The issue of linking research and policy is not unique to health care of the elderly; it has been articulated by numerous stakeholder groups, including those with specific diseases, such as breast cancer. A method of enhancing these links is now being systematically addressed in the Canadian Breast Cancer Initiative with the input of women with breast cancer. The Initiative consists of a number of components and demonstrates a model of consumer participation at multiple levels in setting the agenda for research and policy development, thus enhancing accountability in the transfer of research findings into policy. The concept of consumer participation in linking research and policy is transferable to other diseases and other population groups, such as seniors.

L’art-thérapie porte en terre hexagonale, un lourd bagage de fausses notes conceptuelles, d’hégémonies et de clivages cheminant parfois avec une certaine note d’obscurantisme consensuel. Toujours d’actualité, la répétition de cette dynamique souffre d’un manque d’autocritique et d’auto-analyse constructive. Pourtant les dinosaures de l’art-thérapie d’hier empruntent, lorsqu’ils n’ont pas tiré leur révérence, la voie de la sagesse. Ceux d’aujourd’hui s’échinent à tenir des vestiges, voire des temples vides, même lorsqu’ils empruntent la toge de la transmission. Si jusqu’à l’aube des années 1980, l’art-thérapie était encore l’apanage de la psychiatrie et des psychiatres, elle concerne aujourd’hui des praticiens d’origine multiple et s’étend du développement personnel aux champs du somatique, sans pour autant se cristalliser dans une réelle identité professionnelle. À l’instar d’autres spécialités d’antan, elle erre dans une sorte de flou-doux-mou peu et/ou mal étayée sur une recherche clinique à même de fournir des recommandations pour de bonnes pratiques et un corpus de savoir. Pourtant les approches symptomatologiques, psychopathologiques, phénoménologiques, structurales, pictographiques, psychobiographiques et autres, souvent référencées aux arts et/ou à la psychanalyse, produisent légitimement, sous couvert du piège de la séduction esthétique, une jouissance relativement éloignée du terrain. Quant aux organismes, plus ou moins fédératifs, leur prétention en matière « d’accréditation » des professionnels de l’art-thérapie, se révèle là-aussi bien éloignée du réel de la clinique et des expériences d’autres pays européens (Suisse, par exemple). Enfin, les intitulés des formations, initiales comme continues, jouent sur des ambiguïtés de vocabulaires et d’expressions, difficiles à décrypter par les novices. Nous développerons chacun de ces points en proposant quelques médications génériques pour traiter des pathologies endémiques « de la dame art-thérapie ».

Quelle peut être la place du numérique aujourd’hui en psychiatrie ? Dans la tête de certains professionnels, notamment psychiatres, le numérique peut être l’objet de fantasmes d’omnipotence : le numérique serait l’avenir de la psychiatrie. Pour d’autres, il peut être l’objet de fantasmes : craintes de réductionnisme clinique, menaces pour l’attribution des ressources financières, menaces pour les libertés individuelles… Dans la tête de certains chercheurs, le numérique peut être un formidable outil de traitement de données massives, mais encore réservé à quelques équipes. Dans la tête des patients, ce peut être un gadget supplémentaire où la frontière entre bien-être et santé reste floue. Dans tous les cas, le numérique ne laisse personne indifférent. Pour mieux s’approprier ces nouvelles technologies, il faut aujourd’hui maîtriser les multiples possibilités qu’elles nous offrent, loin d’une quelconque science-fiction ou d’une béatitude naïve. L’objectif de cette session est de sortir des simples notions techniques de la question numérique, ou d’une vision gadget à la mode, et d’explorer dans différents domaines le champ des possibles, limités par des contraintes éthiques et techniques. Ainsi, du point de vue des patients, la recherche d’informations sur les troubles psychiatriques, l’efficacité et la tolérance des traitements sur Internet sont perçues comme normale. Néanmoins, la qualité des informations médicales trouvées sur Internet est très variable, nécessitant un travail de psychoéducation. Du point de vue des psychiatres, le numérique est devenu un support majeur de transmission des informations et des connaissances. Plusieurs sites Internet et applications Smartphone de psychoéducation ou de collecte des données patients ont été développés ces dernières années peuvent aussi servir d’outil pour les thérapeutes . Enfin, d’un point de vue recherche, il est possible maintenant d’exploiter les richesses de nos archives cliniques grâce aux technologies du Web sémantique.

