[Joining forces for prevention: a public health challenge?] / S'unir pour prévenir, un enjeu de santé publique ?

In recent years, and particularly since the 2017 national health strategy, prevention has become one of the priorities in the French healthcare system. It's important to understand why this theme has emerged to the point of changing the title of the Ministry of Health, which is now called the Ministry of Health and Prevention. It is also essential to see how the entire healthcare system, and above all the care system, can mobilize to develop prevention in our country, and thus enable our fellow citizens to live as long as possible in good health.

[Sexual health and vulnerable populations, some background information]. / Santé sexuelle et populations vulnérabilisées, quelques éléments de cadrage.

Taking an interest in the sexual health of vulnerable populations also means taking into account the notion of risky behavior. The aim here is to support and promote these behaviors and reduce the risks that may arise. Faced with such challenges, the public authorities have put this issue on the agenda by developing strategic and operational tools to achieve the objectives defined for 2030.

[Antibiotic resistance, a cross-functional issue (One Health)]. / L'antibiorésistance, un enjeu transversal (One Health).

Antibiotic resistance is a public health issue that must be tackled within the One Health concept. This means continuing efforts to coordinate the action plans of the various ministries, on the one hand, and gaining a better understanding (from a scientific point of view) of the key points in the passage of antibiotic resistance between two sectors, on the other. This article shows how human medicine, veterinary medicine and the environment are affected by this issue.

Compreendendo a violência a partir da teoria winnicottiana / Comprender la violencia a partir de la teoría de Winnicott / Understanding violence from Winnicott's theory / En comprenant la violence par rapport la théorie de Winnicott

Este trabalho busca compreender, sob a perspectiva de Winnicott, a natureza da violência a partir do desenvolvimento emocional do sujeito. Segundo a Organização Mundial da Saúde (2002), a violência é um grave problema de saúde pública que pode ser prevenido. É fundamental um ambiente facilitador que promova cuidado, confiabilidade, segurança e suporte os impulsos agressivos da criança, assim como a implementação de políticas públicas a partir da criação de projetos que ofereçam um ambiente suficientemente bom para que os jovens possam ressignificar seus comportamentos violentos, tornando-os construtivos. Dessa forma, tanto os pais, quanto a sociedade e o Estado têm responsabilidade no que diz respeito ao tratamento e à prevenção da tendência antissocial para resgatar condições rumo a uma vida saudável

Este trabajo busca comprender la naturaleza de la violencia partiendo del desarrollo emocional del sujeto desde la perspectiva de Winnicott. Según la Organización Mundial de la Salud (2002), la violencia es un grave problema de salud pública que se puede prevenir. Es fundamental la existencia de un ambiente facilitador que propicie cuidado, confianza, seguridad y que dé soporte a los impulsos agresivos de los niños, así como la implementación de políticas públicas con proyectos que ofrezcan un ambiente suficientemente bueno para que los jóvenes puedan resignificar sus comportamientos violentos volviéndolos constructivos. De esa forma, tanto los padres como la sociedad y el Estado tienen responsabilidades en lo que se refiere al tratamiento y a la prevención de la tendencia antisocial, para rescatar condiciones para una vida saludable

This study aims to understand the nature of violence from the subject's emotional development according to the perspective of Winnicot. According to the World Health Organization(2002), the violence is a serious problem of health care that can do prevented. It is extremely important, an environment that facilitates, that promotes care, reliability, security and support the children's aggressive impulsive, thus, through the implementation of public policies, based on the creation of projects that offer a good enough environment so that young people can resignifytheir behavior violent, making them constructive. As soon, not only parents, but society and the State have responsibility in the treatment and antisocial prevention, with the purpose of rescuing conditions towards a healthy life

Le travail cherche à comprendre la nature de la violence à partir du développement émotionnel théoriquement proprosé par Winnicott. Selon l'Organisation mondiale de la santé (2002), la violence est un grave problème de santé publique qui peut être évité. Un environnement facilitant, qui favorise la prise en charge, la fiabilité, la sécurité et soutient aux pulsions agressives de l'enfant, ainsi que l'implémentation des politiques publiques, basées sur la création de projets qui offrent un environnement suffisamment bon pour que les jeunes puissent resignifier leurs comportements violents, les rendant constructives, peuvent être des moyens efficaces et fondamentaux pour faire face à la violence. De cette manière, les parents, la société et l'État sont tous responsables du traitement et de la prévention de la tendance antisociale, pour prevenir e favorizer des conditions vers une vie saine

[Preventing radicalisation with the necessary involvement of all]. / Prévenir la radicalisation avec la nécessaire implication de tous.

