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Background: One of the most consistent findings reported in the paediatric cochlear implant (CI) literature is the heterogeneity of language performance observed more in grammatical morphology than in lexicon or pragmatics. As most of the corpus studies addressing these issues have been conducted in English, it is unclear whether their results can be generalized to other languages. In particular, little is known about languages known for their grammatical complexity, such as French. Aims: The aim of this corpus study was to compare the productive use of function words (FWs) and some agreement features (AGRs) in children with CIs and children with typical development (TD) matched for mean length of utterance in words (MLUwords), a general index of grammatical complexity, and auditory experience, as measured by hearing age (HA) and chronological age (CA), respectively. Methods & Procedures: Natural speech samples from 116 monolingual French‐speaking children, including 40 children with CIs followed longitudinally and 76 TD children, were collected. FWs and AGRs were analysed using a Part of Speech Tagger (POS‐T) from the Child Language Data Exchange System (CHILDES). Outcomes & Results: The two groups differed by 3 years for HA and CA. No effect of family socio‐economic status (SES) was found in the CI group. Stepwise regression analyses showed that the two groups did not share the same predictors of MLUwords: plurals and determiners predicted MLUwords in children with CIs, at 2 and 3 years of HA, whereas feminine markers and subject‐pronouns were found to best predict MLUwords in TD children at 2 and 3 years of CA. Structural equation models (SEMs), a combination of confirmatory factor analysis (CFA) and path analysis, yielded a different hierarchical structure of grammatical relations (GRs). Selective difficulties affecting verbal clitics and other pronominal forms were found specifically in the CI group (object‐pronouns, reflexive, relative and past participles). Dependency grammar analysis confirmed these contrasting developmental profiles in multiword utterances, such as preposition/nouns, subject/verbs, and verb/determiner/nouns. Conclusions & Implications: Atypical grammatical patterns in children with CIs reflect a specific architecture of syntactic dependencies of FWs underpinning morphological complexity and syntactic connectivity. Clinical implications are discussed for assessment and intervention planning. What This Paper Adds: What is already known on this subject: The productive use of FWs has been identified as a particular area of weakness in children with CIs compared with TD children. In addition, heterogenous grammatical performance has often been found after 1–3 years of CI use, regardless of demographic factors such as age at implantation, duration of deafness or SES. What this paper adds to existing knowledge: Assessing the early building of FWs and AGRs in children with CIs helps to understand the syntactic complexity and hierarchical structure of their language. Since most corpus studies on grammatical morphology have been conducted in English, it is not clear whether their difficulties can be generalized to other languages. The French language has a system of FWs and inflections that determine the morphophonological properties of nominal and verbal forms. Early grammar learning in children with CIs born with profound deafness were compared with the two groups of TD children matched both for duration of auditory experience (i.e., HA of CI children, CA of TD children) and for MLUwords. We found a similar profile between groups at 2 years but not at 3 years for HA and CA. The two groups do not share the same predictors of MLUwords: namely, plurals and determiners for CI children versus feminine markers and subject pronouns for TD children. They show a different syntactic organization of GRs. Children with CIs struggle with selective difficulties affecting verbal clitics and pronominal forms (object‐pronouns, reflexive, relative and past participles). Consistent with theories of morphophonological richness and syntactic connectivity, our results support the distributional learning hypothesis of language acquisition that infants and toddlers are sensitive to FWs and AGRs at an early age. Specific components of syntactic organization are disrupted in children with CIs. What are the potential or actual clinical implications of this work?: This work has potential clinical implications because it unravels the limitations of morphophonological processing in children with CIs. Its results highlight a specific difficulty in learning FWs and AGRs in a verbal inflectional morphology context. [ABSTRACT FROM AUTHOR]

Genetic relatedness figures heavily in contemporary ethical debates on egg freezing, although the arguments lack empirical‐based evidence. Rather than adding another theoretical view on the moral relevance of genetic connections, this paper instead proposes an empirically grounded perspective based on two independent qualitative interview‐based studies conducted in Belgium and France. Three themes emerge from our empirical data: (1) prioritizing family building; (2) centering the gestational experience of motherhood; and (3) identifying the complexities and limitations of adoption. These themes suggest that the relationship between egg freezing, genetics, biological motherhood, and adoption is highly complex and less straightforward than what is often assumed in the egg freezing debate. Our study provides more detailed insights into women's ambivalent experiences regarding those reproductive options. We discuss the ethical implications of our empirical findings and hold that pursuing genetic desire is not necessarily the main moral reason why women freeze their eggs. [ABSTRACT FROM AUTHOR]

This paper explores how a new French law incorporating a new conceptualization of disability formulated at the international level by the WHO is appropriated at the local level by multidisciplinary teams of professionals in charge of the assessment of disability. Drawing on social representations theory, its concept of cognitive polyphasia and its conceptualization of legal innovation, the paper specifically examines how the teams deal with the tensions between the old and the new models of disability and how the group dynamic is associated with how they do this: by hybridization of old and new models, by selective prevalence according to context, or by displacement of one model. Focus groups with the teams (n = 65 from 10 groups), analysed with indicators of interaction, bring evidence of the three forms. They show how different groups, by drawing differently, depending on their relational dynamics, from a variety of meaning systems circulating at the cultural level, reach different decisions that may lead to different practices in the local implementation of the same laws. We finish by discussing how social representations theory, linking the cultural/global and the interactional/local levels, can enhance our understanding of how socio‐psychological processes intervening in the appropriation of legal innovations may produce different practical implementations of the same new laws. [ABSTRACT FROM AUTHOR]

Background and aims: Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio‐economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. Design: Secondary analysis of survey data. Setting: A cross‐sectional nation‐wide exhaustive 12‐day survey in March 2017 of French youth aged 17–18.5 years participating in the national mandatory civic information day. Participants: A total of 13 314 adolescents answering a pen‐and‐paper questionnaire about their own tobacco consumption and the smoking of their parents. Measurements Risk ratios (RRs) were computed using modified Poisson regressions, and population‐attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. Findings Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50–1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99–2.36) when both parents smoked, compared with non‐smoking parents; the risk associated with living in a non‐intact family was 1.35 (95% CI = 1.26–1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10–1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68–1.98) and RR = 2.10, 95% CI = 1.92–2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. Conclusion: In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio‐economic status is small in comparison. [ABSTRACT FROM AUTHOR]

