Logement et déterminants du bien-être objectif des ménages locataires de Bamako

This research is part of work on the link between housing and objective well-being, combining the characteristics of the utilitarian approach with those of the capabilist approach while highlighting the spatial dimension. It proposes to develop and test a method which makes it possible 1) to identify the potentially constitutive elements of objective well-being in housing and 2) to determine, based on the declared preferences of households, the most suitable housing or the less pleasant for them. Empirical analyzes have revealed to us that the type and size of the household as well as the area of ​​residence appear to be the primary constituent elements of household well-being in housing and that it is in certain peri-urban municipalities in urban centers that their well-being -being in housing would be the highest and at the lowest cost. Thus, the rent paid for accommodation varies depending on the size of the accommodation which also depends on the size of the household and its place of residence. The high cost of rent is a handicap to the objective well-being of the household because it is a burden on its income. However, when the household is well housed, it is spared from several respiratory, skin and infectious diseases. This can allow the household to save on its income in order to ensure the education and good health of its family, the basis of the well-being and development of a nation. Any government policy in the search for development must ensure the well-being of the population and therefore of households. Indeed, the consumption of housing by the household is a key factor in achieving its objective well-being.   Keywords: housing, determinants, objective well-being, tenant households, Bamako Classification JEL: I31 J12 Paper type: Empirical ResearchCette recherche s’inscrit dans les travaux sur le lien entre le logement et le bien-être objectif, alliant les caractéristiques de l’approche utilitariste à celles de l’approche capabiliste tout en mettant à l’honneur la dimension spatiale. Il se propose d’élaborer et de tester une méthode qui permet 1) d’identifier les éléments potentiellement constitutifs du bien-être objectif dans un logement et 2) de déterminer à partir des préférences déclarées des ménages, les logements les plus amènes ou les moins amènes pour eux. Les analyses empiriques nous ont révélé que le type et la taille du ménage ainsi que le milieu de résidence apparaissent comme les premiers éléments constitutifs du bien-être en logement des ménages et que c’est dans certaines communes périurbaines des pôles urbains, que leur bien-être en logement serait le plus élevé et à moindre coût. Ainsi, le loyer payé pour un logement varie en fonction de la taille du logement qui dépend également de la taille du ménage et de son lieu de résidence. Le coût élevé du loyer est un handicape au bien-être objectif du ménage, car c’est un poids sur son revenu. Cependant, lorsque le ménage est bien logé, il est épargné de plusieurs maladies respiratoires, cutanées et infectieuses. Ceci peut permettre au ménage de faire des économies sur son revenu afin d’assurer l’éducation et la bonne santé de sa famille, socle du bien-être et du développement d’une nation. Toute politique gouvernementale, dans la recherche du développement, doivent assurer le bien-être de la population, donc des ménages. En effet, la consommation de logement par le ménage est un facteur clé d’atteinte de son bien-être objectif.     Mots clés : logement, déterminants, bien-être objectif, ménages locataires, Bamako JEL Classification : I31 J12 Type du papier : Recherche empiriqu

A sustainable visual representation of available histopathological digital knowledge for breast cancer grading

