Getting ready for malaria elimination: a check list of critical issues to consider

In recent years, a renewed interest in malaria elimination and eradication has emerged and seems to be rooting in the minds of the scientific community, public health specialists, funding bodies, policy makers and politicians. Malaria eradication will certainly benefit from improved and innovative tools; notwithstanding novel knowledge in fields ranging from basic science to mathematical modelling and health systems research. However, the elimination of malaria also encompasses a broad range of essential aspects that countries and other actors need to consider when thinking of embarking on such an adventure, including the implementation of innovative strategies, the ability to incorporate the most up-to-date evidence into policy, the integration of malaria into the broader health agenda, the strengthening of surveillance and health systems, capacity building, funding, advocacy and, very importantly, research. While in some cases this enthusiasm is clearly justified, some countries are still a long way from realistically advancing towards elimination. This paper attempts to provide guidance on all the necessary issues that should be considered when initiating a malaria elimination program.

Medical geography and phthisic immunity in the high altitudes: The origins of a Therapeutic hypothesis

Medical geography expanded considerably in the 19 th century. Its expansion was aided by a Neo-Hippocratic trend in medical thinking, progress in statistics and hygiene, and an overall vision of geography formulated early in the century by French and German geographers inspired by Alexander von Humboldt. By tracing out the process that prompted certain « doctor-geographers » to put forth the hypothesis of immunity phthisis in elevated regions, this article seeks to show how various trends in medical geography led to the establishment of the « altitude cure » as a treatment for tuberculosis.

Drug assessment by a Pharmacy and Therapeutics committee: from drug selection criteria to use in clinical practice.

BACKGROUND In Spain, hospital medicines are assessed and selected by local Pharmacy and Therapeutics committees (PTCs). Of all the drugs assessed, cancer drugs are particularly important because of their budgetary impact and the sometimes arguable added value with respect to existing alternatives. This study analyzed the PTC drug selection process and the main objective was to evaluate the degree of compliance of prescriptions for oncology drugs with their criteria for use. METHODS This was a retrospective observational study (May 2007 to April 2010) of PTC-assessed drugs. The variables measured to describe the committee's activity were number of drugs assessed per year and number of drugs included in any of these settings: without restrictions, with criteria for use, and not included in formulary. These drugs were also analyzed by therapeutic group. To assess the degree of compliance of prescriptions, a score was calculated to determine whether prescriptions for bevacizumab, cetuximab, trastuzumab, and bortezomib were issued in accordance with PTC drug use criteria. RESULTS The PTC received requests for inclusion of 40 drugs, of which 32 were included in the hospital formulary (80.0%). Criteria for use were established for 28 (87.5%) of the drugs included. In total, 293 patients were treated with the four cancer drugs in eight different therapeutic indications. The average prescription compliance scores were as follows: bevacizumab, 83% for metastatic colorectal cancer, 100% for metastatic breast cancer, and 82.3% for non-small-cell lung cancer; cetuximab, 62.0% for colorectal cancer and 50% for head and neck cancer; trastuzumab, 95.1% for early breast cancer and 82.4% for metastatic breast cancer; and bortezomib, 63.7% for multiple myeloma. CONCLUSION The degree of compliance with criteria for use of cancer drugs was reasonably high. PTC functions need to be changed so that they can carry out more innovative tasks, such as monitoring conditions for drug use.

Automatic landmarks detection in breast reconstruction aesthetic assessment.

This paper addresses a fully automatic landmarks detection method for breast reconstruction aesthetic assessment. The set of landmarks detected are the supraesternal notch (SSN), armpits, nipples, and inframammary fold (IMF). These landmarks are commonly used in order to perform anthropometric measurements for aesthetic assessment. The methodological approach is based on both illumination and morphological analysis. The proposed method has been tested with 21 images. A good overall performance is observed, although several improvements must be achieved in order to refine the detection of nipples and SSNs.

Al lado: Un método para la reducción del sufrimiento mediante decisiones compartidas, en Andalucía

The strategy "Next To", developed in Andalusia, about cooperation between public health services and associations of affected people, to improve the quality of care, has been applied, among other diseases, to the problems of adversity on child health. In order to explore the needs of affected population, it has been made a qualitative study with parents of deceased children, through which it has been identified the key points of improvement in relation to the suffering that occurs in the affected person and their next caregiver environment. The purpose of the study, in addition to identifying areas for improvement, includes providing proposals as recommendations. "Next To" as a participatory and transversal strategy, currently under development, is implicit in the objectives of the Fourth Andalusian Health Plan, since its application encourages the participation and empowerment of people affected by health adversity

Spain in Europe 2004-2008

In March of 2004, the Observatory of European Foreign Policy published a special monograph about Spain in Europe (1996-2004) in digital format. The objective of the monograph was to analyse Spain’s foreign policy agenda and strategy during the period of José María Aznar’s presidency. As the title suggests, one of the initial suppositions of the analysis is the Europeanization of Spanish foreign activities. Is that how it was? Did Aznar’s Spain see the world and relate to it through Brussels? The publication was well received, considering the number of visits received and above all the institutions which asked to link the publication to their web pages. Among these, the EUobserver published the introduction to the piece in English titled Aznar: thinking locally, acting in Europe (described by the EUobserver as a paper of utmost importance). The fact that the elections were held three days after the tragic events of the 11th of March dramatically increased interest in Spain and the implications for Europe. This publication is the second of its type, in this case analysing the period of the Zapatero government (2004-2008). Once again the starting premise (the Europeanization of the agenda and the methods employed) has been considered by the analysts. And once again the articles collected in this publication serve to “triangulate” the analysis. Spain and Europe are two vertices (more or less distant, in essence and in form) which the authors handle in their analysis of the case (third vertex).

España en Europa 2004-2008

En marzo de 2004 el Observatorio de Política Exterior Europea publicó, en versión digital, un monográfico especial sobre España en Europa (1996-2004). Su objetivo era analizar la agenda y la estrategia de España durante el período de José María Aznar en materia de relaciones internacionales. Como bien indicaba el título de aquella publicación, uno de los supuestos de partida del análisis era la europeización de la actividad internacional de España. ¿Era así?, ¿la España de Aznar veía el mundo y se aproximaba a él a través de Bruselas? Aquella publicación tuvo una buena acogida, a la vista de las visitas recibidas y sobre todo de las instituciones que nos pidieron vincular dicha publicación a sus páginas web y, entre ellas, hay que destacar que EUObserver publicó como comentario su artículo introductorio, en versión inglesa, Aznar: thinking locally, acting in Europe (calificado por EUObserver como lectura de máxima relevancia). El hecho de que las elecciones de 2004 se celebraran tres días después de los trágicos acontecimientos del 11-M hizo que el interés por España y por su proyección europea e internacional aumentara de manera destacada. La presente publicación constituye un segundo ejercicio de dicho tipo, en este caso para analizar el período del gobierno Zapatero (2004-2008). Una vez más, el supuesto de partida (la europeización de la agenda y del método) está en la mente de los analistas. Y una vez más los artículos recogidos en esta publicación hacen el ejercicio de “triangular” el análisis. España y Europa son dos vértices (más o menos alejados, en el fondo y en la forma) que los autores manejan en sus análisis de caso (tercer vértice)

España en Europa 1996-2004

Pensar globalmente, actuar localmente” es un slogan imprescindible en el discurso político de nuestros días. Pues bien, la práctica política, en materia de Unión Europea, de los dos gobiernos del Partido Popular, presididos por José María Aznar (1996-2004), nos permite acuñar un slogan de signo bien diferente: “pensar localmente, actuar en Europa”. En efecto, si algo caracteriza a estos ocho años de práctica política de José María Aznar es haber convertido sus preocupaciones domésticas en factor exclusivo de su estrategia europea, con independencia del contexto de cada momento y de la necesidad de encajar objetivos nacionales con objetivos europeos. De ahí que sea lógico que la campaña electoral que ha precedido a las elecciones generales del 14 de marzo no haya recogido ninguno de los temas que dominan en la agenda de la UE en el momento actual. Ni la ampliación, ni la Constitución, ni tampoco el proceso de conformación de un núcleo duro tienen cabida en el debate político españo

