Les autorisations d’équipements lourds d’imagerie médicale : un désordre organisé

Medical imaging is essential for all medical specialties and it is natural that the government wants to create a real healthcare provision policy in this area. Medical imaging and particularly the “heavy” equipment are subject to a regulatory and legal framework. This framework results in respect of administrative authorization mechanism. These authorizations are a major tool for development of medical imaging on French territory. This mechanism is an important instrument of economic regulation in controlling health costs. However, the access to this kind of equipment raises various issues in governance and administration but also in matter of economic regulation, distribution of healthcare supply in medical imaging in health territories and respect of public health issues. The authorization mechanism raises questionings, not only at national and regional level in terms of unequal access, but also at European and international level. Indeed, France is among the last countries in the ranking of CT (computed tomography) and MRI (magnetic resonance imaging) equipment rates in comparison with many OECD (Organization for Economic Cooperation and Development) countries. Now, these authorizations will integrate much more the concepts of accessibility and quality of patient care. The legal and regulatory framework of these authorizations will have to evolve and to adapt to new technologies and practices, which today should be a source of significant cost savings.     

Les décisions d’orientation dépendent-elles des stéréotypes sociaux ? Sous quelles conditions ?

IntroductionIn this research we want to show that influence of social stereotypes linked to the social background on the students’ orientation is not a social fate that cannot be ignored but that there really are conditions that allow to reduce or even suppress those effects. The objective is to test the hypothesis according to which the seniority of the teachers, their type of professional commitment and the fact of working or not in an area earmarked for special educational assistance (prioritary education zone) must allow to significantly reduce the stereotypes effects on the academic judgment.MethodWithin the framework of an experimental research lead in school, we have asked high school teachers to express propositions of continuing studies as well as success predictions from ficticious student files reaching the end of high school. The results confirm that the bias generally observed in academic judgments are reduced in professors having a seniority above 5 years compared to the ones having a seniority lower than 5 years, those who have a strong work commitment, like the “self made persons” or “social activists” types, compared to those having a lower type of work commitment like the “self investors” or “careerists” types and those working in an area earmarked for special educational assistance (prioritary education zone) compared to those who work outside these areas.ConclusionThis research shows that factors likely to limit the effects of social background stereotypes on academic judgments do exist.     

Un cadre psychosocial d’intervention pour accompagner le développement et le déploiement d’une technologie nouvelle

This article presents a psychosocial intervention framework to support the development and deployment of a new technology. This methodology articulates the three phases necessary for the study of the representation of the use and its evolutions (i.e., the usual trajectory): acceptability, acceptance and appropriation. After an argumentative presentation of the methodological choices made, the article continues with the presentation of an example of accompaniment carried out within the framework of the IDViandes project aimed at the development of a traceability device for meat containers Of slaughter within the company SVA Jean-Rozé, subsidiary of the Intermarché group. This example argues in favor of the idea that the use of such a method makes it possible to optimize the successful accompaniment of the development of a technology and thus ensure its future diffusion.     

Méthode d’évaluation des risques psychosociaux auprès de travailleurs déficients intellectuels

While current regulation imposes to take into account psychosocial risks, their evaluation among workers with intellectual disabilities is still lacking. In order to develop an adapted tool, a language skills test was combined with the perception of work situations. Then, an ergonomic analysis was used to confirm the answers to the questionnaire. In a second phase of the study, the questionnaire was tested among a sample of 85 workers with intellectual disabilities. Data collected attested the relevance of this tool by accurately revealing workers’ feelings about their working environment. This study constitutes a first step in the psychosocial risk assessment process for workers with intellectual disabilities.     

Embolie gazeuse cérébrale lors d’une séance d’hémodialyse : aspects médico-légaux : à propos d’une affaire judiciaire

Air embolism is a serious iatrogenic event, concerning many invasive medical therapies. It is a rare but life-threatening adverse event. We report a case of a cerebral air embolism occurring during a renal replacement therapy. We report the case of a court case analyzed in the Department of Legal Medicine of Farhat Hached University Hospital in Sousse, Tunisia, related to a cerebral gas embolism occurring during a session of renal replacement therapy. Then we discuss the medical liability of the medical team involved in this act. Through a draft organic law (law No. 41/2019 on patients’ rights and medical liability), Tunisian jurisprudence aims at resolving legal claims in the field of medical liability by providing more opportunities for an amicable solution and by guaranteeing an adequate and quick compensation of the damage suffered.     

