This study examines how the pre-injury trajectories of injured immigrant workers shape the therapeutic alliance (TA) during work rehabilitation. Based on a longitudinal ethnography conducted in a rehabilitation clinic in Québec, seven trajectories were analyzed through their migratory, professional, and linguistic dimensions. Findings show that professional downgrading, employment precarity, language barriers, and experiences of racism weaken trust-building and the establishment of shared return-to-work goals. When pre-injury employment is perceived as temporary or inadequate, the institutional obligation to return to it generates a symbolic rupture that conflicts with the migrant life project. The study highlights the need for an inclusive and culturally sensitive approach that recognizes immigrant workers’ experiential knowledge as an essential foundation for equitable rehabilitation and a genuine therapeutic alliance.

To meet the demands of Canada’s economy, the number of temporary migrant workers (TMWs) has significantly increased since 2000. However, TMWs are disproportionately represented in jobs characterized by poor working and living conditions. Such exploitation severely impacts their well-being. Addressing this critical issue requires a deeper understanding of the specific effects of employment and immigration status precariousness on the evolution of different dimensions of TMWs’ wellbeing. There is currently a significant lack of robust empirical data on well-being determinants that consider the diverse trajectories of this heterogeneous and vulnerable population. This limits the identification of specific intervention points for various subgroups of TMWs, particularly those experiencing intersectional discrimination. This study addresses these gaps by adopting an intersectional and life-course perspective to examine well-being trajectories among TMWs in Québec. The quantitative component involves a diverse cohort of 1,000 adult TMWs employed in Québec, Canada, who will complete comprehensive questionnaires at three key measurement points over a 24-month period. These questionnaires will capture detailed measures of well-being and factors related to personal, employment/work and social resource losses or gains influencing well-being trajectories. Latent trajectories analysis will be conducted. Additionally, 40 participants who best represent the various identified latent trajectories will engage in qualitative interviews. Thematic analysis of these qualitative data will be integrated with the quantitative findings to provide an in-depth understanding of how social and structural forces shape TMWs’ well-being trajectories. An advisory committee comprising representatives from community organizations, employers, and TMWs will regularly meet to provide professional and personal insights to enhance study methods, materials, and result interpretation. This study will generate novel data to address employment, working, and living condition issues among TMWs, ultimately aiming to enhance their well-being. By integrating theoretical perspectives from many disciplines, the project will significantly contribute to the scientific literature at the intersection of well-being, employment, immigration, and precariousness. Study findings will inform the development of practical tools for employers and for professionals in migration- and well-being-related fields to mitigate risk factors affecting TMWs. A policy brief will also be prepared to communicate findings to policymakers for improving social policies.

In Quebec, injured workers are entitled to medical assistance, wage replacement, and rehabilitation. While many cases are resolved smoothly, ethnographic research reveals that immigrant workers may face disruptions that foster mistrust and hinder recovery. This study examines how mistrust shapes the rehabilitation experiences of immigrant workers and identifies its root causes and impacts. Based on ethnographic observations at a Montreal rehabilitation clinic and 21 in-depth interviews with injured immigrants workers conducted between 2020 and 2024, the research highlights how mistrust emerges from experiences of racism, discrimination, perceived betrayal, employer practices, conflicting medical opinions, and fraudulent behaviors. These factors, often intersecting across institutional systems, contribute to a cumulative burden that impedes recovery and well-being. The findings underscore the need for systemic changes to build trust and improve rehabilitation outcomes for immigrant workers.

