Environmental justice and health practices: understanding how health inequities arise at the local level

While empirical evidence continues to show that people living in low socio-economic status neighbourhoods are less likely to engage in health-enhancing behaviour, our understanding of why this is so remains less than clear. We suggest that two changes could take place to move from description to understanding in this field; (i) a move away from the established concept of individual health behaviour to a contextualised understanding of health practices; and (ii) a switch from focusing on health inequalities in outcomes to health inequities in conditions. We apply Pierre Bourdieu's theory on capital interaction but find it insufficient with regard to the role of agency for structural change. We therefore introduce Amartya Sen's capability approach as a useful link between capital interaction theory and action to reduce social inequities in health-related practices. Sen's capability theory also elucidates the importance of discussing unequal chances in terms of inequity, rather than inequality, in order to underscore the moral nature of inequalities. We draw on the discussion in social geography on environmental injustice, which also underscores the moral nature of the spatial distribution of opportunities. The article ends by applying this approach to the 'Interdisciplinary study of inequalities in smoking' framework.

Electrophysiologic characterization of local abnormal ventricular activities in postinfarction ventricular tachycardia with respect to their anatomic location.

BACKGROUND Local abnormal ventricular activities (LAVA) in patients with scar-related ventricular tachycardia (VT) may appear at any time during or after the far-field electrogram. Although they may be separated from the far-field signal by an isoelectric line and extend beyond the end of surface QRS, they may also appear fused or buried within the QRS. OBJECTIVE The purpose of this study was to characterize LAVA in postinfarction VT patients with respect to their anatomic locations. METHODS Thirty-one patients with postinfarction VT underwent mapping/ablation during sinus rhythm with a three-dimensional electroanatomic mapping system. From a total of 18,270 electrograms reviewed in all study subjects, 1104 LAVA (endocardium 839, epicardium 265) were identified and analyzed. RESULTS The interval from onset of QRS complex to ventricular electrogram (EGM onset) on the endocardium was significantly shorter than the epicardium (P < .001). EGM onset was shortest in the septal endocardium and longest in the inferior and lateral epicardium. There was a significant positive correlation between EGM onset and LAVA lateness as estimated by the interval from surface QRS onset to LAVA (r = 0.52, P < .001). LAVA were more frequently detected after the QRS complex in the epicardium (241/265 [91%]) than in the endocardium (551/839 [66%], P < .001). Only 43% of endocardial septal LAVA were detected after the QRS complex. CONCLUSION Lateness of LAVA is affected to a large extent by their locations. The chance of detecting late LAVA increases when electrogram onset is later. Substrate-based approach targeting delayed signals relative to the QRS complex may miss critical the arrhythmogenic substrate, particularly in the septum and other early-to-activate regions.

Synchrotron x ray induced axonal transections in the brain of rats assessed by high-field diffusion tensor imaging tractography

Since approximately two thirds of epileptic patients are non-eligible for surgery, local axonal fiber transections might be of particular interest for them. Micrometer to millimeter wide synchrotron-generated X-ray beamlets produced by spatial fractionation of the main beam could generate such fiber disruptions non-invasively. The aim of this work was to optimize irradiation parameters for the induction of fiber transections in the rat brain white matter by exposure to such beamlets. For this purpose, we irradiated cortex and external capsule of normal rats in the antero-posterior direction with a 4 mm×4 mm array of 25 to 1000 µm wide beamlets and entrance doses of 150 Gy to 500 Gy. Axonal fiber responses were assessed with diffusion tensor imaging and fiber tractography; myelin fibers were examined histopathologically. Our study suggests that high radiation doses (500 Gy) are required to interrupt axons and myelin sheaths. However, a radiation dose of 500 Gy delivered by wide minibeams (1000 µm) induced macroscopic brain damage, depicted by a massive loss of matter in fiber tractography maps. With the same radiation dose, the damage induced by thinner microbeams (50 to 100 µm) was limited to their paths. No macroscopic necrosis was observed in the irradiated target while overt transections of myelin were detected histopathologically. Diffusivity values were found to be significantly reduced. A radiation dose ≤ 500 Gy associated with a beamlet size of < 50 µm did not cause visible transections, neither on diffusion maps nor on sections stained for myelin. We conclude that a peak dose of 500 Gy combined with a microbeam width of 100 µm optimally induced axonal transections in the white matter of the brain.

Field-scale water transport in unsaturated crystalline rock

Safe disposal of toxic wastes in geologic formations requires minimal water and gas movement in the vicinity of storage areas, Ventilation of repository tunnels or caverns built in solid rock can desaturate the near field up to a distance of meters from the rock surface, even when the surrounding geological formation is saturated and under hydrostatic pressures. A tunnel segment at the Grimsel test site located in the Aare granite of the Bernese Alps (central Switzerland) has been subjected to a resaturation and, subsequently, to a controlled desaturation, Using thermocouple psychrometers (TP) and time domain reflectometry (TDR), the water potentials psi and water contents theta were measured within the unsaturated granodiorite matrix near the tunnel wall at depths between 0 and 160 cm. During the resaturation the water potentials in the first 30 cm from the rock surface changed within weeks from values of less than -1.5 MPa to near saturation. They returned to the negative initial values during desaturation, The dynamics of this saturation-desaturation regime could be monitored very sensitively using the thermocouple psychrometers, The TDR measurements indicated that water contents changed dose to the surface, but at deeper installation depths the observed changes were within the experimental noise. The field-measured data of the desaturation cycle were used to test the predictive capabilities of the hydraulic parameter functions that were derived from the water retention characteristics psi(theta) determined in the laboratory. A depth-invariant saturated hydraulic conductivity k(s) = 3.0 x 10(-11) m s(-1) was estimated from the psi(t) data at all measurement depths, using the one-dimensional, unsaturated water flow and transport model HYDRUS Vogel er al., 1996, For individual measurement depths, the estimated k(s) varied between 9.8 x 10(-12) and 6.1 x 10(-11) The fitted k(s) values fell within the range of previously estimated k(s) for this location and led to a satisfactory description of the data, even though the model did not include transport of water vapor.

Fractionated stereotactic radiotherapy with static field conformal and non coplanar arcs for pediatric patients with craniopharyngioma: analysis of long term visual outcome and endocrine toxicity

We assessed the efficacy and the toxicity for pediatric craniopharyngioma patients of fractionated stereotactic radiotherapy (FSRT). Between May 2000 and May 2009, 9 patients (male to female ratio, 5:4) with craniopharyngiomas underwent FSRT (median dose, 54 Gy). Among the 9 patients, 6 received radiation therapy (RT) for recurrent tumors and 3 for residual disease as adjuvant therapy after incomplete surgery. Median tumor 3 volume was 2.3 cm (range, 0.1-5.8). The median target coverage was 93.7% (range 79.3-99.8%). The median conformity index was 0.94 (range, 0.6-1.4). Dose to the hippocampal region was assessed for all patients. After a median follow-up of 62.5 months (range, 32-127)the treated volume decreased in size in four of eight patients (50%). One patient was lost to follow-up. Local control and survival rates at 3 years were 100% and there were no marginal relapses. One patient, with a chronic bilateral papillary oedema after surgery, visual defect deteriorated after FSRT to a complete hemianopsia. One male patient with normal pituitary function before FSRT presented with precocious puberty at the age of 7.4 years, 24 months after FSRT. Four patients (50%) were severely obese at their last visit. FSRT is a safe treatment option for craniopharyngioma after incomplete resection.

Into the abyss of Lake Geneva: the elemo interdisciplinary field investigation using the MIR submersibles

In summer 2011, the two Russian MIR sub- mersibles were brought to Switzerland to perform deep water dives in Lake Geneva. Research teams from several environmental science institutes, both national and inter- national, participated in this interdisciplinary effort to investigate the deeper parts of Lake Geneva. Using the MIRs allowed the scientists to see and precisely select the sites where they could extract specific sediment cores and carry out detailed in situ measurements at the sediment– water boundary. One focus site was the surrounding of the outlet of the wastewater treatment plant of the City of Lausanne, which discharges into the Vidy Bay. The investigations concentrated on the pollution of the local sediments, pollution-related ecotoxicological risks, micro- bial activity and spreading and removal of the effluents from the bay to the open waters of the lake. The other focus site was the Rhoˆne River delta and its subaquatic canyons, which formed as a result of the long-term interplay of the deposition of river-borne sediments and flood-triggered canyon erosion events.

