Don d'organes: les besoins des infirmières en soins intensifs lors de la prise en soins d'un donneur potentiel et de ses proches : une revue de littérature étoffée

Actuellement, le don d’organes représente une problématique dans le domaine de la santé suisse en raison d’un taux insuffisant de donneurs pour répondre à la demande croissante d’organes. Les difficultés rencontrées par les infirmières en soins intensifs, lors de la prise en soins d’un donneur potentiel et de ses proches, sont encore peu étudiées dans la littérature scientifique. Leur compréhension est alors nécessaire pour améliorer la pratique du don et indirectement augmenter le taux de consentement au DO

Pertinence et validité de tâches complexes dans l’évaluation de futurs enseignants

Ce chapitre interroge la manière d’assurer la pertinence tâches complexes utilisées dans l’évaluation des compétences de futurs enseignants. En d’autres termes, il s’agit d’assurer que le choix des tâches complexes est adéquat pour produire une information pertinente pour prendre une décision. Il présente une démarche articulée autour de cette exigence qui consiste à exposer ces tâches complexes – les auteurs en ont retenues six élaborées dans les Hautes Ecoles Pédagogiques (HEP) vaudoises et fribourgeoises – à la critique de praticiens et en regard d’un cadre théorique

Short-term effects of unilateral lesion of the primary motor cortex (M1) on ipsilesional hand dexterity in adult macaque monkeys

Although the arrangement of the corticospinal projection in primates is consistent with a more prominent role of the ipsilateral motor cortex on proximal muscles, rather than on distal muscles involved in manual dexterity, the role played by the primary motor cortex on the control of manual dexterity for the ipsilateral hand remains a matter a debate, either in the normal function or after a lesion. We, therefore, tested the impact of permanent unilateral motor cortex lesion on the manual dexterity of the ipsilateral hand in 11 macaque monkeys, within a time window of 60days post-lesion. For comparison, unilateral reversible pharmacological inactivation of the motor cortex was produced in an additional monkey. Manual dexterity was assessed quantitatively based on three motor parameters derived from two reach and grasp manual tasks. In contrast to the expected dramatic, complete deficit of manual dexterity of the contralesional hand that persists for several weeks, the impact on the manual dexterity of the ipsilesional hand was generally moderate (but statistically significant) and, when present, lasted less than 20days. Out of the 11 monkeys, only 3 showed a deficit of the ipsilesional hand for 2 of the 3 motor parameters, and 4 animals had a deficit for only one motor parameter. Four monkeys did not show any deficit. The reversible inactivation experiment yielded results consistent with the permanent lesion data. In conclusion, the primary motor cortex exerts a modest role on ipsilateral manual dexterity, most likely in the form of indirect hand postural contro

Short-term effects of unilateral lesion of the primary motor cortex (M1) on ipsilesional hand dexterity in adult macaque monkeys

Although the arrangement of the corticospinal projection in primates is consistent with a more prominent role of the ipsilateral motor cortex on proximal muscles, rather than on distal muscles involved in manual dexterity, the role played by the primary motor cortex on the control of manual dexterity for the ipsilateral hand remains a matter a debate, either in the normal function or after a lesion. We, therefore, tested the impact of permanent unilateral motor cortex lesion on the manual dexterity of the ipsilateral hand in 11 macaque monkeys, within a time window of 60 days post-lesion. For comparison, unilateral reversible pharmacological inactivation of the motor cortex was produced in an additional monkey. Manual dexterity was assessed quantitatively based on three motor parameters derived from two reach and grasp manual tasks. In contrast to the expected dramatic, complete deficit of manual dexterity of the contralesional hand that persists for several weeks, the impact on the manual dexterity of the ipsilesional hand was generally moderate (but statistically significant) and, when present, lasted less than 20 days. Out of the 11 monkeys, only 3 showed a deficit of the ipsilesional hand for 2 of the 3 motor parameters, and 4 animals had a deficit for only one motor parameter. Four monkeys did not show any deficit. The reversible inactivation experiment yielded results consistent with the permanent lesion data. In conclusion, the primary motor cortex exerts a modest role on ipsilateral manual dexterity, most likely in the form of indirect hand postural control

Task-related enhancement in corticomotor excitability during haptic sensing with the contra- or ipsilateral hand in young and senior adults

