Estimation et décomposition de l'efficacité économique des zones irriguées pour mieux gérer les inefficacités existantes

International audienceDans le nouveau contexte de raréfaction de la ressource en eau et l'ouverture de l'économie tunisienne la problématique de l'eau en Tunisie est de plus en plus une question de répartition de la ressource entre usagers et zones qui valorisent différemment l'eau. Ainsi, afin d'assurer une meilleure valorisation globale de la ressource les considérations économiques s'imposent. Dans ce cadre, nous étudions le niveau de performance des zones irriguées au sein du bassin versant de Merguellil en Tunisie centrale. En adoptant une approche paramétrique, les niveaux d'efficacité économique ont été estimés et décomposés en efficacité allocative et technique à partir d'une frontière stochastique de production. Des données de panel ont été utilisées. L'analyse correspond à la période 1994-2003. Les résultats empiriques montrent qu'il existe un différentiel d'efficacité entre les zones étudiées. En effet, les marges de manoeuvre en terme d'amélioration de la production et du profit à l'échelle du bassin sont donc importantes. Pour un niveau donné de production, il est possible d'accroître le profit global d'environ 11 millions de dinars et d'améliorer la valorisation de l'eau par rapport à la situation observée de 53% en éliminant les inefficacités existantes. Dans cet objectif, l'examen des déterminants de l'efficacité économique montre que l'accès aux crédits et l'économie de l'eau affectent celle-ci positivement alors que le poids des petites exploitations et le taux de diversification sont corrélés négativement avec le niveau d'efficacité. Ainsi, une politique foncière d'attribution des titres de propriété aux agriculteurs pour accéder aux crédits pourrait améliorer le niveau global de l'efficacité économique. Soit, une augmentation du profit global d'environ un million de dinars et une amélioration de la valeur de l'eau de 0,031 DT/m3

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis : Fundamentals Of Care for UveitiS (FOCUS) Initiative

Supplemental material available at www.aaojournal.org. Supported by AbbVie, Inc., and the Fundamentals of Care for Uveitis Initiative National Faculty. This manuscript was developed subsequent to an AbbVie-sponsored literature review of noninfectious, nonanterior uveitis. The meeting was conducted to understand the available literature regarding the management of patients with noninfectious, nonanterior uveitis. The program involved a total of 139 experts from 28 countries, who were selected for participation by AbbVie. However, AbbVie was not involved in the development of the manuscript. The authors maintained complete control over the content and this manuscript reflects the opinions of the authors. AbbVie selected the discussion participants and reviewed the final manuscript draft for scientific accuracy, but the authors determined the final content. All authors made substantial contributions to the article or critically revised it for important intellectual content and approved the final manuscript. AbbVie provided funding to invited participants, including honoraria for their attendance at the meetings. Travel to and from the meetings was reimbursed. No payments were made to the authors for the development of this manuscript. Dhinakaran Sambandan, PhD, and Shula Sarner, PhD, of Lucid Partners, Burleighfield House, Buckinghamshire, United Kingdom, provided medical writing and editorial support to the authors in the development of this manuscript; financial support for these services was provided by AbbVie. AbbVie reviewed the manuscript, but was not involved in the methodology, data collection and analysis, or completion of this manuscript.Peer reviewedPublisher PD

Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic reviewof the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE,CINAHL,SCOPUS,BIOSIS, andWeb of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review.Atotal of 44 globally representativegroupmembersmet in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents