HIV/AIDS and national security

McInnes, C., 'HIV/AIDS and national security', in: AIDS and Governance, N. Poku, A. Whiteside and B. Sandkjaer (eds.),(Aldershot: Ashgate, 2007), pp.93-111 RAE2008

The impact of conifer plantation forestry on the ecology of peatland lakes

Blanket bog lakes are a characteristic feature of blanket bog habitats and harbour many rare and threatened invertebrate species. Despite their potential conservation value, however, very little is known about their physico-chemical or biological characteristics in western Europe, and their reference conditions are still unknown in Ireland. Furthermore, they are under considerable threat in Ireland from a number of sources, particularly afforestation of their catchments by exotic conifers. Plantation forestry can potentially lead to the increased input of substances including hydrogen ions (H+), plants nutrients, dissolved organic carbon (DOC), heavy metals and sediment. The aims of this study were to investigate the effect of conifer plantation forestry on the hydrochemistry and ecology of blanket bog lakes in western Ireland. Lake hydrochemistry, littoral Chydoridae (Cladocera) and littoral macroinvertebrate communities were compared among replicate lakes selected from three distinct catchment land use categories: i) unplanted blanket bog only present in the catchment, ii) mature (closed-canopy) conifer plantation forests only present in the catchment and iii) catchments containing mature conifer plantation forests with recently clearfelled areas. All three catchment land uses were replicated across two geologies: sandstone and granite. Lakes with afforested catchments across both geologies had elevated concentrations of phosphorus (P), nitrogen (N), total dissolved organic carbon (TDOC), aluminium (Al) and iron (Fe), with the highest concentrations of each parameter recorded from lakes with catchment clearfelling. Dissolved oxygen concentrations were also significantly reduced in the afforested lakes, particularly the clearfell lakes. This change in lake hydrochemistry was associated with profound changes in lake invertebrate communities. Within the chydorid communities, the dominance of Alonopsis elongata in the unplanted blanket bog lakes shifted to dominance by the smaller bodied Chydorus sphaericus, along with Alonella nana, Alonella excisa and Alonella exigua, in the plantation forestry-affected lakes, consistent with a shift in lake trophy. Similarly, there was marked changes in the macroinvertebrate communities, especially for the Coleoptera and Heteroptera assemblages which revealed increased taxon richness and abundance in the nutrient-enriched lakes. In terms of conservation status, despite having the greatest species-quality scores (SQS) and species richness, three of the four International Union for the Conservation of Nature (IUCN) red-listed species of Coleoptera and Odonata recorded during the study were absent from lakes subject to catchment clearfelling. The relative strengths of bottom-up (forestry-mediated nutrient enrichment) and top-down (fish) forces in structuring littoral macroinvertebrate communities was investigated in a separate study. Nutrient enrichment was shown to be the dominant force acting on communities, with fish having a lesser influence. These results confirmed that plantation forestry poses the single greatest threat to the conservation status of blanket bog lakes in western Ireland. The findings of this study have major implications for the management of afforested peatlands. Further research is required on blanket bog lakes to prevent any further plantation forestry-mediated habitat deterioration of this rare and protected habitat.

Naturaleza de la fertilización y calidad de hortalizas

p.123-134

Groupements arbustifs el mégaphorbiaies du haut Jura français. Quelques aspects particuliers

Tras las observaciones efectuadas durante la sesión de la Amical Internacional de Fitosociogía en la Jura franco-suiza, los autores exponen alganos datos complementarios sobre las comunidades megafórbicas jurasianas con Cicerbita alpina y Adenostyles alliaria y analizan desde un nuevo punto de vista, la comunidad arbustiva de Jun¡perus nana, Pinus uncinata, Sorbus chamaespilus, Laburnum alpinum.., que existen en los pisos subalpino y montano superior del Jura.

