Implantation d’un système d’information socio-sanitaire régional

L’article présente l’implantation d’un système d’information visant la connaissance et la surveillance de l’état de santé de la population dans la région de Trois-Rivières. La finalité d’un tel système est d’être accessible facilement avec le découpage territorial voulu. La clientèle visée est élargie et englobe tous ceux qui s’intéressent à la santé de la population. Les sources de données de ce système sont nombreuses : recensement fédéral, enquêtes et fichiers administratifs. Des ententes sont prises entre les départements de santé communautaire (DSC) et les organismes fournisseurs, afin de faciliter la mise à jour régulière.This paper presents the implementation of an information system on the health situation in Quebec's Trois-Rivières region. Such a system has to be flexible in terms of territorial delimitation, and has to be easily accessible. Data sources are the census, surveys and administrative files. Agreements have been obtained to rapidly up-to-date the information contained in the system.El artítulo presenta la implantación de un sistema de información apuntando el conocimiento y la vigilancia del estado de salud de la población en la región de Trois-Rivières. La finalidad de tal sistema es de ser facilmente accesible con el recorte territorial deseado. La clientela apuntada es ampliada y engloba todos los agentes que se interesan en la salud de la población. Las fuentes de datos de este sistema son numerosas: Censo federal, encuestas y ficheros administrativos. Acuerdos son establecidos entre los departamentos de salud comunitario (DSC) y los organismos proveedores a fin de facilitar la actualización regular

Les concepts de base des Systèmes d’Information Géographique (SIG) : les données et les fonctions générales

La géomatique regroupe l'ensemble des outils et méthodes permettant d'acquérir, de représenter, d'analyser et d'intégrer les informations à référence spatiale issues de sources hétérogènes. Cette discipline, déjà largement développée au sein des unités de recherche devient de plus en plus couramment utilisée par les Unités Expérimentales de l’INRA, notamment par l’utilisation des systèmes d’informations géographiques (SIG). Dans cet article, nous revenons sur les bases nécessaires pour comprendre et utiliser un SIG. Un SIG permet de visualiser et d’analyser des données géographiques de deux formats principaux : le format raster (images satellites, photographies aériennes, cartes scannées, etc.) et le format vecteur qui correspond à une simplification du monde réel en objets graphiques auxquels sont reliées des informations descriptives plus ou moins complexes. Afin que toutes ces données soient superposables pour être analysées ensemble, elles doivent appartenir à un système de coordonnées ; c’est un système de référence permettant d’exprimer la position d’un objet dans ses deux ou trois dimensions. Toutes les données géographiques peuvent être regroupées en base des données spatialisées contenant toutes les informations essentielles pour une bonne utilisation (types de données utilisées, structure des données descriptives, source, date de création, etc.). Les fonctionnalités des SIG permettant l’exploitation des données géolocalisées (données issues de GPS, d'imageries satellitales, de photographies aériennes, de données d’expérimentation...) sont nombreuses. Les principales sont présentées à travers des exemples issus de problématiques rencontrées à l’INRA et sur le logiciels SIG Quantum Gis (QGis : logiciel libre et gratuit). L’utilisation des SIG ne serait pas optimisée sans une bonne qualité des données de référence. Nous dressons ainsi un panorama des données géographiques des grands producteurs de données français, accessibles gratuitement ou à faible coût au monde de la recherche publique depuis ces dernières années. La politique de l’Europe et de la France est de développer le partage de l’information géographique à l’aide des nouvelles technologies sur Internet, sur mobiles et lié au GPS. L’ensemble de ces éléments permet d’envisager une facilité d’accès et de partage à l’information spatialisée que l’on peut également mettre en place à l’INRA

Early detection and prediction of cardiotoxicity after radiation therapy for breast cancer: the BACCARAT prospective cohort study

International audienceBackground Radiotherapy (RT) for breast cancer presents a benefit in terms of reducing local recurrence and deaths resulting from breast cancer but it can lead to secondary effects due to the presence of neighboring cardiac normal tissues within the irradiation field. Breast RT has been shown to be associated with long-term increased risk of heart failure, coronary artery disease, myocardial infarction and finally cardiovascular death more than 10 years after RT. However, there is still a lack of knowledge for early cardiotoxicity induced by breast RT that can appear long before the onset of clinically significant cardiac events. Based on a 2-year follow-up prospective cohort of patients treated with breast RT, the BACCARAT (BreAst Cancer and CArdiotoxicity Induced by RAdioTherapy) study aims to enhance knowledge on detection and prediction of early subclinical cardiac dysfunction and lesions induced by breast RT and on biological mechanisms potentially involved, based on functional and anatomical cardiac imaging combined with simultaneous assessment of multiple circulating biomarkers and accurate heart dosimetry. Methods/Design BACCARAT study consists in a monocentric prospective cohort study that will finally include 120 women treated with adjuvant 3D CRT for breast cancer, and followed for 2 years after RT. Women aged 50 to 70 years, treated for breast cancer and for whom adjuvant 3D CRT is indicated, without chemotherapy are eligible for the study. Baseline (before RT) and follow-up data include measurements of functional myocardial dysfunction including strain and strain rate based on 2D-speckle tracking echocardiography, anatomical coronary lesions including description of plaques in segments of coronary arteries based on Coronary computed tomography angiography, and a wide panel of circulating biomarkers. The absorbed dose is evaluated for the whole heart and its substructures, in particular the coronary arteries. Analysis on occurrence and evolution of subclinical cardiac lesions and biomarkers will be performed and completed with dose-response relationship. Multivariate model of normal tissue complication probability (NTCP) will also be proposed. Discussion Tools and results developed in the BACCARAT study should allow improving prediction and prevention of potential lesions to cardiac normal tissues surrounding tumors and ultimately enhance patients' care and quality of life. Trial registration ClinicalTrials.gov NCT02605512. © 2016 Jacob et al

