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Displaced or depressed? Working in automatable jobs and mental health
No full textAutomation may destroy jobs and change the labor demand structure, thereby potentially impacting workers' mental health. Implementing propensity score matching on French individual survey data, we find that working in an automatable job is associated with a 3 pp increase in the probability of suffering from mental disorders. Fear of automation through fear of job loss, expectation of a required change in skills, and fear of unwanted job mobility seem to be relevant channels to explain the findings
Social patterns of miscarriage reporting and risk: insights from survey data in France
No full textMiscarriages, which are spontaneous pregnancy losses before 20–28 weeks of gestation, affect approximately 15% of recognized pregnancies. Existing population-based evidence of social inequalities in miscarriage risk is inconsistent, partly due to a lack of data. Surveys can be representative of a national population but are subject to underreporting of miscarriages. We examine whether miscarriages are underreported in a French nationally representative survey, FECOND (2010–11), and analyse socioeconomic risk factors for miscarriage. First, we apply a model that estimates miscarriage underreporting. Second, we use multilevel multinomial logistic regressions to examine socio-demographic and epidemiological factors associated with miscarriage. We estimate that 92% of miscarriages were reported, and underreporting was slightly more pronounced among lower-educated women. The estimated prevalence of miscarriages (14% of all pregnancies) is unaffected by underreporting rates and only with small educational differences. Thus, investigating social disparities in miscarriage risk can be done without correcting for reporting bias. Advanced reproductive ages are associated with higher miscarriage risk. Unobserved time-consistent individual characteristics explain the association between miscarriage risk and prior reproductive history. Conversely, education and self-assessed financial conditions are not associated with miscarriage risk. Younger cohorts exhibit a higher miscarriage risk, suggesting an age effect on recall, a cohort effect on pregnancy recognition, or reduced stigma resulting in more reliable reporting of miscarriage. In sum, the miscarriage reporting rate in FECOND survey is relatively high and with only slight social disparities. No large socioeconomic differences were found in miscarriage risk
Vers la couverture sanitaire universelle en Afrique subsaharienne : le paradoxe des mutuelles de santé au Sénégal
No full textDes mutuelles de santé ont été mises en place dans de nombreux pays d’Afrique subsaharienne pour améliorer le recours aux soins et lutter contre les inégalités sociales de santé. C’est le cas au Sénégal, dans des zones rurales où les habitants ne disposaient d’aucune couverture santé. Plusieurs études questionnent leur rôle dans la perspective d’atteindre la couverture sanitaire universelle
Long-term non-progression in children living with HIV: estimates from international cohort data
No full textObjectives: To estimate the probability of long-term nonprogression (LTNP) in the absence of antiretroviral treatment (ART) in children with perinatally acquired HIV, and the impact of LTNP definitions on these estimates.
Design: Analysis of longitudinal routine care data (follow-up to 2016) collected through a collaboration of cohorts of children in routine HIV care across Europe and Thailand.
Methods: LTNP was defined as reaching age 8 years without disease progression (defined as an AIDS diagnosis or immunosuppression based on WHO immunosuppression-for-age thresholds, age-adjusted CD4+z-scores or CD4+ counts). ART initiation was treated as a competing risk (children initiating ART before age 8 were not considered to have LTNP). We included children born domestically in six national HIV cohorts (n = 2481). Additional analyses included domestic-born children enrolled in national cohorts in infancy (aged <12 months, n = 1144, six cohorts), or all domestic-born children in national and nonnational cohorts (n = 4542, 18 cohorts). Results were stratified by birth year.
Results: Among children born domestically in national cohorts in 2004–2007, the probability [95% confidence interval (CI)] of LTNP at age 8 years was 10% (6–15%) based on WHO immunosuppression-for-age criteria. This was lower for children born earlier when ART use was less frequent. Results were similar using other immunosuppression thresholds. Estimates were lower when restricted to domestic-born children in national cohorts enrolled in infancy, and higher when including all domestic-born children.
Conclusion: Up to 10% of children born during 2004–2007 had LTNP at age 8. Our findings may help identify participants with LTNP for research into posttreatment control and HIV cure
Population et changement climatique
No full textAlors qu’elle ne comptait qu’un milliard d’habitants en 1800, la population mondiale a été multipliée par huit en deux siècles, franchissant le seuil des 8 milliards en 2022. D’après les projections des Nations Unies, elle devrait continuer de croître jusqu’à atteindre près de 10 milliards d’ici 2050. Selon une idée répandue, cette « surpopulation » serait l’une des principales causes, sinon la première, du réchauffement climatique et de l’érosion de la biodiversité. Or, le lien ainsi fait entre population et environnement est-il vraiment établi ? La décroissance démographique serait-elle une condition sine qua non de la transition écologique
Cluster Analysis of Palliative Care Patients’ Trajectories in Primary Care: Hospitalization Yes, but Home and Nursing Home Care Above All
No full textBackground: Understanding the environment in which patients live at the end of their lives is essential to improving palliative care for these patients and their families.
Objectives: We aimed to explore the different living places and trajectories of palliative care patients in the last three months of life in primary care and to identify patient characteristics associated with these trajectories.
Methods: This retrospective national study was carried out among a population of adult patients who died a non-sudden death. The trajectories were modeled and classified using sequence analysis, optimal matching, and hierarchical ascendant clustering. Univariate and multivariate multinomial logistic regression compared patient characteristics associated with these trajectories. The focus was on primary care. Patients had to have spent at least one day at home or in a nursing home in the last three months before their death. The research took place between November 2020 and November 2021 in mainland France.
Results: Three hundred adult patients were included in the study. Cluster analysis revealed three main trajectories during the last three months of life: “staying at home” (57%), “staying in a nursing home” (29%), and “moving from home to hospital” (14%). Dementia and having children limited hospitalization. Not having an informal caregiver and having dementia were associated with staying in a nursing home.
Conclusions: Palliative care patients’ living situations and transitions can be tracked using primary care practice data. This study highlights the unique needs of palliative care in home and nursing home settings. Additionally, factors such as dementia and family dynamics play a significant role in determining where patients live, which can help inform clinical practices and research strategies in palliative care
Impact of early life exposure to heat and cold on linguistic development in two-year-old children: findings from the ELFE cohort study
No full textA number of negative developmental outcomes in response to extreme temperature have been documented. Yet, to our knowledge, environmental research has left the question of the effect of temperature on human neurodevelopment largely unexplored. Here, we aimed to investigate the effect of ambient temperature on linguistic development at the age of 2 years-old
La construction scripturale de la légalité. Les pratiques punitives en prison à l’épreuve de leur encadrement juridique
No full textCet article analyse les effets de l’encadrement juridique croissant de la répression disciplinaire en prison. La capacité institutionnelle à punir les prisonnier⸱es pour leur comportement est centrale dans la gestion de la détention. Comment un pouvoir essentiellement asymétrique s’accommode-t‑il de la relative symétrisation imposée par le respect du contradictoire, l’assistance d’un avocat et la possibilité d’un recours ? En deçà d’une combinatoire entre juridicisation et judiciarisation, on s’attache à saisir ces transformations au niveau des écrits professionnels. Il s’agit ainsi de complexifier la relation entre l’application de normes juridiques et l’adoption de procédures écrites que Max Weber place au cœur de son analyse de la bureaucratie. Les écrits professionnels traduisent dans le quotidien carcéral les changements normatifs et les risques – réels ou fantasmés – qu’ils font peser sur l’administration et ses agents. Ils donnent également lieu à des pratiques professionnelles d’évitement, d’apprivoisement ou de monopolisation du pouvoir de l’écrit pour redéfinir celui du droit, participant ainsi à une construction scripturale de la légalité. L’enquête ethnographique et documentaire menée dans deux prisons françaises et une direction interrégionale pénitentiaire montre comment, pour ne pas perdre les marges de manœuvre jugées nécessaires au bon ordre de la détention, ce sont les agents pénitentiaires qui, tout au long de la procédure disciplinaire, maîtrisent l’ensemble de ce qui fait trace et donc de ce qui fait droit. La formalisation du dispositif disciplinaire permet alors de redoubler le pouvoir pénitentiaire du pouvoir de la forme du droit
Impact of hypertension on mortality in adults in Moramanga, Madagascar: a retrospective cohort study in the community
No full textBackground: Hypertension remains a global public health problem. This study aimed to evaluate the impact of hypertension on premature mortality among people living in Moramanga, Madagascar.
Methods: Three communes of Moramanga district have been monitored since 2012 as part of the MHURAM project (Moramanga Health Survey in Urban and Rural Areas in Madagascar). In 2013, individuals aged 15 years and above were surveyed to estimate the prevalence of hypertension and identify risk factors. A follow-up survey was conducted in 2016–2017 to record deaths; causes of death were assessed through verbal autopsy (VA). The occurrence of premature death was evaluated using a retrospective cohort study design applied to data collected from adults aged 30 to 70 who participated in the hypertension survey. Mortality rates and partial life expectancy by sex and hypertension status were estimated using survival analysis; covariates associated with premature risk of mortality were identified using a Cox proportional hazards model. The contribution of causes of death to the difference in partial life expectancy between hypertensive and non-hypertensive individuals was evaluated using a decomposition analysis.
Results: There were 4,472 participants in the hypertension survey aged between 30 and 70 during the follow-up. The average follow-up was 2.7 years per individual, resulting in 11,892 person-years in total with 117 deaths reported giving a mortality rate of 9.8‰ (13.1‰ for males and 7.1‰ for females). An estimated 3.2 years of life was lost among those diagnosed with hypertension compared to normotensive (32.0 years and 35.2 years respectively). Adjusted for gender, smoking habit, sedentary lifestyle, and wealth index, hypertension is a risk factor for premature death [HR = 1.58 95%CI (1.07–2.36)]. Hypertensive individuals also experienced higher all-cause and communicable disease mortality in people aged between 30 and 39 years.
Conclusion: Hypertension is associated with higher risks of premature death in the community of Moramanga. In addition, hypertension contributes not only to mortality via cardiovascular diseases, but also through all causes combined. The health system should enhance prevention efforts, particularly for young hypertensive patients, when risk is most pronounced