Background Recently, anatomic pathology (AP) has seen the introduction of several tools such as slide scanners and virtual slide technologies, creating the conditions for broader adoption of computer aided diagnosis based on whole slide images (WSI). This change brings up a number of new scientific challenges such as the sustainable management of the explicit and unambiguous semantics associated to the diagnostic interpretation of AP images by both humans (pathologists) and computers (image analysis algorithms) . In order to reduce inter-observer variability between AP reports of malignant tumors, the College of American Pathologists edited more than 60 organ-specific Cancer Checklists and associated Protocols (CAP-CC&P). Each checklist includes a set of AP observations that are expected to be reported by pathologists in organ-specific AP cancer reports. Our objective was to i) identify the available histopathological formalized knowledge from NCBO Bioportal and UMLS metathesaurus in the scope of the CAP CC&P for breast cancer grading and ii) to build a sustainable visual representation of this knowledge using UMLS semantic types. Methods Our methodology was applied on the two breast cancer CAP-CC&Ps dedicated to invasive carcinoma (IC) and ductal carcinoma in situ (DCIS). We focused on a subset of quantifiable AP observations of the CAP-CCs - i.e. observable entities that could be computed by image analysis tools and on the corresponding notes in the protocols that unambiguously describe how pathologists should derive a high-level observation (e.g. Nottingham score) from low-level morphological characteristics observed in images (e.g. mitotic count or glandular/tubular differentiation).The notes were annotated manually by two AP experts (gold standard) and automatically by NCBO Annotator using the 508 ontologies available on the NCBO platform. A sub-set of reference ontologies was selected based on their capacities to automatically identify concepts in the notes and compared to the subset of ontologies selected based on their capacity to identify the concepts identified by experts (gold standard). Once automatically extracted from the notes, the concepts belonging to different ontologies, were integrated into a unique graph and organized according to UMLS semantic types. Results The most relevant biomedical ontologies to be used for the annotation of the notes describing quantifiable observable entities of breast cancer CAP-CC&Ps are SNOMED-CT, LOINC, NCIT, NCI CaDSR Value Sets and PathLex. A visual representation integrating 25 concepts from the 5 different ontologies organized according to 11 UMLS semantic types was built to support AP experts for building a formal representation of the low-level quantifiable entities automatically extracted from the CAP-CC&Ps notes. Conclusion The proposed approach and tools, based on the CAP-CC&Ps, aim at supporting AP experts in building a standard-based representation of low-level morphological abnormalities observed in cancer that can be quantified using image analysis tools. This effort is complementary to the Integrating the Healthcare Enterprise (IHE) initiative building a standard-based representation of high-level AP observations required in cancer AP reports. Additional efforts are needed to achieve a workable standard-based formal representation of histopathological knowledge integrating both observable entities reported by humans (pathologists) and quantifiable entities automatically computed by machines. Providing such unique formal representation paves the way for more efficient use of computer aided diagnosis in AP as well as for the development of new biomarkers based on automatic analysis of whole slide images (WSI)

User-centered design of the C3-cloud platform for elderly with multiple diseases - functional requirements and application testing

The number of patients with multimorbidity has been steadily increasing in the modern aging societies. The European C3-Cloud project provides a multidisciplinary and patient-centered “Collaborative Care and Cure-system” for the management of elderly with multimorbidity, enabling continuous coordination of care activities between multidisciplinary care teams (MDTs), patients and informal caregivers (ICG). In this study various components of the infrastructure were tested to fulfill the functional requirements and the entire system was subjected to an early application testing involving different groups of end-users. MDTs from participating European regions were involved in requirement elicitation and test formulation, resulting in 57 questions, distributed via an internet platform to 48 test participants (22 MDTs, 26 patients) from three pilot sites. The results indicate a high level of satisfaction with all components. Early testing also provided feedback for technical improvement of the entire system, and the paper points out useful evaluation methods

Modelling the elimination of river blindness using long-term epidemiological and programmatic data from Mali and Senegal

