Regulatory withdrawal of medicines marketed with uncertain benefits : the bevacizumab case study

Acknowledgements Professor Elizabeth Roughead is funded by a Future Fellowship from the Australian Research Council. The views expressed are those of the authors, the sponsor had no role in the preparation of the manuscript.Peer reviewedPublisher PD

Otros datos y comentarios sobre el sitio de donde se extrajo la Momia de los Quilmes

Fil: Vitry, Christian. Centro para la Conservación de Patrimonio de Alta Montaña (Salta, Argentina

Datos sobre el descubrimiento de la Momia del Cajón

Fil: Vitry, Roberto. Club Amigos de la Montaña (Salta, Argentina

Analisis Customer Experience Dan Lifestyle Model Terhdap Keputusan Menonton Film (Survei Terhadap Member Bioskop Blitzmegaplex Paris Van Java Bandung)

Penonton adalah pelaku utama pembuat keputusan untuk menonton di bioskop dalam industri hiburan. Namun beberapa tahun terakhir terjadi penurunan pertumbuhan jumlah penonton bioskop BlitzMegaplex Paris Van Java Bandung. Hal ini terjadi karena lambatnya laju pertumbuhan jumlah penonton setiap bulannya dan sebagai bioskop yang memiliki konsep beyonds experience, dimensi customer experience BlitzMegaplex Paris Van Java Bandung kurang baik. Melalui upaya penilaian customer experience diharapkan BlitzMegaplex dapat mengevaluasi dimensi customer experience dan memahami lifestyle model penonton pada saat ini. Adapun tujuan dari penelitian ini adalah untuk mengetahui: (1) gambaran customer experience BlitzMegaplex Paris Van Java Bandung (2) gambaran lifestyle model penonton bioskop BlitzMegaplex Paris Van Java Bandung (3) gambaran keputusan menonton bioskop BlitzMegaplex Paris Van Java Bandung(4) besarnya pengaruh customer experience dan lifestyle model terhadap keputusan menonton di Bioskop BlitzMegaplex Paris Van Java Bandung.Metode penelitiannya menggunakan deskriptif dan verifikatif. Sumber data yang dipergunakan adalah primer dan sekunder. Populasi dari penelitian ini adalah member bioskop BlitzMegaplex Paris Van Java Bandung sebanyak 943.164 orang dan diambil sampel penelitian sejumlah 165 orang menggunakan Simple Random Sampling dan Probability Sampling merupakan teknik pengambilan sampel yang penulis pilih. Teknik pengumpulan data dilakukan melalui wawancara, observasi, kuesioner. Untuk mengukur besarnya pengaruh customer experience dan lifestyle model digunakan teknik analisis Regresi Linear Berganda.Hasil penelitian mengungkapkan bahwa analisis customer experience cukup tinggi. Lifestyle model cukup tinggi, dan keputusan menonton cukup tinggi. Customer experience memiliki pengaruh positif terhadap keputusan menonton di bioskop BlitzMegaplex Paris Van Java Bandung. Lifestyle model memiliki pengaruh positif terhadap keputusan menonton di bioskop BlitzMegaplex Paris Van Java Bandun

Vers des solutions nomades au service des exploitants : les services informatiques embarqués. Application à la canne à sucre

Pour répondre à la demande des agriculteurs, plusieurs fournisseurs d'information proposent des services " sur mesure " adaptés aux agricultures des pays tempérés. Pour tenter de combler le fossé en informations agricoles des pays du Sud et répondre à la demande des agriculteurs, le CIRAD a développé un système d'information utilisable par Smartphones et tablettes tactiles: le système Margouill@-mobile. Respectant les standards internationaux, ce système repose sur une architecture orientée objet utilisant un service web original développé par l'équipe Artists du Cirad-Réunion et s'appuyant sur une base de donnée géographique. Grâce à l'utilisation croissante de l'Internet et de la téléphonie mobile par les agriculteurs, la cartographie offrira dans l'avenir de multiples et nouvelles opportunités aux communautés rurales, telles que le système margouill@-mobile et s'appuyant sur des informations issues de capteurs pouvant être fixes, agiles ou mobiles. (Résumé d'auteur

Cost driver analysis of statin expenditure on Australia’s pharmaceutical benefits scheme

The Australian Pharmaceutical Benefits Scheme (PBS) provides universal access to subsidised medicines. In 2013, statins as a class had the highest expenditure on the PBS. To assess the influence of policies and drivers affecting PBS statin utilisation and expenditure between 1992 and 2013. Analyses conducted from 1992 to 2013 and over three distinct time periods, including monthly expenditure/prescription, annual utilisation (calculated as Defined Daily Doses/1000 inhabitants/day) and statin strengths dispensed. The major driver of increased PBS expenditure for statins was increased volumes. After adjusting for inflation, the average PBS expenditure on statin prescriptions was the major negative driver. Other influential drivers included the increased use of newer statins and increased strength of statins dispensed. Whilst the inflation-adjusted reimbursed price of statins decreased, increased utilisation, including increased use of patented statins, increased total statin expenditure. Successful measures adopted by other countries could be applied to Australia to decrease total medicines expenditure

