Encourager le rêve ou confronter à la réalité ? Le dilemme des psychologues conseillers en orientation = Encouraging dream or confronting with reality ? The career counselors dilemma

Savoir s’il faut encourager les consultants à vivre leurs rêves ou, au contraire, les inviter à modérer leurs aspirations pour tenir davantage compte de la réalité peut constituer un véritable dilemme pour les psychologues conseillers en orientation. Cet article propose de considérer cette question au regard de la littérature portant sur les bénéfices et les risques de chacune de ces deux approches. Les apports de l’entretien motivationnel (Miller & Rollnick, 2013) pour éviter les possibles écueils seront présentés. En conclusion, la réflexion sur le rêve et la réalité du métier de psychologue conseiller en orientation sera amorcée.Career counselor may face intense dilemma about whether to encourage their counselees to live their dreams or to moderate their aspirations. This article proposes a literature review aiming at considering the profits and risks of both approaches. Contributions of motivational interviewing (Miller & Rollnick, 2013) to avoid potential pitfalls will be introduced. To conclude, reflections will be initiated on the part of dream and reality in the career counseling profession

Utiliser l'analyse fonctionnelle pour favoriser l'insertion professionnelle des jeunes en rupture d'apprentissage [Using functional analysis to promote employability among young people who interrupted their apprenticeship]

Les jeunes qui rompent leur apprentissage après avoir rencontré des difficultés interpersonnelles sur leur lieu de travail peuvent être anxieux à l’idée d’entreprendre une nouvelle formation professionnelle. Pour répondre à cette problématique, cet article propose d’intégrer l’analyse fonctionnelle aux démarches classiques d’orientation. Cet outil, issu des thérapies cognitives et comportementales, permet de mettre à jour l’enchaînement des cognitions, émotions et comportements face à des situations difficiles, afin d’identifier les ressources de l’individu pour y faire face. Une présentation de cas illustre comment le recours adéquat à cette méthode nécessite d’allier une attitude directive à une posture favorisant l’autonomie du.de la consultant.e

Ammonia trace measurements at ppb level based on near-IR photoacoustic spectroscopy

A photoacoustic sensor using a laser diode emitting near 1532nm in combination with an erbium-doped fibre amplifier has been developed for ammonia trace gas analysis at atmospheric pressure. NH3 concentration measurements down to 6ppb and a noise-equivalent detection limit below 3ppb in dry air are demonstrated. Two wavelength-modulation schemes with 1f and 2f detection using a lock-in amplifier were investigated and compared to maximise the signal-to-noise ratio. A quantitative analysis of CO2 and H2O interference with NH3 is presented. Typical concentrations present in ambient air of 400ppm CO2 and 1.15% H2O (50% relative humidity at 20°C) result in a NH3 equivalent concentration of 36ppb and 100ppb, respectivel

Idiopathic desquamative interstitial pneumonia in a child: a case report.

Desquamative interstitial pneumonia is a rare form of interstitial lung disease in children. Respiratory symptoms appear progressively, are often subtle, and diagnosis is often delayed by a mean of 6 months after onset. High resolution chest computed tomography is the most sensitive imaging technique for demonstrating and identifying interstitial pneumonia. The typical histologic pattern of desquamative interstitial pneumonia, with prominent clustered alveolar macrophages, diffuse reactive alveolar epithelial hyperplasia and globular proteinaceous material, is diagnostic. Desquamative interstitial pneumonia in children can be idiopathic, though it is mostly related to an inborn error of surfactant metabolism. We present the complex clinical course and pathologic findings of a 30-months-old Mauritian and Senegalese girl with idiopathic desquamative interstitial pneumonia and multiple extrapulmonary manifestations. To our knowledge, this is the first case report of desquamative interstitial pneumonia to occur as part of a syndrome with multiple organ involvement. We believe that desquamative interstitial pneumonia is not always associated with mutations of the surfactant proteins, and can still be idiopathic, especially when occurring as part of a syndrome with multiple organ involvement, as described in other interstitial lung diseases

Factors associated with quality of life in elderly hospitalised patients undergoing post-acute rehabilitation: a cross-sectional analytical study in Switzerland.

We investigated whether biopsychosocial and spiritual factors and satisfaction with care were associated with patients' perceived quality of life. This was a cross-sectional analytical study. Data were collected from inpatients at a postacute geriatric rehabilitation centre in a university hospital in Switzerland. Participants aged 65 years and over were consecutively recruited from October 2014 to January 2016. Exclusion criteria included significant cognitive disorder and terminal illness. Of 227 eligible participants, complete data were collected from 167. Perceived quality of life was measured using WHO Quality of Life Questionnaire-version for older people. Predictive factors were age, sex, functional status at admission, comorbidities, cognitive status, depressive symptoms, living conditions and satisfaction with care. A secondary focus was the association between spiritual needs and quality of life. Patients undergoing geriatric rehabilitation experienced a good quality of life. Greater quality of life was significantly associated with higher functional status (r <sub>s</sub> =0.204, p=0.011), better cognitive status (r <sub>s</sub> =0.175, p=0.029) and greater satisfaction with care (r <sub>s</sub> =0.264, p=0.003). Poorer quality of life was significantly associated with comorbidities (r <sub>s</sub> =-.226, p=0.033), greater depressive symptoms (r <sub>s</sub> =-.379, p<0.001) and unmet spiritual needs ( <i>r</i> <sub>s</sub> =-.211, p=0.049). Multivariate linear regression indicated that depressive symptoms (β=-0.961; 95% CIs -1.449 to 0.472; p<0.001) significantly predicted quality of life. Patient perceptions of quality of life were significantly associated with depression. More research is needed to assess whether considering quality of life could improve care plan creation

Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options

Background. Thoughts of self-harm (TSH) are an important marker of mental health risk, and risk for attempted and completed suicide. While there is increasing attention being paid to mental health problems in pregnancy in South Africa (SA), TSH have received less attention despite some cross-sectional studies suggesting that prevalence may be high (12 - 39%). There is a dearth of longitudinal research to inform prevention and treatment.Objectives. To examine the rates of TSH across pregnancy in a longitudinal SA cohort and to investigate factors associated with the onset and persistence of TSH, as well as the relationship between TSH, depression and/or anxiety.Methods. Women were enrolled in a prospective pregnancy cohort (S1000) in Soweto, SA between 2014 and 2016, and assessed using validated screening measures (Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Index short form) in early and later pregnancy. Data were available for 649 women. TSH were determined using EPDS item 10. Logistic regression and bifactor models were used to determine factors associated with TSH across pregnancy.Results. Of the 649 women, 18% reported TSH at some stage during their pregnancy. Prevalence of TSH was slightly higher in early pregnancy (12.5%) than later in pregnancy (11.6%). TSH were associated with a history of mental illness (adjusted odds ratio (aOR) 4.17; 95% confidence interval (CI) 1.3 - 13.7; p=0.020), concurrent depression (aOR 4.8; 95%CI 2.7 - 8.6; p<0.001); marital stress (aOR 1.74; 95% CI 1.0 - 3.0; p=0.040); and practical support (aOR 0.43; 95% CI 0.2 - 1.0; p=0.040) using a multivariate logistic regression. Bifactor analysis examining depression and anxiety scales showed that TSH contributed the highest variance to a shared depression and anxiety factor in early pregnancy. Logistic regressions showed that early depression was a strong predictor of later reports of TSH.Conclusions. The present study shows that the risk of TSH during pregnancy is relatively common, and starts early during pregnancy. Screening approaches could be simplified to encourage healthcare practitioners working in busy and over-burdened public healthcare settings to engage in identifying at-risk women. Efforts in improving early identification of mental health risk in pregnancy should be matched with strengthening of current treatment and referral options. Since practical support and a good marital relationship reduce the risk of TSH, these may be important avenues of focus for designing interventions

Upper and Lower Respiratory Tract Viral Infections and Acute Graft Rejection in Lung Transplant Recipients

Background. Lung transplant recipients are frequently exposed to respiratory viruses and are particularly at risk for severe complications. The aim of this study was to assess the association among the presence of a respiratory virus detected by molecular assays in bronchoalveolar lavage (BAL) fluid, respiratory symptoms, and acute rejection in adult lung transplant recipients. Methods. Upper (nasopharyngeal swab) and lower (BAL) respiratory tract specimens from 77 lung transplant recipients enrolled in a cohort study and undergoing bronchoscopy with BAL and transbronchial biopsies were screened using 17 different polymerase chain reaction—based assays. Results. BAL fluid and biopsy specimens from 343 bronchoscopic procedures performed in 77 patients were analyzed. We also compared paired nasopharyngeal and BAL fluid specimens collected in a subgroup of 283 cases. The overall viral positivity rate was 29.3% in the upper respiratory tract specimens and 17.2% in the BAL samples (P < .001). We observed a significant association between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (P = .012). Conversely, acute rejection was not associated with the presence of viral infection (odds ratio, 0.41; 95% confidence interval, 0.20-0.88). The recovery of lung function was significantly slower when acute rejection and viral infection were both present. Conclusions. A temporal relationship exists between acute respiratory symptoms and positive viral nucleic acid detection in BAL fluid from lung transplant recipients. We provide evidence suggesting that respiratory viruses are not associated with acute graft rejection during the acute phase of infectio

Instruments to Assess Depressive Symptoms and Spiritual Distress Investigate Different Dimensions

Objective: Although affective and spiritual states may share some common clinical features, the precise nature of the relationship between depression and spirituality is still unclear. We tested the hypothesis that two instruments that measure depressive symptoms and spiritual distress describe similar dimensions. Methods: Patients admitted to geriatric rehabilitation (N = 185; mean age 81.3 ± 6.9 years) had depressive symptoms assessed with the 15-item Geriatric Depression Scale (GDS-15) and spiritual distress evaluated with the Spiritual Distress Assessment Tool (SDAT). Results: A principal components analysis pooling GDS-15 and SDAT resulted in a 6-factor solution, with only one factor shared by both dimensions. Conclusions: Depressive symptoms and spiritual distress measured by the two instruments appeared only moderately correlated and corresponded to distinct dimensions