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Using cross-sectional data from a representative sample of the French population (the 2008 Disability Health survey), this paper examines whether the SF-6D, a widely used preference-based measure of health-related quality of life in economic evaluations, fully captures the variation in subjective well-being (SWB) due to chronic illnesses. We conduct a mediation analysis to disentangle the direct and indirect, through the SF-6D, effects of various chronic conditions on SWB (happiness). Our results show that the SF-6D reflects changes in happiness due to most illnesses except mental illness. Changes in SWB mediated by the SF-6D account for 74% of the total effect. The variation unexplained by the SF-6D is significant and increases substantially in the presence of multimorbidity when a chronic illness is combined with anxiety or depression. Overall, our results suggest that the SF-6D incompletely captures the subjective experience of chronically ill patients, especially those with comorbid conditions. • 74% of the effect of chronic illness on happiness is captured by the SF-6D. • The SF-6D does not fully capture the effect of mental illness on happiness. • The effect not captured by the SF-6D increases significantly with multimorbidity. [ABSTRACT FROM AUTHOR]

Transmasculine people (TM) constitute an invisibilized group within the transgender population. Little is known about their relationship to sexuality in transgender medicine. Their presence and needs are still unacknowledged within HIV prevention research and services. Pre-exposure prophylaxis (or PrEP) is an oral medication that prevents HIV in HIV-negative individuals at risk of infection with the virus. This paper proposes to bring TM back into the focus of PrEP research by questioning how they navigate and situate themselves in relation to existing PrEP categorization and services, and how they think about and (re)shape the meanings of PrEP. It is based on the "interpretative descriptive" method and a transfeminist theoretical framework applied to the analysis of ten semi-structured interviews with TM conducted in France between 2019 and 2023. Findings show that PrEP is gendered. We identify specific barriers to getting PrEP as well as to access healthcare and we show that a cisnormative and homonormative approach to prevention generates them. PrEP use and PrEP disclosure are embedded in structural and symbolic power relations between cisgender and transgender MSM that are reflected in the intimate sphere. TM use PrEP to prevent sexual assault and to alleviate the difficulty of condom negotiation. PrEP comes into play following major changes in TM's sexualities and is integrated post-exposure. • Transgender men are excluded from the MSM populations targeted by PrEP. • The uses and non-uses of PrEP by transgender men reveal that PrEP is gendered. • PrEP for HIV reveals unequal power relations between trans and cisgender MSM. • PrEP is embedded in unique temporalities inherent in transgender men's transitions. [ABSTRACT FROM AUTHOR]

Disparities in breast cancer screening are often explained by socioeconomic factors, although a growing body of papers show that risk preference, time orientation and perceptions may explain mammography use. The aim of this paper is to estimate the relative contribution of socioeconomic factors, risk preference, time orientation and perceptions to disparities in breast cancer screening regularity. These determinants are elicited in an experimental laboratory from 178 women aged between 50 and 75 years in France in 2013. The results reveal that risk aversion accounts for 30% of the variance in screening regularity, which is greater than that attributable to socioeconomic determinants (20%), perceptions (11.5%) or time orientation (2%). These results suggest that further investigation on the relationship between risk aversion and screening behaviors is needed to design more comprehensive public health interventions. [ABSTRACT FROM AUTHOR]

Although operating an emergency department (ED) can influence general admission activity of hospitals, most articles that analyze hospital care ignore the potential spillover of emergency activity. In this paper, we examine the consequences of a French reform that encouraged the creation of EDs within private-for-profit (PFP) hospitals in order to decrease congestion in EDs. We use administrative panel data on 365 French PFP hospitals observed between 2002 and 2012. Specifications including hospital fixed-effects are estimated to examine the impact of an ED opening on private hospitals' admission activity, namely inpatient and day-care admissions (ED visits are excluded, but patients admitted following an ED visit are included). We control for shocks that can impact demand for care in hospitals, and we estimate yearly changes before and after the opening. We find that an ED opening is followed by an increase in the number and proportion of inpatient admissions, and by an increase in the length of inpatient stays. A transitory increase in the bed occupancy rate is also observed. In many countries, public and private hospitals compete to some extent. The former provide a public service, while the latter are profit-maximizers that are allowed to specialize in profitable activities. They generally focus on day-care admissions. We provide empirical evidence that private hospitals experience a significant change in the composition of their admissions when they start providing emergency care. Opening an ED creates a new non-selective entryway to private hospitals, resulting in admissions of inpatients with health problems that are more severe. Hence, involving PFP hospitals in the provision of emergency care is likely to make the structure of admissions of private hospitals closer to that of public hospitals. • Financial incentives encouraged the creation of EDs among French private hospitals. • Starting up emergency care spills over to private hospital admissions. • ED opening increases hospital's proportion and length of inpatient admissions. • Results suggest higher severity of patients' conditions after opening. • Structure of stays in private and public hospitals gets more similar after ED opening. [ABSTRACT FROM AUTHOR]

