Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD.

Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.

Exploring Therapeutic Relationships in Pediatric Occupational Therapy: A Meta-Ethnography.

Background. Developing strong therapeutic relationships with families is a crucial aspect of pediatric occupational therapy. However, building such relationships is complex as they involve multiple directions of interaction. Purpose. To provide a thorough interpretation of children's, caregivers', and occupational therapists' experience of the therapeutic relationship. Method. A meta-ethnography was realized to synthesize qualitative studies. A systematic search was carried out using five databases from 2005 to 2022. The CAPS checklist was used to appraise included studies' quality. The analysis was completed using a constant comparison of findings. Findings. Three themes emerged from the 14 studies synthesized. The first theme illustrates that the therapeutic relationship can have different meanings depending on the perspective of children, caregivers, or occupational therapists. The second theme explores the components impacting the experience of the relationship. These include the power dynamics, the communication, and respect for diversity. Finally, the third theme illustrates how the relationship can empower positive change. Implications. Children, caregivers, and occupational therapists each have a perspective that ought to be heard. Occupational therapists should actively ask for children's and caregivers' perspectives to encourage power sharing and effective communication. By doing so, occupational therapists can strengthen the therapeutic relationship, which, in turn, promotes positive change.

[Representations of co-parenthood among primiparous and multiparous fathers-to-be]. / Représentations de la coparentalité des futurs pères primipares et multipares.

From the moment they become pregnant, future parents anticipate how they will coordinate, support and divide the tasks related to their child. This is known as co-parenting. Research carried out in three french gynaecology-obstetrics departments and in social network examined fathers' perceptions of co-parenthood and sought to determine whether these were in line with scientific conceptions of the concept.

[A father's perspective for today's young families?] / Quelle père-spective pour les jeunes familles d'aujourd'hui ?

Today, the distribution of parental roles is organised around an equity that is more than justified, but has the consequence of creating a territorial watershed where the negotiation of values, opinions, wishes and deep-seated needs is constantly activated. Where societal definitions used to provide a framework and contentment for transactions within the couple, the new generation finds itself obliged to cooperate and redefine the spaces and roles of each, with intergenerational issues multiplied tenfold and marital crisis often heightened.

At the Epicentre of the COVID-19 Pandemic in Canada: Experiences and Recommendations of Family Care Partners of an Older Person Living in a Long-Term Care Home.

The roles of family care partners of older persons living in long-term care homes (LTCH) were severely disrupted during the coronavirus disease (COVID-19) pandemic. Our aim was to describe their experiences and to solicit their recommendations for supportive actions. We conducted a critical ethnography with 24 care partners who cared or had cared for an older person living in an LTCH in Québec during the COVID-19 pandemic. We collected data during interviews and used Spradley's method to analyse them. Care partners experienced a forced separation from the older persons they cared for, which resulted in significant distress. Care, including post-mortem care, was considered inadequate and sometimes even inhumane. Communication was inconsistent, and this variability was also noted in visitation rules. Care partners perceived LTCHs as a neglected community. Supportive actions were recommended. The results illustrated the essential contribution of care partners, and the supportive actions they recommended must be a catalyst for change toward more humane care in LTCH settings.

[Process and conduct for organ procurement under Maastricht III]. / Processus et conduite pour un prélèvement d'organes dans le cadre du Maastricht III.

The shortage of transplants and their corollary, the need for transplants, have led France to expand its organ procurement options. Since 2005, France has benefited from a new medical, legal and organizational framework for organ procurement from deceased donors after circulatory arrest, in accordance with Maastricht category III.

[« I was moved by an absolute urgency: I had to know what had always been kept from me ¼]. / « J'étais mû par une urgence absolue: je devais savoir ce qui m'avait toujours été tu ¼.

In certain family configurations, the secrecy of origins is fiercely maintained. The revelation can then occur suddenly, causing a radical upheaval for the person concerned. This is what happened to Alexandre Mercier, who agreed to share his experience with us.

[« The desire to know where I came from pushed me to start the research ¼]. / « La volonté de savoir d'où j'étais issu m'a poussé à commencer les recherches ¼.

This interview retraces the journey of a man who, wishing to know where he came from, decided to go in search of his origins. From wanderings to hesitations, from bitterness to determination, Arthur Kermalvezen Fournis describes the different steps that led him to the truth. A painful but salutary fight.

Building Families' Capacities: Community Forums with Parents and Occupational Therapists.