Significance:We introduce a fast Raman spectroscopy (SSRS) system that reduces acquisition time and enhances data quality, providing a breakthrough in SSRS for real-time applications. We demonstrate its utility in differentiating brain tissue regions based on lipid and protein content. Aim:Our primary goal was to develop a fast SSRS system that enables rapid data acquisition for in vivo applications. We aimed to investigate its effectiveness in differentiating brain tissue types by analyzing lipid and protein content, ultimately enhancing classification accuracy and supporting advancements in medical diagnostics. Approach:We implemented an optimized circuit and signal processing technique to reduce high-frequency noise and improve signal-to-noise ratio. Brain tissue measurements were validated against staining models, and classification accuracy was tested with principal component analysis (PCA) and support vector machine (SVM). Results:Our SSRS system captures spectra in 1 s which is significantly faster than similar systems. This rapid method enables real-time monitoring and accurate classification of brain regions based on lipid-protein content, confirmed by neurofilament and Nissl staining correlations ( R 2 = 0.75 and 0.55, respectively). Tissue classification showed 80.20% accuracy using spectral intensity at the wavenumbers associated with C-H, CH 3 , and CH 2 vibrations and 81.23% accuracy using PCA-derived features (PC1, PC2, and PC3). Conclusions:The fast-SSRS system marks a significant advance in Raman spectroscopy, improving speed and data quality. Our setup captures finer spectral details, facilitating reliable differentiation of tissue types, as verified by staining methods and PCA. This method shows promise for real-time tissue analysis and medical diagnostics, outperforming traditional Raman techniques in speed and data throughput.

The therapeutic alliance is central to occupational rehabilitation, particularly for immigrant workers who face unique challenges of migration and of social and occupational integration. This study explores the development and maintenance of this alliance between immigrant workers with compensated work injuries and their care providers during work rehabilitation. Using ethnography, semi-structured interviews, and focus groups, the qualitative case study involved 7 injured immigrant workers and their interdisciplinary clinical team. The study identified several factors that weakened the alliance, including administrative complexity, conflicting views on pain and disability, cultural stereotypes, and interorganizational communication issues. Many of these challenges were systemic and structural, occurring outside the clinic, complicating the rehabilitation process, and potentially prolonging the duration of disability. This paper discusses these systemic issues and their implications for the rehabilitation of immigrant workers.

The urgency of managing the COVID-19 health crisis in workplaces led to tensions, work overload, and confusion about preventive measures. This study presents a secondary analysis of qualitative data on paradoxes and double binds (PDBs) experienced by precarious essential workers in Canada who interacted with the public and their supervisors. Based on 13 interviews from a larger qualitative dataset, we examine how workers navigated public health recommendations and organisational demands during the pandemic. Findings reveal multiple organisational and managerial PDBs—both COVID-19-related and pre-existing—that contributed to psychological distress and compromised well-being. We argue that PDBs represent a significant occupational health hazard for precarious workers. Addressing these structural contradictions through proactive management strategies could help mitigate workplace tensions, reduce stress, and enhance resilience in both crisis situations and regular organisational contexts. Our study contributes to occupational health and safety (OHS) by underscoring the risks posed by PDBs and advocating for strategies to support vulnerable workers in navigating conflicting demands.

Migration profoundly impacts the health and well-being of individuals and communities worldwide, yet little attention has been given to the concept of mistrust within immigrant healthcare contexts. This article presents a thematic literature review analyzing peer-reviewed articles to explore the nuanced dimensions of mistrust among immigrant populations receiving healthcare. The thematic analysis then carried out reveals that mistrust is mobilized in different ways and four key themes were analyzed: (1) the definition of mistrust given by the authors; (2) their study population, more particularly, who was mistrusting and who/what the object of their mistrust was; (3) the main sources of mistrust identified by the authors and rooted in various life situations and interactions; and finally, (4) the effects of mistrust reported by the authors, which included effects on beliefs, emotions, and behaviors. Understanding and addressing the roots and effects of mistrust are crucial for fostering trust-based healthcare relationships and improving health outcomes for immigrant populations. This research underscores the importance of culturally competent care, effective communication strategies, and policies aimed at reducing systemic biases and discrimination within healthcare systems to build trust and promote health equity among immigrant communities.

