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Usages et pratiques de la digitalisation des soins et des relations : ce que les outils numériques font à la PMA transfrontière
No full textCet article explore divers aspects des usages des outils numériques dans le contexte de la procréation médicalement assistée (PMA) transfrontière, sur la base d’entretiens réalisés auprès de personnes ayant recours à une PMA « hors cadre ». Il met en évidence la place des pratiques numériques lors de la phase d’élaboration du projet parental puis de la mise en œuvre des traitements de PMA. L’article examine par ailleurs la façon dont les outils numériques concourent à l’élargissement des possibles procréatifs au sein du « marché de la fertilité », ainsi que les écueils et les défis inhérents à cette expérience. En comparant les pratiques numériques dans les prises en charge de PMA en France et à l’étranger, nous souhaitons déplacer le questionnement au-delà de l’opposition médecine publique/médecine privée, et ouvrir ainsi de nouvelles pistes de réflexion sur les fonctions et l’appropriation des outils numériques dans la relation de soin
Radical collaboration: Co-creating feminist online graduate courses through a university and museum partnership
No full textIncreasingly, universities are recognizing the need for more dynamic approaches to designing multi-purpose higher education syllabi, to respond to changing student expectations and to foster a more diverse, inclusive and equitable society. We propose here a new model of curriculum development designed to meet this need, specifically in relation to gender justice. Termed ‘radical collaboration’, we speak of an approach in which museum and university professionals work together, with intersectional feminism integral to the methodology and pedagogy. The specific example provided here, of the co-creation of an online graduate module on American Women’s History by the University of Glasgow, UK, in partnership with the Smithsonian Institution, Washington D.C., is explored in some depth. The article concludes by asserting the potential of the model to be applied to other institutional contexts, offering a powerful way for museums and universities to work collaboratively to teach history through a feminist lens
The role of migration for intergenerational mobility
No full textWhen they decide to emigrate, migrants often hope for better socioeconomic prospects for themselves and their children. In this chapter, we review the interdisciplinary empirical literature on social mobility within immigrant families. While immigrants often experience downward mobility upon arrival in the destination country, their children are more likely to be upwardly mobile in terms of both educational attainment and labor-market outcomes. Yet, net of distributional differences between groups, the association between parental and children’s SES (i.e. relative mobility or fluidity) appears more similar in immigrant and native families. Compared to their non-migrant counterparts, immigrant families tend to improve their life chances relative to the origin society. Beyond these master trends, empirical studies show varying patterns between different groups and countries. We explore four main mechanisms accounting for observed differences in mobility: (1) immigrant selection, (2) educational systems, (3) ethnic community and neighborhoods, and (4) racial discrimination
Dénoncer les discriminations vécues à l'université: entre silence, révélation et signalement. Synthèse
No full textÀ partir de l'enquête quantitative ACADISCRI et d'une post-enquête qualitative portant sur l'expérience de discriminations à l’université (auprès d'étudiantes, d’étudiants et de membres du personnel), cette synthèse issue du rapport complet de l'enquête, analyse les facteurs et les mécanismes qui conduisent à signaler institutionnellement les faits subis, à ne les partager que dans des cercles de proches, ou à rester dans le silence et l’isolement. Il explore également les suites données lorsque les faits ont été signalés, et les effets de ces diverses formes de « recours » sur les individus. L’enquête met au jour les obstacles qui entravent les démarches de signalement auprès de l'université. Comme dans de nombreux contextes, l’espace universitaire se caractérise par des rapports de pouvoir et par des modes de fonctionnement qui, non seulement rendent possibles les discriminations, mais pèsent également sur la capacité des individus à les dénoncer. Du
côté des étudiantes et étudiants, une attitude fataliste prédomine, attribuable notamment à une faible connaissance de leurs droits et des dispositifs à solliciter, mais également à un sentiment d’illégitimité à faire valoir ces
droits dans le cadre universitaire, ainsi qu'à un manque de confiance dans la capacité de l'institution à reconnaître et faire cesser le tort subi. Ces dynamiques se retrouvent chez les membres du personnel et concernent notamment celles et ceux occupant des postes précaires ou moins valorisés dans la hiérarchie universitaire. L'enquête met ainsi en lumière un sentiment prégnant d'impuissance chez la plupart des victimes. L'inaction de l'institution pour
réguler certaines situations semble chose courante, souvent connue des étudiants comme des membres du personnel, au moins au sein des filières où les faits ont lieu. Cette inertie contribue à l'émergence de formes de fatalisme face aux discriminations. Selon l'enquête, les (rares) signalements institutionnels effectués donnent lieu à une action des établissements, aboutissent le plus souvent à des arrangements informels et pratiques, prenant généralement la forme de décisions d'éloignement des victimes, dans le cas des étudiantes et étudiants, sans sanction particulière des faits et de leurs auteurs. Mais dans certains cas, aussi, les signalements conduisent à des représailles
envers les personnes qui ont dénoncé les faits.
Le faible nombre de signalements des discriminations, et la très relative réponse institutionnelle peuvent avoir des effets délétères sur les victimes, et sur l’institution universitaire elle-même - voire au-delà. Elle permet en effet aux situations discriminatoires de perdurer, avec toutes les conséquences qui en découlent pour les personnes, et sur leurs trajectoires (arrêt des études, changement de filière ou de poste, troubles physiques, atteintes à la santé mentale…). Par ailleurs, ces situations portent atteinte à l’image des établissements universitaires, et surtout fragilisent la confiance en l’institution, tant de la part de son personnel que de ses usagers
Substantial increase in population exposure to multiple environmental burdens in sub-Saharan Africa (2000-2019)
No full textIn the face of increasing global environmental uncertainties, sub-Saharan Africa stands as a highly vulnerable region with a massive population marked with poverty and inequalities. Moreover, different environmental risk factors can coexist simultaneously as multiple environmental burdens (MEB); however, population exposure to MEB remains unexamined. Here, using open-access spatial data and critical thresholds, we quantify population exposure to four key environmental risk factors: hazardous fine particulate matter (PM2.5) levels, extreme temperature increase, prolonged severe droughts, and green deficit (scarcity of green trees). Further, we explore the concept of MEB, where these risk factors converge. We derive exposure for 2000 and 2019 at the pixel (1 km grid cell) level. We also check how population change, environmental change, and their interaction contribute to the total change in exposure. We found substantial changes in the population exposed from 2000 to 2019, i.e., an increase of ~460 million people to hazardous PM2.5 levels, ~16 million to extreme temperature increase, ~13 million to prolonged severe droughts, and ~246 million to green deficit. Population exposure to at least three of these four environmental risk factors (3EB) has increased by ~246 million. In this increase in exposure to 3EB, the contribution of environmental change is higher (48%), than that of interaction and population change (36% and 15%, respectively). Notably, there are striking disparities in population exposure, its change, and the contributing effects among countries and regions of sub-Saharan Africa
#MeTooGarçons : « 80% des violences ont lieu ou commencent avant l’âge de 18 ans »
No full textLes violences sexuelles à l’encontre des garçons relèvent de rapports de domination liés au genre, à l’âge mais aussi un effet générationnel, englobant une vision spécifique des enfants
The Social Multiplier of Pension Reform
No full textWe study the influence of family members, neighbors and coworkers on retirement behavior. To estimate causal retirement spillovers between individuals, we exploit a pension reform in the Netherlands that creates exogenous variation in peers’ retirement ages, and we use administrative data on the full Dutch population. We find large spillovers in couples, primarily due to women reacting to their husband’s retirement choices. Consistent with homophily in social interactions, the influence of the average sibling, neighbor and coworker is modest, but sizable spillovers emerge between similar individuals in these groups. Additional evidence suggests both leisure complementarities and the transmission of social norms as mechanisms behind retirement spillovers. Our findings imply that pension reforms have a large social multiplier, amplifying their overall impact on retirement behavior by 40%
Organisation of testing services, structural barriers and facilitators of routine HIV self-testing during sexually transmitted infection consultations: a qualitative study of patients and providers in Abidjan, Côte d’Ivoire
No full textBackground
Consultations for sexually transmitted infection (STI) provide an opportunity to offer HIV testing to both patients and their partners. This study describes the organisation of HIV self-testing (HIVST) distribution during STI consultations in Abidjan (Côte d’Ivoire) and analyse the perceived barriers and facilitators associated with the use and redistribution of HIVST kits by STI patients.
Materials and methods
A qualitative study was conducted between March and August 2021 to investigate three services providing HIVST: an antenatal care clinic (ANC), a general health centre that also provided STI consultations, and a dedicated STI clinic. Data were collected through observations of medical consultations with STI patients (N = 98) and interviews with both health professionals involved in HIVST distribution (N = 18) and STI patients who received HIVST kits for their partners (N = 20).
Results
In the ANC clinic, HIV testing was routinely offered during the first prenatal visit. HIVST was commonly offered to women who had been diagnosed with an STI for their partner’s use (27/29 observations). In the general health centre, two parallel pathways coexisted: before the consultation, a risk assessment tool was used to offer HIV testing to eligible patients and, after the consultation, patients who had been diagnosed with an STI were referred to a care assistant for HIVST. Due to this HIV testing patient flow, few offers of HIV testing and HIVST were made in this setting (3/16). At the dedicated STI clinic, an HIVST video was played in the waiting room. According to the health professionals interviewed, this video helped reduce the time required to offer HIVST after the consultation. Task-shifting was implemented there: patients were referred to a nurse for HIV testing, and HIVST was commonly offered to STI patients for their partners’ use (28/53). When an HIVST was offered, it was generally accepted (54/58). Both health professionals and patients perceived HIVST positively despite experiencing a few difficulties with respect to offering HIVST to partners and structural barriers associated with the organisation of services.
Conclusion
The organisation of patient flow and task-shifting influenced HIV testing and offers of HIVST kits. Proposing HIVST is more systematic when HIV testing is routinely offered to all patients. Successful integration requires improving the organisation of services, including task-shifting
La réintégration, une façon de redevenir français
No full textChaque année, autour de 100 000 personnes acquièrent la nationalité française, le plus souvent en lien avec leur situation familiale (mariage, naissance et enfance en France, parents d’enfants français…). Ces acquisitions de nationalité tiennent aussi aux mutations historiques et géopolitiques. Ainsi depuis le début des années 1960, plus de 200 000 personnes sont redevenues françaises après avoir perdu cette nationalité, en particulier lors de l’accès à l’indépendance de territoires colonisés. Cette procédure discrète et méconnue permet d’éclairer certains des « troubles dans la nationalité » de l’ère postcoloniale
Impact of the COVID-19 Pandemic on COPD Patient Mortality: A Nationwide Study in France
No full textWe investigated the mortality patterns of chronic obstructive pulmonary disease (COPD) patients in France relative to a control population, comparing year 2020 to pre-pandemic years 2017-2019.Methods: COPD patient and sex, age and residence matched control cohorts were created from the French National Health Data System. Survival was analyzed using Cox regressions and standardized rates.Results: All-cause mortality increased in 2020 compared to 2019 in the COPD population (+4%), but to a lesser extent than in the control population (+10%). Non-COVID-19 mortality decreased to a greater extent in COPD patients (-5%) than in the controls (-2%). Death rate from COVID-19 was twice as high in the COPD population relative to the control population (547 vs 279 per 100,000 person-years).The direct impact of the pandemic in terms of deaths from COVID-19 was much greater in the COPD population than in the control population. However, the larger decline in non-COVID-19 mortality in COPD patients could reflect a specific protective effect of the containment measures on this population, counterbalancing the direct impact they had been experiencing