bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Clinical Validation of ADHD Behavior Rating Scales
Authors: Snyder Steven M. , Hall James R. , Cornwell Sonya L. , Quintana Humberto
Published: September 2010

The purpose of this review is to assess the range of overall accuracies for Attention Deficit/Hyperactivity Disorder (ADHD) behavior rating scales evaluated in clinical validation studies. Studies were characterized according to the evidence standards of the American Academy of Neurology (AAN). Studies were excluded due to major design problems such as overfitting by discriminant analysis. The 13 included evaluations of rating scales revealed overall accuracy in the range of 59%–79% with a pooled mean of 69% (±7%, standard deviation) and a pooled sample size of 2,228 subjects from nine studies. While some of the excluded studies demonstrated higher overall accuracies (>79%), these studies were observed to have factors in experimental design and statistics that are known to unduly inflate accuracy. We recommend further research following the full AAN standards, namely well-designed, blinded, prospective studies of rating scales applied to clinically representative samples evaluated with a clinical standard.
German Version of the Kuwait University Anxiety Scale: Psychometric Parameters
Authors: Abdel-Khalek Ahmed M. , Rudwan Samer , Reschke Konrad , Tanjour Ismail
Published: September 2010

A German translation of the Kuwait University Anxiety Scale, written originally in Arabic, was prepared. A sample of 207 men and women German college students was recruited. Coefficient alpha was .88, whereas the item-remainder correlations ranged from .21 to .63, denoting good internal consistency. The correlation of the scale with the German form of the Trait Anxiety Scale was .76, indicating high criterion-related validity. Three factors were identified: General, Somatic, and Cognitive/Affective Anxiety. German students scored lower (less anxious) than students from the U.S. and 18 Arab countries. The sex difference was not significant for the German sample.
An Assessment of the Construct Distinctiveness of Stress Arousal and Burnout
Authors: Smith Kenneth J. , Davy Jeanette A. , Everly George S.
Published: September 2010

This study examined the construct and discriminant validity of stress arousal and burnout as measured on the Stress Arousal Scale and the multidimensional role-specific version of the Maslach Burnout Inventory, respectively. The analyses utilized data from 148 individuals randomly selected from a database of 563 respondents to a larger study. The sample responded to a survey sent to members of the American Institute of Certified Public Accountants (AICPA). Sample size used in this study fell within Loehlin's 1992 prescription that for confirmatory factor analysis with two to four factors, a minimum of 100 to 200 cases should be collected. Forty-six respondents indicated that they were partners, principals, or sole practitioners in accounting firms, and 103 indicated that they were staff members (juniors, seniors, or managers). Latent variables were first constructed for the stress arousal and burnout factors. Confirmatory factor analysis was then conducted on the scale data to assess whether the factors would load on their respective underlying theoretical constructs. Finally, a nested model constraining stress arousal and burnout to load on one underlying construct was tested against the hypothesized two-factor model. The results indicated good model fit for the two-factor model and a significant loss of fit for the one-factor model, thus providing strong support for the conceptualization of stress arousal and burnout as distinct constructs.
Association of Pathological Gambling with Depression in Scotland
Authors: Moodie Crawford , Finnigan Frances
Published: September 2010

As most research concerning gambling and depression has been conducted on clinical populations, the present study examined the relationship between gambling and depression across a large sample in Scotland in higher education and the community. A questionnaire-based cluster design involved the distribution of the South Oaks Gambling Screen and the Centre for Epidemiologic Studies Depression Scale mainly to students and staff of higher educational establishments, with small community and gambling samples also included. Thirty-seven colleges and universities across Scotland participated in the research, with a sample of 2,259 people aged sixteen years of age or over ( M = 28.9 yr., SD = 13.4) being obtained. It was found that past-year probable pathological gamblers had significantly higher depression than problem gamblers, nonproblem gamblers, and nongamblers. However, when probable pathological gamblers who had sought treatment were omitted from the analysis, the nontreatment-seeking probable pathological gambling group no longer had significantly higher depression than the problem gambling group. Female problem and probable pathological gamblers had particularly high depressive symptomatology, suggesting comorbid depression may be a prominent feature of problematic female gambling.
Frequency of Cervical and Breast Cancer Screening Rates in a Multi-Ethnic Female College Sample
Authors: Durvasula Ramani S. , Regan Pamela C. , Ureño Oscar , Howell Lisa
Published: September 2010

This exploratory study examined frequency of self-reported cervical and breast cancer screening rates in a multiethnic sample of 331 female university students. In general, rates of lifetime screening were fairly low, with only 41% reporting having ever had a PAP examination and 44% reporting having undergone at least one clinical breast examination. Screening rates differed by ethnicity. Non-Hispanic White and African-American women had higher screening rates than Asian/Pacific Islander and Latina women. The significantly lower rate of screening among the latter groups is of particular concern given the higher cancer mortality rates typically observed in those groups.
Smoking Involvement during Adolescence among African Americans and Puerto Ricans: Risks to Psychological and Physical Well-Being in Young Adulthood
Authors: Brook Judith S. , Balka Elinor B. , Ning Yuming , Whiteman Martin , Finch Stephen J.
Published: September 2010

