L’enfant visiteur en réanimation adulte : vécu psychologique de la visite et dispositifs d’accompagnement

IntroductionWhile ICUs encourage visits from patients’ loved ones, visits from children and adolescents have remained a rather sensitive issue. In an attempt to protect children from a potentially traumatic environment, certain services refuse or restrict their visits.ObjectiveIn this context, the question arises as to whether the visit in intensive care constitutes a psychological risk for the child and adolescents. Based on the literature, this article discusses the experience of the visit on the child, the research methodology implemented with child visitors, and finally the existing support systems.ResultsThe analyzed studies do not consider the psychological disorders associated with ICU visits. Moreover, there are many studies on this field and the methodologies have yet to be developed. Support measures exist but are at the initiative of the intensive care teams.ConclusionThere is now an urgent need to build on the studies focused on this field in order to propose a genuine policy with regard to the reception and support of children visiting ICU patients.     

Vécu des situations à risque d’erreur en réanimation : une étude qualitative auprès des médecins et infirmiers

Intensive care units are considered as services with a high risk of error. More and more studies have measured the incidence and impact of errors in intensive care units, but few of them are centered on the impact of the risk of error for professionals. This study focuses on the perception of the risk of error, how it is experienced, and the way in which professionals cope with it. Forty professionals (20 physicians, 20 nurses) participated in clinical interviews. We transcribed recordings and analysed the data using a phenomenological approach. The risk of error is omnipresent in intensive care units. For nurses with less than one years experience, the risk of error is associated with important manifestations of anxiety. On the contrary, for doctors and nurses who have worked for more than one year in ICU, their experience and the relationship of cooperation built with colleagues gives them a feeling of control over risky situations. Our results show that it is important to take into account the risk of error in order to better target the support and training for the ICU professionals.     

The economics and philosophy of the brain drain: A critical perspective from the periphery

The paper provides a critical perspective on recent contributions to the economics literature, and associated philosophical arguments, that downplay negative effects of skilled migration on developing countries. The assertion that such migration incentivises investment in human capital is shown to rely on shaky theoretical foundations and weak empirical evidence. The associated economic literature suggesting a net positive effect of brain drain is at odds with literatures on the positive effects of human capital and education on economic growth. The manner in which net effects are determined also demonstrates that such contributions are utilitarian in nature. Identifying those who are the worst affected by brain drain, as well as the possible decision of a citizen placed behind the veil of ignorance, supports the view that opposing barriers to brain drain is inconsistent with a Rawlsian social welfare function. The undermining of institutions by skilled emigration is a fundamental consideration neglected by the economics literature without justification and, again, contradicts literatures on growth and institutions within economics. The economic theory of education can also be shown to support the view that depriving governments of the power to limit migration undermines states’ ability to resolve market failures. A number of other issues are identified that deserve greater consideration, including reflexivity in research on brain drain, the political economy of skilled migration and the philosophical status of nation-states. Despite unreliable econometric evidence, there is sufficient basis and justification to act. The paper concludes by briefly sketching possible actions under different degrees of international cooperation.     

Toward the use of approach/avoidance tendencies as attitude measures: Individual- and group-level variability of the ingroup bias

Approach/avoidance paradigms could constitute an interesting alternative in measuring intergroup attitudes, notably if they overcome one criticism often addressed toward classic indirect tasks: Measuring attitudes beyond the influence of cultural knowledge. Using intergroup stimuli and a population likely to be exposed to a similar cultural knowledge, we observed two informative results regarding this issue: Approach/avoidance effects measured by the Visual Approach/Avoidance by the Self Task (VAAST) varied across participants (i.e., consistent with the variability of intergroup attitudes; Experiment 1) and both participants of dominant and non-dominant groups produced an ingroup bias (Experiment 2). A last experiment (Experiment 3) showed that compatibility scores in the VAAST predict trustworthiness ratings of the ingroup/outgroup. This experiment also investigated potential differences between the VAAST and the IAT. These results suggest that approach/avoidance tasks (notably the VAAST) could be relevant to assess personal attitudes when it comes to normatively sensitive topics.     

Factors associated with experts' opinions regarding criminal responsibility in The Netherlands

In many jurisdictions, offenders need to have freely chosen to commit their crimes in order to be punishable. A mental defect or disorder may be a reason for diminished or total absence of criminal responsibility and may remove culpability. This study aims to provide an empirically based understanding of the factors on which experts base their judgements concerning criminal responsibility. Clinical, demographic and crime related variables, as well as MMPI-2 profiles, were collected from final reports concerning defendants of serious crime submitted to the observation clinic of the Dutch Ministry of Justice for a criminal responsibility assessment. Criminal responsibility was expressed along a five-point scale corresponding to the Dutch legal practice. Results showed that several variables contributed independently to experts' opinions regarding criminal responsibility: diagnosis (Axis I and II), cultural background, type of weapon used in committing the crime, and whether the defendant committed the crime alone or with others. In contract to jurisdictions involving a sane/insane dichotomy, the Dutch five-point scale of criminal responsibility revealed that Axis II personality disorders turned out to be mostly associated with a diminished responsibility. MMPI-2 scores also turned out to have a small contribution to experts' opinions on criminal responsibility, independently of mere diagnostic variables. These results suggest that experts base their judgements not only on the presence or absence of mental disorders, but also on cultural and crime related characteristics, as well as dimensional information about the defendant's personality and symptomatology.     

Sublimation and das Ding in Mahler's Symphony no. 8

This paper addresses sublimation in Gustav Mahler's Symphony no. 8 through Lacan's (1986, 1992) notion of das Ding, the Thing. The author reads Lacan as using das Ding, a term taken from Freud, as shorthand for archaic experience. Lacan provides a reference point when he states that "the Kleinian doctrine places the mother's body there" (1992, p. 117). Das Ding refers to unmediated contact with the Other, usually mother, in which traces of a primitive gratification mark the loss of immediacy, point to a lost object, and establish the trajectory of desire. Sublimation is an attempt to bring us into contact with das Ding.     

Federal family and disability policy: special relevance for developmental disabilities

The article reviews the federal statutes and relevant decisions of the U.S. Supreme Court that constitute the core concepts of disability policy and their application to persons with disabilities (especially developmental disabilities) and their families.