Spain in Europe 1996-2004

“Thinking globally, acting locally" is an essential slogan in the current political discourse. Yet, in view of the policies on the European Union carried out by the two governments of the People’s Party (PP) headed by José María Aznar between 1996 and 2004, we could coin a quite different slogan: "thinking locally, acting in Europe". Indeed, José María Aznar’s policy-making during the last eight years has been characterised by turning his domestic concerns into the ‘exclusive factor’ of his European strategy, regardless of the context and the need for fitting in national objectives with Europeans’. Hence, it was natural that the electoral campaign preceding the general elections held on Sunday, 14 March, did not deal with any of the topics prevailing in the EU’s current agenda. Neither enlargement nor the Constitution, nor the process of shaping a core group within the EU, seem to have room in Spain’s political debate...

Institutional entrepreneurship and professionalization of the rural development of the sisal region in Brazil

This work analyses the professionalization of rural development in the Brazilian Northeastern region and how this created opportunities for entrepreneurship when the professional practices of funding bodies were transformed in accordance with local reality. This professionalization has its own characteristics, including fluid formats and the rolling out of networks, and it contributes to the theorization and dissemination of certain practices instead of being concentrated in professional associations and formal links with educational institutions. The main implications are commonly related to institutional processes related to professionalization, such as the emergence of certain organizational formats and the dissemination of professional practices that are considered legitimate. An additional consequence was observed in the area of rural development: the ideas and practices disseminated through professionalization were reinterpreted when the local entrepreneurs adapted them to their own thinking and needs.

Modulation of Higher-Order Olfaction Components on Executive Functions in Humans.

The prefrontal (PFC) and orbitofrontal cortex (OFC) appear to be associated with both executive functions and olfaction. However, there is little data relating olfactory processing and executive functions in humans. The present study aimed at exploring the role of olfaction on executive functioning, making a distinction between primary and more cognitive aspects of olfaction. Three executive tasks of similar difficulty were used. One was used to assess hot executive functions (Iowa Gambling Task-IGT), and two as a measure of cold executive functioning (Stroop Colour and Word Test-SCWT and Wisconsin Card Sorting Test-WCST). Sixty two healthy participants were included: 31 with normosmia and 31 with hyposmia. Olfactory abilities were assessed using the ''Sniffin' Sticks'' test and the olfactory threshold, odour discrimination and odour identification measures were obtained. All participants were female, aged between 18 and 60. Results showed that participants with hyposmia displayed worse performance in decision making (IGT; Cohen's-d = 0.91) and cognitive flexibility (WCST; Cohen's-d between 0.54 and 0.68) compared to those with normosmia. Multiple regression adjusted by the covariates participants' age and education level showed a positive association between odour identification and the cognitive inhibition response (SCWT-interference; Beta = 0.29; p = .034). The odour discrimination capacity was not a predictor of the cognitive executive performance. Our results suggest that both hot and cold executive functions seem to be associated with higher-order olfactory functioning in humans. These results robustly support the hypothesis that olfaction and executive measures have a common neural substrate in PFC and OFC, and suggest that olfaction might be a reliable cognitive marker in psychiatric and neurologic disorders.

Cuestiones controvertidas en evaluación económica (III). Intervenciones sanitarias en tres situaciones especiales: enfermedades raras, tratamientos al final de la vida y externalidades en las evaluaciones.

The development of the economic evaluation of health care interventions has become a support tool in making decisions on pricing and reimbursement of new health interventions. The increasingly extensive application of these techniques has led to the identification of particular situations in which, for various reasons, it may be reasonable to take into account special considerations when applying the general principles of economic evaluation. In this article, which closes a series of three, we will discuss, using the Metaplan technique, about the economic evaluation of health interventions in special situations such as rare diseases and end of life treatments, as well as consideration of externalities in assessments, finally pointing out some research areas to solve the main problems identified in these fields.

