EHESP School of Public Health
Rennes, France
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Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: SSH-2009-1.1.1. | Award Amount: 3.52M | Year: 2010

The GOETE project will analyse the role of school in re-conceptualising education in terms of lifelong learning by combining a life course and a governance perspective. In European knowledge societies adequacy of education means a balance of individual, social and economic aspects. This is operationalised by exploring how educational institutions conceptualise and organise individual educational trajectories. The study covers the period from transition into lower secondary education to transition into upper secondary education/vocational education and training, i.e. the age group between 10 and 16 years. Comparative analysis will focus on the regulation of access to education, of support measures for coping with education and of securing the relevance of education for social integration and the labour market. In 8 EU countries the mixed-method study involves surveys with students, parents and school principals; comparison of teacher training; case studies of local school spaces; discourse analysis; expert interviews with policy makers and stakeholders. On a scientific level, the comparison of the regulation of educational trajectories involves re-conceptualising the social aspects of learning and education under conditions of late modern knowledge societies. It reflects the need for formal education to be embedded in social life worlds, enabled by social support, and complemented by informal and non-formal learning. On a practice and policy level, it will provide information about alternative means of providing children and young people with access to education; of supporting them in coping with education and ensuring the relevance of education by communication and cooperation between school, labour market, other educational actors, students and parents. The communication of findings will include a dialogic model of educational policy planning at local level, training workshops with teachers, youth workers and policy makers, and a European policy seminar.

Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: ENV.2010.1.2.2-2 | Award Amount: 3.67M | Year: 2011

A consortium of world-class scientists from both academia and industry has been assembled to assess the risks to wild animals and humans posed by environmental exposure to pharmaceuticals. Their expertise will be supplemented by an advisory group consisting of representatives of all stakeholders. This project will concentrate on two classes of human pharmaceuticals, namely antibiotics and anti-cancer drugs, because there are good reasons for thinking that these could be of particular concern. In order to conduct sound risk assessments, including providing estimates of uncertainty, it will be necessary to obtain accurate data on both exposure concentrations and effects levels. Hence, new data on both environmental concentrations and effects on aquatic organisms will be produced during the project. The comparative sensitivities of embryos and adults will be determined, and used to reduce uncertainty in the risk assessments. The stable transformation products of the selected pharmaceuticals will also be investigated. All stakeholders and beneficiaries will be represented in the project, so that results are rapidly and reliably transferred to all interested parties. A prototype web-based classification system will be developed during the project with the intention of enabling all EU citizens to make their own informed decisions about the risk posed by human pharmaceuticals to their health and to the health of the environment. The results will able EU regulators and policy makers to make better informed decisions on the issue of pharmaceuticals in the environment.

Roue-Le Gall A.,EHESP School of Public Health | Jabot F.,EHESP School of Public Health
Global Health Promotion | Year: 2017

In France, there is increasing interest in health impact assessments (HIAs) and most are performed on urban projects. The field of expertise is still under development and mostly established within the public health sector. To date, in France, all HIAs conducted in urban planning are stand-alone HIAs disconnected from the required environmental impact assessment (EIA). The paper opens with an introduction of the close and complex relationship between health and urban planning, HIA and a description of key elements needed for understanding the French context. Then, the paper analyses the context and the implementation process for four HIAs in progress in order to understand the specific characteristics of urban development, identify the key stages for introducing a health perspective into urban projects, and extract avenues to be explored when adapting HIAs applied to urban planning in France. Using a qualitative multiple case study design, an analysis framework was built to compare several aspects of the four HIAs and made it possible to highlight three pathways for adapting HIA to the urban planning sector: the schedule, links between the EIA and HIA, and the complementarity of the initiatives to involve residents. Legal measures enable a point of contact that brings health institutions and cities closer together. HIA is yet another tool that public authorities now have at their fingertips to work together in strengthening democracy and in reducing social, geographical and environmental health inequalities. More research must be undertaken to develop an understanding of the practice-related context; to judge HIA’s capacity to draw on existing approaches in different fields; and to explore the different avenues leading to increased health, wellbeing and equity. © 2017, © The Author(s) 2017.

Michel L.,EHESP School of Public Health
Journal of Health Politics, Policy and Law | Year: 2017

This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. © 2017 by Duke University Press.

Agency: European Commission | Branch: FP7 | Program: CSA | Phase: ICT-2007.5.2 | Award Amount: 1.28M | Year: 2008

The project GAP focuses on the area of Patient safety and risk assessment of the challenge 5 of FP7-ICT. It addresses, via specific workshops and studies, all aspects of risk prediction, evaluation of risk factors, evaluation and management tools designed for the preparation of means that allows an intervention in real situations. The project will evaluate insofar as possible all current solutions resulting from civil and military research on computerized decision-making on the topic of crisis management and, more specifically, major health crises. The results of the project will add to the decision-making potential of the unit of information collection on health crises (Emergency Operations Facility of the Directorate General of Health and Consumer Protection) which brings together a range of computerized tools for the collection and transmission of information (H.E.O.F). The primary goal of this project is to bring together the emergent concepts which will permit us in the near future to predict, study, control and remedy the most complex of crises, those that jeopardise health. The challenge is to build a genuine system of health and social defence, and its components (concept, organisation, personnel, equipment, training..), at the European and world levels. The project results should facilitate the creation of this system. At the same time, the partners are aware of the importance of the political decision and commitment. For this reason , GAP is driven from High level representatives of HealthCare Ministries of EU countries and Associated States (Israel). \nThe consortium and the experts associated with the Support Action GAP represent both of the complementary poles of excellence for the successful execution of this mission.

Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-3.2-8 | Award Amount: 3.70M | Year: 2009

Payment systems are fundamental to any health care system, introducing powerful incentives and fierce technical design complexities. DRG-systems aim at fairly assessing the costs of patient treatment, taking into account measurable patient characteristics such as diagnosis or comorbidity but to a varying degree also interventions chosen. Using a representative sample of inpatient data on 10-12 care episodes (representing different medical specialties, diagnostic/ therapeutic procedures, usage of innovative devices & drugs) from hospitals in 10 EU countries (AUT, ENG, EST, FIN, FRA, GER, NET, POL, SPA, SWE), the EuroDRG Project aims at studying the importance of structural factors such as wage levels vis--vis established patient variables and medical decision variables (procedures or using new and emerging technologies) to explain variation in costs within and between European countries. This will allow fair efficiency comparisons among EU hospitals to ensure that DRG-systems provide the intended incentives. A second objective is to investigate the role the quality of care plays to explain costs, an area with practically no European studies but potentially important policy implications. To achieve its objectives, the project is organised in phases: 1. Analysis of national DRG-systems and development of a methodology for trans-national analysis; 2. Trans-national DRG issues - hospital cost functions, efficiency and quality; 3. Translation into practice, synthesis and recommendation. To achieve a high scientific quality and a high policy impact, the strategy involves (based on the successful FP6 HealthBASKET project): encouraging partners to publish in peer-reviewed journals; using excellent links to major international organisations; establishing an EU-wide hospital benchmarking club; organising seminars at major conferences; a final conference with invited experts; involving representatives from countries with emerging DRG-systems (Bulgaria, China, India).

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: YOUNG-5a-2014 | Award Amount: 2.58M | Year: 2015

Existing research suggests that political participation and European orientation of young people depend on how they experience influence and involvement at local level. This reflects that individuals need the experience of self-efficacy to engage in wider communities. Research also reveals that only few young people engage in formalised participation (parties, trade unions, or youth councils) as these are not flexible enough for individualised concerns, biographies and life styles and they reflect patterns of social inequality. The project Spaces and Styles of Participation (PARTISPACE) starts from the assumption that all young people do participate while not all participation is recognised as such. The study asks for the different ways in which young people participate in decisions which concern them and, in general, the life of their communities. How do 15- and 30-year-olds engage with the public in formal, non-formal and informal settings and how is this supported or inhibited by local youth policies and youth work? The countries involved Bulgaria, France, Germany, Italy, Sweden, Switzerland, Turkey and the UK secure contrasting contexts of young peoples growing up as well as differing orientations towards Europe. The design of PARTISPACE includes: National research literature reviews and policy analysis; Analysis of European Social Survey data on young peoples participatory orientations; Local case studies in one major city per country including expert interviews, focus groups discussions, city walks and biographical interviews with young people, ethnographic case studies of formal, non-formal, and informal participatory spaces. Activating and supporting participatory action research by young people themselves. The analysis relates local constellations with national and European patterns and discourses of youth participation. Findings are constantly discussed with representatives of the youth sector at local and European level.

