Impact d'une école de l'asthme sur la consommation en soins et la qualité de vie des enfants de 4 à 12 ans et de leurs parents

L'article a été réalisé en collaboration avec Marie-Elise Verga, infirmière de recherche au DMCP, il a été publié dans les Archives de Pédiatrie, une revue française d'importance pour la profession en novembre 2013. L'impact factor de la revue est de 0.36. Ce travail est centré sur l'évaluation de l'impact d'une école de l'asthme chez l'enfant. L'asthme est la maladie chronique la plus fréquente chez l'enfant, sa prévalence est en augmentation dans le monde depuis plusieurs années. Son impact sur la vie des enfants atteints et de leur famille est important en termes d'absentéisme et de limitation dans les activités de la vie quotidienne. Selon différentes études, la connaissance de la maladie serait un pilier pour l'amélioration de son contrôle. Associée à des compétences personnelles et une médication optimale, elle diminuerait les absences scolaires, la survenue des crises et augmenterait la compliance au traitement. L'Ecole de l'Asthme de l'Hôpital de l'Enfance à Lausanne a été mise en place dans ce but, afin d'offrir, par une équipe pluridisciplinaire, des séances d'éducation thérapeutique tant aux enfants qu'à leur famille. Notre étude exploratoire a pour but d'évaluer l'effet de l'Ecole de l'Asthme sur la consommation en soins et la qualité de vie des enfants de 4 à 12 ans et de leurs parents. 27 enfants ont été inclus durant une année. La qualité de vie a été évaluée chez les enfants et leurs parents au moyen du Paediatric Asthma Quality of Life Questionnaire à l'inclusion et 6 mois plus tard. La consommation en soins a été évaluée sur une période d'un an avant et après l'Ecole de l'asthme par un questionnaire envoyé aux pédiatres. Il s'agit de la première étude de ce genre en Suisse et il y en a très peu à l'étranger. Elle démontre clairement une diminution de la consommation en soins que ce soit les rendez- vous chez le pédiatre, les consultations aux urgences et les hospitalisations. Une amélioration de la qualité de vie retrouvée tant chez les enfants que leurs parents a aussi été observée lors de notre étude. En donnant aux enfants et à leur famille des moyens de mieux gérer la maladie à domicile, l'Ecole de l'Asthme contribue à un meilleur contrôle de cette maladie. Ces premières conclusions valident l'importance d'évaluer cette prise en charge par des études prospectives randomisées. Il existe plusieurs perspectives à développer dans le prolongement de cette étude par exemple inclure des patients non francophones, sachant que les migrants représentent une part importante des consultations en urgences et que leur maladie asthmatique est souvent mal contrôlée. Il faudrait affiner les résultats en comparant nos résultats à ceux d'un groupe contrôle ou d'un groupe avec un enseignement individualisé. Un suivi sur 5 ans permettrait de voir l'impact à long terme. Le côté financier devrait être évalué afin de vérifier la diminution des coûts supposée en rapport à la diminution de la consommation en soins

Five decades of northern land carbon uptake revealed by the interhemispheric CO2 gradient

The global land and ocean carbon sinks have increased proportionally with increasing carbon dioxide emissions during the past decades 1 . It is thought that Northern Hemisphere lands make a dominant contribution to the global land carbon sink 2–7 ; however, the long-term trend of the northern land sink remains uncertain. Here, using measurements of the interhemispheric gradient of atmospheric carbon dioxide from 1958 to 2016, we show that the northern land sink remained stable between the 1960s and the late 1980s, then increased by 0.5 ± 0.4 petagrams of carbon per year during the 1990s and by 0.6 ± 0.5 petagrams of carbon per year during the 2000s. The increase of the northern land sink in the 1990s accounts for 65% of the increase in the global land carbon flux during that period. The subsequent increase in the 2000s is larger than the increase in the global land carbon flux, suggesting a coincident decrease of carbon uptake in the Southern Hemisphere. Comparison of our findings with the simulations of an ensemble of terrestrial carbon models 5,8 over the same period suggests that the decadal change in the northern land sink between the 1960s and the 1990s can be explained by a combination of increasing concentrations of atmospheric carbon dioxide, climate variability and changes in land cover. However, the increase during the 2000s is underestimated by all models, which suggests the need for improved consideration of changes in drivers such as nitrogen deposition, diffuse light and land-use change. Overall, our findings underscore the importance of Northern Hemispheric land as a carbon sink

Five decades of northern land carbon uptake revealed by the interhemispheric CO2 gradient

