966 resultados para aging of the population


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This PhD Thesis is part of a long-term wide research project, carried out by the "Osservatorio Astronomico di Bologna (INAF-OABO)", that has as primary goal the comprehension and reconstruction of formation mechanism of galaxies and their evolution history. There is now substantial evidence, both from theoretical and observational point of view, in favor of the hypothesis that the halo of our Galaxy has been at least partially, built up by the progressive accretion of small fragments, similar in nature to the present day dwarf galaxies of the Local Group. In this context, the photometric and spectroscopic study of systems which populate the halo of our Galaxy (i.e. dwarf spheroidal galaxy, tidal streams, massive globular cluster, etc) permits to discover, not only the origin and behaviour of these systems, but also the structure of our Galactic halo, combined with its formation history. In fact, the study of the population of these objects and also of their chemical compositions, age, metallicities and velocity dispersion, permit us not only an improvement in the understanding of the mechanisms that govern the Galactic formation, but also a valid indirect test for cosmological model itself. Specifically, in this Thesis we provided a complete characterization of the tidal Stream of the Sagittarius dwarf spheroidal galaxy, that is the most striking example of the process of tidal disruption and accretion of a dwarf satellite in to our Galaxy. Using Red Clump stars, extracted from the catalogue of the Sloan Digital Sky Survey (SDSS) we obtained an estimate of the distance, the depth along the line of sight and of the number density for each detected portion of the Stream (and more in general for each detected structure along our line of sight). Moreover comparing the relative number (i.e. the ratio) of Blue Horizontal Branch stars and Red Clump stars (the two features are tracers of different age/different metallicity populations) in the main body of the galaxy and in the Stream, in order to verify the presence of an age-metallicity gradient along the Stream. We also report the detection of a population of Red Clump stars probably associated with the recently discovered Bootes III stellar system. Finally, we also present the results of a survey of radial velocities over a wide region, extending from r ~ 10' out to r ~ 80' within the massive star cluster Omega Centauri. The survey was performed with FLAMES@VLT, to study the velocity dispersion profile in the outer regions of this stellar system. All the results presented in this Thesis, have already been published in refeered journals.

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At global level, the population is increasingly concentrating in the cities. In Europe, around 75% of the population lives in urban areas and, according to the European Environmental Agency (2010), urban population is foreseen to increase up to 80 % by 2020. At the same time, the quality of life in the cities is declining and urban pollution keeps increasing in terms of carbon dioxide (CO2) emissions, waste, noise, and lack of greenery. Many of European cities struggle to cope with social, economic and environmental problems resulting from pressures such as overcrowding or decline, social inequity, health problems related to food security and pollution. Nowadays local authorities try to solve these problems related to the environmental sustainability through various urban logistics measures, which directly and indirectly affect the urban food supply system, thus an integrated approach including freight transport and food provisioning policies issues is needed. This research centres on the urban food transport system and its impact on the city environmental sustainability. The main question that drives the research analysis is "How the urban food distribution system affects the ecological sustainability in modern cities?" The research analyses the city logistics project for food transport implemented in Parma, Italy, by the wholesale produce market. The case study investigates the renewed role of the wholesale market in the urban food supply chain as commercial and logistic operator, referring to the concept of food hub. Then, a preliminary analysis on the urban food transport for the city of Bologna is presented. The research aims at suggesting a methodological framework to estimate the urban food demand, the urban food supply and to assess the urban food transport performance, in order to identify external costs indicators that help policymakers in evaluating the environmental sustainability of different logistics measures

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This PhD Thesis includes five main parts on diverse topics. The first two parts deal with the trophic ecology of wolves in Italy consequently to a recent increase of wild ungulates abundance. Data on wolf diet across time highlighted how wild ungulates are important food resource for wolves in Italy. Increasing wolf population, increasing numbers of wild ungulates and decreasing livestock consume are mitigating wolf-man conflicts in Italy in the near future. In the third part, non-invasive genetic sampling techniques were used to obtain genotypes and genders of about 400 wolves. Thus, wolf packs were genetically reconstructed using diverse population genetic and parentage software. Combining the results on pack structure and genetic relatedness with sampling locations, home ranges of wolf packs and dispersal patterns were identified. These results, particularly important for the conservation management of wolves in Italy, illustrated detailed information that can be retrieved from genetic identification of individuals. In the fourth part, wolf locations were combined with environmental information obtained as GIS-layers. Modern species distribution models (niche models) were applied to infer potential wolf distribution and predation risk. From the resulting distribution maps, information pastures with the highest risk of depredation were derived. This is particularly relevant as it allows identifying those areas under danger of carnivore attack on livestock. Finally, in the fifth part, habitat suitability models were combined with landscape genetic analysis. On one side landscape genetic analyses on the Italian wolves provided new information on the dynamics and connectivity of the population and, on the other side, a profound analysis of the effects that habitat suitability methods had on the parameterization of landscape genetic analyses was carried out to contributed significantly to landscape genetic theory.

