Un point sur la responsabilité civile du fait des prothèses

The evolutions of the medical liability depend on the walking (step) of the jurisprudence, and on that of the European law. Crossings renewed the reflection on the consequences of the protheses failures, and make paradoxically return to the contractual obligation.     

中美救护车车载物品比较

救护车车载物品是院前急救的基础和保障,对院前急救的效率和质量具有十分重要的意义.本文总结并分析了美国救护车车载物品和院前急救的特点:更加注重院前急救人员的个人防护;更加注重对患者的救出;更加注重心脏按压板的运用;更加注重急救箱物品配置的科学性;更加注重对普通物品的利用;更加注重患者的转运.美国西雅图20世纪70年代抢救5 120例院外猝死患者,复苏成功至康复出院者达28.9％;我国上海医疗救护中心1999年抢救猝死患者4 374名,复苏成功率1.35％.我国院前抢救猝死的成功率明显低于美国,或与中美救护车车载物品的不同相关.了解美国救护车车载物品的特点,对我国的院前急救或有借鉴作用.     

Using optical illusions in the shoulder of a cycle path to affect lateral position

An important factor in single-sided accidents of older cyclists is that they ride off the cycle path onto the verge. Two experiments were performed to assess the feasibility of using virtual 3D objects in the verge to affect the lateral position of bicyclists. In the first experiment, different virtual objects were placed in the shoulder and 1150 passing bicyclists were observed using a fixed camera. The (standard deviation of the) lateral position and speed in four conditions with virtual objects differing in colour, structure, or 3D effect were compared with a control condition in which no virtual objects were applied. In a second experiment, the behaviour of 32 bicyclists aged 50 years or older was measured by mounting two digital action cameras with GPS on the participants’ bicycles. The participants cycled a route of approximately 12 km in which several locations were passed, one of these contained 15 virtual objects similar to the ones used in the first experiment placed in the shoulder of the cycle path. Cyclist behaviour was compared with behaviour at a control location consisting of a solitary two-way cycle path with a grass shoulder. Results indicate that the virtual objects in the tested format had little overall effect on cyclists’ behaviour. However, bicyclists were positioned closer to the virtual objects and the shoulder when they looked at the objects or when they reported that they saw them while cycling. This suggests that the overall visibility of the object design may have been too conservative.     

Inferred threat and safety: Symbolic generalization of human avoidance learning

Symbolic generalization of avoidance may underlie the aetiology and maintenance of anxiety disorders. The aim of the present study was to demonstrate inferred threat-avoidance and safety (non-avoidance) behaviours that occur in the presence of stimuli indirectly related to learned threat and safety cues. A laboratory experiment was conducted involving two symbolic stimulus equivalence relations consisting of three physically dissimilar stimuli (avoidance cues: AV1–AV2–AV3 and neutral cues: N1–N2–N3). During avoidance learning involving aversive images and sounds, a key-press avoidance response was trained for one member of one of the relations (AV2) and non-avoidance for another (N2). Inferred threat and safety behaviour and ratings of the likelihood of aversive events were tested with presentations of all remaining stimuli. Findings showed a significantly high percentage of avoidance to both the learned and inferred threat cues and less avoidance to both the learned and inferred safety cues. Ratings in the absence of avoidance were high during training and testing to threat cues and low to safety cues and were generally lower in the presence of avoidance. Implications for associative and behavioural accounts of avoidance, and modern therapies for anxiety disorders are discussed.     

Do Visually Salient Stimuli Reduce Children’s Risky Decisions?

Children tend to overestimate their physical abilities, and that tendency is related to risk for unintentional injury. This study tested whether or not children estimate their physical ability differently when exposed to stimuli that were highly visually salient due to fluorescent coloring. Sixty-nine 6-year-olds judged physical ability to complete laboratory-based physical tasks. Half judged ability using tasks that were painted black; the other half judged the same tasks, but the stimuli were striped black and fluorescent lime-green. Results suggest the two groups judged similarly, but children took longer to judge perceptually ambiguous tasks when those tasks were visually salient. In other words, visual salience increased decision-making time but not accuracy of judgment. These findings held true after controlling for demographic and temperament characteristics.     

PROTECTIVE EQUIPMENT: CONTINUOUS AND CONTINGENT APPLICATION IN THE TREATMENT OF SELF-INJURIOUS BEHAVIOR

This study evaluated the use of protective equipment in treating self-injurious behavior (SIB) exhibited by three retarded persons. In Experiment 1, the equipment was first applied continuously during 20-min sessions in individual multiple baseline designs across settings. Results showed substantial reductions in head hitting, eye gouging, and hand biting. Brief periods of time-out with the protective equipment were later made contingent on SIB and combined with a differential reinforcement procedure. Reduced levels of SIB was maintained with all subjects. Additionally, the amount of time during which the equipment was applied decreased as the SIB diminished. Experiment 2 evaluated the use of contingent protective equipment (the final condition in Experiment 1) when applied directly in the subjects' living uints during the day. During Experiment 2, SIB remained at or below the levels found at the termination of Experiment 1. Finally, in an effort to assess the long-term effectiveness of the procedure, responsibility for implementation was given to the staff who were typically assigned to provide therapy to the subjects. Follow-up probe observations conducted up to 104 days after termination of the final experimental condition showed continued low levels of both SIB and equipment usage. Results of these experiments suggest that contingent protective equipment and differential reinforcement may be effective in reducing chronic self-injury.     

