Research for a Healthy World A UNIQUE CENTRE OF EXCELLENCE

Research for a Healthy WorldA UNIQUE CENTRE OF EXCELLENCE IN PUBLIC HEALTH

ANNUAL REPORT 2012–2014

Contents Message from the Vice-Rector for Research, Creation and Innovation .................................................................... 3 Message from the Director of the IRSPUM ............................................................................................................................ 3 Presenting the IRSPUM ................................................................................................................................................................. 5 The IRSPUM at a glance ................................................................................................................................................................ 6 Research themes .............................................................................................................................................................................. 7 Programs to support emerging and established researchers at the IRSPUM ........................................................ 7 MTGs, chairs and research teams at the IRSPUM ............................................................................................................... 8 MTG1: Social determinants of health ................................................................................................................................ 9 MTG2: Environments and health ...................................................................................................................................... 10 MTG3: Health systems ........................................................................................................................................................... 11 MTG4: Global health ............................................................................................................................................................... 12 MTG5: From knowledge to action .................................................................................................................................... 13 Knowledge translation and dissemination activities ..................................................................................................... 14 Financial statements, April 1, 2012 to March 31, 2014 ................................................................................................. 15 Note: The masculine gender is used in this document to apply to both men and women and for the sole purpose of simplifying the text.

Research for a Healthy World

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MESSAGE FROM THE VICE-RECTOR FOR RESEARCH, CREATION AND INNOVATION

MESSAGE FROM THE DIRECTOR OF THE IRSPUM

The University of Montreal Public Health Research Institute (IRSPUM) is deeply involved in the major social environmental, economic and cultural challenges that are affecting population health both here and elsewhere in the world. The IRSPUM is resolutely tackling these very complex problems, thanks to its remarkable capacity to bring together researchers with deep expertise on a wide variety of issues and methodologies. Through its financial and administrative support to the IRSPUM, the University of Montreal has clearly demonstrated its confidence in this group, which constitutes the largest critical mass of public health researchers in Canada and in the Francophone world. Indeed, the IRSPUM fits squarely within the University’s tradition of excellence in training and research, by mobilizing teams of researchers from eight faculties, one school and one department of the University of Montreal. In summarizing the many activities carried out between 2012 and 2014, this report clearly conveys the dynamism and commitment of the IRSPUM’s researchers, students and staff in their work to improve knowledge and practice in public health. Geneviève Tanguay

This second annual report of the IRSPUM is an eloquent testimonial to the quality and relevance of our research program. Between 2012 and 2014, our researchers and everyone around them—professionals, students, IRSPUM staff, as well as public, private and community sector partners—have spared no effort to share and combine their knowledge to improve the health of our communities. Not a single week goes by in which IRPSUM studies are not used to shed light on one or another public health issue currently in the news: the environment, global health, health systems, the social determinants of health, translating knowledge into action. IRSPUM researchers are contributing undeniably to the improvement of practices and services. At the IRSPUM, advancing knowledge about public health through interdisciplinary and intersectoral collaboration is not just a matter of principle—it’s very much a daily adventure that we’re pursuing, with as much passion as patience, to tackle the major public health challenges of the 21st century!

Lucie Richard


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PRESENTING THE IRSPUM The University of Montreal Public Health Research Institute (IRSPUM) was officially launched in April 2009, building on the firm foundation of three decades of research excellence generated by a number of University of Montreal groups and teams, including the GRIS and the GRASP. The IRSPUM continues to be the largest body of public health researchers working in a university setting in Canada and in the Francophone world. The IRSPUM is funded by the Fonds de recherche du Québec – Santé (FRQ–S) and by the University of Montreal’s Vice-Rectorate for Research, Creation and Innovation. A unique centre of excellence in public health The major public health issues could hardly be more relevant than they are right now. The seriousness and complexity of numerous problems—from environmental impacts to population aging, by way of the Ebola virus or health inequities—present challenges every day to decision-makers, managers and practitioners responsible for health networks both here and elsewhere in the world. Hence the need for scientific programming based on a comprehensive vision of health and enriched by exemplary interdisciplinary and intersectoral synergy. In fact, over the past two years, the IRSPUM has supported the work of more than 200 full or associate researchers, coming from:

