«Tous chercheurs» et «Tous dignes», l’égalité dans la légalité :: un enseignement basé sur les pratiques pédagogiques de « La Maison des Enfants » de Buzet en Belgique est-il concevable dans le système scolaire bernois ? obéit-il aux exigences du Plan d’Études Romand (PER) ?

L’objectif principal de M. Pulver, directeur de l’instruction publique du canton de Berne, pour les prochaines années, est d’instaurer un dialogue pédagogique entre les écoles, et entre les écoles et la Direction de l’instruction publique, afin que celles-ci prennent conscience des moyens qu’elles ont à disposition afin de façonner leur environnement et leur enseignement. Il vaut la peine pour les écoles et le corps enseignant de considérer d’autres formes d’enseignement et de modèles scolaires. La législation scolaire laisse donc, d’une part de larges zones d’initiative à l’enseignant et incite d’autre part à des actions pédagogiques audacieuses. Une telle invitation a encouragé la recherche que j’ai entreprise afin d’envisager la mise en oeuvre, dans ma pratique professionnelle, des pratiques pédagogiques s’inspirant de l’Éducation Nouvelle. Je me suis alors posé cette question : un enseignement fondé sur la mise en recherche des enfants et une appropriation des connaissances passant par l’auto-socio- construction des savoirs et des compétences, de la personne et de la société, chère au mouvement d’Éducation Nouvelle dans lequel s’inscrit «La Maison des Enfants » à Buzet, est-il compatible avec le système scolaire actuel de Suisse romande et plus spécifiquement avec le Plan d’Études Romand (PER) et ses valeurs

Advantages of dietary, exercise-related, and therapeutic interventions to prevent and treat sarcopenia in adult patients: an update

Sarcopenia is the loss of skeletal muscle mass and function with aging. Although the term sarcopenia was first coined in 1989, its etiology is still poorly understood. Moreover, a consensus for defining sarcopenia continues to elude us. Sarcopenic changes in the muscle include losses in muscle fiber quantity and quality, alpha-motor neurons, protein synthesis rates, and anabolic and sex hormone production. Other factors include basal metabolic rate, increased protein dietary requirements, and chronic inflammation secondary to age-related changes in cytokines and oxidative stress. These changes lead to decreased overall physical functioning, increased frailty, falls risk, and ultimately the loss of independent living. Because the intertwining relationships of these factors are complex, effective treatment options are still under investigation. The published data on sarcopenia are vast, and this review is not intended to be exhaustive. The aim of this review is to provide an update on the current knowledge of the definition, etiology, consequences, and current clinical trials that may help address this pressing public health problem for our aging populations

Le droit de la sous-traitance et la nouvelle organisation industrielle aéronautique

