Journal of Next-Generation Research 5.0
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Variabilité spatiale et temporelle du rayonnement solaire global sur une topographie à relief marqué et complexe. Cas de l’île de La Réunion
No full textIn the South-West Indian Ocean, La Réunion Island is located in a strong solar potential. However, its complex topography and tropical climate are obstacles to the best exploitation of renewable energies. Thus, the knowledge of the local solar potential has to be deepen, both on its temporal and spatial variabilities. The research here focuses on this deepening of the local solar deposit. Thus, the use of SARAH-E satellite product (Solar surfAce RAdiation Heliosat - East) allows us to study the irradiance of Reunion Island on 89 pixels and 16 years of hourly data. In a first study, the mean solar potential is mapped by combining its two orbital components: the diurnal and seasonal cycles. Their complementarity permits the extraction of coherent zones with the local atmospheric dynamic. In the second part, the daily perturbations modulating the mean solar potential are detailed in five typical days with specific spatial structures and temporality. We then propose a first link between local solar perturbations and the larger-scale atmospheric processes, namely the Madden-Julian oscillation, the Tropical-Temperate Troughs and Tropical Cyclones. Finally, La Réunion island solar resource is decomposed into (1) an mean cyclic potential, combining seasonal and diurnal evolutions, and (2) typical daily perturbations, with links to larger-scale atmospheric dynamics.Parmi les îles de l’Indianocéanie, La Réunion présente une topographie complexe soumise à un climat tropical fortement variable. Sa localisation dans le sud-ouest de l’océan Indien lui octroie un potentiel solaire important. Concomitamment, son isolement géographique dirige le territoire vers l’autonomie énergétique, par la meilleure intégration des énergies renouvelables dans son mix énergétique. Le verrou de l’exploitation du gisement solaire local réside dans la forte intermittence de cette ressource qui est grandement tributaire de la couverture nuageuse. Ainsi, il est de première nécessité d’approfondir les connaissances du potentiel solaire local, autant en ce qui concerne sa variabilité temporelle que sa répartition spatiale. Les travaux de recherches ici menés s’axent autour de cet approfondissement nécessaire du gisement solaire local. La mesure in situ du rayonnement solaire global n’est pas équitablement répartie sur le département et ne permet donc pas d’établir une cartographie aussi équilibrée que celle offerte par les résolutions de l’imagerie satellitaire. Dans le cadre des travaux de recherches, nous exploitons le produit satellitaire SARAH-E (Solar surfAce RAdiation Heliosat – East) prodigué par le SAF Climat (CM SAF) d’Eumetsat. Les résolutions spatiales et temporelles de SARAH-E permettent d’étudier l’irradiance à la surface de La Réunion sur un total de 89 pixels et de 16 ans de données horaires (0,05°×0.05°, 1999-2015, excluant 2006). Grâce à ces données, nous articulons l’approfondissement de la connaissance du gisement solaire autour de deux méthodologies complémentaires. Dans une première étude, une cartographie du potentiel solaire moyen est établie en combinant ses deux composantes orbitales, soit : les cycles diurne et saisonnier. La complémentarité de cette considération nous permet d’extraire des zones cohérentes tant au niveau spatial que temporel, à l’image de la dynamique atmosphérique locale. En seconde partie, il sera ensuite question de quantifier et qualifier les perturbations possibles pouvant moduler le potentiel solaire moyen dans la journée. Cinq journées-types sont retenues et caractérisées selon leurs structures spatiales et temporalité associée. Par la suite, nous proposons un premier lien entre les perturbations solaires locales et certains processus atmosphériques de plus large échelle. Ainsi, nous estimons des modulations relatives selon l’oscillation de Madden-Julian, les talwegs tropicaux-tempérés et les cyclones. Finalement, nous décomposons la ressource solaire réunionnaise en (1) un potentiel moyen cyclique, selon une combinaison de la variabilité saisonnière à l’évolution diurne, et (2) des perturbations journalières types, présentant des liens avec les dynamiques atmosphériques à plus large échelle
Un état des lieux du risque suicidaire à l’adolescence
No full textInternational audienceSuicidal behaviour in adolescence is a major public health issue. It is the consequence of a sum of individual, relational and environmental difficulties that weaken the subject in a period of great vulnerability. The main aspects of their care consist in developing a good therapeutic link and adapting the adolescent's environment. Prevention is the concern of everyone, especially healthcare professionals who are regularly consulted before suicidal acts.Les conduites suicidaires à l’adolescence sont un enjeu majeur de santé publiqueElles font suite à une constellation de difficultés individuelles, relationnelles et environnementales, qui fragilisent le sujet dans une période de grande vulnérabilitéLe soin passe par le lien thérapeutique et l’adaptation de l’environnement de l’adolescentLa prévention est l’affaire de tous, et particulièrement des soignants, qui sont régulièrement sollicités avant un passage à l’acte
Acceptabilité du dépistage systématique des adolescents suicidants aux urgences
No full textInternational audienceStudies of adolescent suicide screening tools have increased with the development of questionnaires that can be used in paediatric emergency departments. This article proposes a literature review of the acceptability of such interventions. Although these tools are well accepted when they are systematized, their usefulness is determined by the availability of child psychiatric care with the right balance between the adolescent's confidentiality and parental involvement.Les études portant sur les outils de dépistage du suicide à l’adolescence se sont multipliées avec l’essor de questionnaires utilisables aux urgences pédiatriquesUne revue de la littérature établit l’acceptabilité de tels dispositifsMême si ces outils sont bien acceptés lorsqu’ils sont systématisés, leur utilité est conditionnée par la disponibilité de soins pédopsychiatriques avec un juste équilibre entre la confidentialité de l’adolescent et l’implication parentale
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Fluid and electrolytes
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Ureteral obstruction and ruptured kidney following ovarian hyperstimulation syndrome
No full textInternational audienceIn vitro fertilization (IVF) is nowadays a reliable and common method for couple who need medically assisted procreation. Complications are rare. We report in this paper, the case of a woman with severe endometriosis who developed ureteral obstruction complicated by a renal rupture of the fornix due to ovarian hyperstimulation during an IVF attempt. The condition was diagnosed by CT scan and resolved with insertion of double-J catheter in the left ureter
Incidence and natural history of preeclampsia/eclampsia at the university maternity of Antananarivo, Madagascar: high prevalence of the early-onset condition
No full textInternational audienceObjectives: To investigate the incidence of early − (delivery <34 weeks) (EOP) versus late-onset (delivery ≥34 weeks) (LOP) in Madagascar.Study design: Eight months observational study of all preeclamptic/eclamptic women delivering at the maternity of the University Hospital of Befelatanana, Antananarivo, Madagascar. Sociodemographical and obstetrical risk factors are analyzed.Results: Over the study period, we found 142 combined preeclampsia/eclampsia among 4316 births (incidence 3.3% for singleton pregnancies), of which 65 eclampsia (1.5% of all deliveries). The rate of delivery <34 weeks of gestation in preeclamptic women was 37.3% and 38.5% in eclamptic ones. The overall rate of fetal and neonatal mortality was of 50% (71/142). In EO forms the infant death rate was 83% (44/53), of which approximately 33% were due to intrauterine fetal death. In LO forms, the infant death rate was 20% in preeclampsia (15% of fetal deaths), while in case of maternal eclamptic seizures the infant mortality rate was doubled (40%). There were seven maternal deaths (of which four were eclamptic women).Conclusions: We have in Madagascar a high rate of early-onset preeclampsia/eclampsia EOP (37% versus approximately 10% in international literature) and a consequent worrying rate of maternal–fetal mortality. We could find other high incidence of EOP in nine other geographical locations: Guadeloupe (31%), Réunion (31%), Mauritius (34%), Cameroon (37.4%), China (38%), Zimbabwe (58%), Thailand (34%), Turkey (29%), and India (26%). Emerging and tropical countries may belong to the “high rate of EOP standard.” There is an urgent need to have additional data from these areas to confirm the hypothesis
Comment améliorer l’adhésion aux soins des adolescents suicidants après une prise en charge aux urgences : une revue de la littérature
No full textInternational audienceOBJECTIVES:Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents' adherence to care. METHOD:We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED. We also manually consulted the main journals specialized in suicidology (Crisis and Suicide and Life-Threatening Behavior) and adolescence (Journal of the American Academy of Child and Adolescent Psychiatry, Journal of Adolescent Health, Neuropsychiatrie de l'Enfance et de l'Adolescence). We selected the relevant articles describing or evaluating one or more interventions initiated in the ED and designed to promote adolescent adherence to post-emergency care. The results are presented in a narrative review form. RESULTS:Interventions are organized in three groups: interventions that take place solely at the ED (problem-solving interventions and educational interventions directed to families) and interventions that take place during and after emergency care (we included in this group the ED-Care program, the FISP program, and the SAFETY program), to which should be added interventions that take place prior to care, in particular specific trainings for medical and paramedical teams. Small samples and barriers in measuring adherence to care make statistical comparisons difficult, yet the interventions that seem most effective are those that target the time both during and after ED discharge, those which are implemented most rapidly after discharge, those which actively include parents, and those which involve an implication of the families about barriers to follow-up. CONCLUSION:Our results show an effectiveness of complete programs on short-term compliance but no conclusion can be drawn on long-term effects. Most comprehensive care programs are based on the principle of adolescent compliance, which remains problematic. Until today, no ideal protocol exists to improve short-term as well as long-term compliance to care among adolescents after a suicide attempt. We have to improve our understanding of facilitators and barriers to follow-up using quantitative as well as qualitative research studies. Although it is well established that parents' involvement in the early stages of care is essential, little is known about the underlying processes. In these situations, qualitative studies could help to better target interventions that lead more particularly to follow up compliance in adolescence