The major aim of this study was to examine the longitudinal association between adolescent smoking involvement and self-reported psychological and physical outcomes in young adulthood. Participants included 333 African Americans and 329 Puerto Ricans who were surveyed in 1990 in their New York City schools and interviewed in 1995 and 2000-2001, primarily in their homes. The psychological outcomes included ego integration, symptoms of depression, anxiety, and interpersonal difficulty. The physical health measures included a general health rating, number of illnesses, and symptoms of ill health. Also, three scales measured problems due to alcohol, marijuana, and other illicit drug use. Smoking involvement varied by age, sex, and ethnicity but not by socioeconomic status nor by late adolescent parental status. Analysis showed that the relationships between adolescent smoking involvement and psychological and physical health problems in young adulthood remained significant even with control on demographic factors, earlier levels of the outcome variables, and marijuana use. The relationships between smoking behavior and problems with alcohol, marijuana and other illicit drug use were particularly strong. Thus, adolescent smoking seems to have a wide range of clinical implications for young adulthood.
Subjective and Objective Measures of Quality of Life Have Different Predictors for People with Schizophrenia
Authors: Tomotake Masahito , Kaneda Yasuhiro , Iga Jun-Ichi , Kinouchi Sawako , Tayoshi Sumiko , Motoki Ikuyo , Sumitani Satsuki , Yamauchi Ken , Taniguchi Takahide , Ishimoto Yasuhito , Ueno Shu-Ichi , Ohmori Tetsuro
Published: September 2010

This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores –.40 ( p <.001), and with the scores on Interpersonal Relations subscale –.42 ( p <.001), Instrumental Role subscale –.28 ( p = .005), Intrapsychic Foundations subscale –.39 ( p <.001), and Common Objects and Activities subscale –.25 ( p = .014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score –.20 ( p = .05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.
A Constraint-Satisfaction Approach to Studying the Management of Multiple Objectives in Design Problem-Solving
Authors: Chevalier Aline , Cegarra Julien
Published: September 2010

How professional and novice designers manage multiple objectives through constraint satisfaction was studied. An objective is defined as a network of constraints; a constraint is characterized as related to a source (internal or external) and an addressee (e.g., client or user). It has been shown that designers favour objectives related to external constraint (e.g., data from the task) and to the client. Generally, client and external constraints are identical. To study the management of multiple objectives, fifteen web site designers were instructed to design a site according to user's objectives or client's objectives. Our results indicate that the validity status allocated to constraints is more determined by the status of the addressee than by the status of the source, whatever the objective condition that must be satisfied. Possible methodological generalizations are discussed.
Honesty When Lighting Votive Candles in Church: Another Look
Authors: Trinkaus John W.
Published: September 2010

An informal 3-yr. follow-up enquiry of a prior study suggested that the use of electrical, rather than wax, candles seemingly is not a variable relevant to peoples' behavior in paying for lighting votive candles in church. Also, the number of people paying apparently continues to decline: now down (from about 30 percent in 2003) to approximately 25 percent.
Anxiety in Kuwaiti and American College Students
Authors: Abdel-Khalek Ahmed M. , Lester David
Published: September 2010

Samples of Kuwaiti ( n = 646) and American ( n = 320) undergraduates responded to the Kuwait University Anxiety Scale in Arabic and English, respectively. Differences by sex were significant, with women having a higher mean anxiety score than men and by country with Kuwaiti women having a higher anxiety score than American women.
Procedural Justice and Layoff Survivors' Commitment: A Quantitative Review
Authors: Grubb W. Lee
Published: September 2010

Layoffs are common in today's organizations. Most studies that have examined the correlation between procedural justice and the organizational commitment of layoff survivors have yielded positive correlations, but the magnitude of the correlations varies widely. This study is the first to estimate the population correlation and to identify the primary sources that cause variation in the correlation across studies. The results indicated that justice and commitment correlations can always be expected to be positive. Based on a total sample size of 9,080 individuals, the estimated mean population correlation was .34. Variation was primarily explained by attributes of the justice measure where multiple items scales and scales composed of both interactional and procedural justice items yielded higher correlations than single item measures. Therefore, it is important that employers recognize the substantial assuaging affect that procedural and interactional justice can have on survivors' organizational commitment.
College Students with Previous Exposure to Crime Report More PTSD after 9-11-2001
Authors: Saylor Conway , DeRoma Virginia , Swickert Rhonda
Published: September 2010

