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Cet article détaille un processus participatif mis en place sur le bassin versant de la Drôme pour préparer, avec les citoyens, la révision du Schéma d’Aménagement et de Gestion des Eaux. Spécifiquement, des citoyens ont été associés précocement pour choisir et organiser leur propre processus participatif. Cette co-ingénierie les a sensibilisés à l’importance de ces décisions, a initié des apprentissages sociaux et posé les conditions d’une régulation efficiente. Elle a clarifié les liens entre la participation et la gouvernance institutionnelle. Mais l’exercice apparaît abstrait aux participants. Il requiert des règles de participation claires et une initiation aux enjeux et au vocabulaire de la participation. En conclusion, nous suggérons des adaptations de la co-ingénierie de la participation en fonction des attentes et moyens disponibles.

Background: Higher protein intakes may help reduce sarcopenia and facilitate recovery from illness and injury in older adults. However, high-protein diets (HPDs) including animal-sourced foods may negatively perturb the microbiota, and provision of probiotics and prebiotics may mitigate these effects., Objective: The aim of this study was to examine the effects of HPD, with and without a probiotic and/or prebiotic, on gut microbiota and wellness in older women., Design: We conducted an 18-week, double-blind, placebo-controlled, crossover study., Participants/setting: Participants were healthy, older women (mean age±standard deviation=73.7±5.6 years; n=26) recruited from Florida., Intervention: Participants received a weight-maintenance HPD for 2-week periods and the following, in random order: HPD alone (1.5 to 2.2 g/kg/day protein); HPD plus multistrain probiotic formulation (1.54×10 9 Bifidobacterium bifidum HA-132, 4.62×10 9 Bifidobacterium breve HA-129, 4.62×10 9 Bifidobacterium longum HA-135, 4.62×10 9 Lactobacillus acidophilus HA-122, and 4.62×10 9 Lactobacillus plantarum HA-119), HPD plus prebiotic (5.6 g inulin), and HPD plus synbiotic (probiotic plus inulin), separated by 2-week washouts. Stools were collected per period for quantitative polymerase chain reaction (strain recovery) and 16S ribosomal RNA gene amplicon sequencing analyses (microbiota profile). Measures of gastrointestinal and general wellness were assessed., Main Outcome Measures: Microbiota composition and probiotic strain recovery were measured., Statistical Analyses: Microbiota composition was analyzed by Wilcoxon signed-rank test and t test. Secondary outcomes were analyzing using generalized linear mixed models., Results: The microbiota profile demonstrated relative stability with the HPD; representation of Lactobacillus, Lactococcus, and Streptococcus were enhanced, whereas butyrate producers, Roseburia and Anaerostipes, were suppressed. Lactococcus was suppressed with synbiotic vs other HPD periods. Recovery was confirmed for all probiotic strains. Indicators of wellness were unchanged, with the exception of a minimal increase in gastrointestinal distress with inulin. Fat-free mass increased from baseline to study end., Conclusions: An HPD adhering to the recommended acceptable macronutrient distribution ranges maintains wellness in healthy older women and exerts minor perturbations to the microbiome profile, a group that may benefit from a higher protein intake. ClinicalTrials.gov ID: NCT #02445560., (Copyright © 2020 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Microbial metabolism in the gut may alter human bile acid metabolism in a way that beneficially affects lipid homeostasis and therefore cardiovascular disease risk. Deconjugation of bile acids by microbes is thought to be key to this mechanism but has yet to be characterised in blood and stool while observing lipid markers. The aim of this study was to determine the effect of 3 different probiotic strains on plasma and stool bile acids in the context of lipid and glucose metabolism. In this 18-week, randomised, double-blind crossover study, healthy adults (53±8 years) with a high waist circumference underwent a 1-week pre-baseline period and were then randomised to receive 1 capsule/day of Bacillus subtilis R0179 (2.5×10 9 cfu/capsule; n=39), Lactobacillus plantarum HA-119 (5×10 9 cfu/capsule; n=38), Bifidobacterium animalis subsp. lactis B94 (5×10 9 cfu/capsule; n=37) or placebo for 6 weeks. Following a 3-week washout and second pre-baseline week, participants were crossed to the other intervention for 6 weeks followed by a 1-week post-intervention period. Blood and stool samples were collected at the beginning and end of each intervention to measure bile acids, serum lipid profiles, and glucose and insulin levels. Data from the placebo intervention were combined for all participants for analyses. In obese participants, the difference (final-baseline) in the sum of deconjugated plasma bile acids was greater with consumption of B. subtilis (691±378 nmol/l, P =0.01) and B. lactis (380±165 nmol/l, P =0.04) than with placebo (98±176 nmol/l, n=57). No significant differences were observed for any probiotics for stool bile acids, serum lipids, blood glucose or insulin. These data suggest that B. subtilis and B. lactis had no effect on glucose metabolism or serum cholesterol but increased deconjugated plasma bile acids in obese individuals. Additional studies should be conducted to confirm these findings and explore potential mechanisms. This trial was registered at clinicaltrials.gov as NCT01879098.

Clinical effects of antimicrobials and probiotics in combination have been reported, however, little is known about their impact on gut microbiota and its resistome. In this study 16S rRNA gene amplicon, shotgun metagenomics sequencing and antibiotic resistance (ABR) microarray were used on fecal samples of 70 healthy participants, taken at four time points in probiotic (Lactobacillus rhamnosus R0011 and Lactobacillus helveticus R0052) and placebo groups to profile the gut bacterial microbiota and its resistome following administration of amoxicillin-clavulanic acid for one week. Significant shifts in microbiota family composition caused by the antimicrobial in both groups that included decreases in the proportion of Lachnospiraceae, Coriobacteriaceae and unidentified Clostridiales; and notable increases for the proportion of Enterobacteriaceae, Bacteroidaceae and Porphyromonadaceae compared to baseline levels. Resistome showed a corresponding enrichment of ABR genes compared to baseline from such classes as aminoglycosides and beta-lactams that were linked, by in silico inference, to the enrichment of the family Enterobacteriaceae. Despite perturbations caused by short-term antibiotic treatment, both gut microbiota and resistome showed prompt recovery to baseline levels one week after cessation of the antimicrobial. This rapid recovery may be explained by the hypothesis of community resilience.

Background: The number of RN-to-baccalaureate nursing (BSN) programs is increasing; however, nurses continue to voluntarily withdraw at higher rates than expected., Method: A Heideggerian hermeneutic approach was used to interpret the meaning of the experience of RNs, who voluntarily withdraw from their baccalaureate nursing programs. The research aims were to generate a comprehensive understanding of (a) the experiences of RN-to-BSN noncompleters, (b) the meaning noncompleters ascribe to the experience of dropping out, and (c) the interplay between factors that influence dropout decisions., Results: Two overarching patterns of understanding emerged: Withdrawing as Revisiting Failure, and Withdrawing as Impasse: On One Side of the Divide. The factors that influence whether an RN finishes a baccalaureate nursing program are many, but the effect on dignity and well-being are immeasurable., Conclusion: Voluntary withdrawal from an RN-to-BSN program leaves nurses professionally place-bound, affecting not only the individual nurse but also the profession. [J Nurs Educ. 2017;56(5):260-265.]., (Copyright 2017, SLACK Incorporated.)

Broad-spectrum antibiotic use can disrupt the gastrointestinal microbiota resulting in diarrhoea. Probiotics may be beneficial in managing this type of diarrhoea. The aim of this 10-week randomised, double-blind, placebo-controlled, parallel study was to investigate the effect of Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011 supplementation on antibiotic-associated diarrhoea in healthy adults. Subjects were randomised to receive 1 week of amoxicillin-clavulanic acid (875 mg/125 mg) once per day, plus a daily dose of 8×109 colony-forming units of a multi-strain probiotic (n 80) or placebo (n 80). The probiotic or placebo intervention was maintained for 1 week after completion of the antibiotic. Primary study outcomes of consistency and frequency of bowel movements were not significantly different between the probiotic and placebo groups. The secondary outcomes of diarrhoea-like defecations, Gastrointestinal Symptoms Rating Scale scores, safety parameters and adverse events were not significantly different between the probiotic intervention and the placebo. A post hoc analysis on the duration of diarrhoea-like defecations showed that probiotic intervention reduced the length of these events by 1 full day (probiotic, 2·70 (sem 0·36) d; placebo, 3·71 (sem 0·36) d; P=0·037; effect size=0·52). In conclusion, this study provides novel evidence that L. helveticus R0052 and L. rhamnosus R0011 supplementation significantly reduced the duration of diarrhoea-like defecations in healthy adults receiving antibiotics.

Psychological stress is associated with gastrointestinal (GI) distress. This secondary analysis from a randomised, double-blind, placebo-controlled study examined whether three different probiotics could normalise self-reported stress-associated GI discomfort and reduce overall self-reported stress. Undergraduate students (n=581) received Lactobacillus helveticus R0052, Bifidobacterium longum ssp. infantis R0033, Bifidobacterium bifidum R0071, or placebo. Participants self-reported 2 outcomes for a 6-week period, which included final academic exams: daily level of stress (0=no stress to 10=extremely stressed) and weekly three diarrhoea-related symptoms (DS, 1=no discomfort to 7=severe discomfort) using the GI Symptom Rating Scale. Self-reported stress was positively related to DS (P=0.0068). Mean DS scores were lower with B. bifidum versus placebo at week 2 at the average level of stress and the average body mass index (BMI). DS scores were lower with B. bifidum at week 5 versus week 0 and 1 and with B. infantis R0033 at week 6 versus week 0. DS scores were higher when antibiotics were used in the prior week with placebo (P=0.0092). DS were not different with or without antibiotic use with the probiotics. Only B. bifidum had an effect on self-reported stress scores (P=0.0086). The self-reported stress score was also dependent on hours of sleep per day where it decreased by 0.13 for each additional hour of sleep. During a stressful period, B. bifidum R0071 decreases DS and self-reported stress scores. This trial was registered at clinicaltrials.gov as NCT01709825.

We report the first cationic gold(i)-catalyzed one-pot reaction of amide, alkyne and aldehyde followed by cyclization, to successfully access highly substituted oxazoles derivatives in good yields. A single catalyst allows the occurring of this multi-step reaction atom- and step-economically, with water as the only theoretical side product.

The transition-metal-catalyzed amination of aryl halides has been the most powerful method for the formation of aryl amines over the past decades. Phenols are regarded as ideal alternatives to aryl halides as coupling partners in cross-couplings. An efficient palladium-catalyzed formal cross-coupling of phenols with various amines and anilines has now been developed. A variety of substituted phenols were compatible with the standard reaction conditions. Secondary and tertiary aryl amines could thus be synthesized in moderate to excellent yields., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Noise exposure in the workplace is a common reality in Québec, Canada as it is elsewhere. However, the extent to which noise acts as a causal or contributive factor in industrial work-related accidents has not been studied thoroughly despite its plausibility. This article aims to describe the importance or potential importance, during investigations looking into the specific causes of each work-related fatal accident, of noise as an explanatory factor. The written information contained in the accident reports pertaining to contextual and technical elements were used. The study used multiple case qualitative content analysis. This descriptive study was based on the content analysis of the 788 reports from the Commission de la santé et de la sécurité du travail du Québec [Workers' Compensation Board (WCB)] investigating the fatal work-related accidents between 1990 and 2005. The study was descriptive (number and percentages). Noise was explicitly stated as one of the explanatory factors for the fatal outcome in 2.2% (17/788) of the fatal accidents, particularly when the work involved vehicular movement or the need to communicate between workers. Noise was not typically considered a unique cause in the accident, notably because the investigators considered that the accident would have probably occurred due to other risk factors (for example, disregard of safety rules, shortcomings in work methods, and inadequate training). Noise is an important risk factor when communication is involved in work. Since noise is ubiquitous and may also interfere with vigilance and other risk factors for accidents, it may be a much more important contributing factor to accidents than is currently recognized.

Background: While there is a wide body of literature addressing noise-induced hearing loss (NIHL) and hand-arm vibration syndrome (HAVS) independently, relatively few studies have considered the combined effects of noise and vibration. These studies have suggested an increased risk of NIHL in workers with vibration white finger (VWF), though the relationship remains poorly understood., Aims: To determine whether hearing impairment is worse in noise-exposed workers with VWF than in workers with similar noise exposures but without VWF., Methods: The Quebec National Institute of Public Health audiometric database was used in conjunction with work-related accident and occupational diseases data from the Quebec workers' compensation board to analyse differences in audiometry results between vibration-exposed workers in the mining and forestry industries and the overall source population, and between mining and forestry workers with documented VWF and those without VWF. The International Organization for Standardization (ISO) 7029 standards were used to calculate hearing loss not attributable to age., Results: 15751 vibration-exposed workers were identified in an overall source population of 59339. Workers with VWF (n = 96) had significantly worse hearing at every frequency studied (500, 1000, 2000 4000 Hz) compared with other mining and forestry workers without VWF., Conclusions: This study confirms previous findings of greater hearing loss at higher frequencies in workers with VWF, but also found a significant difference in hearing loss at low frequencies. It therefore supports the association between combined noise and hand-arm vibration (HAV) exposure and NIHL., (© The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objective: This study focuses on work-related injuries that required admission to hospital in a population of male workers exposed to occupational noise (≥80 dBA) which some displayed a hearing loss due to their exposure., Methods: The study population count 46 550 male workers, 1670 (3.6%) of whom incurred at least one work-related injury requiring admission to hospital within a period of 5 years following hearing tests conducted between 1987 and 2005. The noise exposure and hearing loss-related data were gathered during occupational noise-induced hearing loss (NIHL) screening. The hospital data were used to identify all members of the study population who were admitted, and the reason for admission. Finally, access to the death-related data made it possible to identify participants who died during the course of the study. Cox proportional hazards model taking into account hearing status, noise levels, age and cumulative duration of noise exposure at the time of the hearing test established the risk of work-related injuries leading to admission to hospital., Results: For each dB of hearing loss, a statistically significant risk increase was observed (HR=1.01 dB 95% CI 1.006 to 1.01). An association (HR=2.36 95% CI 2.01 to 2.77) was also found between working in an occupational ambient noise ≥100 dBA and the risk of injury., Conclusions: From a safety perspective, this issue is highly relevant; especially when workers are exposed to intense ambient noise and NIHL., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: Several probiotic strains have been shown to enhance human resistance to infectious disease. It is speculated that these strains may impose this effect by excretion of anti-microbial components, by competing with pathogens for intestinal nutrients and/or mucosal adhesion sites or modulating the immune system., Objective: A parallel, double-blind, placebo-controlled 4-week intervention was performed in healthy males, to study the effect of a blend of probiotic bacteria (Lactobacillus helveticus Rosell-52, Lactobacillus rhamnosus Rosell-11, Bifidobacterium longum ssp. longum Rosell-175) and a probiotic yeast (Saccharomyces cerevisiae var boulardii CNCM I-1079) on enterotoxigenic Escherichia coli (ETEC) challenge. Primary outcomes studied were fecal ETEC excretion and total fecal output per day., Subjects/methods: Subjects were randomized to the probiotic (5 × 10(9) colony-forming units (CFUs); twice daily; n=30) or placebo group (twice daily; n=30). After 2 weeks, subjects were orally challenged with a live attenuated ETEC (3 × 10(9) CFU), previously demonstrated to induce mild, short-lived symptoms of a foodborne infection. Before and after ETEC challenge, subjects collected 24 h fecal samples. Compliance to study guidelines, stool consistency (Bristol Stool Score), stool frequency, and frequency and severity of gastrointestinal (GI) complaints were recorded by the subjects on a Daily Record Questionnaire., Results: ETEC challenge induced a significant increase in fecal ETEC excretion in both groups. However, a statistically significant increase in fecal output was only observed in the probiotic group. ETEC challenge resulted in a decrease in the percentage of fecal dry weight, and an increase in reported Bristol Stool Score, stool frequency and GI complaints. Dietary probiotics significantly decreased the percentage of fecal dry weight. In addition, ETEC increased C-reactive protein, total secretory Immunoglobulin A (IgA) and Immunoglobulin G Colonization Factor Antigen II., Conclusion: Dietary probiotics did not increase resistance to oral attenuated ETEC challenge in human subjects.

Acute psychological stress is positively associated with a cold/flu. The present randomised, double-blind, placebo-controlled study examined the effect of three potentially probiotic bacteria on the proportion of healthy days over a 6-week period in academically stressed undergraduate students (n 581) who received Lactobacillus helveticus R0052, Bifidobacterium longum ssp. infantis R0033, Bifidobacterium bifidum R0071 or placebo. On each day, participants recorded the intensity (scale: 0 = not experiencing to 3 = very intense) for nine cold/flu symptoms, and a sum of symptom intensity >6 was designated as a day of cold/flu. B. bifidum resulted in a greater proportion of healthy days than placebo (P≤ 0·05). The percentage of participants reporting ≥ 1 d of cold/flu during the 6-week intervention period was significantly lower with B. bifidum than with placebo (P< 0·05). There were no effects of B. infantis or L. helveticus compared with placebo on either outcome. A predictive model accounted for influential characteristics and their interactions on daily reporting of cold/flu episodes. The proportion of participants reporting a cold on any given day was lower at weeks 2 and 3 with B. bifidum and B. infantis than with placebo for the average level of stress and the most commonly reported number of hours of sleep. Daily intake of bifidobacteria provides benefit related to cold/flu outcomes during acute stress.

Objective: The aim of this study, conducted among retired workers (≥65 years), is to estimate the association between long-term risk of cardiovascular disease (CVD) death and (1) duration of occupational noise exposure in career and (2) noise-induced hearing loss (NIHL), the latter being used as an indicator of adverse effects for long-term exposure to occupational noise., Methods: Data from screening activities of occupational NIHL were paired to data from death records and were used for this study. A nested case-control analysis was performed. Each case was matched with three controls for length of follow-up and economic sector. A total of 161 CVD deaths occured during an average follow-up of 6.8 years. Conditional logistic regression models were used to estimate the risk (OR) of CVD death by tertiles of duration of noise exposure and of NIHL., Results: Conditional logistic regression models indicated that prolonged duration of noise exposure (≥36.5 years) (3rd tertile) was associated with an increased risk of CVD death (OR 1.70; 95 % CI 1.10-2.62), as compared with shorter duration (<27 years) (first tertile). Moderate NIHL (2nd tertile) (OR 1.64; 95 % CI 1.04-2.6) and severe NIHL (3rd tertile) (OR 1.66; 95 % CI 1.06-2.60) were also associated with an increase in risk of CVD death., Conclusions: Results are consistent with recent findings on the chronic effects of occupational noise exposure persisting after retirement although it is less than during active working life.