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1.
New Phytol ; 240(5): 1774-1787, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37743552

RESUMEN

Evolutionary radiations of woody taxa within arid environments were made possible by multiple trait innovations including deep roots and embolism-resistant xylem, but little is known about how these traits have coevolved across the phylogeny of woody plants or how they jointly influence the distribution of species. We synthesized global trait and vegetation plot datasets to examine how rooting depth and xylem vulnerability across 188 woody plant species interact with aridity, precipitation seasonality, and water table depth to influence species occurrence probabilities across all biomes. Xylem resistance to embolism and rooting depth are independent woody plant traits that do not exhibit an interspecific trade-off. Resistant xylem and deep roots increase occurrence probabilities in arid, seasonal climates over deep water tables. Resistant xylem and shallow roots increase occurrence probabilities in arid, nonseasonal climates over deep water tables. Vulnerable xylem and deep roots increase occurrence probabilities in arid, nonseasonal climates over shallow water tables. Lastly, vulnerable xylem and shallow roots increase occurrence probabilities in humid climates. Each combination of trait values optimizes occurrence probabilities in unique environmental conditions. Responses of deeply rooted vegetation may be buffered if evaporative demand changes faster than water table depth under climate change.


Asunto(s)
Embolia , Agua Subterránea , Agua/fisiología , Madera/fisiología , Xilema/fisiología , Plantas , Hojas de la Planta/fisiología , Sequías
2.
Nat Commun ; 14(1): 3837, 2023 06 28.
Artículo en Inglés | MEDLINE | ID: mdl-37380662

RESUMEN

Climate change is leading to species redistributions. In the tundra biome, shrubs are generally expanding, but not all tundra shrub species will benefit from warming. Winner and loser species, and the characteristics that may determine success or failure, have not yet been fully identified. Here, we investigate whether past abundance changes, current range sizes and projected range shifts derived from species distribution models are related to plant trait values and intraspecific trait variation. We combined 17,921 trait records with observed past and modelled future distributions from 62 tundra shrub species across three continents. We found that species with greater variation in seed mass and specific leaf area had larger projected range shifts, and projected winner species had greater seed mass values. However, trait values and variation were not consistently related to current and projected ranges, nor to past abundance change. Overall, our findings indicate that abundance change and range shifts will not lead to directional modifications in shrub trait composition, since winner and loser species share relatively similar trait spaces.


Asunto(s)
Ecosistema , Tundra , Semillas , Cambio Climático , Fenotipo
3.
Nat Commun ; 13(1): 3185, 2022 06 08.
Artículo en Inglés | MEDLINE | ID: mdl-35676261

RESUMEN

Due to massive energetic investments in woody support structures, trees are subject to unique physiological, mechanical, and ecological pressures not experienced by herbaceous plants. Despite a wealth of studies exploring trait relationships across the entire plant kingdom, the dominant traits underpinning these unique aspects of tree form and function remain unclear. Here, by considering 18 functional traits, encompassing leaf, seed, bark, wood, crown, and root characteristics, we quantify the multidimensional relationships in tree trait expression. We find that nearly half of trait variation is captured by two axes: one reflecting leaf economics, the other reflecting tree size and competition for light. Yet these orthogonal axes reveal strong environmental convergence, exhibiting correlated responses to temperature, moisture, and elevation. By subsequently exploring multidimensional trait relationships, we show that the full dimensionality of trait space is captured by eight distinct clusters, each reflecting a unique aspect of tree form and function. Collectively, this work identifies a core set of traits needed to quantify global patterns in functional biodiversity, and it contributes to our fundamental understanding of the functioning of forests worldwide.


Asunto(s)
Árboles , Biodiversidad , Bosques , Corteza de la Planta/fisiología , Hojas de la Planta/fisiología , Raíces de Plantas/fisiología , Semillas/fisiología , Árboles/fisiología , Madera/fisiología
4.
Ecol Evol ; 11(19): 13081-13100, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34646454