A sample of 415 university students (52 Crime Victims, 363 Nonvictims) who experienced indirectly the 9/11/01 disaster through media exposure, were administered the Davidson Trauma Scale. Crime victims had significantly more PTSD symptoms related to 9/11 exposure.
Medical and Psychology Students' Disbelief in the Inheritance of Risk Factors for Suicide
Authors: Voracek Martin , Sonneck Gernot
Published: September 2010

Despite convergent evidence for a role of genetic risk factors for suicide stemming from quantitative genetic (family, twin, and adoption designs), molecular genetic, and geographical studies, professionals, likely to be exposed to suicide, appear to disbelieve strongly in the inheritance of risk factors for suicide. In a sample of 1,093 Austrian medical and psychology students, about 80% of respondents did not endorse genetic risk factors for suicide, regardless of their sex, age bracket, field and year of study, and overall knowledge on suicide facts. This may reflect educational gaps, cognitive biases against genetic bases and explanations, or both. One single implication is that this information needs to be incorporated and covered more visibly in medical and psychology textbooks and curricula.
A Comparison of Depression in Children with and without Mothers
Authors: Aral Neriman , Gürsoy Figen , Dizman Hatice
Published: September 2010

The present research investigated depression in children with and without mothers. Differences in depression scores were tested by gender, socio-economic level, the cause of not having a mother, and the age of separation. The sample included 300 fourth and fifth grade elementary school children. Among them, there were 150 children (68 boys and 82 girls) who were living with their mothers and 150 (68 boys and 82 girls) who did not live with their mothers. Each group had an equal number of students ( n = 50) representing three different socio-economic levels (i.e., low, middle, high). Students in the sample came from 39 different public elementary schools. Children's ages varied between 10 and 12 years ( M = 10.8, SD = .6). Teachers, administrators, and school counselors were asked to identify children without mothers. The children who were living with their mothers were randomly chosen. Results showed significant differences in depression between the two groups of children. Furthermore, there was a significant difference by socio-economic level. Depression of children without mothers is significantly associated with the cause of not having a mother and the age when the child was separated from the mother.
Verbal Aggressiveness and State Anxiety of Volleyball Players and Coaches
Authors: Bekiari Alexandra , Patsiaouras Asterios , Kokaridas Dimitrios , Sakellariou Kimon
Published: September 2010

The purpose of the present study was to examine the relation of verbal aggressiveness and state anxiety (somatic, cognitive, and self-confidence) in sports settings based on the ratings by volleyball coaches and their athletes. The sample consisted of volleyball athletes ( n = 208; 98 men and 110 women) and their coaches ( n = 20; 16 men and 4 women). Analysis showed that male volleyball players rated somatic anxiety higher and were more affected by the verbal aggressiveness of their coaches than female volleyball players. No mean differences were significant for male and female coaches on somatic or cognitive anxiety, self-confidence, or verbal aggressiveness. Also, correlation between subscale scores for male and female volleyball players and coaches was found. The correlations of verbal aggressiveness with self-confidence and anxiety were positive for these athletes, leading them to better behavior. This relationship needs further examination in sport settings.
Newspaper Coverage of Injuries Affecting the Spanish Surname Population in Two Counties in Colorado
Authors: Rosales Monica , Smith Sara Anne , Stallones Lorann
Published: September 2010

The present study assessed newspaper reports of injuries affecting individuals with Spanish surnames and compared newspaper reports to hospital injury discharge data in two counties in Colorado. Newspaper reports came from 12 daily and weekly newspapers. Hospital discharge data were obtained from the Colorado Department of Public Health and the Environment. Motor vehicle crashes, assault and legal intervention, and suicide and suicidal acts were counted. A higher proportion of people with Spanish surnames were reported in newspapers than expected based on the hospital discharge data. Motor vehicle injuries were far more frequent based on hospital discharge data than in newspaper reports. Assault and legal intervention injuries were similarly represented by Hispanic ethnicity and absolute numbers in both reporting sources. Suicide and suicidal acts were not often reported in newspapers relative to hospital discharge data; however, the proportion of Hispanics was not significantly different. These findings suggest that the use of newspapers for surveillance of injuries may be helpful, but should not be used in the absence of other data sources.
Valeurs et défis des systèmes de santé français et québécois : introduction au dossier consacré aux rapports Clair et Polton
Authors: Letourmy Alain
Published: September 2010

