[Which place has experimentation in ethology?] / Quelle place pour l'expérimentation en éthologie ?

The experimental approach has been at the center of my thoughts since my baccalaureate of "experimental sciences". Trained in neurosciences, I very quickly chose the field of ethology, thinking I would escape certain experimental approaches and offer myself research more respectful of animal life. Today, I have to note that this option did not necessarily lead to what I had imagined. I have been both the witness and the actor of practices that deserve attention. This path, punctuated by an evolution of the conceptions of our relations with living beings, leads me to question the ethics, sometimes contradictory, of action and knowledge.

Title: Quelle place pour l'expérimentation en éthologie ? Abstract: La démarche expérimentale est au centre de mes réflexions depuis mon baccalauréat « sciences ex ¼. Formé aux neurosciences, j'ai très vite choisi l'éthologie de terrain, pensant échapper à certaines démarches expérimentales et m'offrir des activités de recherche plus respectueuses de la vie animale. Aujourd'hui, je dois constater que cette option n'aboutit pas forcément à ce que j'avais imaginé. J'ai été à la fois le témoin et l'acteur de pratiques qui méritent attention. Ce parcours, jalonné par une évolution des conceptions de nos relations avec les être animés, me conduit à questionner les éthiques, parfois contradictoires, de l'action et de la connaissance.

[Evolution of tutoring in an orthopaedic surgery department: feedback]. / Évolution du tutorat dans un service de chirurgie orthopédique : retour d'expérience.

Tutoring involves a commitment on the part of tutors to welcoming, teaching and supporting student nurses. Tutoring plays a central role in our orthopedic surgery department, and we make it a priority. Its operation evolves according to needs, changes in tutors, student levels and the expectations of the nursing training institute. Our constant commitment to tutoring reflects our awareness of the need to support our future colleagues. Drawing on our various backgrounds and experiences, we felt it necessary to review the way we supervise ISTs and carry out our role as tutors.

[Correlation between Objective structured clinical examinations (OSCE) and knowledge examination scores and analysis of factors associated with better OSCE success in fourth and fifth year medicine students at Dijon university hospital]. / Corrélation entre les notes obtenues aux ECOS et aux épreuves de connaissances et analyse des facteurs associés à une meilleure réussite aux ECOS chez les étudiants de DFASM1 et 2 au CHU de Dijon.

RATIONALE: Objective structured clinical examinations (OSCEs) were introduced to evaluate students not only on their knowledge, but also on their clinical skills and attitudes. The objectives were to study the correlation between OSCE scores and scores obtained to traditional knowledge examinations and to analyse factors associated with better OSCE performance in DFASM1 and 2 students at Dijon university hospital. METHODS: This was a prospective observational study conducted among all fourth and fifth year medical students in Dijon. The scores on the OSCE elective tests (2022) and the average score on the knowledge tests (2021-2022) were collected and their correlation measured. A questionnaire asked students about their demographic characteristics, their investment in formative and practicum OSCEs, their level of empathy (Jefferson questionnaire) and their personality traits (NEO-Pi-R). RESULTS: Of 549 students, 513 completed all tests. Scores on OSCE and faculty knowledge tests were correlated (r=0.39, P<0.001). Of these, 111 (20%) students responded to the questionnaire, and 97 were analized. We did not observe any significant difference between students who performed better on OSCEs than on knowledge tests and those who did not, regarding their age, their investment in formative tests, their personality traits or their level of empathy. CONCLUSION: Our results underline the need to optimize the evaluation of empathy and clinical skills in OSCE tests, using new tools, in order to better discriminate between students on these skills.

Enforced Disappearances and Torture Today: A View from Analytical Psychology 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process: 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process1.

In very rare cases, individuals survive the atrocities of abduction, imprisonment and torture that are part of the hallmark of enforced disappearances. Cases of people who survive torture and seek asylum in a third country help us understand some important aspects related to the crime of enforced disappearance. In the psychotherapy of torture survivors, at an early stage and for a long time, words often do not convey the core of the patient's experience. Survivors usually have tormented bodies in which individual and collective violence, hatred, anger, guilt and shame are painfully inscribed. Corporeal countertransference becomes the only possible way for a therapist to get in touch with a survivor's experience through a kind of body-to-body communication. The centrality of the body in these therapies suggests that the body is the involuntary recipient and container of mass political atrocities and, for this reason, the place where, in the case of horrific social violence, the possibility of social "knowing" is stored and can be retrieved. Thus, when it comes to forced disappearance, the determination of the relatives to get to the truth through the discovery of the remains of their disappeared demonstrates the importance of the body as the final witness of what happened, beyond any possible manipulation.

