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

Abyss Aerosols

Bubble bursting on water surfaces is believed to be a main mechanism to produce submicron drops, including sea spray aerosols, which play a critical role in forming cloud and transferring various biological and chemical substances from water to the air. Over the past century, drops production mechanisms from bubble bursting have been extensively studied. They usually involve the centrifugal fragmentation of liquid ligaments from the bubble cap during film rupture, the flapping of the cap film, and the disintegration of Worthington jets after cavity collapse. Here, we show that a dominant fraction of previously identified as 'bubble bursting' submicron drops are in fact generated via a new mechanism underwater, inside the bubbles themselves before they have reached the surface. These drops are then carried within the rising bubbles towards the water surface and are released in air at bubble bursting. Evidence suggests that these drops originate from the flapping instability of the film squeezed between underwater colliding bubbles. This finding fundamentally reshapes our understanding of sea spray aerosol production and establishes a new role for underwater bubble collisions regarding the nature of transfers through water-air interfaces.Comment: 50 pages, 4 figures, and 10 extended data figure

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

HIV and incarceration: prisons and detention

The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release

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

Bernard Berenson et les historiens d'art français des années 1920-1940

Joceline Rotily, Bernard Berenson et les historiens d'art français des années 1920-1940, p. 961-989. Il faut insister sur la renommée des études de Bernard Berenson -historien d'art américain - dans la France des années 1920-1940. Si Berenson fut apprécié en France plus qu'ailleurs, c'est parce qu'il répondait aux aspirations intellectuelles d'alors. Il aborda l'histoire de l'art comme une science expérimentale, et appela l'attention de l'historien d'art sur les valeurs artistiques et non socio-historiques de l'œuvre d'art. Ses relations avec Gillet - avec qui il partage le goût de la culture médiévale, un catholicisme fervent et le même désintérêt pour l'art moderne, ont abouti à la traduction française de Peintres italiens de la Renaissance. Son élève spirituel, Jean Alazard, traduisit quelques-uns de ses livres. Emile Mâle, à qui il écrit devoir beaucoup, soutint son étude du Specu- (v. au verso) lum humanae salvationis. Henri Focillon, formaliste comme lui, disait découvrit chez Berenson «l'esprit de l'humanité». C'est la notion d'humanisme qui les unit. Plus tard, on relèvera les préjugés esthétiques de Berenson, figure légendaire.Rotily Jocelyne. Bernard Berenson et les historiens d'art français des années 1920-1940. In: Mélanges de l'Ecole française de Rome. Moyen-Age, Temps modernes, tome 97, n°2. 1985. pp. 961-989