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Background and aimsStrategic games, such as poker, require gamblers to develop several skills to perform better than others and to expect a potential gain. Players must remain as unpredictable and unreadable as possible by inhibiting the expression of their emotions in response to both good and bad poker events. The aim of the present study was to compare several aspects of the inhibition process in experienced poker gamblers and controls to better understand how inhibitory control is involved in poker performance.MethodsThirty experienced non-pathological poker gamblers (EG) and thirty healthy controls with no or limited poker experience (HC) completed 3 cognitive tasks. Each task measured a specific type of inhibition: motor inhibition [Go/No-Go task], verbal inhibition [Hayling Sentence Completion Task] and expressive inhibition [expressive suppression task, which combines subjective, expressive (facial EMG) and physiological (skin conductance, heart interbeat interval, cardiovascular and respiratory activation) measures of emotional experience]. Linear mixed models with random effects were performed.ResultsInhibitory control skills were similar between the two groups, regardless of the form of inhibition tested. The only difference observed in EG was a higher ability to partially suppress the physiological expression of emotion. However, this difference was only present for negative and positive emotional induction and was not maintained for emotional induction related to poker situations.Discussion and conclusionsThe development of specific inhibition skills in experienced poker gamblers was not supported and raises questions about the transferability of poker skills previously discussed in the literature.

Les fractures de l’extremite superieure du femur (FESF) surviennent chez des patients âges, le plus souvent fragiles ou polypathologiques. Elles sont responsables d’un taux de mortalite d’environ 25 % a un an et d’une augmentation de la dependance des sujets dans plus d’un tiers des cas. La qualite de la prise en charge des FESF a pour but d’ameliorer la survie, de preserver la qualite de vie et de maintenir l’autonomie fonctionnelle du malade. Une prise en charge multidisciplinaire est alors necessaire pour parvenir a cet objectif en reduisant le delai separant la fracture de l’intervention, en depistant les conditions medicales qui exposent le malade a des complications postoperatoires et en planifiant precocement la sortie du malade âge de l’hopital. La gestion partagee des patients entre les differents intervenants (medecins anesthesistes, chirurgiens, geriatres, soignants, etc.) est a l’origine d’unites specialisees d’orthogeriatrie. Les protocoles d’interventions pluridisciplinaires bases sur l’evaluation des malades et la mise en place de projets de soins cibles figurent au premier plan des actions menees dans ces unites.

La confusion est un symptome frequent qui a un pronostic severe, en particulier si sa prise en charge est retardee. La confusion expose a des hospitalisations prolongees, a une perte fonctionnelle et, enfin, est associee a une surmortalite. Les principaux facteurs de risque de confusion sont l’âge et l’existence d’un syndrome dementiel. Elle peut se depister en utilisant des echelles validees telles que la CAM, et des criteres precis pour retenir ce diagnostic doivent etre reunis. On oppose les confusions par l’intensite de leurs manifestations psychomotrices (confusions hypoactives ou hyperactives) et par leurs durees breves ou prolongees. Les confusions prolongees posent le probleme du diagnostic differentiel avec un syndrome dementiel. Le traitement d’une confusion est avant tout preventif en ciblant les populations a risque et les circonstances cliniques ou elles sont frequentes comme la periode postoperatoire apres une fracture du col femoral.

End-stage renal disease (ESRD) is a common condition observed in the elderly. Ageing represents one of the main risk factors of the disease, in addition to hypertension and diabetes. ESRD can require the initiation of dialysis, which is a costly and complex strategy, particularly for patients aged 80 years or more. When the decision to initiate dialysis is being made by nephrologists, many parameters should be simultaneously considered to evaluate potential benefits for the patient, such as life expectancy, functional independence and, of course, quality of life. This decision-making process could be improved if comprehensive geriatric assessment were performed. Cognitive function and more particularly, a medical history suggesting dementia (which can be misdiagnosed in 50% of demented patients) must be carefully investigated. Indeed, ESRD and dementia share several risk factors such as ageing, but in addition, dementia may negatively impact on weekly dialysis programs and survival of treated patients.