Health inequality target monitoring: update to include data for 2006

These reports summarise progress against Department of Health inequality targets for 2010 in the following areas: Infant mortality; life expectancy at birth for males and for females; cancer (premature mortality rate) and all circulatory diseases (premature mortality rate). Key facts Infant mortality The inequality gap in the infant mortality rate has reduced for the second consecutive period, though not yet by a sufficient amount to meet the target, based on the trend since the current socio economic classifications were introduced in 2001. Life expectancy at birth (males and females) The inequality gaps in male and female life expectancy at birth have both increased since the baseline. If current trends continue, the target would not be met. Cancer mortality The inequality gap in cancer mortality has declined since the baseline (despite a slight increase in the latest period), and the minimum requirement for the 2010 target has already been met. All circulatory diseases mortality The inequality gap in circulatory disease mortality has declined, and is on track to meet the target.

Epidemiology of visceral leishmaniasis through spatial analysis, in Belo Horizonte municipality, state of Minas Gerais, Brazil

The geographic information system approach has permitted integration between demographic, socio-economic and environmental data, providing correlation between information from several data banks. In the current work, occurrence of human and canine visceral leishmaniases and insect vectors (Lutzomyia longipalpis) as well as biogeographic information related to 9 areas that comprise the city of Belo Horizonte, Brazil, between April 2001 and March 2002 were correlated and georeferenced. By using this technique it was possible to define concentration loci of canine leishmaniasis in the following regions: East; Northeast; Northwest; West; and Venda Nova. However, as for human leishmaniasis, it was not possible to perform the same analysis. Data analysis has also shown that 84.2% of the human leishmaniasis cases were related with canine leishmaniasis cases. Concerning biogeographic (altitude, area of vegetation influence, hydrographic, and areas of poverty) analysis, only altitude showed to influence emergence of leishmaniasis cases. A number of 4673 canine leishmaniasis cases and 64 human leishmaniasis cases were georeferenced, of which 67.5 and 71.9%, respectively, were living between 780 and 880 m above the sea level. At these same altitudes, a large number of phlebotomine sand flies were collected. Therefore, we suggest control measures for leishmaniasis in the city of Belo Horizonte, giving priority to canine leishmaniasis foci and regions at altitudes between 780 and 880 m.

Supporting Equity in Higher Education

The rationale for this review centres solely on the need to broaden access to third-level education in order to improve equity and social justice. It is founded on the Government’s social and economic policy objective of reducing and eliminating educational disadvantage, and increasing participation at third level by lower socio-economic groups. The Agreed Programme for Government of June 2002 commits the Government to building a caring and inclusive society and to achieving real and sustained social progress. Similar commitments are reflected in the National Development Plan, the National Anti-Poverty Strategy, the National Children’s Strategy and successive national partnership agreements, including Sustaining Progress. Tackling educational disadvantage is a core principle of social justice. The issues of educational disadvantage and social inclusion, therefore, are key priorities for the Government and, since taking up office, the Minister for Education and Science has emphasised his commitment to improving participation and achievement at every level of education. The need for interventions throughout the education system is well recognised. It is well established that addressing educational disadvantage requires intervention in the context of a continuum of provision from early childhood through to adulthood. Successive governments, of all political persuasions, have recognised this fact and have introduced a range of initiatives at pre-primary, primary and post-primary levels aimed at increasing pupil retention and achievement. These initiatives are currently being reviewed in order to ensure that individuals are enabled to obtain the appropriate supports they require to maximise the benefit they derive from the education system.

Flow-R, a model for susceptibility mapping of debris flows and other gravitational hazards at a regional scale: some case studies

Every year, debris flows cause huge damage in mountainous areas. Due to population pressure in hazardous zones, the socio-economic impact is much higher than in the past. Therefore, the development of indicative susceptibility hazard maps is of primary importance, particularly in developing countries. However, the complexity of the phenomenon and the variability of local controlling factors limit the use of processbased models for a first assessment. A debris flow model has been developed for regional susceptibility assessments using digital elevation model (DEM) with a GIS-based approach.. The automatic identification of source areas and the estimation of debris flow spreading, based on GIS tools, provide a substantial basis for a preliminary susceptibility assessment at a regional scale. One of the main advantages of this model is its workability. In fact, everything is open to the user, from the data choice to the selection of the algorithms and their parameters. The Flow-R model was tested in three different contexts: two in Switzerland and one in Pakistan, for indicative susceptibility hazard mapping. It was shown that the quality of the DEM is the most important parameter to obtain reliable results for propagation, but also to identify the potential debris flows sources.

Saving Mothers' Lives 2006-2008

The eighth Report of the Confidential Enquiries into Maternal Deaths in the UK investigates the deaths of 261 women who died in the triennium 2006-08, from causes directly or indirectly related to pregnancy. The full Report is available for purchase or download from the Centre for Maternal and Child Enquiries (CMACE; www.cmace.org.uk). Although every maternal death is a tragedy, particularly where avoidable factors were identified by the Enquiry process, the overall picture is encouraging. The maternal death rate in the UK continues to decline despite increasing pressures on maternity services and a changing maternal population. For the first time there has been a reduction in the inequalities gap between women living in different socio-economic circumstances, and timely production of guidelines and tools appears to have helped clinical staff to deliver improved clinical care.

The relationships between technology and open education in the development of a resilient higher education

The place of technology in the development of coherent educational responses to environmental and socio-economic disruption is here placed under scrutiny. One emerging area of interest is the role of technology in addressing more complex learning futures, and more especially in facilitating individual and social resilience, or the ability to manage and overcome disruption. However, the extent to which higher education practitioners can utilise technology to this end is framed by their approaches to the curriculum, and the socio-cultural practices within which they are located. This paper discusses how open education might enable learners to engage with uncertainty through social action within a form of higher education that is more resilient to economic, environmental and energy-related disruption. It asks whether open higher education can be (re)claimed by users and communities within specific contexts and curricula, in order to engage with an uncertain world.

Spatial modelling of Lutzomyia (Nyssomyia) whitmani s.l. (Antunes & Coutinho, 1939) (Diptera: Psychodidae: Phlebotominae) habitat suitability in the state of Mato Grosso, Brazil

Lutzomyia (Nyssomyia) whitmani s.l.is the main vector of cutaneous leishmaniasis in state of Mato Grosso, but little is known about environmental determinants of its spatial distribution on a regional scale. Entomologic surveys of this sand fly species, conducted between 1996 and 2001 in 41 state municipalities, were used to investigate the relationships between environmental factors and the presence of the species, and to develop a spatial model of habitat suitability. The relationship between averaged CDC light trap indexes and 15 environmental and socio-economic factors were tested by logistic regression (LR) analysis. Spatial layers of deforestation tax and the Brazilian index of gross net production (IGNP) were identified as significant explanatory variables for vector presence in the LR model, and these were then overlaid with habitat maps. The highest habitat suitability in 2001 was obtained for the heavily deforested areas in the Central-North, South, East, and Southwest of Mato Grosso, particularly in municipalities with lower IGNP values.

Factors associated with seropositivity for anti-Toxoplasma gondiiantibodies in pregnant women of Londrina, Paraná, Brazil

The aim of this study was to evaluate associations between seropositivity for IgG and IgM anti-Toxoplasma gondii antibodies and socio-economic and environmental variables in pregnant women of Londrina, state of Paraná, Brazil. We interviewed 492 pregnant women, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti-T. gondii antibodies by chemiluminescence. A confirmatory diagnosis of acute infection was made by an IgG avidity test. Titres of specific IgG anti-T. gondii were obtained by IFAT. Seropositivity for IgG anti-T. gondii antibodies was observed in 242 women (49.2%) and, of these, six pregnant women (1.2%) showed seropositivity for IgM. Age group, level of education, per capita income, presence of a cat in the house and a habit of eating green vegetables were all factors associated with a greater chance of infection with T. gondii. This study showed that 250 (50.8%) pregnant women were susceptible to T. gondii and considered to be at high risk for toxoplasmosis during pregnancy. Based on the results obtained, is critical to establish a program of health surveillance for toxoplasmosis, in order to contribute to diagnosis and early treatment during the prenatal period. It is also necessary to introduce measures to prevent the Toxoplasma infection in seronegative pregnant women.

