Des principes de responsabilité et de solidarité pour un accès équitable aux soins de santé : le cas des travailleurs de l'informel urbain du Cameroun en situation de vulnérabilité

La question de l’accès financier des personnes socialement défavorisées aux soins de santé est aujourd’hui un enjeu éthique de grande importance dans de nombreux pays à faible revenu ou en voie d’émergence. On peut se demander comment l’équité dans l’accès aux soins peut être rendue effective puisque l’égalité des chances pour tous et la santé sont des pré-requis aux choix de vie et à la réalisation de soi. Les soins de santé sont donc d’une importance éthique particulière du fait qu’ils contribuent à préserver notre statut comme citoyens pleinement fonctionnels. Au Cameroun, bien que des efforts considérables soient consentis par les pouvoirs publics et leurs partenaires extérieurs pour favoriser l’accès aux soins des personnes défavorisées, le secteur de la santé reste encore très marqué par l’inégalité dans l’accès financier aux prestations sanitaires. Les médicaments les plus essentiels ne sont pas financièrement à la portée de tous et les coûts d’accès aux soins ambulatoires et hospitaliers dans les formations sanitaires sont manifestement prohibitifs pour une large frange de la population. Lors des épisodes de maladie, l’accès aux soins se fait par le paiement direct au point d’accès, et la pratique de l’automédication s’est répandue du fait de l’incapacité des personnes socialement défavorisées à payer leurs soins sans courir le risque de perdre l’essentiel de leur revenu. Les mesures de prise en charge sociale ou des systèmes de financement qui garantissent la réduction des inégalités entre les classes sociales sont fortement limitées par les faibles capacités d’une économie qui repose essentiellement sur l’informel. Sur la base de cette réalité, cette thèse analyse à partir du cas des travailleurs vulnérables du secteur informel urbain, la pertinence du choix politique de la couverture universelle santé au Cameroun à travers les principes de responsabilité et de solidarité. La population d’étude choisie est celle des travailleurs vulnérables du secteur informel en considération des problématiques liées à leur accès aux soins de santé, de l’importance de leur apport dans l’économie du pays ( 90 % des travailleurs) et du rôle qu’elle pourrait jouer dans l’atteinte de l’objectif de la couverture universelle santé. La thèse analyse donc, d’une part, les conditions et les modalités de répartition des biens sociaux qui répondent à la nécessaire redistribution équitable des ressources, en l’occurrence l’accès aux soins de qualité. Après avoir montré les préoccupations d’ordre politique, social, économique et éthique liées au problème d’accès universel aux soins, la thèse propose des stratégies opérationnelles susceptibles de conduire à l’amélioration de la qualité des soins et à un assainissement de la gestion du secteur des services de soins (éthique du care et éthique de bonne gouvernance). Aussi, dans la perspective de la recherche d’un financement local soutenable et durable de l’accès de tous aux soins, la thèse propose une approche participative. L’exploration de cette perspective aboutit au résultat qu’une approche inclusive et intégrée de promotion de l’économie informelle (dynamisation de ses activités et potentialisation de ses acteurs) pourrait faire de ce secteur un véritable levier de développement économique et social. Un développement social et solidaire durable et susceptible, sur le long terme, de réaliser l’objectif de la couverture universelle santé. En d’autres termes, elle propose des stratégies de capabilisation et de responsabilisation des travailleurs du secteur informel, en vue d’une société plus impliquée, plus responsable et plus solidaire. Une approche susceptible de matérialiser le droit à la santé, de construire l’autonomie des travailleurs en situation de vulnérabilité et de renforcer leurs capacités contributives à travers une opérationnalisation adaptée au contexte des principes de responsabilité et de solidarité.

Marine yeast Candida MCCF 101 as feed supplement in aquaculture: nutritional quality, optimization of large scale production and evaluation of its protective effect on Koi carp from Aeromonas infection