Background. Parents of a child considered to have special needs are at greater risk of stress and exhaustion. Although many occupational therapy interventions can help these children, they often require significant time and energy from families. Purpose. To document the perspectives of parents and occupational therapists regarding ways to offer services that help build families' capacities without overloading them. Method. A qualitative descriptive design guided online community forums with 41 parents and occupational therapists in Quebec, Canada. Findings. Nine key principles to build the capacities of families without overburdening them were identified. These include being sensitive to possible negative impacts of services, avoiding overwhelming the family with information or recommendations, taking the needed time, highlighting the positive, and offering flexible conditions for services. Implications. Our findings help identify how capacity-building rehabilitation services can be offered to families to optimize positive outcomes and minimize harms.

A Cross-sectional Study of Community-level Physician Retention and Diabetes Management in Rural Ontario.

OBJECTIVE: Our aim in this study was to determine the impact of community-level physician retention on the quality of diabetes care in rural Ontario. METHODS: Using administrative data, we compared diabetes quality of care. We defined retention as the proportion of physicians in a community from one year to the next. We grouped retention level by tertile and added a category for those communities with no physician. RESULTS: Residents of high-retention communities were more likely to have had glycated hemoglobin (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.14) and low-density lipoprotein (OR, 1.17; 95% CI, 1.13 to 1.22) testing, but less likely to have had testing for urine albumin-to-creatine ratio (OR, 0.86; 95% CI, 0.83 to 0.89) or to have received an angiotensin-converting enzyme inhibitor or angiotensin-2 receptor blocker (OR, 0.91; 95% CI, 0.86 to 0.95) or a statin (OR, 0.91; 95% CI, 0.87 to 0.96), when compared with low-retention communities. Communities with no residing physician had care that was equivalent to or better than that in high-retention communities. CONCLUSIONS: Community-level physician retention, based on a 2-year time frame, was significantly related to quality of diabetes care. A closer look at models of care in communities with no residing physician is warranted. Community-level physician retention can be used to assess the impact of physician shortages on diabetes management in rural communities.

[The feminization of precariousness, a growing feature]. / La féminisation de la précarité, une particularité grandissante.

Precariousness (social, health, professional, financial, energy, etc.) affects women more than men. This has consequences for their access to healthcare. Raising awareness of gender inequalities and mobilizing actors to fight against them, make visible the levers to fight against the increase of women's precariousness.

Implications of deficit discourse in the conversations of a mother who requests forced treatment / Implicações do discurso do déficit nas conversas de uma mãe que solicita tratamento forçado / Implications du discours déficitaire sur les conversations d'une mère qui demande traitement forcé / Implicaciones del discurso del déficit en las conversaciones de una madre que solicita tratamiento forzado

Abstract This case study analyzes the implications of deficit discourse on the daily conversations of a mother who requested forced treatment for her son. Data were analyzed drawing on social construction, with an emphasis on positioning theory and deficit discourse. Two episodes displaying deficit discourse were analyzed: one about the son as someone who is powerless, coping with drug use and another about the mother as someone unable to help her son. A sample letter was constructed using relational discourse, which provided new understandings for practice. Results support the benefits of collaborative and relational approaches for people who use drugs and for the emotional support of families.

Resumo Este estudo de caso analisa as implicações do discurso do déficit nas conversas cotidianas de uma mãe que solicitou tratamento forçado para seu filho. Os dados foram analisados a partir da construção social, com ênfase na teoria do posicionamento e do discurso do déficit. Dois episódios foram analisados a partir do discurso do déficit: um sobre o filho como alguém que é impotente no enfrentamento do uso de drogas e outro sobre a mãe como alguém incapaz de ajudar seu filho. Foi construída uma carta ilustrativa a partir do discurso relacional, que proporcionou novos entendimentos para a prática. Os resultados corroboram os benefícios das abordagens colaborativas e relacionais para o suporte emocional de pessoas que usam drogas e suas famílias.

Résumé Cette étude de cas analyse les implications du discours déficitaire sur les conversations quotidiennes d'une mère qui a demandé traitement forcé pour son fils. Les données ont été analysées en s'appuyant sur la construction sociale, en mettant l'accent sur la théorie du positionnement et le discours déficitaire. Deux épisodes ont été analyses utilisant le discours déficitaire: l'un sur le fils en tant que personne impuissante face à l'usage de drogue, et l'autre sur la mère en tant que personne incapable d'aider son fils. Une lettre illustrative a été construit utilisant le discours relationnel, qui a fourni de nouvelles compréhensions pour la pratique. Les résultats confirment les avantages des approches collaboratives et relationnelles pour le soutien émotionnel des personnes qui consomment des drogues et leurs familles.

