To set up pedagogical experiments in a virtual lab: methodology and first results

This paper concerns a methodology for setting up web based experiments by distinguishing two perspectives: the learning perspective (which tasks will be scheduled for pupils and tutors, how they are planned and what learning objectives they may attempt), and separately, the experiment perspective (how teachers or researchers may use trails of this experiment, the first to improve their teaching, the last to various research objectives). The both are described by computable “scenarios” expressed with an educational modeling language, Learning Design Language (LDL). Scenarios are then implemented on a platform (LearningLab platform) to be played by pupils and tutors and further analyzed by exploiting trails of each run

Une infrastructure logicielle pour instrumenter l'expérimentation des EIAH

International audienceCet article a pour objet de présenter une plate-forme logicielle développée dans le but de faciliter le travail des chercheurs dans la mise en place et la réalisation d'expérimentations dans le domaine des EIAH. Ce travail a été réalisé dans le cadre de l'action « Shared Virtual Lab » (SVL) du réseau d'excellence Kaleidoscope, et les outils ont été exploités pour la réalisation d'une expérimentation complexe mettant en oeuvre simultanément plusieurs EIAH développés au sein de l'équipe MeTAH du LIG. Le scénario décrivant l'activité des élèves et des enseignants impliqués dans l'expérimentation est décrit en langage LDL et interprété par la plate-forme. Les traces d'activité produites par les logiciels expérimentés et par la plate-forme sont centralisées dans une base de données XML. Elles ont été exploitées en temps réel par un outil de suivi destiné aux enseignants

Ruptures d'approvisionnement en médicaments anti-infectieux: causes et conséquences

International audienceAnti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs

Transition and control in rotating-disk boundary-layer

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Twelve-year mortality in HIV-infected patients receiving antiretroviral therapy (ART): the role of social vulnerability. The ANRS CO8 APROCO-COPILOTE cohort

International audienceBackground: Although the role of clinical/biological factors associated with mortality has already been explored in HIV-infected patients on antiretroviral therapy (ART), to date little attention has been given to the potential role of social vulnerability. This study aimed to construct an appropriate measure of social vulnerability and to evaluate whether this measure is predictive of increased mortality risk in ART-treated patients followed up in the ANRS CO8 APROCO-COPILOTE cohort.Methods: The cohort enrolled 1,281 patients initiating a protease inhibitor-based regimen in 1997–1999. Clinical/laboratory data were collected every 4 months. Self-administered questionnaires collected psycho-social/behavioural characteristics at enrolment (month [M] 0), M4 and every 8–12 months thereafter. A multiple correspondence analysis using education, employment and housing indicators helped construct a composite indicator measuring social vulnerability. The outcome studied was all-cause deaths occurring after M4. The relationship between social vulnerability and mortality, after adjustment for other predictors, was studied using a shared-frailty Cox model, taking into account informative study dropout.Results: Over a median (IQR) follow-up of 7.9 (3.0–11.2) years, 121 deaths occurred among 1,057 eligible patients, corresponding to a mortality rate (95% CI) of 1.64 (1.37, 1.96)/100 person-years. Leading causes of death were non-AIDS defining cancers (n=26), AIDS (n=23) and cardiovascular diseases (n=12). Social vulnerability (HR [95% CI] =1.2 [1.0, 1.5]) was associated with increased mortality risk, after adjustment for other known behavioural and bio-medical predictors.Conclusions: Social vulnerability remains a major mortality predictor in ART-treated patients. A real need exists for innovative interventions targeting individuals cumulating several sources of social vulnerability, to ensure that social inequalities do not continue to lead to higher mortality

Adherence to and effectiveness of Highly Active Antiretroviral Treatment for HIV infection: assessing the bidirectional relationship

It is well-established that high adherence to HAART is a major determinant of virological and immunological success. Furthermore, psycho-social research has identified a wide range of adherence factors. Our objective was to assess the bi-directional relationship between adherence and response to treatment among patients enrolled in the ANRS CO8 APROCOCOPILOTE study. An econometric approach was implemented through a bivariate twoequation simultaneous system, studying the factors associated with both adherence and undetectability of HIV plasma viral load. Our results highlight that good biological results induced by adherence reinforce continued adherence. This strengthens the argument that patients who do not experience rapid improvements in their immunological and clinical statuses after HAART initiation should be prioritized when developing adherence support interventions. Furthermore, it rules out the hypothesis that HAART leads to "false reassurance" among HIV infected patients.Adherence ; HIV ; relationship between adherence and effectiveness ; simultaneous equations ; GEE

The poetry of Celtic places

This paper examines the radical shift in the place of Celts in the French imagination during the course of the nineteenth century, by focusing on two versions of a passage describing Wales by Michelet: the first written in his travel journal (1834), the second published by his widow (1893). Wales, by virtue of being a Celtic place, allows Michelet to deepen his understanding of France. Whereas juxtaposition of the two versions of his text reveals something of the French state’s attitude toward the ambiguously domestic and exotic Celtic “other.