Croissance et décroissance récentes en Mauricie – Bois-Francs : un essai d’explication

La croissance est inégalement répartie dans la Mauricie - Bois-Francs. Dans la zone agricole, les activités commerciales et les activités indéterminées sont, parmi les variables retenues, les seules à rendre compte, mais très faiblement, de la contraction de l'espace agricole. Au niveau des villages et des villes, le secteur secondaire a subi un net recul, surtout sur la rive gauche du Saint-Laurent, tandis que le tertiaire s'est développé partout, mais surtout dans les centres les plus gros ou les mieux situés. L'organisation spatiale interne de la région explique en partie la répartition inégale du secteur tertiaire tandis qu'elle n'intervient presque pas pour expliquer le recul du secondaire.Growth is spread unequally in the Mauricie - Bois-Francs region. In the agricultural zone, the commercial and undetermined activities are, among the retained variables, the only ones to account if only slightly for the shrinkage of the agricultural area. At the towns and villages level, even if the manufacturing activities have undergone a real regression, mainly on the left bank of the St. Lawrence River, the commercial and service activities have developed unevenly and more significantly in the largest and best located towns and villages. The internal pattern of the area partially explains the unequal distribution of tertiary activity growth, whereas it accounts for nearly nothing in the manufacturing sector in the explanation of the latter's regression

Beyond Constitutional Recognition: Public Challenges for the Defense of Indigenous Rights in Latin America

"This paper establishes the theoretical and analytical foundations for the elaboration of a tentative policy framework for the public defense, enforcement, and promotion of indigenous rights in Latin America. The study proceeds in four sections. It begins by presenting a comprehensive typology of indigenous rights and offering examples of their concrete formulation at the domestic and international levels. This section also summarizes the main difficulties associated with implementing these rights from the point of view of domestic policymakers. The second section debates the literature’s theoretical contributions in outlining the state’s role in the protection of indigenous rights. The third section examines the recent Ecuadorian experience with indigenous rights in order to empirically stress the theory's significance. The final section presents five policy recommendations as well as avenues for further research, providing the basis for a future policy framework."--from pages 153-15

Lumbar spinal muscles and spinal canal study by MRI three-dimensional reconstruction in adult lumbar spinal stenosis

Background: Lumbar spinal stenosis is degenerative disc disease most common manifestation. If stenosisdegree seems poorly related to symptom severity, lumbar muscles role is recognized. Many studiesreport imaging methods, to analyze muscle volumes and fat infiltration (FI), but remain limited due tothe difficulty to represent entire muscle volume variability. Recently a 3D muscle reconstruction protocol(using the deformation of a parametric specific object method (DPSO) and three-point Dixon images) wasreported. It offers the ability to evaluate, muscles volumes and muscle FI.Purpose: To describe, in a lumbar spinal stenosis population, muscle volumes, muscle FI and lumbarspinal canal volume with 3D MRI images reconstructions.Materials and methods: Ten adults presenting L4–L5 lumbar stenosis, were included. After specific MRIprotocol, three-dimensional, muscle and spinal canal, reconstructions were performed. Muscle (psoasand paraspinal muscles) volumes and fat infiltration (FI), the spinal canal volume, age, and height werecorrelated one to each other with Spearman correlation factor. An ANOVA was performed to evaluate theintervertebral level influence (P ≤ 0.05).Results: Muscle volumes correlated with height (r = 0.68 for psoas). Muscles FI correlated with age (r = 0.66for psoas) and lumbar spinal canal volume (r = 0.91). Psoas and paraspinal volumes were maximum atL3–L4 level whereas FI increased from L1–L2 to L5–S1 level.Discussion: These first results illustrate the importance to consider muscles entirely and report correla-tions between muscles FI, lumbar spinal canal volume and age; and between muscle volumes and patientsheight. Muscle degeneration seems more related to muscle FI than muscle volume.Level of evidence: 3.The authors declare that they have no competing interest

Predictors of 1-year compliance with adaptive servoventilation in patients with heart failure and sleep disordered breathing: preliminary data from the ADVENT-HF trial

Despite its effectiveness in suppressing sleep disordered breathing (SDB), positive airway pressure therapy (PAP) is not always well tolerated by patients and long-term adherence can be problematic. Recently, two multicentre, randomised clinical trials (RCTs) tested the effects of PAP for patients with cardiovascular disease and co-existing SDB on morbidity and mortality with negative outcomes [1, 2]. Relatively poor adherence to PAP therapy (mean 3.7 and 3.3 h·day-1, respectively) in these two trials might have contributed to their poor results. Indeed, higher PAP use per day is associated with better clinical outcomes than lower use [3]