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Sample records for lassur klliki tafel-viia

  1. Value of a national administrative database to guide public decisions: From the système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France.

    Science.gov (United States)

    Tuppin, P; Rudant, J; Constantinou, P; Gastaldi-Ménager, C; Rachas, A; de Roquefeuil, L; Maura, G; Caillol, H; Tajahmady, A; Coste, J; Gissot, C; Weill, A; Fagot-Campagna, A

    2017-10-01

    In 1999, French legislators asked health insurance funds to develop a système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) [national health insurance information system] in order to more precisely determine and evaluate health care utilization and health care expenditure of beneficiaries. These data, based on almost 66 million inhabitants in 2015, have already been the subject of numerous international publications on various topics: prevalence and incidence of diseases, patient care pathways, health status and health care utilization of specific populations, real-life use of drugs, assessment of adverse effects of drugs or other health care procedures, monitoring of national health insurance expenditure, etc. SNIIRAM comprises individual information on the sociodemographic and medical characteristics of beneficiaries and all hospital care and office medicine reimbursements, coded according to various systems. Access to data is controlled by permissions dependent on the type of data requested or used, their temporality and the researcher's status. In general, data can be analyzed by accredited agencies over a period covering the last three years plus the current year, and specific requests can be submitted to extract data over longer periods. A 1/97th random sample of SNIIRAM, the échantillon généraliste des bénéficiaires (EGB), representative of the national population of health insurance beneficiaries, was composed in 2005 to allow 20-year follow-up with facilitated access for medical research. The EGB is an open cohort, which includes new beneficiaries and newborn infants. SNIIRAM has continued to grow and extend to become, in 2016, the cornerstone of the future système national des données de santé (SNDS) [national health data system], which will gradually integrate new information (causes of death, social and medical data and complementary health insurance). In parallel, the modalities of data access and protection systems

  2. Le rôle de l'assurance maladie dans le système financier de la santé

    OpenAIRE

    Huang, Xiao Xian

    2011-01-01

    It has been widely recognized that poor health is an important cause of poverty, especiallyamong the low- and middle- income countries. One of the reasons is the absence of publicfinancial protection against the medical consumption risk in these countries. This Phd dissertationis dedicated to discern the role that health insurance could play in the organization of healthfinancial protection system. The dissertation is composed of two parts. The first part discusses theproblems linking to the ...

  3. Importance de la stratégie du marketing-mix en assurances de personnes ( cas de l'assurance scolaire de la CAAR dans la wilaya de Tlemcen)

    OpenAIRE

    Ali-belhadj, Yassine

    2014-01-01

    L'objectif de cette recherche est de déterminer les causes qui frénenet l'évolution du marché national des assurances de personne et la possibilité de le faire développer grâce de l'utilisation du marketing-mix des assurances.la premiére partie traite de l'aspect théorique du marketing des assurances .la deuxiéme partie observera le marketing des assurances en Algérie.

  4. Le rôle de l'assurance maladie sociale dans le système de financement de santé - un regard mondial ainsi qu'une étude de cas pour la Chine

    OpenAIRE

    Huang, Xiaoxian

    2011-01-01

    It has been widely recognized that poor health is an important cause of poverty, especially among the low- and middle- income countries. One of the reasons is the absence of public financial protection against the medical consumption risk in these countries. This Phd dissertation is dedicated to discern the role that health insurance could play in the organization of health financial protection system. The dissertation is composed of two parts. The first part discusses the problems linking to...

  5. Analyse de la direction et États financiers 2016–2017

    International Development Research Centre (IDRC) Digital Library (Canada)

    l'assurance raisonnable qu'il pourra réaliser ses objectifs. Le tableau ... tous les employés et leur fournit des services de santé avant et ...... Le Comité des finances et de l'audit du Conseil des gouverneurs demeure à l'entière disposition des.

  6. Concept Note Guidelines - French

    International Development Research Centre (IDRC) Digital Library (Canada)

    NCDP

    Toutes les dépenses liées aux services fournis par des consultants pour une acvité ... d'importaon, la taxe de vente ou l'assurance sur l'équipement après la ... audit. Si votre établissement recouvre habituellement ses coûts indirects en ...

  7. Consommation de l'eau en sachet et ses effets socio ...

    African Journals Online (AJOL)

    L'eau en sachet est devenue un produit de grande consommation dans les ... chefs d'unité de fabrication sur l'assurance qualité, l'instauration des sachets biodégradables, le contrôle et le .... consommée, il se pose le problème de gestion.

  8. CHARTE D'AUDIT INTERNE

    International Development Research Centre (IDRC) Digital Library (Canada)

    sblanchard

    30 mars 2015 ... Au CRDI, la fonction d'audit interne a pour objet de fournir des ... méthodes de gestion, de manière à fournir l'assurance raisonnable que ... explications des employés du Centre et des entrepreneurs dont il retient les services.

  9. Educating Doctors on Evaluation of Fitness to Drive: Impact of a Case-Based Workshop

    Science.gov (United States)

    Dow, Jamie; Jacques, Andre

    2012-01-01

    Introduction: In 2004, faced with demographic data predicting large increases in the number of older drivers within a relatively short period combined with the realization that screening for driver fitness was largely dependent on health professionals, principally physicians, the Societe de l'assurance automobile du Quebec (SAAQ) initiated…

  10. Long-term vitamin K antagonists treatment patterns of Non-Valvular Atrial Fibrillation (NVAF): a population-based cohort study

    OpenAIRE

    Renoux, Christel; Coulombe, Janie; Suissa, Samy

    2016-01-01

    Background Recent trends in vitamin K antagonists (VKA) use in non-valvular atrial fibrillation (NVAF) are useful to evaluate the potential improvement in management of NVAF since the introduction of new oral anticoagulants. Our objective was therefore to describe the contemporary VKA treatment patterns following NVAF diagnosis. Methods and Results We used the computerized databases of the R?gie de l?assurance maladie du Qu?bec (RAMQ), responsible for administering the universal health care s...

  11. Le jeu de pouvoir dans les magazines d’information politique

    OpenAIRE

    Mouchon, Jean

    2013-01-01

    Les magazines d'information de la fin des années 1980s sont devenus des espaces ritualisés et normés de l'expression politique. Si la recherche d'effets spectaculaires et la participation du public participent au succès de ces émissions de télévision, c'est surtout la confrontation entre les journalistes et les hommes politiques qui l'assurent. L'auteur analyse les différents aspects de leurs relations, de la connivence à la confrontation, sur le plan verbal (linguistique) et sur le plan visu...

  12. Preparation for retirement

    CERN Multimedia

    Ullmann; Bartelemy; Devine

    1983-01-01

    Monsieur Ullmann et d'autres conférenciers comme Messieurs Bartelemy, Devine et Faessler répondront aux questions écrites auparavent. Ses collègues des services donneront après quelque mots d'introduction un aperçu sur les sujets qui intéressent et répondront aussi aux questions supplémentaires de la salle. M. Faessler donnera entre autre quelques tuyaux utiles et pratiqes concernant des particularités de l'AVS. Des questions sur l'assurance Austria seront aussi abordées.

  13. Traité des nouveaux risques précaution, crise, assurance

    CERN Document Server

    Godard, Olivier; Lagadec, Patrick; Michel-Kerjan, Erwann

    2002-01-01

    Au-delà des dénonciations de la technologie prométhéenne, s'appuyant sur les acquis de la recherche économique et d'autres disciplines des sciences sociales, cet ouvrage pionnier rassemble les pièces d'un puzzle dispersé. Le motif en est clair: dégager les axes d'une gouvernance des nouveaux risques. Celle-ci repose sur trois piliers qui organisent le panorama offert : la précaution - de la théorie du risque à celle des régimes politiques dans un univers à la fois non probabiliste et controversé; la prévention et la gestion de crises - dont les traits saillants sont montrés à partir de trois cas exemplaires : la contamination criminelle d'un produit pharmaceutique ; la destruction du réseau électrique québécois en 1998 ; l'épidémie de la vache folle au Royaume-Uni ; l'assurance des risques à grande échelle (désastres naturels, catastrophes technologiques et terrorisme de masse) qui, avérés ou potentiels, bouleversent l'économie de l'assurance. Pourquoi un Traité ? La raison en es...

  14. Contribution to the piloting of quality actions by analysis of practices used by operators to the unforeseen or one off events

    OpenAIRE

    Grandhaye , Jean-Pierre

    1994-01-01

    Not available; L’évolution des démarches qualité conduit à prendre en compte le processus de production selon une logique globale. En effet, les différents apports, outils et démarches ont souvent été techniques et prescriptifs: passage du contrôle, à l'assurance qualité, puis à la qualité totale. En suivant cette évolution, on ne doit plus considérer les unités opérationnelles uniquement comme des systèmes formels maitrisables mais bien comme des ensembles d'acteurs capables de produire déci...

  15. Traité pratique de sécurité incendie

    CERN Document Server

    2016-01-01

    L'ouvrage de référence pour l'exercice des missions de sécurité incendie. Toutes les thématiques de l'incendie organisées en cinq grandes parties : s'informer sur les statistiques récentes, les retours d’expérience, le vocabulaire « métier » et les acteurs publics de la sécurité auprès desquels le lecteur peut trouver informations et conseils ; s'initier aux principes de l'assurance et optimiser l'organisation de la sécurité avec des outils pour la maîtrise du risque incendie, la mise en place d’équipes d’intervention, la formation et l’information du personnel, l’évacuation, la sécurité des travaux et des interventions ; approfondir les connaissances générales de base sur les phénomènes de la combustion, de l’incendie et de l’explosion, les produits dangereux ; maîtriser les techniques et technologies de sécurité des matériels et installations de sécurité (protection passive, désenfumage, détection et mise en sécurité, agents extincteurs, extincteurs, moyens ...

  16. Preparation for retirement seminar

    CERN Multimedia

    HR Department

    2010-01-01

    (Health insurance and wealth and succession planning) During the preparation for retirement seminar in November 2009, the sessions on health insurance in Switzerland and in France unfortunately had to be postponed. Participants in the seminar also expressed interest in an information session on “How to manage your wealth and organize your succession”. The sessions on health insurance will be held on 16 March 2010 and those on managing wealth and succession on 18 March 2010. Programme for Tuesday 16 March 2010 (TH Theory Conference Room, Building 4/3-006): 09:00 Health insurance in Switzerland by Mr. Sandro Breitenstein, Service de l'Assurance Maladie du Canton de Genève 10:00 Coffee break 10:20 Health insurance in France by Mr. Dominique Curtiaud, Caisse Primaire d'Assurance Maladie de l'Ain Programme for Thursday 18 March 2010 (TH Theory Conference Room, Building 4/3-006): 09:00 How to manage your wealth and organize your succession in Switzerland by Mr. Jean-Marc W...

  17. Harrap's Michel Thomas anglais : débutants et faux débutants

    CERN Document Server

    2013-01-01

    Une méthode 100 % audio pour perfectionner très rapidement votre anglais. Des résultats très rapides ° En quelques heures d'écoute, vous acquerrez les connaissances et l'assurance nécessaires pour comprendre et maîtriser l'anglais dans toutes ses complexités. Une pédagogie originale et sans contrainte ° Le cours est structuré en trois parties pour aborder, au fur et à mesure, le vocabulaire, les verbes et les expressions courantes. Il est dispensé par un formateur accompagné d'un Britannique et d'un Américain, qui vous aideront à perfectionner votre prononciation. ° Aucun livre, aucune prise de note : vous pouvez donc vous concentrer sur les explications du formateur. Vous mémorisez facilement et sans effort. ° Une méthode conviviale : vous êtes, dès le début, mis en confiance par la présence orale du formateur et des étudiants et vous percevez nettement les progrès réalisés. Une méthode progressive et un rythme flexible ° Vous pouvez suivre le cours à votre rythme et selon...

