Résumés actualisés de l'évaluation systématique de l'efficacité d'interventions médicales. [Up-to-date résumés of the systematic evaluation of efficacy of medical interventions]

La Cochrane Library (www.thecochranelibrary.com) est une bibliothèque en ligne répertoriant à ce jour plus de 3000 revues systématiques. Ces revues systématiques sont issues de l'activité continue de plus de 50 groupes de revues de la Collaboration Cochrane (www.cochrane.org ), une organisation à laquelle participent plus de 20 000 personnes dans le monde entier et dont le financement est indépendant de sources pouvant créer un conflit d'intérêt. Le public cible est constitué par les professionnels de la santé, les décideurs en matière sanitaire et le public (patients, consommateurs). En sus de la production et de la diffusion de revues systématiques, la Collaboration Cochrane propose également des activités de formation aux méthodes de la médecine factuelle et des revues systématiques. En Francophonie, de telles formations sont proposées par des partenaires du Réseau francophone Cochrane (www.res_franco.cochrane.org ), dont la coordination est assurée depuis Lausanne par une petite équipe basée à l'Institut universitaire de médecine sociale et préventive (IUMSP). [Extrait]

Public Art. Timeline of the XXth Century Evolution

The concept of public art is a polysemic term, and the dispersion of its meaning is reflected in the different ways of working during the XXth Century. It cross the fields of sculpture, monument, visual arts and urban space, defined from a civic perspective. This timeline had been constructed after the publications of my PhD: http://www.tesisenred.net/handle/10803/1549

Urban Governance und nachhaltige Quartiere: Ein Beitrag zur Förderung einer dauerhaft nachhaltigen Stadtentwicklung

