Study objective The ability to make a diagnosis is a crucial skill in emergency medicine. Little is known about the way emergency physicians reach a diagnosis. This study aims to identify how and ...when, during the initial patient examination, emergency physicians generate and evaluate diagnostic hypotheses. Methods We carried out a qualitative research project based on semistructured interviews with emergency physicians. The interviews concerned management of an emergency situation during routine medical practice. They were associated with viewing the video recording of emergency situations filmed in an “own-point-of-view” perspective. Results The emergency physicians generated an average of 5 diagnostic hypotheses. Most of these hypotheses were generated before meeting the patient or within the first 5 minutes of the meeting. The hypotheses were then rank ordered within the context of a verification procedure based on identifying key information. These tasks were usually accomplished without conscious effort. No hypothesis was completely confirmed or refuted until the results of investigations were available. Conclusion The generation and rank ordering of diagnostic hypotheses is based on the activation of cognitive processes, enabling expert emergency physicians to process environmental information and link it to past experiences. The physicians seemed to strive to avoid the risk of error by remaining aware of the possibility of alternative hypotheses as long as they did not have the results of investigations. Understanding the diagnostic process used by emergency physicians provides interesting ideas for training residents in a specialty in which the prevalence of reasoning errors leading to incorrect diagnoses is high.
This study aims to analyze spatio-temporal piezometric data and integrate them with geological, geotechnical, and geophysical data to enhance their interpretation. The research focuses on a site ...located in the Meuse and Haute-Marne departments of France, which has been under investigation since 1994 as part of the surface facilities characterization for the Meuse-Haute-Marne underground laboratory and the CIGEO (Centre Industriel de stockage Géologique) Andra project. These investigations span different spatial and temporal scales. We observed the contribution of water masses associated with external forcing and identified two types of aquifer responses: a rapid response to rainfall events when fractures are well-connected, and minor reactivity at the matrix level. Additionally, we demonstrated that the matrix compartment can be finely characterized through a combined interpretation of piezometric response analysis, fracture analysis, and surface nuclear magnetic resonance (SNMR) soundings. The methodology developed in this project offers an improved understanding of karst piezometry and/or unsaturated zone extension, which is essential for comprehend ding flow dynamics and better constraining the functioning of karst aquifers. Furthermore, this site serves as an ideal workshop for studying flow in fractured media, providing valuable insights into hydrodynamic behavior in complex subsurface environments.
Slow-moving clayey earthslides frequently exhibit seasonal activity suggesting that deformation processes do not only depend on slope and intrinsic geomechanical parameters. On the contrary, seasonal ...motion patterns are frequently observed with acceleration during the wet season and deceleration during the dry season. Within landslides, it is mainly the phreatic water table which is monitored. However, in the case of deep-seated landslides made of heterogeneous lithological units and with several slip surfaces, the characterization of the phreatic water table does not allow to relate satisfactorily the activity of the landslide with environmental parameters such as rainfall and subsequent water infiltration at depth. This paper presents a seasonal analysis of water infiltration within a slow-moving clayey landslide. Results of an extensive geotechnical and geophysical prospect are first exposed. Then, rainfall and water table level time series are analysed for two water tables using the cross-correlation technique: the phreatic water table located a few metres deep and a water table located above a shear surface located 12 m deep. Results show that water infiltrates faster down to the deepest water table. Then, time series were split between “dry” and “wet” seasons and the effective rainfall was computed from the original rainfall time series. Cross-correlation results show that the phreatic water table responds identically to rainfall in both seasons. On the contrary, the water table located above the shear surface has a very contrasting behaviour between summer (mainly drainage) and winter (behaviour similar to the phreatic water table with storage of water during a few weeks). This difference in behaviour is in agreement with the landslide kinematics.