Conspiracy Beliefs (CB) are a key vector of violent extremism, radicalism and unconventional political events. So far, social‐psychological research has extensively documented how cognitive, emotional and intergroup factors can promote CB. Evidence also suggests that adherence to CB moves along social class lines: low‐income and low‐education are among the most robust predictors of CB. Yet, the potential role of precarity—the subjective experience of permanent insecurity stemming from objective material strain—in shaping CB remains largely unexplored. In this paper, we propose for the first time a socio‐functional model of CB. We test the hypothesis that precarity could foster increased CB because it undermines trust in government and the broader political 'elites'. Data from the World Value Survey (n = 21,650; Study 1, electoral CB) and from representative samples from polls conducted in France (n = 1760, Study 2a, conspiracy mentality) and Italy (n = 2196, Study 2b, COVID‐19 CB), corroborate a mediation model whereby precarity is directly and indirectly associated with lower trust in authorities and higher CB. In addition, these links are robust to adjustment on income, self‐reported SES and education. Considering precarity allows for a truly social‐psychological understanding of CB as the by‐product of structural issues (e.g. growing inequalities). Results from our socio‐functional model suggest that implementing solutions at the socio‐economic level could prove efficient in fighting CB. [ABSTRACT FROM AUTHOR]

Attachment disorganization is a significant high-risk factor for infant mental health. Its association with high-risk psychosocial contexts has been clearly identified, but the link between these difficult social contexts and maternal disruptive communication has been poorly explored. The CAPEDP (Compétences Parentales et Attachement dans la Petite Enfance; Parental competences and attachment in early childhood) study assessed the effects of a manualized home-intervention on the mental health of children and its major determinants. In this controlled trial, 440 young, first-time mothers belonging to socially vulnerable populations were recruited. Mothers in the intervention group received psychological support from the 27th week of pregnancy through to their child's second birthday, while both groups received assessment visits at the 3rd, 6th, 9th, 18th, and 24th months of age of the child and benefited from assistance by the research team. When the children reached 12 months of age, an ancillary study, the CAPEDP-Attachment (n = 119) evaluated the effects of this intervention on attachment. The current paper describes the program's impact on this subsample concerning maternal disruptive behavior, while exploring the role of socioeconomic risk factors. Our results showed that: (a) mothers in the intervention (IG) group presented significantly less disruptive communication than those in the control group (CG), even though the CG received a significant level of care over and above that which is available to the public in the French health system as 'care as usual'; (b) having a "low income" and "having given birth prematurely" was associated with maternal disruptive communication; and (c) the intervention impact increased when the model was adjusted for these two variables. Results suggest that attachment focused intervention programs should invest both maternal interactional skills and social and economic vulnerability. [ABSTRACT FROM AUTHOR]

Background: As educational digital technologies are increasingly being used in schools, past research left unanswered the question of these technologies' impact on the socioeconomic achievement gap even when equal access is guaranteed. Objectives: The objectives of the present study are to examine whether and how the socioeconomic achievement gap can be reduced through the use of computer‐assisted instruction (CAI). Methods: We addressed this issue experimentally by comparing CAI to conventional teacher‐led classroom instruction with more than 800 middle and high school students from disadvantaged and highly privileged socioeconomic backgrounds in a range of topics. Results and Conclusions: Both disadvantaged and highly privileged students taught with CAI outperformed those taught with conventional instruction, thus maintaining the socioeconomic achievement gap constant. However, we also found that disadvantaged students receiving CAI performed as well as highly privileged students receiving conventional teacher‐led instruction. Takeaways: The positive effects associated with CAI may therefore help compensate the difficulties of students with a disadvantaged background, a still neglected possibility. Lay Description: What is already known about this topic?: Socioeconomic status affects academic achievement especially in students from disadvantaged backgrounds.Inequal access to digital learning is a by‐product of socioeconomic status.Computer‐assisted instruction is known to yield positive effects on learning. What this paper adds?: It examines the effectiveness of computer‐assisted instruction on reducing the socioeconomic achievement gap when equal access to digital education is guaranteed at the school level.It shows that computer‐assisted instruction (relative to teacher‐led conventional instruction) benefited disadvantaged students and their highly privileged counterparts equally, shifting the socioeconomic achievement gap upward.However, disadvantaged students receiving CAI may reach similar performance level as their highly privileged counterparts receiving conventional instruction, thus compensating the socioeconomic achievement gap. Implications for practice and/or policy: This finding strengthens the importance of targeting teaching methods depending on students' socioeconomic characteristics to allow disadvantaged students to maximize their learning potential and chances to access to higher education. [ABSTRACT FROM AUTHOR]

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Background This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use. Methods A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances. Results Although lifetime cigarette smoking and daily cigarette smoking decreased significantly over the studied time span, suggesting a positive impact of prevention policies, disadvantaged adolescents were consistently more prone to engage in daily cigarette smoking, more so in 2017 than 15 years earlier. In the same time span, transitions from initiation to daily cigarette smoking have shortened, with an accelerated pace among underprivileged adolescents. Conclusions Accelerated transitions from initiation to daily cigarette use are a prevalent trend among disadvantaged adolescents in France. Efforts to mitigate the impact of marketing strategies and to promote health literacy should be pursued to reduce social inequalities in health. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: The objectives of this study were to estimate the age of complementary feeding introduction (CFI) and investigate the related health, demographic, and socio‐economic factors. Analyses were based on 10,931 infants from the French national birth cohort ELFE, born in 2011. Health, demographic, and socio‐economic data concerning infants and parents were collected at birth (face‐to‐face interviews and medical records) and 2 months (telephone interviews). Data on milk feeding and CFI practices were collected at birth and 2 months then monthly from 3 to 10 months using online or paper questionnaires. The associations between both health and social factors and CFI age were tested by multivariable multinomial logistic regressions. The mean CFI age was 5.2 ± 1.2 months; 26% of the infants started complementary feeding before 4 months of age (CF < 4 months), 62% between 4 and 6 months of age, and 12% after 6 months of age (CF > 6 months). CF < 4 months was more likely when mothers smoked, were overweight/obese, younger (<29 years), and used their personal experience as an information source in child caregiving and when both parents were not born in France. CF < 4 months was less likely when the infant was a girl, second‐born, when the mother breastfed longer, and had attended at least one birth preparation class. Mothers of second‐born infants and who breastfed their child longer were more likely to introduce CF > 6 months. Couples in which fathers were born in France and mothers were not born in France were less likely to introduce CF > 6 months. CF < 4 months occurred in more than 25% of the cases. It is important to continue promoting clear CFI recommendations, especially in smoking, overweight, young, not born in France, and nonbreastfeeding mothers. [ABSTRACT FROM AUTHOR]

