BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Impact of altering proximity on snack food intake in individuals with high and low executive function: study protocol.

BACKGROUND: Despite attempts to improve diet at population level, people living in material and social deprivation continue to consume unhealthy diets. Executive function - the ability to regulate behaviour and resist impulses - is weaker in individuals living in deprivation. Dietary interventions that educate and persuade people to reflect on and actively change behaviour may therefore disproportionately benefit individuals who are socioeconomically advantaged and have stronger executive function, thus exacerbating inequalities in health resulting from unhealthy diets. In contrast, manipulating environmental cues, such as how far away a food is placed, does not appeal to reasoned action and is thought to operate largely outside of awareness to influence behaviour. People eat more of a food when it is placed closer to them, an effect seemingly robust to context, food quality and body-weight status. However, previous studies of this 'proximity effect' are limited by small samples consisting mainly of university staff or students, biased towards higher socio-economic position and therefore likely stronger executive function. This study aims to test the hypothesis that placing food further away from a person decreases intake of that food regardless of executive function. METHODS/DESIGN: 156 members of the general public, recruited from low and high socio-economic groups, will be randomised to one of two conditions varying in the proximity of a snack food relative to their position: 20 cm or 70 cm. Participants are told they will be taking part in a relaxation study - and are fully debriefed at the conclusion of the session. The primary outcome is the proportion of participants eating any amount of snack food and the secondary outcome is the mean amount eaten. Executive function is assessed using the Stroop task. DISCUSSION: The proposed study takes a novel step by investigating the effect of proximity on snack food intake in a general population sample consisting of those with high and low executive function, appropriately powered to detect the predicted proximity effect. If this effect occurs irrespective of executive function and socio-economic position, it may have potential to reduce inequalities patterned by socio-economic position if implemented in real-world settings such as shops or restaurants. TRIAL REGISTRATION: Registered with the ISRCTN registry: ISRCTN46995850 on 07 October 2015.This study is supported by the Medical Research Council (MRC) and Sackler Prize, a doctoral training grant awarded to JAH. The study was also partially funded by the Department of Health Policy Research Program (Policy Research Unit in Behavior and Health [PR-UN-0409-10109]).This is the final version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12889-016-3184-

Han Dongfang (en collaboration avec Michaël Sztanke), Mon combat pour les ouvriers chinois (Éditions Michel Lafon, 2014)

Bari Dominique. Han Dongfang (en collaboration avec Michaël Sztanke), Mon combat pour les ouvriers chinois (Éditions Michel Lafon, 2014). In: Recherches Internationales, n°98, 2014. L'Asie du Sud-Est. pp. 193-195

1964 : quand la France reconnaissait la Chine populaire

Bari Dominique. 1964 : quand la France reconnaissait la Chine populaire. In: Recherches Internationales, n°99, 2014. L’économie mafieuse et criminelle internationale. pp. 139-153

Collisions of Ar17+ ions with gaseous and solid targets at a few tens of keV/q probed by X-ray spectroscopy

International audienceCollisions of 15 keV/q Ar17+ ions with neutral atoms and solids have been investigated by high –resolution x-ray spectroscopy allowing, for the first time, a direct comparison in the excited state populations

Genistein induces adipogenesis but inhibits leptin induction in human synovial fibroblasts

It was shown recently that synovial fibroblast transformation into adipocytes reduced the expression of interleukin-6 (IL-6) and IL-8. However, the synovial fibroblast adipogenesis was inhibited in inflammatory conditions induced by the tumor necrosis factor-alpha (TNF-alpha). Furthermore, adipogenesis is often accompanied by leptin production, a proinflammatory adipokine in rheumatic diseases. In this study, we tested the phytohormone genistein for adipogenic and anti-inflammatory properties on human synovial fibroblasts. Results showed that genistein was able to transform synovial fibroblasts into adipocytes that expressed perilipin-A and produced adiponectin, but not leptin. Furthermore, genistein enhanced glucocorticoid-mediated synovial fibroblast adipogenesis and, in parallel, downregulated glucocorticoid-induced leptin and leptin receptor. Endogenous and TNF-alpha-induced expressions of IL-6, IL-8, p38, p65 and C/EBP-beta were also downregulated by genistein, showing its anti-inflammatory properties. Peroxisome proliferator- activated receptor-gamma (PPAR-gamma) agonist, rosiglitazone, had a synergic effect on genistein-induced whereas the non-active tyrosine kinase inhibitor, daidzein, had a significantly inferior adipogenic activity than genistein. The Janus kinase-2 tyrosine kinase inhibitor, AG 490, mimicked the anti-leptin effect of genistein. These results showed that genistein-induced adipogenesis involves PPAR-gamma induction and tyrosine kinase inhibition. In conclusion, genistein, alone or coupled with glucocorticoids, have both adipogenic and anti-inflammatory effects on synovial fibroblasts

Museus Históricos na França: entre a reflexão histórica e a identidade nacional

Historical museums are a current subject in today's academic scenery in France. Two conferences on historical museums which took place by the end of 1996, as well as the reopening of the historical galleries at Versailles Museum early in 1997 show a growing interest in this sort of museum. This article reports the development of museums in France, since the early form of the Museum 01 French monuments, during the French Revolution until the publication, in september 1996, of a Guide to museums and historical collections in France. The A. tries to make clear the changes experienced by these institutions since last century, and to sum up the main arguments around the theme which, alter ali, goes beyond the French and European contexts.1996, de dois colóquios nacionais problematizando os museus desse gênero, bem como a discussão sobre a reabertura das galerias históricas de Versalhes, no início de 1997, demonstram um interesse crescente pela instituição. Este artigo traça um histórico dos museus de história na França, desde sua matriz inicial, delineada no ilfllsée des monllments jrançais durante a Revolução Francesa, até a publicação do Guide des musées et collections d'histoire en France, lançado em setembro de 1996. Através deste percurso, procura-se explicitar as inflexões sofridas pela instituição, desde o século XIX até recentemente, buscando, em especial, situar o conjunto de questionamentos que giram ao redor deste tema que, de resto, ultrapassa o contexto francês e europeu