Expertise et planification territoriale dans l'agglomération toulousaine : les recompositions centre-périphérie à l'oeuvre

ISSN 1276-4930International audienceLa création par la loi Solidarité et Renouvellement Urbain du 13 décembre 2000 des Schémas de Cohérence Territoriale en remplacement des Schémas Directeurs a initié un renouveau de la planification dans lequel se sont engagées de nombreuses agglomérations puisque 333 SCOT étaient approuvés, en cours ou en projet au 1 er janvier 2009. De nombreux travaux se sont saisis de cet objet qui s'impose à la multitude des politiques sectorielles locales (Plans Locaux de l'Habitat, Plans de Déplacements Urbains, Plans locaux d'Urbanisme…) dans une logique de développement durable. Face à des approches qui posent essentiellement la question de la « bonne échelle » de leur périmètre, de leur articulation avec les autres documents sectoriels ou de leur efficacité dans les objectifs qu'ils se sont fixés (Desjardins, Leroux, 2007), notre approche croisera deux entrées : celle du rôle de l'expertise dans les étapes d'élaboration d'un SCOT et celle de la territorialisation attendue ou induite par cette élaboration. Derrière l'expertise, « production d'une connaissance spécifique pour l'action » (Lascoumes, 2002), qui nous conduira à examiner le contenu des diagnostics et modèles de développement proposés, il s'agira aussi de s'intéresser aux figures de l'expert, à leur diversification et à leur concurrence face à des problèmes de plus en plus complexes. Cette complexification va de pair avec celle de l'action publique qui se « territorialise » selon différents processus qui se combinent : mécanismes de décentralisation et de déconcentration de l'Etat qui agit désormais au plus près des territoires locaux, évolution de l'accès à la sphère politique et de son fonctionnement et prise en compte du caractère spatial des problèmes par l'action publique, au détriment d'une approche sectorielle. Face à cette complexité, nous considérerons la territorialisation comme un processus de construction du territoire prenant sa source dans la construction de représentations communes à laquelle l'expertise contribue ou peut contribuer

Why latrines are not used : communities' perceptions and practices regarding latrines in a Taenia solium endemic rural area in Eastern Zambia

Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities' perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints). The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people's approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective

A modified theoretical framework to assess implementation fidelity of adaptive public health interventions

Background: One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness. Discussion: We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet our concerns. We propose modifications to the framework to assess both fidelity and adaptation. Summary: The modified Carroll et al.'s framework we propose may permit a comprehensive assessment of the implementation fidelity-adaptation balance required when implementing adaptive interventions, but more empirical research is needed to validate it

Intrusion and extrusion of water in hydrophobic mesopores

We present experimental and theoretical results on intrusion-extrusion cycles of water in hydrophobic mesoporous materials, characterized by independent cylindrical pores. The intrusion, which takes place above the bulk saturation pressure, can be well described using a macroscopic capillary model. Once the material is saturated with water, extrusion takes place upon reduction of the externally applied pressure; Our results for the extrusion pressure can only be understood by assuming that the limiting extrusion mechanism is the nucleation of a vapour bubble inside the pores. A comparison of calculated and experimental nucleation pressures shows that a proper inclusion of line tension effects is necessary to account for the observed values of nucleation barriers. Negative line tensions of order $10^{-11} \mathrm{J.m}^{-1}$ are found for our system, in reasonable agreement with other experimental estimates of this quantity

Métropolisation et gouvernance urbaine : les dynamiques territoriales du nouveau régionalisme dans les agglomérations de Los Angeles et San Francisco

This work focuses on regional collaborative processes observed in Southern California and in the San Francisco Bay Area. These processes are part of a broader movement, labeled as new regionalism, which affects the American metropolises that are facing major evolutions of their spatial and social forms in a context of global economical competition. These dynamics interact with the regional political economy characterized by two shifts: First, an opposition between the growth coalition that have traditionally ruled the two regions and recent slow-growth movements that have affected the power of the coalition, and then, a shift between proponents of the home rule and the regionalist reformers who historically made several attempts towards regional form of governance. Our work indeed shows that the dynamics of new regionalism can be interpreted as an adaptation of the traditional growth coalition to the changing regional political economy. It also reveals several streams within Californian regionalism, each showing different system of values, methods, objectives and operating and distinctive scales within the region. Even if they diverge of many aspects, the various regional organizations resulting from these dynamics seems to be somehow complementary and to draw an original form of regional power.Ce travail porte sur les dynamiques de coopération municipale dans les agglomérations de Los Angeles et San Francisco. Ces dynamiques de coopération renvoient à un mouvement plus général, qualifié de nouveau régionalisme, qui affecte l'ensemble des métropoles étatsuniennes, soumises à la fois à la pression de la compétition économique mondiale et à des transformations morphologique profondes. Ces dynamiques dépendent également des logiques de construction du maillage territorial et résultent d'un double rapport de force : d'une part, entre les élites tirant profit de la valorisation foncière de la ville et les opposants à l'urbanisation, et d'autre part, entre les partisans de l'autonomie locale et les promoteurs des nombreuses tentatives d'intégration régionale qui ont marqué l'histoire des deux principales agglomérations californiennes. Ce travail montre ainsi qu'à de nombreux égards, les manifestations du nouveau régionalisme peuvent être interprétées comme une adaptation des coalitions de croissance aux mutations récentes des agglomérations. Il met également en évidence l'existence de plusieurs courants constitutifs du régionalisme qui renvoient à des systèmes de valeurs, des objectifs et des modes opératoires distincts, et qui recouvrent des échelons territoriaux différents. Parfois en contradiction, les organisations inspirées de ces différents courants semblent néanmoins s'articuler pour proposer une forme de leadership régional original

