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.     

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.     

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.     

La mémoire d’une pièce d’Euro

An experiment was done to determine how completely and accurrately French people remember the visual details of coins newly introduced in Europe, french Euro coins. The variables manipulated are the age of the subjects (20–29; 30–39; 40–49; 50–59 years old), delay after the introduction of the new coins (1 month, 4 months, 1 year), the type of coin (2 cents, 50 cents, 1 Euro) and the characteristics of the coins (operative versus figurative). Three main results emerged from this experiment. Firstly, performance was poor. Secondly, results are consistent with the idea that the visual details of an object are typically available from memory to the extent that they are useful in everyday life. Thirdly, recall performance does not depend on age, type of coin and delay of introduction of the new coins.     

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.     

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.     

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.     

Le travail coopératif d’équipes de projet d’ingénierie à l’épreuve de l’activité en réunion médiatisée et multi-localisée

Performing in worldwide competition compels companies to be innovative and this unyielding global pressure sparks engineering team projects on a far-reaching scale. The synergy of heterogeneous and dispersed skills supposes to overcome the geographical distance between teammates using sophisticated socio-technical devices. Based upon four grounds of empirical research, this article will examine the function of this media coverage technology with a comprehensive sight of phenomena underlying remote interactions between teammates. Face to the reality of their cooperative activity, experiencing multi-localized virtual meetings with synchronous co-presence, are considered the experience, the resources and the constraints introduced by these terms and working conditions.     

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.     

L’annonce d’un décès en milieu hospitalier

Announcing a death is always a delicate moment for close familial members but also for caregivers. Law gives some precisions about how this information must be delivered. Recently the state council judged that the lack of empathy from caregivers and the late of the death announcement can create a damage. This judgement gives more precisions about how a death announcement must be in a hospital. This topic is pretty similar with the information which must be given to close familial members about organ donation. This latter is definitely more exceptional and the procedure is a way more regulated. There are much rules which explain how this information must be delivered.     

Comment favoriser l’anticipation positive d’un déménagement organisationnel chez des salariés ? Test d’un modèle psychosocio-environnemental

French academic research on organizational relocation is scarce. This study aimed to explore how positive attitudes can be developed before organizational relocation using a psycho-social environmental model. More specifically, this paper analyzes the impact of workplace attachment and socio-professional support on anticipated satisfaction with relocation and the mediating role of the agreement with the top management decision to move. We conducted an empirical study with a sample of 119 employees of an audiovisual company based in France. Results show that anticipated satisfaction with relocation was inhibited by workplace attachment and facilitated by socio-professional support. Moreover, agreement with the change decision to move mediated these relationships.     

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.     

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.     

Conflit d’intérêts et déontologies : l’échec des déontologies existantes et l’improbable (?) succès de la loi

The increasing frequency with which health scandals have come to light since the 1980s has uncovered a great deal of unlawful behavior, both in the pharmaceutical industry and the medical profession, as well as in the world of “experts” (or researchers), along with journalists and specialist media companies. These types of behavior have accumulated and combined to inhibit any reaction from government, thus preventing health policy from playing its role. The State has its share of responsibility in this failure, for having been unable to conserve the impartiality and effectiveness of its administrative actions: it must acknowledge this, which is a whole other problem. However, in the case in point, it is obvious that those texts which must have been breached to allow these health scandals to occur are almost exclusively the result of professional self-regulation, with a wide range of diverse legal values: ethics for the health professions, journalistic ethics, charters between the pharmaceutical industry and media companies, alongside scientific ethical charters. These texts are the result of regulations generated by the professions themselves, drafted to counteract conflicts of interest. The sheer number of cases highlights the failure of these self-regulatory measures, leading to legislation targeting the problem, in particular that of December 29, 2011, which strengthened monitoring in terms of conflicts of interest and penalties against those placing themselves in a conflict of interest situation. Will this legislation, in direct response to the so-called Mediator^® case, be able to succeed where self-regulation failed, swept away as it was by financial considerations? The arbitrations that characterized the drafting of this legislation and the resulting complexity, which affects the decrees, seem to promise many difficulties, particularly due to the scarcity of resources the authorities have to enforce it.     

La création d’animaux chimères porteurs d’organes humains

Generate a human organ in an animal in order to elaborate a stock of available organs for transplantation… This is not the scenario of a science fiction movie but the result of the hard work of some researchers convinced of the feasibility of this major innovation. If the interest of this discovery is undeniable, it generates also many ethical and legal questions.     

L’équipe paramédicale à l’hôpital psychiatrique : Retentissement actuel d’une évolution de deux décennies Analyse d’un entretien de supervision

At the advent of the reform of nursing education in France, this study attempts to give an overview of changes in the work practices of nurses and the employment of nurse’s aides in psychiatric wards of hospitals. Based on the assumption that interaction acts as an interface between the individual on one side and collective systems on the other, the authors approach this issue by analyzing a supervisory meeting of a caregiving team in a psychiatric hospital.     

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.     

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.     

La contraception d’urgence chez les mineures. Une offre illimitée en manque d’évaluation

Avoiding the use of abortion by minors is the aim that has been pursued since 2000 through the facilitated access of young girls to emergency contraception : breaking numerous rules relative to health security and to Social Security, the dispensation is done anonymously and free of charge. However, the analysis shows that the three postulates from which this policy was built – satisfactory benefit/risk ratio of emergency contraception, safety of repeated medication and real efficiency to reduce numbers of unwanted pregnancies and abortion – are not validated. In addition, there are some indications that this policy is not devoid of adverse effects.