Gross and net nitrogen transformation rates and availability in late summer in tall shrub and birch hummock ecosystems of the Canadian low Arctic

Climate change is occurring most rapidly in the Arctic where warming has been twice as fast as the rest of the globe over the last few decades. Arctic soils contain a vast store of carbon and warmer arctic soils may mediate current atmospheric CO2 concentrations and global warming trends. Warmer soils could increase nutrient availability to plants, leading to increased primary production and sequestration of CO2. Presumably because of these effects of warming on shrub ecosystems, shrubs have been expanding across the arctic over the last 50 years, Arctic shrub expansion may track or cause changes in nutrient cycling and availability that favour growth of larger, denser shrubs. This study aimed at measuring gross and net nitrogen cycling rates, major soil nitrogen and carbon pool sizes, and elucidating controls on nutrient cycling and availability between a mesic birch (Betula nana) hummock tundra ecosystem and an ecosystem of dense, tall, birch (B. nana) shrubs. Nitrogen cycling and availability was enhanced at the tall shrub ecosystem compared to the birch hummock ecosystem. Net nitrogen immobilization by microbes was approximately threefold greater at the tall shrub ecosystem. This was in part because of larger microbial biomass nitrogen and carbon (interpreted as a larger microbial community) at the tall shrub ecosystem. Nitrogen inputs via litter were significantly larger at the tall shrub ecosystem and were hypothesized to be the major contributor to the higher dissolved organic and inorganic nitrogen pools in the soil at the tall shrub ecosystem. The results from this study suggest a positive feedback mechanism between litter nitrogen inputs and the enhancement of nitrogen cycling and availability as a driver of shrub expansion across the Arctic.

Stomatal proxy record of CO2 concentrations from the last termination suggests an important role for CO2 at climate change transitions

A new stomatal proxy-based record of CO₂ concentrations ([CO₂]), based on Betula nana (dwarf birch) leaves from the Hässeldala Port sedimentary sequence in south-eastern Sweden, is presented. The record is of high chronological resolution and spans most of Greenland Interstadial 1 (GI-1a to 1c, Allerød pollen zone), Greenland Stadial 1 (GS-1, Younger Dryas pollen zone) and the very beginning of the Holocene (Preboreal pollen zone). The record clearly demonstrates that i) [CO₂] were significantly higher than usually reported for the Last Termination and ii) the overall pattern of CO₂ evolution through the studied time period is fairly dynamic, with significant abrupt fluctuations in [CO₂] when the climate moved from interstadial to stadial state and vice versa. A new loss-on-ignition chemical record (used here as a proxy for temperature) lends independent support to the Hässeldala Port [CO₂] record. The large-amplitude fluctuations around the climate change transitions may indicate unstable climates and that " tipping-point" situations were involved in Last Termination climate evolution. The scenario presented here is in contrast to [CO₂] records reconstructed from air bubbles trapped in ice, which indicate lower concentrations and a gradual, linear increase of [CO₂] through time. The prevalent explanation for the main climate forcer during the Last Termination being ocean circulation patterns needs to re-examined, and a larger role for atmospheric [CO₂] considered.

High-precision ultra-distal Holocene tephrochronology in North America

Far-travelled volcanic ashes (tephras) from Holocene eruptions in Alaska and the Pacific northwest have been traced to the easternmost extent of North America, providing the basis for a new high-precision geochronological framework throughout the continent through tephrochronology (the dating and correlation of tephra isochrons in sedimentary records). The reported isochrons are geochemically distinct, with seven correlated to documented sources in Alaska and the Cascades, including the Mazama ash from Oregon (w7600 years old) and the eastern lobe of the White River Ash from Alaska (~1150 years old). These findings mark the beginning of a tephrochronological framework of enhanced precision across North America, with applications in palaeoclimate, surface process and archaeological studies. The particle travel distances involved (up tow7000 km) also demonstrate the potential for continent-wide or trans-Atlantic socio-economic disruption from similar future eruptions.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

Targeting Siglecs with a sialic acid-decorated nanoparticle abrogates inflammation

