PGI12 Mean Annual Cost Of Patients Hospitalized For Chronic Hepatitis C In France: The Hepc-Lone Study

Las relaciones laborales marítimas se singularizan por caracteres que han propiciado la necesidad de formular instrumentos que tutelen los derechos de la gente de mar. Entre las singularidades más destacadas está el centro de trabajo: el buque. Su casuística para navegar por las aguas de diversos Estados ha dificultado localizar un punto de conexión que determine la ley aplicable. Ello es vértice para conocer quién debe garantizar la protección social del trabajador, y a su vez, es el instrumento para concretar las obligaciones del armador. Uno de los principios que caracterizan la Seguridad Social es el criterio de la territorialidad. Este criterio es complejo de trasladar a las relaciones laborales marítimas por varios factores, entre ellos: porque el buque no es una extensión del territorio del Estado donde el armador matricula a aquel. El principio de territorialidad, de forma tradicional se ha trasladado a las relaciones laborales con el criterio de la ley del Estado de bandera que da nacionalidad a la nave.The Maritime Labour relations are characterized by characters that have led to the need to develop instruments, which regulate the rights of seafarers. Among the most prominent singularities is the centre of work: the vessel. Their case series for navigating the waters of various States has made it difficult to locate a connection point to determine the applicable law. This is key point to know who should guarantee the social protection of the worker, and it is the instrument to concretize the liability of the shipowner. One of the principles that characterize social security is the criterion of territoriality. This criterion is complex to move the maritime labour relations by several factors: the vessel is not an extension of the territory of the State where the ship-owner has registered it. The principle of territoriality, in the traditional form, has been transferred to the labour relations with the criterion of the law of the flag State which gives nationality to the vesse

Late presenters to HIV care and treatment, identification of associated risk factors in HIV-1 infected Indian population

<p>Abstract</p> <p>Background</p> <p>Timely access to antiretroviral therapy is a key to controlling HIV infection. Late diagnosis and presentation to care diminish the benefits of antiretrovirals and increase risk of transmission. We aimed to identify late presenters in patients sent for first CD4 T cell count after HIV diagnosis, for therapy initiation evaluation. Further we aimed at identifying patient factors associated with higher risk of late presentation.</p> <p>Methods</p> <p>Retrospective data collection and analysis was done for 3680 subjects visiting the laboratory for CD4 T cell counts between 2001 and 2007. We segregated the patients on basis of their CD4 T cell counts after first HIV diagnosis. Factors associated with risk of late presentation to CD4 T cell counts after HIV diagnosis were identified using univariate analysis, and the strength of association of individual factor was assessed by calculation of odds ratios.</p> <p>Results</p> <p>Of 3680 subjects, 2936 (83.37%) were defined as late presenters. Late testing varied among age groups, transmission categories, and gender. Males were twice as likely to present late as compared to females. We found significant positive association of heterosexual transmission route (<it>p </it>< 0.001), and older age groups of 45 years and above (<it>p </it>= 0.0004) to late presentation. Female sex, children below 14 years of age and sexual contact with HIV positive spouse were associated with significantly lower risks to presenting late. Intravenous drug users were also associated with lower risks of late presentation, in comparison to heterosexual transmission route.</p> <p>Conclusions</p> <p>The study identifies HIV infected population groups at a higher risk of late presentation to care and treatment. The risk factors identified to be associated with late presentation should be utilised in formulating targeted public health interventions in order to improve early HIV diagnosis.</p

an introduction to personalized ehealth

Personalized medicine can be defined as the adaptation of medical treatments to the specific characteristics of patients. This approach allows health providers to develop therapies and interventions by taking into account the heterogeneity of illnesses and external factors such as the environment, patients' needs, and lifestyle. Technology could play an important role to achieve this new approach to medicine. An example of technology's utility regards real-time monitoring of individual well-being (subjective and objective), in order to improve disease management through data-driven personalized treatment recommendations. Another important example is an interface designed based on patient's capabilities and preferences. These could improve patient-doctor communication: on one hand, patients have the possibility to improve health decision-making; on the other hand, health providers could coordinate care services more easily, because of continual access to patient's data. This contribution deepens these technologies and related opportunities for health, as well as recommendation for successful development and implementation

Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study.

BACKGROUND AND AIMS: Despite advances in our knowledge of effective services for people who use drugs over the last decades globally, coverage remains poor in most countries, while quality is often unknown. This paper aims to discuss the historical development of successful epidemiological indicators and to present a framework for extending them with additional indicators of coverage and quality of harm reduction services, for monitoring and evaluation at international, national or subnational levels. The ultimate aim is to improve these services in order to reduce health and social problems among people who use drugs, such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, crime and legal problems, overdose (death) and other morbidity and mortality. METHODS AND RESULTS: The framework was developed collaboratively using consensus methods involving nominal group meetings, review of existing quality standards, repeated email commenting rounds and qualitative analysis of opinions/experiences from a broad range of professionals/experts, including members of civil society and organisations representing people who use drugs. Twelve priority candidate indicators are proposed for opioid agonist therapy (OAT), needle and syringe programmes (NSP) and generic cross-cutting aspects of harm reduction (and potentially other drug) services. Under the specific OAT indicators, priority indicators included 'coverage', 'waiting list time', 'dosage' and 'availability in prisons'. For the specific NSP indicators, the priority indicators included 'coverage', 'number of needles/syringes distributed/collected', 'provision of other drug use paraphernalia' and 'availability in prisons'. Among the generic or cross-cutting indicators the priority indicators were 'infectious diseases counselling and care', 'take away naloxone', 'information on safe use/sex' and 'condoms'. We discuss conditions for the successful development of the suggested indicators and constraints (e.g. funding, ideology). We propose conducting a pilot study to test the feasibility and applicability of the proposed indicators before their scaling up and routine implementation, to evaluate their effectiveness in comparing service coverage and quality across countries. CONCLUSIONS: The establishment of an improved set of validated and internationally agreed upon best practice indicators for monitoring harm reduction service will provide a structural basis for public health and epidemiological studies and support evidence and human rights-based health policies, services and interventions

L'utilisation du téléphone dans une enquête de santé mentale : analyse de l'impact du rang d'appel, des données manquantes et de l'effet « enquêteur »

Bari ffoi Éric. Vfrc.fr Pierre Rotiiy Michel - Using the telephone for mental health surveys: an analysis of the impact of call rank, non-response and interviewer effect Use of telephone sample surveys on mental health has increased in France in recent years As part of an epidennological survey of the long term psychological consequences of a natural disaster — the 1992 floods in the Vaucluse — this article begins by examining the relationships between call rank and the population's socio demographic characteristics and mental health status, the relationship between missing data, socio demographic characteristics and personality disorders is then examined, finally an attempt is made to evaluate the interviewer effect on the mental health data collected by telephone The results are consistent with those in the literature for the relationship between call rank and socio demographic variables By contrast, no clear relationship is identified between call rank and the various aspects of mental health considered Lastly, non-response on questions of mental health depends on both the socio demographic characteristics and the neurotic tendencies of the respondent The non-response rate and the anxiety level reported by respondents increase when the interviewer is female The implications of these results for telephone collection of data on mental health are discussedBari ffoi Éric, Vfrofr Pierre, Rotu y Michel - L'utilisation du téléphone dans une enquête de santé mentale : analyse de l'impact du rang d'appel, des données manquante:» et de l'effet « enquêteur » Les enquêtes de santé mentale par sondage téléphonique se multiplient en France depuis quelques années Dans le cadre d'une enquête épidemiologique sur les consequences psychologiques à long terme d'une catastrophe naturelle, les inondations de 1992 dans le Vaucluse. on étudie tout d abord les liens entre le rang d'appel, les caractéristiques socio- demographiques de la population et son état de santé mentale L'analyse porte ensuite sur les liens entre les données manquantes, les caractéristiques sociodémographiques et les troubles psychopathologiques, enfin, on évalue l'effet « enquêteur » sur les données de santé mentale recueillies par telephone Les résultats confirment ceux de la littérature quant au lien entre le rang d'appel et les variables sociodémographiques En revanche, la relation entre le rang d'appel et les différentes dimensions de santé mentale étudiées est peu marquee bnfin, l'existence de données manquantes sur les questions de santé mentale depend à la fois des caractéristiques sociodémographiques et des tendances névrotiques du repondant, le taux de données manquantes et le niveau d'anxiété déclarée par les repondants augmentent si l'enquêteur est de sexe féminin Les implications de ces résultats pour le recueil des données de santé mentale par telephone sont discutéesBari ffoi Fric Vfrgfr Pierre. Rotiiy Michel - El uso del teléfono en una encuesta sobre salud mental: análisis del impacto del rango de llamada, de los datos no disponibles y del efecto "encuestador" I as encuestas de salud mental por sondeo telefónico se han multiplicado en Francia en los últimos anos Fn el marco de una encuesta epidemiologica sobre las consecuencias psico- logicas a largo pla/o de una catastrofe natural, las ínundaciones de 1992 en Vaucluse, anali- /amos en primer lugar la relación entre el rango de llamada, las caractensticas souo- demograficas de la poblacion y su estado de salud mental fcn segundo lugar, examinamos la relación entre los datos no disponibles, las caractensticas socio demográficas y los problemas psico-patologicos Para ternnnar, evaluamos el efecto "encuestador' sobre los datos de salud mental recogidos por telefono Los resultados, como la literatura existente, sugieren que exis te una relación entre el rango de llamada y las variables souo-demograficas bn cambio, no se demuestra una tuerte relación entre el rango de llamada y las distintas dimensiones de salud mental La falta de datos sobre salud mental dépende a la ve/ de las caractensticas socio-de- mograficas y de las tendenuas neuróticas del encuestado, la proporción de datos no disponibles y el nivel de ansiedad declarado son mas elevados entre los encuestados de sexo femenino Ы articule discute las implicaciones de estos resultados para la recogida de datos sobre salud mental por telcfonoBaruffol Éric, Verger P., Rotily M. L'utilisation du téléphone dans une enquête de santé mentale : analyse de l'impact du rang d'appel, des données manquantes et de l'effet « enquêteur ». In: Population, 56ᵉ année, n°6, 2001. pp. 987-1010

L'utilisation du telephone dans une enquete de sante mentale: analyse de l'impact du rang d'appel, des donnees manquantes et de l'effet "enqueteur"

Use of telephone sample surveys on mental health has increased in France in recent years. As part of an epidemiological survey of the long-term psychological consequences of a natural disaster-the 1992 floods in the Vaucluse-this article begins by examining the relationships between call rank and the population's socio-demographic characteristics and mental health status; the relationship between missing data, socio-demographic characteristies and personality disorders is then examined; finally an attempt is made to evaluate the interviewer effect on the mental health data collected by telephone. The results are consistent with those in the literature for the relationship between call rank and socio-demographic variables. By contrast, no clear relationship is identified between call rank and the various aspects of mental health considered. Lastly, non-response on questions of mental health depends on both the socio-demographic characteristics and the neurotic tendencies of the respondent. The non-response rate and the anxiety level reported by respondents increase when the interviewer is female. The implications of these results for telephone collection of data on mental health are discussed