La négociation du temps de travail: l'emploi en jeu

International audiencePersistent high unemployment has established the labor relations system in France. Jobs have become an ever more important issue in negotiations about the time spent working. By combining legal and sociological analysis, it is shown that regulatory oversight has, since the 1980s, taken the place of a quite decentralized bargaining process that formed an exception to legal rules. Although jobs often stand at the top of the agenda in negotiations about work-time, it is less an actually targeted objective than a bargaining chip for working out agreements on other topics. The issue of jobs crops up in three types of situations. First of all, jobs may serve as a mere pretext for opening negotiations about the time spent working, Secondly, the jobs issue can also lead to solid commitments in exchange for measures allowing for more flexibility. Thirdly, it may be a formal objective for negotiators bargaining about work-time even though no party has any real interest in reaching such an objective. This diversity of cases and of forms of commitment raises question about the traditional principles of labor law.En France, la pérennité du chômage bouscule plus que jamais la dynamique du système de relations professionnelles. L'emploi est ainsi devenu un enjeu de plus en plus important dans les négociations sur le temps de travail. Croisant analyses juridiques et sociologiques, les auteurs montrent de ce point de vue qu'à un mode tutélaire de réglementation succède, depuis les années 1980, un mode négocié, largement décentralisé et dérogatoire aux règles légales. Par ailleurs, si l'emploi est souvent mis au premier plan dans les négociations sur le temps de travail, il ne l'est pas nécessairement comme un objectif à atteindre ; il est surtout utilisé comme une valeur arbitrage qui facilite la production d'autres types d 'arrangemen

How chronic is polypharmacy in old age? A longitudinal nationwide cohort study

OBJECTIVE: To evaluate the chronicity of polypharmacy among older adults, and to identify factors associated with chronic polypharmacy. DESIGN: Longitudinal cohort study using register data. SETTING: Nationwide, Sweden. PARTICIPANTS: All 711,432 older adults (≥65 years) living in Sweden with 5 or more prescription drugs in October 2010 were included and followed-up until December 2013. Mean age at baseline was 77 (SD, 7.8) years, 59% were women, and 7% lived in nursing homes. MEASUREMENT: Monthly changes in the exposure to polypharmacy. Data regarding prescription drug use were extracted from the Swedish Prescribed Drugs Register. RESULTS: Overall, 82% were continuously exposed to polypharmacy during ≥6 months, and 74% during ≥12 months. The proportion of individuals who remained exposed until the end of the study was 55%. Among the 21,361 individuals who had not been exposed to polypharmacy during the 6-month period before baseline (i.e. with a new episode of polypharmacy), only 30% remained exposed for ≥6 months. The proportion of older adults who spent at least 80% of their follow-up time with polypharmacy was substantially higher among prevalent polypharmacy users at baseline than among those with a new polypharmacy episode (80% vs 24%, p<0.01). Factors associated with chronic polypharmacy included higher age, female gender, living in an institution, chronic multimorbidity, and multi-dose dispensing. CONCLUSION: Polypharmacy is most often chronic, although a substantial share of older adults experience short, recurring episodes of polypharmacy and are thus exposed to its potential harms in a transient rather than persistent manner.Swedish Research Council (2015-03618)Accepte

Experiencing transitions in life of mothers of young children

V magistrskem delu smo raziskovali doživljanje življenjskih prehodov mater majhnih otrok. Teoretični del je bil namenjen pregledu literature s področja blagostanja, življenjskih prehodov in materinstva. Za raziskovanje doživljanja življenjskih prehodov je bil uporabljen psihološko fenomenološki pristop. V skladu s tem smo pridobili vpogled v doživljanje šestih udeleženk, hkrati pa vnaprej nismo predvidevali rezultatov ali postavljali hipotez. Cilj psihološko fenomenološke metode je bil oblikovati splošni opis bistvenih značilnosti doživljanja oziroma osnovne strukture, ki določa raziskovano doživljanje. Na podlagi intervjujev smo oblikovali splošno strukturo doživljanja življenjskih prehodov pri materah majhnih otrok. Ugotovili smo, da je za polovico udeleženk materinstvo najpomembnejši prehod v življenju, za ostale tri pa je na drugem mestu. Bistvene spremembe prehoda v materinstvo je mogoče razdeliti na dva dela: povzamejo občutenje, ki se dotika drugih in okolice ter občutenje, ki jih ima ženska do same sebe. Prav tako materinstvo pomembno zaznamuje doživljanje na področju telesnega, relacijskega, čustvenega in duhovnega blagostanja. Vpogled v doživljanje življenjskih prehodov pri materah majhnih otrok, ki ga daje ta raziskava, je lahko uporabna in v pomoč ljudem, ki profesionalno delujejo na področju psihologije, psihoterapije ali na katerem drugem profesionalnem področju, ki vključuje delo z ljudmi, še posebej z ženskami. Kot tako, bo lahko omogočilo pripravo strokovnih smernic programov za ženske, priprave na starševstvo ali podporne skupine za ženske. Verjamemo pa, da bo delo v pomoč tudi tistim, ki si želijo pridobiti vedenje in znanje o tej tematiki, saj lahko služi kot pomoč pri razumevanju doživljanja žensk, ko se te soočajo z življenjskimi prehodi, predvsem s prehodom v materinstvo.This Masters thesis researches how mothers with young children dealt with and experienced their life transition to the role of being a mother. The theoretical part of the thesis focuses on the literature review from the fields of welfare, life transitions and motherhood. A psychological-phenomenological approach has been used to research the life transitions. Based on this an insight into the transition experience of six women has been received, whereas there were no predictions on the outcome or setting hypothesis. The goal of the psychological-phenomenological method is to form a general description of key characteristics or the basic structure, which describe the researched transition. Based on performed interviews a general structure of experiencing the life transitions with mothers with young children has been made. The results show that for half of women experiencing motherhood is the most important transition in life, whereas the other three placed it to the second position in importance of life transitions. Key changes in the transition to the motherhood can be divided to feelings referring to the surrounding and others and secondly, feelings which a woman experiences with regard to herself. Motherhood also significantly affects woman’s relations to physical, relational, emotional and spiritual well-being. Insight to experiencing the life transitions with mothers with young children which this research offers, is useful and of help to anyone who is professionally involved in the fields of psychology, psychotherapy or any other related field which involves working with people, especially women. As such the thesis can enable preparation of professional guidelines and programs for women, parenthood preparations or support groups for women. We believe, that thesis will also assist to those, that would like to develop knowledge on this topic as it can serve as outreach at understanding of experiencing of women, when these are deal with different life transitions, particulary transition to the motherhood

Régime sans gluten

Tuberculosis, despite its prevention, remains an endemic affection in Morocco. Although rare, pseudo surgical forms and especially peritonitis are mainly due to delayed diagnosis. We report the case of a 30-year-old woman, admitted for peritonitis. The diagnosis of tuberculous peritonitis was established during surgery with macroscopic observation of granulations, and confirmed after biopsy specimens by identification of a giant lymph node cell granuloma with caseous necrosis. Outcome was favorable after appropriate antibiotic therapy. This observation emphasizes the fact that peritonitis, although a rare complication of peritoneal tuberculosis, poses problems of positive and differential diagnosis. Even if treatment is based on antituberculous quadritherapy, surgery is sometimes necessary and should be decided in due time

The ANTENATAL multicentre study to predict postnatal renal outcome in fetuses with posterior urethral valves: objectives and design

Abstract Background Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease. A major issue in the management of PUV is prenatal prediction of postnatal renal function. Fetal ultrasound and fetal urine biochemistry are currently employed for this prediction, but clearly lack precision. We previously developed a fetal urine peptide signature that predicted in utero with high precision postnatal renal function in fetuses with PUV. We describe here the objectives and design of the prospective international multicentre ANTENATAL (multicentre validation of a fetal urine peptidome-based classifier to predict postnatal renal function in posterior urethral valves) study, set up to validate this fetal urine peptide signature. Methods Participants will be PUV pregnancies enrolled from 2017 to 2021 and followed up until 2023 in >30 European centres endorsed and supported by European reference networks for rare urological disorders (ERN eUROGEN) and rare kidney diseases (ERN ERKNet). The endpoint will be renal/patient survival at 2 years postnatally. Assuming α = 0.05, 1–β = 0.8 and a mean prevalence of severe renal outcome in PUV individuals of 0.35, 400 patients need to be enrolled to validate the previously reported sensitivity and specificity of the peptide signature. Results In this largest multicentre study of antenatally detected PUV, we anticipate bringing a novel tool to the clinic. Based on urinary peptides and potentially amended in the future with additional omics traits, this tool will be able to precisely quantify postnatal renal survival in PUV pregnancies. The main limitation of the employed approach is the need for specialized equipment. Conclusions Accurate risk assessment in the prenatal period should strongly improve the management of fetuses with PUV

A picture of medically assisted reproduction activities during the COVID-19 pandemic in Europe

STUDY QUESTION: How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER: MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY: With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN, SIZE, DURATION: A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS, SETTING, METHODS: The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE: By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS: The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations.peer-reviewe

Autonomie de négociation et ordre public social

L’objet de cette contribution, essentiellement d’ordre juridique, est de rendre compte de l’évolution du modèle de négociation collective français pour éclairer sa place contemporaine dans la régulation des rapports de travail, spécialement par rapport à la régulation étatique (Morin et Debabi 1997 ; Morin, 1998). La loi ou la négociation ? Le débat sur les mérites respectifs de l’une ou de l’autre est en effet un débat récurrent dans le système français de relations professionnelles, compte ..