GODEAU (Emmanuelle), L’« esprit de corps ». Mort et sexe dans la formation des internes en médecine

Frange particulière de la population médicale jusqu’en 2002, le groupe des internes en médecine est un objet d’analyse intéressant, en ce qu’il représentait l’élite incontestée de cette communauté. L’auteur de l’ouvrage, médecin et anthropologue, se donne pour objectif de décrypter les pratiques qui se situent aux marges de la formation médicale proprement dite pour comprendre ce qui constitue l’ « esprit de corps » caractérisant ce groupe singulier de futurs médecins. Issue d’un travail de d..

You are safe here: A flyer with re-orientating messages for families of patients with delirium in the intensive care unit

Patients in delirium require trustful communication and re-orientation. We developed a flyer with positive, re-orientating suggestions for families of delirious patients in intensive care units. Suggestions include creating a safe environment, interpreting unusual behaviours positively and fostering mental resilience. Additionally, families are encouraged to prioritize their own well-being, recognizing their crucial role in supporting their loved ones. This flyer offers practical strategies across four key areas: ensuring security and orientation, reframing noises and body experiences, managing agitation and reshaping perceptions. By equipping families with knowledge and tools, this resource aims to promote understanding, resilience and strength to humanize delirium care

A flyer with re-orientating messages for families of patients with delirium in the intensive care unit

Publisher Copyright: © 2024 The Author(s). Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.Patients in delirium require trustful communication and re-orientation. We developed a flyer with positive, re-orientating suggestions for families of delirious patients in intensive care units. Suggestions include creating a safe environment, interpreting unusual behaviours positively and fostering mental resilience. Additionally, families are encouraged to prioritize their own well-being, recognizing their crucial role in supporting their loved ones. This flyer offers practical strategies across four key areas: ensuring security and orientation, reframing noises and body experiences, managing agitation and reshaping perceptions. By equipping families with knowledge and tools, this resource aims to promote understanding, resilience and strength to humanize delirium care.publishersversioninpres

A Neanderthal from the Central Western Zagros, Iran. Structural reassessment of the Wezmeh 1 maxillary premolar

Wezmeh Cave, in the Kermanshah region of Central Western Zagros, Iran, produced a Late Pleistocene faunal assemblage rich in carnivorans along with a human right maxillary premolar, Wezmeh 1, an unerupted tooth from an 8 ± 2 year-old individual. Uranium-series analyses of the fauna by alpha spectrometry provided age estimates between 70 and 11 ka. Crown dimensions place the tooth specimen at the upper limits of Late Pleistocene human ranges of variation. Wezmeh 1 metameric position (most likely a P3) remains uncertain and only its surficial morphology has been described so far. Accordingly, we used micro-focus X-ray tomography (12.5 μm isotropic voxel size) to reassess the metameric position and taxonomic attribution of this specimen. We investigated its endostructural features and quantified crown tissue proportions. Topographic maps of enamel thickness (ET) distribution were also generated, and semilandmark-based geometric morphometric analyses of the enamel-dentine junction (EDJ) were performed. We compared Wezmeh 1 with unworn/slightly-moderately worn P3 and P4 of European Neanderthals, Middle Paleolithic modern humans from Qafzeh, an Upper Paleolithic premolar, and Holocene humans. The results confirm that Wezmeh 1 represents a P3. Based on its internal conformation and especially EDJ shape, Wezmeh 1 aligns closely with Neanderthals and is distinct from the fossil and extant modern human pattern of our comparative samples. Wezmeh 1 is thus the first direct evidence of Neanderthal presence on the western margin of the Iranian Plateau

Évolution des paysages et occupation humaine en mer d’Iroise (Finistère, Bretagne) du Néolithique à l’Âge du Bronze

