Institut catholique de paris

Emotional Competence (EC), which refers to individual differences in the identification, understanding, expression, regulation and use of one's own emotions and those of others, has been found to be an important predictor of individuals' adaptation to their environment. Higher EC is associated with greater happiness, better mental and physical health, more satisfying social and marital relationships and greater occupational success. While it is well-known that EC (as a whole) predicts a number of important outcomes, it is unclear so far which specific competency(ies) participate(s) in a given outcome. This is because no measure of EC distinctly measures each of the five core emotional competences, separately for one's own and others' emotions. This lack of information is problematic both theoretically (we do not understand the processes at stake) and practically (we cannot develop customized interventions). This paper aims to address this issue. We developed and validated in four steps a complete (albeit short: 50 items) self-reported measure of EC: the Profile of Emotional Competence. Analyses performed on a representative sample of 5676 subjects revealed promising psychometric properties. The internal consistency of scales and subscales alike was satisfying, factorial structure was as expected, and concurrent/discriminant validity was good.

Depuis Platon, bien avant lui sans doute, la notion de rcit a suscit nombre de dbats thoriques et de polmiques. Que de contro-verses engendre encore sa seule dfinition... Comme le rcit fait vibrer certaines cordes essentielles de l'identit humaine, il n'y a aucune raison pour que le phnomne s'interrompe un jour.

OBJECTIVES: To review the conceptual bases of Person-centred Integrative Diagnosis (PID) as a component and contributor to person-centred psychiatry and medicine and to outline its design and development. METHOD: An analysis was conducted of the historical roots of person-centred psychiatry and medicine, tracing them back to ancient Eastern and Western civilizations, to the vicissitudes of modern medicine, to recent clinical and conceptual developments, and to emerging efforts to reprioritize medicine from disease to patient to person in collaboration with the World Medical Association, the World Health Organization, the World Organization of Family Doctors, the World Federation for Mental Health, and numerous other global health entities, and with the coordinating support of the International Network for Person-centered Medicine. RESULTS: One of the prominent endeavours within the broad paradigmatic health development outlined above is the design of PID. This diagnostic model articulates science and humanism to obtain a diagnosis of the person (of the totality of the person's health, both ill and positive aspects), by the person (with clinicians extending themselves as full human beings), for the person (assisting the fulfillment of the person's health aspirations and life project), and with the person (in respectful and empowering relationship with the person who consults). This broader and deeper notion of diagnosis goes beyond the more restricted concepts of nosological and differential diagnoses. The proposed PID model is defined by 3 keys: broad informational domains, covering both ill health and positive health along 3 levels: health status, experience of health, and contributors to health; pluralistic descriptive procedures (categories, dimensions and narratives); and evaluative partnerships among clinicians, patients, and families. An unfolding research program is focused on the construction of a practical guide and its evaluation, followed by efforts to facilitate clinical implementation and training. CONCLUSIONS: PID is aimed at appraising overall health through pluralistic descriptions and evaluative partnerships, and leading through a research program to more effective, integrative, and person-centred health care.

The efficient propagation of action potentials along nervous fibers is necessary for animals to interact with the environment with timeliness and precision. Myelination of axons is an essential step to ensure fast action potential propagation by saltatory conduction, a process that requires highly concentrated voltage-gated sodium channels at the nodes of Ranvier. Recent studies suggest that the clustering of sodium channels can influence axonal impulse conduction in both myelinated and unmyelinated fibers, which could have major implications in disease, particularly demyelinating pathology. This comprehensive review summarizes the mechanisms governing the clustering of sodium channels at the peripheral and central nervous system nodes and the specific roles of their clustering in influencing action potential conduction. We further highlight the classical biophysical parameters implicated in conduction timing, followed by a detailed discussion on how sodium channel clustering along unmyelinated axons can impact axonal impulse conduction in both physiological and pathological contexts.

Abstract First published in 1917, this book has long been hailed as a classic and authoritative text. This edition builds on the revision in the sixth edition, and, in recognition of the speed of changes in the field over the last ten years, examines the developments and challenges of modern diplomacy through new chapters on human rights and public/digital diplomacy. Further additions to the seventh edition include the following: the chapters on the history of diplomacy have been expanded to cover modern developments such as the greatly expanded role of multilateral diplomacy; the chapters on international law have been brought up to date, including an examination of latest case studies; the book addresses the greatly expanded number of international organizations, including material on the British EU referendum outcome; and the importance of human rights in international relations as well as public diplomacy receive increased attention, each with its own chapter. The book also includes newly revised chapters on diplomatic communications, privileges, precedence and immunities, diplomatic missions and consular matters, treaties and conferences, and the workings of international tribunals. Furthermore, the volume examines alternative forms of diplomacy, from the work of NGOs to the use of secret envoys, as well as a study of the interaction with intelligence agencies and commercial security firms. Finally, the book highlights the impact of international terrorism and other violent non-state actors on the life and work of a diplomat.

The early roots of the concept of person-centred medicine can be found in the comprehensive notion of health and the personalized approaches to medical care discernible in both Eastern and Western ancient civilizations [1,2]. Other significant precedents include contemporary developments in clinical medicine and public health challenging an overemphasis on specific organs and disease and seeking to place the whole person at the centre of medicine [3]. The recent coordinated global effort towards person-centred medicine started with an inaugural Geneva Conference on Person-centred Medicine in May 2008. It involved the collaboration of major international medical and health organizations and a group of committed clinicians and scholars [4]. The Second Geneva Conference took place on 28 and 29 May 2009 under the auspices of the University of Geneva Medical School and the University Hospitals of Geneva organized by the World Medical Association (WMA), the World Organization of Family Doctors (Wonca) and the International Network for Person-centered Medicine (INPCM), in collaboration with the Council for International Organizations of Medical Sciences (CIOMS), the World Federation for Mental Health (WFMH), the World Federation of Neurology (WFN), the World Association for Sexual Health (WAS), the International Association of Medical Colleges (IAOMC), the World Federation for Medical Education (WFME), the International Federation of Social Workers (IFSW), the International Council of Nurses (ICN), the European Federation of Associations of Families of People with Mental Illness (EUFAMI), the International Alliance of Patients' Organizations (IAPO) and the Paul Tournier Association. The Conference had as principal purposes to examine and discuss key concepts of person-centred medicine and practical approaches for its implementation, to elicit useful initiatives on person-centred medicine and to engage international medical and health organizations on the Conference's theme. The Conference Organizing Committee was composed of J.E. Mezzich (World Psychiatric Association President 2005–2008), J. Snaedal (World Medical Association President 2007–2008), C. van Weel (World Organization of Family Doctors President 2007–2010) and I. Heath (World Organization of Family Doctors Executive Committee Member at Large). The Conference Secretariat was based at the International Center for Mental Health, Mount Sinai School of Medicine, New York University. Financial and in-kind support for the Conference was provided by the University of Geneva, the Paul Tournier Association of Geneva, Person-centered Medicine & Psychiatry Programs, Conference registration fees and the emerging International Network for Person-centered Medicine [5]. The Conference was opened by the Rector of the University of Geneva and the Vice-Dean of its Medical School, as well as by the members of the Conference Organizing Committee. All remarked on the tradition that was being established engaging Geneva as encounter point for the development of person-centred medicine. The first scientific session involved presentations of leaders and representatives of the International Alliance of Patients' Organizations, the International Network for Person-centered Medicine, the World Health Organization, the World Medical Association, the World Organization of Family Doctors, the Council of International Organizations of Medical Sciences and the International Council of Nurses. The presentation of policy statements and relevant institutional programmes reflected the value ascribed by these organizations to person-centred medicine. The abstracts of the presentations made at this and the following sessions of the Second Geneva Conference have been posted at the INPCM website, http://www.personcenteredmedicine.org. Eight special initiatives relevant to person-centred care were presented in the second session. The presentations were made by representatives of several major organizations collaborating in the Second Geneva Conference and other prominent work groups. The diverse experiences presented from a range of fields revealed substantive achievements and promising opportunities for a medicine of the person. Concepts and meanings of person-centred medicine were the subject of the third session. They focused on the role and worth of the person in medicine, the cruciality of sense of identity, empathy and engagement for optimal clinical care, and the value and impact of life experiences for the development in each individual of personalized medicine and health. The fourth session