Quels enjeux pour les soins bucco-dentaires sous anesthésie générale chez les adultes ?

Common dental acts sometimes require to be performed under general anesthesia. This article describes the development of an adult consultation for dental care under general anesthesia at hospital Henri-Mondor in Créteil group. Forty-two people received dental care under general anesthesia during the year 2015 at Henri-Mondor hospital. Thirty-eight percent were aged 21 to 30 years. The main reason for using general anesthesia phobias 56%. The second reason, with 31%, is on disability. Among the type of intervention, 61% represent extractions of permanent teeth. However, our study shows that the indication of general anesthesia must be asked as a last resort. Other alternative techniques exist and must be offered an upstream. General anesthesia tends to grow and be part of a comprehensive treatment of certain categories of patients. General anesthesia comfort remains prohibited.     

Développement des collectifs de travail et développement de la sécurité : une étude sur les décisions à risque en anesthésie

This article highlights the collective dimensions of risk management for patients before an anesthesia. After a phase of observation of real activity, interviews were conducted with 20 anesthetists from two French hospitals. The analysis reveals interindividual diversity in practices. This diversity is explained by the inclusion, in decisions, of knowledge about “distributed” skills in the team and about local “shared practice”. The results establish a link between the site where the anesthetists are working and the choice of an anesthetic technique. They also show that the positioning of anesthetist vis-à-vis the “shared practice” is significantly related to their seniority in the profession. These results open perspectives for research and intervention for the joint development of collective work and safety.     

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.     

Sciences médicales et droit

How does Law unravel and seize Medicine? The relationship between Law and Medicine is tremendously complex. At first sight, Law understands medicine as being a medical science, an applied science, and imposes requirements in this regard, such as respect for the “established scientific knowledge” or “tested medical knowledge”. But Medicine turns out to be “Art”, a clear and authentic expertise which requires techniques reiteration. Seen by Law, Medicine is not classified into either both of these scientific or technical dimensions. Borrowing from human sciences also allows to set requirements for medical humanism.     

Similitudes et différences de perceptions chez des salariés hommes et femmes

This study investigates men and women perceptions in the work, accros the relations between work conditions and job satisfaction. Similarity and difference are questionned about the mean dimensions of the work conditions (factor analysis) as well as the prédictive value of theses dimensions for the job satisfaction (regression analysis). In the same point of view, similarity and difference are analysed about health, importance of life domains and work-family interferences. Men and women seem to organize in the same way work conditions. Three factors are retained (Relations with superiors, Development and autonomy, Work intensity), wich the first two predict job satisfaction, for the men and the women. Nevertheless we note some differences, both about the force of the prediction and about specific item. Results and and futur works are discussed.     

Logique et théorie physique

Conclusion On s'occupe de la logique quantique depuis 1935 et pendant cette période beaucoup de résultats ont été obtenus, encore me suis-je abstenu de mentionner les résultats obtenus ces dernières années par les logiciens dans ce domaine. Certains de ces résultats ont un intérêt direct pour les théories physiques. En particulier on voit de quelles conditions impératives on doit tenir compte quand on effectue un changement de théorie pour passer à une théorie meilleure. L'exemple de la théorie fonctionnelle des corpuscules est significatif.     

Variables latentes et propriétés mentales : pour une épistémologie affirmée pragmatiste et réaliste

The reliability of models with latent variables is questioned by different authors: what is the ontology of mental properties? How to integrate the complex of mental processes with latent variables? All these debates raise the question of the legitimacy of latent variables as methodological approach comparatively to new approaches such as Network analysis. By clearly posing the ontological nature of mental properties as emergent properties of mental processes, and by clearly posing a theory of pragmatist and realistic knowledge, our work seeks to show that latent variables are efficient approaches for inferring mental properties.     

Période périnatale et Rorschach : normes,indicateurs, mentalisation et perspectives théorico-cliniques

ObjectiveThe perinatal period is a maturation phase characterised by the appearance of a radical psychological and identity crisis, little studied by projective methods, in particular the Rorschach inkblot test. The objective of this article is to offer a list of Rorschach norms and indicators adapted to the perinatal population. This is to comprehend the psychological modifications occurring during pregnancy.Materials and methodThe projective Rorschach inkblot test was presented to a representative sample of 54 pregnant primiparous French women. Based on the scoring and analysis methods of the Parisian School, the quantitative norms from the analysis of the psychogram, the chosen cards, and the mentalization indicators were compared to those of the general population.ResultsWith the exception of F +% and H%, all the normative data for the perinatal population are significantly different from those related to the general population (p .005). On a qualitative level, the interpretation of the data highlights the presence of major inhibition mechanisms, associated with a preconscious functioning stasis.ConclusionThe normative data in Rorschach of the perinatal population should be specifically used for the study and psychological support devoted to this population. It also allows a better understanding of the feminine psychologic modifications during pregnancy.