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Introduction: The aim of the OCTAVE project, carried out in healthcare territories in Bretagne and Pays-de-Loire, is to improve the safety of the medication use for elderly people during and after hospitalization. In particular, this involves the completion of a shared medication review by the patient's referring community pharmacist after discharge from hospital, which is then sent to the patient's general practitioner. Communication between these two healthcare professionals is therefore essential to the smooth operation of the project, but is difficult to assess in practice.

Aim of the study: To assess the impact of the OCTAVE project on interprofessional relations between general practitioners and community pharmacists at the end of their patient's path through OCTAVE.

Method: In this qualitative study, 15 semi-structured interviews were conducted between June 2023 and January 2024 with pharmacists and general practitioners in Ille-et-Vilaine, one of whose patients had been included in OCTAVE.

Results: Despite identified needs and a shared desire to limit drug-related side effects among their elderly patients, the OCTAVE project has not led professionals to communicate more with each other. However, community pharmacists took advantage of the project to assert and promote their new missions, which include shared medication reviews. But the lack of information and investment from GPs, as well as the perception of each profession of their own roles, was a clear barrier to stronger cooperation.

Conclusion: OCTAVE has had no direct impact on relations between community pharmacists and general practitioners. Areas for improvement were identified.

Introduction: Advance directives (ADs) allow any person of legal age to express their wishes regarding the conditions for administering, limiting, or withdrawing treatment if they become unable to express themselves. They were introduced in France in 2005 to give patients greater autonomy over their medical care, particularly at the end of life. However, patients make little use of ADs. The aim of this study was to evaluate the benefits of ADs for oncologists and their suggestions for improving the practical impact of the system.

Method: Between January and April 2022, an anonymous survey was conducted via LimeSurvey with physicians from three UNICANCER centers and surgeons attending the 2022 French Society of Surgical Oncology (SFCO) congress. Comprising 27 questions, the survey aimed to analyze the use, perception, and expectations of physicians regarding ADs. The data were subjected to descriptive quantitative analysis and lexical analysis using IRaMuTeQ (Reinert method). A thematic sociological study was also carried out to identify trends based on medical specialties.

Results: The results show that twenty years after the Leonetti Law, a large majority of oncologists are aware of the existence of ADs, find them useful, and would like to have access to them when making a serious decision for an unconscious patient. However, they also highlight the many barriers to their implementation. They explained that ADs rarely clarify the patient's wishes and were often unsuitable for the situations encountered.

Discussion: These findings highlight the fact that ADs cannot replace ongoing discussions about end of life throughout the care pathway to support patients in their reflections. It is therefore important to encourage reflective work around these discussions rather than focusing solely on the production of a final document.

Introduction: Female genital mutilation (FGM) encompasses the total or partial removal of a woman's external genitalia, carried out for no medical reason. Mainly carried out in sub-Saharan Africa, FGM is also practiced in Europe as a result of migration. Although French healthcare professionals say they are concerned, they claim to have insufficient knowledge and practical tools to deal with the subject in their consultations.

Purpose of the study: Faced with this situation, training was offered to healthcare professionals between 2019 and 2023. A total of 150 professionals were trained over this period. A qualitative method was used to evaluate the social impact of the training, with the aim of identifying the effects on and concrete changes to the practices of trained professionals, compared with those of untrained ones. The evaluation methodology was based on 4 periods of observation of training sessions, 15 qualitative semi-structured individual interviews (8 with trained professionals and 7 with untrained professionals), and 5 observation sessions of consultations between trained and untrained professionals and their patients.

Results: The evaluation highlights four main sets of results: on the one hand, the training contributes to reinforcing professionals' theoretical and practical knowledge of FGM, and on the other, to changing the approach they adopt during consultations.

Conclusion: Multidisciplinary support for women who have undergone mutilation is also facilitated. Nevertheless, certain prevention-related aspects of the training, such as learning how to report cases to the public prosecutor, do not seem to have been immediately integrated into their practices.

Introduction: This work examines the effect that clothing adapted to treatment can have during chemotherapy sessions on the emotional representation of the individual, on perceived well-being, and potentially on the evolution of symptoms.

Methods: This case study was carried out on forty-two cancer patients. The questionnaire was administered retrospectively to patients who initially underwent chemotherapy sessions without wearing suitable clothing, then who wore suitable clothing during subsequent chemotherapy treatments.

Results: Significantly, the data suggest that wearing appropriate clothing during chemotherapy leads patients to perceive a reduction in aggravation and the appearance of new symptoms. Greater well-being and positive self image, as well as a more positive image of the illness and treatment, are also significantly associated with the use of adapted clothing during chemotherapy.

Discussion: These data lead us to propose that adapted clothing contributes to the improvement of the positive emotional representation observed. However, we cannot define the extent of their participation in this study.

Introduction: Respecting trans people's right to the highest attainable standard of health, and producing public policy in a context of crisis, are key contemporary global issues. This article examines the production of public policy through a specific analysis of the framing of transition pathways by the Haute Autorité de Santé (French National Authority for Health).

Purpose of the study: Drawing on the research frameworks of critical discourse studies and survivor research, the study applies lexicometric methods to the analysis of normative reference frameworks. Specifically, it focuses on the naming and argumentative strategies of both mitigation and intensification.

Results: Hierarchical top-down clustering using the ALCESTE method revealed a structure made up of three lexically distinct pairs. A similarity analysis revealed 31.6% of trigrams shared with the report by the Inspection Générale des Affaires Sociales (French General Inspectorate for Social Affairs). The differences and similarities observed appear to be neither random nor based on scientific evidence, and emphasize the psychopathologization of trans people to the detriment of their health needs.

Conclusions: Our findings ask questions about health care system governance and, specifically, the production of public policy and norms. The document's structure suggests it is a product of political arbitration, freed from scientific constraints and designed to impose a psychopathological vision justifying control by the health care system. Critical analysis appears to be an effective approach for analyzing how public institutions operate in the context of crisis.