Determinants of Refusal of A/H1N1 Pandemic Vaccination in a High Risk Population: A Qualitative Approach

International audienceBackground: Our study analyses the main determinants of refusal or acceptance of the 2009 A/H1N1 vaccine in patients with cystic fibrosis, a high-risk population for severe flu infection, usually very compliant for seasonal flu vaccine.Methodology/Principal Findings: We conducted a qualitative study based on semi-structured interviews in 3 cystic fibrosis referral centres in Paris, France. The study included 42 patients with cystic fibrosis: 24 who refused the vaccine and 18 who were vaccinated. The two groups differed quite substantially in their perceptions of vaccine- and disease-related risks. Those who refused the vaccine were motivated mainly by the fears it aroused and did not explicitly consider the 2009 A/H1N1 flu a potentially severe disease. People who were vaccinated explained their choice, first and foremost, as intended to prevent the flu’s potential consequences on respiratory cystic fibrosis disease. Moreover, they considered vaccination to be an indirect collective prevention tool. Patients who refused the vaccine mentioned multiple, contradictory information sources and did not appear to consider the recommendation of their local health care provider as predominant. On the contrary, those who were vaccinated stated that they had based their decision solely on the clear and unequivocal advice of their health care provider.Conclusions/Significance: These results of our survey led us to formulate three main recommendations for improving adhesion to new pandemic vaccines. (1) it appears necessary to reinforce patient education about the disease and its specific risks, but also general population information about community immunity. (2) it is essential to disseminate a clear and effective message about the safety of novel vaccines. (3) this message should be conveyed by local health care providers, who should be involved in implementing immunization

Co-direction du numéro "Corps d'enfance", de la revue Corps

International audienc

Anthropologie d'une pratique de santé publique (Le cas de la planification familiale au Mali)

PARIS-Médiathèque MQB (751132304) / SudocPARIS-Fondation MSH (751062301) / SudocSudocFranceF

Grandir à Belsunce (les catégories ordinaires de l'expérience enfantine dans un quartier de Marseille)

Cette thèse est une contribution à la socio-anthropologie de l'enfance. Elle porte sur des enfants âgés de 9 à 12 ans, fils et filles de migrants pour la plupart, grandissant à Belsunce, quartier populaire du centre ville de Marseille. Le but de cette thèse est, en partant de l'expérience quotidienne des enfants, de reconstituer leurs perceptions du monde social dans le contexte de la mondialisation. Ainsi, les enfants mettent en œuvre un ensemble de pratiques ordinaires où s'entrecroisent sociabilités locales et réalités à grande échelle. Ce faisant, ils élaborent et manipulent des formes de catégorisation du monde, créent des appartenances et construisent de l'altérité. L'analyse de ces processus de construction Identitaire enfantine montre que les enfants explicitent le monde à travers un certain nombre de référents qu'ils dotent de pertinence (appartenances ethnique, religieuse), tandis que d'autres sont faiblement revendiqués alors même qu'ils structurent fortement leur expérience (identité d'âge et de genre). Ces catégories ordinaires de l'expérience construisent par ailleurs des formes de rapport à soi spécifiques. Les enfants de Belsunce se pensent en tant que sujet à travers des catégories socialement construites, qui empruntent à la fois aux définitions de soi localement disponibles (le bon élève , le voyou ) et à des ensembles sémantiques et normatifs mondialisés (le c1ando ). Cette étude montre enfin comment les enfants vivent leur inscription dans un certain nombre d'institution publiques et permet de comprendre, ce qui, de leur point de vue, provoque des formes de souffrance socialeThis thesis is a contribution to child socio-anthropology. The subjects were children aged from 9 to 12, mostly children of immigrants, growing up in Belsunce, a working-class neighbourhood in the centre of Marseille. The aim of this thesis is to use children's everyday experiences to reconstruct their perceptions of the social world in a context of globalisation. In a number of children s ordinary activities, one can see local patterns interact with large-scale realities. While performing these activities the children elaborate and construct ways of categorising the world, form groups that belong and construct the 'other'. Analysing this identity construction in children shows that children make the world explicit using referents to which they attach importance (ethnicity, religion) , while other referents are less important, even though they make a big difference to the child s experience (age, gender). These ordinary categories of activity also result in specific types of relation to the self The children of Belsunce think of themselves as subject through socially-constructed categories, which borrow both from locally available definitions (teacher s pet, hooligan ) and from globalised semantic and normative groupings ( illegal ). Finally, the study shows how children experience being members of certain public institutions, and gives their point of view on the causes of social sufferingPARIS3-BU (751052102) / SudocSudocFranceF

Midwives in Niger: An uncomfortable position between social behaviours and health care constraints

Maternal mortality rates are very high in developing countries. In Niamey, the capital of Niger, maternal mortality rate is 280/100,000, in spite of a high concentration of health services and of health personnel. Several studies demonstrated that the efficiency of maternal health services was low, both because the quality and the quantity of work were insufficient. The usual response to the poor performances of health services in developing countries in mainly technical. If improvement of the training of health personnel and re-organization of health services are necessary, they are not sufficient. A good effectiveness of care cannot be achieved without a mutual confident relationship between providers and patients. Focus group discussions were held in Niamey with women users of maternal health services, with student midwives and experienced midwives. Sources of complaints between providers and patients appeared to be numerous. However, they are centered around two themes, delivery techniques and cultural requirements, which correspond to two types of constraints: technical constraints and social representations and practices of the population. A description of traditional practices and beliefs related to delivery were obtained through discussion groups with old women and traditional birth attendants (TBAs). Both women and midwives are tied up by the same social rules (e.g. linguistic taboos, respect and shame) but technical constraints force midwives to violate those rules, making the application of their technical skills very difficult. Thus, the mutual relationship between users and providers is source of dissatisfaction, which often degenerates into an open confrontation. Midwives must learn how to implement obstetrical techniques within specific cultural environments.midwives developing countries user-provider relationship dissatisfaction cultural constraints traditional delivery

La nutrition parentérale à domicile du point de vue des patients (approche anthropologique de la qualité de vie des enfants et de leur famille)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Don de sang : une approche territoriale

International audienc

Intervenir pour réduire les inégalités sociales de santé : des espaces favorables pour expérimenter, pérenniser et diffuser l'intervention – Guide IVRISS d'accompagnement méthodologique

International audienc

Intervenir pour réduire les inégalités sociales de santé : des espaces favorables pour expérimenter, pérenniser et diffuser l'intervention – Guide IVRISS d'accompagnement méthodologique

International audienc

Measures of personal prevention.

<p>Measures of personal prevention.</p