presented and discussed procedures for person-centred diagnosis. Particularly covered were the significance of multilevel explanations and diagnosis in medicine, the key features of a person-centred integrative diagnosis addressed to appraise whole health using standardized and narrative descriptions reflecting interactions among clinicians, patient and family, as well as the prospects for person-centred diagnosis in general medicine. A panel on programmatic contributions for person-centred medicine in a fifth session offered an opportunity for the presentation of brief statements by representatives of 12 collaborating organizations and groups from across the world. They attested to the relevance of person-centred approaches to medicine for an ample range of medical, health and social institutions. The sixth session, at the beginning of the second day of the Conference, discussed procedures for person-centred treatment and health promotion. These included general features of person-centred integrative care, the prospects for a person-centred medical home in the USA, and WHO perspectives on person-centred healthiness, social determinants and health promotion. Person-centred medicine for children and older people was discussed in the Conference seventh session. Such vulnerable populations represent particular challenges and opportunities from scientific and ethical viewpoints. The uniqueness and developmental sensitivity of the child were highlighted. Also pointed out were the complexity of health conditions in older people and the imperative need to attend to their values and perspectives. Training and research on person-centred medicine was the subject of the eighth session. Specific topics included the development of pertinent guidelines and curricula for person-centred clinical care, the assessment of an epistemologically based person-centred medicine at Ambrosiana University in Milan, training and research on communication for person-centred outcomes, and broad programmatic features and objectives of research on person-centred clinical care. The ninth conference session reviewed person-centred health systems and policies. WHO's new focus on persons for the development of more promising global health policies and systems, as affirmed by the latest World Health Assembly, was given pointed attention. Also discussed was the role of health informatics for the construction of personalized medicine and complex health care systems. Last but not least was a review of the role and documented value of the person for the conduction of health care, training and research The final tenth session presented a conference summary and outlined next steps. Among the general conclusions were (1) a commitment to the importance of person-centred medicine for the health of people, noting the participation of a vast array of important medical and health organizations, a wish to share and collaborate and an understanding of the importance of grasping opportunities in the field; (2) the growing availability of resources, including general concepts and procedures as well as teaching materials and research tools; and (3) the importance of fitting the above resources into health care systems and into particular health care encounters, with especial attention to person-centredness as an intrinsic quality rather than as an additional commodity, and the value of comprehensiveness, continuity, and attention to context as crucial features of good clinical care. Anticipated next steps included the following: (1) completion of a joint editorial to be published in an international journal; (2) preparation of a Second Geneva Conference Summary Report, (3) publication of a set of selected papers presented at the Second Geneva Conference; (4) collaboration with WHO on Person-centred Medicine topics related to the 2009 World Health Assembly Resolutions; (5) organization of scientific events relevant to person-centred medicine, such as a prospective New York Conference on Well-Being and Person in Medicine and Health; (6) planning a clearinghouse of Person-centred Medicine documents; (7) upgrading an internet platform to support archival, informational, communicational and programmatic needs; (8) organization of a Third Geneva Conference on Person-centred Medicine in early May 2010, prospectively focused on a team approach across specialties and disciplines; and (9) development of an International Network for Person-centered Medicine to stimulate the above activities and to organize initiatives on conceptual and ethical bases, diagnosis, clinical care, training, research, health systems and public policies. Proposals for future conferences included building bridges to the various specialties in medicine, the participation of different patient groups and the inclusion of representatives of additional health disciplines. Emphasis was made on consolidating the ideas from the first two conferences, and to use that for further work to enhance person-centred medicine. The Second Geneva Conference was distinctly perceived by its participants as a stimulating success in terms of food for thought and shared commitment to build a paradigmatic shift in medicine and health care. A Third Geneva Conference was widely anticipated as the next landmark in this unfolding process with the emerging International Network for Person-centered Medicine as the collaborative and flexible structure to coordinate and move forward a vision and programmatic efforts. In order to extend the impact of the Second Geneva Conference, a plan was arranged with the Journal of Evaluation in Clinical Practice to publish a selection of the papers presented at the Conference. The authors of this Introduction, members of the Board of the International Network for Person-centered Medicine, assumed editorial responsibility to work with the authors of the selected papers in upgrading them for publication. The papers are presented thematically ordered in terms of institutional and policy perspectives, clinical concepts and clinical practice. We hope they offer a valuable contribution to the process of building person-centred medicine.

BACKGROUND: Parents, caregivers and mental health professionals have often reported violence and aggression in children or adolescents with autistic disorder. However, most of these observations derived from anecdotal reports, and studies on frequency and characterization of aggression in autism remain limited. Our objective was to better characterize and understand the different types of aggressive behaviors displayed by a large group of individuals with autism in different observational situations. METHODOLOGY/FINDINGS: The study was conducted on 74 children and adolescents with autism and 115 typically developing control individuals matched for sex, age and pubertal stage. Other-Injurious Behaviors (OIB) were assessed in three observational situations (parents at home, two caregivers at day-care, a nurse and a child psychiatrist during blood drawing) using validated scales. The frequency of OIB was significantly higher in individuals with autism compared to typically developing control individuals during the blood drawing (23% vs. 0%, P<0 .01). The parents observed significantly less OIB in their children than caregivers (34% vs. 58%, P<0.05). In addition, the most frequent concurrent behaviors occurring just before the appearance of OIB in individuals with autism were anxiety-related behaviors and excitation according to the parental as well as the caregiver observation. CONCLUSIONS/SIGNIFICANCE: The results suggest that in a stressful situation, such as the blood drawing, individuals with autism release their stress through behaviors such as OIB, whereas typically developing individuals regulate and express their stress through cognitive skills such as mental coping strategies, symbolization skills with representation and anticipation of the stressful situation, social interaction and verbal or non-verbal communication. The findings underline also the key role of the environment in assessing OIB and developing therapeutic perspectives, with an individual who modulates his/her behavior according to the environment, and an environment that perceives this behavior and reacts to it with different tolerance thresholds according to the observers.

While the formulation of Mihaly Csikszentmihalyi's theory of flow, including the experience dimensions, has remained stable since its introduction in 1975, its dedicated measurement tools, research methodologies, and fields of application, have evolved considerably. Among these, education stands out as one of the most active. In recent years, researchers have examined flow in the context of other theoretical constructs such as motivation. The resulting work in the field of education has led to the development of a new model for understanding flow experience in education, specifically dedicated to adult learning. As a result of both a meticulous analysis of existing models and consideration of more recent developments, a new flow scale has thus been developed. The aim of this study is therefore twofold: to validate the new flow measurement scale dedicated to the educational environment, EduFlow-2, and to test a new theoretical model. Students taking a course ( N = 6,596), some on-site and others in a MOOC, participated. Several scales were administered online at the end of the participants' course during the 2017 academic year. The factor structure of EduFlow-2 was tested using Exploratory Structural Equation Modeling. Several models were tested. The model with a second-order factor best fit the data. We tested the invariance of the flow scale measure for gender and for the type of training (MOOC/on-site). We were able to show that the flow scale is invariant of the modalities of these two variables. Results revealed good psychometric qualities for the scale, making it suitable for both on-site and distance learning. The analysis also revealed significant relationships with the classic variables of motivation, self-efficacy, learning climate, and life satisfaction. Furthermore, all four dimensions of the model were found to be adequate and consistent with the underlying theoretical arguments. In the end, this new, short flow scale and the theoretical model were demonstrated to be promising for future studies in the field of education.

Le corpus des épîtres pauliniennes a été maintes fois commenté par les exégètes grecs et latins du iiie au xe siècle. Il est vrai que la matière des quatorze lettres, authentique ou non, a exercé une influence considérable sur la pensée chrétienne dans ses dimensions théologique, ecclésiologique et disciplinaire. L’article consiste en une présentation synthétique de cette production strictement exégétique et de la bibliographie essentielle qui lui est associée. Il désigne également les principales sources permettant de connaître l’Apôtre et d’expliquer sa correspondance durant le haut Moyen Âge.