Drought avoidance and the effect of local topography on trees in the understorey of Bornean lowland rain forest

The water relations of two tree species in the Euphorbiaceae were compared to test in part a hypothesis that the forest understorey plays an integral role in drought response. At Danum, Sabah, the relatively common species Dimorphocalyx muricatus is associated with ridges whilst another species, Mallotus wrayi, occurs widely both on ridges and lower slopes. Sets of subplots within two 4 -ha permanent plots in this lowland dipterocarp rain forest, were positioned on ridges and lower slopes. Soil water potentials were recorded in 1995-1997, and leaf water potentials were measured on six occasions. Soil water potentials on the ridges (-0.047 MPa) were significantly lower than on the lower slopes (-0.012 MPa), but during the driest period in May 1997 they fell to similarly low levels on both sites (-0.53 MPa). A weighted 40-day accumulated rainfall index was developed to model the soil water potentials. At dry times, D. muricatus (ridge) had significantly higher pre-dawn (-0.21 v. -0.57 MPa) and mid-day (-0.59 v. -1.77 MPa) leaf water potentials than M. wrayi (mean of ridge and lower slope). Leaf osmotic potentials of M. wrayi on the ridges were lower (-1.63 MPa) than on lower slopes (-1.09 MPa), with those for D. muricatus being intermediate (-1.29 MPa): both species adjusted osmotically between wet and dry times. D. muricatus trees were more deeply rooted than M. wrayi trees (97 v. 70 cm). M. wrayi trees had greater lateral root cross-sectional areas than D. muricatus trees although a greater proportion of this sectional area for D. muricatus was further down the soil profile. D. muricatus appeared to maintain relatively high water potentials during dry periods because of its access to deeper water supplies and thus it largely avoided drought effects, but M. wrayi seemed to be more affected yet tolerant of drought and was more plastic in its response. The interaction between water availability and topography determines these species' distributions and provides insights into how rain forests can withstand occasional strong droughts.

Experimental validation of a mean field model of mineralized collagen fiber arrays at two levels of hierarchy

In the course of this study, stiffness of a fibril array of mineralized collagen fibrils modeled with a mean field method was validated experimentally at site-matched two levels of tissue hierarchy using mineralized turkey leg tendons (MTLT). The applied modeling approaches allowed to model the properties of this unidirectional tissue from nanoscale (mineralized collagen fibrils) to macroscale (mineralized tendon). At the microlevel, the indentation moduli obtained with a mean field homogenization scheme were compared to the experimental ones obtained with microindentation. At the macrolevel, the macroscopic stiffness predicted with micro finite element (μFE) models was compared to the experimental stiffness measured with uniaxial tensile tests. Elastic properties of the elements in μFE models were injected from the mean field model or two-directional microindentations. Quantitatively, the indentation moduli can be properly predicted with the mean-field models. Local stiffness trends within specific tissue morphologies are very weak, suggesting additional factors responsible for the stiffness variations. At macrolevel, the μFE models underestimate the macroscopic stiffness, as compared to tensile tests, but the correlations are strong.

Digital Data Collection and Processing in Field and Lab: The Approach of Kinneret Regional Project

The paper showcases the field- and lab-documentation system developed for Kinneret Regional Project, an international archaeological expedition to the Northwestern shore of the Sea of Galilee (Israel) under the auspices of the University of Bern, the University of Helsinki, Leiden University and Wofford College. The core of the data management system is a fully relational, server-based database framework, which also includes time-based and static GIS services, stratigraphic analysis tools and fully indexed document/digital image archives. Data collection in the field is based on mobile, hand-held devices equipped with a custom-tailored stand-alone application. Comprehensive three-dimensional documentation of all finds and findings is achieved by means of total stations and/or high-precision GPS devices. All archaeological information retrieved in the field – including tachymetric data – is synched with the core system on the fly and thus immediately available for further processing in the field lab (within the local network) or for post-excavation analysis at remote institutions (via the WWW). Besides a short demonstration of the main functionalities, the paper also presents some of the key technologies used and illustrates usability aspects of the system’s individual components.

Hygrical shrinkage stresses in tiling systems: Numerical modeling combined with field studies

To track down potential sites of material failure in the tile–mortar–substrate systems, locations and intensities of stress concentrations owing to drying-induced shrinkage are investigated. For this purpose, mechanical properties were measured on real systems and used as input parameters for numerical modeling of the effect of shrinkage of substrate and/or mortar using the finite element code Abaqus. On the base of different geometrical set-ups we demonstrate that stress concentrations in the mortar can become critical when (i) substantial mortar shrinkage occurs, (ii) substrate shrinkage can accumulate over considerable spatial distances, particularly (iii) in situations where the mortar layer is not separated from the substrate by a flexible waterproofing membrane. Hence material failure in the system tile–mortar–substrate can be prevented (or reduced) by (i) an application of the tiles after the major stages of substrate shrinkage, (ii) the use of elasto-plastic deformable tile adhesives which can react elastically on local stress concentrations, (iii) the implementation of flexible membranes, and (iv) a reduction of the field size by the installation of flexible joints.

Dynamics of Traditional Ecological Knowledge, Local Use and Conservation of Native Trees and Shrubs in the Bolivian Andes

Native trees and shrubs are essential components of rural landscapes in the semi-arid inner-Andean valleys of Bolivia. They can be found as hedges and bushes in various agroecosystems such as terrace walls, slopes, field boundaries and fallow land. Their distribution and floristic composition are the result of dynamic spatial and temporal interactions between local farmers and the environment. Local uses of natural resources and biodiversity reflect the constantly evolving Andean culture, which can be generally characterised as an intertwining of the human, natural, and spiritual worlds. The aim of the present ethnobotanical study was to analyse the dynamics of traditional ecological knowledge, to ascertain local farmers’ perceptions and uses of native woody species in Andean communities and to associate the results with local conservation activities for the trees and shrubs concerned. Our case study was carried out within two communities of the Tunari National Park (Dept. Cochabamba) in Bolivia. For data collection, research methods from social science (semi-structured interviews, participative observation, participatory mapping) as well as vegetation surveys were combined. Local actors included women and men of all ages as well as families from different social categories and altitudinal levels of permanent residence. Our study indicates that, due to a multitude of socio-economic pressures (e.g. migration of young people) as well as changes in use of biodiversity (e.g. replacement of native by exotic introduced species), the traditional ecological knowledge base of native trees and shrubs and their respective uses has become diminished over time. In many cases it has led to a decline in people’s awareness of native species and as a consequence their practical, emotional and spiritual relationships with them have been lost. However, results also show that applied traditional ecological knowledge has led to local conservation strategies, which have succeeded in protecting those tree and shrub species which are most widely regarded for their multifunctional, constant and exclusive uses (e.g. Schinus molle, Prosopis laevigata, Baccharis dracunculifolia). The presentation will discuss the question if and how applied traditional ecological knowledge positively contributes to local initiatives of sustainable use and conservation of biodiversity in rural areas.

Irrigation development in Eritrea: potentials and constraints: Proceedings of the workshop of AEAS and SLM Programme Eritrea

Development of irrigation, which is of crucial importance in Eritrea, is perceived by many as the main technique for improving the precarious food security situation in this Sahelian country in the Horn of Africa. The present publication presents the outcome of a nationwide workshop held in 2003, which brought together administrators, scientists, and members of public development agencies and NGOs. These workshop participants presented experiences, lessons learnt, and ideas about how to move forward in relation to development of irrigation in Eritrea. Specifically, the publication deals with the following broad themes, lessons learnt, and experiences in Eritrea: · spate irrigation systems and measurement of performance, as well as experience with modernisation of spate irrigation systems in Eritrea · small-scale irrigation systems and their potentials and pitfalls, including development of low-cost micro irrigation · climate and irrigation, including rainfall forecasts · socio-economic aspects of irrigation, including gender questions, institutional requirements, and irrigation and livelihoods The publication contains an extensive summary in the Tigrinya language, in order to facilitate access to the key findings by local non-English-speaking stakeholders in irrigation development.

European mobility and local political incorporation: The case of British and Romanian residents in Spain

This paper analyses the impact of European mobility in the field of the political nomination of intra-EU migrants in local elections. The study contributes to the debates in the literature related to immigrant nomination and representation by showing how group resources and political opportunities in the country of residence interact with the political opportunities of the European citizenship regime. It argues that the symbolic and legal status of European identity, representation in the European Parliament and strong links between political institutions in the countries of destination and origin play a positive role in boosting immigrant political entrepreneurs’ visibility vis-à-vis host country political actors. In order to illustrate these findings, the paper provides a qualitative comparison of British and Romanian residents in Spain.

Use of pulsed-field gel electrophoresis in surveillance of Salmonella in Houston, Texas

Background. Pulsed-field gel electrophoresis (PFGE) is a laboratory technique in which Salmonella DNA banding patterns are used as molecular fingerprints for epidemiologic study for "PFGE clusters". State and national health departments (CDC) use PFGE to detect clusters of related cases and to discover common sources of bacteria in outbreaks. ^ Objectives. Using Houston Department of Health and Human Services (HDHHS) data, the study sought: (1) to describe the epidemiology of Salmonella in Houston, with PFGE subtype as a variable; and (2) to determine whether PFGE patterns and clusters detected in Houston were local appearances of PFGE patterns or clusters that occurred statewide. ^ Methods. During the years 2002 to 2005, the HDHHS collected and analyzed data from routine surveillance of Salmonella. We implemented a protocol, between May 1, 2007 and December 31, 2007, in which PFGE patterns from local cases were sent via e-mail to the Texas Department of State Health Services, to verify whether the local PFGE patterns were also part of statewide clusters. PFGE was performed from 106 patients providing a sample from which Salmonella was isolated in that time period. Local PFGE clusters were investigated, with the enhanced picture obtained by linking local PFGE patterns to PFGE patterns at the state and national level. ^ Results. We found that, during the years 2002 to 2005, there were 66 PFGE clusters, ranging in size from 2 to 22 patients within each cluster. Between different serotypes, there were marked differences in the sizes of PFGE clusters. A common source or risk factor was found in fewer than 5 of the 66 PFGE clusters. With the revised protocol, we found that 19 of 66 local PFGE patterns were indistinguishable from PFGE patterns at Texas DSHS. During the eight months, we identified ten local PFGE clusters with a total of 42 patients. The PFGE pattern for eight of the ten clusters matched the PFGE patterns for cases reported to Texas DSHS from other geographic areas. Five of the ten PFGE patterns matched PFGE patterns for clusters under investigation at PulseNet at the national level. HDHHS epidemiologists identified a mode of transmission in two of the ten local clusters and a common risk factor in a third local cluster. ^ Conclusion. In the extended-study protocol, Houston PFGE patterns were linked to patterns seen at the state and national level. The investigation of PFGE clusters was more efficacious in detecting a common transmission when local data were linked to state and national data. ^

Ordenamiento territorial y desarrollo local : provincia Cercado, Tarija, Bolivia

El proceso de ordenamiento territorial en Bolivia es relativamente nuevo y por tal razón el avance es mínimo si se piensa en los objetivos alcanzados hasta ahora. El presente trabajo pretende mostrar el avance logrado en uno de los departamentos de Bolivia, Tarija, donde en 5 años, se ha logrado elaborar un plan departamental de ordenamiento territorial y mediante la coordinación interinstitucional (prefectura y gobiernos municipales) se ha iniciado el mismo proceso de a nivel municipal. A partir de estos planes municipales se induce a municipios predominantemente urbanos a trabajar planes de ordenamiento territorial a partir de lineamientos planteados desde la prefectura, con el fin de iniciar los procesos de planificación urbana, actualizar la normativa y elaborar proyectos de desarrollo local. El objetivo del presente trabajo, es mostrar los avances a los que se pretende arribar gracias a un proceso metodológico de ordenamiento territorial incorporado a una dinámica urbana que interactúa constantemente con su área de influencia que en el caso boliviano es normalmente rural; pero además demostrar que el componente interdisciplinario en el caso de la planificación urbana es imprescindible considerando que hasta hace unos años este era un trabajo especifico de los colegas urbanistas y que en una realidad como la latinoamericana casi siempre quedaba en planos y en un viejo anaquel. Por lo tanto a partir de una interdisciplinariedad se puede lograr desarrollo local articulando y optimizando relaciones urbano-rurales que basan su desarrollo en un proceso metodológico como es el caso del ordenamiento territorial. El trabajo, se apoya en la guía metodológica para la elaboración de planes elaboradas por el Ministerio de Desarrollo Sostenible del gobierno boliviano, pero como tal cual su nombre expresa es una guía susceptible a ser adecuada a las exigencias del área de estudio, en este sentido sobre esa base es que se incorporan algunas variables de estudio que permitirán mejorar el producto a nivel de propuesta una vez concluido el trabajo. Contempla varias etapas donde la incorporación de los diferentes actores sociales será una clave para lograr resultados exitosos en la etapa de implementación. Actualmente el plan municipal de la provincia Cercado, es un proyecto a encarar en los próximos meses una vez cumplidos con los requisitos administrativos para iniciar el trabajo técnico que comprenderá un trabajo de campo, para el relevamiento de datos, la elaboración de un diagnóstico integral con dos ámbitos territoriales rural y urbano, para luego proceder al análisis territorial y el planteamiento de propuesta que incluirán políticas, estrategias, acciones y proyectos, pero no solo generará bases para el uso de suelo y la ocupación del territorio, a escala urbana se plantearan los lineamientos para el diseño y la normativa urbana. A partir del cual se definirán proyectos de desarrollo local que nos permita orientarnos hacia la imagen objetivo planteada en la visión del proyecto, este trabajo incluye el aspecto institucional para fortalecer al proceso que hasta esta ahora se encuentra desarticulado; se pretende consolidar el proceso de ordenamiento y dar inicio a otros en escalas de mayor detalle permitiendo la optimización de recursos y el aprovechamiento de las potencialidades y recursos naturales para mejorar la calidad de vida.