La coutume des carabins. Ethnologie de l’internat

Résumé de la thèse : Au départ de ce travail, un paradoxe et une ambiguïté récurrents : la dévalorisation des coutumes et usages des marges de l’apprentissage médical que dans le même temps  nombre de médecins, notamment spécialistes, associent à un « art » d’être interne. Quelle est la place de ces pratiques des marges, sur lesquelles tous les internes et anciens ont à dire, dans l’apprentissage médical ? Quel rôle jouent-elles dans la construction du personnage du médecin spécialiste frança..

Les usages de drogues des plus jeunes adolescents : données épidémiologiques

International audienceAdolescence is often the time of experimentation with psychoactive substances, sometimes leading to more regular use. This paper gives an update of drug consumptions by the young adolescents, from results of recent general population surveys in France, and focuses on the specificity of this consumption when compared to that of older adolescents. It shows that regular uses of such substances usually don't start before the age of 14, but that early initiated adolescents show a higher risk of moving towards more intensive or problematic uses.Through presenting the limitations of such surveys, the authors discuss the nature of the link observed between early experimentation and level of use: while acknowledging the unquestionable prognostic value of early initiation to predict future problematic use, they show that its interpretation should be made with caution when based on such transversal epidemiological surveys.L'adolescence est souvent l'âge de l'expérimentation des substances psychoactives et parfois celui du passage à un usage plus régulier. À travers les résultats d'enquêtes en population générale récentes, cet article fait le point sur les consommations des drogues des plus jeunes en mettant en évidence leurs spécificités relativement aux adolescents plus âgés. Il met en évidence que les usages réguliers des différentes substances ne commencent en général guère avant 14 ans, mais que les adolescents qui se distinguent par la précocité de leur expérimentation présentent un risque nettement plus important de basculer vers un usage plus intensif ou problématique. À travers une présentation des limites méthodologiques des enquêtes utilisées, les auteurs discutent la nature du lien observé entre précocité de l'expérimentation et niveau d'usage : tout en rappelant l'indiscutable valeur pronostique de la précocité du premier usage pour prédire les usages problématiques futurs, ils montrent que son interprétation peut se révéler délicate dans les enquêtes épidémiologiques transversales

Shedding Light on the lifestyle and participation of portuguese adolescents with chronic conditions—Data from the HBSC 2018 Study

Variables associated with lifestyle can constitute either risk or protective factors for the development and progression of chronic conditions (CC). This study intends to explore the differences between adolescents with and without CC and between adolescents whose school participation is affected/not affected by the existing CC with regard to variables related to lifestyle (i.e., sleep, physical activity, BMI, and leisure). In addition, it also intends to analyze the influence of these variables (i.e., CC and lifestyle) regarding the adolescents’ quality of life (QoL). This work is part of the Portuguese HBSC 2018 study. A total of 8215 adolescents participated (52.7% female), with an average age of 14.36 years (SD = 2.28). The results showed that the adolescents with CC and whose school attendance and participation are affected by their CC exhibit more sleep difficulties (i.e., they experience lower sleep quality and have a higher degree of sleepiness), higher BMI levels (i.e., higher values of overweight and obesity), less participation in leisure activities, and a lower perception of QoL. A higher perception of QoL is associated with school participation unaffected by the existing CC, sleeping well, a low level of sleepiness, a more frequent practice of physical activity, a lower BMI, and a greater involvement in leisure activities. Adolescent health and well-being are a prominent issue in terms of public policies, with behavior and lifestyle playing a significant role in this domain. This message needs to be reinforced in regard to families, educators, healthcare professionals, and public sector policies, particularly concerning students with CC.info:eu-repo/semantics/publishedVersio

Condiciones de salud crónicas medidas con cuestionarios de salud general para adolescentes en Europa

The present study intends to assess how chronic health conditions are being evaluated in general health questionnaires aimed at adolescents. A review of questionnaires that contain questions about different domains of the adolescents' lives and about chronic disease and/or disability was performed. Different terminologies regarding the domain of chronic conditions (e.g. long-term illness, disability, medical condition, illnesses/disorders, chronic disease, health problems) and different questions formulations and evaluation measures are used. Some questionnaires include questions about the specific areas affected by the chronic health condition and limitations. This work allowed an overview of the main categories present in the questions about chronic disease/disability that are currently being included in these instruments. It highlights the importance of considering the adolescents with chronic conditions in the general health questionnaires, as this allows for increasing knowledge about their needs and difficulties. Data collection on adolescents with chronic conditions' social participation is very important and should be reinforced through improved questions.El presente estudio pretende evaluar cómo las condiciones crónicas de salud están siendo evaluadas en cuestionarios de salud general dirigidos a adolescentes. Se realizó una revisión de cuestionarios que contienen preguntas sobre diferentes dominios de la vida de los adolescentes y sobre enfermedades crónicas y/o discapacidad. Diferentes terminologías relacionadas con el dominio de las condiciones crónicas (e.g. enfermedad prolongada, discapacidad, condición médica, enfermedades/trastornos, enfermedades crónicas, problemas de salud) y diferentes formulaciones de preguntas y medidas de evaluación son usados. Algunos cuestionarios incluyen preguntas sobre las áreas específicas afectadas por la condición de salud crónica y las limitaciones. Este trabajo permitió una visión general de las principales categorías presentes en las preguntas sobre enfermedad crónica/discapacidad que actualmente están siendo incluidas en estos instrumentos. También destaca la importancia de considerar los adolescentes con condiciones crónicas en los cuestionarios generales de salud, ya que esto permite aumentar el conocimiento sobre sus necesidades y dificultades. La recopilación de datos sobre la participación social de los adolescentes con condiciones crónicas es muy importante y debe reforzarse a través de preguntas mejoradas

