Evaluation by undergraduate medical students of a role-playing training program on the management of acute states of agitation.

OBJECTIVES: Acute states of agitation (ASAs) are frequent in daily medical practice. However, training on real ASAs raises technical and ethical issues, whereas lecture-based teaching hardly addresses some educational objectives, e.g., improving relational skills and team-based coordination. Simulation-based medical education (SBME) is a promising medium to train students on managing ASAs. We have recently implemented a role-playing training module on ASAs. In this scenario, four to five students play the role of the staff, while a trained professional actor plays the agitated patient. A subsequent standardized debriefing is conducted by a senior psychiatrist. A first wave of 219 students participated in a one-session training of this ASA module in June 2015. They completed pre-session and post-session questionnaires aiming to collect "proof-of-concept" data. METHODS: The pre-session questionnaire investigated: previous experience of ASA among students during their clinical training; previous participation in a role-playing SBME; and perceived knowledge of the good practice rules for managing ASAs. The post-session questionnaire investigated among the students if: they thought having been able to appropriately manage the simulated ASA; they found the SBME medium more fitted for training than real situations; they found that the SBME session faithfully reproduced a real ASA; and the session was found useful for transmitting the skills on correct management of ASA. The average level of stress induced by the training was assessed using a numerical rating scale (0-10). RESULTS: Two hundred and six of the 219 students completed the pre-session questionnaire (63% females; response rate 96.7%). A hundred and thirty four students played the scenario and completed the post-session questionnaire (65.7% females; response rate 100%). 38.3% of the responders reported having previously experienced a situation of ASA in their practice, and 31.1% deemed to know the good practices rules for managing an ASA. In post-session, 29.9% of the participants considered that they appropriately managed the ASA, 79.9% deemed that the role-playing session faithfully reproduced a real ASA, and 97% deemed that this SBME was more fitted and useful than a real clinical situation to improve their medical skills. Bivariate analyses revealed that the post-session responses and level of stress were not influenced by previous experience on ASA, previous participation in a SBME role-playing session, or thinking to know the rules for managing ASAs. CONCLUSION: SBME role-playing training appears a promising, realistic, and well-accepted method for teaching the management of ASA.

[Patients taking an active role in their care in ambulatory knee replacement surgery]. / Le patient acteur de sa santé lors d'une arthroplastie de genou en ambulatoire.

National recommendations encourage the development of ambulatory surgery. This form of treatment, reserved mainly for short procedures, can also be used for more complex operations such as a total knee replacement. The teams at Vitré general hospital share their experience and emphasise the need to ensure the compliance of patients and their family.

[Face-lift surgery in ambulatory]. / Lifting cervicofacial en ambulatoire.

OBJECTIVE: The proposal is to demonstrate that facelift surgery is particularly suitable for the care in ambulatory. METHODS: Between 2010 and 2016, 246 patients were operated for a facelift in ambulatory. RESULTS: No major complication arose in this series (241). Among the patients, 98% expressed their satisfaction and would accept again this intervention in ambulatory. CONCLUSION: The facelift can be realized in ambulatory with complete safety. The rate of satisfaction shows a very strong support of the patients for the ambulatory care.

[Parkinson's disease: what gets in the way of the partnership relationship?]. / Maladie de Parkinson : quels freins à la relation de partenariat ?

What difficulties do patients face in being considered as players in their own treatment pathway? What obstacles do they have to overcome to participate in making decisions concerning them? How do they live the patient-caregiver relationship, sometimes felt to be unequal? Here are a few stories from patients with Parkinson's disease.

[Growing up with an EBH, an example of pediatric-adult transition in the field of rare diseases]. / Grandir avec une EBH, un exemple de transition pédiatrie-service d'adultes dans le domaine des maladies rares.

The transition from pediatrics to adult wards concerns all chronic diseases with a pediatric onset, but there are a number of specific features in the case of severe forms of hereditary epidermolysis bullosa: worsening wound surface and chronicity with age, appearance or increase in certain complications (carcinological, renal, nutritional, dental), sometimes difficult therapeutic choices, sometimes life-threatening prognosis. But one of the major problems limiting the patient's autonomy is the difficulty of finding a paramedic to take over skin care, often provided from birth by a parent who has become a caregiver through necessity.

Spousal Support and Relationship Happiness in Adults With Type 2 Diabetes and Their Spouses.

OBJECTIVES: The purpose of this study was to examine the association between the perceptions of spousal support self-efficacy in terms of dietary self-care and relationship happiness. METHODS: Forty-six couples, in which only one spouse has type 2 diabetes, completed questionnaires on perceptions of spousal support self-efficacy and relationship happiness. RESULTS: Using an actor‒partner interdependence model, we found that, when persons with type 2 diabetes were more confident in their spouse's ability to provide them with support regarding their dietary self-care, they reported more relationship happiness. We also found that, when their spouse without diabetes was more confident in their own abilities to provide such support to their partner, they reported more relationship happiness. However, the person with diabetes' confidence in their spouse's support abilities and the spouse's confidence in their own support abilities were not associated with the other partner's relationship happiness. CONCLUSIONS: This study offers a unique dyadic perspective on the determinants of happiness for couples in which one spouse has type 2 diabetes. The perceived quality of spousal support appears to be associated with relationship happiness in committed couples managing diabetes, regardless of the actual support received or provided.