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The spatio-temporal distribution of megistobenthic crustacean assemblages from the Antalya Gulf, located in the Levantine Sea is described. In order to provide a comprehensive overview of the spatio-temporal patterns of the crustacean community, 3 transect including depth of 10, 25, 75, 125 and 200 m, were studied between 2014 and 2015 to investigate their association with a set of environmental parameters in representative months of each season (spring, summer, autumn and winter). For its economic importance in Levantine waters, a focus analysis of deep-water rose shrimp Parapenaeus longirostris (Lucas, 1846) was done, to investigate the length frequency composition of the population of the Antalya Gulf. A total of 58 crustacean species were encountered in the study area, of these species identified, 18 species were recognized as alien species in the Mediterranean Sea. Throughout the year the most frequent species of the study were the hermit crab Pagurus prideaux (Leach, 1815) and Parapenaeus longirostris (Lucas, 1846) followed by the Indo-Pacific swimming crab Charybdis longicollis (Leene, 1938) and by the invasive shrimp Marsupenaeus japonicus (Spence Bate, 1888). Few species contributing to a high amount to the total biomass were found throughout the year. These species were Charybdis longicollis and Parapenaeus longirostris. Stations of the study area showed similar values of diversity indices of benthic crustacean community among the three transect. The highest values of faunistic indices were detected in autumn and winter (October and February), and also varied along the depth gradient, with the highest values found between 25 and 75 meters. The multivariate analyses conducted on the abundance data point out major differences between depths and between seasons. Therefore, according to cluster analysis and ordination over abundance and biomass, three main crustacean assemblages were detected: the first corresponding to shallow bottoms (10, 25 meters), the second corresponding to intermediate waters (75 meters) and the last to deeper waters (125, 200 meters). Depth was the main factor governing the distribution of megistobenthic crustacean in the area. Besides the depth, the structure of the sediment is the most important factor in determining the crustacean assemblage. Therefore, all factors governing the crustacean distribution were found to be related to the bottom depth. The population of Parapenaeus longirostris in the Antalya Gulf showed significant differences in depth. It was found that females dominated the population of the study area (65.11%), and were significantly larger than males for each cohort identified. The size-weight relationships revealed a slight negative allometry in growth, a bit more pronounced in females than in males.

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Cavernous malformations (CCMs) are benign, well-circumscribed, and mulberry-like vascular malformations that may be found in the central nervous system in up to 0.5% of the population. Cavernous malformations can be sporadic or inherited. The common symptoms are epilepsy, hemorrhages, focal neurological deficits, and headaches. However, CCMs are often asymptomatic. The familiar form is associated with three gene loci, namely 7q21-q22 (CCM1), 7p13-p15 (CCM2), and 3q25.2-q27 (CCM3) and is inherited as an autosomal dominant trait with incomplete penetrance. The CCM genes are identified as Krit 1 (CCM1), MGC4607 (CCM2), and PDCD10 (CCM3). Here, we present the clinical and genetic features of CCMs in 19 Swiss families. Furthermore, surgical aspects in such families are also discussed.

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Background The loose and stringent Asthma Predictive Indices (API), developed in Tucson, are popular rules to predict asthma in preschool children. To be clinically useful, they require validation in different settings. Objective To assess the predictive performance of the API in an independent population and compare it with simpler rules based only on preschool wheeze. Methods We studied 1954 children of the population-based Leicester Respiratory Cohort, followed up from age 1 to 10 years. The API and frequency of wheeze were assessed at age 3 years, and we determined their association with asthma at ages 7 and 10 years by using logistic regression. We computed test characteristics and measures of predictive performance to validate the API and compare it with simpler rules. Results The ability of the API to predict asthma in Leicester was comparable to Tucson: for the loose API, odds ratios for asthma at age 7 years were 5.2 in Leicester (5.5 in Tucson), and positive predictive values were 26% (26%). For the stringent API, these values were 8.2 (9.8) and 40% (48%). For the simpler rule early wheeze, corresponding values were 5.4 and 21%; for early frequent wheeze, 6.7 and 36%. The discriminative ability of all prediction rules was moderate (c statistic ≤ 0.7) and overall predictive performance low (scaled Brier score < 20%). Conclusion Predictive performance of the API in Leicester, although comparable to the original study, was modest and similar to prediction based only on preschool wheeze. This highlights the need for better prediction rules.