• 8 faculties, one school and one department of the University of Montreal (medicine, dentistry, arts and sciences, nursing, veterinary medicine, pharmacy, education sciences, law, public health and kinesiology); • 13 other universities or external research institutes (including McGill, Sherbrooke and Laval universities and the Institut de recherche Robert-Sauvé en santé et en sécurité du travail – IRSST); • 9 research centres and other institutions in the healthcare network (including the Institut national de santé publique du Québec (INSPQ), the Montreal Public Health Directorate and the University of Montreal Hospital Research Centre (CRCHUM). The IRSPUM is a unique centre of excellence attracting world-renowned researchers, students, decision-makers and public health practitioners.

Support services that make all the difference The IRSPUM is also a solid team involved at every step of the various research projects. The IRSPUM support team consists of three administrative technicians, two research technicians, a computer technician and a computer analyst, all of whom provide a wide range of services to researchers and their students. Services begin as early as the grant application stage. The team also manages databanks and performs data analyses, designs websites or online questionnaires (see box), and tackles a wide range of computer challenges. Office services and editing support are also available for the preparation of different research products, from the publication of reports to communications regarding various scientific events.

A day in the life of the IRSPUM: one example! In any given neighbourhood, why is it that tobacco use is higher among certain groups of people? The aim of the Interdisciplinary Study of Inequalities in Smoking (ISIS) is to better understand how the living environments of young Montreal adults relate to their health status: http://isis-montreal.ca/index.php/en/. Data collected from the study’s participants and from observations conducted in certain streets are being validated and combined. The statistical analyses currently under way will fuel the work of researchers and their partners, with the ultimate aim of creating the healthiest possible environments for everyone!

Annual Report 2012–2014

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To find out more about IRSPUM researchers and projects, visit our website: www.irspum.umontreal.ca

THE IRSPUM AT A GLANCE

Researchers 2012–2014 Full researchers 80 Associate researchers 124 Subtotal 204 Research fellows 8 Grants 2012–2013 2013–2014 Based on each researcher’s proportionalcontribution1 $6,224,944 $5,729,213 Number of students 2012–2013

(August-September)2013–2014

(August-September) Active Graduated Active Graduated M.Sc. 258 41 283 24 Ph.D. 228 27 229 21 Postdoctoral 29 N.A. 34 N.A. Number of publications 2012 2013 2014 Peer-reviewed articles (published and accepted) 243 260 277 Chapters or books (published and accepted) 69 56 60

1 Calculation broken down according to the part of the budget allocated to each researcher, by year.


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RESEARCH THEMES The development of interdisciplinary research in public health is organized around five poles, which we refer to here as “major thematic groups” (MTG). The following pages present the fields of activity and major achievements in these five MTGs at the IRSPUM. In public health, as in other fields, obtaining infrastructure funding (chairs, centres, teams, research groups) contributes to the development of expertise (see table, next page). In this, the researchers of the IRSPUM are well positioned, having obtained more than $18 million spread over the years 2012 to 2019, primarily from large funding agencies (CIHR, FRQ–NT, FRQ–S, etc.) but also from private grants. The leverage exerted by these chairs and research teams is likewise evident in the many grants and contracts awarded to IRSPUM researchers and associate researchers for specific research projects. PROGRAMS TO SUPPORT EMERGING AND ESTABLISHED RESEARCHERS AT THE IRSPUM Preparing the next generation of researchers is a priority for the MTGs of the IRSPUM. In 2012–2014, the IRSPUM awarded 70 grants for the dissemination of students’ research results, to support the work of preparing articles for publication, as well as making presentations at scientific conferences. Seven doctoral students received fellowships, four of which were offered in association with the CRCHUM. The IRSPUM also funded internships for three postdoctoral researchers and two emerging researchers.


