La réhabilitation psychosociale a l'aube du XXIème siècle. I: Principes, population cible et pathologie en cause

The relatively recent development of the psychosocial rehabilitation has its origins mainly in the progress of modern psychopharmacology, the assertion of the rights of the patients and the result of the studies showing that the evolution of persons suffering from severe and persistent mental illnesses can prove to be positive in many cases. In spite of the heterogeneity of the experiences and of the theoretical references, the core principles of the psychosocial rehabilitation imposed themselves. These principles can be classified according to three levels, that of relational ethics, that of the method of intervention and that of the institutional device. A recent study showed that 2.4@1000 of the general adult population of the Canton of Vaud live in sociotherapeutic and rehabilitation accommodations. In this sample, there is a important percentage of relatively young persons (55.3% are under 40). In institutional accommodation there is a majority of patients suffering from major personality disorders and addiction (40.6%), followed by psychotic disorders (37.2%), persistent mood disorders (12.3%), neurotic disorders (6.6%) and psycho-organic disorders (3.3%). In home based rehabilitation, the ratio of patients with psychotic disorders is more important (53.1%). This difference would indicate that people with schizophrenia would have a better social outcome than personality disorders with addiction

Early change in defence mechanisms and coping in short-term dynamic psychotherapy: relations with symptoms and alliance.

Several patient-related variables have already been investigated as predictors of change in psychodynamic psychotherapy. Defensive functioning is one of them. However, few studies have investigated adaptational processes, encompassing defence mechanisms and coping, from an integrative or comparative viewpoint. This study includes 32 patients, mainly diagnosed with adjustment disorder and undergoing time-limited psychodynamic psychotherapy lasting up to 40 sessions, and will focus on early change in defence and coping. Observer-rater methodology was applied to the transcripts of two sessions of the first part of the psychotherapeutic process. It is assumed that the contextual-relational variable of therapeutic alliance intervenes as moderator on change in adaptational processes. Results corroborated the hypothesis, but only for coping, whereas for defences, overall functioning remained stable over the first 20 sessions of psychotherapy. These results are discussed within the framework of disentangling processes underlying adaptation, i.e., related to issues on trait and state aspects, as well as the role of the therapeutic alliance.

Behavioral assumptions and management ability

The paper explores the consequences that relying on different behavioral assumptions intraining managers may have on their future performance. We argue that training with anemphasis on the standard assumptions used in economics (rationality and self-interest) is goodfor technical posts but may also lead future managers to rely excessively on rational and explicitsafeguarding, crowding out instinctive relational heuristics and signaling a bad human type topotential partners. In contrast, human assumptions used in management theories, because oftheir diverse, implicit and even contradictory nature, do not conflict with the innate set ofcooperative tools and may provide a good training ground for such tools. We present tentativeconfirmatory evidence by examining how the weight given to behavioral assumptions in the corecourses of the top 100 business schools influences the average salaries of their MBA graduates.Controlling for the self-selected average quality of their students and some other schools characteristics, average salaries are seen to be significantly greater for schools whose core MBAcourses contain a higher proportion of management courses as opposed to courses based oneconomics or technical disciplines.

Bases de dades relacionals

Aquest projecte neix de la necessitat de donar una solució a l'associació mundial de jugadors de bàsquet. Se'ns ha demanat crear una nova base de dades on tota la informació dels jugadors de bàsquet i el seu entorn quedin centralitzades.

Disseny i implementació de la base de dades d'un sistema de gestió d'informació de jugadors de bàsquet

L'objectiu d'aquest treball és planificar, dissenyar i implementar la base de dades d'un sistema de gestió d'informació de jugadors de bàsquet que servirà per donar resposta a la necessitat dels jugadors de bàsquet a nivell mundial, de tal forma que es creï una nova plataforma centralitzada per tal d'unificar la informació de cadascun d'ells i permetre els equips i les federacions disposar d'aquesta informació a l'hora d'escollir els jugadors que integraran els diferents equips.

Sistema de gestión de información de jugadores de baloncesto

Proyecto para la gestión de información relativa a jugadores profesionales de baloncesto a nivel mundial, así como de sus estadísticas de juego y contratos.

Mastectomy, body deconstruction, and impact on identity: a qualitative study.

Objectives This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. Design Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. Method Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. Results Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. Conclusion With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.

