L’intervention publique paysagère comme processus normatif

Notre analyse interroge la production sociale de normes concomitante à la définition et à la mise en place d’interventions publiques paysagères à l’échelle locale. Elle montre que cette production normative s’accompagne d’une évolution dans la façon de nommer certains objets matériels. Cette nouvelle dénomination, souvent instable, témoigne de conflits normatifs, tant certaines normes peuvent être difficiles pour certains acteurs à concilier avec celles appliquées jusque-là. Notre étude montre également que ces conflits de normes autour des objets matériels sont autant de signes des usages alternatifs ou combinés de ces objets. On voit de la sorte que les politiques paysagères ont pour effet de reconnaître le « multi-usages » de l’espace rural en renforçant les pratiques liées aux loisirs (randonnées, visites). Elles légitiment en cela l’appropriation de l’espace par le regard, appropriation spécifique qui accompagne ces pratiques.landscape, local public action, norm, rural area

Landscape management with a nature concern: the role of a Natura 2000 classification in awareness raising of land owners for the provision of public goods

Introduction of the International Conference: Although a large majority of Europeans live in urban and peri-urban areas today, it would be difficult to surmise that the landscapes they live in were the object of serious, intentional efforts on the part of policymakers. These landscapes are often considered to be degraded and inhospitable, and are frequently associated with social exclusion and the deterioration of living conditions. The French Ministry of Ecology, Energy, Sustainable Development and the Sea, the Generalitat of Catalonia, the Perpignan urban authority, cities of Girona and Perpignan organise a conference in 2011. Its aim is to reconsider these landscapes that are home to millions of people in Europe and abroad from the standpoint of, on the one hand, improvement projects of which they were the focus, of “ the particular values assigned to them by the interested parties and the population concerned ” and, on the other hand, from the standpoint of efforts made by the latter to redevelop these landscapes. The numerous member states of the Council of Europe that ratified the European Landscape Convention committed themselves, in particular, to giving priority to everyday landscapes and to establishing “procedures for the participation of the general public, local and regional authorities, and other parties with an interest in the definition and implementation of the landscape policies ” . But what is the reality? What is the role that the procedures implemented by public institutions and territorial authorities actually assigned to stakeholder negotiation and participation in the improvement of landscape quality? Among these experiences, which ones make it possible to affirm that these forms of negotiation and participation are a guarantee for success? And beyond projects initiated by political institutions, what about those developed by community-based associations that aim at contributing to the improvement of living environments? Moreover, landscaping projects are increasingly considered as processes that evolve through the acquisition of knowledge provided by the collective experience of analysis and action. Does a landscaping project designed as a process over time and space require specific methods, and if so, which ones? Finally, everyday landscapes are strongly influenced by land-use or economic development projects. What, therefore, does the landscape dimension fit in? These different questions are not just addressed to the scientific community. They also concern institutional actors and landscape practitioners. This conference is therefore open to dialogue between operational methods and cognitive methods. This possibility obviously brings with it a dual requirement. On the one hand, it aims to give voice to landscape “manufacturers”, whoever they may be (professionals, elected officials, experts, NGO members or simple citizens), as well as to researchers, and above all, to encourage the dialogue between these two categories. On the other hand, it aims to enrich the debate with data that will make it possible to assess the effectiveness of the methods implemented, and among them, the methods based on participation or the exchange and sharing of knowledge or action objectives. However, when we speak of effectiveness, we must not limit the issue of landscape quality to its aesthetic aspect alone. We must also know if the methods implemented in the projects made it possible to address the demands of sustainable development and, in particular, if they were able to guarantee generational and intergenerational social equity or the quality of living environments and biodiversity, while allowing individuals and social categories to find their place within society and to think of the future with optimism, for themselves and their descendents. How do the notions of landscape and sustainable development interact and influence each other? How is the time dimension taken into account in landscape projects and public policies? What is their impact on the projects, their means of production and their governance? How are these notions integrated into professional practices? Although this proposal initially focused on densely populated landscapes, that is, urban and peri-urban, it in no way excludes rural, mountain and coastal landscapes from the collective reflection. These landscapes are also home to their inhabitants and maintain relationships with the former that involve complementarities or antagonisms that must be justified and identified. Just like urban landscapes, these landscapes also bear witness to many experiences involving participation and social negotiation

Determinants of the access to remote specialised services provided by national sarcoma reference centres

BACKGROUND: Spatial inequalities in cancer management have been evidenced by studies reporting lower quality of care or/and lower survival for patients living in remote or socially deprived areas. NETSARC+ is a national reference network implemented to improve the outcome of sarcoma patients in France since 2010, providing remote access to specialized diagnosis and Multidisciplinary Tumour Board (MTB). The IGéAS research program aims to assess the potential of this innovative organization, with remote management of cancers including rare tumours, to go through geographical barriers usually impeding the optimal management of cancer patients. METHODS: Using the nationwide NETSARC+ databases, the individual, clinical and geographical determinants of the access to sarcoma-specialized diagnosis and MTB were analysed. The IGéAS cohort (n = 20,590) includes all patients living in France with first sarcoma diagnosis between 2011 and 2014. Early access was defined as specialised review performed before 30 days of sampling and as first sarcoma MTB discussion performed before the first surgery. RESULTS: Some clinical populations are at highest risk of initial management without access to sarcoma specialized services, such as patients with non-GIST visceral sarcoma for diagnosis [OR 1.96, 95% CI 1.78 to 2.15] and MTB discussion [OR 3.56, 95% CI 3.16 to 4.01]. Social deprivation of the municipality is not associated with early access on NETSARC+ remote services. The quintile of patients furthest away from reference centres have lower chances of early access to specialized diagnosis [OR 1.18, 95% CI 1.06 to 1.31] and MTB discussion [OR 1.24, 95% CI 1.10 to 1.40] but this influence of the distance is slight in comparison with clinical factors and previous studies on the access to cancer-specialized facilities. CONCLUSIONS: In the context of national organization driven by reference network, distance to reference centres slightly alters the early access to sarcoma specialized services and social deprivation has no impact on it. The reference networks' organization, designed to improve the access to specialized services and the quality of cancer management, can be considered as an interesting device to reduce social and spatial inequalities in cancer management. The potential of this organization must be confirmed by further studies, including survival analysis

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Gérard Chouquer, Les formes du paysage. Tome 1 : Études sur le parcellaire. Tome 2 : Archéologie du parcellaire.

Michelin Yves. Gérard Chouquer, Les formes du paysage. Tome 1 : Études sur le parcellaire. Tome 2 : Archéologie du parcellaire. . In: Études rurales, n°145-146, 1997. Georges Duby. pp. 177-182

Sanders L. (dir), 2001, Modèles en analyse spatiale, Paris, Hermès lavoisier.

La prise en compte des structures spatiales et de leur évolution est une préoccupation ancienne des géographes et des urbanistes. Cependant, dès lors que l'on s'intéresse à la possibilité d'intervenir sur les phénomènes spatiaux, les analyses détaillées de cas concrets sous forme de monographies comme les approches théoriques déconnectées de la réalité sont inopérantes. La démarche de modélisation, considérée comme une représentation schématique de la réalité pour la rendre plus compréhensibl..

Gérard Chouquer, Les formes du paysage. Tome 1 : Études sur le parcellaire. Tome 2 : Archéologie du parcellaire.

Michelin Yves. Gérard Chouquer, Les formes du paysage. Tome 1 : Études sur le parcellaire. Tome 2 : Archéologie du parcellaire. . In: Études rurales, n°145-146, 1997. Georges Duby. pp. 177-182

Des appareils photo jetables au service d´un projet de développement : représentations paysagères et stratégies des acteurs locaux de la montagne thiernoise

In order to analyse how the representations of usual landscapes have had an influence on land use policy, an experiment has been conducted in the " montagne thiernoise, French massif central " with six elected people. Each one received one disposable camera and a list of questions about his landscape that he had to illustrate with his own pictures. An individual discussion was conducted a second time to define with each one, personal and cultural aspects of his landscapes, what he considered as beautiful or bad elements in these landscapes and what he imagined for the future.As this first test was successful, we consider that this kind of landscape analysis could be useful to prepare a development program in rural areas. Even if this method has to be better, it can soon be used by non-specialist technicians to analyse the influence of landscape representations upon local planning management decisions