Breastfeeding is recommended until 6 months of age, but a wide range of infant formula is available for nonbreastfed or partially breastfed infants. Our aim was to describe infant formula selection and to examine social- and health-related factors associated with this selection. Analyses were based on 13,291 infants from the French national birth cohort Etude Longitudinale Française depuis l'Enfance. Infant diet was assessed at Month 2 by phone interview and monthly from Months 3 to 10 via internet/paper questionnaires. Infant formulas were categorized in 6 groups: extensively or partially hydrolysed, regular with or without prebiotics/probiotics, and thickened with or without prebiotics/probiotics. Associations between type of infant formula used at 2 months and family or infant characteristics were assessed by multinomial logistic regressions. At Month 2, 58.1% of formula-fed infants were fed with formula enriched in prebiotics/probiotics, 31.5% with thickened formula, and 1.4% with extensively hydrolysed formula. The proportion of formula-fed infants increased regularly, but the type of infant formula used was fairly stable between 2 and 10 months. At Month 2, extensively hydrolysed formulas were more likely to be used in infants with diarrhoea or regurgitation problems. Partially hydrolysed formulas were more often used in families with high income, with a history of allergy, or with infants with regurgitation issues. Thickened formulas were used more with boys, preterm infants, infants with regurgitation issues, or in cases of early maternal return to work. The main factors related to the selection of infant formula were family and infant health-related ones. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is widely recognized as one of the leading causes of mortality, and transport accounts for a large part of people's daily physical activity. This study develops a simulation approach to evaluate the impact of the Ile-de-France Urban Mobility Plan (2010-2020) on physical activity, under the hypothesis that the intended transport mode shifts are realized. Methods: Based on the Global Transport Survey (2010, n = 21,332) and on the RECORD GPS Study (2012-2013, n =229) from the French capital region of Paris (Ile-de-France), a simulation method was designed and tested. The simulation method used accelerometer data and random forest models to predict the impact of the transport mode shifts anticipated in the Mobility Plan on transport-related moderate-to-vigorous physical activity (T-MVPA). The transport mode shifts include less private motorized trips in favor of more public transport, walking, and biking trips. Results: The simulation model indicated a mean predicted increase of 2 min per day of T-MVPA, in case the intended transport mode shifts in the Ile-de-France Urban Mobility Plan were realized. The positive effect of the transport mode shifts on T-MVPA would, however, be larger for people with a higher level of education. This heterogeneity in the positive effect would further increase the existing inequality in transport-related physical activity by educational level. Conclusions: The method presented in this paper showed a significant increase in transport-related physical activity in case the intended mode shifts in the Ile-de-France Urban Mobility Plan were realized. This simulation method could be applied on other important health outcomes, such as exposure to noise or air pollution, making it a useful tool to anticipate the health impact of transport interventions or policies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to analyze employees' trajectories within the Accreditation of Prior Experience Learning process (APEL) in France. It seeks to understand how candidates implement this right, the resources and supports required to manage this implementation, and how employer-employee relationships impact on the end result. Design/methodology/approach – The paper draws on a new national survey of more than 3,000 employed APEL candidates, most of whom are women working in the care sector. Findings – The paper argues that individual pathways within this process are influenced more by the socio-economic issues at stake in a given sector, its certification policies, environmental incentives and employer-employee joint investments than by individual characteristics. All these elements go to configure a "capability pathway", comprising individual resources, rights, and environmental, social and individual conversion factors. Practical implications – A better understanding of employers' role and the support they provide during the course of the overall process can help increase the efficiency of lifelong learning. Spaces of mediation at candidates' disposal and real freedom at work, such as exercising one's right to voice and aspiring to development, are determinant. Originality/value – Not much is known about how corporate policies affect individual employee pathways within the framework of the Accreditation of Prior Experience Learning (APEL) process in France. The paper contributes to this literature by using a recent survey econometrically investigating the impact of joint employer-employee investment. [ABSTRACT FROM AUTHOR]

Materials defined as pornographic have always been subject to regulation because of the potential of such items to ‘corrupt and deprave’. Yet the state and law has rarely sought to ban such materials, attempting instead to restrict their accessibility. The outcomes of such interventions have, however, rarely been predictable, an issue we explore with reference to the changing regulation of sex shops in Britain and France since the 1970s. Noting ambiguities in the legal definitions of spaces of sex retailing, this paper traces how diverse forms of control have combined to restrict the location of sex shops, simultaneously shaping their design, management, and marketing. Describing the emergence of gentrified and ‘designer’ stores, this paper demonstrates that regulation has been complicit in a process of neo-liberalization that has favoured more corporate sex shops – without this having ever been an explicit aim of those who have argued for the regulation of sex retailing. [ABSTRACT FROM AUTHOR]

Purpose - The first French context of microfinance dates from the 1980's. As a matter of fact, the "grameen bank" model was imported at this time to France by M. Nowak, through her Association for an individual right to undertake: "Association pour le Droit a I'Initiative Economique" (ADIE). But today the domestic landscape of solidarity-based finance counts plenty of "new" actors, such as: CIGALES, la NEF among others, not to forget intermediated social finance firms: Cooperative banks and public banks with social objectives like the Credits Municipaux. The purpose of this paper is to show how solidarity-based finance actors try to supply banking products and services to those who are excluded from access to the banking system and to test the hypothesis of an alternative financial system that is "socially responsible" in articulation with public and private sectors. Design/methodology/approach - A typology of social banking actors is proposed. The nature of responsibility of each actor of this other kind of finance is described. Findings - Social and solidarity-based economy needs to be recognized by contemporary economics. Solidarity-based finance shows us that another sustainable development model is possible. Originality/value - This paper provides incentive to other social economists to continue this work in cooperation. [ABSTRACT FROM AUTHOR]

This paper investigates whether a satisfactory work environment can promote employee health even after controlling for socioeconomic status and life style factors. A dynamic panel model of health is estimated from worker samples from Denmark, France and Spain, employing both self-assessed general health and the presence of a functional limitation. In all three countries and for both types of health measures, a good perceived work environment is found to be a highly significant determinant of worker health even after controlling for unobserved heterogeneity and minimizing reverse causality. The marginal effect is, however, larger in France and Denmark than in Spain. Several potential explanations for this finding are discussed. Further, a satisfactory working environment is found to be at least as important for employee health as socioeconomic status. Thus, investing in giving workers a satisfying work environment could be a low-cost way of improving employee health. [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]

