Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly:a community-based cross-sectional survey

Context: Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment. Objective: The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population. Design, Setting, and Participants: A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom. Exclusions: Exclusions included current therapy for thyroid disease, thyroid surgery, or treatment within 12 months. Outcome Measure: Tests of thyroid function (TSH concentration and free T 4 concentration in all, with measurement of free T3 in those with low TSH) were conducted. Explanatory Variables: These included all current medical diagnoses and drug therapies, age, gender, and socioeconomic deprivation (Index of Multiple Deprivation, 2004) Analysis: Standardized prevalence rates were analyzed. Logistic regression modeling was used to determine factors associated with the presence of subclinical thyroid dysfunction Results: A total of 5960 attended for screening. Using biochemical definitions, 94.2% [95% confidence interval (CI) 93.8-94.6%] were euthyroid. Unidentified overt hyper- and hypothyroidism were uncommon (0.3, 0.4%, respectively). Subclinical hyperthyroidism and hypothyroidism were identified with similar frequency (2.1%, 95% CI 1.8-2.3%; 2.9%, 95% CI 2.6-3.1%, respectively). Subclinical thyroid dysfunction was more common in females (P < 0.001) and with increasing age (P < 0.001). After allowing for comorbidities, concurrent drug therapies, age, and gender, an association between subclinical hyperthyroidism and a composite measure of socioeconomic deprivation remained. Conclusions: Undiagnosed overt thyroid dysfunction is uncommon. The prevalence of subclinical thyroid dysfunction is 5%. We have, for the first time, identified an independent association between the prevalence of subclinical thyroid dysfunction and deprivation that cannot be explained solely by the greater burden of chronic disease and/or consequent drug therapies in the deprived population. Copyright © 2006 by The Endocrine Society.

Transforming the eastern neighbourhood: the security implications of European Union Activity in Ukraine 2000-2006

This thesis examines the external activities of the European Union conducted in the wider Europe against the backdrop of eastern enlargement. It focuses on the technical aspects of EU diplomacy, using qualitative research methodology to study the programmes and initiatives launched since the year 2000 in the countries lying along the Union’s new border to the east. Drawing on evidence from Ukraine, it hypothesises that the EU is an agent of transformation in the eastern neighbourhood and that this transformation has important implications for the regional order in the post-Soviet space. The thesis constitutes an investigation into the transformational activities engaged by the EU in Ukraine conducted with an eye to their strategic implications. It documents and analyses three instances of EU intervention in Ukraine’s internal processes that relate to management of cross-border traffic in the Ukrainian-Russian borderland, restructuring of the country’s energy sector, and conduct of its contentious presidential election in 2004. It is argued that while these interventions have explicitly sought to advance the Union’s security with respect to certain twenty-first century transnational threats, they have at the same time served to confer important strategic advantages on the EU that include giving the bloc greater knowledge and control over developments in Ukraine and that contribute to the dismantling of infrastructural, institutional and other ties between Kiev and the other Soviet successor states, notably Russia. The effect of the European Union’s actions in the region, whether intended or not, has thus been to undermine any competing regional initiatives that cut across its own functions, and thereby to assert itself as the primary integration project in Europe. By showing how technical interventions in the politics, economics and administration of Ukraine can yield important geopolitical dividends, this thesis demonstrates that, in the context of EU external relations, high and low politics are interlinked.

Accessibility, deprivation and rural planning policies.

