Vers une typologie des dispositifs hybrides de formation en enseignement supérieur

International audienceAssessing the effects of hybrid system requires a descriptive framework to understand and differentiate their effects. In this perspective, this article proposes a typology of hybrid system from their educational, organizational and material characteristics (modalities of articulation of presential and distant phases, teaching approaches, human support, forms of media and mediation related to the use of a techno-environment, degree of openness).L'évaluation des effets des dispositifs hybrides de formation en enseignement supérieur nécessite un cadre descriptif pour en comprendre les effets différenciés. Dans cette perspective, le présent article propose d'établir une typologie des dispositifs hybrides de formation à partir de leurs caractéristiques pédagogiques, organisationnelles et matérielles (modalités d'articulation des phases présentielles et distantes, accompagnement humain, formes de médiatisation et médiation liées à l'utilisation d'un environnement technopédagogique, degré d'ouverture). Il rend également compte, d'un point de vue méthodologique, de la manière dont les chercheurs investis dans le projet européen HySup (2009-12) ont progressivement élaboré ce cadre et en ont fait une première expérimentation

Mucormycose rhino-orbito-cérébral: présentations cliniques [Rhino-orbito-cerebral mucormycosis: clinical presentation]

BACKGROUND: Rhino-orbito-cerebral mucormycosis is an opportunistic rapidly progressive infection affecting almost exclusively diabetic or immunocompromised patients. CASE REPORTS: Three cases are reported. For one patient mucormycosis was the first manifestation of juvenile diabetes and the evolution was favorable. In the second case the infection affected a known diabetic patient and the clinical course was fatal. The third patient was immunocompromised, showed mild clinical features and a rapidly fatal evolution, the diagnosis being made only postmortem. CONCLUSION: These three cases illustrate the wide clinical spectrum of rhino-orbito-cerebral mucormycosis, its serious nature and difficult diagnosis

Pupillary dilation lag is intermittently present in patients with a stable oculosympathetic defect (Horner syndrome)

PURPOSE: To examine the repeatability of detecting pupillary dilation lag in patients with Horner syndrome. DESIGN: Retrospective interventional study. METHODS: Setting: Single referral institution. Patient population: Fifteen patients with unilateral Horner syndrome and 16 subjects with physiologic anisocoria. Intervention procedure: Each subject underwent four pupillometric recordings in darkness. The asymmetry of pupillodilation between the two eyes was calculated as the change in anisocoria between five seconds and 15 seconds in darkness. Pupillary dilation lag was considered present if the asymmetry measured > or =0.4 mm. Main outcome measure: Asymmetry of pupillodilation over four determinations. RESULTS: All subjects demonstrated fluctuations in the calculated asymmetry of pupillodilation. Eight patients (53%) with Horner syndrome demonstrated dilation lag on the first determination; 13 patients (87%) eventually demonstrated it during four determinations. CONCLUSIONS: Pupillary dilation lag is intermittently present in most patients with Horner syndrome. Repeated observations improve the detection rate of dilation lag, a confirmatory sign of an oculosympathetic deficit. Its absence does not rule out Horner syndrome

Beidseitige periphere Teleangiektasien bei Interferon-B1a-behandelten Multiple-Sklerose-Patienten [Peripheral Bilateral Telangiectasiae in Multiple Sclerosis Patients Treated with Interferon B1a]

We describe the ophthalmic features of two patients diagnosed with quiescent relapsing-remitting MS previously treated with IB1a who both exhibited asymptomatic bilateral peripheral retinal telangiectasiae

Neuro-ophthalmic complications of biopsy-proven giant cell arteritis

PURPOSE: To define the spectrum of neuro-ophthalmic complications and clinical presentations of patients with giant cell arteritis (GCA). METHODS: Retrospective study (1977-1994) of clinical charts, fundus photographies and fluorescein angiographies of 66 patients with temporal artery biopsy positive for GCA. RESULTS: Clinical data were adequate for 47 patients. Headaches were reported by 83%, weight loss in 73%, jaw claudication in 68%, scapular pain in 64% and asthenia in 57%. Erythrocyte sedimentation rate was normal in 15%. Neuro-ophthalmic complications were present in 33 cases (70%), including anterior ischemic optic neuropathy (22 cases), choroidal ischemia (17 cases), central or branch retinal artery occlusion (seven cases), and oculomotility disturbances (four cases). Fluorescein angiography was very helpful for detecting choroidal ischemia (80.9% of our cases). Twenty-one patients presented with involvement of several distinct orbital arterial territories and one very unusual patient suffered from an orbital infarction (i.e. ischemia of all orbital structures). CONCLUSIONS: In our series, two-thirds of biopsy-proven GCA patients presented with neuro-ophthalmic complications, ranging from transient visual loss to orbital infarction. Involvement of more than one orbital vascular territory is highly suggestive of an arteritic process. Clinicians should keep in mind the possibility of GCA even when ESR is normal, and fluorescein angiography should be performed. The finding of choroidal ischemia should prompt temporal artery biopsy and steroid therapy