La problématique de la thèse consiste à poser la question suivante, dans quelle condition le cadre juridique du droit de la sous-traitance en France correspond à l’évolution de la relation interentreprises de sous-traitance ? Pour traiter cette question, l’exemple de la construction industrielle aéronautique qui constitue un des cas des plus avancés des nouvelles relations interindustrielles de sous-traitance, peut servir de fil conducteur pour déterminer si le droit de la sous-traitance actuellement en vigueur en France répond au besoin des entreprises, ou bien si celui-ci doit être modifié pour mieux prendre en compte les nouvelles organisations industrielles. Le premier point consiste à analyser l’ensemble des textes juridiques, ainsi que les rapports destinés à les améliorer. Les textes juridiques se composent de la seule loi consacrée à la sous-traitance de 1975 relative à la sous-traitance, ainsi que des dispositions spécifiques portants sur la sous-traitance industrielle du Code de commerce et du Code civil. Récemment, des dispositions juridiques nouvelles relatives à la sous-traitance ont été insérées avec la loi Hamon de 2014. Ces dispositions ont pour but de lutter contre les abus et ont pour objectif de mieux protéger les sous-traitants vis-à-vis du donneur d’ordres. L’analyse des rapports publiés à deux reprises, sur les relations interentreprises de sous-traitance industrielle comprend de nombreuses recommandations dans le but d’adapter le cadre juridique de la sous-traitance à l’évolution des relations industrielles. Il s’agit, notamment des recommandations du rapport Volot de 2010 et du rapport Bourquin de 2013 visant à généraliser le principe de la contractualisation, le renforcement de la protection de la propriété intellectuelle et la mise en place de contrat type par filière. Le deuxième point consiste à réaliser une analyse comparative avec l’étude du cadre juridique de la sous-traitance dans différents pays européens ainsi que dans le cadre de l’Union Européenne. Le troisième point consiste à évaluer les solutions juridiques préconisées à partir de l’expérience de la chaine de sous-traitance aéronautique. Cette analyse permet de prendre en compte l’exemple des contrats de sous-traitance aéronautique pour la fourniture d’élément d’avion notamment pour ce qui concerne des dispositions financières, la propriété intellectuelle et la responsabilité. Cette analyse permet d’obtenir des résultats pour répondre à la problématique de l’adaptation nécessaire du cadre juridique de la sous-traitance en France : D’une part, le cadre juridique actuel et son évolution récente ne permettent pas de prendre en compte suffisamment l’importance de la sous-traitance industrielle, et se contente d’adapter a minima, en modifiant certains articles du Code de commerce. D’autre part, la question du partage de la responsabilité entre le donneur d’ordres et le sous-traitant demeure alors que les conditions de l’organisation industrielle actuelle associe de plus en plus les sous-traitants à la conception et pas seulement à la production des nouveaux produits. Ce qui consiste à faire perdurer une situation de dépendance quasi totale des sous-traitants par rapport aux donneurs d’ordres. Dans ces conditions, l’analyse des relations dans le cadre de l’industrie aéronautique permet à partir des résultats de cette thèse, de proposer trois pistes en faveur d’une nouvelle loi sur la sous-traitance en France. En rendant obligatoire un contrat de sous-traitance écrit et détaillé tel qu’il est pratiqué systématiquement dans la sous-traitance aéronautique. En intégrant des dispositions destinées à protéger les sous-traitants afin de mieux les associer comme c’est le cas dans la construction aéronautique à la conception de nouveaux ensembles et en créant un climat de confiance. Enfin, en instaurant un recours systématique à la médiation interentreprises.Thesis’s problematic of the thesis consists in asking the following question; in what condition the legal framework of the right of the subcontracting in France corresponds to the evolution of the subcontracting intercompany relation? To deal with this question, the example of the aeronautical industrial construction which establishes one of the cases of the most advanced of the new inter-company relations of subcontracting, can serve as connecting thread to determine if the right of subcontracting in force at present in France, answers to the companies need, or if this one must be modified to take the new industrial organizations better into account. The first point consists in analysing all the legal texts as well as the reports intended to improve them. The legal texts are composed of the only law dedicated to the subcontracting of 1975 relating to the subcontracting, as well as the specific requirement regarding industrial subcontracting of the Commercial law and the Civil code. Recently, new legal measures related to the subcontracting were inserted in the law Hamon of 2014. These measures aim at fighting against the abuses and have the objective to better protect the subcontractors towards the contractor. The analysis of the reports on the relations inter-company by industrial subcontracting twice published, includes a number of recommendations aiming to adapt the legal framework of the subcontracting to the evolution of the industrial relations. These are in recommendations from the report Volot of 2010 and the report Bourquin of 2013 in order to generalize the principle of the contractualization, the reinforce the protection of the intellectual property and the implementation of standard contract by sector. The second point consists in carrying out a comparative analysis by studying the legal framework of the subcontracting in various European countries, as well as within the framework of the European Union. The third point consists in estimating the legal solutions recommended from the experience of the aeronautical subcontracting chain. This analysis allows to take into account the example of the contracts of aeronautical subcontracting for the supply of element of plane in particular as regards financial capacities, the intellectual property and the responsibility. This analysis allows getting results in order to answer to issue of necessity of adapting the legal framework of the subcontracting in France: On one hand, the current legal framework and its recent evolution do not allow to take the importance of the industrial subcontracting enough into account, and only adapts at “a minima” level by modifying certain articles of the Commercial law. On the other hand, the question of the storing of the responsibility between the contractor and the subcontractor, carries on while the conditions of the current industrial organization associate more and more the subcontractors with the design, and not only with the production of the new products. Therefore the situation of almost total dependence of the subcontractors with regard to the contractors keeps going. In these conditions, the analysis of the relations within the framework of the aircraft industry, allows from the results of this thesis to suggest three tracks in favour of a new law on the subcontracting in France. By making a written and detailed subcontract compulsory such as it is systematically practised in the aeronautical subcontracting. By integrating measures intended to protect the subcontractors in order to associate them better as it is the case in the aircraft manufacturing in the conception of new groups and by creating a reliable climate. Finally, by establishing a systematic appeal to the intercompany mediation

Further Analyses of the Safety of Verubecestat in the Phase 3 EPOCH Trial of Mild-To-Moderate Alzheimer’s Disease

