Suchergebnisse

Créé par l'ordonnance du 3 décembre 1992, le Port de Bruxelles fonctionne depuis le 1er juin 1993. Avec la STIB, il est l'un des premiers organismes para-régionaux à avoir conclu un contrat de gestion avec la Région. Aujourd'hui, il gère le second port intérieur belge. À l'occasion des vingt ans du Port de Bruxelles, le Courrier hebdomadaire étudie les contrats de gestion successifs auxquels a été soumise la société régionale. L'objectif est d'éclairer les décisions politiques qui ont présidé à l'évolution des installations, du foncier et du fonctionnement du Port, en examinant les positions des différents acteurs régionaux et les arbitrages rendus. Il s'agit également d'analyser la manière dont les contrats de gestion ont été mis en œuvre en fonction des enjeux régionaux, et la mesure dans laquelle ils ont porté le rôle du Port dans l'économie, l'emploi et la mobilité. Cette étude est réalisée par Geneviève Origer, ancienne directrice en charge du développement du Port. La première partie présente la place portuaire bruxelloise dans son environnement urbain et européen, dans ses spécificités (atouts, potentiels et contraintes) et dans ses aspects institutionnels (statuts, organes, financement et obligations). Elle retrace la régionalisation de l'ancienne Société du canal, la mise en place des nouvelles instances et la préparation du premier contrat de gestion du Port de Bruxelles.

<b><i>Background:</i></b> To estimate the prevalence of problem drug use (PDU) and injecting drug use (IDU) in Luxembourg and analyze trends between 1997 and 2009. To assess the feasibility of prevalence estimations based on drug use surveillance systems. <b><i>Methods:</i></b> Serial multi-method PDU/IDU prevalence estimations based upon capture-recapture, Poisson regression, multiplier and back-calculation methods. Comparative analysis of methods and assessment of their robustness to variations of external factors. <b><i>Results:</i></b> National PDU and IDU prevalence rates were estimated at 6.16/1,000 (95% CI 4.62/1,000 to 7.81/1,000) and 5.68/1,000 (95% CI 4.53/1,000 to 6.85/1,000) inhabitants aged 15–64 years, respectively. Absolute prevalence and prevalence rates of PDU increased between 1997 and 2000 and declined from 2003 onwards, whereas IDU absolute prevalence and prevalence rates witnessed an increasing trend between 1997 and 2007. <b><i>Conclusions:</i></b> Drug use surveillance systems can be valuable instruments for the estimation and trend analysis of drug misuse prevalence given multiple methods are applied that rely on serial and representative data from different sources and different settings, control multiple counts and build upon standardized and sustained data collection routines. The described institutional contact indicator revealed to be a useful tool in the context of PDU/IDU prevalence estimations and thus contributes to enhancing evidence-based drug policy planning.

Les abus de drogues posent d'importants défis en termes sociaux, économiques, de sécurité et de santé publique. Quel est le profil socio-économique des consommateurs ? Quelles sont les différentes trajectoires familiales, professionnelles et sociales d'usagers de drogues victimes de surdose fatale ? Quel est l'impact des inégalités sociales dans la survenue de surdoses impliquant des drogues illicites? Quel rôle pourrait avoir la réduction des inégalités sociales ? Quel enjeu pour les stratégies de prévention et de réduction des risques ? Un ensemble de recherches originales menées au Luxembourg, s'appuyant sur des méthodologies innovantes et une revue de littérature scientifique abondante, ont analysé les liens qui existent entre mortalités par surdose de drogues illicites et inégalités socio-économiques d'usagers suivis durant dix-huit ans. Les pistes de réflexion mises en avant dans cet ouvrage permettent de mieux saisir comment les conséquences néfastes pour l'individu, sa famille et la collectivité peuvent être en partie évitées ou réduites grâce à la mise en place de stratégies adaptées de prévention, de programmes de promotion de la santé et d'interventions psycho-socioéducatives. Cet ouvrage fournit des éléments de réflexion aux décideurs politiques, aux intervenants spécialisés en toxicomanie, aux professionnels de santé et du social pour pouvoir mieux décider et agir. ; Académia