Seit den 1990er Jahren werden zunehmend nachhaltige Quartiere realisiert. Dabei besteht häufig eine beachtliche Diskrepanz zwischen den Zielen, die von den beteiligten Akteuren angestrebt werden, deren Umsetzung (Realisierungsphase) und deren Erhalt auf Dauer (Nutzungsphase). Es stellt sich folglich die Frage, auf welche Weise die Projektqualität im Sinne einer nachhaltigen Quartiersentwicklung verbessert werden kann. Diese Projekte sind jedoch enorm komplex aufgrund der großen Interdisziplinarität und Interdependenz ihrer Ziele sowie der vielschichtigen Akteursstrukturen. Sie stellen daher be-sonders hohe Anforderungen an die Projektsteuerung. Das konkrete Ziel dieser Arbeit besteht darin, die Bedeutung einer Prozesssteuerung im Sinne von Urban Governance zur Realisierung und zum Erhalt nachhaltiger Quartiere zu untersuchen. Damit soll einen Beitrag zur Förderung einer nachhalti-gen Stadtentwicklung geleistet werden. Die Arbeit stützt sich auf ein umfassendes theoretisches Fundament zum Thema Governance, wobei die relevanten Elemente für den Kontext nachhaltiger Quartiere herausgearbeitet werden. Die Hypothesen prüfen die Bedeutung der Schlüsselcharakteristika von Urban Governance (Kooperation, Partizipation, Verhandlungen) für die Projektqualität während der Realisierungs- und Nutzungsphase. Eine erste empirische Untersuchung wurde an zwanzig europäischen nachhaltigen Modellquartieren vorgenommen. Stärken und Schwächen aus der Perspektive der Nachhaltigkeit werden analysiert, deren Ursachen identifiziert und Handlungsoptio-nen aufgezeigt. Die Erkenntnisse zeigen die Notwendigkeit einer Verbesserung der Projektsteuerung während der Realisierungs- und der Nutzungsphase. Auf der Grundlage dieser Erkenntnisse wird ein umfassender Ansatz zur empirischen Untersuchung von Urban Governance im Kontext nachhaltiger Quartiere entwickelt. Dieser beruht auf dem akteurzentrierten Institutionalismus und den Merkmalen der Urban Governance. Anhand dieses Ansatzes wird mithilfe von Experteninterviews der Realisierungsprozess des nach-haltigen Quartiers Kronsberg (Hannover) analysiert. Betrachtet werden dabei die beteiligten Akteure und ihre Handlungso-rientierungen, die verwendeten Schlüsselinstrumente sowie aufgetretene Divergenzen zwischen Akteuren und deren Auswirkungen auf die Projekt- und Prozessqualität. Eine Vertiefung relevanter Themenfelder wird anhand der Fallstudie Neu-Oerlikon (Zürich) vorgenommen. Diese empirische Arbeit zeigt, dass eine Prozesssteuerung im Sinne von Urban Governance im Vergleich zu einer klassis-chen hierarchischen Steuerung eine notwendige aber nicht hinreichende Bedingung zur Verbesserung der Projektqualität nachhaltiger Quartiere darstellt. An konkreten Beispielen wird herausgearbeitet, dass der Mehrwert einer solchen Steuerung nur unter bestimmten Voraussetzungen erzielt werden kann: In manchen Situationen ist die Steuerungsform Kooperation und die Interaktionsform Verhandlung in ihrer Wirksamkeit zur Sicherung der Projektqualität begrenzt und hierarchische Interventionen sind notwendig. Nicht ein bestimmtes Steuerungsmodell per se ist geeignet, sondern es kommt auf den Ein-zelfall an: auf die Akteursstruktur, die individuellen und institutionellen Handlungsorientierungen der Akteure und deren Ver-haltensweisen, die Rahmenbedingungen und die Ausgestaltung des Urban Governance-Prozesses. Wenn die Spielregeln dieses Prozesses von den Akteuren nicht wirklich angenommen und gelebt werden, dominieren individuelle und institutio-nelle Akteursinteressen zu Lasten der Projektqualität. Ferner zeigen die Untersuchungen, dass die Partizipation der zukünftigen Quartiersnutzer in der Praxis häufig unzureichend ist. Dies führt zu Einbußen in der Projektqualität. Entscheidend ist auf jeden Fall, dass mindestens ein Akteur, in der Regel die öffentliche Hand, präsent ist, der die Definition anspruchsvoller Nachhaltigkeitsstandards, deren Umsetzung und deren Erhalt sichert sowie die notwendigen Rahmenbedingungen dafür schafft. Diese Arbeit belegt darüber hinaus, dass der Erhalt der Projektqualität während der Nutzungsphase (Faktor Zeit) bisher un-zureichend beachtet und in die Projektplanung einbezogen wird. Gerade dieser Aspekt bestimmt aber, ob das Quartier auch auf Dauer dem Nachhaltigkeitsanspruch gerecht werden kann! Tatsächlich handelt es sich um einen fortlaufenden Prozess, der nicht mit der Einweihung des Quartiers abgeschlossen ist. Vor diesem Hintergrund werden relevante Handlungsfelder beschrieben und die Notwendigkeit der langfristigen Fortsetzung einer Steuerung im Sinne von Urban Governance bzw. der Herausbildung einer Urban Governance-Kultur aufgezeigt. Aus den empirischen Erhebungen werden Erfolgs- und Risikofaktoren für Urban Governance-Prozesse während der Realisierungs- und der Nutzungsphase abgeleitet. Ferner werden bisher vernachlässigte Handlungsfelder (langfristiges Umwelt-management, ökologische Finanzierungsformen, urbane Landwirtschaft, Umweltkommunikation, etc.) eruiert. Die Berücksichtigung dieser Erkenntnisse ist unerlässlich für eine Verbesserung der Projektqualität nachhaltiger Quartiere. ---------------------------------------------- Gouvernance urbaine et quartiers durables: Entre intensions et mise en oeuvre --- Résumé --- Depuis les années 90, la thématique des quartiers durables a gagné en importance, même si leur développement s'est avéré difficile. Le décalage entre les objectifs, leur mise en oeuvre et le projet tel qu'il est vécu par ses habitants est souvent important et nécessite d'être réduit. Un quartier durable est par nature un projet complexe, aux objectifs ambitieux situé à la croisée de multiples champs disciplinaires, mobilisant de nombreux acteurs aux intérêts divergents. De plus, chaque projet, du fait des ses spécificités, requiert un pilotage adapté. L'objectif principal de la recherche vise à analyser la nature du pilotage du processus de conception, de réalisation et d'exploitation des quartiers durables. Ses résultats ont pour ambition de contribuer à optimiser et promouvoir le développement urbain durable. Le fondement théorique de la recherche se base sur le concept de gouvernance urbaine, adapté au contexte particulier de la gouvernance des quartiers durables. La gouvernance urbaine, au sens où nous l'entendons, est un mode de pilotage basé sur la coopération entre les acteurs publics et privés. Les hypothèses centrales du travail testent la portée et les limites des caractéristiques-clefs de la gouvernance urbaine (coopération, participation, négociation), ainsi que l'importance de la notion de pérennité pour la qualité du projet. Dans un premier temps, nous avons analysé vingt quartiers durables modèles européens et identifié leurs atouts et leurs faiblesses en termes de durabilité, ainsi que leurs divers modes de pilotage. Les enseignements tirés de ces exemples révèlent la nécessité d'améliorer le pilotage des projets. Dans un deuxième temps, nous avons élaboré une grille d'analyse fine fondée sur l'approche institutionnelle des acteurs et les caractéristiques-clefs de la gouvernance urbaine. En nous appuyant sur cette grille, nous avons analysé le processus de conception et de réalisation du quartier durable de « Kronsberg » (Hanovre) à l'aide des éléments suivants : les acteurs (avec leurs intérêts et objectifs propres), les instruments d'aménagement du territoire, les modes de pilotage, les zones de divergence et de convergence entre les acteurs, ainsi que leurs impacts sur le processus et le projet. Dans un troisième temps, les hypothèses centrales ont été testées sur le quartier de « Neu-Oerlikon » (Zurich) afin d'approfondir et d'élargir les enseignements tirés de celui de « Kronsberg ». Les résultats des analyses mettent en évidence le fait qu'un pilotage de projet selon le modèle de la gouvernance urbaine est certes une condition nécessaire mais non suffisante pour améliorer la qualité du projet. De plus, la valeur ajoutée de la gouvernance urbaine n'est valable qu'à certaines conditions. En effet, la coopération et la négociation peuvent même, dans certaines situations, réduire la qualité du projet ! Le principal enseignement de la recherche révèle qu'il n'y a pas de mode de pilotage idéal, mais que la qualité d'un projet dépend d'une multitude de facteurs, tels que les constellations d'acteurs, leurs intérêts personnels et institutionnels, les conditions cadres et les « règles du jeu » de la gouvernance urbaine. Si les « règles du jeu » en particulier ne sont pas réellement appropriées par l'ensemble des acteurs, les intérêts et les comportements personnels ou institutionnels prédominent au détriment de la qualité du projet. De même, si la participation des futurs usagers à l'élaboration du projet de quartier durable n'est pas assurée, tant la qualité du projet que sa pérennité en pâtissent. Nous avons également constaté que la présence d'un acteur (en règle générale les autorités publiques) qui veille à la définition d'objectifs ambitieux en matière de développement durable et à leur application constitue un apport essentiel à la qualité du projet. En outre, la recherche met en évidence les carences dans le suivi et le maintien à long terme des qualités de durabilité de la phase d'exploitation des projets de quartiers durables analysés. Dans la phase d'exploitation, le degré de coopération diminue généralement et les modes de fonctionnement et de pilotage sectoriels se mettent en place au détriment de la qualité du projet. Cela confirme la nécessité de poursuivre le processus de pilotage selon le modèle de la gouvernance urbaine au-delà de la phase de réalisation des projets. La recherche précise les enjeux des champs d'action de la phase d'exploitation (domaine encore peu étudié) et démontre la pertinence du mode de pilotage préconisé. Enfin, les analyses permettent d'identifier des facteurs de réussite et de risque susceptibles d'influencer les systèmes de gouvernance urbaine, ainsi que les enjeux des domaines de la durabilité encore négligés (agriculture urbaine, gestion environnementale dans la durée, comportement des usagers, financement équitable, etc.). La prise en compte de ces enseignements est essentielle à l'amélioration de la gestion de futurs projets de quartiers durables. ---------------------------------------------- Urban Governance and Sustainable Neighbourhoods: A Contribution to a Lasting Sustainable Development --- Abstract --- Since the 1990s, sustainable neighbourhoods have become an increasingly important topic. However, their development has proven to be difficult. There is an often considerable gap, which must be reduced, between the initial goals, the way they are implemented and how the project is finally inhabited. A sustainable neighbourhood is inherently a complex project, with ambitious goals that lie at the intersection of multiple disciplines, involving numerous stakeholders with diverging interests. Moreover, each project, due to its specific characteristics, requires an adapted steering. The main goal of this research is to analyse the nature of the steering process during the planning, realisation and use of sustainable neighbourhoods. The results aim to contribute to the promotion of sustainable urban development. The theoretical foundation of this research is based on the concept of urban governance, adapted to the particular context of sustainable neighbourhoods. Urban governance is understood in this work, as a mode of project steering based on the cooperation between public and private stakeholders. The central hypotheses of this work test the importance and the limits of the key characteristics of urban governance (cooperation, participation, negotiation) as well as the importance of continuity for the project quality. To begin with, we surveyed and analysed twenty exemplary European sustainable neighbourhoods and identified their strengths and weaknesses in terms of sustainability, as well as their diverse steering modes. The lessons learned from these examples reveal the need to improve the projects' steering. Secondly we elaborated a detailed framework for analysis founded on stakeholder-centred institutionalism and the key characteristics of urban governance. By systematically applying this framework, we analysed the planning and implementation process of the sustainable neighbourhood "Kronsberg" (Hannover). Our focus was on the following dimensions: the stakeholders (with their particular interests and goals), the instruments of spatial planning, the steering modes, the points of divergence and convergence amongst the stakeholders, as well as their impacts on the process and on the project. The final step was to test the core hypotheses on the neighbourhood "Neu-Oerlikon" (Zürich) in order to broaden the lessons learned from "Kronsberg". The results of the analysis highlight the fact that an urban governance type project steering is certainly a necessary but insufficient condition to improve the project quality. Moreover, the added value of urban governance is only valid under certain conditions. In fact, cooperation and negotiation can even in certain situations reduce the project's quality! The main lesson of this research is that there is not an ideal steering mode, but rather that the quality of the project depends on numerous factors, such as the stakeholder constellation, their individual and institutional interests, the general conditions and the "rules of the game" of urban governance. If these "rules of the game" are not really appropriated by all stakeholders, individual and institutional interests and behaviours predominate at the expense of the project's quality. Likewise, if the future users' participation in the project development is insufficient, both the project's quality and its continuity suffer. We have also observed that the presence of a stakeholder (in general the public authorities) who ensures the definition of ambitious goals in terms of sustainable development and their implementation is crucial for the project's quality. Furthermore, this research highlights the deficiencies in the follow-up and long-term preservation of the sustainability qualities in the neighbourhood projects which we have analysed. In the use phase, the degree of cooperation generally diminishes. Attitudes and project management become more sectorial at the expense of the project's quality. This confirms the need to continue the steering process according to the principles of urban governance beyond the project's implementation phase. This research specifies the challenges that affect the use phase (a still neglected area) and shows the relevance of the recommended steering mode. Finally, the analyses also identify the success and risk factors that may influence urban-governance systems, as well as the challenges of still neglected fields of sustainability (urban agriculture, long-term environmental management, user behaviour, fair funding, etc.). Taking into account these outcomes is essential to improve the management of future sustainable-neighbourhood projects.