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MTGS, CHAIRS AND RESEARCH TEAMS AT THE IRSPUM MTG1 SOCIAL DETERMINANTS OF HEALTH

Leader: Alain Marchand School Environments Research Group (GRES) Work and Mental Health Research Team (ERTSM) MTG2 ENVIRONMENTS AND HEALTH

Leader: Sami Haddad Chair in the Analysis and Management of Toxicological Risks, University of Montreal Chair in Meat Safety Research Swine and Poultry Infectious Diseases Research CentreChair in Air Pollution, Climate Change and Health MTG3 HEALTH SYSTEMS

Leader: François Béland Canada Research Chair on Governance and Transformation of Health Care Organizations and systems Medications as Social Objects Team (MÉOS)Canada Research Chair in Healthcare PluralismSanofi-Aventis Pharmaceutical Chair on Medication Use: Policies and Outcomes MTG4 GLOBAL HEALTH

Leader: Maria-Victoria Zunzunegui WHO Collaborating Centre for Nutrition Changes and DevelopmentGender Differences in Mobility: What We Can Learn about Improving Mobility in Old Age Canada Research Chair in Healthcare Pluralism MTG5 FROM KNOWLEDGE TO ACTION

Leader: Pascale Lehoux Canada Research Chair in Community Approaches and Health Inequalities (CACIS) Canada Research Chair on Innovations in HealthEvidence to Reduce Social Inequalities in Health


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MTG1: Social determinants of health The Social Determinants of Health MTG is based on a broad view of the determinants of health, with particular emphasis on social determinants and social inequalities in health. The shared goal of the researchers in this group is to better understand the complex processes through which people’s social positions, their living and working conditions, their income, and public policies influence and link their life and health trajectories. From that starting point, the researchers work to identify levers for action and to design effective interventions to act upon the personal, collective and structural factors underlying health status and health disparities, as can be seen in the following projects:

• Nancy Beauregard, in the School of Industrial Relations of the Faculty of Arts and Sciences, has set up an interfaculty research team on agricultural health and safety. This is a first initiative in Quebec aimed at the multidisciplinary integration of expertise in social sciences (sociology, industrial relations), health (epidemiology, population health) and veterinary science (microbiology, pathology) around this theme. • For Véronique Dupéré, School of Psychoeducation, Faculty of Arts and Sciences, the 2012–2014 emerging researchers fellowship was a springboard to obtaining various grants and subsidies, including an FRQ–S fellowship for a research program to identify the links between exposure to stressful life circumstances, including physical and mental health problems, and school retention of adolescents. She is also developing projects on the conditions surrounding the transition of vulnerable youth into adulthood. • The team of Alain Marchand, School of Industrial Relations, Faculty of Arts and Sciences, is working on the

mental health of workers, and particularly on gender differences with regard to stress in the workplace and outside of working hours and mental health symptomatology. • Lucie Richard, Faculty of Nursing, is interested in the evaluation and renewal of public health practices.

Health promotion laboratories, inspired by communities of practice, are geared toward professional development and practice changes among practitioners who would like to reinforce their upstream influence on health problems in several areas, such as workplace health, child development, and others. • Since 1998, Louise Séguin, in the Department of Social and Preventive Medicine of the School of Public Health, has been pursuing a research program on the relationship between conditions of poverty and child

health. She has conducted studies both in Quebec, as part of the Health Component of the Quebec Longitudinal Study of Child Development (QLSCD), and at the international level, within the INRICH Network (International Network for Research on Inequalities in Child Health), which she co-founded and which includes about 100 members from England, Australia, Brazil, Chile, and other countries.

WHEN PLAY IS NO LONGER CHILD’S PLAY!Stephanie Alexander, a graduate of the public health doctoral program, under the supervision of Katherine Frohlich, in the Department of Social and Preventive Medicine in the School of Public Health, received the Governor-General’s gold medal and the prize for best thesis in the Faculty of Higher Education and Postdoctoral Studies for her thesis entitled All work and no play …? A critical investigation of an emerging public health discourse on children’s play. This thesis, which included five articles either published or in press, was the subject of extensive media coverage. At the end of a study in which 25 children aged 7 to 11 years in the Montreal region photographed their preferred games, the analyses showed that, for these children, play was an activity that was a source of pleasure and had no particular objective. These results raise questions about certain public health programs in which play is too often instrumentalized to accommodate the priority given to physical activity, to the detriment of several aspects of play that are beneficial for children’s emotional and social health.