The first issue of this journal contains a variety of viewpoints on two recent reports that invite us to engage in a serious political rethinking of the future of the French and Quebec health systems. The editorial begins by describing what the two systems have in common, that is, their underlying values (mutualist funding and state responsibility for health care); the high level of overall economic development and the sector's resulting level of economic and technical development; the generally satisfactory health situation of the population; and finally, the type of challenges to be faced by the two systems in the coming years (changes in demand and supply, need to control growth in public health spending while ensuring equity and quality of services). The editorial then goes on to highlight some of the differences between the two systems related to the organization of socialized funding, the sector's human resources and profiles of the use of services, the concept of care and the specific crises in health care and approaches to reform. Finally, attention is given to the context in which the two reports were requested, the mandates given to the committees, and the methods used to produce the reports.
Quel système de santé à l'horizon 2020 ? Présentation du rapport sur l'avenir du système de santé français
Authors: Polton Dominique
Published: September 2010

The development of frameworks for public services gave rise to an overall consideration of the development of health services across France over a twenty year period. Considerable attention is given to a prospective analysis of the issues to be faced by our health system over the next 20 years and of their territorial aspects. The summary presents a synthesis of the currently recognized factors and possible scenarios for: -the changing economic context and social safety net, -the evolution of needs, -dynamics of supply. The report's proposals to enable the French health system to adapt to these changes revolve around four main aspects: -the space of health services, -prevention and health promotion as an overriding priority, -organization of health services, -the system's capacity to adapt and evolve. Finally, the report examines the assessment of the implementation of the health services framework.
La commission de tous les consensus
Authors: Caris Patricia , Joubert Pierre
Published: September 2010

This article analyzes the various questions that arise within an administration when it comes time to transpose the recommendations of a report, such as the Clair Commission Report, to the reality of managing Quebec's health and social services system. The first part of the article briefly describes the process of consultation and how the report was received in January 2001. The Commission's original method of operating and the considerable media attention generated an impetus to appropriate its work and recommendations by the health system's actors, thus helping to raise expectations about future changes. The second part of the article examines the difficulties associated with the implementation of a key recommendation, the family medicine groups. The report emphasizes in particular the major objectives for restructuring primary care, but leaves it to the political and administrative authorities to determine the methods of implementation. The scope of the required changes and the time needed to implement solutions, which were drawn from experiences developed on a small scale, on a system-wide basis are underestimated, by both the political authorities and the population. The economic situation, structural changes, respect for local dynamics and the time needed are all factors which will influence the capacity to implement the recommendations. Implementation is made even more complex by the difficulty in reconciling administrative and political constraints.
Les déterminants des dépenses de santé : une approche macro-économique
Authors: Mahieu Ronan
Published: September 2010

Les dépenses de santé croissent à un rythme historiquement supérieur à celui du PIB, accréditant l'hypothèse que la santé serait l'exemple type d'un bien supérieur (Newhouse [ 1977]). L'idée n'est sans doute pas sans fondements mais les spécificités de la formation de la demande de soins de santé font qu'une analyse entièrement fondée sur la demande ne saurait fournir un cadre explicatif satisfaisant. L'offre de soins est en effet en mesure de jouer fortement sur la consommation, et tout d'abord via son contenu technologique croissant. Une analyse empirique sur plusieurs pays de l'OCDE tend à montrer que la contribution du progrès technique à la croissance du volume des soins est très importante dans la plupart des pays et du même ordre de grandeur que celle de l'effet revenu. Nous complétons cette analyse en tentant d'appréhender les différences de type institutionnel qui existent entre les systèmes de santé via la typologie établie dans les études de l'OCDE qui distingue les systèmes de type intégré, de remboursement et de contrat. La prise en compte des spécificités institutionnelles suggère des écarts importants selon le type de système considéré. L'accroissement annuel «autonome» (hors effets de revenu, de prix et de progrès technique) dans les systèmes de remboursement s'élèverait à + 1,52 %, soit respectivement 0,59 et 0,68 point de plus que dans les systèmes intégrés et contractuels.
Leçons tirées de l’évaluation d’une coordination gérontologique en France : le centre local d’information et de coordination (CLIC) de Lunel
Authors: Gay Marie , Fages Dominique , Colvez Alain
Published: September 2010

Cet article relate les modalités de l’évaluation d’une coordination gérontologique et se propose de rendre compte des difficultés méthodologiques afférentes. Il reprend les conclusions d’un rapport d’évaluation sur le Centre Local d’Information et de Coordination (CLIC) expérimental du bassin de Lunel dans l’Hérault, réalisé au terme de 5 années de mise en place de cette structure. L’intérêt de ne retenir que des indicateurs d’impact simples est clairement mis en évidence. De même, dans le cadre d’une phase de construction, la nécessité de combiner approches qualitative et quantitative dans ce type d’études se révèle indispensable. Les mesures d’impact au niveau des personnes, à travers la santé perçue ou les taux d’hospitalisation, sont apparues quant à elles encore limitées à ce jour, notamment du fait du manque de fiabilité dans le recueil de l’information.
La stratégie nationale de lutte contre la pauvreté et l’exclusion sociale au Québec, défis économiques et enjeux sociaux
Authors: Outin Jean-Luc
Published: September 2010

