Souviens-toi. Processus de deuil,processus de création

ObjectivesThe authors set out to cast light on certain psychic mechanisms that help to give meaning to death, in particular via objects of great symbolic value, as links between the dead and the survivors.MethodsIn this clinical article using a heuristic methodology, we combine the analysis of a clinical situation of antenatal death, a paradigm of loss with a pathological risk, and that of the artistic creation of Michel Nadjar, linked to the genocide of the Jews.ResultsThe psychic processing of the loss of a loved one is accompanied by considerable psychopathological risk. While funeral rites, whether religious or lay, and the support of the family and the community often provide mourners with a framework that favours the achievement of the period of mourning, so as to continue living with the loss (rather than living with the deceased person), there are certain traumatic situations that make access to a non-pathological mourning process impossible.DiscussionThe authors reappraise the exclusiveness of Freud's mourning and melancholia model, and consider Winnicott's theoretical model of transitional phenomena to cast light on the psychic processes at work.ConclusionsThe creativity operating in the two situations maintains a certain distinction: sublimation for the artist, resurgence of transitional phenomena for the bereaved individual.     

L’Artiste en milieu hospitalier : une expérience musicale en hémodialyse pédiatrique

Culture at the hospital is part of a policy of providing everyone access to culture. This article describes a musical intervention that provides patients and healthcare professionals a central role in creation; qualitatively assesses the benefits of these interventions for children and caregivers; evaluate the lessons learned from this ongoing experience in the pediatric hemodialysis unit of Rouen University Hospital. Ninety-minute sessions take place twice a week, with eight children aged from 18 months to 19 years, during dialysis. To assess the effects of artistic interventions in the unit, a qualitative methodology was chosen (observation grid). The progression of the project is evaluated to highlight what has helped the children and caregivers reach autonomy in artistic creation while respecting the time allotted, the artistic approach, and the esthetics of each participant's creation. The results indicate that this approach allows children to be actors, that the time at the hospital is relativized, and that the relationship with the healthcare professionals is less oriented towards care. A discussion follows on the place of the artist and the untapped potential of bringing patients to the creative act; the issue of esthetics, which then becomes secondary; the complementarity between musical activities and creation, and the role each actor plays in an artistic project. The hospital can provide access to culture; however, it is possible to go further and reveal patients’ creativity.     

从弑父向寻父的转变：晚生代创作转型研究

新世纪以来，随着一批以写农村题材为主的文学作品的问世，毕飞宇、李洱、林白等为中坚的晚生代作家的创作出现了转型迹象，开始有意无意从欲望都市中撤退，在乡村和历史中进行书写，显示了对写作深度和写作意义的自觉思考和追问，呈现了某种历史主义的悲悯情怀。与这种空间的转换相对应的，还有叙事立场从原先的边缘向中心的靠拢，叙事方式上从现时态的写作向过去式的写作，话语方式从原先的反讽式写作向悖论式写作转向，这些文本中呈现出了一种人到中年的精神气质，与现实和解，向历史握手。这种写作固然源于作家写作的探索，更源于现实的召唤，还来自于人到中年的生命体验。     

科学审美创造的美与真善关系

本文认为，科学审美创造的美与真善之间存在着相互影响、相互促进、相互转化的辩证关系；真总是作为善与美的内容和存在的基础；善一方面以真为其目的性内容，一方面又作为内容而存在于美的形式之中；美作为人的本质力量对象化的产物，其令人愉悦的形式包含着真和善的内容。     

医学创新教育模式的探索与实践

创新意识、创新思维和创新能力是创新教育的三要素。吉林大学白求恩医学院通过实行教学机构优化重组,科学、系统地设置课程体系,以及采用丰富多样的教学方法和教学评价体系,着力进行创新意识的开发;通过融入科研思维及渗透临床思维的教学模式,促进创新思维的培养;通过建立以学生为主体及推行以科研为平台的教学模式,提高学生的创新能力。     

中医优势病种护理质量管理模式的建立及应用体会

目的：探讨中医优势病种护理质量管理模式的建立及应用。方法：选取2012年9月-2013年9月我院脑病科和心内科分别收治的脑卒中及胸痹患者作为研究对象,每种优势病种各180例患者,将其按照随机数字分组法分为研究组和对照组,对照组患者采取传统中医疾病护理及质量评价,研究组患者采取中医优势病种护理和质量评价。结果：与对照组相比,研究组患者临床效果明显优于对照组,差异具有统计学意义（P〈0．05）;研究组患者对护理服务质量的满意度明显高于对照组,差异具有统计学意义（P〈0．05）。结论：建立中医优势病种护理管理模式可以对我院中医优势病种的护理方案进行规范化,同时还能改善中医优势病种的护理质量,提高患者对护理质量的满意度以及医院整体形象。     

Perceived impacts of a first wheelchair on social participation

Purpose.?To document perceived impacts in users' daily activities and social roles (social participation) following the acquisition of a first manual or powered wheelchair.

Methods.?A qualitative design with a phenomenological approach was used. Semi-structured interviews were conducted. An interview guide was developed based on the 12 social participation categories in the Disability Creation Process (DCP) conceptual model as themes underlying the questions: ‘What has changed in your daily life since you got your new wheelchair?’ and ‘What has not changed in your daily life that you thought you would do differently with your new wheelchair?’

Results and discussion.?The average age of the ten participants was 64.3 years (±16.3) and 90% had received a manual wheelchair. Four main themes emerged from the detailed analysis: changes in daily activities, expectations not met, impacts on social roles and emotional changes. The participants considered the changes in daily activities to be generally positive. Expectations not met mainly related to outdoor mobility. The participants had not anticipated the impacts on social roles and emotional changes, which demonstrate the complexity of human occupation.

Conclusion.?Getting a wheelchair is a major and complex event in a person's life.     

突破传统办医模式用创新理念构建现代新型医院

从观念、体制、制度和经营创新几方面介绍深圳市中心医院突破传统办医模式,用创新理念构建现代新型医院的做法和成效.在体制上,探索院-校、院-企良性互动的发展战略;在制度上,探索解决深层次矛盾的有效机制;在经营上,探索利于医院可持续发展的产业框架.     

论医药卫生高新科技成果转化的现状与对策

该文简要介绍了我校医药卫生技术成果转化的现状,指出当前医药卫生高新技术成果转化过程中遇到的种种困难和转化工作的不足之处,提出促进医药卫生高新科技成果转化与科技创新是一致的,技术开发必须和市场开发结合起来,努力形成产学研一体化模式和扶持技术成果中介组织是高校医药卫生科技创新工作的重点.     

健康教育在原发性高血压病治疗中的作用

目的：探讨健康教育对原发性高血压病治疗的作用。方法：对100例社区原发性高血压病患者应用相同降压药治疗的基础上,把他们随机分为两组,实验组进行6周多种方式的健康教育,对照组不进行健康教育,6周后观察两组原发性高血压病人疗效,并进行比较分析。结果：实验组疗效明显大于对照组,并且两组有效率比较差异有显著性（P〈0．01）。结论：健康教育能明显提高原发性高血压患者药物治疗的效果。