Objets et sujets de la migration dans l'espace médiatique : construction des discours et des représentations. / Au-delà de la médiatisation : métamorphoses de l’objet.: Colloque International Migrobjets.

Fonds audiovisuel issu d'une coopération entre le programme Migrobjets, le programme Campus-AAR et le programme AAI (Paris, France, 2006-2018).Le programme Migrobjets, financé par le conseil scientifique de l’INALCO dans le cadre de l’AAP Migrations & Altérités travaille depuis mai 2016 sur une analyse pluridisciplinaire des images d’objets concourant à la représentation des migrants et des faits migratoires tels qu’elles apparaissent notamment, mais de manière non exclusive, dans la presse et les réseaux sociaux. >> Plus d'informations sur le site : https://migrobjets.hypotheses.org/490 Modération : Marie Poinsot (Rédactrice en chef Hommes & Migrations, MNHI) // Intervenants : Aude Fanlot (Dépt. Recherche MUCEM) & Isabelle Marquette (Conservatrice, MUCEM) : "Au-delà du médiatique : constituer une collection de musée sur les migrations contemporaines ?" // Anne-Louise Milne (Littérature comparée, London U. in Paris) & Melissa Thackway (Etudes cinématographiques, Inalco, Sciences Po) : "Ghosts of Stalingrad: compositions et recompositions" // Alexandra Galitzine-Loumpet (Anthropologue, CESSMA-Inalco, Migrobjets) : "La trace du pied, la relique et les restes : régimes de représentation et d’exposition de l’expérience migratoire"

Factors Affecting the Agreement Between Emergency Psychiatrists and General Practitioners Regarding Involuntary Psychiatric Hospitalizations

Important discrepancies exist between physicians in deciding when to perform involuntary hospitalization measures (IHMs). The factors underlying these differences are poorly known.We conducted a two-year single-center retrospective study in France on patients who were referred to the emergency department (ED) with an IHM certificate written by a private-practice General Practitioner (GP). For each consultation, the official IHM motive was categorized into four groups: Suicide; Psychosis, Mania, or Melancholia (PMM); Agitation; and Other. The alcohol status of the patient was also noted. The factors underlying the ED psychiatrists' confirmation of the use of IHMs were determined using a logistic regression model. One hundred eighty-nine cases were found (165 patients; 44.2 ± 16 years, 41.3% women). The ED psychiatrists confirmed the use of IHMs in 123 instances (65.1% agreement rate). Multivariate analyses found that IHM disagreement was significantly associated with patient alcohol status and the reason for referral. Specifically, there was an increased risk of IHM disagreement when the patient had an alcohol-positive status (OR = 15.80; 95% CI [6.45-38.67]; p < 0.0001) and when the motive for IHM was "agitation" compared with "suicide" (OR = 11.44; 95% CI[3.38-38.78]; p < 0.0001). These findings reflect significant disparities between GPs and ED psychiatrists regarding the decision to proceed to an IHM

Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients

Rationale: Diaphragm dysfunction is frequently observed in critically ill patients with difficult weaning from mechanical ventilation. Objectives: To evaluate the effects of temporary transvenous diaphragm neurostimulation on weaning outcome and maximal inspiratory pressure. Methods: Multicenter, open-label, randomized, controlled study. Patients aged >= 18 years on invasive mechanical ventilation for >= 4 days and having failed at least two weaning attempts received temporary transvenous diaphragm neurostimulation using a multielectrode stimulating central venous catheter (bilateral phrenic stimulation) and standard of care (treatment) (n = 57) or standard of care (control) (n= 55). In seven patients, the catheter could not be inserted, and in seven others, pacing therapy could not be delivered; consequently, data were available for 43 patients. The primary outcome was the proportion of patients successfully weaned. Other endpoints were mechanical ventilation duration, 30-day survival, maximal inspiratory pressure, diaphragm-thickening fraction, adverse events, and stimulation-related pain. Measurements and Main Results: The incidences of successful weaning were 82% (treatment) and 74% (control) (absolute difference [95% confidence interval (CI)], 7% [-10 to 25]), P = 0.59. Mechanical ventilation duration (mean +/- SD) was 12.7 +/- 9.9 days and 14.1 +/- 10.8 days, respectively, P = 0.50; maximal inspiratory pressure increased by 16.6 cm H2O and 4.8 cm H2O, respectively (difference [95% CI], 11.8 [5 to 19]), P = 0.001; and right hemidiaphragm thickening fraction during unassisted spontaneous breathing was +17% and -14%, respectively, P = 0.006, without correlation with changes in maximal inspiratory pressure. Serious adverse event frequency was similar in both groups. Median stimulation-related pain in the treatment group was 0 (no pain). Conclusions: Temporary transvenous diaphragm neurostimulation did not increase the proportion of successful weaning from mechanical ventilation. It was associated with a significant increase in maximal inspiratory pressure, suggesting reversal of the course of diaphragm dysfunction