Since the Second World War a range of policies have been implemented by central and local government agencies, with a view to improving accessibility to facilities, housing and employment opportunities within rural areas. It has been suggested that a lack of reasonable access to a range of such facilities and opportunities constitutes a key aspect of deprivation or disadvantage for rural residents. Despite considerable interest, very few attempts have been made to assess the nature and incidence of this disadvantage or the reaction of different sections of the population of rural areas to it. Moreover, almost all previous assessments have relied on so-called 'objective' measures of accessibility and disadvantage and failed to consider the relationship between such measures and 'subjective' measures such as individual perceptions. It is this gap in knowledge that the research described in this thesis has addressed. Following a critical review of relevant literature the thesis describes the way in which data on 'objective' and 'subjective' indicators of accessibility and behavioural responses to accessibility problems was collected, in six case study areas in Shropshire. Analysis of this data indicates that planning and other government policies have failed to significantly improve rural resident's accessibility to their basic requirements, and may in some cases have exacerbated it, and that as a result certain sections of the rural population are relatively disadvantaged. Moreover, analysis shows that .certain aspects of individual subjective' assessments of such accessibility disadvantage are significantly associated with more easily-obtained 'objective' measures. By using discriminant analysis the research demonstrates that it is possible to predict the likely levels of satisfaction with access to facilities from a range of 'objective' measures. The research concludes by highlighting the potential practical applications of such indicators in policy formulation, policy appraisal and policy evaluation.

Influence of iron deprivation and sub-inhibitory concentrations of antifungal antibiotics on surface antigens of candida albicans yeast cells

This study examined the effect of iron deprivation and sub-inhibitory concentrations of antifungal agents on yeast cell surface antigen recognition by antibodies from patients with Candida infections. Separation of cell wall surface proteins by sodium dodecyl-polyacrylamide gel electrophoresis (SDS-PAGE) and immunological detection by immunoblotting, revealed that antigenic profiles of yeasts were profoundly influenced by the growth environment. Cells grown under iron-depleted conditions expressed several iron-regulated proteins that were recognized by antibodies from patient sera. An attempt to characterize these proteins by lectin blotting with concanavalin A revealed that some could be glycoprotein in nature. Furthermore, these proteins which were located within cell walls and on yeast surfaces, were barely or not expressed in yeasts cultivated under iron-sufficient conditions. The magnitude and heterogeneity of human antibody responses to these iron-regulated proteins were dependent on the type of Candida infection, serum antibody class and yeast strain. Hydroxamate-type siderophores were also detected in supernatants of iron depleted yeast cultures. This evidence suggests that Candida albicans expresses iron-regulated proteins/glycoproteins in vitro which may play a role in siderophore-mediated iron uptake in Candida albicans. Sequential monitoring of IgG antibodies directed against yeast surface antigens during immunization of rabbits revealed that different antigens were recognized particularly during early and later stages of immunization in iron-depleted cells compared to iron-sufficient cells. In vitro and in vivo adherence studies demonstrated that growth phase, yeast strain and growth conditions affect adhesion mechanisms. In particular, growth under iron-depletion in the presence of sub-inhibitory concentrations of polyene and azole antifungals enhanced the hydrophobicity of C.albicans. Growth conditions also influenced MICs of antifungals, notably that of ketoconazole. Sub-inhibitory concentrations of amphotericin B and fluconazole had little effect on surface antigens, whereas nystatin induced profound changes in surface antigens of yeast cells. The effects of such drug concentrations on yeast cells coupled with host defence mechanisms may have a significant affect on the course of Candida infections.

Is education the panacea for economic deprivation of Muslims? Evidence from wage earners in India, 1987-2005

Few researchers have examined the nature and determinants of earnings differentials among religious groups, and none has been undertaken in the context of conflict-prone multi-religious societies like the one in India. We address this lacuna in the literature by examining the differences in the average log earnings of Hindu and Muslim wage earners in India, during the 1987–2005 period. Our results indicate that education differences between Hindu and Muslim wage earners, especially differences in the proportion of wage earners with tertiary education, are largely responsible for the differences in the average log earnings of the two religious groups across the years. By contrast, differences in the returns to education do not explain the aforementioned difference in average log earnings. In conclusion, we discuss some policy implications.

