HIV infection disrupts the sympatric host-pathogen relationship in human tuberculosis.

The phylogeographic population structure of Mycobacterium tuberculosis suggests local adaptation to sympatric human populations. We hypothesized that HIV infection, which induces immunodeficiency, will alter the sympatric relationship between M. tuberculosis and its human host. To test this hypothesis, we performed a nine-year nation-wide molecular-epidemiological study of HIV-infected and HIV-negative patients with tuberculosis (TB) between 2000 and 2008 in Switzerland. We analyzed 518 TB patients of whom 112 (21.6%) were HIV-infected and 233 (45.0%) were born in Europe. We found that among European-born TB patients, recent transmission was more likely to occur in sympatric compared to allopatric host-pathogen combinations (adjusted odds ratio [OR] 7.5, 95% confidence interval [95% CI] 1.21-infinity, p = 0.03). HIV infection was significantly associated with TB caused by an allopatric (as opposed to sympatric) M. tuberculosis lineage (OR 7.0, 95% CI 2.5-19.1, p<0.0001). This association remained when adjusting for frequent travelling, contact with foreigners, age, sex, and country of birth (adjusted OR 5.6, 95% CI 1.5-20.8, p = 0.01). Moreover, it became stronger with greater immunosuppression as defined by CD4 T-cell depletion and was not the result of increased social mixing in HIV-infected patients. Our observation was replicated in a second independent panel of 440 M. tuberculosis strains collected during a population-based study in the Canton of Bern between 1991 and 2011. In summary, these findings support a model for TB in which the stable relationship between the human host and its locally adapted M. tuberculosis is disrupted by HIV infection.

Análisis de incidentes químicos ocurridos en piscinas de España, 2008-2012.

Objective: Compared historical overview and systematic description of the distribution, features and public health implication of incidents occurred in swimming pools associated with exposure to chemicals, during the period 2008-2012 in Spain. Method: Retrospective observational design, using information reported to the digital mass media internetbased. Records of chemical incidents from a database of 5-year were analyzed to categorize main features. We examined the following variables: year, frequency and geographical location of incidents, class of swimming pool, settings lead to the event, causal factors, chemicals released, exposure ways, balance of victims, attending hospital and evacuated people. Results: 41 chemical incidents were identified in 5 years with a balance of 428 victims, 119 in-patient and 1750 people evacuated. Common profile of a chemical incident in a swimming pool was featured as a municipal setting where a release or hazardous chemical leak, mainly chlorine or mixed with acids occurred. An average of 10 exposed people per event, mostly children, exposed by respiratory airway, needed to be attended in hospital or community health center an annual average of 24 people, including bathers, employees or users. Conclusions: Swimming pools display scenarios with chemical risks that must be evaluated. Planning and implementing preventive measures are priority to mitigate a negative impact for public health. Our findings suggest the convenience of the regulation of a coordinated information system for ongoing surveillance of incidents in swimming pools to enable a safe management of chemical hazards.

Maladies peptiques [Progress in 2008 for acid related diseases]

The treatment of reflux disease did not change in the review period. PPI therapy remains the first line treatment and surgery the second line approach. Endoscopic anti-reflux procedures should be only performed in controlled studies. Beside the classic triple therapy, sequential treatment of Helicobacter pylori infection can today be considered as a first line therapy. PPI are effective in the prevention of gastroduodenal lesions and in the treatment of dyspeptic symptoms induced by NSAIDs treatment. Only patients younger then 65 years and without any risk factors do not need a preventive PPI prescription during classic NSAIDS treatment.

Decision fusion for the classification of hyperspectral data: Outcome of the 2008 GRS-S data fusion contest

The 2008 Data Fusion Contest organized by the IEEE Geoscience and Remote Sensing Data Fusion Technical Committee deals with the classification of high-resolution hyperspectral data from an urban area. Unlike in the previous issues of the contest, the goal was not only to identify the best algorithm but also to provide a collaborative effort: The decision fusion of the best individual algorithms was aiming at further improving the classification performances, and the best algorithms were ranked according to their relative contribution to the decision fusion. This paper presents the five awarded algorithms and the conclusions of the contest, stressing the importance of decision fusion, dimension reduction, and supervised classification methods, such as neural networks and support vector machines.

