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Preparing students to deal with and tolerate uncertainty or ambiguity is a major issue in medical education. There are many English scales to assess tolerance of uncertainty and ambiguity but no French one has ever demonstrated validity evidence for its scores. We selected the Tolerance of Ambiguity in Medical Students And Doctors scale. In a structured process, the original questionnaire was translated, culturally adapted and assessed after administering it to a sample of medical students. Test-retest reliability was tested by presenting the questionnaire to the students again after two months. The assessment of internal consistency reveals satisfactory value. Test-retest reliability is assessed by intraclass correlation that presents good reproducibility of scores obtained by students in first completion and second completion. These results indicate that the French version of the TAMSAD scale can be used to assess French medical students' tolerance to ambiguity.

Keywords: tolérance à l'ambiguïté, incertitude, échelle d'évaluation TAMSAD, pédagogie médicale, épistémologie, tolerance of ambiguity, uncertainty, TAMSAD evaluation scale, medical education, epistemology, tolerância à ambiguidade, incerteza, escala de classificação TAMSAD, pedagogia médica, epistemologia

AbstractAn age-old science, medicine has had to follow in the steps of History for millenniums. Little wonder, then, if medical language and, hence, terminology has always been influenced, over the years, by its successive users. The medical translator is bound to realize that the medical sociolect, far from feeding on an exact and objective terminology, is in fact prey to synchronic as well as diachronic instability.

Keywords: John Berger

As a psychiatrist at a shelter, I accompanied Claude, a homeless man. His dream to travel to South America in his van inspired me to develop nomadic writing in narrative medicine. This approach, derived from the therapeutic encounter, seeks to go beyond biomedical categories to express something about the other in their uniqueness and potential for becoming. One possible strategy is to meet the patient outside institutional clinical settings, paying attention to their concrete relationships. Nomadic writing in narrative medicine also aims to unleash the creative potential of writing itself as an artistic process, transcending the lived experience of illness or the critical analysis of the therapeutic context. This approach could prove particularly useful in psychiatry and with people in situations of social marginalization, thus opening up new perspectives for care.

Keywords: Médecine narrative, rencontre thérapeutique, écriture nomade, Narrative medicine, therapeutic encounter, nomadic writing, vanlife, Medicina narrativa, encuentro terapéutico, escritura nómada, vida en furgoneta, 叙事医学、治疗邂逅, 游牧写作, 货车生活

AbstractA large number of medical terms have been formed without regard for a classic etymological rule, i.e. mixing up Greek and Latin elements. We have identified close to 250 of these Greco-Latin hybrids in medical French and have noted that ten have an etymologically homogeneous synonym, half as much are used somewhat differently than their “pure” “counterpart”, while the others have no such equivalent in use. A similar phenomenon occurs in medical English, although we have been unable to quantify it in the same way. Finally, the goal of banning the use of hybrids from the medical vocabulary appears illusive, except perhaps when creating new words. Hybrids may even be useful, apart from the mere fact that they already are in common use. As a matter of fact, some of them introduce a slight difference of meaning, in an arbitrary but convenient way. Moreover, for the student of medical terminology, learning greco-latin hybrids may be an effective method to memorize etymology.

ABSTRACTBased on a recension of texts that appeared regarding infectious diseases in Quebec's medical periodicals of the nineteenth century, this article concludes that the physician's interest in these diseases evolved in four phases between 1826 and 1899. It seeks to explain this through factors pertaining as much to social as to institutional and scientific history. It also illustrates the increasing involvement of Quebec's physicians in their own scientific reviews, emphasizes the growing importance of ideas borrowed from foreign publications and shows significant differences in the volume of production and the distribution of French and English texts. The article also demonstrates that the various infectious pathologies do not share the same visibility and that the interest they arouse varies according to the intrinsic and circumstantial attributes specific to each disease. Globally speaking, this article lays stress on the fact that infections played a shaping role in the institutionalization of the medical profession in the nineteenth century and that it was mainly around these infections that the physicians elaborated their scientific discourse.

Some thirty projects for alternative health care exist in Belgium. While differing widely in their orientations, these projects are generally set up by health workers outside the State-run medical establishments.Rather than attempting an all-inclusive evaluation of these project, the author raises a certain number of questions: are we in the presence of new attempts to modernize medical power? Do these projects succeed in their objective to give more power to patients? Is there not an implicit tendancy to "medicalize" life through the extension of the concept of health to include that of well-being? What conditions can permit a real participation?Concerning this last point the author suggests that it may be more interesting to encourage the Local Health Centers to participate in various initiatives put forth by various citizens' groups and organizations rather than trying to encourage the population to participate in the Local Health Centers. In this way, the limits and specific role of health care could be fitted into daily life instead of trying to fit daily life into health care. Some examples are offered to illustrate the differences between these two perspectives.Finally, the author raises questions concerning the relationship between health and politics and health work and socio-political action. Health teams must break out of their present isolation both practically, through collaboration with other groups and organization, and ideologically.

Epidemiology Canada now has the second highest number of opioid prescriptions per capita in the world. The rate of prescriptions has increased over the last decade, most notably in adults over 55 years of age. A recognition of the importance of treating pain has influenced this increase, but higher rates of opioid prescribing have produced undesirable outcomes including the misuse of medication as well as an increased number of deaths and emergency department visits attributable to opioids. Diverse psychiatric disorders, such as major depression, now also occur in 40% of those with an opioid use disorder (OUD).Neuroscience We now understand that addictive behaviors are caused by both environmental and genetic factors. Although OUD has historically been perceived as a weakness of character, it is now clear that it is a chronic disease, which results from a complex interaction between a substance, such as opioid, environmental factors, and an individual's genotype. Unfortunately, this evidence has yet to be successfully translated into clinical practice and most physicians are unable to diagnose and manage OUD patients appropriately.Clinical guidelines Many clinical guidelines for the management of chronic, non-cancer pain are available. All guidelines identify the need to assess the patient appropriately and screen for factors associated with misuse before prescribing opioids. Guidelines generally acknowledge that patients should not be denied appropriate pain management, but that some patients will require close supervision and frequent follow-up to prevent the misuse of prescription opioids.

Keywords: opioïdes de prescription, douleur chronique, trouble lié à l'usage des opioïdes, Prescription opioid, chronic pain, opioid use disorder