The Mediterranean Region under Climate Change. A Scientific Update: Abridged English/French Version

This book has been published by Allenvi (French National Alliance for Environmental Research) to coincide with the 22nd Conference of Parties to the United Nations Framework Convention on Climate Change (COP22) in Marrakesh. It is the outcome of work by academic researchers on both sides of the Mediterranean and provides a remarkable scientific review of the mechanisms of climate change and its impacts on the environment, the economy, health and Mediterranean societies. It will also be valuable in developing responses that draw on “scientific evidence” to address the issues of adaptation, resource conservation, solutions and risk prevention. Reflecting the full complexity of the Mediterranean environment, the book is a major scientific contribution to the climate issue, where various scientific considerations converge to break down the boundaries between disciplines

Contingent Valuation of Competing Public Sector Programmes: An Experiment of Single versus Joint Evaluation

In this paper, we compare single and joint evaluation (JE) of competing public sector programmes in a contingent valuation exercise. Using survey data aimed at evaluating WTP for cancer interventions (n = 2628), we disantangle two types of effects of JE: informational effects and sequence effects. By the former, wemean: by presenting different programmes to respondents, they will acquire more information on each programme than they would if each programme was valued in isolation. Sequence effects are underisable and induced by the JE exercise itself: changing the order of the valuation sequence induces different WTP values.Our results show that there are informational effects but no sequence effects. We therefore argue that JE approaches can be added to the armoury of techniques aimed at designing better survey instruments in a way that induces informational effects without incurring problems of sequencing.Single Evaluation; Joint Evaluation Willingness to Pay; Contingent Valuation; Priorities Setting

Editorial

Je ne peux que très vivement me féliciter de l’initiative de la revue Dynamiques Environnementales de consacrer une de ses livraisons de 2016 aux relations environnement et santé, et plus particulièrement à la contribution de la géographie dans ce champ. Le moment ne pouvait être mieux choisi. L’année 2015 a vu un profond renouvellement de l’agenda international sur les questions de développement puisque se sont successivement tenues, en Juillet à Addis-Abeba, la 3e Conférence internationale ..

Early Initiation of Highly Active Antiretroviral Therapies for Aids: Dynamic choice with Endogenous and Exogenous Learning

Criteria for initiation of highly active antiretroviral treatments (HAART) in HIV-infected patients remain a matter of debate world-wide because short-term benefits have to be balanced with costs of these therapies, and restrictions placed on future treatment options if resistant viral strains develop. On the other hand, postponing the introduction of HAART may involve a therapeutic opportunity cost if a patient’s health is allowed to deteriorate to such an extent of becoming unable to benefit from new treatments currently under development when they become available. We introduce a two period model where period one treatment adoption is an irreversible act with future, but uncertain, consequences. New information, both endogenous and exogenous, arises over time and shapes the conditions surrounding the second period therapeutic decision. A surprising result is that, under conditions that appear close to those surrounding the HAART debate, the magnitude of the feared resistance effect has no effect on leaves the optimal treatment decision as far as it is high enough. Le bien-fondé d’administrer précocement des traitements antirétroviraux à haute activité (HAART) aux personnes infectées par le VIH reste objet de débats dans le monde, car leurs bienfaits à court terme peuvent compromettre les traitements futurs si se développent des souches résistantes du virus. Par ailleurs retarder le recours aux HAART comporte un coût d’opportunité thérapeutique si la santé du patient se dégrade au point qu’il ne peut plus bénéficier par la suite des traitements encore en cours de développement. Nous formulons un modèle à deux périodes où l’adoption du traitement de première période est irréversible et engage le futur, alors que des informations et connaissances nouvelles, exogènes et endogènes, déterminent les conditions entourant la décision thérapeutique de deuxième période. Paradoxalement, sous des conditions reflétant bien les enjeux du recours aux HAART, il s’avère que l’effet résistance éventuel a d’autant moins de chance d’importer pour la décision optimale, que sa gravité est élevée.therapeutic decisions, uncertainty, information, irreversibility, treatment, endogenous learning, exogenous learning, décisions thérapeutiques, incertitude, information, irréversibilité, traitement, apprentissage endogène, apprentissage exogène

Early Initiation of Highly Active Antiretroviral Therapies (HAART) for HIV/aids: The Contribution of a Stochastic Dynamic Model of Choice

Criteria for initiation of highly active antiretroviral treatments (HAART) in HIV-infected patients remain a matter of debate world-wide because short-term benefits have to be balanced with costs of these therapies, and restrictions placed on future treatment options if resistant viral strains develop. In order to take into account irreversibility and inertia effects associated with ex ante choices, we propose a simple stochastic dynamic model of sequential therapeutic choice with intermediary revelation of information, in which the efficiency gains from a new effective Therapy in second period are conditional on the results of the treatment in the previous period. We find that identical patients may be administered different treatments at the optimum; for parameters implying an all or nothing cut decision in period 2, a more forward looking decision rule is required in period 1 because there will be little space for adjustment to its consequences. Another finding is that as soon as risks of resistance due to therapeutic failure of initial treatments are significant, as perhaps in developing countries and in marginalized groups of developed countries, differences in the estimation of this risk should not influence the optimal decision about the size of the HIV-infected population eligible for early antiretroviral Therapy. The decision should then be based on pure efficiency/cost considerations. Le bien-fondé d'administrer précocement des traitements antirétroviraux à haute activité (HAART) aux personnes infectées par le VIH reste l'objet de débats dans le monde car leurs bienfaits à court terme peuvent compromettre les traitements futurs si des souches résistantes du virus se développent. Nous formulons un modèle qui combine irréversibilité et inertie dans un cadre de décision thérapeutique séquentielle. L'information se révèle entre la première et la deuxième période, si bien que la décision thérapeutique de deuxième période est conditionnelle à cette information. Il s'avère que des patients identiques peuvent se voir administrer des traitements différents à l'optimum; de plus, pour des paramètres justifiant des décisions bien tranchées en période 2 (à patients identiques traitement identique), la décision de période 1 est plus complexe car il est alors trop tard pour en renverser les conséquences en période 2. Autre résultat: supposons que le risque de résistance est élevé en cas d'échec thérapeutique du traitement initial (pays en développement; groupes défavorisés); nous montrons alors que les différences dans l'estimation de ce risque n'interviennent pas dans le choix optimal de la taille de la population qui se voit administrer le traitement antirétroviral. L'introduction du traitement relève alors purement de considérations d'efficacité et de coût.therapeutic decisions, uncertainty, information, irreversibility, treatment, learning, errors, décisions thérapeutiques, incertitude,information, irréversibilité, traitement, apprentissage, erreurs

'Time is costly': modelling the macroeconomic impact of scaling-up antiretroviral treatment in sub-Saharan Africa.

International audienceBACKGROUND: Macroeconomic policy requirements may limit the capacity of national and international policy-makers to allocate sufficient resources for scaling-up access to HIV care and treatment in developing countries. METHOD: An endogenous growth model, which takes into account the evolution of society's human capital, was used to assess the macroeconomic impact of policies aimed at scaling-up access to HIV/AIDS treatment in six African countries (Angola, Benin, Cameroon, Central African Republic, Ivory Coast and Zimbabwe). RESULTS: The model results showed that scaling-up access to treatment in the affected population would limit gross domestic product losses due to AIDS although differently from country to country. In our simulated scenarios of access to antiretroviral therapy, only 10.3% of the AIDS shock is counterbalanced in Zimbabwe, against 85.2% in Angola and even 100.0% in Benin (a total recovery). For four out of the six countries (Angola, Benin, Cameroon, Ivory Coast), the macro-economic gains of scaling-up would become potentially superior to its associated costs in 2010. CONCLUSION: Despite the variability of HIV prevalence rates between countries, macro-economic estimates strongly suggest that a massive investment in scaling-up access to HIV treatment may efficiently counteract the detrimental long-term impact of the HIV pandemic on economic growth, to the extent that the AIDS shock has not already driven the economy beyond an irreversible 'no-development epidemiological trap'

Variability of attitudes toward early initiation of HAART for HIV infection : a study of French prescribing physicians

