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En 1784, le magnétisme animal, doctrine et pratique médicales, divise la Faculté de médecine de Paris. Partisan du nouveau traitement, le docteur Deslon s’attire de nombreux clients. Certains acceptent de partager publiquement leurs expériences thérapeutiques à travers des récits signés de leurs noms. En réaction aux rapports hostiles au magnétisme animal de l’Académie des Sciences et de la Société royale de Médecine, ils produisent un plaidoyer en faveur de Deslon. Ce conflit interne à la Faculté de médecine se mue alors en une question médicale débattue publiquement, au nom de l’intérêt général, par des médecins, des non-professionnels de la santé et des malades. Maître d’œuvre de son propre espace d’affirmation au cœur des débats médicaux, ce nouveau public est un acteur avec lequel les experts de la médecine composent pour ne pas solliciter l’intervention royale. Protéiforme, il dénonce le despotisme de la Faculté et son seul souci de préserver ses intérêts corporatifs. In 1784, animal magnetism, doctrine and medical practice, founded the Faculty of medicine of Paris. In agreement with the new treatment, doctor Deslon has numerous patients. Some agree to share their therapeutic experiences in public through stories signed accounts and go so far as to produce a plea in favor of Deslon in reaction to hostile reports to animal magnetism from the Academy of Sciences and the Royal Society of Medicine. So, this internal conflict at the Faculty of medicine turns into a medical question debated publicly in the name of the general interest by non-health professionals, patients and doctors. Creator of its own space of affirmation at the heart of medical debates, this new public is an actor with which medical experts must come to terms so as not to have to seek royal intervention. Composed of various elements, it denounces the despotism of the Faculty and its only purpose to safeguard its corporate interests.

The extension of biological inheritance beyond gene-centrism is at the center of many debates in evolutionary biology, but it has been relatively ignored in the field of biomedicine. The purpose of this prospective paper is to highlight the potential impact of a new vision of inheritance on medical theory, notably on the concept of hereditary disease. It is also to underline some related practical and social issues.L’hérédité étendue en biomédecine - Briser le silence.L’extension du concept d’hérédité au-delà du tout génétique a fait l’objet de nombreux débats en biologie de l’évolution, mais elle a été relativement ignorée dans le champ de la biomédecine. L’objectif de cet article prospectif est de souligner les conséquences potentielles d’une vision renouvelée de l’hérédité sur la théorie médicale, notamment sur le concept de maladie héréditaire, ainsi que de mettre en évidence certains enjeux pratiques et sociaux connexes.

8220;Health service#8221;, a French national service-learning program for health profession students, was launched in 2018. It aimed at developing knowledge and skills in health promotion and prevention. The purpose of this study was to assess the local implementation of this program, among medical, pharmacy, midwifery and physical therapy students at the Grenoble Alps University.Relevant data were extracted from the placement reports, the directors#8217; feedback forms and an on-line questionnaire for students. We described the teams, the actions, the targeted publics, the students#8217; satisfaction and directors#8217; satisfaction.400 students participated in this service-learning program (207 medical students, 93 pharmacy students, 39#160;midwifery students and 61 physical therapy students). 92#160;teams took actions in 91 institutions, including 90 secondary schools. 96.0% of the students were in interprofessional teams. Of 7,926#160;people reached, 7,872 (99.3%) were secondary school pupils. The main issues addressed were the substance-use prevention program based on life skills development, Unplugged (55#160;schools) and screen time and cyberstalking (17 schools).This program achieved interprofessional education and practice, with health-student-delivered activities. Interdisciplinarity was a core strength of the#8220;Health service#8221;. Areas for improvement were the communication and the reimbursement of transportation expenses.

