1,229 research outputs found
Conseil-santé dans la médecine de premier recours, partie 2
Les maladies non transmissibles (MNT, en anglais «non-communicable diseases») ont gagné du terrain dans le monde entier. Les approches de conseil fourni au cabinet médical ont déjà été présentées dans un premier article. Le présent article se
consacre aux conditions permettant à ces approches de déployer leur efficacité au niveau de la population. Ceci est illustré sur la base des programmes suisses actuels «Vivre sans tabac», PAPRICA et «Coaching Santé» ainsi que de l’exemple historique «Ça débouche sur quoi?»
Uptake and efficacy of a systematic intensive smoking cessation intervention using motivational interviewing for smokers hospitalised for an acute coronary syndrome: a multicentre before-after study with parallel group comparisons.
To compare the efficacy of a proactive approach with a reactive approach to offer intensive smoking cessation intervention using motivational interviewing (MI).
Before-after comparison in 2 academic hospitals with parallel comparisons in 2 control hospitals.
Academic hospitals in Switzerland.
Smokers hospitalised for an acute coronary syndrome (ACS).
In the intervention hospitals during the intervention phase, a resident physician trained in MI systematically offered counselling to all smokers admitted for ACS, followed by 4 telephone counselling sessions over 2 months by a nurse trained in MI. In the observation phase, the in-hospital intervention was offered only to patients whose clinicians requested a smoking cessation intervention. In the control hospitals, no intensive smoking cessation intervention was offered.
The primary outcome was 1 week smoking abstinence (point prevalence) at 12 months. Secondary outcomes were the number of smokers who received the in-hospital smoking cessation intervention and the duration of the intervention.
In the intervention centres during the intervention phase, 87% of smokers (N=193/225) received a smoking cessation intervention compared to 22% in the observational phase (p<0.001). Median duration of counselling was 50 min. During the intervention phase, 78% received a phone follow-up for a median total duration of 42 min in 4 sessions. Prescription of nicotine replacement therapy at discharge increased from 18% to 58% in the intervention phase (risk ratio (RR): 3.3 (95% CI 2.4 to 4.3; p≤0.001). Smoking cessation at 12-month increased from 43% to 51% comparing the observation and intervention phases (RR=1.20, 95% CI 0.98 to 1.46; p=0.08; 97% with outcome assessment). In the control hospitals, the RR for quitting was 1.02 (95% CI 0.84 to 1.25; p=0.8, 92% with outcome assessment).
A proactive strategy offering intensive smoking cessation intervention based on MI to all smokers hospitalised for ACS significantly increases the uptake of smoking cessation counselling and might increase smoking abstinence at 12 months
Borrelia burgdorferi sensu lato in Ixodes ricinus ticks collected from migratory birds in Southern Norway
<p>Abstract</p> <p>Background</p> <p><it>Borrelia burgdorferi </it>sensu lato (s.l.) are the causative agent for Lyme borreliosis (LB), the most common tick-borne disease in the northern hemisphere. Birds are considered important in the global dispersal of ticks and tick-borne pathogens through their migration. The present study is the first description of <it>B. burgdorferi </it>prevalence and genotypes in <it>Ixodes ricinus </it>ticks feeding on birds during spring and autumn migration in Norway.</p> <p>Methods</p> <p>6538 migratory birds were captured and examined for ticks at Lista Bird Observatory during the spring and the autumn migration in 2008. 822 immature <it>I. ricinus </it>ticks were collected from 215 infested birds. Ticks were investigated for infection with <it>B. burgdorferi </it>s.l. by real-time PCR amplification of the 16S rRNA gene, and <it>B. burgdorferi </it>s.l. were thereafter genotyped by melting curve analysis after real-time PCR amplification of the <it>hbb </it>gene, or by direct sequencing of the PCR amplicon generated from the <it>rrs </it>(16S)-<it>rrl </it>(23S) intergenetic spacer.