Les freins au dépistage du cancer à titre personnel chez les médecins et reflexion sur l'entité médecin-malade (Etude qualitative auprès de neuf médecins généralistes strasbourgeois)

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

HISTOIRE DE L'ENSEIGNEMENT DE LA MEDECINE GENERALE A STRASBOURG

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Facebook : un outil d’apprentissage en éducation médicale ?

Contexte : La génération actuelle d’étudiants en santé fait partie des digital natives. Ils ont une appétence naturelle pour les technologies de l’information et de la communication pour l’enseignement (TICE). La majorité des étudiants utilisent les réseaux sociaux dans un cadre personnel. Les fonctionnalités de Facebook sont équivalentes à celles des plateformes électroniques. Il paraît possible de l’utiliser dans la formation médicale. Buts : L’objectif principal de ce travail était de faire une mise au point sur l’utilisation de Facebook en tant qu’outil pédagogique dans le cadre de la formation médicale. L’objectif secondaire était de discuter de ses potentialités de soutien motivationnel dans un dispositif pédagogique de formation en médecine. Méthodes : Une revue de la littérature scientifique a été réalisée. Cette recherche a été complétée par une étude de la littérature grise. Sur les 73 articles sélectionnés, 40 répondaient aux critères d’inclusion. Résultats : Les points positifs de Facebook dans ce dispositif étaient : une maîtrise de l’outil, l’esprit d’initiative des étudiants, la production de synthèse et aide au développement d’une « intelligence collective ». Les limites retrouvées étaient : la peur de partager son travail, le regard de l’enseignant sur le profil des étudiants, la perte de la limite entre vie privée et vie publique, la distractibilité des étudiants. Nous proposons un modèle de dispositif pédagogique utilisant Facebook. Ce modèle est susceptible d’agir positivement sur le profil motivationnel des apprenants. Conclusion : Facebook peut être utilisé comme un outil d’apprentissage en éducation médicale. Sa mise en application dans un enseignement hybride lui fournit un potentiel motivationnel

Impact of an online learning by concordance program on reflection

Abstract Background Learning by concordance (LbC) is a recent approach that introduces learners to the complexity and uncertainty of clinical practice. Some data on LbC suggest that it stimulates reflection in future clinicians. We developed an online LbC training program on electrocardiogram (ECG) interpretation in general practice at the University of Strasbourg, France, and conducted an exploratory qualitative study to document the impact of this ECG learning-by-concordance training program on reflection in participants. Methods We created 18 clinical vignettes on ECG interpretation based on a review of the literature on frequent and serious cardiovascular diseases that can be identified using an ECG in general practice. The training program was delivered online to postgraduate general practice students in two faculties of medicine. We conducted a qualitative study based on thematic analysis of two focus groups and six individual interviews. Inductive and deductive coding were performed. The five major components of reflection in the Nguyen model were used in the deductive coding: (i) thoughts and actions, (ii) attentive, critical, exploratory, and iterative processes (ACEI), (iii) underlying conceptual frame, (iv) change and (v) self. Results Two focus groups and six individual interviews were conducted. The qualitative analysis indicated 203 codes in the focus groups and 206 codes in the individual interviews, which were divided into five groups based on the components of reflection in the Nguyen model: (i) the self; (ii) attentive, critical, exploratory, and iterative interactions with (iii) one’s thoughts and actions; and (iv) a view on both the change itself and (v) the underlying conceptual frame. Inductive coding revealed interesting insights into the impact of the identity of the panel members, the absence of a scoring system and the question of uncertainty in ECG reading. Conclusions This study supports the claim that the use of LbC in the context of ECG interpretation could foster reflection in future general practitioners. We discuss future research avenues on instructional design of LbC and reflection

Biogeographical dynamics from higher-level phylogenies: avoiding biases through randomizations

International audienceHistorical biogeography analyses, used to infer spatial dynamics of organisms through their evolutionary history, often consider the distribution of higher taxa (like that of a genus, subfamily, family, etc.) despite only including a subsample of their representatives. When tips of the tree have the ranges of multiple species instead of individual species, the outcomes of all relevant methods and softwares are conceptually wrong. This is because they are designed for species-level phylogenies and can thus lead to several biases: widespread ancestors, high uncertainties and wrong estimation of dispersal probabilities. Here we present an approach that aims at minimizing these biases through biogeographical analyses based on multiple randomizations of the possible ranges for a given group. We computed historical biogeography analyses based on simulated random trees and infer the ancestral ranges from the group’s ranges considering three settings: (i) classical, considering all areas represented within the group; (ii) randomizing possible ranges for the group; and (iii) as (ii), but weighting according to the actual ranges of species within the group. In addition, we used these three approaches on a genus-level phylogeny of wild silkmoths (Lepidoptera, Saturniidae). Our results from simulated phylogenies revealed that randomization approaches are more precise than classical analyses. They also helped resolve the complex biogeographical dynamics of Saturniidae. We emphasize here the biases induced when considering multiple species ranges at the tips of a phylogeny, and recommend the use of a randomization approach when inferring biogeographica

Prevalence of cramps in patients over the age of 60 in primary care : a cross sectional study

Cramps are involuntary painful muscle contractions that mainly affect older people. Cramps may cause severe pain and sleep disturbance. Little information exists on the prevalence and the main features of cramps in primary care settings. The objective of this study was to estimate the prevalence and the main features of cramps among primary care patients aged 60 years and older

The Challenge of DNA Barcoding Saproxylic Beetles in Natural History Collections—Exploring the Potential of Parallel Multiplex Sequencing With Illumina MiSeq

International audienceSaproxylic beetles are important bioindicators of forest health but their enormous diversity makes their identification challenging. As an example, the French fauna of saproxylic beetles alone contains 2,663 species in 72 families. Recently, DNA barcoding was proposed as a promising tool for the identification and monitoring of saproxylic beetle species. However, the rate of DNA barcode recovery from specimens of natural history collections using standard Sanger sequencing protocols remains low and challenges the construction of reference libraries. In this study, we test the potential of high-throughput sequencing (HTS) technology to reduce this shortfall by increasing sequencing success rate and lowering processing cost per specimen. Using a dual-indexing strategy for library construction and sequencing on the Illumina MiSeq platform, we successfully sequenced the DNA barcodes of 286 dry-pinned saproxylic beetles out of 521 specimens aged from 1 to 17 years and sampled in natural history collections. Age at sequencing did not affect sequence recovery and the success rate (54.9%) of our approach is comparable to that obtained using Sanger sequencing technology in another study targeting beetle specimens from natural history collections, but the cost per specimen is significantly reduced when using HTS. Finally, we shortly discuss how the newly produced DNA barcodes contribute to the existing library and we highlight a few interesting cases in which the new sequences question current species boundaries

PASSIFOR: A reference library of DNA barcodes for French saproxylic beetles (Insecta, Coleoptera)

Saproxylic beetles – associated with dead wood or with other insects, fungi and microorganisms that decompose it – play a major role in forest nutrient cycling. They are important ecosystem service providers and are used as key bio-indicators of old-growth forests. In France alone, where the present study took place, there are about 2500 species distributed within 71 families. This high diversity represents a major challenge for specimen sorting and identification. The PASSIFOR project aims at developing a DNA metabarcoding approach to facilitate and enhance the monitoring of saproxylic beetles as indicators in ecological studies. As a first step toward that goal we assembled a library of DNA barcodes using the standard genetic marker for animals, i.e. a portion of the COI mitochondrial gene. In the present contribution, we release a library including 656 records representing 410 species in 40 different families. Species were identified by expert taxonomists, and each record is linked to a voucher specimen to enable future morphological examination. We also highlight and briefly discuss cases of low interspecific divergences, as well as cases of high intraspecific divergences that might represent cases of overlooked or cryptic diversity

Additional file 6: of Prevalence of cramps in patients over the age of 60 in primary care : a cross sectional study

AF Table 5: duration of cramps detailed for each cramps sufferer of the study population. Date of onset of cramps specified for each patient reporting cramps. (CSV 5 kb