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The socio-cultural impact of the introduction of motorbike taxis in the rural community of Tombel, South West region, Cameroon” seeks to bring out the impact of commercial motorbike taxis on the lifestyle of the Bakossi. The principal objective of this research is to show how the introduction of motorbike taxis has modified the lifestyle of the Tombel population. This anthropological research defines the profile of a motorbike taxi rider, his role in society, the perception of the population towards this activity and the impact of this activity on the lifestyle of the rural population of Tombel. This study reveals that motorbike taxi riders are essentially made up of youths from all works of life who earn a living by riding a motorbike taxi on a daily bases for commercial purposes. The revenue earn here goes a long way to sustain the livelihood of the rider and his entourage, becoming an ascension tool into the social ladder. The activity is very dangerous not only for the riders buts also for the passengers because of the risks involved in riding for most of the riders do not have the basic knowledge of the road code. This research also reveals that motorbike taxi has become the preferred means of public transport of most inhabitants of Tombel to the point of monopolising certain destinations. The population of Tombel perceives this activity as an instrument of change that has brought development and progress. But this activity also constitutes a social ill because of the prevalent sexual promiscuity encouraged by the riders. This activity has also gotten a cultural impact on the society, changing perceptions and being involve in rituals. Motorbike taxis have become a force to reckon with in the organisation of the community. They are a “response from below” to the transport crises in Cameroon.

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This work was devoted to individual child development. Psychogenetic research has emphasised the importance of social factors in children's intellectual development and two social factors are looked at here, family size and birth order. The effect of the formal parameters is, however, very unstable and they should therefore be considered together with certain informal factors. Of these, parental educational style, which is an expression of national traditions at the family level, is of particular interest. Educational style is culture-dependent and only a comparative cross-cultural study can reveal the real mechanisms through which educational style influences children's intellectual and personality development. Dumitrascu carried out an experimental cross-cultural study dedicated to the effects of family environment on child intellectual development. This involved three distinct populations, each of which has a distinct status in their geographical area, namely Romanians, Romanies from Romania, and Russians from the Republic of Moldova. It showed a significant difference between child intelligence in those from large families and in only children, with a huge gap in the case of Romany children. This suggests that the simultaneous action of several negative factors (low socio-economic status, large family size, socio-cultural isolation of the population) may delay a child's development. Subjected to such a precarious environment, Romany children do not seek self-realisation but rather struggle to overcome hardship and the majority remain outside civilisation. Unfortunately, adult Romanies rarely show concern about their children's successful social integration, placing no value on the school as a major socialising tool. This leads to the conclusion that a major effort is needed to help Romanies' social integration.

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Through studying German, Polish and Czech publications on Silesia, Mr. Kamusella found that most of them, instead of trying to objectively analyse the past, are devoted to proving some essential "Germanness", "Polishness" or "Czechness" of this region. He believes that the terminology and thought-patterns of nationalist ideology are so deeply entrenched in the minds of researchers that they do not consider themselves nationalist. However, he notes that, due to the spread of the results of the latest studies on ethnicity/nationalism (by Gellner, Hobsbawm, Smith, Erikson Buillig, amongst others), German publications on Silesia have become quite objective since the 1980s, and the same process (impeded by under funding) has been taking place in Poland and the Czech Republic since 1989. His own research totals some 500 pages, in English, presented on disc. So what are the traps into which historians have been inclined to fall? There is a tendency for them to treat Silesia as an entity which has existed forever, though Mr. Kamusella points out that it emerged as a region only at the beginning of the 11th century. These same historians speak of Poles, Czechs and Germans in Silesia, though Mr. Kamusella found that before the mid-19th century, identification was with an inhabitant's local area, religion or dynasty. In fact, a German national identity started to be forged in Prussian Silesia only during the Liberation War against Napoleon (1813-1815). It was concretised in 1861 in the form of the first Prussian census, when the language a citizen spoke was equated with his/her nationality. A similar census was carried out in Austrian Silesia only in 1881. The censuses forced the Silesians to choose their nationality despite their multiethnic multicultural identities. It was the active promotion of a German identity in Prussian Silesia, and Vienna's uneasy acceptance of the national identities in Austrian Silesia which stimulated the development of Polish national, Moravian ethnic and Upper Silesian ethnic regional identities in Upper Silesia, and Polish national, Czech national, Moravian ethnic and Silesian ethnic identities in Austrian Silesia. While traditional historians speak of the "nationalist struggle" as though it were a permanent characteristic of Silesia, Mr. Kamusella points out that such a struggle only developed in earnest after 1918. What is more, he shows how it has been conveniently forgotten that, besides the national players, there were also significant ethnic movements of Moravians, Upper Silesians, Silesians and the tutejsi (i.e. those who still chose to identify with their locality). At this point Mr. Kamusella moves into the area of linguistics. While traditionally historians have spoken of the conflicts between the three national languages (German, Polish and Czech), Mr Kamusella reminds us that the standardised forms of these languages, which we choose to dub "national", were developed only in the mid-18th century, after 1869 (when Polish became the official language in Galicia), and after the 1870s (when Czech became the official language in Bohemia). As for standard German, it was only widely promoted in Silesia from the mid 19th century onwards. In fact, the majority of the population of Prussian Upper Silesia and Austrian Silesia were bi- or even multilingual. What is more, the "Polish" and "Czech" Silesians spoke were not the standard languages we know today, but a continuum of West-Slavic dialects in the countryside and a continuum of West-Slavic/German creoles in the urbanised areas. Such was the linguistic confusion that, from time to time, some ethnic/regional and Church activists strove to create a distinctive Upper Silesian/Silesian language on the basis of these dialects/creoles, but their efforts were thwarted by the staunch promotion of standard German, and after 1918, of standard Polish and Czech. Still on the subject of language, Mr. Kamusella draws attention to a problem around the issue of place names and personal names. Polish historians use current Polish versions of the Silesian place names, Czechs use current Polish/Czech versions of the place names, and Germans use the German versions which were in use in Silesia up to 1945. Mr. Kamusella attempted to avoid this, as he sees it, nationalist tendency, by using an appropriate version of a place name for a given period and providing its modern counterpart in parentheses. In the case of modern place names he gives the German version in parentheses. As for the name of historical figures, he strove to use the name entered on the birth certificate of the person involved, and by doing so avoid such confusion as, for instance, surrounds the Austrian Silesian pastor L.J. Sherschnik, who in German became Scherschnick, in Polish, Szersznik, and in Czech, Sersnik. Indeed, the prospective Silesian scholar should, Mr. Kamusella suggests, as well as the three languages directly involved in the area itself, know English and French, since many documents and books on the subject have been published in these languages, and even Latin, when dealing in depth with the period before the mid-19th century. Mr. Kamusella divides the policies of ethnic cleansing into two categories. The first he classifies as soft, meaning that policy is confined to the educational system, army, civil service and the church, and the aim is that everyone learn the language of the dominant group. The second is the group of hard policies, which amount to what is popularly labelled as ethnic cleansing. This category of policy aims at the total assimilation and/or physical liquidation of the non-dominant groups non-congruent with the ideal of homogeneity of a given nation-state. Mr. Kamusella found that soft policies were consciously and systematically employed by Prussia/Germany in Prussian Silesia from the 1860s to 1918, whereas in Austrian Silesia, Vienna quite inconsistently dabbled in them from the 1880s to 1917. In the inter-war period, the emergence of the nation-states of Poland and Czechoslovakia led to full employment of the soft policies and partial employment of the hard ones (curbed by the League of Nations minorities protection system) in Czechoslovakian Silesia, German Upper Silesia and the Polish parts of Upper and Austrian Silesia. In 1939-1945, Berlin started consistently using all the "hard" methods to homogenise Polish and Czechoslovakian Silesia which fell, in their entirety, within the Reich's borders. After World War II Czechoslovakia regained its prewar part of Silesia while Poland was given its prewar section plus almost the whole of the prewar German province. Subsequently, with the active involvement and support of the Soviet Union, Warsaw and Prague expelled the majority of Germans from Silesia in 1945-1948 (there were also instances of the Poles expelling Upper Silesian Czechs/Moravians, and of the Czechs expelling Czech Silesian Poles/pro-Polish Silesians). During the period of communist rule, the same two countries carried out a thorough Polonisation and Czechisation of Silesia, submerging this region into a new, non-historically based administrative division. Democratisation in the wake of the fall of communism, and a gradual retreat from the nationalist ideal of the homogeneous nation-state with a view to possible membership of the European Union, caused the abolition of the "hard" policies and phasing out of the "soft" ones. Consequently, limited revivals of various ethnic/national minorities have been observed in Czech and Polish Silesia, whereas Silesian regionalism has become popular in the westernmost part of Silesia which remained part of Germany. Mr. Kamusella believes it is possible that, with the overcoming of the nation-state discourse in European politics, when the expression of multiethnicity and multilingualism has become the cause of the day in Silesia, regionalism will hold sway in this region, uniting its ethnically/nationally variegated population in accordance with the principle of subsidiarity championed by the European Union.