Sepsis is the most frequent cause of death in hospitalized patients, and severe sepsis is a leading contributory factor to acute respiratory distress syndrome (ARDS). At present, there is no effective treatment for these conditions, and care is primarily supportive. Murine sialic acid-binding immunoglobulin-like lectin-E (Siglec-E) and its human orthologs Siglec-7 and Siglec-9 are immunomodulatory receptors found predominantly on hematopoietic cells. These receptors are important negative regulators of acute inflammatory responses and are potential targets for the treatment of sepsis and ARDS. We describe a Siglec-targeting platform consisting of poly(lactic-co-glycolic acid) nanoparticles decorated with a natural Siglec ligand, di(α2→8) N-acetylneuraminic acid (α2,8 NANA-NP). This nanoparticle induced enhanced oligomerization of the murine Siglec-E receptor on the surface of macrophages, unlike the free α2,8 NANA ligand. Furthermore, treatment of murine macrophages with these nanoparticles blocked the production of lipopolysaccharide-induced inflammatory cytokines in a Siglec-E-dependent manner. The nanoparticles were also therapeutically beneficial in vivo in both systemic and pulmonary murine models replicating inflammatory features of sepsis and ARDS. Moreover, we confirmed the anti-inflammatory effect of these nanoparticles on human monocytes and macrophages in vitro and in a human ex vivo lung perfusion (EVLP) model of lung injury. We also established that interleukin-10 (IL-10) induced Siglec-E expression and α2,8 NANA-NP further augmented the expression of IL-10. Indeed, the effectiveness of the nanoparticle depended on IL-10. Collectively, these results demonstrated a therapeutic effect of targeting Siglec receptors with a nanoparticle-based platform under inflammatory conditions.

Irish language education and the national ideal: The dynamics of nationalism in Northern Ireland

Since the beginning of the Northern Ireland conflict in the late 1960s, Irish nationalism has been identified as a prominent force in the political culture of the state. Recent studies have suggested, however, that the ‘Nationalist’ population has become increasingly content within the new political framework created by the peace process and the aspiration for Irish unity diminished. In placing the Northern Ireland situation within the theoretical framework of nationalism, this paper will analyse how these changing priorities have been possible. Through an analysis of Irish language study in Northern Ireland's schools, the paper will examine how the political ideals espoused by the nationalist Sinn Féin Party reflected the priorities of the ‘nationalist community’. It will be contended that the relationship between the ideology and ‘the people’ is much more complex than is often allowed for and that educational inequalities are a significant contributing factor to this.

Prevalência de parasitoses intestinais nas crianças e conhecimentos, atitudes e práticas dos encarregados de educação - Estratégias de Intervenção (Ilha do Fogo, Cabo Verde)

As doenças tropicais negligenciadas persistem exclusivamente em populações de baixa renda e marginalizadas, sendo esquecidos os progressos necessários para a sua prevenção, eliminação e erradicação. A lista destas doenças é extensa, na qual está incluída a doença parasitária intestinal com origem em agentes infecciosos como os protozários e os helmintas. De distribuição mundial, estas infecções ocorrem frequentemente em regiões quentes, húmidas e desprovidas de saneamento básico, afectando particularmente crianças e adultos jovens, devido à sua susceptibilidade e exposição. As infecções causadas por parasitas intestinais são muitas vezes assintomáticas ou com predomínio de sintomas inespecíficos, e dependendo da carga parasitária e do estado nutricional das crianças podem contribuir para o atraso de crescimento, défice ponderal e dificuldade de aprendizagem. Neste contexto, foi realizado um estudo para determinar a prevelência de parasitoses intestinais nas crianças em idade escolar e os conhecimentos, atitudes e práticas dos seus encarregados de educação, na Ilha do Fogo, Cabo Verde. A amostra abrangeu 200 crianças em idade escolar, sendo 41,7% do sexo masculino e 58,3% do sexo feminino, com idades compreendidas entre os 6 e os 16 anos. Foi observada uma amostra de fezes por cada indivíduo, tendo sido utilizadas as técnicas de laboratório de observação directa e a técnica de concentração de Ritchie, ambas com coloração de lugol. Às crianças do estudo foram também avaliadas as variáveis antropométricas, idade, estatura e peso. Aos encarregados de educação das crianças foi aplicado um questionário para identificação dos conhecimentos, atitudes e práticas relativamente à infecção por parasitas intestinais. Foram observados parasitas intestinais em 51,8% das crianças. Das sete espécies de parasitas intestinais encontradas as mais frequentes foram a Entamoeba coli e Entamoeba histolytica/dispar, seguindo-se a Giardia intestinalis e Enterobius vermicularis e, por fim Iodomoeba buetschlii, Hymenolepis nana e Ascaris lumbricóides. A associação parasitária mais frequentemente encontrada verificou-se entre as espécies Entamoeba coli e Entamoeba histolytica/dispar. Cinquenta por cento das crianças apresentavam um estado de malnutrição aguda, 14,87% um estado de malnutrição crónica e 28,40% um estado de malnutrição global. Os conhecimentos, atitudes e práticas de prevenção de infecções parasitárias intestinais por parte dos encarregados de educação, revelaram algumas deficiências. A procura de diferenças/associações entre a variável Estar parasitado e outras variáveis em estudo, permitiu concluir que as crianças parasitadas viviam em habitações com menor número de quartos, não tinham o hábito de lavar sempre as mãos depois de defecar, não bebiam água desinfectada na escola, e não tinham casa de banho na habitação. Consideramos três actores locais como indispensáveis na implementação das medidas de controlo das parasitoses intestinais na Ilha do Fogo: as delegacias de saúde, as delegações de educação e as autarquias dos três concelhos (S.Filipe, Santa Catarina e Mosteiros). Como grupos alvo e beneficiários directos da intervenção propomos a comunidade escolar (alunos, encarregados de educação, gestores, professores e cozinheiras) e os profissionais de saúde (médicos, enfermeiros, agentes sanitários e técnicos de laboratório). Como intervenções gerais definimos a formação, a educação para a saúde, a desparasitação regular, os rastreios, o diagnóstico e tratamento precoce, a melhoria do saneamento e da higiene.

