teacher education programs, the teaching profession, and the mental health field.

La stigmatisation des aidants familiaux de personnes atteintes par la maladie d’Alzheimer

Le vieillissement de la population entraîne une hausse des maladies chroniques telle que la maladie d’Alzheimer dans nos sociétés occidentales. L’enjeu du vieillissement se répercute aussi dans les réformes de nos politiques sociales, et plus généralement dans la gestion des services publics. Dans ce contexte, le régime de santé publique québécois connaît diverses modifications concernant la prestation de soins de première ligne. De nouveaux acteurs acquièrent des rôles et des responsabilités définissant des enjeux particuliers. Nous étudierons l’un de ces enjeux. Ce mémoire vise à spécifier les processus sociaux à la base de l’isolement des aidants familiaux de personnes atteintes par la maladie d’Alzheimer. La stigmatisation des aidants et les microprocessus afférents sont les principaux mécanismes analysés. Les données sont extraites d’entrevues semi-structurées réalisées avec une cohorte d’aidants familiaux (N=60) suivie longitudinalement depuis le début de leur trajectoire de soins. Une démarche qualitative soutient ce projet. Nous avons analysé un échantillon de douze participants au moyen d’une approche séquentielle. Trois processus typiques ont été identifiés : le stigma de forme en ruptures (séparation sociale), le stigma de forme transitoire (stigma transitoire) et le stigma de forme anomique (anomie sociale). Les résultats suggèrent que les réseaux sociaux des aidants sont soumis à un ensemble de conditions favorisant la structuration du stigma social, la principale condition étant un enjeu de pouvoir concernant le contrôle de la personne malade. Les aidants conjoints de personnes atteintes sont plus enclins à la stigmatisation en début de trajectoire.

L’identification et l’impact de différents types de réseaux sociaux dans les trajectoires de vie de personnes assistées sociales

Ce mémoire traite du rôle des réseaux sociaux dans les trajectoires de vie des personnes qui vivent de l’aide sociale au Québec. La discrimination et la stigmatisation sont des processus émanant de rapports sociaux dans lesquels peuvent être inscrites ces personnes du fait de leurs conditions de vie précaires. L’analyse des réseaux sociaux pourrait nous permettre de découvrir certaines dynamiques, propres à ces rapports sociaux, en portant sur leur caractère qualitatif et temporel. Nous avons eu recours aux récits de vie afin d’identifier certains réseaux sociaux émergeant du discours et d’élaborer un modèle d’analyse qualitative des réseaux sociaux dans une perspective de trajectoire de vie. Cette étape a permis de percevoir l’existence d’un lien entre certains événements importants du récit et les transformations des relations. Nous avons également relevé dans le discours des indicateurs de la qualité des contacts selon leur contribution « positive », « négative » ou « neutre » dans la trajectoire. La comparaison des trajectoires des personnes sélectionnées a permis d’identifier des morphologies de réseaux similaires et de dresser une typologie. Les types ont pu être identifiés en fonction des trois catégories dominantes de contacts évoquées par les répondants : la famille, les connaissances, et les organismes. La mention de l’aide sociale, de contacts en psychiatrie ou même le passage sous silence par le répondant d’une de ces catégories a permis de nuancer la typologie et de recenser onze types de réseaux. Afin d’évaluer l’intérêt de ce modèle d’analyse, nous avons tenté une opérationnalisation exploratoire de la typologie.