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.

Economics of Ornamental Fisheries in Kerala

Comprehensive studies integrating production, consumption and marketing of ornamental fishes were never conducted in the past in Kerala and this study is an attempt to highlight the dynamics in a systematic manner by making a primary empirical study. The advantages of such an approach are many. First, the study entails detailed empirical data under a given time frame on various inter linked economic activities in ornamental fisheries sector. Second, the study tries to improve upon the previous discipline-bound studies by adopting an integrated approach. As Kerala has diverse ecological and climatic conditions, case studies on various ornamental fish production systems help identifying suitable culture practice for selected environmental conditions. One of the major conclusions of this study as explained in the concluding chapter is that although Kerala is blessed with favourable geographic and climatic conditions needed for developing ornamental fishery, diverse local conditions and requirements contain adopting modern methods of enterprise development.Consumer studies conducted would help to identify the demand of ornamental fishes and the factors leading to it. Market studies would help in understanding the forces behind domestic market, which is very promising, but neglected. Viability studies throw light on the economic performance of both the production systems and the trading units of ornamental fishes. Despite the economic significance of ornamental fisheries industry, its development has been constrained due to various bio-technical, cultural, socio-economic, organisational and above all, institutional and policy failures. The outcome of the study would identify constraints facing the industry and institutional arrangements for development.

Hydrogeology,Stratigraphy and evolution of the Palaeo-Lagoon (kole land basin ) in the central Kerala coast, India

The present investigation on " Hydrology, stratigraphy, and evolution of the palaeo-lagoon (Koleland basin)in the Central Kerala coast, India" is an integrated approach based on hydrogeological,geophysical,hydrochemical and stratigraphic aspects.A strong scientific data base of the study area is generated using interpretation of well observation and water quality analysis. The salient findings of the present study are given to provide a holistic picture on the hydrogeology (including groundwater resource and its quality),stratigraphy and evolution of the palaeo-lagoon

Coastal and ground water pollution in Kavaratti island, Lakshadweep sea

The tiniest Union territory of India, Lakshadweep, is an archipelago, with an area of 32 Sq. km. consisting of 12 atolls, three reefs and five submerged banks, lies between 8° and 12°30'N latitudes and 71° and 74" E longitudes. It is one of the most important and critical territories of India from economic and defence point of view. Specialised environment having typical geological set up, Lakshadweep is ecologically sensitive to even slight climatic or anthropogenic interference. Pollution of coastal seas, over exploitation and contamination of the fresh water sources are thus become great concerns to the existence of the island. Typical geological set up and interference cause threat to the ecology of the fragile environment and resources of the island as well as its resources. Marine pollution and ground water contamination are concerns in this regard. Even though attentions were made to assess the physico—chemical and bacteriological status of the marine and groundwater systems separately, an integrated approach has not been evolved. The present study with its broad objectives is attempted for an integrated assessment of microbiological, physicochemical and biological characteristics of the surrounding seawater and microbiological and physico—chemical characteristics of the ground water in Kavaratti island. The entire study has been organised in 4 chapters

Development of a portable composite equipment for coastal fishery and hydrographic investigations

This thesis reports on the details of the works done to develop a complete system for acquisition of the important marine environmental parameters namely, current, current direction, salinity, temperature and depth. It encompaéps transducers,signalconditioners display arrangements and remote controlled multiplexer which constitue the system. The various associate instruentation and environmental requisites and problems have been discussed and solved to considerable extend. The design and development features of this composite system includes an integrated approach in order to make the final equipment to be simple, inexpensive and easy for operation from small and large boats. This could be achieved with the successful development of all required components with features matching between them, such as sensors, signals conditioners remote operated multiplexers, comon display methods, quick performance check and calibration methods. The major success rests on the development of sensors with excellent performance characteristics suitable for marine environment. out of the 5 sensors. that of current salinity and depth are quite noval types with specific advantages. The environmental effects have been eliminated to the required extend. The common signal conditioner for salinity, temperature and depth has noval design features for achieving simplicity, reliability and accomodating the three sensors of different functional requirements.

Provenance, Isolation and Characterisation of Organic Matter in the Cochin Estuarine Sediment-“a Diagenetic Amino Acid Marker Scenario

Cochin estuarine system is among the most productive aquatic environment along the Southwest coast of India, exhibits unique ecological features and possess greater socioeconomic relevance. Serious investigations carried out during the past decades on the hydro biogeochemical variables pointed out variations in the health and ecological functioning of this ecosystem. Characterisation of organic matter in the estuary has been attempted in many investigations. But detailed studies covering the degradation state of organic matter using molecular level approach is not attempted. The thesis entitled Provenance, Isolation and Characterisation of Organic Matter in the Cochin Estuarine Sediment-“ A Diagenetic Amino Acid Marker Scenario” is an integrated approach to evaluate the source, quantity, quality, and degradation state of the organic matter in the surface sediments of Cochin estuarine system with the combined application of bulk and molecular level tools. Sediment and water samples from nine stations situated at Cochin estuary were collected in five seasonal sampling campaigns, for the biogeochemical assessment and their distribution pattern of sedimentary organic matter. The sampling seasons were described and abbreviated as follows: April- 2009 (pre monsoon: PRM09), August-2009 (monsoon: MON09), January-2010 (post monsoon: POM09), April-2010 (pre monsoon: PRM10) and September- 2012 (monsoon: MON12). In order to evaluate the general environmental conditions of the estuary, water samples were analysed for water quality parameters, chlorophyll pigments and nutrients by standard methods. Investigations suggested the fact that hydrographical variables and nutrients in Cochin estuary supports diverse species of flora and fauna. Moreover the sedimentary variables such as pH, Eh, texture, TOC, fractions of nitrogen and phosphorous were determined to assess the general geochemical setting as well as redox status. The periodically fluctuating oxic/ anoxic conditions and texture serve as the most significant variables controlling other variables of the aquatic environment. The organic matter in estuary comprise of a complex mixture of autochthonous as well as allochthonous materials. Autochthonous input is limited or enhanced by the nutrient elements like N and P (in their various fractions), used as a tool to evaluate their bioavailability. Bulk parameter approach like biochemical composition, stoichiometric elemental ratios and stable carbon isotope ratio was also employed to assess the quality and quantity of sedimentary organic matter in the study area. Molecular level charactersation of free sugars and amino acids were carried out by liquid chromatographic techniques. Carbohydrates are the products of primary production and their occurrence in sediments as free sugars can provide information on the estuarine productivity. Amino acid biogeochemistry provided implications on the system productivity, nature of organic matter as well as degradation status of the sedimentary organic matter in the study area. The predominance of carbohydrates over protein indicated faster mineralisation of proteinaceous organic matter in sediments and the estuary behaves as a detrital trap for the accumulation of aged organic matter. The higher lipid content and LPD/CHO ratio pointed towards the better food quality that supports benthic fauna and better accumulation of lipid compounds in the sedimentary environment. Allochthonous addition of carbohydrates via terrestrial run off was responsible for the lower PRT/CHO ratio estimated in thesediments and the lower ratios also denoted a detrital heterotrophic environment. Biopolymeric carbon and the algal contribution to BPC provided important information on the better understanding the trophic state of the estuarine system and the higher values of chlorophyll-a to phaeophytin ratio indicated deposition of phytoplankton to sediment at a rapid rate. The estimated TOC/TN ratios implied the combined input of both terrestrial and autochthonous organic matter to sedimentsAmong the free sugars, depleted levels of glucose in sediments in most of the stations and abundance of mannose at station S5 was observed during the present investigation. Among aldohexoses, concentration of galactose was found to be higher in most of the stationsRelative abundance of AAs in the estuarine sediments based on seasons followed the trend: PRM09-Leucine > Phenylalanine > Argine > Lysine, MON09-Lysine > Aspartic acid > Histidine > Tyrosine > Phenylalanine, POM09-Lysine > Histadine > Phenyalanine > Leucine > Methionine > Serine > Proline > Aspartic acid, PRM10-Valine > Aspartic acid > Histidine > Phenylalanine > Serine > Proline, MON12-Lysine > Phenylalanine > Aspartic acid > Histidine > Valine > Tyrsine > MethionineThe classification of study area into three zones based on salinity was employed in the present study for the sake of simplicity and generalized interpretations. The distribution of AAs in the three zones followed the trend: Fresh water zone (S1, S2):- Phenylalanine > Lysine > Aspartic acid > Methionine > Valine ῀ Leucine > Proline > Histidine > Glycine > Serine > Glutamic acid > Tyrosine > Arginine > Alanine > Threonine > Cysteine > Isoleucine. Estuarine zone (S3, S4, S5, S6):- Lysine > Aspartic acid > Phenylalanine > Leucine > Valine > Histidine > Methionine > Tyrosine > Serine > Glutamic acid > Proline > Glycine > Arginine > Alanine > Isoleucine > Cysteine > Threonine. Riverine /Industrial zone (S7, S8, S9):- Phenylalanine > Lysine > Aspartic acid > Histidine > Serine > Arginine > Tyrosine > Leucine > Methionine > Glutamic acid > Alanine > Glycine > Cysteine > Proline > Isoleucine > Threonine > Valine. The abundance of AAs like glutamic acid, aspartic acid, isoleucine, valine, tyrosine, and phenylalanine in sediments of the study area indicated freshly derived organic matter.

Differential induction, isolation, physicochemical and molecular characterization of temperate phages of environmental Vibrio cholerae as evidence of phage mediated Horizontal Gene Transfer

The resurgence of the enteric pathogen Vibrio cholerae, the causative organism of epidemic cholera, remains a major health problem in many developing countries like India. The southern Indian state of Kerala is endemic to cholera. The outbreaks of cholera follow a seasonal pattern in regions of endemicity. Marine aquaculture settings and mangrove environments of Kerala serve as reservoirs for V. cholerae. The non-O1/non-O139 environmental isolates of V. cholerae with incomplete ‘virulence casette’ are to be dealt with caution as they constitute a major reservoir of diverse virulence genes in the marine environment and play a crucial role in pathogenicity and horizontal gene transfer. The genes coding cholera toxin are borne on, and can be infectiously transmitted by CTXΦ, a filamentous lysogenic vibriophages. Temperate phages can provide crucial virulence and fitness factors affecting cell metabolism, bacterial adhesion, colonization, immunity, antibiotic resistance and serum resistance. The present study was an attempt to screen the marine environments like aquafarms and mangroves of coastal areas of Alappuzha and Cochin, Kerala for the presence of lysogenic V. cholerae, to study their pathogenicity and also gene transfer potential. Phenotypic and molecular methods were used for identification of isolates as V. cholerae. The thirty one isolates which were Gram negative, oxidase positive, fermentative, with or without gas production on MOF media and which showed yellow coloured colonies on TCBS (Thiosulfate Citrate Bile salt Sucrose) agar were segregated as vibrios. Twenty two environmental V. cholerae strains of both O1 and non- O1/non-O139 serogroups on induction with mitomycin C showed the presence of lysogenic phages. They produced characteristic turbid plaques in double agar overlay assay using the indicator strain V. cholerae El Tor MAK 757. PCR based molecular typing with primers targeting specific conserved sequences in the bacterial genome, demonstrated genetic diversity among these lysogen containing non-O1 V. cholerae . Polymerase chain reaction was also employed as a rapid screening method to verify the presence of 9 virulence genes namely, ctxA, ctxB, ace, hlyA, toxR, zot,tcpA, ninT and nanH, using gene specific primers. The presence of tcpA gene in ALPVC3 was alarming, as it indicates the possibility of an epidemic by accepting the cholera. Differential induction studies used ΦALPVC3, ΦALPVC11, ΦALPVC12 and ΦEKM14, underlining the possibility of prophage induction in natural ecosystems, due to abiotic factors like antibiotics, pollutants, temperature and UV. The efficiency of induction of prophages varied considerably in response to the different induction agents. The growth curve of lysogenic V. cholerae used in the study drastically varied in the presence of strong prophage inducers like antibiotics and UV. Bacterial cell lysis was directly proportional to increase in phage number due to induction. Morphological characterization of vibriophages by Transmission Electron Microscopy revealed hexagonal heads for all the four phages. Vibriophage ΦALPVC3 exhibited isometric and contractile tails characteristic of family Myoviridae, while phages ΦALPVC11 and ΦALPVC12 demonstrated the typical hexagonal head and non-contractile tail of family Siphoviridae. ΦEKM14, the podophage was distinguished by short non-contractile tail and icosahedral head. This work demonstrated that environmental parameters can influence the viability and cell adsorption rates of V. cholerae phages. Adsorption studies showed 100% adsorption of ΦALPVC3 ΦALPVC11, ΦALPVC12 and ΦEKM14 after 25, 30, 40 and 35 minutes respectively. Exposure to high temperatures ranging from 50ºC to 100ºC drastically reduced phage viability. The optimum concentration of NaCl required for survival of vibriophages except ΦEKM14 was 0.5 M and that for ΦEKM14 was 1M NaCl. Survival of phage particles was maximum at pH 7-8. V. cholerae is assumed to have existed long before their human host and so the pathogenic clones may have evolved from aquatic forms which later colonized the human intestine by progressive acquisition of genes. This is supported by the fact that the vast majority of V. cholerae strains are still part of the natural aquatic environment. CTXΦ has played a critical role in the evolution of the pathogenicity of V. cholerae as it can transmit the ctxAB gene. The unusual transformation of V. cholerae strains associated with epidemics and the emergence of V. cholera O139 demonstrates the evolutionary success of the organism in attaining greater fitness. Genetic changes in pathogenic V. cholerae constitute a natural process for developing immunity within an endemically infected population. The alternative hosts and lysogenic environmental V. cholerae strains may potentially act as cofactors in promoting cholera phage ‘‘blooms’’ within aquatic environments, thereby influencing transmission of phage sensitive, pathogenic V. cholerae strains by aquatic vehicles. Differential induction of the phages is a clear indication of the impact of environmental pollution and global changes on phage induction. The development of molecular biology techniques offered an accessible gateway for investigating the molecular events leading to genetic diversity in the marine environment. Using nucleic acids as targets, the methods of fingerprinting like ERIC PCR and BOX PCR, revealed that the marine environment harbours potentially pathogenic group of bacteria with genetic diversity. The distribution of virulence associated genes in the environmental isolates of V. cholerae provides tangible material for further investigation. Nucleotide and protein sequence analysis alongwith protein structure prediction aids in better understanding of the variation inalleles of same gene in different ecological niche and its impact on the protein structure for attaining greater fitness of pathogens. The evidences of the co-evolution of virulence genes in toxigenic V. cholerae O1 from different lineages of environmental non-O1 strains is alarming. Transduction studies would indicate that the phenomenon of acquisition of these virulence genes by lateral gene transfer, although rare, is not quite uncommon amongst non-O1/non-O139 V. cholerae and it has a key role in diversification. All these considerations justify the need for an integrated approach towards the development of an effective surveillance system to monitor evolution of V. cholerae strains with epidemic potential. Results presented in this study, if considered together with the mechanism proposed as above, would strongly suggest that the bacteriophage also intervenes as a variable in shaping the cholera bacterium, which cannot be ignored and hinting at imminent future epidemics.

