Outcome Assessment of a Dedicated HIV Positive Health Care Worker Clinic at a Central Hospital in Malawi: A Retrospective Observational Study

BACKGROUND: Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007. METHODS AND FINDINGS: Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized. CONCLUSIONS/SIGNIFICANCE: Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings

Patients' and Practitioners' Views of Knee Osteoarthritis and Its Management: A Qualitative Interview Study

PURPOSE: To identify the views of patients and care providers regarding the management of knee osteoarthritis (OA) and to reveal potential obstacles to improving health care strategies. METHODS: We performed a qualitative study based on semi-structured interviews of a stratified sample of 81 patients (59 women) and 29 practitioners (8 women, 11 general practitioners [GPs], 6 rheumatologists, 4 orthopedic surgeons, and 8 [4 GPs] delivering alternative medicine). RESULTS: Two main domains of patient views were identified: one about the patient-physician relationship and the other about treatments. Patients feel that their complaints are not taken seriously. They also feel that practitioners act as technicians, paying more attention to the knee than to the individual, and they consider that not enough time is spent on information and counseling. They have negative perceptions of drugs and a feeling of medical uncertainty about OA, which leads to less compliance with treatment and a switch to alternative medicine. Patients believe that knee OA is an inevitable illness associated with age, that not much can be done to modify its evolution, that treatments are of little help, and that practitioners have not much to propose. They express unrealistic fears about the impact of knee OA on daily and social life. Practitioners' views differ from those of patients. Physicians emphasize the difficulty in elaborating treatment strategies and the need for a tool to help in treatment choice. CONCLUSIONS: This qualitative study suggests several ways to improve the patient-practitioner relationship and the efficacy of treatment strategies, by increasing their acceptability and compliance. Providing adapted and formalized information to patients, adopting more global assessment and therapeutic approaches, and dealing more accurately with patients' paradoxal representation of drug therapy are main factors of improvement that should be addressed

Desjeux Dominique, Stratégies paysannes en Afrique noire. Le Congo. Essai sur la gestion de l'incertitude.

Hirschhorn Monique. Desjeux Dominique, Stratégies paysannes en Afrique noire. Le Congo. Essai sur la gestion de l'incertitude.. In: Revue française de sociologie, 1988, 29-4. Sociabilité et action collective. pp. 707-709

François Dubet : le plus classique des sociologues français contemporains ?

Dans une période où les sociologies de l’individu (Martuccelli & de Singly, 2009) occupent en France le devant de la scène, où la plupart des études et des recherches sociologiques relèvent de la microsociologie, où une sociologie sans société (Touraine, 1981) se développe, il faut une certaine audace pour prendre comme objet le problème des modes d’existence et de fonctionnement des sociétés occidentales actuelles. Même si beaucoup de sociologues français se réfèrent encore à la société dans..

Préface. La communauté : du concept à l’idée directrice

Y a-t-il encore un intérêt aujourd’hui à s’interroger sur le concept de communauté ? N’est-il pas atteint de quatre maux : la polysémie, l’idéologisation, la naturalisation, l’obsolescence qui lui font perdre toute opérationnalité ? Ne doit-on, comme nous y invitait Philippe Besnard (1987) à propos de l’anomie, jeter « dans les poubelles de l’histoire disciplinaire » ces concepts aux contenus trop flous qui ne sont que des sources de confusion ? Mais comment alors justifier cet ouvrage consac..

Lalive d'Epinay Christian et alii, Vieillesses. Situations, itinéraires et modes de vie des personnes âgées aujourd'hui.

Hirschhorn Monique. Lalive d'Epinay Christian et alii, Vieillesses. Situations, itinéraires et modes de vie des personnes âgées aujourd'hui.. In: Revue française de sociologie, 1984, 25-3. pp. 509-511

Desjeux Dominique, Stratégies paysannes en Afrique noire. Le Congo. Essai sur la gestion de l'incertitude.

Hirschhorn Monique. Desjeux Dominique, Stratégies paysannes en Afrique noire. Le Congo. Essai sur la gestion de l'incertitude.. In: Revue française de sociologie, 1988, 29-4. Sociabilité et action collective. pp. 707-709

Le « mouvement » des sociétés : un défi pour la sociologie ? Détour par la sociologie de la société française depuis l’après-guerre

Afin de répondre à la question de savoir si la sociologie doit changer pour relever le défi que constituent les sociétés en mouvement, l’auteure propose un détour méthodologique par la sociologie des transformations qu’a connues la société française depuis l’après-guerre. Après en avoir refait l’histoire, elle en analyse les caractéristiques et les conditions de production. Ce qui lui permet de mettre à jour les obstacles que les sociologues doivent surmonter pour être capable de saisir le mouvement des sociétés.To answer the question of whether sociology must change to meet the challenge of societies in motion, the author proposes a methodological detour through the sociology of transformations experienced by French society since the postwar period. After summing up the background, she proposes an analysis of the characteristics and conditions of production. This allows her to update the obstacles that sociologists must overcome to be able to capture the movement of societies.Con el fin de responder a la cuestión de saber si la sociología debe cambiar para aceptar el desafío que constituyen las sociedades en movimiento, la autora propone un giro metodológico a través de la sociología de las transformaciones, que caracterizó a la sociedad francesa luego de la post-guerra. Luego de haber re hecho la historia, la sociología de las transformaciones analiza las características y las condiciones de producción. Ello permite poner al día a los obstáculos que los sociólogos deben ser capaces de superar para comprender el movimiento de las sociedades