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.     

Maintenance of Gains in Relationship and Individual Functioning Following the Online OurRelationship Program

In the United States, more than 40% of marriages end in divorce and more than one third of intact marriages are distressed. Unfortunately, only a minority of couples seek couple therapy to improve their relationships. Online interventions, with their increased reach and reduced costs, offer the potential to improve relationships nationwide. The online OurRelationship program has been shown in previous nationwide studies to improve relationship and individual functioning. The present study examined whether initial gains in the OurRelationship program were maintained in the following year and whether the extent of maintenance varied across important demographic and individual factors. In this study, 151 distressed heterosexual couples (302 individuals) who were randomized to the OurRelationship program were assessed 3 and 12 months following the intervention. Initial gains in relationship satisfaction, relationship confidence, and negative relationship quality were maintained through 12 months; positive relationship quality significantly improved over follow-up. Furthermore, couples maintained their initial gains in depressive symptoms, perceived health, work functioning, and quality of life; anxious symptoms continued to significantly decrease over follow-up. Finally, there was no evidence that historically underserved groups—racial/ethnic minorities, lower income couples, or rural couples—experienced greater deterioration. In fact, Hispanic couples reported continued improvement in relationship confidence and negative relationship quality in the 12 months following the program. The ability of the OurRelationship program—an 8-hour, primarily self-help program—to create long-lasting improvements in distressed relationships indicates it may have the potential to improve the lives of distressed couples on a broad scale.     

Pigeons prefer to invest early for future reinforcers

Five pigeons were trained in a series of conditions in which food was delivered after 25 responses, but only when a different (Investing) response had been made before the 25 responses had been completed. If an Investing response was not made, the 25 responses ended in blackout. In various conditions, effective Investing responses either had to be made before the first of the 25 responses, or anywhere within the 25 responses; and effective Investing responses either resulted in a stimulus change or did not. Pigeons Invested even when the consequences were temporally and spatially distant, but Investing was most likely when it produced an immediate stimulus change. When given the choice, pigeons preferred to make Investing responses at the beginning of a trial. These findings again demonstrate that behavior may be maintained by events that are separated in time and space from the present.