A ten-years-after impact analysis of a Companion Modelling approach. Final evaluation report: The 'Plan d'Occupation et d'Affectation des Sols (POAS)' operation in the rural community of Ross Bethio in Senegal

The approach: 1. Companion Modeling (ComMod) is a participatory approach used over the 15 years all over the world in order to help a diversity of stakeholders progress to reach an agreement about how to collectively deal with a given issue (multiple uses of natural resources, conflict resolution, value chain organization, land uses planning, policy participatory design, participatory monitoring and evaluation...). The approach achieves lasting impacts for empowerment at both local and national levels thanks to a twofold specificity: methodological and strategic. 2. The methodology focuses on a specific capacity building objective: to let the targeted groups learn by doing right from the first step, through an autonomous and collective practice of designing solutions to a common issue, then assessing and improving these solutions. The role of the support team is limited to monitoring only. The aim is to establish a dynamic autonomous learning-by-doing process which will continue after the light external intervention and make incremental empowerment impacts from local to national levels. 3. The approach also strongly focuses on defining an initial institutional strategy to impact the whole institutional context, from local to national levels. The strategy is defined around the identification of the needed first and smallest change of the local context for a first but lasting impact on empowerment, and, from there, the prior relationships and capacity building that need to be established to set in motion the essential first socio institutional step previously identified. 4. As a result, ComMod approach consists in a light support of (i) the prior design of an empowerment strategy, and (ii) three 2 days participatory workshops (for about 25 people, from the local aimed group) dispatched on 2 years. 5. The empowerment strategy is collectively designed by a local strategic alliance rallied at the beginning of the project. Then participatory workshops used specific role playing games in which participants themselves design the game, and then test their own ideas on how to collectively deal with the issue. These simulation games enable participants to explore future scenarios, by 'playing' their ideas and assessing the consequences in the game/model. As the roles of the different players preserve the diversity of stakeholders, potential impacts are assessed for each stakeholder's group, in peculiar distinguishing disadvantaged groups. 6. Lasting empowerment impacts on local autonomy are expected after the intervention, and both at local and national levels, thanks to the autonomous learning-by-doing process: (i) local autonomous improvement of the initial participatory decisions and (ii) progressive autonomous advocacy to embed local issues into national policies. 7. The approach is mastered by an increasing international community of practice (www.commod.org), which provides reference people, guidelines, training materials and trainings. The evaluation: 8. Between April and July 2012, IFAD has supported the evaluation of the oldest ComMod experiment ("Opération Poas" 1999-2000, Senegal River Valley, Senegal). The objective of this past intervention was to empower rural district councils so that they would be able to autonomously (i) design then manage a local land uses planning, (ii) oppose higher powers (specially centralized State agencies) to defend local interests and points of view; (iii) embed their local needs in national policy frameworks. The chosen site for the experiment was the largest and most complex rural district of Senegal: the Ross Bethio Communauté Rurale, that covers the whole Delta of Senegal River. 9. Evaluation showed sustainable local impacts, whether in the short term (e.g. after three 2-days-workshops, the district council has designed and implemented its own planning to deal with the key issues it has chosen; this also represented a step for the district council to learn about more inclusiveness in its decision-making), or in the medium term (e.g. after the end of the support, the district council found alone the means to develop infrastructure, to organize internally to manage the issue, and even to efficiently defend local needs from top-down programs and behaviors), or in the long term (e.g. 12 years after, some local councils still use their 'Poas' plan to oppose to land grabbing). 10. Evaluation also showed national impacts, whether in the short term (e.g. 2 years after the end of the support, a council of ministers council stipulated that the method should taken up in the whole country), or in the medium term (e.g. each regional plan takes into account the local land uses needs identified during the Poas experiment), and in the long term (e.g. 12 years after, the methodology designed by the local council during the ComMod experiment is acknowledged throughout country, but also in some bordering countries, to set district land uses planning). 11. These different impacts have been reached through an autonomous progressive diffusion, from the initial (1998-2000) well-thought capacity- and relationships--building and institutional strategic facilitation

