Éditeur(s) : Center for the Humanities and the Public Sphere, University of Florida Center for the Humanities and the Public Sphere, University of Florida ( Gainesville, FL )
Résumé : (Biographical) Dr. Louise Ivers is Chief of Mission for Partners In Health (PIH) in Haiti, an international non-profit organization that provides direct health care and social services to poor communities around the world, supported by research and advocacy. She is an Assistant Professor of Medicine at Harvard Medical School and an Associate Physician in the Division of Global Health Equity at Brigham and Women's Hospital (BWH). She completed her residency in Internal Medicine at Massachusetts General Hospital (MGH) and a fellowship in Infectious Diseases at the combined MGH/BWH program. Dr. Ivers also received a diploma in Tropical Medicine and Hygiene from the London School of Hygiene & Tropical Medicine and a Master of Public Health from the Harvard School of Public Health. Dr. Ivers implements health programs, and is interested in improving the delivery of healthcare in resource poor settings, the provision of care to the rural and urban poor, as well as patient-oriented investigation that offers solutions to barriers to healthcare. She balances her time between management of PIH Haiti, direct clinical service, and operational research. Dr. Ivers has contributed to published articles on HIV/AIDS, food insecurity, and the prevention of mother-to-child transmission of HIV. Current projects include investigating the impact of targeted food assistance to people with HIV infection in rural Haiti, the effectiveness of ARV therapies on viral suppression in community-based programs, and humanitarian assistance in response to the January 2010 earthquake. Dr. Ivers has served as a Technical Advisor to the WHO and also mentors Haitian and American physicians.
(Funding) Sponsored by the Caleb and Michele Grimes Fund in the CLAS Dean's Office and organized by the Center for the Humanities and the Public Sphere.

Droits : All rights reserved by the source institution.

Éditeur(s) : Université des Antilles AREBio Groupe de recherche BIOSPHERES : BIOlogie, Sciences Physiques & Humaines pour les énergies Renouvelables, l
Extrait de : 1er colloque international BIOSPHERES, du 18 au 20 juin 2019. Université des Antilles
Description : This study provides detailed data regarding the quality of diagnosis and management of patients with prostate cancer in Martinique. Providing data on prostate cancer is essential for the development of high-priority public health measures for the Caribbean.

Droits : CC-BY-NC-ND - Attribution - Pas d'utilisation commerciale - Pas de modification
Permalien : http://www.manioc.org/fichiers/V19082
V19082

Éditeur(s) : Ministry of Healthand Environment, Department of Nursing Ministry of Healthand Environment, Department of Nursing ( Nassau, Bahamas )
Résumé : (Statement of Responsibility) Ministry of Health and Environment
Graduation ceremony programme held 10:30 a.m., Friday, January 10, 1997, Grosvenor Close Campus, College of The Bahamas
Includes names of graduates of the First Line Management Course, Critical/Intensive Care Unit Course, and Psychiatric Trained Nurses 1995-1996.
Bahamas

Droits : [cc by-nd] This item is licensed with the Creative Commons Attribution No Derivatives License. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
http://ufdc.ufl.edu/AA00026739/00001

Éditeur(s) : INRA : Institut National de la Recherche Agronomique Université des Antilles. Service commun de la documentation
Extrait de : 52e congrès annuel de la Société caribéenne des plantes alimentaires / 52nd annual meeting of the Caribbean food crops society (CFCS), du 10 au 16 juillet 2016. INRA, CFCS
Description : In the Global South, improvement of agricultural outputs is eagerly awaited. While by 2050, its population will double areas devoted to agriculture will decrease exacerbating undernutrition of the poor. Unfortunately, the demand for fresh locally-produced meat products is not satisfied yet in the tropics. So, efficiency in animal productions is essential to allow coverage of protein nutritional needs of people, both in quality and quantity. In the Caribbean territories mixed farming systems are the most common farming systems (about 80%) and can constitute a solution to reach food sovereignty in such limited and isolated spaces. Lessons to be learned from these systems involve improving animal performance while respecting the natural balance with environment and maintaining the multi-functionality of plants and animals. Firstly, the natural (or selected) comfort zone of animal and plants must fit with the farm conditions, insuring thereby animal survival and welfare. Enhancement of adaptation to stresses (biotic, abiotic and socio- economic) in species or animal genotypes is a key element implying their equilibrium with the farm environment. This approach underpins for the farmer an integrated management of animal health, nutrition, genetics, reproduction, in close relationship with other compartments of the farming system. Secondly, animal adaptation may be completed by resilience ability within systems. Animals have to produce although facing stresses. Finally, the animal must be efficient that is to say must reconcile physiological functions of production, reproduction with adaptation functions. This optimization leads to decreased inputs and to overall efficiency of mixed farming systems at the end. The aim of the breeder is to choose the animal producing the best balance between output-reproduction-adaptation, at the individual or the flock scale combining genetic and physiological diversity. The underlying idea is to give to humans and animals their right place in the food chain taking into account the farmers? skills and wills. This idea is included in the agroecological approach and may give guidelines for food sovereignty worldwide.
Siècle(s) traité(s) : 21
Droits : CC-BY-NC-ND - Attribution - Pas d'utilisation commerciale - Pas de modification
Permalien : http://www.manioc.org/fichiers/V16318
V16318

