Introduction and Aims: A study was undertaken to verify reports of an increasing presence of crack in downtown Montréal, and to investigate the influence of crack availability on current drug use patterns among street-based cocaine users. Design and Methods: The study combined both qualitative and quantitative methods. These included long-term intensive participant-observation carried out by an ethnographer familiar with the field and a survey. The ethnographic component involved observations and unstructured interviews with 64 street-based cocaine users. Sampling was based on a combination of snowballing and purposeful recruitment methods. For the survey, structured interviews were conducted with a convenience sample of 387 cocaine users attending HIV/HCV prevention programs, downtown Montréal. Results: A gradual shift has occurred in the last ten years, with the crack street market overtaking the powder cocaine street market. Although the data pointed to an increase in crack smoking, 54.5% of survey participants both smoked and injected cocaine. Drug market forces were major contributing factors to the observed modes of cocaine consumption. While the study focused primarily on cocaine users, it became apparent from the ethnographic fieldwork that prescription opioids (POs) were very present on the streets. According to the survey, 52.7% of participants consumed opioids, essentially POs, with 88% of them injecting these drugs. Discussion and Conclusions: Despite the increased availability of crack, injection is still present among cocaine users due at least in part to the concurrent increasing popularity of POs.

Evidence has linked residential instability and engagement in high-risk behaviors. This paper longitudinally examines the relationship between changes in residential stability and changes in HIV risk behaviors among Montréal street youth (SY). Between April 2006 and May 2007, 419 SY (18-25 years old) were recruited in a cohort study. SY (using Montréal street youth agencies services) were eligible if they had had at least one 24-hour episode of homelessness in the previous 30 days. Baseline and follow-up interviews, carried out every 3 months, included completion of a questionnaire (based on Life History Calendar Technique) assessing daily sleeping arrangements since the last interview, and monthly sexual and drug use behaviors. Using mixed-effects logistic regression method, we examined the association between various risk behaviors and residential stability, reached when a youth resided in any of the following settings for a whole month: own place; friends'/partner's/parent's place; any types of housing service (excluding emergency shelters). Analyses were carried out controlling for gender, age, education level, lifetime duration of homelessness, childhood sexual trauma, and lifetime mental health disorders. This calls for more integrated services combining both individual and structural-level interventions to improve the health of street youth.

Aim We tested the efficacy of a brief intervention based on motivational interviewing (MI) to reduce high‐risk injection behaviours over a 6‐month period among people who inject drugs (PWID). Design A single‐site two‐group parallel randomized controlled trial comparing MI with a brief educational intervention (EI). Setting A study office located in downtown Montréal, Canada, close to the community‐based harm reduction programmes where PWID were recruited. Participants PWID who had shared drug injection equipment or shared drugs by backloading or frontloading in the month prior to recruitment were randomized to either the MI (112) or EI (109) groups. Intervention The MI aimed to (1) encourage PWID to voice their desires, needs and reasons to change behaviours; (2) boost motivation to change behaviours; and (3) when the person was ready, support the plan he or she chose to reduce injection risk behaviours. The EI consisted of an individual session about safe injection behaviours. Measurements The primary outcome was defined as having any of these risk behaviours at 6 months: having shared syringes, containers, filters or water to inject drugs in the previous month and backloading/frontloading; each behaviour was examined separately, as secondary outcomes. Findings The probability of reporting a risk injection behaviour decreased in both the MI and the EI groups. At 6‐month follow‐up, participants who reported any risk behaviours were 50% [odds ratio (OR) = 0.50; confidence interval (CI) = 0.13–0.87] less likely to be in the MI group than in the EI group as well as those who reported sharing containers (OR = 0.50; CI = 0.09–0.90). PWID who reported sharing equipment excluding syringes were 53% less likely to be in the MI group (OR = 0.47; CI = 0.11–0.84). Conclusions A brief motivational interviewing intervention was more effective than a brief educational intervention in reducing some high risk injecting behaviours up in the subsequent 6 months.

