Consumption of alcohol, cigarettes and illegal substances among physicians and medical students in Brandenburg and Saxony (Germany)

<p>Abstract</p> <p>Background</p> <p>Patients regard health care professionals as role models for leading a healthy lifestyle. Health care professionals' own behaviour and attitudes concerning healthy lifestyle have an influence in counselling patients. The aim of this study was to assess consumption of alcohol, cigarettes and illegal substances among physicians and medical students in two German states: Brandenburg and Saxony.</p> <p>Methods</p> <p>Socio-demographic data and individual risk behaviour was collected by an anonymous self-administered questionnaire. Physicians were approached via mail and students were recruited during tutorials or lectures.</p> <p>Results</p> <p>41.6% of physicians and 60.9% of medical students responded to the questionnaire; more than 50% of the respondents in both groups were females. The majority of respondents consumed alcohol at least once per week; median daily alcohol consumption ranged from 3.88 g/d (female medical students) to 12.6 g/d (male physicians). A significantly higher percentage of men (p < 0.05) reported hazardous or harmful drinking compared to women. A quarter of all participating physicians and one third of all students indicated unhealthy alcohol-drinking behaviour. The majority of physicians (85.7%) and medical students (78.5%) were non-smokers. Both groups contained significantly more female non-smokers (p < 0.05). Use of illegal substances was considerably lower in physicians (5.1%) than medical students (33.0%). Male students indicated a significantly (p < 0.001) higher level of illegal drug-use compared to female students.</p> <p>Conclusion</p> <p>More than one third of the medical students and health care professionals showed problematic alcohol-drinking behaviour. Although the proportion of non-smokers in the investigated sample was higher than in the general population, when compared to the general population, medical students between 18-24 reported higher consumption of illegal substances.</p> <p>These results indicate that methods for educating and promoting healthy lifestyle, particularly with respect to excessive alcohol consumption, tobacco use and abuse of illegal drugs should be considered.</p

Calculation of Direct Antiretroviral Treatment Costs and Potential Cost Savings by Using Generics in the German HIV ClinSurv Cohort

BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of antiretroviral therapy, and might allow a more rational allocation of resources within the German health care system

HIV incidence estimate combining HIV/AIDS surveillance, testing history information and HIV test to identify recent infections in Lazio, Italy

<p>Abstract</p> <p>Background</p> <p>The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number of persons detected as recently infected.</p> <p>Methods</p> <p>We used data from HIV/AIDS surveillance in the period 2004-2008 to identify newly diagnosed persons. These were classified with recent/non-recent infection on the basis of an avidity index result, or laboratory evidence of recently acquired infection (i.e., previous documented negative HIV test within 6 months; or presence of HIV RNA or p24 antigen with simultaneous negative/indeterminate HIV antibody test). Multiple imputation was used to impute missing information. The incidence estimate was obtained as the number of persons detected as recently infected divided by the estimated probability of detection. Estimates were stratified by calendar year, transmission category, gender and nationality.</p> <p>Results</p> <p>During the period considered 3,633 new HIV diagnoses were reported to the regional surveillance system. Applying the model, we estimated that in 2004-2008 there were 5,465 new infections (95%CI: 4,538-6,461); stratifying by transmission category, the estimated number of infections was 2,599 among heterosexual contacts, 2,208 among men-who-have-sex-with-men, and 763 among injecting-drug-users. In 2008 there were 952 (625-1,229) new HIV infections (incidence of 19.9 per 100,000 person-years). In 2008, for men-who-have-sex-with-men (691 per 100,000 person-years) and injecting drug users (577 per 100,000 person-years) the incidence remained comparatively high with respect to the general population, although a decreasing pattern during 2004-2008 was observed for injecting-drug-users.</p> <p>Conclusions</p> <p>These estimates suggest that the transmission of HIV infection in Lazio remains frequent and men-who-have-sex-with men and injecting-drug-users are still greatly affected although the majority of new infections occurs among heterosexual individuals.</p

Production of charged pions, kaons and protons at large transverse momenta in pp and Pb-Pb collisions at sNN\sqrt{s_{NN}} = 2.76 TeV

Transverse momentum spectra of $\pi^{\pm}, K^{\pm}$ and $p(\bar{p})$ up to $p_T$ = 20 GeV/c at mid-rapidity, |y| $\le$ 0.8, in pp and Pb-Pb collisions at $\sqrt{s_{NN}}$ = 2.76 TeV have been measured using the ALICE detector at the LHC. At intermediate $p_T$ (2-8 GeV/c) an enhancement of the proton-to-proton ratio, (p + \bar{p})/(\pi^+ + \pi^-\(), with respect to pp collisions is observed and the ratio reaches 0.80 in central Pb-Pb collisions. The measurement of the nuclear modification factors for \(\pi^{\pm}, K^{\pm} and $p(\bar{p})$ indicates that within the systematic and statistical uncertainties they are the same at high $p_T$ (> 10 GeV/c), suggesting that the chemical composition of leading particles from jets in the medium is similar to that of vacuum jets.publishedVersio

Mid-Staffordshire:a case study of failed governance and leadership?

Hadronic resonances are unique tools to investigate the interplay of re-scattering and regeneration effects during the hadronization phase in heavy-ion collisions. Measurements in small collision systems provide a necessary baseline for heavy-ion data, help to tune pQCD inspired event generators and give insight into the search for the onset of collective effects. As the ϕ meson has a longer lifetime compared to other resonances, it is expected that its production would be much less affected by regeneration and re-scattering processes. We report on measurements of ϕ meson production in minimum bias pp collisions at different beam energies and as a function of charged particle multiplicity with the ALICE detector at the LHC. The results include the transverse momentum (pT) distributions of ϕ as well as the particle yield ratios. Finally, we have also studied the ϕ effective strangeness content by comparing our results to theoretical calculations

Spin alignment measurements using vector mesons with ALICE detector at the LHC

We present new measurements related to spin alignment of K*0 vector mesons at mid-rapidity for Pb–Pb collisions at √sNN = 2.76 and 5.02 TeV. The spin alignment measurements are carried out with respect to production plane and 2nd order event plane. At low pT the spin density matrix element ρ00 for K*0 is found to have values slightly below 1/3, while it is consistent with 1/3, i.e. no spin alignment, at high pT. Similar values of ρ00 are observed with respect to both production plane and event plane. Within statistical and systematic uncertainties, ρ00 values are also found to be independent of √sNN. ρ00 also shows centrality dependence with maximum deviation from 1/3 for mid-central collisions with respect to both the kinematic planes. The measurements for K*0 in pp collisions at √s = 13 TeV and for K0S (a spin 0 hadron) in 20-40% central Pb–Pb collisions at √sNN = 2.76 TeV are consistent with no spin alignment.publishedVersio

Tuberculosis among people living with HIV/AIDS in the German ClinSurv HIV Cohort: long-term incidence and risk factors

BACKGROUND: Tuberculosis (TB) still presents a leading cause of morbidity and mortality among people living with HIV/AIDS (PLWHA), including those on antiretroviral therapy. In this study, we aimed to determine the long-term incidence density rate (IDR) of TB and risk factors among PLWHA in relation to combination antiretroviral therapy (cART)-status. METHODS: Data of PLWHA enrolled from 2001 through 2011 in the German ClinSurv HIV Cohort were investigated using survival analysis and Cox regression. RESULTS: TB was diagnosed in 233/11,693 PLWHA either at enrollment (N = 62) or during follow-up (N = 171). The TB IDR during follow-up was 0.37 cases per 100 person-years (PY) overall [95% CI, 0.32-0.43], and was higher among patients who never started cART and among patients originating from Sub-Saharan Africa (1.23 and 1.20 per 100PY, respectively). In two multivariable analyses, both patients (I) who never started cART and (II) those on cART shared the same risk factors for TB, namely: originating from Sub-Saharan Africa compared to Germany (I, hazard ratio (HR); [95% CI]) 4.05; [1.87-8.78] and II, HR 5.15 [2.76-9.60], CD4+ cell count <200 cells/μl (I, HR 8.22 [4.36-15.51] and II, HR 1.90 [1.14-3.15]) and viral load >5 log(10) copies/ml (I, HR 2.51 [1.33-4.75] and II, HR 1.77 [1.11-2.82]). Gender, age or HIV-transmission risk group were not independently associated with TB. CONCLUSION: In the German ClinSurv HIV cohort, patients originating from Sub-Saharan Africa, with low CD4+ cell count or high viral load at enrollment were at increased risk of TB even after cART initiation. As patients might be latently infected with Mycobacterium tuberculosis complex, early screening for latent TB infection and implementing isoniazid preventive therapy in line with available recommendations is crucial

Aggregating and Analysing Opinions for Argument-based Relations

We present measurements of hadronic resonance, strange and multi-strange particle production in collisions of Xe-Xe and Pb-Pb at the center-of-mass energies of √sNN = 5.44 and 5.02 TeV, respectively, by the ALICE collaboration at the LHC. Particle ratios are presented as a function of multiplicity for K0 s , Λ, Ξ−, Ξ¯ +, Ω−, Ω¯ +, ρ(770)0, K∗(892)0, φ(1020) and Λ(1520). Our results are discussed and compared with predictions of QCD-inspired event generators. Additionally, comparisons with lower energy measurements and smaller systems are also presented

Increasing altruistic and cooperative behaviour with simple moral nudges

The conflict between pro-self and pro-social behaviour is at the core of many key problems of our time, as, for example, the reduction of air pollution and the redistribution of scarce resources. For the well-being of our societies, it is thus crucial to find mechanisms to promote pro-social choices over egoistic ones. Particularly important, because cheap and easy to implement, are those mechanisms that can change people's behaviour without forbidding any options or significantly changing their economic incentives, the so-called "nudges". Previous research has found that moral nudges (e.g., making norms salient) can promote pro-social behaviour. However, little is known about whether their effect persists over time and spills across context. This question is key in light of research showing that pro-social actions are often followed by selfish actions, thus suggesting that some moral manipulations may backfire. Here we present a class of simple moral nudges that have a great positive impact on pro-sociality. In Studies 1-4 (total N = 1,400), we use economic games to demonstrate that asking subjects to self-report "what they think is the morally right thing to do" does not only increase pro-sociality in the choice immediately after, but also in subsequent choices, and even when the social context changes. In Study 5, we explore whether moral nudges promote charity donations to humanitarian organisations in a large (N = 1,800) crowdfunding campaign. We find that, in this context, moral nudges increase donations by about 44 percent