[Climate and environmental crisis impacts on women's health: What specificities? What can be done?] / Impacts de la crise environnementale et climatique sur la santé de la femme : quelles spécificités ? Que peut-on faire ?

OBJECTIVE: Pollution is one of the world's largest risk factors for disease and premature death. In Europe, it is responsible for approximately 20% of mortality. Chemicals exposure can occur by inhalation, ingestion or skin contact and begins in utero. Pollutants can be divided into three categories: endocrine disruptors (pesticides, PFAS, plastics, dioxins, etc.), heavy metals (cadmium, mercury and lead…) and nanomaterials. Climate change and air pollution are other main health threats. METHODS: Literature review using PubMed and ResearchGate databases and institutional websites. RESULTS: Endocrine disruptors are identified as significant risk factors for the reproductive health with negative documented impacts following prenatal or adult exposure. Climate change and air pollution can cause gender-based health disparities. Numerous scientific arguments show that chemical pollution and climate change disproportionately impact women, both on a social and biological level. Populations in precarious situations among which women are over-represented suffer the most severe social consequences including in France. There are several gender-specific domestic or occupational exposures to pollutants, most often to the disadvantage of women compared to men. Finally, although very few gendered data exist in environmental health, there are sexual-based physiological vulnerabilities concerning the metabolism of pollutants and the capacity to adapt to heat. CONCLUSION: Facing this threat of gender inequity in sexual and reproductive health and rights' width, women's health professionals have a major role to play in initiating new ways to assess and reduce the environmental health burden in women.

Indigenous Identity and Household Food Insecurity are Associated with Poor Health Outcomes in Canada.

Purpose: To examine whether Indigenous identity and food insecurity combined were associated with self-reported poor health.Methods: Data from the 2015-2016 Canadian Community Health Survey and multiple logistic regression were employed to evaluate the association between Indigenous identity, household food insecurity, and health outcomes, adjusted for individual and household covariates. The Alexander Research Committee in Alexander First Nation (Treaty 6) reviewed the manuscript and commented on the interpretation of study findings.Results: Data were from 59082 adults (3756 Indigenous). The prevalence of household food insecurity was 26.3% for Indigenous adults and 9.8% for non-Indigenous adults (weighted to the Canadian population). Food-secure Indigenous adults, food-insecure non-Indigenous adults, and food-insecure Indigenous adults had significantly (p < 0.001) greater odds of poor health outcomes than food-secure non-Indigenous adults (referent group). Food-insecure Indigenous adults had 1.96 [95% CI:1.53,2.52], 3.73 [95% CI: 2.95,4.72], 3.00 [95% CI:2.37,3.79], and 3.94 [95% CI:3.02,5.14] greater odds of a chronic health condition, a chronic mental health disorder, poor general health, and poor mental health, respectively, compared to food-secure non-Indigenous adults.Conclusions: Health policy decisions and programs should focus on food security initiatives for all Canadians, including addressing the unique challenges of Indigenous communities, irrespective of their food security status.

[Programme d'été sur le vieillissement de l'Institut du vieillissement des Instituts de Recherche en Santé du Canada : trois pistes de réflexion de participants du Québec].

Chaque année, les Instituts de recherche en santé du Canada (IRSC) subventionnent le Programme d'été sur le vieillissement (PEV). Cette année, la semaine de formation qui rassemblait des étudiants canadiens de tous les cycles supérieurs avait pour thème la recherche multidisciplinaire au quatrième âge. Cette note de recherche présente trois éléments de réflexion de deux participants de l'édition 2023 du PEV : 1) les enjeux liés au vieillissement sont des occasions de transformer les paradigmes de la recherche; 2) la recherche collaborative doit être sociétale, et s'étendre au-delà du cercle restreint des milieux universitaires; 3) les critères d'équité, de diversité et d'inclusion intégrés aux projets de recherche doivent se refléter au sein des organisations qui mènent la recherche.

Racial/Ethnic Disparities in Psychiatric Traits and Diagnoses within a Community-based Sample of Children and Youth: Disparités raciales/ethniques dans les traits et diagnostics psychiatriques au sein d'un échantillon communautaire d'enfants et de jeunes.