As a recent public policy, the prevention of radicalisation has been built in response to an evolving phenomenon. The implementation of tools for reporting and monitoring people undergoing radicalisation will begin in 2014. Although there is no standard profile of radicalised people, the target group for these systems is mainly young people, adults or minors. In terms of prevention of radicalisation, care covers a broad spectrum of interventions and professionals.

Agenda feminista e serviços de cuidado infantil: brasil, argentina e uruguai / Agenda féministe et politiques de garde d´enfants: brésil, argentine et uruguay / Agenda feminista y servicios de cuidado infantil: brasil, argentina y uruguay / Feminist agenda and child care services: brazil, argentina and uruguay

Resumo Neste artigo, investigamos o nível de aderência dos serviços de cuidado de crianças de zero a três anos à agenda feminista de políticas públicas. Para isso, realizamos um estudo de casos qualitativo de três países latino-americanos (Brasil, Argentina e Uruguai), durante o "giro à esquerda". Analisando três indicadores parametrizados (elegibilidade, cobertura e tipo de jornada), identificamos avanços maiores no Uruguai, mais restritos na Argentina e intermediários no Brasil. A variação positiva foi maior para elegibilidade e cobertura, do que para tipo de jornada. Concluímos que essa assimetria na variação dos indicadores sugere que os avanços decorrem principalmente do reconhecimento dos direitos das crianças à educação, e, secundariamente, do compromisso com a igualdade de gênero.

Résumé Cet article examine le niveau d'adhésion à l'agenda féministe des politiques publiques concernant les services de garde d'enfants de zéro à trois ans. A ce fin, nous avons mené une étude de cas qualitative dans trois pays d'Amérique latine (Brésil, Argentine et Uruguay) à l'époque de leur "tournant à gauche". En analysant trois indicateurs paramétrés (éligibilité), couverture et modalités d'accueil), nous avons constaté que les progrès les plus importants concernaient l'Uruguay et les moindres l'Argentine alors qu'au Brésil ils étaient. La variation positive était plus significative. Pour l'égibilité et la couverture que pour les modalités d'accueil. Nous avons conclu que cette asymétrie dans la variation des indicateurs suggère que les progrès découlent plutôt de la reconnaissance des droits de l'enfant à l'éducation, et, secondairement, de l'engagement en faveur de l'égalité de genre.

Resumen En este artículo, investigamos el nivel de adhesión de los servicios de cuidado infantil (cero a tres años) a la agenda feminista de políticas públicas. Para esto, realizamos un estudio de casos cualitativo de tres países latinoamericanos (Brasil, Argentina y Uruguay), durante el "giro a la izquierda". Analizando tres indicadores parametrizados (elegibilidad, cobertura y tipo de jornada), logramos encontrar avances mayores en Uruguay, más restrictos en Argentina e intermedios en Brasil. Además, los resultados fueron más positivos para a elegibilidad y cobertura que para el tipo de jornada. Concluimos que esa diferencia apunta que los avances que ocurrieron están, primero, relacionados al reconocimiento de los derechos de la infancia y, secundariamente, al compromiso con la igualdad de género.

Abstract In this article, we investigate the level of adherence of childcare services (zero to three years of age) to the feminist public policy agenda. To do so, we conducted a qualitative case study of three Latin American countries (Brazil, Argentina, and Uruguay), during the "left turn". Analyzing three parameterized indicators (eligibility, coverage, and type of school day), we identified greater progress in Uruguay, more restricted in Argentina and intermediate in Brazil. The positive variation was greater for eligibility and coverage, than for type of school day. We concluded that the results are related with the recognition of the right to childhood, firstly, and with commitment to gender equality, secondly.

