L'approche centrée solutions: mise en lien avec le partenariat avec les parents dans les structures d'accueil de l'enfance

Mon travail de mémoire porte sur l’approche centrée solutions dans le partenariat avec les familles au sein des structures d’accueil de l’enfance. Le but de ma recherche a été de développer des idées et des techniques propres au solutionnisme afin d’améliorer le partenariat avec les familles. J’ai donc, en premier lieu, détaillé la méthode en expliquant les différentes techniques spécifiques à ce modèle. Par la suite, j’ai mis en lien cette recherche avec les pratiques d’intervention que l’on utilise en structure pour accompagner les familles (collaboration et partenariat). De plus, j’ai établi des liens concrets entre le solutionnisme et le partenariat avec les familles. Et en dernier lieu, j’ai mis en évidence les points forts ainsi que les limites qu’un tel modèle peut apporter aux différents acteurs de la structure

La Suisse et la francophonie

Cet article a pour objet d’examiner l’étonnante évolution des rapports entre la Suisse (État fédéral, pluri-culturel à majorité germanophone et neutre) et la francophonie : indifférence et méfiance au départ; intérêt soutenu ensuite. Le débat sur la participation de la Confédération au premier Sommet de la francophonie est engagé au moment où la Suisse sort d’une longue crise politique dominée par la question jurassienne. La Suisse choisira dès lors le statut d’observateur à Paris-Versailles par refus d’introduire la langue comme facteur de politique étrangère. À Dakar, un pas est franchi : la Suisse devient membre à part entière des sommets. Elle justifie dorénavant son adhésion à la francophonie par des intérêts de politique étrangère.This article examines the surprising evolution of relations between Switzerland (a federal, neutral, pluricultural state with a german speaking majority) and the francophonie : suspicion and indifférence at the beginning; sustained interest afterward. The debate surrounding the Confederation's participation at the first Francophonie Summit occurred immediately following a long political crisis dominated by the Jurassian issue. Consequently, Switzerland chose an observer's status at Paris-Versailles since it refused to introduce language as a foreign policy variable. At Dakar, Switzerland became a full member of the Summits. Ever since, Switzerland has justified its membership to the Francophonie on the basis of foreign policy interests

Astrocyte sodium signaling and neuro-metabolic coupling in the brain.

At tripartite synapses, astrocytes undergo calcium signaling in response to release of neurotransmitters and this calcium signaling has been proposed to play a critical role in neuron-glia interaction. Recent work has now firmly established that, in addition, neuronal activity also evokes sodium transients in astrocytes, which can be local or global depending on the number of activated synapses and the duration of activity. Furthermore, astrocyte sodium signals can be transmitted to adjacent cells through gap junctions and following release of gliotransmitters. A main pathway for activity-related sodium influx into astrocytes is via high-affinity sodium-dependent glutamate transporters. Astrocyte sodium signals differ in many respects from the well-described glial calcium signals both in terms of their temporal as well as spatial distribution. There are no known buffering systems for sodium ions, nor is there store-mediated release of sodium. Sodium signals thus seem to represent rather direct and unbiased indicators of the site and strength of neuronal inputs. As such they have an immediate influence on the activity of sodium-dependent transporters which may even reverse in response to sodium signaling, as has been shown for GABA transporters for example. Furthermore, recovery from sodium transients through Na(+)/K(+)-ATPase requires a measurable amount of ATP, resulting in an activation of glial metabolism. In this review, we present basic principles of sodium regulation and the current state of knowledge concerning the occurrence and properties of activity-related sodium transients in astrocytes. We then discuss different aspects of the relationship between sodium changes in astrocytes and neuro-metabolic coupling, putting forward the idea that indeed sodium might serve as a new type of intracellular ion signal playing an important role in neuron-glia interaction and neuro-metabolic coupling in the healthy and diseased brain

A novel optical intracellular imaging approach for potassium dynamics in astrocytes.