<p>Abstract</p> <p>Background</p> <p>Haptic sensing with the fingers represents a unique class of manipulative actions, engaging motor, somatosensory and associative areas of the cortex while requiring only minimal forces and relatively simple movement patterns. Using transcranial magnetic stimulation (TMS), we investigated task-related changes in motor evoked potential (MEP) amplitude associated with unimanual haptic sensing in two related experiments. In Experiment I, we contrasted changes in the excitability of the hemisphere controlling the task hand in young and old adults under two trial conditions, i.e. when participants either touched a fine grating (<it>smooth trials</it>) or touched a coarse grating to detect its groove orientation (<it>grating trials</it>). In Experiment II, the same contrast between tasks was performed but with TMS applied over the hemisphere controlling the resting hand, while also addressing hemispheric (right vs. left) and age differences.</p> <p>Results</p> <p>In Experiment I, a main effect of <it>trial type </it>on MEP amplitude was detected (p = 0.001), MEPs in the task hand being ~50% larger during grating than smooth trials. No interaction with age was detected. Similar results were found for Experiment II, <it>trial type </it>having a large effect on MEP amplitude in the resting hand (p < 0.001) owing to selective increase in MEP size (~2.6 times greater) for grating trials. No interactions with age or side (right vs. left) were detected.</p> <p>Conclusions</p> <p>Collectively, these results indicate that adding a haptic component to a simple unilateral finger action can elicit robust corticomotor facilitation not only in the working hemisphere but also in the opposite hemisphere. The fact that this facilitation seems well preserved with age, when task difficulty is adjusted, has some potential clinical implications.</p

Corticotectal Projections From the Premotor or Primary Motor Cortex After Cortical Lesion or Parkinsonian Symptoms in Adult Macaque Monkeys: A Pilot Tracing Study

The corticotectal projections, together with the corticobulbar (corticoreticular) projections, work in parallel with the corticospinal tract (CST) to influence motoneurons in the spinal cord both directly and indirectly via the brainstem descending pathways. The tectospinal tract (TST) originates in the deep layers of the superior colliculus. In the present study, we analyzed the corticotectal projections from two motor cortical areas, namely the premotor cortex (PM) and the primary motor cortex (M1) in eight macaque monkeys subjected to either a cortical lesion of the hand area in M1 (n = 4) or Parkinson’s disease-like symptoms PD (n = 4). A subgroup of monkeys with cortical lesion was subjected to anti-Nogo-A antibody treatment whereas all PD monkeys were transplanted with Autologous Neural Cell Ecosystems (ANCEs). The anterograde tracer BDA was used to label the axonal boutons both en passant and terminaux in the ipsilateral superior colliculus. Individual axonal boutons were charted in the different layers of the superior colliculus. In intact animals, we previously observed that corticotectal projections were denser when originating from PM than from M1. In the present M1 lesioned monkeys, as compared to intact ones the corticotectal projection originating from PM was decreased when treated with anti-Nogo-A antibody but not in untreated monkeys. In PD-like symptoms’ monkeys, on the other hand, there was no consistent change affecting the corticotectal projection as compared to intact monkeys. The present pilot study overall suggests that the corticotectal projection is less affected by M1 lesion or PD symptoms than the corticoreticular projection previously reported in the same animals

Diabète sucré secondaire à une endocrinopathie : quand y penser ?

An endocrine disease can be associated with glucose intolerance or diabetes mellitus, and the latter can falsely be considered as type 2 diabetes. Glycemic imbalance can be a direct or indirect consequence of excessive hormone production. Endocrine diseases such as acromegaly, Cushing's syndrome and pheochromocytoma can increase glucose production and cause insulin resistance. Hyperthyroidism, hyperaldosteronism, glucagonoma and somatostatinoma lead to hyperglycemia by other physiopathological mechanisms detailed in this article. When a clinical picture suggests an endocrine disease, several analyses need to be done in order to avoid treatment escalation of diabetes

Trois générations de herbartiens en Suisse romande. Modalités et conditions d’un transfert dans le champ pédagogique

Entre 1875 et 1925, l’influence de l’herbartisme se fait sentir en Suisse romande, dans le champ pédagogique. L’étude des écrits de trois pédagogues représentatifs permet de dégager l’évolution du mouvement, la manière dont circule un savoir nouveau, et les résistances qu’il suscite dans des conditions historiques données. Un des premiers partisans de Herbart en Suisse, Xavier Ducotterd, fait sa carrière en Allemagne, mais cherche à promouvoir, par ses articles dans des revues pédagogiques suisses, une pédagogie fondée sur des principes de psychologie et de philosophie érigés en système, sans succès. François Guex a plus de moyens pour arriver au même but. De nouvelles chaires de pédagogie suscitent beaucoup d’espoirs, en vue de la professionnalisation des enseignants. Avec Ernest Briod, on assiste à la dernière période de l’herbartisme en Suisse romande. Le système herbartien s’expose aux critiques de la psychologie expérimentale qui lui substitue d’autres méthodes scientifiques. Les trois personnalités évoquées attendaient de l’herbartisme la conciliation de différentes tendances idéologiques qui traversaient l’enseignement public. Il s’agissait non seulement d’enjamber les frontières nationales, mais également confessionnelles, politiques et institutionnelles. </p