OBJECTIVE: Racial/ethnic disparities in the prevalence of psychiatric disorders have been reported, but have not accounted for the prevalence of the traits that underlie these disorders. Examining rates of diagnoses in relation to traits may yield a clearer understanding of the degree to which racial/ethnic minority youth in Canada differ in their access to care. We sought to examine differences in self/parent-reported rates of diagnoses for obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders after adjusting for differences in trait levels between youth from three racial/ethnic groups: White, South Asian and East Asian. METHOD: We collected parent or self-reported ratings of OCD, ADHD and anxiety traits and diagnoses for 6- to 17-year-olds from a Canadian general population sample (Spit for Science). We examined racial/ethnic differences in trait levels and the odds of reporting a diagnosis using mixed-effects linear models and logistic regression models. RESULTS: East Asian (N = 1301) and South Asian (N = 730) youth reported significantly higher levels of OCD and anxiety traits than White youth (N = 6896). East Asian and South Asian youth had significantly lower odds of reporting a diagnosis for OCD (odds ratio [OR]East Asian = 0.08 [0.02, 0.41]; ORSouth Asian = 0.05 [0.00, 0.81]), ADHD (OREast Asian = 0.27 [0.16, 0.45]; ORSouth Asian = 0.09 [0.03, 0.30]) and anxiety (OREast Asian = 0.21 [0.11, 0.39]; ORSouth Asian = 0.12 [0.05, 0.32]) than White youth after accounting for psychiatric trait levels. CONCLUSIONS: These results suggest a discrepancy between trait levels of OCD, ADHD and anxiety and rates of diagnoses for East Asian and South Asian youth. This discrepancy may be due to increased barriers for ethnically diverse youth to access mental health care. Efforts to understand and mitigate these barriers in Canada are needed.

We know that there is there are differences in the prevalence of childhood mental illnesses by race/ethnic group, which may be related to disproportionate access to mental health care. What is unknown is whether there this difference in prevalence is related to differences in the presence of symptoms for mental illness or whether children and youth from marginalized racial/ethnic groups have symptoms but are not getting diagnosed. This information is needed to understand the degree to which children and youth from marginalized race/ethnicity groups are accessing mental health care in Canada. We tested the differences in reported symptoms and diagnosis of three common and impairing childhood-onset disorders (obsessive-compulsive disorder­OCD), attention-deficit/hyperactivity disorder­ADHD and anxiety disorders) in children and youth (6­17 years of age) living in Canada that were from three racial/ethnic groups: White, South Asian and East Asian. East Asian and South Asian youth reported significantly higher levels of OCD and anxiety traits than White youth. However, East Asian and South Asian youth were significantly less likely than White youth to have a reported diagnosis of OCD, ADHD or anxiety even after accounting for symptom levels for each disorder. Our findings suggest that East and South Asian children are less likely than White children to get a diagnosis for common mental illness even if they have symptoms of that mental illness. This gap in receiving a diagnosis might be because of more barriers to mental health care for children and youth from marginalized racial/ethnic groups but we need more research to pinpoint the cause.

Knowledge Gaps Regarding Indigenous Health in Occupational Therapy: A National Survey.

Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendations to address identified gaps and inform responses from the profession. Method. A national needs survey was created and distributed to occupational therapists across Canada to determine the knowledge of occupational therapists about Indigenous health. Survey results were analyzed using thematic analysis and descriptive statistics. Findings. Data collected from 364 survey responses informed six distinct themes representing knowledge gaps of occupational therapists related to Indigenous health as follows: lack of foundational knowledge, power relations, lifelong learner, need for appropriate tools/approaches, respectful collaboration, and environmental influences. Implications. The project offers insight into the role of the occupational therapy profession in the process of reconciliation. Insights are focused on decolonizing occupational therapy practice, building trusting relationships with Indigenous Peoples, and the provision of appropriate training for occupational therapists to engage in culturally safer practices.

Beyond the Body: Using Photovoice to Explore Social Determinants of Diabetes With South Asian Adolescents in the Peel Region of Ontario, Canada.

OBJECTIVES: The higher prevalence of diabetes in the South Asian (SA) population living in Canada spans across generations and is often associated with individual risk factors while undermining the social determinants of health (SDOH). There is a scarcity of studies on the perspectives of SA adolescents with a family history of type 2 diabetes mellitus (T2DM). Learning directly from these adolescents can fill a major gap by providing insight on how the SDOH contribute to disproportionate rates of T2DM in SA immigrant communities. METHODS: In this study, we used Photovoice, which is a community-based participatory research (CBPR) method that involves the use of photography to visually capture the challenges of diabetes prevention from the perspective of those with lived experiences. A group of 15 SA youth were recruited from an adolescent diabetes education program in the Peel Region of Ontario. The youth discussed their images and accompanied written narratives during focus groups. RESULTS: Four themes emerged from the thematic analysis of the photographs and participant narratives that influence the manifestation of T2DM in SA communities: 1) immigration and resettlement stressors; 2) food insecurity; 3) unhealthy school environments; and 4) academic pressures. CONCLUSIONS: Findings suggest the need to address T2DM as a response to unjust conditions and environments rather than as an epidemic entrenched in genetic predisposition, culture, and poor lifestyle choices.

[Importance de la nature, des opportunités d'activités, de leur accessibilité et de leur publicisation pour favoriser la santé positive, la participation sociale et l'équité en santé d'Estriens âgés].

Cette étude visait à explorer comment les composantes clés de l'environnement des communautés favorisent les résultantes de santé d'Estriens âgés, plus précisément leur santé positive, leur participation sociale et leur équité en santé. Une étude de cas multiples a été réalisée auprès de cinq communautés estriennes (cas) à l'aide de groupes de discussion focalisée (1/communauté) regroupant un total de 49 participants connaissant bien les communautés respectives, soit 47 aînés, 1 conseillère municipale et 1 technicienne en loisir. En rendant accessible et équitable la réalisation d'activités importantes pour les aînés, la nature, une offre d'activités variée, des moyens de communication efficace et les mesures favorisant l'équité avaient une influence positive sur les résultantes de santé. Des facteurs individuels tels qu'un niveau élevé de scolarité et un statut socioéconomique favorable avaient aussi une influence positive. Ces résultats permettent d'outiller les décideurs souhaitant favoriser un vieillissement actif et en santé.

Pour une santé publique en faveur d'une justice épistémique.

La santé publique s'oriente de plus en plus vers l'étude des structures oppressives (telles que le racisme, le sexisme, ou le validisme) et de leur influence sur le marché de l'emploi, les systèmes éducatifs et judiciaires, et l'accès aux systèmes de santé de qualité. Ce commentaire vise à proposer une réflexion sur la manière dont ces structures influencent également la façon de faire de la santé publique. À travers le concept d'injustice épistémique, qui décrit le fait que l'organisation sociale influence la possibilité de connaître et de faire valoir sa connaissance dans une société donnée, nous montrons qu'en tant qu'acteur.rice de santé publique, nous pouvons reproduire et renforcer des injustices sociales. Les injustices épistémiques sont la plupart du temps le fruit de structures et de pratiques quotidiennes. Il est nécessaire de développer l'utilisation d'outils permettant de favoriser la réflexivité pour faciliter la mise en perspective des injustices et des privilèges.

Meaningful Activity, Psychosocial Wellbeing, and Poverty During COVID-19: A Longitudinal Study.

Background: Only a few studies have explored experiences of meaningful activity and associations with psychosocial wellbeing during COVID-19. None reflect a Canadian context or focus on persons living in poverty. Purpose: To identify experiences and associations between meaningful activity and psychosocial wellbeing for persons living in poverty during the first year of COVID-19. Method: We delivered a quantitative survey at three time points during the first year of the pandemic supplemented by qualitative interviews at Time(T) 1 and 1 year later at T3. Findings: One hundred and eight participants completed T1 surveys, and 27 participated in qualitative interviews. Several statistically significant correlations between indices of meaningful activity engagement and psychosocial wellbeing were identified across T1-T3. Meaningful activity decreased from T1-T3 [X2 (2, n = 49) = 9.110, p < .05], with a significant decline from T2-T3 (z = -3.375, p < .001). In T1 qualitative interviews, participants indicated that physical distancing exacerbated exclusion from meaningful activities early in the pandemic. At T3 (1 year later), they described how classist and ableist physical distancing policies layered additional burdens on daily life. Implications: Meaningful activity engagement and psychosocial wellbeing are closely associated and need to be accounted for in the development of pandemic policies that affect persons living in low income. Occupational therapists have a key role in pandemic recovery.

Predictors of Tri-council Funding Among Nutrition Researchers in Canada.

Purpose: Barriers in research for women and dietitians have been documented. We sought to describe tri-council funding awarded within the nutrition discipline according to institution type, academic rank, gender, dietitian status, and primary research methods used.Methods: Using an online search methodology, faculty members with research appointments were identified from nutrition departments offering accredited dietetic programs and/or at Canada's collective of research-intensive universities known as U15. All data regarding faculty members, their institutions, and funding were collected through publicly available websites and Scopus. Tri-council funding associated with the nominated principal investigator, from a 5-year period, 2013-2014 to 2017-2018, was extracted. Binary logistic regression was used to test for predictors of receiving any tri-council operating funds within the 5-year period.Results: Faculty members (n = 237) from 21 institutions were identified for inclusion. Those from U15 institutions, at the full professor rank, nondietitians, men, and those who engaged in primarily quantitative research methods (vs. qualitative or mixed-methods) were significantly more likely to hold any tri-council funding during the eligible period. Dietitians (n = 76) were significantly less likely to hold tri-council funding, independent of institution, rank, gender, and primary research methods utilized.Conclusions: The apparent under-funding of academic dietitians from federal tri-council sources requires exploration.

Underrepresented Voices: Impacts of Social Determinants of Health on Type 1 Diabetes Family Management in Single-Parent, Black Families.

OBJECTIVES: Social determinants of health (SDOH) impact families' ability to manage chronic illnesses such as type 1 diabetes (T1D). Black, single parents have unique SDOH-related resource needs and concerns when caring for a child with a chronic illness, yet their voices are underrepresented in the pediatric T1D literature. The aim of this qualitative study was to identify and explore the SDOH that influence T1D management in Black, single-parent families. METHODS: In this 2-phase qualitative study we used content analysis to explore themes derived from 3 nominal group technique sessions and semistructured interviews, with 20 self-identified Black, single parents of a child with T1D. RESULTS: Parents encountered various SDOH-related issues that negatively influenced management of their children's T1D. Six major themes emerged from the parent-generated list of SDOH-related barriers: 1) lack of parent and child emotional and physical support systems, 2) maintaining parent and child's physical and mental health, 3) pain management with medication administration, 4) clinical team empathy, 5) provider communication, and 6) economic burden of food costs. CONCLUSIONS: These exploratory findings contribute to the knowledge base required to guide development of culturally relevant, individual- and population-level interventions for racially and compositionally minority families, to increase health equity and address racial health disparities in T1D. Routine assessment of family social support context and resources, better integration of community-level social services into clinical health encounters and clinician bias and communication training are advised starting points to address the specific needs of racial and ethnic minority families experiencing the greatest social and clinical challenges.

Mind the Gap(s): Reflective supervision/consultation as a mechanism for addressing implicit bias and reducing our knowledge gaps.

Mental health-related professions, like many fields, have begun reexamining common practices and opportunities following the 2020 reawakening to the need for antiracist practices/policies. This push includes encouraging both seasoned professionals and newer trainees to do inward and outward work to increase self- and other-awareness and recognize biases. Often, it is unclear where to begin, and this deeper reflection can bring up uncomfortable realizations about oneself, colleagues, and even broader professions. Doing this deep work is most beneficial when done in a community that can provide support and further challenge. Thus, the practice of reflective supervision/consultation (RSC) is well-suited for integration of conversations about bias (implicit and explicit) as well as racism/antiracism. The current paper provides background on these concepts, the model of RSC, and specific examples of diversity, equity, and inclusion principles within the infant and early childhood mental health (IECMH) field. Parallels are drawn to existing "key concepts" of reflective supervision to provide examples for integrating conversations about bias into reflective supervision. Finally, specific tools and strategies for use are offered as starting points, with encouragement for supervisors to continue to generate ideas and tools for these important conversations. Next steps and implications for broader practice are also discussed.

Las profesiones relacionadas con la salud mental, como muchos campos, han comenzado a reexaminar las prácticas comunes y oportunidades a partir del despertar a la necesidad de prácticas/políticas antirracistas de 2020. Este esfuerzo incluye el darle ánimo tanto a profesionales experimentados como a los que inician su entrenamiento a hacer labor interna y externa para incrementar el propio conocimiento consciente y el de otros y reconocer los prejuicios. A menudo, no está claro dónde comenzar, y esta más profunda reflexión puede sacar a relucir comprensiones que incomodan, tanto propias como de colegas y aun dentro de la gama amplia de profesiones. Hacer este profundo trabajo resulta más beneficioso cuando se hace dentro de una comunidad que puede ofrecer apoyo y fomentar el reto. Por tanto, la práctica de la consulta/supervisión con reflexión (RSC) está bien posicionada para integrar conversaciones acerca de prejuicios (implícitos y explícitos) así como sobre el racismo/antirracismo. El presente estudio aporta el trasfondo de estos conceptos, el modelo RSC, y ejemplos específicos de principios de diversidad, equidad e inclusión dentro del campo de salud mental infantil y la temprana niñez (IECMH). Se extraen paralelos con los "conceptos claves" de supervisión con reflexión existentes con el fin de aportar ejemplos para integrar conversaciones acerca de prejuicios en la supervisión con reflexión. Finalmente, se ofrecen herramientas y estrategias específicas para usarse como puntos de partida, estimulando a los supervisores a continuar generando ideas y herramientas para estas importantes conversaciones. También se discuten los próximos pasos e implicaciones para la más amplia práctica.