Transforming personal experience and emotions through education to cultural diversity: an interplay between unicity and genericity

When subjects studied at school are close to societal discourses and to the students' social identities, when they have high emotional resonance, is it possible to enable the students to distance themselves from their emotions and personal experience, and to conceptualise them? Examining the relation between emotion and learning through the lens of socio-cultural psychology, the aim of our study was to shed light on "secondarisation" processes, that is, processes that transform personal experience and emotions into conceptualised forms of thinking. We analysed 85 video-recorded lessons in education for cultural diversity involving 12 teachers (of primary and secondary schools). Having identified episodes in which emotions were put into words or personal experience was reported, we analysed the use of pronouns (taken as indicators of secondarisation processes) and found a recurrent pattern: "the unicity-genericity routine". We illustrate the functioning of this routine with various excerpts taken from lessons in education for diversity taught in the classes of two teachers in primary school. The results show that the interplay between unicity and genericity works as a discursive resource for the development of secondarisation processes.

Didactique de la géographie et formation initiale des enseignants spécialistes : conception et première évaluation du nouveau dispositif de formation initiale des enseignants de géographie du Secondaire supérieur à la HEP Vaud

Geography as a school subject is specifically thought for and by the schools. The contents of the school subject, nowadays, do not reflect the concerns and the evolution of the discipline as such. Nevertheless, official curricula set school objectives that address issues affecting the world and people's lives. These issues are coherent with the ones addressed by geography as a social science, that is to say the study of how people and their environment interact and how societies are interconnected through space. On an every day basis, Geography as a school subject is most of the time reduced to accumulating knowledge outside any given context. This knowledge may even be partially untrue or old and the related activities focus on low cognitive tensions. These practices do not contribute to the learners' understanding of the world because it does not allow them to build a geographical competence, which they. will need as future citizens in order to make responsible choices when they are confronted to questions related to how the locations of human and physical features are influenced by each other and how they interact across space. The central part of the text relies on the ideas and the processes discussed in the publications, which constitute the published file; it is divided into two parts. The first part (chapter 4) presents a didactic approach, which gives meaningful insights into Geography as a school subject and shows a brief account of the theoretical background that supports it. This socio-constructivist approach relies on the main following features: a priming stage (élément déclencheur), which presents geographical knowledge as an issue to be explored, discussed or solved; the issue is given to learners;. the planning of the teaching-learning sequence in small units launched by the main issue in the priming stage ; the interconnections of geographical knowledge with integrative concepts ; the synthetic stage or reporting stage where final concepts and knowledge are put together in order to be learned. Such an approach allows learners to re-invest the knowledge they have built themselves. This knowledge is organised by geographical integrative concepts, which represent true thinking operative tools and with which key issues in the geographical thinking are associated. The second part of the text (chapter 5) displays the didactic principles that governed the conception of the new initial training course for the future upper secondary school teachers at the HEP Vaud. The ambition of this course is to prepare future teachers to plan and realize the teaching of geography that provides pupils with the tools to understand better how people and their environment interact and how societies are interconnected through space. One of the tools for the teachers is the conceptual framework, whose most salient interest is to be relevant at every stage of the preparation and planning of the teaching, including the necessary epistemological reflection that should always be present. The synthesis of the text starts with a short account of the first evaluation of the new course. Various reflections on the future concerns and issues, that the didactics and methodology of Geography will be confronted with, constitute the synthesis.

Space for thought: Representation of body boundaries and intellectual efficiency in children

Aim: The psychoanalytic theories of Bion, Anzieu, Berger and Gibello postulate that the development of thinking depends upon the formation of a psychic space. This thinking space has its origin in the body and in our interpersonal relations. This study aims to validate this psychodynamic hypothesis. Method: A group of 8- to 14-year-old children participated in this research. The presence of a thinking space was operationalized by the "barrier" and "penetration" scores on the Rorschach's Fisher and Cleveland scales and intellectual efficiency was measured using a short version of the WISC-IV. Results: Results show that extreme scores on the "barrier" and "penetration" variables predict a lower intellectual level than average scores on the same variables. Conclusion: The development of thinking and personality are undoubtedly linked and the "barrier" and "penetration" variables are useful measures when evaluating the development of a space for thought.