La Política Europea de España 2008-09

Aquest working paper és la versió espanyola delcapítulo escrit per les autores sobre la política Europeade Espanya per a un anuari alemany sobre construccióneuropea (W. Weidenfeld i W. Wessels (Hrsg.). Jahrbuchder Europäischen Integration 2008/09, Institut furEuropäische Politik. Europa Union Verlag, en premsa). Esther Barbé escriu aquest capítol per al Jahrbuchregularmente des de 1990

Indicadores de desempeño educativo regional: metodología y resultados para los cursos 2005-06 a 2008-09

En este trabajo se construyen algunos indicadores de desempeño para los sistemas educativos no universitarios de las regiones españolas durante los cursos 2005-06 a 2008-09 a partir de información suministrada por diversas publicaciones del Ministerio de Educación. Estos indicadores permiten ofrecer respuestas a la pregunta de qué comunidades autónomas obtienen los mejores resultados educativos de acuerdo con una serie de criterios de desempeño definidos con claridad que recogen tanto aspectos de proceso (acceso a, éxito en y duración de los distintos ciclos educativos) como de resultados medidos en términos de la adquisición de conocimientos. Con el fin de poder hacer comparaciones válidas entre sistemas educativos que se enfrentan a circunstancias muy diversas, hemos construido también indicadores de valor añadido depurando los índices brutos de desempeño de los efectos de dos variables externas que tienen un fuerte impacto sobre los mismos: la disponibilidad de recursos económicos y el nivel educativo de las familias, aproximado por el número medio de años de escolarización de la población adulta.

Relaciones UE-Ucrania 1991-2003: Una política de reacción

El estudio revisa la evolución de los instrumentos de la acción exterior de la CE/UE hacia Ucrania desde la independencia de este país, en diciembre de 1991. Las principales conclusiones del estudio son: 1) Ucrania ha ido ascendiendo de manera lineal en la agenda de política exterior de la Unión. 2) La prioridad que ha guiado la acción exterior hacia Ucrania ha sido el mantenimiento de la estabilidad en este país para evitar las externalidades negativas que su desestabilización podría comportar para la seguridad de la Unión. 3) Aunque el interés securitario ha sido fundamental a lo largo de todo el período analizado, la agenda de seguridad de la UE se ha ampliado considerablemente. 3) La política de la UE hacia Ucrania se ha guiado más por la reacción ante los acontecimientos en el contexto europeo e internacional que por un diseño o estrategia clara hacia este país. 4) La política de vecindad intenta paliar este déficit de estrategia.

Mapeamento dos indicadores de desempenho organizacional em pesquisas da área de Administração, Ciências Contábeis e Turismo no período de 2000 a 2008

A questão da avaliação do desempenho organizacional continua sendo uma atividade fundamental na gestão empresarial. Os indicadores de desempenho assumem papel central, por configurarem-se como instrumentos capazes de fornecer informações para o processo de tomada de decisão. No estudo aqui apresentado, objetivou-se investigar, sob a ótica da avaliação de desempenho organizacional, as características dos indicadores de desempenho utilizados nas pesquisas da área de Administração, Ciências Contábeis e Turismo, no período de 2000 a 2008. Optou-se por uma pesquisa de caráter descritivo, com abordagem qualitativa e quantitativa, que identificou 2.646 artigos que apresentavam no título, no resumo e/ou nas palavras-chave as terminologias: avaliação, desempenho, performance, decisão, mensuração, avaliação de desempenho e assessment. Desses, selecionaram-se os artigos que apresentavam os termos indicador, critério, atributo e medida, resultando em 85 artigos que tiveram seus conteúdos analisados. Constatou-se que 61,14% dos artigos analisados apresentavam a terminologia indicador de desempenho (ID), e 73% não apresentavam o conceito de ID. Os indicadores utilizados apresentavam, em sua maioria, foco econômico-financeiro e eram quantitativos com mensuração ordinal. Em linhas gerais, os indicadores de desempenho organizacionais conseguiram atingir o objetivo de auxiliar no processo decisório, uma vez que 76% dos artigos investigados apresentaram as vantagens de sua aplicação.