Les professions liées à la santé mentale, comme dans d'autres domaines, ont commencé à réexaminer leurs pratiques courantes et les opportunités qui se présentent après le réveil de 2020 quant au besoin de pratiques et de politiques antiracistes. Cette pression comprend l'encouragement aux professionnels chevronnés et à ceux nouvellement formés de travailler sur eux-mêmes et à l'extérieur afin d'augmenter leur conscience de soi et leur conscience des autres et de reconnaître les préjugés qui existent. Souvent on ne sait pas par où commencer et cette réflexion plus profonde peut amener à des réalisations inconfortables sur soi-même, ses collègues et mêmes des professions au sens plus large. Faire ce travail est particulièrement bénéfique quand il est fait dans une communauté qui peut offrir son soutien et pousser au défi. Dans ce contexte la pratique de la consultation/supervision de réflexion (RSC) est particulièrement adaptée à l'intégration de conversations sur les préjugés (implicites et explicites) ainsi que sur le racisme/l'antiracisme. Cet article offre un arrière-plan à ces concepts, le modèle de la RSC ainsi que des exemples spécifiques de diversité, d'équité et de principes d'inclusion au sein du domaine de la santé mentale du nourrisson et de la petite enfance (IECMH). Des parallèles sont établis avec des 'concepts clés' qui existent de supervision de réflexion afin d'offrir des exemples d'intégration de conversations sur les préjugés dans la supervision de réflexion. Enfin des outils et des stratégies spécifiques pour l'utilisation sont offerts comme points de départ, tout en encourageant les superviseurs à continuer de générer des idées et des outils pour ces conversations importantes. Les prochaines étapes ainsi que les implications pour la pratique plus large sont également discutées.

At the feet of storytellers: Equity in early relational health conversations.

Early Relational Health (ERH) focuses attention on family-baby relationships during the first 1000 days of life. Positive ERH enhances child health and development and family wellbeing. Universal, early identification of RH and vulnerability could add value to care. How to screen, when, where, and with whom is the question. Tools and models for screening are practitioner-centered. Bias can affect family engagement and outcomes. This may be problematic for African American families. Authors present findings of a discourse analysis and phenomenological study of experiences of African American families' and HealthySteps Specialists' (HSS) of color with screening ERH in Washington, D.C., USA (N = 13). Findings indicate relevance, acceptance and utility may be influenced by positionality, cultural context, issues of equity, and engagement in mutual reflection. A family-centered approach that opened space for non-dominant knowledge about ERH made positive differences in engagement and utility for families and practioners alike. Health and vulnerability were detected reliably using this approach. Outcomes include new theories about ERH-focused visits with African American families and infants, and a new model for centering ERH in pediatric practice, entitled Early Relational Health Conversations. ERH-C is a family reflection model, not necessarily dyadic. It may have value for other populations. Future directions in ERH-C research are suggested.

La Temprana Salud de la Relación (ERH) enfoca su atención en las relaciones entre la familia y el bebé durante los primeros 1000 días de vida. Una positiva ERH mejora la salud y el desarrollo del niño y el bienestar de la familia. Una identificación universal y temprana de RH y la vulnerabilidad pudieran ser valiosas para el cuidado. La pregunta es cómo detectar, cuándo, dónde y con quién. Las herramientas y los modelos para la detección se centran en los profesionales de la práctica. Los prejuicios pueden afectar la participación familiar y los resultados. Esto pudiera ser problemático para familias afroamericanas. Los autores presentan resultados de un análisis discursivo y un estudio fenomenológico de experiencias de las familias afroamericanas y los especialistas de HealthySteps (HSS) de raza negra con respecto a la detección de ERH en Washington, D.C. (N = 13). Los resultados indican relevancia, aceptación y utilidad para las familias afroamericanas y que circunstancias de posición, contexto cultural, asuntos de equidad y participación en reflexión mutua pudieran influir a los HSS. Un acercamiento centrado en la familia que abrió la oportunidad para el conocimiento no dominante acerca de ERH produjo diferencias positivas en la participación y utilidad tanto para las familias como los profesionales de la práctica. La salud y la vulnerabilidad se detectaron confiablemente usando este acercamiento. Los resultados incluyen nuevas teorías sobre los acercamientos a la detección y un nuevo modelo de detección: Las Conversaciones de la Temprana Salud de la Relación (ERH-C). ERH-C es un modelo de reflexión familiar, no necesariamente diádico. El mismo pudiera ser valioso para otros grupos de población. Se aportan futuras directrices en la investigación de ERH-C.

