Psychiatrie sous double contrainte, enjeux de la planification en santé mentale [Psychiatry under double bind, issue of the planification in mental health]

Given the important modifications of the "Loi sur l'Assurance maladie (LAMal)", this article gives a contribution to the hospital planification by identifying the main factors that have determined the current organisation of the psychiatric care network. We notice a gap between the orientations of these networks and the funding scheme forecast in the framework of the LAMal. In order to preserve the progressions of these last years and to avoid the negative effects of a too restrictive funding act for the assignment of the public psychiatry, the planification must result in a consensus between the state, the insurances and the multiple actors of the mental health. Otherwise, this will be done to the detriment of the activities of secondary prevention, of coordination in the network, of support to the natural helpers, and of intervention to the vulnerable populations.

Dancing double binds : feminine virtue and women’s work in Kinshasa

Les femmes de Kinshasa, en République Démocratique du Congo, ont toujours été actives dans le commerce local. L’élévation de leur niveau d’études, ainsi que des circonstances économiques difficiles nécessitant deux salaires par famille, les poussent aujourd’hui vers de nouveaux métiers. Alors qu’elles deviennent plus visibles dans les sphères politiques et économiques, elles sont sujettes à de nouvelles formes de méfiance et d’accusation morale. C'est dans ce contexte que les notions de féminité et de vertu féminine sont définies aujourd'hui. Lorsque les femmes congolaises émigraient vers la ville de Léopoldville à l’ère coloniale, elles étaient confrontées à de nouvelles attentes sociales. Il était attendu qu’elles se « modernisent » et se « civilisent » tout en gardant leur rôle « traditionnel » au foyer et auprès de leur famille. Je voudrais démontrer que ce paradoxe continue d’influencer les représentations de la vertu féminine à Kinshasa aujourd'hui, notamment en établissant une distinction entre la femme « vertueuse » et « non vertueuse ». Cette thèse explore les façons dont les femmes participent et négocient leur nouveau statut et rôle à la lumière de ce paradoxe. Plutôt que de réifier la dichotomie locale entre la femme « vertueuse » et « non vertueuse », j’explore les causes sous-jacentes et les résultats inattendus de ces catégorisations. Je porte une réflexion sur la vertu féminine comme étant construite et influencée par ce qu'on pourrait nommer le « triple patriarcat » alimenté par des valeurs « traditionnelles », par des initiatives coloniales et postcoloniales menées par l'état, ainsi que par des discours pentecôtistes. J’examine d’autre part comment ces facteurs ont engendré une double contrainte, un dilemme en la forme d’injonctions contradictoires, encourageant les femmes à jouer simultanément des rôles opposés, et à devoir soigneusement gérer leur image en public. Je montre enfin que cette double posture des femmes alimente la méfiance entre les deux sexes, impactant sur la perception des femmes au travail et dans la société de manière générale, de même que les projections qu’en fait la culture populaire. Car c'est une des professions les plus visibles pour les femmes de Kinshasa, le rôle de danseuse de concert est très utile pour illuminer les défis auxquels ces femmes sont confrontées. Cette thèse fournit donc un portrait ethnographique des danseuses, et se penche sur leur statut d’objets publics de désir afin de révéler la façon dont leur visibilité met en évidence les conceptions locales de la liberté, du pouvoir et de la féminité.

SEMELHANÇAS ENTRE UPTAKE E TRACE: CONSIDERAÇÕES SOBRE TRADUÇÃO

This study is a reflection about the similarities between uptake and trace, and translation taken as an event - at once possible and impossible - which deflagrates and constitutes meaning through the language game played by the subjects of communication: text-translator. Both Austin and Derrida, each one on his own way, show that meaning is part of the human language process. The uptake, in Austin s point of view, guarantees the existence of human language, assured by a process of recognition between the subjects of communication, process through which the production of meaning takes place. The trace, according to Derrida, deflagrates, through the human language, the crashing of meaning and destroys the possibility of someone reaching the origin. In this study, taking into consideration the similarities between uptake and trace, I try to disclose translation taken as an event which at once contaminates the languages and is contaminated by them.

