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.     

L’évaluation du risque de récidive et l’intervention basée sur les données probantes : les conditions nécessaires à l’implantation de méthodes structurées d’évaluation et d’intervention efficaces

The results of different studies on the best practices of the prevention of recidivism are clear: it is possible to reduce the risk of recidivism of offenders through efficient intervention. Structured risk assessment combined with practices based on risk, need and responsivity principals may reduce the risk of recidivism by up to 30%. These programs, developed primarily in Canada, require adaptations to better suit a French context. The present article proposes to revise the main stages essential to the introduction of a new evaluation and intervention strategy based on evidence, namely, the exploration, the preparation of the establishment, the creation and implementation themselves, the sustainability approach and the introduction of evaluative research studies. The advantages of considering such an implementation strategy are discussed.     

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.     

L’élargissement de l’assistance médicale à la procréation (AMP)

The opening of medically assisted procreation (MPA) for single women and couples of women, that is, apart from medical indications of infertility, raises the main question of the eradication of the father and of the paternal branch of the child's descent, which is difficult to reconcile with respect for the rights of the child, who has the right to know and be cared for his parents, as far as possible (International Convention on Human Rights of the child, Article 7 – 1). Moreover, the MPA claim for women appears to be an opportunity to lift the therapeutic lock to generalize access to artificial procreation, including fertile male/female couples, the most numerous being the target the most lucrative in the procreation market contained to date by the therapeutic objective assigned by the law to the MPA.     

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.     

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 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.     

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’indépendance du médecin à nouveau proclamée

In the must-known “Vincent Lambert case”, many jurisdictions have had to adjudicate on what was submitted to them. The latest decision from Châlons-en-Champagne's administrative court almost went unnoticed. However, the judgment turns out to be truly significant. It reminds that the principles of medical doctor's independence and freedom of action are simply fundamentals and unavoidable. The patient management practitioner shall not be regarded as a mere executor of an earlier decision taken by a medical colleague.     

La compréhension d’un scénario médical à partir d’images sans texte : l’apport des représentations sociales

In this study, participants (n = 125) were shown a sequence of four images illustrating the medication scenario. Depending on the results of a pre-test (n = 384), the sequence is composed of typical images, non-typical images or mixed. Depending on the case, the instructions given to the participants are neutral, or it induces the representation of the drug. Participants must identify the scenario described in the sequence of images proposed to them. The sequence of typical images gives rise to the better identification. The mixed sequence gives rise to comparable scores following non-typical images when the instruction is neutral and to comparable scores following typical images when the instruction induces the representation of the drug.     

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.     

L’anxiété maternelle de séparation et l’aménagement du temps de travail

In order to examine the reasons of the choice and the effectiveness of the strategies of conciliation related to the adaptation of working time, we present two empirical studies which investigate the relationships between the level of maternal separation anxiety and the choice of the duration of the schedules of work. The first study was conducted among two groups of working mothers, one of 41 mothers working at full-time, the other of 33 mothers having chosen to work part-time. The second study relates to 45 employees of mass marketing having the possibility of choosing nonstandard work schedules (early the morning, late the evening) or in day. The results confirm that, on a psychological level, the question of worked time is crucial for the active mothers. They illustrate how the new constraints related to the changes of the world of work (flexibility and precariousness) can be sometimes undergone by the women, sometimes appropriated by them in order to reconcile work and their family role.     

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.     

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.     

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’expérience fraternelle confrontée à la déficience intellectuelle

IntroductionThe present study aims to evaluate the influence of intellectual deficiency on the lifestyle of brothers and sisters.ObjectiveThe objective is to determine whether or not a child's intellectual deficiency has an influence on the nature of the fraternal relationship. We studied the functionality of the familial typology, the feeling of social integration, and the degree of depression in brothers and sisters of children with intellectual disability.MethodThis research was carried out with 34 brothers and sisters of children faced with intellectual disabilities, aged between 6 and 12 years old, and the results were compared with those collected from a test group of 24 children.ResultsThe comparative study shows little differences between siblings and families confronted to intellectual disability and those who are not. The nature of the fraternal relationships differ however as the modality of proximity and conflicts are less expressed by siblings of children faced with intellectual disabilities. Furthermore the correlational study stresses the importance of siblings’ rivalry, the feeling of social integration, and the degree of depression.ConclusionWith these results now uncover risk and protection factors to children confronted to intellectual disabilities among their siblings     

Développer l’apprentissage,la coopération et l’identité organisationnelle en milieu hospitalier Evaluation de l’impact d’un Dispositif d’Immersion Structuré

In this article we analyse the effects of an innovative approach adopted in a hospital institution. Using a specific framework, this approach consists of placing staff into a department other than their own. The objectives of this approach relate to cognition, identity and organisational behaviour. Based on thematic and structural analysis of 25 interviews, this evaluation shows that the effects of the intervention are consistent with the anticipated objectives on several levels: (1) learning about ways of functioning and working in the host department, (2) growth of co-operation between departments, (3) the development of a feeling of organisational belonging.