BACKGROUND: We investigated the impact of the COVID-19 crisis on mental health of professionals working in the intensive care unit (ICU) according to the intensity of the epidemic in France. METHODS: This cross-sectional survey was conducted in 77 French hospitals from April 22 to May 13 2020. All ICU frontline healthcare workers were eligible. The primary endpoint was the mental health, assessed using the 12-item General Health Questionnaire. Sources of stress during the crisis were assessed using the Perceived Stressors in Intensive Care Units (PS-ICU) scale. Epidemic intensity was defined as high or low for each region based on publicly available data from Santé Publique France. Effects were assessed using linear mixed models, moderation and mediation analyses. RESULTS: In total, 2643 health professionals participated; 64.36% in high-intensity zones. Professionals in areas with greater epidemic intensity were at higher risk of mental health issues (p < 0.001), and higher levels of overall perceived stress (p < 0.001), compared to low-intensity zones. Factors associated with higher overall perceived stress were female sex (B = 0.13; 95% confidence interval [CI] = 0.08-0.17), having a relative at risk of COVID-19 (B = 0.14; 95%-CI = 0.09-0.18) and working in high-intensity zones (B = 0.11; 95%-CI = 0.02-0.20). Perceived stress mediated the impact of the crisis context on mental health (B = 0.23, 95%-CI = 0.05, 0.41) and the impact of stress on mental health was moderated by positive thinking, b = - 0.32, 95% CI = - 0.54, - 0.11. CONCLUSION: COVID-19 negatively impacted the mental health of ICU professionals. Professionals working in zones where the epidemic was of high intensity were significantly more affected, with higher levels of perceived stress. This study is supported by a grant from the French Ministry of Health (PHRC-COVID 2020).

"This study examines the international protection granted to displaced civilians during the Iraqi, Bosnian, Somali and Rwandan conflicts. Using thematic and comparative approaches, Cecile Dubernet provides the reader with a systematic analysis of the ways in which relief and protection were promised and delivered to people on the move." "Clear and intellectually stimulating, this volume is not only an important tool for students of international relations, security and development studies seeking to understand today's responses to humanitarian crises, but it also raises numerous questions for researchers, academics and policy makers interested in post-cold war issues."--BOOK JACKET.

Résumé Voilà quinze ans que les premiers sites web de journaux ont vu le jour, questionnant peu à peu les études de sciences sociales sur le journalisme. Cet article propose une revue de littérature internationale de ces travaux, en faisant apparaître à la fois les continuités historiques des activités journalistiques et les ruptures à l’œuvre. Six questionnements se dégagent de l’ensemble des recherches : l’innovation technique dans la presse ; la production de l’information en ligne ; la contribution des internautes au travail de l’information ; la recomposition des identités professionnelles ; les modèles économiques de la presse en ligne ; les usages de l’information sur internet.

À l’inverse de celui des châteaux, des cathédrales et des villes, le monde rural du Moyen Âge ne suscite guère d’image en nous. Bien que regroupant plus de 80 % de la population et affairé à produire nourriture, cuir, laine ou bois si nécessaires à tous, il reste encore très mal connu. Et pour cause : les textes sont presque muets sur ces humbles, et les données concrètes sur leur cadre de vie font largement défaut, en particulier pour ces âges que l’on dit encore volontiers obscurs, entre les Grandes Invasions et l’an mil ! Lacune qui tend aujourd’hui à se combler : les opérations archéologiques préventives suscitées ces vingt dernières années dans la plaine du Lyonnais, la Bresse lyonnaise ou le Dauphiné septentrional par les grands travaux (TGV, autoroutes, zones d’aménagement concerté, etc.) ont livré quantité d’informations, aussi bien sur l’habitat, l’alimentation, l’outillage ou les pratiques agricoles de ces paysans que sur l’évolution de leur mode de vie ou les transformations de leur environnement. Voici désormais accessible cette documentation considérable restée jusque-là en grande partie inédite. Sous la direction d’Élise Faure-Boucharlat, à qui l’on doit déjà Pots et potiers en Rhône- Alpes, l’équipe de publication rassemble une vingtaine de personnes qui ont contribué à restituer les divers aspects de la vie matérielle des populations paysannes. Afin d’ouvrir des perspectives d’interprétation historique, l’ouvrage repose sur une double démarche : présenter ces données archéologiques de façon relativement détaillée et les replacer dans une perspective élargie, sous forme de synthèse thématique. Sur les questions encore en débat, il a paru intéressant d’exposer la diversité des points de vue. Ainsi sont abordés aussi bien l’héritage antique - rupture ou continuité ? - le cadre et l’évolution du peuplement, que la révision des critères traditionnels de datation du haut Moyen Âge ou la part respective du bois et de la pierre dans la construction rurale.

