La doctrine d’Afriean Spir. Les objets d’expérience ne coïncident pas avec la norme logique. La méthode de réflexion. L’évident de fait et la certitude rationnelle. La nature et l’origine du concept a priori. Son unité. Jugement identique et jugement synthétique. Le principe d’identité comme principe de toute connaissance. Les applications de la pensée fondamentale de Spir dans le domaine de la morale et de la religion. L’importance historique de cette pensée.

Julien Claparède-Petitpierre Cet article aborde la question du bien-être à partir du problème sociologique et psychologique de la socialisation. Deux types de théories distinctes de la socialisation sont ici cernés qui posent de façon différente la question du rapport entre émotions et bien-être. En premier lieu, les théories de la répression (Freud) et des sentiments moraux (Elster) font du processus de socialisation une expérience d’émotions négatives puissantes suscitées par l’intériorisation du jugement moral d’autrui dans la psyché individuelle. Qu’elle soit (...) naturalisante (Freud) ou culturaliste (Benedict, Elster), cette approche repose sur l’idée d’une contradiction entre les aspirations pulsionnelles de l’individu et les réquisits moraux du groupe. Cette contradiction, qui induit une violence affective (angoisse du rejet, honte) et un renoncement systématique aux satisfactions du désir, montre la socialisation comme un processus conflictuel générant inévitablement du mal-être. En second lieu, les théories de l’apprentissage font de la socialisation un processus générateur de bien-être dans la mesure où la découverte cognitive des règles qui structurent le champ social permet à l’individu de devenir un acteur social compétent et à l’aise dans les interactions quotidiennes. Ces théories distinguent l’affectivité de haute intensité, générée par l’angoisse ressentie par l’acteur social incompétent et désorienté, de l’affectivité de basse intensité reposant sur le sentiment de confiance affectant l’acteur social compétent (Quéré). Cette seconde approche illustre l’intérêt que porte l’individu à la maîtrise des règles sociales. Quoique distinctes, ces deux positions ne s’opposent pas, voire semblent pouvoir être articulées à profit. (shrink)

L'édification spatio-temporelle dont se sert un observateur isolé pour représenter ses résultats de mesures comporte la construction d'un espace physique qui, quoique non catégorique, est applicable sur l'espace euclidien à trois dimensions. Aucun argument ne permet de décider si l'espace est euclidien ou non euclidien. Les expériences permettent seulement à l'observateur d'affirmer que l'espace est pratiquement euclidien en son voisinage.

Background and objectives: Summary measures of overall health inequality are independent of group membership and enable international comparisons of distribution of health. We compare inequality between and within countries over time and identify normative issues underlying such comparisons. Methods: We used a set of modeled historical life tables for 193 World Health Organization member states from the years 1990, 2000 and 2008 and calculated inequality in age at death and inequality-adjusted life expectancy. Results: Our calculations suggest that overall health inequalities (...) in age at death have been decreasing in the period 1990–2008 in most countries of the world. Only 20 countries experienced increasing distribution in age at death. Simultaneously, overall life expectancy has increased in 85 per cent of all countries. Thus, the combined measure IALE has improved globally. The same overall trend of reduced health inequality applies to all groups of countries stratified by income level. Conclusion: Overall health inequalities, in addition to average health outcomes, could be reported regularly to monitor the health status of populations and the performance of health systems. We find, on normative grounds, the combined measure IALE to be preferable to measuring trends in inequality only. Likewise, we find the Absolute GiniH to be preferable to Relative GiniH. (shrink)

Background In the context of limited health care budgets in countries where Neglected Tropical Diseases are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. Objectives The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi-criteria decision-making matrix, and (...) 3) discuss the conditions under which this decision-making procedure should be carried out in a real-world decision-making context. Methods This paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi-criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases. Discussion Our in vitro multi-criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil-transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision-making process and we stress the limitations of this study exercise. Conclusion By exploring how several criteria relevant to the multi-facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

BackgroundIn the context of limited health care budgets in countries where Neglected Tropical Diseases (NTDs) are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost‐effectiveness analyses may lead to biased and insufficiently justified priorities.ObjectivesThe objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi‐criteria decision‐making matrix, and 3) discuss (...) the conditions under which this decision‐making procedure should be carried out in a real‐world decision‐making context.MethodsThis paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi‐criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases.DiscussionOur in vitro multi‐criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil‐transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision‐making process and we stress the limitations of this study exercise.ConclusionBy exploring how several criteria relevant to the multi‐facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)