L’organisation du travail en milieu hospitalier et ses effets sur la santé des infirmières

Cet article présente l'état des connaissances sur l'organisation du travail infirmier et ses effets sur la santé physique et mentale des infirmières. Ensuite, il traite d'un modèle conceptuel que nous proposons pour approcher une telle problématique. Ce dernier suppose des relations entre la charge de travail, source potentielle de problèmes de santé, l'autonomie et le soutien social comme modérateur de la charge ou de ses effets.This article covers the actual knowledge on the organization of infirmary work and its effects on nurses' physical and mental health. Then it proposes a conceptual model to study the question. This model is concerned with the relationship between the work load, a potential source of health problems and the autonomy and the social support which may relieve the load or its effects

Approaches to considering sex and gender in continuous professional development for health and social care professionals : an emerging paradigm

Consideration of sex and gender in research and clinical practice is necessary to redress health inequities and reduce knowledge gaps. As all health professionals must maintain and update their skills throughout their career, developing innovative continuing professional education programs that integrate sex and gender issues holds great promise for reducing these gaps. This article proposes new approaches to partnership, team development, pedagogical theory, content development, evaluation and data management that will advance the integration of sex and gender in continuing professional development (CPD). Our perspectives build on an intersectoral and interprofessional research team that includes several perspectives, including those of CPD, health systems, knowledge translation and sex and gender

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Les politiques d’égalité professionnelle des entreprises pour l’accès des femmes aux postes de décision économique : espoirs et progrès, au Québec et au Canada

Québec initially adopted a voluntary approach in the area of employment equity. Constraints were then gradually added to force changes which were slow in coming. This article describes the development of the institutional framework and, based on selected statistics, illustrates the unequal progress made by women. We will show that legal constraints are a powerful incentive for implementing programs aimed at employment equity for women, since compulsory measures seem to have more effect than declarations or voluntary commitments related to equity made by organizations. We maintain that the power of stereotyped representations and of behavioural patterns can only be overcome by a lever such as a legal obligation. It is important to continue to identify the conditions required to foster the desired changes if real equality is to be achieved in the workplace.Le Québec a tout d’abord adopté une approche volontaire en matière d’égalité en emploi, puis des contraintes ont progressivement été ajoutées pour forcer les changements qui tardaient à s’opérer. Le présent article relate l’évolution du cadre institutionnel et illustre, à partir de certaines statistiques, les progrès inégaux réalisés par les femmes. Nous montrerons que les contraintes légales constituent de réels stimulants en ce qui concerne l’implantation de programmes visant l’équité en emploi pour les femmes, les mesures obligatoires semblant avoir plus d’effet que les déclarations ou les engagements volontaires des organisations à l’égard de l’équité. Nous soutenons l’idée que la force des représentations stéréotypées et celle des habitudes de comportement ne peuvent être contrées que par un levier tel qu’une obligation légale. L’identification des conditions requises pour favoriser les changements souhaités doit être poursuivie si l’on veut atteindre une réelle égalité dans les milieux de travail.Lee-Gosselin Hélène. Les politiques d’égalité professionnelle des entreprises pour l’accès des femmes aux postes de décision économique : espoirs et progrès, au Québec et au Canada. In: Santé, Société et Solidarité, n°1, 2008. De l’égalité de droit à l’égalité de fait : Françaises et Québécoises entre législation et réalité. pp. 59-65

Femmes au travail

Le thème « Femmes au travail » de ce numéro de Recherches féministess'inscrit dans une perspective de changement social qui s'opère dans les rapports sociaux de sexe, voire dans les catégorisations sociales, tant dans le domaine du travail que dans ses rapports avec le privé. Les articles soulignent une évolution certaine dans les questionnements et les méthodologies de recherches féministes, et proposent un regard nouveau sur des phénomènes de féminisation à partir de professions peu observées jusqu'à présent. Ils proposent aussi des stratégies pour prévenir ou combattre la discrimination systémique présente dans les lieux de travail. Le changement social s'impose comme dénominateur commun entre les articles : raffinement du cadre conceptuel des rapports sociaux de sexe (Daune-Richard et Devreux) ; réversibilité sexuelle de secteurs du marché du travail : féminisation de certaines professions au Québec, comme la médecine (Dufort) et la pharmacie (Collin) ; la féminisation de la main-d’œuvre vieillissante (Bellemare, Poulin-Simon et Tremblay) ; ou la masculinisation des postes de direction dans les établissements d'éducation (Baudoux) ; les représentations de jeunes femmes quant à leurs rôles sociaux dans l'avenir (Lortie-Lussier) ; des propositions pour corriger les grilles servant de base à l'évaluation des emplois (Gaucher).The articles in this issue of Recherches féministesunderline changes in femenist questions and methodologies pertaining to women's work and its relation with private life. They also propose strategies to fight systemic descrimination in the work place. A.-M. Daune-Richard and A.-M. Devreux develop the sociological concept of « rapport social de sexe » while J. Collin and F. Dufort analyse respectively the feminization of the pharmaceutical and medical professions. C. Baudoux documents the inverse phenomenon of masculinization of higher administrative posts in educational establishments through implicit selection criteria that are discriminatory against women and D. Bellemare, L. Poulin Simon and D.-G. Tremblay examine the situation of aging women in the labor force. Two notes by M. Lortie-Lussier and D. Gaucher present and discuss respectively the aspirations of young female university students and innovative axes of analysis for a non-sexist job evaluation system

Gender and success in entrepreneurship research: A critical perspective

peer reviewedThis paper aims to challenge the conventional definition of success in entrepreneurship. It pinpoints the inadequacy of its masculine gendered definition to take into account the vision of women entrepreneurs (WEs). It focuses on the concept of success and its various meanings for WEs. The paper is grounded in three qualitative studies on WEs undertaken in Quebec, France and Belgium, reaching 151 diverse entrepreneurs. The findings reveal that the commonly accepted definition and measure of entrepreneurial success, business growth and financial performance, is not adequate for most WE s. Broader visions of success and complex meanings exist among Wes; success is a multi-dimensional reality rather than a simple dominant goal: profits or growth. Our contribution is to challenge the relevance of traditional theoretical frameworks in entrepreneurship, and we plead for their widening, for women and men. We also propose a conceptual grid to reconsider success in entrepreneurship which could be exploited in other research