Peacefull: A French mindfulness-based intervention for adolescents with chronic pain a feasibility study.

INTRODUCTION: Pediatric chronic pain can lead to serious consequences in terms of daily functioning and global quality of life. Mindfulness-based intervention (MBI) approaches that emphasize accepting rather than controlling pain have gained increasing attention in adults with chronic pain. The effectiveness of MBIs for chronic pain in the pediatric population remains unknown. The aim of the Peacefull program was to study the feasibility in France of a mindfulness program for adolescents with chronic pain, based on a program especially developed in Canada and Belgium. METHOD: An MBI for adolescents consisting of eight 90-min sessions was provided. It focused on building skills and incorporated mindfulness meditation, exercises, and activities especially adapted to teenagers with chronic pain. RESULTS: A total of 27 adolescents aged 12-17 years who were diagnosed with a chronic pain condition were enrolled in five cohorts from April 2018 to June 2021. The completion rate of the Peacefull program was 88.89 with no dropouts and good completion of outcome measures. Secondary outcomes were assessed before the program, at the end, and 3 months later. A trend toward an improvement was observed on the mean average score for the Visual Analog Scale (VAS), but it was not statistically significant. Scores increased significantly over time on the Functional Disability Inventory (FDI), and pain catastrophizing also improved. CONCLUSIONS: Although the findings regarding the effectiveness of Peacefull programs were inconsistent and insufficient, they can be indicative of the benefits of mindfulness as an adjuvant treatment for adolescents with chronic pain.

Vitamin D and calcium intakes in general pediatric populations: A French expert consensus paper.

OBJECTIVES: Nutritional vitamin D supplements are often used in general pediatrics. Here, the aim is to address vitamin D supplementation and calcium nutritional intakes in newborns, infants, children, and adolescents to prevent vitamin D deficiency and rickets in general populations. STUDY DESIGN: We formulated clinical questions relating to the following categories: the Patient (or Population) to whom the recommendation will apply; the Intervention being considered; the Comparison (which may be "no action," placebo, or an alternative intervention); and the Outcomes affected by the intervention (PICO). These PICO elements were arranged into the questions to be addressed in the literature searches. Each PICO question then formed the basis for a statement. The population covered consisted of children aged between 0 and 18 years and premature babies hospitalized in neonatology. Two groups were assembled: a core working group and a voting panel from different scientific pediatric committees from the French Society of Pediatrics and national scientific societies. RESULTS: We present here 35 clinical practice points (CPPs) for the use of native vitamin D therapy (ergocalciferol, vitamin D2 and cholecalciferol, vitamin D3) and calcium nutritional intakes in general pediatric populations. CONCLUSION: This consensus document was developed to provide guidance to health care professionals on the use of nutritional vitamin D and dietary modalities to achieve the recommended calcium intakes in general pediatric populations. These CPPs will be revised periodically. Research recommendations to study key vitamin D outcome measures in children are also suggested.

Properties of cellulose/pectins composites: implication for structural and mechanical properties of cell wall.

The primary cell wall of dicotyledonous plants can be considered as a concentrated polymer assembly, containing in particular polysaccharides among which cellulose and pectins are known to be the major components. In order to understand and control the textural quality of plant-derived foods, it is highly important to elucidate the rheological and microstructural properties of these components, individually and in mixture, in order to define their implication for structural and mechanical properties of primary plant cell wall. In this study, the rheological and microstructural properties of model systems composed of sugar-beet microfibrillated cellulose and HM pectins from various sources, with varied degrees of methylation and containing different amounts of neutral sugar side chains, were investigated. The influence of the presence of calcium and/or sodium ions and the biopolymer concentrations on the properties of the mixed systems were also studied. The characterizations of the mixed system, considered as a simplified model of primary plant cell wall, showed that whatever the structural characteristics of the pectins, the ionic conditions of the medium and the biopolymer concentrations, the gelation of the composite was mainly controlled by cellulose. Thus, the cellulose network would be the principal component governing the mechanical properties of the cell walls. However, the neutral sugar side chains of the pectins seem to play a part in the interactions with cellulose, as shown by the interesting viscoelastic properties of cellulose/apple HM pectins systems. The rigidity of cellulose/pectins composite was strongly influenced by the structural characteristics of pectins. The particular properties of primary plant cell walls would thus result from the solid viscoelastic properties of cellulose, its interactions with pectins according to their structural characteristics (implication of the neutral sugar side chains and the specific potential calcic interactions) and of the distribution of the components in separate phases.

Structure of arabinogalactan-protein from Acacia gum: from porous ellipsoids to supramolecular architectures.