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The project aimed to use results of contamination of city vegetation with heavy metals and sulphur compounds as the basis for analysing the integral response of trees and shrubs to contamination, through a complex method of phytoindication. The results were used to draw up recommendations on pollution reduction in the city and to develop the method of phytoindication as a means of monitoring environmental pollution in St. Petersburg and other large cities. Field investigations were carried out in August 1996, and 66 descriptions of green areas were made in order to estimate the functional state of plants in the Vasileostrovsky district. Investigations of the spectrum reflecting properties of plants showed considerable variation of albedo meanings of leaves under the influence of various internal and external factors. The results indicated that lime trees most closely reflect the condition of the environment. Practically all the green areas studied were in poor condition, the only exceptions being areas of ash trees, which are more resistant to environmental pollution, and one lime-tree alley in a comparatively unpolluted street. The study identified those types of trees which are more or less resistant to complex environmental pollution and Ms. Terekhina recommends that the species in the present green areas be changed to include a higher number of the more resistant species. The turbidimetric analysis of tree barks for sulphates gave an indication of the level and spatial distribution of each pollutant, and the results also confirmed other findings that electric conductivity is a significant feature in determining the extent of sulphate pollution. In testing for various metals, the lime tree showed the highest contents for all elements except magnesium, copper, zinc, cadmium and strontium, again confirming the species' vulnerability to pollution. Medium rates of concentration in the city and environs showed that city plants concentrate 3 times as many different elements and 10 times more chromium, copper and lead than do those in the suburbs. The second stage of the study was based on the concept of phytoindication, which presupposes that changes in the relation of chemical elements in regional biological circulation under the influence of technogenesis provide a criterion for predicting displacements in people's health. There are certain basic factors in this concept. The first is that all living beings are related ecologically as well as by their evolutionary origin, and that the lower an organism is on the evolutionary scale, the less adaptational reserve it has. The second is that smaller concentrations of chemical elements are needed for toxicological influence on plants than on people and so the former's reactions to geochemical factors are easier to characterise. Visual indicational features of urban plants are well defined and can form the basis of a complex "environment - public health" analysis. Specific plant reactions reflecting atmospheric pollution and other components of urbogeosystems make it possible to determine indication criteria for predicting possible disturbances in the general state of health of the population. Thirdly the results of phytoindication investigations must be taken together with information about public health in the area. It only proved possibly to analyse general indexes of public health based on statistical data from the late 1980s and early 1990s as the data of later years were greatly influenced by social factors. These data show that the rates of illness in St. Petersburg (especially for children) are higher than in Russia as a whole, for most classes of diseases, indicating that the population there is more sensitive to the ecological state of the urban environment. The Vasileostrovsky district had the second highest sick rate for adullts, while the rate of infant mortality in the first year of life was highest there. Ms. Terekhina recommends further studies to more precisely assess the effectiveness of the methods she tested, but has drawn up a proposed map of environmental hazard for the population, taking into account prevailing wind directions.

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A patent foramen ovale (PFO) is a common finding present in 25% of the population. A relationship between PFO and several clinical conditions such as stroke, migraine, platypnea-orthodeoxia syndrome, neurological decompression illness in divers, high altitude pulmonary edema, sleep apnea, and economy class syndrome have been documented. Observational non-randomized studies have shown percutaneous PFO closure more effective than medical treatment for stroke prevention, in particular in patients with complete closure as well as in patients with more than one cerebrovascular event at baseline. In the case of migraine, PFO closure has been shown to result in a marked reduction in migraine burden or migraine days. PFO anatomy, epidemiological data on associated clinical conditions, comparison between percutaneous closure and medical treatment, as well as the technical aspect of the procedure are described in this review.

