L'accompagnement de la construction de la chaîne associative groupale dans un groupe de patients schizophrènes

International audienceLe travail a pour but d’étudier, à partir de séquences cliniques d’un groupe de paroles, constitué de patients schizophrènes en institution spécialisée, le processus de construction d’une chaîne associative groupale. Les auteurs décrivent comment les productions morcelées et dissociées de patients schizophrènes, délirants et hallucinés, en situation de groupe, peuvent, dans certaines conditions, devenir progressivement une chaîne associative de groupe, prenant en compte les productions de chacun. Est plus particulièrement étudié comment ces patients, très régressés, sont pourtant aptes à « prêter à l’autre » des fonctions psychiques non disponibles pour eux-mêmes, comme, par exemple, la figuration. Il s’agit d’une fonction phorique particulière, le groupe devient un lieu de mise en commun et partage une « coopérative psychique » de fonctions non disponibles à chaque participant

A branching process model of heterogeneous DNA damages caused by radiotherapy in in vitro cell cultures

International audienceThis paper deals with the dynamic modeling and simulation of cell damage heterogeneity and associated mutant cell phenotypes in the therapeutic responses of cancer cell populations submitted to a radiotherapy session during in vitro assays. Each cell is described by a finite number of phenotypic states with possible transitions between them. The population dynamics is then given by an age-dependent multi-type branching process. From this representation, we obtain formulas for the average size of the global survival population as well as the one of subpopulations associated with 10 mutation phenotypes. The proposed model has been implemented into Matlab© and the numerical results corroborate the ability of the model to reproduce four major types of cell responses: delayed growth, anti-proliferative, cytostatic and cytotoxic

Translating the multi-actor approach to research into practice using a workshop approach focusing on species mixtures

The EIP-Agri multiactor approach was exemplified during a 3-day workshop with 63 project participants from the EU H2020 funded project "Redesigning European cropping systems based on species MIXtures". The objective was to share firsthand experience of participatory research among researchers who were mostly not familiar with this approach. Workshop participants were divided into smaller multidisciplinary groups and given the opportunity to interact with representatives from eight actor positions in the value chain of the agrifood cooperative Terrena located in Western France. The four stages of the workshop were: (1) key actor interviews, (2) sharing proposed solutions for overcoming barriers, and (3) developing possible interdisciplinary concepts. Expressions of frustration were recorded serving both as a motivation for group members to become more aware of the scientific concerns and practices of their colleagues, as well as a recognition that some researchers have better skills integrating qualitative approaches than others. Nevertheless, the workshop format was an effective way to gain a common understanding of the pertinent issues that need to be addressed to meet overall multiactor-approach objectives. Working with the actor networks was identified and emphasized as a means to overcome existing barriers between academia and practice in order to coproduce a shared vision of the benefits of species mixture benefits. (C) The Author(s) 2021. Published by Higher Education Press

Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke

BACKGROUND Trials of patent foramen ovale (PFO) closure to prevent recurrent stroke have been inconclusive. We investigated whether patients with cryptogenic stroke and echocardiographic features representing risk of stroke would benefit from PFO closure or anticoagulation, as compared with antiplatelet therapy. METHODS In a multicenter, randomized, open-label trial, we assigned, in a 1:1:1 ratio, patients 16 to 60 years of age who had had a recent stroke attributed to PFO, with an associated atrial septal aneurysm or large interatrial shunt, to transcatheter PFO closure plus long-term antiplatelet therapy (PFO closure group), antiplatelet therapy alone (antiplatelet-only group), or oral anticoagulation (anticoagulation group) (randomization group 1). Patients with contraindications to anticoagulants or to PFO closure were randomly assigned to the alternative noncontraindicated treatment or to antiplatelet therapy (randomization groups 2 and 3). The primary outcome was occurrence of stroke. The comparison of PFO closure plus antiplatelet therapy with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 2, and the comparison of oral anticoagulation with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 3. RESULTS A total of 663 patients underwent randomization and were followed for a mean (+/- SD) of 5.3 +/- 2.0 years. In the analysis of randomization groups 1 and 2, no stroke occurred among the 238 patients in the PFO closure group, whereas stroke occurred in 14 of the 235 patients in the antiplatelet-only group (hazard ratio, 0.03; 95% confidence interval, 0 to 0.26; P<0.001). Procedural complications from PFO closure occurred in 14 patients (5.9%). The rate of atrial fibrillation was higher in the PFO closure group than in the antiplatelet-only group (4.6% vs. 0.9%, P = 0.02). The number of serious adverse events did not differ significantly between the treatment groups (P = 0.56). In the analysis of randomization groups 1 and 3, stroke occurred in 3 of 187 patients assigned to oral anticoagulants and in 7 of 174 patients assigned to antiplatelet therapy alone. CONCLUSIONS Among patients who had had a recent cryptogenic stroke attributed to PFO with an associated atrial septal aneurysm or large interatrial shunt, the rate of stroke recurrence was lower among those assigned to PFO closure combined with antiplatelet therapy than among those assigned to antiplatelet therapy alone. PFO closure was associated with an increased risk of atrial fibrillation

Les cadres culturels à l\u27épreuve des mutations contemporaines : enjeux subjectifs et intersubjectifs

Communication : les institutions spécialisés française inscrites dans une orientation psychanalytiqu

Les dispositifs d’intervention clinique en institution

Cet article présente de manière synthétique la théorisation et la découpe originales de l’intervention clinique en institution en référence au modèle que Jean-Claude Rouchy nous a proposé. Il présente et discute trois repères essentiels à la compréhension de sa démarche méthodologique : le concept de dispositif ; la place de l’analyste ; les différents dispositifs d’analyse en institution. Ce modèle offre un repérage particulièrement précieux pour le clinicien, trouvant ainsi un adossement fiable et consistant lui permettant de résister créativement à la déliaison, voire au chaos, qu’il rencontre de plus en plus massivement dans sa clinique d’intervention, soumise aux bouleversements du méta-cadre contemporain