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.     

Stress perçu et santé physique des doctorants dans les universités françaises

Few studies have focused on PhD students in France despite the fact that this population appears to be particularly vulnerable to stress and often faces precariousness. This research investigated associations between socio-demographic factors, health behaviours, perceived stress and physical health in a wide sample of PhD students (n = 1923) in order to have a better understanding of this population's specificities. Our results indicated that stress is a critical issue among PhD candidates. Predictors of perceived stress were: gender, age, satisfaction with supervision, sleep quality and sports practice. Findings from this study confirm the relevance of the transactional model to investigate students’ health issues and suggest that physical activity and stress management should be encouraged through health promotion programs.     

The mismeasure of a young man: an alternative reading of autism through a co-constructed fictional story

The combination of academic article and the fictional story it contains represents an attempt to convey our combination of qualitative participatory research and collaborative creative writing as used in a project with a group of young people with disabilities. Through our story involving the fictional character Jasper, we have tried to distil some of the essence of his real-life inspiration, Peter, a young man with autism. At the same time, we recognise the impossibility of “pinning down” any character as a representation of any psychological condition. By questioning the boundaries between science and art, and by considering alternative ways of creating research reports, we present the story as an alternative reading of autism. We suggest that the value of fiction in this context is that it allows a reframing of problems while presenting readers with an accessible means of connecting with others across disciplinary, methodological, and social divides.     

Effectiveness of testosterone therapy for masculinizing voice in transgender patients: A meta-analytic review

Background: Testosterone therapy is the predominant treatment for voice masculinization in transgender patients. Although lowering of voice fundamental frequency (f₀) occurs with testosterone therapy, evidence suggests voice and gender identity may not fully align—i.e., voice-gender congruence may not be achieved—with its use.

Aim: This meta-analytic review evaluates the effectiveness of testosterone therapy to masculinize voice in transgender patients.

Methods: Multiple electronic databases were queried (inclusion dates: from database inception up to October 27, 2017) to identify original research on voice masculinization using testosterone therapy. Nineteen articles were included in this meta-analytic review, which followed PRISMA guidelines. In addition to qualitative analyses, random effects proportion meta-analyses were performed on data related to f₀, voice-gender congruence, voice problems, and satisfaction with voice.

Results: A meta-analysis on f₀ data showed after 1 year of testosterone therapy a combined estimate of 21% of participants (95% confidence interval [CI]: 5%–43%; I²: 59.9%) did not achieve cisgender male normative frequencies (f₀ ≤ 131 Hz). Meta-analyses on incomplete voice-gender congruence and voice problems indicated combined estimates of 21% (95% CI: 10%–34%; I²: 0.0%) and 46% (95% CI: 14%–79%; I²: 90.2%), respectively. Regarding incomplete satisfaction with voice, a meta-analysis showed a combined estimate of 16% (95% CI: 7%–28%; I²: 0.0%).

Discussion: We found that not all transgender patients using testosterone therapy to masculinize voice should expect f₀ lowering to cisgender male normative frequencies after 1 year. The vocal transition may involve voice problems for many patients, and some might not achieve voice-gender congruence without additional, voice-specific intervention. Given these findings, a voice evaluation should occur prior to initiating testosterone therapy and involve counseling on expectations for voice. Transgender patients who pursue voice masculinization may need management from laryngology and speech and language therapy to improve voice-gender congruence, mitigate voice problems, and increase satisfaction with voice.     

UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS,SUBSTANCE‐ABUSING MOTHERS

This article tested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance‐abusing mothers. Participants were 119 homeless mothers (ages 18–24 years) and their young children (ages 0–6 years). Mothers responded to questions about their depressive symptoms, emotion regulation, parenting stress, and child behavior problems. A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk. This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.     

越轨同伴交往与青少年睡眠问题的交叉滞后分析

本研究采用交叉滞后设计探讨越轨同伴交往与青少年睡眠问题之间的双向关系。通过越轨同伴交往问卷与匹兹堡睡眠质量指数（PSQI）对广东省某地区887名青少年（43.90%男生; M = 15.55）进行为期一学年的追踪研究。在控制了性别、年龄后,结果发现:（1）学年初始的睡眠问题可以显著正向预测青少年学年末的越轨同伴交往（b2 = 0.12, SE = .05, p < .05）,即青少年在学年初始睡眠问题越多,学年末则表现出更多的越轨同伴交往;（2）研究并未发现学年初始的青少年越轨同伴交往可以显著预测其学年末的睡眠问题（b1 = –0.07, SE = .06, p > .05）。因此,本研究的结果支持了睡眠问题对青少年越轨同伴交往的单向预测作用,即睡眠问题可能是增加青少年越轨同伴交往的重要风险因素之一。     

The Effect of Locus of Control on University Students' Mental Health: Possible Mediation through Self-Esteem and Coping

The purpose of this study was to examine the effect of locus of control on university students' mental health and to examine possible mediational roles of self-esteem and coping. A total of 418 university students completed Rotters I-E Scale, Self-liking/self-competence Scale, Endlers Coping with Stressful Situations Scale and Depression, Anxiety and Stress Scale. The results showed that external locus of control, lower self-liking and self-competence, as well as less problem-focused and more emotion-focused coping predict more symptoms of depression, anxiety, and stress in university students. However, mediational analysis revealed that the effect of locus of control was fully mediated by self-esteem and coping, with self-liking and emotion-focused coping being the strongest mediators. Results suggest that beliefs about control affect beliefs about one's self-worth and coping strategies, which in turn can affect one's mental health.