Cet article fait état d’une partie des résultats d’une recherche menée auprès de personnes étudiantes internationales (PÉI) qui fréquentaient des universités québécoises pendant la pandémie de COVID-19. La recherche portait sur les usages sociaux des technologies de l’information et de la communication (TIC) et sur la qualité de vie des PÉI en période de confinement. Les résultats présentés et discutés dans cet article se rapportent plus spécifiquement aux expériences et perceptions des PÉI sur les mesures et les services offerts par les universités en contexte de confinement. Afin de répondre à cet objectif, des entretiens semi-dirigés, menés auprès de 40 PÉI, ont permis d’aborder en profondeur l’expérience de vie personnelle et les perceptions des PÉI dans le contexte du confinement. Selon les PÉI, les mesures déployées par les universités québécoises couvraient cinq aspects principaux de la vie étudiante : (1) les cours et la recherche, (2) l’évaluation des apprentissages, (3) les ressources d’aide, (4) les finances personnelles et (5) la santé mentale et physique. De plus, les PÉI ont identifié (6) des mesures non prises par les universités et ils ont pu exprimer (7) leur appréciation sur l’ensemble des mesures prises par les universités. Les principaux constats sur les sept catégories de réponse nous ont permis d’identifier différentes pistes d’amélioration en tenant compte des particularités des PÉI. Parmi ces pistes d’amélioration, la reconnaissance des spécificités des différents groupes et communautés ainsi que le renforcement des compétences interculturelles des décideurs dans les institutions d’enseignement permettraient de concevoir des interventions, des programmes et des politiques efficaces envers les PÉI, et ce, tout particulièrement en temps de pandémie.

Imaging depth-resolved birefringence and optic axis orientation with polarization sensitive optical coherence tomography (PS-OCT) unveils details of tissue structure and organization that can be of high pathophysiologic, mechanistic, and diagnostic value. For catheter-based PS-OCT, the dynamic rotation of the fiber optic probe, in addition to the polarization effects of the system components, complicates the reliable and robust reconstruction of the sample's optic axis orientation. Addressing this issue, we present a new method for the reconstruction of absolute depth-resolved optic axis orientation in catheter-based PS-OCT by using the intrinsic retardance of the protecting catheter sheath as a stable guide star signal. Throughout the paper, we rigorously inspect the retardance and optic axis orientation of the sheath and validate our method by imaging a birefringent phantom with known optic axis orientation. Reconstructing the optic axis orientation of the phantom, placed at different locations around the catheter, we measured an average absolute deviation (AAD) for the mean optic axis orientation over cross-sectional images of 3.28°, even with significant bending stress on the catheter. This corresponds to an almost three-fold improvement compared to our earlier method (optic axis AAD of 9.41°). We finally highlight the capability of our reconstruction with stereotactic catheter-based PS-OCT of a fresh sheep brain.

Significance:We assess the feasibility of using diffuse reflectance spectroscopy (DRS) and coherent anti-Stokes Raman scattering spectroscopy (CARS) as optical tools for human brain tissue identification during deep brain stimulation (DBS) lead insertion, thereby providing a promising avenue for additional real-time neurosurgical guidance. Aim:We developed a system that can acquire CARS and DRS spectra during the DBS surgery procedure to identify the tissue composition along the lead trajectory. Approach:DRS and CARS spectra were acquired using a custom-built optical probe integrated in a commercial DBS lead. The lead was inserted to target three specific regions in each of the brain hemispheres of a human cadaver. Spectra were acquired during the lead insertion at constant position increments. Spectra were analyzed to classify each spectrum as being from white matter (WM) or gray matter (GM). The results were compared with tissue classification performed on histological brain sections. Results:DRS and CARS spectra obtained using the optical probe can identify WM and GM during DBS lead insertion. The tissue composition along the trajectory toward a specific target is unique and can be differentiated by the optical probe. Moreover, the results obtained with principal component analysis suggest that DRS might be able to detect the presence of blood due to the strong optical absorption of hemoglobin. Conclusions:It is possible to use optical measurements from the DBS lead during surgery to identify WM and GM and possibly the presence of blood in human brain tissue. The proposed optical tool could inform the surgeon during the lead placement if the lead has reached the target as planned. Our tool could eventually replace microelectrode recordings, which would streamline the process and reduce surgery time. Further developments are required to fully integrate these tools into standard clinical procedures.

