Objectives
To assess:1) if HIV screening with rapid tests in neighbourhoods with a substantial African community is feasible and acceptable among GPs and patients; 2) HIV seroprevalence.
Methods
Multicenter prospective study with 10 trained physicians. Use of HIV standard test and INSTI Ultrarapid test. Inclusion criteria: MSM, sex worker, multiple sexual partners, having returned or coming from a country with high HIV prevalence, IVDU, Indicator conditions as defined by HIV Indicator Diseases across Europe Study, having an AIDS‐defining illness, having had a recent pregnancy or abortion; or presenting other risks.
Results
From August 2010 to August 2011, 10 trained GPs offered an HIV test to 224 patients: 51% ♀, 48% ♂, 43% Caucasians, 45% Africans. Inclusion criteria: 32% ”high risk group”, 9% returning from an endemic country, 29% with an indicator condition; 12 patients (6%) refused the standard test. The INSTI was offered to 217(97%), 197 performed with 2 reactive rapid tests confirmed. The seroprevalence according to ethnic origin was 0% among Caucasians and 2.2% among Africans and was 1.5% among patients with an indicator condition. 1087 consecutive consultations of the same GPs were recorded: 42% patients had ≥1 inclusion criteria among which 41% of offered tests, that is to say 59% of “missed opportunities”. The reasons for not offering the test as recorded for 55% of patients:“not indicated” 44.5%, “no time” 33%, “impossible to propose” 15%, test completed previously 11%, known HIV‐positive 4%.
Conclusions
Standard and rapid tests are well received by patients but were usually not offered by doctors who have been trained.
Risk assessment of genetically modified (GM) crops includes an evaluation of hazard and exposure to newly expressed crop constituents, exemplified herein by newly expressed proteins (NEPs). Guidance directing dietary exposure assessments (DEAs) is limited and/or globally inconsistent. Best practices for conducting DEAs are presented and include a preliminary problem formulation step to determine if a formal DEA is necessary to support the risk assessment. If a formal DEA is deemed necessary, the type of exposure (acute or chronic) and the availability of food consumption data relevant to the targeted population should be identified. Exposure should be estimated initially using a simple, straight-forward, and fit-for-purpose DEA (unrefined DEA) approach while ensuring relevance to the risk question. Unrefined assessments, which are very likely to overestimate exposure, provide a high level of protection to consumers of GM crops. If refinement of the DEA is necessary, then the simplest refinements that meet the needs of the risk assessment should be implemented. DEAs are not scientifically necessary for NEPs in GM crops if a hazard has not been identified, since risk is a function of both hazard and exposure. Nonetheless, dietary exposure assessments are sometimes required for regulatory purposes, and this publication outlines some key best practices and considerations for their conduct.
https://doi.org/10.21423/jrs-v08mathesius
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