RESUMEN

Adaptive capacity, one of the three determinants of vulnerability to climate change, is defined as the capacity of species to persist in their current location by coping with novel environmental conditions through acclimation and/or evolution. Although studies have identified indicators of adaptive capacity, few have assessed this capacity in a quantitative way that is comparable across tree species. Yet, such multispecies assessments are needed by forest management and conservation programs to refine vulnerability assessments and to guide the choice of adaptation measures. In this paper, we propose a framework to quantitatively evaluate five key components of tree adaptive capacity to climate change: individual adaptation through phenotypic plasticity, population phenotypic diversity as influenced by genetic diversity, genetic exchange within populations, genetic exchange between populations, and genetic exchange between species. For each component, we define the main mechanisms that underlie adaptive capacity and present associated metrics that can be used as indices. To illustrate the use of this framework, we evaluate the relative adaptive capacity of 26 northeastern North American tree species using values reported in the literature. Our results show adaptive capacity to be highly variable among species and between components of adaptive capacity, such that no one species ranks consistently across all components. On average, the conifer Picea glauca and the broadleaves Acer rubrum and A. saccharinum show the greatest adaptive capacity among the 26 species we documented, whereas the conifers Picea rubens and Thuja occidentalis, and the broadleaf Ostrya virginiana possess the lowest. We discuss limitations that arise when comparing adaptive capacity among species, including poor data availability and comparability issues in metrics derived from different methods or studies. The breadth of data required for such an assessment exemplifies the multidisciplinary nature of adaptive capacity and the necessity of continued cross-collaboration to better anticipate the impacts of a changing climate.

5.
BMC Public Health ; 21(1): 1684, 2021 09 16.
Artículo en Inglés | MEDLINE | ID: mdl-34530800

RESUMEN

BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer burden worldwide. In France, it is the second most common cause of cancer death after lung cancer. Systematic uptake of CRC screening can improve survival rates. However, people with limited health literacy (HL) and lower socioeconomic position rarely participate. Our aim is to assess the impact of an intervention combining HL and CRC screening training for general practitioners (GPs) with a pictorial brochure and video targeting eligible patients, to increase CRC screening and other secondary outcomes, after 1 year, in several underserved geographic areas in France. METHODS: We will use a two-arm multicentric randomized controlled cluster trial with 32 GPs primarily serving underserved populations across four regions in France with 1024 patients recruited. GPs practicing in underserved areas (identified using the European Deprivation Index) will be block-randomized to: 1) a combined intervention (HL and CRC training + brochure and video for eligible patients), or 2) usual care. Patients will be included if they are between 50 and 74 years old, eligible for CRC screening, and present to recruited GPs. The primary outcome is CRC screening uptake after 1 year. Secondary outcomes include increasing knowledge and patient activation. After trial recruitment, we will conduct semi-structured interviews with up to 24 GPs (up to 8 in each region) and up to 48 patients (6 to 12 per region) based on data saturation. We will explore strategies that promote the intervention's sustained use and rapid implementation using Normalization Process Theory. We will follow a community-based participatory research approach throughout the trial. For the analyses, we will adopt a regression framework for all quantitative data. We will also use exploratory mediation analyses. We will analyze all qualitative data using a framework analysis guided by Normalization Process Theory. DISCUSSION: Limited HL and its impact on the general population is a growing public health and policy challenge worldwide. It has received limited attention in France. A combined HL intervention could reduce disparities in CRC screening, increase screening rates among the most vulnerable populations, and increase knowledge and activation (beneficial in the context of repeated screening). TRIAL REGISTRATION: Registry: ClinicalTrials.gov. TRIAL REGISTRATION NUMBER: 2020-A01687-32 . Date of registration: 17th November 2020.


Asunto(s)
Neoplasias Colorrectales , Médicos Generales , Alfabetización en Salud , Anciano , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer , Humanos , Área sin Atención Médica , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
Nat Ecol Evol ; 5(8): 1123-1134, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34112996

RESUMEN

Ecological theory is built on trade-offs, where trait differences among species evolved as adaptations to different environments. Trade-offs are often assumed to be bidirectional, where opposite ends of a gradient in trait values confer advantages in different environments. However, unidirectional benefits could be widespread if extreme trait values confer advantages at one end of an environmental gradient, whereas a wide range of trait values are equally beneficial at the other end. Here, we show that root traits explain species occurrences along broad gradients of temperature and water availability, but model predictions only resembled trade-offs in two out of 24 models. Forest species with low specific root length and high root tissue density (RTD) were more likely to occur in warm climates but species with high specific root length and low RTD were more likely to occur in cold climates. Unidirectional benefits were more prevalent than trade-offs: for example, species with large-diameter roots and high RTD were more commonly associated with dry climates, but species with the opposite trait values were not associated with wet climates. Directional selection for traits consistently occurred in cold or dry climates, whereas a diversity of root trait values were equally viable in warm or wet climates. Explicit integration of unidirectional benefits into ecological theory is needed to advance our understanding of the consequences of trait variation on species responses to environmental change.


Asunto(s)
Bosques , Dispersión de las Plantas , Clima , Fenotipo , Agua
7.
Glob Ecol Biogeogr ; 29(2): 281-294, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32063745

RESUMEN

AIM: Alien plant species can cause severe ecological and economic problems, and therefore attract a lot of research interest in biogeography and related fields. To identify potential future invasive species, we need to better understand the mechanisms underlying the abundances of invasive tree species in their new ranges, and whether these mechanisms differ between their native and alien ranges. Here, we test two hypotheses: that greater relative abundance is promoted by (a) functional difference from locally co-occurring trees, and (b) higher values than locally co-occurring trees for traits linked to competitive ability. LOCATION: Global. TIME PERIOD: Recent. MAJOR TAXA STUDIED: Trees. METHODS: We combined three global plant databases: sPlot vegetation-plot database, TRY plant trait database and Global Naturalized Alien Flora (GloNAF) database. We used a hierarchical Bayesian linear regression model to assess the factors associated with variation in local abundance, and how these relationships vary between native and alien ranges and depend on species' traits. RESULTS: In both ranges, species reach highest abundance if they are functionally similar to co-occurring species, yet are taller and have higher seed mass and wood density than co-occurring species. MAIN CONCLUSIONS: Our results suggest that light limitation leads to strong environmental and biotic filtering, and that it is advantageous to be taller and have denser wood. The striking similarities in abundance between native and alien ranges imply that information from tree species' native ranges can be used to predict in which habitats introduced species may become dominant.

8.
Glob Chang Biol ; 26(1): 119-188, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31891233

RESUMEN

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives.


Asunto(s)
Acceso a la Información , Ecosistema , Biodiversidad , Ecología , Plantas
9.
Nat Ecol Evol ; 2(12): 1906-1917, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30455437

RESUMEN

Plant functional traits directly affect ecosystem functions. At the species level, trait combinations depend on trade-offs representing different ecological strategies, but at the community level trait combinations are expected to be decoupled from these trade-offs because different strategies can facilitate co-existence within communities. A key question is to what extent community-level trait composition is globally filtered and how well it is related to global versus local environmental drivers. Here, we perform a global, plot-level analysis of trait-environment relationships, using a database with more than 1.1 million vegetation plots and 26,632 plant species with trait information. Although we found a strong filtering of 17 functional traits, similar climate and soil conditions support communities differing greatly in mean trait values. The two main community trait axes that capture half of the global trait variation (plant stature and resource acquisitiveness) reflect the trade-offs at the species level but are weakly associated with climate and soil conditions at the global scale. Similarly, within-plot trait variation does not vary systematically with macro-environment. Our results indicate that, at fine spatial grain, macro-environmental drivers are much less important for functional trait composition than has been assumed from floristic analyses restricted to co-occurrence in large grid cells. Instead, trait combinations seem to be predominantly filtered by local-scale factors such as disturbance, fine-scale soil conditions, niche partitioning and biotic interactions.


Asunto(s)
Rasgos de la Historia de Vida , Dispersión de las Plantas , Plantas , Bosques , Pradera
10.
Ecol Appl ; 28(5): 1245-1259, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29645330

RESUMEN

Canada's forests are shaped by disturbances such as fire, insect outbreaks, and droughts that often overlap in time and space. The resulting cumulative disturbance risks and potential impacts on forests are generally not well accounted for by models used to predict future impacts of disturbances on forest. This study aims at projecting future cumulative effects of four main natural disturbances, fire, mountain pine beetle, spruce budworm and drought, on timber volumes across Canada's forests using an approach that accounts for potential overlap among disturbances. Available predictive models for the four natural disturbances were used to project timber volumes at risk under aggressive climate forcing up to 2100. Projections applied to the current vegetation suggest increases of volumes at risk related to fire, mountain pine beetle, and drought over time in many regions of Canada, but a decrease of the volume at risk related to spruce budworm. When disturbance effects are accumulated, important changes in volumes at risk are projected to occur as early as 2011-2041, particularly in central and eastern Canada. In our last simulation period covering 2071-2100, nearly all timber volumes in most of Canada's forest regions could be at risk of being affected by at least one of the four natural disturbances considered in our analysis, a six-fold increase relative to the baseline period (1981-2010). Tree species particularly vulnerable to specific disturbances (e.g., trembling aspen to drought) could suffer disproportionate increases in their volume at risk with potential impacts on forest composition. By 2100, estimated wood volumes not considered to be at risk could be lower than current annual timber harvests in central and eastern Canada. Current level of harvesting could thus be difficult to maintain without the implementation of adaptation measures to cope with these disturbances.


Asunto(s)
Sequías , Incendios , Agricultura Forestal , Herbivoria , Árboles/fisiología , Animales , Canadá , Modelos Biológicos , Mariposas Nocturnas/fisiología , Gorgojos/fisiología
11.
Ecol Appl ; 26(7): 2103-2115, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27755733

RESUMEN

The disruption of hydrological connectivity by human activities such as flood regulation or land-use changes strongly impacts riparian plant communities. However, landscape-scale processes have generally been neglected in riparian restoration projects as opposed to local conditions, even though such processes might largely influence community recovery. We surveyed plant composition of field edges and riverbanks in 51 riparian zones restored by tree planting (565 1-m2 plots) within two agricultural watersheds in southeastern Québec, Canada. Once the effects of environmental variables (hydrology, soil, agriculture, landscape, restoration) were partialled out, three models of spatial autocorrelation based on Moran's eigenvector maps and asymmetric eigenvector maps were compared to quantify the pathways and direction of the spatial processes structuring riparian communities. The ecological mechanisms underlying predominant spatial processes were then assessed by regression trees linking species response to spatial gradients to seed and morphological traits. The structure of riparian communities was predominantly related to unidirectional spatial gradients from upstream to downstream along watercourses, which contributed more to species composition than bidirectional gradients along watercourses or overland. Plant traits selected by regression trees explained 22% of species response to unidirectional upstream-downstream gradients in field edges and 24% in riverbanks, and predominantly corresponded to seed traits rather than morphological traits of the adult plants. Our study showed that even in agriculturally open landscapes, water flow remains a major force structuring spatially riparian plant communities by filtering species according to their seed traits, thereby suggesting long-distance dispersal as a predominant process. Preserving hydrological connectivity at the watershed-scale and restoring riparian plant communities from upstream to downstream should be encouraged to improve the ecological integrity of rivers running through agricultural landscapes.


Asunto(s)
Agricultura , Organismos Acuáticos/fisiología , Ecosistema , Plantas/clasificación , Ríos , Demografía , Monitoreo del Ambiente , Restauración y Remediación Ambiental , Fenómenos Fisiológicos de las Plantas , Quebec
12.
Glob Ecol Biogeogr ; 25(2): 238-249, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27499698

RESUMEN

AIM: Current interest in forecasting changes to species ranges have resulted in a multitude of approaches to species distribution models (SDMs). However, most approaches include only a small subset of the available information, and many ignore smaller-scale processes such as growth, fecundity, and dispersal. Furthermore, different approaches often produce divergent predictions with no simple method to reconcile them. Here, we present a flexible framework for integrating models at multiple scales using hierarchical Bayesian methods. LOCATION: Eastern North America (as an example). METHODS: Our framework builds a metamodel that is constrained by the results of multiple sub-models and provides probabilistic estimates of species presence. We applied our approach to a simulated dataset to demonstrate the integration of a correlative SDM with a theoretical model. In a second example, we built an integrated model combining the results of a physiological model with presence-absence data for sugar maple (Acer saccharum), an abundant tree native to eastern North America. RESULTS: For both examples, the integrated models successfully included information from all data sources and substantially improved the characterization of uncertainty. For the second example, the integrated model outperformed the source models with respect to uncertainty when modelling the present range of the species. When projecting into the future, the model provided a consensus view of two models that differed substantially in their predictions. Uncertainty was reduced where the models agreed and was greater where they diverged, providing a more realistic view of the state of knowledge than either source model. MAIN CONCLUSIONS: We conclude by discussing the potential applications of our method and its accessibility to applied ecologists. In ideal cases, our framework can be easily implemented using off-the-shelf software. The framework has wide potential for use in species distribution modelling and can drive better integration of multi-source and multi-scale data into ecological decision-making.

13.
Ann Gen Psychiatry ; 14(1): 3, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25632295

RESUMEN

BACKGROUND: Under-prescription of antidepressants (ADs) among people meeting the criteria for major depressive episodes and excessive prescription in less symptomatic patients have been reported. The reasons influencing general practitioners' (GPs) prescription of ADs remain little explored. This study aimed at assessing the influence of GP and patient characteristics on AD prescription. METHODS: This cross-sectional study was based on a sample of 816 GPs working within the main health care insurance system in the Seine-Maritime district of France during 2010. Only GPs meeting the criteria for full-time GP practice were included. The ratio of AD prescription to overall prescription volume, a relative measure of AD prescription level, was calculated for each GP, using the defined daily dose (DDD) concept. Associations of this AD prescription ratio with GPs' age, gender, practice location, number of years of practice, number of days of sickness certificates prescribed, number of home visits and consultations, number and mean age of registered patients, mean patient income, and number of patients with a chronic condition were assessed using univariate and multivariate analysis. RESULTS: The high prescribers were middle-aged (40-59) urban GPs, with a moderate number of consultations and fewer low-income and chronic patients. GPs' workload (e.g., volume of prescribed drug reimbursement and number of consultations) had no influence on the AD prescription ratio. GPs with more patients with risk factors for depression prescribed fewer ADs, however, which could suggest the medications were under-prescribed among the at-risk population. CONCLUSIONS: Our study described a profile of the typical higher AD prescriber that did not include heavy workload. In future work, a more detailed assessment of all biopsychosocial components of the consultation and other influences on GP behavior such as prior training would be useful to explain AD prescription in GP's practice.

14.
Biopsychosoc Med ; 8: 17, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25110516

RESUMEN

BACKGROUND: The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs'. METHODS: During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP. RESULTS: The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems. CONCLUSION: AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.

15.
PLoS One ; 9(2): e90437, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24587362

RESUMEN

The functional trait-based approach is increasingly used to predict responses of ecological communities to disturbances, but most studies target a single taxonomic group. Here, we assessed the resilience of a forest ecosystem to an overabundant herbivore population by assessing changes in 19 functional traits for plant, 13 traits for ground beetle and 16 traits for songbird communities after six years of controlled browsing on Anticosti Island (Quebec, Canada). Our results indicated that plants were more responsive to 6 years of reduced browsing pressure than ground beetles and songbirds. However, co-inertia analysis revealed that ground beetle communities responded in a similar way than plant communities with stronger relationships between plant and ground beetle traits at reduced deer density, a pattern not detected between plant and songbird. High deer density favored plants species that reproduce vegetatively and with abiotic pollination and seed dispersal, traits implying little interaction with animal. On the other hand, traits found at reduced deer density mostly involved trophic interaction. For example, plants in this treatment had fleshy fruits and large seeds dispersed by birds or other animals whereas ground beetle species were carnivorous. Overall, our results suggest that plant communities recovered some functional components to overabundant herbivore populations, since most traits associated with undisturbed forests were reestablished after six years of deer reduction. The re-establishment of functional plant communities with traits involving trophic interaction induces changes in the ground-beetle trait community, but forest structure remains likely insufficiently heterogeneous to shift the songbird trait community within six years.


Asunto(s)
Escarabajos/fisiología , Ciervos/fisiología , Semillas/fisiología , Pájaros Cantores/fisiología , Árboles/fisiología , Análisis de Varianza , Distribución Animal/fisiología , Animales , Ecosistema , Islas , Dispersión de las Plantas/fisiología , Dinámica Poblacional , Quebec , Reproducción , Semillas/anatomía & histología
16.
BMC Fam Pract ; 14: 85, 2013 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-23782853

RESUMEN

BACKGROUND: As in other European countries, the French vaccination schedule changes according to epidemiological and socio-economic situations. Further changes are planned for 2013, including the withdrawal of one dose for primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. A partnership between the French Technical Vaccination Committee and the French Institute for Health and Medical Research designed a study to assess primary care physicians' agreement about this modification. METHODS: Qualitative study with focus groups and semi-structured interviews in France. Four focus groups were conducted with physicians, supplemented by four individual interviews. RESULTS: The physicians of the survey had accepted the suggested vaccination schedule well. A few concerns had been underlined: fear of less follow-up care for infants resulting from the removal of one visit driven by the primary vaccination; fear of loss of vaccine efficacy; suspicion of the existence of financial arguments at the origin of this change; and adjustment to current vaccination schedule. Several suggestions were made: providing strong support from health authorities; developing stable and simple recommendations; providing effective tools for monitoring patient's vaccination status. CONCLUSIONS: Physicians' opinions suggested a good acceptance of a possible change about primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. Physicians' suggestions resulted from this qualitative study on a new vaccination schedule. It showed how that their involvement was feasible for preparing the implementation of a new vaccination schedule.


Asunto(s)
Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Vacunas contra Haemophilus/administración & dosificación , Esquemas de Inmunización , Médicos de Atención Primaria/psicología , Vacunas contra Poliovirus/administración & dosificación , Pautas de la Práctica en Medicina/estadística & datos numéricos , Vacunación/psicología , Adulto , Anciano , Niño , Difteria/prevención & control , Femenino , Grupos Focales , Francia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Relaciones Médico-Paciente , Médicos de Atención Primaria/estadística & datos numéricos , Poliomielitis/prevención & control , Atención Primaria de Salud/estadística & datos numéricos , Investigación Cualitativa , Tétanos/prevención & control , Tos Ferina/prevención & control
17.
BMC Fam Pract ; 14: 55, 2013 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-23641784

RESUMEN

BACKGROUND: Antidepressants (ADs) are commonly prescribed in primary care and are mostly indicated for depression. According to the literature, they are now more frequently prescribed for health conditions other than psychiatric ones. Due to their many indications in a wide range of medical fields, assessing the appropriateness of AD prescription seems to be a challenge for GPs. The aim of this study was to review evidence from guidelines for antidepressant prescription for non-psychiatric conditions in Primary Care (PC) settings. METHODS: Data were retrieved from French, English and US guideline databases. Guidelines or reviews were eligible if keywords regarding 44 non-psychiatric conditions related to GPs' prescription of ADs were encountered. After excluding psychiatric and non-primary care conditions, the guidelines were checked for keywords related to AD use. The latest updated version of the guidelines was kept. Recent data was searched in the Cochrane Database of Systematic Reviews and in PubMed for updated reviews and randomized control trials (RCTs). RESULTS: Seventy-eight documents were retrieved and were used to assess the level of evidence of a potential benefit to prescribing an AD. For 15 conditions, there was a consensus that prescribing an AD was beneficial. For 5 others, ADs were seen as potentially beneficial. No proof of benefit was found for 15 conditions and proof of no benefit was found for the last 9. There were higher levels of evidence for pain conditions, (neuropathic pain, diabetic painful neuropathy, central neuropathic pain, migraine, tension-type headaches, and fibromyalgia) incontinence and irritable bowel syndrome. There were difficulties in summarizing the data, due to a lack of information on the level of evidence, and due to variations in efficacy between and among the various classes of ADs. CONCLUSIONS: Prescription of ADs was found to be beneficial for many non-psychiatric health conditions regularly encountered in PC settings. On the whole, the guidelines were heterogeneous, seemingly due to a lack of trials assessing the role of ADs in treatment strategies.


Asunto(s)
Antidepresivos/uso terapéutico , Enfermedad Crónica/tratamiento farmacológico , Mal Uso de los Servicios de Salud/prevención & control , Guías de Práctica Clínica como Asunto/normas , Atención Primaria de Salud/normas , Medicina Basada en la Evidencia , Humanos , Pautas de la Práctica en Medicina/normas
18.
BMC Fam Pract ; 12: 99, 2011 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-21943348

RESUMEN

BACKGROUND: One-tenth of France's population is prescribed at least one antidepressant, primarily by General Practitioners. The reasons for this high prescription rate remain unclear. One-third of these prescriptions may not comply with clinical practice guidelines, and 20% are potentially unrelated to any psychiatric condition. Our aim was to explore how GPs declare they use antidepressants in daily practice and understand their reasons for prescribing them. METHOD: Six focus groups including a total of 56 rural and urban GPs, with four interviews were performed. The topic guide focused on reasons for prescribing antidepressants in various primary care situations. Phenomenological analysis was performed by four researchers. RESULTS: Antidepressants were seen as useful and not harmful. Personal assessment based on experience and feeling determined the GPs' decisions rather than the use of scales. Twenty-four "non-psychiatric" conditions possibly leading to prescription of antidepressants in primary care were found. CONCLUSIONS: The GPs reported prescribing antidepressants for a wide range of conditions other than depression. The GPs' decision making process is difficult and complex. They seemed to prefer to focus on their difficulties in diagnosing depression rather than on useless overtreatment. Instead of using the guidelines criteria to detect potential cases of useful prescription, physicians tend to use their own tools based on gut feelings, knowledge of the patient and contextual issues.


Asunto(s)
Antidepresivos/uso terapéutico , Actitud del Personal de Salud , Médicos Generales/psicología , Adulto , Anciano , Antidepresivos/normas , Toma de Decisiones , Femenino , Grupos Focales , Francia , Médicos Generales/normas , Adhesión a Directriz , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina , Medicamentos bajo Prescripción/uso terapéutico , Investigación Cualitativa
19.
Am J Pathol ; 177(4): 1958-68, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20724589

RESUMEN

Citrullinemia type I (CTLN1, OMIM# 215700) is an inherited urea cycle disorder that is caused by an argininosuccinate synthetase (ASS) enzyme deficiency. In this report, we describe two spontaneous hypomorphic alleles of the mouse Ass1 gene that serve as an animal model of CTLN1. These two independent mouse mutant alleles, also described in patients affected with CTLN1, interact to produce a range of phenotypes. While some mutant mice died within the first week after birth, others survived but showed severe retardation during postnatal development as well as alopecia, lethargy, and ataxia. Notable pathological findings were similar to findings in human CTLN1 patients and included citrullinemia and hyperammonemia along with delayed cerebellar development, epidermal hyperkeratosis, and follicular dystrophy. Standard treatments for CTLN1 were effective in rescuing the phenotype of these mutant mice. Based on our studies, we propose that defective cerebellar granule cell migration secondary to disorganization of Bergmann glial cell fibers cause cerebellar developmental delay in the hyperammonemic and citrullinemic brain, pointing to a possible role for nitric oxide in these processes. These mouse mutations constitute a suitable model for both mechanistic and preclinical studies of CTLN1 and other hyperammonemic encephalopathies and, at the same time, underscore the importance of complementing knockout mutations with hypomorphic mutations for the generation of animal models of human genetic diseases.


Asunto(s)
Argininosuccinato Sintasa/fisiología , Citrulinemia/etiología , Modelos Animales de Enfermedad , Hiperamonemia/etiología , Mutación Missense/genética , Alelos , Animales , Arginina/farmacología , Western Blotting , Movimiento Celular , Cerebelo/anomalías , Citrulinemia/tratamiento farmacológico , Discapacidades del Desarrollo/tratamiento farmacológico , Discapacidades del Desarrollo/etiología , Femenino , Trastornos del Crecimiento/tratamiento farmacológico , Trastornos del Crecimiento/etiología , Humanos , Hiperamonemia/tratamiento farmacológico , Técnicas para Inmunoenzimas , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Mutantes , Óxido Nítrico/metabolismo , Fenotipo , Benzoato de Sodio/farmacología , Síndrome
20.
Ecol Lett ; 13(1): 76-86, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19917052

RESUMEN

Ecosystem resilience depends on functional redundancy (the number of species contributing similarly to an ecosystem function) and response diversity (how functionally similar species respond differently to disturbance). Here, we explore how land-use change impacts these attributes in plant communities, using data from 18 land-use intensity gradients that represent five biomes and > 2800 species. We identify functional groups using multivariate analysis of plant traits which influence ecosystem processes. Functional redundancy is calculated as the species richness within each group, and response diversity as the multivariate within-group dispersion in response trait space, using traits that influence responses to disturbances. Meta-analysis across all datasets showed that land-use intensification significantly reduced both functional redundancy and response diversity, although specific relationships varied considerably among the different land-use gradients. These results indicate that intensified management of ecosystems for resource extraction can increase their vulnerability to future disturbances.


Asunto(s)
Agricultura , Biodiversidad , Fenómenos Fisiológicos de las Plantas , Bases de Datos Factuales , Modelos Biológicos , Dinámica Poblacional
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