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Cet article étudie les liens entre l’intérieur et l’extérieur des prisons au prisme de l’histoire commune entre radio et détention. Les années 80 sont marquées par l’essor des radios libres et des programmes dédiés aux personnes détenues. Par une approche historique centrée sur cette décennie, nous étudierons la façon dont la radio rebat les cartes des conditions d’existence mais surtout d’expression des détenu·e·s, désormais doté·e·s de cet outil de liaison pour passer outre les murs des prisons. Par l’analyse comparée des archives des radios associatives Spaghetti Al Dente et Parloir Libre – l’une musicale, l’autre anticarcérale – nous restituerons le spectre radiophonique d’alors pour mieux saisir les enjeux de ces transmissions (du lien affectif des prisonnier·e·s au soutien à leurs luttes). This article studies the links between the inside and the outside of prisons through the prism of the common history between radio and detention. The 1980s were marked by the rise of free radio and programs dedicated to prisoners. Through a historical approach focused on this decade, we will study the way radio reshuffles the cards of the living conditions but above all of expression of inmates, henceforth endowed with this linking tool to pass beyond the walls of prisons. Through a comparative analysis of the archives of the associative radio stations Spaghetti Al Dente and Parloir Libre – one musical, the other anti-prison – we will restore the radio spectrum of that time, to better grasp the stakes of these transmissions (from the prisoners' emotional link to the support of their struggles).

OBJECTIVE The non-neuronal cholinergic system represents non-neuronal cells that have the biochemical machinery to synthetize de novo and/or respond to acetylcholine (ACh). We undertook this study to investigate this biochemical machinery in chondrocytes and its involvement in osteoarthritis (OA). METHODS Expression of the biochemical machinery for ACh metabolism and nicotinic ACh receptors (nAChR), particularly α7-nAChR, in human OA and murine chondrocytes was determined by polymerase chain reaction and ligand-binding. We investigated the messenger RNA expression of the human duplicate α7-nACh subunit, called CHRFAM7A, which is responsible for truncated α7-nAChR. We assessed the effect of nAChR on chondrocytes activated by interleukin-1β (IL-1β) and the involvement of α7-nAChR using chondrocytes from wild-type (WT) and α7-deficient Chrna7-/- mice. The role of α7-nAChR in OA was explored after medial meniscectomy in WT and Chrna7-/- mice. RESULTS Human and murine chondrocytes express the biochemical partners of the non-neuronal cholinergic system and a functional α7-nAChR at their cell surface (n = 5 experiments with 5 samples each). The expression of CHRFAM7A in human OA chondrocytes (n = 23 samples) correlated positively with matrix metalloproteinase 3 (MMP-3) (r = 0.38, P < 0.05) and MMP-13 (r = 0.48, P < 0.05) expression. Nicotine decreased the IL-1β-induced IL-6 and MMP expression, in a dose-dependent manner, in WT chondrocytes but not in Chrna7-/- chondrocytes. Chrna7-/- mice that underwent meniscectomy (n = 7) displayed more severe OA cartilage damage (mean ± SD Osteoarthritis Research Society International [OARSI] score 4.46 ± 1.09) compared to WT mice that underwent meniscectomy (n = 9) (mean ± SD OARSI score 3.05 ± 0.9; P < 0.05). CONCLUSION The non-neuronal cholinergic system is functionally expressed in chondrocytes. Stimulation of nAChR induces antiinflammatory and anticatabolic activity through α7-nAChR, but the anticatabolic activity may be mitigated by truncated α7-nAChR in human chondrocytes. In vivo experiments strongly suggest that α7-nAChR has a protective role in OA.

