64 research outputs found
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05â2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Grecs et indigĂšnes de la Catalogne Ă la mer Noire
Le programme de travail qui aboutit Ă ce livre sâinscrit dans le cadre du rĂ©seau dâexcellence europĂ©en Ramses2, initiĂ© par la Maison mĂ©diterranĂ©enne des sciences de lâhomme. Une demi-douzaine de tables rondes ont rĂ©uni entre 2006 et 2008, dâun bout Ă lâautre de la MĂ©diterranĂ©e (Ă EmpĂșries, Aix-en-Provence, Palerme, Naples, AthĂšnes), quelque soixante-dix chercheurs essentiellement français, italiens et espagnols, mais aussi anglais, grecs, bulgares, roumains, canadiens et russes. Il sâagissait dâĂ©tudier les rapports dâacculturation entre colons grecs et populations indigĂšnes, en tenant compte des diffĂ©rences gĂ©ographiques et chronologiques mais aussi de lâhistoriographie et des habitudes de recherche des diverses institutions. Les nombreuses communications qui ont jalonnĂ© les six tables rondes sont ici la plupart du temps prĂ©cĂ©dĂ©es de textes introductifs. Une premiĂšre partie, consacrĂ©e aux approches rĂ©gionales, permet dâillustrer lâĂ©tat de la recherche dans quelques rĂ©gions choisies (autour dâEmpuries, dâHimĂšre, de Marseille, de VĂ©lia, en Thrace et en mer Noire). La seconde partie, thĂ©matique, aborde un certain nombre de thĂšmes de recherche dans les rĂ©gions prĂ©cĂ©dentes, mais aussi dans dâautres rĂ©gions du monde de la colonisation grecque. Le point de vue adoptĂ© dans ce livre est dâabord celui de la culture matĂ©rielle ; lâapproche en est essentiellement archĂ©ologique. On se demandera par exemple quels sont les indices archĂ©ologiques qui permettent de dire si un site est habitĂ© par des Grecs, par des indigĂšnes ou par une population âmixteâ, et comment ces indices ont Ă©tĂ© apprĂ©ciĂ©s selon les pĂ©riodes et selon les rĂ©gions. Beaucoup de communications prĂ©sentent des synthĂšses rĂ©gionales ou thĂ©matiques, mais une large place est faite Ă©galement Ă des sites inĂ©dits, pour lesquels on nâa pas hĂ©sitĂ© Ă livrer une abondante documentation (plans, matĂ©riel de fouille). Câest en effet par le renouvellement de la documentation archĂ©ologique que nous pouvons espĂ©rer avancer dans la comprĂ©hension des rapports dâacculturation entre les colons grecs et les populations locales
Contacts et acculturations en Méditerranée occidentale
La question des contacts entre les diffĂ©rents peuples qui bordent les rives de la MĂ©diterranĂ©e nord occidentale est lâun des sujets phares de la recherche archĂ©ologique de ces trente derniĂšres annĂ©es. Que lâon parle dâĂ©poque archaĂŻque et classique ou de Protohistoire et dâĂąge du Fer, les Ă©changes et les processus dâacculturation de ces peuples qui entrĂšrent alors en contact les uns avec les autres : Grecs, Celtes, PhĂ©niciens, IbĂšres, Ligures, Ătrusques, ont retenu lâattention des chercheurs travaillant sur lâexpansion grecque dans ces rĂ©gions, sur les trafics commerciaux, sur les Ă©changes culturels. LâĆuvre de Michel Bats (Directeur de recherche honoraire du CNRS) traverse toutes ces thĂ©matiques : la prĂ©sence des PhocĂ©ens et des Ătrusques dans le bassin occidental de la MĂ©diterranĂ©e, lâacculturation et les identitĂ©s ethno-culturelles, les recherches sur la cĂ©ramique et ses usages dans une perspective anthropologique, lâappropriation de lâĂ©criture par les sociĂ©tĂ©s protohistoriques. Ses collĂšgues et amis, en organisant ce colloque et en participant Ă ces actes, entendent lui tĂ©moigner leur amitiĂ© et leur dette intellectuelle. Ce volume rĂ©unit des articles des meilleurs spĂ©cialistes, actuels de la question - des chercheurs de toute la MĂ©diterranĂ©e - autour des quatre grands thĂšmes que nous venons dâĂ©voquer afin tout Ă la fois de dresser un bilan et de dĂ©finir de nouvelles perspectives. Cet ouvrage prĂ©sente donc aussi bien des synthĂšses - sur la prĂ©sence grecque en Espagne, sur lâorigine de lâĂ©criture, sur les pratiques funĂ©raires, sur les identitĂ©s culturelles et ethniques - que des dĂ©couvertes rĂ©centes concernant la thĂ©matique des contacts et de lâacculturation en MĂ©diterranĂ©e nord occidentale : lâagglomĂ©ration du Premier Ăąge du Fer de La Cougourlude (Lattes, HĂ©rault) fouillĂ©e durant lâĂ©tĂ© 2010 ; le sanctuaire hellĂ©nistique de Cumes et les fouilles rĂ©centes de Fratte en Italie ; les ateliers de potiers de Rosas en Espagne ; les derniĂšres dĂ©couvertes dâOlbia de Provence
Bognon C. 1988. â Les vĂ©gĂ©taux dans la vie du peuple WE, CĂŽte d'Ivoire. ThĂšse de Doctorat de l'UniversitĂ© Pierre et Marie Curie
Puig Henri. Bognon C. 1988. â Les vĂ©gĂ©taux dans la vie du peuple WE, CĂŽte d'Ivoire. ThĂšse de Doctorat de l'UniversitĂ© Pierre et Marie Curie. In: Journal d'agriculture traditionnelle et de botanique appliquĂ©e, 34á” annĂ©e,1987. p. 187
Breedlove, D. E. & R. M. Laughlin. â The Flowering of Man. A Tzotzil Botany of Zinacantan
Puig Henri. Breedlove, D. E. & R. M. Laughlin. â The Flowering of Man. A Tzotzil Botany of Zinacantan. In: Journal de la SociĂ©tĂ© des AmĂ©ricanistes. Tome 81, 1995. pp. 356-358
ElĂ©ments pour une rĂ©flexion sur la modĂ©lisation de la forĂȘt tropicale humide : a-t-on les connaissances requises ?
Many factors influence the tropical rain forest regeneration. Some of them are rather well known (tree-fall gaps), some others not. A number of less known factors are quoted here, they should be carefully studied if the tropical rain forest ecosystem functioning has to be understood and a fortiori if it has to be modelized.
In the tropics, flowering and fructification phenomena happen on particular periods of the year and reach their maximum either during the dry or the rainy season ; and are obviously adapted to such seasonal environment. However, important disynchronisms are recognized among species, populations of the same species, trees of a population and sometimes even within a tree crown. The determinism of the flowering, the fructification, as well as the foliation phenology is far from being explained. What are the causes of this determinism ? May it be considered as a global phenomenon with multiple components ? What are the consequences of phenological variability on the regeneration processes ?
The forest dynamics studies allowed to establish functional models that tend to show that the tropical rain forest is an heterogeneous system in space and time. This structural heterogeneity can be apprehended in several ways ; the tree-fall gaps theory is one of them, the «empty places » theory is another one. The plant physiognomic and functional organization is built on the opposition «empty places-full places ». The understanding of the spatial distribution of forms in space and time as well as the role of this distribution on the forest functioning is one of the keys of the forest dynamic understanding. Is the «empty-place » an indicator of the forest structure and dynamics ? Is the «empty-place » filling an homoge neity or heterogeneity factor ?
The most revealing variations of the tropical forest heterogeneity are structural. This heterogeneity can be observed at three perception levels : general or continental level, regional level and local level. Changing the scale brings up numerous methodological problems. The absence of correlations among scales or levels is another lack. Extrapolations are hasardous and comparisons may only be established with caution. The predictibility of the evolution and its variability are uncertain due to a deficient knowledge of the parameters governing the forest dynamics.
Beyond the importance of improving our very deficient knowledge on the species diversity, it is essential to understand the mechanisms leading to this ecosystem diversity. The attempt to link the structures to the processes should help our understanding on how the biological diversity takes place, continues or decreases. How to identify the relative contribution of the biodiversity factors such as the spatial heterogeneity, in time variability or biogeographical history ? Is an ecosystem species diversity higher than the necessary one for its functional efficiency ? Is there a redundancy of species effecting the same function ? How to estimate the redundancy ? Function of key-species in the ecosystem functioning ? Function of key-resources ? What are the effects of human disturbances on keeping or loosing the biodiversity ? Communities vulnerability and resistance against species introductions and/or extinctions (cf. Miconia calvescens in Tahiti) ?
The uses and management of the tropical rain forest must be considered as positive actions against the increasing destruction of this forest. They are numerous. Let us see two examples. The Amazonian extractivism, defined as any activity of gathering natural forest products of vegetal, animal or mineral origin for trade, seems to be successful from the social and ecological point of view as well as from the economical one. However, if carried on without discernment, it may lead to a progressive disappearing of the resources and become depredatory. Is the extractivism exportable and how ?
Agroforestry is considered as the most convenient alternative to a sustainable agriculture production in the humid tropics. Agroforestry is rather successful in some tropical countries. In spite of the progresses made during the last twenty years many studies are still necessary. One of the main questions is the following : Are the recognised agroforestry successes exportable in other tropical countries and how ? In any case, new researches have to be conducted. They should deal with the study of forest regrowth after cultivation and with the fallows management.Les facteurs qui interviennent dans la rĂ©gĂ©nĂ©ration de la forĂȘt tropicale humide sont nombreux. Certains sont insuffisamment connus et devaient faire lâobjet dâĂ©tudes plus approfondies si lâon veut comprendre le fonctionnement de cet Ă©cosystĂšme et a fortiori modĂ©liser la forĂȘt tropicale humide.
Sous les latitudes tropicales, le fait que la floraison et la fructification se produisent Ă des pĂ©riodes privilĂ©giĂ©es de lâannĂ©e semble plaider en faveur dâun comportement adaptĂ© aux variations saisonniĂšres du milieu extĂ©rieur. Cependant, on constate lâexistence de disynchronismes importants entre espĂšces, entre populations dâune mĂȘme espĂšce, entre individus dâune mĂȘme population et parfois dans la cime dâun mĂȘme individu. Le dĂ©terminisme de la phĂ©nologie de la floraison et de la fructification se pose : quelles en sont les causes ? Est-ce un phĂ©nomĂšne global Ă composantes multiples ? Quelles sont les consĂ©quences de la variabilitĂ© phĂ©nologique sur la rĂ©gĂ©nĂ©ration ?
LâhĂ©tĂ©rogĂ©nĂ©itĂ© structurale peut ĂȘtre apprĂ©hendĂ©e sous diffĂ©rents angles : le chablis en est un, les «espaces vides » en sont un autre. Lâobservation des «espaces vides » ressort dâune analyse physionomique. Lâorganisation physionomique et fonctionnelle des vĂ©gĂ©taux se construit sur lâopposition espaces vides-espaces pleins. Comprendre lâĂ©tagement et le fonctionnement des formes dans lâespace et dans le temps et le rĂŽle de cet agencement sur le fonctionnement de la forĂȘt est une des clĂ©s de la dynamique forestiĂšre.
Les variations qui traduisent le mieux lâhĂ©tĂ©rogĂ©nĂ©itĂ© des forĂȘts tropicales sont de type structural. Cette hĂ©tĂ©rogĂ©nĂ©itĂ© sâobserve Ă trois niveaux de perception : niveau gĂ©nĂ©ral ou continental, niveau rĂ©gional, niveau stationnel. Passer dâune Ă©chelle Ă lâautre pose de nombreux problĂšmes mĂ©thodologiques. Les extrapolations et la prĂ©dictibilitĂ© de lâĂ©volution dans le temps et de sa variabilitĂ© se heurte Ă la maĂźtrise incomplĂšte des paramĂštres qui rĂ©gissent la dynamique forestiĂšre.
Au-delĂ de lâimportance de faire avancer nos connaissances, trĂšs incomplĂštes, sur la diversitĂ© spĂ©cifique il importe de comprendre les mĂ©canismes qui induisent la diversitĂ© des Ă©cosystĂšmes. Relier les structures aux processus devrait aider Ă comprendre comment se met en place, se maintient ou se rĂ©duit la diversitĂ© biologique. Quels sont les facteurs de la biodiversitĂ© ? DiversitĂ© spĂ©cifique et efficacitĂ© fonctionnelle ? Y a-t-il redondance dâespĂšces qui accomplissent la mĂȘme fonction ? Comment Ă©valuer la redondance ? RĂŽles des espĂšces-clĂ©s et des ressources-clĂ©s ? Quels sont les effets des perturbations anthropiques sur le maintien ou la perte de la biodiversitĂ© ? VulnĂ©rabilitĂ© et rĂ©sistance aux introductions et/ou aux extinctions dâespĂšces.
Les usages et la gestion de la forĂȘt tropicale humide doivent ĂȘtre envisagĂ©s comme des rĂ©actions constructives Ă la destruction croissante de cette forĂȘt. A titre dâexemple, lâextractivisme amazonien semble ĂȘtre un succĂšs tant sur le plan social et Ă©cologique (conservation des ressources) quâĂ©conomique. MenĂ© sans discernement, il peut conduire Ă la disparition progressive des ressources et devenir dĂ©prĂ©dateur. Lâextractivisme est-il exportable et dans quelles conditions ? Lâagroforesterie est considĂ©rĂ©e comme lâalternative la mieux adaptĂ©e pour une production agricole stable dans les tropiques humides. Mais une des principales questions qui se posent est la suivante : les rĂ©ussites agroforestiĂšres reconnues sont-elles exportables dans dâautres pays tropicaux et dans quelles conditions ?Puig Henri. ElĂ©ments pour une rĂ©flexion sur la modĂ©lisation de la forĂȘt tropicale humide : a-t-on les connaissances requises ?. In: Revue d'Ăcologie (La Terre et La Vie), tome 50, n°3, 1995. pp. 199-208
Observations ethnobotaniques sur les plantes utiles d'un village Otomi de la Sierra de Puebla, Mexique
Within the scope of an interdisciplinary research program of the French CNRS in Mexico, the uses of plants in an Otomi village of the Sierra de Puebla have been surveyed with particular reference to cultivated and semi-cultivated plants. Lists of ornamental plants, medicinal plants, plants providing building material and other uses are also given.Turra E., Puig Henri. Observations ethnobotaniques sur les plantes utiles d'un village Otomi de la Sierra de Puebla, Mexique. In: Journal d'agriculture traditionnelle et de botanique appliquée, 25ᔠannée, bulletin n°2, Avril-juin 1978. pp. 85-96
- âŠ