L’article de Jean-Luc Outin présente une analyse, vue de la France, de la loi votée au Québec sur la lutte contre la pauvreté et l’exclusion sociale. L’auteur souligne l’inspiration fortement libérale de cette loi, mais aussi son ambition qui apparaît plus grande - et plus concrète - que celle de la loi française de lutte contre les exclusions. L’article analyse les cinq principales orientations définies par la loi québécoise et en propose une lecture critique, enrichie d’une comparaison avec la loi française. L’inspiration libérale de la loi ressort clairement des dispositifs concernant la sécurité du revenu qui visent à définir un seuil de ressources, variable selon la composition familiale, que l’État devrait garantir, soit par le biais de programmes de transferts, soit par la fiscalité, pour compléter les revenus propres des ménages. Mais la loi québécoise affiche aussi des ambitions plus fortes pour prévenir l’exclusion sans se limiter, comme en France, à la gestion des conséquences les plus graves de l’exclusion.
Pauvreté et indicateurs de conditions de vie en France – Résultats de l’enquête permanente sur les conditions de vie menée par l’Institut national de la statistique et des études économiques (INSEE) – Évolution 1997-2001
Authors: Crenner Emmanuelle , Dumartin Sylvie
Published: September 2010

Menée en France par l’Institut national de la statistique et des études économiques (INSEE), l’enquête permanente sur les conditions de vie (PCV) permet d’analyser différents indicateurs sociaux. Cet article expose tout d’abord l’ensemble des indicateurs sociaux retenus dans l’enquête et les raisons pour lesquelles ils ont été choisis. Présentés en quatre groupes (situation budgétaire, retards de paiement, restrictions de consommation et conditions de logement), ces indicateurs permettent de calculer un score global qui représente le nombre de difficultés éprouvées dans la vie quotidienne et de calculer un taux de pauvreté en termes de conditions de vie. Après avoir donné l’évolution de ce taux de pauvreté sur la période 1997-2001, les résultats sont présentés pour chacun des groupes d’indicateurs et par catégorie sociale.
Du licenciement à l’exclusion : situation des salariés licenciés dans la Chine d’aujourd’hui
Authors: Tang Jun
Published: September 2010

The article first describes how unemployment was portrayed in socialist ideology in China and how, based on this ideology, the occupational safety of Chinese workers, which was mainly the responsibility of the firm, was constructed. This system was weakened by the structural adjustment of the economy following the reform and opening-up of China. The political decision to turn hidden unemployment into open unemployment swelled the number of “displaced workers”. The experimental reform of the social protection system, which started in July 2001 and should spread throughout the country, should lead to a deterioration of the situation of these workers, with high risks of poverty and exclusion. The article concludes with two suggestions to prevent this exclusion: first, establish labour standards in the labour market and second, improve mechanisms for guaranteed minimum income. The author also points out that the peasants, who represent a vast majority of the Chinese population, are still without social coverage, which is the most severe form of social exclusion.
L’évaluation de la qualité des soins aux personnes âgées
Authors: Barberger-Gateau Pascale , Moty Céline , Pérès Karine
Published: September 2010

This article raises a number of methodological problems related to the assessment of the quality of elder care. In France, the quality of elder care is assessed in the context of reform of the health and social services system and is based on recent laws which are profoundly changing the operating rules of structures. As in any area of care, assessment in gerontology may concern structure, processes or results. A major limitation in the gerontological field is the small number of relevant reference systems. It is difficult to attribute the results observed to intervention in a context of polypathology and complex intervention. Appropriate indicators of the quality of care must be developed and validated, particularly to compare performances of residential and care structures. Despite these problems, assessment of the quality of elder care is even more crucial because this population is large and frail and may find it difficult to express their needs and expectations because they often have cognitive deficits.
Sonder l’opinion des personnes agées quant à la qualité des services à domicile : approches, instruments, constats
Authors: Firbank Oscar
Published: September 2010

Recueillir l’opinion que les personnes âgées ont des soins et des services à domicile (SSAD) dont elles bénéficient constitue un préalable à toute démarche cherchant à mieux gérer la qualité de la prestation. L’exercice, cependant, présente des obstacles en raison des caractéristiques des SSAD, du milieu où ils sont prodigués et des difficultés que les usagers âgés éprouvent pour exprimer leur point de vue sur la question. Plusieurs instruments et méthodes de collecte de données ont été testés à différents endroits, avec des résultats plus ou moins satisfaisants. Cet article propose une analyse systématique des instruments développés pour sonder l’opinion des personnes âgées quant à la qualité des SSAD. L’information ayant servi à sa rédaction provient d’une recension des écrits sur la qualité des SSAD que nous avons réalisée. La conclusion de l’article résume les différents moyens utilisés et considère certaines des difficultés propres à l’articulation entre l’évaluation de la qualité des services faite par les personnes âgées et celle formulée par les intervenants professionnels
La protection défaillante de la santé des travailleurs autonomes et des sous-traitants en droit québécois de la santé au travail
Authors: Lippel Katherine
Published: September 2010