Jouer avec diverses sources de régulation foncière : le pluralisme sahélien

En Afrique sahélienne, la situation foncière se caractérise par l'imbrication de normes et d'instances en matière de régulation foncière, reposant à la fois sur des pratiques locales informelles (mais reconnues par les populations) et sur un droit foncier légal où l'essentiel du territoire demeure au sein de l'État. Les acteurs du foncier s'appuient en pratique plus sur un portefeuille de sources de régulations dans lequel ils puisent selon le contexte, plutôt que sur une seule référence de régulation reconnue et appliquée par tous. Sur la base d'une expérimentation s'appuyant sur un jeu de rôle pour tester la réalité et les conditions de ces comportements locaux de mobilisation et d'usage de différentes sources de régulation foncière, l'article propose des premières pistes de réflexion pour appréhender les contextes dans lesquels s'intégreraient les futures politiques foncières mises en place par les États sahéliens, dont le Sénégal, où a été conduite la présente recherche

Régime sans gluten

Tuberculosis, despite its prevention, remains an endemic affection in Morocco. Although rare, pseudo surgical forms and especially peritonitis are mainly due to delayed diagnosis. We report the case of a 30-year-old woman, admitted for peritonitis. The diagnosis of tuberculous peritonitis was established during surgery with macroscopic observation of granulations, and confirmed after biopsy specimens by identification of a giant lymph node cell granuloma with caseous necrosis. Outcome was favorable after appropriate antibiotic therapy. This observation emphasizes the fact that peritonitis, although a rare complication of peritoneal tuberculosis, poses problems of positive and differential diagnosis. Even if treatment is based on antituberculous quadritherapy, surgery is sometimes necessary and should be decided in due time

Risques et adaptation nutritionnelle en cancérologie

This article starts with a presentation of Caycedian Sophrology. We then evaluate its impact on stress reduction through a questionnaire on a students’ population. It appears that stress level increases between the two sessions in the control group while it decreases in the experimental group

Thermal Flows

Flows of thermal origin and heat transfer problems are central in a variety of disciplines and industrial applications. The present book entitled Thermal Flows consists of a collection of studies by distinct investigators and research groups dealing with different types of flows relevant to both natural and technological contexts. Both reviews of the state-of-the-art and new theoretical, numerical and experimental investigations are presented, which illustrate the structure of these flows, their stability behavior, and the possible bifurcations to different patterns of symmetry and/or spatiotemporal regimes. Moreover, different categories of fluids are considered (liquid metals, gases, common fluids such as water and silicone oils, organic and inorganic transparent liquids, and nano-fluids). This information is presented under the hope that it will serve as a new important resource for physicists, engineers and advanced students interested in the physics of non-isothermal fluid systems; fluid mechanics; environmental phenomena; meteorology; geophysics; and thermal, mechanical and materials engineering

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

The separation of civil and military powers : a comparative study

Cette thèse entend démontrer par le recours à la comparaison que le principe de séparation des pouvoirs civils et militaires constitue un élément fondamental des Etats de tradition libérale. En droit, elle prend la forme d’incompatibilités. Dans un premier temps, suite aux expériences de confusion des pouvoirs civils et militaires cette séparation a pris la forme d’une incompatibilité entre le militaire et l’électeur. Dans un second temps, cette séparation a pris la forme d’une incompatibilité entre le militaire et le représentant.This comparative study aims to demonstrate that the principle of separation of civil and military powers is a fundamental part of States with liberal tradition. In law it takes the form of incompatibilities. In law, it takes the form of incompatibilities. Initially, following the experiences of confusion of civil and military powers that separation has taken the shape of an incompatibility between the military and the voter. In a second step, this separation has taken the shape of a mismatch between the military and the representative

CONTRIBUTION DE L'ETUDE DU GENOTYPE DE L'APOLIPOPROTEINE E AU DIAGNOSTIC POSITIF ET DIFFERENTIEL DE LA MALADIE D'ALZHEIMER

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF