Social differences in avoidable mortality between small areas of 15 European cities: an ecological study

Health and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation. Methods: We determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality. Results: Mortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe. Conclusions: There are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants

Enhancing the efficiency of freight transport by using simulation

The role of transport in the economy is twofold. As a sector of economic activity it contributes to a share of national income. On the other hand, improvements in transport infrastructure create room for accelerated economic growth. As a means to support railways as a safe and environmentally friendly transportation mode, the EU legislation has required the opening of domestic railway freight for competition from beginning of year 2007. The importance of railways as a mode of transport has been great in Finland, as a larger share of freight has been carried on rails than in Europe on average. In this thesis it is claimed that the efficiency of goods transport can be enhanced by service specific investments. Furthermore, it is stressed that simulation can and should be used to evaluate the cost-efficiency of transport systems on operational level, as well as to assess transportation infrastructure investments. In all the studied cases notable efficiency improvements were found. For example in distribution, home delivery of groceries can be almost twice as cost efficient as the current practice of visiting the store. The majority of the cases concentrated on railway freight. In timber transportation, the item with the largest annual transport volume in domestic railway freight in Finland, the transportation cost could be reduced most substantially. Also in international timber procurement, the utilization of railway wagons could be improved by combining complementary flows. The efficiency improvements also have positive environmental effects; a large part of road transit could be moved to rails annually. If impacts of freight transport are included in cost-benefit analysis of railway investments, up to 50 % increase in the net benefits of the evaluated alternatives can be experienced, avoiding a possible inbuilt bias in the assessment framework, and thus increasing the efficiency of national investments in transportation infrastructure. Transportation systems are a typical example of complex real world systems that cannot be analysed realistically by analytical methods, whereas simulation allows inclusion of dynamics and the level of detail required. Regarding simulation as a viable tool for assessing the efficiency of transportation systems finds support also in the international survey conducted for railway freight operators; operators use operations research methods widely for planning purposes, while simulation is applied only by the larger operators.

The governmental organization's role in railway freight market's liberalization -building knowledge through Swedish and Polish operators' experiences

Globalization has increased transport aggregates’ demand. Whilst transport volumes increase, ecological values’im portance has sharpened: carbon footprint has become a measure known world widely. European Union together with other communities emphasizes friendliness to the environment: same trend has extended to transports. As a potential substitute for road transport is noted railway transport, which decreases the congestions and lowers the emission levels. Railway freight market was liberalized in the European Union 2007, which enabled new operators to enter the markets. This research had two main objectives. Firstly, it examined the main market entry strategies utilized and the barriers to entry confronted by the operators who entered the markets after the liberalization. Secondly, the aim was to find ways the governmental organization could enhance its service towards potential railway freight operators. Research is a qualitative case study, utilizing descriptive analytical research method with a normative shade. Empirical data was gathered by interviewing Swedish and Polish railway freight operators by using a semi-structured theme-interview. This research provided novel information by using first-hand data; topic has been researched previously by utilizing second-hand data and literature analyses. Based on this research, rolling stock acquisition, needed investments and bureaucracy generate the main barriers to entry. The research results show that the mostly utilized market entry strategies are start-up and vertical integration. The governmental organization could enhance the market entry process by organizing courses, paying extra attention on flexibility, internal know-how and educating the staff.

Ontogenetic dietary changes in male South American fur seals Arctocephalus australis in northern and central Patagonia, Argentina.

This study assessed ontogenetic dietary changes in male South American fur seals Arctocephalus australis in northern and central Patagonia (Argentina) using stable isotope ratios (δ15 N and δ13 C) in vibrissae and bones. Sucking pups were characterised by higher δ15 N values and lower δ13 C values than older specimens. Weaning was associated with a marked drop of δ15 N values, both in bone and vibrissae. Such a drop was inconsistent with the consumption of local prey and may reveal movement to distant foraging grounds or physiological changes associated with either fasting or rapid growth. Stable isotope ratios indicated that juveniles fed more pelagically than subadults and adults, but that there were no major differences between the 2 latter age categories. As subadults and adults are rather similar in body mass and are much larger than juveniles, body mass may play a role in the ontogenetic dietary changes reported. Nevertheless, demersal benthic prey were always scarce in the diet of male fur seals, which relied primarily on Argentine shortfin squid and small pelagic fish throughout life, though adults also consumed large amounts of decapod crustaceans available at shallow depths. Vibrissae did not reveal regular oscillations of δ15 N or δ13 C, except in 1 individual. Thus, male fur seals from northern and central Patagonia do not appear to migrate regularly between isotopically distinct areas, although nomadic displacements cannot be ruled out.