Decreased Sialidase Activity in Alveolar Macrophages of Guinea Pigs Exposed to Coal Mine Dust

International audienceThe origin of immune dysfunctions that are observed in pneumoconiotic miners still remains unknown. There is evidence that the carbohydrate moiety of membrane glycoconjugates is of primary importance in many functions of immunocompetent cells. The glycosylation, and especially the sialylation level of membrane components of various lymphocyte and macrophage subsets, vary depending on the state of cellular differentiation and activation. Sialidases, which may regulate the amount of sialic acids exposed on the cell membrane, can thus be considered as immunoregulatory enzymes. In this report, the sialidase activity has been measured in alveolar macrophages (AM) and in cell-free bronchoalveolar lavage fluid (BALF) from guinea pigs exposed for 4 months to coal mine dust at a concentration of 300 mg/m3. The samples were collected by bronchoalveolar lavage 2 months after cessation of exposure. The sialidase activity in the cell-free fluid and in the purified alveolar macrophages showed a 10-fold decrease (p < 0.001). Kinetic parameters of the enzyme such as K(m) and optimum pH did not change. This changed activity was specific for sialidase, as two other lysosomal glycosidases, beta-galactosidase and N-acetylglucosaminidase, showed unchanged activities. These results suggest the possibility that, by inducing a decreased sialidase activity, exposure to coal mine dust may lead to a modified expression of AM membrane-associated sialic acids giving rise to altered immune functions (i. e., phagocytosis, antigen processing response to cytokines, etc.)

Secondary school and university students' simple reasoning about inclined plane

Ce travail propose un modèle cognitif simple permettant de représenter les connaissances des lycéens de classe terminale scientifique et des étudiants de première année universitaire, à propos du plan incliné. La notion de «schéma de connaissance» nous a conduits à stratifier en plusieurs niveaux de modélisation les schémas construits parles élèves. Une description particulière de ces niveaux est présentée, à partir des réponses données à des questions posées au cours d'entretiens individuels ou de tests écrits. Quelques interprétations utiles pour l'enseignement en sont tirées

Patients pathways to tuberculosis diagnosis and treatment in a fragmented health system : a qualitative study from a south Indian district

Background: India's Revised National Tuberculosis (TB) Control Programme (RNTCP) offers free TB diagnosis and treatment. But more than 50% of TB patients seek care from private practitioners (PPs), where TB is managed sub-optimally. In India, there is dearth of studies capturing experiences of TB patients when they navigate through health facilities to seek care. Also, there is less information available on how PPs make decisions to refer TB cases to RNTCP. We conducted this study to understand the factors influencing TB patient's therapeutic itineraries to RNTCP and PP's cross referral practices linked to RNTCP. Methods: We conducted in-depth interviews on a purposive sample of 33 TB patients and 38 PPs. Patients were categorised into three groups: those who reached RNTCP directly, those who were referred by PPs to RNTCP and patients who took DOT from PPs. We assessed patient's experiences in each category and documented their journey from initial symptoms until they reached RNTCP, where they were diagnosed and started on treatment. PPs were categorised into three groups based on their TB case referrals to RNTCP: actively-referring, minimally-referring and non-referring. Results: Patients had limited awareness about TB. Patients switched from one provider to the other, since their symptoms were not relieved. A first group of patients, self-medicated by purchasing get rid drugs from private chemists over the counter, before seeking care. A second group sought care from government facilities and had simple itineraries. A third group who sought care from PPs, switched concurrently and/or iteratively from public and private providers in search for relief of symptoms causing important diagnostic delays. Eventually all patients reached RNTCP, diagnosed and started on treatment. PP's cross-referral practices were influenced by patient's paying capacity, familiarity with RNTCP, kickbacks from private labs and chemists, and even to get rid of TB patients. These trade-offs by PPs complicated patient's itineraries to RNTCP. Conclusions: India aims to achieve universal health care for TB. Our study findings help RNTCP to develop initiatives to promote early detection of TB, by involving PPs and private chemists and establish effective referral systems from private sectors to RNTCP

Synthesis, Structure and Electrochemical Behavior of New RPONOP (R = tBu, iPr) Pincer Complexes of the Fe2+, Co2+, Ni2+ and Zn2+ ions.

