Suicide is a major public health issue that can occur at any age. It is the second leading cause of death in the 15-29 year old group worldwide. In France, the VigilanS healthcare system offers posthospital support for people who have attempted suicide in various regions, including Lorraine. This tool for monitoring and preventing recidivism mobilizes by phone calls multi-professional teams specially trained in this type of remote care.

OBJECTIVE: To make clinical practice guidelines for intrapartum care for healthy women and non-pharmacologic approaches for pain management.
METHODS: Review of the literature of articles published between January 2000 and September 2017 in English and French language from the Medline database, the Cochrane Library and recommendations from international institutes.
RESULTS: During the initial examination of a pregnant woman, it is recommended to take note of the pregnancy monitoring file and its possible birth plan; perform an anamnesis, inquire about her wishes and physiological and emotional needs; and perform a clinical examination (Consensus agreement). If the woman seems to be in labor, it is recommended to offer a vaginal examination (Consensus agreement). In case of premature rupture of membranes, it is recommended not to systematically perform a vaginal examination if the woman has no painful contractions (Consensus agreement). During the first stage of labor, the surveillance of the woman includes at least: a surveillance of the haemodynamic parameters every four hours; an evaluation of the frequency of uterine contractions every 30minutes and for 10minutes during the active phase; surveillance of spontaneous urination; the proposition of a vaginal examination every two to four hours or before if the patient asks for it, or in case of sign of call (Consensus agreement). During the second stage, it is recommended to use a partograph; to monitor hemodynamic parameters every hour; to evaluate the frequency of uterine contractions every 30minutes and for ten minutes; to monitor and note spontaneous urination; to offer a vaginal examination every hour (Consensus agreement). Whether on admission or during labor, it is recommended to evaluate the pain and offer the patient different ways to relieve it (Consensus agreement). It is recommended that all women have continuous, individual and personalized support, during labor and delivery (grade A); to implement the necessary human and material resources allowing women to change position regularly (Consensus agreement).
CONCLUSIONS: Routine practices must be abandoned to implement those that are scientifically justified. The management of pain is essential. Every woman should have continuous, individual and personalized support during labor and delivery.

OBJECTIVE: Our aim in this study was to evaluate the feasibility of a home-based diabetes prevention program, delivered by interdisciplinary certified diabetes educators (CDEs), and customized for postpartum women with recent gestational diabetes mellitus (GDM).
METHODS: This pilot randomized trial recruited women with GDM from 24 to 40 weeks gestation from 4 centres, and trained 10 CDEs in behaviour coaching, physical activity (PA) and low glycemic index education. Women were randomized after 3 months postpartum to standard care (1 visit) or 1 of 3 24-week coaching interventions (1 visit and 12 telephone calls): i) PA and diet, ii) PA only or iii) diet only. Feasibility outcomes included recruitment, retention, adherence and satisfaction.
RESULTS: Of 1,342 eligible patients, 392 were actively invited (29.3%) and 227 (16.9%) consented. Of these, 149 (65.6%) were randomized postpartum, of whom 131 (87.9%) started the program and 105 (70.5%) attended the final assessment. Intervention arm participants completed a median 75% (interquartile range, 50% to 92%) of telephone calls. Visit and call duration were a mean 71.4 (standard deviation, 13.8) and 18.1 (standard deviation, 6.5) minutes, respectively. Participants reported excellent/very good satisfaction 73% of the time, and 87% would recommend the program to others.
CONCLUSIONS: A home-based diabetes prevention program customized for postpartum women with GDM can be feasibly delivered by CDEs, and it is associated with >70% retention, adherence and satisfaction.

This article traces the way autonomy has become a recognised value in health care in France. In a country that based its social fundamentals on the very idea of solidarity for many years, autonomy has long been considered a foreign \'Anglo-American principle\'. Taking the example of the end-of-life debate, the article shows, however, how the use of the French term \'accompagnement\' allowed autonomy to be redefined and to be associated with the concept of solidarity. Exploring the arguments used over the past 25 years in professional guidelines, parliamentary reports, ethics committee reports, and legal texts, the authors describe the shift that took place in public and legal discourses on end-of-life care. The analysis demonstrates how the scope of autonomy has been limited by other social values, such as the protection of the dying person, in order to become an accepted social value in its own right. The example of the French end-of-life debate shows that depending on how the concept of autonomy is adapted and applied in a specific context, it can be compatible with the idea of solidarity. Such compatibility has been challenged previously in the international bioethics debate. By demonstrating the possibility of combining autonomy and solidarity, this article makes an important contribution to the international bioethics debate and to the dialogue between countries that are often perceived as significantly different.

This pilot project aims to test and see the relevance of the direct observation method to collect data on the barriers and facilitators to attending public places by seniors with TBI. The study is based on the conceptual framework VADA WHO which focuses on the development of friendly built and technological environments for seniors. Three elderly people participated in the study, recruited from an ongoing project, The Citizen Intervention in Community Living (APIC), in the presence of their personalized attendant. The study shows the feasibility of the method in terms of its acceptability and resources mobilized. It shows its relevance to access additional data that would have been difficult to obtain using others methods (e.g., semi-structured interview), such as the identification of the strategies used by the participants to address the obstacles encountered (avoidance, travel planning, use of physical and preventative support of the personalized attendant).

OBJECTIVE: Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels.
METHODS: The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies.
RESULTS: A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, -0.50 to -0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, -0.76 to -0.38), compared to shorter diabetes health coaching exposure (≤6 months) (-0.23%; 95% CI, -0.37 to -0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up.
CONCLUSIONS: Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care.