  18. Harrap's Michel Thomas anglais : perfectionnement

    CERN Document Server

    2013-01-01

    Une méthode 100 % audio pour perfectionner très rapidement votre anglais. Des résultats très rapides ° En quelques heures d'écoute, vous acquerrez les connaissances et l'assurance nécessaires pour comprendre et maîtriser l'anglais dans toutes ses complexités. Une pédagogie originale et sans contrainte ° Le cours est structuré en trois parties pour aborder, au fur et à mesure, le vocabulaire, les verbes et les expressions courantes. Il est dispensé par un formateur accompagné d'un Britannique et d'un Américain, qui vous aideront à perfectionner votre prononciation. ° Aucun livre, aucune prise de note : vous pouvez donc vous concentrer sur les explications du formateur. Vous mémorisez facilement et sans effort. ° Une méthode conviviale : vous êtes, dès le début, mis en confiance par la présence orale du formateur et des étudiants et vous percevez nettement les progrès réalisés. Une méthode progressive et un rythme flexible ° Vous pouvez suivre le cours à votre rythme et selon...

  19. Harrap's Michel Thomas anglais : vocabulaire

    CERN Document Server

    2013-01-01

    Une méthode 100 % audio pour perfectionner très rapidement votre anglais. Des résultats très rapides ° En quelques heures d'écoute, vous acquerrez les connaissances et l'assurance nécessaires pour comprendre et maîtriser l'anglais dans toutes ses complexités. Une pédagogie originale et sans contrainte ° Le cours est structuré en trois parties pour aborder, au fur et à mesure, le vocabulaire, les verbes et les expressions courantes. Il est dispensé par un formateur accompagné d'un Britannique et d'un Américain, qui vous aideront à perfectionner votre prononciation. ° Aucun livre, aucune prise de note : vous pouvez donc vous concentrer sur les explications du formateur. Vous mémorisez facilement et sans effort. ° Une méthode conviviale : vous êtes, dès le début, mis en confiance par la présence orale du formateur et des étudiants et vous percevez nettement les progrès réalisés. Une méthode progressive et un rythme flexible ° Vous pouvez suivre le cours à votre rythme et selon...

  20. Has the Introduction of Laparoscopic Heller Myotomy Altered the Treatment Paradigm of Achalasia?

    Directory of Open Access Journals (Sweden)

    Lorenzo E Ferri

    2005-01-01

    Full Text Available Although surgical myotomy is well established as the most effective and durable treatment for achalasia, wide acceptance of this procedure as a first-line treatment has been hampered by perceived invasiveness and morbidity. Laparoscopic myotomy has significantly reduced surgical trauma and morbidity while maintaining effectiveness. The effect of laparoscopic myotomy on the treatment pattern for achalasia is not currently known. All patients undergoing surgical myotomy in Quebec from 1997 to 2002 were identified from the Régie de l'assurance maladie du Québec billing database; previous endoscopic treatment was documented from 1990 to the time of surgery. Patients were divided into two groups (prelaparoscopy and postlaparoscopy defined by the approximate date when laparoscopic myotomy became generally available in Quebec. A questionnaire examining treatment preference for achalasia was sent to all Quebec gastroenterologists. The number of myotomies performed in Quebec remained stable (prelaparoscopy = 28.7/year; postlaparoscopy = 33/year, but were performed on an older population. The rate of preoperative endoscopic treatment did not differ from prelaparoscopy (29.2% to postlaparoscopy (23.3%. However, the time interval between the last endoscopy and myotomy diminished significantly. Questionnaire response rate was 41% (60 of 147. Although myotomy was recognized as the most effective treatment (54 of 60, only 22 of 60 gastroenterologists would refer a healthy patient for myotomy as initial treatment. Other choices included dilation (33 of 60, Botulinum toxin (two of 60 or calcium channel blockade (three of 60. Despite a decrease in time interval between endoscopic treatment and surgery, no decrease in the rate of existing endoscopic therapies occurred after laparoscopic myotomy became widely available. The benefits and minimal risks associated with laparoscopic myotomy need to be more effectively communicated by referring physicians.

  1. Impact of nursing home admission on health care use and disease status elderly dependent people one year before and one year after skilled nursing home admission based on 2012-2013 SNIIRAM data.

    Science.gov (United States)

    Atramont, A; Bourdel-Marchasson, I; Bonnet-Zamponi, D; Tangre, I; Fagot-Campagna, A; Tuppin, P

    2017-09-18

    The aim of this study was to compare disease status and health care use 1 year before and 1 year after skilled nursing home (SNH) admission. People over the age of 65 years admitted to SNH during the first quarter of 2013, covered by the national health insurance general scheme (69% of the population of this age), and still alive 1 year after admission were identified (n = 14,487, mean age: 86 years, women: 76%). Their reimbursed health care was extracted from the Système National d'Information Interrégimes de l'Assurance Maladie (SNIIRAM) [National Health Insurance Information System]. One year after nursing home admission, the most prevalent diseases were cardiovascular/neurovascular diseases and neurodegenerative diseases (affecting 45% and 40% of people before admission vs 51% and 53% after admission, respectively). Physical therapy use increased (43% vs 64% of people had at least one physical therapy session during the year, with an average of 47 vs 84 sessions/person during the year), while specialist consultations decreased (29% of people consulted an ophthalmologist at least once during the year before admission vs 25% after admission; 27% vs 21% consulted a cardiologist). Hospitalization rates were lower during the year following institutionalization (75% vs 40% of people were hospitalized at least once during the year), together with a lower emergency admission rate and a higher day admission rate. Analysis of the new French reimbursement database specific to SNH shows that nursing home admission is associated with a reduction of some forms of outpatient care and hospitalizations.

  2. Plan d'assurance qualité (PAQ) un outil de partenariat

    CERN Document Server

    Pasquali, J

    1998-01-01

    En matière d'assurance qualité, la formalisation du système qualité est nécessaire pour démontrer la conformité par rapport au modèle (ex : ISO 9001, 9002 ou 9003). Dans ce cadre, certains contractants mettent en place un plan d'assurance qualité PAQ destiné à contenir les dispositions spécifiques à l'exécution de leur contrat avec le CERN. Si le PAQ, outil du système qualité du contractant, régit la relation « ST-contractant », il n'en demeure pas moins qu'une définition précise de « ce que l'on veut » s'avère indispensable. L'assurance qualité est censée garantir la régularité de la qualité pour obtenir la confiance des clients et réduire les coûts par la réduction des contrôles et des dysfonctionnements. Cela suppose qu'en amont, la parfaite prise en compte des besoins du client final de la part de « ST »soit assurée. Cela le sera d'autant plus et mieux, qu'avec la démarche "Qualité", ST pourra pleinement se concentrer sur son rôle de conseiller, d'expert technique et...

  3. Prevalence and economic burden of cardiovascular diseases in France in 2013 according to the national health insurance scheme database.

    Science.gov (United States)

    Tuppin, Philippe; Rivière, Sébastien; Rigault, Alexandre; Tala, Stéphane; Drouin, Jérôme; Pestel, Laurence; Denis, Pierre; Gastaldi-Ménager, Christelle; Gissot, Claude; Juillière, Yves; Fagot-Campagna, Anne

    2016-01-01

    Cardiovascular diseases (CVDs) constitute the second leading cause of death in France. The Système national d'information interrégimes de l'assurance maladie (SNIIRAM; national health insurance information system) can be used to estimate the national medical and economic burden of CVDs. To describe the rates, characteristics and expenditure of people reimbursed for CVDs in 2013. Among 57 million general health scheme beneficiaries (86% of the French population), people managed for CVDs were identified using algorithms based on hospital diagnoses either during the current year (acute phase) or over the previous 5 years (chronic phase) and long-term diseases. The reimbursed costs attributable to CVDs were estimated. A total of 3.5 million people (mean age, 71 years; 42% women) were reimbursed by the general health scheme for CVDs (standardized rate, 6.5%; coronary heart disease, 2.7%; arrhythmias/conduction disorders, 2.1%; stroke, 1.1%; heart failure, 1.1%). These frequencies increased with age and social deprivation, and were higher in Northern and Eastern France and Réunion Island. The total sum reimbursed by all schemes for CVDs was € 15.1 billion (50% for hospital care and 43% for outpatient care [including 15% for drugs and 12% for nurses/physiotherapists]); coronary heart disease accounted for € 4 billion, stroke for € 3.5 billion and heart failure for € 2.5 billion (i.e. 10% of the total expenditure reimbursed by all national health insurance schemes for all conditions). CVDs constitute the leading group in terms of numbers of patients reimbursed and total reimbursed expenditure, despite a probable underestimation of both numbers and expenditure. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. [Rates of total and free PSA prescriptions in France (2012-2014)].

