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The purpose of this study is to describe the underlying theory and the challenges involved in implementing an intervention to access health care services for migrants with precarious status (MPS) in Montreal. The description of the underlying theory of the intervention was based on a documentary analysis and a workshop with clinicians ( n = 9). The challenges were identified through concept mapping ( n = 28) and in-depth interviews ( n = 13). The results of the study indicated that the aims of the intervention were to provide access to health care to MPS primarily to avoid any further health status deterioration. The most significant challenges identified were sustainable funding resources and improved access to care and protection for MPS. The interviews indicated that MPS are difficult to reach out; public health care system rules are unclear; resource constraints make it difficult to provide adequate and continuing care; and advocacy activities are difficult to organize.

While access to healthcare for permanent residents in Canada is well known, this is not the case for migrants without healthcare coverage. This is the first large-scale study that examines the unmet healthcare needs of migrants without healthcare coverage in Montreal. 806 participants were recruited: 436 in the community and 370 at the NGO clinic. Proportions of individuals reporting unmet healthcare needs were similar (68.4% vs. 69.8%). The main reason invoked for these unmet needs was lacking money (80.6%). Situations of not working or studying, not having had enough food in the past 12 months, not having a medical prescription to get medication and having had a workplace injury were all significantly associated with higher odds of having unmet healthcare needs. Unmet healthcare needs were more frequent among migrants without healthcare coverage than among recent immigrants or the citizens with health healthcare coverage (69%, 26%, 16%). Canada must take measures to enable these individuals to have access to healthcare according to their needs in order to reduce the risk of worsening their health status, something that may have an impact on the healthcare system and population health. The Government of Quebec announced that all individuals without any healthcare coverage will have access to COVID-19 related health care. We hope that this right, the application of which is not yet obvious, can continue after the pandemic for all health care.

International audience; Atrazine, a pesticide belonging to the s‐triazine family, is one of the most employed pesticides. Due to its negative impact on the environment, it has been forbidden within the European Union since 2004 but remains abundant in soils. For these reasons, its behavior in soils and water at the atomic scale is of great interest. In this article, we have investigated, using DFT, the adsorption of atrazine onto two different clay surfaces: a pyrophyllite clay and an Mg‐substituted clay named montmorillonite, with Ca2+ compensating cations on its surface. The calculations show that the atrazine molecule is physisorbed on the pyrophyllite surface, evidencing the necessity to use dispersion‐corrected computational methods. The adsorption energies of atrazine on montmorillonite are two to three times larger than on pyrophyllite, depending on the adsorption pattern. The computed adsorption energy is of about −30 kcal mol−1 for the two most stable montmorillonite‐atrazine studied isomers. For these complexes, the large adsorption energy is related to the strong interaction between the chlorine atom of the atrazine molecule and one of the Ca2+ compensating cations of the clay surface. The structural modifications induced by the adsorption are localized: for the surface, close to substitutions and particularly below the Ca2+ cations; in the molecule, around the chlorine atom when Ca2+ interacts strongly with this basic site in a monodentate mode. This study shows the important role of the alkaline earth cations on the adsorption of atrazine on clays, suggesting that the atrazine pesticide retention will be significant in Ca2+‐montmorillonite clays.

Background Precarious status migrants are a group of persons who are vulnerable, heterogeneous, and often suspicious of research teams. They are underrepresented in population-based research projects, and strategies to recruit them are described exclusively in terms of a single cultural group. We analyzed the recruitment strategies implemented during a research project aimed at understanding precarious status migrants’ health status and healthcare access in Montreal, Canada. The research sample consisted of 854 persons recruited from a variety of ethnocultural communities between June 2016 and September 2017. This article analyzes the strategies implemented by the research team to respond to the challenges of that recruitment, and assess the effectiveness of those strategies. Based on the results, we share the lessons learned with a view to increasing precarious status migrants’ representation in research. Method A mixed sequential design was used to combine qualitative data gathered from members of the research team at a reflexive workshop (n = 16) and in individual interviews (n = 15) with qualitative and quantitative data collected using the conceptual mapping method (n = 10). Results The research team encountered challenges in implementing the strategies, related to the identification of the target population, the establishment of community partnerships, and suspicion on the part of the individuals approached. The combination of a venue-based sampling method, a communications strategy, and the snowball sampling method was key to the recruitment. Linking people with resources that could help them was useful in obtaining their effective and non-instrumental participation in the study. Creating a diverse and multicultural team helped build trust with participants. However, the strategy of matching the ethnocultural identity of the interviewer with that of the respondent was not systematically effective. Conclusion The interviewers’ experience and their understanding of the issue are important factors to take into consideration in future research. More over, the development of a community resource guide tailored to the needs of participants should be major components of any research project targeting migrants. Finally, strategies should be implemented as the result of a continuous reflexive process among all members of the research team. Electronic supplementary material The online version of this article (10.1186/s12874-019-0683-2) contains supplementary material, which is available to authorized users.

