[Ecology: The blind spot in pathology research]. / Écologie : l'angle mort de la recherche en ACP.

INTRODUCTION: The 2015 Paris Agreement has been the first restrictive agreement in the fight against climate change. The newer generations of pathologists, who feel more anxiety due to environmental problems than their predecessors, are asked to publish research works while they are harder and harder to and in a context of demographical tensions. We wanted to measure the rise of ecology research in pathology since the Paris Agreement. MATERIAL & METHODS: Over a ten years study period (2013-2022), we have identified via PubMed the number of articles in which forty-three terms taken from the sustainable development vocabulary appeared in ten renowned international pathology journals, selected for their SJR index from ScimagoJr and their impact factor, plus the Annales de pathologie, and compared their means of incidence between the 2013-2015 (m1) and 2016-2022 (m2) periods. The same process has been applied for "artificial intelligence", "deep learning" and "digital pathology". RESULTS: A total of 1336 articles have been identified. Only "digital pathology" (fromm1=8,33 to m2=23,29; p=0,010) and "deep learning" (fromm1=0 to m2=10,14; p=0,034) saw their incidence rise significantly. A significant decrease has been observed with "biological" (fromm1=70,00 to m2=56,86; p=0,020). DISCUSSION-CONCLUSIONS: Pathology reacts to trends but research in ecology has remained in the blind spot since 2015. However there seems to be an awakening as editorials, articles and communications in congress have blossomed the last two years.

[Supporting students to take care of their health]. / Permettre aux étudiants d'être acteurs de leur santé.

The current health crisis is impacting the vision of the present and the future. It is not a matter of feeling "sacrificed", but rather of discovering a new way of approaching the world around us. This is the case for our representations of health and the interdependence of people and generations.

[Artificial intelligence and the nursing profession]. / L'intelligence artificielle et le métier infirmier.

New technologies have revolutionised our society. Artificial intelligence is bringing about radical changes to the healthcare sector.

How is the Lives Saved Tool (LiST) used in the global health community? Results of a mixed-methods LiST user study.

BACKGROUND: The Lives Saved Tool (LiST) is a computer-based model that estimates the impact of scaling up key interventions to improve maternal, newborn and child health. Initially developed to inform the Lancet Child Survival Series of 2003, the functionality and scope of LiST have been expanded greatly over the past 10 years. This study sought to "take stock" of how LiST is now being used and for what purposes. METHODS: We conducted a quantitative survey of LiST users, qualitative interviews with a smaller sample of LiST users and members of the LiST team at Johns Hopkins University, and a literature review of studies involving LiST analyses. RESULTS: LiST is being used by donors, international organizations, governments, NGOs and academic institutions to assist program evaluation, inform strategic planning and evidenced-based decision-making, and advocate for high-impact interventions. Some organizations have integrated LiST into internal workflows and built in-house capacity for using LiST, while other organizations rely on the LiST team for support and to outsource analyses. In addition to being a popular stand-alone software, LiST is used as a calculation engine for other applications. CONCLUSIONS: The Lives Saved Tool has been reported to be a useful model in maternal, newborn, and child health. With continued commitment, LiST should remain as a part of the international health toolkit used to assess maternal, newborn and child health programs.

The effects of family planning and other factors on fertility, abortion, miscarriage, and stillbirths in the Spectrum model.

BACKGROUND: The Lives Saved Tool (LiST) estimates the effects of maternal and child health interventions on mortality rates and the number of deaths. The family planning module in Spectrum interacts with LiST by providing estimates of the effects of scaling up family planning use on the number of live births, miscarriages, abortions, and stillbirths. METHODS: We use the proximate determinants of fertility framework to estimate the effects of changes in contraceptive use, proportion married, postpartum insusceptibility, abortion and sterility on the total fertility rate. We extend this framework to estimate the number of intended and unintended pregnancies and the resulting live births, abortions, stillbirths, and miscarriages. RESULTS: We apply the model to four countries (Mali, Kenya, Indonesia, and Ukraine) to demonstrate possible trends with a range of family planning and fertility levels. In high-fertility countries, such as Mali, increases in contraceptive use will partially compensate for the increasing number of women of reproductive age to reduce the annual increases in pregnancies and births. Most unintended pregnancies occur to women defined as having unmet need for contraception. In low-fertility countries, increases in contraceptive use may reduce abortion rates and low levels of unmet need mean that most unintended pregnancies are due to method failure. CONCLUSIONS: The family planning module in Spectrum provides a useful framework to incorporate changes in contraceptive practices and pregnancy outcomes in the LiST calculations of mortality rates and deaths.