    Science.gov (United States)

    Tuppin, Philippe; Leboucher, Claire; Peyre-Lanquar, Gabrielle; Lamy, Pierre-Jean; Gabach, Pierre; Rébillard, Xavier

    2017-10-01

    In 2010, the French Haute Autorité de santé (National Health Authority) confirmed the limited value of prostate cancer (PCa) screening by total prostate-specific antigen (PSA) assay. This study was designed to determine the modalities of ordering total PSA or free PSA assays (in the absence of PCa) according to various parameters and the corresponding sums reimbursed. Men aged 40 years and older covered by the national health insurance general scheme (73% of the French population) between 2012 and 2014 were selected. Data were derived from the Système national d'information inter-régimes de l'assurance maladie (Sniiram) (National health insurance information system) database. In 2014, 27% of the 11.6 million men 40 years and older underwent at least one total PSA assay and 5.6% underwent at least one free PSA assay, with marked variations according to the presence or absence of treated lower urinary tract symptoms (LUTS) (53% and 15% vs 24% and 5%) and from one administrative department to another. The peak total PSA assay rate was observed between the ages of 65 and 74 years: 64% of men with LUTS, 46% without LUTS. Between 2012 and 2014, men in whom at least one PSA assay had been performed underwent a mean of 1.8 total PSA assays and 1.7 free PSA assays, with means of 2.3 and 2, respectively, in the presence of LUTS. General practice specialists ordered 91% of the PSA tests reimbursed in 2014 (92% for total PSA and 87% for free PSA) and urologists ordered 4% of reimbursed tests. The total sum reimbursed was €28.5 million, comprising €8.7 million for free PSA. An average of 10 laboratory tests was performed at the same time as the PSA assay in the absence of treated LUTS. Total PSA and free PSA assays are performed in a large number of men, although the value of these tests as first-line test before biopsy remains controversial. These PSA assays are associated with many other laboratory tests looking for possible abnormalities, especially in younger

  5. Could driving safety be compromised by noise exposure at work and noise-induced hearing loss?

    Science.gov (United States)

    Picard, Michel; Girard, Serge André; Courteau, Marilène; Leroux, Tony; Larocque, Richard; Turcotte, Fernand; Lavoie, Michel; Simard, Marc

    2008-10-01

    A study was conducted to verify if there is an association between occupational noise exposure, noise-induced hearing loss and driving safety expanding on previous findings by Picard, et al. (2008) that the two factors did increase accident risk in the workplace. This study was made possible when driving records of all Quebec drivers were made available by the Societe de l'assurance automobile du Quebec (SAAQ is the state monopoly responsible for the provision of motor vehicle insurance and the compensation of victims of traffic accidents). These records were linked with personal records maintained by the Quebec National Institute of Public Health as part of its mission to prevent noise induced hearing loss in the workplace. Individualized information on occupational noise exposure and hearing sensitivity was available for 46,030 male workers employed in noisy industries who also held a valid driver's permit. The observation period is of five years duration, starting with the most recent audiometric examination. The associations between occupational noise exposure levels, hearing status, and personal driving record were examined by log-binomial regression on data adjusted for age and duration of exposure. Daily noise exposures and bilateral average hearing threshold levels at 3, 4, and 6 kHz were used as independent variables while the dependent variables were 1) the number of motor vehicle accidents experienced by participants during the study period and 2) participants' records of registered traffic violations of the highway safety code. The findings are reported as prevalence ratios (PRs) with their 95% confidence intervals (CIs). Attributable numbers of events were computed with the relevant PRs, lesser-noise, exposed workers and those with normal hearing levels making the group of reference. Adjusting for age confirmed that experienced workers had fewer traffic accidents. The data show that occupational noise exposure and hearing loss have the same effect on

