Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

Child Victimization and Poly-Victimization in a Community Sample of Adolescents in Northern Chile

The aim of this article is to report the prevalence of youth victimization and poly-victimization in northern Chile. Using the Juvenile Victimization Questionnaire, a sample of 706 adolescents ages 12 to 17 were surveyed. The results indicated that 89% of the participants had experienced victimization at least once in their lives and 76.8% had experienced at least 1 experience of victimization in the past year. The most frequent forms were conventional crimes (70% and 54.7%), witnessing and indirect victimization (63.2% and 45.2%), and peer and sibling victimization (50.0% and 34.6%), for the lifetime and the past year, respectively. Sexual victimization was less common for both time periods, but still relevant (15.9% lifetime and 9.9% past year). Older females and younger adolescents presented a higher risk of victimization particularly in conventional crimes and victimization by caregivers. As for poly-victimization, 21% of the adolescents presented between 4 and 6 different forms of victimization (the low poly-victimization group) and 16% reported seven or more (the high poly-victimization group) in the last year. The results showed that child and adolescent victimization is a significant problem in Chile. Percentages of victimization in Chilean adolescents were higher than those found in Europe or North America. Results from the group of poly-victims reinforces the need to evaluate the multiple forms of victimization that affect adolescents in Chile and to prioritize it in the design of the treatment of the consequences of violence, taking into account differences in gender and age.     

Interethnic Marriages and Relationships of the Tlingits in the Russian–American Period and Their Significance

This article deals with relationships and marriages of the Tlingit with immigrants from the Russian Empire as well as with representatives of other European and non-European peoples during the period when Alaska belonged to the Russian Empire. Matrimonial relations existed in two variants: legal, sanctified by the church, and in the form of permanent extramarital cohabitation or casual relationships. The latter variant absolutely predominated. With this, there was a sharply reflected gender imbalance, since men absolutely predominated among the immigrants, and therefore Tlingit women emerged in the role of marriage partners in the overwhelming majority of cases. A directly opposite pattern was observed in Tlingit contacts with the Athapaskans and to some extent with the Eyak. Matrimonial connections exerted influence on the workings of the Russian colonization, stimulated growth in mixed populations, and facilitated gradual acculturation of the Tlingit, along with contributing to the expansion of their ethnic territory.     

Effect of Body Image on Tunisian Women’s Sexual Functioning

The objective of this study was to identify the perception of body image by Tunisian women and their spouses and to examine its impact on female sexuality. Our study involved 300 Tunisian women who had been married for at least 1 year and consulted in primary care medicine during the months of June and July 2016. Each participant completed a questionnaire covering four areas: women’s perception of their body, the perception of the spouses of the latter as it was reported by the participants, sexual activity, and the impact of body perception on sexual activity. The participants were satisfied with their bodies in 51% of cases. This satisfaction was associated with perceiving the body as physically attractive (p?=?0.007), young (p?=?0.047) and as a source of confidence (p?<?0.001). Compared to women dissatisfied with their bodies, those satisfied declared satisfaction of sexual desire (p?=?0.005), reaching orgasm (p?=?0.001), taking the initiative in sexual activity (p?=?0.003) and preparation for sex (p?=?0.006). Perceived satisfaction of the partner with the female body was related to a more positive sexuality in women, specifically to women’s sexual satisfaction (p?=?0.018), women taking sexual initiative (p?=?0.014) and preparation for sex (p?=?0.001). Our study indicates the important impact of a positive perception of the body image of Tunisian women by themselves and by their spouses on their sexuality. It would be interesting to consider these aspects in the management of female sexual disorders.     

How Does Homelessness Affect Parenting Behaviour? A Systematic Critical Review and Thematic Synthesis of Qualitative Research

The adverse social and physical conditions of homelessness pose significant developmental risks for children, which may be compounded or buffered by the quality of parenting behaviour they are exposed to. There is currently a limited understanding of how parents approach their care-giving role and responsibilities while adjusting to the experience of homelessness. Advancing knowledge in this area is essential for developing acceptable, appropriate and effective interventions to support highly marginalised and vulnerable homeless families. This review explored homeless parents’ perceptions of how homelessness affects their parenting behaviour and identified adaptive strategies that parents may use to mitigate the potentially negative impacts of homelessness on the quality of care-giving. A systematic search of four electronic databases (ASSIA, PsycINFO, Web of Science and MEDLINE) identified 13 published qualitative studies, all originating from the USA, which explored parenting behaviour in homeless contexts. The studies were critically appraised using the CASP qualitative assessment tool. Thematic synthesis identified the following determinants of parenting behaviour; negative self-concept in the parental role, parental mental health, material resources, challenges to autonomy and self-efficacy, daily hassles, physical environment and service context, stigma, child characteristics and lack of support. These were synthesised thematically using existing models of parenting determinants and positive parenting. Findings indicate substantive impacts of homelessness on parental mental health, parenting authority, material resources, parenting environments and social support. Parents developed a number of adaptive methods to negotiate the challenges of homeless parenting such as maintaining a positive mindset, cherishing the parental role and developing practical strategies. We conclude with recommendations that service providers should tailor parenting support to resource-constrained circumstances and that further research is required in order to better understand experiences of homeless parents in other international contexts.     