Background Nocebo effect (NE) defines any declared negative side effect of a drug that is non-specific, non-explained by its pharmacokinetic, and non-dose dependant. Recently, it has been pointed out as the main factor that reduces the retention rate of switches from a biologic originator (BO) to biosimilars (BS) in rheumatology. Objectives To identify the risk factors (RFs) and interventions strategies to reduce the NE in rheumatism and musculoskeletal diseases (RMDs), and more specifically in BS switches. Methods MEDLINE, Embase and Cochrane databases were systematically searched (inception to 15th November 2018) using relevant keywords: search1: “musculoskeletal diseases” and “nocebo” or “non-specific side effect” (NS-SE); search2: “biosimilars” and “nocebo” or “non-specific side effect”. Inclusion criteria were: studies on pharmacological treatments, studies investigating RFs for NE or NS-SEs, studies specifically describing an intervention aimed to reduce NE. Studies on non-RMDs and fibromyalgia were excluded. Results Of 212 and 639 references screened respectively in search1 and search2, 151 duplications were deleted, 32 mentioning NE or equivalent were read in full text by 2 independent investigators and consensually selected. No study met inclusion criteria for NE risk factors: 6 studies investigated the RFs of discontinuation after switch to BS, 3 with etanercept (ETN), 3 with infliximab (IFX), one investigated risk factors of back switch (meaning return from BS ETN to BO ETN), one study analyzed a genetic factor of intolerance to methotrexate (MTX) in juvenile idiopathic arthritis (JIA) and one study assessed the RFs for overall discontinuation of biologics. Although contextual factors were mentioned, no study tested RFs on NE responders only. RFs for a negative outcome were low self-efficacy, small-size rheumatology department, early start of IFX BS after its introduction on the market. Only 5 studies met the inclusion criteria for specific interventions to reduce NE. One was about countermeasures used to reduce MTX intolerance in children with JIA: including covert dosing and taste masking, with no significant results. The other four studies aimed to reduce NE related to a switch: by a shared decision-making method (ETN, one study), another by a structured communication strategy (ETN, one study) and two by a standardized information (ETN, one study; IFX, one study). Rate of NS-SE was mentioned in 3 studies, and the outcome (NS-SE rate compared to NE-SE rate of control group) was mentioned in only 2 studies. However, the assessment of intervention efficacy was not possible, since comparison was performed with historical cohorts. Conclusion Although nocebo effect is an important issue in rheumatology, especially as an explicative factor for limiting the retention rate when switching from biologic originators to biosimilars, its risk factors and intervention strategies to prevent it are poorly known. Our results encourage studies to better understand the risk factors associated with nocebo effect and the means to reduce it, particularly in the context of switches from bio-originators to biosimilars. Disclosure of Interests None declared

Background: Nonspecific subjective adverse effects (NSAE), usually considered as related to a nocebo effect (NE), have been identified as a barrier to the acceptability of switches from biologic originators (BO) to biosimilars (BS). Objectives: To assess the efficacy of a multidisciplinary team intervention to reduce the NE among inflammatory arthritis (IA) patients concerned by systematic switch from originator Infliximab (OI) to the biosimilar infliximab (BI) SB2. Methods: The intervention was part of a multidisciplinary patient education (PE) program. It was developed in 4 steps. Step 1: we conducted first semi-directive qualitative interviews with 5 patients treated by other intravenous (IV) biologics. Interviews showed: fears about efficacy and tolerability of BSs, need for information (particularly on the difference between BSs and generics), importance of sharing their experience of adverse effects (AE) with health practitioners (HP), and having the opportunity to switch back. The wish to discuss the nurses’ own experience of BSs was prominent. Step 2: a meeting with the multidisciplinary team (3 rheumatologists, 1 resident, 1 pharmacist, 3 nurses, 1 peer-patient from a patient’s association) was set up for designing the intervention based on the interviews, on non-systematic literature review about switches and on patients’ perspective regarding NE. Step 3: Consensual agreement on the intervention and the chosen pieces of language to be used by all HPs. The intervention included written and oral information by the nurses; nurse-led PE; if necessary, distribution of an informative leaflet made by the team. Step 4: Implementation of the intervention. The rheumatologist had the entire appreciation for discontinuing the BS or not. Inclusion criteria were all IA patients treated with OI. The primary outcome was SB2 retention rate (RT) at 34 weeks, secondary outcomes were the number of NSAEs leading to SB2 discontinuation; the comparison of the RT and NSAE rate of the cohort with 1) RT and NSAEs rate of a systematic switch from another Infliximab BS (CT-P13) to SB2 made at the same period in the same rheumatology department 2) RT and NSAEs rate of switches in other published European cohorts (1,2,3). Results: Fourty-five patients were included from March 12th, 2018 to May 25 th, 2018, median follow up was 34 weeks, 17 rheumatoid arthritis (RA), 23 spondyloarthritis (SpA) and 5 psoriatic arthritis (PSA) patients were included. Mean OI duration before switch was 9.4 years. The switch RT from OI to SB was 41/45 (91,2%) and NSAE (1/45). RT was significantly higher than in other European cohorts (p Conclusion: An intervention based on a multidisciplinary patient education team where nurses have a prominent role is effective in reducing the NE when switching from the originator infliximab to its biosimilar. Disclosure of Interests: None declared