Sociotropy and autonomy have been described as personality styles promoting the occurrence of stress in individuals. The SAS (for sociotropy-autonomy scale) corresponds to a 60-item instrument devoted to sociotropy and autonomy estimation in various populations. However, the different SAS versions display variations in item scoring, in scale structure and in factor composition. Furthermore, there is a lack of scale invariance analysis. Consistent with a larger work dedicated to understanding contributors of students' achievement during their trainings, the objective of this study was devoted to a refinement of French SAS item properties and to a measure of scale invariance in order to ensure that the French SAS be a trustable tool to measure sociotropy and autonomy among first- year students. Because a preliminary analysis invalidated several SAS items, a second objective has consisted of the definition and validation of a new scale estimating social dependency in students.In all, 2365 students registered in first year of technological training (n=778) and health training (n=1587) were enrolled. They were asked to electronically answer the 60-item French SAS. The responses were collected between October and November 2017 for students registered in technological formation, and between March and April 2018 for health students. Item-score correlation coefficients (rIn all, 1223 responses were collected and analysed. GLB and ω coefficients calculated for the full SAS indicated unacceptable internal consistency. Of the 60 items, 40 did not meet the acceptance criteria (i. e. rThis work has invalidated the use of the overall 60-item French SAS to measure sociotropy and autonomy in first year students. By contrast, the refinement of the French SAS items led to a trustable 20-item instrument to investigate social dependency. Scale invariance characteristics allow confident statistical comparisons between sub-groups. This work shows that first-year female students registered in health or technological trainings exhibit a higher social dependency than males. Furthermore, first-year female health students show more social dependency than their technological counterparts. Because the conditions of recruitment of first-year students in heath formations in France are planned to change in September 2020, future studies will be warranted to analyse their social dependency.

In January 2015, in accordance with decades of scientific work based on maintaining contact, was born an innovative device for suicide prevention: VigilanS. To ensure this link, the choice was made to build a team with an equal number of nurses and psychologists, all located within the medical regulation. Nowadays, they are named "VigilanSeur": an original entity that highlights the emergence of this new profession, at the crossroads of several disciplines.

The objective of this article is to describe the results of a situational analysis of training, recruitment and deployment of health workers conducted in Togo in 2015, in order to inform the new Human Resources for Health plan.The research was conducted according to a mixed methods approach, using both qualitative and quantitative methods. Data concerning fourteen professional categories were collected from the Ministry of Health, health training institutions, students, employers and health workers. Data collection and analysis were based on a conceptual framework depicting the training-recruitment-deployment chain. Each step in this chain influences the efficiency and efficacy of the entire chain: each step can lead to loss of health workers, loss of time or financial resources and can consequently have an impact on the availability, accessibility and quality of health workers in Togo.The study identified twelve areas of improvement that could constitute future strategies for health workers, comprising five areas related to education, five areas related to personnel recruitment and two areas related to deployment.The study proposed a conceptual framework and indicators for regular monitoring of the training-recruitment-deployment chain to allow in-depth analysis of its dynamics. This approach supports the formulation of appropriate strategies and better follow-up of the effects of interventions by the Ministry of Health.

TFIID and SAGA are two multi-subunit complexes which play important roles in transcription and that contain the TAF10 subunit. By immunoprecipitation followed by mass spectrometry, we analyzed the composition of TFIID and SAGA complexes in the embryo as well as in different cellular contexts. TFIID and SAGA complexes subunits were detected in different proportions depending on the cellular context. By gel filtration, we also detected distinct TFIID sub-complexes. In the absence of TAF10, TFIID and SAGA assembly is severely impaired but neither early somitogenesis nor global gene expression is affected. Steady-state and newly transcribed mRNA analyses in mES cells suggest that TFIID and SAGA are generally required for transcription initiation. However, the decrease of mRNA synthesis is compensated., TFIID et SAGA sont deux complexes importants pour la transcription, contenant la sous-unité TAF10. Nous avons analysé leur composition dans l’embryon murin et différents contextes cellulaires par immuno-précipitation et spectrométrie de masse. Les sous unités des complexes TFIID et SAGA ont été détectées en proportion différente selon le type cellulaire. Par filtration sur gel, des sous-complexes de TFIID ont aussi été détectés. En absence de TAF10, l’assemblage de TFIID et SAGA est fortement affecté mais la formation des somites n’est pas initialement affecté ni l’expression globale des gènes. L’analyse des niveaux d’ARN totaux et naissants dans les cellules ES murines suggèrent que TFIID et SAGA sont requis globalement pour l’initiation de la transcription, mais que la diminution de la synthèse des ARNm est compensée.

The objective of this study was to elucidate the conditions of emergence of patient safety issues in the public debate and the limits to implementation of patient safety in the current health system.A narrative review of the international literature was conducted by searching PubMed, Cairn and Persée databases.The database search retrieved 2,206 documents, 48 of which were included in the study. The theme of patient safety has spread worldwide, but emerged late in France. The delayed emergence of patient safety in France is essentially related to the euphemistic approach to the problem of patient safety, the difficulty of adopting systematic reasoning, the lack of human resources management levers and the ambiguous position of patients in relation to patient safety.

