Cross-Cultural Adaptation and Validation of the Spinal Function Sort (SFS) for French- and German-Speaking Patients with Back Complaints

Aim: Functional subjective evaluation through questionnaire is fundamental, but not often realized in patients with back complaints, notably because of lack of validated tools, in accordance with recognized psychometric criteria. The Spinal Function Sort (SFS), developed according to actual standards, was only validated in English. The aim of this study is to translate, adapt and validate the French and German version of the SFS.Method and material: The translation and cross-cultural adaptation were performed following the methodology proposed by the American Association of Orthopedist Surgeon. A total of 344 patients, presenting varied back complaints (especially degenerative and traumatic), took part in this study in a tertiary French- (n=87; mean age 44y; 17 women) and German-speaking (n=257; mean age 41y; 53 women) center. Test-retest reliability was quantified using the intraclass correlation coefficient (ICC) and construct validity was assessed by estimating the Pearson's correlation with the SF-36 physical and mental scales, the Visual Analogue Scale for Pain Intensity (VAS), and subscales of the Hospital Anxiety and Depression Scale (HADS).Results: Respectively for the French and German version, ICC were 0.98 and 0.94. Correlations 0.63 and 0.67 with the SF-36 Physical Functioning subscale; 0.60 and 0.52 with the SF-36 Physical Summary Scale ; -0.33 and -0.51 with the VAS ; -0.08 and 0.25 with the SF-36 Mental Health scale; 0.01 and 0.28 with the SF-36 Mental Summary Scale; -0.26 and -0.42 with the HADS depression; -0.17 and -0.45 with the HADS anxiety.Discussion: For both the French and German version of the SFS, the reliability was excellent. Convergent construct validity with SF-36 physical scales is good, moderated with the VAS. We find out a low correlation with SF-36 mental scales (divergent construct validity). We find out a low correlation with HADS subscales in the French version, and a moderate one in the German version. Selection bias, chronicity of the complaints, as well as cultural differences could explain these results. In conclusion, both the French and German version of the SFS are valid and reliable for evaluation of perceived functional capacity for patients with back complaints.

Susceptibility and adaptation to human TRIM5α alleles at positive selected sites in HIV-1 capsid.

Numerous in vitro studies attribute to human TRIM5α some modest anti-HIV-1 activity and human population studies suggest some differential effect of TRIM5α polymorphisms on disease progression. If the activity of TRIM5α were relevant in vivo, it could result in positive selection on the viral capsid. To address this issue, we identified 10 positively selected sites in HIV-1 capsid from multiple viral strains and generated 17 clade B viruses carrying a minor (i.e. low frequency) residue or an alanine at those positions. All recombinant viruses were susceptible to the modest effect of common human TRIM5α and allelic variants R136Q, and H419Y; H43Y and G249D TRIM5α were generally inactive. Increased sensitivity to TRIM5α was observed for some capsid variants, suggesting that minor residues are selected against in human populations. On the other hand, the modest potency of human TRIM5α does not translate in escape mutations in the viral capsid.

Local adaptation maintains clinal variation in melanin-based coloration of European barn owls (Tyto alba).

Ecological parameters vary in space, and the resulting heterogeneity of selective forces can drive adaptive population divergence. Clinal variation represents a classical model to study the interplay of gene flow and selection in the dynamics of this local adaptation process. Although geographic variation in phenotypic traits in discrete populations could be remainders of past adaptation, maintenance of adaptive clinal variation requires recurrent selection. Clinal variation in genetically determined traits is generally attributed to adaptation of different genotypes to local conditions along an environmental gradient, although it can as well arise from neutral processes. Here, we investigated whether selection accounts for the strong clinal variation observed in a highly heritable pheomelanin-based color trait in the European barn owl by comparing spatial differentiation of color and of neutral genes among populations. Barn owl's coloration varies continuously from white in southwestern Europe to reddish-brown in northeastern Europe. A very low differentiation at neutral genetic markers suggests that substantial gene flow occurs among populations. The persistence of pronounced color differentiation despite this strong gene flow is consistent with the hypothesis that selection is the primary force maintaining color variation among European populations. Therefore, the color cline is most likely the result of local adaptation.

PROX1 Promotes Metabolic Adaptation and Fuels Outgrowth of Wnt(high) Metastatic Colon Cancer Cells.

