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Purpose: To highlight the way a public policy aiming to achieve a 50% decrease of pesticides use in France reframed advice provision in public and private networks. Design/methodology/approach: We developed a framework to analyze intermediation in a public funded network, a farmers' association, and a network of co-operatives. The framework captures how advice provision is organized for supporting farmers in redesigning their cropping systems and achieving large-scale farmer participation in such change processes. Findings: (1) All three networks recognize the value of on-farm redesign for pioneers, and the role of farmers' groups but significant differences appear between the networks' intermediary practices and objects; (2) These differences can be related to their way to balance between evidence-based knowledge and farmer's practical experience and ownership of the target; (3) The public DEPHY farm network appears to be an arena in which different advisory models compete; (4) Also specific intermediary practices and objects to involved new farmers in a transition towards less pesticide use were designed, scaling up and out issues are still challenging both public and private advisory organizations. Practical implications: intermediation skills and objects are still to be developed to support on-farm redesign alongside with large-scale farmer participation, and to identify and overcome systemic barriers. Policy makers and advisory boards should clarify their underlying assumptions regarding the triggers for change. Theoretical implications: The framework is a relevant contribution to understand transition in the making and the way AKIS players fail to reassess their underlying assumptions regarding the way to achieve scaling up and out processes. Originality/value: Analyzing relations between public and private networks by exploring the way such networks design and perform intermediation to implement a public policy.

Background & Aims: Controlled attenuation parameter (CAP) evaluated with transient elastography (FibroScan®) is a recent method for non-invasive assessment of steatosis. Its usefulness in clinical practice is unknown. We prospectively investigated the determinants of CAP failure and the relationships between CAP and clinical or biological parameters in a large cohort of consecutive patients., Methods: All CAP examinations performed in adult patients with suspected chronic liver disease were included. CAP failure was defined as zero valid shot. The following factors were analyzed for their influence on CAP value and the relationships between CAP and clinico-biological parameters: age, gender, body mass index, waist circumference, hypertension, diabetes, metabolic syndrome, alcohol use, liver stiffness measurement, indication, and different biological parameters., Results: CAP failure occurred in 7.7% of 5323 examinations. By multivariate analysis, factors independently associated with CAP measurement failure were female gender, BMI, and metabolic syndrome. By multivariate analysis, factors significantly associated with elevated CAP were BMI [25-30]kg/m(2), BMI >30kg/m(2), metabolic syndrome, alcohol >14 drink/week and liver stiffness >6kPa. CAP increased with the number of parameters of metabolic syndrome, BMI, waist circumference, the presence of diabetes or hypertension, and the cause of the disease. In the 440 patients with liver biopsy, for the diagnosis of steatosis >10%, steatosis >33%, and steatosis >66%, AUROCs of CAP were 0.79 (95% CI 0.74-0.84, p<0.001), 0.84 (95% CI 0.80-0.88, p<0.001), 0.84 (95% CI 0.80-0.88, p<0.001), respectively., Conclusions: CAP provides an immediate assessment of steatosis simultaneously with liver stiffness measurement. The strong association of CAP with the metabolic syndrome and alcohol use could be of interest for the follow-up of NAFLD or alcoholic patients., (Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)