Instances d'aliénation: portrait du patient tiraillé 1. Individu et contexte [Instances of alienation: portrait of the torn patient. I. Individual and context].

While the past decades were marked by an increased interest for the existential situation of man suffering from disease, the mechanisms alienating the patient from himself and from his context have been poorly investigated. These mechanisms, though operating in a dynamic interaction, will be discussed here sequentially. The first part of this article focuses on individual mechanisms of alienation emerging from the relationship the patient establishes with his body and psyche and on those related to his relational context. The aim is not to comprehensively describe these phenomena, but to discuss--based on clinical vignettes--some examples and their implications. The second part of the article describes some mechanisms of alienation that are incorporated in the medical apparatus and the dominant discourses.

[Portrait de M. Clémenceau] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57649

Critical thinking and accuracy of nurses' diagnoses. Part II: application of cognitive skills and guidelines for self-development

Part I of this article, the author explained the difficulties of achieving accuracy of nurses' diagnoses, the relevance of critical thinking to the achievement of accuracy, and newer views of critical thinking. In Part II, the critical thinking dimensions identified as important for nursing practice are applied in the diagnostic process using a case study of a 16 year old girl with type 1 diabetes. Application of seven cognitive skills and ten habits of mind illustrate the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.

Cliché de M. Lamoureux [portrait d'une femme] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57190

[Portrait du] duc Johann Albrecht [de Mecklenburg] qui fut le 1er régent de Brunswick [décédé le 16/2/20] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58113

[Portrait du] vice-amiral Sidney Fremantle : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58211

Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III).

Study design:Cross-sectional validation study.Objectives:To develop and validate a self-report version of the Spinal Cord Independence Measure (SCIM III).Setting:Two SCI rehabilitation facilities in Switzerland.Methods:SCIM III comprises 19 questions on daily tasks with a total score between 0 and 100 and subscales for 'self-care', 'respiration & sphincter management' and 'mobility'. A self-report version (SCIM-SR) was developed by expert discussions and pretests in individuals with spinal cord injury (SCI) using a German translation. A convenience sample of 99 inpatients with SCI was recruited. SCIM-SR data were analyzed together with SCIM III data obtained from attending health professionals.Results:High correlations between SCIM III and SCIM-SR were observed. Pearson's r for the total score was 0.87 (95% confidence interval (CI) 0.82-0.91), for the subscales self-care 0.87 (0.81-0.91); respiration & sphincter management 0.81 (0.73-0.87); and mobility 0.87 (0.82-0.91). Intraclass correlations were: total score 0.90 (95% CI 0.85-0.93); self-care 0.86 (0.79-0.90); respiration & sphincter management 0.80 (0.71-0.86); and mobility 0.83 (0.76-0.89). Bland-Altman plots showed that patients rated their functioning higher than professionals, in particular for mobility. The mean difference between SCIM-SR and SCIM III for the total score was 5.14 (point estimate 95% CI 2.95-7.34), self-care 0.89 (0.19-1.59), respiration & sphincter management 1.05 (0.18-2.28 ) and mobility 3.49 (2.44-4.54). Particularly patients readmitted because of pressure sores rated their independence higher than attending professionals.Conclusion:Our results support the criterion validity of SCIM-SR. The self-report version may facilitate long-term evaluations of independence in persons with SCI in their home situation.

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58008

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58009

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58013

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58012

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58011

[Portrait de Louis] Vasseur, athlète : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58010

Julliard [portrait du boxeur] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58119

[Portrait de] M. Clémenceau : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57648