Réflexions d’un médecin expert et d’un juriste autour d’un exercice pratique de droit médical

We offer a reflection around a clinical case of nosocomial infection allowing us to address the difficulties faced by experts and lawyers and other jurists in matters of medical liability. This case is the result of an exercise proposed within the framework of the national DIU (interuniversity diploma) in medical accidents for which the two authors are responsible in Amiens and Bordeaux. The writing was enriched with the responses of the students. This clinical case makes it possible to approach the compensation for nosocomial infections, to compare the amicable procedure before the conciliation and compensation commission for medical accidents and the procedure before a judicial or administrative jurisdiction. Finally, the reflection focuses on patient information, especially protected adult, and access to the medical file. It is not a question here of detailing the medical care but of discussing medical responsibility and the rights of the patients.     

La cross-évaluation : une approche d’évaluation et de développement des processus de travail inter-équipes

Organizational agility has become an increasing focus for companies and has led to the emergence of new developmental methods. This article presents the cross-evaluation as an approach to evaluating and developing inter-team interface efficacity. Though 360 degrees feedback collective processes are being evaluated, and during reflexive workshops they decide what improvements to make in their team functioning. Based on a literature review and more specifically on the theories of social identity and groupthink this article describes the scientific bases of the cross-evaluation method and the biases that can be involved and how to reduce them. It suggests new avenues of research and practical suggestions for practitioners about an inter-team development method.     

Évolutions récentes de la responsabilité pour défaut d’information

It is wrongly that one would think that the question of the information due by the physician to the patient is not likely of any further developments. Four recent rulings provide the perfect illustration and lead to consider that this duty to inform has attained a genuine autonomy. In some instances, the compensation arising out of the failure to inform may depart from the strict framework of loss of chance in which many believed it was confined to.     

Parcours : développement d’une stratégie de prévention de la récidive adaptée aux milieux ouverts

Experiments show that applying RNR principles “in the real world” within the context of probation can reduce recidivism, provided that evidence-based intervention models are used. In Quebec, probation officers agreed to take part in a pilot project whereby the Parcours program (Pathways) was transposed into a series of interview outlines to be used in a community setting. The experiment took place over a one-year period, the management of convicted offenders consisting in around 10 30 to 90-minute interviews. These interviews addressed: motivation for change, beliefs, values and cognitive distortions, as well as the adoption of relapse prevention strategies. Results were positive enough to authorize the deployment of Parcours en milieu ouvert (Pathways in community settings) in all sectors. This approach could be implemented in France, where at the instigation of the Council of Europe, new European probation rules recommend the establishment of interventions based on evidence-based models.     

Défaut d’information préalable : présomption de la souffrance morale et préjudice d’impréparation

The Conseil d’État, relatively to the ruling dated the 16th of June 2016, keeps defining the legal regime of the harm of unpreparedness which consists in a violation of the health professionals’ duty to inform their patients, based on article L. 1111-2 of Code de la santé publique. Moreover, it can be highlighted a shared understanding between the judicial and administrative jurisprudences. Yet, the Conseil d’État is likely withholding the patients’ right to information that the Cour de cassation may have headed toward.     

Le développement d’un outil de mesure des comportements inadaptés au travail auprès de directions d’établissements scolaires du Québec

This study focuses on developing a measuring tool for unsuitable behaviour in the workplace. The tool has been developed from school principals. To do so, exploratory factor analyses have been conducted. Data have been collected from 232 senior staff members from school facilities across Quebec. Participants were invited to answer an online questionnaire. The results obtained help to classify inappropriate work behaviour into one factor. In addition to its theoretical value, this research brings several significant contributions to practice.     

Les déterminants du décrochage dans l’enseignement secondaire : une revue de littérature

IntroductionDropping out of school is a research topic with various dimensions: non-graduation, school leaving, absenteeism, school failure and school refusal. It involves processes determined by various factors – individual, social, familial and institutional. Individual determinants have specifically been studied in the recent literature. They involve demographic and academic indicators, behaviors, attitudes and mental health of the student, as well as specific types of school refusal. The aim of our study is to update knowledge in this specific field, and highlight underlying problems and methodological issues raised in the literature.MethodDropping out of school is defined as leaving school without a qualification. It involves a process of specific disengagement, which is non-reducible to the negative counterpart of school commitment. The present article is a review of literature from PsycInfo on the individual determinants of dropping out of school. It is based on 50 articles published between 2010 and 2017, related to the following topics: school dropouts, school leavers, school refusal, and academic failure. Five exclusion criteria were used: studies with single factor analysis, literature review, sample excluding secondary education, sample of less than n = 100, non-general, non-mixed, or composed of a sociodemographic minority.ResultsSchool performance and early risk behaviors (substance use disorders, sexuality) remain the best determinants of dropping out throughout the duration of schooling. Psychopathological factors, anxiety, depression and externalized disorders can play a direct or indirect role in the prediction of dropping out. Lack of psycho-emotional support strongly supports the intention to drop out. Motivation has an unequal predictive value, depending on the type of construct or theoretical model used. Inappropriate beliefs, low self-esteem, pessimism, creativity appear as indirect determinants of dropping out. School burnout, understood as emotional, physical and mental exhaustion due to education, directly causes a break between the student and the school.DiscussionMethodological bias can modify the significance of determinants such as gender, academic achievement and retention. Greater knowledge about the relationships between determinants, the profiles of at-risk students and temporalities should help clarify students’ trajectories and the processes at work in different school contexts. Recommendations to educational staff are put forward regarding the detection of individual indicators of dropping out.     