Éditeur(s) : HAL CCSD
Résumé : International audience
Many countries are legally obliged to embrace ecosystem-based approaches to fisheries management. Reductions in bycatch and physical habitat damage are now commonplace, but mitigating more sophisticated impacts associated with the ecological functions of target fisheries species are in their infancy. Here we model the impacts of a parrotfish fishery on the future state and resilience of Caribbean coral reefs, enabling us to view the tradeoff between harvest and ecosystem health. We find that the implementation of a simple and enforceable size restriction of >30 cm provides a win:win outcome in the short term, delivering both ecological and fisheries benefits and leading to increased yield and greater coral recovery rate for a given harvest rate. However, maintaining resilient coral reefs even until 2030 requires the addition of harvest limitations (<10% of virgin fishable biomass) to cope with a changing climate and induced coral disturbances, even in reefs that are relatively healthy today. Managing parrotfish is not a panacea for protecting coral reefs but can play a role in sustaining the health of reefs and high-quality habitat for reef fisheries.
http://hal.univ-reunion.fr/hal-01369752

hal-01369752
http://hal.univ-reunion.fr/hal-01369752
DOI : 10.1073/pnas.1601529113

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Few studies have considered using environmental amenities to explain social health inequalities.Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels. METHODS: The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial--scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics. RESULTS: The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0.003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway. CONCLUSIONS: These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this.
ISSN: 1471-2393

inserm-00878362
http://www.hal.inserm.fr/inserm-00878362
http://www.hal.inserm.fr/inserm-00878362/document
http://www.hal.inserm.fr/inserm-00878362/file/1471-2393-13-191.pdf
DOI : 10.1186/1471-2393-13-191

Résumé : By looking at the common thread between 4 programs* in which the IFREMER Palavas (34, Languedoc-Roussillon region in France) station took part, this report show the evolution over 20 years in the perception of the pathology of farmed fish, and of the sea bass in particular (Dicentrarchus labrax). During the 1990’s farming techniques became sufficiently reliable to enable to distinguish between problems of a zootechnical nature and those with a pathological origin. In anticipation of future illnesses, the necessary tools and monitoring were implemented in order to study the immune system of the sea bass. These methods arose from the recent creation of anti-immunoglobin monoclonal probes in the sea bass. These techniques, together with others, served to search for a solution to the nodavirus epidemic which struck in1996. In the absence of a cure for this virus, the research focused on knowledge of the virus, its epidemiology and vaccine development. Despite interesting scientific results, the solution withheld to curb the Nodavirus epidemic was zootechnical. This pragmatic outcome catalysed reflections on the role of pathology, leading to notions of health, animal well-being and image. Management choices in the health of farmed fish stocks became a parameter, amongst others, included in a global commercial and farming policy. * Définition des critères d’évaluation de l’immunocompétente chez le loup et le turbot. UMR1 Université Montpellier II IFREMER ; Nodavirus disease of cultured marine fish in Europe. FAIR PL98 4036 EU; Recherche de moyens de dépistage et prévention de la nodavirose du bar. ANVAR 9804041J ; Welfare and Health in Sustainable Aquaculture WEALTH. E.U N°501984.
En prenant comme fil conducteur les travaux de 4 programmes* auxquels a participé la station IFREMER de Palavas (34), ce rapport montre l’évolution sur 20 ans de la perception de la pathologie des poissons d’élevages et du loup en particulier (Dicentrarchus labrax). Dans les années 1990 les techniques d’élevages devinrent suffisamment fiables pour permettre de distinguer les problèmes d’origines zootechniques de ceux d’origines pathologiques. En prévision des futures maladies potentielles, les outils d’étude et de suivi du système immunitaire spécifique du loup furent mis en place. Ils découlaient de la création récente de sondes monoclonales anti-immunoglobulines de loup. Ces techniques, couplées à d’autres, servirent à chercher une solution à l’épidémie de nodavirose des années 1996. En l’absence de traitement pour un virus l’accent fut mis sur la connaissance du virus, de son épidémiologie et de la vaccination. Bien que les résultats scientifiques furent très satisfaisants la solution trouvée pour juguler l’épidémie de Nodavirose fut zootechnique. Cette issue pragmatique catalysa une réflexion sur le rôle de la pathologie qui maturait depuis plusieurs années et qui déboucha sur la notion de santé, de bien être des animaux et d’image. Les choix de gestion de la santé des cheptels devinrent un paramètre, parmi d’autres, s’incluant dans d’une politique globale d’élevage et commerciale * Définition des critères d’évaluation de l’immunocompétente chez le loup et le turbot. UMR1 Université Montpellier II IFREMER ; Nodavirus disease of cultured marine fish in Europe. FAIR PL98 4036 EU; Recherche de moyens de dépistage et prévention de la nodavirose du bar. ANVAR 9804041J ; Welfare and Health in Sustainable Aquaculture WEALTH. E.U N°501984.

Droits : 2013 Ifremer
http://archimer.ifremer.fr/doc/00167/27866/26103.pdf
http://archimer.ifremer.fr/doc/00167/27866/26105.pdf
http://archimer.ifremer.fr/doc/00167/27866/26106.pdf
http://archimer.ifremer.fr/doc/00167/27866/

Éditeur(s) : Université de La Rochelle
Résumé : Shrimp aquaculture in New Caledonia is a developing industry, exclusively based on the species Litopenaeus stylirostris. However, it is subject to mortalities during grow out as observed all over the world. Since 1993, shrimp reared during the cold period are affected by a disease named "syndrome 93". As a consequence, the whole industry has become seasonal and produces essentially during the warm season. The climatic conditions during the periods of transition between the two main seasons could be responsible for an environmental stress and the origin reason for mortality outbreaks. Stocking density is the main risk factor. It increases the probability of the appearance and development of the epizooty in the pond. The "Summer Syndrome", a septicemic vibriosis caused by Vibrio nigripulchritudo, was identified for the first time in December 1997 in an intensive shrimp farm (DF). It has become enzootic ever since and is expressed after 50d of rearing. Since 2003, two others farms located near DF have developed the disease. As a consequence, the summer syndrome is considered to be a potential threat for all the industry. Between 1991 and 2005, the increase of feed input and nitrogen levels in feed has led to a significant increase in the growth rate over the years in the farms affected by the disease. In consequence, an early eutrophication of the water is observed, which is concomitant with the beginning of the mortality outbreaks. An early eutrophication and the virulence level of the pathogen are considered as the main risk factors of the disease. Factors may act synergistically to explain the summer syndrome. As part of a multidisciplinary approach (pathology – physiology – environment), two high-frequency surveys were carried out to analyse the pond ecosystem. Since the feed quantity increases with the biomass of shrimp, the eutrophication level of the pond ecosystem will also tend to increase with the duration of rearing. During the first part of the rearing, the abundance of each picoplankton type is exceptionally high and picophytoplankton dominated the autotrophic compartment. The nanophytoplankton dominated the second part of the rearing and was more unstable. The shift from pico to nanophytoplankton could be considered as an environmental stress and was observed in relation to the beginning of the mortalities, whatever the disease. Shift intensity could play a role by inducing directly or indirectly a stress for shrimp and/or a growth and/or virulence factors of the pathogen. Results from sediment studies show that mortality was best characterized by TAN concentration in pore water and even more when the TAN concentration was high. TAN and pH are potential stress factors for shrimp reared in ponds affected by these diseases.
L'aquaculture mondiale de crevettes est un secteur à très forte croissance. Toutefois, les problèmes liés aux maladies dans les élevages ne cessent d'augmenter depuis 1980. Au cours du développement de la filière de Nouvelle-Calédonie, deux épisodes saisonniers de mortalités associées à la présence de Vibrio pathogènes sont apparus et ont fortement perturbé les techniques et les schémas de production. Les premières mortalités hivernales, décrites sous le nom de « syndrome 93 » ont été observées en mai 1993. Elles ont affecté depuis tous les élevages de saison froide de toutes les fermes de production. Les conditions climatiques pendant les périodes de transitions entre les deux principales saisons caractérisant le climat de la Nouvelle-Calédonie, seraient responsables d'un stress environnemental à l'origine du déclenchement du syndrome 93. La densité initiale d'ensemencement, apparaît comme le principal facteur de risque, augmentant la probabilité d'apparition de la maladie et l'ampleur de ses effets. Le « syndrome d'été » a été identifié pour la première fois en 1997 dans une ferme pratiquant une production intensive. Il s'est déclaré depuis 2003 dans deux autres fermes géographiquement proches. Les mortalités apparaissent 58 jours en moyenne après l'ensemencement des post-larves dans les bassins. La recherche d'une croissance maximale des animaux a induit, avec les années, une intensification progressive du système caractérisée par une augmentation de la quantité d'aliment distribuée. L'examen des données historiques fait apparaître une eutrophisation du milieu de plus en plus précoce concomitante au déclenchement des mortalités. En l'état actuel de nos connaissances, cette évolution précoce de l'écosystème en présence de façon récurrente de la souche hautement pathogène du Vibrio incriminé et à une période où la fréquence des mues des crevettes est élevée, constitue le principal facteur de risque de la maladie. Avec l'apport croissant en aliment, la colonne d'eau évolue vers une autotrophie croissante alors que le sédiment devient de plus en plus hétérotrophe au fur et à mesure que l'élevage progresse. Au cours du processus d'eutrophisation, le compartiment autotrophe montre une succession de deux assemblages. Le picophytoplancton domine sur la première partie de l'élevage et laisse place à du nanophytoplancton en seconde partie. Cette phase de transition, concomitante à l'apparition des mortalités quel que soit le syndrome, caractérise un stress environnemental dont l'intensité pourrait favoriser ou non le déclenchement des mortalités. Les suivis de différents indicateurs dans les sédiments - pH, potentiel d'oxydoréduction et concentration en ammoniaque dans l'eau interstitielle – indiquent dans les bassins déclarant les épizooties des conditions qui ont été définies expérimentalement comme potentiellement plus stressantes pour les animaux.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/2007/these-2643.pdf
http://archimer.ifremer.fr/doc/00000/2643/

