城市退休老年人社会参与、健康自评与心理健康的关系

目的：了解城市退休老年人社会参与、健康自评与心理健康之间的关系,为促进其心理健康发展提供依据。方法：采用老年人社会参与量表、老年人心理健康量表(MHIE-UV)以及健康自评对992名城市退休老年人进行调查。结果：研究对象社会参与得分为(29.28±4.57)分,健康自评得分为(3.33±0.92)分,心理健康得分为(35.5±7.49)分。城市退休老年人健康自评得分与社会参与、心理健康呈正相关(r=0.315,P<0.01;r=0.429,P<0.01),社会参与与心理健康呈正相关(r=0.554,P<0.01),社会参与在健康自评与心理健康之间存在部分中介作用,中介效应占总效应的34.1%。结论：城市退休老年人社会参与、健康自评与心理健康状况之间两两显著相关,健康自评可直接影响或通过社会参与的中介作用间接影响心理健康状况。     

Créativité numérique et innovation thérapeutique : recréer un lieu de soin sur Minecraft

ObjectivesToday, video games are recognized as an excellent tool for therapeutic mediation with young children with Autism Spectrum Disorder (ASD), playing the role of a malleable medium facilitating the evolution of group dynamics and creating a play area between the child and the adult, a space of creativity and shared pleasure allowing them to “be together,” to communicate, and to enter into a secure and holding-type intersubjective relationship. This is why we wanted to maintain this type of treatment during the general lockdown imposed in France in March 2020.MethodWe set up a virtual activity based on the use of the video game Minecraft, after having reconstituted our outpatient clinic for children and adolescents on a private server. Following the end of the lockdown, we were able to experiment with two workshops: one face-to-face; and the other in video therapy.ResultsWe were able to observe similarities and differences in the use of this medium by our young ASD patients, but also in the way in which this treatment allowed us to “put a little institution” back into the daily lives of youth during lockdown. Thus, we were able to see that the content of the Minecraft game, and more specifically the reconstructed clinic, functioned as a space of holding for the adolescents. The comparison between the digital institution and the real institution was present throughout the session in the adolescents’ exploratory actions. However, they were never “tricked” by this virtual reality, each one considering this digital clinic as a simple simulation of the institution where they go for treatment.DiscussionIt should be noted, however, that this type of mediation is not the easiest to set up for a team of professionals. Indeed, we were confronted with certain difficulties, notably the amount of time required to recreate the clinic in the game, problems with the private servers, the quality of the hardware, and the extraordinary public health situation.ConclusionThis therapeutic workshop with digital mediation allowed the very early establishment of a group dynamic and of a group psychic envelope. Therapy sessions conducted in Minecraft allowed us to work on group dynamics, on the real and digital representations of a place of care, on the children's identity references (therapeutic groups, home, etc.), and on their capacity to play in a group. The adolescents enrolled were able to individually search for their own identity markers, according to their place in the institution. Finally, the Minecraft project allowed for the emergence of many interactions and shared emotions between the members of the therapeutic group (children and adults).     

Birth weight,weight over the adult life course and risk of breast cancer

Breast cancer has been suggested to potentially have prenatal origins. We examined associations between birth weight, body mass index (BMI) at four-time points over 25 years of adulthood, and risk of postmenopausal breast cancer, with emphasis on whether the association between birth weight and risk of breast cancer was mediated by weight and height changes over the adult life course. Postmenopausal women (n = 70,397) aged 50–79 years without breast cancer at enrollment (1993–1998) were followed up to 25 years. Weight and height were measured at baseline. Birth weight, and weights at ages 18, 35 and 50 were self-reported. Breast cancer cases were centrally adjudicated. Compared to women with birth weight of 6–8 pounds, women with birth weight of <6 pounds had lower risk of breast cancer (HR = 0.88 95% CI: 0.79–0.99). 44% and 21% of the relationship between birth weight and breast cancer risk was mediated by adult height and weight at baseline, respectively. Birth weight of 8 pounds or more was not associated with risk of postmenopausal breast cancer. Weight gain in adulthood was associated with increased risk of breast cancer regardless of time periods. In conclusion, lower birthweight was associated with lower risk of postmenopausal breast cancer, and this reduction in risk was significantly mediated by childhood or adolescent growth, especially by adult height. Our data suggest that reaching and maintaining a healthy weight during adulthood is key in the prevention of breast cancer.     

Le travail de l’exil à l’adolescence. Dispositif d’étayage groupal et de médiation par la bande dessinée

ObjectiveThe exile is particularly traumatic for adolescents who, in the host country, live the post-migration experience in uncertainty. In order to enhance the continuous sense of being and the imaginary of a group of young unaccompanied minors, and to promote the narrative of their exile, we have set up a group mediated by comics. We strive to understand how and by which processes a comic mediation group could enable the support of the continuous sense of being as well as the imagination in a group of unaccompanied minors.MethodSix (n = 6) adolescents aged 15 to 17 were invited to design a group comic strip. Participants were invited to create a comic in group. The study was divided in three specific times: (1) the first was to invent a story, (2) the second was to do a storyboard and (3) the third and last one consisted in the creation of a comic. The group proceeded in X session and each session ended with a speaking time. We chose to create a comic as a medium because of its formal qualities: the specificity and complexity of its codes seemed appropriate to work on the time and space. Therefore, the breaks and discontinuities as essential parts of the comic structure allowed the participants to work out their temporal and special experiences of exile. As working in group enables to enhance the creative processes, we have designed and set up a comic mediation group.ResultsWe observed that the creation of the comic facilitates the updating of break and loss experiences, because of its formal structure. This sometimes made the group envelope porous and fragile, and damaged the group associative chain. The mediation group allowed participants to express and transform their primary affects through images and words, which led them to go from a fixed time to a historicized time. The comic became an object that represents the individual psychic reality work, the group work but also refers to the common societal reality that concerns those adolescents. Through the comic, they question the adults, the institutions and the environments that are supposed to protect them. The structure of the comic and the group setting helped participants to restore a sense of security. Moreover, the secure and containing space created by the setting allowed the group to enhance its imagination.DiscussionThe setting permitted participants to be in an active position, which supported them in the process of identity reconstruction. They used comics to transform and make sense of a painful part of their story in order to appropriate it. It is necessary to keep doing research on this subject to improve the support given for this young people. Moreover, it is essential to offer them places where they can be accompanied in the crossing of their exile experience.