Design status of ASPIICS, an externally occulted coronagraph for PROBA-3

The "sonic region" of the Sun corona remains extremely difficult to observe with spatial resolution and sensitivity sufficient to understand the fine scale phenomena that govern the quiescent solar corona, as well as phenomena that lead to coronal mass ejections (CMEs), which influence space weather. Improvement on this front requires eclipse-like conditions over long observation times. The space-borne coronagraphs flown so far provided a continuous coverage of the external parts of the corona but their over-occulting system did not permit to analyse the part of the white-light corona where the main coronal mass is concentrated. The proposed PROBA-3 Coronagraph System, also known as ASPIICS (Association of Spacecraft for Polarimetric and Imaging Investigation of the Corona of the Sun), with its novel design, will be the first space coronagraph to cover the range of radial distances between ~1.08 and 3 solar radii where the magnetic field plays a crucial role in the coronal dynamics, thus providing continuous observational conditions very close to those during a total solar eclipse. PROBA-3 is first a mission devoted to the in-orbit demonstration of precise formation flying techniques and technologies for future European missions, which will fly ASPIICS as primary payload. The instrument is distributed over two satellites flying in formation (approx. 150m apart) to form a giant coronagraph capable of producing a nearly perfect eclipse allowing observing the sun corona closer to the rim than ever before. The coronagraph instrument is developed by a large European consortium including about 20 partners from 7 countries under the auspices of the European Space Agency. This paper is reviewing the recent improvements and design updates of the ASPIICS instrument as it is stepping into the detailed design phase

The seeds of divergence: the economy of French North America, 1688 to 1760

Generally, Canada has been ignored in the literature on the colonial origins of divergence with most of the attention going to the United States. Late nineteenth century estimates of income per capita show that Canada was relatively poorer than the United States and that within Canada, the French and Catholic population of Quebec was considerably poorer. Was this gap long standing? Some evidence has been advanced for earlier periods, but it is quite limited and not well-suited for comparison with other societies. This thesis aims to contribute both to Canadian economic history and to comparative work on inequality across nations during the early modern period. With the use of novel prices and wages from Quebec—which was then the largest settlement in Canada and under French rule—a price index, a series of real wages and a measurement of Gross Domestic Product (GDP) are constructed. They are used to shed light both on the course of economic development until the French were defeated by the British in 1760 and on standards of living in that colony relative to the mother country, France, as well as the American colonies. The work is divided into three components. The first component relates to the construction of a price index. The absence of such an index has been a thorn in the side of Canadian historians as it has limited the ability of historians to obtain real values of wages, output and living standards. This index shows that prices did not follow any trend and remained at a stable level. However, there were episodes of wide swings—mostly due to wars and the monetary experiment of playing card money. The creation of this index lays the foundation of the next component. The second component constructs a standardized real wage series in the form of welfare ratios (a consumption basket divided by nominal wage rate multiplied by length of work year) to compare Canada with France, England and Colonial America. Two measures are derived. The first relies on a “bare bones” definition of consumption with a large share of land-intensive goods. This measure indicates that Canada was poorer than England and Colonial America and not appreciably richer than France. However, this measure overestimates the relative position of Canada to the Old World because of the strong presence of land-intensive goods. A second measure is created using a “respectable” definition of consumption in which the basket includes a larger share of manufactured goods and capital-intensive goods. This second basket better reflects differences in living standards since the abundance of land in Canada (and Colonial America) made it easy to achieve bare subsistence, but the scarcity of capital and skilled labor made the consumption of luxuries and manufactured goods (clothing, lighting, imported goods) highly expensive. With this measure, the advantage of New France over France evaporates and turns slightly negative. In comparison with Britain and Colonial America, the gap widens appreciably. This element is the most important for future research. By showing a reversal because of a shift to a different type of basket, it shows that Old World and New World comparisons are very sensitive to how we measure the cost of living. Furthermore, there are no sustained improvements in living standards over the period regardless of the measure used. Gaps in living standards observed later in the nineteenth century existed as far back as the seventeenth century. In a wider American perspective that includes the Spanish colonies, Canada fares better. The third component computes a new series for Gross Domestic Product (GDP). This is to avoid problems associated with using real wages in the form of welfare ratios which assume a constant labor supply. This assumption is hard to defend in the case of Colonial Canada as there were many signs of increasing industriousness during the eighteenth and nineteenth centuries. The GDP series suggest no long-run trend in living standards (from 1688 to circa 1765). The long peace era of 1713 to 1740 was marked by modest economic growth which offset a steady decline that had started in 1688, but by 1760 (as a result of constant warfare) living standards had sunk below their 1688 levels. These developments are accompanied by observations that suggest that other indicators of living standard declined. The flat-lining of incomes is accompanied by substantial increases in the amount of time worked, rising mortality and rising infant mortality. In addition, comparisons of incomes with the American colonies confirm the results obtained with wages— Canada was considerably poorer. At the end, a long conclusion is provides an exploratory discussion of why Canada would have diverged early on. In structural terms, it is argued that the French colony was plagued by the problem of a small population which prohibited the existence of scale effects. In combination with the fact that it was dispersed throughout the territory, the small population of New France limited the scope for specialization and economies of scale. However, this problem was in part created, and in part aggravated, by institutional factors like seigneurial tenure. The colonial origins of French America’s divergence from the rest of North America are thus partly institutional