Éditeur(s) : Société Nationale de Protection de la Nature
Résumé : Monitoring of French Polynesia coral reefs and their recent development.-French Polynesia, consisting of 118 islands in the centre of the Pacific Ocean, has more than 15 000 km(2) of reefs and lagoons managed by the local government. Tourism and pearl culture are the two main economic resources of the country. Polynesian coral reefs are extremely diverse and are among those for which we have thorough knowledge. The exploitation of local resources has been recorded for multiple decades and includes : coral materials, fishing, harvest and export of mother-of-pearl molluscs, pearl production, and ornamental fish. All over the country, many monitoring programmes have been launched to measure the health of reefs and the natural and anthropogenic perturbations that they suffer : hurricanes and seismic events, water quality, health of benthic and fish communities, pearl oyster pathology and radiobiology. These data, collected over the last few decades, allowed to define the relative importance of natural and anthropogenic degradation on reefs and lagoons, and to explain the present status of reefs at different spatial scales. Devastating hurricanes are rare (1903-1906, 1982-1983 and occasionally at other times), but they may annihilate outer slope coral communities on some islands. Bleaching events with considerable coral mortality at different geographical scales occurred mainly in 1991, 1994 and 2003. Outbreaks of Acanthaster destroyed numerous reefs (lagoons and outer slopes) from 1978-1982 and a new demographic wave began in 2006 at many Society islands. Eutrophication events only occurred occasionally and only in some lagoons. Whereas natural catastrophic events degrade the coral reef ecosystem across many islands, at the archipelago or even regional scale, anthropogenic degradation is limited to a few Society Islands, occurring rarely on atolls and not at all on those (one third) which are uninhabited. The main causes of reef degradation in some areas of Tahiti and Moorea include the embankment of fringing zones, coral mining, overfishing, absence of urban sewage treatment and the development of leisure and tourism activities. Because of its large geographical extent, one may conclude that major reef degradation in French Polynesia is caused by catastrophic natural events. On the other hand, anthropogenic degradation is more localized. Unfortunately, the synergistic effects of these causes of degradation prevent reefs from recovering. Optimum coral cover on French Polynesian outer reef slopes is between 50-60%. After a major destructive impact (hurricane, bleaching, Acanthaster) a reef is reduced to less than 10% coral cover, however if no more major disturbance events occur a reef will recover in about 12 years. Most of the 15 000 km(2) of reefs and lagoons in French Polynesia are in good health, and along with their neighbouring reefs in East and Central Pacific they are considered as the least degraded reefs worldwide and at a low risk of becoming degraded in the few next decades. However, we are more and more anxious about the future of reefs in the world particularly because present simulations predict that major impacts of climate change would include : elevation of sea surface temperatures, increase in the strength of hurricanes and acidification of seawater which will affect the formation of coral structures.
La Polynésie française, 118 îles au coeur du Pacifique, possède une surface de plus de 15 000 km2 de récifs et lagons gérés par le gouvernement polynésien. Le tourisme et la perliculture représentent les deux ressources économiques majeures du Pays. Les formations récifales très diversifiées sont parmi les mieux connues. Plusieurs suivis d'exploitation des ressources sont opérationnels depuis des décennies : granulats coralliens, pêche pour l'alimentation, collecte et exportation de mollusques nacriers, production de perles, poissons d'ornement. À l'échelle du Pays de très nombreux programmes de surveillance de l'état des récifs et des perturbations qu'ils subissent, naturelles et anthropiques, ont été mis en place : perturbations cycloniques et sismiques, qualité des eaux, état de santé des peuplements benthiques et ichtyologiques, pathologie des nacres, radiobiologie. Toutes ces données recueillies au fi l des décennies ont permis d'établir l'importance relative des dégradations naturelles et anthropiques sur les récifs et lagons polynésiens et d'expliquer leur état de santé actuel en considérant différentes échelles spatiales. Les périodes cycloniques dévastatrices pour les récifs sont rares (1903-1906, 1982-1983 et épisodiquement) mais les cyclones ont parfois anéanti les communautés coralliennes de pentes externes dans certaines îles. Les blanchissements suivis de mortalités importantes à des échelles spatiales diverses, ont été surtout ceux de 1991, 1994 et 2003. Les explosions démographiques d'Acanthaster ont détruit de nombreux récifs (lagons et pentes externes) en 1978-1982 et une nouvelle pullulation s'amplifie depuis 2006 dans plusieurs îles de la Société. Les crises dystrophiques n'ont perturbé qu'épisodiquement certains lagons. [...]
Revue d'Ecologie de la Terre et de la Vie (0249-7395) (Société Nationale de Protection de la Nature), 2008 , Vol. 63 , N. 1-2 , P. 145-177

Droits : 2008 Société Nationale de Protection de la Nature
http://archimer.ifremer.fr/doc/2008/publication-4558.pdf
http://archimer.ifremer.fr/doc/00000/4558/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. Infant mortality is an important indicator of the health status of a population. Recent literature suggests that neighborhood deprivation status can modify the effect of air pollution on preterm delivery, a known risk factor for infant mortality. We investigated the effect of neighborhood social deprivation on the association between exposure to ambient air NO2 and infant mortality in the Lille and Lyon metropolitan areas, north and center of France, respectively, between 2002 and 2009. We conducted an ecological study using a neighborhood deprivation index estimated at the French census block from the 2006 census data. Infant mortality data were collected from local councils and geocoded using the address of residence. We generated maps using generalized additive models, smoothing on longitude and latitude while adjusting for covariates. We used permutation tests to examine the overall importance of location in the model and identify areas of increased and decreased risk. The average death rate was 4.2‰ and 4.6‰ live births for the Lille and Lyon metropolitan areas during the period. We found evidence of statistically significant precise clusters of elevated infant mortality for Lille and an east-west gradient of infant mortality risk for Lyon. Exposure to NO2 did not explain the spatial relationship. The Lille MA, socioeconomic deprivation index explained the spatial variation observed. These techniques provide evidence of clusters of significantly elevated infant mortality risk in relation with the neighborhood socioeconomic status. This method could be used for public policy management to determine priority areas for interventions. Moreover, taking into account the relationship between social and environmental exposure may help identify areas with cumulative inequalities.
ISSN: 0048-9697

inserm-00838330
http://www.hal.inserm.fr/inserm-00838330
DOI : 10.1016/j.scitotenv.2013.03.027
PUBMED : 23563257

