Stratégies de communication au service de la formation: quelques outils pratiques [Effective communication strategies to frame the trainer-trainee dialogue in the clinical setting].

Communication between trainer and trainee plays a central role in teaching and learning in the clinical environment. There are various strategies to frame the dialogue between trainee and trainer. These strategies allow trainers to be more effective in their supervision, which is important in our busy clinical environment. Communication strategies are well adapted to both in- and out-patient settings, to both under- and postgraduate contexts. This article presents three strategies that we think are particularly useful. They are meant to give feedback, to ask questions and to present a case.

Les paradoxes de l'argumentation en contexte d'éducation : s'accorder sur les désaccords. Analyse d'interactions argumentatives dans un dispositif de formation en psychologie à l'Université

Dans le chapitre « Les paradoxes de l'argumentation en contexte d'éducation: s'accorder sur les désaccords », Muller Mirza part de l'idée qu'à la différence des situations ordinaires de désaccords, les dispositifs utilisant l'argumentation dans des contextes d'éducation demandent aux participants précisément de résoudre ces désaccords. Leur sont donc interdites, par contrat plus ou moins implicite, les échappatoires auxquelles nous recourons volontiers dans les discours quotidiens qui permettent d'éviter de problématiser la question en discussion. C'est dire qu'elle aborde directement une difficulté souvent signalée dans les études sur l'argumentation en contexte éducatif : la tension entre d'une part l'expression de points de vue différents, étape nécessaire à la construction des connaissances, et d'autre part la préservation de la relation entre les interlocuteurs, de leurs faces. Le chapitre propose comme objet de discussion le rôle de cette tension dans des situations d'apprentissage en analysant des productions argumentatives réalisées dans le cadre d'un dispositif particulier. Il invite ainsi à une réflexion non seulement sur les ingrédients des dispositifs pédagogiques qui permettraient de prendre en compte cette tension mais aussi sur les méthodes d'analyse des interactions argumentatives. L'étude de cas met en scène des étudiants de master en psychologie sociale, dans le cadre d'un jeu de rôle : ils sont placés dans la perspective de leur futur métier, et figurent des psychologues conseillant des éducateurs face à des jeunes qui utilisent des insultes racistes entre eux. Le dispositif mis en oeuvre satisfait quatre exigences d'ordre théorique, favorables selon l'auteure à une bonne résolution des désaccords : le ménagement des faces des interlocuteurs en fixant des rôles ne correspondant pas nécessairement aux positions de chacun ; la construction de connaissances,préalable à la discussion ; la médiation de l'échange par un outil, ici un « chat », qui permet d'échanger les points de vue et d'apporter une dimension réflexive en cours d'interaction sur les points de vue exprimés ; le fait de donner du sens à l'activité, en simulant une situation professionnelle potentielle. L'analyse des échanges a été réalisée sur onze corpus constitués par les étudiants en petits groupes de trois ou quatre travaillant sur un logiciel de « chat ». Les questions abordées étaient les suivantes : Comment les interlocuteurs négocient-ils les désaccords qui apparaissent au cours des échanges? Ces désaccords sont-ils propices à une problématisation? Les participants mettent-ils en oeuvre des dynamiques d'« exploration » du désaccord relevé? Cette analyse, inspirée d'une approche socioculturelle reprise en partie des travaux de Neil Mercer sur les « discours exploratoires », met en évidence des dynamiques argumentatives de qualité au cours desquels les désaccords sont non seulement exprimés mais également problématisés au sein des groupes. Elle met entre autres en évidence que le sens de l'activité pour les étudiants est en partie tributaire d'un contrat didactique et pédagogique : leurs échanges sont la base de leur évaluation universitaire. Néanmoins la similitude entre situation d'enseignement et situation professionnelle a largement été perçue par les étudiants et motivante pour eux, ce qui a certainement concouru également à la qualité des échanges.

p-Nitrobenzyloxycarbonyl (pNZ) as Temporary Na-Protecting Group for Mild Solid-Phase Peptide Synthesis. Avoiding Diketopiperazine and Aspartimide Formation

p-Nitrobenzyloxycarbonyl was used as temporary protecting group for the -amino function in solid-phase peptide synthesis. The corresponding derivatives are solids, easy to be synthesized, and perform well in the solid-phase mode. pNZ is removed in practical neutral conditions in the presence of catalytic amounts of acid. They are orthogonal with the most common protecting groups used in peptide chemistry. They are specially useful in combination with Fmoc chemistry to overcome those side reactions associated with the used of the piperidine such DKP and aspartiimide formation. The flexibility of pNZ can be very useful for the preparation of libraries of small organic molecules.

Auto Poisoning of the Respiratory Chain by a Quorum-Sensing-Regulated Molecule Favors Biofilm Formation and Antibiotic Tolerance.