The structure of the arabinogalactan-protein (AGP) fraction of the gum exudate of Acacia senegal (gum Arabic) isolated from hydrophobic interaction chromatography was investigated using HPSEC-MALLS, small angle neutron scattering and TEM observations. Literature reported that the AGP structure of gum Arabic adopts a very compact conformation in solution due to the attachment of short arabinoside side chains and much larger blocks of carbohydrate to the polypeptidic backbone. The present study revealed that AGP in solution had a weight average molecular weight Mw of 1.86×10(6) g mol(-1) and a radius of gyration Rg of 30 nm. In addition, two exponent values were identified in the Rg, [η], Rh and ρ vs. Mw relationships highlighting two types of conformations depending on the molecular weight range considered: a low molar mass population with long-chain branching and a compact conformation and a high molar mass population with short-chain branching and an elongated conformation. AGP would behave in solution as a branched or hyper-branched polymer with conformations ranging from globular to elongated shape depending on the size of the carbohydrate branches. Small angle scattering form factor revealed an elongated average conformation corresponding to a triaxial ellipsoid while inverse Fourier transform of the scattering form factor gave a maximum dimension for AGP of 64 nm. Transmission electron microscopy highlighted the existence of two types of flat objects with thicknesses below 3-5 nm, single particles with a more or less anisotropic spheroidal shape and aggregated structures with a more elongated shape. A remarkable feature of all particle morphologies was the presence of an outer structure combined to an inner more or less porous network of interspersed chains or interacting structural blocks, as previously found for the arabinogalactan (AG) main molecular fraction of Acacia gum. However, clear differences were observed in the density and morphology of the inner porous network, probably highlighting differences in the degree of branching. The existence of assembled AG as part of the AGP family was confirmed using TEM micrographs at high resolution. Fused AGP dimers, trimers, tetramers and multimers were also identified. These molecular assemblies questioned about the nature of interactions involved.

Solution conformations of pectin polysaccharides: determination of chain characteristics by small angle neutron scattering, viscometry, and molecular modeling.

The solution behavior of pectin polysaccharides has been investigated by small angle neutron scattering (SANS), viscosimetric, and molecular modeling studies. The samples used in the experimental study were obtained from apple and citrus and had degrees of methylation ranging from 28 to 73%, with a rhamnose content lying between 0.6 and 2.2%. Persistence lengths, derived from intrinsic viscosity measurements, ranged from 59 to 126 A, whereas those derived by SANS were between 45 and 75 A. These values correspond to 10-17 monomer units. The modeling simulations were performed for both homogalacturonan itself and homogalacturonan carrying various degrees of rhamnose inserts (rhamnogalacturonan). This required the evaluation of the accessible conformational space for the eight disaccharides that represent the constituent repeating segments of the homogalacturonan and rhamnogalacturonan polysaccharides. For each dimer, complete conformational analysis was accomplished using the flexible residue method of the MM3 molecular mechanics procedure and the results used to access the configurational statistics of representative pectic polysaccharide chains. For homogalacturonan, an extended chain conformation having a persistence length of 135 A (corresponding to 30 monomers) was predicted. The inclusion of varying amounts of rhamnose units (5-25%) in the model in strict alternating sequence with galacturonate residues (equivalent to the rhamnogalacturonan "hairy region" chains) only slightly reduced the calculated persistence length. The extended overall chain conformation remained relatively unchanged as a consequence of the self-cancellation of the kinking effects of successive paired rhamnose units.

[Patient admission and induced abortion. A different mode: homeopathy and sophrology]. / Un suivi différent: homéopathie et sophrologie.

PIP: Unlike classic allopathic medicine in which specific drugs are given for specific symptoms, homeopathic prescriptions take into account the specificity of each patient. Different patients have different reactions to the same illness. Homeopathic practitioners sometimes prescribe different remedies for each patient suffering a particular illness. Two nurses and a midwife at the abortion service of the Center for Social Gynecology in Marseilles received training in homeopathic medicine which they applied to their work with abortion patients. A very complete and detailed questioning is necessary to identify the prescription that will be best adapted to the overall psychological, somatic, and etiological circumstances of the patient. Changes noted since the beginning of the pregnancy are especially noted. During the medical consultation, homeopathy may be proposed by the physician for patients who are particularly stressed. The anxiety and fear experienced by the referred patients can have physical consequences. The opportunity given to the patient to express herself and the individualized remedies prescribed enable the procedure to be completed under better conditions. Sophrology is the study of consciousness, its modifications, and the physical, psychological, and physiological means that can modify it for therapeutic or prophylactic purposes. A psychiatrist in Barcelona developed sophrology and began to teach it in 1960. The goal of sophrology is to achieve mental relaxation through muscular relaxation. Application of the principles of sophrology in an abortion service must be adapted to the structure and function of the service. Most patients have no knowledge of the method. Explanations must be rapid, clear, and simplified if patients are to obtain benefit. The practitioner instructs the patient in a calm voice to be aware of and maintain breathing, and uses positive words to suggest that the patient relax. Personnel with adequate training in sophrology can assist patients in overcoming their anguish and pain. A slowing of the heartbeat and better oxygenation result from use of the method.^ieng