<b><i>Background/Aim:</i></b> We analysed gender differences in national fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011 (n = 340). <b><i>Methods:</i></b> Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence. Bivariate and logistic regression analysis of male/female differences according to sociodemographics, forensic evidence and drug use trajectories. <b><i>Results:</i></b> The burden of deaths caused by FOD on the general national mortality was higher for men (PMR^/100 = 0.55) compared with women (PMR^/100 = 0.34). Compared with their male peers, women were younger at the time of death (t = 3.274; p = 0.001) and showed shorter drug use careers (t = 2.228; p = 0.028). Heroin use was recorded more frequently in first drug offences of female victims (AOR = 6.59; 95% CI 2.97-14.63) and according to forensic evidence, psychotropic prescription drugs were detected to a higher degree in females (AOR = 2.019; 95% CI 1.065-3.827). <b><i>Conclusion:</i></b> The time window between the onset of illicit drug use and its fatal outcome revealed to be shorter for women versus men included in our study. Early intervention in female drug users, routine involvement of first-line healthcare providers and increased attention to use of poly- and psychotropic prescription drugs might contribute to prevent premature drug-related death and reduce gender differences.

The Ruby Pipeline originates in Opal, Wyoming, travels westward across Utah and Nevada, and terminates in Malin, Oregon. Almost 360 miles of the line is in Nevada, where it crosses through some of the most remote, sparsely populated land in the lower 48 states. Despite the remote nature of this corridor, it has produced a rich archaeological record reflecting a dynamic history of land-use pattern changes over a period of at least 13,000 years. Archaeological excavations were conducted at 578 prehistoric sites prior to construction of the pipeline. The sites were distributed across four ecological regions, including (from west to east): the High Rock Country, Upper Lahontan Basin, Upper Humboldt Plains, and Thousand Springs Valley. First evidence of human occupation dates to the Paleoindian (14,500-12,800 cal b.p.) and Paleoarchaic (12,800-7800 cal b.p.) periods, when people spent most of their time in the High Rock Country where important economic resources reached their highest densities. Paleoindian findings are limited to a series of Great Basin Concave Base projectile points and small obsidian flaked stone concentrations. Paleoarchaic sites are much more common, and tend to be represented by Great Basin Stemmed projectile points, bifaces, and a limited number of other flaked stone tools. Most of these assemblages reflect small groups of hunters refurbishing their tool kits as they traveled through the area. An important exception to this pattern was found at Five Mile Flat along the west end of pluvial Lake Parman where two significant habitation sites dating to 11,180 cal b.p. were discovered. One of these sites includes a house floor, which is the oldest ever found in the Great Basin. Despite the warm-dry conditions that characterized much of the middle Holocene, it appears that human populations nearly doubled during the Post-Mazama Period (7800-5700 cal b.p.). Most activity remained concentrated in the High Rock Country, but evidence for occupation begins to trickle out into the Upper Lahontan Basin and Upper Humboldt Plains regions as well. Most of the artifact assemblages remain rather narrow, often composed of Northern Side-notched and Humboldt Concave Base points, bifaces, and debitage, and reflect use of the region by mobile groups of hunters. Major changes took place with the arrival of the Early Archaic (5700-3800 cal b.p.) and continued forward into the Middle Archaic Period (3800-1300 cal b.p.). Early Archaic projectile points are largely represented by Humboldt and Gatecliff forms. It appears that population densities increased almost fourfold from the preceding interval, and all four regions experienced significant occupation for the first time. Simultaneous to this population increase and dispersal, a full complement of site types began to emerge, with large-scale residential areas becoming significant for the first time. This trend continued forward into the Middle Archaic Period where the relative frequency of residential sites almost doubled compared with the Early Archaic interval. Plant macrofossil and archaeofaunal assemblages also become more abundant and diversified at this time, probably marking a broadening of the diet breadth. This general trajectory extends into the Late Archaic (1300-600 cal b.p.) and Terminal Prehistoric periods, as people continued to expand into a wider range of habitats. This was particularly the case for the latter interval, as the habitat preferences that made sense for over 12,000 years were upended, with population densities highest in the Upper Humboldt Plains and Thousand Springs Valley. This reorientation corresponds to the arrival of Numic speaking populations, especially the Western Shoshone who appear to have reached northern Nevada much earlier than the Northern Paiute, and is probably linked to a greater emphasis on small-seeded plants that are abundantly present in their territory. Although low ranked compared to many other foods, with the proper technology and work organization, small seeds could support higher population densities than was the case earlier in time. Finally, the discovery of obsidian in multiple Terminal Prehistoric sites from sources located much farther away than any other time in the past may signal the earliest use of horses in northern Nevada

