Are we living longer but less healthy? Trends in mortality and morbidity in Catalonia (Spain), 1994-2011

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity as indicated by disease have appeared in Europe and other developed regions. It is likely that better treatment, preventive measures and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity from major causes of death and links of these with survival to provide estimates of life expectancy with and without diseases and functioning loss. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity; mortality information comes from the Spanish National Statistics Institute. Our findings show that at age 65 the percentage of life with disease increased from 52% to 70% for men, and from 56% to 72% for women; the expectation of life unable to function increased from 24% to 30% for men and 40% to 47% for women between 1994 and 2011. These changes were attributable to increases in the prevalences of diseases and moderate functional limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.

Urban conservation areas and sustainable development: exploring the relationship

With increasing emphasis being placed on concentrating development in urban areas and improving the quality of life in British cities and towns, the importance of accommodating necessary development without compromising the valued heritage and architectural quality of urban areas is now becoming central to sustainable urban development. Urban conservation policy and practice has the potential to contribute to this and other aspects of sustainability. This paper explores this contribution and develops an analytical framework which draws out the key linkages between conservation area policy and sustainable development. The framework is then used to research the potential and actual contribution of urban conservation policy and practice in England, using a selective survey and two case studies (i.e. Winchester and Basingstoke). The main conclusions from the research are that: Conservation area policy can make a significant contribution to the principles of sustainable development; Most local planning authorities in England have not fully woken-up to this potential and have not developed policies or practices to address it; and Urban conservation policy needs to develop a more proactive approach in which local planning authorities actively guide and encourage new development with regard to use, design, layout, methods of construction, materials and energy efficiency.

Organizing for sustainable procurement: theories, institutions and practice

That construction procurement needs to be re-organized to make it more sustainable implies that there is a problem with the current situation. Starting from this assumption, an overview of construction procurement sets the scene for a discussion of some recent developments relating to organizational frameworks for sustainable construction procurement. Emergent theories dealing with sustainable procurement are considered. There is a plethora of standards and guidance documents for organizing sustainable procurement, originating from a variety of organizations involved. These considerations form the context for approaches being used in practice to achieve sustainable procurement. The Chapter concludes with reflections on why current approaches are insufficient. It seems difficult to persuade clients to spend less money over the life cycle of their buildings. Future directions needed to translate sustainable procurement from rhetoric to reality include the development of suitable incentives and appropriate organizational structures.

Autonomy Markers in Brazilian Adults With Intellectual Disabilities

The objective of the study was to investigate the relationship between autonomy markers in adult people with intellectual disabilities (ID) and variables such as intelligence quotient (IQ), early aging, and literacy. Participants were 47 adults with ID (33 men; aged 28-58 years with nonspecific etiology, 34 literate). All participants were trainees at the Center for Training of Capacity and Orientation for Employment at Associação de Pais e Amigos dos Excepcionais de São Paulo, São Paulo State, Brazil. They were divided into two age groups: younger (n = 27, mean age 31.85; +/- 2.23), and older (n = 38, mean age 41.84; +/- 5.54). They were administered intelligence scales twice, and answered questions related to social participation, community integration, and choice-making; the percentage of item responses leaning toward self-determination and freedom in choice-making was considered in defining the autonomy score. For both groups, IQ declined from the first to the second assessment. Autonomy scores were more determined by IQ classification than by literacy. Authors concluded that autonomy in people with ID is a multifactorial phenomenon associated with cognitive decline.

Exploring the effectiveness of development research with a monitoring and learning approach

There is a growing demand for better understanding of the link between research, policy and practice in development. This article provides findings from a study that aimed to gain insights into how researchers engage with their non-academic partners. It draws on experiences from the National Centre of Competence in Research North-South programme, a development research network of Swiss, African, Asian and Latin American institutions. Conceptually, this study is concerned with research effectiveness as a means to identify knowledge useful for society. Research can be improved and adapted when monitoring the effects of interactions between researchers and non-academic partners. Therefore, a monitoring and learning approach was chosen. This study reveals researchers' strategies in engaging with non-academic partners and points to framing conditions considered decisive for soccessful interactions. It concludes that reserachrs need to systematically analyse the socio-political context in which they intervene. By providing insights from the ground and reflecting on them in the light of the latest theoretical concepts, this article contributes to the emerging literature founded on practice-based experience.