Annual public health and economic benefits of seasonal influenza vaccination: a European estimate

BACKGROUND: Vaccination is currently the most effective means of preventing influenza infection. Yet evidence of vaccine performance, and the impact and value of seasonal influenza vaccination across risk groups and between seasons, continue to generate much discussion. Moreover, vaccination coverage is below recommended levels. METHODS: A model was generated to assess the annual public health benefits and economic importance of influenza vaccination in 5 WHO recommended vaccination target groups (children 6 – 23 months of age; persons with underlying chronic health conditions; pregnant women; health care workers; and, the elderly, 65 years of age) in 27 countries of the European Union. Model estimations were based on standard calculation methods, conservative assumptions, age-based and country-specific data. RESULTS: Out of approximately 180 million Europeans for whom influenza vaccination is recommended, only about 80 million persons are vaccinated. Seasonal influenza vaccination currently prevents an annual average of between 1.6 million and 2.1 million cases of influenza, 45,300 to 65,600 hospitalizations, and 25,200 to 37,200 deaths. To reach the 75% vaccination coverage target set by the EU Council Recommendation in 2009, an additional 57.4 million person would need to be vaccinated in the elderly and other risk groups. By achieving the 75% target rate set in EU-27 countries, average annual influenza- related events averted would increase from current levels to an additional +1.6 to +1.7 million cases, +23,800 to +31,400 hospitalization, +9,800 to +14,300 deaths, +678,500 to +767,800 physician visits, and +883,800 to +1,015,100 lost days of work yearly. Influenza-related costs averted because of vaccination would increase by an additional + €190 to + €226 million yearly, in vaccination target groups. CONCLUSIONS: Full implementation of current influenza vaccination recommendations of 75% vaccination coverage rate (VCR) in Europe by the 2014–2015 influenza season could immediately reduce an important public health and economic burden

Femtosecond laser polishing of pure copper surfaces with perpendicular incidence

Over the past few years, femtosecond (fs) laser processing has drawn a growing interest in a wide range of applications as it offers the possibility to process the surface morphologies of metals and semiconductors. In contrast to other polishing techniques, laser polishing offers a flexible and non-contact solution, thereby avoiding potential external contamination, while enabling a precise selection of processing areas. We investigated the influence of fs laser parameters on surface roughness of pure copper and ablation thickness, focusing on highlighting the importance of fluence and scanning overlap. With a two-step processing strategy, composed of coarse and fine polishing steps, surfaces with Sa < 400 nm were achieved, representing a 98% reduction from the high roughness of 15 μm on initial surfaces. This research demonstrated the possibility of directly polishing rough parts using a fs laser with a perpendicular incidence. © 202

A Rapid Evidence Appraisal of influenza vaccination in health workers: an important policy in an area of imperfect evidence

IntroductionThe World Health Organization recommends vaccination of health workers (HWs) against influenza, but low uptake is intransigent.We conducted a Rapid Evidence Appraisal on: the risk of influenza in HWs, transmission risk from HWs to patients, the benefit of HW vaccination, and strategies for improving uptake. We aimed to capture a ‘whole-of-system’ perspective to consider possible benefits for HWs, employers and patients.MethodsWe executed a comprehensive search of the available literature published from 2006 to 2018 in the English language. We developed search terms for seven separate questions following the PICO framework (population, intervention, comparators, outcomes) and queried nine databases.ResultsOf 3784 publications identified, 52 met inclusion criteria. Seven addressed HW influenza risk, of which four found increased risk; 15 addressed influenza vaccine benefit to HWs or their employers, of which 10 found benefit; 11 addressed influenza transmission from HWs to patients, of which 6 found evidence for transmission; 12 unique studies addressed whether vaccinating HWs produced patient benefit, of which 9 concluded benefits accrued. Regarding the number of HWs needed to vaccinate (NNV) to deliver patient benefit, NNV estimates ranged from 3 to 36,000 but were in significant disagreement. Fourteen studies provided insights on strategies to improve uptake; the strongest evidence was for mandatory vaccination.ConclusionsThe evidence on most questions related to influenza vaccination in HWs is mixed and often of low-quality. Substantial heterogeneity exists in terms of study designs and settings, making comparison between studies difficult. Notwithstanding these limitations, a majority of studies suggests that influenza vaccination benefit HWs and their employers; and HWs are implicated in transmission events. The effects of vaccinating HWs on patient morbidity and mortality may include reductions in all-cause mortality and influenza-like illness (ILI). Taken together, the evidence suggests that HW vaccination is an important policy for HWs themselves, their employers, and their patients

Loi et culture en pays Aborigenes ; anthropologie des resaux autochtones du Kimberley, Nord-Ouest de l'Australie

This thesis concerns Indigenous agency, socio-political and cultural systems,\ud and their reproduction by means of performances within the contemporary Australian\ud state. It examines the cultural politics of Indigeneity developed by Kimberley\ud Aboriginal people through their regional organisations. It presents an ethnographic\ud study of Indigenous modes of representation and organisation based on fieldwork\ud carried out with the Kimberley Aboriginal Law and Culture Centre, a grass-roots\ud Indigenous regional organisation federating thirty distinct groups, between 2005 and\ud 2007. As such, the thesis gives particular attention to contemporary Indigenous\ud practices of cultural representation and political action. The study aims at providing an\ud anthropological understanding of the continuing cultural and political salience of the\ud difference between Aboriginal people and Kartiyas.\ud \ud Engaging with the concept and practice of Law and Culture, initial research\ud questions have been reframed in terms of the reproduction of the Kimberley as a set of\ud Indigenous countries. Developing a relational approach, using a regional and a local\ud perspective, the thesis provides with accounts of the relational field of\ud interdependencies between the Australian State and its Indigenous habitants.\ud Experiential and historical constructions of Country, cultural logics of Indigenous ritual\ud and political agency, processes of indigenisation of the Australian modernity and\ud current models of Indigenous sustainable development in the Kimberley are\ud successively examined in order to allow for a processual and performative\ud understanding of Indigenous articulations of their subjectivity, agency and identity. The\ud thesis develops a theoretical framework discussing intercultural and ontological models\ud of Indigeneity and argues for a territorialising and performative approach to the\ud definition of Indigenous singularities, drawing on the Indigenous concepts of Country\ud and Law and Culture to frame anew notions of orality, culture and land

Les infections virales à manifestations cutanées chez le chien

LYON1-BU Santé (693882101) / SudocTOULOUSE-EN Vétérinaire (315552301) / SudocSudocFranceF

La Nocardiose chez les patients transplantés d'organe et de moëlle osseuse

LYON1-BU Santé (693882101) / SudocSudocFranceF

L’évolution du regard sociétal sur les pratiques avec les équidés : en quoi pèse-t-il sur nos décisions et nos organisations ?

National audienc