Rev Epidemiol Sante
-
Rev Epidemiol Sante · Oct 2013
[Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view].
A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes. In North-America and Europe, several countries have thus developed national or regional chronic disease management programs. In Switzerland, such initiatives have only emerged recently. In 2010, the canton of Vaud set up the "Diabetes Cantonal Program", within the framework of which we conducted a study designed to ascertain the opinions of both diabetic patients and healthcare professionals on the elements that could be integrated into this program, the barriers and facilitators to its development, and the incentives that could motivate these actors to participate. ⋯ The identification of the elements to consider, barriers, facilitators and incentives to participate to a chronic disease management program, obtained by exploring the opinions of patients and healthcare professionals, should favour its further development and implementation.
-
Rev Epidemiol Sante · Aug 2013
Review[Homicide, schizophrenia and substance abuse: a complex interaction].
The prevalence of homicide perpetrators with a diagnosis of schizophrenia is 6% in Western countries populations. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link. The aim of this systematic review was to clarify the role of substance abuse in the commission of murder in people suffering from schizophrenia. ⋯ Defining subgroups of violent schizophrenic patients would avoid stigmatization and would help to prevent the risk of homicide by offering a multidisciplinary care which would take into account any substance abuse.
-
Closing the Gap in a Generation, the final report of the Commission on Social Determinants of Health (CSDH) proposed that inequities in power, money and resources were responsible for much of the inequalities in health within and between countries. A toxic combination of poor policies and programmes, unfair economic arrangements and bad governance led to inequalities in the conditions of daily life: the circumstances in which people are born, grow, live, work, and age. Our message is that there needs to be a cross-government commitment to action on social determinants of health. With this commitment, the knowledge synthesised in our report suggests that there is much that can be done at the practical level.
-
Rev Epidemiol Sante · Jun 2013
[Statistical and epidemiological methods used in biomedical research: implications for initial medical education].
The main source of key medical information consists in original articles published in peer-reviewed biomedical journals. Reported studies use increasingly sophisticated statistical and epidemiological approaches that first require a solid understanding of core methods. However, such understanding is not widely shared among physicians. Our aim was to assess whether the basic statistical and epidemiological methods used in original articles published in general biomedical journals are taught during the first years of the medical curriculum in France. ⋯ More teaching of the core methods underlying the understanding of sophisticated methods and illustrations should be included in the early medical curriculum so that physicians can read the scientific literature critically for their medical education.
-
Rev Epidemiol Sante · Apr 2013
[Introduction of innovative high-risk medical devices in Europe: are clinical efficacy and safety guaranteed?].
Innovative high-risk medical devices, such as new types of heart valves or hip prostheses, become available on the European market more rapidly than in USA. This is due to the European legislation allowing early marketing of innovative high-risk medical devices before high-quality clinical evidence is obtained from randomized controlled trials. ⋯ For innovative high-risk devices, and while awaiting a reworked Medical Device Directive, patient risk should be minimized by limiting the market introduction of novel high-risk devices with minimal clinical data to physicians with the necessary training and expertise. The new European legislation should require the premarket demonstration of clinical efficacy and safety, using a randomized controlled trial if possible, and a transparent clinical review, preferably centralized.