The Wnt pathway is abnormally activated in the majority of colorectal cancers, and significant knowledge has been gained in understanding its role in tumor initiation. However, the mechanisms of metastatic outgrowth in colorectal cancer remain a major challenge. We report that autophagy-dependent metabolic adaptation and survival of metastatic colorectal cancer cells is regulated by the target of oncogenic Wnt signaling, homeobox transcription factor PROX1, expressed by a subpopulation of colon cancer progenitor/stem cells. We identify direct PROX1 target genes and show that repression of a pro-apoptotic member of the BCL2 family, BCL2L15, is important for survival of PROX1(+) cells under metabolic stress. PROX1 inactivation after the establishment of metastases prevented further growth of lesions. Furthermore, autophagy inhibition efficiently targeted metastatic PROX1(+) cells, suggesting a potential therapeutic approach. These data identify PROX1 as a key regulator of the transcriptional network contributing to metastases outgrowth in colorectal cancer.

Methodological adaptation for nematodes extration in forest soils of the southern Mata Atlântica

The objective of this work was to clarify whether the method to extract nematodes from European soils is suitable for forest soils and litter in the eastern of Paraná state, Brazil, and whether nematode abundance differs between sites with different ecosystems and levels of human interference. The study sites were situated in the coastal area of the Serra do Mar, near the town of Antonina, in Eastern Paraná, Brazil. Cobb's sieving and decanting method was more appropriate than ISO method, since extraction efficiency was higher and intra-sample variability was significantly lower. In order to achieve an extraction efficiency higher than 90%, Cobb's method was modified. For the extraction of nematodes from litter, the Baermann funnel, with an extraction time of 48 hours, yielded an extraction efficiency higher than 90%. Nematode abundance in litter was higher than in soil. The mean number of individuals extracted from the litter increased with the age stage of the forest sites sampled, and there was no difference in the number of individuals in the soil of the four forest sites. Mean nematode abundance in soil in banana plantations was about twice as high compared to the banana-palmito mixed stands and to the forest sites.

Educational achievement in Swiss childhood cancer survivors compared with the general population.

BACKGROUND: The objective of this study was to describe educational achievements of childhood cancer survivors in Switzerland compared with the general population. In particular, the authors investigated educational problems during childhood, final educational achievement in adulthood, and its predictors. METHODS: Childhood cancer survivors who were aged <16 years at diagnosis from 1976 to 2003 who had survived for ≥5 years and were currently ages 20 to 40 years received a postal questionnaire during 2007 to 2009. Controls were respondents of the Swiss Health Survey ages 20 to 40 years. Educational achievement included compulsory schooling, vocational training, upper secondary schooling, and university degree. The analysis was weighted to optimize comparability of the populations. The authors analyzed the association between demographic and clinical predictors and educational achievement using multivariable logistic regression. Subgroup analyses focused on survivors aged ≥27 years. RESULTS: One-third of survivors encountered educational problems during schooling (30% repeated 1 year, and 35% received supportive tutoring). In the total sample, more survivors than controls achieved compulsory schooling only (8.7% vs 5.2%) and fewer acquired a university degree (7.3% vs 11%), but more survivors than controls achieved an upper secondary education (36.1 vs 24.1%). In those aged ≥27 years, differences in compulsory schooling and university education largely disappeared. In survivors and controls, sex, nationality, language region, and migration background were strong predictors of achievement. Survivors of central nervous system tumors or those who had a relapse had poorer outcomes (P < .05). CONCLUSIONS: Childhood cancer survivors encountered problems during schooling and completed professional education with some delay. However, with the exception of patients who had central nervous system tumors and those who experienced a relapse, the final educational achievement in survivors of child cancer was comparable to that of the general population.

Characterization of the molecular mechanisms of insulin exocytosis and of their adaptation to physiopathological conditions