[What Kind of Doctors Will be Needed in the Future?] / Welche Ärztinnen und Ärzte braucht es in der Zukunft?

What Kind of Doctors Will be Needed in the Future? Abstract: To get a notion regarding the future of medical doctors, the changes in the health care system and in society must be considered, for only then can the future professional profile be envisaged. The following text shall illustrate why more diversity among patients and staff as well as more diverse care settings are to be expected due to the coming social developments. Consequently, the professional role of medical doctors will become more fluid and more fragmentary. Medical careers will include more role changes in the future, and the question of co-evolution in the health professions will become much more relevant. All this raises fundamental considerations regarding education and training, but also regarding one's professional identity.

Uma juventude privada de escola: luto e sonhos em tempos de pandemia / Una juventud privada de escuela: duelo y sueños en tiempos de pandemia / A youth deprived of school: mourning and dreams in times of pandemic / Une jeunesse privée d'école: deuil et rêve en temps de pandémie

No contexto brasileiro de fechamento de escolas devido à pandemia da Covid-19, diante de múltiplas formas de crise social e de um projeto de destruição do país liderado pelas autoridades políticas, esta contribuição testemunha como os jovens que encontramos no momento da transição entre o ensino médio e a universidade no âmbito de um projeto de pesquisa viveram este período. As entrevistas realizadas trouxeram à tona a importante questão do relacionamento deles com a escola, enquanto instituição, nesse momento existencial de projeção. A pesquisa destaca o fato de que estes jovens foram capazes de atravessar estas crises se apoiando em uma forma de escola internalizada, um traço identificatório que tornou possível o trabalho psíquico do luto, permitindo-lhes não cair em um estado melancólico

En el contexto brasileño de cierre de escuelas debido a la pandemia del Covid-19, frente a múltiples formas de crisis socialy a un proyecto de destrucción del país liderado por las autoridades políticas, esta contribución da testimonio de cómo vivieron este período los jóvenes que conocimos en el momento de la transición entre la enseñanza media y la universidad en el marco de un proyecto de investigación. Las entrevistas realizadas sacaron a la luz la importante cuestión de su relación con la escuela, como institución,en este momento existencial de proyección. La investigación destaca el hecho de que estos jóvenes pudieron atravessar estas crisis apoyándose en una forma interiorizada de escuela, un rasgo de identificación que hizo posible el trabajo psíquico del duelo, permitiéndoles no caer en un estado melancólico

In the Brazilian context of school closures due to the Covid-19 pandemic, in the face of multiple forms of social crisis and a project of destruction of the country led by the political authorities, this contribution bears witness to how the young people we met at the moment of transition between high school and university within the framework of a research project experienced this period. The interviews conducted brought to light the important issue of their relationship with school, as an institution, at this existential moment of projection. The research highlights the fact that these young people were able to cross these crises by relying on an internalized form of school, an identificatory trait that made possible the psychic work of mourning, allowing them not to fall into a melancholic state

Dans le contexte brésilien de fermeture des écoles en raison de la pandemie de la Covid-19, face aux multiples formes de crises sociales et à un projet de destruction du pays mené par les autorités politiques, cette contribution témoigne de comment les jeunes rencontrés au moment du passage entre le lycée et l'université dans le cadre d'une recherche ont vécu cette période. Les entretiens menés ont fait émerger la question importante de leur rapport à l'école, en tant qu'institution,dans ce moment existentiel de projection. La recherche met en lumière le fait que ces jeunes ont pu traverser ces crisesen s'appuyant sur une forme d'école intériorisée, un trait identificatoire qui a renduossible le travail psychique du deuil,leur permettant de ne pas tomber dans un état mélancolique

Práticas de saúde e subjetivação: a emergência do sujeito previdenciário / Health practices and subjectivation: the emergence of the preventative subject / Pratiques de santé et subjectivation: lémergence du sujet préventif / Prácticas de salud y subjetivación: la emergencia del sujeto previsional

Resumo Na trilha histórica da relação dos sujeitos com a saúde, interessa-nos analisar os processos de subjetivação neste percurso e as variações nas práticas de saúde modernas. Partimos da bibliografia de pensadores da subjetividade/saúde e forjamos uma pequena história das práticas de saúde no século XX: no início do século, a saúde tem o corpo como objeto; décadas depois, agrega-se o fator risco, tornando os modos de viver objeto de controle; o avanço da ciência molecular no final do mesmo século engendra uma ambivalência à saúde, quando torna o sujeito virtualmente doente pelo risco iminente da contingência genética, e a própria tecnociência promete prever, prevenir e modificar essa condição. Nosso ponto de chegada sugere a emergência de uma noção previdenciária de saúde como um imperativo: produzir saúde incessantemente no presente para diminuir o risco e garantir mais-vida futura. Forjar-se-ia uma subjetividade previdenciária que atualiza a forma moderna de sujeito?

Abstract We analyze the subjectivities of the historicalrelationship between subjects and their health and its subsequent variations in modern health practices. As a starting point, referenced by the bibliography of subjectivity and/or health thinkers, we describe a short history of health practices throughout the twentieth century: in the early century, health had the body as its sole object; decades later, the risk factor is then included, turning lifestyles the object of control; the advancement of molecular science at the end of the same century leads to ambivalence in health, as it allows to regard the subject as virtually ill based on the imminent risk of genetic contingency, and technoscience itself promises to predict, prevent, and modify such condition. The results suggest a novel notion of preventative health as an imperative has emerged: one must produce health incessantly in the present to decrease risk and to guarantee a value-added life. Would preventive subjectivity evolve in a manner that updates the modern form of the subject?

Résumé Au cours historique de la relation entre les sujets et leur santé, nous sommes intéressés à analyser la subjectivité dans ce parcours et les variations subséquentes dans les pratiques de santé modernes. En partant des références bibliographie des penseurs de la subjectivité et/ou de la santé, nous avons construit une brève histoire des pratiques de santé au cours du XXe siècle : au début du siècle, la santé a pour seul objet le corps ; des décennies plus tard, le facteur de risque a été ajouté, faisant des modes de vie objet du contrôle ; le progrès de la science moléculaire au tournant du même siècle engendre une ambivalence à la santé, en rendant le sujet virtuellement malade en raison du risque imminent de contingence génétique et c'est la technoscience elle-même qui promet de prévoir, de prévenir et de modifier cette condition. Notre point d'arrivé suggère l'émergence d'une notion de santé préventive comme impératif : il faut incessamment produire la santé dans le présent pour diminuer le risque et garantir plus-vie future. Une subjectivité préventive serait-elle utilisée pour actualiser la forme moderne du sujet ?

Resumen En la historia de la relación de los sujetos con la salud, nos interesa analizar los procesos de subjetivación y las variaciones en las prácticas de salud modernas. Con base en la bibliografía de pensadores de subjetividad/salud, forjamos una breve historia de las prácticas de salud a lo largo del siglo XX: a principios del siglo, la salud tiene el cuerpo como objeto; décadas después, se agrega el factor riesgo, haciendo los modos de vivir objeto de control; el avance de la ciencia molecular en el final del mismo siglo engendra una ambivalencia a la salud, cuando hace el sujeto virtualmente enfermo por el riesgo inminente de la contingencia genética, y la tecnociencia misma promete predecir, prevenir y modificar esta condición. Nuestra conclusión sugiere la aparición de una noción previsional de salud como un imperativo: producir salud incesantemente en el presente para disminuir el riesgo y garantizar más vida futura. ¿Se forjaría una subjetividad previsional que actualiza la forma moderna de sujeto?

Notas sobre o futuro da psicanálise / Notes on the future of psychoanalysis / Notas sobre el futuro del psicoanálisis / Des notes sur l'avenir de la psychanalyse

RESUMO Propomos a ideia de que, para pensar o futuro da psicanálise, faz-se necessário recuperar a perspectiva histórico-temporal, evitando que as bolhas do presente impeçam um olhar em perspectiva. É preciso reconhecer nossos acertos e erros, nossos recalques e recusas defensivas, para quem sabe imaginar um futuro que não esteja condenado à compulsão à repetição. Apresentamos uma reflexão sobre o nosso lugar no cenário das práticas clínicas e sobre o diferencial que temos a oferecer aos jovens profissionais que nos procuram para formação. Sugerimos que, quando inspiradas na psicanálise, na sua ética, mesmo que pontuais e breves, diferentes modalidades de intervenção podem fazer parte da formação no nosso Instituto. Isso permitiria que os analistas atendessem demandas diferentes, que solicitassem adaptações técnicas, mas ancorados numa sólida base metodológica da psicanálise, desenvolvendo assim, ao longo da sua formação, um enquadre interno capaz de dar conta dessa variedade de demandas. Apresentamos a ideia de que transmitir e enriquecer de forma transformadora nosso legado não deve ser pautado por uma verdade imutável a ser imposta, mas por uma tradição vista como fonte inspiradora, que possa ser interrogada e sujeita a críticas e revisões.

ABSTRACT This text proposes the idea that thinking of the future of psychoanalysis brings the need to recover the historical time perspective, avoiding the blur of the present, to see a clear perspective. It is necessary to acknowledge what we have done right and wrong, our repressions and defensive denials, for those who can imagine a future where compulsion and repetition are not likely to be included. We propose the reflection on our place in clinical practice situations and the differential we have to offer those young professionals who look for us for their education and the demands for the current clinical practice. We suggest that when inspired by Psychoanalysis and its ethics, even when specific or brief, different methods of intervention may be part of our Institute. This would allow analysts to respond to any kind of request, requiring technical adjustment, but having a solid methodological basis of Psychoanalysis, developing an internal adjustment during their education and being able to deal with any kind of request. We present the idea that sharing and enriching our legacy in a transformative way may not be based by some imposed and unchangeable truth, but as an inspiring source, that may be questioned, criticized and revised.

RESUMEN El texto propone la idea de que pensar en el futuro del Psicoanálisis implica recuperar la perspectiva histórico-temporal, evitando que las burbujas del presente impidan una mirada en perspectiva. Es necesario reconocer nuestros aciertos y errores, nuestras limitaciones y denegaciones defensivas, para tal vez imaginar un futuro que no esté condenado a la compulsión y repetición. Proponemos la reflexión sobre nuestro lugar en el escenario de las prácticas clínicas y del diferencial que tenemos a ofrecer a los jóvenes profesionales que nos buscan para formación y las demandas de la clínica actual. Recomendamos que cuando estén inspiradas en el Psicoanálisis en su ética, aunque puntual y brevemente, diferentes modalidades de intervención puedan ser parte de la formación de nuestro instituto. Eso permitiría que los analistas atiendan a diferentes demandas, que soliciten adaptaciones técnicas, pero ancladas en una sólida base metodológica del Psicoanálisis, para poder desarrollar a lo largo de su formación un encuadre interno capaz de cumplir con esa diversidad de demandas. Presentamos la idea de que transmitir y enriquecer de manera trasformadora nuestro legado no debe ser pautado por una verdad inmutable impuesta, sino como fuente inspiradora que puede ser cuestionada y que está sujeta a críticas y revisiones.

RÉSUMÉ Ce texte propose l'idée que penser l'avenir de la psychanalyse rend nécessaire la récupération de la perspective historique temporelle, en évitant que les bulles du présent empêchent un regard en perspective. Il faut reconnaître nos réussites et nos échecs, notre refoulement et nos refus défensifs, pour celui qui sait imaginer un avenir qui ne soit pas condamné à la compulsion et à la répétition. On propose la réflexion concernant notre place dans le panorama des pratiques cliniques et du différentiel qu'on peut offrir aux jeunes professionnels qui nous recherchent pour la formation et les demandes de la clinique actuelle. Nous suggérons que lorsque la psychanalyse et son éthique inspirent différentes modalités d'interventions, même que ponctuelles et brèves, celles-ci puissent faire partie de la formation dans notre Institut. Cela permettrait que les analystes répondent à des demandes différentes qui nécessitent d'adaptations techniques, mais ils resteront ancrés dans une solide base méthodologique de la psychanalyse, en développant ainsi tout au long de sa formation un cadre interne capable de rendre compte de cette variété de demandes. Nous présentons l'idée que transmettre et enrichir de façon transformatrice notre héritage, ne doit pas être défini par la vérité immuable qu'on impose, mais en tant qu'une source inspiratrice qui peut être questionnée, soumise à la critique et à des révisions.

O futuro da psicanálise em dez minutos / The future of psychoanalysis in ten minutes / El futuro del psicoanálisis en 10 minutos / L'avenir de la psychanalyse en dix minutes

Com base em seu amplo percurso e experiência pessoal como psicanalista, o autor se debruça sobre a história da psicanálise para considerar como os aspectos fundamentais da descoberta freudiana estão presentes na psicanálise dos tempos atuais. Em interlocução com analistas em formação, pondera sobre a necessidade de se desenvolver um idioma comum, entre analista e paciente, para o diálogo com pacientes borderline, enfatizando a necessidade de discussão da técnica psicanalítica tradicional para além do debate acerca da frequência de sessões semanais. Conclui que analistas de hoje e de amanhã devem continuamente aprender o ofício, e estar em contato com as mudanças tecnológicas e sociais do mundo em que vivemos.

