Performing better? A focus on sexual health services in England. Full report

This report draws attention to the extent of sexual ill health in England and the wide variation of levels of this ill health between different communities. It highlights relevant policy and initiatives underway to tackle sexual health across England.

Performing better? A focus on sexual health services in England: Summary

This summary identifies the issues, presents some findings from our pilot review, and highlights the key policies, guidance and initiatives aimed at improving sexual health services and sexual health in England. A more detailed analysis is in the full report.

World class healthcare for London. Mind the gap! A briefing on equity of health and healthcare in the capital

This briefing provides an overview of equity of access to some of the essential elements of healthcare in the capital

Gestion académica de un centro de formación

El projecte consisteix en una aplicació que permet a institucions dedicades a la formació gestionar millor la comunicació entre alumnes i professors.

Guide for World Class Commissioners Promoting Health and Well-being: Reducing Inequalities

One of the core missions of commissioners is to reduce health inequalities. Promoting health and well-being is necessary but not sufficient, and it is essential thatimprovements in commissioning and consequent improvements in service delivery, will not widen the gapbetween different groups in society. It is, of course,already difficult enough to decide how to commission services to promote health and well-being. There are practical, economic and ethical issues involved, but if in addition the commissioner wishes to ensure that the gap between the most healthy and the least healthy does not widen, they will have to think hard and commission carefully. It is also crystal clear that it would be wrong to let 152 Primary Care Trusts find out for themselves how to do this. Firstly, it would be a massive waste of resources, and secondly, many Primary Care Trusts would be unable to deliver. This Guide has been produced by knowledge harvesting; by gathering the knowledge that commissioners have created and accrued, about successes as well as failures; and blending it into a single readable Guide.

Choosing Better Oral Health: An Oral Health Plan for England

This action plan sets out to inform and provide support for dental practices as they focus more on preventative care under new contractual arrangements which will be in place from 1 April 2006. Designed to improve oral health both nationally and locally, this plan also sets out to assist and support Primary Care Trusts (PCTs) in meeting their new responsibilities for dental services under the Health and Social Care (Community Health and Standards) Act 2003. This legislation extends their remit to assessing local oral health needs and commissioning the appropriate services to tackle long standing oral health inequalities.

Education for a Changing World - Green Paper

Education for a Changing World - Green Paper. Provided by the Department of Education and Skills, Ireland.

Supporting A Better Transition From Second Level To Higher Education: Key directions and Next Steps

Supporting A Better Transition From Second Level To Higher Education. Provided by the Department of Education and Skills, Ireland.

Tuberculosis in the New World: a study of ribs from the Schild Mississippian population, West-Central Illinois

Vertebral lesions have been the main evidence for infection by the Mycobacterium tuberculosis complex (MTC) in paleopathology. Skeletal involvement is expected in a small percentage of infected individuals. Recently, several authors report a correlation between rib lesions and tuberculosis (TB) complex infection. This study tests the hypothesis that rib lesions can serve as a useful marker for MTC infection within the Mississippian Schild skeletal collection from West-Central Illinois. Ribs from 221 adults and juveniles were examined, and affected individuals were tested for TB complex infection. DNA from rib samples of affected individuals was amplified with primers targeting the IS6110 insertion element, which is common to all members of the TB complex. Although it cannot allow discrimination between different species of TB, IS6110 is present in many copies within their genomes, and its presence is thus an indication of MTC infection. The results support the use of rib lesions as a marker for TB infection. Additionally, we demonstrate that MTC DNA can be recovered from ribs that lack lesions in individuals who have lesions of other bones. We recommend that an examination of ribs be incorporated into investigations for TB.