Background:Nonspecific subjective adverse effects and symptoms (NSAE/NSS), usually considered as related to a nocebo effect (NE), have been identified as a barrier to the acceptability of switches from biologic originators (BO) to biosimilars (BS) in rheumatology. A multidisciplinary team intervention with a prominent role of nurses has provided a reduction of the NE assessed in the short-term during a systematic switch from originator Infliximab (OI) to the biosimilar infliximab SB2 (ref.1).Objectives:To assess the intervention outcomes after one-year follow up in comparison with a historical cohort.Methods:The intervention was developed after a literature search and semi-directive interviews of patients, and included consensual communication towards patients, with a prominent role of nurses (Ref.1). All patients with chronic inflammatory rheumatic diseases (CIRD) treated by OI were included and followed-up in routine care. The outcomes were I) SB2 retention rate (RR) II) SB2 discontinuation rate due to a presumed NE, defined as lack of efficacy with no objective criteria for increased inflammation or non-objective and non-specific adverse event, either occurring after the switch and disappearing after back-switch or change of biologic. Criteria for NSAE/NSS in the historical cohort were the same lack of efficacy or subjective adverse events and disappearance after change of biologic BD. Medium-term (12 months) SB2 outcomes were assessed and compared with I) the data obtained in the short-term (34 weeks) II) the data from an historical cohort of CIRD patients treated by OI in the same rheumatology department, using Kaplan-Meier survival curve.Results:Forty-five patients were prospectively included for the switch from March 2018 to August 2018: 17 with rheumatoid arthritis (RA), 28 with spondylarthritis (SpA); 55% were women, mean age was 53.2 (SD: 2,1), and mean time under OI was 113.5 (SD9.3). For the historical cohort, the 52 patients treated with OI between December 2016 and January 2017 were included and their data collected at baseline and one year. Fifty-nine percent were women, mean age at inclusion was 50.25 (1.2), and mean time under OI was 94.8 (9.4).SB2 RR did not differ from the OI RR in the historical cohort: 91.2% and 96.2% respectively at 34 weeks (p = 0.41); 84.4% and 88.5% respectively at 12 months (p = 0.52) (figure 1). The SB2 RR was significantly higher than in three other European cohorts at 34 weeks (mean RR 73.6%, pSB2 and OI discontinuations due to NSAE/NSS at 34 weeks were 2,2 % and 1.9% respectively; at 12 months 6,6% and 1.9% respectively (p= 0.6).Conclusion:An intervention based on a tailored communication with a prominent role of nurses was effective in reducing the NE when switching from OI to SB2 in the short term, compared with an historical cohort and other European cohorts. The one-year follow-up showed no statistical difference in RR or NE compared with our historical cohort. The present study shows that appropriate interventions may be developed to improve the outcome of switches to biosimilars.Figure 1:Treatment withdrawal free survival curves (SB2 in switched cohort and OI in historical cohort).Kaplan Meir survival curves. Comparison with Log-Rank test between OI to SB2 cohort and historical OI cohort, p = 0.520. OI : original infliximab.References:[1] Petit J. Ann Rheum Dis, volume 78, supplement 2, year 2019, page A1447[2] Glintborg B. et al. Ann Rheum Dis 2017;76:1426–31.[3] Nikiphorou E. et al. Expert Opin Biol Ther 2015;15:1677–83.[4] Boone NW. et al. Eur J Clin Pharmacol 2018;:1–7.Acknowledgments:Dr Margaux Boisson Service de rhumatologie du Professeur Kahan, Hôpital Cochin, APHP.Disclosure of Interests:Juliette Petit: None declared, Marie Antignac: None declared, Karine Louati: None declared, Sandra Desouches: None declared, Nathalie DEPARIS: None declared, Regine Baratto: None declared, Rosemarie POILVERD: None declared, Sylvie Dartout: None declared, Francis Berenbaum Grant/research support from: TRB Chemedica (through institution), MSD (through institution), Pfizer (through institution), Consultant of: Novartis, MSD, Pfizer, Lilly, UCB, Abbvie, Roche, Servier, Sanofi-Aventis, Flexion Therapeutics, Expanscience, GSK, Biogen, Nordic, Sandoz, Regeneron, Gilead, Bone Therapeutics, Regulaxis, Peptinov, 4P Pharma, Paid instructor for: Sandoz, Speakers bureau: Novartis, MSD, Pfizer, Lilly, UCB, Abbvie, Roche, Servier, Sanofi-Aventis, Flexion Therapeutics, Expanscience, GSK, Biogen, Nordic, Sandoz, Regeneron, Gilead, Sandoz, Catherine Beauvais Speakers bureau: Abbvie, MSD, Roche, UCB, Mylan, Sanofi

Depuis une dizaine d’annees, les changements ideologiques dans le champ de la protection de l’enfance se traduisent par des lois, des modifications structurelles des institutions, des contraintes budgetaires mais egalement par de nouveaux regards sur la personne en situation d’assistance. Cet article interroge les repercussions de ces changements sur les pratiques des professionnels qui accompagnent des jeunes majeurs places dans trois etablissements de l’association Jean Cotxet et confies a l’Aide sociale a l’enfance dans le cadre d’un Contrat jeune majeur.

Dans cet article est presentee l’analyse de plus de 200 ecrits de jeunes places par l’Aide sociale a l’enfance ou par la Protection judiciaire de la jeunesse demandant une poursuite de leur prise en charge durant leur majorite (de leurs 18 ans a 21 ans maximum). Ces lettres datent des annees 70 jusqu’a aujourd’hui. Elles refletent dans leur epaisseur et surtout dans leur contenu (termes employes, sujets valorises, presentation de soi) a la fois les nouvelles pratiques de rationalisation mises en place dans l’accompagnement social (par le projet individuel, par la contractualisation des mesures d’assistance) ainsi que d’autres pratiques laissant une large marge de manœuvre a la subjectivite des acteurs (l’importance donnee a la relation individuelle entre usager et intervenant).