International audienceThe coordination chemistry of the M2+ ions of the first row elements iron, cobalt, nickel and zinc was explored with the ligands RPONOP (2,6-(R2PO)(C5H3N), R = iPr and tBu). Syntheses and characterization of the complexes Fe(RPONOP)Br2, Co(tBuPONOP)Cl2, Ni(RPONOP)I2 and Zn(RPONOP)I2 (R = tBu, iPr) are reported together with the crystal structures of Fe(RPONOP)Br2 (R = iPr and tBu), Co(tBuPONOP)Cl2, Co(iPrPONOP)Cl(m-Cl)CoCl2(THF), Ni(iPrPONOP)I2, Zn(iPrPONOP)I2 and of the oxidation product Zn[tBuP(=O)ONOP(=O)]I2 resulting from reaction with oxygen. The electrochemical behavior of the M(tBuPONOP)X2 complexes has been investigated in acetonitrile. While the nickel compound is stable, all the complexes are sensitive to dissociation of the RPONOP ligand or ligand scrambling in strongly coordinating media. Catalytic activity in formic acid dehydrogenation with TONs up to 1143 has been found for Ni(tBuPONOP)I2

Near-Field Ultrasound Mammography

We introduce in this note a near-field formulation of the acoustic field scattered by a fluid object supposed to be weakly heterogeneous (Born approximation). This derivation is based on the Huygens-Fresnel principle that describes the scattered field as the result of the interferential scheme of all the secondary spherical waves. This derivation leads us to define a new Fourier transform that we name the Elliptical Fourier transform. The latter provides an elliptical spectrum whose harmonic components, the weighted elementary basis functions, have an elliptical spatial support. Based on these elliptical projections, we define the Elliptical Radon transform that allows us to establish a near-field extension of the Fourier Projection-Slice theorem. Thanks to these spectral and tomographic transforms, we show that it is possible to reconstruct either the impedance or the celerity maps of an acoustical model characterized in terms of impedance and celerity fluctuations.We observe that this formulation is very close to that one developed in the far field domain where the Radon transform pair is derived from an harmonic plane wave decomposition. This formulation allows us to introduce the Ductal Tomography, following the example of the Ductal Echography, that provides a systematic inspection of each mammary lobe, in order to reveal lesions at an early stage. In that aim, we develop 2D anatomic breast computer phantoms corresponding to an axial cross-section of the ductolubular structure in healthy and pathological situations. The goal is also, from the practitioner's point of view, to compare the recognized DE reference with the high potential tomographic approach.Nous introduisons par cette note une formulation originale en champ proche, du champ ultrasonore diffracté par un organe faiblement contrasté – le sein – (Approximation de Born). Cette formulation est fondée sur le principe d'Huygens-Fresnel qui construit ce champ sur la base d'un schéma interférentiel à partir des sources secondaires sphériques. Cette approche nous amène à définir une nouvelle transformée de Fourier dite «elliptique» dont le spectre (du même nom) s'établit sur une famille de fonctions de base – les composantes harmoniques – qui présentent un support spatial ellipsoïdal caractéristique des senseurs actifs multi-statiques. Ces projections elliptiques nous permettent de définir la transformée de Radon Elliptique qui fonde une extension en champ proche du théorème coupe-projection. Grâce à ces transformées spectrale et tomographique, nous montrons qu'il est possible de reconstruire les cartographies de fluctuation d'impédance en réflexion et de célérité en transmission. Nous observons que l'algorithme est très proche de celui universellement utilisé en champ lointain, basé sur une décomposition harmonique de type ondes planes. Cette formulation nous permet, à l'instar de l'échographie, de jeter les bases de la tomographie ductale offrant une inspection systématisée de chaque lobe en vue de la détection précoce du cancer du sein. Dans ce but, des fantômes numériques anatomiques 2D de sein correspondant à une coupe axiale de la structure ductolobulaire dans des situations saines et pathologiques sont développés, afin de valider les modèles précités d'analyse et d'inversion des données en champ proche. Ils permettent aussi une comparaison réaliste des procédés échographique (référence du radiologue) et tomographique, avec, pour cette dernière modalité, un avantage confirmé