Résumé large public Le glucose est une source d'énergie essentielle pour notre organisme, indispensable pour le bon fonctionnement des cellules de notre corps. Les cellules β du pancréas sont chargées de réguler l'utilisation du glucose et de maintenir la glycémie (taux de glucose dans le sang) à un niveau constant. Lorsque la glycémie augmente, ces dernières sécrètent l'insuline, une hormone favorisant l'absorption, l'utilisation et le stockage du glucose. Une sécrétion insuffisante d'insuline provoque une élévation anormale du taux de glucose dans le sang (hyperglycémie) et peut mener au développement du diabète sucré. L'insuline est sécrétée dans le sang par un mécanisme particulier appelé exocytose. Une meilleure compréhension de ce mécanisme est nécessaire dans l'espoir de trouver des nouvelles thérapies pour traiter les 170 millions de personnes atteintes de diabète sucré à travers le monde. L'implication de diverses protéines, comme les SNAREs ou Rabs a déjà été démontrée. Cependant leurs mécanismes d'action restent, à ce jour, peu compris. De plus, l'adaptation de la machinerie d'exocytose à des conditions physiopathologiques, comme l'hyperglycémie, est encore à élucider. Le but de mon travail de thèse a été de clarifier le rôle de deux protéines, Noc2 et Tomosyn, dans l'exocytose ; puis de déterminer les effets d'une exposition prolongée à un taux élevé de glucose sur l'ensemble des protéines de la machinerie d'exocytose. Noc2 est un partenaire potentiel de deux Rabs connues pour leur implication dans les dernières étapes de l'exocytose, Rab3 et Rab27. Grâce à l'étude de différents mutants de Noc2, j'ai montré que l'interaction avec Rab27 permet à la protéine de s'associer avec les organelles de la cellule β contenant l'insuline. De plus, en diminuant sélectivement l'expression de Noc2, j'ai déterminé l'importance de cette protéine pour le bon fonctionnement du processus d'exocytose et le relâchement de l'insuline. Quant à Tomosyn, une protéine interagissant avec les protéines SNAREs, j'ai démontré son importance dans la sécrétion d'insuline en diminuant de manière sélective son expression dans les cellules β. Ensuite, grâce à une combinaison d'approches moléculaires et de microscopie, j'ai mis en évidence le rôle de Tomosyn dans les dernières étapes de l'exocytose. Enfin, puisque la sécrétion d'insuline est diminuée lors d'une hyperglycémie prolongée, j'ai analysé l'adaptation de la machinerie d'exocytose à ces conditions. Ceci m'a permis de découvrir que l'expression de quatre protéines essentielles pour le processus d'exocytose, Noc2, Rab3, Rab27 et Granuphilin, est fortement diminuée lors d'une hyperglycémie chronique. L'ensemble de ces données met en évidence l'importance de Noc2 et Tomosyn dans la sécrétion d'insuline. L'inhibition, par un taux élevé de glucose, de l'expression de Noc2 et d'autres protéines indispensables pour l'exocytose suggère que ce phénomène pourrait contribuer au développement du diabète sucré. Résumé L'exocytose d'insuline, en réponse au glucose circulant dans le sang, est la fonction principale de la cellule β. Celle-ci permet de stabiliser le taux de glucose sanguin (glycémie). Le diabète de type 2 est caractérisé par une glycémie élevée due, principalement, à un défaut de sécrétion d'insuline en réponse au glucose. La compréhension des mécanismes qui contrôlent l'exocytose d'insuline est essentielle pour clarifier les causes du diabète sucré. Plusieurs composants impliqués dans ce processus ont été identifiés. Ceux-ci incluent les SNAREs Syntaxin-1, VAMP2 et SNAP25 et les GTPases Rab3 et Rab27 qui jouent un rôle dans les dernières étapes de l'exocytose. Pendant mon travail de thèse, j'ai étudié le rôle de Noc2, un des partenaires de Rab3 et Rab27, dans l'exocytose d'insuline. Nous avons déterminé que Noc2 s'associe aux granules de sécrétion d'insuline grâce à son interaction avec Rab27. La diminution de l'expression de Noc2 dans la lignée cellulaire β INS-1E, par ARN interférence, influence négativement la sécrétion d'insuline stimulée par différents sécrétagogues et prouve que cette protéine Noc2 est essentielle pour l'exocytose d'insuline. L'interaction avec Munc13, une protéine impliquée dans l'arrimage des vésicules, suggère que Noc2 participe au recrutement des granules d'insuline à la membrane plasmique. Ensuite, j'ai analysé l'adaptation de la machinerie d'exocytose