Influence of medication risks and benefits on treatment preferences in older patients with multimorbidity

Multimorbidity is associated with use of multiple medicines, increased risk of adverse events and treatment conflicts. This study aimed to examine how older patients with multimorbidity and clinicians balance the benefits and harms associated with a medication and in the presence of competing health outcomes. Interviews were conducted with 15 participants aged ≥65 years with 2 or more chronic conditions. Three clinical scenarios were presented to understand patient preference to take a medicine according to i) degree of benefit, ii) type of adverse event and impact on daily living and iii) influence of comorbid conditions as competing health outcomes. Semi-structured interviews were also conducted with participants (n=15) and clinicians (n=5) to understand patient preferences and treatment decisions, in the setting of multimorbidity. The median age of participants was 79 years, 55% had 5 or more conditions and 47% took 8 or more medicines daily. When the level of benefit of the medicine ranged from 14% to 70%, 80% of participants chose to take the medicine, but when adverse effects were present, this was reduced to 0-33% depending upon impact on daily activities. In the presence of competing health outcomes, 13%-26% of patients chose to take the medicine. Two-thirds of patients reported that their doctor respects and considers their preferences and discussed medication benefits and harms. Interviews with clinicians showed that their overall approach to treatment decision-making for older individuals with multimorbidity was based upon 2 main factors, the patients' prognosis and their preferences. The degree of benefit gained was not the driver of patients' preference to take a medicine; rather, this decision was influenced by type and severity of adverse effects. Inclusion of patient preferences in the setting of risks and benefits of medicines with consideration and prioritization of competing health outcomes may result in improved health outcomes for people with multimorbidity.Gillian E Caughey, Kirsty Tait, Agnes I Vitry, Sepehr Shaki

Le concept de système agri-urbain confronté aux réalités des villes du sud de la Méditerranée : le cas de Meknès (Maroc)

L'objectif de cette communication est de considérer l'agriculture urbaine et périurbaine comme l'un des éléments significatifs et originaux de la conception d'une ville durable et de mettre à l'épreuve le concept de système agri - urbain. Dans cette perspective nous nous appuyons sur des travaux menés à Meknès, ville marocaine de 650 000 habitants environ. Nous avons réalisé une analyse diachronique de l'évolution de l'occupation des sols puis une série d'enquêtes et d'entretiens avec les acteurs de l'urbain et de l'agriculture dans une diversité de situations dans la ville et à sa périphérie. Ce travail a été complété par une analyse historique des politiques publiques et par un atelier participatif " prospective territoriale 2040 " mobilisant une trentaine de personnes des secteurs public et associatif afin de confronter nos perceptions des évolutions du territoire. Une synthèse de ces travaux est présentée dans une première partie, ensuite nous abordons les intérêts du concept de système agri - urbain durable en particulier le fait de nous obliger à identifier les acteurs, leurs relations, leurs capacités de coordination et d'apprentissage dans le temps et dans l'espace. Ces connaissances sont utiles aux décideurs, techniciens et aux citoyens pour faire émerger des systèmes de gouvernance territoriale fonctionnels et ancrés localement et qui ne relèvent pas seulement du transfert de modèles de développement élaborés dans d'autres pays et continents. (Résumé d'auteur

High-resolution characterization of the diffusion of light chemical elements in metallic components by scanning microwave microscopy

International audienceAn original sub-surface, high spatial resolution tomographic technique based on scanning microwave microscopy (SMM) is used to visualize in-depth materials with different chemical compositions. A significant phase difference in SMM between aluminum and chromium buried patterns has been observed. Moreover this technique was used to characterize a solid solution of a light chemical element (oxygen) in a metal lattice (zirconium). The large solubility of the oxygen in zirconium leads to modifications of the properties of the solid solution that can be measured by the phase shift signal in the SMM technique. The signal obtained in cross-section of an oxidized Zr sample shows the excellent agreement between phase shift profiles measured at different depths. Such a profile can reveal the length of diffusion of the oxygen in zirconium under the surface. The comparison with the oxygen concentration measured by nuclear reaction analysis shows excellent agreement in terms of length of diffusion and spatial distribution of the oxygen. A rapid calibration shows a linear dependence between the phase shift and the oxygen concentration. The SMM method opens up new possibilities for indirect measurements of the oxygen concentration dissolved in the metal lattic