An examination of the determinants of entrepreneurship at the regional level:the case of East Midlands region

Despite the importance of new firms to the economy, determinants of start-ups have mainly been examined at a country level and discussion of regional entrepreneurial activity has received less attention. Since there are significant variations in entrepreneurship rates across and within countries, such an investigation at a regional level would help in gaining an in depth understanding of the impact of the individual level resource endowments and neighbourhood characteristics on an individual’s decision to engage in entrepreneurial activity. The main aim of the thesis is to explore various theories of entrepreneurship and develop integrated frameworks for examining the determinants of entrepreneurial activity at a neighbourhood level in the East Midlands region in England. The specific objectives of the thesis are to examine how the individual level resources and the neighbourhood characteristics: (i) combine to influence an individual to engage in the different stages of the entrepreneurial process, (ii) influence natives and migrants to engage in start up activity and (iii) influence women and men to become self-employed and ambitious entrepreneurs. In terms of the methodology, the empirical analysis is based on two databases combined: 2006 to 2009 GEM East Midlands region and the English Index of Multiple Deprivation dataset. Based on the critical review of the literature on entrepreneurship the thesis develop theoretical frameworks which led to formulate hypotheses related to the differentiated impact of both individual and neighbourhood level factors on the propensity of an individual to be involved in entrepreneurial activity. The findings indicate that the determinants of entrepreneurial activity vary with human, financial and the local environment factors affecting the entrepreneurial process. Finally, the thesis calls for caution when developing and applying generic and specific policy measures aimed at promoting entry into entrepreneurship.

The EU's support for democratic governance in the Eastern neighbourhood:the role of transition experience from the New Member States

The European Union seems to place an increasing rhetorical emphasis on harnessing the transition experience of the new member states. This article examines whether the EU actually makes use of this experience in its promotion of democratic governance in the eastern neighbourhood. The main conclusion is that while reform priorities of the EU in the region are aligned with transition experience, the actual participation of actors from the new members in implementing EU-financed projects aimed at promoting democratic governance is limited. This contradiction should be resolved or it will further erode the credibility of the EU's external policies.

Planning the neighbourhood economy:land-use plans and the economic potential of urban residential neighbourhoods in the Netherlands

This article investigates the relationship between zoning by-laws, as put forward in governmental land-use plans and the viability of urban residential neighbourhood economies. The Dutch planning tradition has long been characterized by strict separation of functions and top-down planning. We argue that profound changes in social and economic structures make land-use planning practices less suitable for the current policy formula of "mixed urban milieus". Although the residential neighbourhood might not be the location of large firms, it definitely attracts small ones, and facilitates starting businesses whose presence (and potential growth) can be beneficial to the city as a whole. We present a typology of spatial patterns of neighbourhood economies based on land-use plans and describe whether these are related to the distinctive economic development of the neighbourhood over the period 1999-2007. © 2013 Taylor & Francis.

The power of the powerless:neighbourhood based self-help networks of the poor in Istanbul

Recent poverty research focuses on the household responses to poverty through structure vs. agency perspectives. The human agency perspective, however, provides us important insights for looking beyond these simplistic tendencies which assume poor people as inherently passive, or envision them as helpless victims. In Turkey, politicians view poverty as a temporary and manageable problem which can be dealt with the provision of more charity or community support. Migrant networks, informal sector work and social assistance are considered to be important mechanisms that would provide resources for the poor. This paper argues that for some of the poor households none of these mechanisms provide sufficient resources. Instead, neighbourhood-based small-group solidarities and self-help networks enable those poor to develop collective capabilities and make ends meet. The paper also reveals that in Turkey, the implementation of social policies for poverty reduction could bring about relationships of patronage and in some cases contribute to existing inequalities.

Framing the EU’s policy towards the neighbourhood:the strategic approach of the Seventh European Parliament (2009–2014)

The Lisbon treaty afforded the European Parliament (EP) increased powers in foreign policy. These have included new legislative competences in the area of international agreements or the European Union’s (EU) relations with third party states. This article analyses the way the last mandate of the EP, which was the first to benefit from the changes introduced by the Lisbon treaty, framed EU foreign policy. More specifically, it explores the way in which the EP strategically framed the EU’s approach towards the neighbourhood countries. The focus on the neighbourhood is justified by the fact that it is the most salient area of the EU’s foreign policy. The article shows that the EP pushed for the EU to have a stronger presence in the neighbourhood. The EP also strategically aimed that it should have a more central role in shaping the EU’s approach towards the neighbourhood.