L’intervention en situation de crise

Cet aricle est une revue de la littérature extensive sur l'intervention de crise. Les auteurs explorent les fondements théoriques de cette approche et les évaluent grâce à une analyse approfondie des recherches sur ce sujet. Plus précisément, ils énoncent une définition de la crise, les classifient, explicitent son processus et décrivent comment se réalise une intervention en situation de crise. Dans la deuxième partie, ils examinent le phénomène de Ia dépendance et les facteurs déterminants au cours de ce processus. Ensuite, ils scrutent le postulat des facteurs précipitants pour déboucher, suite à sa critique, sur la nécessité de considérer les facteurs médiateurs comme variables explicatives de la résolution de la crise.This article is an extensive review of literature on crisis intervention. The authors explore the theoretical grounds of this approach and rate them by means of a thorough analysis of the research done on the subject. More precisely they elaborate a definition of a crisis, provide a classification of same, explain its process and describe how the intervention develops in a crisis situation. They examine, in the second part, the dependence phenomenon, and the determining factors encountered. Then, they study the notion of the triggering factors that lead them to the necessity of taking into account the mediatory factors and explanatory variables in the resolution of the crisis

How do general dental practitioners perceive and deal with orthodontic bonded retainers?

Introduction: Long-term follow-up and management of orthodontic bonded retainers require a strong collaboration between orthodontists and general dental practitioners (GDPs). This study aimed to evaluate if Eastern French GDPs were aware of bonded retainers' complications and side effects and if they were willing to take part in their long-term follow-up. Methods: Two-hundred and eighteen randomly selected GDPs were invited to answer an online questionnaire. The initial sections covered their experience and management with bonded retainers. In the final sections, GDPs were asked their opinion on the responsibility for long-term follow-up of patients wearing fixed retainers and on the mutual communication between orthodontists and GDPs. Statistical analysis involved descriptive statistics and Fisher exact tests. Results: Response rate was 32.6% (n 5 71). The vast majority of GDPs were familiar with loose retainers, but only 45.2% were willing to repair them. Respondents offering orthodontic services on a regular basis were more likely to insert retainers and repair loose or broken retainers (P \ 0.001). Approximately 18.6% of GDPs were aware of third-order side effects encountered with unintentionally active retainers bonded to all 6 anterior teeth. For 88.8% of GDPs, permanent retention was justified, whereas 90% of the dentists refused to be responsible for longterm supervision of fixed retainers. In addition, 67.1% were interested in further training on orthodontic retention, and 92.9% would appreciate clinical guidelines. Conclusions: Knowledge about the harmful side effects of bonded retainers was evaluated as insufficient among surveyed GDPs. Long-term follow-up of patients wearing bonded retainers raises issues that should be addressed globally by enhancing mutual communication, practitioners' education, and patients' involvement. (Am J Orthod Dentofacial Orthop 2021;160:e1-e8

Innovating in Teaching Collaborative Practice with a Large Student Cohort at Université de Montréal

Université de Montréal implemented an interprofessional education (IPE) curriculum on collaborative practice in a large cohort of students (>1,100) from 10 health sciences and psychosocial sciences training programs. It is made up of three one-credit undergraduate courses (CSS1900, CSS2900, CSS3900) spanning the first 3 years of training. The course content and activities aim for development of the six competency domains identified by the Canadian Interprofessional Health Collaborative. This paper describes the IPE curriculum and highlights the features contributing to its success and originality. Among main success key factors were: administrative cooperation among participating faculties, educators eager to develop innovative approaches, extensive use of clinical situations conducive to knowledge and skill application, strong logistic support, close cooperation with health care delivery organizations, and partnership between clinicians and patients. A distinguishing feature of this IPE curriculum is the concept of partnership in care between the patient and caregivers. Patients’ representatives were involved in course planning, and patients were trained to become patients-as-trainers (PT) and cofacilitate interprofessional discussion workshops. They give feed- back to students regarding integration and application of the patient partnership concept from a patient’s point of view. Lire l'article/Read the article : http://openurl.ingenta.com/content?genre=article&issn=0090-7421&volume=42&issue=4&spage=97E&epage=106

Cryptocrine Signaling in the Thymus Network and T Cell Education to Neuroendocrine Self-Antigens

peer reviewedBoth during phylogeny and ontogeny the thymus appears as a nodal point between the two major systems of cell-to-cell signaling, the neuroendocrine and immune systems. This review presents the experimental observations which support a dual role in T cell selection played by the thymic repertoire of neuroendocrine polypeptide precursors. Through the mode of cryptocrine intercellular signaling thymic neuroendocrine-related precursors synthesized in thymic epithelial cells have been shown to influence the early steps in T cell differentiation. In addition, thymic neuroendocrine-related polypeptides are a source of self-antigens which are presented by the major histocompatibility system of the thymic epithelium. Preliminary data also suggest that the intrathymic T cell education to neuroendocrine self-antigens is not strictly superimposible to the antigen presentation by dedicated presenting cells. Insulin-like growth factor-II (IGF-II) was identified as one dominant member of the insulin family expressed by thymic epithelial and nurse cells. The intrathymic presentation of IGF-II or IGF-II derived self-antigens is under current investigation. If further confirmed, the central tolerogenic properties of IGF-II could be considered in the elaboration of a strategy for an efficient and safe prevention of insulin-dependent diabetes