Soins pénalement ordonnés et positionnements professionnels : des pratiques au carrefour de la Santé et de la Justice

At the crossroad of Health and Justice, penally ordered care underlies professional practices, the articulation of which can turn out to be delicate. Here we tackle the relevance and practical application of these measures. For that purpose, semi-directive interviews and field observations have been conducted with probation agents, judges (who follow up the way sentences are executed) and psychologists. The professionals’ comments and experiences show the complexity of these measures, which intend to make “care” into a recidivism prevention tool. Misconceptions appear about theory, practices and interprofessional relationships. The idea of “care” as a sole medical term appears to be ineffective and calls for the creation of new practices.     

It’s how you say it – The extended Theory of Planned Behaviour explains active transport use in cardiac patients depending on the type of self-report in a hypothesis-generating study

Physical activity (PA) plays an essential part in the secondary prevention of persons with coronary heart disease (CHD). A substantial amount of PA can be gained through increasing the use of active transport modes (walking or cycling for at least 10 min/day) in CHD patients’ daily routine, benefiting the mortality and morbidity rate as well as the environment. The current study aims to investigate the utility of the Theory of Planned Behaviour (TPB) framework extended with habit strength, in understanding the behavioural intention and the behaviour of using active transport modes during the daily travel routine of CHD patients. A cross-sectional survey was conducted from 131 CHD patients. The behaviour was measured using three self-report methods; 1) scale measure, the walking or cycling frequency, 2) direct ATS (Active Travel Score, PA calculated by the directly reported aggregated time spent per day for walking or cycling for travel purposes), and 3) indirect ATS (PA calculated by combining the duration spent on trips by walking and cycling from the self-reported one-day travel diary). Additionally, the participants completed surveys on the direct measures of TPB constructs and habit strength. The results indicated that the TPB constructs explained a 38% variance in the intention to use active transport modes of CHD patients, by which the variance increased to 59% with the addition of habit strength. On the contrary, different behavioural measures were explained differently by TPB and habit strength. The scale measure of behaviour was best predicted (up to 21%) by TPB and habit strength. However, the direct and indirect measures of behaviour were poorly explained (up to 3% and 10% only, respectively). Habit strength moderated the relationship between behaviour (scale measure) and behavioural intention. Surprisingly, higher behavioural intention resulted in a lower behavioural frequency when the habit strength to be active is low. This suggests a limited control over the behaviour thus indicating the intention-behaviour gap. The current study findings highlight the inconsistent predictive utility of TPB across different types of behavioural self-report measures, targeted at the use of active transport modes in CHD patients. However, considering this study as hypothesis-generating, further research is necessary to replicate and extend these findings.     

Depression Screening,Assessment, and Treatment for Patients with Coronary Heart Disease: A Review for Psychologists

Depression prevalence is between 15% and 20% in coronary heart disease patients, such as those with angina, or after a myocardial infarction or coronary artery bypass graft surgery. The presence of depression places a coronary heart disease patient at twofold higher risk for further major cardiac events and death, as well as poor quality of life and early exit from the labour force. As a consequence, several learned societies, including the National Heart Foundation of Australia, have published guidelines that recommend questionnaire screening to improve identification and management strategies for depression in coronary heart disease patients. Psychologists in hospitals, community settings, and private practice can have a key role in the realisation of the National Heart Foundation of Australia's aims. We review the recent guidelines and outline implications for psychologists to identify and manage depression in coronary heart disease patients. The evidence reviewed suggests that cognitive‐behavioural therapy and problem‐solving therapy are frontline non‐pharmacological interventions for depression in CHD patients.     

帕金森病诊断标记物系统回顾与展望

本篇综述总结了帕金森病的诊断、鉴别诊断和病程监测的各领域的生物学标记物的研究进展。其中重点介绍了神经影像学和生物化学领域的生物学标记物,也是当前研究较为成熟的两大领域。神经影像学标记物以多巴胺能影像及非多巴胺能影像为代表,生物化学标记物为包括a一突触核蛋白在内的多种蛋白和激素,两者的结合能够有效提高疾病诊断的特异性和灵敏性。同时文章还介绍了当前研究的热点——帕金森病的前驱诊断手段,即在疾病典型的运动症状和非运动症状出现前便可预测帕金森病的诊断手段。     

炎症性肠病的药物治疗现状及进展

炎症性肠病（IBD）病程迁延反复,影响患者生活质量,耗费卫生资源。虽然传统药物如5-氨基水杨酸、糖皮质激素、免疫抑制剂等仍是目前治疗主流,但是大量有关发病机制的研究以及循证医学的发展对IBD的治疗产生了积极的推进作用。IBD的治疗正步入免疫调节的生物学时代,多种新型生物制剂的出现为IBD的治疗提供了新的策略和选择。现就目前IBD药物治疗现状以及最新进展进行综述,以期对临床IBD治疗提供参考。     

Narcotrend监测下右美托咪定对冠心病患者麻醉诱导期血流动力学的影响

观察Narcotrend监测下右美托咪定联合丙泊酚靶控输注用于冠心病患者非心脏手术麻醉诱导时对血流动力学的影响.合并冠心痛行非心脏手术患者40例,随机分为两组：Dex组（n=20,患者在诱导前静脉泵注右美托咪定0.5μg/kg,15min内输注完毕）,对照组（n=20,等量生理盐水,方法同Dex组）.记录给药前后及诱导期间患者的血流动力学变化.对照组在气管插管即刻以及气管插管3min后血流动力学指标值均高于插管前,气管插管5min后平均动脉压（MAP）低于插管前（P＜0.05）,Dex组无明显差异.麻醉诱导前15min静脉注射0.5μg/kg右美托咪定可以使冠心病患者丙泊酚靶控输注诱导期间血流动力学更加平稳.     

阿尔茨海默病的诊治新进展

流行病学数据的更新表明阿尔茨海默病（A D ）已成为全球健康问题。早期应用生物标志物的AD新诊断标准广泛应用和临床试验不断失败的鲜明反差提示AD治疗的艰巨性。AD和其他慢性疾病的共病研究不断深入。生活方式干预作为非药物治疗备受重视。     

基层医院实施《诊疗与防控手足口病指南》的困境

探讨实施卫生部所颁发的手足口病诊疗与防控指南存在的难点.通过实践,依据指南,笔者将近几年工作中所遇到处理各种肠道病毒感染病例存在的问题加以分析,列出实施指南存在诸多临床及非临床的影响因素,包括：（1）上报、隔离引起的矛盾;（2）诊断、治疗、转诊引起的矛盾;（3）处理肠道病毒71型（EV71）感染、疱疹性咽峡炎等与手足口病的矛盾.较多的矛盾令基层医院依照目前的指南难以良好地开展工作,期待更完善的指南以及各地医疗主管部门制定切合实际的、可行的、各种具体的防控预案.     

Improving Interaction Competencies With Children—A Pilot Feasibility Study to Reduce School Corporal Punishment

High prevalence rates of corporal punishment in schools worldwide and the associated negative mental health issues show the need for interventions addressing this problem. Yet, so far there are very few intervention studies aimed at altering corporal punishment administered by teachers, particularly in low- or middle-income countries.

To conduct a feasibility study of the newly developed intervention approach, Interaction Competencies with Children for Teachers (ICC-T)—a training workshop designed to prevent corporal punishment and improve the teacher-student relationship.

The 1-week ICC-T intervention was conducted with 30 teachers in a Tanzanian primary school. Participants filled out a survey before, directly after, and 3 months following the intervention.

The widespread use of corporal punishment indicated strong demand for a preventive intervention. The feasibility of ICC-T was good: Despite challenging conditions, implementation of the training and participants’ acceptance was high. Further, participants reported a good integration of the training’s core elements in their daily working routine, improvements in the teacher-student relationships, and in the students’ behavior.

ICC-T shows a promising feasibility in the Tanzanian teacher sample. These encouraging results highlight the need for further studies testing the efficacy, sustainability, and effects of ICC-T on the students’ well-being.     

Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.