La Santé Relationnelle Précoce (SRP en français) met l'attention sur les relations famille-bébé durant les 1000 premiers jours de la vie. Une SRP positive renforce la santé de l'enfant, le développement, et la santé de la famille. Une identification universelle et précoce de la Santé Relationnelle et de la vulnérabilité pourrait ajouter de la valeur aux soins. La question se pose: comment dépister, quand, où et avec qui. Les outils et les modèles de dépistages sont centrés sur les praticiens. La partialité peut affecter l'engagement de la famille et les résultats. Ceci peut s'avérer problématique pour les familles noires. Les auteurs présentent les résultats d'une analyse de discours et d'une étude phénoménologique des expériences des familles noires et des Spécialistes de Healthy Steps (HSS) racialisés avec le dépistage ERH à Washington DC aux Etats-Unis (N = 13). Les résultats indiquent que la pertinence, l'acceptation et l'utilité peuvent être influencées par la position, le contexte culturel, les problèmes d'équité et l'engagement dans une réflexion mutuelle. Une approche centrée sur la famille qui a ouvert un espace pour des connaissances non-dominantes à propos de la SRP a fait une différence positive dans l'engagement et l'utilité pour les familles ainsi que pour les praticiens. La santé et la vulnérabilité ont été détectés avec fiabilité en utilisant cette approche. Les résultats incluent de nouvelles théories sur les visites centrées sur la SRP avec des familles noires et leurs nourrissons, et un nouveau modèle de centrage de la SRP dans la pratique pédiatrique, appelée Conversations sur la Santé Relationnelle Précoce. La C-SRP est un modèle de réflexion familiale, pas nécessairement dyadique. Ce modèle peut avoir une valeur pour d'autres populations. Des directions futures pour des recherches sur la C-SRP sont suggérées.

At the feet of storytellers: Implications for practicing early relational health conversations.

A family- and culturally-centered approach to conversations about early relational health (ERH) can open up opportunities for universal family engagement. The appraisal of family-baby relational health is more trustworthy and useful when there is attunement to family voice and facilitator bias. Early Relational Health Conversations (ERH-C) is a model for ERH promotion and intervention. This model has eight components: preparing and entering the ERH-C space, accessing strength and knowledge in a healing-centered space, pausing and co-creating, storytelling, witnessing, mutual reflection, affirming, and claiming their relationship narrative, and mutual insight. It is a paradigm shift in working with African American families and possibly other historically marginalized families who are also impacted by structural racism. The eight components are explained, and examples are given from the perspective of an Africentric worldview. The importance of cultural humility, attuning to and honoring family culture is emphasized. Insights for implementation in primary care and other settings are provided. Healing-centered engagement practices embedded in ERH-C have the potential to move ERH work into the social justice arena. The ERH-C is a family reflection model. Ideas for future directions for ERH-C are discussed.

Un acercamiento a conversaciones sobre la salud de la temprana relación (ERH) con base en la familia y en el medio cultural puede abrir oportunidades para la participación familiar universal. La evaluación de la salud de la relación familia-bebé es más confiable y útil cuando hay un ajuste a la voz de la familia y a los prejuicios del mediador. Las Conversaciones de la Salud de la Temprana Relación (ERH-C) es un modelo para la promoción e intervención ERH. Este modelo tiene ocho componentes: preparar y entrar en el espacio de ERH-C, evaluar la fortaleza y el conocimiento en un espacio centrado en la sanación, detenerse y co-crear, contar historias, ser testigo, reflexión mutua, afirmar y reclamar la narrativa de su relación, mutuo aporte de ideas. Se trata de un cambio de paradigma cuando se trabaja con familias afroamericanas y posiblemente con otras familias históricamente marginalizadas que también reciben el impacto del racismo estructural. Se explican los ocho componentes y se dan ejemplos desde la perspectiva de una vista mundial afro-céntrica. Se enfatiza la importancia de la humildad cultural, estar en sintonía con y honrar la cultura familiar. Se aportan ideas para la implementación en el cuidado primario y otros escenarios. Las prácticas de participación centradas en la sanación que son parte de ERH-C tienen la posibilidad de incorporar ERH dentro del campo de la justicia social. ERH-C es un modelo de reflexión de familia. Se discuten ideas para directrices futuras de ERH-C.