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This study analyzes the trend of environmental concern in Switzerland using data from the International Social Survey Program (ISSP) 1993, 2000, and 2010. First, we compare the observed trend with indicators of the intensity of public debate regarding the environment. The results show that both the number of articles dealing with environmental issues in print newspapers and the debates in the Swiss parliament strongly increased during the observed period. The ecological awareness of the population, however, remained constant over this time. Second, we scrutinize the "social basis" of environmental concern paying particular attention to individuals' time preferences. Third, we investigate the relationship between environmental concern and proenvironmental behavior, on the one hand, and the relation of concern and the acceptance of governmental regulations, on the other hand.

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Objective. The purpose of the study is to provide a holistic depiction of behavioral & environmental factors contributing to risky sexual behaviors among predominantly high school educated, low-income African Americans residing in urban areas of Houston, TX utilizing the Theory of Gender and Power, Situational/Environmental Variables Theory, and Sexual Script Theory. Methods. A cross-sectional study was conducted via questionnaires among 215 Houston area residents, 149 were women and 66 were male. Measures used to assess behaviors of the population included a history of homelessness, use of crack/cocaine among several other illicit drugs, the type of sexual partner, age of participant, age of most recent sex partner, whether or not participants sought health care in the last 12 months, knowledge of partner's other sexual activities, symptoms of depression, and places where partner's were met. In an effort to determine risk of sexual encounters, a risk index employing the variables used to assess condom use was created categorizing sexual encounters as unsafe or safe. Results. Variables meeting the significance level of p<.15 for the bivariate analysis of each theory were entered into a binary logistic regression analysis. The block for each theory was significant, suggesting that the grouping assignments of each variable by theory were significantly associated with unsafe sexual behaviors. Within the regression analysis, variables such as sex for drugs/money, low income, and crack use demonstrated an effect size of ≥ ± 1, indicating that these variables had a significant effect on unsafe sexual behavioral practices. Conclusions. Variables assessing behavior and environment demonstrated a significant effect when categorized by relation to designated theories.

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BACKGROUND Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline electrocardiographic (ECG) abnormalities can refine risk prediction for HF. METHODS We examined a prospective cohort of 2,915 participants aged 70 to 79 years without preexisting HF, enrolled between April 1997 and June 1998 in the Health, Aging, and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index. RESULTS At baseline, 380 participants (13.0%) had minor, and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 participants (16.6%) developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% CI 0.96-1.68) for minor and 1.99 (95% CI 1.61-2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR 1.94, 95% CI 1.38-2.72 for new and HR 2.35, 95% CI 1.82-3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events, and 1.4% of the overall population. The net reclassification index across the Health ABC HF risk categories was 0.11 (95% CI 0.03-0.19). CONCLUSIONS Among older adults, baseline and new ECG abnormalities are independently associated with increased risk of HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.

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The Chakhama Valley, a remote area in Pakistan-administered Kashmir, was badly damaged by the 7.6-magnitude earthquake that struck India and Pakistan on 8 October 2005. More than 5% of the population lost their lives, and about 90% of the existing housing was irreparably damaged or completely destroyed. In early 2006, the Aga Khan Development Network (AKDN) initiated a multisector, community-driven reconstruction program in the Chakhama Valley on the premise that the scale of the disaster required a response that would address all aspects of people's lives. One important aspect covered the promotion of disaster risk management for sustainable recovery in a safe environment. Accordingly, prevailing hazards (rockfalls, landslides, and debris flow, in addition to earthquake hazards) and existing risks were thoroughly assessed, and the information was incorporated into the main planning processes. Hazard maps, detailed site investigations, and proposals for precautionary measures assisted engineers in supporting the reconstruction of private homes in safe locations to render investments disaster resilient. The information was also used for community-based land use decisions and disaster mitigation and preparedness. The work revealed three main problems: (1) thorough assessment of hazards and incorporation of this assessment into planning processes is time consuming and often little understood by the population directly affected, but it pays off in the long run; (2) relocating people out of dangerous places is a highly sensitive issue that requires the support of clear and forceful government policies; and (3) the involvement of local communities is essential for the success of mitigation and preparedness.