Understanding water infiltration and transfer in soft‐clay shales slopes is an important scientific issue, especially for landsliding. Geochemical investigations are carried out at the Super‐Sauze ...and Draix‐Laval landslides, both developed in the Callovo‐Oxfordian black marls, with the objective to define the origin of the groundwater. In situ investigations, soil leaching experiments and geochemical modeling are combined to identify the boundaries of the hydrological systems. At Super‐Sauze, the observations indicate that an external water flow occurs in the upper part of the landslide at the contact between the weathered black marls and the overlying formations, or at the landslide basement through a fault network. Such external origin of water is not observed at the local scale of the Draix‐Laval landslide but is detected at the catchment scale with the influence of deep waters in the streamwater quality of low river flows. Hydrogeological conceptual models are proposed emphasizing the role of the interactions between local (slope) and regional (catchment) flow systems. The observations suggest that this situation is a common case in the Alpine area. Expected consequences of the regional flows on slope stability are discussed in term of rise of pore water pressures and physicochemical weathering of the clay shales.
The real-time impact of European projects Bertrand, Catherine
Médecine de catastrophe, urgences collectives,
December 2022, 2022-12-00, Letnik:
6, Številka:
4
Journal Article
Le mot de la Présidente Bertrand, Catherine
Médecine de catastrophe, urgences collectives,
June 2022, 2022-06-00, Letnik:
6, Številka:
2
Journal Article
Water quality is subject to frequent changes in the Drean-Annaba alluvium aquifer. Water-rock interaction can not be the only process that produces the observed modification, but dryness that the ...country knew during the last two decades has highly contributed to the water quality changes. During this period, irregularities in the distribution of rainfalls, in time and space, have been observed. As a result, a periodicity in hydrochemical changes in water of wells and rivers is noticed. Statistical, the principals components analysis (PCA) tools and Tickel diagram have been used to show, through chemical presentation, these effects. The results show, indeed, seasonal changes of water quality for the period 1999-2000. From a cationic point of view, a competition between alkaline and alkaline earths is shown. On the other hand, from an anionic point of view, there is a transition from chlorides to sulphates and may be to bicarbonates. The present work was carried out in a relatively small area and this was useful to show the relationship that existed between dryness and water quality of both the aquifer system and surface water.
COVID-19: A disaster Bertrand, Catherine; Lecarpentier, Eric
Médecine de catastrophe, urgences collectives,
March 2022, Letnik:
6, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Natural and technological disasters have now been joined by the COVID-19 pandemic, which has affected all countries since 2020. This article shows the extent to which the pandemic fulfils the ...definition of a disaster in the light of the situation facing Martinique and other islands. This article illustrates the value of the lessons learned from the experiences shared between the partners of the European Horizon 2020 No Fear project during the first waves. It also demonstrates that the pandemic interferes with the appropriate response to other parallel disasters: the explosion in Beirut, heat waves, fires, floods, earthquakes, hurricanes, confrontations and crowd movements, migratory flows from Afghanistan, etc. Thoughts on ways of better preparing and anticipating, as well as fostering cooperation and international aid are presented, as they may be discussed on a national level, within the European Commission or NATO.
Aux catastrophes naturelles, technologiques, il faut ajouter la pandémie COVID-19 qui impacte tous les pays depuis 2020. L’article montre en quoi la pandémie répond à la définition d’une catastrophe au regard de la situation à laquelle la Martinique et d’autres îles sont confrontées. L’article montre l’intérêt des leçons issues des expériences partagées entre les partenaires du projet européen Horizon 2020 No Fear pendant les premières vagues. Il montre également que la pandémie interfère avec la réponse à apporter à d’autres catastrophes co-existantes : explosion à Beyrouth, vagues de chaleur, incendies, inondations, tremblements de terre, ouragans, affrontements et mouvements de foule, flux migratoires depuis l’Afghanistan, etc. Des réflexions pour mieux se préparer et anticiper, favoriser la coopération et l’aide internationale sont présentées telles qu’elles peuvent être discutées au plan national, au sein de la commission européenne ou de l’OTAN.
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