à des concentrations supraphysiologiques de glucose. Le niveau d'expression de Rab3 et Rab27 et de leurs effecteurs Granuphilin/S1p4 et Noc2 est fortement diminué par une exposition prolongée des cellules β à haut glucose. L'effet observé est en relation avec l'induction de l'expression de ICER, un facteur de transcription surexprimé dans des conditions d'hyperglycémie et également dans des modèles génétiques de diabète de type 2. La surexpression de ICER dans des cellules INS-1E diminue l'expression de Rab3, Rab27, Granuphilin/Slp4 et Noc2 et par conséquent l'exocytose d'insuline. Ainsi, l'induction de ICER, après une exposition prolongée à haut glucose, régule négativement l'expression de protéines essentielles pour l'exocytose et altère la sécrétion d'insuline. Ce mécanisme pourrait contribuer au dysfonctionnement de l'exocytose d'insuline dans le diabète de type 2. Dans la dernière partie de ma thèse, j'ai investigué le rôle de la protéine Tomosyn-1 dans la formation du complexe SNARE. Cette protéine a une forte affinité pour Syntaxin-1 et contient un domaine SNARE. Tomosyn-1 est concentrée dans les régions cellulaires enrichies en granules de sécrétion. La diminution sélective de l'expression de Tomosyn-1 induit une réduction de l'exocytose stimulée par différents sécrétagogues. Cet effet est dû à un défaut de fusion des granules avec la membrane plasmique. Ceci nous indique que Tomosyn-1 intervient dans une phase importante de la préparation des vésicules à la fusion, qui est nécessaire à l'exocytose. Abstract: Insulin exocytosis from pancreatic β-cells plays a central role in blood glucose homeostasis. Diabetes mellitus is a complex metabolic disorder characterized by secretory dysfunctions in pancreatic β-cells and release of amounts of insulin that are inappropriate to maintain blood glucose concentration within normal physiological ranges. To define the causes of β-cell failure a basic understanding of the molecular mechanisms that control insulin exocytosis is essential. Some of the molecular components involved in this process have been identified, including the SNARE proteins VAMP2, Syntaxin-1 and SNAP25 and the two GTPases, Rab3 and Rab27, that regulate the final steps of insulin secretion. I first investigated the role of Noc2, a potential Rab3 and Rab27 partner, in insulin secretion. I found that Noc2 associates with Rab27 and is recruited by this GTPase on insulin- containing granules. Silencing of the Noc2 gene by RNA interference led to a strong impairment in the capacity of the β-cell line INS-1E to respond to secretagogues, indicating that appropriate levels of the protein are essential for insulin exocytosis. I also showed that Noc2 interacts with Munc13, a protein that controls vesicle priming, suggesting a possible involvement of Noc2 in the recruitment of secretory granules at the plasma membrane. In the second part of my thesis, I investigated the adaptation of the molecular machinery of exocytosis to physiopathological conditions. I found that the expression of Rab3, Rab27 and of their effectors Granuphilin/Slp4 and Noc2 is dramatically decreased by chronic exposure of β-ce1ls to supraphysiological glucose levels. The observed glucotoxic effect is a consequence of the induction of ICER, a transcriptional repressor that is increased by prolonged hyperglycemia and in genetic models of type 2 diabetes. Overexpression of ICER reduced Granuphilin, Noc2, Rab3 and Rab27 levels and inhibited exocytosis. These results suggest that the presence of inappropriate levels of ICER diminishes the expression of a group of proteins essential for exocytosis and contributes to defective insulin release in type 2 diabetes. In the last part of my thesis, I focused my attention on the role of Tomosyn-1, a Syntaxin-1 binding protein possessing a SNARE-like motif, in the control of SNARE complex assembly. I found that Tomosyn-1 is concentrated in cellular compartments enriched in insulin-containing secretory granules. Silencing of Tomosyn-1 did not affect the number of secretory granules docked at the plasma membrane but decreased their release probability, resulting in a reduction in stimulus-induced insulin exocytosis. These findings suggest that Tomosyn-1 is involved in a post-docking event that prepares secretory granules for fusion and is necessary to sustain exocytosis in response to insulin secretagogues.