Abstract: The concept of ‘neighbourhood’ as a unit of analysis has received considerable research attention over the last decade. Many of these studies raise the question of the influence of local characteristics on variations in health and more recently, researchers have sought to understand how the neighbourhood can influence individual health through individual behaviour. Relatively few studies discuss the question of the borders and definition of a neighbourhood but we know that the results from health or population datasets are very sensitive to how zones are constructed – part of the Modifiable Areal Unit Problem (MAUP). In reality, we know that neighbourhoods are not constrained by artificial statistical boundaries, but rather exist as complex multi-dimensional living communities. This paper tries to better represent the reality on the ground of these communities to better inform studies of health. In this work, we have developed an experimental approach for the automated design of neighbourhoods using a small tessellated cell as a basic building block. Using the software AZTool, we considered population, shape and homogeneity constraints to develop a highly innovative approach to zone construction. The paper reports the challenges and compromises involved in building these new synthetic neighbourhoods. We provide a fully worked example of how our new synthetic homogeneous zones perform using data from Strasbourg, France. We examine data on Asthma reported through calls to the emergency services, and compare these rates with an index of multiple deprivation (NDI) which we have constructed and reported elsewhere. Higher correlations between Asthma and NDI were found using our newly constructed synthetic zones than using the existing French census areas of similar size. The significance of our work is that we show that careful construction of neighbourhoods – which we claim are more realistic than census areas – can greatly aid unpacking our understanding of neighbourhood relationships between health and the social and physical environments. [Copyright &y& Elsevier]

The controversy over packing therapy used in psychiatry was studied here to illustrate how leading associations can influence public health policies. The main French associations of parents with autistic children succeeded in obtaining the prohibition of packing, announced by the French Secretary of State to the Ministry of Health in April 2016. Parents and professionals who had observed the positive effects of packing when nothing else worked for their part wondered what could be done for self-harming patients. The political authorities followed the opinion of the main associations of parents with autistic children at the expense of that of professionals. In this paper, the actions and discourse of the associations against packing are explored, as are the arguments of the psychiatrists who defend packing therapy. The different phases in the controversy from the first opposition in 2005 and the role of opinion leaders in associations are analyzed. The strategies to discredit psychiatry and to promote behavioral methods are also studied to understand the shift in the balance of power from professionals to association leaders. The mobilization of the associations prompted some psychiatrists to conduct evidence-based research and to formalize their practice. The controversy over packing, involving political decision-making processes, ethical issues and clinical questions, enables us to illustrate a case of lobbying by associations. • The controversy over packing illustrates how associations can influence public policy. • This controversy involves a political decision, ethical issues and clinical questions. • A shift in the balance of power from professionals to association leaders has been shown. • A case of lobbying by associations has been described. [ABSTRACT FROM AUTHOR]

Abstract This paper investigates the short-term effects of transition into retirement on health within couples using French household data. We rely on a semi-parametric difference-in-differences method to account for the endogeneity of the retirement decision. We compare the health trajectories of respondents who retire to those of respondents who remain employed over the same period after balancing their pre-retirement characteristics using a matching procedure. We also look at potential spillover effects within the couple by comparing health changes for spouses of respondents who retire to those of respondents who remain employed. We find that transition into retirement has a short-term beneficial effect on respondents' self-assessed health. Conversely, we fail to find any significant effect of respondents' retirement on their spouses' health. Highlights • In France, retirement tends to improve individuals' self-assessed health in the short run. • This result holds only for workers employed in jobs with low physical burden. • Respondents' retirement decision has no significant effect on their spouses' health. [ABSTRACT FROM AUTHOR]