Bioavailability of fluoride administered as sodium fluoride or monofluorophosphate to humans

A double-bind cross-over study was conducted on four healthy subjects, aged 19-29 years, in order to determine the relative bioavailability and other pharmacokinetics features of fluoride (F) after single oral administration in fasting conditions of 2 mg F as sodium F (NaF) or sodium monofluorophosphate (MFP). The bioavailability was evaluated on the basis of the plasma levels and of the urinary excretion of F. Blood was sampled before and during the 8 h after the administration of the test solutions. For F excretion urine was sampled 12 h before the study and over the 8 h after the administration. Data were tested for statistically significant differences by ANOVA and Tukey`s post hoc tests, and also by Student`s t-test (p < 0.05). For the two formulations, the pharmacokinetics of F in plasma was characterized by a rapid absorption and by a peak (C-max = 0.1 mu g/mL) which was reached 20 min after administration, followed by a biphasic elimination. In the 8 h following the administration the urinary excretion of F accounted for 35-41% of the administered dose, without significant differences between the two formulations. The AUCs (+/- S.D.) for NaF and MFP were 21.15 (+/- 0.58) and 19.04 (+/- 1.75) min mu g mL(-1), respectively, and were not significantly different (p = 0.079). Based on the AUC and C-max of F in plasma and on the urinary excretion of F during the 8 h following administration, the relative bioavailabilities of the two F formulations were equivalent. (c) 2008 Elsevier B.V. All rights reserved.

Aprendizagem e Comunicação em Bateson: A exigência de uma epistemologia Formal e Complexa

RESUMO: Para Bateson, a mudança social radicaria numa mudança epistemológica profunda que incidisse sobretudo na educação e na comunicação (onde incluía a sua teorização psicológica). Essa revolução paradigmática, baseada na lógica formal de Whitehead e Russell, evitaria discursos ditos científicos destituídos de rigor. Aqui, analisamos hermeneuticamente o seu pensamento, salientando os limites que a lógica formal encontra nas experiências éticas, religiosas e estéticas. Sem essa revolução, encontramo-nos condenados à estagnação intelectual, pois formamos cidadãos sem capacidade de aprender a aprender, que possibilitaria a capacidade de produzir abduções, inferência lógica tão necessária na produção do raciocínio humano; o seu desenvolvimento garantiria a capacidade de pensar/construir complexamente o mundo, interligando os saberes; poucos são também aqueles que explicitam e argumentam a favor das suas crenças, base axiomática da capacidade abdutiva. A organização social (via sistema educativo, formal e não formal) se constrói com sujeitos que raramente possuem mentes bem estruturadas, favorecedoras de passagem de patamares de aprendizagem para outros superiores. Antes se estimula a confusão de tipos lógicos, tomando o todo pela parte, por exemplo. Bateson critica também o sistema de avaliação quantitativo, diminuindo a possibilidade de formação do pensamento abstrato e formal, como a filosofia e a matemática exigem.

Visual word learning in good and poor readers

Forty students from regular, grade five classes were divided into two groups of twenty, a good reader group and a' poor reader group, on the basis. of their reading scores on Canadian Achievement Tests. .The subjects took. part in four experimental conditions iM which they .learned lists of pronounceable and unprono~nceable pseudowords, some with semantic referents, and responded to questions designed tci test visual perceptu~l learning and lexical ·and semantic association learning. It' was hypothesized "that the good reade~ group would be able to make use of graphemic and phonemic redundancy patterns in order to improv~·visuSl perceptual learning and lexical and semantic association lea~ningto a greater extent. than would .the poor reader gr6up. The data supported this hypothesis, and also indicated that, although the poor readers were less adept at using familiar sound and letter patterns, they were more dependent on· such pa~terns as an aid to visual recognition memory and semantic recall than were the good readers. It wa.s postulated that poor readers are in a double- ~ . bind situatio~ of having to choose between using weak graphemic-semantic associations or gr~pheme-phoneme associations which are also weak and which have hindered them in developing automaticity in. reading.

Reproduire pour déconstruire : le paradoxe de l'engagement dans la série Body techniques de Carey Young

La série Body Techniques (2007) a été réalisée par l’artiste britannique Carey Young dans le cadre d’une résidence offerte par la biennale de Sharjah, aux Émirats Arabes Unis. Les huit photographies de format tableau constituant la série montrent l’artiste qui, portant l’uniforme d’une femme d’affaires, réinterprète huit œuvres célèbres associées à la mouvance de l’art conceptuel. Des paysages singuliers, situés aux abords des villes de Sharjah et Dubaï, servent de toile de fond à ces actions et leur confèrent une aura futuriste. La présente analyse tâche de démontrer que la série est habitée par un paradoxe remettant en question le statut d’art engagé que l’artiste revendique pour son œuvre. Ce paradoxe se manifeste à travers trois axes, autour desquels s’articule notre réflexion : les médiations se glissant entre Body Techniques et les œuvres que la série réinterprète, la déconstruction du « médium » du paysage, et le rôle actif occupé par le dispositif photographique. Cet examen attentif de chacune des occurrences du paradoxe permet de révéler Body Techniques comme une incarnation exemplaire de la double contrainte traversant toute œuvre d’art contemporain engagé : celle permettant aux artistes de critiquer le système auquel ils participent, mais les forçant en retour à participer au système qu’ils critiquent.