International audience; BACKGROUND:Knowledge about the health impacts of the absence of health insurance for migrants with precarious status (MPS) in Canada is scarce. MPS refer to immigrants with authorized but temporary legal status (i.e. temporary foreign workers, visitors, international students) and/or unauthorized status (out of legal status, i.e. undocumented). This is the first large empirical study that examines the social determinants of self-perceived health of MPS who are uninsured and residing in Montreal.METHODS AND FINDINGS:Between June 2016 and September 2017, we performed a cross-sectional survey of uninsured migrants in Montreal, Quebec. Migrants without health insurance (18+) were sampled through venue-based recruitment, snowball strategy and media announcements. A questionnaire focusing on sociodemographic, socioeconomic and psychosocial characteristics, social determinants, health needs and access to health care, and health self-perception was administered to 806 individuals: 54.1% were recruited in urban spaces and 45.9% in a health clinic. 53.9% were categorized as having temporary legal status in Canada and 46% were without authorized status. Regions of birth were: Asia (5.2%), Caribbean (13.8%), Europe (7.3%), Latin America (35.8%), Middle East (21%), Sub-Saharan Africa (15.8%) and the United States (1.1%). The median age was 37 years (range:18-87). The proportion of respondents reporting negative (bad/fair) self-perception of health was 44.8%: 36.1% among migrants with authorized legal status and 54.4% among those with unauthorized status (statistically significant difference; p

The number of vulnerable migrants in Canada is on the rise. While debates on immigration policies have been at the forefront, there has been little dialogue regarding the health and well-being of refugees, asylum-seekers and non-status migrants despite the significant health inequities that these populations face. In this context, health research that aims to understand migrants' realities, develop appropriate health and social services and policies, and empower these populations, is needed more than ever. Participatory action research (PAR) is one approach for conducting relevant and empowering research with migrants, however it remains underutilized due to inadequate funding, infrastructure and support. PAR addresses real-life challenges, emphasizes collaboration with communities, and involves all stakeholders, including community-based organizations, in the co-construction and implementation of practical solutions. In this commentary, we call for more research with and for migrants, particularly in the form of PAR, as well as for more targeted funding initiatives and research conditions (University, funding agencies) that foster and support this type of research.

The objective of the authors in this study was to qualitatively explore occupational therapists’ role in providing driving-related services to people with mental illnesses. Two focus groups composed of 20 occupational therapists were conducted. The data regarding current and ideal role, barriers, and facilitators for implementing those services were analyzed using inductive analysis. A strong message was that occupational therapists have a central role in providing driving-related services including screening, assessment, and interventions for people with mental illnesses. But, comfort in fulfilling this role is limited because of the lack of evidence-based research and validated evaluation tools. More education and research is recommended.

L’acces aux services delivrant des soins de sante est particulierement difficile pour les populations migrantes, que ce soit en France ou au Quebec. Cela peut etre du a l’absence d’assurance maladie liee au statut migratoire ou a la duree de residence, mais pas seulement. Souvent les raisons de cette absence d’acces aux soins de sante sont plus implicites que l’absence de prise en charge financiere (barrieres administratives, langage, complexite du systeme de sante). En outre, au Quebec, il est demande aux professionnels et aux etablissements de sante de majorer les tarifs de 200 % pour les personnes sans assurance maladie. Pour les femmes enceintes et les enfants, ce manque d’acces aux soins de sante, injuste, ne fait que s’accumuler aux autres difficultes rencontrees et accentuer leur vulnerabilite. En effet, l’adversite connue par les enfants de la periode fœtale a la petite enfance a des impacts considerables sur leur sante physique, psychique et mentale, a court et a long terme. Notre communication vise a discuter des moyens a mettre en place pour changer les conditions d’acces aux soins de sante des femmes enceintes et des enfants migrants, qui n’ont pas d’assurance medicale au Quebec et qui n’ont pas d’acces aux soins de sante en France, et de tenter de tirer des lecons des deux pays. Nous avons realise une enquete a Montreal : un questionnaire de plus de 80 questions a ete realise par des assistants de recherche, qui a eux tous parlaient plus de 15 langues differentes, aupres de pres de 900 migrants sans assurance medicale entre 2016 et 2017. Le travail de cette enquete, realisee en partenariat avec des acteurs de Medecin du Monde, de la societe civile, des associations et du milieu communautaire a ete particulierement efficace pour realiser un plaidoyer important aupres des acteurs politiques et en sante afin de demander un changement dans la loi. Il pourrait etre interessant de realiser une demarche similaire en France pour pallier les differents defis d’acces aux soins de sante. En parallele, les nombreux dispositifs du systeme public en France, pourraient etre des exemples a suivre outre-Atlantique.