Adaptation culturelle et validation d'un outil en français du Québec pour mesurer l'intensité de la dyspnée chez les patients atteints de maladies pulmonaires

Le Modified Dyspnea Index (MDI) est un outil multidimensionnel développé pour améliorer le degré d’objectivité dans l’évaluation de la dyspnée. Cette étude avait pour but de faire l’adaptation transculturelle du MDI pour la population franco-canadienne et à en tester la fidélité et la validité auprès de patients atteints d’hypertension artérielle pulmonaire (HTP) ou de maladies interstitielles pulmonaires (MIP). La fidélité a été évaluée selon le critère de l’équivalence interjuges. La validité a été évaluée selon le critère de validité convergente en ayant comme base la théorie des symptômes déplaisants et en utilisant les mesures de la condition clinique (classe fonctionnelle et fonction pulmonaire), de la capacité physique, de la pratique d’activités physiques et de la qualité de vie. La proportion d’agrément entre les juges a été satisfaisante, renforçant l’évidence de fidélité. Les corrélations observées entre le MDI et les autres variables suggèrent fortement la validité du MDI auprès d’une population atteinte d’HTP ou de MIP dans le contexte franco-canadien.The Modified Dyspnea Index (MDI) is a multidimensional tool developed to improve the level of objectivity in the assessment of dyspnea. This study was aimed at proceeding to the cross-cultural adaptation of the MDI for the French-Canadian population and testing its reliability and validity among patients with pulmonary arterial hypertension (PAH) or interstitial lung disease (ILD). The criterion of interrater equivalence was used to evaluate the reliability. Validity was assessed according to the criterion of convergent validity using the Theory of Unpleasant Symptoms as conceptual model to guide the hypothesis. Then the MDI was tested against the measures of clinical status (functional class and lung function), physical capacity, physical activity and quality of life. The proportion of agreement between judges was satisfactory, reinforcing the evidence of reliability. Observed correlations between MDI and other variables strongly suggest the validity of the MDI with a population of HTP or MIP patients in the French-Canadian context

Comment intégrer la maîtrise de la flore adventice dans le cadre général d'un système de production intégrée ?

Colloque du 2 décembre 2008 à DijonIntegrated production consists in substituting the use of chemical inputs by others technical interventions, using a set of agronomic reasoning and rules. In this paper, several studies of integrated production are first reported. The experiments were carried out for annual crops, in long term experiments, or were conducted by farmers. This review points out the lack of deep modifications in weeding practices in those trials, compared with the changes in nitrogen fertilisation or crop protection against diseases for example. This first conclusion is related to the characteristics of the weed flora. The relationships between the different technical practices, involved in cropping systems, and the evolution of the weed populations are presented. We therefore discuss how far the weed management must and can be adapted in new cropping systems following today the principles of integrated production. Finally, prospects for researches useful for integrating weed management in designing new cropping systems are discussed.La production intégrée peut être définie comme un ensemble de principes et de raisonnements agronomiques visant à remplacer autant que possible l'utilisation des intrants de synthèse par d'autres interventions. Nous présentons tout d'abord plusieurs expériences de production intégrée ayant été conduites dans des essais annuels pour des itinéraires techniques, dans des essais de longue durée pour des systèmes de culture complets, ou chez des agriculteurs. Il ressort de cet inventaire que la question de la gestion des adventices donne le plus souvent lieu à des modifications limitées même dans le cas de productions mettant en oeuvre des systèmes de culture profondément transformées. Ce constat est mis en regard des spécificités de la flore adventice dans le champ cultivé, et nous rappelons les conséquences des différentes techniques culturales mises en oeuvre dans les systèmes de culture sur l'évolution de la flore adventice. Ce rappel permet de discuter les conséquences prévisibles des différentes évolutions actuelles des systèmes de culture, comme la simplification du travail du sol ou l'allongement des successions. En conclusion, les recherches à mener pour permettre une meilleure prise en compte de l’évolution de la flore adventice dans la conception de systèmes de cultures sont discutées

Polarization experiments

Possible instrumental set--ups for the measurement of CMB polarization are reviewed in this article. We discuss existing and planned instruments, putting special emphasis on observational, instrumental, and data processing issues for the detection of very low polarization signals of prime cosmological interest. A short prospective summary is included

Social learning for enhancing social-ecological resilience to disaster-shocks : a policy Delphi approach