Abstract: Lacking any conventional definition, the phenomenon of so-called “bed-blockers” concerns the issue of long-stay inpatients in short-term units. Our paper explores this question in the context of French Emergency Rooms (ERs) and focuses not on “bed-blocking” as a patient phenomenon but rather on the social constructs developed around these patients by ER professionals. In this paper, we present a case study on one of these “bed-blockers” and venture some hypotheses regarding this phenomenon. On the one hand, it appears as a dysfunction in the healthcare system. Indeed, French ERs take on patients that specialized medical units are reluctant to admit, either because they do not fit into any one specific scientific or clinical category, or because they are not “profitable” when analyzed using care-management tools. On the other hand, bed-blockers play an important role in building a positive identity for the French emergency doctors and personnel performing the “dirty work” of treating them. [Copyright &y& Elsevier]

Abstract: Yoga is becoming more and more fashionable all around the world. This activity, partly considered as therapeutic, reveals contemporary ways of producing global practices. Via a questionnaire completed by individuals at yoga centres in India and France, the paper analyses this phenomenon using the concept of therapeutic landscapes. Furthermore, it examines how these therapeutic landscapes are influenced by globalisation. Bringing together the concepts of therapeutic landscapes, globalisation and the practice of yoga, the paper analyses the production and reproduction of yogic therapeutic landscapes in the world''s space. Constituted of natural physical elements and built structures, these therapeutic landscapes are also strongly linked to emotional qualities and intimate feelings evoked by the place and related to health and well-being. The paper also underlines that the emergence of internationally recognised therapeutic landscapes demands a cultural and social geographical approach that could help to examine the repercussions of local and global phenomena on therapeutic landscapes. Indeed, very often, yogis, all around the world, refer to ideal places where they rarely go. Consequently, they create an imagined therapeutic environment that the paper describes. [Copyright &y& Elsevier]

In this paper, we address two issues: i) how hospital employment changes with local unemployment, according to the type of hospital ownership, and ii) whether this relationship changed after the implementation of a pro-competitive reform that made hospitals more similar. A 2006–2010 French panel of 1695 hospitals over five waves allows us to consider within-hospital employment changes. We first find that higher local unemployment is associated with greater employment in State-owned hospitals, but not for any other hospital ownership type: French local authorities then seem to respond to depressed local labour markets by increasing employment in State-owned hospitals. After the full implementation of the pro-competitive reform hospital funding became based only on activity and no longer on some historical budget. Theoretically, the new reimbursement system should break the relationship between public-hospital employment and local unemployment. Our results reveal that the reform worked as expected in less-deprived areas: reducing employment and eliminating the correlation between local unemployment and State-owned hospital employment. However, in higher-unemployment areas, public-hospital employment remains counter-cyclical. Poor local labour-market health then seems to trump financial incentives in determining employment in public hospitals. [ABSTRACT FROM AUTHOR]

It has been suggested recently that measures of Subjective Well-Being (SWB) instead of preferences could be employed to determine relative weights for the dimensions of health-related quality of life (HRQol) with the aim of developing health utility indexes for economic evaluation purposes. In this context, this paper addresses the possibility of reprioritization response shift in SWB. It examines whether the association between dimensions of HRQol and SWB changes over time in chronically ill patients. 215 women newly diagnosed for breast cancer in a French hospital between 2010 and 2012 completed the Satisfaction with Life Scale (SWLS) and the EORTC QLQ-C30 HRQol questionnaires over a two-year period. We estimated hierarchical random coefficients models for the repeated SWLS measures while allowing for time-varying parameters for the scales of the QLQ-C30 to test for reprioritization. Our findings suggest that women adapt to breast cancer by giving greater weight over time to the social dimension of HRQol. This possibility of reprioritization response shift should be considered in researches trying to develop SWB-based health utility values to inform the allocation of resources in health care. [ABSTRACT FROM AUTHOR]

Recent scholarship has focused on the role that cross-border social and economic ties play in shaping health outcomes for migrant populations. Nevertheless, the extant empirical work on this topic has paid little attention to the health impacts of cross-border separation from close family members. In this paper we examine the association between cross-border ties—and cross-border separation—with the health of sub-Saharan African (SSA) migrant adults living in metropolitan France using data from the nationally representative “Trajectoire et Origines” survey (n = 1980 SSA migrants). In logistic regression analyses we find that remitting money and having a child abroad are each associated with poor health among women, but not men. The effect of remittances on health is also modified by the location of one's children: remittance sending is associated with poor health only for SSA-migrants separated from their children. These findings underscore the importance of examining both cross-border connection and cross-border separation in studies of immigrant health, and also underscore the heterogeneous relationships between cross-border ties and health for men and women. This is the first study to our knowledge that examines the relationship between cross-border ties and health for migrants in Europe, with a focus on SSA-migrants in France. These findings have important implications for the health of the growing immigrant and refugee populations in Europe and around the globe. [ABSTRACT FROM AUTHOR]