Marine yeast have been regarded as safe and showing a beneficial impact on biotechnological process. It provides better nutritional and dietary values indicating their potential application as feed supplements in aquaculture. Brown et al. (1996) evaluated all the marine yeasts characterised with high protein content, carbohydrate, good amino acid composition and high levels of saturated fats. However, there is paucity of information on marine yeasts as feed supplements and no feed formulation has been found either in literature or in market supplemented with them. This statement supported by Zhenming et al. (2006) reported still a lack of feed composed of single cell protein (SCP) from marine yeasts with high content of protein and other nutrients. Recent research has shown that marine yeasts also have highly potential uses in food, feed, medical and biofuel industries as well as marine biotechnology (Chi et al., 2009; 2010). Sajeevan et al. (2006; 2009a) and Sarlin and Philip (2011) demonstrates that the marine yeasts Candida sake served as a high quality, inexpensive nutrient source and it had proven immunostimulatory properties for cultured shrimps. This strain has been made part of the culture collection of National Centre for Aquatic Animal Health, Cochin University of Science and Technology as Candida MCCF 101. Over the years marine yeasts have been gaining increased attention in animal feed industry due to their nutritional value and immune boosting property.Therefore, the present study was undertaken, and focused on the nutritional quality, optimization of large scale production and evaluation of its protective effect on Koi carp from Aeromonas infection

One-sided jet at milliarcsecond scales in LS I +61˚ 303

We present Very Long Baseline Interferometry (VLBI) observations of the high mass X-ray binary LS I +61˚303, carried out with the European VLBI Network (EVN). Over the 11 hour observing run, performed ~10 days after a radio outburst, the radio source showed a constant flux density, which allowed sensitive imaging of the emission distribution. The structure in the map shows a clear extension to the southeast. Comparing our data with previous VLBI observations we interpret the extension as a collimated radio jet as found in several other X-ray binaries. Assuming that the structure is the result of an expansion that started at the onset of the outburst, we derive an apparent expansion velocity of 0:003 c, which, in the context of Doppler boosting, corresponds to an intrinsic velocity of at least 0:4 c for an ejection close to the line of sight. From the apparent velocity in all available epochs we are able to establish variations in the ejection angle which imply a precessing accretion disk. Finally we point out that LS I +61˚303, like SS 433 and Cygnus X-1, shows evidence for an emission region almost orthogonal to the relativistic jet

El TLC con Estados Unidos: una oportunidad para Colombia

Los procesos de integración que se han venido consolidando a lo largo de las últimas dos décadas han permitido el incremento de la productividad, la inversión e inserción de la economía colombiana en los mercados mundiales. Sin embargo, ha sido Estados Unidos el socio comercial más importante y decisivo para el comercio internacional de nuestros productos. Por tal motivo, la consolidación de un Tratado de Libre Comercio con este país será una oportunidad única para potenciar el desarrollo económico interno, la consolidación de una alianza estratégica para Colombia e, incluso, permitirá el fortalecimiento de nuestras relaciones con los mercados europeos y asiáticos.-----The integration processes that have been taking place in the last two decades have allowed an increase in productivity and investment, and the insertion of Colombian economy in world markets. However, the United States have been Colombia’s most important and decisive commercial partner for trading its products at an international level. Therefore, the consolidation of a Free Trade Agreement with that country will be a unique opportunity for boosting Colombia’s internal economic development and consolidating a strategic partnership; it will also strengthen our relations with European and Asian markets.

Influencia de la comunidad de clústers en las relaciones estratégicas comunitarias y el marketing compartido

Un clúster es entendido por la gran mayoría como un gran conglomerado de empresas que giran en torno a un objetivo, en su gran mayoría económico. Su intención es competir con otros conglomerados en cuanto a precios y cantidades, ya que de manera individual no podrían. En consecuencia, esta unión se utiliza en un principio para crear ventajas tanto competitivas como comparativas en contra de la competencia, lo cual genera un valor a esta unión, con el fin de producir fidelidad en el cliente y recordación de todos los productos que tal unión brinde. Según estudios realizados por diversos autores, en muchas ocasiones, los clúster no se crean con una finalidad económica, sino como desarrollo de un perfil comunitario que ayude a la sociedad y las organizaciones que la componen. La base de las relaciones se centra en la comunicación y en las diversas técnicas que existen en ese ámbito para asegurar la sostenibilidad de la organización. Dentro de estas relaciones, se le da un reconocimiento a la educación y la cultura en donde se encuentra ubicado el clúster, ya que las estrategias que se implementen se relacionan directamente con las necesidades de los clientes, generando en el pensamiento de la comunidad la perdurabilidad y sostenibilidad como efecto del desarrollo social.

Educación musical: Investigamos, luego avanzamos

Este texto hace referencia al importante avance experimentado en el campo de la investigación en educación musical en estos últimos años, avance que nos ha proporcionado importantes transformaciones en la manera de organizar la enseñanza y el aprendizaje de la música. Se insta sobre la necesidad de apoyar a los profesionales de la música que tengan interés por adquirir capacidad investigadora, así como de potenciar el trabajo conjunto entre el profesorado perteneciente a las enseñanzas especializadas de música y a las enseñanzas de música universitarias. Todo ello contribuirá a un mejor y más profundo conocimiento de nuestras áreas de estudio y al crecimiento y fortalecimiento de las mismas.

