Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990-2014.

OBJECTIVES: The ability to translate increases in life expectancy into additional years in good health is a crucial challenge for public health policies. We question the success of these policies in Switzerland, a forerunner of longevity, through the evolution of healthy life expectancy (HLE) across socioeconomic groups. METHODS: Education-specific HLE conditioning on surviving to age 30 was computed for 5-year periods from the Swiss National Cohort, a mortality follow-up of the entire resident population, and the Swiss Health Interview Survey, reporting self-rated health. We compare time trends and decompose them into health, mortality and education components. RESULTS: Between 1990 and 2015, comparable gains in LE (males: 5.02 years; females: 3.09 years) and HLE (males: 4.52 years; females: 3.09 years) were observed. People with compulsory education, however, experienced morbidity expansion, while those with middle and high education experienced morbidity compression. CONCLUSIONS: Divergence of morbid years by educational levels may reflect unequal access to preventive care due to high out-of-pockets contributions in the healthcare system. This growing gap and the exhaustion of the educational dividend jeopardize future increases in HLE.

Activities of an intravenous formulation of itraconazole in experimental disseminated Aspergillus, Candida, and Cryptococcus infections.

An intravenous (i.v.) formulation of itraconazole was evaluated in disseminated fungal infection models in guinea pigs. In acute disseminated Candida albicans and Aspergillus fumigatus infections, treatment at 5 mg/kg of body weight twice a day (b.i.d.) significantly prolonged survival. In these models and in animals with chronic disseminated cryptococcosis, itraconazole given i.v. at 2.5 and 5 mg/kg b.i.d. greatly reduced the proportions of organs with culture-detectable fungal burdens. The efficacy of i.v. itraconazole in these animal models justifies its further investigation for the treatment of life-threatening mycoses in humans.

Fertility and migration in the heart of the industrial revolution.

PIP: This study examines demographic growth and change in Tilleur in the valley of Meuse in Belgium during 1807-80 during the process of industrialization and urbanization. The proportion of immigrants (foreigners and Flemings) increased from 15% in 1807 to 65% in 1856. After 1856, population and industrial growth stabilized. During 1856-66 the proportion of natives stabilized, and the proportion of Flemings increased. It is argued that in Tilleur there were two phases: a foundation phase of industrial and population growth and a phase of maturation with decreased non-native population and greater similarity between groups. Immigrants contributed to the birth rate in greater proportions than their proportion in the population of Tilleur. During 1847-66 native population increased annually from 2.4% to 3.8%. Migrants' annual increases were diminished by the effects of mortality but expanded by the influence of in-migration. During 1857-66 the proportion of foreigners declined and marked the transition to a new phase. During 1830-66 the sex ratio grew from 93 to 119. During the Industrial Revolution in Tilleur, women shifted from outnumbering to undernumbering men. The iron and coal in the region attracted men. The sex ratio among the Flemish was 214 in 1866. In 1830 the proportion of fertile women was higher among immigrants and declined thereafter. Age at marriage rose for natives and declined for immigrants. The native population structure by sex, age, and marriage did not favor the birth rate. During 1866-80 the birth rate of foreign immigrants and rural natives declined, the birth rate of natives doubled, and the gap between these two groups narrowed. The changes among immigrants during the foundation phase led to fertility decline in the maturation phase. Marriage and migration interactions linked the industrial revolution with the demographic transition.^ieng

[Health and citizenship in contemporary Belgium]. / Santé et citoyenneté dans la Belgique contemporaine.

We summarize the relations between the development of health policies and the definition of citizenship in Belgium during the 19th and 20th centuries. In the limited scope of the present article we describe the main developments and offer a plausible introduction to subsequent studies. We aim to show that thanks to the scientific study of the changes that took place during two centuries, we can understand the reasons why there are currently so many contradictions in health policy. It is hoped that our findings will help us to better understand the present and prepare for the future.

[Using statistics of tuberculosis clinics and hospitals in the social and epidemiological history of the "white plague" in the late nineteenth and early twentieth centuries]. / Les statistiques des dispensaires antituberculeux et des hôpitaux au service de l'histoire sociale et de l'épidémiologie de la "peste blanche" fin XIXe-début XXe siècle.

During the late XIXth and the beginning of the XXth centuries, the struggle against tuberculosis is a strong reason to redefine health as social gaming, and not as individual gaming anymore. Here the number of actors increases on the market of medical cares, involving some tensions. This paper compares (by the means of death causes statistics) people affected and treated in a local hospital, and those treated in the antitubercular health centres from the province of Liège. It studies the respective contribution of hospital records and statistics list of health centres to the historical epidemiology of the "white plague" and to social history of the health.

[The population of the big university hospitals in Belgium from the early nineteenth century to the end of the twentieth century]. / La population des grands hôpitaux universitaires belges du début du XIXe à la fin du XXe siècle.

This paper is the synthesis of researches concerning the university hospitals of Gand, Liège and Louvain in Belgium. First, you will find an abstract of the analysis and main results. The interpretation topics are then approached with three different points of view: the sources, being hospital or medical records, their qualities and their limits; the structure of the institutions and their consequences on the social structure of the patients; the impact of the demographic transition. The hospital, which was one reserved to poor adults, has progressively been authorized to "non-profitables", children first, then old people, so that the ageing of patients largely exceeds that of the population itself.