Health Impact Assessment contributing to Healthy Public Policy

Published by Public Health, April 2009 IPH recently coordinated and was guest editor for a minisymposium on Health Impact Assessment for the journal, Public Health. Three aricles contributed to the minisymposium which included an article from IPH on how HIA can contribute to healthy public policy. An article reviewing the right to the highest attainable standard of health from Paul Hunt and Gillian MacNaughton and a review of the strengths and weakneses of quantitiative methods used in HIA from Emer O'Connell and Fintan Hurley. The minisymposium evolved from the 8th International HIA conference ‘Healthy Public Policy – is Health Impact Assessment the Cornerstone’ hosted by IPH.

Frequency of CCR5 Delta-32 Mutation in Human Immunodeficiency Virus (HIV)-seropositive and HIV-exposed Seronegative Individuals and in General Population of Medellin, Colombia

Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion. Modifications in coreceptors for HIV entrance to target cells are one of the factors that block the infection. We studied the frequency of Delta-32 mutation in ccr5 gene in Medellin, Colombia. Two hundred and eighteen individuals distributed in three different groups were analyzed for Delta-32 mutation in ccr5 gene by polymerase chain reaction (PCR): 29 HIV seropositive (SP), 39 exposed seronegative (ESN) and 150 individuals as a general population sample (GPS). The frequency of the Delta-32 mutant allele was 3.8% for ESN, 2.7% for GPS and 1.7% for SP. Only one homozygous mutant genotype (Delta-32/Delta-32) was found among the ESN (2.6%). The heterozygous genotype (ccr5/Delta-32) was found in eight GPS (5.3%), in one SP (3.4%) and in one ESN (2.6%). The differences in the allelic and genotypic frequencies among the three groups were not statistically significant. A comparison between the expected and the observed genotypic frequencies showed that these frequencies were significantly different for the ESN group, which indirectly suggests a protective effect of the mutant genotype (Delta-32/Delta-32). Since this mutant genotype explained the resistance of infection in only one of our ESN persons, different mechanisms of protection must be playing a more important role in this population.

Chagas disease and human migration

Human Chagas disease is a purely accidental occurrence. As humans came into contact with the natural foci of infection might then have become infected as a single addition to the already extensive host range of Trypanosoma cruzi that includes other primates. Thus began a process of adaptation and domiciliation to human habitations through which the vectors had direct access to abundant food as well as protection from climatic changes and predators. Our work deals with the extraction and specific amplification by polymerase chain reaction of T. cruzi DNA obtained from mummified human tissues and the positive diagnosis of Chagas disease in a series of 4,000-year-old Pre-Hispanic human mummies from the northern coast of Chile. The area has been inhabited at least for 7,000 years, first by hunters, fishers and gatherers, and then gradually by more permanent settlements. The studied specimens belonged to the Chinchorro culture, a people inhabiting the area now occupied by the modern city of Arica. These were essentially fishers with a complex religious ideology, which accounts for the preservation of their dead in the way of mummified bodies, further enhanced by the extremely dry conditions of the desert. Chinchorro mummies are, perhaps, the oldest preserved bodies known to date.

An investigation on the pay-off to generic competences for core employees in Catalan manufacturing firms

The aim of this paper is to measure the returns to human capital. We use a unique data set consisting of matched employer-employee information. Data on individuals' human capital include a set of 26 competences that capture the utilization of workers' skills in a very detailed way. Thus, we can expand the concept of human capital and discuss the type of skills that are more productive in the workplace and, hence, generate a higher payoff for the workers. The rich information on firm's and workplace characteristics allows us to introduce a broad range of controls and to improve previous research in this field. This paper gives evidence that the returns to generic competences differ depending on the position of the worker in the firm. Only numeracy skills are reward independent of the occupational status of the worker. The level of technology used by the firm in the production process does not directly increase workers’ pay, but it influences the pay-off to some of the competences. JEL Classification: J24, J31

Comunidad y ciudadanía activa: fenomenología de una ocupación ética en un contexto de inmigración

La teoria i la praxi de la investigació qualitativa actual és hereva de la tradició fenomenològica. L’objectiu de la investigació està relacionat amb la comprensió profunda de les dimensions de l’educació i el treball, així com la seva significació per a les dones i els homes amb històries de vida marcades per la immigració. També, el treball de la investigació actual analitza la construcció de una identitat individual i col•lectiva de les dones i els homes amb una història d’immigració i reflexiona com desenvolupen el seu compromís a través d’una ocupació ètica. Es fa èmfasi en els elements transversals de la cultura i les construccions de gènere dins del domini de treball i educació. El mètode biogràfic narratiu es va utilitzar per estudiar les qüestions plantejades per la investigació. El procés de triangulació de les veus de les dones, els homes i de l’organització participant es va duu a terme per assegurar la validesa dels resultats i es van interpretar els indicadors de la recerca des del marc teòric proposat. A mode de conclusió, el treball es refereix a la formació permanent i considera que la violació del dret a l’educació és un factor que limita les oportunitats d’experimentar aquest tipus d’ocupació i, té efectes en la integritat personal i col·lectiva. Esperem que aquesta investigació pugui contribuir a la política d’immigració de les diferents organitzacions.

Identification of Human T-lymphotropic Virus Type I (HTLV-I) Subtypes Using Restrited Fragment Length Polymorphism in a Cohort of Asymptomatic Carriers and Patients with HTLV-I-associated Myelopathy/tropical Spastic Paraparesis from São Paulo, Brazil

Although human T-lymphotropic virus type I (HTLV-I) exhibits high genetic stability, as compared to other RNA viruses and particularly to human immunodeficiency virus (HIV), genotypic subtypes of this human retrovirus have been characterized in isolates from diverse geographical areas. These are currently believed not to be associated with different pathogenetic outcomes of infection. The present study aimed at characterizing genotypic subtypes of viral isolates from 70 HTLV-I-infected individuals from São Paulo, Brazil, including 42 asymptomatic carriers and 28 patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), using restricted fragment length polymorphism (RFLP) analysis of long terminal repeat (LTR) HTLV-I proviral DNA sequences. Peripheral blood mononuclear cell lysates were amplified by nested polymerase chain reaction (PCR) and amplicons submitted to enzymatic digestion using a panel of endonucleases. Among HTLV-I asymptomatic carriers, viral cosmopolitan subtypes A, B, C and E were identified in 73.8%, 7.1%, 7.1% and 12% of tested samples, respectively, whereas among HAM/TSP patients, cosmopolitan A (89.3%), cosmopolitan C (7.1%) and cosmopolitan E (3.6%) subtypes were detected. HTLV-I subtypes were not statistically significant associated with patients' clinical status. We also conclude that RFLP analysis is a suitable tool for descriptive studies on the molecular epidemiology of HTLV-I infections in our environment.

New developments of peace research: The impact of recent campaigns on disarmament and human security

The present text, based on previous work done by the authors on peace research (Grasa 1990 and 2010) and the disarmament campaigns linked to Human Security (Alcalde 2009 and 2010), has two objectives. First, to present a new agenda for peace research, based on the resolution/transformation of conflicts and the promotion of collective action in furtherance of human security and human development. Second, to focus specifically on collective action and on a positive reading of some of the campaigns that have taken place during the last decades in order to see how the experiences of such will affect the future agenda for peace research and action for peace.

A monoclonal antibody which blocks the function of factor D of human complement.

Factor D is an essential enzyme for activation of complement by the alternative pathway (AP). It has been difficult to obtain mouse monoclonal antibodies (Mabs) which block the function of factor D. We have developed a strategy to obtain such Mabs using a double screening procedure of the initial clones. We selected the clone whose supernatant had the lowest level of anti-factor D Ab by ELISA and abolished factor D haemolytic activity. Addition of this Mab to human serum was shown to abolish conversion of C3 by cobra venom factor, haemolysis of rabbit erythrocytes, and activation of C3 and C5 by cuprophane dialysis membranes.

Parenteral sparfloxacin compared with ceftriaxone in treatment of experimental endocarditis due to penicillin-susceptible and -resistant streptococci.

A new, investigational, parenteral form of sparfloxacin was compared with ceftriaxone in the treatment of experimental endocarditis caused by either of three penicillin-susceptible streptococci or one penicillin-resistant streptococcus. Both drugs have prolonged half-lives in serum, allowing single daily administration to humans. Sparfloxacin had relatively low MICs (0.25 to 0.5 mg/liter) for all four organisms and was also greater than or equal to eight times more effective than the other quinolones against 21 additional streptococcal isolates recovered from patients with bacteremia. Ceftriaxone MICs were 0.032 to 0.064 mg/liter for the penicillin-susceptible strains and 2 mg/liter for the resistant isolate. Both antibiotics resulted in moderate bacterial killing in vitro. Rats with catheter-induced aortic vegetations were inoculated with 10(7) CFU of the test organisms. Antibiotic treatment was started 48 h later and lasted either 3 or 5 days. The drugs were injected at doses which mimicked the kinetics in human serum produced by one intravenous injection of 400 mg of sparfloxacin (i.e., the daily dose expected to be given to human adults) and 2 g of ceftriaxone. Both antibiotics significantly decreased the bacterial densities in the vegetations. However, sparfloxacin was slower than ceftriaxone in its ability to eradicate valvular infection caused by penicillin-susceptible bacteria. While this difference was quite marked after 3 days of therapy, it tended to vanish when treatment was prolonged to 5 days. In contrast, sparfloxacin was very effective against the penicillin-resistant isolate, an organism against which ceftriaxone therapy failed in vivo. No sparfloxacin-resistant mutant was selected during therapy. Thus, in the present experimental setting, this new, investigational, parenteral form of sparfloxacin was effective against severe infections caused by both penicillin-susceptible and penicillin-resistant streptococci.

Identification of human T-cell lymphotropic virus infection in a semi-isolated Afro-Brazilian quilombo located in the Marajó Island (Pará, Brazil)

Antibodies to human T-cell lymphotropic virus-1 and 2 (HTLV-1 and 2) were tested in 259 inhabitants (98 males and 161 females) of four villages of the Marajó Island (Pará, Brazil) using enzyme immunoassays (ELISA and Western blot). Types and subtypes of HTLV were determined by nested polymerase chain reaction (PCR) targeting the pX, env and 5´LTR regions. HTLV-1 infection was detected in Santana do Arari (2.06%) and Ponta de Pedras (1%). HTLV-2 was detected only in Santana do Arari (1.06%). Sequencing of the 5´LTR region of HTLV-1 and the phylogenetic analysis identified the virus as a member of the Cosmopolitan Group, subgroup Transcontinental. Santana do Arari is an Afro-Brazilian community and the current results represent the first report of HTLV-1 infection in a mocambo located in the Brazilian Amazon region.

Urban and suburban malaria in Rondônia (Brazilian Western Amazon) II: perennial transmissions with high anopheline densities are associated with human environmental changes

Longitudinal entomological surveys were performed in Vila Candelária and adjacent rural locality of Bate Estaca concomitantly with a clinical epidemiologic malaria survey. Vila Candelária is a riverside periurban neighborhood of Porto Velho, capital of the state of Rondônia in the Brazilian Amazon. High anopheline densities were found accompanying the peak of rainfall, as reported in rural areas of the region. Moreover, several minor peaks of anophelines were recorded between the end of the dry season and the beginning of the next rainy season. These secondary peaks were related to permanent anopheline breeding sites resulting from human activities. Malaria transmission is, therefore, observed all over the year. In Vila Candelária, the risk of malaria infection both indoors and outdoors was calculated as being 2 and 10/infecting bites per year per inhabitant respectively. Urban malaria in riverside areas was associated with two factors: (1) high prevalence of asymptomatic carriers in a stable human population and (2) high anopheline densities related to human environmental changes. This association is probably found in other Amazonian urban and suburban communities. The implementation of control measures should include environmental sanitation and better characterization of the role of asymptomatic carriers in malaria transmission.

Ética y muerte digna

This book is an study about the bill of Death with Dignity Act, written by the Andalusian Commission on Healthcare Ethics and Research. The aim of the Act would be to “establish the criteria and conditions to be adopted by the health system to guarantee adequate healthcare during life’s final process based on the prevention of suffering and respect for each person’s dignity and free choice”.

Toxoplasma gondii: 1908-2008, homage to Nicolle, Manceaux and Splendore

The discovery of Toxoplasma gondii independently by Nicolle and Manceaux (1908) and Splendore (1908) was to open a "Pandora's Box" that has led research on this parasite into a number of scientific disciplines. In the 100 years since its discovery, the mystery surrounding T. gondii and its inter-relationship with humans has continued to provide a stimulating source of material in many areas of research, resulting in the publication of almost 20,000 papers and a number of books. This flood of diverse information shows no sign of abating, with an average of 10 papers per week appearing in PubMed. Herein, it is impossible to do more than provide a very superficial comment on what has become a massive body of scientific information. T. gondii has many unique features and seems to be the "exception to almost every rule" thus acting as a focus for research in disciplines from epidemiology to immunology to human behaviour to cell biology to human disease. In this review a number of the historical advances will be mentioned and combined with a description of the basic biology of the parasite.

Ética y muerte digna, historia de una ley : El proceso de regulación jurídica de la atención sanitaria al final de la vida en Andalucía (España)

End-of-life healthcare in any part of the world is always rife with ethical conflicts and legal challenges. In this matter, the opinions and preferences of patients, family members, healthcare professionals, society as a whole and politicians may differ or diverge entirely1. Nevertheless, death comes to all eventually; it is part of human life itself. The fact remains that we will all die. Therefore, it is natural for all societies to seek the necessary consensus for guaranteeing that individuals can live, and die, in a way befitting their nature, i.e., humanely and with full dignity. This article tells the story of how the citizens of Andalusia, in the south of Spain, reached this majority consensus during the process of drafting and approving a law regulating this issue: Law 2/2010, of 8 April, on personal rights and guarantees to die in dignity.

Sobre geografía moral

Els geògrafs s’inclouen tant en el camp de les ciències de la terra com en el de les ciències socials, tot i que també es poden considerar filòsofs morals, perquè es preocupen i s’interessen pels valors, els costums i les aspiracions humanes de no només limitar-se a sobreviure, sinó també d’aconseguir una vida fructuosa i agradable. En aquest intent per aconseguir una bona vida, els éssers humans han hagut d’organitzar-se i servir-se del poder, amb el qual és fàcil, per altra banda, cometre abusos contra els més febles i també contra la natura. El vessant moral és inevitable en qualsevol detallada consideració de la realitat humana. Aquest article pretén explorar l’esmentat vessant en societats senzilles i complexes, és a dir, tant entre els pobles caçadors-recol·lectors com en aquelles cultures més sofisticades que han transformat el camp, el jardí i la ciutat