Problematizing Sexual Harassment in Residential Long-Term Care: The Need for a More Ethical Prevention Strategy.

La promotion des droits sexuels dans les établissements de soins de longue durée est complexe sur le plan éthique, étant donné que ce milieu est à la fois une résidence et un lieu de travail. Bien que les données empiriques démontrent que le bien-être des soignants professionnels et des résidents sont inextricablement liés, les politiques publiques au Canada ne reconnaissent généralement pas cette relation et continuent de se concentrer isolément sur le bien-être des résidents ou des travailleurs. Les conséquences problématiques de cette situation sont particulièrement mises en évidence lorsque l'on considère les défis associés à la prévention du harcèlement sexuel envers les travailleurs, dans un contexte où l'on ne veut pas restreindre indûment la liberté d'expression sexuelle des résidents atteints de démence. Nous avons utilisé l'approche « Quel est le problème représenté ? ¼ ("What's the Problem Represented to be?") de Carol Bacchi pour analyser de façon critique un plan d'action canadien récent visant à prévenir la violence et le harcèlement sexuels. Notre analyse suggère que cette approche de prévention du harcèlement sexuel n'est pas une politique publique prometteuse et pourrait même contribuer à augmenter le phénomène qu'elle vise à corriger. Il est donc urgent de concentrer les efforts de prévention sur les facteurs structurels de ce phénomène afin de soutenir les droits sexuels des soignants et des résidents.Supporting sexual rights in residential long-term care is ethically complex. The well-being of care workers and residents is inextricably linked, and increasingly recognized empirically, yet public policy in Canada generally continues to exclusively focus on either the well-being of residents or workers. The consequences of this are particularly evident when we consider how to prevent sexual harassment towards workers without unjustly restricting the freedom of sexual expression for residents living with dementia. Employing Carol Bacchi's "What's the Problem Represented to be?" approach, we critically analysed a recent Canadian action plan to prevent sexual violence and harassment. Our analysis suggests that this policy is less than promising and may reproduce the very phenomenon it is intended to redress. The need to refocus prevention efforts on the structural factors implicated in this phenomenon is urgent if we are to support the sexual rights of both care workers and residents.

Macro e micro-olhares na prevenção do suicídio: um aprendizado de mão dupla / Macro and micro looks at suicide prevention: two-way learning / Macro y micro miradas a la prevención del suicidio: aprendizaje bidireccional / Macro et microregards sur la prévention du suicide: un apprentissage à double sens

Este trabalho, escrito a seis mãos, busca oferecer olhares distintos e complementares a respeito de um tema multifacetado: a prevenção ao suicídio. Os autores trazem dados atualizados das taxas de suicídio no Brasil e no mundo, com a informação alarmante de que os números no Brasil cresceram, enquanto no mundo caíram. Tratam de políticas públicas que se mostraram efetivas na diminuição dos casos, contextualizam a intersecção teórica e clínica desse tema entre psicanálise e psiquiatria, discorrem a respeito das reações contratransferenciais do profissional da saúde mental ao lidar com a problemática dos pacientes que apresentam ideação, plano ou tentativa de suicídio com uma vinheta clínica ilustrativa e encerram o trabalho abordando uma perspectiva ética não comum à nossa cultura brasileira, de que existem países que reconhecem como legítimo o desejo de morte de pacientes com transtornos mentais graves, sendo possível a realização oficial e assistida da eutanásia.

This work, written by six hands, seeks to offer different and complementary perspectives on a multifaceted theme: suicide prevention. The authors provide up-to-date data on suicide rates in Brazil and around the world, with alarming information that numbers in Brazil have grown while in the world they have fallen. They present public policies that have been effective in reducing cases, contextualize the theoretical and clinical intersection of this theme between psychoanalysis and psychiatry, discuss the countertransference reactions of mental health professionals when dealing with the problem of patients with ideation, plan or attempt of suicide with an illustrative clinical vignette and conclude the work presenting an ethical perspective not common to our Brazilian culture, that there are countries that recognize as legitimate the wish of death of patients with severe mental disorders being possible the official and assisted accomplishment of euthanasia.

Este trabajo, escrito a seis manos, busca ofrecer perspectivas diferentes y complementarias sobre un tema multifacético: la prevención del suicidio. Los autores aportan datos actualizados sobre las tasas de suicidio en Brasil y en todo el mundo, con información alarmante de que las cifras en Brasil han aumentado, mientras que en el mundo han disminuido. Presentan políticas públicas que han sido efectivas en la reducción de casos, contextualizan la intersección teórica y clínica de este tema entre el psicoanálisis y la psiquiatría, discuten las reacciones de contratransferencia de los profesionales de la salud mental al tratar el problema de los pacientes con ideación, plan o intento de suicidio con un caso clínico ilustrativo y concluyen el trabajo presentando una perspectiva ética no común a nuestra cultura brasileña, de que existen países que reconocen como legítimo el deseo de muerte de pacientes con trastornos mentales graves, siendo posible la realización oficial y asistida de la eutanasia.

Cet ouvrage, écrit à six mains, cherche à offrir des regards différents et complémentaires sur un thème aux faces multiples : la prévention du suicide. Les auteurs fournissent des données actualisées sur les taux de suicide au Brésil et dans le monde, avec une information alarmante selon laquelle les chiffres au Brésil ont augmenté tandis que dans le reste du monde, ils ont diminué. Ces chercheurs présentent des politiques publiques qui se sont montrées efficaces pour la réduction du nombre de cas, qui contextualisent l'intersection théorique et clinique de ce thème entre psychanalyse et psychiatrie et, au moyen d'une vignette clinique illustrative, ils exposent des réactions de contre-transfert du professionnel de la santé mentale lorsqu'il est en face de la problématique des patients atteints d'idéation, ayant un projet de suicide ou qui en ont fait une tentative. Ils terminent le travail, en présentant une perspective éthique qui n'est pas habituelle dans la culture brésilienne, c'est-à-dire, qu'il est des pays qui reconnaissent comme légitime le désir de décès des patients souffrant de troubles mentaux graves où il est possible la réalisation officielle et assistée de l'euthanasie.

Examining the intersection of policy and occupational therapy: A scoping review.

BACKGROUND.: Policy has direct bearing on occupational therapy practice and is a key dimension of the environment. To date, there has not been a synthesis of how policy is addressed in the occupational therapy literature. PURPOSE.: The purpose of this review is to identify and analyze the ways that policy is addressed in the occupational therapy literature. METHOD.: We conducted a scoping review of literature on policy and occupational therapy. Articles were analyzed deductively using a policy framework and inductively to identify overarching themes. FINDINGS.: Sixty-four papers were included for analysis. We present the descriptive information of the included articles according to policy type, sphere of action, stage of policy development, level, and actors. The qualitative analysis uncovered two broad concepts: "awareness" about the relationship between policy and practice and messages pertaining to "action." IMPLICATIONS.: There are numerous areas for further research into the policy-occupational therapy nexus, as policy has numerous pathways to shape practice. Practitioners will benefit from better understanding these pathways and actively engaging to align policy with the values of the profession.

Uma partida em qualquer porto, um navegar por mares loucos.. / A trip to any harbor, a sailing through crazy seas.. / Una salida de cualquier puerto, un navegar por locos mares.. / Un départ chez n'importe quel port, une navigation en oceans fous ..

O artigo reflete sobre a escuta clínica a partir de uma pesquisa-intervenção participativa e avaliativa das práticas de cuidado em saúde mental na rede de atenção básica, realizada na região metropolitana do estado do Rio Grande do Sul. Sustentado no método cartográfico, o estudo foi desenvolvido com grupos de interesse, stakeholders, que reuniram usuários, trabalhadores e gestores da rede de atenção psicossocial de cada um dos seis municípios participantes. As narrativas extraídas de cenas cotidianas de um dos municípios pesquisados são apresentadas com a finalidade de destacar as dificuldades que tanto os trabalhadores como a comunidade têm em acolher os sofrimentos psíquicos expressos na discursividade psicótica. Ao final, aponta-se o quanto a clínica da reforma psiquiátrica teria a aprender com as experimentações desviantes que a loucura e as pesquisas participativas podem ofertar quando operadas sob uma ética da diferença.

The article reflects on clinical listening from a participatory and evaluative intervention research on mental health care practices in the primary health care network in the metropolitan region of the state of Rio Grande do Sul. Based on the cartographic method, the study was developed with stakeholders, who gathered users, workers and managers of the psychosocial care network of each of the six participating municipalities. The narratives extracted from daily fscenes of one of the cities surveyed are presented with the purpose of highlighting the difficulties that both workers and the community have in accepting the psychic sufferings expressed in psychotic discursiveness. In the end, it is pointed out how much the clinic of psychiatric reform would have to learn from the deviant experiments that madness and participatory research can offer when operated under an ethic of difference.

El trabajo se refiere a la escucha clínica a partir de una investigación-intervención participativa y evaluativa de las prácticas de cuidado en salud mental en la red de atención básica, realizada en la región metropolitana del estado del Rio Grande del Sur. Sujetado en el método cartográfico, el estudio fue desarrollado con grupos de interés, stakeholders, que reunieron usuarios, trabajadores y gestores de la red de atención psicosocial de cada unos de los pueblos participantes. Las narrativas extraídas de escenas cotidianas de uno de los pueblos investigados son presentadas con el objetivo de enfocar las dificultades que tanto los trabajadores cuanto la comunidad tienen en acoger los sufrimientos psíquicos expresos en la discursividad psicótica. Al final, se indica cuanto la clínica de la reforma psiquiátrica tendría a aprender con las experiencias desviadas que la locura y las investigaciones participativas pueden ofrecer cuando operadas bajo una ética de la diferencia.

L'article aborde l'écoute clinique à partir d'une recherche-intervention participative et évaluative sur les pratiques de soins de santé mentale dans le réseau de soins de santé primaires de la région métropolitaine de l'État du Rio Grande do Sul au Brésil. Sur la base de la méthode cartographique, l'étude a été développée avec des groupes d'intérêts,, qui ont réuni des utilisateurs, des travailleurs et des directeurs du réseau de soins psychosociaux de chacune des six municipalités participantes. Les récits extraits des scènes quotidiennes de l'une des municipalités participantes sont présentés dans le but de mettre en évidence les difficultés rencontrées par les travailleurs et par la communauté pour accepter les troubles psychiques exprimées dans le discursivité psychotique. À la fin, il est souligné combien la clinique de réforme psychiatrique aurait à apprendre avec des expériences déviantes que la folie et la recherche participative peuvent offrir lorsqu'elles fonctionnent dans une éthique de la différence.

Services, systems, and policies affecting mobility device users' community mobility: A scoping review: Services, systèmes et politiques influençant la mobilité dans la communauté des utilisateurs d'aides à la mobilité : examen de la portée.

BACKGROUND: Opportunities to travel from one place to another in the community, or community mobility, are especially important for mobility device users' ability to participate fully in society. However, contextual challenges to such mobility exist. PURPOSE: This study summarizes the literature on existing community mobility barriers and facilitators of mobility device users created by services, systems, and policies as defined by the International Classification of Functioning, Disability, and Health (ICF). METHOD: Arksey and O'Malley's approach for scoping studies was used for the review. The extraction chart was organized following the ICF, and frequency counts were used to report the data. FINDINGS: The findings suggest that certain factors, such as transportation, open-space planning, and architecture and construction, influence community mobility opportunities. However, little attention has been paid to services, systems, and policies in the research literature, limiting the knowledge on the subject. IMPLICATIONS: Further research is needed to examine the relationship between specific services, systems, and policies and mobility device users' mobility within their communities.

Pets, Social Participation, and Aging-in-Place: Findings from the Canadian Longitudinal Study on Aging.

ABSTRACTThe objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization's age-friendly communities framework were relevant to understanding these findings.