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MTG2: Environments and health Researchers in the Environments and Health MTG are studying the biological, chemical and physical stressors that threaten the quality of living environments and population health, and are also developing surveillance systems. Their studies are geared toward evaluating and characterizing levels of environmental contamination and of population exposure to various contaminants, as well as their potential effects on health, and assessing, both quantitatively and qualitatively, the attendant risks. They are particularly interested in the surveillance and control of infectious and zoonotic diseases, as well as the risks of occurrence of various diseases, injuries or deaths in the population. • Michel Gérin, in the Department of Environmental and Workplace Health, and his team have been studying the prevention of silicosis and cancer in the construction industry. They have compiled an original databank of more than 4,000 items regarding workplace exposure to silica in this sector. Modelling the data by trade and by task, they have been able to identify potential avenues of prevention in higher-risk situations. This databank has been shared with the more than 15 research and prevention institutions in Canada, the United States, Europe and Australia that have requested it. • Josée Harel, in the Faculty of Veterinary Medicine, and her collaborators have shown that the Escherichia coli O157:H7 strain of bacteria can grow in the human intestinal environment. This is the strain that causes “hamburger disease”, or hemolytic-uremic syndrome, which can result in death in infected persons, and particularly in children. They have also determined why this bacteria prefers human intestines. In fact, O157:H7 is able to use chemical substances present in the human intestine, some of which influence strain virulence. “E. Coli 0157:H7’s ability to use metabolites as a source of nutrients provides the nutritional and competitive advantage needed for its survival, and beyond that, the presence of certain metabolites modulates virulence,” explains Josée Harel. This knowledge will be helpful in selecting appropriate food or probiotics to deprive E. coli 0157:H7 of this vital source of energy. This method should help limit this bacteria’s propagation in the food chain. • Kannan Krishnan, in the Department of Environmental and Workplace Health, received the 2013 Award of Merit from the Society of Toxicology of Canada, an award that highlights outstanding contributions to the field of toxicology in the country. This award recognized the program of original research that has helped to improve the analysis of risks associated with environmental contaminants by constructing pharmacokinetic models based on animal physiology and the molecular structure of chemical substances. • Sami Haddad, in the Department of Environmental and Workplace Health of the School of Public Health, is interested in various types of solvent abuse. He has contributed to the assessment of risks associated with chronic inhalation of low doses of ethanol among workers and in the population at large. In another study on exposure to various solvents, he developed models for interpreting the results of molecular biological markers that are used to support certain diagnoses.

PREVENTING THE EFFECTS OF TRAFFIC NOISE ON POPULATION HEALTHThe team of Audrey Smargiassi, Department of Environmental and Workplace Health in the School of Public Health, has conducted several studies on the risks associated with noise emanating from environmental sources: characterization of noise exposure in Montreal; assessment of the risks associated with noise at Pierre-Elliott Trudeau Airport; and exploration of the effects on sleep and cardiovascular health in relation to levels of ambient noise. These results indicate that significant proportions of residents are exposed to levels of noise that exceed the limits recommended by the World Health Organization. These studies have been used by the Montreal Public Health Directorate in its interventions to influence urban planning and development in the Greater Montreal area by recommending the introduction of a regional policy to minimize noise from automotive, rail and air traffic. This would involve introducing planning criteria and sound-reduction norms in sectors that present high noise levels and limiting certain uses through the development of comprehensive land use policies for the region.


