La médiation en santé : Contribution à une étude des conflits et des différends dans la relation de soins

Mediation may be defined as the action of the mediator who mediates between two or more persons to resolve a conflict or dispute. In the field of health, especially in caring relationships conflicts and disputes may happen actually. Health affects the state of being of the persons, their privacy, their integrity and so relationships which arise from this with health care providers are necessarily influenced with a certain sensitivity. That is why this area is regarded as a potentiel provider of stress. Therefore, it is of interest to study the mediation as an unique alternative to resolve a dispute. To focus on the legal nature of the mediation is essential to differentiate it from other alternatives and to assess strengths and weaknesses of such an approach. This will then allow to apply a suitable legal regime to mediation. Because of the current shortcomings, particularly with regard to the supervision of the mediator, the finding of an inevitable reshuffle mediation scheme should be made. This will necessarily combine flexibility and supervision for an optimal efficiency.La médiation peut se définir comme l’action de celui qui est médiateur et qui s’interpose entre deux ou plusieurs personnes pour résoudre un conflit ou un différend. Dans le domaine de la santé et plus particulièrement dans la relation de soins, des conflits et des différends peuvent survenir. La santé touche en effet à l’état des personnes, à leur intimité, à leur intégrité et les relations qui en découlent avec les professionnels de santé sont nécessairement empreintes d’une certaine sensibilité. C’est pourquoi ce secteur est considéré comme pourvoyeur potentiel de tensions. Il est donc intéressant d’étudier la résolution des conflits ou différends inhérents à la relation de soins, par un mode singulier et alternatif de règlement des différends : la médiation. L’étude de la nature juridique de ce processus est indispensable pour le différencier des autres modes alternatifs et exposer clairement ses forces et ses faiblesses. Ceci permettra ensuite de lui appliquer un régime juridique adéquat. En raison des manquements actuels, particulièrement au regard de l’encadrement du statut de médiateur, le constat d’un inévitable remaniement du régime de la médiation devra être effectué. Celui-ci devra impérativement allier souplesse et encadrement du mécanisme dans le but d’une efficacité optimale

Measuring Happiness: From Fluctuating Happiness to Authentic–Durable Happiness

On the basis of the theoretical distinction between self-centeredness and selflessness (Dambrun and Ricard, 2011), the main goal of this research was to develop two new scales assessing distinct dimensions of happiness. By trying to maximize pleasures and to avoid displeasures, we propose that a self-centered functioning induces a fluctuating happiness in which phases of pleasure and displeasure alternate repeatedly (i.e., Fluctuating Happiness). In contrast, a selfless psychological functioning postulates the existence of a state of durable plenitude that is less dependent upon circumstances but rather is related to a person’s inner resources and abilities to deal with whatever comes his way in life (i.e., Authentic–Durable Happiness). Using various samples (n = 735), we developed a 10-item Scale measuring Subjective Fluctuating Happiness (SFHS) and a 13-item scale assessing Subjective Authentic–Durable Happiness (SA–DHS). Results indicated high internal consistencies, satisfactory test–retest validities, and adequate convergent and discriminant validities with various constructs including a biological marker of stress (salivary cortisol). Consistent with our theoretical framework, while self-enhancement values were related only to fluctuating happiness, self-transcendence values were related only to authentic–durable happiness. Support for the distinction between contentment and inner-peace, two related markers of authentic happiness, also was found

Comment on "First Observation of Ground State Dineutron Decay: 16Be"

A recent measurement [Spyrou et al., PRL 108, 102501 (2012)] of the in-flight decay of 16Be into 14Be+n+n has been interpreted as the first case of dineutron emission. Here we point out that the inclusion of the n-n interaction neglected in the description of the direct three-body decay can generate strong enhancements at low n-n relative energy and angle, as observed, without any need to invoke dineutron decay.Comment: Final version, published in Physical Review Letter

Structure of unbound neutron-rich 9^{9}He studied using single-neutron transfer

The 8He(d,p) reaction was studied in inverse kinematics at 15.4A MeV using the MUST2 Si-CsI array in order to shed light on the level structure of 9He. The well known 16O(d,p)17O reaction, performed here in reverse kinematics, was used as a test to validate the experimental methods. The 9He missing mass spectrum was deduced from the kinetic energies and emission angles of the recoiling protons. Several structures were observed above the neutron-emission threshold and the angular distributions were used to deduce the multipolarity of the transitions. This work confirms that the ground state of 9He is located very close to the neutron threshold of 8He and supports the occurrence of parity inversion in 9He.Comment: Exp\'erience GANIL/SPIRAL1/MUST

