[Production of knowledge using data collected by associations of patients: The fibromyalgia example]. / Production de savoirs à partir de données collectées par les associations de malades - L'exemple de la fibromyalgie.

To respond to the social challenge of medical knowledge democratisation, numerous initiatives have been developed: information, training or consultation of patients or research applications funded by associations of patients. Only a few numbers of collaborations are initiated by the persons directly involved (patients and relatives) or fulfill association research need. We have adopted and tested such an approach with the French fibromyalgia association (Fibromyalgie France). Our work demonstrates the interest to use data collected by associations of patients to answer to their questioning or to rise further relevant research questions. Such participative approach will have a pertinent and significant impact on the knowledge of diseases and on the development of collaborative actions of research, providing a better answer to patient needs, while being methodologically rigorous.

TITLE: Production de savoirs à partir de données collectées par les associations de malades - L'exemple de la fibromyalgie. ABSTRACT: Pour répondre au défi sociétal de démocratisation de l'accès à la connaissance, différentes initiatives de recherches participatives se développent : actions d'information, de formation ou de consultation des citoyens ou par l'intermédiaire de demandes de financement par des chercheurs auprès des associations. Cependant, peu des collaborations chercheurs-malades sont à l'initiative des personnes concernées, les patients et leurs familles. Nous avons adopté et testé cette démarche à la demande et en coopération avec l'association Fibromyalgie France.

Self-medication in pain management: The state of the art of pharmacists' role for optimal Over-The-Counter analgesic use.

BACKGROUND AND OBJECTIVE: Self-medication is associated with an important utilization of Over-The-Counter (OTC) analgesics. The medical outcome resulting from therapeutic options bypassing the physician prescription is a major issue. In that context, pharmacists are expected to play a crucial role. The main objective of this review was to analyse the state-of-the art of pharmacists' role in pain management self-medication. DATABASES AND DATA TREATMENT: An expert multidisciplinary group dedicated to self-medication in pain was established. Selection of publications was performed from PubMedand EMBASE databases which was based on the use of "pain" and/or "self-medication" and/or "self-care" and/or "analgesics" and/or "painkillers" keywords, restricted to the past 10 years. RESULTS: A total of 480 papers were identified, 49 of which papers were considered relevant and finally kept for final discussion, on OTC pain management and pharmacist's role. Literature analysis demonstrates that OTC analgesics are generally safe when appropriately used. Risks associated with misuse or inappropriateness depend on patients' vulnerability (elderly, pregnancy) or behaviour. Social cognitive theory-based intervention and multimedia applications improve self-medication but do not replace health care professional advice Pharmacists' interventions may improve the benefits and safety of OTC analgesic medication, with a better management of pain. CONCLUSIONS: Considering the heterogeneity of patients' knowledge and behaviour reported worldwide, inappropriate use of OTC pain medication should not be underestimated. Community pharmacists are ideally placed to guide self-medication or recommend a medical advice when needed. Embedding pharmacists in primary care pain management is essential and pharmacist-led medication coupled with an appropriate training of pharmacy staffs should be encouraged. SIGNIFICANCE: Analgesics are widely used without prescription, all over the world. They represent the largest market of OTC drugs, with an overall benefit/risk ratio favourable when appropriately used. Because of potential individual risks associated to the ailment or to the patient's behaviour, pharmacists' interventions have proven to optimize analgesic self-medication, provided that pharmacy staffs are both available and more specifically trained. In the future, in pain management, especially self-medication, pharmacists should play an increasing role and should be included in educational programmes and pain management guidelines.

Gnetum africanum: a wild food plant from the African forest with many nutritional and medicinal properties.

Gnetum africanum is a forest liana that grows abundantly in Central Africa, South America, and tropical and subtropical Asia. Its leaves are eaten as a vegetable, either raw or finely chopped and cooked; they are also widely used as an ingredient in soups and stews and are much in demand for their nutritional and therapeutic properties. In the latter application, various fractions of G. africanum are used medicinally to treat many different illnesses. Many studies have also shown that the chemical composition of the leaves of this plant gives it significant nutritional properties, and its high fiber, protein, and calorie content support these claims. Several molecular compounds related to the families of stilbenes, glycosylflavones, and flavonostilbenes have been isolated and identified in the leaf extract of this plant. These molecules give the plant its interesting properties and biological activities.