Copyright of Regional Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION In October 2016, the first edition of Mois sans tabac (Tobacco-Free Month) was launched, a campaign which had invited French smokers to challenge themselves to quit smoking for the whole month of November. We aimed to study the effectiveness of this social marketing intervention on quit attempts (QA) in the general French population, and to study possible differences according to sociodemographic characteristics. METHODS This study used data from the 2017 Health Barometer survey, a random survey conducted by telephone on 25319 individuals. It included 6341 respondents who reported that they were daily smokers when the Mois sans tabac campaign was launched in 2016. The association between self-declared exposure to the campaign and making a QA has been studied using multivariate logistic regressions. RESULTS Exposure to the 2016 Mois sans tabac campaign is associated with a QA lasting at least 24 hours in the final quarter of 2016 (AOR=1.32; 95% CI: 1.07-1.63, p<0.01), with a QA lasting at least 30 days (AOR=1.95; 95% CI: 1.31-2.91, p<0.001), and being abstinent at the time of the interview in 2017 (AOR=2.39; 95% CI: 1.37-4.15, p<0.01). A dose-effect relationship is observed between the frequency of exposure to the campaign and QA, which is mostly explained by the number of sources of exposure (television, radio, posters, the press, the internet and social networks). Although certain priority groups (e.g. manual workers, the unemployed) had poorer recall of the campaign than other groups, the impact of self-reported exposure to the campaign on QA in unemployed people or those with less than high school educational level appears to have been greater. CONCLUSIONS These analyses suggest the effectiveness of the 2016 Mois sans tabac intervention, in a context of strengthening public tobacco control policies in France, which may have contributed to the drop in smoking observed between 2016 and 2019. [ABSTRACT FROM AUTHOR]

• Regression models for daily mobility, commute distance, time and car use. • Traditional gender roles and relations remain operative in contemporary households. • Lower distances and time are due to women's job status and lower car access. • Evidence for the suitability of the gender interaction terms in our econometric models. • Working men and working women do not have the same sensitivity to mobility determinants. Gender is commonly identified as a key explanatory factor for travel behaviour. Since women's role in societal structure has changed in the past few decades, the question arises as to whether the "gender" factor still plays a decisive role in differences in mobility within the working population. The aim of this paper is to extend the research on gendered differences in mobility by providing an in-depth analysis of how the main determinants of daily mobility affect male and female workers differently. Unlike previous research, our econometric models included terms that express the interactions between the explanatory variables (socioeconomic variables and transport mode access) and a dichotomous gender variable, to accurately identify the marginal impact of gender on mobility indicators. Based on the Rhône-Alpes regional household travel survey (2012–2015), which includes France's second largest urban area, the results show that even if gender differences in employment status and access to the private car are eliminated, differences in travel patterns between men and women would still be observed because the two genders do not have identical factor sensitivities. From a policy perspective, these results suggest that authorities have to adopt a gender perspective to ensure that in the future urban mobility policies provide gender equity in the context of the sustainable development of transport networks. [ABSTRACT FROM AUTHOR]

Inequalities in health status between social groups have been on the agenda as a problem for policymakers in France and Belgium in recent years. But the constitutive arguments that French and Belgian policy elites use to frame the problem of health inequalities in public discourse - arguments about what health inequalities are, where they come from, and how they might be corrected - differ in ways that run counter to expectations based on the geography and sociology of health inequalities in the two countries. Belgian national policy documents steer clear of discussing the very large regional inequalities in health, focusing instead on differences between groups defined by socioeconomic status. Meanwhile, French documents emphasize territorial inequalities over those linked to social class. Systematic content analysis of policy documents and interviews with over 50 health policy experts and actors in Belgium and France shed light on this puzzle. In both countries, political elites employ policy discourses about health inequalities that paper over the most salient and contentious political cleavages of the day. In doing so, they are constrained by historically rooted definitions of (in)equity, as well as nationally specific institutions of financing and redistribution. [ABSTRACT FROM AUTHOR]

Background: To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances.Objective: To analyse factors associated with GPs' knowledge of these circumstances.Methods: Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship.Results: Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases.Conclusion: Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to assess the determinants of corruption-control (CC) with freedom dynamics (economic, political, press and trade), government quality (GQ) and a plethora of socio-economic factors in 46 African countries using updated data. Design/methodology/approach -- A quantile regression approach is employed while controlling for the unobserved heterogeneity. Principal component analysis is also used to reduce the dimensions of highly correlated variables. Findings -- With the legal origin fundamental characteristic, the following findings have been established. First, while political freedom increases CC in a bottom quantile of English common-law countries, there is no such evidence in their French civil-law counterparts. Second, GQ consistently improves CC across all quantiles in English common-law countries but fails to exert the same effect in middle quantiles of French civil-law countries. Third, economic freedom ameliorates CC only in common-law countries with low existing CC levels (bottom quantiles). Fourth, The authors find no significant evidence of a positive "press freedom"-CC nexus and having the status of low-income English common-law (French civil law) countries decreases (increases) CC. From a religious domination scenario, the authors also find the following. First, political and trade freedoms only reduce CC in Christian-dominated countries while press freedom has a mitigation effect in both religious cultures (though more consistent across quantiles of Christian-oriented countries). Second, GQ is more pro-CC in Christian than in Muslim-dominated countries. Third, while economic freedom has a scanty negative nexus with CC in Christian-oriented countries, the effect is positive in their Muslim-dominated counterparts. Fourth, having a low-income status in countries with Christian common-law tradition improves CC. Originality/value -- The authors complement the literature on the fight against corruption in Africa by employing recently documented additional factors that should be considered in corruption studies. JEL Classifications -- C10, H10, K10, 010, O55 [ABSTRACT FROM AUTHOR]

At the end of the eighteenth century, England and France both underwent revolutions: France the French Revolution, England the industrial revolution. This note sheds new light on these contrasting experiences in the histories of England and France by looking at the evolution of real consumer prices in London and Paris in the centuries leading up to 1800. Whilst in London, building workers were facing low and stable consumer prices over the period, leaving plenty of scope for a demand-driven consumer revolution (in particular after 1650), their Parisian counterparts had to engage in a year-long grind to maintain a decent living, and often had to cut consumption to make ends meet. The exercise conducted in the present paper gives a quantitative and economic underpinning to the notion that the French revolution did not arise out of nowhere, but rather had its roots in centuries of hardship amongst working class people as they struggled to make a living. [ABSTRACT FROM AUTHOR]

Abstract: It is a little over 30 years since Jim Callaghan''s Labour Government passed the 1978 Inner Urban Areas Act. The following year marked a shift in power to Margaret Thatcher''s Conservative Government and a very different approach to urban regeneration. These developments established and shaped the approach to urban regeneration in England for a generation. The economic context and the urban changes of the 1970s and 1980s and the nature of these responses put England at the forefront of the evolution of this type of urban policy in Europe. It is therefore timely to reflect on 30 years of urban regeneration and to do so from a comparative perspective, setting the English experience alongside that of Germany and France. In this paper the authors compare the experiences of these three countries. The great benefit of international comparison is that it allows the observer to step outside their own institutions and context, to compare with other countries and to look back at their own country from a new, foreign, perspective. The emphasis of this paper is on the contingent and contextualised nature of actions designed to foster urban regeneration. This reinforces the rationale for studying the evolution of this policy field in different nation-state settings. One of the commonly cited advantages of cross-national comparative research as a means of generating understanding and explanations of different social phenomena, is its ability to account for the influence of context in moulding societal responses to different issues. Accordingly, following an introduction, the second part of this paper provides an account of the different national socioeconomic and physical contexts which obtain in each country. This is in turn followed by an explanation of the evolution of urban regeneration policies in each country. Informed by this evidence the paper then offers a comparative discussion of the changing aims, mechanisms and achievements of urban regeneration, and the extent to which policy in each country is path dependent. Through this analysis the paper makes a qualitative contribution to the general theory of urban regeneration rather than offering precise advice on the details of policy and its implementation. Whilst the authors would claim some degree of internationality, there is no doubt that the strongest perspective brought to bear in this comparative study is a English perspective. The strongest conclusions compare English experiences with those of Germany and France, rather than between the latter two countries. [Copyright &y& Elsevier]

This article makes two contributions to the empirical analysis of the socioeconomic achievement of ethnic minorities. The first contribution is methodological. The author relies on a discussion of the concept of equality of opportunity to analyze how the disadvantage suffered by ethnic minorities should be defined and empirically measured. The second contribution is empirical. The author estimates the disadvantage suffered by second-generation immigrants in the access to education, employment, and earnings in France. Contrary to most papers in this area, the author identifies second-generation immigrants in a consistent way, using information of parental geographic and national origin. He also discusses the extent to which measured [ABSTRACT FROM AUTHOR]

This paper proposes two original measures of socioeconomic polarization, in order to quantify phenomena that are not always taken into account by social inequality measures. Our approach is inspired by the literature on bivariate inequality (the concentration index) and univariate polarization. Like the concentration index, our social polarization measures can be easily computed thanks to a “convenient” regression and decomposed into their determinants. Moreover changes in polarization can also be decomposed into their causes. The paper also provides an empirical illustration of our methods for the probability of reporting excellent or very good health, using cross-sectional data on French women. The findings suggest that after 65 years of age, social polarization in this probability decreases whereas social inequality remains stable. Consequently social polarization conveys additional information to that contained in the concentration index. [ABSTRACT FROM AUTHOR]

Background: European comparative studies documented a clear North-South divide in socioeconomic inequalities with cancer being the most important contributor to inequalities in total mortality among middle aged men in Latin Europe (France, Spain, Portugal, Italy). The aim of this paper is to investigate educational inequalities in mortality by gender, age and causes of death in France, with a special emphasis on people aged 75 years and more.Methods: We used data from a longitudinal population sample that includes 1% of the French population. Risk of death (total and cause specific) in the period 1990-1999 according to education was analysed using Cox regression models by age group (45-59, 60-74, and 75+). Inequalities were quantified using both relative (ratio) and absolute (difference) measures.Results: Relative inequalities decreased with age but were still observed in the oldest age group. Absolute inequalities increased with age. This increase was particularly pronounced for cardiovascular diseases. The contribution of different causes of death to absolute inequalities in total mortality differed between age groups. In particular, the contribution of cancer deaths decreased substantially between the age groups 60-74 years and 75 years and more, both in men and in women.Conclusions: This study suggests that the large contribution of cancer deaths to the excess mortality among low educated people that was observed among middle aged men in Latin Europe is not observed among French people aged 75 years and more. This should be confirmed among other Latin Europe countries. [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]

Simple Summary: That the original French life tables are not stratified in terms of deprivation whilst the background mortality in the general population differs according to socio-economic position, social gradient in the net survival of patients with cancer, as was found in a previous study, could be due, at least partly, to socially-determined co-morbidities. We found that the social gradient in cancer net survival was reduced using simulated deprivation-specific life tables. This study alerts us to the fact of this overestimation in the social gradient in cancer net survival using the original life tables, which, in a few cases, can be so important that conclusions might be wrong (e.g., prostate cancer). As this work relies upon simulated rather than real data, we were not able to precisely quantify the potential bias resulting from the lack of deprivation-specific life tables. This present study points to how important it is to create proper deprivation-specific life tables in order to accurately investigate social inequalities in cancer net survival analyses. Background: In cancer net survival analyses, if life tables (LT) are not stratified based on socio-demographic characteristics, then the social gradient in mortality in the general population is ignored. Consequently, the social gradient estimated on cancer-related excess mortality might be inaccurate. We aimed to evaluate whether the social gradient in cancer net survival observed in France could be attributable to inaccurate LT. Methods: Deprivation-specific LT were simulated, applying the social gradient in the background mortality due to external sources to the original French LT. Cancer registries' data from a previous French study were re-analyzed using the simulated LT. Deprivation was assessed according to the European Deprivation Index (EDI). Net survival was estimated by the Pohar–Perme method and flexible excess mortality hazard models by using multidimensional penalized splines. Results: A reduction in net survival among patients living in the most-deprived areas was attenuated with simulated LT, but trends in the social gradient remained, except for prostate cancer, for which the social gradient reversed. Flexible modelling additionally showed a loss of effect of EDI upon the excess mortality hazard of esophagus, bladder and kidney cancers in men and bladder cancer in women using simulated LT. Conclusions: For most cancers the results were similar using simulated LT. However, inconsistent results, particularly for prostate cancer, highlight the need for deprivation-specific LT in order to produce accurate results. [ABSTRACT FROM AUTHOR]

The association between health status and deprivation is well established. However, it is difficult to measure deprivation at an individual level and already-existing indices in France are not validated or do not meet the needs of health practitioners. The aim of this work was to establish a validated, easy-to-use, multidimensional, relevant index that was representative of the population in the Paris metropolitan area. From the SIRS 2010 cohort study, 14 socio-economic characteristics were selected: health insurance, educational background, socio-professional category, professional status, feelings of loneliness, emotional situation, household type, income, perceived financial situation, social support (support in daily life, financial and emotional), housing situation, and migration origin. In addition, a total of 12 health status, healthcare use, and nutrition-related variables were also selected. Content validity and internal validity of the index were explored. The 14 socio-economic indicators were associated to varying degrees with poorer health status, less use of healthcare, and poorer nutrition and were distributed across the 14 multiple-choice questions of the index. Each answer was rated from 0 to 2. The index value of 10 that isolates 20% of the most deprived individuals was used as threshold. "Being deprived," as defined with this value, was significantly associated with 9 of the 12 studied health variables. This index could be a relevant instrument in the assessment of deprivation and social inequalities of health. [ABSTRACT FROM AUTHOR]

Background: Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. Methods: We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. Results: In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007). Conclusions: The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants. [ABSTRACT FROM AUTHOR]

What Is Known and Objective: The dispensing of clotting factor concentrates in hospital pharmacies imposes accessibility constraints on patients and their caregivers, thereby increasing the disease burden. Very few studies have addressed these issues so far in terms of individual perceptions and actual difficulties. The PHAREO study aims to report patient's perception of treatment accessibility and evaluate spatial accessibility. Methods: The PHAREO study is an observational survey based on a questionnaire specifically designed for the study purpose in collaboration with patients' representatives in the second demographic and economic French region. Results and Discussion: We collected 293 responses (participation rate of 64.1%) which show that 89.8% of respondents were either very or rather satisfied with regard to access to treatment. However, respondents reported difficulties in accessing the hospital pharmacy. The data also showed that 79.2% of respondents tended to over‐estimate travel time which was reported above their acceptable threshold for 39.2% of them. The main determinants of dissatisfaction were parental burden (OR 2.5 [1.3; 4.8], p = 0.008) and waiting time at the hospital pharmacy (OR 1.5 [1.1;2.0], p = 0.016, per 10 min increase). What Is New and Conclusion: The PHAREO study provides subjective and objective data regarding satisfaction levels of persons with haemophilia and other coagulation deficiencies, with a high representativeness rate for patients on prophylaxis (87.5%). Both respondents and hospital pharmacists pled for an evolution of the current dispensing circuit to improve access to treatment and reduce the burden for patients. Currently, the community pharmacists are apart from the dispensing circuit. The authors propose improvements in the pathway of care for patients and their caregivers by including the community pharmacists alongside the hospital pharmacists in a centralized coordination scheme. [ABSTRACT FROM AUTHOR]

Purpose: For decades, consistent associations between breastfeeding and children's neurodevelopment have been attributed to breastmilk content in long-chain polyunsaturated fatty acids (LC-PUFAs). However, the beneficial effect of LC-PUFA enrichment of infant formula on neurodevelopment remains controversial. This study examined the association of LC-PUFA enrichment of infant formulas with neurodevelopment up to age 3.5 years. Methods: Analyses were based on 9372 children from the French nationwide ELFE birth cohort. Monthly from 2 to 10 months, parents declared their infant's feeding mode, including breastfeeding and the name of the infant formula, which allowed for identifying formulas enriched in arachidonic (ARA), eicosapentaenoic (EPA) and/or docosahexaenoic (DHA) acids. Neurodevelopment was assessed at age 1 and 3.5 years with the Child Development Inventory (CDI-1 and CDI-3.5); at 2 years with the MacArthur-Bates Communicative Development Inventories (MB-2); and at 3.5 years with the Picture Similarities subtest of the British Ability Scale (BAS-3.5). Associations were assessed by linear regression adjusted for any breastfeeding duration and main confounding factors, including socioeconomic characteristics. Results: One-third of formula-fed infants consumed LC-PUFA-enriched formulas. Most of these formulas were enriched in both DHA and ARA, and about 10% of infants consumed formula further enriched in EPA. LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores at age 1 (CDI-1, − 0.16 [− 0.39, 0.07]), age 2 (MB-2, 0.78 [− 0.33, 1.89]), or age 3.5 (CDI-3.5, − 0.05 [− 0.27, 0.17]; BAS-3.5, − 0.93 [− 2.85, 0.98]). Conclusion: In the ELFE study, LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores up to 3.5 years. [ABSTRACT FROM AUTHOR]

Background: Excessive screen time in infancy and childhood has been associated with consequences on children's development and health. International guidelines call for no screen time before age 2 years, whereas in France, the most prominent guidelines recommend no screen before age 3 years. However, data are lacking on parental adherence to the no-screen guideline for toddlers and factors of adherence in France. Using data from the French nationwide Elfe birth cohort, we estimated adherence to the no-screen guideline at age 2 years and examined related factors, including sociodemographic characteristics, parental leisure activities and screen time. Methods: In 2011, 18,329 newborns and their parents were enrolled in 349 randomly selected maternity units across mainland France. At age 2 years, screen exposure of 13,117 toddlers was reported by parents in phone interviews. Data on sociodemographic characteristics, parental leisure activities and screen time were collected from both parents. Three patterns of parental leisure activities were derived by principal component analysis: literate (e.g.,reading), screen-based, and physical/artistic activities. Multivariable logistic regression models were used to examine the associations of sociodemographic characteristics, parental leisure activities and parental screen time with adherence to the no-screen guideline for toddlers. Results: Overall, 1809/13,117 (13.5%) families adhered to the no-screen guideline for toddlers. Adherence was reduced with maternal age < 40 years, low parental education, single-parent household and parental migration status. After adjusting for sociodemographic characteristics, adherence to the guideline was positively associated with a parental literate activity pattern (mothers: odds ratio [95% confidence interval]: 1.15 [1.08, 1.22]); fathers: 1.15 [1.07, 1.23]) and negatively with a screen-based activity pattern (mothers: 0.73 [0.69, 0.77]; fathers: 0.81 [0.76, 0.87]). With each additional hour of parental screen time, mothers and fathers were less likely to adhere to the guideline (mothers: adjusted odds ratio 0.80 [0.77, 0.83]; fathers: 0.88 [0.85, 0.91]). Conclusions: Adherence to the no-screen guideline for toddlers in France was low. Parental leisure activities and parental screen time are major factors of adherence to the no-screen guideline and could be considered in targeted public health interventions. [ABSTRACT FROM AUTHOR]

Background The prevalence of overweight and obesity has increased in various countries. Normal weight before pregnancy is important to protect maternal and newborn health. This study aimed to describe the evolution of body mass index (BMI) before pregnancy in France and explore its association with two measures of socioeconomic status (SES), education and household income. Methods Data were from four national perinatal surveys in France in 1998, 2003, 2010 and 2016 to describe the time evolution of maternal BMI. We explored the links between BMI and women's characteristics in the most recent period (2010–2016 surveys) since income information was not available before. Risk ratios (RRs) of underweight, overweight and obesity for each measure of SES were computed by using multivariable Poisson regression models. Results Overweight and obesity prevalence increased between 1998 and 2016, from 6% to 12% for obesity. Both were inversely associated with SES (higher prevalence among least educated and poorest women), with strong variations for each social indicator, even in multivariable analyses including both. Combining education and income revealed a wide gradient; RR for obesity was 6.01 (95% confidence interval 4.89–7.38) with low education and income <2000 euros/month vs. high education and income ≥4000 euros/month. Conclusions Public policies must implement programs to limit the increase in overweight and its unequal distribution in the population, alongside other policies to address the societal determinants of the obesogenic environment. Health professionals need to advise women to improve their eating and physical activity to limit weight gain from childhood to early adulthood. [ABSTRACT FROM AUTHOR]

