Spatio-temporal trends of mortality in small areas of Southern Spain

Background: Most mortality atlases show static maps from count data aggregated over time. This procedure has several methodological problems and serious limitations for decision making in Public Health. The evaluation of health outcomes, including mortality, should be approached from a dynamic time perspective that is specific for each gender and age group. At the moment, researches in Spain do not provide a dynamic image of the population’s mortality status from a spatio-temporal point of view. The aim of this paper is to describe the spatial distribution of mortality from all causes in small areas of Andalusia (Southern Spain) and evolution over time from 1981 to 2006. Methods: A small-area ecological study was devised using the municipality as the unit for analysis. Two spatiotemporal hierarchical Bayesian models were estimated for each age group and gender. One of these was used to estimate the specific mortality rate, together with its time trends, and the other to estimate the specific rate ratio for each municipality compared with Spain as a whole. Results: More than 97% of the municipalities showed a diminishing or flat mortality trend in all gender and age groups. In 2006, over 95% of municipalities showed male and female mortality specific rates similar or significantly lower than Spanish rates for all age groups below 65. Systematically, municipalities in Western Andalusia showed significant male and female mortality excess from 1981 to 2006 only in age groups over 65. Conclusions: The study shows a dynamic geographical distribution of mortality, with a different pattern for each year, gender and age group. This information will contribute towards a reflection on the past, present and future of mortality in Andalusia.

Using problem-based learning for introducing producer theory and market structure in intermediate microeconomics

This paper shows how instructors can use the problem‐based learning method to introduce producer theory and market structure in intermediate microeconomics courses. The paper proposes a framework where different decision problems are presented to students, who are asked to imagine that they are the managers of a firm who need to solve a problem in a particular business setting. In this setting, the instructors’ role isto provide both guidance to facilitate student learning and content knowledge on a just‐in‐time basis

Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy

Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a worldwide network of laboratories that carried out basic and applied research supporting the planning and evaluation of national Chagas disease control programmes. The present article reviews the current epidemiological trends for Chagas disease in Latin America and the future challenges in terms of epidemiology, surveillance and health policy.

Towards economic and monetary union: changing trends in payment systems for new european members

The objective of this paper is preciselyto study the evolution of payment systems within the accession countries between 1996 and 2003 and compare them with those of the E.U. and the Eurozone countries

The allometry of non-employment. What can compositional data analysis tell us about labour market performance across the UK's regions?

The low levels of unemployment recorded in the UK in recent years are widely cited asevidence of the country’s improved economic performance, and the apparent convergence of unemployment rates across the country’s regions used to suggest that the longstanding divide in living standards between the relatively prosperous ‘south’ and the more depressed ‘north’ has been substantially narrowed. Dissenters from theseconclusions have drawn attention to the greatly increased extent of non-employment(around a quarter of the UK’s working age population are not in employment) and themarked regional dimension in its distribution across the country. Amongst these dissenters it is generally agreed that non-employment is concentrated amongst oldermales previously employed in the now very much smaller ‘heavy’ industries (e.g. coal,steel, shipbuilding).This paper uses the tools of compositiona l data analysis to provide a much richer picture of non-employment and one which challenges the conventional analysis wisdom about UK labour market performance as well as the dissenters view of the nature of theproblem. It is shown that, associated with the striking ‘north/south’ divide in nonemployment rates, there is a statistically significant relationship between the size of the non-employment rate and the composition of non-employment. Specifically, it is shown that the share of unemployment in non-employment is negatively correlated with the overall non-employment rate: in regions where the non-employment rate is high the share of unemployment is relatively low. So the unemployment rate is not a very reliable indicator of regional disparities in labour market performance. Even more importantly from a policy viewpoint, a significant positive relationship is found between the size ofthe non-employment rate and the share of those not employed through reason of sicknessor disability and it seems (contrary to the dissenters) that this connection is just as strong for women as it is for men

Analysing trends in cardiovascular mortality: some methodological points.

This paper comments on the drop in coronary heart disease mortality observed in Switzerland among middle-aged men since the mid-seventies. Several methodological points are made regarding the consistency of this decline (relationships with mortality from other causes), and the reasons for this drop (possible change in population mix). It is suggested that a more complete use of vital statistics is still possible and that this can provide useful clues for the assessment and the interpretation of mortality trends in the field of cardiovascular epidemiology.

PRIM an Open Mobile Robot Platform. Motivation, Present and Future Trends

This paper is focused on the robot mobile platform PRIM (platform robot information multimedia). This robot has been made in order to cover two main needs of our group, on one hand the need for a full open mobile robotic platform that is very useful in fulfilling the teaching and research activity of our school community, and on the other hand with the idea of introducing an ethical product which would be useful as mobile multimedia information point as a service tool. This paper introduces exactly how the system is made up and explains just what the philosophy is behind this work. The navigation strategies and sensor fusion, where machine vision system is the most important one, are oriented towards goal achievement and are the key to the behaviour of the robot

Diabétologie : nouveautés en médecine 2007 [Trends in diabetes]

Une méta-analyse concernant l'utilisation de la rosiglitazone chez les diabétiques de type 2 a révélé une augmentation significative du risque d'infarctus du myocarde et une tendance à la surmortalité cardiovasculaire. La méthodologie de cette étude ainsi que ses conclusions ont été beaucoup critiquées. Cette étude montre les limites des méta-analyses auxquelles on prête un rang manifestement trop élevé dans la hiérarchie des niveaux de preuve. L'étude 4T a évalué trois schémas d'insuline dans le traitement du diabète de type 2. Les résultats à un an montrent que seule une minorité des patients atteignent les objectifs. Post-Steno 2 a été présenté au congrès européen du diabète. Ces nouvelles données confirment que le traitement intensifié de tous les facteurs de risque cardiovasculaire permet une réduction majeure de la mortalité cardiovasculaire après 13,3 ans. A recent meta-analysis on the rosiglitazone in the treatment of type 2 diabetes revealed a significant increased risk of myocardial infarction and a trend to a higher cardiovascular mortality. In the following month after this publication, the methodology as its conclusions were criticized. This study shows the limits of the meta-analyses to which one lends a row obviously too high in the hierarchy of the levels of evidence. The study 4T evaluated 3 insulin strategies in the treatment of the type 2 diabetes. The results at one year show that only a minority of the patients achieve the goals. Post-Steno 2 was presented at the European congress diabetes. These new data confirm that the intensified treatment of all cardiovascular factors risk allows a major reduction of cardiovascular mortality after 13.3 years

Trends in mortality from major cancers in the americas : 1980-2010

BACKGROUND: Between the 1970's and 2000 mortality in Latin America showed favorable trends for some common cancer sites, including stomach and male lung cancer in most countries. However, major concerns were related to mortality patterns from other cancers, particularly in women. We provide an up-to-date picture of patterns and trends in cancer mortality in Latin America. METHODS: We analyzed data from the World Health Organization mortality database in 2005-2009 for 20 cancer sites in 11 Latin American countries and, for comparative purposes, in the USA and Canada. We computed age-standardized (world) rates (per 100 000 person-year) and provided an overview of trends since 1980 using joinpoint regression models. RESULTS: Cancer mortality from some common cancers (including colorectum and lung) is still comparatively low in Latin America, and decreasing trends continue for some cancer sites (including stomach, uterus, male lung cancers) in several countries. However, there were upward trends for colorectal cancer for both sexes, and for women lung and breast cancer mortality in most countries. During the last decade, lung cancer mortality in women rose by 1-3% per year in all Latin American countries except Mexico and Costa Rica, whereas rises of about 1% were registered for breast cancer in Brazil, Colombia and Venezuela. Moreover, high mortality from cancer of the cervix uteri was recorded in most countries, with rates over 13/100 000 women in Cuba and Venezuela. In men, upward trends were registered in prostate cancer mortality in Brazil and Colombia, but also in Cuba, where the rate in 2005-2009 was more than twice that in the USA (23.6 versus 10/100 000). CONCLUSIONS: Tobacco control, efficient screening programs, early cancer detection and widespread access to treatments continue to be a major priority for most Latin American countries.

Trends in qualifying biomarkers in drug safety. Consensus of the 2011 meeting of the spanish society of clinical pharmacology.

In this paper we discuss the consensus view on the use of qualifying biomarkers in drug safety, raised within the frame of the XXIV meeting of the Spanish Society of Clinical Pharmacology held in Málaga (Spain) in October, 2011. The widespread use of biomarkers as surrogate endpoints is a goal that scientists have long been pursuing. Thirty years ago, when molecular pharmacogenomics evolved, we anticipated that these genetic biomarkers would soon obviate the routine use of drug therapies in a way that patients should adapt to the therapy rather than the opposite. This expected revolution in routine clinical practice never took place as quickly nor with the intensity as initially expected. The concerted action of operating multicenter networks holds great promise for future studies to identify biomarkers related to drug toxicity and to provide better insight into the underlying pathogenesis. Today some pharmacogenomic advances are already widely accepted, but pharmacogenomics still needs further development to elaborate more precise algorithms and many barriers to implementing individualized medicine exist. We briefly discuss our view about these barriers and we provide suggestions and areas of focus to advance in the field.

Proyecto MOFM: Made of Felt Market

Proyecto para la creación de una tienda electrónica utilizando J2EE (JPA, Servlets) para la comercialización de productos de fieltro elaborados a mano.