Little is known about the course of homelessness among youth between the ages of 18 and 25 despite the many characteristics distinguishing them from adolescents and from older street-involved populations. We examined the residential trajectories of homeless young adults in Montréal over a 21-month period and identified determinants of various trajectory profiles. The 365 study participants (79 % men, mean age 21.9 years) were followed for an average of 515 days (range 81-630 days). We assessed housing status with a questionnaire based on the residential follow-back calendar designed by the New Hampshire Dartmouth Research Center. Using latent growth analysis to examine achievement of residential stability over time, we observed three different trajectories: group 1 presented a low probability of housing throughout the entire study period; group 2 showed a high probability of early and stable housing; group 3 displayed a fluctuating pattern. Protective correlates of residential stability included high school education, birth in Canada, and presence of mental health problems. Drug abuse or dependence was associated with a decreased probability of housing.

Objective: Cocaine use and mental health disorders have both been separately identified as risk factors for blood borne virus infection. However, the contribution of specific underlying aspects of mental health to risks is not well documented. The aim of this study was to examine the association between psychological distress and risk behaviors for HIV and Hepatitis C infection among cocaine users.Methods: Individuals who either smoked or injected cocaine were recruited in community-based and addiction treatment programs located in downtown Montreal. Participants were asked to complete an interviewer-administered questionnaire assessing psychological distress based on the Kessler scale (K10). Three-month risk behaviors outcomes included drug injection material sharing (needle, dilution water, cooker, filters, backloading, frontloading or wash), and smoking equipment sharing. Socio-demographic data, severity of cocaine dependence and other substances use information were also collected. Statistical analyses were conducted using logistic regression.Results: Severe psychological distress was reported by 202 (34.3%) out of 589 participants (86.2% male; 76.6% ≥ 30y.o.). The prevalence of sharing was: 14.8% for needles, 24.9% for other injection equipment (378 injectors) and 68.3% for smoking material (508 smokers). Multivariate analysis showed that injectors with severe psychological distress were more likely to report needle sharing (Adjusted Odds Ratio (AOR): 2.1, 95% CI: 1.1-3.8). No significant association was found between K10 score and sharing of other paraphernalia. Conclusion:Severe psychological distress increases the risk of needle sharing, a major risk factor for HIV and HCV infection, but not sharing of other paraphernalia. These results suggest differential psychological mechanisms according to sharing practices. They also support the importance of screening for psychological distress in order to implement adequate preventive interventions aimed at cocaine users.

L'analyse des deux premières revues des infirmières canadiennes-françaises témoigne des efforts déployés par une élite pour établir un modèle particulier de professionnalisation. Membres du clergé, soeurs hospitalières et médecins souhaitent, en fondant La Veilleuse (1924-1927), contrer l'implantation du modèle laïque de l'infirmière professionnelle canadienne-anglaise. Ils font la promotion d'un modèle apostolique basé sur l'identité féminine et nationale. La création de La Garde-malade canadienne-française (1928-1956) devient toutefois nécessaire devant le désengagement des médecins et la laïcisation croissante de la pratique infirmière. Malgré une plus grande ouverture à l'égard du caractère scientifique des soins infirmiers, on continue de proposer un modèle spécifique de l'infirmière professionnelle canadienne-française jusqu'à la Révolution tranquille.The purpose of this article is to study the specific professional model developed by the first French-Canadian nursing publications. Members of the church, nuns and physicians were all trying through La Veilleuse (1924-1927) to establish a model of nursing based on the apostolate of French-Canadian women opposed to the Anglo-Canadian model The creation of La Garde-malade canadienne-française (1928-1956) became an obligation with the gradual defection of physicians from the French-Canadian model and the progressive secularization of nursing. More open to the scientific character of nursing, the review continued to promote a specific claim of the French-Canadian nurse until the Quiet Revolution

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Three hybrid systems were compared to a solvent-based low-VOC system. The goal of the project was to determine if the hybrid systems met the requirements of the kitchen cabinet and furniture industries. Adhesion of each system to the substrate was first evaluated, and significant differences were recorded. Subsequently, resistance to heat and moisture was evaluated using hot box and hot and cold check tests. These tests indicated that the experimental systems generally performed relatively well in terms of thermal resistance, but the appearance of those prepared from solvent-borne sealers and lacquers were less stable. The chemical resistance of these systems was also studied. The ability of the finish to withstand the effects of substances typically found in a kitchen was tested, as was their resistance to detergents and water. All the systems performed very well in vertical testing. Volatile organic compound emissions were finally measured after conditioning times of 3 and 21 days. These tests showed that the different systems behaved quite differently. The systems prepared with solvent-borne sealers and lacquers produced a high level of VOCs at the beginning of the test, with a rapid decrease thereafter, while the opposite was observed in systems based on water-borne sealers and lacquers.