Brincar nas, com e apesar das telas / Playing with, on and in spite of the screens / Jugar con, en y a pesar de las pantallas / Jouer avec, dans et malgré les écrans

Este trabalho está inserido em uma pesquisa que buscou explorar as articulações forjadas entre crianças e telas durante o isolamento físico imposto pela pandemia da COVID-19. O objetivo aqui foi analisar como as brincadeiras se desenrolaram nesse momento tão especial, levando em conta a presença das telas. Nossos principais referenciais teóricos foram a psicanálise e a Teoria Ator-Rede e adotamos a cartografia como metodologia, a fim de explorar o campo em toda sua fluidez e complexidade. Utilizamos questionários online e entrevistas com responsáveis e crianças. Foi possível observar que as crianças não deixaram de brincar por causa das telas, mas puderam construir múltiplas e singulares articulações, brincaram nas, com e apesar das telas

This article is part of a piece of research that sought to explore the articulations forged between children and screens during the physical isolation imposed by the COVID-19 pandemic. The goal was to analyse how children's games developed in this particular moment, taking into account the presence of digital screens. In order to explore the research field in all its fluidity and complexity, our main theoretical references were psychoanalysis and Actor-Network Theory. Besides this, we adopted cartography as a methodology where online questionnaires and interviews with parents and children were carried out. It was possible to observe that the children didn't stop playing because of the screens but were able to build multiple and unique articulations, playing on, with and in spite of the screens

Este trabajo es parte de una investigación que buscó explorar las articulaciones entre los niños y las pantallas durante el aislamiento físico impuesto por la pandemia del COVID-19. El objetivo aquí fue analizar cómo se desarrollaron los juegos en este momento tan especial, teniendo en cuenta la presencia de las pantallas. Nuestros principales referentes teóricos fueron el psicoanálisis y la Teoría del Actor-Red y adoptamos la cartografía como metodología para explorar el campo en toda su fluidez y complejidad. Utilizamos encuestas virtuales y entrevistas con responsables y niños. Se pudo observar que los niños no dejaron de jugar por causa de las pantallas, sino que lograron construir múltiples y singulares articulaciones, jugaron en, com y a pesar de las pantallas

Ce travail s'inscrit dans une recherche qui visait à explorer les articulations forgées entre les enfants et les écrans lors de l'isolement physique imposé par la pandémie de COVID-19. L'objectif était d'analyser le déroulement des jeux dans ce moment particulier, en tenant compte de la présence des écrans. Nos principales références théoriques étaient la psychanalyse et la théorie de l'acteur-réseau et nous avons adopté la cartographie comme méthodologie afin d'explorer le domaine dans toute sa fluidité et complexité. Nous utilisons des questionnaires en ligne et des entretiens avec les parents et les enfants. Il a été possible de constater que les enfants n'ont pas arrêté de jouer à cause des écrans, mais ils ont su construire des articulations multiples et uniques, ils ont joué dans, avec et malgré les écrans

Sciences et État: note critique sur quelques propositions théoriques / Sciences and the State: a critical note on some theoretical propositions

L'effusion théorique au sein des science and technological studies rend parfois difficile la saisie de lignes directrices ou de points d'appui stables. La question des rapports entre pratiques scientifiques et État offre l'occasion de mesurer les écarts entre différents corpus théoriques. Dans cet article, nous avons considéré trois propositions théoriques récentes. La new production of knowledge écarte, au nom d'un soubassement idéologique néolibéral, la notion d'État de son horizon conceptuel. La théorie de l'acteur-réseau, dissolvant les structures instituées dans l'enchaÎnement des acteurs, ignore la forme-État. Enfin, les régimes de savoirs accordent une place importante à l'État en tant que ressource pour l'agencement de la production savante.

The profusion of theories within science and technological studies sometimes makes it hard to find lines of direction or stable points of support. The question of the relations between scientific practices and the state affords an opportunity to appraise the differences between theoretical corpi. The present article explores three recent theoretical propositions. In the name of a neoliberal ideological foundation, the new production of knowledge has eliminated the notion of State from its conceptual horizon. Actor-network theory, suspending the structures instituted within the chain of actors, ignores the state-form. Lastly, regime of knowledge theory accords the state a special role as a source in managing the production of knowledge.

El actor y el espectador: De Freud a Lacan / The actor and the audience: from Freud to Lacan / L’acteur et le spectateur. de Freud à Lacan

Teniendo en cuenta los aportes de Freud y Lacan, en este texto se trata, por una parte, de mirar cuál es la función del actor en la representación teatral o parafraseando al segundo de estos autores ¿Qué añade el actor a la obra escrita? de otro lado, profundizar en los mecanismos que en el espectador ponen en juego para conectarse con la obra y el actor, suscitando las vivencias y emociones propias de la experiencia teatral...

Taking in account Freud and Lacan works, this paper questions about what is the actor function in a theatrical performance; paraphrasing Lacan: What does the actor add to the written work? On the other hand, deeping into the mechanisms that the member of the audience uses to put in contact with the play and the actor, arousing his/her own life experiences and emotions through the theatrical experience...

En prenant compte des apports de Freud et de Lacan, ce texte essaie de voir quel est le rôle de l’acteur dans la représentation théâtrale, ou – si l’on reprend les mots du deuxième de ces auteurs: Qu’est ce qui l’acteur apporte à l’œuvre écrite ? D’autre part, il essaie d’aller plus loin dans les mécanismes mis en jeu par le spectateur afin de se connecter avec l’œuvre et avec l’acteur, suscitant ainsi les expériences vécues et les émotions propres de l’expérience théâtrale...