The effects of non-focused extracorporeal shock waves on neuronal morphology, function and analgesia in horses

These studies were conducted to elucidate the regional analgesic effect that is observed clinically after treatment of orthopedic disorders with application of extracorporeal shock waves in horses. Regional analgesia after treatment with extracorporeal shock waves presents a concern because it may eliminate protective limiting mechanisms and may place equine athletes with predisposing lesions at risk of sustaining career- or life-ending injuries. Direct percutaneous application of non-focused extracorporeal shock waves to palmar digital nerves in the pastern area of horses resulted in decreased sensory nerve conduction velocities compared with untreated control nerves at 3, 7, and 35 days after treatment. Transmission electron microscopy revealed distinct morphological changes consisting of extensive separation and disruption between the different layers of the myelin sheath in large- to medium-sized myelinated axons of treated palmar digital nerves. Treatment of selected areas of the metacarpus in horses with non-focused extracorporeal shock waves failed to identify a regional analgesic effect when cutaneous sensation was assessed by comparing the nociceptive threshold (limb withdrawal reflex latency, LWRL) between treated and non-treated areas after stimulation with a focused light source. The LWRL responses in all horses were comparable in treated and control areas over time with a significant decrease noted at most sites and time points compared with baseline values

Evolving biosecurity frameworks

The relationship between infectious disease and security concerns has undergone an evolution since the end of the Cold War. What was previously seen as two separate domains – public health and national security – have, through various events and disease outbreaks in the last 15 years, become intertwined and as a result biosecurity policies now need to address a spectrum of disease threats that encompass natural outbreaks, accidental releases and the deliberate use of disease as weapons

Critique du travail

Les vertus du travail sont célébrées à pleins poumons dans les mass media, sous le leitmotiv de la sauvegarde de l’industrie ou du capitalisme cognitif, de la rigueur et de l’épargne, de l’esprit d’entreprise et du soutien aux pigeons. Ce discours dominant cache mal son inquiétude, au vu de séries noires de suicides au travail, d’un chômage de masse sans fin et de contestations publiques à l’encontre des politiques de précarisation, du retrait du Contrat Première Embauche au programme actuel de la Commission européenne. La finalité de plus en plus voyante du travail semble être uniquement d’alimenter la machine marchande, de reproduire le capital. Ici et là, une critique du travail émerge : dans la réfraction, la résistance passive, la rébellion, mais aussi dans le champ éditorial et à travers des essais théoriques. Adorno, Gorz ou Castoriadis sortent des archives pour garnir à nouveau les barricades. À l’occasion du présent numéro, nous rééditons d'ailleurs un ouvrage majeur du fondateur de Variations, Jean-Marie Vincent : Critique du travail. Le faire et l'agir (http://variations.revues.org/224)

What is driving HTA decision-making? Evidence from cancer drug reimbursement decisions from 6 European countries

Background Decisions on the reimbursement of the same cancer drugs are different across European countries, but empirical work on the reasons behind these differences has been scarce. The main objective of this paper is to make a methodological contribution to existing research, specifically by outlining the systematic process of analysis to address such questions and determining the factors that might lead to different drug reimbursement decisions, and to explore its application in the field of oncology. Methods Reimbursement decisions on cancer drugs in six European countries (Belgium, England, Poland, Portugal, Scotland, and Sweden) between 2006 and 2014 were included in the study. A taxonomy was developed, comprising two groups of variables (system-level and product-specific) and an econometric model was specified (multilevel mixed-effects ordered probit). Results Only one in six evaluations in the sample reach the same reimbursement recommendation. Most health system variables were not determinants of a higher or lower probability of a positive reimbursement recommendation. However, the probability of reimbursement was higher when a drug was considered cost-effective by NICE/SMC and when there was a financial Managed Entry Agreement. This work also demonstrated a possible econometric approach for analysing differences in reimbursement decisions and contributes a structured approach for collecting and preparing data for such analyses. Conclusions Drug reimbursement decisions can be analysed in detail along a set of factors that are related to each decision. This information is essential, not only for understanding why a particular drug is accepted in one country and not in another but also when trying to implement a new HTA system or reform an existing one. This analysis provides policy makers and stakeholders with a model that enables a better understanding of the factors that drive HTA decisions and is adaptable to answer similar questions. Moreover, the data collection limitations encountered and described in this work shed light on the need for greater accessibility and transparency in HTA systems and regarding HTA outcomes.This research was funded under the European 7th Framework Programme with Advance-HTA (no305,983). The results presented reflect the author’s views. The EC is not liable for any use of the information communicated