El turismo en los espacios naturales protegidos. Análisis de los objetos de consumo turístico y del comportamiento de los turistas en los parques naturales de Liguria

The objectives of the thesis are identify in the current tourism landscape, tourist typologies which are capable of ensuring an adequate level of sustainability, ie that take into account the need to establish effective partnerships between major players in the touristic sector: 1. Looking for practical examples of more responsible tourism forms with resources. 2. Stressing the role played by ecotourism, this form of tourism according to the qual makes your holiday visitors relate more directly conscious of environmental and sociocultural present in the venue. 3. identifying actions to ensure the protection of the environment and the economic take off by traditionally depressed areas. 4. identifying objects aimed at boosting tourism consumption of a natural protected area interpreted as ideal as post-Fordist real space and identify profiles of tourists in protected areas. Also if tourism products linked to nature, culture and cuisine can help to revitalize the Ligurian coastal tourism 5. Checking if the regional system of protected areas has produced results in both environmental protection and endogenous development through tourism. 6. Quantifying the actual supply of the areas studied. 7. Checking if the three parks studied were identified and developed specific objects of tourist consumption.

Identification of nonlinear systems using generalized kernel models

Nonlinear system identification is considered using a generalized kernel regression model. Unlike the standard kernel model, which employs a fixed common variance for all the kernel regressors, each kernel regressor in the generalized kernel model has an individually tuned diagonal covariance matrix that is determined by maximizing the correlation between the training data and the regressor using a repeated guided random search based on boosting optimization. An efficient construction algorithm based on orthogonal forward regression with leave-one-out (LOO) test statistic and local regularization (LR) is then used to select a parsimonious generalized kernel regression model from the resulting full regression matrix. The proposed modeling algorithm is fully automatic and the user is not required to specify any criterion to terminate the construction procedure. Experimental results involving two real data sets demonstrate the effectiveness of the proposed nonlinear system identification approach.

Humoral immunity following chickenpox is influenced by geography and ethnicity

Objectives To investigate the contribution of ethnicity and geographical location to varicella-zoster virus (VZV) serostatus and antibody concentrations. Methods The presence and concentrations of antibodies to VZV were measured in 639 Bangladeshi women born in Bangladesh (BBB), 94 Bangladeshi women born in the UK (BUK) and 262 White women born in the UK (WUK). The results were anaylsed in relation to demographic and social data. Results BBB women were significantly less likely to be VZV seropositive at all ages than both BUK and WUK women. However, the odds of a Bangladeshi-born woman being seropositive increased by 1.04 for each year under the age of 15 spent in the UK. In contrast, antibody concentrations were significantly lower in ethnic Bangladeshi women, irrespective of country of birth. White, but not Bangladeshi women, showed evidence of antibody boosting over time despite the latter having more exposure to children. Conclusion Geographical location during childhood is the major influence on age of primary infection with VZV while the level of antibody is related to ethnicity. Since the risk of re-infection with VZV following both natural infection and vaccination is increased as antibody concentrations fall, these results have implications for VZV vaccination programmes particularly in non-White populations.

Researcher development: the impact of undergraduate research opportunity programmes on students in the UK

Undergraduate research opportunity programmes (UROP) are common in North America where research has confirmed their benefits. These schemes are gaining ground in the UK, and this article provides evidence for how UK students are benefiting from the experience. Results suggest UROP makes a significant contribution to the research capabilities and confidence of participating students, boosting their understanding of both research and their own subjects. Whilst offering considerable benefits to student learning, there is no evidence that UROP schemes on their current small scale attract additional students to postgraduate research, since the majority that participate are already interested in postgraduate study. However, at an individual level, most students report increased confidence and appreciation of the realities of the research process, and desire to progress on to postgraduate study following the placement, indicating that schemes may have the potential to cultivate new research confidence and interest if expanded.

Farm productivity and efficiency in rural Bangladesh: the role of education revisited

This article reassesses the debate over the role of education in farm production in Bangladesh using a large dataset on rice producing households from 141 villages. Average and stochastic production frontier functions are estimated to ascertain the effect of education on productivity and efficiency. A full set of proxies for farm education stock variables are incorporated to investigate the ‘internal’ as well as ‘external’ returns to education. The external effect is investigated in the context of rural neighbourhoods. Our analysis reveals that in addition to raising rice productivity and boosting potential output, household education significantly reduces production inefficiencies. However, we are unable to find any evidence of the externality benefit of schooling – neighbour's education does not matter in farm production. We discuss the implication of these findings for rural education programmes in Bangladesh.

The identity of crop pollinators helps target conservation for improved ecosystem services

Insect pollinated mass flowering crops are becoming more widespread and there is a need to understand which insects are primarily responsible for the pollination of these crops so conservation measures can be appropriately targeted in the face of pollinator declines. This study used field surveys in conjunction with cage manipulations to identify the relative contributions of different pollinator taxa to the pollination of two widespread flowering crops, field beans and oilseed rape. Flower visiting pollinator communities observed in the field were distinct for each crop; while field beans were visited primarily by a few bumblebee species, multiple pollinator taxa visited oilseed, and the composition of this pollinator community was highly variable spatially and temporally. Neither pollinator community, however, appears to be meeting the demands of crops in our study regions. Cage manipulations showed that multiple taxa can effectively pollinate both oilseed and field beans, but bumblebees are particularly effective bean pollinators. Combining field observations and cage manipulations demonstrated that the pollination demands of these two mass flowering crops are highly contrasting, one would benefit from management to increase the abundance of some key taxa, whilst for the other, boosting overall pollinator abundance and diversity would be more appropriate. Our findings highlight the need for crop specific mitigation strategies that are targeted at conserving specific pollinator taxa (or group of taxa) that are both active and capable of crop pollination in order to reduce pollination deficits and meet the demands of future crop production.

Climate-driven spatial mismatches between British orchards and their pollinators: increased risks of pollination deficits

Understanding how climate change can affect crop-pollinator systems helps predict potential geographical mismatches between a crop and its pollinators, and therefore identify areas vulnerable to loss of pollination services. We examined the distribution of orchard species (apples, pears, plums and other top fruits) and their pollinators in Great Britain, for present and future climatic conditions projected for 2050 under the SRES A1B Emissions Scenario. We used a relative index of pollinator availability as a proxy for pollination service. At present there is a large spatial overlap between orchards and their pollinators, but predictions for 2050 revealed that the most suitable areas for orchards corresponded to low pollinator availability. However, we found that pollinator availability may persist in areas currently used for fruit production, but which are predicted to provide sub-optimal environmental suitability for orchard species in the future. Our results may be used to identify mitigation options to safeguard orchard production against the risk of pollination failure in Great Britain over the next 50 years; for instance choosing fruit tree varieties that are adapted to future climatic conditions, or boosting wild pollinators through improving landscape resources. Our approach can be readily applied to other regions and crop systems, and expanded to include different climatic scenarios.

Global networks, cities and economic performance: Observations from an analysis of cities in Europe and the USA

The network paradigm has been highly influential in spatial analysis in the globalisation era. As economies across the world have become increasingly integrated, so-called global cities have come to play a growing role as central nodes in the networked global economy. The idea that a city’s position in global networks benefits its economic performance has resulted in a competitive policy focus on promoting the economic growth of cities by improving their network connectivity. However, in spite of the attention being given to boosting city connectivity little is known about whether this directly translates to improved city economic performance and, if so, how well connected a city needs to be in order to benefit from this. In this paper we test the relationship between network connectivity and economic performance between 2000 and 2008 for cities with over 500,000 inhabitants in Europe and the USA to inform European policy.

ENSO and greenhouse warming

The El Niño/Southern Oscillation (ENSO) is the dominant climate phenomenon affecting extreme weather conditions worldwide. Its response to greenhouse warming has challenged scientists for decades, despite model agreement on projected changes in mean state. Recent studies have provided new insights into the elusive links between changes in ENSO and in the mean state of the Pacific climate. The projected slow-down in Walker circulation is expected to weaken equatorial Pacific Ocean currents, boosting the occurrences of eastward-propagating warm surface anomalies that characterize observed extreme El Niño events. Accelerated equatorial Pacific warming, particularly in the east, is expected to induce extreme rainfall in the eastern equatorial Pacific and extreme equatorward swings of the Pacific convergence zones, both of which are features of extreme El Niño. The frequency of extreme La Niña is also expected to increase in response to more extreme El Niños, an accelerated maritime continent warming and surface-intensified ocean warming. ENSO-related catastrophic weather events are thus likely to occur more frequently with unabated greenhouse-gas emissions. But model biases and recent observed strengthening of the Walker circulation highlight the need for further testing as new models, observations and insights become available.