Aim In France, following a long-term decline in smoking prevalence, an increase in smoking was observed between 2005 and 2010, an unusual occurrence in countries in the 'mature' stage of the smoking epidemic. By contrast, smoking prevalence in England, the neighbouring country, continued its long-term decline. Methods We identified and translated recent reports on smoking and tobacco control in France and using these assessed the main data sources on smoking and compared them with similar sources in England, in order to explore possible explanations. In France, national smoking prevalence data are collected 5-yearly, minimizing opportunities for fine-grained analysis; the comparable study in England is implemented annually. Results We identified several probable causes of the recent increased prevalence of smoking in France, the primary one being the absence of sufficient price rises between 2005 and 2010, due probably to the lack of a robust tobacco control strategy, which also appeared to have empowered tobacco industry influence. Funding to compensate tobacconists appears to incentivize tobacco sales and is significantly higher than tobacco control funding. Conclusions Mindful of the limitations of a case-study approach, the absence of sufficient price rises in the context of a weak tobacco control strategy seems the most likely explanation for the recent increase in smoking prevalence in France. A new cancer control plan and a national smoking reduction programme have been proposed by the French government in 2014 which, depending on implementation, may reverse the trend. In both countries, the higher levels of smoking among the more disadvantaged groups are of great concern and require greater political leadership for effective action. [ABSTRACT FROM AUTHOR]

This article explores subjective perceptions of retirement in France, using original quantitative data on the customers of a not-for-profit insurance company. The sample contains individuals aged 40–84, who are either in the labour force (N = 923) or retired (N = 705). Perceptions of retirement are measured using closed questions on views of the retirement transition (these views can be positive, negative or neutral) and definitions of retirement (retirement can be interpreted as a period of freedom, boredom, greater risk of precariousness, etc.). Using a number of different social indicators, we examine whether differences in social conditions translate into heterogeneous perceptions. We also investigate whether social differences in perceptions fade away with increasing age. Both working-age individuals and retirees generally have a positive view of the retirement transition and often define retirement as a period of freedom. Perceptions of retirement are shaped by social conditions: a higher level of education and income, greater wealth, better health and stronger social involvement go hand in hand with rosier perceptions. Moreover, we uncover a strengthening of this social gradient with increasing age. Finally, perceptions are positively correlated with satisfaction in various domains, for retirees. [ABSTRACT FROM AUTHOR]

Whereas the feasibility and effectiveness of Internet-based epidemiologic research have been established, methodological support for the quality of such data is still accumulating. We aimed to identify sociodemographic differences among members of a French cohort according to willingness to provide part of one's 15-digit national identification number (personal Social Security number (PSSN)) and to assess response consistency based on information reported on the sociodemographic questionnaire and that reflected in the PSSN. We studied 100,118 persons enrolled in an Internet-based prospective cohort study, the NutriNet-Santé Study, between 2009 and 2013. Persons aged 18 years or more who resided in France and had Internet access were eligible for enrollment. The sociodemographic profiles of participants with discordant data were compared against those of participants with concordant data via 2-sided polytomous logistic regression. In total, 84,442 participants (84.3%) provided the first 7 digits of their PSSN, and among them 5,141 (6.1%) had discordant data. Our multivariate analysis revealed differences by sex, age, education, and employment as regards response consistency patterns. The results support the quality of sociodemographic data obtained online from a large and diverse volunteer sample. The quantitative description of participant profiles according to response consistency patterns could inform future methodological work in e-epidemiology. [ABSTRACT FROM AUTHOR]

Background Few studies have considered using environmental amenities to explain social health inequalities. Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels. Methods The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial-scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics. Results The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0.003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway. Conclusions These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this. [ABSTRACT FROM AUTHOR]

While typologies of substance use disorder are very informative, they are still scarcer. The aim of this study was to consider a classification system of substance use among adolescents based on types of substance used and levels of use, and to compare identified groups on sociodemographic characteristics, mental and physical health factors, and other psychological indices. A total of 23,294 17-year-old French adolescents were assessed on mental health factors (depression, suicide, visits to a mental health professional), physical health factors (health self-perception, body shape perception, body mass index), family relationships, perceptions of substance use risk, and vision of the future. Hierarchical Cluster Analysis identified four classes of adolescents: 'Adolescents who use Occasionally/experimentally Tobacco and Alcohol' (n = 7328, 35.3%), 'Adolescents who do not use drugs' (n = 5218, 25.1%), 'Adolescents who use Tobacco, Alcohol, Cannabis' (n = 6804, 32.8%), and 'Adolescents who use Multi-drugs' (n = 1403, 6.8%). The two first were mostly high school girls, with no mental and physical health issue, accurate perception of substances uses risk, and positive vision of their future. They differed regarding parental socioeconomic status and body mass index. The two latest were mostly boys, with poor school performance, bad family relationships, mental health issues, incorrect perception of substances uses risk, and negative vision of their future. They differed regarding parental socioeconomic status, weight and weight perception. Our results confirm the heterogeneous nature of drug use in adolescents, the relevance of typologies, and their importance for future public health policy. [ABSTRACT FROM AUTHOR]

