Les métamorphoses du système de santé

The normative framework intervened in recent years to renovate and establish a coherent framework to the hospital system questions the bipartite division between private medicine and public medicine. The state supervision, consolidated by the Law of 26 January 2016 on the modernization of the health system, blurs the boundaries and involves renewing the qualification of our health system.     

Psychoanalytic aspects of inpatient treatment

This paper looks at the experience of inpatient hospital treatment at the Cassel Hospital and how formal psychoanalytic psychotherapy, with its emphasis on the transference and the inner world, fits into that context and orientates itself to some of the realities of the setting. It outlines how psychotherapy and nursing can work to inform and enrich each other, and what is psychoanalytic about the overall work. A bridge of understanding is built using the patients' perceptions of, adjustment to and conflict about the inpatient setting, and the affective impact of the processes on patients and staff alike. Two clinical examples of severe child abuse family cases are given, the first of Munchhausen syndrome by proxy, the second in which a baby sibling had been killed. They show how in-depth psychoanalytic work with mother and child and individual psychotherapy of the child can be combined with psychotherapy of the parents and intensive work in the therapeutic community. Such a combination can contribute, even in cases of severe pathology, to the development of the relationship between mother and child and promote successful rehabilitation in the outside community.     

A case of prosopagnosia with some preserved covert remembrance of familiar faces

This paper presents the detailed analysis of a case of prosopagnosia in a 54-year-old male farmer following bioccipital vascular disease. In-depth clinical investigations confirmed the diagnosis of prosopagnosia and revealed the absence of any associated defect, except for a slight aspecific disturbance of the short-term memory. Further study of this case indicated that the trouble was not concerned with the class of complex visual stimuli, was not even concerned with facial expressions or unknown faces, was not a perceptual defect, but was related mainly to the operation of individualization. The memory hypothesis was thus retained and supported. Moreover, exploration of the difficulty indicated that the deficiency was limited to defective access to conscious information concerning faces and information associated with these faces (name, context, etc.), effectively stored in memory.     

L’expertise en responsabilité hospitalière dans le secteur public : l’exemple de l’AP–HP

Public hospitals in France are submitted to special rules different from those in private hospitals. Missions of judicial experts are quite similar but some differences may be found during expertal meetings.     

Effectiveness of therapy group in women with localized breast cancer

Background/ObjectiveBreast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments.MethodParticipants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS).ResultsA statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention.ConclusionsThe results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.     

下腰痛综合征的诊治与人文思想

检索1989年～2005年间讨论医院伦理委员会功能的论文,通过文献研究的方法,对论及医院伦理委员会功能之论文的历年篇数变化情况、发表论文地区、作者所属机构、发表刊物及所探讨的功能等几个方面进行整理、归纳、统计,并对所得结果进行分析。