Une approche aux conversations sur la Santé Relationnelle Précoce (SRP), centrée sur la famille et la culture, peut ouvrir de nouvelles portes pour l'engagement de la famille universel. L'appréciation de la santé relationnelle famille-bébé est plus digne de confiance et utile que lorsqu'il y a une harmonisation avec la voix de la famille et une partialité de la part du facilitateur. Les Conversations sur la Santé Relationnelle Précoce (C-SRP) est un modèle de promotion de ls SRP et d'intervention. Ce modèle comprend huit aspects: la préparation et l'entrée de l'espace C-SRP, l'accès aux forces et aux connaissances dans un espace centré sur la guérison, faire une pause et créer ensemble, la narration, le témoignage, la réflexion mutuelle, l'affirmation de la narration de la relation et sa revendication, et la perspicacité mutuelle. Ce modèle présente un changement de paradigme dans le travail avec les familles noires américaines et peut-être également d'autres familles marginalisées qui sont aussi impactées par le racisme structurel. Les huit composantes sont expliquées et des exemples sont données de la perspective d'une vision du monde africentrique. L'importance de l'humilité culturelle, d'être à l'écoute de la culture de la famille et d'honorer la culture familiale est également soulignée. Des idées pour la mise en pratique au sein des soins primaires et d'autres contextes sont offertes. Des pratiques d'engagement centrées sur la guérison encastrées dans la C-SRP peuvent faire progresser le travail de SRP vers le domaine de la justice sociale. La C-SRP est un modèle de réflexion de la famille. Des idées de directions futures pour la C-SRP sont discutées.

Are professors of human nutrition faculty at Canadian universities representative with respect to common social constructs of gender and race?

Attributes such as sex and race/ethnicity are associated with inequities in representation. The objective of this study was to assess representation of 2 social constructs, gender and race, of professors of human nutrition in Canada. Using information publicly available October 2021, individuals with the title of assistant, associate, or full professor were identified on websites of 20 Canadian universities offering undergraduate and/or graduate degrees in human nutrition. Individuals were subjectively stratified to social constructs, i.e., white, racialized, or Indigenous, based on photographs, ethnic origin of a surname, and regional and ethnic origin disclosures on university websites, LinkedIn, social media, etc. Gender was assigned based on publicly available photographs and self-disclosed pronouns (when available). Of the 190 individuals, 80% were white, 16.4% were racialized, and 2.6% were Indigenous peoples. The majority (65.3%) were women. In a subset with established doctoral thesis dates and dates of hire at their current institution (n = 153), racialized and Indigenous professors, especially assistant and associate, had earned their doctorate and been hired more recently than their white peers. This study is limited because only individuals with professorial titles were included and the assignment of social constructs for race and gender was subjective. Nevertheless, it establishes an understanding of the proportions of professors of human nutrition who are white, racialized, Indigenous, women, and men. Novelty: Canadian universities strive to be equitable, diverse, and inclusive. One hundred and ninety professors of human nutrition were stratified using social constructs for race and gender. Findings: 65% Women, 80% white, 16.4% racialized, and 2.6% Indigenous.

Travail de care des travailleuses de la santé en situation de pandémie de COVID-19 : quel engagement de la part des autorités gouvernementales?

La COVID-19 a pressé les gouvernements à intervenir à l'aide de données partielles sur l'efficacité des moyens. Les femmes sont particulièrement touchées car elles sont plus nombreuses à s'occuper des autres. Cette étude a pour but de comprendre l'influence des décisions politiques sur les conditions de vie et de travail des travailleuses de la santé. Une analyse des interventions gouvernementales de santé publique du Québec et des revendications des travailleuses de la santé retrouvées dans les documents journalistiques et les communiqués de presse officiels du gouvernement (13 avril au 1er juillet 2020) a été effectuée. Les résultats démontrent le manque de reconnaissance des autorités face à certains types de care, ainsi qu'une inadéquation dans les moyens de prise en charge pour prendre soin de la population. Le peu de reconnaissance des conditions de vie et de travail lors de décisions politiques engendre une répartition inéquitable des fardeaux associés à la pandémie.

Call to action: Centering blackness and disrupting systemic racism in infant mental health research and academic publishing.

The Infant Mental Health Journal is committed to ending systemic racism and promoting diversity, equity, and inclusion in academic publishing. IMHJ unequivocally denounces all forms of racism and white supremacy, including systemic racism in academic publishing. We commit to investigating and working to terminate the ways in which systemic racism has become normalized in academic publishing, including examining our practices and processes at IMHJ. We invite you to join us in intentional, anti-racist work through your scholarship. As part of this effort, IMHJ has updated the author guidelines to include new information regarding how authors can express the ways in which they are engaging with intention in diverse, anti-racist research. These guidelines are available under the author guidelines section on the IMHJ website (https://onlinelibrary.wiley.com/journal/10970355). As a second immediate response relative to promoting diverse, equitable, and inclusive research, IMHJ is releasing the following Call to Action, focusing on centering Blackness in infant and early childhood mental health research. This call is designed as a first step in our efforts, and IMHJ looks forward to coming initiatives aimed at disrupting systemic racism in infant and early childhood mental health research for the many scholars studying and working with diverse populations marginalized by racism and systemic inequities.

