Hepatitis C and HIV combined screening in primary care: A cluster randomized trial.

Hepatitis C virus (HCV) and HIV are major causes of worldwide disease. We aimed to evaluate the effect of a combined screening programme, which included a risk-assessment questionnaire and rapid tests for point-of-care diagnosis, on screening and new diagnosis rates. This prospective, cluster randomized study was carried out in primary care. The intervention arm included a 4-hour educational programme, the use of a risk-assessment questionnaire and rapid tests. In the control centres, only the educational intervention was provided. The main variables compared were the screening coverage and the number and rate of new HCV and HIV diagnoses. Of a total of 7991 participants, 4670 (58.5%) and 2894 (36.2%) presented a risk questionnaire for HIV or HCV, respectively. The younger participants, men and those from Latin America and Eastern Europe, showed the greatest risk of presenting with a positive questionnaire. The overall screening coverage was higher within the intervention arm (OR 17.7; 95% CI 16.2-19.5; P < .001). Only two HIV-positives were identified compared to one in control centres. The rate of HCV diagnoses was higher among intervention centres, with 37 versus seven positive tests (OR 5.2; 95% CI 2.3-11.6; P < .001). Of them, 10 were new diagnoses and 27 had been previously diagnosed, although not linked to care. In conclusion, a simple operational programme can lead to an increase in HCV and HIV screening rates, compared to an exclusively educational programme. The selection of at-risk patients with a self-questionnaire and the use of rapid tests significantly increased the diagnostic rate of HCV infection.

The Training on Universal Design for All: A Case Study from the European Higher Education Area in Spain.

The European Higher Education Area was a landmark in undergraduate and postgraduate training throughout the European Union. Despite the changes it led regarding the contents of all study programmes, there were two issues that remained unsolved. Firstly, gender mainstreaming, and secondly, training in universal accessibility and design for all. Our aim is to analyse the second issue that remains unresolved and share the solution that Spanish university education has drawn up supported by the tertiary sector. Therefore, any physical, social or virtual product must be based on universal design from a training approach. As teachers, our mission is to change the way in which each product is perceived, so that any design is based on universal design standards. In this article, we will explain the pioneering role of the University of Jaen regarding universal design training in Spain. It is essential to be supported by local and global organisations from the beginning, to create specific environments for discussion and design a study plan for all individuals. The main mission is to train but also to raise awareness regarding diversity, as well as training plurality ambassadors from a multidisciplinary approach. The Master's Degree previously mentioned is a pioneering education programme in Spain and it offers training opportunities to all Latin America. It has been on-going for six years and it is updated on an annual basis in order to reflect a changing social reality and provide any professional with online access to the set of subjects composing the programme. Until now, it has been carried out in two different plans: Master's Degree in Universal Design and Design for All, and Master's Degree in Accessibility for Smart City; the Global City. It has already trained more than 250 professionals and one of its main features is the diverse background of students and teachers, in which plurality and diversity converge in their interest for universal design.

Diversity of "Pedestrians on Wheels", New Challenges for Cities in 21st Century.

Traditionally, pedestrians were identified as singular entities with standard needs. Reality shows us that pedestrian diversity is a reality that is becoming increasingly complex. How does urban design face the changing reality of pedestrian typologies? In the same way that in the 20th century the car set aside horse carriages and pedestrians, in the 21st century pedestrians are returning to take centre stage with regard to motor vehicles, but with new formalizations that imply new considerations in the design of streets, many of they are still unsolved. Citizens strolling on scooters, skates, skateboard, segway, unicycles, are added to the already traditional baby strollers, wheelchairs, and suitcases with wheels … "pedestrians on wheels" that pose new challenges of coexistence and design. Own functional requirements to walk and maneuver, to see and be seen … functional requirements of coexistence with other pedestrians that make a different use of the street (people looking at shop windows, pedestrians with umbrellas, reading on the smartphone…) or changes of use of the same space when the conditions are different: snow, strong sun, fog, at night … These are considerations of Universal Accessibility and Design for all that we cannot leave out while our society progresses. This paper identifies some of these new needs and studies this new pedestrian mobility is carried out through a progressive analysis in three phases: 1 classification of the different user of the street, 2 study of the Personal Mobility Devices (PMD) and 3 the new accessibility barriers that arise with the use of PMD. As a result, some action strategies are pointed out to respond to the difficulties of accessibility derived from this new reality and to integrate them into the Universal Design of the urban public space.