7 research outputs found
Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery
Peer reviewe
Ăvaluer la durabilitĂ© des exploitations agricoles d'un territoire Ă l'aide d'une mĂ©thode multicritĂšre : intĂ©gration des impacts environnementaux et des services Ă©cosystĂ©miques
The agriculture was profoundly transformed in France after the Second World War in order to recover food sovereignty. The intensification of agriculture through the use of synthetic products and machinery has had repercussions on ecosystems, human health and the economy. In order to better identify ways to limit the negative impacts of agriculture, methods using indicators have been developed to assess the sustainability of farms. In parallel, a lot of work on ecosystem services has emerged to find out how agriculture can rely on the biological processes of agricultural ecosystems to achieve its ecological transition. This thesis aims to provide knowledge on the joint assessment of environmental impacts and ecosystem services by developing a new method for assessing the sustainability of agricultural systems.Firstly, a state of the art of the literature was carried out on 262 methods of environmental sustainability assessment in agriculture and the themes covered by these methods. This synthesis revealed that very few methods organise their indicators in a conceptual framework. Furthermore, so-called predictive indicators are little used and ecosystem service indicators are rarely integrated into these methods.A conceptual framework was then developed for the new sustainability assessment method of agricultural systems, based on the conceptual framework of the MASC 2.0 method and on the EFESE study for the integration of the concept of farmerâs benefit and ecosystem services. This conceptual framework is composed of 22 themes including 7 benefits, 15 environmental impacts, and each theme is characterised by direct or indirect factors. An analytical framework for the joint assessment of environmental impacts and ecosystem services was also proposed. Finally, to implement the conceptual framework, several innovative indicators of environmental impacts and ecosystem services were designed.Lastly, this new method was applied to a case study of 33 arable farms in the Champagne crayeuse (France). The joint assessment of environmental impacts and ecosystem services made it possible to go further in the characterisation of farms than the simple opposition between conventional and organic farming. Indeed, one farm has interesting potential ES levels and low environmental impacts, while being economically efficient. In order to fully assess the sustainability of farms, the work undertaken during this thesis needs to be extended by further developing the economic and social aspects and by integrating dynamic aspects. Similarly, the results need to be confirmed in other pedoclimatic contexts.Lâagriculture a Ă©tĂ© profondĂ©ment transformĂ©e en France aprĂšs la seconde guerre mondiale afin de retrouver une souverainetĂ© alimentaire. Lâintensification de lâagriculture via lâutilisation de produits de synthĂšse et de machines a eu des rĂ©percussions sur les Ă©cosystĂšmes, la santĂ© des Hommes ainsi que sur lâĂ©conomie. Afin de mieux comprendre comment limiter les impacts nĂ©gatifs de lâagriculture, des mĂ©thodes utilisant des indicateurs ont Ă©tĂ© dĂ©veloppĂ©es pour Ă©valuer la durabilitĂ© des exploitations agricoles. En parallĂšle, de nombreux travaux sur les services Ă©cosystĂ©miques sont apparus afin de savoir comment lâagriculture peut sâappuyer sur les processus biologiques des Ă©cosystĂšmes agricoles afin de rĂ©aliser sa transition Ă©cologique. Cette thĂšse a pour but dâapporter des connaissances sur lâĂ©valuation conjointe des impacts environnementaux et des services Ă©cosystĂ©miques en dĂ©veloppant une nouvelle mĂ©thode dâĂ©valuation de la durabilitĂ© des systĂšmes agricoles.En premier lieu, un Ă©tat de lâart de la littĂ©rature a Ă©tĂ© rĂ©alisĂ© sur 262 mĂ©thodes dâĂ©valuation de la durabilitĂ© environnementale en milieu agricole et des thĂšmes traitĂ©s par ces mĂ©thodes. Cette synthĂšse a mis en Ă©vidence que trĂšs peu de mĂ©thodes organisent leurs indicateurs dans un cadre conceptuel. De plus, les indicateurs dits prĂ©dictifs sont peu utilisĂ©s et les indicateurs de services Ă©cosystĂ©miques sont rarement intĂ©grĂ©s dans ces mĂ©thodes.Un cadre conceptuel a ensuite Ă©tĂ© dĂ©veloppĂ© pour la nouvelle mĂ©thode dâĂ©valuation de la durabilitĂ© des exploitations agricoles en se basant sur le cadre conceptuel de la mĂ©thode MASC 2.0 et sur lâĂ©tude EFESE pour lâintĂ©gration du concept dâavantage pour lâagriculteur et des services Ă©cosystĂ©miques. Ce cadre conceptuel est composĂ© de 22 thĂšmes dont 7 avantages, 15 impacts environnementaux et chaque thĂšme est caractĂ©risĂ© par des facteurs directs ou indirects. Un cadre analytique pour lâĂ©valuation conjointe des impacts environnementaux et des services Ă©cosystĂ©miques a aussi Ă©tĂ© proposĂ©. Enfin, pour mettre en oeuvre le cadre conceptuel, plusieurs indicateurs innovants dâimpacts environnementaux et de services Ă©cosystĂ©miques ont Ă©tĂ© conçus.Pour finir, cette nouvelle mĂ©thode a Ă©tĂ© appliquĂ©e sur un cas dâĂ©tude de 33 exploitations en grandes cultures dans la Champagne crayeuse. LâĂ©valuation conjointe des impacts environnementaux et des services Ă©cosystĂ©miques a permis dâaller plus loin dans la caractĂ©risation des exploitations que la simple opposition agriculture conventionnelle versus agriculture biologique. En effet, une exploitation a des niveaux de SE potentiels intĂ©ressants et de faibles impacts environnementaux, tout en Ă©tant performante Ă©conomiquement. Afin dâĂ©valuer pleinement la durabilitĂ© des exploitations agricoles, le travail entrepris durant cette thĂšse doit ĂȘtre Ă©tendu en dĂ©veloppant davantage les volets Ă©conomique et social et en intĂ©grant des aspects dynamiques. De mĂȘme les rĂ©sultats sont Ă confirmer dans dâautres contextes pĂ©doclimatiques
A predictive indicator assessing effect of cropping system and surrounding landscape on biodiversity
Biodiversity is a key component of agricultural ecosystems and belongs to one of the exceeded planetary boundaries. In the quest for innovation to mitigate impact, it is essential to have tools to assess the anthropogenic impact on biodiversity. In this study, we developed a new indicator, I-BIO that aimed to predict the impacts of management practices and the influence of the landscape on overall biodiversity at species group level. I-BIO encompassed four groups: microorganisms, vegetation, invertebrates and vertebrates. This predictive indicator was built using DEXi software that facilitates the design of hierarchical decision trees, based on input variables in the form of qualitative classes, aggregated using utility functions. I-BIO was constructed using data from a long-term platform in Scotland and then applied to two data sets in France and one in Scotland. The results showed that the lowest class is predominant for all branches especially for invertebrates and soil invertebrates. Monte Carlo sampling was used to test for sensitivity. Then, a validation step was carried out to compare I-BIO outputs with real data using data on the four groups from Scottish and French datasets. I-BIO predictions of weed and soil invertebrate abundance conformed to field data. Due to low numbers of samples, validation of microorganisms, flying invertebrates and vertebrates predictions require more data. Future developments of I-BIO will focus on predictions specifically to assess the impact of management on species richness. Avenues for improvement include a better integration of landscape features and the history of agricultural practices as they both have a great influence on biodiversity
RePP'Air - Comprendre les mécanismes de transferts de produits phytosanitaires dans l'air pour une appropriation par la profession agricole.
The RePP'Air project aims to better understand the processes of transfer of plant protection products inthe air through the implementation of a measurement device on 7 sites in France, associated with surveysof agricultural practices on site. After 4 years of study, the RePP'Air project made it possible to betterunderstand the mechanisms influencing the transfers in the air, to sensitize the farmers and farmersorganisations, so that the agricultural sector appropriates this subject and the existing levers of action.Prospects for further work were also identified. The richness of this project also lies in its unprecedentedpartnership between agricultural actors, air actors, agronomic research and vocational schools, which hasenabled progress to be made on this topic of shared interest.Le projet RePPâAir vise Ă mieux apprĂ©hender les processus de transferts de produits phytosanitaires dansl'air via la mise en place d'un rĂ©seau de 7 dispositifs de mesures sur des espaces agricoles français,associĂ© Ă des enquĂȘtes de pratiques agricoles sur chaque site. AprĂšs 4 annĂ©es dâĂ©tude, le projetRePPâAir a permis de mieux comprendre les mĂ©canismes influençant les transferts dans lâair, sensibiliserla profession, de façon Ă ce que le secteur agricole soit dâapproprie ce sujet et les leviers dâactionsexistants pour limiter les risques de transfert. Des pistes de travail Ă approfondir ont Ă©galement Ă©tĂ©identifiĂ©es. La richesse de ce projet rĂ©side aussi dans son partenariat inĂ©dit entre les acteurs agricoles,les acteurs de lâair, de la recherche agronomique et de lâenseignement agricole qui a permis dâavancersur cette thĂ©matique dâintĂ©rĂȘts partagĂ©
UK Head and neck cancer surgical capacity during the second wave of the COVIDâ19 pandemic: Have we learned the lessons? COVIDSurg collaborative
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4âweeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4âweeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, PÂ =Â 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, PâConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease