L'automatisme Psychologique.

Se encuentran dificultades muy particulares y queda uno expuesto a grandes peligros, cuando se intenta extraer conclusiones generales de estos largos estudios experimentales. Los extraños hechos que hemos revisado, las seductoras teorías que hemos entrevisto a propósito de éste o aquél problema, parecen arrastrarnos a la hipótesis más aventureras de la filosofía. Las especulaciones de los antiguos autores hilozoistas sobre la vida universal y la conciencia universalmente extendida, las teorías más modernas sobre la persistencia de las ideas en la memoria y sobre el carácter indestructible del pensamiento, ¿acaso no se vinculan estrechamente a nuestras experiencias sobre la catalepsia, la sugestión terapéutica y los actos subconscientes? Pero abordar estos supuestos, por muy seductores que sean, sería salir enteramente del método que hemos asumido y pasar, como decía la antigua lógica, de un género a otro. Uno de los grandes méritos de estos nuevos estudios de psicología, aunque esto parezca singular, es que son susceptibles de error

L'automatisme Psychologique.

Se encuentran dificultades muy particulares y queda uno expuesto a grandes peligros, cuando se intenta extraer conclusiones generales de estos largos estudios experimentales. Los extraños hechos que hemos revisado, las seductoras teorías que hemos entrevisto a propósito de éste o aquél problema, parecen arrastrarnos a la hipótesis más aventureras de la filosofía. Las especulaciones de los antiguos autores hilozoistas sobre la vida universal y la conciencia universalmente extendida, las teorías más modernas sobre la persistencia de las ideas en la memoria y sobre el carácter indestructible del pensamiento, ¿acaso no se vinculan estrechamente a nuestras experiencias sobre la catalepsia, la sugestión terapéutica y los actos subconscientes? Pero abordar estos supuestos, por muy seductores que sean, sería salir enteramente del método que hemos asumido y pasar, como decía la antigua lógica, de un género a otro. Uno de los grandes méritos de estos nuevos estudios de psicología, aunque esto parezca singular, es que son susceptibles de error

Approche hiérarchique pour la segmentation du cervelet en IRM chez le nouveau-né : une étude expérimentale

International audienceMorphometric analysis of brain structures is of high interest for premature neonates, in particular for defining predictive neurodevelopment biomarkers. This requires beforehand, the correct segmentation of structures of interest from MR images. Such segmentation is however complex, due to the resolution and properties of data. In this context, we investigate the potential of hierarchical image models, and more precisely the binary partition tree, as a way of developing efficient, interactive and user-friendly 3D segmentation methods. In particular, we experiment the relevance of texture features for defining the hierarchy of partittions constituting the final segmentation space. This is one of the first uses of binary partition trees for 3D segmentation of medical images. Experiments are carried out on 19 MR images for cerebellum segmentation purpose.L'analyse morphométrique des structures cérébrales chez le prématuré est un sujet de plus en plus étu-dié dans le milieu médical afin de définir des biomar-queurs de neurodéveloppement. Cela nécessite dans un premier temps une segmentation de bonne qualité des structures d'intérêt à partir d'IRM cérébrales. Ce type de segmentation est complexe à réaliser en raison de la résolution et des propriétés des IRM. Dans ce contexte, nous étudions le potentiel des modèles hiérarchiques et plus précisément l'arbre binaire de partitions, comme outil de segmentation 3D interactive et d'utilisation aisée. En particulier, nous étudions l'intérêt des textures pour définir la structure hiérarchique fournissant la segmentation finale. Ce travail constitue l'une des premières utilisations des arbres binaires de partitions pour la segmentation 3D d'images médicales. Les ex-périences sont réalisées sur 19 images IRM pour la segmentation du cervelet

The importance of the general practitioner as an information source for patients with hereditary haemochromatosis

Objective To explore hereditary haemochromatosis (HH) patients’ perspectives on genetic information, namely the types of sources used, preferred or trusted. Methods A survey online was conducted by the European Federation of Associations of Patients with Haemochromatosis (EFAPH) and applied to members of nine National Associations. Results From a total of 1019 validated questionnaires, 895 respondents had performed a genetic testing for HH. From these, 627 self-declared that they were sufficiently informed about the implications of the genetic test to their health. The majority (66%) obtained the information from a specialist doctor, but would like to obtain it from the family doctor. However, the specialist was still the one they trusted more (69%). Regarding the 298 respondents who did not feel sufficiently informed, the majority (78%) also would like to have information from the family doctor although they also trusted the specialist more (75%). A different perspective was reported when patients were asked about the implications of the genetic testing to their family members, where the majority of respondents preferred obtaining information from a specialist (69%). Conclusion This study elucidates the patients’ needs for information and identifies the general practitioner (GP) as the preferred source to obtain information about HH. Practice implications These results may have important implications in future strategies for HH awareness, giving a special emphasis on GPs as the main players

