24 research outputs found
La pratique du metal entre quĂȘte individualiste et recherche dâancrage social
Cet article rend compte des rĂ©sultats dâune recherche exploratoire ayant pour objectif de comprendre le sens que les musiciens de metal donnent Ă leur pratique. Les rĂ©sultats vont rĂ©vĂ©ler la prĂ©sence marquĂ©e, dâune part, dâun besoin de visibilitĂ© sociale et dâautonomisation individuelle et, dâautre part, dâun fort dĂ©sir dâancrage social. Deux tendances qui paraissent Ă la fois significatives de lâĂ©volution de nos modes de vie contemporains et dĂ©pendantes de lâimage que ce style musical colporte au sein de nos sociĂ©tĂ©s
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance
INTRODUCTION
Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic.
RATIONALE
We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs).
RESULTS
Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants.
CONCLUSION
Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century
Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study
The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (â„40 years) from general populations across the world.
The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28â828 participants.
The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12â502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry.
On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected
Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU
Contains fulltext :
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Les nouvelles masculinitĂ©s en Suisse : une approche par lâidĂ©ologie de genre et la rĂ©partition du travail rĂ©munĂ©rĂ© et non rĂ©munĂ©rĂ© au sein des couples
Cadre de la recherche : Dans les sociétés occidentales postmodernes, des hommes adoptent désormais des comportements
traditionnellement Ă©tiquetĂ©s comme fĂ©minins, notamment dans la rĂ©partition des rĂŽles autour de lâenfant. En Suisse,
lâinvestissement concret des hommes est toutefois caractĂ©risĂ©, globalement et en comparaison des femmes, par une implication
moindre dans les tĂąches domestiques et familiales, qui diminue encore aprĂšs la naissance dâun enfant. Objectifs : Partant de ce constat,
cet article explore le rapport entre lâidĂ©ologie genrĂ©e et lâengagement des hommes et des pĂšres dans ce domaine. MĂ©thodologie : Ă lâaide de modĂšles statistiques multivariĂ©s,
notre analyse tente de dĂ©terminer si les attitudes envers la vie familiale et lâĂ©galitĂ© ont une influence sur lâimplication domestique et familiale des hommes.
Nous mobilisons pour cela plus de 25 000 entretiens téléphoniques effectués entre 2000
et 2011 dans le cadre du Panel suisse de ménages (PSM). Résultats : Les résultats font ressortir quatre
formes de masculinitĂ©. « Lâhomme professionnel » construit sa masculinitĂ©
essentiellement dans lâinvestissement professionnel sur le marchĂ© du travail et
financier au sein du mĂ©nage. « Lâhomme orthodoxe » reste le pourvoyeur principal des
revenus, sans pour autant dĂ©daigner les tĂąches mĂ©nagĂšres. NĂ©anmoins, il sâoccupe surtout
de celles qui sont socialement définies comme étant masculines. « Le traditionnel
gestionnaire » a un profil similaire, si ce nâest quâil prend Ă©galement en charge des
tĂąches dites nĂ©gociables, les tĂąches administratives du mĂ©nage. « Lâhomme inclusif » est
celui qui partage le plus le temps de travail rémunéré et non rémunéré avec sa compagne.
Conclusions : En
dĂ©finitive, ces diffĂ©rents profils sâexpliquent moins par la mise en pratique dâune
idéologie de genre que par des facteurs institutionnels ou pragmatiques comme le capital
économique et humain à disposition des partenaires.Contribution : En proposant une typologie de
lâimplication dans le travail non rĂ©munĂ©rĂ© dâhommes en Suisse et en examinant de maniĂšre
empirique plusieurs explications des différences constatées, cet article apporte une
contribution originale à la connaissance des masculinités en contexte familial.Research Framework: In postmodern Western society, men have adopted behaviour that is
traditionally labelled as being feminine, particularly when it comes to the distribution
of child rearing roles. In Switzerland, the tangible investment of men is generally
characterized, in comparison to women, by a lesser involvement in domestic and familial
tasks, which is reduced further following the birth of a child. Objectives:
Using this statement as our starting point, this article explores the relationship
between gender ideology and the investment of men and fathers in this area. Methodology:
Using multi-variate statistics models, our analysis attempts to determine whether
attitudes to family life and equality have an influence on the domestic and familial
involvement of men. We conducted over 25,000 telephone interviews between 2000 and 2011
as a part of the Swiss Household Panel (SHP). Results: Our
results showed four types of masculinity. The âProfessional Manâ essentially builds his
masculinity through their professional implication in the employment and financial
aspects of the household. The âOrthodox Manâ remains the main financial provider though
they do not eschew domestic tasks. Regardless, they tend to take care of tasks that are
socially defined as being masculine. The âTraditional Managerâ has a similar profile
though they only take charge of tasks that are negotiable such as the administrative
aspects of the home. The âInclusive Manâ shares more time between paid and unpaid work
with their partner. Conclusions:
These different profiles are less explained by the practical application of a gender
ideology than by institutional and pragmatic factors such as economic and human capital
and the disposition of partners.Contributions:
By offering a typology for involvement in unpaid work for Swiss men and by empirically
examining several explanations for the stated differences, this article provides an
original contribution to the understanding of masculinity in a familial context
Simulation de modÚles mécaniques à base topologique à l'aide de rÚgles de transformation de graphes
National audienceCet article présente un cadre général et générique qui combine un modÚle mécanique et un modÚle topologique (les cartes généralisées) pour l'animation physique d'objets maillés déformables. Ce cadre permet d'utiliser, en 2D ou 3D, plusieurs types de maillages, éventuellement basés sur des mailles élémentaires différentes. Il permet la simulation de nombreux modÚles physiques avec des propriétés diverses d'homogénéité et d'isotropie. Toutes les informations mécaniques sont stockées dans le modÚle topologique, aucune structure auxiliaire n'est nécessaire. Le logiciel Jerboa a été utilisé car son langage à base de rÚgles a permis un prototypage rapide des différents modÚles
A modular approach based on graph transformation to simulate tearing and fractures on various mechanical models
This paper introduces an extension of a general framework that allows the simulation of various mechanical models
(discrete or continuous ones, for different kinds of meshes, in any dimension). This framework relies on a topological
model and a rule-based language, that performs sub-graph matching and, possibly, transformations. This
extension allows topological modifications such as tearing and fractures for all the implemented physical models.
A general process has been used to simulate fractures and tearing: the topological transformation is described using
the provided rule-based language and its application is triggered when a selected criterion is verified. Several
criteria are proposed, that depend upon the strain or stress generated by a single or a set of interactions. This
method raises the question of the link between the location where a criterion is applied and the mesh elements
involved in a modification. This question has motivated us to design new criteria which are closely related to the
mesh modification. Using this method, a minimal number of mechanical data need to be updated after a transformation
and any interaction relying on mesh features (vertex, edge, face, volume) that are suppressed or split can
be automatically ignored
A general physical-topological framework using rule-based language for physical simulation
International audienceThis paper presents a robust framework that combines a topological model (a generalized map or G-map) and a physical one to simulate deformable objects. The framework is general since it allows a general simulation of deformations (1) in different dimensions (2D or 3D), (2) with different types of meshes (triangular, rectangular, tetrahedral, hexahedral, and combinations of them...) and (3) physical models (mass/spring, linear FEM, co-rotational, mass/tensor). Any mechanical information is stored in the topological model and is used in combination with the neighboring relations to compute the equation of motions. To design this model, we have used JERBOA, a rule-based language relying on graph transformations to handle G-maps. This tool has been helpful to build and test different physical models in a little time