How can one assess the quality of life of older people – particularly those with Alzheimer's disease – from the point of view of their opportunities to do valued things in life? This paper is an attempt to answer this question using as a theoretical framework the capability approach. We use data collected on 8841 individuals above 60 living in France (the 2008 Disability and Health Household Survey) and propose a latent variable modelling framework to analyse their capabilities in two fundamental dimensions: freedom to perform self-care activities and freedom to participate in the life of the household . Our results show that living as a couple, having children, being mobile and having access to local shops, health facilities and public services enhance both capabilities. Age, household size and male gender (for one of the two capabilities) act as impediments while the number of impairments reduces both capabilities. We find that people with Alzheimer's disease have a lower level and a smaller range of capabilities (freedom) when compared to those without, even when the latter have several impairments. Hence they need a special attention in policy-making. [ABSTRACT FROM AUTHOR]

Attention Deficit Hyperactivity Disorder (ADHD) has been medicalized in the United States since the 1960s. Primarily used in North America until the 1990s, ADHD diagnosis and treatment have increasingly been applied internationally. After documenting the expansion of ADHD in a global context, this paper presents five brief international examples examining ADHD usage and expansion: the United Kingdom, Germany, France, Italy and Brazil. We then identify and describe several vehicles that facilitate the migration of the ADHD diagnosis: the transnational pharmaceutical industry; the influence of western psychiatry; moving from ICD to DSM diagnostic criteria; the role of the Internet including the related advent of easily accessible online screening checklists; and advocacy groups. Finally, we discuss what this globalization of a diagnosis reflects about the potential global medicalization of other conditions. [ABSTRACT FROM AUTHOR]

In this paper, we conduct a multi-criteria correspondence test to assess the extent of discrimination in access to employment against candidates with a hearing disability and compare it to three other potential grounds for discrimination: ethnicity, place of residence and gender. From October 2019 to February 2020, we sent 2315 applications to 463 job vacancies in the Paris region in France for two occupations, administrative managers and caregiver assistants, in both the private and public sectors. We find that discrimination on the grounds of disability is similar in scope to that found on the grounds of ethnicity in the profession of administrative manager, but discrimination against the disabled candidate is half that experienced by the North African candidate in the profession of caregiver assistant. Moreover, discrimination on the grounds of disability is twice as high in the profession of caregiver assistant, a role which requires more interaction with public, as in the profession of administrative manager. We do not find any evidence of a difference in callback rates based on place of residence or gender. Finally, we cannot conclude that hiring discrimination is systematically lower in the public sector than in the private sector, nor that being eligible for a public subsidy reduces hiring discrimination against the disabled candidate. • Multi-criteria correspondence experiment including disability. • Discrimination in hiring on the basis of hearing disability and ethnicity. • No discrimination in hiring on the grounds of gender or location. • Discrimination in hiring not always lower in the public sector. • Public subsidy does not appear to increase candidate with disability's success rate. [ABSTRACT FROM AUTHOR]

Mental health evaluation within a legal setting is widely seen as a power to judge. The aim of this paper is to challenge this current thesis, which was popularised by Michel Foucault, who encapsulated the notion in a brief sentence: "The sordid business of punishing is thus converted into the fine profession of curing" (Foucault, 2003: 23). On the basis of an ethnography of a French district court (between September 2008 and May 2009, n = 60 trials) including interviews with judges (n = 10) and psychiatrists (n = 10), we study the everyday penal treatment of sexual offenders using psychiatric reports. Our findings show how (i.) the expectations of the judges select the psychiatrists' skills (based on the following criteria for their reports: accessibility of knowledge, singularization and individualization of content) and (ii.) reframe the psychiatric report as a moral tool. The clinical reasoning of forensic psychiatrists in their reports offer moral affordances due to their clinical caution regarding the risk of recidivism (therapeutic and criminological reversal, moral prevention). Both the judges' evaluation and the psychiatrists' clinical authority are shaped by a moral economy of dangerousness, which eclipses the idea of lack of criminal responsibility. In conclusion, we show that these unintended effects are necessarily of interest to most clinical practitioners engaged in work as expert witnesses. [ABSTRACT FROM AUTHOR]

