The importance of not being Ernest: An archaeology of child's play in Freud's writings (and some implications for psychoanalytic theory and practice).

In psychoanalysis, the question of child's play owes its fame to child psychoanalysts. Before the emergence of child psychoanalysis, however, Sigmund Freud had evoked the question of child's play in his works many times. Surprisingly, his views on play remain generally underestimated - with the notable exception of the famous "fort-da" game that, by irresistibly attracting innumerable comments to itself, has come to overshadow, in the author's view, the whole Freudian conception of play. This paper therefore aims at archeologically re-examining this notion in the Freudian corpus. It intends to show that, far from being limited to an object of study as "interpreted," play is also called upon for what it offers heuristically as "interpreting," especially when Freud is faced with metapsychological obstacles. Two main strands of this theoretical conception of play are identified (a "deficit" and a "surplus" conception). The paper then highlights how the Freudian conception of play is intimately linked to his melancholy theory of the psyche and of culture. Finally, the paper changes tack in order to briefly suggest that this reconsideration of play might have psychoanalytic implications on two issues, namely the status of child's play in analysis and the more general question of interpretation.

[Interventions for smoking cessation among low socioeconomic status smokers: a literature review]. / Interventions pour l'arrêt du tabac chez les fumeurs de faible niveau socio-économique : synthèse de la littérature.

INTRODUCTION: In most western countries, smoking appears to be highly differentiated according to socio-economic level. Two systematic reviews published in 2014 showed that most of the recommended interventions for smoking cessation, particularly individual interventions, tend to increase social inequalities in health. An analysis of the most recent literature was carried out in order to provide policy makers and stakeholders with a set of evidence on the modalities of interventions to encourage and help disadvantaged smokers quit smoking. METHODS: This review was based on articles published between January 2013 and April 2016. Only studies conducted in European countries or countries in stage 4 of the tobacco epidemic (USA, Canada, Australia, New Zealand) were included. Selected articles were double-screened. RESULTS: Twenty-three studies were identified, including evaluation of media campaigns, face-to-face behavioural support, phone- and web-based support or awareness of passive smoking among children. Some interventions adapted to precarious populations have been shown to be effective. CONCLUSIONS: Some characteristics would facilitate access and improve the support of disadvantaged groups, including a local intervention, a proactive approach and co-construction with targeted smokers.

"Psychoanalysis partagé": Winnicott, The Piggle, and the set-up of child analysis.

Forty years after its publication in 1977, The Piggle has recently provoked new interest among researchers. Most notably, the real "Gabrielle" has shared her story with D. Luepnitz and the analytical community. Joining in this vibrant discussion, this paper aims at shedding new light on the case by focusing on The Piggle as a "set-up," namely on the heterogenous ensemble of discursive and non-discursive elements which determined the analytical process. This reconsideration, although grounded in a Lacanian framework, supposes opening a dialogue between the French and English-speaking literature on the case. Three issues are at stake. First the paper intends to uncover the logic at work in the cure, studying it from the perspective of the analyst and the child, but also from that of the parents. Second, this triple focus is key to a reconsideration of the set-up of psychoanalysis with children more generally-in so far as it questions the function of infantile neurosis and what Winnicott calls "psychoanalysis partagé." Third, it will look at the powerful effects of co-writing and co-publishing with the parents-considered as part of the set-up itself rather than exterior to the process of the cure-on the analytical outcome.

Winnicott's theory of playing: a reconsideration.

"Playing is itself a therapy," argues Winnicott, in one of the most famous phrases in the history of psychoanalysis. Despite its seductiveness, this paper suggests that this powerful proposition should be reconsidered. Winnicott's extraordinary ability to transmit his theory in jargon-free language should not conceal the singularity of his conception of playing. Questioning the triad of play/playing/game may, therefore, be theoretically illuminating and clinically constructive. After examining (1) the stumbling blocks of Winnicott's concept of playing and the negative part implied by its dialectics, this paper will highlight (2) the markers Winnicott offers us to identify the reasons behind some failures he noted, and (3) their consequences on the reception of play activity in the cure. This will lead us to propose a discontinuity between the play activity phenomenologically speaking (what we call "play") and what Winnicott defines as the event of discovering the self through creative experience (what he calls "playing") in order to rethink the question of what is "therapeutic." Our conclusion that "some types of play without playing may also have a therapeutic function" will show the distance travelled in relation to Winnicott's initial proposition.

Systemic Measures and Legislative and Organizational Frameworks Aimed at Preventing or Mitigating Drug Shortages in 28 European and Western Asian Countries.

Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.

Freudian modalities of disbelief.

This article can be characterized as a 'rediscovery' of a notion of psychoanalysis that had disappeared or had been confused by later operations. The authors explore a Freudian notion that has been unjustly misunderstood, especially because of the multiple ways in which 'Unglaube' - disbelief - has been translated. We shall establish the archaeology of this term in Freud by extracting its three significant modes. Firstly, paranoiac disbelief designates an unconscious process of the rejection of belief in the subject's first encounter with a sexual reality that is always traumatic. Secondly, the obsessional neurotic's disbelief, which we shall call 'incredulity', is a secondary, less radical refusal of belief, one that is different from its paranoiac counterpart. Finally, we shall envision a third - dialectical - type of disbelief, which Freud called 'act of disbelief' and which will enable us to approach the fundamental epistemic and ethical stakes for psychoanalysis.