The Tool for Supporting a Gradual Return to Work (TS-GRTW) allows implementation of gradual RTW by facilitating collaboration between employers and workers with MSD-related work disabilities. This tool was adapted for use with workers who have common mental disorders, taking some vulnerability factors into account. The aim is to test the usability of this adapted tool with individuals responsible for disability management in workplaces. A simple descriptive design was retained. Purposive sampling was used to recruit 23 individuals working for at least the previous year in disability management in their workplace. Various types of workplaces were sought. Semi-structured interviews were conducted and transcribed. The verbatim were analyzed based on a qualitative approach.“ The participants (6 M, 17 F, mean age 42.6 years, SD 8.1) came from 10 activity sectors, mostly in large companies. Many of them (17/23) saw benefits in using the tool in their organization, as it allows to: 1. standardize the RTW process, 2. delegate tasks to managers and supervisors, 3. structure communication among stakeholders, 4. monitor actions 5. motivate worker engagement, and 6. foster common understanding and legitimization of the process within the organization. A large proportion of participants (17/23) envisaged using the tool. Certain organizational constraints could limit implementation (e.g. lack of time). Our results support the usability of the adapted TS-GRTW by potential users. However, our results mainly reflect large companies, which often have structures in place. The next step would be to test usability with the workers and its implementation.

BackgroundIn Quebec, injured workers have access to medical assistance, wage replacement indemnities, and rehabilitation measures, with most injuries resolved easily. However, a small percentage of cases require a lengthy rehabilitation process, which is particularly complex when involving immigrants. The therapeutic alliance is at the heart of the process, involving mutual trust and confidence and a degree of consensus about the therapeutic interventions to be used and, ultimately, the return to work.ObjectiveThis article delves into the concept of mistrust as more than the absence of trust, and sheds light on its role in the rehabilitation process of immigrant workers.MethodDrawing from a literature review on mistrust of immigrants in the healthcare setting and comprehensive studies on the rehabilitation process, a conceptual framework for understanding mistrust in this context is proposed.ResultsVulnerable situations, such as precarious employment and/or temporary immigration status, create fertile ground for mistrust. Negative experiences with healthcare professionals or systems further exacerbate mistrust, as do social stigmas within the rehabilitation system. Cross-cultural miscommunications such as differences in communication styles or beliefs about illnesses further complicate matters, emphasizing the need for culturally sensitive approaches.ConclusionAddressing mistrust requires understanding its origins and consequences, as well as providing guidelines for practitioners to enable them to recognize and manage it effectively. Further research is crucial to deepen our understanding of mistrust among immigrant workers and develop strategies for promoting trust and cooperation throughout the rehabilitation process.