Dans de très rares cas, des personnes survivent aux atrocités de l'enlèvement, de l'emprisonnement et de la torture qui caractérisent les disparitions forcées. Les cas de personnes qui survivent à la torture et demandent l'asile dans un pays tiers nous aident à comprendre certains aspects importants liés au crime de disparition forcée. Dans la psychothérapie des survivants de la torture, à un stade précoce et pendant longtemps, les mots ne transmettent souvent pas le cœur de l'expérience du patient. Les survivants ont généralement des corps tourmentés dans lesquels la violence individuelle et collective, la haine, la colère, le sentiment de culpabilité et la honte sont douloureusement inscrites. Le contre-transfert corporel devient le seul moyen possible pour un thérapeute d'entrer en contact avec l'expérience d'un survivant par une sorte de communication de corps à corps. La centralité du corps dans ces thérapies suggère que le corps est le destinataire involontaire et le conteneur des atrocités politiques de masse et, pour cette raison, le lieu où, dans le cas d'une violence sociale horrible, la possibilité d'un "savoir" social est stockée et peut être récupérée. Ainsi, lorsqu'il s'agit de disparitions forcées, la détermination des des membres de la famille à accéder à la vérité en retrouvant les restes de la personne disparue montre l'importance du corps en tant que dernier témoin de ce qui a eu lieu, au-delà de toute manipulation.

En casos muy raros, las personas sobreviven a las atrocidades del secuestro, el encarcelamiento y la tortura que forman parte del sello distintivo de las desapariciones forzadas. Los casos de personas que sobreviven a la tortura y buscan asilo en un tercer país nos ayudan a comprender algunos aspectos importantes relacionados con el delito de desaparición forzada. En la psicoterapia de supervivientes de tortura, en una fase temprana y durante mucho tiempo, las palabras no suelen transmitir el núcleo de la experiencia del paciente. Los supervivientes suelen tener cuerpos atormentados en los que se inscriben dolorosamente la violencia individual y colectiva, el odio, la ira, el sentimiento de culpa y la vergüenza. La contratransferencia corporal se convierte en la única vía posible para que un terapeuta entre en contacto con la experiencia de un superviviente a través de una especie de comunicación cuerpo a cuerpo. La centralidad del cuerpo en estas terapias sugiere que el cuerpo es el receptor involuntario y el contenedor de las atrocidades políticas masivas y, por esta razón, el lugar donde, en el caso de la violencia social horrorosa, se almacena y puede recuperarse la posibilidad del "conocimiento" social. Así, cuando se trata de desapariciones forzadas, la determinación de los familiares por llegar a la verdad a través del hallazgo de los restos de sus desaparecidos demuestra la importancia del cuerpo como testigo final de lo sucedido, más allá de cualquier posible manipulación.

[The operating room, a place of training with multiple benefits for future professionals]. / Le bloc opératoire, un lieu de stage aux multiples bénéfices pour les futurs professionnels.

The importance of internships, as part of the alternating training of nursing students, is no longer in question. Thus, to obtain their diploma, out of the 180 European credits expected, 60 come from these placements. Although very specific and not very much involved in the training of students in initial training, an internship in the operating room is very instructive and contributes to the development of multiple nursing knowledge and skills.

[Borderline personality disorder: state of knowledge and attitudes among french-speaking mental health professionnals]. / Trouble de la personnalité borderline: état des connaissances et des représentations auprès de praticiens francophones en santé mentale.

OBJECTIVES: Patients suffering from borderline personality disorder are very prevalent in various settings (emergency rooms, psychiatric and general hospitals, ambulatory consultations). However, it remains one of the most stigmatized and neglected mental health conditions, albeit being an area that is responsible for very interesting advances in psychotherapy. Today, the prognosis of patients with borderline personality disorder is rather favorable, provided that they follow a dedicated psychotherapy. Conceptions about this condition therefore deserve to be updated as it is sufficiently described in the literature that negative attitudes towards these patients diminish the quality of care they receive as well as their prognosis, and that these attitudes change with training. We decided to study the state of knowledge and attitudes towards borderline personality disorder in a group of French-speaking caregivers interested in these patients. METHODS: Between 2019 and 2020, at the start of training sessions in psychotherapeutic approaches to borderline personality disorder, we provided two questionnaires to 126 caregivers from various professional backgrounds (psychiatrists or child psychiatrists, psychologists, mental health nurses, social workers). The first consisted of 13 questions with 3 choice answers aimed at testing knowledge about borderline personality disorder and the second of 11 questions in the form of a Likert scale aimed at evaluating attitudes towards these patients (e.g. degree of comfort, involvement, hope, avoidance with these patients) adapted frome a questionnaire of Blake and colleagues. RESULTS: The sample consisted of 126 caregivers (69 psychiatrists/pedopsychiatrists; 19 mental health nurses; 23 psychologists; 14 social workers). Fifty three of them (42.06 %) worked in an outpatient setting (either in a state facility or in private practice), 50 (39.68 %) worked in an inpatient psychiatric unit, 13 (10.32%) in both care systems, and 10 (7.94 %) worked in other facilities such as sheltered homes or workshops for persons with psychiatric disabilities. The average number of years in postgraduate training was 7.73 (SD=5.67; rank=0 to 31), and 35 (27.78%) had received at least one training course on borderline disorder in the past. The mean age of the sample was 37.89 (SD=10.08; rank=20 to 64) and there were 76 women (60.32%) and 50 men (39.68%). Concerning the first questionnaire (knowledge), the rate of correct responses among caregivers was relatively low (54%) considering that the vast majority of those assessed were caregivers already trained in mental health who were working with patients suffering from borderline personality disorder. The results showed a significant knowledge gap among professionals, in particular in the nursing profession, illustrating an ever more flagrant shortfall in formations in this sub-population. Concerning the second questionnaire (attitudes), the answers showed that attitudes of caregivers towards patients with borderline personality disorder were still tinged with fear and lack of confidence in taking charge of them. Thus, one participant out of five would have liked to avoid these patients, more than 12% of caregivers did not appreciate them, and 23% thought that they were manipulative. In addition, nearly half of the caregivers surveyed had low confidence in their ability to make a positive difference in the lives of borderline patients. However, there was a recognition of their distress as well as a demand for dedicated training. CONCLUSIONS: Stigmas and ignorance persist around patients with borderline personality disorder. Current training courses do not allow caregivers who are on the front lines (in particular nurses) and who wish to be trained to acquire sufficient knowledge and tools necessary for the care of patients suffering from this disorder. This calls for an improvement in training as well as a reflection on the most appropriate approaches possible to the various target audiences.

[State of knowledge on sleep apnea syndrome, attitudes and practices of doctors in Niamey, Niger]. / État des lieux des connaissances, attitudes et pratiques des médecins de Niamey sur le syndrome d'apnées obstructives du sommeil.

RATIONALE: Sleep apnea syndrome (SAS) is a public health problem. In African countries, it is an underdiagnosed pathology. Our objective was to assess SAS knowledge, attitudes and practices among doctors in Niamey, Niger. METHOD: A 6-month descriptive cross-sectional study was conducted from December 1, 2018 to May 31, 2019, involving 307 doctors working in health facilities in Niamey. RESULTS: Two hundred and seventy-two doctors (88.59%) responded, of whom 51.47% (n=140) were medical specialists, 32.35% (n=88) general practitioners and 16.18% (n=44) specialist doctors. Their level of knowledge was insufficient or fair in 77.94% (n=212) and 16.91% (n=46) of cases respectively. Their main source of information was the education they had received during university courses (61.03% [n=166]). The most commonly cited types of SAS were obstructive in 66.18% (n=180) of their responses and central in 30.15% (n=82). For adults, the main perceived risk factor for SAS was obesity (79.41% [n=216]) and among children, enlarged tonsils (68.75% [n=187]). For the most part, they were not familiar with the scale for assessing degree of daytime sleepiness (87.13% [n=237]) or with the baseline diagnostic examination for SAS (75.40% [n=205]). More than ¾ (n=221 or 81.25%) of the doctors never mentioned SAS to their patients and 59.93% (n=163) and 56.99% (n=155) of them referred a suspected case of SAS to an ENT specialist or a pulmonologist, respectively. Almost all of the doctors (94.85% [n=258]) wished to receive training on SAS. CONCLUSION: In a majority of cases, level of relevant knowledge was insufficient. Doctors need training on sleep apnea syndrome.

Evaluation des connaissances théoriques des étudiants en médecine sur les gestes de premiers secours en République Démocratique du Congo: Theoretical knowledge assessment of medical students on first aid in the Democratic Republic of Congo.

Introduction: The Democratic Republic of Congo regularly faces several health emergencies. The presence of medical doctors in the first line of the response is a spontaneous phenomenon. Gaps in first aid knowledge have been identified in the population; hence the need for training. Medical students could play a crucial role in this context. This study assesses the theoretical knowledge of first aid among them. Methods: Our study is descriptive and transversal. It was conducted from June 01 to August 30, 2021 in the Faculty of Medicine of the Catholic University of Graben. Our sample consisted of 279 students. Data collection was done through a survey questionnaire covering various aspects of first aid. Data were processed using Epi Info software. The chi-square test was used to estimate the association of variables with knowledge and a p-value <0.05 was considered as significant. Results: No participant demonstrated a satisfactory level of theoretical knowledge of first aid while 38.7% and 61.3% demonstrated an intermediate and low level respectively. A positive association was noted between the study level, a previous training in first aid and the level of knowledge. The media is the main source of information. Nearly half of the students said they had never taken a rescue action because of lack of knowledge (47.7%). The vast majority (98%) had a positive attitude regarding the introduction of first aid in school's curriculum. Conclusion: Our study showed a poor level of first aid knowledge among medical students, but a great willingness to learn. There is a great need to incorporate first aid trainings in all training curricula in the DRC.

Introduction: La République Démocratique du Congo fait régulièrement face à plusieurs urgences sanitaires. La présence des médecins en première ligne dans la riposte y est un phénomène spontané. Des lacunes ont été identifiées dans la connaissance des premiers secours au sein de la population; d'où la nécessité de formation. Les étudiants en médecine y joueraient un rôle crucial. Cette étude évalue les connaissances théoriques en premiers secours chez ceux-ci. Méthodologie: Notre étude est de type descriptif et transversal. Elle a été conduite du 01 Juin au 30 Août 2021 à la Faculté de médecine de l'Université Catholique du Graben. Notre échantillon était constitué de 279 étudiants. La collecte des données a été faite par un questionnaire d'enquête couvrant divers aspects des premiers secours. Les données ont été traitées par le logiciel Epi Info version 3.4.5. Résultats: Aucun participant n'a démontré un niveau satisfaisant de connaissances théoriques en premiers secours tandis que 38,7% et 61,3 % ont démontré un niveau intermédiaire et bas respectivement. Une corrélation positive a été notée entre la promotion d'étude, une formation antérieure en premiers secours et le niveau de connaissance. Le média est la principale source d'information. Près de la moitié des étudiants ont affirmé n'avoir jamais posé un geste de premier secours à cause du manque de connaissance (47,7%). La quasi-totalité a montré une attitude positive en rapport avec l'introduction d'une formation en premiers secours en milieu universitaire. Conclusion: Cette étude a démontré un faible niveau de connaissances des gestes de premiers secours parmi les étudiants en médicine, mais une volonté d'apprendre. Il y a nécessité d'intégrer la formation en gestes de premiers secours dans tous les curriculums de l'enseignement en RDC.

[An initial lack of knowledge of the perineal anatomy does not influence the learning of intermittent self-catheterization in women]. / La méconnaissance initiale de l'anatomie périnéale n'influence pas l'apprentissage de l'auto-sondage intermittent chez la femme.

AIM: To evaluate the impact of female perineal anatomy knowledge on the success of a first learning of intermittent self-catheterization (ISC). METHODS: Thirty subjects benefited from educational diagnosis, training and follow-up during 2 visits in a neuro-urology department. Three knowledge anatomical tests were carried out: a freehand drawing, then a diagram to be annotated and a self-location of the following 6 structures (labia majora, labia minora, clitoris, urethral meatus, vaginal orifice, anus) as well as a physiological knowledge test. A correction was made after annotating the diagram to perfect the learning process before performing the procedure. RESULTS: Of the women studied, 83.3% had a neurological pathology and 77.7% had a gyneco-obstetrical history. Half of them had undergone perineal rehabilitation. Our study shows a lack of knowledge of the perineum prior to learning self-catheterization: 43.3% thought they knew it partially and 46.7% reported that they did not know it. Fifty-three percent of the subjects did not indicate the urethral meatus and 43.3% did not annotate the vaginal orifice on the diagram. Difficulties in anatomical transposition were observed: the urethral meatus was self-located in only 43.3% of subjects and 30% did not locate the vaginal orifice. Previous perineal rehabilitation was not benefical in the self-recognition of anatomical structures. However, all the patients, including those who did not initially locate the urethral meatus, acquired the technique of ISC. CONCLUSION: Intial perineal anatomy ignorance in women was frequent but was not an obstacle to learning ISC. LEVEL OF PROOF: 4.