Objectives: The co-occurrence of multiple medical or psychosocial conditions (geriatric syndromes (GS) and age-related diseases) is a growing concern in older people. Given the diversity of these conditions and their complex interactions, our aim was to determine whether they could be structured into synthetic dimensions in order to facilitate the management of multimorbidity. Design: The underlying structure of 10 GSs and 8 age-related diseases was identified using a multiple correspondence analysis (MCA), and confronted to subjective and objective health outcomes. Setting: Community residents from Bordeaux City (France) older than 75 years in 2010 Participants: 630 adults aged 75+ years who lived in Bordeaux and participated in the 10-year follow-up of the Three-City study. Measurements: GSs included physical frailty, cognitive impairment and dementia, dependency, depressive symptoms, polymedication, thinness, falls, sensory deficit, social isolation, incontinence. Age-related diseases were cancer, cardiac diseases, peripheral vascular diseases, diabetes, hypertension, pulmonary diseases, osteoporosis, other chronic diseases. Association of the MCA-derived independent dimensions was assessed with 10-year visit subjective health and well-being, and with incident death and entry into institution during the remaining cohort follow-up. Results: Most of the participants (82%) had at least two age-related syndromes or diseases. The MCA structured the 18 conditions into three major dimensions: Degradation (D) driven by GS, Vascular (V), and Psychosocial (P) representing 68.7%, 7.4%, and 5.7% of the total variance, respectively. Dimension D was a strong predictor of future death and institutionalization. Dimensions D and P were strongly associated with current well-being. Conclusions: This work confirmed that multimorbidity is very common among older adults, and demonstrated the essential role of GS as manifestations of aging, even more than age-related diseases. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has focused health systems on supporting patients affected by this virus. Meanwhile in the community, many other contained patients could only use self‐care strategies, especially in countries that have set up a long and strict containment such as France. The study aimed to compare coping strategies deployed by patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS; a poorly recognised syndrome) to those with better known and referenced chronic conditions. An online flash survey was conducted during the containment period in partnership with French Patients Organizations including ME/CFS national association. Therefore, 'Brief COPE' version of Lazarus and Folkman's Ways of Coping Check List has been adapted to the specificity of the containment. The survey was e‐distributed in France from 15 April to 11 May 2020. Differences of coping strategies were analyzed using Wilcoxon–Mann–Withney test. Amongst 637 responses, 192 were complete, presenting a wide variety of diseases, including 93 ME/CFS. The latter have significantly different coping strategies than recognised diagnosed diseases patients: similar uses of emotion focused coping but less uses of seek social support and problem‐focused copings. In conclusion, coping strategies are different for those who deal with the daily experience of ME/CFS, highly disabling chronic condition with diagnostic ambiguity, low degree of medical and social recognition and without treatment. Better understanding of those strategies is needed to provide the means for health promotion researchers, managers and clinicians, to accompany those patients. [ABSTRACT FROM AUTHOR]

Summary: This paper presents a field investigation on hydrogeomorphic adjustments of small streams in a 147km2 periurban catchment, the Yzeron River catchment located in France. The rapid development of periurban areas in the world is now considered as one of the main factor impacting river systems. Urban disturbances are most of the time associated with irreversible alterations of the hydrological regime, the sediment yields, with major ecological impacts and additional socio-economical costs. Nineteen stream reaches have been considered in this study, with drainage areas ranging from 0.2 to 33.9km2 and total impervious areas ranging from 1% to 52% of the basin surface. A regional analysis was led in order (i) to quantify the hydrogeomorphic adjustments of stream channels in this periurban context, i.e. the ratios between observed values and reference/rural values; and (ii) to identify the main anthropogenic controlling factors of these adjustments. Results show that urban river channels experience a global enlargement, with a mean bankfull discharge ratio of 1.8, bankfull width and depth ratios of 1.3 and a bankfull area ratio of 1.8. This study also outlines the global increase of hydrogeomorphic adjustments with the increase of the fraction of impervious area and the level of disturbance of the flood regime. However, local anthropogenic factors seem to be much more relevant to explain the highest adjustment ratios at several river reaches (enlargement ratio up to 55). The vicinity of a river reach with road sewers and/or the urban areas is identified to be a very important factor that affects significantly the smallest streams (drainage area less than 5km2). On the contrary, at several reaches no significant deepening or widening was observed although roads/urban sewers and urban areas were identified in their catchment. Several hypotheses are proposed, but additional works with new data (river monitoring) would be needed to propose management and/or restoration guidelines in periurban catchments. [Copyright &y& Elsevier]

Abstract: This paper sets out to highlight and quantify the effect of individual and contextual deprivation on both access to a car driving licence and on actual driving of a car among young licence-holders in the Rhône Département (France). The three stages by which adolescents and very young adults become autonomous with regard to driving have been subjected to multilevel analyses, using a Household Travel Survey: (i) whether young persons participate in the early driving scheme at 16–17years of age, (ii) whether young persons of 18–24years of age hold a driving licence, and (iii) whether young licence-holders actually drive a car. At these three stages, social inequalities can be observed. This study highlights the considerable impact socioeconomic (individual but also contextual) factors and gender have on inequalities of access to car driving. Underprivileged groups suffer from disadvantages that accumulate at each stage (driving licence and car driving). The multilevel analysis of access to the car among young persons shows that considering the effects of the geographical context improves our understanding of travel inequalities. [Copyright &y& Elsevier]

Abstract: Decision on biodiversity management at regional level must often be based on both ecological and socio-economic measures. For these last ones, many social, economic and political issues must be taken into account in the same time, and many stakeholders’ interests may be concerned by the decisions to be taken based on the measures chosen. In some cases, only monetary evaluations of biodiversity changes are proposed, which exclusively favor economic considerations, whereas social and governance problems might also be involved. Our paper presents a method based on the “principle of representative diversity”, allowing to obtain a reduced set of indicators equitably distributed among the different stakeholders and the different focal areas for biodiversity management. We have successfully applied this method to a case study, in the Ile-de-France region, in France, for drafting socio-economic indicators for the Regional Strategy for Biodiversity. Biodiversity stakeholders in the region have been invited to participate to three working groups, each of which is representative for a class of ecological services, i.e., “Regulation services”, “Provisioning services” and “Cultural services”. In a first meeting, stakeholders discussed the major stakes for the relationships between biodiversity and socio-economic activities in the region (i.e., Regional Focal Areas). Based on extensive literature study of indicators describing relationships between biodiversity and humans, we drafted a list of “candidate indicators”, which we distributed among the focal areas validated by the working groups. Stakeholders met a second time for choosing, among these indicators, the most representative 5 ones for each focal area. Finally, the principle of representative diversity allowed us to select a final set of 27 indicators, balanced between the different focal areas and the different stakeholders. After an introductory section presenting the literature background of our approach and describing the specific indicator needs of the Ile-de-France region, Section describes the method. Section presents the results of its application, going into detail for two examples of use of the principle of representative diversity. The last section discusses the results and concludes on the usefulness of the method, both theoretically and for the Ile-de-France region. [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: Cost–benefit analysis (CBA) is a tool used to evaluate the potential socio-economic impact of public investment choices. In many countries, particularly in France, this tool is used to support decision-making related to transportation infrastructure. In the context of difficult budgetary arbitrations, taking the multiple effects of the different choices into account makes choosing among transport infrastructure investments a two-fold problem. On the one hand, public decision-makers have limited resources that they must use in the best way possible. On the other hand, when choosing among alternative investment projects, the decision-makers reveal their priorities (based on the importance they assign to the different projects), and these priorities must be perceived as legitimate. Based on a case study of how French institutions use the CBA method, this paper examines how the use of cost–benefit analysis interacts with the use of public debate and stakeholder participation in France today. This French case illustrates the difficulty of striking the right balance between the expert knowledge produced by CBA methods and the knowledge produced by the participation of various stakeholders in the decision-making process. [Copyright &y& Elsevier]