Publisher Copyright: © 2021, Emerald Publishing Limited.Purpose: The plethora of contributions to social learning has resulted in a wide range of interpretations, meanings and applications of social learning, both within and across disciplines. However, advancing the concept and using social learning methods and tools in areas like disaster-shocks requires interdisciplinary consolidation of understandings. In this context, the primary focus of this paper is on the contributions of social learning to disaster risk reduction (DRR). Design/methodology/approach: By applying a three-round policy Delphi process involving 18 purposefully selected scholars and expert-practitioners, the authors collected data on the meanings of social learning for two groups of professionals, DRR and social-ecological resilience. The survey instruments included questions relating to the identification of the core elements of social learning and the prospects for enhancing social-ecological resilience. Findings: The results revealed strong agreement that (1) the core elements of social learning indicate a collective, iterative and collaborative process that involves sharing/networking, changes in attitudes and knowledge and inclusivity; (2) social learning from disasters is unique; and (3) linkages between disciplines can be built by promoting interdisciplinarity, networks and knowledge platforms; collaboration and coordination at all levels; and teaching and practicing trust and respect. Social learning is useful in preparing for and responding to specific disaster events through communication; sharing experience, ideas and resources; creating synergies for collective action and promoting resilience. Research limitations/implications: The policy Delphi process involved a limited number of participants to control the quality of the data. To the best of the authors’ knowledge, this paper is the first of its kind to identify the core elements of social learning, specifically, in the disaster-shock context. It also makes significant contributions to the interdisciplinary integration issues. Practical implications: The practical implications of this study are related to pre-disaster planning and mitigation through the application of social learning on disaster-shocks. Social implications: The social implications of this study are related to valuing social learning for the improvement of disaster planning, management, and policy formulation and implementation in reducing disaster risks. Originality/value: The study provides a consensus view on the core elements of social learning and its role in DRR and resilience building. Relevant to all stages of DRR, social learning is best characterized as a collective, iterative and collaborative process. It can be promoted by enhancing networking and interdisciplinarity.Peer reviewe

Diversity of experimentation by farmers engaged in agroecology

International audienceAbstractAgroecology questions the production of generic knowledge. Rather than searching for the best practices for large-scale transfer, it would be more efficient to help farmers find their own solutions. A promising activity for farmers is experimentation because it answers their needs and helps them learn. However, how agroecological practices are tested by farmers in their own experiments is still poorly known. In this study, we examined the short-term experimental activity, i.e., experiments carried out at a yearly scale in pre-defined fields. Seventeen farmers in south eastern France were surveyed. The farmers practiced conventional or organic farming and cultivated either arable or market garden crops. Experiments on agroecological practices were characterized, located along a timeline, and discussed with them. To conduct the interviews with the farmers, each experiment was described in three stages: (1) designing the experiment, (2) managing it in real time, and (3) evaluating the results of the experiment. The data collected in the interviews were first analyzed to build a descriptive framework of farmers’ experiments, after which hierarchical cluster analysis was used to analyze the diversity of the farmers’ experiments. Here, we propose for the first time a generic framework to describe farmers’ experiments at a short time scale based on the consistency between the Design, Management, and Evaluation stages. We used the framework to characterize the diversity of farmers’ experiments and identified four clusters. The originality of this work is both building a descriptive framework resulting from in-depth analyses of farmers’ discourse and using statistical tools to identify and interpret the groups of experiments. Our results provide a better understanding of farmers’ experiments and suggest tools and methods to help them experiment, a major challenge in the promotion of a large-scale agroecological transition

Agroecosystem management and biotic interactions: a review

Increasing the use of synthetic fertilisers and pesticides in agroecosystems has led to higher crop yields, accompanied by a decline in biodiversity at the levels of field, cropping system and farm. Biodiversity decline has been favoured by changes at landscape level such as regional farm specialisation, increases in field size, and the removal of hedgerows and woodlots. The loss of biodiversity in agroecosystems has increased the need for external inputs because beneficial functions are no longer provided by beneficial species as natural enemies of crop pests and ecosystem engineers. This trend has led to a strong reliance on petrochemicals in agroecosystems. However, many scientists have been arguing for more than two decades that this reliance on petrochemicals could be considerably reduced by a better use of biotic interactions. This article reviewsoptions to increase beneficial biotic interactions in agroecosystems and to improve pest management and crop nutrition whilst decreasing petrochemical use. Four agronomic options are presented. First, it has been shown that the choice of cultivar, the sowing date and nitrogen fertilisation practices can be manipulated to prevent interactions between pests and crop, in either time or space. Nevertheless, the efficacy of these manipulations may be limited by pest adaptation. Second, beneficial biotic interactions may result from appropriate changes to the habitats of natural enemies and ecosystem engineers, mediated by soil and weed management. Here, knowledge is scarce, and indirect and complex effects are poorly understood. Third, changes achieved by crop diversification and, fourth, by landscape adaptation are promising. However, these practices also present drawbacks that may not necessarily be outweighed by beneficial effects. Overall, these four management approaches provide a powerful framework to develop sustainable agronomic practices

Prediction of the intestinal resistome by a three-dimensional structure-based method

The intestinal microbiota is considered to be a major reservoir of antibiotic resistance determinants (ARDs) that could potentially be transferred to bacterial pathogens via mobile genetic elements. Yet, this assumption is poorly supported by empirical evidence due to the distant homologies between known ARDs (mostly from culturable bacteria) and ARDs from the intestinal microbiota. Consequently, an accurate census of intestinal ARDs (that is, the intestinal resistome) has not yet been fully determined. For this purpose, we developed and validated an annotation method (called pairwise comparative modelling) on the basis of a three-dimensional structure (homology comparative modelling), leading to the prediction of 6,095 ARDs in a catalogue of 3.9 million proteins from the human intestinal microbiota. We found that the majority of predicted ARDs (pdARDs) were distantly related to known ARDs (mean amino acid identity 29.8%) and found little evidence supporting their transfer between species. According to the composition of their resistome, we were able to cluster subjects from the MetaHIT cohort (n = 663) into six resistotypes that were connected to the previously described enterotypes. Finally, we found that the relative abundance of pdARDs was positively associated with gene richness, but not when subjects were exposed to antibiotics. Altogether, our results indicate that the majority of intestinal microbiota ARDs can be considered intrinsic to the dominant commensal microbiota and that these genes are rarely shared with bacterial pathogens

Population distribution and burden of acute gastrointestinal illness in British Columbia, Canada

BACKGROUND: In developed countries, gastrointestinal illness (GI) is typically mild and self-limiting, however, it has considerable economic impact due to high morbidity. METHODS: The magnitude and distribution of acute GI in British Columbia (BC), Canada was evaluated via a cross-sectional telephone survey of 4,612 randomly selected residents, conducted from June 2002 to June 2003. Respondents were asked if they had experienced vomiting or diarrhoea in the 28 days prior to the interview. RESULTS: A response rate of 44.3% was achieved. A monthly prevalence of 9.2% (95%CI 8.4 – 10.0), an incidence rate of 1.3 (95% CI 1.1–1.4) episodes of acute GI per person-year, and an average probability that an individual developed illness in the year of 71.6% (95% CI 68.0–74.8), weighted by population size were observed. The average duration of illness was 3.7 days, translating into 19.2 million days annually of acute GI in BC. CONCLUSION: The results corroborate those from previous Canadian and international studies, highlighting the substantial burden of acute GI

EHS Rapid Guideline: Evidence-Informed European Recommendations on Parastomal Hernia Prevention—With ESCP and EAES Participation

Background: Growing evidence on the use of mesh as a prophylactic measure to prevent parastomal hernia and advances in guideline development methods prompted an update of a previous guideline on parastomal hernia prevention.Objective: To develop evidence-based, trustworthy recommendations, informed by an interdisciplinary panel of stakeholders.Methods: We updated a previous systematic review on the use of a prophylactic mesh for end colostomy, and we synthesized evidence using pairwise meta-analysis. A European panel of surgeons, stoma care nurses, and patients developed an evidence-to-decision framework in line with GRADE and Guidelines International Network standards, moderated by a certified guideline methodologist. The framework considered benefits and harms, the certainty of the evidence, patients’ preferences and values, cost and resources considerations, acceptability, equity and feasibility.Results: The certainty of the evidence was moderate for parastomal hernia and low for major morbidity, surgery for parastomal hernia, and quality of life. There was unanimous consensus among panel members for a conditional recommendation for the use of a prophylactic mesh in patients with an end colostomy and fair life expectancy, and a strong recommendation for the use of a prophylactic mesh in patients at high risk to develop a parastomal hernia.Conclusion: This rapid guideline provides evidence-informed, interdisciplinary recommendations on the use of prophylactic mesh in patients with an end colostomy. Further, it identifies research gaps, and discusses implications for stakeholders, including overcoming barriers to implementation and specific considerations regarding validity