Vernacular museum: communal bonding and ritual memory transfer among displaced communities

Eclectically curated and largely ignored by the mainstream museum sector, vernacular museums sit at the interstices between the nostalgic and the future-oriented, the private and the public, the personal and the communal. Eluding the danger of becoming trivialised or commercialised, they serve as powerful conduits of memory, which strengthen communal bonds in the face of the ‘flattening’ effects of globalisation. The museum this paper deals with, a vernacular museum in Vanjärvi in southern Finland, differs from the dominant type of the house museum, which celebrates masculinity and social elites. Rather, it aligns itself with the small amateur museums of everyday life called by Angela Jannelli Wild Museums (2012), by analogy with Lévi-Strauss’ concept of ‘pensée sauvage’. The paper argues that, despite the present-day flurry of technologies of remembering and lavishly funded memory institutions, there is no doubt that the seemingly ‘ephemeral’ institutions such as the vernacular museum, dependent so much on performance, oral storytelling, living bodies and intimate interaction, nevertheless play an important role in maintaining and invigorating memory communities

ANALISIS TINGKAT KERENTANAN TANAH LONGSOR DI WILAYAH PERKOTAAN TAHUNA DENGAN MENGGUNAKAN GIS

Wilayah Perkotaan Tahuna merupakan daerah yang cukup rawan terhadap tanah longsor. Adapun faktor penyebab antara lain : Intensitas curah hujan yang tinggi, kemiringan lereng yang terjal, penggunaan lahan bervariasi yang terjadi akibat aktivitas manusia yang kurang memperhatikan keseimbangan lingkungan.Tujuan penelitian ini untuk menganalisis tingkat kerentanan tanah longsor di Wilayah Perkotaan Tahuna dengan menggunakan gis. Penelitian ini menggunakan teknik metode deskriptif kuantitatif dan analisis spasial dengan bantuan alat analis GIS ( Geografis Informasi Sistem) dan analisis analisis skoring dengan teknik pengumpulan data primer (observasi lapangan dan wawancara langsung) data pengumpulan data sekunder (studi literatur, mengunjungi instansi pemerintah/organsisasi terkait dan searching data/ informasi di media internet). Dari hasil penelitian yang dilakukan maka dapat di tarik kesimpulan bahwa dengan memperhitungkan parameter kerentanan demografi, kerentanan ekonomi, kerentanan fisik dan kerentanan lingkungan di dapat 5 klasifikasi tingkat kerentanan : tidak rentan, sedikit rentan, agak rentan dan sangat rentan. Untuk kategori tingkat kerentanan sangat rentan di Kecamatan Tahuna memiliki luasan 269.712ha (1,45%) meliputi 4 Kelurahan : Bungalawang, Manente, Sawang Bendar, Soataloara Dua dan Kecamatan Tahuna Timur kategori tingkat kerentanan sangat rentan memiliki lusasan 112.472ha (0.82%) meliputi 3 Kelurahan : Lesa, Tapuang, Tona Dua. Kata Kunci: Wilayah Perkotaan Tahuna, Kerentanan, Longsor, Geografi Informasi Siste

Assessment of Obstetric and Neonatal Health Services in Developing Country Health Facilities

OBJECTIVE: To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality. STUDY DESIGN: In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/medications, and procedures including cesarean section. RESULTS: The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals. CONCLUSIONS: Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required.Fil: Manasyan, Albert. Centre for Infectious Disease Zambia; Zambia. University of Alabama at Birmingahm; Estados UnidosFil: Saleem, Sarah. Aga Khan University; PakistánFil: Koso Thomas, Marion. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados UnidosFil: Althabe, Fernando. Instituto de Efectividad Clínica y Política de Salud. Departamento de Investigación en Salud Madre e Infantil. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pasha, Omrana. Aga Khan University; PakistánFil: Chomba, Elwyn. Centre for Infectious Disease Zambia; Zambia. University of Alabama at Birmingahm; Estados Unidos. University of Zambia; ZambiaFil: Goudar, Shivaprasad S.. KLE; IndiaFil: Patel, Archana. Indira Gandhi Government Medical College; IndiaFil: Esamai, Fabian. Moi University; KeniaFil: Garces, Ana. Francisco Marroquin University; GuatemalaFil: Kodkany, Bhala. KLE; IndiaFil: Belizan, Jose. Instituto de Efectividad Clínica y Política de Salud. Departamento de Investigación en Salud Madre e Infantil. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: McClure, Elizabeth M.. Research Triangle Institute; Estados UnidosFil: Derman, Richard J.. Christiana Health Care; Estados UnidosFil: Hibberd, Patricia. Indiana University; Estados UnidosFil: Liechty, Edward A.. Massachusetts General Hospital for Children; Estados UnidosFil: Hambidge, K. Michael. State University of Colorado Boulder; Estados UnidosFil: Carlo, Waldemar A.. Centre for Infectious Disease Zambia; ZambiaFil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados UnidosFil: Moore, janet. Research Triangle Institute; Estados UnidosFil: Wright, Linda L.. Eunice Kennedy Shriver National Institute of Child Health and Human Development; Estados UnidosFil: Goldenberg, Robert L.. Columbia University; Estados Unido

