L'information préventive pour réduire la vulnérabilité aux risques d'inondation, élaboration et efficacité d'une réponse sociale

En France depuis la fin des années 1980 l'information préventive sur les risques et catastrophes naturelles constitue un outil de réduction de la vulnérabilité. Ailleurs en Europe, l'information est en effet rarement codifiée de façon aussi précise.La mise en oeuvre d'une politique aussi fortement affichée suscite pourtant un certain nombre d'interrogations, traitées par des travaux de psychologie ou psychologie sociale mais moins par la géographie ou la sociologie des politiques publiques. Nous proposons donc une analyse interdisciplinaire de cette politique, reposant sur l'évaluation de son effectivité et de son efficience ainsi que sur l'étude de ses dimensions socio-spatiales. Au-delà, cette réflexion peut conduire à faire émerger des enseignements relatifs à la prévention du changement climatique

La mise en ligne des informations liées aux risques : véritable outil de prévention ou alibi ?

International audienceCet article fait le point sur la mise en ligne des informations liées à deux types de risques (technologiques -inondations), à caractère industriel ou naturel, afin de déterminer si cette mise à disposition des informations peut constituer un véritable outil de prévention ou si elle ne représente, en fait, qu'un simple alibi pour les pouvoirs publics

Proteger la naturaleza en España y en Francia. Un análisis comparado del proceso de aplicación de la directiva europea Hábitat

En este artículo, sus autores analizan el proceso de aplicación de la Directiva europea Hábitat en espacios naturales incluidos en la red Natura 2000. Concretamente, estudian varios casos en Francia y en España, comparando el sistema político-administrativo y la dinámica social surgida en torno a la definición del espacio natural objeto de protección y a la puesta en marcha del programa europeo destinado a la conservación de la biodiversidad. En primer lugar, se compara el procedimiento utilizado en ambos países para la definición de los llamados «lugares de interés comunitario» (LIC), mostrando cómo en Francia se propicia la participación de los grupos sociales implicados, mientras que en España son los departamentos de medio ambiente de los gobiernos regionales los que asumen el principal protagonismo. En segundo lugar, se analiza en cada caso el grado de vertebración de los grupos sociales, comprobando hasta qué punto se produce o no una conciliación de intereses en torno al espacio natural protegido. La principal conclusión de la investigación realizada consiste en afirmar que no es el sistema administrativo ni la voluntad conservacionista de los departamentos de medio ambiente el factor que ejerce mayor influencia en el éxito de las políticas ambientales, sino el contexto socioeconómico local, de modo que allí donde se produce una conciliación previa de intereses en torno a un equilibrio entre conservación de la naturaleza y desarrollo económico, hay más posibilidades de que se pueda dar una adecuada gestión del programa.This article analyses the implementation process of the EU Directive Habitats in natural areas belonging to the network Nature 2000. Particularly, its authors study some cases in France and Spain, comparing the administrative systems and the social dynamics involved in the implementation of this European policy, which is designed to foster the conservation of biodiversity. Firstly, the procedures used in both countries to define the so-called LIC are compared; in this respect, it is shown that in France, the government has sought the participation of various social groups, whereas in Spain, the implementation process has been dominated by the environmental agencies of regional governments. Secondly, the interaction between interest groups is analysed in order to see if they manage to balance conflicting interests regarding the natural area concerned. The study's main conclusion is that in both countries, the social and economic context at the local level, rather than the administrative system or the conservationist attitudes of government agencies, constitutes the key for explaining the success or failure of environmental policies. Consequently, the probability of success in terms of program implementation is higher in areas where, a bargaining process among local interest groups has previously generated a suitable equilibrium between environmental protection and economic development interests

Governance, priorities and policies in national research for health systems in West Africa (Guinea Bissau, Liberia, Mali, Sierra Leone)

Contributions to the content of this paper through interviews, presentations and mapping exercises were made by country teams present at the March 2011 Dakar workshopWorkshop objectives (2011) identified shared problems that could be tackled through collective strategies, and action plans to be tailored to each country (Guinea Bissau, Liberia, Mali and Sierra Leone). Goals for research for health (R4H) system strengthening were identified as priority areas for development in the four countries. The papers provide a descriptive review of key elements of the national health research systems in each country, and present a cross-country comparison, highlighting similarities and differences in country needs and challenges with respect to R4H system development

Backward waters, modern waters: Perception-Based Regional Mapping territory uses and water-related sanitary stakes in Luang Phabang area (Lao PDR)

