La "bientraitance", exploration du concept et essai d'utilisation en santé publique: une expérience à Fribourg (Suisse). ["Bientraitance": conceptual exploration and an example of its application in public health: an experience from Fribourg, Switzerland]

Since the year 2000, the concept of "bientraitance" (for which no equivalent term has yet emerged in either the English or German language) has gained widespread credence among educators, sociologists and health professionals in France and Belgium. This concept emphasizes a constructive approach to care and education rather than merely one of prevention of disasters. Applied in public health, and in particular to mental health promotion, the use of the concept of "bientraitance" can help promote both effectiveness and meaning in the design and planning of community interventions. The article presents an example of an intervention for children and adolescents in Fribourg, Switzerland. The underpinning hypothesis is that the children and youth groups (such as sports clubs, artistic and cultural associations, scouts and guides) represent largely untapped, or under-tapped, informal health resources with a favourable cost-effectiveness profile. "Bientraitance" criteria are used in selecting certain associations offering structured extracurricular group educational activities and collective out-of-school (or after school) programmes. Support is provided to the organisations selected for recruiting new members, in particular those with potentially lower levels of access, for example disabled children or new migrants. The results will be evaluated for the impact of participation in various out-of-school activities on health and health determinants from a prospective and comparative perspective. This paper shows how the concept of "bientraitance" can be useful in the development of a public health intervention.

Vulnerability to schizophrenia: relevance of patients' subjective experience for empirical and clinical work.

Efforts are being made by clinicians and researchers to accurately delineate phenotypic traits of individuals at enhanced risk of schizophrenia. This issue is important for a better understanding of the etiopathogenic mechanisms of the disease and for the building up of programs of primary prevention. We suggest that disturbances of subjective experience, although difficult to operationalize, are an important-but until now neglected-core component of schizophrenia spectrum disorders. We advocate the development of valid and reliable instruments in order to allow the assessment of basic symptoms and disturbances of Self-experience. Delineation of vulnerability to schizophrenia cannot rely solely on neuropsychological and neurophysiological data, as prevention programs will be performed mainly by clinicians.

Intégrer le genre dans la formation médicale prégraduée: peut-on transférer l'expérience néerlandaise sur sol suisse ? Etude exploratoire menée au sein de l'École de médecine de l'Université de Lausanne (FBM/UNIL) pour l'année académique 2009-2010

[Table des matières] Résumé. Zusammenfassung. 1. Introduction. 2. Intégrer le genre dans les études de médecine : la " Success Story " néerlandaise. 2.1 En amont du projet national de 2002-2005. 2.1.1 L'étude pilote menée à l'Université Radboud à la fin des années 1990. 2.2 Integrating Gender into the Core Curriculum: le déroulement du projet national (2002-2005). 3. Enseignement prégradué en médecine à Lausanne: quelle place pour le genre ? Etat des lieux pour l'année académique 2009-2010. 3.1 Inventaire: quelques fleurs dans le désert ? 3.2 La situation lausannoise à l'aune des exigences du projet néerlandais. 3.3 L'organisation de l'enseignement à l'École de médecine de Lausanne suite à la réforme des années 2000. 3.4 Le développement des études genre à l'Université de Lausanne et en Suisse: quel impact sur la médecine ? 4. Inclure le genre dans les études prégraduées de médecine : le cadre au niveau suisse. 4.1 Quelles possibilités de soutien au niveau des instruments nationaux de pilotage de la formation médicale prégraduée ? 5. Quelles possibilités de transfert ? Des questions pour l'avenir. 5.1 Comment transférer l'expérience néerlandaise? 5.2 Quelles activités pourraient être entreprises au niveau national ? 6. Annexes.

Subjective mental time: the functional architecture of projecting the self to past and future.

Abstract Human experience takes place in the line of mental time (MT) created through 'self-projection' of oneself to different time-points in the past or future. Here we manipulated self-projection in MT not only with respect to one's life events but also with respect to one's faces from different past and future time-points. Behavioural and event-related functional magnetic resonance imaging activity showed three independent effects characterized by (i) similarity between past recollection and future imagination, (ii) facilitation of judgements related to the future as compared with the past, and (iii) facilitation of judgements related to time-points distant from the present. These effects were found with respect to faces and events, and also suggest that brain mechanisms of MT are independent of whether actual life episodes have to be re-experienced or pre-experienced, recruiting a common cerebral network including the anteromedial temporal, posterior parietal, inferior frontal, temporo-parietal and insular cortices. These behavioural and neural data suggest that self-projection in time is a fundamental aspect of MT, relying on neural structures encoding memory, mental imagery and self.

La perception subjective de l'effet des neuroleptiques chez des patients schizophrènes ambulatoires: une étude transversale [Subjective perception of the effect of neuroleptics by outpatient schizophrenic patients: a cross-sectional study].

Subjective response to neuroleptics is essential to long term observance of treatment and quality of life of patients. Numerous factors (pharmacological, relational and psychopathological) are responsible of this subjective response. Objectives of this study are: (a) to examine psychometric features of the french version of the Drug Attitude Inventory (DAI-30) [13] and (b) to explore pharmacological, relational and psychopathological factors related to this subjective response. Subjects and methods: 78 subjects were rated (self rated response rate 61% (n = 48)) for (a) subjective response to neuroleptics, (b) compliance, (c) therapeutic alliance, (d) symptoms (e) severity of disorder. RESULTS: Factor analysis yielded 2 main clinically relevant factors, similar to the original version: (I) global subjective response and (II) specific subjective response. Internal consistency is high. Correspondance analysis showed two important dimensions in the treatment of schizophrenic patients: (I) Recovery--aggravation, (II) Therapeutic ambition--positive or negative symptoms. CONCLUSION: French version of DAI-30 seems to have a similar structure and psychometric features as the original version. It shows concordance with the degree of compliance. Pharmacological factors are not the only factors implicated in subjective response, but are still to be identified. Limitations of our study are: (a) nonhomogenous indication for treatment, (b) small rate and degree of non compliance in our sample. Relationships between therapeutic ambition, type of symptoms and treatment outcome should be further studied.

Veille bibliographique sur la surveillance biologique de l'exposition aux produits chimiques au poste de travail : l'expérience d'un réseau francophone multidisciplinaire

Une veille bibliographique est organisée depuis 2005 sur la surveillance biologique aux produits chimiques en milieu de travail (SBEPC MT). Elle a été mise en place par le réseau francophone multidisciplinaire, composé de l'INRS (France), l'IRSST (Québec) et l'UCL (Belgique). Cet article dresse le bilan de l'information récoltée et analysée, de 2009 à 2012, au travers de 435 articles sélectionnés. Plusieurs thèmes d'intérêt ou d'actualités font l'objet d'une analyse plus approfondie, dont notamment les pesticides, les hydrocarbures aromatiques, le benzène, le mangannèse, la variabilité biologique, les dosages cutanés et frottis de surface, les dosages dans l'air expiré ou encore la spectrométrie de masse.

Discours sur l'expérience et la raison, dans lequel on montre la nécessité de les joindre dans la physique, dans la médecine et dans la chirurgie, par Monsieur Bayle,...

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