Adaptation of anthurium cultivars as cut flowers in a subtropical area

The objective of this work was to evaluate the adaptation of anthurium (Anthurium andraeanum) cultivars as cut flowers in a subtropical area, located in north of Paraná State, Brazil. The Apalai, Ianomami, Kinã, nK 102, Parakanã, Rubi, and Terena cultivars were cultivated in a nursery under 80% shade. The number of leaves and inflorescences, floral stem length, length and width of inflorescences, and spadix length were evaluated. The experimental design was in completely randomized blocks, with six replicates and five plants per plot. During the 18 months evaluated, 'Parakanã' produced 11 inflorescences per plant, whereas the other cultivars produced seven to nine inflorescences per plant. The number of leaves produced per plant was: 'Ianomami', 25; 'Parakanã', 20; 'Apalai' and 'Terena', 15; 'Kinã' and 'Rubi', 11; and 'nK 102', 9. The Apalai, nK 102, Parakanã, and Rubi cultivars are the most recommended as cut flowers; the Ianomami cultivar is not recommended as a cut flower in this region.

Etalonnage de trois épreuves de recognition continue : Effets de l'âge, du sexe et du niveau socio-professionnel sur les mesures de discrimination et de biais de réponse. [Standardization of three continuous recognition test forms - Effects of age, sex and socio-economic level on measurements of discrimination and response bias.]

Nous présontons l'étalonnage d'un test mnésique de recognition dans un échantillon de 180 adultes francophones de la Suisse Romande. Le test comprend trois formes utilisant un matériel verbal (mots) ou non verbal (visages ou paysages). Une attention particulière est accordée à l'âge dans la présentation des résultats. Celui-ci affecte plus précocement et plus intensément la performance aux formes non verbales qu'à la forme verbale du test. Il induit également une importante augmentation du nombre de fausses reconnaissances pour les formes non verbales.

Educational Opportunity through The Advocate

This communication tool comes from the Office of the State Long-Term Care Ombudsman to long-term care facilities administrators and directors. The Office's objective is to share information regarding various topics of long term care.

Learning in the working place: the educational potential of a multihead microscope in pathology postgraduate training.

Training future pathologists is an important mission of many hospital anatomic pathology departments. Apprenticeship-a process in which learning and teaching tightly intertwine with daily work, is one of the main educational methods in use in postgraduate medical training. However, patient care, including pathological diagnosis, often comes first, diagnostic priorities prevailing over educational ones. Recognition of the unique educational opportunities is a prerequisite for enhancing the postgraduate learning experience. The aim of this paper is to draw attention of senior pathologists with a role as supervisor in postgraduate training on the potential educational value of a multihead microscope, a common setting in pathology departments. After reporting on an informal observation of senior and junior pathologists' meetings around the multihead microscope in our department, we review the literature on current theories of learning to provide support to the high potential educational value of these meetings for postgraduate training in pathology. We also draw from the literature on learner-centered teaching some recommendations to better support learning in this particular context. Finally, we propose clues for further studies and effective instruction during meetings around a multihead microscope.

Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.

OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.

Risk and global change : developing scientific methods for advocacy and awareness raising