The onchocerciasis transmission models EPIONCHO and ONCHOSIM have been independently developed and used to explore the feasibility of eliminating onchocerciasis from Africa with mass (annual or biannual) distribution of ivermectin within the timeframes proposed by the World Health Organization (WHO) and endorsed by the 2012 London Declaration on Neglected Tropical Diseases (i.e. by 2020/2025). Based on the findings of our previous model comparison, we implemented technical refinements and tested the projections of EPIONCHO and ONCHOSIM against long-term epidemiological data from two West African transmission foci in Mali and Senegal where the observed prevalence of infection was brought to zero circa 2007–2009 after 15–17 years of mass ivermectin treatment. We simulated these interventions using programmatic information on the frequency and coverage of mass treatments and trained the model projections using longitudinal parasitological data from 27 communities, evaluating the projected outcome of elimination (local parasite extinction) or resurgence. We found that EPIONCHO and ONCHOSIM captured adequately the epidemiological trends during mass treatment but that resurgence, while never predicted by ONCHOSIM, was predicted by EPIONCHO in some communities with the highest (inferred) vector biting rates and associated pre-intervention endemicities. Resurgence can be extremely protracted such that low (microfilarial) prevalence between 1% and 5% can be maintained for 3–5 years before manifesting more prominently. We highlight that post-treatment and post-elimination surveillance protocols must be implemented for long enough and with high enough sensitivity to detect possible residual latent infections potentially indicative of resurgence. We also discuss uncertainty and differences between EPIONCHO and ONCHOSIM projections, the potential importance of vector control in high-transmission settings as a complementary intervention strategy, and the short remaining timeline for African countries to be ready to stop treatment safely and begin surveillance in order to meet the impending 2020/2025 elimination targets

Dynamics of antigenemia and transmission intensity of Wuchereria bancrofti following cessation of mass drug administration in a formerly highly endemic region of Mali

Background After seven annual rounds of mass drug administration (MDA) in six Malian villages highly endemic for Wuchereria bancrofti (overall prevalence rate of 42.7%), treatment was discontinued in 2008. Surveillance was performed over the ensuing 5 years to detect recrudescence. Methods Circulating filarial antigen (CFA) was measured using immunochromatographic card tests (ICT) and Og4C3 ELISA in 6–7 year-olds. Antibody to the W. bancrofti infective larval stage (L3) antigen, Wb123, was tested in the same population in 2012. Microfilaraemia was assessed in ICT-positive subjects. Anopheles gambiae complex specimens were collected monthly using human landing catch (HLC) and pyrethrum spray catch (PSC). Anopheles gambiae complex infection with W. bancrofti was determined by dissection and reverse transcriptase polymerase chain reaction (RT-PCR) of mosquito pools. Results Annual CFA prevalence rates using ICT in children increased over time from 0% (0/289) in 2009 to 2.7% (8/301) in 2011, 3.9% (11/285) in 2012 and 4.5% (14/309) in 2013 (trend χ 2  = 11.85, df =3, P = 0.0006). Wb123 antibody positivity rates in 2013 were similar to the CFA prevalence by ELISA (5/285). Although two W. bancrofti-infected Anopheles were observed by dissection among 12,951 mosquitoes collected by HLC, none had L3 larvae when tested by L3-specific RT-PCR. No positive pools were detected among the mosquitoes collected by pyrethrum spray catch. Whereas ICT in 6–7 year-olds was the major surveillance tool, ICT positivity was also assessed in older children and adults (8–65 years old). CFA prevalence decreased in this group from 4.9% (39/800) to 3.5% (28/795) and 2.8% (50/1,812) in 2009, 2011 and 2012, respectively (trend χ 2  = 7.361, df =2, P = 0.0067). Some ICT-positive individuals were microfilaraemic in 2009 [2.6% (1/39)] and 2011 [8.3% (3/36)], but none were positive in 2012 or 2013. Conclusion Although ICT rates in children increased over the 5-year surveillance period, the decrease in ICT prevalence in the older group suggests a reduction in transmission intensity. This was consistent with the failure to detect infective mosquitoes or microfilaraemia. The threshold of ICT positivity in children may need to be re-assessed and other adjunct surveillance tools considered

A collaborative platform for management of chronic diseases via guideline-driven individualized care plans

Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans. We also report the results of usability studies carried out in four pilot sites by patients and clinicians

Localisation, personalisation and delivery of best practice guidelines on an integrated care and cure cloud architecture : the C3-cloud approach to managing multimorbidity