</p> <p>Results</p> <p><it>B. burgdorferi </it>s.l. were detected in 4.4% of the ticks. The most prevalent <it>B. burgdorferi </it>genospecies identified were <it>B. garinii </it>(77.8%), followed by <it>B.valaisiana </it>(11.1%), <it>B. afzelii </it>(8.3%) and <it>B. burgdorferi </it>sensu stricto (2.8%).</p> <p>Conclusion</p> <p>Infection rate in ticks and genospecies composition were similar in spring and autumn migration, however, the prevalence of ticks on birds was higher during spring migration. The study supports the notion that birds are important in the dispersal of ticks, and that they may be partly responsible for the heterogeneous distribution of <it>B. burgdorferi </it>s.l. in Europe.</p
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HIV Treatment as Prevention: Systematic Comparison of Mathematical Models of the Potential Impact of Antiretroviral Therapy on HIV Incidence in South Africa
Background: Many mathematical models have investigated the impact of expanding access to antiretroviral therapy (ART) on new HIV infections. Comparing results and conclusions across models is challenging because models have addressed slightly different questions and have reported different outcome metrics. This study compares the predictions of several mathematical models simulating the same ART intervention programmes to determine the extent to which models agree about the epidemiological impact of expanded ART. Methods and Findings: Twelve independent mathematical models evaluated a set of standardised ART intervention scenarios in South Africa and reported a common set of outputs. Intervention scenarios systematically varied the CD4 count threshold for treatment eligibility, access to treatment, and programme retention. For a scenario in which 80% of HIV-infected individuals start treatment on average 1 y after their CD4 count drops below 350 cells/µl and 85% remain on treatment after 3 y, the models projected that HIV incidence would be 35% to 54% lower 8 y after the introduction of ART, compared to a counterfactual scenario in which there is no ART. More variation existed in the estimated long-term (38 y) reductions in incidence. The impact of optimistic interventions including immediate ART initiation varied widely across models, maintaining substantial uncertainty about the theoretical prospect for elimination of HIV from the population using ART alone over the next four decades. The number of person-years of ART per infection averted over 8 y ranged between 5.8 and 18.7. Considering the actual scale-up of ART in South Africa, seven models estimated that current HIV incidence is 17% to 32% lower than it would have been in the absence of ART. Differences between model assumptions about CD4 decline and HIV transmissibility over the course of infection explained only a modest amount of the variation in model results. Conclusions: Mathematical models evaluating the impact of ART vary substantially in structure, complexity, and parameter choices, but all suggest that ART, at high levels of access and with high adherence, has the potential to substantially reduce new HIV infections. There was broad agreement regarding the short-term epidemiologic impact of ambitious treatment scale-up, but more variation in longer term projections and in the efficiency with which treatment can reduce new infections. Differences between model predictions could not be explained by differences in model structure or parameterization that were hypothesized to affect intervention impact
Quantum numbers of the state and orbital angular momentum in its decay
Angular correlations in decays, with , and , are used to measure
orbital angular momentum contributions and to determine the value of
the meson. The data correspond to an integrated luminosity of 3.0
fb of proton-proton collisions collected with the LHCb detector. This
determination, for the first time performed without assuming a value for the
orbital angular momentum, confirms the quantum numbers to be .