This study assessed prescribing physicians' attitudes toward early initiation of HAART, three months after the dissemination of the first French official treatment guideline. Telephone interviews have been made in a national random sample of physicians with full- or part-time practice in hospital departments delivering care for HIV-infected patients. Questionnaires included hypothetical clinical cases. Logistic regression compared characteristics of respondents according to attitudes toward HAART. Among the 483 respondents (response rate = 87.0%), agreement was high with official recommendations to systematically initiate HAART with protease inhibitors (PIs) for patients with CD4+ cell counts &lt; or = 300/mm3, following a diagnosis of acute primary HIV infection, or for HIV sexual risk post-exposure prophylaxis. Confronted with a case of a naive asymptomatic patient with stable 450 CD4+/mm3, 34.6% would prescribe HAART with PIs in any case, and 29.8% only if the patient has plasma viral load &lt; or = 10,000 HIV RNA copies/ml. The remaining 35.6% would not prescribe PIs and were older, had limited activity in HIV care and expressed more interest in alternative medicines. To avoid a confusing impact of variability of clinical attitudes toward uncertainties associated with antiretroviral treatments among HIV-infected patients, shared decision-making between patient and physician should be promoted for initiation of HAART. [Authors]]]> Antiretroviral Therapy, Highly Active ; Attitude of Health Personnel ; HIV Infections ; Physician's Practice Patterns oai:serval.unil.ch:BIB_63B3A6A350EB 2022-05-07T01:19:14Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_63B3A6A350EB Logopenic syndrome and corticobasal dysfunction in a "benign" type 3 familial cortical myoclonic tremor with epilepsy. info:doi:10.1016/j.seizure.2015.01.004 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.seizure.2015.01.004 info:eu-repo/semantics/altIdentifier/pmid/25645643 Magnin, E. info:eu-repo/semantics/article article 2015 Seizure, vol. 25, pp. 84-86 info:eu-repo/semantics/altIdentifier/eissn/1532-2688 urn:issn:1059-1311 eng oai:serval.unil.ch:BIB_63B3CEEF0A46 2022-05-07T01:19:14Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_63B3CEEF0A46 Guidelines zur Behandlung von Aphasien. Schweizerische Aerztezeitung Aphasie, Suisse info:eu-repo/semantics/article article 2005 Bulletin des Médecins Suisses = Schweizerische Ärztezeitung, vol. 86, no. 40, pp. 2290-2297 urn:issn:1424-4012 ger https://serval.unil.ch/resource/serval:BIB_63B3CEEF0A46.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_63B3CEEF0A466 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_63B3CEEF0A466 info:eu-repo/semantics/submittedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_63B487FEFFA8 2022-05-07T01:19:14Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_63B487FEFFA8 Preliminary results on the postmortem measurement of 3-beta-hydroxybutyrate in liver homogenates. info:doi:10.1007/s00414-013-0870-3 info:eu-repo/semantics/altIdentifier/doi/10.1007/s00414-013-0870-3 info:eu-repo/semantics/altIdentifier/pmid/23722498 Palmiere, C. Mangin, P. Werner, D. info:eu-repo/semantics/article article 2013 International Journal of Legal Medicine, vol. 127, no. 5, pp. 943-949 info:eu-repo/semantics/altIdentifier/eissn/1437-1596 urn:issn:0937-9827 <![CDATA[The concentrations of 3-beta-hydroxybutyrate (3HB) in blood and two liver samples were retrospectively examined in a series of medicolegal autopsies. These cases included diabetic ketoacidosis, nondiabetic individuals presenting moderate to severe decompositional changes and nondiabetic medicolegal cases privy of decompositional changes. 3HB concentrations in liver sample homogenates correlate well with blood values in all examined groups. Additionally, decompositional changes were not associated with increases in blood and liver 3HB levels. These results suggest that 3HB can be reliably measured in liver homogenates when blood is not available at autopsy. Furthermore, they suggest that metabolic disturbances potentially leading or contributing to death may be objectified through liver 3HB determination even in decomposed bodies

Introduction. Climate change in the Mediterranean

The Intergovernmental Panel on Climate Change (IPCC), whose work played a major role in the ‘historic’ agreement reached at the 21st Conference of the Parties to the United Nations Framework Convention on Climate Change (COP 21) in Paris in December 2015, has shown that the Mediterranean Basin is one of the most vulnerable areas of the planet to climate change. COP 22 will take place in Marrakesh from 7 to 18 November but ahead of this event, Morocco hosted MedCOP Climate, the Mediterranean c..