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目的:探讨精神疾病患者劳动能力鉴定状况及与其相关问题。方法:分析1998至2002年共187例精神疾病患者的劳动能力鉴定资料,并进行不同年代、不同诊断、不同级别的组问比较。结果:除1998年外,其余各年度基本资料相似;诊断以精神分裂症为主,精神发育迟滞为次;前者的平均年龄最大、病期最短、累计病休时间最长、残疾级别最低,后者反之。结论:劳动能力鉴定应按有关标准执行,但目前仍存在一些有待进一步完善的问题。  相似文献   
3.
Mental disorders represent in France for the Social Security the second post of spending in consumption of care with 11,4 billion euro, that is 10,6% of the spending, behind the diseases of the circulatory system. They stay in the rank of the pathologies justifying the allocation of a disability pension, representing 26,7% of invalids. It is to say the importance of the psychiatric expertise for the Social Security. This type of expertises is particular among the expertises in psychiatry because the objective of the expertise is to establish an arbitrage between the position of CPAM's doctor and his regular doctor. Effectively, except legal flaw, the opinion of the expert imposes upon the parts (parties). The realization of the expertise and its editorial staff are detailed in their specificities. Problem specific of the psychiatry are approached as well as the functions (offices) of the expert which are well beyond arbitrator's role towards a function of teacher and intermediary.  相似文献   
4.
The author criticizes theorists show, phenomenon of “administrative ecstasy”, and dominance of political correctness against truth and scientifically established facts. He tells three professional experiences where he refuses the official position, preferring the politically incorrect: mental report, AIDS in prisons, care reform in his own prison psychiatric department.  相似文献   
5.
Due to a national theoretical training provided to all resident for many years and the ongoing discussions to change the organization of the resident training of specialized study diploma (SSD) of nephrology, a survey was done to assess the perception of skills acquired in the management of different clinical situations in terms of knowledge, expertise and attitudes. The expected results are intended to identify new training procedures for future nephrologists in France. The study was performed in 112 resident from 3rd and 4th year of nephrology resident training attending an educational seminar of the University College of Nephrology Teachers in May 2014. The survey was conducted with a self-administered anonymous questionnaire to assess the perception of the acquisition of different skills. The results show a heterogeneity acquisition between different areas of skills suggesting possible improvement with development of outpatient activity or with training in specialized units such as for peritoneal dialysis or plasma exchange activity. Therefore, these findings suggest further structuring of the regional training and development of the simulation training to acquire the expertise and attitudes. Finally, the use of an evaluation book of skills acquired throughout the training could be interesting in the context of standardization of validating training of nephrologists as proposed in the reform of the SSD of nephrology.  相似文献   
6.
In Le Mans on 2 February 1933: Christine and Lea Papin murdered savagely their patroness Mrs Léonie Lancelin and her daughter, Geneviève, at their home. A trial that excited the whole of France and defrayed the chronicle. Pierre Schützenberger (1888–1973) was the head doctor at the mental asylum of Le Mans. The day after the crime, he was appointed as psychiatric expert. As a few weeks later, he shall be assisted in this task by Victor Truelle (1871–1938) and Jacques Baruk (1872–1975). Every two was alienists. The first was a head doctor at Sainte-Anne hospital in Paris and the second at Saint-Gemmes-sur-Loire asylum near Anger. The experts took the clear position of the absolute responsability of the defendants. A correspondence between Schützenberger and the psychiatrist Louis Le Guillant (1900–1968) allows us, on the one hand, to go behind the scenes of this expertise, which was vigorously challenged during and after the trial and, on the other hand, to situate it in the context of the 1930s. There was not a possible psychological analysis for P. Schützenberger in this case. As illustrated his non-published conference on freudism that was held on 9th March 1933. When reading one of this we note that he was very sceptical by the introduction of Psychoanalysis, which appeared to him to be a backward step compared with the French Somatical School's use of biological notions in Psychopathology.  相似文献   
7.

Objective

To evaluate the effect of pulmonary rehabilitation (PR) on exercise performance and quality of life in patients with chronic obstructive pulmonary disease (COPD) with different degrees of static lung hyperinflation (LH).

Design

Retrospective cohort study.

Setting

PR network.

Participants

A cohort of 1981 patients with COPD (55% men; age: 66.8±9.3y; forced expiratory volume in the first second%: 50.7±19.5; residual volume [RV]%: 163.0±49.7).

Intervention

An interdisciplinary PR program for patients with COPD consisting of 40 sessions.

Main Outcome Measures

Participants were stratified into 5 quintiles according to baseline RV and were evaluated on the basis of pre- and post-PR 6-minute walk distance (6MWD), constant work rate test (CWRT), and Saint George’s Respiratory Questionnaire (SGRQ), among other clinical parameters.

Results

With increasing RV quintile, patients were younger, more frequently women, had lower forced expiratory volume in the first second%, lower body mass index and fat-free mass index, shorter 6MWD, shorter CWRT, and worse SGRQ scores (P<.01). All RV strata improved after PR in all 3 outcomes (P<.001). Nevertheless, higher, compared to lower RV categories, had lower ΔCWRT (P<.01) but similar Δ6MWD (P=.948) and ΔSGRQ (P=.086) after PR.

Conclusions

LH in COPD is related to younger age, female sex, lower body weight, worse exercise capacity and health status, but did not prevent patients from benefitting from PR. LH, however, influences walking and cycling response after PR differently.  相似文献   
8.
Young adults more accurately remember own-age than older faces. We tested whether this own-age bias (OAB) is reduced by increased experience. Young experts (geriatric nurses) and controls performed a recognition experiment with young and old faces. Critically, while control participants demonstrated better memory for young faces, no OAB was observed in the experts. Event-related potentials revealed larger N170 and P2 amplitudes for young than old faces in both groups, suggesting no group differences during early perceptual processing. At test, N250 repetition effects were more anteriorily distributed for own- than other-age faces in control participants, whereas experts showed no corresponding effects. A larger late positive component (LPC) for old than young faces was observed in controls, but not in experts. Larger LPCs may reflect prolonged stimulus processing compromising memory retrieval. In sum, experience with other-age faces does not affect early perceptual processing, but modulates later stages related to memory retrieval.  相似文献   
9.
The Région Languedoc-Roussillon is the umbrella organisation for an interconnected and integrated project on AHA covering the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing. All sub-activities (A1: electronic pharmaceutical file, A2: falls prevention initiative, A3: frailty, B3: chronic respiratory diseases, chronic diseases with comorbidities, oral health and hepatitis virus C chronic infection, C2 and D4 active and independent living and handicap) are included in MACVIA-LR that has a strong political commitment and includes all stakeholders (public, private, patients, policy makers). It is one of the Reference Sites of the European Innovation Partnership on Active and Healthy Ageing built around chronic diseases, ageing and handicap. The framework of MACVIA-LR has the vision that the prevention and management of CDs is essential for AHA promotion and for the reduction of handicap. The main objective of MACVIA-LR is to develop innovative solutions for a network of Living Labs in order to improve the care of patients affected by CDs in the Languedoc-Roussillon area and to disseminate the innovation.  相似文献   
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