International audienceThis paper examines the suitability of the PBRM, a mapping tool based on the perceptions of local stakeholders, for assessing the connection between land uses and health issues. The area, rural Laos around Luang Phabang city, between the Mekong River valley and mountains, seems to have overcome the formal territorial organization based on exposure risks towards an organization based on access to health and medical facilities. In addition, differential access to safe drinking water has been quite solved by the implementation of private can distribution networks. However, these rapid changes accentuate the social gap between well-connected lowlands and valleys on one hand, and mountain areas on the other hand, increasingly sidelined from this transition. Methodologically, PBRM method explores broader issues at a broader scale but does not give an easy access to non-spatial criteria. Plus, the limits of the SHUs (Spatial Homogeneous Unit) the PBRM establishes are geographically precise regarding topology but not spatiality. These results are action-oriented towards local and development-oriented issues

Everyday vulnerabilities and ''social dispositions'' in the Malian Sahel, an indication for evaluating future adaptability to water crises?

International audienceSince the 1970s, precipitation in the Sahel has decreased and become very irregular, leading to widespread drought, whilst the human need for water has rapidly increased. A new ''dispositions''-based approach was adapted in order to analyse human interactions with environmental hazards and applied to the case of Hombori village in northeastern Mali. This article explores how the population and political stakeholders perceive, live with and respond to the increasing scarcity of water. It also explores how their current vulnerability and ability to cope with variations in available water resources indicate future adaptability to climate shocks. On the one hand, this research shows how the population copes with variations in water resource availability: the population's socio-spatial organisation explains the inhabitants' exposure to this problem and some of the factors affecting vulnerability, the elderly and women being the hardest hit. The water issue is generally managed on a ''day-to-day'' basis and considered a big problem only in the dry season, thus lowering any incentive for self-protection. The main two variables that could explain this kind of risk management are the conflicting local governance and current social rules. On the other hand, the discussion of results, based on a conceptual model of social responses, explains why these current ''social dispositions'' to cope with and even address the water scarcity issue do not guarantee future adaptability to climate change

Formas de Hispanidad

Este texto presenta estudios sobre las múltiples formas de hispanidad, desarrollados en los últimos años por destacados investigadores del mundo hispánico que, poco a poco, han estado construyendo un nuevo espacio de investigación para una creciente y activa comunidad científica. En este libro el lector encontrará estudios con enfoques desde la ciencia política, la teoría política, la historia, la filosofía, la sociología, la economía, los estudios literarios y culturales, entre otras perspectivas académicas. Los aportes de cada aproximación teórica y disciplinar están orientados al logro de una meta común: la de reconstruir y reinterpretar la tradición histórica hispánica, desmantelando prejuicios ideológicamente provocados, con el fin de comprender los fenómenos políticos que la caracterizan. Por las mismas razones este libro se sitúa en el debate sobre las formas de escritura de la historia, que no es sólo un debate de teoría de la historia sino también de filosofía de lo histórico

Development of a Clinical Prediction Score Including Monocyte-to-Lymphocyte Ratio to Inform Tuberculosis Treatment Among Children With HIV: A Multicountry Study

BACKGROUND: Clinical pediatric tuberculosis (TB) diagnosis may lead to overdiagnosis particularly among children with human immunodeficiency virus (CHIV). We assessed the performance of monocyte-lymphocyte ratio (MLR) as a diagnostic biomarker and constructed a clinical prediction score to improve specificity of TB diagnosis in CHIV with limited access to microbiologic testing. METHODS: We pooled data from cohorts of children aged ≤13 years from Vietnam, Cameroon, and South Africa to validate the use of MLR ≥0.378, previously found as a TB diagnostic marker among CHIV. Using multivariable logistic regression, we created an internally validated prediction score for diagnosis of TB disease in CHIV. RESULTS: The combined cohort had 601 children (median age, 1.9 [interquartile range, 0.9-5.3] years); 300 (50%) children were male, and 283 (47%) had HIV. Elevated MLR ≥0.378 had sensitivity of 36% (95% confidence interval [CI], 23%-51%) and specificity of 79% (95% CI, 71%-86%) among CHIV in the validation cohort. A model using MLR ≥0.28, age ≥4 years, tuberculin skin testing ≥5 mm, TB contact history, fever >2 weeks, and chest radiograph suggestive of TB predicted active TB disease in CHIV with an area under the receiver operating characteristic curve of 0.85. A prediction score of ≥5 points had a sensitivity of 94% and specificity of 48% to identify confirmed TB, and a sensitivity of 82% and specificity of 48% to identify confirmed and unconfirmed TB groups combined. CONCLUSIONS: Our score has comparable sensitivity and specificity to algorithms including microbiological testing and should enable clinicians to rapidly initiate TB treatment among CHIV when microbiological testing is unavailable

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries