Sports et Olympisme après la Première Guerre mondiale
In: Relations internationales: revue trimestrielle d'histoire, Issue 111, p. 347-364
ISSN: 0335-2013
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In: Relations internationales: revue trimestrielle d'histoire, Issue 111, p. 347-364
ISSN: 0335-2013
International audience ; Les situations d'étiage, et plus généralement de sécheresse et de rareté d'eau, font l'objet d'attentions croissantes, sous l'effet conjugué des politiques publiques et d'événements répétés de manques d'eau. Ainsi, la "Directive Cadre sur l'Eau" (DCE) entrée en vigueur en décembre 2000, fixe dans ses objectifs la nécessité d'une gestion quantitative de la ressource en eau afin de garantir un équilibre entre la ressource disponible et son utilisation. Les indicateurs hydrologiques tels que le module et le débit mensuel quinquennal sec (QMNA5) donnent des informations pour la gestion quantitative de la ressource. Irstea d'Aix-en-Provence a développé une méthode régionale de cartographie de l'aléa hydrologique à l'échelle de la France. Elle permet de modéliser les écoulements mensuels, grâce à un modèle hydrologique, et d'en déduire les valeurs statistiques d'étiage pour tout bassin versant. L'utilisation des réanalyses SAFRAN a permis le développement d'une structure distribuée exploitant cette information disponible sur tout le territoire national et adaptée à une gamme de fonctionnements hydrologiques variés. La prise en compte d'une information sur la neige a permis d'améliorer la qualité de la simulation des bassins versants sous influence nivale. La démarche s'est appuyée sur un large échantillon de bassins (840) répartis sur tout le territoire national. / Severe low-water levels, and more generally droughts and water scarcity situations, are the subject of increasing attention, under the combined effect of repeated events of water shortage and of public policies (European Water Framework directive). There is a demand for the elaboration of management support tools for low-water levels and water shortage situations as well as for assistance in the prediction of low-flow statistical discharge values. Such statistical values, as the mean annual discharges and the quinquennial monthly low-water runoffs, are useful hydrological indicators relevant for water resources management. Irstea of ...
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Dans le cadre de ses activités de recherche et d'appui aux politiques publiques, Irstea a mis en ½uvre la méthode SHYREG. L'aboutissement de ce travail est la mise à disposition des services de l'état d'une base de donnée sur les quantiles de débit de crue à l'exutoire de bassins versants non-jaugés. Il s'agit des quantiles de crue estimés pour différentes durées (de la pointe au débit en 3 jours) pour des périodes de retour allant de 2 à 1000 ans. Cette notice présente la méthode et sa mise en ½uvre sur l'ensemble du territoire français. Elle présente les performances de la méthode et ses limites d'utilisation.
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Dans le cadre de ses activités de recherche et d'appui aux politiques publiques, Irstea a mis en ½uvre la méthode SHYREG. L'aboutissement de ce travail est la mise à disposition des services de l'état d'une base de donnée sur les quantiles de débit de crue à l'exutoire de bassins versants non-jaugés. Il s'agit des quantiles de crue estimés pour différentes durées (de la pointe au débit en 3 jours) pour des périodes de retour allant de 2 à 1000 ans. Cette notice présente la méthode et sa mise en ½uvre sur l'ensemble du territoire français. Elle présente les performances de la méthode et ses limites d'utilisation.
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International audience ; Because it is not possible to monitor every little river tributary, flash floods occur most often on small ungauged catchments. In this case, the development and the evaluation of a flood alert system are a real challenging issue, since no data is by definition available to validate results at the scale of interest. To try to solve this problem, the use of additional information simply saying "this area were flooded or not" can be of great help. By comparing on a continuous period (and not only for pre-identified events) the alerts emitted by the tested warning procedure and the damages locally reported, it becomes possible to get a more objective picture of the usefulness of the warning method. The application presented in this communication concerns the evaluation of the AIGA flash flood warning method (Javelle et al, 2010, doi:10.1016/j.jhydrol.2010.03.032) carried out on a 10 000 km2 mountainous area located in the South-East of France (region of Nice). Different rainfall input data (interpolated raingauges network and different radar rainfall products) are compared. The evaluation is carried out for the 2008-2010 period, using both gauged hydrological stations (15 stations) and flood damages reports made on ungauged locations by local authorities. The interest and limit of using this last data is discussed. The interest of using X-band radar data in mountainous areas for flood alert is also investigated. This work is accomplished with the financial support of the RHYTMME project, funded by the European Union, the Provence-Alpes-Cote d'Azur Region and the French Ministry of Ecology. The X-band radar data used in the study were provided by NOVIMET in the framework of the Interreg FRAMEA and CRISTAL projects.
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In: Natural hazards and earth system sciences: NHESS, Volume 14, Issue 2, p. 295-308
ISSN: 1684-9981
Abstract. Flood frequency analysis (FFA) aims at estimating quantiles with large return periods for an extreme discharge variable. Many FFA implementations are used in operational practice in France. These implementations range from the estimation of a pre-specified distribution to continuous simulation approaches using a rainfall simulator coupled with a rainfall–runoff model. This diversity of approaches raises questions regarding the limits of each implementation and calls for a nation-wide comparison of their predictive performances. This paper presents the results of a national comparison of the main FFA implementations used in France. More accurately, eight implementations are considered, corresponding to the local, regional and local-regional estimation of Gumbel and Generalized Extreme Value (GEV) distributions, as well as the local and regional versions of a continuous simulation approach. A data-based comparison framework is applied to these eight competitors to evaluate their predictive performances in terms of reliability and stability, using daily flow data from more than 1000 gauging stations in France. Results from this comparative exercise suggest that two implementations dominate their competitors in terms of predictive performances, namely the local version of the continuous simulation approach and the local-regional estimation of a GEV distribution. More specific conclusions include the following: (i) the Gumbel distribution is not suitable for Mediterranean catchments, since this distribution demonstrably leads to an underestimation of flood quantiles; (ii) the local estimation of a GEV distribution is not recommended, because the difficulty in estimating the shape parameter results in frequent predictive failures; (iii) all the purely regional implementations evaluated in this study displayed a quite poor reliability, suggesting that prediction in completely ungauged catchments remains a challenge.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
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Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
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