Bases de datos XML nativas

Conèixer les diferents opcions a l'hora d'emmagatzemar dades i documents amb format XML. Familiaritzar-se amb els SGBD nadius i l'accés i maneig de la informació. Conèixer diferents formes d'accés al SGBD, conèixer les APIs disponible Centre en el llenguatge Java. Integració de tots els coneixements adquirits, desenvolupant una aplicació que accedeixi i gestioni dades emmagatzemades al SGBD.

Cumulative risk factors for adolescent alcohol misuse and its perceived consequences among 16 to 20 year old adolescents in Switzerland.

AIMS: To assess the cumulative impact of environmental and individual factors associated with adolescent alcohol misuse and their correlation with self-reported consequences of drinking. METHOD: Cross-sectional school-based survey of a nationally representative sample of 7548 post-mandatory school students and apprentices aged 16-20 years, Switzerland 2002. Alcohol misuse defined by frequency of alcohol use, episodes of drunkenness and driving while drunk. RESULTS: Fifteen significant risk factors were identified among both boys, and girls. An individual score of cumulated risk factors was created by adding the risk factors. The association between the score and the likelihood of being engaged in alcohol misuse was highly significant and dose-dependent (p<.001). A significant proportion of adolescents report perceived adverse consequences of their alcohol consumption. A linear trend (p<.001) was found between the score of risk factors and the proportion of respondents reporting problems related to drinking such as diminished school performance, physical hazard, relational problems and current risky sexual behavior. CONCLUSION: Risk factors for adolescent alcohol misuse are cumulative and can be synthesized into an individual score correlated with the likeliness of misuse. A further indication of the validity of this score is its linear relationship with self-reported problems related to drinking.

Alteritzar la singularitat: veus per a una pedagogia de l'experiència

Parte de la investigación en torno a la realidad educativa que se ha desarrollado durante los últimos años se caracteriza por intentar encontrar formas de interpretación orientadas a significar los procesos formativos centrados en las vivencias singulares de los agentes que participan de la educación así como en la posibilidad que éstas ofrecen de devenir experiencia, eso es,vivencia concienciada. A raíz de las mismas podemos observar como la biografía apunta a ser una de las más emblemáticas formalizaciones del proceso de narración de vivencias. Pero, aún cuando la misma se perfila como una de las narraciones que más promueven la interpretación e intercambio de vivencias, posibilitando la reflexión e, incluso, formación mediada, la biografía todavía presenta como forma teorética algunos escollos. Los cuales, pueden ser utilizados como preguntas base para formular una voz de las pedagogías de la experiencia. Justamente, interrogarse y repensar su factibilidad es el tema que se ensaya en el presente artículo.

Entorn de gestió de dades d'ornitologia

Des de fa uns anys, des de l’EPS de la UVic, s’està duent a terme el desenvolupament d’un dispositiu electrònic que proporciona la capacitat de capturar dades sobre un niu d’ocells. El projecte e-niu, que es pot seguir a www.tutara.info/e-niu, està actualment en una fase de test., i s’ha desenvolupat sobretot la part hardware. Aquest projecte té com a objectiu principal crear un entorn web per poder gestionar les dades que s’obtenen del niu d’ocells informatitzat (e-niu). Les dades que ens arriben dels e-nius estan en un arxiu de text, i el que es pretén és que l’usuari que controla el niu, pugui fer diversos anàlisis de les dades d’aquest. A més de poder veure els resultats en diversos tipus de gràfics, també se li vol donar la opció de treure els resultats en format taula o en format Excel, un format aquest últim, molt interessant, ja que donaria a les dades una gran possibilitat de ser tractades posteriorment, com fer seleccions del tipus de dades, treure percentatges, crear altres tipus de gràfics, etc. L’altre gran objectiu és el fet de poder treballar en la creació d’un entorn web complert a nivell gairebé professional amb l’aprenentatge que això comporta, ja que s’ha aplicat la tecnologia client-servidor, és a dir, que el llenguatge de programació està dins el servidor, i quan algun usuari l’executa, el sistema només li envia la presentació en HTML. El sistema de programació que es fa servir és el de les tres capes. La capa de dades, que està formada per una base de dades relacional del tipus MySQL i és on emmagatzemarem tota la informació. La capa de programació de la que s’encarrega el llenguatge PHP, és on s’efectua tot el tractament de les dades i finalment, la capa de presentació, que és la que s’encarrega de mostrar les dades al client en el navegador mitjançant els templates de HTML.

