The influence of neighbourhood formality status and socio-economic position on self-rated health among adult men and women: a multilevel, cross sectional, population study from Aleppo, Syria

Background There is substantial evidence from high income countries that neighbourhoods have an influence on health independent of individual characteristics. However, neighbourhood characteristics are rarely taken into account in the analysis of urban health studies from developing countries. Informal urban neighbourhoods are home to about half of the population in Aleppo, the second largest city in Syria (population>2.5 million). This study aimed to examine the influence of neighbourhood socioeconomic status (SES) and formality status on self-rated health (SRH) of adult men and women residing in formal and informal urban neighbourhoods in Aleppo. Methods The study used data from 2038 survey respondents to the Aleppo Household Survey, 2004 (age 18–65 years, 54.8% women, response rate 86%). Respondents were nested in 45 neighbourhoods. Five individual-level SES measures, namely education, employment, car ownership, item ownership and household density, were aggregated to the level of neighbourhood. Multilevel regression models were used to investigate associations. Results We did not find evidence of important SRH variation between neighbourhoods. Neighbourhood average of household item ownership was associated with a greater likelihood of reporting excellent SRH in women; odds ratio (OR) for an increase of one item on average was 2.3 (95% CI 1.3-4.4 (versus poor SRH)) and 1.7 (95% CI 1.1-2.5 (versus normal SRH)), adjusted for individual characteristics and neighbourhood formality. After controlling for individual and neighbourhood SES measures, women living in informal neighbourhoods were less likely to report poor SRH than women living in formal neighbourhoods (OR= 0.4; 95% CI (0.2- 0.8) (versus poor SRH) and OR=0.5; 95%; CI (0.3-0.9) (versus normal SRH). Conclusions Findings support evidence from high income countries that certain characteristic of neighbourhoods affect men and women in different ways. Further research from similar urban settings in developing countries is needed to understand the mechanisms by which informal neighbourhoods influence women’s health.

La utopía interior: Superación del dualismo en los ensayos de Ernesto Sábato

My research attempts to demonstrate how Sábato’s essays have pursued a progressive path that reflects the evolving process of his vision. In light of his essays, I will delineate the themes of solitude, death, desperation, robotization of man, and finally, hope as the antithesis. In my analysis I examine the model created in Sartre’s Existentialism. I also visit the model followed by Nicholas Berdyaeff, who at least offers the possibility of salvation in a world conceived by and for Nothingness. I investigate how these and other tendencies had an initial influence on the essays studied in my research. I concentrate on those essays whose discourse is conditioned by the philosophical foundations of a being that inquires and discerns, discovers and denounces, and finally struggles with the impossibility of reaching the absolute. This foresight, at times apocalyptic, at times utopian, is already present in Sábato’s early works. In my study I attempt to establish how Sábato, in oscillating between the demonic and the romantic, the infernal and utopian, constructs his vision of the world through the symbiotic intertwining of both the fictional and essayistic genres. I focus on an author compromised by a constant debate with the paradoxes and dichotomies that, according to Sábato himself, define Modernity.

Infants' selective attention to faces and prosody of speech: The roles of intersensory redundancy and exploratory time

One of the overarching questions in the field of infant perceptual and cognitive development concerns how selective attention is organized during early development to facilitate learning. The following study examined how infants' selective attention to properties of social events (i.e., prosody of speech and facial identity) changes in real time as a function of intersensory redundancy (redundant audiovisual, nonredundant unimodal visual) and exploratory time. Intersensory redundancy refers to the spatially coordinated and temporally synchronous occurrence of information across multiple senses. Real time macro- and micro-structural change in infants' scanning patterns of dynamic faces was also examined. ^ According to the Intersensory Redundancy Hypothesis, information presented redundantly and in temporal synchrony across two or more senses recruits infants' selective attention and facilitates perceptual learning of highly salient amodal properties (properties that can be perceived across several sensory modalities such as the prosody of speech) at the expense of less salient modality specific properties. Conversely, information presented to only one sense facilitates infants' learning of modality specific properties (properties that are specific to a particular sensory modality such as facial features) at the expense of amodal properties (Bahrick & Lickliter, 2000, 2002). ^ Infants' selective attention and discrimination of prosody of speech and facial configuration was assessed in a modified visual paired comparison paradigm. In redundant audiovisual stimulation, it was predicted infants would show discrimination of prosody of speech in the early phases of exploration and facial configuration in the later phases of exploration. Conversely, in nonredundant unimodal visual stimulation, it was predicted infants would show discrimination of facial identity in the early phases of exploration and prosody of speech in the later phases of exploration. Results provided support for the first prediction and indicated that following redundant audiovisual exposure, infants showed discrimination of prosody of speech earlier in processing time than discrimination of facial identity. Data from the nonredundant unimodal visual condition provided partial support for the second prediction and indicated that infants showed discrimination of facial identity, but not prosody of speech. The dissertation study contributes to the understanding of the nature of infants' selective attention and processing of social events across exploratory time.^

Forecasting future prevalence of type 2 diabetes mellitus in Syria

Background Type 2 diabetes mellitus (T2DM) is increasingly becoming a major public health problem worldwide. Estimating the future burden of diabetes is instrumental to guide the public health response to the epidemic. This study aims to project the prevalence of T2DM among adults in Syria over the period 2003–2022 by applying a modelling approach to the country’s own data. Methods Future prevalence of T2DM in Syria was estimated among adults aged 25 years and older for the period 2003–2022 using the IMPACT Diabetes Model (a discrete-state Markov model). Results According to our model, the prevalence of T2DM in Syria is projected to double in the period between 2003 and 2022 (from 10% to 21%). The projected increase in T2DM prevalence is higher in men (148%) than in women (93%). The increase in prevalence of T2DM is expected to be most marked in people younger than 55 years especially the 25–34 years age group. Conclusions The future projections of T2DM in Syria put it amongst countries with the highest levels of T2DM worldwide. It is estimated that by 2022 approximately a fifth of the Syrian population aged 25 years and older will have T2DM.

Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006

Background Despite advances made in treating coronary heart disease (CHD), mortality due to CHD in Syria has been increasing for the past two decades. This study aims to assess CHD mortality trends in Syria between 1996 and 2006 and to investigate the main factors associated with them. Methods The IMPACT model was used to analyze CHD mortality trends in Syria based on numbers of CHD patients, utilization of specific treatments, trends in major cardiovascular risk factors in apparently healthy persons and CHD patients. Data sources for the IMPACT model included official statistics, published and unpublished surveys, data from neighboring countries, expert opinions, and randomized trials and meta-analyses. Results Between 1996 and 2006, CHD mortality rate in Syria increased by 64%, which translates into 6370 excess CHD deaths in 2006 as compared to the number expected had the 1996 baseline rate held constant. Using the IMPACT model, it was estimated that increases in cardiovascular risk factors could explain approximately 5140 (81%) of the CHD deaths, while some 2145 deaths were prevented or postponed by medical and surgical treatments for CHD. Conclusion Most of the recent increase in CHD mortality in Syria is attributable to increases in major cardiovascular risk factors. Treatments for CHD were able to prevent about a quarter of excess CHD deaths, despite suboptimal implementation. These findings stress the importance of population-based primary prevention strategies targeting major risk factors for CHD, as well as policies aimed at improving access and adherence to modern treatments of CHD.

La utopía interior: superación del dualismo en los ensayos de Ernesto Sábato

My research attempts to demonstrate how Sábato’s essays have pursued a progressive path that reflects the evolving process of his vision. In light of his essays, I will delineate the themes of solitude, death, desperation, robotization of man, and finally, hope as the antithesis. In my analysis I examine the model created in Sartre’s Existentialism. I also visit the model followed by Nicholas Berdyaeff, who at least offers the possibility of salvation in a world conceived by and for Nothingness. I investigate how these and other tendencies had an initial influence on the essays studied in my research. I concentrate on those essays whose discourse is conditioned by the philosophical foundations of a being that inquires and discerns, discovers and denounces, and finally struggles with the impossibility of reaching the absolute. This foresight, at times apocalyptic, at times utopian, is already present in Sábato’s early works. In my study I attempt to establish how Sábato, in oscillating between the demonic and the romantic, the infernal and utopian, constructs his vision of the world through the symbiotic intertwining of both the fictional and essayistic genres. I focus on an author compromised by a constant debate with the paradoxes and dichotomies that, according to Sábato himself, define Modernity.