Inhomogénéité des évaluations de durée d’incapacité totale de travail. Comparaison d’évaluations des durées d’incapacité totale de travail entre les médecins légistes,les médecins généralistes et les urgentistes

Setting a total length for time off work is a forensic act that all physicians must be able to perform. Given the importance of the legal consequences of this evaluation, it seems desirable that this practice is mastered by all practitioners. However, in practice there is often a disparity between forensic assessments and evaluations provided by other practitioners. To assess this difference in evaluation, we conducted a retrospective study, looking at 4 years of archives, of victims of Marseille's forensic service (CHU Timone), and highlighted a disparity between medical examiners, GPs and emergency physician's assessments. In both comparisons between medical examiners versus GPs (n = 367) or medical examiners versus emergency physicians (n = 511), were found in one third of cases of forensic requalification. The majority of checks on where GP's (80%) determined on over 8 days leave were reassessed under this limit by a medical examiner. This trend is reversed for the majority of (61%) requalification cases of emergency assessments (assessment over eight days by medical examiners. This study, proving a fact long suspected, raises many questions about these disparities evaluation we have discussed.     

Réalité virtuelle et santé des personnes âgées institutionnalisées. Vers un EHPAD 2.0 ?

Virtual reality (VR) is used in general health care: prevention, physical medicine, chronic and acute pain, quality of life in palliative care, and in psychiatry: anxiety, depression, addiction, psychosis. Our objective is showing VR using among elderly people in French retirement home. Virtual reality is showing efficacy as distraction, anti-pain, tranquillising, antidepressant methods. It should be an answer to many elderly health problems. VR is easy to use, with low side effects. Non-drug treatments among elderly people are recommended. Used as complementary or alternative medicine, VR must be shaped for using with old and fragile people in retirement home.     

Relations entre réflexivité d’équipe,mémoire transactive et efficacité interventionnelle perçue chez les policiers-opérateurs du RAID

The objective of this study is to examine the influence of explicit (team reflexivity) and implicit (transactive memory) coordination processes on the perceived interventional effectiveness of specialized elite units (RAID) of the French national police. We test the hypothesis that transactive memory is a mediating process in the relationship between team reflexivity and perceived effectiveness. One hundred and three police-officers representing the seven French police special units replied to a questionnaire. The results show that perceived effectiveness is positively related to task reflexivity and transactive memory. The relationship between task reflexivity and perceived effectiveness is mediated by the integrated component of transactive memory (bootSE = 0.05, 95% BCa CI [0.004, 0.19]). The theoretical and practical implications are discussed with regard to the development of debriefing methods and teamwork training for the development of shared mental models.     

Suicide lié au travail et prévention

Regarding social law, work-related suicide can be qualified as a professional risk, in particular as a work accident. It's the option chosen by case-law. The idea is to compensate: qualifying suicide as a work accident provides a social security compensation to the suicided employee's family and, in certain cases, the possibility to sue the employer. But, this case-law does not really question the prevention of the suicide before its commitment. In Labour law, the employer's obligation to prevent risks must face the risk of work-related suicide.     

Responsabilité médicale et « option »

Medical liability is, in civil law, the suit of a breach of the contract. But, sometimes, it depends of the law of torts (that is the reference in common law). The patient cannot choose between the two systems. If the damage proceeds of a contractual negligence, there is only a conctractual liability. Two projects of law ((ministry of justice) are in another way; they will offer the option. Is it a good solution for the patient?     

Flexibilité cognitive,attention sélective et fluidité verbale sémantique dans trois dimensions de schizophrénie : psychotique,négative et de désorganisation

The aim of this study was to explore specific pattern of cognitive dysfunctions related to three schizophrenic dimensions: disorganisation, negative and psychotic, resulting from principal component analyse applied to PANSS's items. We assessed executive functions/dysfunctions in 42 schizophrenics (APA, 1994). Data suggest that principal component analyse performed on the 30 items of PANSS identify homogenous schizophrenia dimensions. Results show that disorganisation dimension was associated with low performances in selective attention (Stroop test), negative dimension were associated to low performances in cognitive flexibility (Wisconsin Card Sorting test) and in semantic verbal fluency. However, no significant correlation was found between psychotic dimension and cognitive dysfunctions. On the whole, our study contributes to the comprehension of specific patterns of cognitive disorders in the schizophrenic dimensions. Results is detailed and discussed.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

Un regard structural sur l’inégalité des genres au travail : La causalité des différences « genrées » dans les caractéristiques de réseau de l’employé

This study aims at identifying gender differences in network structure and, hence, at understanding the underlying nature of gender inequalities in organisations. The hypotheses address four ego-network characteristics: network size and density, and ego’s centrality and brokerage. Contrary to the existing body of literature, none significant isolated gender difference in network structure is identified. Instead, those gender differences are triggered exclusively by organisational status, that is to say, they are due to the increased level of power. Thus, organisational status is considered as moderating the relationship between gender and network structure’s characteristics. Some further perspectives are suggested to clarify and generalise the phenomena observed.