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Involving a wide-range of stakeholders at different moments in the planning of urban adaptation to climate change can help to overcome different barriers to adaptation, such as a lack of common perception, or control over options. This Article argues for an approach that involves a wide range of actors throughout the planning process in order to confront the challenges of urban adaptation to climate change. It builds on the results of a three-year participatory action research project to identify the catalysts with which local administrations can overcome the lack of data, the low level of engagement around the climate issue, and the cause-and-effect linkages of climate change impacts on the urban environment. Significant factors include territorial rootedness, leveraging actors' experience, interaction between actors, as well as the valuing of local actors as experts of territorial management rather than as novices with regard to climate change adaptation. In addition to contributing towards the engagement of a large number of stakeholders around adaptation issues, a planning process that involves representatives from various sectors and during several stages contributes to a greater understanding of these issues and their linkages. It follows that such a process will bring changes to urban practices by better articulating local concerns about climatic issues. Policy relevanceAlthough participation is commonly advocated in policy responses to climate change, only few empirical studies have investigated the ways in which local actors' knowledge can be integrated into climate change adaptation planning processes. The article builds on the results of an action research project carried out in Québec City, Canada, to address the relevance of involving a progressively broader range of actors as the adaptation process moves through its various phases. Given that a multitude of barriers to adaptation are at play at different times in a municipality, collaborations between local stakeholders emerge as a key factor. These collaborations provide greater insight into the linkages between climate change impacts and the urban environment and, in doing so, bring into question ordinary urban management and design practices.

A case of HIV‐associated cardiac non‐Hodgkin's lymphoma (NHL) is described, and the epidemiologic and clinicopathologic features of 21 cases previously reported in the literature are analyzed. All patients were homosexual males, and the cardiac NHL was the first acquired immune deficiency syndrome‐defining condition in the majority. Patients were referred with nonspecific clinical findings including dyspnea and tachycardia, but rapid progression of cardiac dysfunction was frequent after symptoms appeared. Echocardiography constitutes the most useful noninvasive procedure in the diagnosis of cardiac NHL. Most of the patients had disseminated disease at initial presentation; pathologically, the lymphomas were of B lymphocyte origin and of high‐grade subtypes. Prognosis of HIV‐associated cardiac NHL is generally poor, although clinical remission has been observed with combination chemotherapy. Cardiac lymphomas in HIV‐associated patients are typically high‐grade and often disseminate early. Although the prognosis is poor, patients in whom dissemination has not occurred could have longer survival under systemic chemotherapy.

For cities, climate change is a major concern due to its severe impacts and its inherent complexity. City and building designers could be pivotal actors, but have yet to fully take on this role. Research can support adaptation action through greater collaboration with practitioners and a better understanding of their knowledge and practices. This paper presents results from a research project undertaken in Toulouse (France) last year. Urban practitioners were consulted through an online survey and observed in action during two design workshops. The findings highlight: (i) the hidden knowledge within design practice; (ii) the importance of providing designers with solution-focused and form-giving data; and (iii) the potential offered by design constraints to trigger changes in the practices of professionals.

For mid-latitude cities, higher summer temperatures due to climate change are a cause for concern because they aggravate the urban heat island phenomenon and reduce thermal comfort inside buildings. By acquiring the appropriate knowledge and skills, architects and urban designers can become key actors in adaptation to climate change. Two workshops bringing together architects and urban designers provided evidence of deficiencies in this area. We hypothesize that a design support tool (DST) focused on the issue of adaptation of midlatitude cities to rising summer temperatures could help improve knowledge and skills of professionals in the field. The first section presents the results taken from a review and classification of DSTs, which highlight the tools' features that are likely to reach this goal. Tools of the "hybrid" category seem most appropriate. To verify this, seven DSTs were selected and tested by fourteen students enrolled in a graduate-level architecture design studio. The second section presents the results from this test, including an analysis of the final projects, a webbased questionnaire and two focus groups. The relevance of hybrid approaches is established, but the results bring into question the capacity of a single DST to meet the individual and multiple needs of professionals.Please cite this article as: Dubois, C., et al., Design support tools to sustain climate change adaptation at the local level: A review and reflection on their suitability. Frontiers of Architectural Research (2015), http://dx.

Prevalence of S. maltophilia was higher in dysglycemic patients, supporting the idea that S. maltophilia is a marker of disease severity in CF.

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