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MTG3: Health systems The Health Systems MTG responds to a growing concern focused particularly on adapting health system funding models to fit the objectives being targeted. The projects in this MTG are geared toward better understanding transformations in healthcare policy, governance, organization and management; at examining their impacts on performance; and at identifying innovations and levers for improving clinical practice and management methods. This MTG’s projects target issues in four priority areas: primary care services, healthcare performance, population aging, and the workforce. • As part of the deployment of the Dossier santé du Québec (DSQ – Quebec Health File), Claude Sicotte, in the Health Administration Department of the School of Public Health, has analyzed the implementation of the

electronic medical prescription (eRx) system and documented exchanges of clinical data between family medicine groups and community pharmacies in the National Capital and Lanaudière regions. These results showed that physicians and pharmacists had a good understanding of the advantages that the eRx system offered them, beginning with the ability to access a complete pharmaceutical profile: legibility (moving away from handwritten prescriptions), improved validity of information networked among several professionals, greater productivity, etc. This study revealed, however, that when using the system, both the physicians and the pharmacists came up against the same shortcomings, which were the limitations of the technology used to transfer the DSQ data to the local systems of the medical clinics and community pharmacies. • Carl-Ardy Dubois, in the Faculty of Nursing, was honoured with the Peter Reizenstein Award for the best article of 2013 by the International Journal for Quality in Health Care. In that article, he presented the results of the MURI project (modèles d'organisation et d'utilisation des ressources infirmières – models for the organization and use of nursing resources) and its impact on care outcomes. Several other projects related to service organization and quality were also carried out, on topics such as innovative work organization practices to contend with staff shortages, or models for organizing clinical microsystems in long-term care. As well, a knowledge synthesis regarding quality indicators known to be nursing-sensitive identified 12 indicators that will be the subject of a major grant proposal to assess their implementation, on a pilot basis, in various care contexts in four Quebec healthcare institutions.

PRIMARY CARE THAT IS ACCESSIBLE, CONTINUOUS AND INTEGRATEDPursuing studies aimed at improving the performance of Quebec’s health system in terms of its capacity to offer accessible, continuous and integrated primary care services, Roxane Borgès Da Silva, a member of the Faculty of Nursing and a 2012–2014 IRSPUM emerging researcher, has obtained a research fellowship from the Fonds de recherche du Québec en santé (FRQ–S). Her research program encompasses several projects, including: • in collaboration with the Montreal and Montérégie health and social services agencies, a study of the impacts of primary care organizational transformations on interorganizational networks, on interprofessional collaborations, and on the population’s experience of care; • in collaboration with researchers from Université Laval and Université du Québec en Outaouais, an evaluation of postnatal services offered by perinatal resource centres, based on the health services evaluation framework developed in her doctoral thesis; • a study of physicians’ multiple practice settings as a form of networking and collaboration, to understand their impact on primary care services provision and on chronic illness management.


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MTG4: Global health Global health is a field of research and practice that focuses on improving health and achieving equity from a world-wide perspective. The inter-connectedness of people, goods and ideas is associated with the globalization of environments, lifestyles, and, of course, major health issues: it is in developing countries—where 4 out of 5 of the world’s inhabitants live—that the problems and challenges of public health are among the most serious. Moreover, given the growing importance of the social and health issues related to immigration in Quebec and in Canada, the Global Health MTG is currently developing a new research program in this area (see box). • Several researchers in this MTG are working in partnership with researchers in low- and middle-income countries to find solutions to their populations’ health problems. Two such examples are the studies being carried out as part of the International Mobility in Aging Study (Maria-Victoria Zunzunegui, Department of Social and Preventive Medicine of the School of Public Health) and the TRANSNUT Program (Hélène Delisle, Department of Nutrition) studying the coexistence of nutritional deficiency disorders and obesity. Annette Leibing, Faculty of Nursing, is also pursuing her medical anthropology research in Brazil, looking at

Alzheimer’ s disease and mental health in the elderly and, more recently, new biotechnologies.

• Thomas K. LeGrand, in the Department of Demography of the Faculty of Arts and Sciences, played a key role in organizing and then publishing the proceedings of a seminar on youth migration and transition to

adulthood in developing countries for the International Union for the Scientific Study of Population. For the young men and women in these countries, migration (rural–rural, rural–urban, or into other countries) may be a process of empowerment that opens up new horizons, but it can also entail serious risks and place them in situations of physical and psychological vulnerability upon arrival in their new destinations. These studies have enabled certain issues in this field to be explored in greater depth, such as the often illicit international migration of young people, about which little is known even now, despite the magnitude of this phenomenon in certain countries.