ABSTRACTElucidating the coupling between the structure and the function of the brain and its development across maturation has attracted a lot of interest in the field of network neuroscience in the last fifteen years. Mounting evidence support the hypothesis that the onset of certain brain disorders is linked with the interplay between the structural architecture of the brain and its functional processes, often accompanied with unusual connectivity features. This paper introduces a method called the Network-based statistic–simultaneous node investigation (NBS-SNI) that integrates both representations into a single framework, and identifies connectivity abnormalities in case-control studies. With this method, significance is given to the properties of the nodes, as well as to their connections. This approach builds on the well-established Network-based statistic (NBS) proposed in 2010. We uncover and identify the regimes in which NBS-SNI offers a gain in statistical resolution to identify a contrast of interest using synthetic data. We also apply our method on two real case-control studies, one consisting of individuals diagnosed with autism and the other consisting of individuals diagnosed with early-psychosis. Using NBS-SNI and node properties such as the closeness centrality and local information dimension, we found hypo and hyperconnected subnetworks and show that our method can offer a 9 percentage points gain in prediction power over the standard NBS.AUTHOR SUMMARYWe propose an extension to the well-known Network-based statistic (NBS) dubbed NBS-SNI, where the extension SNI stands for simultaneous node investigation. The goal of this approach is to integrate nodal properties such as centrality measures into the statistical network-based framework of NBS to probe for abnormal connectivity between important nodes in case-control studies. We expose the regimes where NBS-SNI offers greater statistical resolution for identifying a contrast of interest using synthetic data and test the approach with a real autism-healthy dataset which contains both the structural (DTI) and functional (fMRI) brain networks of each individual. We also tested our approach on a second dataset of individuals diagnosed with early-psychosis. In the second case, our framework is supplemented by incorporating the anatomically derived measures of intrinsic curvature index and gray matter volume directly as a node property, rather than the structural networks, thereby illustrating the versatility of our approach.

PURPOSE:Immigrant workers are more likely to suffer work-related injuries compared to native-born Canadians. Their physical rehabilitation usually involves physiotherapy. This study sought to better understand the experiences of injured immigrant workers receiving compensation and physiotherapy treatments. MATERIALS AND METHODS:We conducted a qualitative study using an interpretive descriptive methodology. Semi-structured interviews were completed with 10 compensated immigrant workers about the physiotherapy services they received. Transcripts were analyzed thematically and with an intersectional lens. RESULTS:Two major themes were identified: 1) complex pathways to physiotherapy, and 2) key pillars of physiotherapy experiences. The first theme demonstrates that a lack of familiarity with the health and compensation systems, delayed access to physiotherapy, and cumulative burdens complicate the care of immigrant workers. The second theme shows that moral/emotional support, pain relief, and the recognition of sociocultural beliefs and fears are key aspects to improving the experiences of care for these workers. CONCLUSIONS:This study offers new insights into physiotherapy in the context of a work injury, which may help physiotherapists adapt care to the complex needs of immigrant workers. The intersectional lens used in the analysis offers interesting ways of accounting for the multiple social identities of these workers.

Abstract Introduction Work disability affects a growing number of workers aged 55 or over (W55+), but little is known about the challenges they face. This study aims to describe the perceived needs of work rehabilitation professionals in order to improve services offered to W55+. Methods This study used a descriptive design with purposive sampling. Occupational therapists, physical therapists, and psychologists were recruited in various workplaces. Qualitative interviews based on the work disability paradigm were conducted and transcribed, and a thematic analysis was performed. Results Sixteen (16) participants (average age 38 years) were interviewed, with near equal representation across men and women, as well as disciplines. The participants identified issues related to the workers themselves (e.g. less capacity to meet the work demands, mitigated engagement), the workplace (e.g. lack of recognition and support) and the insurer (e.g. lack of flexibility in certain rules). They also described how problems of communication with other stakeholders hinder interventions. Five actions aiming to (1) better equip health professionals for interventions with W55+; (2) facilitate communications; (3) support coordination; (4) raise awareness about specific issues and needs of these workers, and (5) promote integrated prevention management in workplaces are proposed to address these concerns. Discussion The results reveal close interactions between systems, and hence the need for action across them. Conclusion Perspectives of employers, insurers and workers need to be documented in order to identify and prioritize the needs to be addressed and actions to be taken to better support the return to work of W55+.