Depuis près de dix ans, des recherches archéologiques sont menées dans l’archipel de Molène par une équipe pluridisciplinaire. Ce secteur s’avère particulièrement riche en vestiges du Néolithique et de l’Âge du Bronze. Une concentration exceptionnelle de monuments mégalithiques y a été mise en évidence. Plusieurs habitats sont attestés par la présence d’un bâtiment (Beg ar Loued, Molène) ou de dépotoirs domestiques riches en faune et en mobilier. Ces données nous renseignent sur la chronologie des occupations du secteur et nous permettent, pour la première fois en Bretagne, d’esquisser le mode de vie des hommes de la Préhistoire récente. Afin de pousser plus loin la réflexion, il nous a paru nécessaire de mieux comprendre l’évolution de l’environnement en contexte insulaire, par de nouvelles recherches sur les variations du niveau marin corrélées à l’étude du paysage végétal, de la géomorphologie et de la faune.Les résultats issus des reconstitutions paléogéographiques montrent que l’archipel était déjà constitué au Néolithique moyen II, déconnecté du continent par le chenal du Four dont la traversée nécessitait l’utilisation d’embarcations. Très bien conservés, les monuments mégalithiques de l’archipel sont donc le fait de populations insulaires ayant fréquentées l’archipel sur une longue période, débutant dès le milieu du ve et jalonnant les ive, iiive et iie millénaires avant J.-C. La répartition des sépultures mégalithiques reflète des stratégies d’implantations qui répondent à des choix culturels et à des contraintes naturelles, sur un territoire soumis à un morcellement progressif du fait des dynamiques érosives qui accompagnent la remontée du niveau marin. Durant tout le Néolithique et l’Âge du Bronze, l’isolement géographique n’a cessé de s’accroître, sans donner lieu pour autant à des particularismes culturels marqués, les innovations techniques et artistiques de cette époque ayant pénétré au sein des sociétés insulaires. Néanmoins, l’éloignement croissant des îles a encouragé la recherche de moyens de subsistance basés sur l’exploitation intense des ressources littorales, à travers la collecte de coquillages et de crustacés, la pratique de la pêche et de la chasse côtière. Tournées vers la mer, ces populations n’ont pas négligé les ressources qu’offraient les zones terrestres, comme en témoigne la précocité des pratiques agropastorales dans l’archipel.During almost ten years, an archaeological survey has been carried out in Molène Archipelago by a multidisciplinary team. The area appears to be particularly rich in Neolithic and Bronze Age remains and an exceptional concentration of megaliths has been brought to light. Several settlments are confirmed by dry-stone structures like in Beg ar Loued or by shell middens harbouring large quantities of bones and artefacts. These data give precious indications on the occupation chronology of the area. Moreover they allow for the first time in Brittany to reconstruct the everyday life during the late Prehistory. A prerequisite to this reconstruction was a better understanding of the environment evolution during this period, which locally implies a better knowledge of sea level fluctuations and its effects on landscapes as well as on vegetal and faunal resources.Results obtained via the paleogeographic reconstructions show that the archipelago during the Middle Neolithic II was already disconnected from the mainland by the Four channel which required boats to be crossed. Very well preserved, the megalithic monuments have therefore been erected and used by islanders being present on the archipelago for a long period time, starting from the middle of the Vth millenium BC, and spreading through the IV, III and IInd millenia. The distribution of the megalithic tombs reveals landscape occupation strategies which answer both cultural choices and natural constraints in a territory that undergoes a progressive fragmentation due to the dynamic of erosion linked to the rise of the sea level. Throughout the entire Neolithic and Bronze Age, geographic isolation has continued to increase, but in the meantime it did not imply specific cultural aspects, technical and artistic innovations having reached these island societies. Nevertheless, the increasing remoteness of the islands has fostered the search for livelihoods based on the intense exploitation of coastal ressources, through the gathering of seashells and shellfishes, fishing and coastal hunting. Although facing the sea, these people did not neglect what the land areas could offer as evidenced by the earl agro-pastoral practices in the archipelago

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Abstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The nonperturbative functional renormalization group and its applications

The renormalization group plays an essential role in many areas of physics, both conceptually and as a practical tool to determine the long-distance low-energy properties of many systems on the one hand and on the other hand search for viable ultraviolet completions in fundamental physics. It provides us with a natural framework to study theoretical models where degrees of freedom are correlated over long distances and that may exhibit very distinct behavior on different energy scales. The nonperturbative functional renormalization-group (FRG) approach is a modern implementation of Wilson's RG, which allows one to set up nonperturbative approximation schemes that go beyond the standard perturbative RG approaches. The FRG is based on an exact functional flow equation of a coarse-grained effective action (or Gibbs free energy in the language of statistical mechanics). We review the main approximation schemes that are commonly used to solve this flow equation and discuss applications in equilibrium and out-of-equilibrium statistical physics, quantum many-particle systems, high-energy physics and quantum gravity.Comment: v2) Review article, 93 pages + bibliography, 35 figure

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake