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Cost of Carbon in the Total Cost of a Healthcare Procedure: Example of Micro-Costing Study in a French Setting
No full textInternational audienceBackground: Economic evaluation aims to compare the costs and results of health strategies to inform public decision making. Although sometimes suggested, until now no national evaluation agency has recommended formally incorporating the cost of greenhouse gas (GHG) emissions generated by health interventions into the estimation of healthcare costs.Objective: The objective of this study was to test and discuss the feasibility of estimating and including the contribution of GHG emissions cost to the total cost of a surgical intervention, with the example of robot-assisted total knee arthroplasty (RTA), using a micro-costing approach.Methods: The study was conducted in June 2022 at the William Morey Hospital (France). Data regarding all of the resources (labor, medical equipment, consumables), as well as energy consumption, staff commuting and waste treatment were collected and valued from the hospital point of view. Greenhouse gas emissions were valued using a cost-effectiveness approach. Several sensitivity analyses were performed.Results: The mean cost per patient of an RTA was estimated to be €4755.65, of which €152.64 (3.21 %) would be attributable to GHG emissions. The contribution of GHG emissions in the overall cost of a health intervention was highly dependent on the convention used for the price of carbon.Conclusion: Despite persistent theoretical and practical challenges, adding the estimation of GHG emission costs in the economic evaluation of health interventions may provide institutional decision makers with information that allows them to allocate the public healthcare resources more efficiently
A significant doubling of rockfall rates since the Little Ice Age in the Mont-Blanc massif, inferred from 10Be concentrations and rockfall inventories.
No full textInternational audienceBy combining cosmogenic nuclide data and rockfall inventories, we have employed a rigorous methodology to focus on long-term erosion trends and the increase in rockfall in the Mont-Blanc massif (European Alps) over the last century. To do this, we used mathematical formulations based on power law integration, which enabled us to identify the complex links between rockfall distribution and erosion rates. Our approach was applied to the Mer de Glace basin (Mont-Blanc massif), where we combined analyses of 10Be concentration in the supraglacial load (based on 8 samples) with Terrestrial Laser Scanning (TLS) data capturing 123 rockfalls ranging from 1 to 566 m3, as well as direct observations of 71 rockfalls ranging from 100 to 20,000 m3. Within the overlapping volume range of both inventories, power law fitting yields a common exponent (b-value) of 0.75 ± 0.18. However, the TLS-derived rockfall rate (ā in m-2.yr-1) is approximately 5 times higher than that derived from the observation-based inventory. This difference is probably linked to the current intense permafrost degradation affecting scanned rockwalls at altitudes below 3800 m a.s.l. The 20,000 m3 rockfall documented by the network of observers has a statistical return time estimated at <6 years, which suggests that larger or more significant rockfalls will occur in the future. Based on a two-segment power law, the erosion rate is estimated at > 4.1 mm.yr-1 for the period 2006–2011.According to our study of glacial dynamics, the supraglacial clasts sampled aggregate ̴800 rockfalls greater than 1 m3 that occurred diachronically between 1845 and 1987 but whose cumulative total corresponds to <7 years of present rockwall erosion rate in the upper Mer de Glace basin. The mean 10Be concentration of the 8 supraglacial samples is 2.7 ± 1.3 104 at.g-1 and was obtained when exposing rock faces subjected to erosion of <1.2 ± 1 mm.yr-1. The erosion rate would, therefore, have significantly increased between the Little Ice Age (maximum 2.2 mm.yr-1 from 10Be result) and the beginning of the 21st century (minimum 4.1 mm.yr-1 for 2003–2011 surveys). These erosion rates do not consider past volume rockfalls greater than those observed recently and are minimal erosion rate estimates. Nevertheless, they highlight the increase in mass movement hazards linked to global warming via permafrost degradation in high-altitude rockwalls
Unsupervised classification of non-linear dynamics in optical fiber propagation using intensity clustering
No full textInternational audienceWe demonstrate that centroid-based clustering of normalized intensity profiles is able to successfully isolate different classes of pulses associated with physically distinct regimes of nonlinear and dispersive propagation in optical fiber. Remarkable for its simplicity, this approach shows how analysis of only the temporal intensity profiles of propagating pulses, even at relatively limited sampling resolution, reveal sufficient similarities to allow physical classification of different classes of propagation behavior
Harnessing trait-environment interactions to predict ecosystem functions
No full textInternational audienceIn a changing world, predicting ecosystem functions is essential to ensuring human well‐being and survival. However, commonly used trait‐based predictive approaches frequently lack predictive power. Statistical and conceptual attempts to better incorporate environmental factors into trait‐based predictions have done so by integrating indirect, trait‐mediated effects therein. Here, we define ecosystem functions as changes in the state, position, or nature of energy or matter within an ecosystem, and then illustrate how environmental factors can directly affect ecosystem functions. Given that the effects of organismal traits and environmental factors are not necessarily additive, we also propose that interactions between organismal traits and environmental factors (hereafter, trait–environment interactions) have explanatory power. We propose a conceptual framework in which organismal traits, environmental factors, and trait–environment interactions, together with the environment's effects on traits (plasticity) and traits’ effects on the environment (ecosystem engineering), can explain ecosystem functions. We conclude by discussing the importance of considering trait–environment interactions and identifying future avenues of exploration
How the built environment influences pollinator diversity in urban landscapes: An analysis of French cities using participative data
No full textInternational audienceMost of our knowledge of the factors favoring pollinating insects in urban areas arises from studies focused on urbanization gradients. However, when it comes to differentiating among types of built fabric according to their capacity to host pollinators, few information can be found. In this paper, we study the influence of built fabric patterns on pollinating insects using open data from citizen science and covering the whole of France. With pollinator richness as the response variable in a model focused on urban agglomerations, we test the relevance of spatial metrics describing the building patterns while accounting for other drivers such as plant species, season, climate, and the connectivity of herbaceous habitats. We divide the data into subsets covering varying ranges of building densities, to explore those for which built fabric types exhibit the greatest differences. Our results show that only a focus on moderate building densities reveals clear differences between built fabric types. In this case, the areas with old individual housing appear to be more favorable than other patterns dominated by individual housing built in the post-war period and in the late twentieth century. These results outline the potential of the coupling of participative naturalist data with geographical data
Conduire une audition pour cartographier les risques d'atteintes à la probité dans la fonction publique
No full textThe prevention and fight against attacks on integrity (corruption, favoritism, illegal taking of interests, etc.) constitute a major challenge for local authorities. However, many existing methodological guides are limited to general principles, without offering a concrete framework for conducting audits with agents. However, the audit - through the collection of field information, the evaluation of practices and precise knowledge of processes - is a decisive tool for developing risk mapping adapted to each context. In this article, we offer you an interview methodology and a list of key questions to ask during the audit, with the aim of drawing up a detailed map of the risks of integrity violations within your community .La prévention et la lutte contre les atteintes à la probité (corruption, favoritisme, prise illégale d'intérêts, etc.) constituent un enjeu majeur pour les collectivités territoriales. Pourtant, de nombreux guides méthodologiques existants se limitent à des principes généraux, sans offrir de trame concrète pour mener des audits auprès des agents. Or, l'audit -par le recueil d'informations de terrain, l'évaluation des pratiques et la connaissance précise des processus -est un outil déterminant pour élaborer une cartographie des risques adaptée à chaque contexte. Dans cet article, nous vous proposons une méthodologie d'entretien et une liste de questions clés à poser lors de l'audit, dans le but de dresser une cartographie détaillée des risques d'atteintes à la probité au sein de votre collectivité.L'élaboration d'une cartographie des risques d'atteintes à la probité dans les collectivités territoriales s'est progressivement imposée à la suite de la loi du 9 décembre 2016, dite loi Sapin II, qui encourage la mise en oeuvre de programmes anticorruption et recommande l'identification formalisée des zones de vulnérabilité. Les orientations délivrées par la Haute Autorité pour la Transparence de la Vie Publique, notamment dans son « Guide déontologique. Manuel à l'usage des responsables publics et des référents déontologues 1 », et par l'Agence Française Anticorruption dans ses divers documents de référence (dont le « Guide pratique à destination des Régions. Mettre en place un dispositif de maîtrise des risques d'atteintes à la probité 2 », « Les recommandations de l'AFA » ou encore le « Guide pratique à l'attention des élus du bloc communal 3 »), s'accordent sur l'importance de la cartographie comme outil préventif et pédagogique. Les collectivités disposent ainsi de ressources méthodologiques pour aborder cette démarche, qu'il s'agisse de définir les étapes de l'identification, de l'évaluation et du classement des risques ou de distinguer les catégories d'actes susceptibles de relever de la corruption, du favoritisme ou de la prise illégale d'intérêts.En revanche, ces divers guides se concentrent largement sur l'objectif final que constitue la cartographie elle-même, plutôt que sur les moyens de recueillir l'information la plus précise possible auprès des agents et des élus. Il en résulte une carence notable sur la conduite concrète d'investigations internes, alors même que l'implication de la base opérationnelle et la remontée de retours d'expérience constituent le socle de toute analyse pertinente. Les textes se bornent souvent à décrire la démarche d'évaluation du risque ou à recommander
Les déterminants du choix de spécialisation dans le cadre du nouveau baccalauréat général
No full textInternational audienceCette communication propose de s'intéresser aux inégalités de choix d'orientation scolaire dans l'enseignement secondaire à la lumière de la dernière réforme du baccalauréat général et technologique. Plus précisément, il est étudié le nouveau système d'enseignements de spécialité (EDS), venu remplacer les anciennes séries (ES, L et S) de la voie générale, et qui implique à la fois une orientation plus précoce et plus complexe des lycéens. Une base de données d'environ 15,000 bacheliers de la session 2022 a été constituée à partir de données issues de la plateforme Parcoursup et des bases publiques sur les établissements scolaires du secondaire. L'objectif de ce travail de recherche est, d'une part, d'identifier les nouveaux profils de spécialisation à partir des choix d'EDS des lycéens et de leurs caractéristiques, et d'autre part, d'expliciter les déterminants individuels et contextuels de ces choix. Pour cela, il a été réalisé une Classification Ascendante Hiérarchique (CAH), pour obtenir des profils de spécialisation, puis des modèles de régression logistique binaire pour étudier l'effet net de chaque facteur sur ces différents profils
Réflexions sur les nouvelles formes de l’évaluation des politiques et des dispositifs en éducation
No full textInternational audienc
Geometry and dynamics of Hitchin grafting representations
No full text119 pages, 6 figures, comments welcome!The Hitchin component of the character variety of representations of a surface group into for some can be equipped with a pressure metric whose restriction to the Fuchsian locus equals the Weil-Petersson metric up to a constant factor. We show that if the genus of is at least , then the Fuchsian locus contains quasi-convex subsets of infinite diameter for the Weil--Petersson metric whose diameter for the path metric of the pressure metric is finite. This is established through showing that biinfinite paths of bending deformations have controlled bounded length. To this end we give a geometric interpretation of Fock--Goncharov positivity and show that bending deformations of Fuchsian representations stabilize a uniform Finsler quasi-convex disk in the symmetric space