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Focussing on the first interview and reflecting the two major themes underlying all the papers--the constant analysis of counter-transference and the need for quite real external third party in the treatment of the most serious pathologies-- the author shows that it is not enough to cling to the representations we have of patients, but that it is important to inquire into their conceptions of their problems and how they foresee the psychoanalyst's help. If the patients' "therapeutic theory" differs from what we are thinking about proposing to them, it is advisable to explain it to them briefly and to allow them to reflect upon it when we are not present. The goal is to show them that we are not placing ourselves in a relationship in which a therapist prescribes a treatment to a sick person, but that we are offering them a collaborative relationship. This usually makes it possible to avoid too frequent premature interruptions, which are admittedly disappointing for the therapist, but above all harmful for the patients. [ABSTRACT FROM AUTHOR]

The authors recount the beginnings of the interest for psychoanalysis in Canada, the context of the foundations of the Canadian Psychoanalytic Society and of its Institute, the linguistic and geographical reasons for the creation of its first branches and their later expansion, the journals and some authors and the training models, and conclude with an overview of the psychoanalytically oriented external groups. [ABSTRACT FROM AUTHOR]

End stage renal disease is a major public health problem in the French Departments of Guadeloupe and Guiana because of the high prevalence of both type 2 diabetes and hypertension. We investigated factors associated with an emergency start of dialysis, 3 months' quality of life for patients starting a first replacement therapy in Guadeloupe and French Guiana using the data of the Réseau épidémiologie et information en néphrologie network, completed with data from the quality of life questionnaires SF-36 and KDQoL. A total of 242 patients (184 in Guadeloupe and 58 in Guiana) were included. An emergency start was found for 112 (46.5%) patients (Guiana: 74.1%; Guadeloupe: 37.7%). In the multivariate model, an emergency start was associated with the number of nephrology consultations in the year before dialysis and the creation of an arteriovenous fistula prior to the first dialysis. The quality of life scores did not differ between the groups emergency start or not but were higher than those measured in mainland French studies on dialyzed population. Lack of nephrology consultations and dialysis preparation are the main factors associated with an emergency start of the first dialysis, highlighting the need to adapt the provision of care for chronic kidney disease in these departments., (Copyright © 2018 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.)