Socio-professional Characteristics Research Articles

Prevalence of work related upper limb disorders and the associated psychosocial factors among midwives

BackgroundWork related upper limb disorders (WRULDs) are a major occupational health concern. The health field, with its various occupational categories, is a conducive environment for the emergence of these conditions. Midwives are particularly at risk for WRULDs. ObjectiveTo determine the prevalence of WRULDs among midwives exersing at a Tunisian academic maternity and identify its associated factors. MethodsThis is a cross-sectional descriptive study conducted among midwives working at the maternity Departement of the Farhat Hached Teaching Hospital in the central region of Tunisia, during the period from March to May 2016. This study was based on a self-administered questionnaire including socio-professional characteristics, the “Nordic” questionnaire for the assessment of WRULDs in the last 12 months and the last 7 days, and the job content questionnaire for the evaluation of the psychosocial environment at work. ResultsA total of 54 midwives participated to our study with a response rate of 84.3%. The mean age was 46.1 + 8.7 years. In the last week before the study, the median number of deliveries performed by midwives per day was 3. Job strain was noted in 33.3% of cases. During the last 12 months, the prevalence of WRULDs was 90.7%. The complaints were located at the neck in 72.7% of cases. For the last seven days, this prevalence was 53.7%. Obesity and upper limb trauma history were significantly associated with WRULDs over the last 7 days. No social-occupational risk factors were associated with WRULDs in midwives in the last 12 months. ConclusionOur study found a high prevalence of WRULDs in midwives, emphasizing the need of adequate prevention in order to reduce the importance of this occupational disease and its harmful consequences.

Knowledge, Attitudes and Practices of the Health Personnel of the Pediatric and Gynecology-Obstetrics Departments of the Bouaké University Hospital Center (CHU) regarding the Intestinal Microbiota and the First 1000 Days of Life

Introduction: The harmonious development of the intestinal microbiota during the first 1000 days of life promotes the child’s immediate and future good health. The objective of the study was to evaluate the knowledge and practices of health personnel on the intestinal microbiota and the first 1000 days of life for the improvement of child health. Methods: Knowledge, attitudes and practices (KAP) type survey conducted among health personnel of the pediatric and gynecology-obstetrics departments of the Bouake University Hospital from July 1 to 31, 2017. All consenting agents working in the said services and present at the time of the study were included. The parameters studied concerned socio-professional characteristics, knowledge of the intestinal microbiota, and knowledge and practice of the first 1000 days. The data analysis was descriptive and analytical with a significance threshold p ≤ 0.05. Results: Out of 224 active agents, 76 (30 men, 46 women) participated in the survey, i.e. 33.9%. The respondent came from the gynecology-obstetrics (54%) and pediatrics (46%) departments and had professional experience >5 years in 38%. Thirty-eight percent of the respondents had a good knowledge of the intestinal microbiota. Concerning the first 1000 days of life, 64.5% of the respondents had a good knowledge of the first 1000 days overall. They advised exclusive breastfeeding for up to 6 months in 95% of cases. When breastfeeding was not feasible, the main criterion for choosing the infant formula was the composition (57.1%). They proposed a standard infant formula (43%), enriched with prebiotic (29.4%), enriched with probiotic (21.6%), a symbiotic (6%). Good knowledge of the intestinal microbiota was associated with belonging to the paediatric service (p = 0.013), socio-professional category (p = 0.031), year of experience >5 years (p = 0.032) and the first 1000 days of life to year of experience >5 years (p 0.01). Conclusion: The health personnel interviewed did not have a good knowledge of the intestinal microbiota and the first 1000 days. Capacity building is needed.

Individual Behaviors and COVID-19 Lockdown Exit Strategy: A Mid-Term Multidimensional Bio-economic Modeling Approach.

As of mid-2020, eradicating COVID-19 seems not to be an option, at least in the short term. The challenge for policy makers consists of implementing a suitable approach to contain the outbreak and limit extra deaths without exhausting healthcare forces while mitigating the impact on the country's economy and on individuals' well-being. To better describe the trade-off between the economic, societal and public health dimensions, we developed an integrated bioeconomic optimization approach. We built a discrete age-structured model considering three main populations (youth, adults and seniors) and 8 socio-professional characteristics for the adults. Fifteen lockdown exit strategies were simulated for several options: abrupt or progressive (4 or 8 weeks) lockdown lift followed by total definitive transitory final unlocking. Three values of transmission rate (Tr) were considered to represent individuals' barrier gesture compliance. Optimization under constraint to find the best combination of scenarios and options was performed on the minimal total cost for production losses due to contracted activities and hospitalization in the short and mid-term, with 3 criteria: mortality, person-days locked and hospital saturation. The results clearly show little difference between the scenarios based on the economic impact or the 3 criteria. This means that policy makers should focus on individuals' behaviors (represented by the Tr value) more than on trying to optimize the lockdown strategy (defining who is unlocked and who is locked). For a given Tr, the choices of scenarios permit the management of the hospital saturation level with regard to both its intensity and its duration, which remains a key point for public health. The results highlight the need for behavioral or experimental economics to address COVID-19 issues through a better understanding of individual behavior motivations and the identification of ways to improve biosecurity compliance.

Women in Maxillofacial Surgery and Otolaryngology; Career Obstacles and Success Factors.

Little is known on career factors and expectations for female oral and maxillofacial surgeons (OMFS) in developing countries. The study aimed to explore career perceptions of females in 2 related surgical specialties: oral and maxillofacial surgery and otolaryngology (ENT) with a focus on career obstacles and success factors. A structured questionnaire was distributed to female surgeons working in Jordan in the 2 surgical specialties. Questions addressed socio-professional characteristics and career-promoting and hindering factors. All surgeons registered in both specialties were invited. A total of 56 surgeons participated in the survey. Age range was 29 to 55 years (mean = 38.55 ± 5.799). Significantly more OMFS surgeons were single (P = 0.000) younger (P = 0.003), and had fewer years of experience (P = 0.01) than ENT surgeons. Significantly more ENT surgeons perceived the "hard working" attribute and "better communication skills" as career-promoting factors (P = 0.04, P = 0.015, respectively). Further, significantly more ENT surgeons believed that females in the surgical profession help in changing the traditional surgical stereotype linked with the male gender (93.8% ENT in contrast to 75% OMFS, P = 0.047), and expressed a preference for female mentors (48% ENT in contrast to 0% OMFS, P = 0.000). The results of this study indicate that female OMFS surgeons have different socio-professional characteristics and perceptions to their peers in ENT surgery, and this mainly manifested in professional experience, marital status, and important career perceptions. They seem to lack confidence in female participation and promotion of the surgical career, and they show preference for having exclusively male mentors.

Patient distrust in pharmaceutical companies: an explanation for women under-representation in respiratory clinical trials?

BackgroundPatient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.The primary objective of this study is to determine the variables associated with patient acceptation or refusal to participate in clinical research. Specifically, we sought to evaluate if distrust in pharmaceutical companies and associated psychosocial factors could represent a recruitment bias in clinical trials and thus threaten the applicability of their results.MethodsThis prospective, multicenter survey consisted in the administration of a self-questionnaire to patients during a pulmonology consultation. The 1025 questionnaires distributed collected demographics, socio-professional and basic health literacy characteristics. Patients were asked to rank their level of trust for pharmaceutical companies and indicate their willingness to participate in different categories of research (pre or post marketing, sponsored by an academic institution or pharmaceutical company).Logistic regression was used to determine factors contributing to “trust” versus “distrust” group membership and willingness to participate in each category of research.ResultsOne thousand patients completed the survey, corresponding to a response rate of 97.5%. Data from 838 patients were analyzed in this study.48.3% of respondents declared that they trusted pharmaceutical companies, while 35.5% declared distrust. Being female (p = 0.042), inactive in the employment market(p = 0.007), and not-knowing the name of one’s disease(p = 0.010) are factors related to declared distrust. Distrust-group membership is associated with unwillingness to participate in certain categories of trials such as pre-marketing and industry-sponsored trials.ConclusionDistrust in pharmaceutical companies is associated with a specific patient profile and with refusal to participate in certain subcategories of trials. This potential recruitment bias may explain the under-representation of certain categories of patients such as women in pre-marketing drug trials.

Политейнмент и влияние его стратегий на языковую личность политика

The article considers the relationship between the language / speech biography of the patient with aphasia and the process of his speech rehabilitation. This research project focuses on correlation between the patient’s language / speech biography and systemic connections of words in his mental lexicon. The relevance of the study consists in designing of recovery exercises adapted to the specific language / speech biography of patients with aphasic disorders. The research material includes: 1) statistical data on sociological characteristics of patients, gathered at the local Neurorehabilitation Center from 2014 to 2018; 2) 18 questionnaires filled in by the relatives of patients in question; 3) interviews with healthy Russian native speakers, whose socio-professional characteristics are similar to characteristics of one of the target groups of the patients; 4) a corpus of interview scripts processed with the program Sketch Engine; 5) 16 patients’ speech assessment sheets completed in accordance with the Wasserman scale (it designed to determine speech disorders of patients with a local cerebrovascular accident). The main results of this project are: 1) completing a sociolinguistic portrait of people at risk of aphasia with the similar language and speech biographies; 2) lists of most frequent words, collocations and automated verbal series (phrases and sayings) specific to people without speech pathologies; 3) identification of the language / speech biography features that affect mental lexicon; 4) exercises to speed up speech rehabilitation 5) their validation and assessment of effectiveness in clinical practice.

ATTITUDES IN FRONT OF DEATH: NURSES’ VIEWS IN THE HOSPITAL ENVIRONMENT

ABSTRACT Objective: to analyze the relationship between personal characteristics and the profile of attitudes towards death among nurses in a Portuguese hospital. Method: a cross-sectional, quantitative, exploratory and descriptive study, carried out in a hospital in the North of Portugal, with 981 nurses, who answered a questionnaire composed by the scale of evaluation of the Profile of Attitudes about Death. Data collection was carried out in February and March 2018 in the services, and the findings went through descriptive and analytical statistical analysis with the aid of the SPSS software. Results: the nurses revealed to have the attitudes of approach (36.29 points), fear (27.82 points), neutrality (27.25 points), avoidance (17.48 points) and escape (15.52 points) in the face of death, and these were associated with the different socio-occupational characteristics of these professionals, including gender, marital status, age, having children, type of employment relationship, professional category, specialty, time of service, and the practice or belief of some religion. Conclusion: the profile of the nurses' attitudes towards death is influenced by their socio-professional characteristics, which points to the importance of rethinking training strategies in the academic environment, in health organizations and in services, favoring the better reception of patients and family members, but also in relieving the suffering of the professionals in the face of finitude.

Influence of work conditions on nurses mental health disorders: a cross sectional study among 132 nurses

Background: Hospital caregivers are particularly exposed to several constraints related to work environment, which can affect them mental health and the quality of care delivered. The aim of this study was to determine the degree of psychic suffering and evaluate its determinants among Tunisian nurses. Materials and methods: A cross-sectional survey was conducted in seven district hospitals in Tunisia. The study was conducted over a period of three months. Data collection was assessed by a pre-established survey describing socio-professional characteristics of participants. The General Health Questionnaire (GHQ) was used to study participants' mental health. Results: One hundred thirty two nurses have participated, of which 62.6% were women. The study population was relatively young, with a mean age of 41 ± 11 years and average job tenure of 17 ± 11 years. In this study, 13.7% of participants worked on permanent night shift. The rate of psychic suffering among nurses is estimated at 73.3%. A mental health disorder was reported by 73.3% of health care workers, correlated after logistic regression to job tenure (p = 0.02, OR = 2.26, CI = [1.08-4.7]) and poor relationship within the health care and medical team (p = 0.05, OR = 1.2, CI [0.9-1.5]). Conclusion: further studies are needed to better assess these risks and plan appropriate preventive actions.

METHODS FOR COMMUNICATION PROCESSES ENHANCEMENT IN THE “PROVIDER-CONSUMER (LEARNER)” SYSTEM OF EDUCATIONAL SERVICES

The aim: To determine learners' (doctors) needs and draw up proposals for upgrading educational communication processes in the "provider-consumer" system of educational services. Materials and methods: The biblio-semantic, biostatistic and sociological methods were used. 754 author questionnaires were processed. Results: The socio-professional characteristics of learning service consumers at Shupyk National Medical Academy of Postgraduate Education were analyzed as well as studied their proposals. Evaluating communication interactions in the "provider-consumer" system of educational services concerned determining the most comfortable organizational modes of education for a consumer, making a careful analysis of the learning service characteristics by "accessibility" and "effectiveness" criteria. The determination methodology and research results can be used by universities and colleges regardless of the educational program specialization. Conclusions: Ensuring the educational communication processes effectiveness in the "provider-consumer" system of educational services is achieved by studying learners' adaptation according to such principal criteria as organizational modes of education, the learning service accessibility and effectiveness. The learning service providers adjust customer requirements to the capabilities of a particular educational institution (personnel availability, facilities and resources etc.) and so that they ensure competitiveness.

Socio-Professional Characteristics of Russian and Foreign Cosmonauts/Astronauts

Представлены результаты сравнительного анализа социопрофессиональных характеристик российских и зарубежных космонавтов/астронавтов. В основе – данные сайта НИИ «Центра подготовки космонавтов имени Ю.А. Гагарина», а также других открытых источников. Исследуются такие характеристики, как полученная специальность, отношение к военной службе и воинские звания, научная продуктивность, среднее количество совершенных полетов, виды дополнительной деятельности, сферы занятости после завершения карьеры. Большинство анализируемых показателей российских космонавтов и их зарубежных коллег, имеющих опыт космического полета, схожи. Но отмечаются и различия: доля гражданских лиц среди астронавтов значительно выше, чем среди российских коллег; у космонавтов выше показатели научной продуктивности; после завершения карьеры астронавты чаще занимаются бизнесом, космонавты чаще занимают руководящие государственные должности и уходят в политику.

Burnout among Teachers in Higher Education: An Empirical Study of Higher Education Institutions in Portugal

Burnout is considered by the World Health Organization an extreme response to cumulative and prolonged occupational stress, with teachers being among the professionals most affected by it. This disease influences physical and psychological well-being, negatively affecting the relationship between teachers and students. It also compromises the quality of teaching, thus inducing absenteeism and increasing professional abandonment. Our study examines the degree of incidence of Burnout affecting Professors from the Portuguese Higher Education Institutions. The first study was carried out on a sample of 520 teachers. A proportion of 41 (7.9%) Higher Education Teachers scored high on Burnout. A second phase of the study was conducted to gather data on socio-demographic and socio-professional characteristics of teachers affected by Burnout. The MBI (Maslach Burnout Inventory) and another questionnaire was built for this purpose and were used to collect the study data. The results indicate the majority of teachers affected by Burnout were female (63.4%). Most of them are between 40 and 59 years old (75.6%) and married (68.3%). Overall, 41.5% had 10 to 19 years of service and 39.0% between 20 and 29 years of service. The teachers with an undetermined contract (48.8%) and temporary contract (36.6%) displayed higher levels of Burnout, but the self-employment worker (4.9%) appears in a residual amount. Teachers most affected by Burnout are from Public Polytechnic Institutes (48.8%), followed by Public University teachers (41.5%). Teacher’s Burnout is a serious problem and should be considered by the Higher Education Institutions regarding the development of good teaching practice.

Assessing the Implementation of the Infection Prevention Principles’s in Maternity Wards from the Functional Health District Hospitals of the Region of Hauts Bassins, Burkina Faso.

Introduction: This study evaluated the application of infection prevention and control (ICP) measures by midwives in the delivery rooms and maternity suites at the five district hospitals in the Region of Hauts Bassins, Burkina Faso. Methods: This was a cross-sectional study conducted from 02 August 2015 to 12 June 2016. The data collected were: socio-professional characteristics, knowledge of ICP, attitudes towards handwashing, ICP practices, and service organization. Results: Of the 65 agents surveyed, 60.0% were untrained about ICP after basic training, and 78.5% with no supervision for at least four years. The scores were : knowledge (64.7%), attitude (68.1%), domains of practice (<85%). None of the maternity hospitals had the four bins for instrument processing. The organization of services was insufficient. Conclusion: The infection prevention and control is insufficiently implemented, requiring capacity building and reorganization of services in a spirit of quality assurance.

Discrimination of people living with hiv/aids: a survey with dentists in Abidjan, Côte d’Ivoire

Abstract Background Despite several decades of fighting HIV infection, discrimination against people living with this infection persists, even among health professionals. Understanding the determinants of discriminatory attitudes of dentists is a first step towards access to oral health care and improved care for people living with HIV (PLHIV). Objectives To analyse the determinants of discriminatory attitudes towards people living with HIV among dentists in Côte d’Ivoire. Methods A cross-sectional survey was conducted among dentists in Abidjan in 2016. In addition to socio-professional characteristics, a questionnaire collected information on their knowledge about HIV (transmission, hiv-related oral diseases) and their individual perception (fear of being contaminated, cross-contamination...). The chi2 test for independent sampling was used to identify factors associated with discriminatory attitudes (threshold α = 5%). Results A total of 120 dentists were interviewed: 61.3% from the public sector; 56.7% men; 54.2% in couple; 53.3% had participated in continuing education on HIV; 29.2% did not know HIV-related diseases and transmission modes and 69.2% reported fear of being infected during care; 44.2% reported informing staff of the patient’s HIV status. The proportion of dentists with discriminatory attitudes was estimated at 69.2%. The main associated factors were: female gender (p = 0.001), living in couple (p = 0.000), lack of knowledge of the risk of HIV transmission after a blood exposure accident (p = 0.000), the law protecting people living with HIV in Côte d’Ivoire (p = 0.009) and fear of being infected (p = 0.000). Conclusions The results of this study show that the determinants of discriminatory attitudes among dentists result from their lack of knowledge of the disease, justifying the need to strengthen their continuing education on HIV/AIDS infection. Key messages Dentists discrimination towards people living with HIV infection result from their lack of knowledge about the infection. It’s essential to strengthen their knowledge about HIV in order to improve access to care for people living with HIV.

Evaluation of psychosocial constraints among grocery stores workers in Tunisia

The identification of psychosocial constraints in the sector of mass retail is necessary to set up and guide preventive strategies. To evaluate the prevalence of psychosocial constraints among employees working in a large supermarket chains. A descriptive cross-sectional survey conducted in employees of grocery stores. The study was based on a questionnaire exploring their socio-professional characteristics and on the Karasek questionnaire. 245 workers participated in the study. The average age was 32.4±6.4 years. Sex-ratio was 0.84. Occupational seniority was 6.3 years (min=1 year; max=18 years). The category of employees was the most represented (56%); the cashiers and the executives represented respectively 24.5 and 19.5%. A job strain situation was observed in 28.2 % of cases. It varied significantly with occupational seniority (p=0.03). The employees and the cashiers represented the most exposed posts. A high job demands was observed in 48,2% of the cases. The employees working in a supermarket are more exposed than those working in a minimarket (p<0,001). A low job control was found in 61.2 % of cases. It was more important among the employees having a permanent employment contract (p=0.01). A low job suport was found in 65,3% of cases. A situation of isostrain was observed in 20%. According our results, workers in grocery stores are exposed to psychosocial risk factor. The implementation of strategies to reduce stress factors at work is required.

Charakterystyka społeczno-zawodowa pielęgniarek onkologicznych na Dolnym Śląsku

Charakterystyka społeczno-zawodowa pielęgniarek onkologicznych na Dolnym Śląsku

Holistic Management of Persons with Mental Disorders: Cases of Caregivers Center Psycho Neuro Pathology (CNPP) in Kinshasa in the DRC

Introduction People with mental disorders are found in all countries of the world, but their support depends on each conceptual and organizational modality in strength in their respective countries. A serious problem arises in the holistic care of these patients by the fact that there is a lack of interest by their families, NGOs and the Congolese state, what grows them to be wandering day and night to across the major arteries of the Capital without any support, nor their admission to hospitals. The small group that can be admitted for care in hospitals, is also confronted with the institutional realities that do not allow that holistic care, especially since it takes days and the improvement seems to be too slow and mutigious. Why this study with caregivers to evaluate their work in relation to holistic care. Material and Method Our study is descriptive correlational. The study population is made up of 136 caregivers working at the Neuro Psycho-Pathological Center (CNPP) in Kinshasa, than we regarded to be an exhaustive sample given the importance of the study. To collect the data, we used the live observation, the interview and the questionnaires administered to the caregivers. The study was conducted for 1 month from 03.01.2019 to 01.04.2019. The SPSS software version 20 enabled us to analyze the data of our research by resorting to the statistical calculation commonly used for the frequencies. We have presented the p-value at the threshold of 0.5. There is a significant link i.e. the p-value is from 0.001 to 0.499, at this moment our time null hypothesis is maintained and in the case of p-value 0.501 to 0.999. They are regarded as weakly significant, our assumption is automatically alternate. Results The results showed that 53.8% of careers were between the ages of 41 - 60; 69.8% of the male caregivers were compared to 30.8% female, 69.8% were the A3 nurses and 34.6% of these nurses had a seniority of 31 - 40 years. The study shows also that working conditions of carers characterized by the lack of means of transportation at 96.2%, the crisis turnover at 92.3%. There are significant differences enter some socio-professional characteristics (qualifications and seniority) and the implementation by caregivers of standards-based patient care and the ad-vancement of mental health, since all p values of X2 are less than 0.05. Therefore, being older and more qualified influences this application. Conclusion There are several laws around the world, including the Public Health Codes which include in their objectives the organization of a mental health service and the fight against mental illnesses, which implies the setting up of a Committee for the fight against mental illnesses and a structure that can take care of patients aftercare.

Kyiv Vice-Governor (1860-s – 1917): Historic and Political Portrait

This article briefly reviews the authorities, conferred to the vice-governor by the supreme imperial bodies in the system of provincial government and reasons, which were followed by the central authorities during their appointment. The personnel assets of vice-governor corps of the Kyiv Governorate is considered and their socio-professional characteristics (nationality, age, education, material status, generic assignment) are determined. During carrying out investigations it was found that applicants for the position of Kyiv vice-governor had a considerable experience of government services: ranging from a gubernial secretary (12 rank) to an actual state councillor (4 rank), who held higher imperial official positions (vice-governor, official on special assignments at a Minister of the Interior) before assignment to a position of vice-governor in the Kyiv Governorate, had the special confidence of Imperator, Minister of the Interior or Governor-General.&#x0D; Keywords: vice-governor, Kiev province, provincial government, functionary, P. Seletsky,B. Kashkaryov

Prevalence of consumption of psychoactive substances amongst dockers.

Dockers in the port facilities are exposed to significant psychosocial risks (stress, suffering at work, etc.) related to heavy organisational, environmental, physical, chemical constraints, etc. These workers are particularly affected by the consumption of psychoactive substances because of the dangerousness and complexity of their work. To what extent can these numerous occupational risks be at the origin of behaviour favouring the consumption of psychoactive substances? However, in our country no study has investigated toxic habits in this population. The aim of this study was to determine the prevalence of the use and misuse of psychoactive substances amongst dockers, and to appreciate the poly-consumption according to socio-demographic and occupational characteristics. This cross-sectional study was conducted amongst 665 dockers. The interview took place at the occupational health service and lasted between 15 and 20 minutes for each person respecting the confidentiality. The questionnaire covered socio-demographic characteristics, socio-professional characteristics, and toxic habits (tobacco, alcohol, cannabis and others psychotropic substances). The misuse was assessed by specific tests: Fagerström test for tobacco smoking, Cannabis Abuse Screening Test (CAST) and Alcohol Use Disorders Identification Test (AUDIT). The prevalence of use was 30.5% for tobacco smoking, 9.1% for cannabis smoking, and 16.5% for alcohol consumption. The prevalence of toxic habits was significantly higher in handlers than in machinery operators: tobacco smoking (39.7% vs. 27%; p = 0.002), snuff tobacco (12.5% vs. 4.6%; p = 0.001), hookah (7.6% vs. 2%; p = 0.001), cannabis smoking (20.6% vs. 4.5%; p = 0.001) and alcohol consumption (22.3% vs. 14.3%; p = 0.019). Amongst consumers, the prevalence of dependence or misuse was 45.3% for tobacco smoking, 56.7% for cannabis smoking and 44.5% for alcohol consumption. Fifty-two point five per cent had no toxic habit, 36.7% had one toxic habit, 9.9% two toxic habits, and 0.9% three toxic habits. The most frequent associations were tobacco-alcohol (6.5%), and tobacco-cannabis (3%). Occupational health professionals have to play a key role in raising awareness and fighting against consumption of psychoactive substances amongst dockers.

Analyse des dossiers d’asthme professionnel reconnu sur une période de 15 ans dans une population du Nord de la Tunisie

Because of their frequency and their medical and socioprofessional impact, respiratory diseases, particularly asthma, are a major occupational health problem. Indeed, these diseases are currently the third most common occupational disease reported to the CNAM in Tunisia. ObjectivesTo describe the socioprofessional, clinical and paraclinical characteristics of occupational asthma in Tunisia in the private sector, to identify the occupational risk factors that cause this disease, and to evaluate the medicolegal consequences of compensation for this occupational disease. MethodsA descriptive and retrospective cross-sectional study covering all cases of occupational asthma recognized as occupational diseases and compensated in the northern region of Tunisia, studied by medical commissions empowered to set rates for permanent partial disability caused by either a work-related injury or an occupational disease over a period of 15 years (2002–2016). ResultsA total of 127 cases of occupational asthma were collected between January 2002 and December 2016 in the northern region of Tunisia, corresponding to 11% of all occupational diseases recognized during this period study. The average patient age of is 40.47 years, with a slight predominance among females (59%). The average duration of exposure is 13.92 years. The sector most concerned is the clothing and textile industry (33.07%), with a rise in the automotive accessories sector (15.74%) in the northern region of Tunisia. The allergens to which workers were exposed were mainly textile and vegetable dust, including 32.28% cotton. In second place were isocyanates with 29 cases (22.83%), followed by formic aldehyde (9.44%) and flour 8.66%. Association of occupational allergic rhinitis with occupational asthma was reported in 26/127 cases. In total, 13,712 working days were lost and the average IPP rate was 22%; 70% of our population are no longer active and have lost their jobs after compensation. ConclusionThe prognosis of occupational asthma depends on early and rigorous diagnosis as well as the establishment of a consensual approach in the compensation practices adapted to the actual situation prevailing in our country.

Современная дипломатическая служба как рефлексивный институт

The article provides a substantiation of diplomatic service as a reflective institution. Since the mid-1980s, the attention of researchers has increasingly concentrated on such new features of modern society as institutional and individual reflexivity, which permits to speak about the formation of reflexive modernity that has replaced the industrial modernity. This new state of society is characterized by accelerating and increasing of social and cultural dynamics, which qualitatively change the functionality of structures and people’s activities. Accordingly, a reflexive sociology emerged with a new theoretical and methodological means that entailed ‘rediscovery’ of the realities of the information society, the nature of communications, international relations, and diplomatic service. The modern (in the context of the information society, electronic media and communication, networked in its organization, ‘liquid’ stage) diplomatic service is turning into a reflexive socio-political institution. The activity of the diplomatic service is reflexive information and communication process carried out by the system of specialized bodies (ministry of foreign affairs and its overseas missions) for the implementation of foreign-policy tasks set by top political leadership of the country, on the basis of general public interest, by specific diplomatic means. Diplomats also acquire a reflexive nature. Being initially individuals who receive strict instructions from central office, they turn into diplomatic agents, whose essence of activity is now primarily the reflection of different cultures and interests, the search and harmonization of joint, compromised, mutually acceptable positions and actions. In addition to reflecting the environment, in which the modern diplomatic service operates, the self-reflection of the diplomatic community, the self-change of its specific socio-professional characteristics, have great importance for the effectiveness of its activities. The author observes the most distinctly institutionalized reflections focusing at the case of the diplomatic service of France, which is the precursor of and, in many respects, still stays the model for the diplomatic services of other states.