Rehabilitation and reintegration needs of female inmates and promotion mental health in Georgian prison

RESUMO: As mulheres presas encontram-se num sistema essencialmente dirigido por e concebido para homens. As mulheres que entram na prisão geralmente vêm de ambientes marginalizados e desfavorecidos e muitas vezes têm histórias de violência e abuso físico e sexual. As mulheres presas são um grupo particularmente vulnerável, uma vez que dentro do sistema prisional as suas necessidades de saúde e higiene são muitas vezes negligenciadas. O primeiro passo para o desenvolvimento de programas e práticas sensíveis ao género é compreender as características das mulheres delinquentes e definir fatores de vida específicos que contribuem para a formação do comportamento criminoso de mulheres. Em junho de 2012 foi realizada uma investigação na única prisão feminina da Geórgia, para estudar as necessidades mentais e psicossociais das mulheres presas. O objetivo da pesquisa foi o desenvolvimento de programas de apoio pertinentes para a reabilitação, ressocialização e reintegração, e a elaboração de recomendações práticas para a gestão das prisões. Foi desenvolvido um instrumento de pesquisa (inquérito) com uma fundamentação conceptual baseada em quatro principais teorias: Teoria dos Caminhos (Pathways Theory), teoria do desenvolvimento psicológico da mulher (Theory of Women’s Psychological Development), Trauma e Teorias da Dependência (Trauma and Addiction Theories). Foram inquiridas 120 mulheres presas. Os resultados deste estudo mostram que muitas das necessidades das mulheres presas são diferentes das dos homens e requerem estratégias adaptadas às suas características e situações psicossociais específicas. A maioria das mulheres encarceradas é jovem, enérgica, pode trabalhar, tem profissão e família. As presas sofrem de problemas psicológicos e muitas vezes são rejeitadas pelas suas famílias. Uma parte substancial das mulheres presas tem múltiplos problemas de saúde física e mental. A maioria delas tem filhos e sofre com o facto das crianças estarem a crescer longe da mãe. Com base nos resultados desta investigação é possível elaborar um contexto promotor do planeamento e desenvolvimento de serviços com um enfoque de género na prisão. Na perspetiva de longo prazo, o conhecimento das necessidades básicas e a introdução de programas e serviços com necessidades específicas pertinentes irá beneficiar as presas e as suas famílias, e melhorar a eficácia do sistema de justiça criminal.----------ABSTRACT: Female inmates find themselves in a system essentially run by men for men. Women who enter prison usually come from marginalized and disadvantaged backgrounds and are often characterized by histories of violence, physical and sexual abuse. Female prisoners constitute an especially vulnerable group given their specific health and hygienic needs within the system are often neglected. The first step in developing gender-sensitive program and practice is to understand female offenders’ characteristics and the specific life factors that shape women’s patterns of offending. In June 2012 a research was carried out in the Georgian only female prison facility to assess the mental and psychosocial needs of women prisoners, aiming to develop effective support programs for their rehabilitation, re-socialization and reintegration, as well as to elaborate new recommendations concerning prison management. A survey instrument (questionnaire) was developed within a theoretical framework based on four fundamental theories: Pathways Theory, Theory of Women’s Psychological Development and Trauma and Addiction Theories. Sample size was defined to be 120 surveyed persons. The study showed that needs of incarcerated women were different from those of men, thus requiring approaches tailored to their specific psychosocial characteristics and situations. The basic population of imprisoned women consisted of young, energetic, working-age females, most often with a professional qualification. Female prisoners suffered from psychological problems and are were more likely to be rejected by their families. Most of them had children and suffered that the children were growing without mothers. A substantial proportion of women offenders had multiple physical and mental health problems. Based on the study findings a conceptual framework can be elaborated towards planning and developing gender-sensitive services in prison. In the long-term perspective, acknowledgement of baseline needs and introduction of the relevant needs-specific programs and services may benefit women prisoners as well as their families, improving the effectiveness of the criminal justice system.