Bacterial programmed cell death and quorum sensing are direct examples of prokaryote group behaviors, wherein cells coordinate their actions to function cooperatively like one organism for the benefit of the whole culture. We demonstrate here that 2-n-heptyl-4-hydroxyquinoline-N-oxide (HQNO), a Pseudomonas aeruginosa quorum-sensing-regulated low-molecular-weight excreted molecule, triggers autolysis by self-perturbing the electron transfer reactions of the cytochrome bc1 complex. HQNO induces specific self-poisoning by disrupting the flow of electrons through the respiratory chain at the cytochrome bc1 complex, causing a leak of reducing equivalents to O2 whereby electrons that would normally be passed to cytochrome c are donated directly to O2. The subsequent mass production of reactive oxygen species (ROS) reduces membrane potential and disrupts membrane integrity, causing bacterial cell autolysis and DNA release. DNA subsequently promotes biofilm formation and increases antibiotic tolerance to beta-lactams, suggesting that HQNO-dependent cell autolysis is advantageous to the bacterial populations. These data identify both a new programmed cell death system and a novel role for HQNO as a critical inducer of biofilm formation and antibiotic tolerance. This newly identified pathway suggests intriguing mechanistic similarities with the initial mitochondrial-mediated steps of eukaryotic apoptosis.

NG2 glia are required for vessel network formation during embryonic development.

The NG2(+) glia, also known as polydendrocytes or oligodendrocyte precursor cells, represent a new entity among glial cell populations in the central nervous system. However, the complete repertoire of their roles is not yet identified. The embryonic NG2(+) glia originate from the Nkx2.1(+) progenitors of the ventral telencephalon. Our analysis unravels that, beginning from E12.5 until E16.5, the NG2(+) glia populate the entire dorsal telencephalon. Interestingly, their appearance temporally coincides with the establishment of blood vessel network in the embryonic brain. NG2(+) glia are closely apposed to developing cerebral vessels by being either positioned at the sprouting tip cells or tethered along the vessel walls. Absence of NG2(+) glia drastically affects the vascular development leading to severe reduction of ramifications and connections by E18.5. By revealing a novel and fundamental role for NG2(+) glia, our study brings new perspectives to mechanisms underlying proper vessels network formation in embryonic brains.

Amiodarone biokinetics, the formation of its major oxidative metabolite and neurotoxicity after acute and repeated exposure of brain cell cultures.

The difficulty in mimicking nervous system complexity and cell-cell interactions as well as the lack of kinetics information has limited the use of in vitro neurotoxicity data. Here, we assessed the biokinetic profile as well as the neurotoxicity of Amiodarone after acute and repeated exposure in two advanced rodent brain cell culture models, consisting of both neurons and glial cells organized in 2 or 3 dimensions to mimic the brain histiotypic structure and function. A strategy was applied to evidence the abiotic processes possibly affecting Amiodarone in vitro bioavailability, showing its ability to adsorb to the plastic devices. At clinically relevant Amiodarone concentrations, known to induce neurotoxicity in some patients during therapeutic treatment, a complete uptake was observed in both models in 24h, after single exposure. After repeated treatments, bioaccumulation was observed, especially in the 3D cell model, together with a greater alteration of neurotoxicity markers. After 14days, Amiodarone major oxidative metabolite (mono-N-desethylamiodarone) was detected at limited levels, indicating the presence of active drug metabolism enzymes (i.e. cytochrome P450) in both models. The assessment of biokinetics provides useful information on the relevance of in vitro toxicity data and should be considered in the design of an Integrated Testing Strategy aimed to identify specific neurotoxic alerts, and to improve the neurotoxicity assay predictivity for human acute and repeated exposure.

Spontaneous perforation of gallbladder with intrahepatic biloma formation: sonographic signs and correlation with computed tomography

Spontaneous perforation of gallbladder is a severe and infrequent complication of acute cholecystitis that requires early and accurate diagnosis. Concomitant development of intrahepatic collections is rarely observed in such cases. The present report emphasizes the relevance of imaging studies in this setting, describing the typical sonographic and tomographic findings for the diagnosis of such condition.

Brief report : Academic amotivation in light of the dark side of identity formation

The study intended to determine motivational profiles of first-year undergraduates and aimed their characterization in terms of identity processes. First, a cluster analysis revealed five motivational profiles: combined (i.e., high quantity of motivation, low amotivation); intrinsic (i.e., high intrinsic, low introjected and external regulation, low amotivation); "demotivated" (i.e., very low quantity of motivation and amotivation); extrinsic (i.e., high extrinsic and identified regulation and low intrinsic and amotivation); and "amotivated" (i.e., low intrinsic and identified, very high amotivation). Second, using Lebart's (2000) methodology, the most characteristic identity processes were listed for each motivational cluster. Demotivated and amotivated profiles were refined in terms of adaptive and maladaptive forms of exploration. Notably, exploration in breadth and in depth were underrepresented in demotivated students compared to the total sample; commitment and ruminative exploration were under and overrepresented respectively in amotivated students. Educational and clinical implications are proposedand future research is suggested.