Indicateurs de résultats du Promedro III, situation en 2008 : rapport final

[Table des matières] 1. Introduction. 1.1. Rappel du mandat. 1.2. Méthode. 2. Résultats. 2.1. Indicateurs du nombre de consommateurs. 2.2. Indicateurs des problèmes en relation (ou non) avec les drogues chez les jeunes. 2.3. Indicateurs en relation avec la consommation problématique de drogues dures en général. 2.4. Indicateurs des conséquences négatives pour les usagers de drogues illégales. 2.5. Indicateurs des conséquences négatives pour la société. 3. Annexe.

La Pacificación en el mundo actual. Estrategias europeas para la resolución de conflictos

¿Cómo se podría comprometer la Comunidad Internacional, en un mundo globalizado, para la resolución de conflictos?. En el siglo XXI, pasa necesariamente por un cuestionamiento de los métodos tradicionalmente empleados para la resolución de conflictos y la seguridad (frente a nuevos escenarios nuevas estrategias). Éstas toman forma en las doctrinas de la prevención, transformación, resolución de conflictos, gestión de crisis, y seguridad multidimensional/colectiva. Trasladándolo a Europa, la implantación de políticas comunes en las zonas en conflicto, urge cada día más. No existe una acción exterior colectiva ante el estallido de una crisis, porque al final siempre acaban prevaleciendo las decisiones de los Estados más poderosos. Es este mismo proceso decisional, anclado en las posturas realistas, el que bloquea o retarda todo intento de reacción común. Mientras, la violencia se sucede y asistimos impotentes a escenarios bélicos o escaladas, bajo la mirada atrapada de Occidente. La UE se enfrenta a un desafío cada vez más presente, por conseguir una acción globalizadora en materia de derechos humanos, porque frente a la globalización económica surge la necesidad de contrarestar sus efectos, globalizando también los derechos humanos. Cabría revisar las respuestas y capacidades europeas ante el estallido de una crisis.

Declining stroke and myocardial infarction mortality between 1989 and 2010 in a country of the African region.

BACKGROUND AND PURPOSE: In low- and middle-income countries, the total burden of cardiovascular diseases is expected to increase due to demographic and epidemiological transitions. However, data on cause-specific mortality are lacking in sub-Saharan Africa. Seychelles is one of the few countries in the region where all deaths are registered and medically certified. In this study, we examine trends in mortality for stroke and myocardial infarction (MI) between 1989 and 2010. METHODS: Based on vital statistics, we ascertained stroke and MI as the cause of death if appearing in any of the 4 fields for immediate, intermediate, underlying, and contributory causes in death certificates. RESULTS: Mortality rates (per 100 000, age-standardized to World Health Organization standard population) decreased from 1669/710 (men/women) in 1989 to 1991 to 1113/535 in 2008-10 for all causes, from 250/140 to 141/86 for stroke, and from 117/51 to 59/24 for MI, corresponding to proportionate decreases of 33%/25% for all-cause mortality, 44%/39% for stroke, and 50%/53% for MI over 22 years. The absolute number of stroke and MI deaths did not increase over time. In 2008 to 2010, the median age of death was 65/78 years (men/women) for all causes, 68/78 for stroke, and 66/73 for MI. CONCLUSIONS: Between 1989 and 2010, age-standardized stroke and MI mortality decreased markedly and more rapidly than all-cause mortality. The absolute number of cardiovascular disease deaths did not increase over time because the impact of population aging was fully compensated by the decline in cardiovascular disease mortality. Stroke mortality remained high, emphasizing the need to strengthen cardiovascular disease prevention and control.