Lessons from the 2018 drought for management of local water supplies in upland areas : a tracer-based assessment

Funding Information: We would like to acknowledge financial support from the UK Natural Environment Research Council (project NE/P010334/1) via a CASE industrial studentship with Chivas Brothers. David Drummond, Katya Dimitrova-Petrova and Eva Loerke are thanked for assistance with fieldwork, while we acknowledge Dr Aaron Neill for his advice on young water fraction analyses. Trevor Buckley and staff at the Glenlivet Distillery are thanked for on-site assistance and supply of data and abstraction records. We thank Audrey Innes, Dr Bernhard Scheliga, and Dr Ilse Kamerling for their support with the laboratory isotope analysis. Publisher Copyright: © 2020 The Authors. Hydrological Processes published by John Wiley & Sons Ltd. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Peer reviewedPublisher PD

Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol

<p>Abstract</p> <p>Background</p> <p>Diabetic patients show an increased prevalence of non-dipping arterial pressure pattern, target organ damage and elevated arterial stiffness. These alterations are associated with increased cardiovascular risk.</p> <p>The objectives of this study are the following: to evaluate the prognostic value of central arterial pressure and pulse wave velocity in relation to the incidence and outcome of target organ damage and the appearance of cardiovascular episodes (cardiovascular mortality, myocardial infarction, chest pain and stroke) in patients with type 2 diabetes mellitus or metabolic syndrome.</p> <p>Methods/Design</p> <p><b>Design</b>: This is an observational prospective study with 5 years duration, of which the first year corresponds to patient inclusion and initial evaluation, and the remaining four years to follow-up.</p> <p><b>Setting</b>: The study will be carried out in the urban primary care setting.</p> <p><b>Study population</b>: Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between 20-80 years of age. A total of 110 patients meeting all the inclusion criteria and none of the exclusion criteria will be included.</p> <p><b>Measurements</b>: Patient age and sex, family and personal history of cardiovascular disease, and cardiovascular risk factors. Height, weight, heart rate and abdominal circumference. Laboratory tests: hemoglobin, lipid profile, creatinine, microalbuminuria, glomerular filtration rate, blood glucose, glycosylated hemoglobin, blood insulin, fibrinogen and high sensitivity C-reactive protein. Clinical and 24-hour ambulatory (home) blood pressure monitoring and self-measured blood pressure. Common carotid artery ultrasound for the determination of mean carotid intima-media thickness. Electrocardiogram for assessing left ventricular hypertrophy. Ankle-brachial index. Retinal vascular study based on funduscopy with non-mydriatic retinography and evaluation of pulse wave morphology and pulse wave velocity using the SphygmoCor system. The medication used for diabetes, arterial hypertension and hyperlipidemia will be registered, together with antiplatelet drugs.</p> <p>Discussion</p> <p>The results of this study will help to know and quantify the prognostic value of central arterial pressure and pulse wave velocity in relation to the evolution of the subclinical target organ damage markers and the possible incidence of cardiovascular events in patients with type 2 diabetes mellitus.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier: NCT01065155</p

Caractérisation de la vulnérabilité agricole pour l'évaluation économique des politiques de gestion des inondations

International audienceFlood management policies promoted by French government impact agriculture land in two ways. Firstly, they may be designated as potential areas for flood expansion. Secondly, since the 2003 law, local authorities have the right to flood these areas more than those which have been deemed to be more vulnerable (urban areas). Meanwhile, policy-driven appraisals of flood management projects are becoming commonplace in France. This highlights the need to better understand agricultural vulnerability and to develop methods for quantifying it. To introduce our approach, we first present the research conducted by Plan Loire which marks a shift away from existing practices of agriculture vulnerability assessment by considering vulnerability at the farm scale rather than at the plot scale. Based on ex-post flood damage assessment and the results of stakeholders questionnaires in the agricultural sector, forty seven determinants of farm vulnerability to flooding were identified and classified. These determinants were used to draft a guide for farmers. This guide aims to highlight the impacts their farm activities could face in case of flooding and to identify measures to mitigate their vulnerability. At the present, this guide is used along the Rhone River and will be probably used along the Loire River in the future. The current application of these guides to mitigate vulnerability of farms revealed the need for further research which is partly presented here. By focusing on the farming system, we aimed at providing a framework to economically assess agricultural vulnerability to flooding. Firstly, we identified flood effects at the farming system scale including possible interactions with the territorial scale, in order to propose a conceptual model which provides a framework for economic assessment. Finally, we discuss the implications for projects economic appraisal. The provided framework for agricultural vulnerability assessment would enable a selection of most efficient measures to mitigate farm vulnerability using a ratio depending on the agricultural context. It would also help to prioritize projects to reduce vulnerability by economic appraisal at a wider spatial scale such as water basin.En France, peu de travaux ont été consacrés à la caractérisation de la vulnérabilité des zones agricoles exposées aux inondations, encore moins à son utilisation dans le cadre d'une évaluation économique de politique de gestion des inondations. Nous proposons dans cet article un modèle conceptuel de la vulnérabilité agricole pouvant servir à une telle évaluation, lorsque les politiques visent à une modification de l'événement physique à l'origine de l'inondation ou à une modification de la vulnérabilité des enjeux exposés à cet événement