Quasi‐Experimental Single‐Subject Design: Comparing Seeking Safety and Canine‐Assisted Therapy Interventions Among Mentally Ill Female Inmates

This repeated measures quasi‐experimental study evaluated the effectiveness of 2 interventions, Seeking Safety and canine‐assisted therapy, with female prisoners with trauma histories on a mental health unit. Results indicate both are effective at reducing anxiety, depression, and posttraumatic stress disorder.     

A COMPARISON OF NONCONTINGENT REINFORCEMENT AND SENSORY EXTINCTION AS TREATMENTS FOR SELF-INJURIOUS BEHAVIOR

We compared the effects of two treatments, noncontingent reinforcement (NCR) and sensory extinction (EXT), on the self-injurious behavior (SIB) exhibited by 3 individuals with developmental disabilities. Results of a functional analysis indicated that their SIB was not maintained by social reinforcement, as indicated by undifferentiated responding across assessment conditions or higher rates of responding in the alone condition. Prior to treatment, leisure probes were conducted to identify highly preferred items for use in the NCR condition, and equipment probes were conducted to identify devices that produced the greatest behavioral suppression for use in the EXT condition. Following baseline, treatment was implemented in a multiple baseline across subjects design, and the effects of NCR and EXT were compared in a multielement format. During NCR sessions, participants had continuous access to a highly preferred item. During EXT sessions, participants wore equipment (gloves or protective sleeves) that seemed to attenuate stimulation directly produced by their SIB, while still allowing the behavior to occur. Results indicated that both procedures were effective in reducing SIB, although NCR was associated with either more rapid or greater overall response suppression.     

Dimensions of driver anger, aggressive and highway code violations and their mediation by safety orientation in UK drivers

Aggressive behaviour on the roads is reported to be on the increase. This study administered Driving Anger Scale (Deffenbacher et al. (1994). Development of a driving anger scale. Psychological Reports, 74, 83–91.), the Driver Behaviour Questionnaire, and the Driving Skill Inventory to a sample of 270 British drivers. Factor analysis of the Driving Anger Scale items yielded three factors measuring anger generated by the reckless driving, direct hostility and impeded progress by others—contrary to the six subscales found with the original US sample. Younger drivers and low mileage drivers were more likely to exhibit all three types of driving anger, but no differences between male and female drivers were found. In addition, a driver’s safety orientation predicted (negatively) anger evoked by impeded progress and direct hostility whereas self-assessed perceptual-motor skills were positively related to anger generated by impeded progress. Both Highway Code and aggressive violations were significantly related to the anger factors, and, using the procedure by Baron and Kenny (Baron & Kenny (1986). The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.), the prediction of violating behaviour (Driver Behaviour Questionnaire) by reported anger was shown to be mediated by the self-assessed safety skill scale but not the perceptual-motor skill scale (Driver Skill Inventory), and moderated by neither. Implications for driver education countermeasures are noted.     

A rational-emotive group intervention for preventing and coping with stress among safety officers

A stress management and prevention workshop for nonclinical industrial workers using rational-emotive principles with 18 months followup is reported. Twenty-two senior safety officers participated in an intervention program of five weekly meetings aimed at improving cognitive skills and assertiveness mainly by decreasing irrational thought processes. We hypothesized an increase in assertiveness, and a decrease in irrational beliefs, and emotional and cognitive stress symptoms (manifested in somatic complaints and cognitive weariness). Assertiveness improved and somatic complaints and irrationality decreased in the short term. Eighteen months later, cognitive weariness was also reduced. The other improvements were still evident, but not to the same extent as short-term effects. Although the workshop improved rationality, further practice would be needed in the behavioral aspect of stress prevention to achieve long-term improvements in assertiveness.Talma Kushnir, Ph.D., is a social and medical psychologist at the Occupational Health and Rehabilitation Institute, Raanana, Israel, and teaches psychology and health promotion at the Tel-Aviv University Medical School.Ruth Malkinson, Ph.D., fellow and RET trainer and supervisor of the Institute for RET, and teaches at the School of Social Work and Medical School at Tel-Aviv University, Israel. Both authors contributed equally to this studyThis study was supported by the Committee for Preventive Action and Research in Occupational Health, The Ministry of Labor and Social Affairs, Jerusalem, Israel.The authors thank Estie Weisberg for her administrative assistance in organizing the workshops.