Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol.

BACKGROUND: Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants. METHODS: This theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane's framework on health systems' responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers. DISCUSSION: This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach-particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

[Sarcoidosis]. / Sarcoïdose.

"Urticaire chronique. Au moins un Français sur cinq aura de l'urticaire au moins une fois dans sa vie, mais il ne développera une urticaire chronique que dans 10 % des cas. Le médecin doit savoir reconnaître les caractéristiques essentielles du diagnostic : papules oedémateuses érythémateuses fugaces durant chacune moins de 24  heures +/- angioedèmes durant moins de 72  heures et survenant pendant plus de 6  semaines (quasi) quotidiennement. Toute différence avec cette définition doit faire consulter un dermatologue pour les diagnostics différentiels. Il faut expliquer au patient que l'urticaire chronique n'est pas allergique, qu'elle peut être spontanée ou ne se déclencher que dans certaines circonstances(friction, froid, etc.), ne nécessite un bilan que dans de rares cas, tout en restant à l'écoute sur l'altération de la qualité de vie ressentie. Un traitement en paliers doit être proposé en s'aidant des recommandations françaises sur l'urticaire chronique disponibles en ligne depuis 2019 : antihistaminiques anti-H1 de 2e  génération exclusivement, si besoin à posologie augmentée, puis, en cas d'échec bien défini, adresser à un spécialiste pour un traitement de palier  3 par biothérapie ou immunosuppresseur."