Prevalência de parasitas intestinais em crianças a frequentar a escola primária no Bairro Lucrécia, no Lubango, Angola, e sua relação com o estado nutricional e anemia

Introdução: Os parasitas intestinais são responsáveis por morbilidade em crianças de todo mundo, em especial nos países de baixa renda. Os estudos têm vindo a demonstrar o seu impacto negativo no estado nutricional e o seu contributo na etiologia da anemia. Pretendeu-se determinar a prevalência de parasitas intestinais em crianças dos 5 aos 12 anos de idade, a frequentar a escola primária no Bairro Lucrécia, no Lubango, Angola, e explorar a sua relação com o estado nutricional e anemia. Material e Métodos: Foi efectuado um estudo observacional, transversal e analítico, cuja colheita de dados se realizou entre Setembro e Outubro de 2010. A amostra foi constituída por 328 crianças. Realizou-se a detecção microscópica de parasitas intestinais e identificação molecular dos parasitas Entamoeba histolytica e Entamoeba dispar. O estado nutricional foi avaliado através dos z-scores do peso para a idade, da estatura para a idade e do IMC para a idade. A concentração de hemoglobina foi determinada através de um hemoglobinómetro portátil. Resultados: A prevalência de parasitas intestinais patogénicos foi de 44,2%, destacando-se Ascaris lumbricoides com 22,0%, Giardia lamblia com 20,1% e Hymenolepis nana com 8,8%. Na microscopia foi encontrada uma prevalência de Entamoeba histolytica/dispar de 13,7%, tendo sido posteriormente identificada, por diagnóstico molecular, uma prevalência de 13,1% para E. dispar e 0,3% para E. histolytica. A prevalência de baixo peso, subnutrição crónica e subnutrição aguda foi de, respectivamente, 36,1%, 41,5% e 30,2%. A probabilidade das crianças terem subnutrição crónica ou subnutrição aguda aumentou com o facto de terem 10 anos ou mais. As crianças co-infectadas por protozoários e helmintas apresentaram uma maior probabilidade de terem subnutrição crónica. A prevalência de anemia foi de 21,6%, encontrando-se a mesma significativamente associada à infecção por H. nana. A probabilidade das crianças estarem anémicas aumentou com o facto de terem menos de 10 anos. Adicionalmente nas crianças desparasitadas com albendazol ou mebendazol há 2 meses e meio ou menos verificou-se uma maior prevalência de infecção por G. lamblia (28,6%) em comparação com as desparasitadas há mais de 2 meses e meio (13,7%), tendo sido essa diferença estatisticamente significativa. Discussão e Conclusões: Emergiu deste estudo a importância da co-infecção com helmintas e protozoários no aumento da probabilidade das crianças terem subnutrição crónica e foi encontrada uma associação estatisticamente significativa entre a infecção por H. nana e a anemia. Será importante desenhar futuros estudos que investiguem o poder patogénico do H. nana e o modo como é efectuada a desparasitação com albendazol ou mebendazol, pois ao ser eficaz contra a infecção por A. lumbricoides, poderá aumentar a susceptibilidade à infecção por G. lamblia.