An Assessment of Traffic Safety in Urban Deer Herd Management Zones in Iowa, 2010

Many states are striving to keep their deer population to a sustainable and controllable level while maximizing public safety. In Iowa, measures to control the deer population include annual deer hunts and special deer herd management plans in urban areas. While these plans may reduce the deer population, traffic safety in these areas has not been fully assessed. Using deer population data from the Iowa Department of Natural Resources and data on deer-vehicle crashes and deer carcass removals from the Iowa Department of Transportation, the authors examined the relationship between deer-vehicle collisions, deer density, and land use in three urban areas in Iowa that have deer management plans in place (Cedar Rapids, Dubuque, and Iowa City) over the period 2002 to 2007. First, a comparison of deer-vehicle crash counts and deer carcass removal counts was conducted at the county level. Further, the authors estimated econometric models to investigate the factors that influence the frequency and severity of deer-vehicle crashes in these zones. Overall, the number of deer carcasses removed on the primary roads in these counties was greater than the number of reported deervehicle crashes on those roads. These differences can be attributed to a number of reasons, including variability in data reporting and data collection practices. In addition, high rates of underreporting of crashes were found on major routes that carry high volumes of traffic. This study also showed that multiple factors affect deer-vehicle crashes and corresponding injury outcomes in urban management zones. The identified roadway and non-roadway factors could be useful for identifying locations on the transportation system that significantly impact deer species and safety and for determining appropriate countermeasures for mitigation. Efforts to reduce deer density adjacent to roads and developed land and to provide wider shoulders on undivided roads are recommended. Improving the consistency and accuracy of deer carcass and deer-vehicle collision data collection methods and practices is also desirable.