Cet article examine d’un point de vue juridique, et à partir de l’analyse de cas, la protection sociale offerte, en droit québécois, aux travailleurs autonomes et aux sous-traitants autonomes ou salariés, en matière de santé au travail. L’analyse permet de constater que les véritables travailleurs autonomes sont soustraits à toute protection offerte par la Loi sur la santé et la sécurité du travail

et sont en grande partie exclus des mécanismes de protection du revenu en cas de maladie incapacitante. Les faux autonomes et les salariés de sous-traitants bénéficient, en principe, des lois régissant la prévention et l’indemnisation, mais l’analyse de cas permet de constater que l’application de ces lois est problématique dans leur cas et que les mécanismes visant la protection de la santé sont difficilement applicables dans certains cas de sous-traitance. L’article conclut en présentant certaines recommandations visant à mieux garantir, en conformité avec la

Charte des droits et libertés de la personne,

la protection de la santé de toutes les personnes qui travaillent au Québec. Ces recommandations comprennent l’instauration d’une stratégie collective de mutualisation des risques qui permettrait une protection des travailleurs autonomes contre les pertes de revenus en cas de maladie, la reconnaissance du droit à l’indemnisation pour tout salarié, y compris les travailleurs «domestiques» et les salariés sans permis de travail, et l’instauration d’une responsabilité solidaire des donneurs d’ouvrage et des sous-traitants quant à la protection des droits des salariés en matière de prévention et d’indemnisation.
La construction sociale des inégalités de santé – L’exemple des cancers professionnels
Authors: Thébaud-Mony Annie
Published: September 2010

Morbidity and mortality indicators in France attest to a strong expansion in the cancer epidemic which compels an examination of both the search for the causes and the production of inequalities in cancer. The risk of dying from cancer before age 65 is four times higher for a blue-collar worker than for a white-collar worker. However, occupational cancers recognized in 2002 by the Caisse nationale d’assurance maladie des travailleurs salariés

(national employee health insurance fund) represent less than 1 percent of the annual number of new cancer cases. This article examines the production of knowledge related to inequalities in cancer, the importance attached to occupational risks, and presents a multidisciplinary approach of action-research in public health to identify the inequalities in the recognition of cancers as an occupational disease. Based on knowledge established on the causes of cancer and the social inequalities in cancer, Part One will examine the knowledge produced to date and its limitations. Part Two will present the research question, the methodological tools and the initial results of the action-research process related to the surveillance of occupational cancers implemented since 2002 in Seine-Saint-Denis, by highlighting the contribution of each discipline to data production. In line with the international literature on the relations between social precarization, work and health, these results highlight the precarization of rights to compensation in cases of occupational cancer and raise questions about the backlash of inequality based on the visibility and the very knowledge of workrelated cancers.
Parcours de précarité et couverture sociale
Authors: Frigul Nathalie
Published: September 2010

Today, in France, 10 percent of the population are living below the poverty line. In 20 years, social inequalities have increased in all spheres of life and have intensified in the areas of employment and work. The principles of social protection based on occupational income are making it necessary for an increasingly greater mass of people to rely on welfare mechanisms because they have been deprived of paid employment on a long-term basis and are no longer covered for social risks. These processes of switching over from a situation of rights accessible through work to a situation of welfare certainly affect the health coverage and the deterioration of physical and mental health. The latter is even often due to the working conditions previous to the job termination. Thus, an analysis of health conditions can enhance our understanding of a number of precarization processes. In 2002, a sociological survey of welfare recipients in poor health was conducted in the Somme département. Based on a case study, this article examines a number of processes of construction of medical unemployability, from paid employment to the different paths leading to welfare and, based on its uses, the mechanisms of managing disability either through the special industrial accidents/ occupational disease (IA/ OD) plan or by meeting the conditions for recognition as a disabled worker by the Commission technique d’orientation et de reclassement professionnel (Cotorep, technical commission of orientation and occupational reclassification).
Conciliation travail/famille : quel prix pour l’emploi et le travail des femmes ? À propos de la protection de la grossesse et de la maternité en France et au Québec
Authors: Bretin Hélène , De Koninck Maria , Saurel-Cubizolles Marie-Josèphe
Published: September 2010