Background: Verubecestat, a BACE1 inhibitor that reduces Aβ levels in the cerebrospinal fluid of humans, was not effective in a phase 3 trial (EPOCH) of mild-to-moderate AD and was associated with adverse events. To assist in the development of BACE1 inhibitors, we report detailed safety findings from EPOCH. Methods: EPOCH was a randomized, double-blind, placebo-controlled 78-week trial evaluating verubecestat 12 mg and 40 mg in participants with mild-to-moderate AD diagnosed clinically. The trial was terminated due to futility close to its scheduled completion. Of 1957 participants who were randomized and took treatment, 652 were assigned to verubecestat 12 mg, 652 to verubecestat 40 mg, and 653 to placebo. Adverse events and relevant laboratory, vital sign, and ECG findings were assessed. Results: Verubecestat 12 mg and 40 mg were associated with an increase in the percentage of participants reporting adverse events versus placebo (89 and 92% vs. 82%), although relatively few participants discontinued treatment due to adverse events (8 and 9% vs. 6%). Adverse events that were increased versus placebo included falls and injuries, suicidal ideation, weight loss, sleep disturbance, rash, and hair color change. Most were mild to moderate in severity. Treatment differences in suicidal ideation emerged within the first 3 months but did not appear to increase after 6 months. In contrast, treatment differences in falls and injuries continued to increase over time. Conclusions: Verubecestat was associated with increased risk for several types of adverse events. Falls and injuries were notable for progressive increases over time. While the mechanisms underlying the increased adverse events are unclear, they may be due to BACE inhibition and should be considered in future clinical development programs of BACE1 inhibitors

Frailty Index and incident mortality, hospitalization and institutionalization in Alzheimer's disease: data from the ICTUS study.

BACKGROUND: The identification of an objective evaluation of frailty capable of predicting adverse outcomes in Alzheimer's disease is increasingly discussed. The purpose of this study was to investigate whether the Frailty Index (FI) predicts hospitalization, institutionalization, and mortality in Alzheimer's disease patients. METHODS: A prospective multicenter cohort study (follow-up = 2 years) that included 1,191 participants with Alzheimer's disease was carried out. The outcomes of interest were incident hospitalization, institutionalization, and mortality. The FI was calculated as the ratio of actual to thirty potential deficits, that is, deficits presented by the participant divided by 30. Severity of dementia was assessed using the Clinical Dementia Rating score. Cox proportional hazard models were performed. RESULTS: Mean age of the study sample was 76.2 (SD = 7.6) years. A quadratic relationship of the FI with age was reported at baseline (R 2 = .045, p < .001). The FI showed a statistically significant association with mortality (age- and gender-adjusted hazard ratio [HR] = 1.019, 95% confidence interval [CI] = 1.002-1.037, p = .031) and hospitalization (age- and gender-adjusted HR = 1.017, 95% CI = 1.006-1.029, p = .004) and a borderline significance with institutionalization. When the Clinical Dementia Rating score was simultaneously included in the age- and gender-adjusted models, the FI confirmed its predictive capacity for hospitalization (HR = 1.019, 95% CI = 1.006-1.032, p = .004), whereas the Clinical Dementia Rating score was the strongest predictor for mortality (HR = 1.922, 95% CI = 1.256-2.941, p = .003) and institutionalization (HR = 1.955, 95%CI = 1.427-2.679, p < .001). CONCLUSIONS: The FI is a robust predictor of adverse outcomes even after the stage of the underlying dementia is considered. Future work should evaluate the clinical implementation of the FI in the assessment of demented individuals in order to improve the personalization of care

Higher vitamin D dietary intake is associated with lower risk of alzheimer&#039;s disease: a 7-year follow-up

BACKGROUND: Hypovitaminosis D is associated with cognitive decline among older adults. The relationship between vitamin D intakes and cognitive decline is not well understood. Our objective was to determine whether the dietary intake of vitamin D was an independent predictor of the onset of dementia within 7 years among women aged 75 years and older.METHODS: Four hundred and ninety-eight community-dwelling women (mean, 79.8 3.8 years) free of vitamin D supplements from the EPIDemiology of OSteoporosis Toulouse cohort study were divided into three groups according to the onset of dementia within 7 years (ie, no dementia, Alzheimer\u27s disease [AD], or other dementias). Baseline vitamin D dietary intakes were estimated from self-administered food frequency questionnaire. Age, body mass index, initial cognitive performance, education level, physical activity, sun exposure, disability, number of chronic diseases, hypertension, depression, use of psychoactive drugs, and baseline season were considered as potential confounders. RESULTS: Women who developed AD (n = 70) had lower baseline vitamin D intakes (mean, 50.3 19.3 mug/wk) than nondemented (n = 361; mean intake = 59.0 29.9 mug/wk, p = .027) or those who developed other dementias (n = 67; mean intake = 63.6 38.1 mug/wk, p = .010). There was no difference between other dementias and no dementia (p = .247). Baseline vitamin D dietary intakes were associated with the onset of AD (adjusted odds ratio = 0.99 [95% confidence interval = 0.98-0.99], p = .041) but not with other dementias (p = .071). Being in the highest quintile of vitamin D dietary intakes was associated with a lower risk of AD compared with the lower 4 quintiles combined (adjusted odds ratio = 0.23 [95% confidence interval = 0.08-0.67], p = .007). CONCLUSIONS: Higher vitamin D dietary intake was associated with a lower risk of developing AD among older women