Services "amis des jeunes": promouvoir des soins adaptés aux adolescents [Youth friendly health services: how to promote quality health care for adolescents].

Beaucoup de jeunes éprouvent des difficultés à demander une aide médicale et psychosociale alors qu'ils en auraient bien besoin. Cela est lié au processus d'autonomisation propre à cette période de la vie : les adolescents souhaitent résoudre leurs problèmes eux-mêmes. Pour améliorer la qualité des soins aux jeunes, l'Organisation mondiale de la santé, avec l'UNICEF et d'autres organismes, a développé le concept de youth friendly health services ; services amis des jeunes. Ce concept repose sur plusieurs principes, comme l'accessibilité, la flexibilité, une formation spécifique du personnel, le respect de la neutralité et de la confidentialité, compétences communicationnelles, etc. L'application de cette approche ne se limite pas aux centres spécialisés en médecine de l'adolescence, mais devra être progressivement implantée dans toutes les structures de soins accueillant des jeunes. Many young people have difficulties requesting medical or psychosocial support, although some badly need it. This difficulty is related to the fact that, as part of their search for autonomy, young people prefer to solve their problems by themselves. To improve the quality of care, the World Health Organization, UNICEF and allied organizations have developed the concept of "Youth friendly health services". This concept includes policies and strategies to improve the accessibility and flexibility, staff's competence and communication skills, etc. Such an approach should not be limited to specialized centers for adolescent health. It should be adopted by all health care institutions dealing with young people.

Variations of plasmid content in Rickettsia felis.

BACKGROUND: Since its first detection, characterization of R. felis has been a matter of debate, mostly due to the contamination of an initial R. felis culture by R. typhi. However, the first stable culture of R. felis allowed its precise phenotypic and genotypic characterization, and demonstrated that this species belonged to the spotted fever group rickettsiae. Later, its genome sequence revealed the presence of two forms of the same plasmid, physically confirmed by biological data. In a recent article, Gillespie et al. (PLoS One. 2007;2(3):e266.) used a bioinformatic approach to refute the presence of the second plasmid form, and proposed the creation of a specific phylogenetic group for R. felis. METHODOLOGY/PRINCIPAL FINDINGS: In the present report, we, and five independent international laboratories confirmed unambiguously by PCR the presence of two plasmid forms in R. felis strain URRWXCal(2) (T), but observed that the plasmid content of this species, from none to 2 plasmid forms, may depend on the culture passage history of the studied strain. We also demonstrated that R. felis does not cultivate in Vero cells at 37 degrees C but generates plaques at 30 degrees C. Finally, using a phylogenetic study based on 667 concatenated core genes, we demonstrated the position of R. felis within the spotted fever group. SIGNIFICANCE: We demonstrated that R. felis, which unambiguously belongs to the spotted fever group rickettsiae, may contain up to two plasmid forms but this plasmid content is unstable.