When pharmacotherapeutic recommendations may lead to the reverse effect on physician decision-making

For long the medical literature has shown that patients do not always receive appropriate care, including pharmacotherapeutic treatment. To achieve improved patient care, a number of physician-oriented interventions are being delivered internationally in an attempt to implement evidence based medicine in routine daily practice of medical practitioners. The pharmacy profession has taken an active role in the delivery of intervention strategies aimed at promoting evidence based prescribing and improved quality and safety of medicine use. However, the medical literature also supports the notion that valid clinical care recommendations do not always have the desired impact on physician behaviour. We argue that the well-established theory of psychological reactance might at least partially explain instances when physicians do not act upon such recommendations. Reactance theory suggests that when recommended to take a certain action, a motivational state compels us to react in a way that affirms our freedom to choose. Often we choose to do the opposite of what the recommendation is proposing that we do or we just become entrenched in our initial position. The basic concepts of psychological reactance are universal and likely to be applicable to the provision of recommendations to physicians. Making recommendations regarding clinical care, including pharmacotherapy, may carry with it implied threats, as it can be perceived as an attempt to restrict one’s freedom of choice potentially generating reactance and efforts to avoid them. By identifying and taking into account factors likely to promote reactance, physician-oriented interventions could become more effective

Afficher ses titres de noblesse scolaire ? Stratégies de présentation de soi des élèves nationaux et internationaux dans les grandes écoles françaises

Cet article porte sur les stratégies de présentation de soi des élèves nationaux et internationaux de quatre grandes écoles prestigieuses (Polytechnique, ENS Ulm, HEC, Sciences Po). La fonction de consécration remplie par les concours d'entrée dans ces grandes écoles françaises a été décrite par Bourdieu comme conférant un « titre de noblesse scolaire » qui accompagnera à vie les élèves. Mais comment ce changement statutaire se traduit-il subjectivement? Est-il identique pour les élèves nationaux et internationaux? L’observation comparée des stratégies de présentation de soi de ces deux populations étudiantes montre que les implications de ce changement obéissent à des logiques radicalement différentes. Les données de l’enquête suggèrent que l'évolution identitaire, à la différence de l'évolution statutaire, est le fruit d'un processus, qui passe d’abord par une transformation du regard d'autrui mais reste également dépendante de la charge symbolique inégale qui s’attache aux grandes écoles sur la scène nationale et sur la scène internationale. Ainsi les membres de ces écoles d'élite apprennent à gérer stratégiquement leur présentation de soi, selon les contextes et les publics rencontrés, alternant entre rapport communicationnel et rapport instrumental à l’identité. La discussion des résultats relie ces questions à la problématique de la méritocratie et suggère que croiser une sociologie des élites scolaires et une sociologie de l'identité est une piste féconde à explorer pour prendre toute la mesure des transformations de la formation des élites, dans un contexte d’internationalisation croissante

Réponse de quelques espèces modèles à des inhibiteurs de l'acétolactate synthase utilisés seuls ou cumulés

National audienc

Réponse de quelques espèces modèles à des inhibiteurs de l'acétolactate synthase utilisés seuls ou cumulés

National audienc

β-Amyrin Synthase1 Controls the Accumulation of the Major Saponins Present in Pea (Pisum sativum).

The use of pulses as ingredients for the production of food products rich in plant proteins is increasing. However, protein fractions prepared from pea or other pulses contain significant amounts of saponins, glycosylated triterpenes that can impart an undesirable bitter taste when used as an ingredient in foodstuffs. In this article, we describe the identification and characterization of a gene involved in saponin biosynthesis during pea seed development, by screening mutants obtained from two Pisum sativum TILLING (Targeting Induced Local Lesions IN Genomes) populations in two different genetic backgrounds. The mutations studied are located in a gene designated PsBAS1 (β-amyrin synthase1), which is highly expressed in maturing pea seeds and which encodes a protein previously shown to correspond to an active β-amyrin synthase. The first allele is a nonsense mutation, while the second mutation is located in a splice site and gives rise to a mis-spliced transcript encoding a truncated, nonfunctional protein. The homozygous mutant seeds accumulated virtually no saponin without affecting the seed nutritional or physiological quality. Interestingly, BAS1 appears to control saponin accumulation in all other tissues of the plant examined. These lines represent a first step in the development of pea varieties lacking bitterness off-flavors in their seeds. Our work also shows that TILLING populations in different genetic backgrounds represent valuable genetic resources for both crop improvement and functional genomics