L’expertise médicale au temps des pandémies : l’exemple des cancers

Medical law suits were interrupted during the COVID-19 pandemia and judicial process will come shortly back to the normal. Pandemia induced delays in the cancer diagnosis and treatment. These modifications were validated by expert consensus from the medical societies. However in the coming years it is highly possible that patients think they were victims of a “loss of chance” and ask for a compensation. The various situations in which physicians can be involved are described and recommendations for the management of medical charts are discussed.     

L’évolution des normes face au développement des objets de santé connectés

A lot of connected objects can be sold on the Internet and in some general stores. These products can be used in a health environment; they can help to promote a healthy lifestyle. But they do not always have a well determined legal status, that is established to protect the patients or the healthcare professionals. The connected objects can support innovation. They can become an essential help for the patients and the healthcare professionals, nevertheless they can be at the origin of physical injuries, if they are badly used.     

L’instrumentalisation managériale des espaces de délibération formels: l’expérience des enseignantes du préscolaire/primaire

This study examines formal deliberation spaces’ structure and how they translate into collegial work structures. Based on a critical experientialist work theory and a materialist feminist perspective it considers formal deliberation spaces and teachers’ lived experiences. The methodology relies on a qualitative research design involving 25 primary school teachers and individual and group interviews. The results show many mandatory formal deliberation spaces within the work organization and highlight the limited possibilities for teachers to deliberate their day-to-day experiences within these spaces. The findings render visible the process by which the structure of formal deliberation spaces can be moulded and instrumentalized to benefit the administration and render invisible teachers’ lived experience, leading to institutional silencing.     

L’insertion professionnelle des enseignants débutants au Québec

With an aim of checking if educational circles took into account the professional induction of their beginning teachers, in the context of the renewed teacher educational formation, we investigated the working experience of newly graduated high-school teachers from University of Montreal in the years 1998-1999-2000. This study also tries to see if the renewed teacher educational formation inaugurated in 1994 plays a facilitating role in the beginning high school teachers’ induction and if professional exhaustion is part of their problems. The results obtained indicate that 94 % (N=165 out of 176) of the beginners participating in our study considered to have succeeded in their professional insertion. Most of them find their initial formation adequate. They say to be especially satisfied of the quantity and quality of the training courses and state that their formation covers well the various aspects of the actual teacher’s task. Beginners also find that school Commissions should greatly improve their facilitating measures of professional insertion. The results of the investigation showed that the professional insertion of the beginners is more difficult in the absence of helping measures. Finally, although the majority of beginners complain about the heaviness of their task, the investigation reveals that professional exhaustion does not play a part in the success or failure of their induction.     

Les publications des experts médicaux : l’exemple de l’anesthésie-réanimation

Forensic expertise becomes dominant in our society. Several reports questioned the competence of medical experts. We analysed the scientific competence of the 136 experts in Anaesthesia, Intensive Care and Emergency Medicine from senior courts in France. For that purpose, we made the choice of the H-Index and the number of scientific publications as markers of quality, using Google Scholar and PubMed databases. Thirty-five percent of experts have an H-Index equal to zero and 27 % never published. Out of the 104 experts who published at least one scientific article, 27 (26 %) did not publish for at least 10 years. The present study illustrates the great heterogeneity of the medical expert population regarding our criterions of judgement. This questions the selection and the operating mode of legal experts. There is a major difference with the selection process performed by the French Conciliation and Compensation Commissions. We propose that the official scholarly societies should be consulted during the appointment process.     

Le développement contemporain des régimes juridiques des conflits d’intérêts : l’exemple du secteur de la santé

The conceptualization of conflicts of interests and deployment of their regulatory systems are primarily modes of economic and managerial health control. When did the legal regime of conflicts of interests, which formalizes the process, clash with the conditions of professional practice? Not all assumptions of friction or opposition of interests necessarily constitute a conflict of interests. All public sector professionals have interests but not all their interests generate conflicts. The aim of public declaration of interests is to reveal the relations of interest in order to allay suspicion. Most frequently in the form of soft law system, the declaration of interests is a way of warning about the existence of a “grey zone” or time of deontological risk. It was changed by the law of 29 December 2011     

L’attitude défaitiste des responsables d’équipe : un frein à l’innovation?

The goal of this study is to investigate the role of defeatist attitude in regard to process innovation by considering the mediating role of group potency and the moderating effect of collective autonomy. Data was gathered from 101 work teams (381 members and 101 immediate supervisors) in a public safety organization located in Canada. Results show that group potency may have a mediating role in the relationship between defeatist attitude and process innovation. Moreover, results indicate that the relationship between group potency and process innovation is moderated by collective autonomy, such that this relationship is stronger when the level of collective autonomy is high.     

Évaluation de l’efficacité d’un traitement cognitif-comportemental pour le trouble d’anxiété généralisée combiné à des stratégies de régulation des émotions et d’acceptation et d’engagement expérientiel

The objective of this article is to examine the efficacy of a new cognitive-behavioral treatment, which combines emotion regulation strategies, and acceptance and commitment-based strategies to cognitive-behavioral supported treatment for generalized anxiety disorder (GAD). A single-case multiple baseline design was used to measure the effect of a 19-week treatment on three participants. Semi-structured interviews, self-report questionnaires, and daily self-monitoring were used to assess symptoms of GAD, general anxiety, depression, and quality of life. These instruments were administered at different times. At post-treatment, two out of the three participants showed a clinically significant improvement and no longer met GAD criteria. These results were maintained at the three-month follow-up. For the third participant, a considerable improvement was observed at the end of treatment but only reached clinical significance at the follow-up. The results of this study suggest that this type of treatment was effective in reducing anxiety and depression symptoms and in improving quality of life of GAD patients. Controlled studies involving bigger sample sizes are needed to determine the efficacy of this new treatment. Future research should also examine the separate and specific contribution of each therapy component in treatment efficacy.     

Modification des représentations sociales des métiers d’infirmier et d’animateur socioculturel chez des étudiants grâce à une action de santé publique menée en interdisciplinarité

Health care and social care professionals are increasingly encouraged to exchange views and to define prevention actions, in order to respond to the needs of the users in a targeted and personalized way. The objective of this study is to analyze the impact of interdisciplinary work between a group of nursing students and a group of third-year degree students in social intervention, on their respective representations concerning their future profession. One hundred and twenty-nine nursing students and 41 third-year degree students in social intervention responded twice to a specific questionnaire, built up from the skills listed in the respective competency framework of the two groups of students. The results indicate that after designing and carrying out a public health action with specific audiences (children, teenagers, students, people in precarious situations, people with disabilities), the two groups of students experience a meaningful change in the social representation of each other's profession: it moves from a role of care or animation technician to a more complex vision of the two professions, more in connection with the competency frameworks. It is therefore for the initial training to prepare them early for interdisciplinary work, so that they become professionals capable of responding appropriately to the specific needs of users.     

Évaluer l’évolution psychologique des travailleurs d’Ésat : questions méthodologiques

ObjectiveTo point at and to discuss of some methodological problems in studies about psychological evolution of schizophrenic workers in ESAT (protected work).MethodFirst, the presentation of an empirical study (N: 25 schizophrenics) on this question, presentation of her results (no significant correlation between duration of work in ESAT and the assessed psychological dimensions (self esteem, depression, satisfaction with life, psychosocial skills); secondly, to point her methodological limits (epistemological, choice of instruments, comprehension of the specificity of the clinical situation). In conclusion some methodological propositions are indicated for a best apprehension of this complex situation (psychological evolution of these schizophrenic workers).     

Le travail collectif à l’épreuve des restructurations organisationnelles

The ergonomic analysis of work (Daniellou, 1996; Wisner, 1996) and especially the psychological analysis of real working activity (Leplat, 2000) allow investigating the main factors of work situations. The objective is to show the influence on the nursing representations of psychiatric services that are restructured, of the initial working situations, the projects, the restructuring models. The analyses assess the nursing representations of psychiatric services that are restructured, the projects, the restructuring models, the real working activity. The data show impacts of collective work and restructuring models, especially the damaging consequences of fusions. The results enable the authors to discuss from the points of views of theory, methodology and interventions.     

L’épuisement professionnel des enseignants en début de carrière

In the literature on the professional integration of teachers burnout is often invoked to at least partially explain the high percentage of those quitting the profession after a five-year practice or less. Teachers’ burnout implies emotional distress, viewing pupils as « things » (instead of as human beings), and being unsure of one’s teaching abilities. While this not always leads to quit teaching, victims of burnout can hardly escape pessimism and cynicism about their profession. This paper is made up of two parts: 1) a discussion of teachers’ burnout; 2) some suggestions for keeping teachers on the job.     

Effet placebo et valeur de sens dans l’évaluation des psychothérapies

The evaluation of psychotherapies is on the point of constituting a major stake for the actors of the psychic care under the pressure of the public authorities. The scientific reach which we intend to give to these evaluations must be questioned at an epistemological level. The author questions the status of the placebo effect as well as the methodology of the evaluation of the psychotherapies by the technique of test-retest in the interpretation of the results of randomized studies. He criticizes the interpretation of quantitative data when they are treated as natural values, outside any anthropological theory.     

Étude de l’efficience des mécanismes inhibiteurs chez des patients arabophones avec lésions frontales

Our work purpose was to study the impact of focal frontal lesions on the inhibitors processes. We used two arabophone versions of Hayling task and the Stroop task with condition of flexibility. In comparison with 13 control subjects matched by age, gender and level of education, frontal patients were (1) significantly slower in both task without been disproportionately slower in the condition needed inhibition, (2) committed significantly more errors than control subjects in the second part of Hayling task showed inhibition deficit, (3) laterality of frontal lesions had no incidence on performance, (4) individual analysis showed multiples dissociated deficits but also showed correlations between scores of rapidity, flexibility and inhibition. In conclusion, among all of performances, scores of errors in the Stroop and the Hayling tasks seemed to be the more sensitive to the frontal damage. Patients with the lowest performance in both inhibition tasks were those who presented lesions involving both the medial and lateral frontal cortex, the anterior cingulated cortex and/or orbitofrontal cortex.