Abstract: International policies regulating clinical ethics committees'' (CEC) roles are non-existent. Nonetheless, CECs have established themselves in several countries and there exist striking differences in the way these work. This international practice variation stems from the ways CECs developed, within particular legal, political, social and professional contexts. National guidelines and normative documents have been published in many countries regarding CECs. To better understand CECs'' evolution and differences in various countries, we reviewed guidelines, position statements and normative papers which describe and frame the development of CECs in the United States, the United Kingdom, Canada and France. Systematic content analysis addressed guideline development, CECs'' roles, consultation methods and CEC members'' education requirements. Differing contexts informed the ways in which guidelines were developed. American CECs, established within a strongly litigious context are perceived to play strong decision-making roles, whereas British CECs, encouraged by clinicians, endorse a more supportive model. Canadian guidelines focus on the role of the ethicist, while the French model is interested in a theoretical interdisciplinary approach. This analysis shows important challenges facing the implementation of accountable CECs in different contexts and can help inform future policy development. [Copyright &y& Elsevier]

Abstract: In this paper, we study the smoking behavior of students aged from 18 to 25 using four cross-section data sets collected in France from 1997 to 2006. We focus on the role played by student income and parental resources. We find that both the probability of smoking and the number of cigarettes smoked are positively correlated to family resources. Among students, only wages earned and transfers received from parents increase smoking participation. However, sensitivity to income remains weak since a rise of 1% in income of either the students or their parents leads to an increase in smoking prevalence of about 0.15–0.20%. [Copyright &y& Elsevier]

Abstract: This study identifies undocumented immigrants’ obstacles to realizing their health care rights in France. The ethnographic fieldwork informing this study was carried out in Paris from March 2007 to July 2008. Research findings are based on (1) participant observation carried out in two grassroots health associations catering to undocumented immigrants in Paris (one providing legal and medical aid to undocumented immigrants from sub-Saharan Africa, and another focused specifically on assisting undocumented individuals seeking a visa for medical reasons, as well as women victims of domestic violence); (2) a review of legislative debates on the issue of healthcare access for undocumented immigrants in France, and (3) recently published reports on healthcare access for the undocumented in Europe. The paper analyzes how interaction among intangible factors — namely social stigmatization, precarious living conditions, and the climate of fear and suspicion generated by increasingly restrictive immigration policies — hinders undocumented immigrants’ access to health care rights and, furthermore, minimizes immigrants’ sense of entitlement to such rights in this European context. Intangible factors such as fear and suspicion have powerful “subjectivation” effects, which influence how both undocumented immigrants and their interlocutors (i.e., healthcare providers) think about “deservingness.” Medical anthropology is in a unique position to demonstrate and theorize these factors and effects, which inform contemporary debates about migration and “health ethics.” [Copyright &y& Elsevier]

Abstract: The literature reports an association between neighbourhood deprivation and individual depression after adjustment for individual factors. The present paper investigates whether vulnerability to neighbourhood features is influenced by individual “activity space” (i.e., the space within which people move about or travel in the course of their daily activities). It can be assumed that a deprived residential environment can exert a stronger influence on the mental health of people whose activity space is limited to their neighbourhood of residence, since their exposure to their neighbourhood would be greater. Moreover, we studied the relationship between activity space size and depression. A limited activity space could indeed reflect spatial and social confinement and thus be associated with a higher risk of being depressed, or, conversely, it could be linked to a deep attachment to the neighbourhood of residence and thus be associated with a lower risk of being depressed. Multilevel logistic regression analyses of a representative sample consisting of 3011 inhabitants surveyed in 2005 in the Paris, France metropolitan area and nested within 50 census blocks showed, after adjusting for individual-level variables, that people living in deprived neighbourhoods were significantly more depressed that those living in more advantaged neighbourhoods. We also observed a statistically significant cross-level interaction between activity space and neighbourhood deprivation, as they relate to depression. Living in a deprived neighbourhood had a stronger and statistically significant effect on depression in people whose activity space was limited to their neighbourhood than in those whose daily travels extended beyond it. In addition, a limited activity space appeared to be a protective factor with regard to depression for people living in advantaged neighbourhoods and a risk factor for those living in deprived neighbourhoods. It could therefore be useful to take activity space into consideration more often when studying the social and spatial determinants of depression. [Copyright &y& Elsevier]