Alcohol and tobacco use in Portuguese adolescents: The relationship with social factors, future expectations, physical and psychological symptoms

The influence that social factors (relationship with teachers, peers and family support), future expectations, physical and psychological symptoms exert on the adolescents’ tobacco and alcohol consumption is analyzed, and the differences between users and non-users are analyzed as well. This work is part of the HBSC study. The results show that substance use is associated with more physical and psychological symptoms, worse relationship with teachers and peers, less family support, and lower future expectations. It is important to intervene towards the construction of more positive future expectations and relationships and the promotion of physical and psychological well-being, as protective factors against substance use.Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

Trends in educational differences in adolescent daily smoking across Europe, 2002-10

Background: Across Europe, tobacco use is more prevalent among secondary school students attending vocational tracks compared with students attending academic tracks. The purpose of the present study is to describe trends in social inequality in daily smoking among adolescents between 2002 and 2010 by addressing both absolute social inequality (prevalence difference between vocational and academic tracks) and relative social inequality (prevalence ratio) in seven European countries. Methods: Analyses were based on data from 15-year-olds who participated in the Health Behaviour in School-aged Children study in 2002, 2006 and 2010 in Belgium, Croatia, France, Germany, Hungary, Italy and The Netherlands (total N = 32 867). Results: Overall, daily smoking decreased between 2002 and 2010 in Belgium, France, Germany and The Netherlands, increased in Croatia and remained stable in Hungary and Italy. Considerable differences in daily smoking according to educational track existed in all countries. Absolute educational inequalities increased dramatically in Croatia and Italy, while relative inequalities showed a tendency to increase in all countries (significant in Belgium and The Netherlands). Conclusions: Conclusions on social inequality in adolescent smoking may appear differently when described by absolute and relative measures. Especially the large increase in absolute educational inequalities in daily smoking in Croatia and Italy are worrisome and warrant attention from the public health domain. The findings underline the need for appropriate smoking policies and interventions in vocational schools across Europ

Parents' Support and Knowledge of Their Daughters' Lives, and Females' Early Sexual Initiation In Nine European Countries

The association between early sexual initiation and parenting practices (e.g., support and knowledge) has not been tested in multiple European population-based samples using the same instrument

Sleep and sex sleep in adolescence : sex matters?

© 2019 All rights reservedObjective: Sleep is of upmost importance for everybody and especially for adolescents who face life and leisure challenges that may impair their sleep. This study aimed to verify if girls are at a higher risk to present sleep problems and if associations of a sleep perception are different between sexes even when accounting for biological maturation. Methods: Data is from the HBSC Portuguese survey 2014, all variables were self-reported. Participants were 3869 adolescents (2057 girls), mean age 14.8 years. Participants’ socio-demographic characteristics included sex, age, school grade, father and mother education; besides participants were inquired about sleep duration and characteristics of their sleep quality. Results: Sleep deprivation was reported by 13.1% of the adolescents (girls 14.3%, boys 11.7%, p<0.05). The most prevalent characteristics of poor sleep quality were waking up tired (50.8%) and difficulties falling asleep (19.5%), for both girls presented higher prevalence than boys. Overall, girls presented a poorer sleep health with low quality and quantity of sleep. Furthermore, associations of an enough and good sleep were different between boys and girls, even when controlling for the impact of delayed pubertal maturity. Discussion: Together with screen time, substance use, poorer nutrition, sedentary behaviours and abuse of screen time, sleep is an issue that must be addressed by professionals, families and public policies with impact in family life and family routines. Modelling a health education in schools should include the sleep topic. In addition, yes, sex matters and must be included on board.info:eu-repo/semantics/publishedVersio

Cannabis experimentation among students with cognitive disorders in special units (ULIS) in mains stream schools

© Edimark. Les articles publiés dans Le Courrier des addictions le sont sous la seule responsabilité de leurs auteurs. Tous droits de traduction, d’adaptation et de reproduction par tous procédés réservés pour tous pays. © décembre 1998Globally, current inclusive education policies allow students with cognitive disorders to participate in community/school life, however, such an increasing exposition might raise their level of detrimental behaviours as well, namely substance use. This study aims to: 1) describe cannabis experimentation rates among cognitively impaired adolescents schooled in special units (ULIS) in junior high-schools, compared to mainstream students; and 2) to explore factors associated with substance experimentation among ULIS students. A cross-sectional experimental study adapted from the international HBSC/WHO questionnaire was conducted among 700 ULIS students with a mean age of 14.2 years and 7023 students in mainstream junior high-school (mean age: 13.6). Only students aged 14 or more were considered in the analyses (382 ULIS students; 2642 mainstream junior high-school students). The proportion of students in inclusive education enrolled in ULIS who have already experimented cannabis is not as high as among their non-disabled peers (9.1% among ULIS students vs . 20.9% among mainstream junior high-school students), yet is far from being negligible. Thus, to have epidemiological data on cannabis experimentation in intellectually disabled students is crucial to adapt interventions and policies to the cognitive level and specificities of this group of adolescents, in order to increase their chances and opportunities later in adulthood.Actuellement, grâce aux politiques d’éducation inclusive, le nombre d’élèves avec une défi cience cognitive scolarisés en milieu ordinaire s’accroît. Si cette inclusion leur permet désormais de participer à la vie scolaire et communautaire, elle les expose aux conduites potentiellement à risque pour la santé, comme l’expérimentation de substances psychoactives. Les objectifs de cette étude sont d’estimer la prévalence de l’expérimentation de cannabis parmi les adolescents scolarisés en Unités localisées pour l’inclusion scolaire (ULIS), de la comparer à celle chez leurs pairs, et d’explorer les facteurs associés à l’expérimentation du cannabis chez les élèves d’ULIS. En 2014, une étude pilote adaptée de l’enquête internationale HBSC/OMS a été conduite parmi 700 élèves d’ULIS (âge moyen : 14,2 ans) et 7 023 autres collégiens (âge moyen : 13,6 ans). Seuls les élèves de 14 ans ou plus ont été considérés dans les analyses (382 en ULIS ; 2 642 en classe ordinaire). La proportion d’élèves ayant déjà expérimenté le cannabis est plus faible en ULIS que chez les autres collégiens (9,1 % parmi les élèves d’ULIS versus 20,9 % parmi les autres), sans pour autant être négligeable. Ainsi, le recueil de données épidémiologiques sur l’expérimentation du cannabis parmi les élèves avec un défi cit cognitif s’avère nécessaire afi n de mettre en place des programmes de prévention ciblés et adaptés à leurs capacités cognitives et, ainsi, d’augmenter leurs chances et opportunités à l’âge adulte.La recherche concernant les élèves d’ULIS a été financée par un appel d’offre de la MiRe-DRESS et la CNSA (AAR 2012 Handicap et perte d’autonomie ; A13011BS-DREES/CNSA). La collaboration entre la France et le Portugal est financée par le Partenariat Hubert-Curien PESSOA 2015 (projet n° 33701NJ). Teresa Santos est financée par une bourse de thèse de la Fondation portugaise pour la science et la technologie (FCT) [référence SFRH/BD/82066/2011]. HBSC est une enquête internationale conduite sous l’égide de l’OMS/EURO. La liste complète des chercheurs participants se trouve sur le site de HBSC: http://www.HBSC.org. L’enquête HBSC 2014, en France, est pilotée par le service médical du rectorat de Toulouse (ministère de l’Éducation nationale) et l’équipe 2 de l’UMR1027 Inserm/UPS ; elle est financée par Santé publique France et l’Observatoire français des drogues et des toxicomanies (OFDT).info:eu-repo/semantics/publishedVersio

Decreases in adolescent weekly alcohol use in Europe and North America: evidence from 28 countries from 2002 to 2010

Background: This study examined trends in adolescent weekly alcohol use between 2002 and 2010 in 28 European and North American countries. Methods: Analyses were based on data from 11-, 13- and 15-year-old adolescents who participated in the Health Behaviour in School-Aged Children (HBSC) study in 2002, 2006 and 2010. Results: Weekly alcohol use declined in 20 of 28 countries and in all geographic regions, from 12.1 to 6.1% in Anglo-Saxon countries, 11.4 to 7.8% in Western Europe, 9.3 to 4.1% in Northern Europe and 16.3 to 9.9% in Southern Europe. Even in Eastern Europe, where a stable trend was observed between 2002 and 2006, weekly alcohol use declined between 2006 and 2010 from 12.3 to 10.1%. The decline was evident in all gender and age subgroups. Conclusions: These consistent trends may be attributable to increased awareness of the harmful effects of alcohol for adolescent development and the implementation of associated prevention efforts, or changes in social norms and conditions. Although the declining trend was remarkably similar across countries, prevalence rates still differed considerably across countrie