Identités complexes et espaces publics contemporains : trajectoires scolaires et biographiques de jeunes Belges et Anglais « d’origine immigrée »

À partir d’entretiens socio-biographiques menés en Angleterre (Birmingham) et en Belgique (Bruxelles) auprès de jeunes en fin de scolarité secondaire issus des groupes d’immigration les plus significatifs, cet article développe un certain nombre d’hypothèses concernant les processus de construction identitaire de cette génération. L’équation traditionnelle entre réussite scolaire et assimilation, d’une part, et échec et postures « essentialistes », d’autre part, est partiellement mise en cause à partir d’une conception non totalisante des identités. Ainsi, les stratégies identitaires mises au jour, allant d’une posture « essentialiste » à une posture « assimilationniste » en passant par une série de postures intermédiaires plus complexes, sont analysées comme autant de « répertoires identitaires » mobilisables selon les contextes. Les jeux ne sont toutefois pas totalement ouverts, puisque les contraintes spécifiques aux différents contextes scolaires pèsent sur les répertoires mobilisables. L’article aborde enfin la question des ressources (socio-cognitives, socioculturelles et socio-biographiques) nécessaires à l’individu pour construire un rapport réflexif à son « identité dans plusieurs mondes ».This article is based on socio-biographical interviews carried out in Birmingham, England and Brussels, Belgium with youth drawn from the largest immigrant population in each city and at the end of their post-secondary schooling. It puts forward several hypotheses about the construction of this generation’s identity. A non-totalising conceptualisation of identity questions the usual links considered to exist between school achievement and assimilation, on the one hand, and failure and an essentialist stance, on the other. “Identity repertoires,” mobilised according to each particular context, are identity strategies that range from an essentialist stance to one of assimilation, with a number of more complex intermediary positions existing as well. The game is never totally open, however, because constraints within the different educational contexts limit the repertoires that can be mobilised. Finally the article raises the question of resources (socio-cognitive, socio-cultural and socio-biographical) that individuals need in order to construct a reflexive relationship to their “identity in several worlds.

Impacts of climate change on public health in Australia

Provides information, opinions and recommendations relevant to assessing the potential impacts of climate change on public health in Australia, as well as guidelines for decision-making in responding to these impacts. It aims to: draw attention to the potential impacts of climate change on health in Australia; discuss the policies and issues related to the impacts of climate change on health; present prioritised recommendations to decision-makers on policies and practices which may assist mitigation of and adaptation to the most serious of the identified impacts; provide guidance which will assist appropriate people and agencies to allocate resources to the highest priority problems; and provide a comprehensive list of references which provide reliable evidence about the potential impacts of climate change on health in Australia. The immediate and longer-term impacts of climate change have the potential to affect Australian health and social environments seriously, and as such, demand and deserve attention by Federal and State Governments and agencies within the Australian public health sector. Policymakers are faced with pressing issues of funding and delivering health services for an ageing society with an ever increasing burden of chronic disease and expectations of access to high-technology, high cost interventions. However, the impacts of future climate change on public health may potentially generate very large healthcare costs if current strategies for healthcare are inadequate. Successful advocacy of new policies and practices by credible and influential groups must use language which can be understood by the people who are to be influenced. This advocacy must be supported by reliable evidence. Climate-related catastrophes (droughts, floods, cyclones, other storms, bush fires) occur frequently in Australia. The demonstrably high variability in the incidence and severity of such phenomena present a challenge to scientists to discover and demonstrate any correlations between the catastrophes and the slow changes of climatic indices due to climate change. Public health organisations must start to develop alternative, more effective, practices to manage the complex issues related to climate change while continuing to implement their traditional primary, secondary and tertiary preventive models. A new approach, based on ecological principles, will be required to navigate through the complex and interrelating health causes. The public health sector must strengthen existing approaches for effective climate change adaptation strategies, including assessing regional health risks to identify vulnerable and resilient populations, collecting enhanced surveillance data and developing monitoring indicators. This approach must be based on: providing sound scientific evidence for predicting the likely outcomes and thus to take preventive or responsive action; and reorienting the public health sector towards greater comprehension and use of ecological understandings and approaches. Recommendations Politicians, health bureaucrats and other interested parties must formulate comprehensive, coherent policies to address the direct and indirect impacts of climate change on public health, including allocation of appropriate financial resources as part of a National Plan for Health in Responding to Climate Change. The National Health and Medical Research Council should be tasked with ensuring coordinated, comprehensive funding to support research into the health impacts of climate change. Research organisations and health institutions must collaborate to develop cost-effective, long-term, longitudinal studies on the impacts of climate change on the physical, biological and social environments that will affect Australian’s public health. Advocates must develop proposals which demonstrate cost savings to government over three to six years, or one or two electoral cycles. Little will be achieved in the current fiscal environment if proposed policies and practices will incur significant new budgetary expenses to governments or their agencies. Managing the impacts of climate change on public health will also involve several other sectors, such as water, planning, building, housing and transport infrastructure. Appropriate institutions should work towards a multi-level, interdisciplinary and integrated response to raise the importance of the impacts of climate change on public health. A comprehensive surveillance system would monitor the inter-relationship of environmental, social and health factors. Observational studies are important to monitor recent and present disease patterns and incidence to inform modelling of future disease patterns. They could also provide baselines for environmental health indicators, which can periodically be monitored and measured in order to inform program evaluation. The public health sector must integrate planned, evidence-based adaptations into existing preventive activities. Useful methodologies might include: a risk assessment approach such as Health Impact Assessment (HIA); an appropriate range of Environmental Health Indicators (EHIs); a “Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework”; and a systematic ecological health framework. The opposite of vulnerability is resilience – our capacity to respond to challenging or new circumstances. The factors which encourage resilience needs to be better understood. The public health sector must communicate concepts of risk, and develop strategies to encourage greater resilience. To understand how we can minimise vulnerability of individuals and communities to climate change we must identify those populations which are most at risk, including those for whom climate change will act as a stress multiplier for existing public health problems. The health sector must communicate climate change as a human health issue rather than just an “environmental problem”. The focus should be on effective, realistic and sustainable solutions rather than problems characterised as bleak and unresolvable