Wastewater usage in urban and peri-urban agricultural production systems: scenarios from India

The role urban and peri-urban agriculture (UPA) plays in reducing urban poverty and ensuring environmental sustainability was recognized by the Millennium Development Goals (MGDs). India is the world’s largest democratic nation with a population of 1.2 billion. The rapid urbanization and high proportion of people below the poverty line along with higher migration to urban areas make India vulnerable to food crisis and urbanization of poverty. Ensuring jobs and food security among urban poor is a major challenge in India. The role of UPA can be well explained and understood in this context. This paper focuses on the current situation of UPA production in India with special attention to wastewater irrigation. This question is being posed about the various human health risks from wastewater irrigation which are faced by farmers and labourers, and, secondly by consumers. The possible health hazards involve microbial pathogens as well as helminth (intestinal parasites). Based on primary and secondary data, this paper attempts to confirm that UPA is one of the best options to address increasing urban food demand and can serve to complement rural supply chains and reduce ecological food prints in India. “Good practice urban and peri-urban agriculture” necessitates an integrated approach with suitable risk reduction mechanisms to improve the efficiency and safety of UPA production.

Asociación entre psoriasis y el control de diabetes mellitus tipo 2

La psoriasis es una enfermedad que se caracteriza por un proceso inflamatorio crónico y exagerado local y sistémico. Se ha encontrado en la literatura una relación entre la psoriasis y el desarrollo de patologías como diabetes mellitus tipo 2 y el mal control de estas patologías, lo cual aumenta la morbimortalidad de estos pacientes. El presente estudio mostró que no se encontró asociación entre psoriasis y el control de la DM2 , y que la variable mas significativa sobre el control es la adherencia al tratamiento hipoglicemiante.

The dynamics of local hiv-1 epidemics: the colombian and belgian cohorts

We aimed to characterize the HIV-1 epidemic of the Belgian and Colombian cohorts using an integrated approach that includes socio-demographic information, clinical data, and viral sequences, analyzed with statistical and phylogenetic approaches.

Modelo de gestión del conocimiento para una empresa del sector de insumos químicos para la industria farmacéutica, cosmética y de alimentos: caso Disaromas S.A.

La creación de conocimiento al interior de las organizaciones es visible mediante la dirección adecuada del conocimiento de los individuos, sin embargo, cada individuo debe interactuar de tal manera que forme una red o sistema de conocimiento organizacional que consolide a largo plazo las empresas en el entorno en el que se desenvuelven. Este documento revisa elementos centrales acerca de la gestión de conocimiento visto desde varios autores y perspectivas e identifica puntos clave para diseñar un modelo de gestión de conocimiento para una empresa del sector de insumos químicos para la industria farmacéutica, cosmética y de alimentos de la ciudad de Bogotá.