From his extensive background and personal experience as a psychoanalyst, the author looks at the history of psychoanalysis to consider how the fundamental aspects of Freudian discovery are present in psychoanalysis today. In dialogue with training analysts, he considers the need to develop a common language, between analyst and patient, for the dialogue with borderline patients, placing the need for discussion of traditional psychoanalytical technique beyond the debate about the frequency of weekly sessions. He concludes that analysts of today and tomorrow must continually learn the art and be in touch with the technological and social changes of the world in which we live.

A partir de su amplia trayectoria de trabajo y su experiencia personal como psicoanalista, el autor examina la historia del psicoanálisis para considerar cómo los aspectos fundamentales del descubrimiento freudiano están presentes en el psicoanálisis hoy en día. En el diálogo con los analistas en formación, se plantea la necesidad de desarrollar un lenguaje común, entre el analista y el paciente, para el diálogo con los pacientes fronterizos, situando la necesidad de la discusión de la técnica psicoanalítica tradicional más allá del debate sobre la frecuencia de las sesiones semanales. Concluye que los analistas de hoy y de mañana deben aprender continuamente el oficio y estar en contacto con los cambios tecnológicos y sociales del mundo en el que vivimos.

À partir de sa vaste expérience de psychanalyste, l'auteur se penche sur l'histoire de la psychanalyse pour examiner comment les aspects fondamentaux de la découverte freudienne sont présents dans la psychanalyse aujourd'hui. En dialogue avec les analystes en formation, il réfléchit à la nécessité de développer un langage commun, entre analyste et patient, pour le dialogue avec les patients borderline, plaçant le besoin de discussion de la technique psychanalytique traditionnelle au-delà du débat sur la fréquence des séances hebdomadaires. Il conclut que les analystes d'aujourd'hui et de demain doivent continuellement apprendre le métier et être en contact avec les changements technologiques et sociaux du monde dans lequel nous vivons.

Reflexões acerca do futuro da psicanálise / Reflections on the future of psychoanalysis / Reflexiones sobre el futuro del psiconálisis / Réflexions sur l'avenir de la psychanalyse

A Associação dos Membros Filiados (AMF) ao Instituto de Psicanálise da Sociedade Brasileira de Psicanálise de São Paulo completa 50 anos. Este texto foi escrito para o simpósio comemorativo dessa data, organizado em torno do eixo passado, presente e futuro. A autora se propõe a pensar o futuro da psicanálise, com base em um ensaio ficcional sobre uma psicanálise distópica.

The Association of Candidates (amf) of the Institute of Psychoanalysis of the Brazilian Society of Psychoanalysis of São Paulo (SBPSP) celebrates 50 years. This article was written for the commemorative symposium of this date, organized on the axis: past, present and future. The author intends to think about the future of Psychoanalysis, based on a fictional essay about a dystopian Psychoanalysis.

La Asociación de Candidatos (amf) del Instituto de Psicoanálisis de la Sociedad Brasileña de Psicoanálisis de São Paulo celebra 50 años. Este texto fue escrito para el simposio conmemorativo de esta fecha, organizado en el eje: pasado, presente y futuro. La autora se propone pensar sobre el futuro del psicoanálisis, a partir de un ensayo ficticio sobre un psicoanálisis distópico.

L'Association des Candidats (amf) du Institut de Psychanalyse de la Société Brésilienne de Psychanalyse de São Paulo fête ses 50 ans en 2020. Ce texte a été écrit pour le colloque commémoratif de cette date, organisé autour de l'axe: passé, présent et futur. L'auteur propose de réfléchir à l'avenir de la psychanalyse, à partir d'un essai fictif sur une psychanalyse dystopique.

Transcultural child psychiatry: its history, present status and future challenges.

INTRODUCTION: To provide a historical review of transcultural child psychiatry in Canada and discuss its future mandate within traditional mental health services. METHOD: To present a summary of some key papers and chapters in the literature which describe the history and present status of transcultural child psychiatry since its inception 30 years ago. RESULTS: There is a virtual absence of transcultural material in the early editions of the most valued textbooks of child and adolescent psychiatry. This has only begun to change during the past 5 years. In Canada, work has centered around recently arrived immigrant and refugee children with comparatively little work being done with other minority groups. CONCLUSION: Transcultural child psychiatry remains a profoundly understaffed subspecialty. To change this, university departments of child psychiatry should initiate the formation of groups of transculturally aware clinicians and researchers.