Hepatitis C Virus Infection Epidemiology among People Who Inject Drugs in Europe: A Systematic Review of Data for Scaling Up Treatment and Prevention

Background: People who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. The availability in the literature of information on seven main topic areas (incidence, chronicity, genotypes, HIV co-infection, diagnosis and treatment uptake, and burden of disease) to guide HCV treatment and prevention scale-up for PWID in the 27 countries of the European Union is systematically reviewed. Methods and Findings: We searched MEDLINE, EMBASE and Cochrane Library for publications between 1 January 2000 and 31 December 2012, with a search strategy of general keywords regarding viral hepatitis, substance abuse and geographic scope, as well as topic-specific keywords. Additional articles were found through structured email consultations with a large European expert network. Data availability was highly variable and important limitations existed in comparability and representativeness. Nine of 27 countries had data on HCV incidence among PWID, which was often high (2.7-66/100 person-years, median 13, Interquartile range (IQR) 8.7–28). Most common HCV genotypes were G1 and G3; however, G4 may be increasing, while the proportion of traditionally ‘difficult to treat’ genotypes (G1+G4) showed large variation (median 53, IQR 43–62). Twelve countries reported on HCV chronicity (median 72, IQR 64–81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%, IQR 0.2–28). Undiagnosed infection, assessed in five countries, was high (median 49%, IQR 38–64), while of those diagnosed, the proportion entering treatment was low (median 9.5%, IQR 3.5–15). Burden of disease, where assessed, was high and will rise in the next decade. Conclusion: Key data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID

Crowding‐out or crowding‐in? Direct voice, performance‐related pay, and organizational innovation in European firms

International audienceBuilding on motivation crowding theory (MCT), this article contributes to the human resources management (HRM)‐innovation debate by examining the potential trade‐offs between HRM practices targeted to increase employees' intrinsic motivation, such as direct employee voice (EV), and the presence of extrinsic incentives in the form of individual and collective performance‐related pay (PRP). The results of the analysis on more than 22,000 European establishments show support for the positive relationship between EV and a firm's organizational innovation, and that this relationship is weaker in companies that adopted individual PRP schemes (piece‐rate plans). Moreover, while we found that collective PRP (profit‐sharing) does not moderate the relationship between EV and organizational innovation, a positive and significant moderation effect emerged when the combined presence of individual and collective PRP was considered. By advocating that the coexistence of multiple forms of PRP could overcome the crowding‐out effect of individual PRP on EV, the study contributes to the HRM debate by also calling for a better understanding of the potential contingencies between different HRM practices when innovation is focus of the analysis

New trajectories in worker voice: integrating and applying contemporary challenges in the organization of work

This paper aims to encourage a debate on the proposed transactive relationship between voice and contemporary social, economic and technological (SET) developments. Specifically, we propose that SET developments change how work is approached, organized and designed, and that these changes challenge employee rights, roles and responsibilities. How employees deal with these challenges affects their well-being and health, and whether organizations and societies can develop sustainably. While voice is a way for employees to have a say in these developments, we argue that SET changes can be times at which voice is threatened. Moreover, we propose that SET changes urge us to question and reshape our understanding of voice. We propose that a functional conceptualization of voice provides opportunities to integrate existing approaches which are often scattered across disciplines, and is inclusive of new opportunities and constraints that come with SET developments. Using examples of two meta-trends, we illustrate how SET changes challenge traditional conceptualizations of voice and identify â new trajectoriesâ to expand more inclusive forms of voice and more useful research paradigms. These meta-trends are digitalization (including new business models and employment forms, alternative/flexible work arrangements, technology-mediated communication) and diversification (including internationalization and marginalized/minority groups)