Background: C3-Cloud is an integrated care ICT infrastructure offering seamless patient-centered approach to managing multimorbidity, deployed in three European pilot sites. Challenge: The digital delivery of best practice guidelines unified for multimorbidity, customized to local practice, offering the capability to improve patient personalization and benefit. Method: C3-Cloud has adopted a co-production approach to developing unified multimorbidity guidelines, by collating and reconciling best practice guidelines for each condition. Clinical and technical teams at pilot sites and the C3-Cloud consortium worked in tandem to create the specification and technical implementation. Results: C3-Cloud offers CDSS for diabetes, renal failure, depression and congenital heart failure, with over 300 rules and checks that deliver four best practice guidelines in parallel, customized for each pilot site. Conclusions: The process provided a traceable, maintainable and audited digitally delivered collated and reconciled guidelines

Comparison of Different Sampling Methods to Catch Lymphatic Filariasis Vectors in a Sudan Savannah Area of Mali

There is a need for better tools to monitor the transmission of lymphatic filariasis and malaria in areas undergoing interventions to interrupt transmission. Therefore, mosquito collection methods other than human landing catch (HLC) are needed. This study aimed to compare the Ifakara tent trap type C (ITTC) and the Biogents sentinel trap (BGST) to the HLC in areas with different vector densities. Mosquitoes were collected in two villages in Mali from July to December in 2011 and 2012. The three methods were implemented at each site with one ITTC, one BGST, and one HLC unit that consisted of one room with two collectors—one indoor and the other outdoor. The Anopheles collected in 2011 were individually dissected, whereas those from 2012 were screened in pools using reverse transcription-polymerase chain reaction (RT-PCR) to determine the maximum infection prevalence likelihood (MIPL) for Wuchereria bancrofti and Plasmodium falciparum. The dissection of the females also allowed to assess the parity rates, as well its results. Over the 2 years, the HLC method collected 1,019 Anopheles, yields that were 34- and 1.5-fold higher than those with the BGST and ITTC, respectively. None of the dissected Anopheles were infected. The RT-PCR results showed comparable MIPL between HLC and ITTC for W. bancrofti with one infected pool from each trap’s yield (respectively 0.03% [0.0009–0.2%] and 0.04% [0.001–0.2%]). For P. falciparum, no infected pool was recovered from BGST. The ITTC is a good alternative to HLC for xenomonitoring of program activities

Temporal and spatial analysis of the 2014-2015 Ebola virus outbreak in West Africa

West Africa is currently witnessing the most extensive Ebola virus (EBOV) outbreak so far recorded. Until now, there have been 27,013 reported cases and 11,134 deaths. The origin of the virus is thought to have been a zoonotic transmission from a bat to a two-year-old boy in December 2013 (ref. 2). From this index case the virus was spread by human-to-human contact throughout Guinea, Sierra Leone and Liberia. However, the origin of the particular virus in each country and time of transmission is not known and currently relies on epidemiological analysis, which may be unreliable owing to the difficulties of obtaining patient information. Here we trace the genetic evolution of EBOV in the current outbreak that has resulted in multiple lineages. Deep sequencing of 179 patient samples processed by the European Mobile Laboratory, the first diagnostics unit to be deployed to the epicentre of the outbreak in Guinea, reveals an epidemiological and evolutionary history of the epidemic from March 2014 to January 2015. Analysis of EBOV genome evolution has also benefited from a similar sequencing effort of patient samples from Sierra Leone. Our results confirm that the EBOV from Guinea moved into Sierra Leone, most likely in April or early May. The viruses of the Guinea/Sierra Leone lineage mixed around June/July 2014. Viral sequences covering August, September and October 2014 indicate that this lineage evolved independently within Guinea. These data can be used in conjunction with epidemiological information to test retrospectively the effectiveness of control measures, and provides an unprecedented window into the evolution of an ongoing viral haemorrhagic fever outbreak.status: publishe