[Highlighting the Lived Experience of Families: Family Peer Support Services Initiative]. / Mettre à contribution le vécu expérientiel des familles : l'initiative Pair Aidant Famille.

To support personal recovery, any person with a mental illness should have access to a range of practices recommended by scientific evidence. The peer support are some of the services recommended by the Mental Health Commission of Canada for the reduction of the economic and social burden of mental illness. If peer support from families is poorly documented, peer support and mutual aid from users have been the subject of several studies. Based on two studies in which she participated, addressing the needs of families, and its experience as a non-profit support organization for families, the Quebec Society of Schizophrenia (QSS) has reflected on the family support problem upon entry in the health system as well as the involvement of families as peer support. This article presents the implementation pilot project of Family Peer Support services initiative, fruit of collaboration between QSS and University Institute of Mental Health in Montreal and the issues and recommendations of the first year of implementation.

Reasons for migration among medical students from Karachi.

CONTEXT: The subject of economic migration among health care professionals has received intense attention. However, the aetiology of this migration has not been rigorously evaluated in Pakistan. Such knowledge can potentially influence health care and academic policies. Our current study proposes to quantify the relative contributions of various personal, professional and economic variables among final-year medical students in Karachi. METHODS: A self-administered structured questionnaire using a 10-point scale was developed and piloted among Karachi medical students. Additional open-ended questions were included to allow us to capture information not otherwise covered in the questionnaire. SPSS software was used for data entry and analysis. RESULTS: Over 95% of Aga Khan University (AKU) and over 65% of Baqai University (BU) final-year medical students intend to proceed abroad for their postgraduate training. The 2 most important factors behind this intent as pointed out by the students are poor salary structure (AKU mean score 8.94 +/- 1.73, BU mean score 7.14 +/- 2.6) and poor quality of training in the home country (AKU mean score 9.20 +/- 1.20, BU mean score 8.68 +/- 2.03). Other interesting factors captured through the open-ended questions were the poor work environment and lack of rigor in teaching of residents in domestic university hospitals. Over 50% of final-year medical students cited these issues as major reasons behind their decision to migrate.

Distribution of lower urinary tract symptoms (LUTS) in adult women.

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms. DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002. SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center. RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence was the highest reported complaint (38.4%) followed by burning (34.4%), frequency (26%), painful micturition (20.4%), urge incontinence (18.8 %), incomplete emptying of bladder (14.4%), dribbling (12.4%) and poor stream (8.4%). Forty-three percent of the women with LUTS never consulted a health care provider for their problem. CONCLUSION: Although the distribution of LUTS among females was found to be high, the patients did not consider it important enough to consult a health care provider. There is a need to create awareness among females regarding LUTS and the need to consult a health care provider for their problems.

[Expected and received assistance from informal social support for aged people in heart surgery]. / Aide attendue et reçue du réseau de soutien social informel par des personnes âgées subissant une chirurgie cardiaque.

This study describes and compares the importance and availability of expected and received types of assistance, during the convalescence period at home, from the informal social support network, as perceived by older persons undergoing heart surgery. The research design is descriptive and comparative. Barrera's conceptual framework has been integrated to Roy's model of adaptation. The 45 participants, 31 men and 14 women with a mean age of 74 years (SD = 3.37 years), underwent myocardium revascularisation, valve replacement, or a combination of both surgeries. The day before the heart surgery and one month following the hospital discharge, the participants completed a French modified and adapted version of the "Inventory of Socially Supportive Behaviors" (Lepage, 1984) to identify perceived importance and availability of expected and received types of assistance (material, physical, emotional, guidance, and feedback) while at home on convalescence. Repeated-measure MANOVAs result in significant interactions between importance and availability of assistance, and between the day before heart surgery and one month following hospital discharge in three categories of assistance (emotional, p = 0.002; guidance, p = 0.003; feedback, p = 0.001). ANOVAs indicate that older persons perceive, one month after hospital discharge, the received assistance as important as anticipated the day before their surgery, but its availability is less. It is therefore important for nurses to reevaluate and adapt their pre-operative teaching program for older persons, especially as pertaining to the significant 15 types of assistance, and according to available resources from the informal social support network, and to mobilize the formal support network before hospital discharge.