Astrocytes fulfill a central role in regulating K+ and glutamate, both released by neurons into the extracellular space during activity. Glial glutamate uptake is a secondary active process that involves the influx of three Na+ ions and one proton and the efflux of one K+ ion. Thus, intracellular K+ concentration ([K+]i) is potentially influenced both by extracellular K+ concentration ([K+]o) fluctuations and glutamate transport in astrocytes. We evaluated the impact of these K+ ion movements on [K+]i in primary mouse astrocytes by microspectrofluorimetry. We established a new noninvasive and reliable approach to monitor and quantify [K+]i using the recently developed K+ sensitive fluorescent indicator Asante Potassium Green-1 (APG-1). An in situ calibration procedure enabled us to estimate the resting [K+]i at 133±1 mM. We first investigated the dependency of [K+]i levels on [K+]o. We found that [K+]i followed [K+]o changes nearly proportionally in the range 3-10 mM, which is consistent with previously reported microelectrode measurements of intracellular K+ concentration changes in astrocytes. We then found that glutamate superfusion caused a reversible drop of [K+]i that depended on the glutamate concentration with an apparent EC50 of 11.1±1.4 µM, corresponding to the affinity of astrocyte glutamate transporters. The amplitude of the [K+]i drop was found to be 2.3±0.1 mM for 200 µM glutamate applications. Overall, this study shows that the fluorescent K+ indicator APG-1 is a powerful new tool for addressing important questions regarding fine [K+]i regulation with excellent spatial resolution

Quetiapine Dosage Across Diagnostic Categories

Objective The aim of the current study was to evaluate quetiapine doses used across diagnosis categories in a sample of psychiatric inpatients. Methods Discharge letters of all adult inpatients who had received quetiapine between 1999 and 2005 were retrospectively reviewed. Logistic regressions were carried-out to assess links between quetiapine discharge dosage (≥800mg/day vs. <800mg/day), diagnostic categories, substance abuse or dependence, benzodiazepine discharge doses, age and sex. Results The data of 231 patients were included. Five hundred and for discharge documents were analyzed: 113 for psychotic disorders, 190 for personality disorders, 134 for bipolar and schizoaffective bipolar disorders, 29 for unipolar depression or anxiety disorders, and 35 for mental retardation. Considering psychotic disorders as a reference group, patients with personality disorders were statistically significantly less likely to be in the high quetiapine dosage group at discharge (P=0.007, OR=0.1 and CI [0.03; 0.6]). Conclusions Quetiapine seems to be used in a variety of clinical situations, with a wide range of doses and a lower dosage in patients treated for personality disorder

Le travail de groupe à l'école primaire: pratiques enseignantes et enjeux

Mon mémoire traite des enjeux des travaux de groupe et des différentes pratiques enseignantes. Mes lectures montrent que le travail de groupe existe depuis le XXème siècle et qu’il s’est mis en place dans nos classes au fil des années. D’après les livres lus, le travail de groupe doit être bien organisé et le rôle de l’enseignant est très important lors de ces travaux. J’ai interviewé plusieurs enseignants qui m’ont confirmé ces propos et qui ont diverses pratiques du travail de groupe. On constate que malgré cette diversité, tous sont d’accord pour dire que le travail coopératif avantage tous les élèves du point de vue social et permet aux élèves en difficulté scolairement de mieux comprendre par l’explication d’un pair. La variation de la formation des groupes ainsi que de l’organisation du travail permet aux élèves de développer des compétences sociales nécessaires à leur vie future. D’après les enseignants interrogés, le travail de groupe est indispensable en classe et peut se faire lors de chaque discipline. Les objectifs sociaux que l’on vise sont dans la transdisciplinarité et peuvent se travailler à tout moment. L’évaluation est toutefois difficile pour ce qui est des apprentissages, mais il est toutefois important de faire une mise en commun suite à un travail de groupe

Body composition using bio-impedance analysis in pediatric patients with inflammatory bowel disease. Corcordance with dual energy X-ray absorptiometry and comparison with healthy controls

Introduction: Growth is a central process in paediatrics. Weight and height evaluation are therefore routine exams for every child but in some situation, particularly inflammatory bowel disease (IBD), a wider evaluation of nutritional status needs to be performed. Objectives: To assess the accuracy of bio-impedance analysis (BIA) compared to the gold standard dual energy X-ray absorptiometry (DEXA) in estimating percentage body fat (fat mass; FM) and lean body mass (fat free mass; FFM) in children with inflammatory bowel disease (IBD). To compare FM and FFM levels between patients with IBD and healthy controls. Methods: Twenty-nine healthy controls (12 females; mean age: 12.7 ± 1.9 years) and 21 patients (11 females; 14.3 ± 1.3 years) were recruited from August 2011 to October 2012 at our institution. BIA was performed in all children and DEXA in patients only. Concordance between BIA and DEXA was assessed using Lin's concordance correlation and the Bland-Altman method. Between-group comparisons were made using analysis of variance adjusting for age. Results: BIA-derived FM% showed a good concordance with DEXA-derived values, while BIA-derived FFM% tended to be slightly higher than DEXA-derived values (table). No differences were found between patients and controls regarding body mass index (mean ± SD: 19.3 ± 3.3 vs. 20.1 ± 2.8 kg/m2, respectively; age-adjusted P = 0.08) and FM% (boys: 25.3 ± 10.2 vs. 22.6 ± 7.1%, for patients and controls, respectively; P = 0.20; girls: 28.2 ± 5.7 vs. 26.4 ± 7.7%; P = 0.91). Also, no differences were found regarding FFM% in boys (74.9 ± 10.2 vs. 77.4 ± 7.1%; P = 0.22) and girls (71.8 ± 5.6 vs. 73.5 ± 7.7%; P = 0.85). Conclusion: BIA adequately assesses body composition (FM%) in children with IBD and could advantageously replace DEXA, which is more expensive and less available. No differences in body composition were found between children with IBD and healthy controls

Brain-derived neurotrophic factor stimulates energy metabolism in developing cortical neurons.

Brain-derived neurotrophic factor (BDNF) promotes the biochemical and morphological differentiation of selective populations of neurons during development. In this study we examined the energy requirements associated with the effects of BDNF on neuronal differentiation. Because glucose is the preferred energy substrate in the brain, the effect of BDNF on glucose utilization was investigated in developing cortical neurons via biochemical and imaging studies. Results revealed that BDNF increases glucose utilization and the expression of the neuronal glucose transporter GLUT3. Stimulation of glucose utilization by BDNF was shown to result from the activation of Na+/K+-ATPase via an increase in Na+ influx that is mediated, at least in part, by the stimulation of Na+-dependent amino acid transport. The increased Na+-dependent amino acid uptake by BDNF is followed by an enhancement of overall protein synthesis associated with the differentiation of cortical neurons. Together, these data demonstrate the ability of BDNF to stimulate glucose utilization in response to an enhanced energy demand resulting from increases in amino acid uptake and protein synthesis associated with the promotion of neuronal differentiation by BDNF

Impact of Psychiatrists' Qualifications on the Rate of Compulsory Admissions

Despite efforts to reduce coercion in psychiatry, involuntary hospitalizations remain frequent, representing more than half of all admissions in some European regions. Since October 2006, only certified psychiatrists are authorized to require a compulsory admission to our facility, while before all physicians were, including residents. The aim of the present study is to assess the impact of this change of procedure on the proportion compulsory admissions. All medical records of patients admitted respectively 4months before and 4month after the implementation of the procedure were retrospectively analyzed. This search retrieved a total of 2,227 hospitalizations for 1,584 patients. The overall proportions of compulsory and voluntary admissions were 63.9% and 36.1% respectively. The average length of stay was 32days (SD±64.4). During the study period, 25% of patients experienced two hospitalizations or more. The most frequent patients' diagnoses were affective disorders (30%), psychotic disorders (18.4%) and substance abuse disorders (15.7%). Compared with the period before October 2006, patients hospitalized from October 2006 up were less likely to be hospitalized on a compulsory basis (OR=0.745, 95% CI: 0.596-0.930). Factors associated with involuntary admission were young age (20years or less), female gender, a diagnosis of psychotic disorder and being hospitalized for the first time. Our results strongly suggest that limiting the right to require compulsory admissions to fully certified psychiatrists can reduce the rate of compulsory versus voluntary admission

HON Label and DISCERN as Content Quality Indicators of Health-Related Websites

Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net” (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patient