Da Roit B.,EHESP School of Public Health | Le Bihan B.,EHESP School of Public Health
Milbank Quarterly | Year: 2010

Context: In response to increasing care needs, the reform or development of long-term care (LTC) systems has become a prominent policy issue in all European countries. Cash-for-care schemes - allowances instead of services provided to dependents - represent a key policy aimed at ensuring choice, fostering family care, developing care markets, and containing costs. Methods: A detailed analysis of policy documents and regulations, together with a systematic review of existing studies, was used to investigate the differences among six European countries (Austria, France, Germany, Italy, the Netherlands, and Sweden). The rationale and evolution of their various cash-for-care schemes within the framework of their LTC systems also were explored. Findings: While most of the literature present cash-for-care schemes as a common trend in the reforms that began in the 1990s and often treat them separately from the overarching LTC policies, this article argues that the policy context, timing, and specific regulation of the new schemes have created different visions of care and care work that in turn have given rise to distinct LTC configurations. Conclusions: A new typology of long-term care configurations is proposed based on the inclusiveness of the system, the role of cash-for-care schemes and their specific regulations, as well as the views of informal care and the care work that they require. © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

Benmarhnia T.,EHESP School of Public Health
Environmental health : a global access science source | Year: 2014

Heat and air pollution are both associated with increases in mortality. However, the interactive effect of temperature and air pollution on mortality remains unsettled. Similarly, the relationship between air pollution, air temperature, and social deprivation has never been explored. We used daily mortality data from 2004 to 2009, daily mean temperature variables and relative humidity, for Paris, France. Estimates of chronic exposure to air pollution and social deprivation at a small spatial scale were calculated and split into three strata. We developed a stratified Poisson regression models to assess daily temperature and mortality associations, and tested the heterogeneity of the regression coefficients of the different strata. Deaths due to ambient temperature were calculated from attributable fractions and mortality rates were estimated. We found that chronic air pollution exposure and social deprivation are effect modifiers of the association between daily temperature and mortality. We found a potential interactive effect between social deprivation and chronic exposure with regards to air pollution in the mortality-temperature relationship. Our results may have implications in considering chronically polluted areas as vulnerable in heat action plans and in the long-term measures to reduce the burden of heat stress especially in the context of climate change.

Le Bihan B.,EHESP School of Public Health
Health and Social Care in the Community | Year: 2012

This article investigates the impact of policy measures on the organisation of home-based care for older people in France, by examining the balance between formal and informal care and the redefinition of the initial familialist model. It focuses on the specific cash for care scheme (the Allocation personnalisée d'autonomie - Personalised allowance for autonomy) which is at the core of the French home-based care policy. The author argues that in a redefined context of 'welfare mix', the French public strategy for supporting home-based care in France is articulated around two major objectives, which can appear contradictory. It aims to formalise a professional care sector, with respect to the employment policy while allowing the development of new forms of informal care, which cannot be considered to be formal employment. The data collection is two-fold. Firstly, a detailed analysis was made of different policy documents and public reports, together with a systematic review of existing studies. Secondly, statistical analysis on home-based care resources were collected, which was not easy, as home-care services for older people in France are part of a larger sector of activity, 'personal services' (services à la personne). The article exposes three main findings. First, it highlights the complexity of the formalisation process related to the introduction of the French care allowance and demonstrates that formalisation, which facilitates the recognition of care as work, does not necessarily mean professionalisation. Second, it outlines the diversity of the resources available: heterogeneous professional care, semi-formal forms of care work with the possibility to employ a relative and informal family care. Finally, the analysis outlines the importance of the regulation of cash payments on the reshaping of formal and informal care and comments on its impact on the redefinition of informal caring activities. © 2012 Blackwell Publishing Ltd.

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