La Revista de Salud Mental Infantil está comprometida a terminar el racismo sistémico y promover la diversidad, la equidad y la inclusividad en las publicaciones académicas. La Revista IMHJ censura categóricamente toda forma de racismo y supremacía de la raza blanca, incluyendo el racismo sistémico en publicaciones académicas. Estamos comprometidos a investigar y trabajar para erradicar los medios por los cuales el racismo sistémico se ha convertido en la norma en las publicaciones académicas, incluyendo el examinar nuestras prácticas y procesos dentro de la Revista IMHJ. Les invitamos a que se nos unan en nuestro esfuerzo intencional, antirracista, por medio de sus investigaciones profesionales. Como parte de este esfuerzo, la Revista IMHJ ha actualizado los parámetros para los autores para incluir nueva información acerca de cómo los autores pueden expresar de qué maneras están trabajando con intención en investigaciones diversas, antirracistas. Estos parámetros se encuentran disponibles bajo la sección de parámetros de autor en la página electrónica de la Revista IMHJ (https://onlinelibrary.wiley.com/journal/10970355). Como una segunda respuesta inmediata en relación con el fomento de la investigación diversa, igualitaria e incluyente, la Revista IMHJ presenta esta Llamada a la Acción, la cual se enfoca en centralizar la Negritud en la investigación de salud mental en infantes y la temprana niñez. Esta llamada está diseñada como un primer paso en nuestros esfuerzos y la Revista IMHJ anticipa próximas iniciativas dedicadas a poner fin al racismo sistémico en la investigación sobre salud mental en infantes y la temprana niñez para los muchos investigadores profesionales que estudian y trabajan con grupos diversos de población marginalizados por el racismo y las desigualdades sistémicas.

Le Infant Mental Health Journal s'engage à mettre fin au racisme endémique et à promouvoir la diversité, l'équité, et l'inclusion dans les publications académiques. L'IMHJ dénonce sans équivoque toutes les formes de racisme et de suprématie de la race blanche, y compris le racisme systémique dans les publications académiques. Nous nous engageons à déterminer comment le racisme systémique s'est normalisé dans les publications académiques et nous nous engageons à travailler à éradiquer cette normalisation ainsi qu'à examiner et à disséquer les pratiques et les processus de l'IMHJ. Nous vous invitons à nous rejoindre dans ce travail intentionnel, délibéré et anti-raciste à travers vos recherches. Dans cette optique l'IMHJ a mis à jour les directives pour les auteurs afin d'inclure plus d'informations sur la manière dont les auteurs peuvent exprimer les façons dont ils s'engagent délibérément dans des recherches diverses et anti-racistes. Ces directives sont disponibles dans la section « directives pour auteurs ¼ dans le site de IMHJ (https://onlinelibrary.wiley.com/journal/10970355). De plus, en tant que deuxième réaction immédiate liée à la promotion de recherches diverses, équitables et inclusives, l'IMHJ rend publique l'Appel à l'Action suivant, mettant l'accent sur la nécessité de centrer la condition noire dans les recherches sur la santé mentale du nourrisson et de la petite enfance. Cet appel est le premier pas de nos efforts et l'IMHJ attend avec intérêt les initiatives à venir se donnant pour but de contrecarrer le racisme systémique dans les recherches sur la santé mentale du nourrisson et de la petite enfance pour les nombreux chercheurs étudiant et travaillant avec des populations diverses marginalisées par le racisme et les inéquités systémiques.

The Concept of Oppression and Occupational Therapy: A Critical Interpretive Synthesis.

Background. Occupational therapy and occupational science literature include growing attention to issues of justice, marginalization, and rights. In contrast, the concept of oppression has scarcely been employed. Purpose. This paper investigates how adding the concept of oppression may enhance occupational therapy approaches to injustice, prioritizing a focus on structural causes, and facilitating conscientious action. Method. A critical interpretive synthesis explored insights from authors who name oppressions in occupational therapy and occupational science literature. In total, a sample of 28 papers addressing oppression, ableism, ageism, classism, colonialism, heterosexism, racism, and/or sexism was selected for inclusion. Findings. Four themes were identified: oppression and everyday doing; effects of structures and power; responding and resisting; and oppression within occupational therapy. Implications. Incorporating oppression within the plurality of social discourse may help occupational therapists to avoid individualistic explanations, attend to relationships between social structures and constrained occupations, frame intersectional analysis, and engage in praxis.