Estimates of global and regional potential health gains from reducing multiple major risk factors

Background Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. Methods We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Results Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Interpretation Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions, The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.

The undergraduate level (1st study cycle) as a fundamental platform/standard for the development of Urban and Regional Planning in higher education programs

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

Notes on health care planning in Latin America and the Caribbean

Attention is called to the fact that the efforts to improve health of populations in Latin America have generally failed. The inequality in the distribution of ill-health is great. The authors accept the fact that the lack of resources available to the health sector may be a restriction towards the improvement of the situation, but they argue that a much more important issue is the misuse of such resources and their maldistribution within the health sector. The lack of integration and coordination between the health services, the conflict of public and private health systems, the under-utilization of existing services and the gap between planning and real implementation are discussed.

Self-perceived health status in older adults: regional and sociodemographic inequalities in Spain

OBJECTIVE: To assess regional and sociodemographic differences in self-perceived health status among older adults. METHODS: A face-to-face quality of life survey was conducted in a representative sample of the Spanish population comprising 1,106 non-institutionalized elderly aged 60 or more in 2008. Logistic regression models were used to explain self-perceived health status according to the EuroQol Group Visual Analogue Scale (EQ-VAS). Independent variables included sociodemographic and health characteristics as well as the nomenclature of territorial units for statistics level 1 (NUTS1: group of autonomous regions) and level 2 (NUTS 2: autonomous regions). RESULTS: Younger and better off respondents were more likely to have a positive self-perceived health status. Having no chronic conditions, independence in performing daily living activities and lower level of depression were also associated with positive self-perceived health status. People living in the south of Spain showed a more negative self-perceived health status than those living in other regions. CONCLUSION: The study results point to health inequality among Spanish older adults of lower socioeconomic condition and living in the south of Spain. The analysis by geographic units allows for international cross-regional comparisons.

Regional variation in toxoplasmosis seronegativity in the São Paulo metropolitan region

Toxoplasmosis is a highly prevalent zoonotic human infection caused by the Apicomplexa protozoon Toxoplasma gondii. The acute disease is usually mild or asymptomatic, except for foetal infection transmitted by acutely infected pregnant women, which courses as a devastating disease. In order to determine possible regional variations in risk factors, we studied the frequency of seronegativity in areas of the São Paulo Metropolitan Region, comparing liters and age groups. The prevalence of seronegativity was determined retrospectively in 1286 pregnant women receiving prenatal care at public health services in four selected areas of the São Paulo Metropolitan Region of similar socioeconomic background. The São Paulo City area had the higher frequency of seronegativity (41.1%), followed by the Northwest (31.5%) and Southwest (29.9%) areas, with similar intermediate levels, and by the Northeast (22.5%) area with the lowest frequency (p<0.001). A rough estimate disclosed about 280 infected infants/year in the São Paulo Metropolitan Region. Serological titers analyzed by age group suggested a decline in antibody levels with age, as shown by a lower frequency of higher titers in older groups. Our study emphasizes the importance of determining the regional prevalence of toxoplasmosis for proper planning of public health prenatal care.

Territorial Strategic Planning as a support instrument for Regional and Local Development : a comparative analysis between Lisbon and Barcelona metropolitan areas - a first approach

Trabalho de Projecto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Metropolização, Planeamento Estratégico e Sustentabilidade.

The influence of the regional basic diet from northeast Brazil on health and nutritional conditions of mice infected with Schistosoma mansoni

Protein nutritionalstatus indicators were studied in weanling albino Swiss mice infected with S. mansoni andfed the Regional Basic Diet (RBD)from Northeast Brazil, a multideficient diet of low-protein content. Each mouse was infected percutaneously with 80 cercariae. The experiment lasted 63 days. The growth curve, food consumption, protein intake, weight gain, Protein Efficiency Ratio (PER) and Net Protein Ratio (NPR) were the parameters investigated. RBD-fed mice showed a marked weight loss, a lower food and protein intake, a slower body weight gain and lower rates of food protein utilization when compared to casein-fed animals. Differences between infected and non-infected mice were not consistent. The present results suggest that the effects of RBD-induced malnutrition on health and nutritional conditions of the mice are more severe than those of Manson's schistosomiasis, in the initial phase of the disease.

Territorial Strategic Planning as a support instrument for Regional and Local Development: a comparative analysis between Lisbon and Barcelona Metropolitan Areas

MARQUES, B.P. (2011) "Territorial Strategic Planning as a support instrument for Regional and Local Development: a comparative analysis between Lisbon and Barcelona Metropolitan Areas", in Atas do 17.º Congresso da APDR, do 5.º Congresso de Gestão e Conservação da Natureza e do Congresso Internacional da APDR/AECR, Bragança e Zamora, pp. 1265-1272, ISBN 978-989-96353-2-6.

Policing and planning child and adolescent neuropsychiatry : the reform process in Bologna 2009-2014

Desde a aprovação do plano de saúde mental regional em Itália ... o Departamento Local de Saúde Mental e Perturbações aditivas em Bolonha, tem desenvolvido um projeto de reforma cujo objectivo é inovar o sistema de saúde mental local. ...ABSTRACT: Since the Regional mental health plan 2009-2011 was approved in Italy the Department of Mental Health and addictions of the Bologna local health trust developed as a laboratory aimed at innovating the mental health systen locally. ...

La institucionalización de la Comunidad Regional Punilla (Provincia de Córdoba): estudio y promoción de metodologías de diseño participativo y gestión asociada de políticas públicas para el desarrollo. The institution of Punilla Regional Community: study and promotion of participative metodologies for the associated planning and management of development policies.

Durante el período 2006-2008, las actividades de investigación y asistencia técnica de este equipo enfatizaron en la necesaria práctica social y política de horizontalidad en las relaciones, en la 'dimensión intersubjetiva o relacional de la regionalización' (Cáceres, 2006) en el marco de la Comunidad Regional Punilla (CRP), considerando a la identidad regional como un condicionante relevante de la 'construcción de la región como unidad de acción(Boisier, 2003). Así, durante ese período, se ha ido conformando un espacio 'regional' de composición multiactoral, social y gubernamental, para el trabajo asociativo (PROFIM, SIP, UCC 2007, 2008). Con el propósito de profundizar el Programa, este proyecto propone el fortalecimiento institucional de la CRP a través de la formalización del escenario participativo regional (Poggiese, 2001, 2002) para el diseño y gestión asociada de políticas de desarrollo. Tales propósitos y mecanismos están previstos en la Ley Orgánica de Regionalización de la Provincia de Córdoba (9.206/04) y en las normativas regionales derivadas de ésta a través de la figura del 'Consejo de la Sociedad Civil'. Con base en la observación del proceso desarrollado en Punilla desde el año 2006, esta propuesta suscribe el carácter interdisciplinario e intersectorial de la red social y política en la que se sustentará el Consejo y la lógica 'procesal y consensual' de su construcción, considerando, además, la nueva configuración del mapa político de la CRP a partir de los resultados electorales del año 2008 en tanto cambios estructurales en la relación gobierno y oposición que se presentan como una oportunidad para desarrollar los espacios públicos participativos que la sociedad regional puede ocupar para canalizar institucionalmente sus demandas. El proyecto busca 'analizar' pero también 'promover' el proceso de cambio político y social en marcha para facilitar su 'ampliación democrática' (Redín y Moroni, 2003), reflexionado críticamente y poniendo en cuestión algunos de los supuestos que han caracterizado a la retórica de la regionalización provincial: la existencia de una sociedad civil debidamente organizada en cada una de las regiones, cuya concurrencia al proceso decisorio puede asegurarse una vez 'abiertos' -formalizados- los canales de participación; la superación de la dirección bottom up en los procesos de toma de decisiones y la preeminencia de modalidades de 'articulación intermunicipal' para la gestión de políticas allí donde la Ley y las ordenanzas locales declaran establecida una 'Comunidad Regional'. El cuestionamiento de dichos supuestos sustenta, en definitiva, las preguntas que delimitan los temas- problema que se abordarán a partir de este trabajo.

Screening for health impacts in Local Area Planning in Donegal County Council (2004)

In 2004 an interagency team consisting of members the North Western Health Board and Donegal County Council commissioned the IPH to conduct a HIA screening exercise on planning policy in Donegal. This involved an overview of literature, analysis of policy documents, contact with Planning Officers and observation of public consultation meetings. Following completion of the final report, the intention is to produce a user-friendly template to enable planners to incorporate a health dimension into their decision making.

IPH response to Department of the Environment, Heritage and Local Government and the Department for Regional Development Spatial Strategies

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. As an all-island body, the Institute of Public Health in Ireland particularly welcomes that the Framework for Collaboration has been co-produced by the Department for Regional Development and the Department of the Environment, Heritage and Local Government. In addition the Institute of Public Health welcomes a more holistic approach to spatial planning that takes into account the environment and sustainable economic development. A clean environment and a more equitable distribution of prosperity have associated health benefits, as outlined in the IPH’s Active travel – healthy lives (2011) and Health impacts of the built environment- a review (2006).