CO-CONSTRUCTION OF KNOWLEDGE BETWEEN RESEARCHERS AND FARMERS IN TECHNICAL INNOVATION PROCESSES: LEARNING FROM DIRECT SEEDING IN THE BRAZILIAN CERRADOS

N° ISBN - 978-2-7380-1284-5International audienceThe Unaí Project (Brazilian Cerrados) uses a participatory approach inspired by the principles of Action-research to strengthen innovation processes within the context of the Agrarian Reform Sector. It associates as partners scientists, farmers, trainers and development agents and focuses both on the socio-technical and organisational dimensions of innovation. This paper presents the results of a sociological assessment of the encounter between farmers and scientists in connection with the development of knowledge related to direct seeding cropping systems within the framework of the Unai project. The objective was to analyse the complementarities and difficulties in terms of knowledge exchange and production. There was convergence of representations between farmers and researchers about the practical issues related to direct seeding. But there were differences about the overall role of direct-seeding and specifically of cover crops in the production process. Farmers and researchers did not share the same perception of the value of participation, with the former placing a premium on affective and social factors. Farmers' participation in the conception of innovations has several methodological implications, including the necessary formalization of roles and responsibilities of each actor and the development of intermediary actors

Impact of RSV test positivity, patient characteristics, and treatment characteristics on the cost of hospitalization for acute bronchiolitis in a French university medical center (2010–2015)

BackgroundIn young children, respiratory syncytial virus (RSV)-related bronchiolitis is typically more severe than other respiratory tract infections, with a greater need for oxygen therapy and respiratory support. Few studies have compared the cost of hospitalization with regard to virological status. The objective of this study was to compare the costs of hospitalization for RSV-positive vs. RSV-negative bronchiolitis in a French university medical center between 2010 and 2015.MethodsThe cost models were compared using conventional goodness-of-fit criteria. Covariates included the characteristics of the patients, pre-existing respiratory and non-respiratory comorbidities, superinfections, medical care provided, and the length of stay.ResultsRSV was detected in 679 (58.3%) of the 1,164 hospital stays by children under 2 years with virological data. Oxygen therapy and respiratory support were twice as frequent for the RSV-positive cases. The median hospitalization cost was estimated at €3,248.4 (interquartile range: €2,572.1). The cost distribution was positively skewed with a variation coefficient (CV = standard deviation/mean) greater than one (mean = €4,212.9, standard deviation = €5,047, CV = 1.2). In univariate analyses, there was no significant cost difference between the RSV-positive and RSV-negative cases. In the best multivariate model, the significant positive effect of RSV positivity on cost waned after the introduction of medical care variables and the length of stay. The results were sensitive to the specification of the model.ConclusionsIt was impossible to firmly conclude that hospitalization costs were higher for the RSV-positive cases

The co-construction of knowledge between researchers and farmers in technical innovation processes: learning from direct seeding in the Brazilian Cerrados

International audienceLe dispositif de recherche-expérimentation-formation du projet Unaí (Minas Gerais-Brésil) s'inspire du corpus méthodologique de la Recherche-Action. Il associe agriculteurs, chercheurs et agents de développement au processus de construction de l'innovation, dans sa double dimension sociotechnique et organisationnelle. L'article présente les résultats d'une analyse sociologique des confrontations de connaissances entre chercheurs et agriculteurs lors de la mise au point de systèmes de Semis direct dans le cadre de ce projet. L'étude analyse les interfaces entre ces différentes catégories d'acteurs et questionne les modalités de production et de compréhension mutuelle des connaissances. Il y a convergence entre les représentations des chercheurs et des agriculteurs concernant les aspects pratiques autour du semis direct et de son introduction. Par contre, on observe des différences de perception du rôle du semis direct et des plantes de couverture dans le système de production. Agriculteurs et chercheurs n'accordent pas la même valeur à la participation, les premiers priorisant les relations affectives et sociales. L'association des agriculteurs au dispositif de conception et d'expérimentation de l'innovation pose divers problèmes méthodologiques, en particulier la formalisation des rôles et des responsabilités ainsi que la mise en place d'acteurs intermédiaires

Les Inegalites De Sante : Mesure Et Determinants Rapport du projet Interreg : La santé et les comportements de santé dans le Sud-Est de l’Angleterre et le Nord de la France

Le travail sur les inégalités de santé se structure autour de deux axes principaux : Dans un premier temps, nous cherchons à appréhender la corrélation entre l’état de santé et la vulnérabilité de la population dans les deux régions. Dans une visée comparative, il s’agit notamment de comparer l’intensité de la relation statistique entre les taux comparatifs de mortalité et un indicateur de défaveur sociale dans le Nord de la France et dans le Sud-est de l’Angleterre, à partir de données agrégées et spatialisées ; Dans un second temps, nous cherchons à apprécier les inégalités de santé à partir des données d’enquêtes en population générale conduites des deux côtés de la Manche. Nous proposons une méthodologie statistique originale permettant d’identifier les principaux déterminants des variations d’état de santé entre individus. Ce rapport est naturellement organisé en deux parties. Chaque partie aborde la question des données disponibles, présente la méthodologie statistique mobilisée et discute les résultats obtenus

