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Which psychotherapy(ies) for psychotraumatised subjects? Today is referenced hundreds of psychotherapeutic approaches that hold many differences! Different theories and psychotherapeutic techniques contribute to what is common to assemble under the same term of "psychotherapy" practices based on an interpersonal relationship to cure illnesses, to resolve a disorder, to appease maladjustment or suffering. We will present the most common cares offered by psychotraumatology: the cognitive and behavioral psychotherapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR) and psychodynamic psychotherapies before discussing their mechanisms of action. If "schools" sometimes sell contradictory practices, in fact, common principles and techniques are actually shared by three psychotherapeutic orientations. © 2015.


Continuous professional development is the new programme which will govern the continuous education of all health care professionals. It will become fully operational during the course of 2013. It encourages interprofessional coherence as well as the coordination of national or regional plans. The composition of the CPD programmes combines the analysis of practices and the perfecting of skills.


Chaze T.,Institute for Radiological Protection and Nuclear Safety | Slomianny M.-C.,Lille University of Science and Technology | Milliat F.,Institute for Radiological Protection and Nuclear Safety | Tarlet G.,Institute for Radiological Protection and Nuclear Safety | And 6 more authors.
Molecular and Cellular Proteomics | Year: 2013

Exposure of the skin to ionizing radiation leads to characteristic reactions that will often turn into a pathophysiological process called the cutaneous radiation syndrome. The study of this disorder is crucial to finding diagnostic and prognostic bioindicators of local radiation exposure or radiation effects. It is known that irradiation alters the serum proteome content and potentially post-translationally modifies serum proteins. In this study, we investigated whether localized irradiation of the skin alters the serum glycome. Two-dimensional differential in-gel electrophoresis of serum proteins from a man and from mice exposed to ionizing radiation showed that potential post-translational modification changes occurred following irradiation. Using a large-scale quantitative mass-spectrometry-based glycomic approach, we performed a global analysis of glycan structures of serum proteins from non-irradiated and locally irradiated mice exposed to high doses of γ-rays (20, 40, and 80 Gy). Non-supervised descriptive statistical analyses (principal component analysis) using quantitative glycan structure data allowed us to discriminate between uninjured/slightly injured animals and animals that developed severe lesions. Decisional statistics showed that several glycan families were down-regulated whereas others increased, and that particular structures were statistically significantly changed in the serum of locally irradiated mice. The observed increases in multiantennary N-glycans and in outer branch fucosylation and sialylation were associated with the up-regulation of genes involved in glycosylation in the liver, which is the main producer of serum proteins, and with an increase in the key proinflammatory serum cytokines IL-1β, IL-6, and TNFα, which can regulate the expression of glycosylation genes. Our results suggest for the first time a role of serum protein glycosylation in response to irradiation. These protein-associated glycan structure changes might signal radiation exposure or effects. © 2013 by The American Society for Biochemistry and Molecular Biology, Inc.


Coutier D.,Hopital dinstruction des armees Percy
Annales Medico-Psychologiques | Year: 2015

In August 2013, in the acme of the Syrian crisis, the French State decides on the implementation of a medical surgical structure bound for the Syrian refugees, positioned within the camp of Za'atari in Jordan, a few kilometers away from the Syrian border. In front of the obvious fact of the psychic wounds of this bruised, saddened population and in exile, the medicopsychologic urgency will override the surgical aspect, so the device will evolve allowing the implementation of a binomial psychiatrist/psychologist. The operation "Tamour" is atypical because it places the action of the Health service for the benefit of the refugees in the center of its mission, and not in its kingly mission of support of the armed forces. The psychological problems of the Syrian refugees are in direct link with the related traumatic experiences of the civil war horrors (torture, rape, executions, bombing raids), but also with the insecurity and violence of life in the long course on a refugee camp of more than 140,000 people. We will also develop the particular work with children through mediations, distinct from the support for adults. Finally, particular attention will be paid on the experience of the military detachment, disarmed and without enemy, dispossessed of their warrior ideal, risking a difficult identification with the exiles statute of Syrian refugees. © 2015.


Falzone E.,Hopital dinstruction des armees Percy | Hoffmann C.,Hopital dinstruction des armees Percy | Keita H.,University Paris Diderot
Drugs and Aging | Year: 2013

Elderly people represent the fastest-growing segment of our society and undergo surgery more frequently than other age groups. Effective postoperative analgesia is essential in these patients because inadequate pain control after surgery is associated with adverse outcomes in elderly patients. However, management of postoperative pain in older patients may be complicated by a number of factors, including a higher risk of age- and disease-related changes in physiology and disease-drug and drug-drug interactions. Physiological changes related to aging need to be carefully considered because aging is individualized and progressive. Assessment of pain management needs to include chronological age, biological age with regard to renal, liver and cardiac functions, and the individual profile of pathology and prescribed medications. In addition, ways in which pain should be assessed, particularly in patients with cognitive impairment, must be considered. Cognitively intact older patients can use most commonly used unidimensional pain scales such as the visual analogue scale (VAS), verbal rating scale (VRS), numeric rating scale (NRS) and facial pain scale (FPS). VRS and NRS are the most appropriate pain scales for the elderly. In older patients with mild to moderate cognitive impairment, the VRS is a better tool. For severe cognitively impaired older patients, behavioural scales validated in the postoperative context, such as Doloplus-2 or Algoplus, are appropriate. For postoperative pain treatment, most drugs (e.g. paracetamol, nonsteroidal anti-inflammatory drugs, nefopam, tramadol, codeine, morphine, local anaesthetics), techniques (e.g. intravenous morphine titration, subcutaneous morphine, intravenous or epidural patient-controlled analgesia, intrathecal morphine, peripheral nerve block) and strategies (e.g. anticipated intraoperative analgesia or multimodal analgesia) used for acute pain management can be used in older patients. However, in view of pharmacokinetic and pharmacodynamic changes in older persons, the higher incidence of co-morbidities and concurrent use of other drugs, each must be carefully adjusted to suit each patient. Evaluation of treatment efficacy and incidence and severity of adverse events should be monitored closely, and the concept of 'start low and go slow' should be adopted for most analgesic strategies. © 2012 Springer International Publishing Switzerland.

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