The debate about knowledge-production in sociology has pitted “internalist” accounts, which pay close attention to the places, practices, and tools of knowledge, against “externalist” accounts of institutions and fields. Using psychoanalysis as a case, this paper develops an approach that integrates these traditions by comparing the differentiation of places, tools and practices of knowledge production. The paper shows that, in a context in which other areas of practice increasingly differentiate research, diagnosis and treatment in spaces, tools, and professional roles, psychoanalysis invokes that differentiation rhetorically but refuses to differentiate its practice. Psychoanalysts insist on a specific setting – the couch and the psychoanalytic relationship – as central to all aspects of their knowledge-production but they do not adapt this space to pursue any of these purposes in their own right. This analysis explains some of the problems psychoanalysis has with its environment and the specific form divisions take within psychoanalysis. As an unusual case of non-differentiation, psychoanalysis highlights the role differentiation plays in other areas of knowledge-production.

In Canada, provincial and territorial laws address circumstances in which a substitute decision-maker may be appointed for an adult deemed legally incapable of making decisions in one or more areas of life. We searched for provincial and territorial laws that explicitly address substitute decision-making about research participation, and found significant differences among Canadian jurisdictions. In some provinces and territories there is no direct statutory guidance on the issue. Differences among jurisdictions that address substitute decision-making about research in legislation include whether judicial intervention is required to authorize the substitute decision-maker, whether any advance directive in place must explicitly authorize the decision about research in order for a proxy to consent, and how risk and benefit thresholds beyond which substitute consent to research is prohibited are articulated. It is imperative that government, researchers, and the Canadian public revisit the principles underpinning substitute decision-making about research in light of national and international norms, in order to lend clarity and consistency to this area of law and research practice.

Ces descriptions schématiques d'actions de Recherche et Technologie, sont situées dans un parcours collatéral en relation avec les débuts des projets Ariane. Elles ont été conduites à l'aide de groupements interdisciplinaires dont les GdR du CNRS, et comportant des acteurs scientifiques, enseignants-chercheurs, ingénieurs, technologues et industriels. La démarche technologique et industrielle de construction est présentée à l'aide des fonctions techniques en mécanique. L'objet technique est visé, à partir de conditions initiales des objectifs affichés comme projet, par la mise en œuvre des flux d'énergies, de produits, d'acteurs, et d'informations industrielles. Ceci s'associe à la maîtrise du comportement en utilisation effective et à l'utilisation des connaissances exprimées par la recherche et l'enseignement. On incorpore donc au long du déroulé opératoire des repères, lieu de couplages amont/aval et aval/amont.

In the years prior to independence, farmers had access to the international market through the production of export crops which at that time received considerable input from research. Access to export crops has dwindled, support for research by national governments is disappointing, human resource development is inadequate, donor funding is uncoordinated, and the food crisis has taken on political dimensions. The assumption that direct importation of western technology can solve the problems of Africa is no longer valid in the face of several failures. The challenge to national agricultural research systems and the problems associated with the generation or adapting of farmer-oriented, location-specific technologies for sustaining agricultural production are discussed. Examples are drawn from India and an agenda for action, involving national governments, the international agricultural research centres and donors, in resolving these problems is presented.

The legume pod-borer, Maruca testulalis, continues to be a major limitation to successful cowpea cultivation in many countries. During the past decade, research on this insect has increased in scope and intensity at international agricultural research centres and a number of universities. The work that has been done on the biology and control of this pest at the International Institute of Tropical Agriculture (IITA) is briefly discussed with emphasis on the development of a management strategy centred around host plant resistance, and some suggestions for future research direction are given.