Intersetorialidade em saúde mental: tensões e desafios em cidades do sudeste e nordeste brasileiro / Intersectoriality in mental health: tensions and challenges in cities of southeastern and northeastern Brazil / Intersectorialidad en salud mental: tensiones y retos en ciudads del sudeste y del nordeste brasileño / L'intersectionnalité dans la santé mentale: tensions et défis dans villes du sud-est et du nord-est brésilien

Este artigo aborda a problemática da intersetorialidade no campo da saúde mental no Brasil, analisando suas práticas na cidade de Belo Horizonte, em Minas Gerais, e Natal, no Rio Grande do Norte. A partir das ideias de Deleuze e Guattari e tomando como campo de análise as pesquisas realizadas pelas autoras nas duas cidades, pensamos a estratégia da intersetorialidade como um rizoma, como uma rede que se autoengendra por agenciamentos com os mais variados elementos da realidade, permitindo ao mesmo tempo rastrear as reproduções e os deslocamentos inventivos que se libertam das estruturas cristalizadas presentes da ação intersetorial. Concluímos que, embora em regiões distintas, com territórios singulares, a intersetorialidade ainda encontra os seguintes desafios: falta de articulação entre sistemas e serviços, precariedade de comunicação entre as equipes, sensação de sobrecarga de trabalho dos profissionais, risco de psicologização dos casos e falta de avaliação das ações em conjunto após os encaminhamentos.

This article discusses intersectioriality in the field of brazilian mental health, analyzing its practices in the city of Belo Horizonte, Minas Gerais and in the city of Natal, Rio Grande do Norte. Based on the ideas of Deleuze and Guattari and taking the analysis made in the researches made by the authors in the two cities, we approach the strategy of intersectoriality as a rhizome, like a network that is self-engendered by assemblages with the most varied elements of reality, allowing at the same time to trace the reproductions and the inventive displacements that detaches of crystallized structures of intersectorial action. We conclude that, although in different regions, with unique territories, the intersectoriality still faces the following challenges: lack of articulation between systems and services, precarious communication between teams, feeling of work overload, risk of psychologizing of cases and lack of evaluations together after the referrals.

Este artículo aborda el problema de la interseccionalidad en el campo de la salud mental en Brasil, examinando sus prácticas en la ciudad de Belo Horizonte, Minas Gerais y en Natal, Rio Grande do Norte. A partir de las ideas de Deleuze y Guattari y tomando como análisis de la investigación de campo realizada por los autores en las dos ciudades, pensamos que la estrategia intersectorial como un rizoma, con una red que autoengendra por ensamblajes con varios elementos de la realidad, permitiendo al mismo tiempo la reproducción y los movimientos de la invención que liberan las estructuras cristalizadas presente en la acción intersectorial. Llegamos a la conclusión de que, aunque en diferentes regiones y las zonas unicas, la intersectorialidad encuentra los siguientes desafíos: falta de coordinación entre los sistemas y servicios, la precariedad de la comunicación entre los equipos, sensación de sobrecarga de trabajo, la psicologización riesgo de casos y la falta de evaluaciones las acciones juntos después de referencias.

Ce texte cherche à discuter l'intersectionnalité dans le domaine de la santé mentale au Brésil, en analysant leurs pratiques dans la ville de Belo Horizonte, Minas Gerais et Natal, Rio Grande do Norte. Pour ce faire, les nous avons pris les idées Deleuze et Guattari' et le champ de anlayses des recherches menées par les auteurs dans les deux villes. Dasns ce contexte, nous pensons la stratégie intersectorielle comme un rhizome, comme un réseau qui si produit par des assemblages avec divers éléments de la réalité, en permettant lalecture de les reproductions et des mouvements inventifs qui libèrent des structures cristallisées présente d'action intersectorielle. Nous concluons que, bien que dans différentes régions, avec des territoires individuels, l'intersectorialité trouve encore les défis suivants: manque de coordination entre les systèmes et services, la précarité de la communication entre les équipes, le sens de la surcharge de travail professionnel, la psychologisation de scas et le manque des évaluations des actions ensemble après les références.

[Mobilising caregivers to prevent radicalisation]. / Mobiliser les soignants pour prévenir la radicalisation.

The policy for the prevention of radicalisation is based on the mobilisation of all government departments and territorial authorities as well as the coordination of social partners. In response to this challenge, health and social sector professionals have a key role to play both in detecting and managing people in the process of becoming radicalised.