Les catastrophes sont souvent perçues comme des événements rapides et aléatoires. Si les déclencheurs peuvent être soudains, les catastrophes, elles, sont le résultat d'une accumulation des conséquences d'actions et de décisions inappropriées ainsi que du changement global. Pour modifier cette perception du risque, des outils de sensibilisation sont nécessaires. Des méthodes quantitatives ont été développées et ont permis d'identifier la distribution et les facteurs sous- jacents du risque.¦Le risque de catastrophes résulte de l'intersection entre aléas, exposition et vulnérabilité. La fréquence et l'intensité des aléas peuvent être influencées par le changement climatique ou le déclin des écosystèmes, la croissance démographique augmente l'exposition, alors que l'évolution du niveau de développement affecte la vulnérabilité. Chacune de ses composantes pouvant changer, le risque est dynamique et doit être réévalué périodiquement par les gouvernements, les assurances ou les agences de développement. Au niveau global, ces analyses sont souvent effectuées à l'aide de base de données sur les pertes enregistrées. Nos résultats montrent que celles-ci sont susceptibles d'être biaisées notamment par l'amélioration de l'accès à l'information. Elles ne sont pas exhaustives et ne donnent pas d'information sur l'exposition, l'intensité ou la vulnérabilité. Une nouvelle approche, indépendante des pertes reportées, est donc nécessaire.¦Les recherches présentées ici ont été mandatées par les Nations Unies et par des agences oeuvrant dans le développement et l'environnement (PNUD, l'UNISDR, la GTZ, le PNUE ou l'UICN). Ces organismes avaient besoin d'une évaluation quantitative sur les facteurs sous-jacents du risque, afin de sensibiliser les décideurs et pour la priorisation des projets de réduction des risques de désastres.¦La méthode est basée sur les systèmes d'information géographique, la télédétection, les bases de données et l'analyse statistique. Une importante quantité de données (1,7 Tb) et plusieurs milliers d'heures de calculs ont été nécessaires. Un modèle de risque global a été élaboré pour révéler la distribution des aléas, de l'exposition et des risques, ainsi que pour l'identification des facteurs de risque sous- jacent de plusieurs aléas (inondations, cyclones tropicaux, séismes et glissements de terrain). Deux indexes de risque multiples ont été générés pour comparer les pays. Les résultats incluent une évaluation du rôle de l'intensité de l'aléa, de l'exposition, de la pauvreté, de la gouvernance dans la configuration et les tendances du risque. Il apparaît que les facteurs de vulnérabilité changent en fonction du type d'aléa, et contrairement à l'exposition, leur poids décroît quand l'intensité augmente.¦Au niveau local, la méthode a été testée pour mettre en évidence l'influence du changement climatique et du déclin des écosystèmes sur l'aléa. Dans le nord du Pakistan, la déforestation induit une augmentation de la susceptibilité des glissements de terrain. Les recherches menées au Pérou (à base d'imagerie satellitaire et de collecte de données au sol) révèlent un retrait glaciaire rapide et donnent une évaluation du volume de glace restante ainsi que des scénarios sur l'évolution possible.¦Ces résultats ont été présentés à des publics différents, notamment en face de 160 gouvernements. Les résultats et les données générées sont accessibles en ligne (http://preview.grid.unep.ch). La méthode est flexible et facilement transposable à des échelles et problématiques différentes, offrant de bonnes perspectives pour l'adaptation à d'autres domaines de recherche.¦La caractérisation du risque au niveau global et l'identification du rôle des écosystèmes dans le risque de catastrophe est en plein développement. Ces recherches ont révélés de nombreux défis, certains ont été résolus, d'autres sont restés des limitations. Cependant, il apparaît clairement que le niveau de développement configure line grande partie des risques de catastrophes. La dynamique du risque est gouvernée principalement par le changement global.¦Disasters are often perceived as fast and random events. If the triggers may be sudden, disasters are the result of an accumulation of actions, consequences from inappropriate decisions and from global change. To modify this perception of risk, advocacy tools are needed. Quantitative methods have been developed to identify the distribution and the underlying factors of risk.¦Disaster risk is resulting from the intersection of hazards, exposure and vulnerability. The frequency and intensity of hazards can be influenced by climate change or by the decline of ecosystems. Population growth increases the exposure, while changes in the level of development affect the vulnerability. Given that each of its components may change, the risk is dynamic and should be reviewed periodically by governments, insurance companies or development agencies. At the global level, these analyses are often performed using databases on reported losses. Our results show that these are likely to be biased in particular by improvements in access to information. International losses databases are not exhaustive and do not give information on exposure, the intensity or vulnerability. A new approach, independent of reported losses, is necessary.¦The researches presented here have been mandated by the United Nations and agencies working in the development and the environment (UNDP, UNISDR, GTZ, UNEP and IUCN). These organizations needed a quantitative assessment of the underlying factors of risk, to raise awareness amongst policymakers and to prioritize disaster risk reduction projects.¦The method is based on geographic information systems, remote sensing, databases and statistical analysis. It required a large amount of data (1.7 Tb of data on both the physical environment and socio-economic parameters) and several thousand hours of processing were necessary. A comprehensive risk model was developed to reveal the distribution of hazards, exposure and risk, and to identify underlying risk factors. These were performed for several hazards (e.g. floods, tropical cyclones, earthquakes and landslides). Two different multiple risk indexes were generated to compare countries. The results include an evaluation of the role of the intensity of the hazard, exposure, poverty, governance in the pattern and trends of risk. It appears that the vulnerability factors change depending on the type of hazard, and contrary to the exposure, their weight decreases as the intensity increases.¦Locally, the method was tested to highlight the influence of climate change and the ecosystems decline on the hazard. In northern Pakistan, deforestation exacerbates the susceptibility of landslides. Researches in Peru (based on satellite imagery and ground data collection) revealed a rapid glacier retreat and give an assessment of the remaining ice volume as well as scenarios of possible evolution.¦These results were presented to different audiences, including in front of 160 governments. The results and data generated are made available online through an open source SDI (http://preview.grid.unep.ch). The method is flexible and easily transferable to different scales and issues, with good prospects for adaptation to other research areas. The risk characterization at a global level and identifying the role of ecosystems in disaster risk is booming. These researches have revealed many challenges, some were resolved, while others remained limitations. However, it is clear that the level of development, and more over, unsustainable development, configures a large part of disaster risk and that the dynamics of risk is primarily governed by global change.