Sweeps Tickets

Sweeps tickets including: an envelope that says “sweep tickets from Miss Hillman which contains a Toronto Dominion Bank envelope containing 1 Hospitals’ Trust (1940) Dublin ticket; A Toronto Dominion Bank piece of stationary containing 2 Hospitals’ Trust (1940) Dublin tickets; A Toronto Dominion Bank envelope with “Mrs. Band” written of the back, containing 2 Irish Hospitals’ Sweepstakes Tickets (1958); 1 Toronto Dominion Bank envelope with Mrs. M. W. Band typed on the front, containing 2 Irish Hospitals’ Sweepstakes Tickets (1957) and 4 Hospitals’ Trust (1940) Dublin tickets; 1 Toronto Dominion Bank envelope containing 1 Irish Hospitals’ Sweepstake ticket (1958); 1 Toronto Dominion Bank envelope containing 4 Irish Hospitals’ Sweepstakes tickets (1958) all 4 of these tickets have Margaret W. Band written on the back but one also has “Nana” and one has “Hi-Boy” also written on it, 1940, 1957-1958

Facteurs socioéconomiques associés à l’usage des médicaments psychotropes chez les hommes et les femmes âgés de 65 à 74 ans vivant dans la communauté : l’étude internationale sur la mobilité des personnes âgées (IMIAS).

Objectif de l’étude : Estimer l'association entre la position socioéconomique et l'utilisation des médicaments psychotropes dans cinq populations différentes chez les personnes âgées de 65-74 ans. Méthode : L'échantillon d'étude était composé de 1995 personnes avec des données issues de la première vague de collecte de 2012 faite par l’International Mobility in Aging Study (IMIAS). Il se composait de 401 participants de Saint- Hyacinthe (Québec), 398 de Kingston (Ontario), 394 personnes âgées de Tirana (Albanie), 400 de Manizales (Colombie) et 402 de Natal (Brésil). Tous les médicaments psychotropes consommés pendant les 15 derniers jours ont été identifiés au cours d'une visite à domicile et codés selon la classification ATC. Les médicaments psychotropes inclus étaient les anxiolytiques, sédatifs et hypnotiques (ASH), les antidépresseurs (ADP) et les analgésiques/antiépileptiques/antiParkinson (AEP). Les associations entre la prévalence de la consommation des médicaments psychotropes et l'éducation, le revenu et l’occupation ont été estimés avec des ratios de prévalence (RP) obtenus en ajustant une régression de Poisson et en utilisant le modèle comportemental de Andersen et Newman sur l'utilisation des services de santé et en contrôlant les besoins (les maladies chroniques et la dépression), les facteurs prédisposants (âge et sexe) ainsi que les facteurs facilitants (en utilisant le site d'étude en tant que mandataire des facteurs lié au système de santé et à l'environnement). Résultats : Les personnes âgées vivant dans les sites canadiens consommaient plus de médicaments psychotropes que celles vivant dans les sites à l'extérieur du Canada, elles consommaient moins d’ASH à Manizales et ne consommaient pas d’ADP en Albanie. Les inégalités socioéconomiques varient selon les sites. Dans les sites canadiens, le faible niveau socioéconomique était associée à une plus grande consommation de médicaments psychotropes : en particulier, les personnes à faible niveau d’instruction consommaient plus d’antidépresseurs et celles à faible revenu consommaient plus d’AEP. Dans les sites de recherche d'Amérique latine, les personnes âgées de niveau d’instruction et de revenu élevé consommaient plus antidépresseurs et celles avec des occupations manuelles consommaient plus d’analgésiques/antiépileptiques/antiParkinson. À Tirana (Albanie), il n'y avait pas de consommation de médicaments antidépresseurs, mais la consommation d’ASH était plus élevée chez les personnes à faible revenu. Les analyses multivariées du modèle final cache les différences entre les sites qui se sont révélées dans les analyses spécifiques au niveau du Canada, de l’Amérique Latine et d’Albanie. Conclusion : Il existe des inégalités socioéconomiques liées à la consommation des médicaments psychotropes chez les personnes âgées. Ces inégalités varient selon les sites. L'utilisation des médicaments psychotropes était plus fréquente chez les personnes les moins instruites et les plus pauvres au Canada alors que l'inverse était vrai dans les sites d'Amérique latine. L'Albanie était caractérisée par une absence de consommation d'antidépresseurs alors qu’il y avait une plus grande utilisation des anxiolytiques, sédatifs et hypnotiques dans les groupes à faible revenu.