[Linking up medico-social care and psychiatry for adolescents with an intellectual disability]. / Faire le lien entre médicosocial et psychiatrie pour l'adolescent déficient intellectuel.

The medical-educational institute in Quimperlé caters for teenagers aged between 13 and 16. While its missions are centred on the construction of a project and the provision of on-going and effective support for the young users, there are sometimes major difficulties relating to the links to be established with psychiatry. Young people with mental health conditions require shared and collective care. Three clinical cases reflect the successes and failures of this cross-disciplinary approach.

[Child protection, a question of society]. / La protection de l'enfance, une question de société.

Child protection is a sector undergoing major changes in which local authorities play a central role. There are several different types of child protection measures covering different needs: monitoring in the home, foster family, placement in a children's home or a stay in a mother-and-baby centre for young mothers. For all these children and adolescents, leaving care is a key moment which requires support.

[Inequity of compensation trajectories for victims of medical injuries. A survey in the French out-of-court settlement mechanism]. / Inégalités dans les parcours d'indemnisation des victimes d'accidents médicaux. Une enquête au sein du dispositif français de règlement amiable.

BACKGROUND: In France little is known about either the characteristics of people who take legal action because they believe themselves to be victims of harm caused by medical activity, or about their complaint trajectory. The law of 4th March 2002 created an out-of-court settlement mechanism which aims to reduce inequitable access to compensation experienced by victims faced with legal procedures that are both lengthy and costly. This mechanism now occupies a central position among the avenues of recourse available to patients and their families. METHODS: The study relates to the exhaustive database of 18,258 requests for compensation filed with the out-of-court settlement mechanism between 2003 and 2009. It takes 4 series of variables into account: (1) the characteristics of the people concerned by the request, (2) the recourse practices, (3) the result of the requests, (4) the characteristics of the commissions with whom they dealt. Univariate and multivariate analyses were performed, in particular to find factors relating to the different responses given to the requests. RESULTS: Of the requests filed with the out-of-court settlement mechanism, 34.5% led to compensation being awarded, 30.7% were deemed inadmissible and 34.8% were rejected on the basis of expert opinions. The risk of inadmissibility was greater when the victim was a woman, undeceased, or a minor aged between 1 and 17; it bore no relation to standard of living. Recourse to a lawyer (24%) depended on various characteristics, in particular the age and vital status of the victim. It is associated to the decrease of the risk of inadmissibility and to the increase of the chances of receiving compensation. There were significant differences in the ways requests were processed (depending on where they were filed), in the time it took to examine the case, and in the tendency to reject requests before or after expert medical opinion. CONCLUSION: This study offers the first ever description of the population of patients and families who accessed the out-of-court settlement mechanism for medical claims in France. It looks at how, within the mechanism, the diversity of practices impacts inequity and experiences during the compensation process.

PUBLIC POLICY, CHILD DEVELOPMENT RESEARCH AND BOYS AT RISK: CHALLENGING, ENDURING AND NECESSARY PARTNERSHIP.

Research findings documenting the issues and challenges of boys prebirth through age 5 years have barely penetrated the arena of public policy making nor has it permeated the public agenda of politicians, government, or other funding stakeholders. The purpose of this article is to articulate pathways for researchers to enter into the policy-making process. We review critical issues related to implementing the process of public policy. We argue that the policy process needs to be informed by more dynamic theoretical models of human development, and that researchers and clinicians need to be exposed more deeply to the processes required to inform and subsequently change public policy. We contend that most quantitative research on boys at risk occurs at the micro- and the mesosystem level rather than at the exo- and the macrosystem levels where structural societal policies embedded in economic and racial inequities contribute to risk. Researchers, clinicians, and policy makers need to create collaborative partnerships designed to develop, advocate, and implement more evidence-based policies designed to enhance the quality of life for boys at risk.