Ecologie industrielle de l'aluminium, flux de matières et d'énergie : réalités et enjeux du recyclage

Dans les dernières années du 20ème siècle, l'aluminium a fait l'objet de beaucoup de communications outrancières et divergentes cautionnées par des scientifiques et des organismes faisant autorité. En 1986, la société PECHINEY le décrète perpétuel tel le mouvement « L'aluminium est éternel. Il est recyclable indéfiniment sans que ses propriétés soient altérées », ce qui nous avait alors irrité. Peu de temps après, en 1990, une communication tout aussi outrancière et irritante d'une grande organisation environnementale, le World Wild Fund, décrète que « le recyclage de l'aluminium est la pire menace pour l'environnement. Il doit être abandonné ». C'est ensuite à partir de la fin des années 1990, l'explosion des publications relatives au développement durable, le bien mal nommé. Au développement, synonyme de croissance obligatoire, nous préférons société ou organisation humaine et à durable, mauvaise traduction de l'anglais « sustainable », nous préférons supportable : idéalement, nous aurions souhaité parler de société durable, mais, pour être compris de tous, nous nous sommes limités à parler dorénavant de développement supportable. Pour l'essentiel, ces publications reconnaissent les très graves défauts de la métallurgie extractive de l'aluminium à partir du minerai et aussi les mérites extraordinaires du recyclage de l'aluminium puisqu'il représente moins de 10% de la consommation d'énergie de la métallurgie extractive à partir du minerai (on verra que c'est aussi moins de 10% de la pollution et du capital). C'est précisément sur le recyclage que se fondent les campagnes de promotion de l'emballage boisson, en Suisse en particulier. Cependant, les données concernant le recyclage de l'aluminium publiées par l'industrie de l'aluminium reflètent seulement en partie ces mérites. Dans les années 1970, les taux de croissance de la production recyclée sont devenus plus élevés que ceux de la production électrolytique. Par contre, les taux de recyclage, établis à indicateur identique, sont unanimement tous médiocres comparativement à d'autres matériaux tels le cuivre et le fer. Composante de l'industrie de l'aluminium, le recyclage bénéficie d'une image favorable auprès du grand public, démontrant le succès des campagnes de communication. A l'inverse, à l'intérieur de l'industrie de l'aluminium, c'est une image dévalorisée. Les opinions émises par tous les acteurs, commerçants, techniciens, dirigeants, encore recueillies pendant ce travail, sont les suivantes : métier de chiffonnier, métier misérable, métier peu technique mais très difficile (un recycleur 15 d'aluminium n'a-t-il pas dit que son métier était un métier d'homme alors que celui du recycleur de cuivre était un jeu d'enfant). A notre avis ces opinions appartiennent à un passé révolu qu'elles retraduisent cependant fidèlement car le recyclage est aujourd'hui reconnu comme une contribution majeure au développement supportable de l'aluminium. C'est bien pour cette raison que, en 2000, l'industrie de l'aluminium mondiale a décidé d'abandonner le qualificatif « secondaire » jusque là utilisé pour désigner le métal recyclé. C'est en raison de toutes ces données discordantes et parfois contradictoires qu'a débuté ce travail encouragé par de nombreuses personnalités. Notre engagement a été incontestablement facilité par notre connaissance des savoirs indispensables (métallurgie, économie, statistiques) et surtout notre expérience acquise au cours d'une vie professionnelle menée à l'échelle mondiale dans (recherche et développement, production), pour (recherche, développement, marketing, stratégie) et autour (marketing, stratégie de produits connexes, les ferro-alliages, et concurrents, le fer) de l'industrie de l'aluminium. Notre objectif est de faire la vérité sur le recyclage de l'aluminium, un matériau qui a très largement contribué à faire le 20ème siècle, grâce à une revue critique embrassant tous les aspects de cette activité méconnue ; ainsi il n'y a pas d'histoire du recyclage de l'aluminium alors qu'il est plus que centenaire. Plus qu'une simple compilation, cette revue critique a été conduite comme une enquête scientifique, technique, économique, historique, socio-écologique faisant ressortir les faits principaux ayant marqué l'évolution du recyclage de l'aluminium. Elle conclut sur l'état réel du recyclage, qui se révèle globalement satisfaisant avec ses forces et ses faiblesses, et au-delà du recyclage sur l'adéquation de l'aluminium au développement supportable, adéquation largement insuffisante. C'est pourquoi, elle suggère les thèmes d'études intéressant tous ceux scientifiques, techniciens, historiens, économistes, juristes concernés par une industrie très représentative de notre monde en devenir, un monde où la place de l'aluminium dépendra de son aptitude à satisfaire les critères du développement supportable. ABSTRACT Owing to recycling, the aluminium industry's global energetic and environmental prints are much lower than its ore extractive metallurgy's ones. Likewise, recycling will allow the complete use of the expected avalanche of old scraps, consequently to the dramatic explosion of aluminium consumption since the 50's. The recycling state is characterized by: i) raw materials split in two groups :one, the new scrap, internal and prompt, proportional to semi-finished and finished products quantities, exhibits a fairly good and regular quality. The other, the old scrap, proportional to the finished products arrivïng at their end-of--life, about 22 years later on an average, exhibits a variable quality depending on the collect mode. ii) a poor recycling rate, near by that of steel. The aluminium industry generates too much new internal scrap and doesn't collect all the availa~e old scrap. About 50% of it is not recycled (when steel is recycling about 70% of the old scrap flow). iii) recycling techniques, all based on melting, are well handled in spite of aluminium atiiníty to oxygen and the practical impossibility to purify aluminium from any impurity. Sorting and first collect are critical issues before melting. iv) products and markets of recycled aluminium :New scraps have still been recycled in the production lines from where there are coming (closed loop). Old scraps, mainly those mixed, have been first recycled in different production lines (open loop) :steel deoxidation products followed during the 30's, with the development of the foundry alloys, by foundry pieces of which the main market is the automotive industry. During the 80's, the commercial development of the beverage can in North America has permitted the first old scrap recycling closed loop which is developing. v) an economy with low and erratic margins because the electrolytic aluminium quotation fixes scrap purchasing price and recycled aluminium selling price. vi) an industrial organisation historically based on the scrap group and the loop mode. New scrap is recycled either by the transformation industry itself or by the recycling industry, the remelter, old scrap by the refiner, the other component of the recycling industry. The big companies, the "majors" are often involved in the closed loop recycling and very seldom in the open loop one. To-day, aluminium industry's global energetic and environmental prints are too unbeara~ e and the sustainaЫe development criteria are not fully met. Critical issues for the aluminium industry are to better produce, to better consume and to better recycle in order to become a real sustainaЫe development industry. Specific issues to recycling are a very efficient recycling industry, a "sustainaЫe development" economy, a complete old scrap collect favouring the closed loop. Also, indirectly connected to the recycling, are a very efficient transformation industry generating much less new scrap and a finished products industry delivering only products fulfilling sustainaЫe development criteria.