  6. Trends and determinants of antiresorptive drug use for osteoporosis among elderly women.

    Science.gov (United States)

    Perreault, Sylvie; Dragomir, Alice; Desgagné, Alain; Blais, Lucie; Rossignol, Michel; Blouin, Julie; Moride, Yola; Ste-Marie, Louis-Georges; Fernandès, Julio Cesar

    2005-10-01

    It has been established that women who have had a first osteoporotic fracture are at a significantly greater risk of future fractures. Effective antiresorptive treatments (ART) are available to reduce this risk, yet little information is available on trends in ART drug use among the elderly. The objective is to estimate the rate ratio (RR) of having an ART prescription filled among elderly women and its relation to selected determinants from 1995 through 2001. A cohort design was used. Through random sampling, we selected 40% of the women aged 70 years and older listed in the Régie de l'assurance maladie du Québec (RAMQ) health database. The women were grouped into four cohorts (for 1995, 1996, 1998 and 2000). January 1 was established as the index date within each cohort (1995, 1996, 1998 and 2000). The dependent variable was the RR of having at least one prescription of ART drugs filled during the year following the index date among women with and without prior use. ART users were divided in two groups: bone-specific drugs (bisphosphonates, calcitonin, raloxifen) and HRT (hormone replacement therapy). The independent variable was whether or not (control) there had been an osteoporotic-related fracture. The RR was determined for having at least one prescription of bone-specific drugs or of HRT filled during the year following the index date using a Cox regression adjusted for age, chronic disease score (CDS) and prior bone mineral density (BMD) test. Crude rates of BMD testing (per 500 person-years) ranged from 20.4 (1995) to 41.1 (2000) in women who had had an osteoporotic-related fracture, and from 4.4 to 15.3 in controls. The crude rate of women (per 100 person-years) who had had an osteoporotic-related fracture and who took at least one bone-specific drug during follow-up ranged from 1.9 in 1995 to 31 in 2000 among those with prior osteoporotic-related fracture, and from 0.5 in 1995 to 11 in 2000 for controls; the corresponding figures for HRT ranged 6.7 in

  7. Preservation of refrigerated calf meat pieces by ionization; Conservation par ionisation de morceaux de viande de veau refrigeres

    Energy Technology Data Exchange (ETDEWEB)

    Hassouna, M. [Ecole Superieure des Industries Alimentaires, El Khadra Tunis (Tunisia); Besbes, M.; Ben Hassen, A.; Mahjoub, A.; Maalej, M.

    1998-07-01

    temperature were particularly important in the range of 50 to 70 degree C [French] L'influence de la dose d'ionisation et de la réfrigération à + 4 °C sur la durée de conservation de morceaux de cuisses de veau préemballés sous vide partiel a été étudiée. L'effet des doses de 1, 2, 3, 4 et 5 kGy sur l'évolution de leur composition chimique et bactériologique au cours de 28 jours d'entreposage a été mesuré. La dosimétrie in vivo par thermoluminescence s'avère une technique très performante pour le contrôle de la dose reçue, ainsi que sa répartition au sein d'un lot de viande traitée, ce qui constitue généralement un aspect fondamental de l'assurance qualité des denrées alimentaires ionisées. Alors que les doses d'ionisation de 1 ou 2 kGy se sont révélées insuffisantes pour prolonger la durée de conservation des viandes traitées, celles de 3, 4 ou 5 kGy sont très efficaces car elles inhibent radicalement le développement de germes témoins de contamination fécale (coliformes totaux, coliformes fécaux et entérobactéries) et maintiennent les germes totaux et les bactéries psychrotrophes radiorésistantes à des teneurs respectivement normales et inférieures à la valeur de putréfaction superficielle (10{sup 7} UFC g{sup -1}) à tous les stades de la conservation. Les agents de toxi-infections alimentaires (Salmonella, anaérobies sulfito-réducteurs et Stapltylococcus aureus) sont absents aussi bien dans les échantillons de viande témoin que dans ceux traités. Par ailleurs, dans les morceaux de viande ionisée à des.