Les vicissitudes du préjudice d’agrément

The fate of the loss of amenity has always been related to the right of recourse of the third-party payers against the person in charge of the damage. The loss of amenity has been recognized by Law of the 27 December 1973. It was at that time that it was excluded from the recourse of the third-party payers. It was not the case of the physiological injuries which had always been submitted to the recourse of the third-party payers. At first, these injuries had included the disorders in the conditions of existence. But in 2005, the Dintilhac nomenclature adopted a restrictive conception of the loss of amenity. This damage is now defined as the impossibility to practice regularly a specific activity of sport or leisure. In addition, the Law of 21 December 2006 imposed on third-party payers to exercise their action only on pecuniary damage. The physiological injuries were therefore excluded from this action. The strict definition of loss of amenity is both adopted in Civil Law and Social law. But in these two areas, the analysis of the judicial practice reveals that it is undermined the right for the full repair of the victims under their loss of amenity. Accordingly, the question of the opportunity to widen once more the definition of the loss of amenity arises today.     

Processus d’élaboration et de validation d’un questionnaire portant sur le développement des compétences émotionnelles lors du mentorat

Objective and methodThe aim of this article is to provide a portrait of the emotional competencies developed by school principals (n = 359) in a mentoring context by developing a seven-step questionnaire by Frenette et al. (2019) presenting various proofs of validity.ResultsThe analyses conducted support a factorial structure with two correlated aspects of emotional competencies (self and others). School principals in Quebec develop more emotional competencies related to the aspect of others than for themselves during mentoring. A further analysis indicates that school principals develop more two dimensions of Emotional competencies: Identification and Understanding. The results also show that 77.26 % of respondents indicated that they developed emotional skills during mentoring.ConclusionThe results provided an understanding of the importance of emotional competencies in education, and specifically in school management. It also revealed the importance of emphasizing the role of mentoring in their development. To our knowledge, the questionnaire developed in this study is one of the first to measure the development of emotional competencies during a mentoring relationship.     

Sensibilité développementale théorique et empirique des items de la Batterie d’Évaluation Cognitive et Socio-émotionnelle (BECS) pour l’évaluation du développement psychologique de très jeunes enfants au développement typique

The Social and Cognitive Evaluation Battery (SCEB) is an instrument specifically created for the examination of pre-school and school-aged children with autism and intellectual disability and recommended by the French High Health Authority (HAS, 2010, 2011, 2012, 2018). The SCEB explores 16 functional abilities, in both cognitive and socio-emotional areas and allows the calculation of domains and areas developmental levels and heterogeneity indices for the global, cognitive and socio-emotional areas. Each of the 16 domains of the SCEB includes behavioral items hierarchized into 4 developmental levels corresponding to 4 age periods (level 1: 4–8 months; level 2: 8–12 months; level 3: 12–18 months; level 4: 18–24 months). The child's assessment provides a profile of the 16 levels of cognitive and socio-emotional development that can be interpreted within the framework of Piaget's (1977) and Fisher's (1980) theory. The study tests the developmental sensitivity of level scores and their adjustment to chronological ages and developmental ages assessed with the Brunet-Lézine Scale for 65 young typical developmental French children aged from 4 months to 24 months. The results show high sensitivity of scores and satisfactory adjustment to chronological and developmental age differences. Normative benchmarks are also given for indices of heterogeneity of development profiles, heterogeneity that decreases with age. Thus, the scores are interpretable in reference to theoretical models and can be used for the study of all developmental characteristics in infant and toddlers’ children with and without neurodevelopmental disorder.     

Prise en charge psychologique des détenus délinquants sexuels : une pratique des limites

Based on the experience of one of the authors and with the aid of three case studies, the conditions of psychological care for sex offenders during their imprisonment and the difficulty with which the psychologist is confronted will be examined. The first case underlines the risk of the criminal being reduced to the criminal act committed and losing touch with humanity. The case also illustrates how the period at the beginning of imprisonment is a favourable period in terms of allowing the recognition of committed act. The second case refers, on the contrary, to the nature of care request in penitential institutions, which does not arise from an authentic demand from the patients. In order to create this authentic demand, it is necessary to introduce measures based on mediation or interpellation technique. The third case illustrates the difficulty met by the psychologist in positioning himself between care ethic and the pressure from the society concerning the risk of criminal relapse.