Oncogenic RET Kinase domain mutations perturb the autophosphorylation trajectory by enhancing substrate presentation in trans

To decipher the molecular basis for RET kinase activation and oncogenic deregulation, we defined the temporal sequence of RET autophosphorylation by label-free quantitative mass spectrometry. Early autophosphorylation sites map to regions flanking the kinase domain core, while sites within the activation loop only form at later time points. Comparison with oncogenic RET kinase revealed that late autophosphorylation sites become phosphorylated much earlier than wild-type RET, which is due to a combination of an enhanced enzymatic activity, increased ATP affinity, and surprisingly, by providing a better intermolecular substrate. Structural analysis of oncogenic M918T and wild-type RET kinase domains reveal a cis-inhibitory mechanism involving tethering contacts between the glycine-rich loop, activation loop, and αC-helix. Tether mutations only affected substrate presentation but perturbed the autophosphorylation trajectory similar to oncogenic mutations. This study reveals an unappreciated role for oncogenic RET kinase mutations in promoting intermolecular autophosphorylation by enhancing substrate presentation

Search for low lying dipole strength in the neutron rich nucleus 26^{26}Ne

Coulomb excitation of the exotic neutron-rich nucleus $^{26}$Ne on a $^{nat}$Pb target was measured at 58 A.MeV in order to search for low-lying E1 strength above the neutron emission threshold. Data were also taken on an $^{nat}$Al target to estimate the nuclear contribution. The radioactive beam was produced by fragmentation of a 95 A.MeV $^{40}$Ar beam delivered by the RIKEN Research Facility. The set-up included a NaI gamma-ray array, a charged fragment hodoscope and a neutron wall. Using the invariant mass method in the $^{25}$Ne+n channel, we observe a sizable amount of E1 strength between 6 and 10 MeV. The reconstructed $^{26}$Ne angular distribution confirms its E1 nature. A reduced dipole transition probability of B(E1)=0.49$\pm$0.16 $e^2fm^2$ is deduced. For the first time, the decay pattern of low-lying strength in a neutron-rich nucleus is obtained. The results are discussed in terms of a pygmy resonance centered around 9 MeV

The N = 16 spherical shell closure in 24O

The unbound excited states of the neutron drip-line isotope 24O have been investigated via the 24O(p,p')23O+n reaction in inverse kinematics at a beam energy of 62 MeV/nucleon. The decay energy spectrum of 24O* was reconstructed from the momenta of 23O and the neutron. The spin-parity of the first excited state, observed at Ex = 4.65 +/- 0.14 MeV, was determined to be Jpi = 2+ from the angular distribution of the cross section. Higher lying states were also observed. The quadrupole transition parameter beta2 of the 2+ state was deduced, for the first time, to be 0.15 +/- 0.04. The relatively high excitation energy and small beta2 value are indicative of the N = 16 shell closure in 24O.Comment: to be submitted to Physical Review Letter

Modelling LAI at a regional scale with ISBA-A-gs: comparison with satellite-derived LAI over southwestern France

International audienceA CO2-responsive land surface model (the ISBAA- gs model of M´et´eo-France) is used to simulate photosynthesis and Leaf Area Index (LAI) in southwestern France for a 3-year period (2001–2003). A domain of about 170 000 km2 is covered at a spatial resolution of 8 km. The capability of ISBA-A-gs to reproduce the seasonal and the interannual variability of LAI at a regional scale, is assessed with satellite-derived LAI products. One originates from the CYCLOPES programme using SPOT/VEGETATION data, and two products are based on MODIS data. The comparison reveals discrepancies between the satellite LAI estimates and between satellite and simulated LAI values, both in their intensity and in the timing of the leaf onset. The model simulates higher LAI values for the C3 crops than the satellite observations, which may be due to a saturation effect within the satellite signal or to uncertainties in model parameters. The simulated leaf onset presents a significant delay for C3 crops and mountainous grasslands. In-situ observations at a mid-altitude grassland site show that the generic temperature response of photosynthesis used in the model is not appropriate for plants adapted to the cold climatic conditions of the mountainous areas. This study demonstrates the potential of LAI remote sensing products for identifying and locating models' shortcomings at a regional scale