INTERNATIONAL MIGRATION, INTERGENERATIONAL VULNERABILITY AND HEALTHTaking note of the rise and diversification in immigration in Canada as a whole and in Quebec, Maria-Victoria Zunzunegui, in the School of Public Health, has rallied many collaborators around the theme of international migration, intergenerational vulnerability and health. While there is considerable heterogeneity in the migratory experiences and integration trajectories of immigrant populations, as well as between different generations, there are certain groups who find themselves in vulnerable situations that can affect their well-being. This vulnerability, which may be transmitted from one generation to the next in the host society, is the subject of a new scientific program for which several different grants are being sought. The plan is to create a transdisciplinary Quebec network of researchers who will, among other things, document existing databases related to transnational migration, intergenerational vulnerability and well-being and identify interventions that have either already been carried out or that are currently under way to address the needs identified.


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MTG5: From knowledge to action Researchers working in the From Knowledge to Action MTG are developing knowledge on processes and tools for using the results of public health research in ways that strengthen the links between research, practice and decision-making. Their studies focus particularly on themes related to knowledge use and exchange and on developing models and methods for systematically evaluating interventions to improve population health. They are also interested in the analysis of the social, political and ethical processes that structure the implementation of health and public policies.

• Damien Contandriopoulos, in the Faculty of Nursing, conducted a study that suggested a significant

decrease in the productivity of physicians in Quebec. In fact, preliminary results of the analysis of data from the Régie de l’assurance maladie du Québec (RAMQ) showed that, despite significant investments in physician remuneration in Quebec, the volume of medical services was either stagnating or decreasing. These preliminary results, and the subsequent publication of a scientific article, led to a number of news reports and articles that opened up a wide public debate on the appropriateness of decisions related to investments in the area of physician remuneration. • Networks of community organizations working on food security in Quebec asked the Chair in Community Approaches and Health Inequalities (CACIS – Chaire Approches communautaires et inégalités de santé), directed by Louise Potvin, in the Department of Social and Preventive Medicine of the School of Public Health, to study the impacts of food security interventions. With the particular contribution of Federico

Roncarolo, postdoctoral fellow, this study revealed important differences between people who benefited from traditional interventions, such as direct food aid, and those who took part in interventions in which they took charge of their own nutrition, such as collective kitchens. Using a systematic knowledge transfer strategy involving managers and workers in these community organizations (conferences, tools, training the trainers), the results of this study will be directed toward actions to solve problems related to access to adequate food and healthy living conditions.

DRAW ME A FUTURE! As part of this project, Pascale Lehoux, in the Department of Health Administration in the School of Public Health, examined the potential of an innovative system for thinking about ethical and social issues raised by new health technologies. This process was based on three fields of knowledge: fiction, used as a means of exploring difficult issues in non-threatening ways; public deliberation, which encourages participants to weigh and carefully consider arguments; and prospective thinking, which elicits a plausible future to elicit participants’ reflection. To project participants into a not-so-distant future (2030–2040), the team imagined three technologies inspired by current trends. A series of video capsules (http://www.hinnovic.org/dessine-moi-un-futur-recherche) was created to illustrate the functioning of each technology. These three videos were the subject of discussion in four workshops attended by ten participants, who then were joined by other participants recruited from the general public for an online forum. Participants were presented with hypothetical personal and collective dilemmas for discussion in relation to each technology. The results of this study will be used for teaching purposes in the fields of ethics, design, health policy, and medical sociology.