Former contre les discriminations (ethno)culturelles

Pourquoi consacrer un dossier à la formation des personnels scolaires à la prévention des discriminations, en particulier (ethno)culturelles ? La lutte contre les préjugés et les discriminations figure aujourd’hui explicitement à l’agenda des politiques éducatives, dans un contexte où l’École est vivement rappelée à sa mission de favoriser l’égalité, le vivre ensemble et la démocratie. Cette injonction mérite d’être prise au sérieux. Les questions « classiques » – mais non nécessairement réso..

Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety. Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered.  Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge. Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake. Acknowledgments:  We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process &nbsp

Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety.   Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered.  Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge.   Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake.   Acknowledgments:  We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process   Authors’ contributions: All authors contributed equally to this work.   Conflict of interest: None declared   Source of funding: None declare

Vers des politiques d’éducation « capacitantes » ?

Ce texte traite des limites des politiques éducatives en Communauté française de Belgique, interrogées à l’aune de la théorie des capacités d’Amartya Sen. Les auteurs soutiennent l’hypothèse selon laquelle l’action publique récente en matière d’éducation témoigne d’un double déplacement des politiques d’égalité des chances, traditionnellement axées sur la redistribution de ressources éducatives : par l’intérêt pour l’égalisation des résultats, d’une part, et par une préoccupation pour les facteurs individuels, collectifs et institutionnels facilitant ou non l’usage des ressources éducatives par tous les élèves, d’autre part. Ils montrent cependant à quel point ces politiques restent trop sommaires et ambiguës pour que l’on puisse réellement parler de politiques d’éducation capacitantes.This paper deals with the limitations of educational policies in the French-speaking Belgian community, which were studied in the light of Amartya Sen’s theory of human capacity. The authors suggest that public action in the educational field reflects a shift of emphasis in equal opportunity policies: these have no longer been focusing on the redistribution of educational resources as they used to, but rather on the need to obtain equal results and on determining the individual, collective and institutional factors promoting the use of educational resources by all pupils alike. The authors show, however, that these policies are still far too flimsy and ambiguous to be really able to speak about a “capacitating” educational policy.Im vorliegenden Beitrag sollen die Grenzen der Erziehungs und Bildungspolitik in der frankophonen Gemeinschaft Belgiens auf der Grundlage des Fähigkeiten-Ansatzes von Amartya Sen aufgezeigt werden. Dabei vertreten die Autoren die Ansicht, dass die jüngsten Maßnahmen in Sachen Bildung in zweifacher Hinsicht über die traditionell auf der Umverteilung von Bildungsressourcen beruhende Politik der Chancengleichheit hinausgehen, nämlich hinsichtlich der Gleichstellung der Ergebnisse als auch der Berücksichtigung individueller, kollektiver sowie institutioneller Faktoren, die den Schülern den Zugang sowie die Nutzung von Bildungsressourcen erleichtern oder erschweren können. Nach Auffassung der Autoren bleiben diese politischen Maßnahmen allerdings zu allgemein und sind zu widersprüchlich, als dass man von einer „befähigenden“ Bildungspolitik sprechen könnte

Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study

Acknowledgements We would like to thank all of the participants in our study and the midwives and gynaecologists of the participating practices and hospitals respectively. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on request.Peer reviewedPublisher PD

Neurogenic foreign accent syndrome: Articulatory setting, segments and prosody in a Dutch speaker

Foreign accent syndrome (FAS) can be defined as a motor speech disorder in which patients develop a speech accent which is notably different from their premorbid habitual accent. This paper aims to provide an explicit description of the neurolinguistic and phonetic characteristics of a female speaker of Belgian Dutch who suffered from neurogenic FAS in which she developed a French/German foreign accent after a left hemisphere stroke. A detailed phonetic analysis of the speaker’s pronunciation errors revealed problems at both the segmental and suprasegmental level. At the segmental level a wide variety of pronunciation errors were observed which are consistent with a tense articulatory setting: creaky voice, strengthening of fricatives into stops and more carefully articulated consonants and vowels. The data suggest that the perception of the French accent may have resulted from a combination of speech pathology features and unaffected regional pronunciation characteristics of the patient’s Standard Dutch. In contrast to the traditional view in the literature that FAS represents a primary dysprosodic disturbance, a detailed analysis of the speaker’s intonation contours by means of the stylization method revealed the entirely correct implementation of the most common pitch contours of Standard Dutch. This unique finding shows that FAS does not by definition follow from disruption of prosodic processing. However, the frequency of occurrence of the different types of pitch contours was clearly deviant since the patient very frequently used the Dutch continuation rise. It is hypothesized that this might represent a deliberate strategy of the speaker to stay in control of the speaking situation by keeping the speaking turn which she is at continuous risk of losing as the result of long and frequent pausing

Comprehensive Quantitative Spatiotemporal Gait Analysis Identifies Gait Characteristics for Early Dementia Subtyping in Community Dwelling Older Adults

Background: Recent studies associated gait patterns with cognitive impairment stages. The current study examined the relation between dementia type and spatiotemporal gait characteristics under different walking conditions in pre and mild neurocognitive disorder stage.Methods: Community-dwelling older adults (age 50+) with memory complaints consulting a memory clinic underwent, at baseline and during follow-up (every 4 months), a standard dementia assessment and a comprehensive spatiotemporal gait analysis [walking on an electronic walkway at usual pace (UP) with and without a counting-backwards (CW) or animal-reciting dual-task (AW), at fast (FP) and at slow (SP) pace]. At baseline the participants were categorized according to the Clinical Dementia Rating (CDR) scale. At the end of the study, the dementia diagnosis was used to stratify the categories in three outcome groups: developed “No-dementia,” “AD+FTD” (grouping Alzheimer's or Fronto-temporal dementia) or “VascD+LBD” dementia (grouping Vascular dementia or Lewy body dementia). The gait characteristics were compared per category in paired groups. Sub-analyzing in the ≥70-years-old participants evaluated the age effect.Results: Five hundred and thirty-six participants, age 50-to-95-years old were followed for 31-to-41 months. In the CDR 0, no differences were seen between eventual dementia and no-dementia individuals. In the CDR 0.5, CW dual task cost (DTC) step width was larger in the imminent “AD+FTD” and AW (normalized) gait speed was slower in the future “VascD+LBD” group compared to the no-dementia participants. Slower UP (normalized) gait speed differed the future “VascD+LBD” from the “AD+FTD” individuals. In the CDR 1: Wider steps in UP, SP and CW differed the “VascD+LBD” from the “AD+FTD” group. In the ≥70-years old CDR 0 category, higher AW cycle time variability in the imminent “AD+FTD” dementia group, wider UP step width and higher AW cycle time variability in the “VascD+LBD” group differed them from the no-dementia group up to 3 years before dementia diagnosis. The distinctive gait characteristics between the no-dementia and the imminent dementia groups in CDR 0.5 and CDR 1 remained the same as in the overall group. However, no gait differences were found between “VascD+LBD” and “AD+FTD” groups in the pre-dementia stages.Conclusion: Distinctive spatiotemporal gait characteristics were associated with specific dementia types up to 3 years before diagnosis. The association is influenced by the cognitive stage and age