The leishmaniases - survival and expansion in a changing world: a mini-review

The number of cases of visceral and cutaneous leishmaniasis is increasing globally at an alarming rate irrespective of the region and the leishmaniases are amongst the top emergent diseases in spite of control measures. In the present review attention is drawn to some of the reasons for this. The leishmaniases have expanded beyond their natural ecotopes due to the ecological chaos caused by man and this in turn affects the levels of his exposure to the vectors. Examples of how different phenomana (such as war, civilian migration, immuno-suppression caused by medication and viral infections, globalization of work and leisure and transmission outside endemic areas) contribute to the spread and increase of the disease are discussed.

More productive in vitro culture of Cryptosporidium parvum for better study of the intra- and extracellular phases

The great difficulties in treating people and animals suffering from cryptosporidiosis have prompted the development of in vitro experimental models. Due to the models of in vitro culture, new extracellular stages of Cryptosporidium have been demonstrated. The development of these extracellular phases depends on the technique of in vitro culture and on the species and genotype of Cryptosporidium used. Here, we undertake the molecular characterization by polymerase chain reaction-restriction fragment lenght polymorphism of different Cryptosporidium isolates from calves, concluding that all are C. parvum of cattle genotype, although differing in the nucleotide at positions 472 and 498. Using these parasites, modified the in vitro culture technique for HCT-8 cells achieving greater multiplication of parasites. The HCT-8 cell cultures, for which the culture had not been renewed in seven days, were infected with C. parvum sporozoites in RPMI-1640 medium with 10% IFBS, CaCl2 and MgCl2 1 mM at pH 7.2. Percentages of cell parasitism were increased with respect to control cultures (71% at 48 h vs 14.5%), even after two weeks (47% vs 1.9%). Also, the percentage of extracellular stages augmented (25.3% vs 1.1% at 96 h). This new model of in vitro culture of C. parvum will enable easier study of the developmental phases of C. parvum in performing new chemotherapeutic assays.