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  • 1
    Electronic Resource
    Electronic Resource
    Risk Perception and Social Acceptability of Technologies: The French Case (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Risk analysis 9 (1989), S. 0 
    Details
    ISSN: 1539-6924
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: The authors present results of a February 1987 survey on judged frequency of mortality causes and risk perception of technologies in a representative sample of the French population. Although the French context is very different, and the impact of public controversies have been very limited on technological choices such as the nuclear energy program, strong similarities in risk perception of technologies are observed with results from U.S. surveys. Results, which could be worthwhile for other countries, suggest that risk perception is influenced by two different types of components. The first influence is the global feeling of “security” that society procures to its members. Such feeling depends on the individual's socioeconomic status, subjective state of health, and personal discomfort in daily life, and explains individual aversion to risk independently of the mortality causes or technologies involved. The second influence is the degree of perceived social legitimization of the activities involving risks. Risks of medical and transportation activities are strongly opposed to illegitimate risky behaviors (smoking, drugs, alcohol); technologies which have been an object of public debate (nuclear plants, the chemical industry, lead in gasoline) have an intermediate position reflecting the remaining uncertainties of public opinion about their risk–benefit balancing. Tentative conclusions for risk communication are proposed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1539-6924.1989.tb01242.x
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  • 2
    Electronic Resource
    Electronic Resource
    Mandatory prenatal screening for the human immunodeficiency virus: the experience in south-eastern France of a national policy, 1992–1994 (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the impact of the 1993 French National Policy which made it mandatory to offer screening for the presence of human immunodeficiency virus (HIV) to all pregnant women who planned to give birth, although women remained free to refuse the test.Design Successive surveys in April 1992 and May 1994 in south-eastern France. Logistic regressions were performed to identify factors which affected access to HIV testing for women who gave birth and those who terminated their pregnancy, and for each year of study.Main outcome measures Attitudes and access to HIV testing among pregnant women, irrespective of pregnancy outcome.Setting All obstetrics and gynaecology departments and abortion clinics in the region.Population 3497 women in 1992 (2775 who were delivered and 722 who chose termination) and 3407 in 1994 (2701 who were delivered and 766 who chose termination). The response rates were 82% and 88%, respectively.Results In 1994 of women who were delivered, 73% had an HIV test, compared with 63% in 1992 (P 〈 0.001); however of women who terminated their pregnancy, only 28% had an HIV test, compared with 245% in 1992 (P not significant), although they were more at risk for HIV infection. Socioeconomic differences affecting access to testing were reduced between 1992 and 1994, but only among women who gave birth.Conclusion Introduction of a policy which makes it mandatory to offer HIV screening to all women who intended to have their baby improved access to screening but did not improve the rate of preventative counselling. A mandatory requirement to offer HIV screening should be extended to women who request termination of pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb10085.x
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  • 3
    Electronic Resource
    Electronic Resource
    Relationship between HIV-1 viral load and continued drug use in untreated infected injection drug users (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Addiction biology 4 (1999), S. 0 
    Details
    ISSN: 1369-1600
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The role of continued drug use in development of AIDS has been investigated, using mainly CD4+ cells as outcome variable. The objective of this study was to verify whether continued drug use can influence HIV-1 plasma viral load.We used cross-sectional enrolment data of the HIV-infected IDUs cohort study Manif 2000 (October 1995-October 1996), recruiting patients in hospital departments of Marseilles, Nice and Paris suburbs. To minimize biases due to differential access to health care, only patients receiving outpatient care for at least 2 years but with no antiretroviral treatment were selected for analysis (n = 108). Available information regarding clinical and laboratory information from medical records and clinical examination as well as drug use and HIV-related risk practices were obtained by a face-to-face and a self-administered questionnaire. Patients denying recent heroin injection were cross-validated by a serological assay to detect morphine. Forty-two patients (39%) reported recent heroin injection; among those denying recent use (n=66), eight (positive for serum morphine assay) were re-classified as IDUs. A difference of 0.35 log in viral load was observed between active and ex-IDUs which increases (0.6 log, p=0.03) in those who have been using drugs for 10 years or more.This result persisted when adjusted for CD4+ counts, clinical stage or years since diagnosis. Continued drug use may have a significant but limited impact on HIV viral load only in patients with a longer history of drug use. Consequences of persisting drug use on long-term progression to AIDS has to be investigated further.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1080/13556219971704
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  • 4
    Electronic Resource
    Electronic Resource
    Injecting misuse of buprenorphine among French drug users (2001)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. To evaluate the extent to which the introduction (February 1996) of ambulatory prescriptions of buprenorphine for drug maintenance treatment (DMT) has been associated with its intravenous illicit use by French injecting drug users (IDUs). Design. Cross-sectional survey (September 1997), using self-administered questionnaires, in a sample of IDUs recruited at 32 pharmacies, four needle exchange programmes and three syringe vending machines. Setting. Thirty-nine sites where IDUs have access to sterile syringes in the city of Marseille (South-Eastern France). Participants. Sample of IDUs attending community pharmacies, vending machines and needle exchange programs to obtain equipment. Measurement. To compare characteristics of IDUs who declared that they only injected buprenorphine in the prior 6 months versus the rest of the sample. Findings. Among the 343 respondents (response rate = 70.7%), 33.8% were polydrug users who occasionally injected buprenorphine in parallel to heroin and/or cocaine, while 23.9% only injected buprenorphine in the previous 6 months. IDUs in this latter group were younger, injected more frequently, and were more frequently on buprenorphine DMT, but they were less likely to be HIV-infected and to declare HIV-related injecting risky behaviours. Conclusions. Substantial risk of injecting misuse is associated with large-scale diffusion of buprenorphine DMT. A more stringent regulation for medical dispensation of buprenorphine than the current French general freedom of prescription for all physicians, including general practicioners in ambulatory care, may be necessary in other countries which are considering the diffusion of buprenorphine DMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.96226710.x
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  • 5
    Electronic Resource
    Electronic Resource
    Ethical Issues in the Economic Assessment of Health Care Technologies (1999)
    Springer
    Health care analysis 7 (1999), S. 153-165 
    Details
    ISSN: 1573-3394
    Keywords: ethics ; welfare economics ; cost-benefit analysis ; health care technologies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper challenges traditional views which oppose health economics and medical ethics by arguing that economic assessment is a necessary complement to medical ethics and can help to improve public participation and democratic processes in choices about resource allocation for health care technologies. In support of this argument, four points are emphasized: (1) Most current biomedical ethical debates implicitly deal with economic issues of resource allocation. (2) Clinical decisions, which usually respect the Hippocratic code of ethics, are nevertheless influenced by economic incentives and constraints. (3) Economic assessment is concerned with both efficiency and equity and potential trade-offs between the two, which means that ethical judgements are always embedded in welfare economics. (4) The real debate is not between economics on the one side and medical ethics on the other. Rather it is between different ethical conceptions of social justice and the contrasting approaches they entail to reconciling individual interests and preferences with collective goods and welfare.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009437104347
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