In the context of the evolution of care practices, continuing training enables caregivers to keep their practices up-to-date and to treat the patient more as a whole, by drawing on their experience in the field. Trainers support them in the development of academic and practical skills for which the expertise of patients plays a significant and recognised role. Patient-trainers enable caregivers to understand the constraints of chronicity and its treatment, not always visible when a purely clinical approach is adopted. They also help to raise awareness of the capacities for action and adaptation.

Analysis of interactions between professionals and patients with chronic diseases reveals a space invested by professional expertise in which APA teachers occupy their own distinctive position./ce:para.

Objective: To analyse the impact of the alcohol market on the implementation of strong-willed public alcohol abuse prevention policies based on a critical review of the literature. Method: Documentary research and analysis of the alcohol market economic data were performed. An overview of public alcohol abuse prevention policies was conducted from a historical perspective by distinguishing drunkenness control policies, protection of vulnerable populations, and the fight against drink driving and drinking in the workplace. Results: Public alcohol abuse prevention policies are primarily designed to reduce the harmful consequences of alcohol occurring as a result of a drinking episode (motor vehicle accident, highway accidents, etc.), while neglecting the long-term consequences (cancer, cirrhosis, etc.). Moreover, while taxation is one of the major public health tools used to reduce the costs of alcohol-related damage on society, the State exercises legislative and tax protection for alcoholic beverages produced in France. In particular, wine benefits from a lower tax rate than other stronger forms of alcohol (spirits, liquors, etc.). The economic weight of the alcohol market can provide an explanation for these public alcohol abuse prevention policies. Conclusion: In view of the mortality caused by alcohol abuse, France must implement a proactive public policy. An alcohol taxation policy based on the alcohol content, a minimum unit pricing for alcohol, or higher taxes on alcohol are public policies that could be considered in order to reduce alcohol-related mortality.

Healthcare professionals require good quality of vision. The main objective of this study is to evaluate the satisfaction and vision quality after laser vision correction in healthcare professionals.This is a monocentric retrospective study. An online 25-question survey was sent to ametropic physicians, surgeons and nurses who underwent corneal refractive surgery with laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between July 2012 and February 2016. Questionnaire responses were recorded anonymously by the internet survey site. These patients' pre- and postoperative data were analyzed.In total, 2491 laser vision corrections were performed during this time frame. One hundred and fifty-eight patients were healthcare providers; 131 received the survey, and 111 responded. Ninety-nine were surgeons, 60 were medical physicians, and 32 were nurses. Ninety-one percent reported that they were satisfied with their postoperative vision quality, 63.9% even reported an improvement in their quality of vision compared with their corrected preoperative vision, 92.8% reported that they would have the procedure again, and 94.6% would recommend the procedure to a family member or a patient. Visual outcomes showed high levels of efficacy and predictability.While healthcare professionals require good quality of vision, those who had undergone laser vision correction reported the same satisfaction as the general population and would recommend the procedure to their family, friends and patients.

Few data exist on the prevalence of symptoms and risk of obstructive sleep apnea syndrome (OSAS) among professionals of a health facility, or they often work in shift schedule and night. Under these conditions, an undetected OSAS may affect alertness and attention in professional acts. The purpose of this study was to determine the prevalence and risk factors of OSAS among professionals of a health facility.It is a descriptive cross-sectional study conducted among 773 participants working at the university hospital of Pointe-à-Pitre and volunteers to answer the Berlin questionnaire. We also collected among respondents, abdominal and neck circumference and medical history.Women accounted for 67% (n=520) of the sample and men 32.7% (n=253). The mean age was 42±11.1 years. We noted a high prevalence of OSAS symptoms (snoring at 69% to 26% daytime sleepiness) and SAS risk factors (hypertension reported to 18%, BMI30kg/mIt seems interesting to propose to health workers who have risk factors for sleep apnea syndrome identified in this study, OSAS screening by the Berlin Questionnaire. This could be implemented for example as part of occupational medicine.

Public health is a multidisciplinary activity whose fields of action are acquiring an increasingly broad. The Service de santé des armées (SSA) has always had a culture of public health problems thanks to doctors specialized in the treatment of major diseases. Often involved in public health activities, health professionals nevertheless have a fragmented vision. The objective was to describe the social representations of public health of military healthcare workers.The responders were doctors, nurses, veterinarians and pharmacists practicing in different areas of SSA (caregivers, administrators, policy makers) and were interviewed by telephone. A question of spontaneous evocation on the representations of public health in the army was asked. The overall lexical analysis was performed according to the method of rank-frequency. Categorical analysis was conducted to better understand the whole lexical field use.There were 90 responders. The most salient terms were "prevention, epidemiological surveillance and vaccination". The categorical analysis showed that doctors used a lexical field primarily focused on diseases and risk behaviors, nurses on the specifics of military surveillance and policy makers about the cross-discipline.Public health in the army is mainly represented by epidemiological surveillance and prevention. Given the non-mentioned fields, a strengthening of communication on the current challenges of public health would probably improve adherence of healthcare professionals since public health takes on more and more importance in the development of the national health policy and management of health crises.

