Tentative de suicide des adolescents: accueil, evaluation, orientation [Suicide attempt: encounter, evaluation, orientation].

Le suicide et les tentatives de suicide des adolescents sont des enjeux de santé publique majeurs. En s'appuyant sur le modèle de soins développé à Genève, nous décrivons les différents temps nécessaires pour accueillir, évaluer et orienter un adolescent pris dans un mouvement suicidaire. Un temps d'accueil et d'évaluation pédiatrique, puis un temps d'évaluation psychiatrique et enfin un temps d'orientation à l'issue duquel est proposée une prise en charge spécifique. En fonction des caractéristiques cliniques du jeune (impulsivité, symptomatologie anxio-dépressive...), de sa capacité d'engagement dans les soins et de la qualité des liens du réseau, la prise en charge sera soit ambulatoire intensive, soit hospitalière. Suicide and suicide attempts of adolescents are major public health issues. Based on a model of care developed in Geneva, we describe the conditions necessary to evaluate and guide a teenager trapped in a suicidal behavior. First of all, there must be some time dedicated to pediatric assessement followed by a psychiatric evaluation and finally, the adolescent can be oriented toward specific treatment. Depending on the clinical characteristics of the young adolescent and according to his willingness to engage himself in intensive follow-up (impulsivity, anxious?--depressive symptomatology...), cares will be given either as outpatient with close monitoring or inpatient.

Introduction: L'orientation scolaire et professionnelle en Suisse

L'introduction au numéro thématique de L'OSP sur la Suisse décrit quelques particularités institutionnelles, politiques et socioéconomiques de ce pays, afin de situer les différentes contributions. Elle expose également les logiques retenues pour le choix des contributions.

Assembly of the Escherichia coli RuvABC resolvasome directs the orientation of holliday junction resolution.

Genetic recombination can lead to the formation of intermediates in which DNA molecules are linked by Holliday junctions. Movement of a junction along DNA, by a process known as branch migration, leads to heteroduplex formation, whereas resolution of a junction completes the recombination process. Holliday junctions can be resolved in either of two ways, yielding products in which there has, or has not, been an exchange of flanking markers. The ratio of these products is thought to be determined by the frequency with which the two isomeric forms (conformers) of the Holliday junction are cleaved. Recent studies with enzymes that process Holliday junctions in Escherichia coli, the RuvABC proteins, however, indicate that protein binding causes the junction to adopt an open square-planar configuration. Within such a structure, DNA isomerization can have little role in determining the orientation of resolution. To determine the role that junction-specific protein assembly has in determining resolution bias, a defined in vitro system was developed in which we were able to direct the assembly of the RuvABC resolvasome. We found that the bias toward resolution in one orientation or the other was determined simply by the way in which the Ruv proteins were positioned on the junction. Additionally, we provide evidence that supports current models on RuvABC action in which Holliday junction resolution occurs as the resolvasome promotes branch migration.