Outcomes Associated With Esophageal Perforation Management

International audienceObjective: To evaluate outcomes associated with esophageal perforation (EP) management at a national level and determine predictive factors of 90-day mortality (90dM), failure-to-rescue (FTR), and major morbidity (MM, Clavien-Dindo 3-4). Background: EP remains a challenging clinical emergency. Previous population-based studies showed rates of 90dM up to 38.8% but were outdated or small-sized. Methods: Data from patients admitted to hospitals with EP were extracted from the French medico-administrative database (2012–2021). Etiology, management strategies, and short and long-term outcomes were analyzed. A cutoff value of the annual EP management caseload affecting FTR was determined using the “Chi-squared Automatic Interaction Detector” method. Random effects logistic regression model was performed to assess independent predictors of 90dM, FTR, and MM. Results: Among 4765 patients with EP, 90dM and FTR rates were 28.0% and 19.4%, respectively. Both remained stable during the study period. EP was spontaneous in 68.2%, due to esophageal cancer in 19.7%, iatrogenic postendoscopy in 7.3%, and due to foreign body ingestion in 4.7%. Primary management consisted of surgery (n = 1447,30.4%), endoscopy (n = 590,12.4%), isolated drainage (n = 336,7.0%), and conservative management (n = 2392,50.2%). After multivariate analysis, besides age and comorbidity, esophageal cancer was predictive of both 90dM and FTR. An annual threshold of ≥8 EP managed annually was associated with a reduced 90dM and FTR rate. In France, only some university hospitals fulfilled this condition. Furthermore, primary surgery was associated with a lower 90dDM and FTR rate despite an increase in MM. Conclusions: We provide evidence for the referral of EP to high-volume centers with multidisciplinary expertise. Surgery remains an effective treatment for EP

Cloning and characterization of the human V3 pituitary vasopressin receptor

AbstractArginine-vasopressin (AVP) plays a determinant role in the normal ACTH response to stress in mammals. We cloned a human cDNA coding a 424 amino acid G-protein coupled receptor structurally related to the vasopressin/oxytocin receptor family. When expressed in COS cells, this receptor binds AVP with a high affinity (Kd = 0.55 ± 0.13 nM) and is functionally coupled to phospholipase C. Competition studies with peptidic or non peptidic AVP analogues reveal that it is pharmacologically distinct from V1a and V2 AVP receptors and therefore it is designated V3. RT-PCR analysis shows that the human V3 receptor is expressed in normal pituitary and also in kidney, but is undetectable in liver, myometrium and adrenal gland. Northern blot analysis reveals a ∼4.8 kb messenger in human corticotropic pituitary adenomas

Table3_Impact of RSV test positivity, patient characteristics, and treatment characteristics on the cost of hospitalization for acute bronchiolitis in a French university medical center (2010–2015).docx

BackgroundIn young children, respiratory syncytial virus (RSV)-related bronchiolitis is typically more severe than other respiratory tract infections, with a greater need for oxygen therapy and respiratory support. Few studies have compared the cost of hospitalization with regard to virological status. The objective of this study was to compare the costs of hospitalization for RSV-positive vs. RSV-negative bronchiolitis in a French university medical center between 2010 and 2015.MethodsThe cost models were compared using conventional goodness-of-fit criteria. Covariates included the characteristics of the patients, pre-existing respiratory and non-respiratory comorbidities, superinfections, medical care provided, and the length of stay.ResultsRSV was detected in 679 (58.3%) of the 1,164 hospital stays by children under 2 years with virological data. Oxygen therapy and respiratory support were twice as frequent for the RSV-positive cases. The median hospitalization cost was estimated at €3,248.4 (interquartile range: €2,572.1). The cost distribution was positively skewed with a variation coefficient (CV = standard deviation/mean) greater than one (mean = €4,212.9, standard deviation = €5,047, CV = 1.2). In univariate analyses, there was no significant cost difference between the RSV-positive and RSV-negative cases. In the best multivariate model, the significant positive effect of RSV positivity on cost waned after the introduction of medical care variables and the length of stay. The results were sensitive to the specification of the model.ConclusionsIt was impossible to firmly conclude that hospitalization costs were higher for the RSV-positive cases.</p

Table1_Impact of RSV test positivity, patient characteristics, and treatment characteristics on the cost of hospitalization for acute bronchiolitis in a French university medical center (2010–2015).docx

BackgroundIn young children, respiratory syncytial virus (RSV)-related bronchiolitis is typically more severe than other respiratory tract infections, with a greater need for oxygen therapy and respiratory support. Few studies have compared the cost of hospitalization with regard to virological status. The objective of this study was to compare the costs of hospitalization for RSV-positive vs. RSV-negative bronchiolitis in a French university medical center between 2010 and 2015.MethodsThe cost models were compared using conventional goodness-of-fit criteria. Covariates included the characteristics of the patients, pre-existing respiratory and non-respiratory comorbidities, superinfections, medical care provided, and the length of stay.ResultsRSV was detected in 679 (58.3%) of the 1,164 hospital stays by children under 2 years with virological data. Oxygen therapy and respiratory support were twice as frequent for the RSV-positive cases. The median hospitalization cost was estimated at €3,248.4 (interquartile range: €2,572.1). The cost distribution was positively skewed with a variation coefficient (CV = standard deviation/mean) greater than one (mean = €4,212.9, standard deviation = €5,047, CV = 1.2). In univariate analyses, there was no significant cost difference between the RSV-positive and RSV-negative cases. In the best multivariate model, the significant positive effect of RSV positivity on cost waned after the introduction of medical care variables and the length of stay. The results were sensitive to the specification of the model.ConclusionsIt was impossible to firmly conclude that hospitalization costs were higher for the RSV-positive cases.</p