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KNOWLEDGE TRANSLATION AND DISSEMINATION ACTIVITIES The IRSPUM is a very active centre for knowledge dissemination and exchange. In addition to the influence exerted by researchers, fellows and students through presentations at various conferences and scientific colloquia, there are another 20 or so seminars offered each year to the public health research and practice community. The IRSPUM scientific seminars take place every two weeks during the fall and winter semesters and are generally broadcast simultaneously online and archived for later consultation in the media library, accessible through the IRSPUM’s website. These seminars are the product of numerous IRSPUM collaborations with the home departments of the conference presenters, or with research units that have invited international speakers or other organizations working in public health. These seminars cover a wide range of public health issues, whether in relation to specific problems (health inequalities, organizational performance, mental health, etc.) or situations affecting certain populations (elderly, immigrants, indigenous communities, etc.), all of which may be examined at the local, provincial, national or international (Brazil, West Africa, etc.) levels. Two major conferences were held under the IRSPUM banner. An international scientific conference on the theme of Chronic illness and the new public health: vision, research, intervention was held in October 2013. Currently an issue at the forefront of public health research, the management of chronic illnesses is a reliable indicator of a health system’s capacity to deal with complex health problems. This conference was held in the context of the G3 accord signed in 2012 between the Free University of Brussels, the University of Geneva, and the University of Montreal. It involved 25 speakers from five countries (Canada, the United States, the United Kingdom, Switzerland and Belgium) and attracted 125 participants. This conference received contributions from the Quebec Public Health Institute, the Quebec Population Health Research Network, the Montreal Health and Social Services Agency, and the University of Montreal Public Health Students Association. Another conference, on the theme of Ethical issues related to resource constraints and their impacts on the health system, was organized in November 2013 by the bioethics programs of the Department of Social and Preventive Medicine, with a scientific committee made up of IRSPUM members. Bringing together 190 participants, 23 speakers and 11 presenters who responded to the call for contributions, this conference was a resounding success! The aim of the conference was to share the results of studies on resource constraints in the health system and the resulting ethical issues. It was also intended to inform the different actors at all levels of decision-making and to spark new initiatives, in terms of both research and interventions. A book is currently being developed from the materials presented at this conference. At the initiative of the Ethics and Population Health Axis of the Quebec Population Health Research Network, the IRSPUM has taken part in organizing Bioethics Café evenings. This activity is designed to bring together people from both the academic and community settings. For instance, in March 2014, a debate was held with the title “Is everyone crazy? Looking at the DSM-5”. These evenings provide a good opportunity for researchers to meet the challenge of putting an issue into lay language—in this case, the well-known Diagnostic and Statistical Manual of Mental Disorders—and for citizens to take part and broaden their reflections on current issues in health.


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FINANCIAL STATEMENTS, APRIL 1, 2012 TO MARCH 31, 2014 2012–2013 2013–2014 GRANTS FRQ–S $750,000 $600,000 CEDAR $150,000 $150,000 Priority funds $250,000 $257,000 FESP $25,000 Total grants $1,175,000 $1,007,000 Balance brought forward from previous years $926,769 $281,190 Balance available $2,101,769 $1,288,190

DIRECT EXPENSES Training grants: Master’s $1,000 Doctoral $103,056 $64,500 Postdoctoral $110,833 $82,000 Emerging researchers $225,279 $111,206 Dissemination activities $47,329 $98,735 Infrastructure support $574,540 $29,832 Research salaries $394,974 $413,283 Research equipment purchases $18,944 $10,046 Total direct expenses $1,474,955 $810,602

INDIRECT EXPENSES Administrative salaries $260,988 $265,042 Administrative support $23,955 $18,919 Other indirect expenses $60,681 $54,156 Total indirect expenses $345,624 $338,117

TOTAL EXPENSES $1,820,579 $1,148,719 Balance carried forward $281,190 $139,471


Research for a Health World A UNIQUE CENTRE OF EXCELLENCE IN PUBLIC HEALTH To contact us: Postal address: University of Montreal Public Health Research Institute (IRSPUM) 7101 Avenue du Parc Pavilion P.O. Box 6128, Centre-Ville Station Montreal, Quebec, Canada H3C 3J7 Civic address: University of Montreal Public Health Research Institute (IRSPUM) 7101 Avenue du Parc, Room 3187-03 Montreal, Quebec, Canada H3N 1X9 Telephone: (514) 343-6185 Email: [email protected] Website: http://www.irspum.umontreal.ca

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Research for a Healthy World A UNIQUE CENTRE OF EXCELLENCE