Impression management, myth creation and fabrication in private social and environmental reporting: insights from Erving Goffman

This paper explores the nature of private social and environmental reporting (SER). From interviews with UK institutional investors, we show that both investors and investees employ Goffmanesque, staged impression management as a means of creating and disseminating a dual myth of social and environmental accountability. The interviewees’ utterances unveil private meetings imbued with theatrical verbal and physical impression management. Most of the time, the investors’ shared awareness of reality belongs to a Goffmanesque frame whereby they accept no intentionality, misrepresentation or fabrication, believing instead that the ‘performers’ (investees) are not intending to deceive them. A shared perception that social and environmental considerations are subordinated to financial issues renders private SER an empty encounter characterised as a relationship-building exercise with seldom any impact on investment decision-making. Investors spoke of occasional instances of fabrication but these were insufficient to break the frame of dual myth creation. They only identified a handful of instances where intentional misrepresentation had been significant enough to alter their reality and behaviour. Only in the most extreme cases of fabrication and lying did the staged meeting break frame and become a genuine occasion of accountability, where investors demanded greater transparency, further meetings and at the extreme, divested shares. We conclude that the frontstage, ritualistic impression management in private SER is inconsistent with backstage activities within financial institutions where private financial reporting is prioritised. The investors appeared to be in a double bind whereby they devoted resources to private SER but were simultaneously aware that these efforts may be at best subordinated, at worst ignored, rendering private SER a predominantly cosmetic, theatrical and empty exercise.

Impression management, fabrication and myth creation in private social and environmental reporting: insights from Erving Goffman

This paper explores the nature of private social and environmental reporting (SER). From interviews with UK institutional investors, we show that both investors and investees employ Goffmanesque, staged impression management as a means of creating and disseminating a dual myth of social and environmental accountability. The interviewees’ utterances unveil private meetings imbued with theatrical verbal and physical impression management. Most of the time, the investors’ shared awareness of reality belongs to a Goffmanesque frame whereby they accept no intentionality, misrepresentation or fabrication, believing instead that the ‘performers’ (investees) are not intending to deceive them. A shared perception that social and environmental considerations are subordinated to financial issues renders private SER an empty encounter characterised as a relationship-building exercise with seldom any impact on investment decision-making. Investors spoke of occasional instances of fabrication but these were insufficient to break the frame of dual myth creation. They only identified a handful of instances where intentional misrepresentation had been significant enough to alter their reality and behaviour. Only in the most extreme cases of fabrication and lying did the staged meeting break frame and become a genuine occasion of accountability, where investors demanded greater transparency, further meetings and at the extreme, divested shares. We conclude that the frontstage, ritualistic impression management in private SER is inconsistent with backstage activities within financial institutions where private financial reporting is prioritised. The investors appeared to be in a double bind whereby they devoted resources to private SER but were simultaneously aware that these efforts may be at best subordinated, at worst ignored, rendering private SER a predominantly cosmetic, theatrical and empty exercise.

Per un'etica della letteratura: la cornice il doppio legame nell'opera di J. M. Coetzee

The elusive fiction of J. M. Coetzee is not a work in which you can read fixed ethical stances. I suggest testing the potentialities of a logic based on frames and double binds in Coetzee's novels. A double bind is a dilemma in communication which consists on tho conflicting messages, with the result that you can’t successfully respond to neither. Jacques Derrida highlighted the strategic value of a way of thinking based on the double bind (but on frames as well), which enables to escape binary thinking and so it opens an ethical space, where you can make a choice out of a set of fixed rules and take responsibility for it. In Coetzee’s fiction the author himself can be considered in a double bind, seeing that he is a white South African writer who feels that his “task” can’t be as simply as choosing to represent faithfully the violence and the racism of the apartheid or of choosing to give a voice to the oppressed. Good intentions alone do not ensure protection against entering unwittingly into complicity with the dominant discourse, and this is why is important to make the frame in which one is always situated clearly visible and explicit. The logic of the double bind becomes the way in which moral problem are staged in Coetzee’s fiction as well: the opportunity to give a voice to the oppressed through the same language which co-opted to serve the cause of oppression, a relation with the otherness never completed, or the representability of evil in literature, of the secret and of the paradoxical implications of confession and forgiveness.