Difficulties associated with outpatient management of drug abusers by general practitioners. A cross-sectional survey of general practitioners with and without methadone patients in Switzerland.

BACKGROUND: In Switzerland, general practitioners (GPs) manage most of the patients receiving methadone maintenance treatment (MMT). METHODS: Using a cross-sectional postal survey of GPs who treat MMT patients and GPs who do not, we studied the difficulties encountered in the out-patient management of drug-addicted patients. We sent a questionnaire to every GP with MMT patients (556) in the French-speaking part of Switzerland (1,757,000 inhabitants). We sent another shorter questionnaire to primary care physicians without MMT patients living in the Swiss Canton of Vaud. RESULTS: The response rate was 63.3%. The highest methadone dose given by GPs to MMT patients averaged 120.4 mg/day. When asked about help they would like to be given, GPs with MMT patients primarily mentioned the importance of receiving adequate fees for the care they provide. Secondly, they mentioned the importance of better training, better knowledge of psychiatric pathologies, and discussion groups on practical cases. GPs without MMT patients refuse to treat these patients mostly for emotional and relational reasons. CONCLUSION: GPs encounter financial, relational and emotional difficulties with MMT patients. They desire better fees for services and better training.

La Multi-metodología Autobiográfica Extendida (MAE). Una estrategia cualitativa para estudiar la identidad, los fondos de conocimiento y las formas de vida

La multi-metodología autobiográfica es una aproximación cualitativa que combina distintas técnicas para estudiar la construcción narrativa de la identidad. El objetivo de este artículo es ofrecer una revisión de dicho enfoque a partir de una expansión de los distintos instrumentos cualitativos utilizados. Más concretamente, la multi-metodología autobiográfica extendida (MAE) consta de cuatro grupos de técnicas: entrevistas en profundidad (historia de vida, entrevista de fondos de conocimiento y la entrevista de Durand), el retrato o dibujo identitario revisado (dibujo identitario, auto-definición, tarea identitaria de las diez definiciones), el análisis de los artefactos-rutinas-formas de vida (diario de una semana, detección de artefactos, rutinas a través de fotografías, rutinas educativas a través de fotografías ) y la utilización de distintos “mapas psicológicos o psicogeográficos” (cronograma, genograma, ecomapa, geomapa y mapa relacional). Después de definir la identidad, los fondos de conocimiento y las formas de vida como posibles objetos de estudio en ciencias sociales, el artículo describe e ilustra las distintas técnicas que componen la metodología propuesta. Se concluye recomendando la triangulación de técnicas cualitativas narrativas basadas en el lenguaje, el caso de las tradicionales entrevistas en profundidad, con determinados procedimientos visuales, a partir de la utilización de fotografías o representaciones gráficas

Que cache l'agenda caché [What is behind the hidden agenda?]

The physicians often forget to ask their patients if they would like to discuss other complaints or topics. It is sometimes quite difficult to explore the patient's complaints; while the physicians tend to focus on the immediate problem, the patients may have not only one, but several hidden agendas during a visit. In a caring relation there is a clear advantage to clarify the implicit. The search for the hidden agenda is to improve the care of i) biomedical problems ii) the social quest presented to the physicians. The sentence "Oh, by the way, doctor..." should not be only understood as an information but also as a relational expression and a reaction to the imminent separation from the physician.

Autism in schizophrenia revisited.

The concept of autism is reviewed in its historical evolution. It is suggested that the Bleulerian insistence on the withdrawal component in autism contributed to the decline of its use in adult psychiatry. Phenomenology offers another approach to grasping the nature of autism as a relational (subject-outer world) phenomenon. European phenomenological psychiatry in the field of schizophrenia is introduced and its attempts to reveal the essence of autism are presented. Autism is here considered as a "loss of vital contact with reality" (Minkowski), "inconsistency of natural experience" (Binswanger), or "the global crisis of common sense" (Blankenburg). It is proposed that autism represents dysfunctional perceptual/expressive attunement to the outer world. The usefulness of this concept is briefly examined in relation to the diagnosis and etiopathogenesis of schizophrenia.