Significance Raman spectroscopy is a valuable technique for tissue identification, but its conventional implementation is hindered by low efficiency due to scattering. Addressing this limitation, we are further developing the wavelength-swept Raman spectroscopy approach. Aim We aim to enhance Raman signal detection by employing a laser capable of sweeping over a wide wavelength range to sequentially excite tissue with different wavelengths, paired with a photodetector featuring a fixed narrow-bandpass filter for collecting the Raman signal at a specific wavelength. Approach We experimentally validate our technique using a fiber-based swept-source Raman spectroscopy setup. In addition, simulations are conducted to assess the efficacy of our approach in comparison with conventional spectrometer-based Raman spectroscopy. Results Our simulations reveal that the wavelength-swept configuration leads to a significantly stronger signal compared with conventional spectrometer-based Raman spectroscopy. Experimentally, our setup demonstrates an improvement of at least 200x in photon detection compared with the spectrometer-based setup. Furthermore, data acquired from different regions of a fixed monkey brain using our technique achieves 99% accuracy in classification via k-nearest neighbor analysis. Conclusions Our study showcases the potential of wavelength-swept Raman spectroscopy for tissue identification, particularly in highly scattering media, such as the brain. The developed technique offers enhanced signal detection capabilities, paving the way for future in vivo applications in tissue characterization.

PurposeDespite evidence of efficacy, the effectiveness of telerehabilitation in real-world clinical settings is still largely unknown. Telerehabilitation requires a substantial transformation of the organization and delivery of traditional services. Considering that a virtual setting can create unique challenges for providing physiotherapy services and given the physical and potential hands-on nature of evidence-based assessments and interventions, it is important to investigate what injured workers think of receiving physiotherapy care via telerehabilitation and to examine if rehabilitation needs are adequately met.MethodsA qualitative interpretive description study was conducted to explore the perspectives and experiences of 17 injured workers receiving physiotherapy via telerehabilitation. Data were collected through semi-structured interviews with participants from three provinces in Western Canada and analysed using thematic analysis. Qualitative rigour criteria of epistemological integrity, analytic logic, interpretive authority, and representative credibility were considered throughout this study.ResultsImplementation of telerehabilitation during the COVID-19 pandemic resulted in mixed perceptions from injured workers. Some viewed telerehabilitation as a resourceful option for providing services during the pandemic lockdown, resulting in maintained communications while overcoming barriers to services (e.g., rural/remote workers, transportation barriers, etc.). However, many thought telerehabilitation was inferior to in-person therapy for assessment and when 'hands-on' interaction was needed. Many believed a hybrid option may be ideal now that pandemic restrictions are lifted, with telerehabilitation supplementing in-person physiotherapy when needed.ConclusionsTelerehabilitation was viewed as a resourceful option during the pandemic and in certain clinical situations (e.g., rural/remote). Workers should be able to make informed choices about service delivery format.

IntroductionThe issue of communications in the public space, and in particular, in the workplace, became critical in the early stages of the SARS-CoV-2 pandemic and was exacerbated by the stress of the drastic transformation of the organization of work, the speed with which new information was being made available, and the constant fear of being infected or developing a more severe or even fatal form of the disease. Although effective communication is the key to fighting a pandemic, some business sectors were more vulnerable and affected than others, and the individuals in particular socio-demographic and economic categories were proportionately more affected by the number of infections and hospitalizations, and by the number of deaths. Therefore, the aim of this article is to present data related to issues faced by essential workers interacting with the public and their employers to mitigate the contagion of SARS-CoV-2 (COVID-19) at work.MethodsFollowing the constructivist paradigm, an interpretative qualitative design was used to conduct one-on-one interviews with precarious/low-wage, public-contact workers (N = 40), managers (N = 16), and key informants (N = 16) on topics related to their work environments in the context of COVID-19 prevention.ResultsThis article has highlighted some aspects of communication in the workplace essential to preventing COVID-19 outbreaks (e.g., access to information in a context of fast-changing instructions, language proficiency, transparency and confidentiality in the workplace, access to clear guidelines). The impact of poor pre-pandemic working relations on crisis management in the workplace also emerged.DiscussionThis study reminds us of the need to develop targeted, tailored messages that, while not providing all the answers, maintain dialog and transparency in workplaces.