Éditeur(s) : HAL CCSD John Libbey Eurotext
Résumé : International audience
Environmental health risk assessment is commonly used in France for risk management purposes. The Methodology section of the "Société française de santé environnement" (French Society for Environmental Health) seeks to improve the utility and implementation of risk assessment in France. An initial operational objective is to make a list of short-, intermediate- and long-term improvements. This inventory is based in part on the experience and expertise of society members in this area and in part on their analysis of "Science and Decisions: Advancing Risk Assessment" (National Research Council 2009). In this paper, the Society recommends modifications in the indications for and use of risk assessments, during each of the four stages of the process: hazard identification and dose-response assessment, exposure assessment, risk characterization, and results interpretation. Some may be implemented now, while others need consensus building or research because of gaps in knowledge. Environmental health risk assessment must be understood as a decision tool for risk management in situations of uncertainly. Thus, appropriate linkage is required between decision making and assessment, and between the methods and the expected results.
L'évaluation des risques sanitaires est fréquemment utilisée en France dans les processus de décision en santé environnementale. La section " Méthodologie d'évaluation des risques sanitaires " de la Société française de santé environnement (SFSE) s'est donnée pour objectif de proposer des éléments de réflexion et des outils méthodologiques en vue d'améliorer l'utilité et les pratiques de l'évaluation des risques sanitaires. Un premier objectif opérationnel est l'inventaire des améliorations possibles à court, moyen et long termes à apporter à la démarche et à son utilisation. Ce travail s'est fondé, d'une part, sur la pratique et l'expertise des membres de la section, et, d'autre part, sur une lecture critique du rapport " Science and Decisions : Advancing Risk Assessment " publié en 2009 par le National Research Council et portant également sur les évolutions de la démarche. Dans cet article, la section restitue les conclusions de cet inventaire critique et propose un certain nombre d'améliorations en termes d'indications et d'utilisations de l'évaluation des risques sanitaires pour chacune des quatre étapes : identification des dangers et relation dose-réponse ; évaluation de l'exposition ; caractérisation des risques ; et interprétation des résultats. Certaines recommandations peuvent être mises en oeuvre immédiatement ; d'autres, en préalable à leur mise en oeuvre, nécessitent un consensus ou encore de la recherche car les connaissances manquent. En conclusion, la section insiste sur le fait que l'évaluation des risques sanitaires doit être comprise comme une aide à la décision en situation d'incertitude ; l'articulation entre le contexte décisionnel et l'évaluation, sa méthodologie et les résultats attendus est donc primordiale.
ISSN: 1635-0421

ineris-00963325
https://hal-ineris.archives-ouvertes.fr/ineris-00963325
DOI : 10.1684/ers.2011.0435
INERIS : EN-2012-016

Éditeur(s) : HAL CCSD
Résumé : International audience
Objectives: To assess the adhesion of French obstetricians and gynecologists to the French clinical practice guidelines for pregnancy loss, issued by the French College of Obstetricians and Gynecologists, one year after publication.Methods: An online vignette-based study was emailed to a sample of French obstetricians and gynecologists to compare their management of women with missed early miscarriage and incomplete early miscarriage. A descriptive statistical analysis was performed comparing the rates of appropriate management for these two indications before and after the release of the guidelines.Results: Of the 404 specialists contacted, 143 completed the questionnaire. Forty-three percent stated that they had changed their practices following the release of the guidelines. The rate of adhesion was moderate for the management of missed early miscarriage (53% after publication of the guidelines versus 42% before, P = 0.001) with a trend to avoid watching-and-waiting management. The rate of adhesion was poor for the management of incomplete early miscarriage (43% after the publication of the guidelines versus 27% before, P < 0.001) with a lower use of misoprostol.Conclusion: Adhesion to the French guidelines appears to be moderate for the management of missed early miscarriage and low for the management of incomplete early miscarriage.
ISSN: 24687847

hal-01558814
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01558814
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01558814/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01558814/file/Le%20Gouic%20et%20al.%20-%20Evaluation%20of%20adherence%20to%20French%20clinical%20practic.pdf
DOI : 10.1016/j.jogoh.2017.03.005

Éditeur(s) : HAL CCSD John Libbey Eurotext
Résumé : National audience
The most recent data on prevalence of chronic hepatitis B and C in the French Overseas Territories (FOT) show great variability among these territories with a prevalence rising from 0.46 to 3.4% for HBs Antigen and from 0.02 to 0.67%for anti HCV antibodies. The modes of transmission rely mainly for HBV on sexual or materno-fetal exposure, especially among people from non-French border endemic areas, and for HCV on blood or nosocomial route. Good adhesion of the treating physicians and pediatricians to vaccination has significantly reduced the prevalence of HBV in the ten past years, with an estimated coverage of 75 to 85%depending on the territories. Although there is still a high prevalence of HBV in some FOT, the screening policy and management are based on those carried out inmetropolitan France, which seems insufficient and inadequate to the situation of these territories. Regarding the therapeutic management of HCV, the means attributed to FOT have been identical to those of metropolitan France but the small number of specialist practitioners and remoteness contributed to provision of new molecules later in certain territories. Medical pluridisciplinary sessions have been implemented and based on the universitary or regional hospitals. Copyright © 2017 John Libbey Eurotext.
ISSN: 2115-3310

hal-01485859
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01485859
DOI : 10.1684/hpg.2016.1379

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
The purpose of this investigation was to characterize the management and prognosis of severe Pneumocystis jirovecii pneumonia (PJP) in human immunodeficiency virus (HIV)-negative patients. An observational cohort study of HIV-negative adults with PJP documented by bronchoalveolar lavage (BAL) through Gomori-Grocott staining or immunofluorescence, admitted to one intensive care unit (ICU) for acute respiratory failure, was undertaken. From 1990 to 2010, 70 patients (24 females, 46 males) were included, with a mean age of 58.6 ± 18.3 years. The mean Simplified Acute Physiology Score (SAPS)-II was 36.9 ± 20.4. Underlying conditions included hematologic malignancies (n = 21), vasculitis (n = 13), and solid tumors (n = 13). Most patients were receiving systemic corticosteroids (n = 63) and cytotoxic drugs (n = 51). Not a single patient received trimethoprim-sulfamethoxazole as PJP prophylaxis. Endotracheal intubation (ETI) was required in 42 patients (60.0 %), including 38 with acute respiratory distress syndrome (ARDS). In-ICU mortality was 52.9 % overall, reaching 80.9 % and 86.8 %, respectively, for patients who required ETI and for patients with ARDS. In the univariate analysis, in-ICU mortality was associated with SAPS-II (p = 0.0131), ARDS (p < 0.0001), shock (p < 0.0001), and herpes simplex virus (HSV) or cytomegalovirus (CMV) on BAL (p = 0.0031). In the multivariate analysis, only ARDS was associated with in-ICU mortality (odds ratio [OR] 23.4 [4.5-121.9], p < 0.0001). PJP in non-HIV patients remains a serious disease with high in-hospital mortality. Pulmonary co-infection with HSV or CMV may contribute to fatal outcome.
ISSN: 0934-9723

inserm-00872789
http://www.hal.inserm.fr/inserm-00872789
DOI : 10.1007/s10096-012-1730-7
PUBMED : 22930407

Éditeur(s) : HAL CCSD European Respiratory Society
Résumé : IF 8.332
International audience
The respiratory manifestations of eosinophilic granulomatosis with polyangiitis (EGPA) have not been studied in detail. In this retrospective multicentre study, EGPA was defined by asthma, eosinophilia and at least one new onset extra-bronchopulmonary organ manifestation of disease. The study population included 157 patients (mean±SD age 49.4±14.1 years), with a mean±SD blood eosinophil count of 7.4±6.4×109 L-1 at diagnosis. There was a mean±SD of 11.8±18.2 years from the onset of asthma to the diagnosis of EGPA, of 1.4±8.4 years from the first onset of peripheral eosinophilia to the diagnosis of EGPA, and of 7.4±6.4 years from EGPA diagnosis to the final visit. Despite inhaled and oral corticosteroid treatment, the severity of asthma increased 3-6 months before the onset of the systemic manifestations. Asthma was severe in 57%, 48%, and 56% of patients at diagnosis, at 3 years, and at the final visit, respectively. Persistent airflow obstruction was present in 38%, 30%, and 46% at diagnosis, at 3 years, and at the final visit, respectively. In EGPA, asthma is severe, antedates systemic manifestations by a mean of 12 years, and progresses to long-term persistent airflow obstruction despite corticosteroids in a large proportion of patients, which affects long-term management and morbidity. Copyright © 2016 ERS.
ISSN: 0903-1936

hal-01406073
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01406073
DOI : 10.1183/13993003.00097-2016
PUBMED : 27587545

Éditeur(s) : Université des Antilles Études caribéennes
Résumé : La Martinique possède 55 km2 de récifs coralliens, 50 d’herbiers et 20 de mangroves. Ces trois écosystèmes produisent des biens et services dont la valeur est estimée à quelque 250 millions d’euros par an. Près de 60 % de cette valeur est issue des usages directs liés aux activités récréatives (plongée, excursion, récréation balnéaire) induites pour l’essentiel par le tourisme et celles liées à la pêche (professionnelle et de plaisancière). Les services écosystémiques (assimilés aux usages indirects) tels que la protection des côtes, l’absorption/séquestration de carbone, la production de biomasse de poissons et l’épuration de l’eau sont conséquents puisque leur valeur annuelle s’élève à 94 millions € soit 38 % de la valeur totale. La valeur de ce qui a trait au non-usage des récifs, herbiers et mangroves (lié à la volonté de transmettre un patrimoine écologique pour l’essentiel ou encore à la satisfaction de savoir que les récifs sont en bon état) se traduit par une création de valeur de l’ordre de 10 millions €/an. Les herbiers et les mangroves contribuent le plus (par km2) à la création de valeur (respectivement 2,16 millions €/km2, 1,87 million €/km2 contre 1,78 million €/km2 pour les récifs). Ils doivent donc bénéficier de mesures de protection et surtout de valorisation au même titre que les récifs coralliens qui font déjà l’objet d’une attention particulière.
Martinique possesses 55 km2 of coral reefs, 50 of sea grass and 20 of mangroves. These three ecosystems produce services for a value estimated at 250 millions € per year. About 60% of this value originates from directs uses such as recreational activities (diving, excursions, beach activities, etc.) induce by tourism and fishery. Ecosystem services (indirect uses) such as coastal protection, carbon sequestration, biomass production and water purification are significant since their sum value reaches annually 94 millions € (38% of the total economic value). Non-use value links to the improvement of the health of coastal ecosystem is estimated to 10 millions € per year. At the ecosystem level, sea grass and mangrove contribute the more (per km2) to the wealth creation (respectively 2,16 millions €/km2, 1,87 million €/km2 against 1,78 million €/km2 for the reefs). They need therefore to benefit from protection and management measures in the same magnitude than the reefs already received.
Martinique

Droits : info:eu-repo/semantics/openAccess
urn:doi:10.4000/etudescaribeennes.4410
http://journals.openedition.org/etudescaribeennes/4410

Éditeur(s) : HAL CCSD
Résumé : poster presentation, 22nd European Meeting on Hypertension and Cardiovascular protection, London,26-29 April 2012
OBJECTIVE: Several studies demonstrate that the perception of overweight is associated with attempts at weight control in overweight subjects. Our objective is to describe the factors associated with the perception of overweight in an adult Caribbean population, and in particular, to assess the relationship between the perception of overweight and previous medical diagnosis of overweight. METHOD AND DESIGN: Consant was a cross-sectional study carried out in 2007 on a representative sample of the adult Guadeloupean population. Included were 1,005 subjects aged 25-74 years, drawn from stratified random sampling, and interviewed at home. The perception of overweight was evaluated by the question: "Do you consider yourself to be overweight?" with a binary response. RESULTS: Among overweight subjects (Body Mass Index ≥ 25 kg/m2, n = 576), 38.6% provided an incorrect assessment of their weight status. This proportion falls to 17.4% in those who stated to have previously received a medical diagnosis of overweight. However, only 48.8% of overweight subjects stated to have received such a diagnosis. A logistic regression shows that the underestimation of weight status is associated with the absence of previous diagnosis for overweight (OR: 5.35 - p < 10-3), as well as an age greater than or equal to 55 years (OR: 2.91 - p < 10-3), a BMI of less than 30 kg/m² (OR: 2.26 - p: 0.001), the male sex (OR: 1.86 - p: 0.004), and a low income level (OR: 1.62 - p: 0.030), but not a lack of awareness regarding the role of weight control in the prevention of cardiovascular diseases. Similar results are observed if waist circumference is taken as a factor instead of BMI. CONCLUSION: In this population, the lack of medical diagnosis of overweight was the leading factor associated with misperception of overweight. Screening for overweight therefore appears to be one of the preconditions to weight management, and remains a fundamental but often unused element in the fight against obesity.
https://hal.univ-antilles.fr/hal-00739785

Droits : info:eu-repo/semantics/OpenAccess
hal-00739785
https://hal.univ-antilles.fr/hal-00739785
https://hal.univ-antilles.fr/hal-00739785/document
https://hal.univ-antilles.fr/hal-00739785/file/The_lacksur screening_is_the_leading_factor_associated_with_the_misperceptionsur overweight_cor.pdf

Éditeur(s) : Pergamon-elsevier Science Ltd
Résumé : Society's needs for a network of in situ ocean observing systems cross many areas of earth and marine science. Here we review the science themes that benefit from data supplied from ocean observatories. Understanding from existing studies is fragmented to the extent that it lacks the coherent long-term monitoring needed to address questions at the scales essential to understand climate change and improve geo-hazard early warning. Data sets from the deep sea are particularly rare with long-term data available from only a few locations worldwide. These science areas have impacts on societal health and well-being and our awareness of ocean function in a shifting climate. Substantial efforts are underway to realise a network of open-ocean observatories around European Seas that will operate over multiple decades. Some systems are already collecting high-resolution data from surface, water column, seafloor, and sub-seafloor sensors linked to shore by satellite or cable connection in real or near-real time, along with samples and other data collected in a delayed mode. We expect that such observatories will contribute to answering major ocean science questions including: How can monitoring of factors such as seismic activity, pore fluid chemistry and pressure, and gas hydrate stability improve seismic, slope failure, and tsunami warning? What aspects of physical oceanography, biogeochemical cycling, and ecosystems will be most sensitive to climatic and anthropogenic change? What are natural versus anthropogenic changes? Most fundamentally, how are marine processes that occur at differing scales related? The development of ocean observatories provides a substantial opportunity for ocean science to evolve in Europe. Here we also describe some basic attributes of network design. Observatory networks provide the means to coordinate and integrate the collection of standardised data capable of bridging measurement scales across a dispersed area in European Seas adding needed certainty to estimates of future oceanic conditions. Observatory data can be analysed along with other data such as those from satellites, drifting floats, autonomous underwater vehicles, model analysis, and the known distribution and abundances of marine fauna in order to address some of the questions posed above. Standardised methods for information management are also becoming established to ensure better accessibility and traceability of these data sets and ultimately to increase their use for societal benefit. The connection of ocean observatory effort into larger frameworks including the Global Earth Observation System of Systems (GEOSS) and the Global Monitoring of Environment and Security (GMES) is integral to its success. It is in a greater integrated framework that the full potential of the component systems will be realised. Crown Copyright (C) 2011 Published by Elsevier Ltd. All rights reserved.
Progress In Oceanography (0079-6611) (Pergamon-elsevier Science Ltd), 2011-10 , Vol. 91 , N. 1 , P. 1-33

Droits : 2011 Published by Elsevier Ltd. All rights reserved.
http://archimer.ifremer.fr/doc/00044/15557/15923.pdf
DOI:10.1016/j.pocean.2011.05.001
http://archimer.ifremer.fr/doc/00044/15557/

Éditeur(s) : EDP Sciences
Résumé : The diversity of reef ecosystems, the multiplicity of reef resource uses and the breadth of the range of the island socio-cultural contexts concerned make coral reef fisheries (CRF) management in the South Pacific a complex task. The health and state of the targeted resources depend both on ecosystem characteristics (as determined by ecological and biological factors) and on fishing pressure, whose effects are only partly known. Increasing harvests from commercial and recreational fishing increasingly overlap with traditional Subsistence activity, creating an important CRF management challenge. This paper presents a new approach to CRF assessment and monitoring by providing a set of multidisciplinary indicators. The fisheries system is assessed from three different viewpoints: ecology of targeted populations, exploitation and the broader socio-econornic fishery context. The use of complementary indicators chosen from each of these fields could balance the chronic lack of human and financial resources for the management of these fisheries. We suggest the use of these indicators through an assessment grid or an indicator dashboard specifically adapted to given situations and management objectives determined through a participatory approach. The operational efficiency of this dashboard depends on i) dialogue between users, ii) the objectivity of the proposed monitoring, iii) the Visual transcription of divergent/convergent interests amongst stakeholders, and iv) stakeholder involvement in the decision-making process. The use and constraints of such a tool are described with reference to Ouvea atoll (New-Caledonia, South Pacific) for which an analysis of available indicators for assessing fisheries status is presented.
La diversité des écosystèmes coralliens, la multiplicité des modalités d'exploitation de leurs ressources et l'hétérogénéité des contextes socio-culturels insulaires rendent complexe la gestion des pêcheries récifo-lagonaires du Pacifique sud. La santé et l'évolution de ces ressources dépendent, d'une part, des caractéristiques propres de l'écosystème (obéissant à des facteurs biologiques et écologiques) et, d'autre part, de la pression de pêche dont certains effets seulement sont établis. La pêche traditionnelle aux fins de subsistance est aujourd'hui concurrencée par des activités à visées commerciales et récréatives, qui accroissent les prélèvements et soulèvent de nouveaux enjeux de gestion. L'article propose une approche pour l'évaluation et le suivi de ces pêcheries basée sur un ensemble d'indicateurs pluridisciplinaires. Le système « Pêche » est analysé de trois points de vue complémentaires : l'écologie des peuplements exploités, l'exploitation halieutique sensu stricto et le contexte économique et social plus large des pêcheries. La mise en place d'indicateurs issus de ces trois domaines vise à compenser le manque chronique de moyens financiers et humains pour la gestion des pêcheries coralliennes des îles du Pacifique sud. Nous suggérons que leur utilisation s'effectue au travers d'une grille d'évaluation ou tableau de bord répondant à des situations précises et des objectifs de gestion définis lors d'une approche participative. La portée opérationnelle de ce tableau de bord de gestion de la pêche repose sur i) la concertation engagée entre les usagers, ii) l'objectivité du suivi préconisé, iii) la transcription visuelle des intérêts convergents et/ou divergents des acteurs, et iv) leur implication dans le processus de décision. Les modalités et contraintes d'application de cet outil sont décrites sur l'exemple de l'atoll d'Ouvéa (Nouvelle-Calédonie, Pacifique Sud), pour lequel une analyse des indicateurs disponibles pour décrire l'état des pêcheries a été réalisée.
Aquatic Living Resources (0990-7440) (EDP Sciences), 2005-07 , Vol. 18 , N. 3 , P. 199-213

Droits : 2005 EDP Sciences, IFREMER, IRD
http://archimer.ifremer.fr/doc/2005/publication-716.pdf
DOI:10.1051/alr:2005026
http://archimer.ifremer.fr/doc/00000/716/

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Despite improvements in air quality in developed countries, air pollution remains a major public health issue. To fully assess the health impact, we must consider that air pollution exposure has both physical and psychological effects; this latter dimension, less documented, is more difficult to measure and subjective indicators constitute an appropriate alternative. In this context, this work presents the methodological development of a new scale to measure the perception of air quality, useful as an exposure or risk appraisal metric in public health contexts. On the basis of the responses from 2,522 subjects in eight French cities, psychometric methods are used to construct the scale from 22 items that assess risk perception (anxiety about health and quality of life) and the extent to which air pollution is a nuisance (sensorial perception and symptoms). The scale is robust, reproducible, and discriminates between subpopulations more susceptible to poor air pollution perception. The individual risk factors of poor air pollution perception are coherent with those findings in the risk perception literature. Perception of air pollution by the general public is a key issue in the development of comprehensive risk assessment studies as well as in air pollution risk management and policy. This study offers a useful new tool to measure such efforts and to help set priorities for air quality improvements in combination with air quality measurements.
ISSN: 0272-4332

hal-00876409
https://hal.archives-ouvertes.fr/hal-00876409
DOI : 10.1111/j.1539-6924.2012.01862.x
PUBMED : 22852801