Abstract: Morality is one of the most important elements of social actions, specifically in medical settings. Unfortunately, in social science, morality is often undertheorized and can lead to moralism. The aim of the paper is to test the “moral economy theory” which highlights the link between some local moral evaluations and a political context. We focus on “treatment” as therapeutic tool and as moral regulation of patients in a French remand centre. On the basis of an ethnography of forms of care for prisoners (2009–2010), and semi-directed interviews with working mental health professionals (n = 10), we analyse their engagement and their moral expectations of the prisoners under their care. Firstly, we show how prisoners are selected and then converted into patients deserving of attention (expectations of honesty, sincerity and compliance). Secondly, we show how these patients are divided into three main intervention categories, in which the treatment is both therapeutic and moral (expectations of responsibility, recognition of guilt, and self-esteem). Finally, we discuss these moral criteria within a new moral economy of vulnerability. [Copyright &y& Elsevier]

Abstract: As in other European countries, specialised psychiatric hospitals were established throughout France during the 19th Century. The construction of these hospitals can be considered as the concrete expression of a therapeutic innovation which recognized insanity as an illness that could be treated in such specialised institutions. The spatial diffusion of these innovative institutions through 19th and 20th century France is analysed and we explore how far this can be understood through theories of diffusion of innovations including geographical models of hierarchical and expansion diffusion (or whether other conceptual models are more appropriate). The research reported here particularly focuses on the period 1800–1961. It involved the construction of an original historical database of both psychiatric hospitals and information on the cities where these institutions were located. This was used to examine and interpret the different phases of development of psychiatric institutions and the parts of the country and types of geographical setting where they were concentrated. A multiple correspondence analysis was then performed to examine the connections between different aspects of the diffusion process. The study shows the limitations of classical models of spatial diffusion, which are found to be consistent with some, but not all aspects of the development of psychiatric institutions in France. An alternative political ecology approach seems more appropriate to conceptualise the various processes involved; national policies, social representations, medicalisation of care of mental illness, and urban and economic growth all seem to be associated with the emergence of a variable and complex pattern. This paper also opens a large field of research. Compared with other western countries, the geography of French psychiatric care is relatively under-researched, although there has been a strong spatial dimension to mental health policy in the country. This analysis provides a context for studies of more contemporary processes of French deinstitutionalisation, which is strongly structured by the past heritage of these large asylum facilities. [Copyright &y& Elsevier]

Abstract: How, and to what extent, do patient organisations renew traditional forms of social participation and protest? This question is examined, drawing on a socio-historical case study of the Association Française contre les Myopathies—French Muscular Dystrophy Organisation (AFM). The originality of the AFM is that it has not been content to endorse the classic role of representation of people with muscular dystrophy (MD) and their families. It has also articulated and structured different social spaces that allow people suffering from genetic diseases and severe disabilities to be considered as fully-fledged human beings, persons, and citizens within those spaces. Based on quantitative data and methods, this paper aims to characterize this reconfiguration of social spaces that the AFM has undertaken. My contention is that it has given shape to a different form of collective mobilization, one in which the patient organisation is a mediator between different social actors, as much as a patients’ representative. It helps a new issue, here MD, to emerge so that the largest possible collective designate it as a general public concern. As we shall discuss, this renews the question of patients’ collective identity and citizenship. [Copyright &y& Elsevier]

Western medicine is seen as universally valid, but in reality it displays a wide range of national and local variability. Our paper focuses on one such case of local variation: the widespread use of progestins in France to treat various pre- menopausal conditions as well as for contraception. The case of progestins allows us to explore how specific styles of research may come to dominate a particular local medical culture, and how they are influenced by changing criteria of scientific validity and wider social relations. We argue that in the 1980s and 1990s a single prestigious research-oriented Parisian hospital service played a dominant role in the transformation of progestins into scientifically validated medical practice. This status was not called seriously into question until recently when foreign research on a different form of hormone therapy suggested that risk was associated with their use. We also propose that both the research around and medical use of progestins in France was shaped by the positive attitude of many French women, including feminists, to hormonal therapies and to the non-surgical specialty most closely associated with hormones, medical gynaecology. [ABSTRACT FROM AUTHOR]

This article sets out to provide a demographic analysis of the production of social inequality through IVF trajectories in a reproductive technology centre of a French hospital. However specific this example may be, it reveals one of the paradoxes of social inequalities in health: lay experience of risk in reproductive technology shows profound inequalities related to social status, despite the fact that equality would seem to be guaranteed in France, since the social security system covers the full cost of the treatments. We will try to understand this paradox through a lifecourse approach. Thus, it will be shown that social inequality in reproductive health is deeply rooted in social scenarios of infertility that lead to differentiated medical experience: there is little benefit and even a worsening in the situation of lower class women, who were faced with unpredictable risks related to the collective testing of these new technologies. Conversely, the possibility of inventing new lifestories, which may or may not include motherhood, was given to upper class women who take calculated risks to delay the scheduling of their pregnancies. In short, this study confirms that the production of social inequality in reproductive health can only be understood in connection with the social dynamics of lifestyles, resulting in specific medical patterns. This paper also leads to the assumption that these social scenarios are related to attempts to enhance the different forms of capital: economic, cultural and social capital. In addition, the presence of risks aggravates this inequality process. This raises another question: do reproductive technologies result in reinforcing social inequality? [Copyright &y& Elsevier]

The past few decades have witnessed the increasingly active participation of patient organisations in research activities concerning them. They contribute substantially to the funding of scientific and clinical research. More importantly, certain patient organisations take strategic decisions concerning that research, and contribute to the production of knowledge on their diseases. In France, the AFM (Association Franc¸aise contre les Myopathies—French Muscular Dystrophy Organisation), is a striking illustration. The paper argues that the model of the AFM's engagement in research—the “partnership model”—is original insofar as it renews the power relations between patients and professionals found in two classic models: the “auxiliary model” and the “emancipatory model”. Based on a long-term study of the French Muscular Dystrophy Organisation, this “partnership model” is characterised and its implications discussed in three respects: the possible generalisation of the mode of relations it establishes between patients and professionals; its effects on the steering of research; and its consequences for the dynamics of patient organisations movements. [Copyright &y& Elsevier]

As Covid-19 spreads across the world, governments turn a hopeful eye towards research and development of a vaccine against this new disease. But it is one thing to make a vaccine available, and it is quite another to convince the public to take the shot, as the precedent of the 2009 H1N1 influenza illustrated. In this paper, we present the results of four online surveys conducted in April 2020 in representative samples of the French population 18 years of age and over (N = 5018). These surveys were conducted during a period when the French population was on lockdown and the daily number of deaths attributed to the virus reached its peak. We found that if a vaccine against the new coronavirus became available, almost a quarter of respondents would not use it. We also found that attitudes to this vaccine were correlated significantly with political partisanship and engagement with the political system. Attitudes towards this future vaccine did not follow the traditional mapping of political attitudes along a Left-Right axis. The rift seems to be between people who feel close to governing parties (Centre, Left and Right) on the one hand, and, on the other, people who feel close to Far-Left and Far-Right parties as well as people who do not feel close to any party. We draw on the French sociological literature on ordinary attitudes to politics to discuss our results as well as the cultural pathways via which political beliefs can affect perceptions of vaccines during the COVID-19 pandemic. • Almost a quarter of the French population would not get vaccinated against COVID-19. • Attitudes are correlated with political partisanship and engagement with politics. • Attitudes do not follow the traditional separation between Left-wing and Right-wing. • Refusal is associated with proximity radical parties and to abstention. [ABSTRACT FROM AUTHOR]

This paper deals with coopetition in the healthcare sector, where in developed countries providers are experiencing a growing paradox between cooperation, as encouraged by authorities, and competition, in terms of resources or market share. Via comprehensive research methodology, we carry out a case study on a French Cancer Control Unit that simultaneously competes and cooperates with other local cancer treatment providers. We focus on different professional groups and their perceptions of coopetitive outcomes. Firstly, we show that different generic coopetitive situations exist and can be distinguished according to their degree of spontaneity, complementarity and value creation. Depending on these situations, felt outcomes differ from one professional group to another, highlighting that coopetition is a very complex reality and experienced differently by different individuals. Secondly, harmony created by coopetition is generally under-estimated, whereas it could be used as a catalyst to help managers implement coopetition. • Perceptions of coopetitive outcomes depend on healthcare professional groups. • Perceptions depend on the actual nature of the coopetitive situation. • Value creation, rivalry degree and spontaneity characterize coopetitive situations. • Feelings about coopetitive outcomes can be either 'tension' or 'harmony'. [ABSTRACT FROM AUTHOR]