Experience collecting interim data on mortality: an example from the RALES study

INTRODUCTION: The Randomized Aldactone Evaluation Study (RALES) randomized 822 patients to receive 25 mg spironolactone daily and 841 to receive placebo. The primary endpoint was death from all causes. Randomization began on March 24, 1995; recruitment was completed on December 31, 1996; follow-up was scheduled to continue through December 31, 1999. Evidence of a sizeable benefit on mortality emerged early in the RALES. The RALES data safety monitoring board (DSMB), which met semiannually throughout the trial, used a prespecified statistical guideline to recommend stopping for efficacy. At the DSMB's request, its meetings were preceded by an 'endpoint sweep', that is, a census of all participants to confirm their vital status. METHODS: We used computer simulation to evaluate the effect of the sweeps. RESULTS: The sweeps led to an estimated 5 to 8% increase in the number of reported deaths at the fourth and fifth interim analyses. The data crossed the statistical boundary at the fifth interim analysis. If investigators had reported all deaths within the protocol-required 24-h window, the DSMB might have recommended stopping after the fourth interim analysis. DISCUSSION: Although endpoint sweeps can cause practical problems at the clinical centers, sweeps are very useful if the intervals between patient visits or contact are long or if endpoints require adjudication by committee, reading center, or central laboratory. CONCLUSION: We recommend that trials with interim analyses institute active reporting of the primary endpoints and endpoint sweeps

“They Love Their Patients”: Client Perceptions of Quality of Postabortion Care in North and South Kivu, the Democratic Republic of the Congo

Background: Postabortion care (PAC) is a lifesaving intervention that, when accessible and of good quality, can prevent the majority of abortion-related deaths. However, these services are only sporadically available and often of poor quality in humanitarian settings. CARE International, the International Rescue Committee, and Save the Children strengthened the Congolese Ministry of Health to provide PAC, including voluntary contraceptive services, in North and South Kivu, DRC. Objective: We aimed to gain understanding of the demographic and clinical characteristics of PAC clients, the experiences of women who sought PAC at supported health facilities, and the women’s perceptions of the quality of care received. We also explored how client perspectives can inform future PAC programming. Methods: A PAC register review extracted sociodemographic and clinical data on all PAC clients during a 12-month period between 2015 and 2016 at 69 supported facilities in 6 health zones. In-depth interviews were conducted between September 2016 and April 2017 with 50 women who sought PAC in the preceding 3 months at supported health facilities. Interviews were recorded, transcribed, and translated into French for analysis. Thematic content analysis was subsequently used as the data analytic approach. Results: In 12 months, 1,769 clients sought PAC at supported facilities; 85.2% were at less than 13 weeks gestation. Over 80% of PAC clients had a uterine evacuation, and of these, 90% were treated with manual vacuum aspiration. The majority (75.2%) of PAC clients chose voluntary postabortion contraception. All but one interview participant reported seeking PAC for a spontaneous abortion, although most also reported their pregnancy was unintended. Clients were mostly made aware that PAC was available by community health workers or other community members. Experiences at the supported facilities were mostly positive, particularly in regards to client-provider interactions. Most women received contraceptive counseling during PAC and selected a modern method of contraception immediately after treatment. However, knowledge about different methods of contraception varied. Nearly all women said that they would advise another woman experiencing abortion complications to seek PAC at a supported health facility. Conclusions: The findings demonstrate the successful implementation of good-quality, respectful PAC in North and South Kivu. Overall, they suggest that the organizations’ support of health workers, including competency-based training and supportive supervision, was successful