La "bientraitance", exploration du concept et essai d'utilisation en santé publique: une expérience à Fribourg (Suisse). ["Bientraitance": conceptual exploration and an example of its application in public health: an experience from Fribourg, Switzerland]

Since the year 2000, the concept of "bientraitance" (for which no equivalent term has yet emerged in either the English or German language) has gained widespread credence among educators, sociologists and health professionals in France and Belgium. This concept emphasizes a constructive approach to care and education rather than merely one of prevention of disasters. Applied in public health, and in particular to mental health promotion, the use of the concept of "bientraitance" can help promote both effectiveness and meaning in the design and planning of community interventions. The article presents an example of an intervention for children and adolescents in Fribourg, Switzerland. The underpinning hypothesis is that the children and youth groups (such as sports clubs, artistic and cultural associations, scouts and guides) represent largely untapped, or under-tapped, informal health resources with a favourable cost-effectiveness profile. "Bientraitance" criteria are used in selecting certain associations offering structured extracurricular group educational activities and collective out-of-school (or after school) programmes. Support is provided to the organisations selected for recruiting new members, in particular those with potentially lower levels of access, for example disabled children or new migrants. The results will be evaluated for the impact of participation in various out-of-school activities on health and health determinants from a prospective and comparative perspective. This paper shows how the concept of "bientraitance" can be useful in the development of a public health intervention.

Reflexiones sobre el espacio público = Thoughts on Public Space

En este artículo planteamos una aproximación a la idea de espacio público como articulador del conjunto de acontecimientos que intervienen en la vida de las ciudades. Entendemos este fenómeno como una red poliédrica y multidimensional, cuyo estudio pasa por el análisis de diversas problemáticas: la identificación de los límites entre espacio público y esfera pública; la conformación del espacio público construido; la aproximación teórica al fenómeno desde la contemporaneidad; la dimensión social del espacio público; y finalmente la perspectiva de la gestión de las ciudades. Todas estas dimensiones expresan una mirada crítica del objeto i ponen en valor niveles de trabajo interdisciplinar y multiescala, fundamentales para entender e intervenir en el espacio público de la ciudad contemporánea.

Education on Urban Corridor Issues Through Computer Animation, TR-419, 2003

This project was undertaken in coordination with the Environmental Assessment process on the Mt. Vernon Road Improvements project in Cedar Rapids, Iowa. The goal of the research was to determine the cost effectiveness of combined photo-imaging and computer animation as a presentation tool describing public road improvements. The Public Hearing, in combination with the involvement of a Citizen's Resource Group, afforded an opportunity to have an evaluation of the processes by interested citizens who were not familiar with engineering drawings or the construction industry. After the initial viewing of a draft version of the video, the Resource Group made recommendations to the staff developing the video. Discussion of these recommendations led to the development of an animated composite section that showed a combination of situations typically encountered throughout the project corridor, as well as critical considerations. The composite section did not show specific locations and therefore, individuals were not distracted by looking for the details pertaining to their properties. Concentration on the concepts involved rather than specifics provided the opportunity for a more thorough understanding by the citizens. The development of the composite concept was the primary discovery of the research.

Public Art, strategies for the regeneration of public space

This paper discusses some of the key concepts in the consideration of public art as a central element in urban regeneration processes, especially in reference to its role in the processes of citizen participation.