The is found to decay predominantly through S wave and an upper limit
of at C.L. is set on the fraction of D wave.Comment: 16 pages, 4 figure
First observation and amplitude analysis of the decay
The decay is observed in a data sample
corresponding to of collision data recorded by the LHCb
experiment during 2011 and 2012. Its branching fraction is measured to be
where the uncertainties are statistical, systematic and from
the branching fraction of the normalisation channel , respectively. An amplitude analysis of the resonant
structure of the decay is used to measure the
contributions from quasi-two-body ,
, and
decays, as well as from nonresonant sources. The
resonance is determined to have spin~1.Comment: 39 pages, 10 figures, submitted to Phys. Rev. D. Updated following
erratum 10.1103/PhysRevD.93.11990
Study of and decays and determination of the CKM angle
We report a study of the suppressed and favored
decays, where the neutral meson is detected
through its decays to the and CP-even and
final states. The measurement is carried out using a proton-proton
collision data sample collected by the LHCb experiment, corresponding to an
integrated luminosity of 3.0~fb. We observe the first significant
signals in the CP-even final states of the meson for both the suppressed
and favored modes, as well as
in the doubly Cabibbo-suppressed final state of the decay. Evidence for the ADS suppressed decay , with , is also presented. From the observed
yields in the , and their
charge conjugate decay modes, we measure the value of the weak phase to be
. This is one of the most precise
single-measurement determinations of to date.Comment: 22 pages, 9 figures; All figures and tables, along with any
supplementary material and additional information, are available at
https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2015-020.htm
Observation of resonances consistent with pentaquark states in decays
Observations of exotic structures in the channel, that we refer to
as pentaquark-charmonium states, in decays are
presented. The data sample corresponds to an integrated luminosity of 3/fb
acquired with the LHCb detector from 7 and 8 TeV pp collisions. An amplitude
analysis is performed on the three-body final-state that reproduces the
two-body mass and angular distributions. To obtain a satisfactory fit of the
structures seen in the mass spectrum, it is necessary to include two
Breit-Wigner amplitudes that each describe a resonant state. The significance
of each of these resonances is more than 9 standard deviations. One has a mass
of MeV and a width of MeV, while the second
is narrower, with a mass of MeV and a width of MeV. The preferred assignments are of opposite parity, with one
state having spin 3/2 and the other 5/2.Comment: 48 pages, 18 figures including the supplementary material, v2 after
referee's comments, now 19 figure
Differential branching fraction and angular analysis of decays
The differential branching fraction of the rare decay is measured as a function of , the
square of the dimuon invariant mass. The analysis is performed using
proton-proton collision data, corresponding to an integrated luminosity of 3.0
\mbox{ fb}^{-1}, collected by the LHCb experiment. Evidence of signal is
observed in the region below the square of the mass. Integrating
over 15 < q^{2} < 20 \mbox{ GeV}^2/c^4 the branching fraction is measured as
d\mathcal{B}(\Lambda^{0}_{b} \rightarrow \Lambda \mu^+\mu^-)/dq^2 = (1.18 ^{+
0.09} _{-0.08} \pm 0.03 \pm 0.27) \times 10^{-7} ( \mbox{GeV}^{2}/c^{4})^{-1},
where the uncertainties are statistical, systematic and due to the
normalisation mode, , respectively.
In the intervals where the signal is observed, angular distributions are
studied and the forward-backward asymmetries in the dimuon ()
and hadron () systems are measured for the first time. In the
range 15 < q^2 < 20 \mbox{ GeV}^2/c^4 they are found to be A^{l}_{\rm FB} =
-0.05 \pm 0.09 \mbox{ (stat)} \pm 0.03 \mbox{ (syst)} and A^{h}_{\rm FB} =
-0.29 \pm 0.07 \mbox{ (stat)} \pm 0.03 \mbox{ (syst)}.Comment: 27 pages, 10 figures, Erratum adde
Search for hidden-sector bosons in decays
A search is presented for hidden-sector bosons, , produced in the decay
, with and
. The search is performed using -collision data
corresponding to 3.0 fb collected with the LHCb detector. No significant
signal is observed in the accessible mass range
MeV, and upper limits are placed on the branching fraction product
as
a function of the mass and lifetime of the boson. These limits are of
the order of for lifetimes less than 100 ps over most of the
range, and place the most stringent constraints to date on many
theories that predict the existence of additional low-mass bosons.Comment: All figures and tables, along with supplementary material, are
available at
https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2015-036.htm
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