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- Razavi, H., et al.
(författare)
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Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study
- 2017
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Ingår i: Lancet Gastroenterology & Hepatology. - : Elsevier BV. - 2468-1253. ; 2:5, s. 325-336
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Tidskriftsartikel (refereegranskat)abstract
- Background Hepatitis C virus (HCV) is a leading cause of liver-related morbidity and mortality worldwide. In the European Union (EU), treatment and cure of HCV with direct-acting antiviral therapies began in 2014. WHO targets are to achieve a 65% reduction in liver-related deaths, a 90% reduction of new viral hepatitis infections, and 90% of patients with viral hepatitis infections being diagnosed by 2030. This study assessed the prevalence of HCV in the EU and the level of intervention required to achieve WHO targets for HCV elimination. Methods We populated country Markov models for the 28 EU countries through a literature search of PubMed and Embase between Jan 1, 2000, and March 31, 2016, and a Delphi process to gain expert consensus and validate inputs. We aggregated country models to create a regional EU model. We used the EU model to forecast HCV disease progression (considering the effect of immigration) and developed a strategy to acehive WHO targets. We used weighted average sustained viral response rates and fibrosis restrictions to model the effect of current therapeutic guidelines. We used the EU model to forecast HCV disease progression (considering the effect of immigration) under current screening and therapeutic guidelines. Additionally, we back-calculated the total number of patients needing to be screened and treated to achieve WHO targets. Findings We estimated the number of viraemic HCV infections in 2015 to be 3 238 000 (95% uncertainty interval [UI] 2 106 000-3 795 000) of a total population of 509 868 000 in the EU, equating to a prevalence of viraemic HCV of 0.64% (95% UI 0.41-0.74). We estimated that 1 180 000 (95% UI 1 003 000-1 357 000) people were diagnosed with viraemia (36.4%), 150 000 (12 000-180 000) were treated (4.6% of the total infected population or 12.7% of the diagnosed population), 133 000 (106 000-160 000) were cured (4.1%), and 57 900 (43 900-67 300) were newly infected (1.8%) in 2015. Additionally, 30 400 (26 600-42 500) HCV-positive immigrants entered the EU. To achieve WHO targets, unrestricted treatment needs to increase from 150 000 patients in 2015 to 187 000 patients in 2025 and diagnosis needs to increase from 88 800 new cases annually in 2015 to 180 000 in 2025. Interpretation Given its advanced health-care infrastructure, the EU is uniquely poised to eliminate HCV; however, expansion of screening programmes is essential to increase treatment to achieve the WHO targets. A united effort, grounded in sound epidemiological evidence, will also be necessary.
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- Kamekis, A., et al.
(författare)
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Patients intention to consume prescribed and non-prescribed medicines: A study based on the theory of planned behaviour in selected European countries
- 2018
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Ingår i: Journal of Clinical Pharmacy and Therapeutics. - : WILEY. - 0269-4727 .- 1365-2710. ; 43:1, s. 26-35
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Tidskriftsartikel (refereegranskat)abstract
- What is known and objectivePolypharmacy has a significant impact on patients health with overall expenditure on over-the-counter (OTC) medicines representing a substantial burden in terms of cost of treatment. The aim of this study, which was conducted within the framework of a European Project funded by the European Union under the Seventh Framework Programme and was entitled OTC-SOCIOMED, was to report on possible determinants of patient behaviour regarding the consumption of medicines, and particularly OTCs, in the context of primary care. MethodsA multicentre, cross-sectional study was designed and implemented in well-defined primary healthcare settings in Cyprus, the Czech Republic, France, Greece, Malta and Turkey. Patients completed a questionnaire constructed on the basis of the theory of planned behaviour (TPB), which was administered via face-to-face interviews. Results and discussionThe percentage of patients who had consumed prescribed medicines over a 6-month period was consistently high, ranging from 79% in the Czech Republic and 82% in Turkey to 97% in Malta and 100% in Cyprus. Reported non-prescribed medicine consumption ranged from 33% in Turkey to 92% in the Czech Republic and 97% in Cyprus. TPB behavioural antecedents explained 43% of the variability of patients intention to consume medicines in Malta and 24% in Greece, but only 3% in Turkey. Subjective norm was a significant predictor of the intention to consume medicines in all three countries (Greece, Malta and Turkey), whereas attitude towards consumption was a significant predictor of the expectation to consume medicines, if needed. What is new and conclusionThis study shows that parameters such as patients beliefs and influence from family and friends could be determining factors in explaining the high rates of medicine consumption. Factors that affect patients behavioural intention towards medicine consumption may assist in the formulation of evidence-based policy proposals and inform initiatives and interventions aimed at increasing the appropriate use of medicines.
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- Souliotis, G. A., et al.
(författare)
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Production of neutron-rich nuclides and radioactive beams by intermediate energy 238 U fission
- 1997
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Ingår i: Physical Review C. - 2469-9993 .- 2469-9985. ; 55:5, s. 2146-2149
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Tidskriftsartikel (refereegranskat)abstract
- The yields of neutron-rich fission fragments from the interaction of 20 MeV/nucleon 238U with 208Pb have been measured. The production mechanism of these fragments is consistent with sequential fission following a quasielastic or deep inelastic collision. Substantial yields of very n-rich fragments are observed. The importance of these data for generation of n-rich radioactive beams by fission of intermediate-energy projectiles is discussed.
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- Lionis, Christos, et al.
(författare)
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Integrated people-centred primary health care in Greece: unravelling Ariadnes thread
- 2019
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Ingår i: Primary Health Care Research and Development. - : CAMBRIDGE UNIV PRESS. - 1463-4236 .- 1477-1128. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- The 40th anniversary of the World Health Organization Alma-Ata Declaration in Astana offered the impetus to discuss the extent to which integrated primary health care (PHC) has been successfully implemented and its impact on research and practice. This paper focuses on the experiences from Greece in implementing primary health care reform and lessons learned from the conduct of evidence-based research. It critically examines what appears to be impeding the effective implementation of integrated PHC in a country affected by the financial and refugee crisis. The key challenges for establishing integrated people-centred primary care include availability of family physicians, information and communication technology, the prevention and management of chronic disease and migrant and refugees health. Policy recommendations are formulated to guide the primary health care reform in Greece, while attempting to inform efforts in other countries with similar conditions.
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- Zyromski, KE, et al.
(författare)
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Fusion enhancement in the S-32,S-38+Ta-181 reaction
- 2001
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Ingår i: PHYSICAL REVIEW C. - : AMERICAN PHYSICAL SOC. - 0556-2813. ; 6302:2
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Tidskriftsartikel (refereegranskat)abstract
- We measured the capture-fission excitation functions for the S-32+Ta-181 reaction and the S-38+Ta-181 reaction. (The radioactive S-38 beam was produced by projectile fragmentation.) In the S-32-induced reaction, an incomplete fusion component was observed
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