Apoyo social a drogodependientes en programa de mantenimiento con metadona en una prisión

Goal: To learn more about the social support available to patients participating in a prison methadone maintenance program (PMM). Methodology: Descriptive, with controls. Setting: A penitentiary in Albolote (Granada) Population Sample: The total prison population was 1,579; 364 patients were included in the PMM; 35 were female and 329 were male. 60 patients, 7 women and 53 men, were used as cases. 30 non-drug dependent prisoners, 3 women and 27 men, were the control group. They had no antecedents of problems with drug addiction. Interventions: Interviews with cases and controls to learn about their addictive antecedents, family structure, socio-economic level, and a hetero-applied MOS questionnaire was completed. Percentages of each social support variable were obtained and compared using the chi-squared technique. Results: The overall support received is low in 38 cases (74.5%) and in 9 controls (30%): p = 0.0001. OR 0.1466, confidence interval at 95% (0.0538-0.3989). Support received is normal in 13 cases (25%) and 21 controls (70%): p = 0.0007. OR 0.69, confidence interval at 95% (0.44-0.93). All of the variables were statistically significant for non-drug addicts, except for emotional support, which was the same for both groups. Conclusion: The perception of inmates participating in the methadone maintenance program was that they received less social support than the non-drug dependent inmates.

Risk factors associated with human papillomavirus infection in two populations from Rio de Janeiro, Brazil

We investigated human papillomavirus (HPV) infection in two female populations from diverse socio-economic strata from the state of Rio de Janeiro and we also investigated the possible co-factors related to infection and the progression to cancer. In Group I, the reference group of this study, 10.7% of the patients presented HPV infection, as detected by generic PCR, while in Group II (low socio-demographic conditions) HPV was detected in 31.1% of the samples. HPV16 was the most prevalent virus type found in both Groups I and II (5.3% and 10%, respectively), followed by HPV 18 (1.3% and 4.7%, respectively). Although only a small sample was analysed, we detected differences among the groups regarding the rates of HPV infection, HPV types, age, ethnicity, familial income, schooling, marital status, parity, tobacco smoking and oral contraceptive use. For Group I, the Papanicolaou test was the most powerful independent factor associated with HPV status, followed by an age of under 30 years old, the number of sexual partners and black ethnicity. Our data are in agreement with the co-factors that are typically described for the developed world. For Group II, the Pap test was also the most relevant variable that was analysed, but the history of other sexually transmitted diseases and the use of alcohol were additional factors that were implicated in infection. These findings point out the need for the development of general and specific strategies for HPV screening of all Brazilian women.

What explains electoral turnout in Swiss municipalities?

What explains the higher electoral turnout in some of the Swiss municipalities? Since there are important differences as far as size, socio-economic structure, importance, political systems and the prevailing political culture are concerned, the Swiss municipalities offer a laboratory-like field of research. Using aggregate level data from our own surveys and from official sources covering the whole country this paper investigates the determinants of voting turnout at the local level. It comes to the following conclusion: The level of electoral turnout in Swiss municipalities depends to an important extent on institutional variables. If the executive is elected in a citizens' assembly there are considerably fewer people participating than in elections at the polls. PR also has a positive effect on turnout, whereas it cannot be shown that having a local parliament leads to higher turnout (and thus to increased interest in politics). Another important variable is the size of a municipality. In smaller municipalities turnout is consistently higher than in bigger ones. As for the importance of Catholicism for turnout, our study confirms the findings of Freitag (2005) at the cantonal level. The Catholic milieu has a positive impact on participation

Factors related to transmission of and infection with Schistosoma mansoni in a village in the South-eastern Region of Brazil

In this transversal study, factors related to infection with and transmission of Schistosoma mansoni were explored. Based on stool examinations of two Kato-Katz smears of a single sample, the prevalences of schistosomiasis and geohelminths were established. In a multivariable analysis, sets of demographic, socio-economic and water contact pattern variables were tested for strength of relation with infection. Males presented a 3.39-times higher risk for infection than females. The age groups between 10-19 years and 20-30 years showed risks of infection 7.1- and 7.5-times higher, respectively, than the control age group between 0-10 years. Individuals practicing leisure activities had a 1.96-times higher risk than those without these activities. The malacological survey identified snails of the species Biomphalaria glabrata, Biomphalaria straminea and Biomphalaria tenagophila. Two exemplars of B. glabrata (0.53%) proved positive for S. mansoni. The socio-economic improvements observed in the locality suggest a protective and preventive effect towards infection with schistosomiasis, which requires further investigation with a longitudinal and more detailed study design. Considering our findings, a proposal for an integrated control program should be based on two pillars: one horizontal, which involves social empowerment and health education, and another more vertical, which delivers treatment and infrastructure improvements.

Evolutionary histories of expanded peptidase families in Schistosoma mansoni

Schistosoma mansoni is one of the three main causative agents of human schistosomiasis, a major health problem with a vast socio-economic impact. Recent advances in the proteomic analysis of schistosomes have revealed that peptidases are the main virulence factors involved in the pathogenesis of this disease. In this context, evolutionary studies can be applied to identify peptidase families that have been expanded in genomes over time in response to different selection pressures. Using a phylogenomic approach, we searched for expanded endopeptidase families in the S. mansoni predicted proteome with the aim of contributing to the knowledge of such enzymes as potential therapeutic targets. We found three endopeptidase families that comprise leishmanolysins (metallopeptidase M8 family), cercarial elastases (serine peptidase S1 family) and cathepsin D proteins (aspartic peptidase A1 family). Our results suggest that the Schistosoma members of these families originated from successive gene duplication events in the parasite lineage after its diversification from other metazoans. Overall, critical residues are conserved among the duplicated genes/proteins. Furthermore, each protein family displays a distinct evolutionary history. Altogether, this work provides an evolutionary view of three S. mansoni peptidase families, which allows for a deeper understanding of the genomic complexity and lineage-specific adaptations potentially related to the parasitic lifestyle.

La force motrice hydraulique au service du développement économique helvétique : L'exemple du réseau d'eau sous pression à Lausanne 1868-1914

The success story of hydroelectricity long influenced and dominated Swiss scholarly literature devoted to the history of technology. This means of conducting power, which emerged at the end of the 19th century and is still dominating today, has attracted much more attention than technologies that have been shadowed by its success. In spite of their important contribution to Swiss economic development, the distribution networks of pressurized water have been neglected by scholars. This article contributes to close this historiographic gap by analyzing the introduction of pressurized water distribution in 1876 in Lausanne, in the context of the building of the first Swiss cable funicular between Lausanne and Ouchy. This article shows how pressurized water distribution transformed socio-economic practices in the urban areas in which it was adopted. Indeed, this innovation, which allowed the use of distant hydraulic resources, enabled the rationalization of industrial and artisanal production as well as improved the density of the urban industrial base. By facilitating the introduction of electric lighting, pressurized water networks played a key role in the early development, and further successes, of the Swiss hydroelectric industry.

Ecologia del tram final del riu Ebre: la comunitat de macròfits i macroinvertebrats associats

Durant els últims anys al tram final del riu Ebre s’han produit canvis molt importants a l’ecosistema fluvial: l’augment de la transparència de l’aigua ha comportat una proliferació massiva de macròfits que ha provocat canvis en l’estructura tròfica i en la composició de les comunitats biològiques, representant un greu perill per espècies amenaçades com Margaritifera auricularia. A més del problema ecològic, els macròfits estan provocant molts problemes socio-econòmics perjudicant les captacions d’aigua (centrals nuclears, hidroelèctriques i regadius), creant problemes per a la navegació fluvial, i afavorint la proliferació d’espècies molestes com la mosca negra (Simulium erythrocephalum). Entre les diferents causes que podrien explicar aquests canvis en l’ecosistema hi ha: la disminució del fòsfor dissolt, la regularització i la disminució de cabals, i l’aparició d’espècies introduides com el musclo zebra. Segurament es tractarà d’un efecte combinat de les diferents causes però és necessari analitzar-les per tal de conèixer quines tenen més incidència i així, poder proposar mesures de gestió per als problemes ecològics que pateix el tram final de l’Ebre. Al present projecte de tesi (inclós en el projecte d’I+D: efectes de la millora de la qualitat de l'aigua i de l'alteració del règim de cabals sobre les comunitats biològiques del tram final del riu Ebre) s’estudiarà la comunitat de macròfits i macroinvertebrats associats per tal de determinar el paper que tenen en el canvis que s’han produit al riu durant els últims anys.