This article enhances our knowledge of the construction of social inequalities in health by examining social policies that specifically relate to work/ family balance. The article focuses on the period of a child’s birth and argues that the latter is also a public health issue. Based on examples drawn from research studies conducted in France and Québec, a gap can be observed between the goals set when adopting regulatory and social measures aimed at protecting pregnant women at work or those who are on maternity leave, and the result of their implementation given the context of social relations. Particular attention is focused on maternity leave in France and Québec’s policy of re-assigning pregnant workers. Paid employment provides mothers with many advantages that they do not want to give up. However, the data presented suggest that in both Québec and France, the measures included in public policies and programs are not fully effective because they take shape in a social and cultural reality which limits the recognition of the legitimacy of women’s work and employment.
Mortalité et revenu en France : construction et résultats d’une enquête cas-témoins
Authors: Jusot Florence
Published: September 2010

Bien qu’il existe une longue tradition d’étude de la mortalité différentielle en France, les liens existants entre mortalité et revenu n’ont jusqu’à présent jamais été étudiés. Ceci s’explique par le manque d’information sur le revenu dans les bases de données démographiques utilisées pour étudier la mortalité. Cet article présente une base de données qui a été créée afin d’étudier le risque individuel de décès selon le revenu en France. Il s’agit d’une enquête cas-témoins réalisée à partir de deux bases de données fiscales: l’enquête sur le patrimoine au décès en 1988 et l’enquête sur les revenus fiscaux des ménages de l’année 1990. L’exploitation de cette enquête cas-témoins permet de mettre en évidence une forte corrélation entre revenu et mortalité. Cette relation existe tout au long de la distribution des revenus, indépendamment de l’effet des catégories socioprofessionnelles. Les résultats indiquent une surmortalité liée à la pauvreté mais aussi un effet moins attendu, un effet protecteur de la richesse.
Les inégalités d’accès aux services de santé et leurs déterminants au Burkina Faso
Authors: Haddad Slim , Nougtara Adrien , Ridde Valéry
Published: September 2010

À l’instar de nombreux pays du Sud, le Burkina Faso a mis en place, au cours de la dernière décennie, une ambitieuse réforme sanitaire visant notamment à améliorer l’accessibilité des services sanitaires. L’article vise à analyser les inégalités d’accès aux services de santé plusieurs années après l’implantation de la réforme. Les analyses reposent sur les données d’une enquête conduite auprès de 1 604 ménages (12775 personnes) de trois régions du pays. Les résultats révèlent d’importantes différences dans l’accès aux formations publiques. Plus de la moitié des personnes malades provenant de ménages du quintile de revenu le plus élevé ont utilisé les services publics avant la fin de la première semaine d’un épisode de maladie, alors que moins d’une personne sur quatre l’a fait parmi les ménages les plus pauvres. Deux semaines après le début de la maladie, un homme malade sur deux s’est rendu dans une formation sanitaire publique pour obtenir des soins alors que c’est le cas de moins d’une femme sur deux. Toutes choses étant égales par ailleurs, la propension à utiliser les services d’un professionnel lors d’un épisode de maladie est presque trois fois plus importante dans les familles appartenant au quintile de revenu le plus élevé qu’elle ne l’est dans celles du quintile de revenu le plus faible. D’indéniables progrès ont été réalisés dans l’amélioration de la couverture sanitaire et l’accessibilité géographique. Mais les inégalités d’accès aux soins demeurent frappantes et l’accessibilité financière des services publics reste limitée, notamment pour des groupes tels que les femmes, les plus pauvres et les personnes vivant en zone rurale.
«Notre force de changement » – L’évolution de la périnatalité au Québec – 1973-2003
Authors: Valentini Hélène
Published: September 2010

La périnatalité québécoise a vécu de nombreuses et profondes mutations au cours des trente dernières années. Façonnée par divers mouvements sociaux et féministes, jalonnée de politiques et programmes sectoriels, l’heure est actuellement au bilan, à la reconduction ou à l’identification de nouveaux objectifs. La particularité du Québec réside dans le fait que l’élaboration de ces diverses politiques et programmes a été fortement imprégnée des valeurs et des revendications des mouvements d’humanisation de la naissance au début des années 80, alors que les taux d’interventions obstétricales sont alarmants et que des problèmes sociosanitaires persistent. Les colloques «Accoucher ou se faire accoucher» de 1980 alimenteront la dynamique de la périnatalité au Québec dans les années qui suivent. La vague d’humanisation se répand dans les milieux institutionnels de la santé. La légalisation de la profession de sagefemme figure parmi les faits marquants de cette époque. L’objectif de cet article est de retracer l’évolution de la périnatalité au cours des trente dernières années, de décrire brièvement et de situer ses principaux cadres structurants, en soulignant le contexte dans lequel ils ont été planifiés.
Le programme québécois « Naître égaux – Grandir en santé » Étude des effets sur la santé des mères et des nouveau-nés
Authors: Brodeur Jean-Marc
Published: September 2010