Conceptualisation de la vulnérabilité des exploitations agricoles face au risque d'inondation dans le cadre de l'évaluation économique

National audienceFlood management policies promoted by French government impact agriculture land in two ways. Firstly, they may be designated as potential areas for flood expansion. Secondly, since the 2003 law, local authorities have the right to flood these areas more than those which have been deemed to be more vulnerable (urban areas). Meanwhile, policy-driven appraisals of flood management projects are becoming commonplace in France. This highlights the need to better understand agricultural vulnerability and to develop methods for quantifying it. To introduce our approach, we first present the research conducted by Plan Loire which marks a shift away from existing practices of agriculture vulnerability assessment by considering vulnerability at the farm scale rather than at the plot scale. Based on ex-post flood damage assessment and the results of stakeholders questionnaires in the agricultural sector, forty seven determinants of farm vulnerability to flooding were identified and classified. These determinants were used to draft a guide for farmers. This guide aims to highlight the impacts their farm activities could face in case of flooding and to identify measures to mitigate their vulnerability. At the present, this guide is used along the Rhone River and will be probably used along the Loire River in the future. The current application of these guides to mitigate vulnerability of farms revealed the need for further research which is partly presented here. By focusing on the farming system, we aimed at providing a framework to economically assess agricultural vulnerability to flooding. Firstly, we identified flood effects at the farming system scale including possible interactions with the territorial scale, in order to propose a conceptual model which provides a framework for economic assessment. Finally, we discuss the implications for projects economic appraisal. The provided framework for agricultural vulnerability assessment would enable a selection of most efficient measures to mitigate farm vulnerability using a ratio depending on the agricultural context. It would also help to prioritize projects to reduce vulnerability by economic appraisal at a wider spatial scale such as water basin.En France, peu de travaux ont été consacrés à la caractérisation de la vulnérabilité des zones agricoles exposées aux inondations, encore moins à son utilisation dans le cadre d'une évaluation économique de politique de gestion des inondations. Nous proposons dans cet article un modèle conceptuel de la vulnérabilité agricole pouvant servir à une telle évaluation, lorsque les politiques visent à une modification de l'événement physique à l'origine de l'inondation ou à une modification de la vulnérabilité des enjeux exposés à cet événement

Analyse multicritères : application aux mesures de prévention des inondations. Guide méthodologique.

La décision de mettre en oeuvre des mesures de prévention des inondations doit être précédée d'une évaluation des mesures projetées. Cette évaluation doit permettre d'établir la pertinence, la faisabilité, l'efficacité et l'efficience du programme de mesures. L'analyse multicritères fait partie des outils d'évaluation disponibles pour juger du bien-fondé des mesures de prévention proposées par un maître d'ouvrage. Ce dispositif d'aide à la décision, appliqué de manière systématique pour les projets importants, permet de comparer les mesures entre elles à l'échelle du territoire national et de faire un choix entre plusieurs options de mesures sur un même territoire. L'attribution éventuelle de fonds publics peut reposer ainsi sur une base méthodologique commune et objective

Different patterns of insulin resistance in relatives of type 1 diabetic patients with retinopathy or nephropathy

OBJECTIVE- Insulin resistance may be a risk factor for diabetic microangiopathy, which may have a familial component. We carried out a family-based study to determine which components of the insulin resistance syndrome are associated with diabetic retinopathy and nephropathy in type 1 diabetes. RESEARCH DESIGN AND METHODS- The Genesis France-Belgium Study is a multicenter binational study designed to investigate the genetic factors involved in the microvascular complications of type 1 diabetes using a family-based design. Probands were type 1 diabetic patients with diabetic retinopathy (classified as background, preproliferative, or proliferative) and possibly diabetic nephropathy (absent, incipient, established, or advanced). The insulin resistance score of their first-degree relatives was calculated according to their BMI and history of arterial hypertension, lipid disorders, and type 2 diabetes. RESULTS- The insulin resistance score of relatives was positively correlated with the albumin excretion rate (P = 0.0009) and fasting plasma glucose (P = 0.0003) and HbA(1c) (P < 0.0001) concentrations. This score was higher in the relatives of probands with than in those without diabetic nephropathy (P = 0.0370). Similarly, it was higher in relatives of subjects with proliferative diabetic retinopathy than in those of probands without, even after controlling for subjects with versus without diabetic nephropathy (P = 0.0379). However, the components of the insulin resistance score in relatives differed according to the severity of diabetic retinopathy or nephropathy in the probands. Obesity and history of arterial hypertension were most common in relatives of probands with proliferative diabetic retinopathy, whereas obesity and history of lipid disorders were most common in the relatives of probands with diabetic nephropathy. CONCLUSIONS- Familial insulin resistance segregates with diabetic complications: lipid disorders and obesity segregate with diabetic nephropathy, whereas arterial hypertension and obesity segregate with diabetic retinopathy