Concepções de conselheiros tutelares acerca da infância: interconexões entre risco e proteção / Conceptions of guardianship board about childhood: interconnections between risk and protection / Concepciones de concejales tutelares acerca de la infancia: interconexiones entre riesgo y protección / Conceptions de conseillers de tutelle a propos de la petite enfance: interconnexions entre les risques et la protection

O processo histórico da construção do lugar social da criança no Brasil pode ser entendido como permeado por ambivalências a respeito das concepções de criança e das políticas públicas voltadas a essa população no país. Tais concepções se materializam nas intervenções dos profissionais do Sistema de Garantia de Direitos. O objetivo deste trabalho consiste em apresentar como profissionais de instituições socioassistenciais compreendem a criança em situação de risco; problematizando-se as contradições presentes nos discursos dos atores sociais envolvidos. Por meio de entrevistas com conselheiros tutelares de uma região do Distrito Federal, empreendeu-se uma leitura crítica dos discursos dos profissionais, apontando-se sentidos construídos acerca da criança como sujeito da falta e à situação de risco como engendrada por famílias empobrecidas e negligentes para com os direitos básicos das crianças. Pontua-se que a emergência política das crianças na sociedade brasileira poderá acontecer via reformulações nos sentidos atribuídos pelos profissionais às crianças atendidas.

The historical process of childhood social place construction in Brazil can be understood as permeated by ambivalence about the child's conceptions. Such concepts are materialized in the interventions of professionals Rights Guarantee System. The objective of this study is to present how professional social assistance institutions understand the child and the child at risk. Through interviews with tutelary counselors of a region of the Federal District, it was possible to undertake a critical reading of the speeches of professionals, building up towards areas related to the child as the subject of fault and the risk as engendered by impoverished families and neglectful for the basic rights of children. Finally, it points out that the political emergence of children in Brazilian society will happen through reformulations about the meanings constructed by social actors.

El proceso histórico de la construcción del lugar social de la infancia en el Brasil es permeado por ambivalencias en las concepciones dirigidas a los niños. Tales concepciones si materializan en las intervenciones de los profesionales del sistema de la garantía de los derechos. El objetivo de este trabajo es dar a conocer como los profesionales de los servicios socioassistenciais entienden el niño en la situación del riesgo. En las entrevistas con miembros de un consejo tutelar de una región del Districto Federal, emprendió una lectura crítica de los discursos, construyéndose sentidos referentes al niño como de la carencia y en situación del riesgo según la condición empobrecida de las familias negligentes para con sus derechos fundamentales. El trabajo pontua que la política de la emergencia de los niños en la sociedad brasileña podrá suceder por medio de transformaciones en las concepciones de los agentes sociales acerca de la infancia.

Le processus historique de la construction du lieu social de l'enfant au Brésil peut être compris comme imprégné par ambivalences sur les opinions de l'enfant et la politique publique face à cette population dans le pays. Ces conceptions se matérialisent dans les interventions du système professionnel de garantie des droits. L'objectif de ce travail est de présenter comment les professionnels des institutions d'aide sociale comprendrent l'enfant en situation de risque; en questionnant les contradictions du discours des acteurs sociaux impliqués. Les entrevues avec des conseillers tutélaires d'une région du District Fédéral ont entrepris une lecture critique du discours des professionnels, indicant des significations construits sur l'enfant en tant que sujet de la faute et de la situation de risque engendré par des familles pauvres et négligentes en face aux droits fondamentaux des enfants. On remarque que l'émergence politique des enfants dans la société brésilienne pourrait arriver à partir de reformulations dans les sens appliquées par les professionnels aux enfants desservis.

[Healthy ageing in a linguistic minority situation in Canada: issues, challenges and collective mobilization]. / Vieillir en sante en situation minoritaire linguistique au Canada: enjeux, defis et mobilisation collective.

In Canada, the health of both French and English speakers living in linguistic minority situations is a subject of interest to several researchers and community organizations. This article draws upon a symposium on the theme of healthy ageing in a linguistic minority situation, presented at the 4th International Colloquium for Local and Regional Health Programmes. Three aspects are presented: the identification of factors associated with perceived health, home care and malnutrition screening. The results describe: (a) The determinants of perceived health, such as health care services, the vitality of the minority community and education; (b) The lack of changes to home care services, despite the ageing of the population; and (c) The high prevalence of malnutrition among the elderly in New Brunswick, Canada. Finally, we make suggestions regarding the design and implementation of a national policy on ageing in Canada, in order to ensure high-quality services along the entire health continuum.