Remesas y desarrollo económico. Un análisis empírico del caso mexicano

El objetivo de este trabajo es contribuir a identificar el efecto de las remesas que envían los emigrantes a sus comunidades de origen en México. Del mismo modo, se estudia el efecto que la participación de la mujer tiene en este proceso. La fuente de información es el Consejo Nacional de Población de México CONAPO y contiene variables a nivel estatal y municipal para el año 2000. La base de datos contiene índices de desarrollo humano, intensidad migratoria y remesas para los 2443 municipios mexicanos. La evidencia empírica sugiere que las remesas tienen un impacto positivo sobre los niveles de desarrollo de las comunidades receptoras. No obstante, la relación entre remesas y desarrollo es no lineal. Adicionalmente, se en contró que el efecto positivo que tienen las remesas sobre el desarrollo es más alto cuando la cabeza de familia de los hogares receptores es mujer.

Análisis comparado del ordenamiento territorial a escala regional de Barcelona y el Randsad 2005 – 2013. Reflexiones para el caso colombiano

El presente estudio quiere analizar la construcción de la dimensión regional como proceso de interacción entre el conjunto de asentamientos humanos y de unas relaciones políticas, jurídicas, históricas, económicas y funcionales alrededor de ese espacio determinado que aborda la interdependencia territorial. A partir de la concepción que la aglomeración urbana es intrínsecamente regional, el trabajo aborda tres casos de estudio: el Randstad en Holanda, el Área Metropolitana de Barcelona y la Mesa de Planificación Regional Bogotá – Cundinamarca como configuraciones que permiten la formación de acuerdos coordinados básicos para un abordaje integral de la gestión del territorio. De las particularidades de cada caso se elaboran comparaciones que establecen que la configuración de acuerdos regionales es influida por una práctica política y de ordenamiento territorial determinada. Fundamentándose en la comparación, el aparte final el texto establece establecen algunas orientaciones para la consolidación regional en Colombia como proceso de apoderamiento de lo local.

Research based design: competition proposal for the Cyprus news agency

The paper attempts to explore the interrelation between a) the architects’ individualism and “pre-structures” b) research- based findings during the design process through experimentation and c)an integrated design approach, where morphology, construction and bioclimatic design are integrated from an early design stage. Through a thorough presentation and analysis of a competition proposal for the Cyprus News Agency, we discuss a number of important findings in relation to the present and possibly future form of the design studio. We suggest that the designer’s “prestructures” may not only be the basis for creative action, but also the basis for understanding and interpretation. Design informed and enriched at every stage by a research-based process, might well be the transmission and transformation of “prestructures”, a process of elaboration and discovery which facilitates and enhances design creativity and possibly allows for a multiplicity of approaches through a range of possibilities. Furthermore, an integrated approach from the early stages of the design process facilitates innovation in materials and systems.

Fine sediment delivery and transfer in lowland catchments: modelling suspended sediment concentrations in response to hydrological forcing

Fine sediment delivery to and storage in stream channel reaches can disrupt aquatic habitats, impact river hydromorphology, and transfer adsorbed nutrients and pollutants from catchment slopes to the fluvial system. This paper presents a modelling toot for simulating the time-dependent response of the fine sediment system in catchments, using an integrated approach that incorporates both land phase and in-stream processes of sediment generation, storage and transfer. The performance of the model is demonstrated by applying it to simulate in-stream suspended sediment concentrations in two lowland catchments in southern England, the Enborne and the Lambourn, which exhibit contrasting hydrological and sediment responses due to differences in substrate permeability. The sediment model performs well in the Enborne catchment, where direct runoff events are frequent and peak suspended sediment concentrations can exceed 600 mg l(-1). The general trends in the in-stream concentrations in the Lambourn catchment are also reproduced by the model, although the observed concentrations are low (rarely exceeding 50 mg l(-1)) and the background variability in the concentrations is not fully characterized by the model. Direct runoff events are rare in this highly permeable catchment, resulting in a weak coupling between the sediment delivery system and the catchment hydrology. The generic performance of the model is also assessed using a generalized sensitivity analysis based on the parameter bounds identified in the catchment applications. Results indicate that the hydrological parameters contributing to the sediment response include those controlling (1) the partitioning of runoff between surface and soil zone flows and (2) the fractional loss of direct runoff volume prior to channel delivery. The principal sediment processes controlling model behaviour in the simulations are the transport capacity of direct runoff and the in-stream generation, storage and release of the fine sediment fraction. The in-stream processes appear to be important in maintaining the suspended sediment concentrations during low flows in the River Enborne and throughout much of the year in the River Lambourn. Copyright (c) 2007 John Wiley & Sons, Ltd.