Étude du parcours de soins des patientes lors d’une interruption volontaire de grossesse médicamenteuse réalisée par le médecin généraliste à La Réunion
No full textIntroduction: Outpatient medicated VTP (Voluntary Termination of Pregnancy) has been authorised since 2004 in France and concerns approximately one thousand patients per year in Reunion. Only eleven general practitioners (GP) are licensed to perform them. The main objective of this study was to provide indicators on the sound pathway of patients performing a medicated VTP by a general practitioner in Reunion Island, from the access to additional exams to the average time of care and access to other health professionals. Method: This was an epidemiological, descriptive and cross-sectional survey over a three month period in 2017. Results: Seven general practitioners included 71 patients in this study. The decision to perform an abortion for the women in the sample was a quick decision (less than 2 days) in more than half of the cases. The first doctor consulted was a general practitioner in 80% of situations. The time between the decision to perform an abortion and the first medication taken with mifepristone was 7.5 days on average. The average number of consultations was 2.8, 1.3 blood tests and 1.5 ultrasounds. 16 patients had performed post-VTP consultation. Discussion: This survey of the care pathway of patients performing an outpatient medicated VTP by a general practitioner, draws up an inventory of the situation in Réunion, conditions of access and care for women. These results are as many tracks for a better knowledge of abortionsIntroduction : L’IVG médicamenteuse en ambulatoire est autorisée depuis 2004 en France et concerne environ mille patientes par an à La Réunion. Seulement onze médecins généralistes sont agréés pour les réaliser. L’objectif principal de cette étude était de fournir des indicateurs sur le parcours de soins des patientes réalisant une IVG médicamenteuse par un médecin généraliste à la Réunion, de l’accès aux examens complémentaires au délai de la prise en charge ainsi que l’accès aux autres professionnels de santé. Méthode : Il s’agissait d’une enquête épidémiologique, descriptive et transversale sur une période de trois mois en 2017. Résultats : Sept médecins généralistes ont inclus 71 patientes dans cette étude. La décision de réaliser une IVG pour les femmes de l’échantillon était une décision rapide (inférieure à 2 jours) dans plus de la moitié des cas. Le premier médecin consulté était un médecin généraliste dans 80 % des situations. La durée entre la décision de réaliser une IVG et la première prise médicamenteuse de mifépristone était de 7,5 jours en moyenne. Le nombre moyen de consultations était de 2,8, de prises de sang 1,3 et d’échographies 1,5. 16 patientes avaient réalisé la consultation post IVG. Discussion : Cette enquête sur le parcours de soins des patientes réalisant une IVG médicamenteuse en ambulatoire par un médecin généraliste, dresse un état des lieux à La Réunion, des conditions d’accès et de prise en charge des femmes. Ces résultats sont autant de pistes pour une meilleure connaissance des IVG, donc une meilleure prévention et une réalisation optimal
Racine et Euripide, les « frères amis ». Préceptes aristotéliciens dans la Thébaïde
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Branched-Chain Amino Acid Database Integrated in MEDIPAD Software as a Tool for Nutritional Investigation of Mediterranean Populations
No full textInternational audienceBranched-chained amino acids (BCAA) are essential dietary components for humans and can act as potential biomarkers for diabetes development. To efficiently estimate dietary intake, we developed a BCAA database for 1331 food items found in the French Centre d'Information sur la Qualité des Aliments (CIQUAL) food table by compiling BCAA content from international tables, published measurements, or by food similarity as well as by calculating 267 items from Greek, Turkish, Romanian, and Moroccan mixed dishes. The database embedded in MEDIPAD software capable of registering 24 h of dietary recalls (24HDR) with clinical and genetic data was evaluated based on archived 24HDR of the Saint Pierre Institute (France) from 2957 subjects, which indicated a BCAA content up to 4.2 g/100 g of food and differences among normal weight and obese subjects across BCAA quartiles. We also evaluated the database of 119 interviews of Romanians, Turkish and Albanians in Greece (27-65 years) during the MEDIGENE program, which indicated mean BCAA intake of 13.84 and 12.91 g/day in males and females, respectively, comparable to other studies. The MEDIPAD is user-friendly, multilingual, and secure software and with the BCAA database is suitable for conducting nutritional assessment in the Mediterranean area with particular facilities for food administration