texte critique et trad. J. ChÂtillon et M. Duchet-Suchaux, introduction, notes et index J. Longère,(Sources chrétiennes, 419)

Background: Intensive care units (ICU) are among the healthcare services most affected by the COVID-19 crisis. Stressors related to insecurity, unpredictability, patient death and family distress are significant, and put healthcare workers (HCWs) at high risk of post-traumatic stress disorder (PTSD). The aims of this study were to measure the prevalence of post-traumatic stress disorder in HCWs and to identify risk factors and protective factors during the epidemic in France. Methods: During the first peak of the epidemic (from 22 April to 13 May 2020), we assessed sources of stress (PS-ICU scale), mental health (GHQ-12) and coping strategies (Brief-COPE). Three months later (03 June to 6 July 2020), PTSD was assessed using the IES-R scale, with additional questions about sources of support. Data were collected using self-report questionnaires administered online. Results: Among 2153 professionals who participated in the study, 20.6% suffered from potential PTSD, mostly intrusion symptoms. Risk factors for the development of PTSD were having experienced additional difficult events during the crisis, having a high level of psychological distress, a high level of perceived stress related to the workload and human resources issues, the emotional burden related to the patient and family, and stressors specific to COVID-19 during the first peak of the crisis. The use of positive thinking coping strategies decreased the relationship between perceived stress and the presence of PTSD, while social support seeking strategies increased the relationship. Finally, the HCWs preferred to use support from colleagues, relatives and/or a psychologist, and very few used the telephone hotlines. Conclusion: The epidemic has had a strong traumatic impact on intensive care HCWs. Given the risk of PTSD, we need to consider implementing easily-accessible support services that focus on positive thinking coping strategies, during and after the crisis.

BACKGROUND: The ICU (intensive care unit) involves potentially traumatic work for the professionals who work there. This narrative review seeks to identify the prevalence of post-traumatic stress disorder (PTSD) among ICU professionals; how PTSD has been assessed; the risk factors associated with PTSD; and the psychological support proposed. METHODS: Three databases and editorial portals were used to identify full-text articles published in English between 2009 and 2022 using the PRISMA method. RESULTS: Among the 914 articles obtained, 19 studies met our inclusion criteria. These were undertaken primarily during the Covid-19 period (n = 12) and focused on nurses and assistant nurses (n = 10); nurses and physicians (n = 8); or physicians only (n = 1). The presence of mild to severe PTSD among professionals ranged from 3.3 to 24% before the pandemic, to 16-73.3% after the pandemic. PTSD in ICU professionals seems specific with particularly intense intrusion symptoms. ICU professionals are confronted risk factors for PTSD: confrontation with death, unpredictability and uncertainty of care, and insecurity related to the crisis COVID-19. The studies show that improved communication, feeling protected and supported within the service, and having sufficient human and material resources seem to protect healthcare professionals from PTSD. However, they also reveal that ICU professionals find it difficult to ask for help. CONCLUSION: ICU professionals are particularly at risk of developing PTSD, especially since the Covid-19 health crisis. There seems to be an urgent need to develop prevention and support policies for professionals.

Troubles in social communication as well as deficits in the cognitive treatment of emotions are supposed to be a fundamental part of autism. We present a case study based on multimodal interaction between a mobile robot and a child with autism in spontaneous, free game play. This case study tells us that the robot mediates the interaction between the autistic child and therapist once the robot-child interaction has been established. In addition, the child uses the robot as a mediator to express positive emotion playing with the therapist. It is thought that the three-pronged interaction i.e., child-robot-therapist could better facilitate the transfer of social and emotional abilities to real life settings. Robot therapy has a high potential to improve the condition of brain activity in autistic children.

Introduction: The Impostor Phenomenon (IP) refers to a psychological experience characterized by unjustified feelings of intellectual and professional fraud, accompanied by the fear of not maintaining performance and of being exposed. IP is receiving increasing attention in the fields of psychological health at work and occupational psychology as well as among the general public, since it affects the functioning of both individuals and organizations. The aim of this scoping review is to map the range of interventions that have been conducted to address IP among individuals experiencing it in a professional context. Methods: The search and selection process to identify relevant reports was conducted using the PRISMA-ScR methodology and JBI recommendations and resulted in the selection of 31 studies. Results: The results reported concerning the characteristics of the studies, the interventions described, and the effects identified are heterogeneous. More than half of the studies used research designs (experimental, pre-experimental, exploratory, etc.). Two major types of intervention emerge: training and counseling. The effectiveness of the interventions varies according to the evaluation methodology that was used, although most authors conclude that the proposed intervention is relevant. Discussion: In light of these results, recognizing and educating individuals regarding the various manifestations of IP, as well as offering support in a group context, appear to be primary intervention levers. Future intervention proposals should explore psychosocial and educational influences as well as the impact of the immediate environment on IP-related beliefs.

People with metastatic breast cancer face many challenges and disparities in obtaining optimal cancer care. These challenges are accentuated in underserved patient populations across Europe, who are less likely to receive quality healthcare for reasons including socioeconomic inequalities, educational or cultural status, or geographic location. While there are many local and national initiatives targeted to address these challenges, there remains a need to reduce disparities and improve access to healthcare to improve outcomes, with a focus on multidisciplinary stakeholder engagement. In October 2019, a range of experts in metastatic breast cancer, including healthcare professionals, patient representatives, policymakers and politicians, met to discuss and prioritize the critical needs of underserved patient populations with metastatic breast cancer in Europe. Six key challenges faced by these communities were identified: the need for amplification of the metastatic breast cancer patient voice, better and wider implementation of high-quality guidelines for metastatic breast cancer, more collaboration between stakeholders, tailored support for patients from different cultural and ethnic backgrounds, improved data sharing, and work-related issues. The Expert Panel then conceived and discussed potential actionable goals to address each key challenge. Their conclusions present a set of interrelated approaches to address the different challenges and could serve as the basis for concerted improvement of the lives of patients with metastatic breast cancer in Europe.

Abstract Fonio ( Digitaria exilis (Kippist) Stapf) and Bambara groundnut ( Vigna subterranea ( L. ) Verdc. ) are native crops grown at a small scale in Mali that have potential to support agricultural productivity under climate change. A community biodiversity management approach was explored in this study as a means to reinforce the cultivation of these crops by increasing farmers' access to intraspecific diversity and developing capacities of community institutions for their management. The research involved six communities in Ségou and Sikasso regions. Multiple varieties of fonio (10–12) and Bambara groundnut (8–12) were established in diversity fields in each site over 2 years where farmers engaged in experiential learning over the crop cycle. Significant adoption of fonio and Bambara groundnut was detected in several study sites. The precise drivers of adoption cannot be definitively determined but likely include increased seed access and awareness gained through the diversity field fora, seed fairs and community seed banks. No significant yield advantage was detected for any of the varieties in the diversity fields, which showed variable performance by site and year. The number of varieties registered and managed by community seed banks in each site increased from 1–5 varieties of each crop to 11–12 varieties following the interventions. The number of Bambara groundnut varieties cultivated in farmers' fields also increased, while there was evidence of a slight decline in fonio diversity in some communities. The results of this study can inform efforts to strengthen seed systems and cultivation of neglected and underutilized species in Africa.