La Bible se raconte : initiation à l'analyse narrative

La Bible est l'un des plus fabuleux trésors d'histoires de l'humanité. Car depuis la nuit des temps, les croyants racontent. Mais pas n'importe quoi. Longuement façonnés dans l'oralité, patiemment rédigés, les récits bibliques obéissent à de subtiles règles de composition. Derrière les histoires apparemment naives se cache la fine stratégie d'un narrateur. Grâce à ses qualités pédagogiques, le livre de Daniel Marguerat et Yvan Bourquin s'est imposé comme un manuel de référence pour l'initiation à l'analyse narrative des textes bibliques. Il a été traduit en plusieurs langue. Pour cette 4e édition, l'étude de l'intrigue et de la construction des personnages a été renouvelée. Avec clarté, ses auteurs ont aménagé un parcours qui permet de découvrir les outils de l'analyse narrative, d'étudier leur application, d'évaluer leur efficacité. Toute la magie de la lecture biblique s'en trouve éclairée.

Molecular neuro-oncology in clinical practice: a new horizon.

Primary brain tumours are heterogeneous in histology, genetics, and outcome. Although WHO's classification of tumours of the CNS has greatly helped to standardise diagnostic criteria worldwide, it does not consider the substantial progress that has been made in the molecular classification of many brain tumours. Recent practice-changing clinical trials have defined a role for routine assessment of MGMT promoter methylation in glioblastomas in elderly people, and 1p and 19q codeletions in anaplastic oligodendroglial tumours. Moreover, large-scale molecular profiling approaches have identified new mutations in gliomas, affecting IDH1, IDH2, H3F3, ATRX, and CIC, which has allowed subclassification of gliomas into distinct molecular subgroups with characteristic features of age, localisation, and outcome. However, these molecular approaches cannot yet predict patients' benefit from therapeutic interventions. Similarly, transcriptome-based classification of medulloblastoma has delineated four variants that might now be candidate diseases in which to explore novel targeted agents.

Narrative Diagrammatik. Mit einer Modellanalyse: Die Diagrammatik des "Decameron"

Taking as a starting point the seeming inconsistency of late-medieval romances notoriously 'run wild' (verwildert), this article is concerned with the description of an abstract form of narrative coherence that is based on the notion of the diagrammatic. In a first section, this concept is illustrated in a simplified manner by an analysis of Boccaccio's Decameron based on two levels of spatial structure: that of the autograph Berlin manuscript (Codex Hamilton 90) and that of the recipient's mental visualisation of the relations between the frame and the tales of the work. It is argued that the connectivity of the work as a whole depends on the perception of those two spatial representations of the plot. A second section develops this concept in a more theoretical fashion, drawing on Charles Sanders Peirce's notion of diagrammatic reasoning as a way of perceiving relations through mental and material topological representations. Correspondingly, a view of narrative is proposed that does not depend on the traditional perspective of temporal sequence but emphasizes the spatial structure of literary narrative. It is argued that these conditions form the primary ontological mode of narrative, whereas the temporal development of a story is an aesthetic illusion that has been specifically stimulated by the narrative conventions of approximately the past three centuries and must thus be considered a secondary effect. To conclude, an interpretation in miniature of an aspect of Heinrich von Neustadt's Apollonius von Tyrland that seems to have 'run wild' is undertaken from a diagrammatic perspective.

Central nervous system stimulants and sport practice.

BACKGROUND AND OBJECTIVES: Central nervous system (CNS) stimulants may be used to reduce tiredness and increase alertness, competitiveness, and aggression. They are more likely to be used in competition but may be used during training to increase the intensity of the training session. There are several potential dangers involving their misuse in contact sports. This paper reviews the three main CNS stimulants, ephedrine, amfetamine, and cocaine, in relation to misuse in sport. METHODS: Description of the pharmacology, actions, and side effects of amfetamine, cocaine, and ephedrine. RESULTS: CNS stimulants have psychotropic effects that may be perceived to be ergogenic. Some are prescription drugs, such as Ephedra alkaloids, and there are issues regarding their appropriate therapeutic use. Recently attention has been given to their widespread use by athletes, despite the lack of evidence regarding any ergogenic or real performance benefit, and their potentially serious side effects. Recreational drugs, some of which are illegal (cocaine, amfetamines), are commonly used by athletes and cause potential ergolytic effects. Overall, these drugs are important for their frequent use and mention in anti-doping laboratories statistics and the media, and their potentially serious adverse effects. CONCLUSIONS: Doping with CNS stimulants is a real public health problem and all sports authorities should participate in its prevention. Dissemination of information is essential to prevent doping in sport and to provide alternatives. Adequate training and education in this domain should be introduced.

L'essor de nouvelles lectures en exégèse : l'analyse narrative

Quelques théologiens des différentes confessions chrétiennes (catholique, orthodoxe et protestante) se sont réunis du 4 au 8 septembre 2002 au Monastère de Bose (Italie) pour étudier un sujet brûlant : « Comment faire de la théologie aujourd'hui ? ». Les principales conférences ont abordé avec audace les thèmes controversés de la recherche contemporaine : les changements culturels et leur influence sur la manière de faire de la théologie ; la responsabilité des théologiens devant l'Église et le monde ; les différentes lectures de la Bible ; la vie liturgique et paroissiale ; la pertinence du dogme christologique ; la nouvelle spiritualité ; le renouveau de l'Église orthodoxe.

Le conseil génétique: aspects théoriques et pratique en prénatal [Genetic counselling: theoretical aspects and prenatal practice]

Le conseil génétique doit fournir aux individus une information médicale précise et un soutien psychologique. L'importance des principes d'autonomie et de confidentialité, dogmes du conseil génétique, est renforcée par la nouvelle loi suisse (LAGH). Dans certains pays, une grande partie du conseil génétique est assurée par des conseillers en génétique non médecins ayant une formation postgraduée spécifique. Le conseil génétique joue un rôle grandissant dans différents domaines de la médecine. En particulier, il est indispensable dans le contexte du prénatal où les couples reçoivent des informations complexes et doivent bénéficier d’un soutien pour prendre une décision. Genetic counselling provides families with accurate medical information and psychological support. Respect and concern for the emotional well-being should be taken into account while discussing genetics aspects and recurrence risks. The importance of autonomy and confidentiality, central to genetic counselling, is reinforced by the new Swiss law (LAGH). In many countries, most of the genetic counselling is provided by genetic counsellors who have a specialised post-graduate training. Genetic counselling plays an increasing role in different medical specialities. In particular, it is essential in the context of prenatal and pre-conceptual care, where couples are confronted to complex information and should have access to appropriate support during the decision-making process

Methadone maintenance treatment (MMT) in general practice or in specialized centers: profile of patients in the Swiss Canton of Vaud.

We studied profile of patients (n=1782) treated in specialized centers and general practice (GP) enrolled in methadone maintenance treatment (MMT) programs during 2001 in the Swiss Canton of Vaud. We found that GPs treated the majority of patients (76%). Specialized centers treated a higher proportion of patients with uncontrolled intravenous use of cocaine and heroin, and prescribed neuroleptics as concomitant medication three times more frequently than GPs. Patients treated in specialized centers were more likely to undergo screening for HIV, HBV, HCV, and receive complete HBV immunization. In conclusion, specialized centers are more likely to treat severely addicted patients and patients with a poor global assessment (physical, psychiatric, and social).

Swiss clinical practice guidelines on field cancerization of the skin.

Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes. The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.

The gap between scientific evidence and clinical practice : 5-aminosalicylates are frequently used for the treatment of Crohn's disease

BACKGROUND: There is uncertain evidence of effectiveness of 5-aminosalicylates (5-ASA) to induce and maintain response and remission of active Crohn's disease (CD), and weak evidence to support their use in post-operative CD. AIM: To assess the frequency and determinants of 5-ASA use in CD patients and to evaluate the physicians' perception of clinical response and side effects to 5-ASA. METHODS: Data from the Swiss Inflammatory Bowel Disease Cohort, which collects data since 2006 on a large sample of IBD patients, were analysed. Information from questionnaires regarding utilisation of treatments and perception of response to 5-ASA were evaluated. Logistic regression modelling was performed to identify factors associated with 5-ASA use. RESULTS: Of 1420 CD patients, 835 (59%) were ever treated with 5-ASA from diagnosis to latest follow-up. Disease duration >10 years and colonic location were both significantly associated with 5-ASA use. 5-ASA treatment was judged to be successful in 46% (378/825) of treatment episodes (physician global assessment). Side effects prompting stop of therapy were found in 12% (98/825) episodes in which 5-ASA had been stopped. CONCLUSIONS: 5-Aminosalicylates were frequently prescribed in patients with Crohn's disease in the Swiss IBD cohort. This observation stands in contrast to the scientific evidence demonstrating a very limited role of 5-ASA compounds in the treatment of Crohn's disease.