The global land and ocean carbon sinks have increased proportionally with increasing carbon dioxide emissions during the past decades 1 . It is thought that Northern Hemisphere lands make a dominant contribution to the global land carbon sink 2–7 ; however, the long-term trend of the northern land sink remains uncertain. Here, using measurements of the interhemispheric gradient of atmospheric carbon dioxide from 1958 to 2016, we show that the northern land sink remained stable between the 1960s and the late 1980s, then increased by 0.5 ± 0.4 petagrams of carbon per year during the 1990s and by 0.6 ± 0.5 petagrams of carbon per year during the 2000s. The increase of the northern land sink in the 1990s accounts for 65% of the increase in the global land carbon flux during that period. The subsequent increase in the 2000s is larger than the increase in the global land carbon flux, suggesting a coincident decrease of carbon uptake in the Southern Hemisphere. Comparison of our findings with the simulations of an ensemble of terrestrial carbon models 5,8 over the same period suggests that the decadal change in the northern land sink between the 1960s and the 1990s can be explained by a combination of increasing concentrations of atmospheric carbon dioxide, climate variability and changes in land cover. However, the increase during the 2000s is underestimated by all models, which suggests the need for improved consideration of changes in drivers such as nitrogen deposition, diffuse light and land-use change. Overall, our findings underscore the importance of Northern Hemispheric land as a carbon sink

Acceptability of self-collected vaginal samples for HPV testing in an urban and rural population of Madagascar

Objective: To evaluate the acceptability of self-collected vaginal samples for HPV testing in women living in rural and urban areas of Madagascar. Materials and Methods: Participants were recruited in a health care center (urban group) and smaller affiliated dispensaries (rural group). They were invited to perform unsupervised self-sampling for HPV testing and to answer a questionnaire on socio-demographic information, cervical cancer knowledge and self-sampling acceptability. Results: A total of 300 women were recruited. Median age was 44.1 years (range 29-65 years) in the urban group and 40.9 years (range 29-65 years) in the rural group. Urban women had improved knowledge on HPV, cervical cancer and cervical cancer screening (p<0.05) as compared to rural women. Urban women lived closer to a health care center (P<0.05), had fewer different sexual partners (P<0.05) and later first sexual intercourse (p=0.07). Unlike urban women, most rural women were married (p<0.05). Conclusion: Acceptability of self-sampling for HPV testing was similarly excellent in both groups despite their difference in terms of socio-demographic factors and knowledge about cervical cancer

Seismic Constraints on the Thickness and Structure of the Martian Crust from InSight

NASA¿s InSight mission [1] has for the first time placed a very broad-band seismometer on the surface of Mars. The Seismic Experiment for Interior Structure (SEIS) [2] has been collecting continuous data since early February 2019. The main focus of InSight is to enhance our understanding of the internal structure and dynamics of Mars, which includes the goal to better constrain the crustal thickness of the planet [3]. Knowing the present-day crustal thickness of Mars has important implications for its thermal evolution [4] as well as for the partitioning of silicates and heat-producing elements between the different layers of Mars. Current estimates for the crustal thickness of Mars are based on modeling the relationship between topography and gravity [5,6], but these studies rely on different assumptions, e.g. on the density of the crust and upper mantle, or the bulk silicate composition of the planet and the crust. The resulting values for the average crustal thickness differ by more than 100%, from 30 km to more than 100 km [7]. New independent constraints from InSight will be based on seismically determining the crustal thickness at the landing site. This single firm measurement of crustal thickness at one point on the planet will allow to constrain both the average crustal thickness of Mars as well as thickness variations across the planet when combined with constraints from gravity and topography [8]. Here we describe the determination of the crustal structure and thickness at the InSight landing site based on seismic receiver functions for three marsquakes compared with autocorrelations of InSight data [9].We acknowledge NASA, CNES, partner agencies and institutions (UKSA, SSO,DLR, JPL, IPGP-CNRS, ETHZ, IC, MPS-MPG) and the operators of JPL, SISMOC, MSDS, IRIS-DMC and PDS for providing SEED SEIS data. InSight data is archived in the PDS, and a full list of archives in the Geosciences, Atmospheres, and Imaging nodes is at https://pds-geosciences.wustl.edu/missions/insight/. This work was partially carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration. ©2021, California Institute of Technology. Government sponsorship acknowledge

The consolidated European synthesis of CO2 emissions and removals for the European Union and United Kingdom: 1990-2018