Le programme Naître égaux - Grandir en santé

est un programme qui s’adresse à des femmes enceintes ayant moins de onze années de scolarité et dont le revenu familial est en deçà du seuil de pauvreté. De janvier 1994 à novembre 1998, 1 340 femmes enceintes défavorisées ont été réparties au hasard entre, d’une part, un groupe expérimental recevant, à partir de la 20e semaine de grossesse, des suppléments alimentaires (oeufs, lait, jus d’orange) et un suivi personnalisé et, d’autre part, un groupe contrôle recevant des suppléments alimentaires seulement. Dans l’ensemble, les résultats ne permettent pas de constater de différence significative entre le groupe expérimental et le groupe contrôle tant en ce qui a trait à l’insuffisance de poids à la naissance, au retard de croissance intrautérine ou à la prématurité. Par contre, le programme a eu un effet positif et significatif sur le niveau moyen des symptômes dépressifs postnatals des nouvelles mères. On a aussi noté une forte tendance à faire moins d’anémie postnatale chez les femmes qui ont bénéficié du programme ainsi qu’une fréquence plus élevée d’allaitement maternel après l’accouchement parmi les mères d’origine canadienne. Finalement, sur le plan du soutien social, les femmes du groupe expérimental ont reçu plus d’aide matérielle et elles ont eu plus de possibilités de se confier. Les résultats de ce programme interpellent directement le réseau de la santé et des services sociaux pour qu’il fasse de la réduction des inégalités un véritable enjeu de santé publique. Il faut, hors de tout doute, agir d’abord en amont, avant que les femmes défavorisées ne deviennent enceintes.
Mise en place et évaluation des réseaux de soins périnatals : expériences françaises et étrangères
Authors: Gouyon-Cornet Béatrice , Quantin Catherine , Sagot Paul , Gouyon Jean Bernard
Published: September 2010

Les réseaux de soins périnatals se définissent comme un ensemble organisé de plusieurs personnes physiques ou morales dispersées dans une zone territoriale donnée. Ils ont reçu un fondement légal en France en 1998. Il a alors été demandé aux établissements de coordonner leurs activités pour mettre à la disposition des mères et des nouveaunés les plateaux techniques correspondant à leurs besoins. Des obstacles d’ordre institutionnel, liés à l’absence de cadre administratif, sont apparus. Une autre difficulté est celle de l’évaluation de la qualité des soins au sein des réseaux. Pour lever ces difficultés et favoriser le développement des réseaux, un accompagnement méthodologique et budgétaire est nécessaire.
Le Réseau mère-enfant : une expérience québécoise innovatrice
Authors: Lanouette Monique
Published: September 2010

Le Réseau mère-enfant est un regroupement de vingt centres hospitaliers situés en périphérie du CHU mère-enfant Ste-Justine qui initient, implantent et évaluent des projets cliniques en vue d’améliorer la qualité, l’accessibilité et la continuité des soins et services offerts aux mères et aux enfants au sein des établissements partenaires. Les premières réalisations du Réseau mèreenfant ont démontré l’intérêt des milieux pour des projets cliniques développés en réseau, de même que leur impact sur l’amélioration des pratiques. La recherche d’excellence dans les soins ainsi que la vocation académique du CHU mère-enfant Ste-Justine ont incité à la priorisation du travail en réseau et à la confirmation de l’engagement des partenaires au développement de projets et activités cliniques, académiques et technologiques. Le Réseau mère-enfant étant bien implanté, des liens de communications sont établis entre les répondants médicaux et professionnels des secteurs de pédiatrie et périnatalogie des différents centres et donnent lieu à l’actualisation de plusieurs projets cliniques. Le Réseau mèreenfant est en constante évolution et son avenir est lié à l’engagement et au dynamisme des professionnels impliqués, ainsi qu’à la création des réseaux de soins intégrés, actuellement en voie d’implantation au Québec.
Les inégalités sociales de santé en France
Authors: Leclerc Annette , Niedhammer Isabelle
Published: September 2010

Social inequalities in mortality in France are relatively well known, at least for adults. Data are available also on general morbidity (health “less than good”, impairments and disability). Tobacco and alcohol consumption, leisure physical exercise and obesity are also documented in relation with socioeconomic status. The most striking result is the magnitude of social inequalities for adult men, documented for the period 1982-1996. The health expectancy of a men of 35 classified as higher professional is 7.5 years more than that of an unskilled worker of the same age. For women the corresponding difference is 4 years. Those social inequalities in mortality are larger in France than in other European countries. The study of social inequalities in mortality according to causes of deaths shows that some causes of death play an important role; some others, especially cardiovascular diseases, explain a relatively small part of social inequalities, especially if France is compared with northern European countries. Since data are not available yet for the most recent period, it is difficult to know whether those specificities of France are reducing. In the future, new data will be available; they will allow to get a more precise picture of the situation in France, and to develop comparisons with other countries.