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Le Touquet – Paris-Plage, France

Te Velde E.,Erasmus University Rotterdam | Te Velde E.,University Utrecht | Habbema D.,Erasmus University Rotterdam | Leridon H.,INED | And 2 more authors.
Human Reproduction | Year: 2012

Background Postponement of childbearing since the 1970s has led to an increase in permanent involuntarily childlessness. We will address the magnitude of this trend, the effect of IVF/ICSI and the effect on total fertility rate (TFR an often used demographic measure for the level of fertility) in six EU countries.Methods Using a fertility micro-simulation model, we estimate the effect of postponement of first motherhood on permanent involuntary childlessness in six representative European countries since 1970/1985: Sweden, Austria, Czech Republic, The Netherlands, West Germany and Spain. To estimate the effect of IVF/ICSI on this trend, we use data on the Results of all IVF/ICSI cycles performed in The Netherlands in 2003 and 2004. Results Permanent involuntary childlessness approximately doubled since 1970s and rose to ∼4 in the Czech Republic and to ∼7 in Spain with the other countries in between. If all couples entitled to have IVF/ICSI were to be treated, the effect of postponement would almost have been neutralized. However, only a limited proportion of eligible couple are being treated. Without postponement, TFRs would have been between 0.03 and 0.05 higher. Conclusions The effect of postponement on permanent involuntary childlessness is considerable. So far IVF/ICSI only had a slight effect on this trend. The impact of postponement on TFRs is small compared with other demographic trends. © 2012 The Author.

Legleye S.,INED | Legleye S.,French Institute of Health and Medical Research | Legleye S.,University of Paris Descartes | Kraus L.,Ift Institute For Therapieforschung | And 4 more authors.
European Addiction Research | Year: 2012

The present study aims at validating the Cannabis Abuse Screening Test (CAST) in a clinical sample of adolescent and young adult cannabis users seeking treatment. Applying a classical test theory approach using DSM-IV diagnoses as gold standard, two versions of the CAST questionnaire are compared. The sample consisted of 140 subjects aged 15-26 years (mean 18.9) recruited from two cannabis treatment centers. Gold standard diagnoses were assessed using the Adolescent Diagnostic Interview-Light. Internal structure and consistency of the CAST were assessed by principal component analysis and Cronbach's α. Optimal thresholds were defined using receiver operating characteristic analysis. Both the binary and the full test version revealed unidimensional structures with moderate to satisfactory internal consistency (α = 0.66 and 0.73). Screening properties were unsatisfactory when the CAST was compared against cannabis dependence. With regard to cannabis use disorders, both test versions yielded comparable and good sensitivity and specificity at cut-off 3 (binary: 92.2%, 66.7%) and 6 (full: 93.0%, 66.7%). Overall, the full CAST may be used for screening cannabis use disorders in clinical settings. Further research may use validation methods that do without gold standard. Copyright © 2012 S. Karger AG.

Bajos N.,French Institute of Health and Medical Research | Prioux F.,INED | Moreau C.,French Institute of Health and Medical Research
Revue d'Epidemiologie et de Sante Publique | Year: 2013

Background: The number of women resorting to abortion several times has increase continuously in France since 1975, similar to the situation in many countries where contraception is widely available and used. The analysis of time trends in so-called "repeat" abortion across social, demographic and contraceptive characteristics can be helpful in capturing the social meaning of this practice and informing policies for sexual and reproductive health. Methods: The present analysis was based on statistical reports of abortions performed in France from 1990 to 2007 and on data from the National Survey of Abortion Patients, a representative sample of 7067 women undergoing an abortion in France. Chi2 and logistic regression models were used for the statistical analysis. Results: Increase in "repeated" abortion was seen across all groups of the population but was greater in women under 30, women who live alone and students. Women presenting for a second abortion were more likely to report the pregnancy followed a contraceptive failure than women presenting for an abortion for the first time. Conclusion: The trend for an increasing use of multiple abortions over time occurs primarily because of longer time between first intercourse and first child. Having several abortions is an expression of the difficulties women have in managing daily contraceptive use in the context of more diversified emotional and sexual trajectories. Position du problème: Le nombre de femmes ayant recours plusieurs fois à l'interruption volontaire de grossesse (IVG) ne cesse de s'accroître depuis 1975en France comme dans de nombreux pays où la contraception est d'un accès facile. L'analyse du recours dit «répété« à l'IVG au fil du temps et selon les caractéristiques sociales, démographiques et contraceptives des femmes contribue à éclairer la signification sociale que recouvre cette pratique et à évaluer les politiques de santé sexuelle et reproductive. Méthodes: L'analyse porte sur les bulletins statistiques d'IVG de 1990à 2007et sur les données de l'enquête nationale sur le recours à l'IVG en France, collectées par la Direction de la recherche, des études, de l'évaluation et des statistiques (Drees) auprès d'un échantillon aléatoire de 7067femmes en France métropolitaine. Les méthodes usuelles d'analyse uni- et multivariée ont été utilisées. Résultats: L'augmentation du recours répété à l'IVG est observée dans toutes les catégories de la population mais plus marquée chez les femmes âgées de moins de 30. ans, chez celles qui vivent seules et les étudiantes. Les femmes se présentant pour une deuxième IVG déclarent plus que les autres avoir utilisé une méthode de contraception au moment où elles se sont trouvées enceintes. Conclusion: L'augmentation du recours multiple à l'IVG au fil du temps traduit avant tout l'allongement de la période entre le premier rapport sexuel et le premier enfant. Le fait d'avoir plusieurs IVG renvoie aux difficultés de gérer un parcours contraceptif sans failles dans le cadre de trajectoires affectives et sexuelles de plus en plus diversifiées. © 2013 Elsevier Masson SAS.

Gobillon L.,INED | Wolff F.-C.,University of Nantes
Urban Studies | Year: 2011

In this paper, a study is made of the mobility and housing choices of the elderly when retiring, using household data collected in France. From a theoretical viewpoint, individuals are likely to decrease their housing quantity because of an income loss when retiring, but they may also increase it to benefit from more housing comfort for leisure. Using the 1992 Trois Générations survey, it is first shown that housing mobility at retirement is substantial in France, with a variety of self-reported motives. Then, using the 1994-2001 French Europanel survey, evidence is found of both upsizing and downsizing for mobile recent retirees. In many cases, housing adjustments lead to a correction of the initial disequilibrium between the number of rooms and the number of occupants. However, a significant proportion of mobile recent retirees improve the quality of their dwelling. © 2011 Urban Studies Journal Limited.

Leridon H.,INED
Medecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie | Year: 2013

This paper deals with the possible outcome of human reproductive processes in a relatively near future.

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