Background: Cardiac surgery is a growing activity in Sub-Saharan Africa, however, data related to long-term mortality are scarce. We aimed to analyze outcome data of cardiac interventions in two hospitals in Cameroon over 10 years' period. Methods: we conducted a retrospective analytical and descriptive study at the Douala General Hospital and Yaoundé General Hospital. All patients operated between January 2007 and December 2017, or their families were contacted by phone between January and April 2018 for a free of charges medical examination. Results: Of a total of 98 patients operated during the study period, 8 (8.2%) were lost to follow-up. Finally, 90 patients [49 (54.4%) women and 41 (45.6%)] men were included. The mean age was 49±22 years (range, 13-89 years). The surgical indications were valvular heart diseases in 37 (41.1%) cases, congenital heart diseases in 11 (12.2%) cases, chronic constrictive pericarditis in 4 (4.4%) cases, and intra cardiac tumor in 1 (1.1%) case. Valve replacement was the most common type of surgery carried out in 37 (41.1%) cases-mostly with mechanical prosthesis. Pacemaker-mostly dual-chambers were implanted in 36 (40.0%) patients. The median follow-up was 26 months. The overall late mortality was 5.7%, and the overall survival rates at 5 and 10 years were 95.5% and 94.4% respectively. The overall survival rates at 5 and 10 years for mechanical valve prosthesis were 93.3% and 90% respectively. The survival at 10 years was 100% for patients with bioprosthesis. The survival rates at 10 years were 94.1% and 100% respectively for dual and single chamber pacemaker. Conclusions: Long-term outcome of cardiac surgery in hospitals in Cameroon are acceptable with low mortality rate. However, outcome metrics beyond mortality should be implemented for a prospective data collection. ; SCOPUS: ar.j ; info:eu-repo/semantics/published

Background: People who inject drugs (PWID) are a key population affected by hepatitis C virus (HCV). Treatment options are improving and may enhance prevention; however access for PWID may be poor. The availability in the literature of information on seven main topic areas (incidence, chronicity, genotypes, HIV co-infection, diagnosis and treatment uptake, and burden of disease) to guide HCV treatment and prevention scale-up for PWID in the 27 countries of the European Union is systematically reviewed. Methods and Findings: We searched MEDLINE, EMBASE and Cochrane Library for publications between 1 January 2000 and 31 December 2012, with a search strategy of general keywords regarding viral hepatitis, substance abuse and geographic scope, as well as topic-specific keywords. Additional articles were found through structured email consultations with a large European expert network. Data availability was highly variable and important limitations existed in comparability and representativeness. Nine of 27 countries had data on HCV incidence among PWID, which was often high (2.7-66/100 person-years, median 13, Interquartile range (IQR) 8.7–28). Most common HCV genotypes were G1 and G3; however, G4 may be increasing, while the proportion of traditionally 'difficult to treat' genotypes (G1+G4) showed large variation (median 53, IQR 43–62). Twelve countries reported on HCV chronicity (median 72, IQR 64–81) and 22 on HIV prevalence in HCV-infected PWID (median 3.9%, IQR 0.2–28). Undiagnosed infection, assessed in five countries, was high (median 49%, IQR 38–64), while of those diagnosed, the proportion entering treatment was low (median 9.5%, IQR 3.5–15). Burden of disease, where assessed, was high and will rise in the next decade. Conclusion: Key data on HCV epidemiology, care and disease burden among PWID in Europe are sparse but suggest many undiagnosed infections and poor treatment uptake. Stronger efforts are needed to improve data availability to guide an increase in HCV treatment among PWID.