Reliable quantification of the sources and sinks of atmospheric carbon dioxide (CO2), including that of their trends and uncertainties, is essential to monitoring the progress in mitigating anthropogenic emissions under the Kyoto Protocol and the Paris Agreement. This study provides a consolidated synthesis of estimates for all anthropogenic and natural sources and sinks of CO2 for the European Union and UK (EU27 + UK), derived from a combination of state-of-the-art bottom-up (BU) and top-down (TD) data sources and models. Given the wide scope of the work and the variety of datasets involved, this study focuses on identifying essential questions which need to be answered to properly understand the differences between various datasets, in particular with regards to the less-well-characterized fluxes from managed ecosystems. The work integrates recent emission inventory data, process-based ecosystem model results, data-driven sector model results and inverse modeling estimates over the period 1990-2018. BU and TD products are compared with European national greenhouse gas inventories (NGHGIs) reported under the UNFCCC in 2019, aiming to assess and understand the differences between approaches. For the uncertainties in NGHGIs, we used the standard deviation obtained by varying parameters of inventory calculations, reported by the member states following the IPCC Guidelines. Variation in estimates produced with other methods, like atmospheric inversion models (TD) or spatially disaggregated inventory datasets (BU), arises from diverse sources including within-model uncertainty related to parameterization as well as structural differences between models. In comparing NGHGIs with other approaches, a key source of uncertainty is that related to different system boundaries and emission categories (CO2 fossil) and the use of different land use definitions for reporting emissions from land use, land use change and forestry (LULUCF) activities (CO2 land). At the EU27 + UK level, the NGHGI (2019) fossil CO2 emissions (including cement production) account for 2624 Tg CO2 in 2014 while all the other seven bottom-up sources are consistent with the NGHGIs and report a mean of 2588 (± 463 Tg CO2). The inversion reports 2700 Tg CO2 (± 480 Tg CO2), which is well in line with the national inventories. Over 2011-2015, the CO2 land sources and sinks from NGHGI estimates report-90 Tg C yr-1 ± 30 Tg C yr-1 while all other BU approaches report a mean sink of-98 Tg C yr-1 (± 362 Tg of C from dynamic global vegetation models only). For the TD model ensemble results, we observe a much larger spread for regional inversions (i.e., mean of 253 Tg C yr-1 ± 400 Tg C yr-1). This concludes that (a) current independent approaches are consistent with NGHGIs and (b) their uncertainty is too large to allow a verification because of model differences and probably also because of the definition of "CO2 flux"obtained from different approaches. The referenced datasets related to figures are visualized. © 2021 Ana Maria Roxana Petrescu et al

Detection and long-term quantification of methane emissions from an active landfill

Landfills are a significant source of fugitive methane (CH4) emissions, which should be precisely and regularly monitored to reduce and mitigate net greenhouse gas emissions. In this study, we present long-term, in situ, near-surface, mobile atmospheric CH4 mole fraction measurements (complemented by meteorological measurements from a fixed station) from 21 campaigns that cover approximately 4 years from September 2016 to December 2020. These campaigns were utilized to regularly quantify the total CH4 emissions from an active landfill in France. We use a simple atmospheric inversion approach based on a Gaussian plume dispersion model to derive CH4 emissions. Together with the measurements near the soil surface, mainly dedicated to the identification of sources within the landfill, measurements of CH4 made on the landfill perimeter (near-field) helped us to identify the main emission areas and to provide some qualitative insights about the rank of their contributions to total emissions from the landfill. The two main area sources correspond, respectively, to a covered waste sector with infrastructure with sporadic leakages (such as wells, tanks, pipes, etc.) and to the last active sector receiving waste during most of the measurement campaigns. However, we hardly managed to extract a signal representative of the overall landfill emissions from the near-field measurements, which limited our ability to derive robust estimates of the emissions when assimilating them in the atmospheric inversions. The analysis shows that the inversions based on the measurements from a remote road further away from the landfill (far-field) yielded reliable estimates of the total emissions but provided less information on the spatial variability of emissions within the landfill. This demonstrates the complementarity between the near- and far-field measurements. According to these inversions, the total CH4 emissions have a large temporal variability and range from ∼ 0.4 to ∼ 7 t CH4 d−1, with an average value of ∼ 2.1 t CH4 d−1. We find a weak negative correlation between these estimates of the CH4 emissions and atmospheric pressure for the active landfill. However, this weak emission–pressure relationship is based on a relatively small sample of reliable emission estimates with large sampling gaps. More frequent robust estimations are required to better understand this relationship for an active landfill.</p

Temporal and spatial instability in neutral and adaptive (MHC) genetic variation in marginal salmon populations

The role of marginal populations for the long-term maintenance of species’ genetic diversity and evolutionary potential is particularly timely in view of the range shifts caused by climate change. The Centre-Periphery hypothesis predicts that marginal populations should bear reduced genetic diversity and have low evolutionary potential. We analysed temporal stability at neutral microsatellite and adaptive MHC genetic variation over five decades in four marginal Atlantic salmon populations located at the southern limit of the species’ distribution with a complicated demographic history, which includes stocking with foreign and native salmon for at least 2 decades. We found a temporal increase in neutral genetic variation, as well as temporal instability in population structuring, highlighting the importance of temporal analyses in studies that examine the genetic diversity of peripheral populations at the margins of the species’ range, particularly in face of climate change