The formation of the International Advisory Council for Biosystematic Services in Entomology (IACBSE) in Hamburg at the XVIIth International Congress of Entomology in 1984 is described and its composition and long-term objectives are stated. These include fostering the development of biosystematic research and identification services on a world basis by co-ordinating and assisting interactions and exchange of information between organizations and individuals, and by establishing a series of Working Groups on major projects. The main user needs for biosystematic services are also summarized. The particularly important needs of medical, agricultural and forestry entomology are emphasized and other needs for the support of faunal surveys, conservation, ecology, physiology, biogeography, litigation, amateur and general public interest are noted.

Certain demographic characteristics, including the limited size and stabiliiy of the population of Denmark, account for the development of genetic, epidemiological and prospective studies in the Danish psychiatric research context. Moreover, despite the predominance of biological psychiatry, psychotherapy arouses the interest of young psychiatrists.

Research is especially concentrated in university centers such as Copenhagen, Aarhus and Odense. The Institute of Psychiatric Demography, directed by Annalise Dupont, is responsible for centralizing data concerning hospitalized patients. It lias thus been possible to carry out longitudinal studies of patients presenting manic-depressive disorders, schizophrenia and mental retardation, as well as surveys on the prevalence of suicide according to region, and genetic studies based on the observation of monozygotic twins. The studies on schizophrenia particularly deal with the incidence of cancer and the influence of life events. The cytogenetics laboratory, directed by Johannes Nielsen, is especially concerned with the follow-up of 25,000 children born in the Obstetrics Department of the Aarhus University Hospital.

There are numerous other areas of research: comparative studies of the ICD 8 and the DSM III; studies dealing with the use of lithium in affective disorders; studies on the response to and modes of action of electroconvulsive therapy; ongoing studies of neurotic patients, conducted for more than 20 years; surveys on the efficacy of psychotherapy in schizophrenic patients.

The existence of benzodiazepine receptors was discovered by the research cenrter of the St Hans Hospital in Copenhagen. Current research at this center is devoted to the study of dopamine receptors, the relations between LSD receptors and serotonine, and study of the GABA System.

Although research is thriving in Denmark at present, it is threatened by a reduction in credits; the author analyzes the reasons behind this threat.

A brief outline is provided of the recent developments of psychiatric research in Italy. In the field of psychiatric epidemiology, the contributions by the Psychiatric Department of Verona University and the Chair of Mental Hygiene of Pavia University, based on the application of the psychiatric register, are summarized. On the clinical side, emphasis is laid on the research on schizoaffective disorders by the Naples group and on the course and outcome of depression by the Pisa group. In the framework of psychobiological research, the studies carried out in the Psychiatric Department of Milan University on the role of HLA antigens as genetic markers of vulnerability to schizophrenia are mentioned, as well as those by the Naples group on cerebrospinal fluid levels of noradrenaline and on platelet MAO activity in schizophrenics.

Finally, in the field of clinical psychopharmacology, the interest of Italian researchers in the topics of prediction of response to psychotropic drugs (especially lithium) and of monitoring of antidepressant plasma levels is emphasized.

The prospect for psychiatric research in Britain is bleak. The U.K. government reduced its funding of British Universities by about 10 % between 1980 and 1983 and is now imposing further reductions of about 2 % a year for the foreseeable future. Funding of the Research Councils is also being reduced at a similar rate. As a result many academic and technical posts in our medical schools have already been lost or “frozen” and many more seem destined to disappear before the end of the decade. Although charitable bodies like the Wellcome Foundation are attempting to provide additional funds to offset the damage serious harm is being done to British medical research, and to British science in general.

Psychiatric research suffers along with everything else. For the past generation our strength and our most important achievements have been in social psychiatry. Very few departments have the laboratories or the expertise to mount fundamental biological research and in the present financial climate they have little hope of acquiring this capacity. The Medical Research Council spends its shrinking funds as wisely as it can and there is still a great deal of expertise in our university departments and MRC units, but our capacity to compete with the United States is waning fast. We will do our best to continue to do research which is well designed, innovative and useful. But unless our financial predicament changes we will be responsible for a decreasing proportion of the most important and influential studies, particularly in the biological sphere in which the major developments of the next decade are likely to come.