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ObjectivesVisual impairment is a disability affecting a large number of people worldwide, who are more likely to experience difficulties in their daily lives, impacting on their quality of life, independence, mobility and state of health. However, there is a lack of progress in the field of healthcare for individuals living with a visual impairment. The objectives of this study were (1) to illustrate the usual clinical practices of physicians to support the care of individuals with a visual impairment and (2) to identify the components considered to reduce risks resulting from the prescription of medications to these individuals.Methods and analysisSemi-structured interviews were conducted with French-speaking physicians via videoconference in Belgium. Participants were recruited voluntarily and using the snowball method. An interview guide was developed to meet the objectives of the study. Interviews were carried out until theoretical data saturation, recorded, transcribed verbatim and analysed in a double-blind fashion using thematic analysis. Data were organised using NVivo V.14 software.ResultsThree themes were addressed in the 24 interviews: consultation with patients with a visual impairment, prescribing medications to patients with a visual impairment and medication risk management for patients with a visual impairment. Most participants reported that they had not received specific education in visual impairment. Some physicians reported that they did not differentiate between patients living with a visual impairment and other patients, while others reported taking some additional measures.ConclusionsThis qualitative study highlighted a lack of knowledge and awareness among physicians regarding visual impairment and at-risk medications in these patients. The development of recommendations and tools is a solution to improve the quality of care for patients living with a visual impairment.

Base composition is highly variable among and within plant genomes, especially at third codon positions, ranging from GC-poor and homogeneous species to GC-rich and highly heterogeneous ones (particularly Monocots). Consequently, synonymous codon usage is biased in most species, even when base composition is relatively homogeneous. The causes of these variations are still under debate, with three main forces being possibly involved: mutational bias, selection and GC-biased gene conversion (gBGC). So far, both selection and gBGC have been detected in some species but how their relative strength varies among and within species remains unclear. Population genetics approaches allow to jointly estimating the intensity of selection, gBGC and mutational bias. We extended a recently developed method and applied it to a large population genomic dataset based on transcriptome sequencing of 11 angiosperm species spread across the phylogeny. We found that at synonymous positions, base composition is far from mutation-drift equilibrium in most genomes and that gBGC is a widespread and stronger process than selection. gBGC could strongly contribute to base composition variation among plant species, implying that it should be taken into account in plant genome analyses, especially for GC-rich ones.

Barriers to management of HCV in injection drug users are related to patients, health providers, and facilities. In a primary care drug user's addiction centre we studied access to HCV standard of care before and after using an onsite total care concept provided by a multidisciplinary team and noninvasive liver fibrosis evaluation. A total of 586 patients were seen between 2002 and 2004. The majority, 417 patients, were HCV positive and of these patients 337 were tested positive for HCV RNA. In 2002, patients were sent to the hospital. with the Starting of 2003, patients were offered standard of care HCV management in the center by a team of general practitioners, a consultant hepatologist, psychiatrists, nurses, and a health counsellor. Liver fibrosis was assessed by a non invasive method. In 2002, 6 patients had liver fibrosis assessment at hospital facilities, 4 patients were assessed with liver biopsy and 2 patients with Fibrotest-Actitest. 2 patients were treated for HCV at hospital. In 2003 and 2004, 224 patients were assessed with Fibrotest-Actitest on site. Of these, 85 were treated for HCV. SVR was achieved in 43%. We conclude that the combination of an onsite multidisciplinary team with the use of a noninvasive assessment method led to improved management of HCV infection in drug users' primary care facility.

Base composition is highly variable among and within plant genomes, especially at third codon positions, ranging from GC-poor and homogeneous species to GC-rich and highly heterogeneous ones (particularly Monocots). Consequently, synonymous codon usage is biased in most species, even when base composition is relatively homogeneous. The causes of these variations are still under debate, with three main forces being possibly involved: mutational bias, selection and GC-biased gene conversion (gBGC). So far, both selection and gBGC have been detected in some species but how their relative strength varies among and within species remains unclear. Population genetics approaches allow to jointly estimating the intensity of selection, gBGC and mutational bias. We extended a recently developed method and applied it to a large population genomic datasets based on transcriptome sequencing of 11 angiosperm species spread across the phylogeny. We found that base composition is far from mutation-drift equilibrium in most genomes and that gBGC is a widespread and stronger process than selection. gBGC could strongly contribute to base composition variation among plant species, implying that it should be taken into account in plant genome analyses, especially for GC-rich ones.