Resumen Este estudio de caso analiza las implicaciones del discurso del déficit en las conversaciones diarias de una madre que solicitó tratamiento forzado para su hijo. Los datos fueron analizados a partir de la construcción social, con énfasis en la teoría del posicionamiento y el discurso del déficit. Se analizaron dos episodios a partir del discurso del déficit: uno sobre el hijo como alguien que es impotente frente al uso de drogas y otro sobre la madre como alguien incapaz de ayudar a su hijo. Se construyó una carta ilustrativa utilizando el discurso relacional, que proporcionó nuevas comprensiones para la práctica. Los resultados respaldan los beneficios de los enfoques colaborativos y relacionales para el soporte emocional de las personas que usan drogas y sus familias.

[Incest, a genocidal crime]. / L'inceste, un crime génocidaire.

Incest covers multiple situations that have in common family dynamics where the absolute prohibition to have sexual relations with one of its members is not respected. It is a fundamental taboo in our Western societies where the family is considered as a system structuring the relationships between individuals. How can we understand the family transactions that can lead to such situations? What do we know today about families where incest occurs? What is the place of each member of this family, whether he or she is an actor, a witness, or totally unaware of the facts? What happens to the victims of such acts? Here is an insight into these different questions based on our experience as psychotherapists and researchers.

[Accompanying young girls who are victims of incest, a necessarily holistic approach]. / Accompagner les jeunes filles victimes d'inceste, une approche nécessairement holistique.

Accompanying child and adolescent victims of incest towards reconstruction requires professionals trained in the specificities of this intra-family sexual violence. The Jean-Bru shelter, which takes in young girl victims, has developed the expertise of a complementary multi-partner approach and offers socio-educational, medical-psychological and legal support, for the benefit of a personalized global project that also includes the family link.

[From the announcement of the disease to its psychic resonance on the family group]. / De l'annonce de la maladie à ses résonances psychiques sur le groupe familial.

The sick child legitimately focuses all the attention and concerns of his family and caregivers around him. However, the support offered to those around the child is of fundamental importance and of double interest, both for the psychological benefit of the family and for the young patient himself.

[What are the obstacles to drawing up a death certificate in a home setting ? A survey of doctors in Normandy]. / Quels freins à l'établissement du certificat de décès à domicile ? Enquête auprès de médecins sur le territoire de Normandie.

INTRODUCTION: Drafting a death certificate is an obligation for any physician called upon to note a death. It has a legal and epidemiological impact. The objective of this study is to highlight the obstacles encountered by professionals when this process takes place in a home setting. METHOD: A study was carried out by means of a questionnaire sent to doctors in the Normandy region. RESULTS: One fifth (20%) of the general practitioners (GPs), 25% of the SAMU practitioners (intervening in mobile emergency throughout the country), 27.3% of SOS doctors (intervening 24 hours a day in the deceased person's home in the absence of a GP) stated that they had at least once refused to establish a death certificate. Only 36.4% of SOS doctors, 62.5% of emergency physicians and 41% of GPs considered the drafting of a death certificate to be one of their mandatory missions. No less than 17% of GPs, 25% of SAMU doctors and 9% of SOS doctors stated that due to lack of time, they were occasionally unable to travel to fill out a death certificate, a factor causing delays that were detrimental, especially for the surviving relatives. We highlighted several other obstacles to the completion of death certificates: the difficulty of completing them accurately without knowledge of the deceased person's history, possible inability of professionals on tight schedules to deal with unforeseen requests and, more rarely, the issues raised by an absence of remuneration. CONCLUSION: Our study highlights major obstacles in the preparation of death certificates, obstacles that should be taken into consideration insofar as they affect the quality of the data collected, and entail ethical challenges.

A noção de afeto no direito de família: diálogo com a psicopatologia e a psicanálise / The notion of affect in family law: dialogue with psychopathology and psychoanalysis / La notion d'affect en droit de la famille: dialogue avec la psychopathologie et la psychanalyse / La noción de afecto en el derecho de familia: diálogo con la psicopatología y el psicoanálisis

O artigo procura discutir a proposição de que o afeto seja um dos principais determinantes de reconhecimento das relações familiares contemporâneas no direito, campo discursivo que legitima oficialmente a família. Para isso, realizou-se uma pesquisa teórica na qual explora-se a noção de afeto na linguagem cotidiana, na qual ele equivale a emoções, sentimentos e paixões, para cotejá-la com as definições da semiologia em psicopatologia, que também apresenta dificuldade em conceituar a referida noção. Utiliza-se, então, a psicanálise como teoria para ampliar a discussão, entendendo-se o afeto como efeito no Eu e no corpo da relação com o Outro por meio do significante. Isso permite incluir na leitura das relações familiares o desejo e a demanda, o que pode se traduzir em uma consideração do afeto para além de sua dimensão imaginária e contribuir para o trabalho dos psicólogos que lidam na interface com o direito de família.

Resumos This paper discusses the assumption that affect is a key determinant in recognizing contemporary family relations in law, a discursive field that officially legitimizes the family. To do so, a theoretical research explores the notion of affect in everyday language, which equates it to emotions, feelings, and passions, comparing it with the definitions of psychopathological semiology, which also fails to conceptualize the aforementioned notion. Psychoanalysis is used, therefore, to broaden the discussion, understanding affect as an effect produced by relations with the Other in the Self and in the body through the signifier. This allows us to include desire and demand in the reading of family relations, and thus to consider affect beyond its imaginary dimension and contribute to the work of psychologists who deal with family law.

Cet article interroge l'hypothèse selon laquelle l'affect est un déterminant essentiel de la reconnaissance des relations familiales contemporaines en droit, un champ discursif qui légitime officiellement la famille. Pour ce faire, une recherche théorique explore la notion d'affect dans le langage courant, qui l'assimile aux émotions, aux sentiments et aux passions, en la comparant aux définitions de la sémiologie en psychopathologie, qui ne parvient pas non plus à conceptualiser ladite notion. La psychanalyse est donc utilisé pour élargir la discussion, en comprenant l'affect comme un effet produit par les relations avec l'Autre sur le Moi et le corps à travers le signifiant. Cela nous permet d'inclure le désir et la demande dans la lecture des relations familiales, et donc de considérer l'affect au-delà de sa dimension imaginaire et de contribuer au travaux des psychologues qui s'occupent du droit de la famille.

El artículo trata de discutir la proposición de que el afecto sea uno de los principales determinantes de reconocimiento de las relaciones familiares contemporá-neas en el derecho, campo discursivo que legitima oficialmente la familia. Para ello se llevó a cabo una investigación teórica en la que se explora la noción del término afecto en el lenguaje cotidiano, en el cual es sinónimo de emociones, sentimientos y pasiones, para cotejarla con las definiciones de la semiologia psicopatológica, rama que también encuentra dificultad en definir esta noción. Por eso, se recurre al psicoanálisis como teoría con el fin de ampliar la discusión, entendiendo el afecto como efecto en el Yo y en el cuerpo de la relación con el Otro por medio del significante. Esto permite incluir en la lectura de las relaciones familiares el deseo y la demanda, lo que puede traducirse en una evaluación del afecto más allá de su dimensión imaginaria y contribuir así al labor de los psicólogos que actúan en la interfaz del derecho de familia.

[The expectations of families in Ehpad]. / Les attentes des famillesen Ehpad.

Taking into account the needs and expectations of families in residential care facilities for the dependent elderly (Ehpad) leads to their satisfaction with the care given to their institutionalized relative. A relational charter participate to prevent conflicts and misunderstandings between the various formal (caregivers) and informal (families) care providers at the bedside of residents. Families must feel invited to the Ehpad and recognized in their place in their role of care, at least relational. Some families, however, remain firmly anchored in an irrefragable hostility. Solidarity in the teams and the robustness of the care project are essential here.

[Continuity of hospital care at home]. / Continuité des soins hospitaliers à domicile.

Born in 1945 in the United States, the activity of home hospitalization (HH) did not stop developing in France after the 1950s. However, it was not recognized by the regulatory authorities and supervisory bodies until 1970. HH allows patients suffering from serious acute or chronic pathologies to continue to benefit seven days a week, twenty-four hours a day, at home, from technical and complex, frequent and coordinated care, inaccessible to city care. It is a central health policy issue in patient care.

Family Feeding Practices of Parents on Prince Edward Island: A Focus on Responsive Feeding.

The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children's hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.