The impact of the educational process has been shown to improve the quality of life of patients with chronic disease and their involvement in the management of their daily treatments, particularly in the field of diabetes patients. Usually, several health professionals are involved in the accompaniment of chronic patients. Currently, the health professional has few continuing education training programms that can help to support patients with chronic diseases and to better communicate with colleagues from other disciplines. The purpose of this article is to describe and present a new education program designed for all health care professional working in the filed of the chronic disease.

HIV-1 pre-mRNA splicing depends upon 4 donor and 8 acceptor sites, which are used in combination to produce more than 40 different mRNAs. To further characterize nuclear factors involved in these processes, we purified RNP complexes formed by incubation of SLS2-A7 transcripts in HeLa cell nuclear extracts by affinity chromatography to identify new associated proteins. We showed that, in addition to the well known hnRNP A1 inhibitor of site A7, nucleolin, hnRNP H and hnRNP K interact directly with SLS2-A7 RNA. We demonstrated that hnRNP K has multiple binding sites in the vicinity of site A7 and that binds cooperatively to hnRNP A1 to the A7 RNA region and limits the A7 utilization in vitro. As hnRNP A1 is a negative regulator of several HIV-1 splicing sites (A1, A2, A3), we tested whether hnRNP K may also reinforce hnRNP A1 inhibition at these sites. Surprisingly, hnRNP K activated in vitro splicing of the D1-A1, D1-A2 and D1-A3 introns. Interestingly, hnRNP K was found to reinforce strongly the ASF/SF2 activity at site A2, which indicates that depending on the splicing site hnRNP K can be a splicing activator or inhibitor. To test how hnRNP K influences the relative utilization of HIV-1 splicing sites in cellulo, we used plasmid p PSP containing all the HIV-1 splicing sites and tested the effect of over-expression in HeLa cells on alternative splicing of the PSP RNA. Doubling the amount of hnRNP K in HeLa cells led to a drastic change of the PSP RNA alternative splicing, which confirms the strong influence of hnRNP K on alternative splicing. Moreover, increase of cellular concentration of hnRNP K strongly decrease the viral Nef protein production. hnRNP K protein affects A7 splicing regulation but also regulates the majority of regulated splicing sites of HIV. By extension of the study of hnRNP K effect to other HIV-1 splicing sites, we discovered that hnRNP K is a general regulator of HIV-1 splicing, L'épissage est une étape clef de la multiplication du VIH-1. Par utilisation de 4 sites donneurs et 8 sites accepteurs d'épissage, plus de 40 ARNm différents sont produits. Une approche protéomique nous a permis d'identifier de nouvelles protéines interagissant avec la région de l'ARN viral contenant le site A7. Nous avons démontré l'interaction directe avec l'ARN viral de 5 des protéines identifiées (nucléoline, hnRNP A1/B, hnRNP H et hnRNP K). Nous avons montré que hnRNP K a plusieurs sites de fixation dans la région du site A7 et que hnRNP A1et hnRNP K se lient de façon coopérative. Nous avons montré un effet inhibiteur de hnRNP K sur l'épissage au site A7. Comme la protéine hnRNP A1 est un régulateur négatif de plusieurs sites accepteurs d'épissage (A1, A2, A3, A7), nous avons testé si la protéine hnRNP K pouvait renforcer l'inhibition à ces sites. En fait, hnRNP K active l'épissage in vitro des introns entre le site donneur D1 et les sites accepteurs A1, A2 et A3. Nous avons montré que la protéine hnRNP K renforce fortement l'activité de ASF/SF2 au site A2, ce qui indique que selon le contexte, la protéine hnRNP K peut être activatrice ou inhibitrice de l'épissage du VIH-1. J'ai observé de plus que la surexpression de la protéine hnRNP K dans des cellules HeLa, transfectées avec le plasmide p PSP contenant le virus VIH-1 dépourvu de ses capacités d'encapsidation, produit un changement très marqué de l'épissage alternatif de l'ARN PSP, ce qui confirme la forte influence de hnRNP K sur l'épissage alternatif du VIH-1. L'augmentation de la concentration cellulaire de hnRNP K dans les cellules HeLa conduit aussi à une diminution de la protéine virale Nef. La protéine hnRNP K intervient donc non seulement dans la régulation du site A7, mais aussi dans celle de la majorité des sites d'épissage régulés de l'ARN du VIH. L'action de cette protéine sur plusieurs des sites d'épissage montre que la protéine hnRNP K est probablement un régulateur général de l'épissage de VIH-1

The use of safe and efficacious vaccines in occupational settings to protect workers from diseases to which they may be exposed is obvious and has been included in the employment law. Healthcare workers are particular exposed. Immunization has two purposes : protect the worker from contracting a disease, but also prevent him from disseminating the disease to weakened patients. It is important not only to take into account existing recommendations for immunization, but also to envisage their extension to teachers and staff of nurseries and primary schools. Routine vaccination against whooping cough, varicella, measles and hepatitis A is particularly warranted in these categories. Recommendations should also extend to medical students who are too often poorly protected and insufficiently warned against potential occupational exposure to pathogens and dissemination to their patients.

Turpentined vapour baths with coniferous oil. This article presents the history of turpentined vapour baths used to treat rheumatismes. In the same time appeared patent medicines made with coniferous oil, sold by chemist near those baths establishments., Cet article met en perspective la pratique médicale antirhumatismale de bains thermo-résineux et la fabrication de quelques spécialités pharmaceutiques produites par des pharmaciens de l'Est de la France à la fin du XIXe siècle. L'auteure reconstitue l'histoire de ces bains de vapeur térébenthines, présente quelques spécialités à base de résineux et donne quelques renseignements en annexe sur les établissements thermo-résineux les plus fameux de l'époque., Raynal Cécile. Des bains de vapeurs térébenthinés aux pastilles de Pin mugho. In: Revue d'histoire de la pharmacie, 94ᵉ année, n°355, 2007. pp. 341-360.

Midwives appear to be the health care workers exposed to the highest rates of bloodborne injury. In this paper - based on a national survey - we describe the bloodborne injuries occurring in this profession.During the year 2003, 241 hospitals took part in a national survey of bloodborne injuries. Employees registered anonymous standardized reports of bloodborne events with the Occupational Medicine Unit. The data were processed by the coordination center for the fight against nosocomial infections (C. CLIN) which is in charge of the national analysis of all the events reported in this database.169 of the 6973 bloodborne events reported during 2003 (2.4%), were signed by midwives or midwife students. The first three most frequent accidents reported were: ocular projections during childbirth, pricks when repairing episiotomy, pricks or cuts when handling soiled instruments.Improving knowledge of risk as well as promotion of protection/prevention measures well adapted to this profession should be helpful in optimizing future attitudes.

Portugal has adopted the Beveridgian model of National Health Service after the revolution of 1974. However, certain principles have been proclaimed long before that date. In particular, equity in access to and solidarity in financing of health care have been emphasized since many decades, although not yet completely implemented nowadays. The NHS is managed by the Ministry of Health who employed in 1999 approximatively 115,500 professionals. In 1998, the Portuguese NHS had 245 medical doctors and 334 nurses per 100,000 population. As concerns ambulatory care, the NHS deploys throughout the country health centers where GPs act as gatekeepers. The NHS is plagued by several chronic shortcomings: politics and politicians are deeply involved in its decision-making process, its information system is weak, manpower planning is lacking, the medical careers outside hospitals are not appreciated, continuing education of health workers is neglected, the working conditions and skill-mix are deteriorating and, finally, the remuneration system is outdated.

Dr Camille Delvaille (1835-1904) was a physician in Bayonne. He wrote many books about scientific problems and social medicine; he was one of the first to suggest medical control at school. In a book, written in 1865, he studied everyday practice in France. He complained against the "Officiers de Sante" who exercised medicine mainly in the countryside but were not doctors and had followed very short medical studies. Dr Delvaille deplored that it meant two kinds of cares: doctors for top people and Officiers de Sante for poor patients. In fact, the end of the Officiat de Sante occured only in 1892. Dr Delvaille studied also some problems related to medical demography; he purposed for our country a law cutting down foreign practice in France. Then, he put forward nomination of Professors or hospital's physicians through an examination instead of routine cooptation. Some of his minds are ahead and were applied later.

Codification is a major issue. As a new Code of Public Health is under way, pharmacists have to decide whether they will join with the other health professions or prefer to stand a part.