Reflexiones sobre el espacio público = Thoughts on Public Space

En este artículo planteamos una aproximación a la idea de espacio público como articulador del conjunto de acontecimientos que intervienen en la vida de las ciudades. Entendemos este fenómeno como una red poliédrica y multidimensional, cuyo estudio pasa por el análisis de diversas problemáticas: la identificación de los límites entre espacio público y esfera pública; la conformación del espacio público construido; la aproximación teórica al fenómeno desde la contemporaneidad; la dimensión social del espacio público; y finalmente la perspectiva de la gestión de las ciudades. Todas estas dimensiones expresan una mirada crítica del objeto i ponen en valor niveles de trabajo interdisciplinar y multiescala, fundamentales para entender e intervenir en el espacio público de la ciudad contemporánea.

High Priority Corridors for Access Management Near Large Urban Areas in Iowa, 2002

This research project was intended to produce a strategy for addressing current and future access management problems on state highway routes located just outside urban areas that serve as major routes for commuting into and out of major employment centers in Iowa. There were two basic goals: (1) to develop a ranking system for identifying high-priority segments for access management treatments on primary highways outside metro and urban areas and (2) to focus efforts on routes that are major commuting routes at present and in the future. The project focused on four-lane expressways and two-lane arterials most likely to serve extensive commuter traffic. Available spatial and statistical data were used to identify existing and possible future problem corridors with respect to access management. The research team developed a scheme for ranking commuter routes based on their need for attention to access management. This project was able to produce rankings for corridors based on a variety of factors, including proportion of crashes that appear to be access-related, severity of those crashes, and potential for improvement along corridors. Frequency and loss were found to be highly rank correlated; because of this, these indicators were not used together in developing final priority rankings. Most of the highest ranked routes are on two-lane rural cross sections, but a few are four-lane expressways with at-grade private driveways and public road intersections. The most important conclusion of the ranking system is that many of the poor-performing corridors are located in a single Iowa Department of Transportation district near two urban areas--Des Moines and Ames. A comprehensive approach to managing access along commuting corridors should be developed first in this district since the potential benefits would be highest in that region.

05028-010 Urban Watershed of Dickinson Cty Lakes Final Report

The Dickinson SWCD is applying for $486,800 over three years from the Watershed Improvement Fund to enhance water quality in Dickinson County through an impairment-based, locally directed watershed improvement project dealing specifically with storm water runoff. The LID Project will provide a cost share incentive and technical expertise to individual and business owners in specially targeted districts who are willing to implement low impact development techniques such as rain gardens, bioswales, pervious paving to reduce storm water runoff from their properties. Goals for the project include: 1) Defining and prioritizing urban watersheds in the Iowa Great Lakes region for implementation of Low Impact Development Practices; 2) Providing technical expertise in the form of a graduate assistant/project manager to design and oversee construction; 3) Continuing public education of such practices and their local existence through project kiosk, brochures, County Naturalist programs, local cable television shows, tours and other interactions of the Clean Water Alliance with its 50 partners in the area concerned about water quality; and 4) Completing 125 separate projects over a three year period.

From Master Plan to punctual interventions. Slums in Barcelona

The sloppy process of urbanization that took place in the outskirts of Barcelona from mid XIXth to mid XXth century resulted on large informal slums with evident urban deficiencies. The Metropolitan Masterplan of 1976 and its subsequent amendments could only partially improve the conditions of these areas of the city. Since 2005 some initiatives, in which local community or academic research played an important role, were undertaken following a tactical approach. The paper summarizes six proposed strategies that are a reaction to the traditional planning and zoning approach for the area. Some of them are currently been discussed or have already been included in the planning framework of the city.

Public Art, strategies for the regeneration of public space

This paper discusses some of the key concepts in the consideration of public art as a central element in urban regeneration processes, especially in reference to its role in the processes of citizen participation.

Urban transport governance reform in Barcelona

The unusual mixed public-private structure of the urban bus market in the metropolitan area of Barcelona provides an interesting context in which to analyze the management challenges and opportunities of the partial privatization of public services. Initiatives used by the public regulator to promote competition for contracts, such as short term concessions to private contractors and the removal of entry barriers, have considerable potential for improving efficiency and quality. The growth in the share of routes managed by private firms in recent years shows that privatization is a credible threat that may well stimulate improved performance among public managers. The type of reform implemented in Barcelona is of interest to all metropolitan areas large enough to operate under constant returns to scale regimes, and suitable for potential concessions of routes in segregated areas inside the metropolitan area, so as not to miss out on the benefits of economies of density.