[Preventing chronic back pain at the workplace: action-research at the workplace]. / Prévention des lombalgies chroniques en câblerie: une recherche-action en entreprise.

An intervention to prevent chronic back pain and muscular-skeletal disorder (MSD) was implemented in the second half of 2003 at an automobile factory targeting employees from the cable construction division who were redeployed internally to a another division of the plant. This action-research consisted of exploring the benefits of establishing specialized gym classes for back exercises and re-education at the workplace to help prevent chronic lower back pain. Employees who had previously reported lower back pain that was either slightly disabling to none incapacitating and those who were in-line to be redeployed to another division were all offered the opportunity to undertake a medical exam and physical therapy check-up and to respond to a self-administered questionnaire in order to assess the functional state of of each employee, his perception of pain, and the manifestation and impact of this in daily life. Employees were oriented to appropriate gym and physical therapy classes for re-educating and improving back strength under the supervision of a physical therapist. As a follow-up to this, in between sessions, the workers were invited to redo the assessment tests in order to assess and appraise the value of the effects of the exercises. The action-research carried out in the workplace shows a positive contribution of the gym classes specialized for back exercises and re-education training to the improvement of the status of those persons suffering from lower back pain. In addition, placing employees in new professional positions following their completion of these gym and physicals therapy sessions proves to be essential for validating the acquisition of knowledge gained and the commitment to adjusting to the job position.

[Therapeutic patient education for children and adolescents: some dentofacial orthopedic reflections]. / Éducation thérapeutique de l'enfant et de l'adolescent: réflexions éthiques en orthopédie dento-faciale.

Non-compliance and, even more, abandonment of treatment raise many questions. From a medical and economic point of view, these occurrences affect the efficiency of the proposed therapy. These failures therefore invite us to question the nature and purpose of health care providers' mission. Adherence of the patient to medical advice is a key factor to the success of the therapy. Therefore, how can we modify the patient's behaviour, particularly when dealing with teenage patients? How can we adopt and make our own a therapeutic strategy encouraging cooperation of patients? Patient education, recently integrated into the French public health code (Code de la santé publique), brings new elements to answer these questions. The purpose of the present work is to question the concept of patient education, notably with regards to medical ethics. What can patient education bring to medical practices that face non compliance or deficiency of adherence to treatment recommendations? What new perspectives does patient education bring, notably regarding medical practices?

Genetic and physiological data implicating the new human gene G72 and the gene for D-amino acid oxidase in schizophrenia.

A map of 191 single-nucleotide polymorphism (SNPs) was built across a 5-Mb segment from chromosome 13q34 that has been genetically linked to schizophrenia. DNA from 213 schizophrenic patients and 241 normal individuals from Canada were genotyped with this marker set. Two 1,400- and 65-kb regions contained markers associated with the disease. Two markers from the 65-kb region were also found to be associated to schizophrenia in a Russian sample. Two overlapping genes G72 and G30 transcribed in brain were experimentally annotated in this 65-kb region. Transfection experiments point to the existence of a 153-aa protein coded by the G72 gene. This protein is rapidly evolving in primates, is localized to endoplasmic reticulum/Golgi in transfected cells, is able to form multimers and specifically binds to carbohydrates. Yeast two-hybrid experiments with the G72 protein identified the enzyme d-amino acid oxidase (DAAO) as an interacting partner. DAAO is expressed in human brain where it oxidizes d-serine, a potent activator of N-methyl-D-aspartate type glutamate receptor. The interaction between G72 and DAAO was confirmed in vitro and resulted in activation of DAAO. Four SNP markers from DAAO were found to be associated with schizophrenia in the Canadian samples. Logistic regression revealed genetic interaction between associated SNPs in vicinity of two genes. The association of both DAAO and a new gene G72 from 13q34 with schizophrenia together with activation of DAAO activity by a G72 protein product points to the involvement of this N-methyl-d-aspartate receptor regulation pathway in schizophrenia.