Background: Many patients with several concurrent medical conditions (multimorbidity) are seen in the primary care setting. A thorough understanding of outcomes associated with multimorbidity would benefit primary care workers of all disciplines. The purpose of this systematic review was to clarify the relationship between the presence of multimorbidity and the quality of life (QOL) or health-related quality of life (HRQOL) of patients seen, or likely to be seen, in the primary care setting.

Une catastrophe naturelle ne correspond pas seulement à l'arrivée d'un malheur effroyable et subit, mais constitue un long processus dans lequel s'engagent les sinistrés. Dans la logique de cette perspective, par la présente réflexion, nous nous proposons d'examiner, à l'aide des écrits scientifiques et des entrevues menées auprès de victimes des inondations survenues dans une région du Québec – le Saguenay – en juillet 1996, les trois points qui vont suivre. Tout d'abord, il y a lieu de voir comment les chercheurs analysent les difficultés qui surviennent à la suite d'un désastre. Il importe ensuite de s’attarder aux considérations méthodologiques, aux caractéristiques sociodémographiques et à l'état de santé postdésastre des sinistrés. Et, enfin, il s'agit d'analyser les principales situations stressantes qui se sont imposées aux sinistrés tout au long du parcours. Il sera alors possible pour les intervenants sociaux de mieux comprendre et aider les victimes, et ce, tout au long du processus.A natural disaster not only involves the appearance of a sudden and appalling calamity but also constitutes a long ongoing process in which the victims are totally involved, a series of events filled with pitfalls in which ideas, emotions, and feelings clash. By using this perspective to analyze scientific evidence and interviews with the victims of the floods of July 1996 in the Saguenay region of Québec, this paper proposes to examine the three following points. First of all, it is important to understand how researchers analyze the difficulties that arise following a disaster. Secondly, it is essential to see these methodological considerations. Finally, there remains the analysis of the principal stressful situations imposed on victims throughout the event

Resilience moderates the association between community belonging and social participation among community-dwelling older women and, especially, men. Interventions targeting social participation should consider the potential impact of resilience on improving community belonging. Future studies should investigate why resilience moderates associations between community belonging and social participation, and how to enhance resilience among older adults.

BackgroundAmong the strategies used to reform primary care, the participation of nurses in primary care practices appears to offer a promising avenue to better meet the needs of vulnerable patients. The present study explores the perceptions and expectations of patients with multimorbidity regarding nurses' presence in primary care practices.Methods18 primary (health) care patients with multimorbidity participated in semi-directed interviews, in order to explore their perceptions and expectations in regard to the involvement of nurses in primary care practices. Interviews were audio-recorded and transcribed. After reviewing the transcripts, the principal investigator and research assistants performed thematic analysis independently and reached consensus on the retained themes.ResultsPatients with multimorbidity were open to the participation of nurses in primary care practices. They expected greater accessibility, for both themselves and for new patients. However, the issue of shared roles between nurses and doctors was a source of concern. Many patients held the traditional view of the nurse's role as an assistant to the doctor in his or her various duties. In general, participants said they were confident about nurses' competency but expressed concern about nurses performing certain acts that their doctor used to, notwithstanding a close collaboration between the two professionals.ConclusionPatients with multimorbidity are open to the involvement of nurses in primary care practices. However, they expect this participation to be established using clear definitions of professional roles and fields of practice.

On July 6 2013, a train derailment occurred in the small town of Lac-Mégantic, Quebec, Canada, causing a major human and environmental disaster. In this case study, we comprehensively describe and analyze actions taken by the Public Health Department of the Eastern Townships, in close collaboration with community-based organizations, during both the impact phase emergency response and the post-impact recovery operations that continued for months. Due to the complexity of the event, public health actions needed to be broadly diversified. Preventive measures targeted chemical, physical, biological, and psychosocial hazards in the short-, medium- and long-term. Our analyses yielded valuable lessons that will improve and inform our response to future events while serving as a basis for developing a conceptual framework for public health emergency preparedness.