Transformation of Adolescent Peer Relations in the Social Media Context: Part 2—Application to Peer Group Processes and Future Directions for Research

As social media use becomes increasingly widespread among adolescents, research in this area has accumulated rapidly. Researchers have shown a growing interest in the impact of social media on adolescents’ peer experiences, including the ways that the social media context shapes a variety of peer relations constructs. This paper represents Part 2 of a two-part theoretical review. In this review, we offer a new model for understanding the transformative role of social media in adolescents’ peer experiences, with the goal of stimulating future empirical work that is grounded in theory. The transformation framework suggests that the features of the social media context transform adolescents’ peer experiences by changing their frequency or immediacy, amplifying demands, altering their qualitative nature, and/or offering new opportunities for compensatory or novel behaviors. In the current paper, we consider the ways that social media may transform peer relations constructs that often occur at the group level. Our review focuses on three key constructs: peer victimization, peer status, and peer influence. We selectively review and highlight existing evidence for the transformation of these domains through social media. In addition, we discuss methodological considerations and key conceptual principles for future work. The current framework offers a new theoretical perspective through which peer relations researchers may consider adolescent social media use.     

Review of the Evidence for Motivation Deficits in Youth with ADHD and Their Association with Functional Outcomes

Preeminent theories of attention-deficit/hyperactivity disorder (ADHD) suggest that motivation deficits are core underlying features of the disorder. However, it is currently unclear whether empirical evidence supports the assertion that significant group (ADHD v. comparison) differences in motivation exist or that problems with motivation contribute to the functional impairments that youth with ADHD experience. Accordingly, this review focused on evaluating and summarizing the empirical literature on the presence of motivation deficits and their association with functional outcomes in samples of youth with ADHD. Twenty studies met the review inclusion criteria. Results support the assertion that youth with ADHD have lower academic-related motivation in comparison to their peers and that motivation plays an important role in academic outcomes, with the strongest evidence to date for reading achievement. However, the available evidence is limited, and few existing studies are aligned with the much larger theoretical and empirical motivation literature in typically developing youth. Given preliminary evidence that motivation plays a role in the academic impairments of youth with ADHD, the review concludes with a discussion of whether current ADHD interventions adequately target motivation and highlights important future directions.     

What’s on Sale? A Discourse Analysis of Four Distinctive Online Escort Advertisement Websites

Technological advances have contributed to the changing structure and organisation of sex work, heralding a dramatic growth in sex workers soliciting and advertising the selling of sex via the Internet. This study was concerned with four distinctive, independent online escort markets—male heterosexual, female heterosexual, gay and lesbian. A discourse analysis was conducted on ten online advertisements from each escort sample, in order to analyse how different online escorts advertise their sexual services in relation to gender, sexuality and social class. The findings reveal core differences between each of the escort samples in relation to gender and power dynamics. Findings highlighted that maleness and masculinity-as-power play a role whether we are looking at men as the buyers or the sellers of escort services. In stark contrast, advertisements presented femaleness and femininity as objectified, submissive and/or vulnerable regardless as to whether we are looking at women as the buyers or the sellers of escort services.     

Medical Trainees’ Readiness for the Promotion of Sexual Health in Tunisia: A Cross Sectional Study

In the Arab and Muslim countries, there are several taboos of sexuality. To overcome the latter, and to distinguish between cultural and scientific data, sexual education is a key measure, especially during medical studies. The purpose of this study was to assess the knowledge of the Tunisian medical trainees and to identify their sources of information concerning sexuality. We conducted a survey among medical trainees of the faculty of medicine of Sfax, in Tunisia. An anonymous questionnaire was distributed to 171 and completed by 157 trainees (91.8%). The sources of knowledge about sexuality were: friends (81.5%; N = 128), internet (77.1%; N = 121), television and movies (68.2%; N = 107), courses at the faculty (40.1%; N = 63) and parents (22.9%; N = 36). The score of correct answers was higher than or equal to 75% for 28 trainees (17.8%). It was on average 63.3%. It was correlated with male gender (p = 0.006), being a second-year trainee (p = 0.017) and television and movies as a source of knowledge about sexuality (p = 0.008). Masturbation was considered pathological by 17.2% of participants (N = 27). A 5-min period of intercourse was deemed sufficient to have a female orgasm by 44 trainees (28%). Andropause and menopause are inconsistent with a satisfying sexuality according to 44.6% (N = 70) and 56.1% (N = 88) of the participants respectively.