Public health expenditure and spatial interactions in a decentralized national health system

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a potential solution is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions

Temporal and spatial dynamics of benthic invertebrate communities in an alpine glacier-fed alluvial system

Summary The present thesis work focused on the ecology of benthic invertebrates in the proglacial floodplain of the Rhone in the Swiss Alps. The main glacial Rhone River and a smaller glacial tributary, the Mutt River, joined and entered a braiding multi-thread area. A first part concentrated on the disruption of the longitudinal patterns of environmental conditions and benthic invertebrate fauna in the Rhone by its tributary the Mutt. The Mutt had less harsh environmental conditions, higher taxonomic richness and more abundant zoobenthos compared to the Rhone upstream of the confluence. Although the habitat conditions in the main stream were little modified by the tributary, the fauna was richer and more diverse below the confluence. Colonisation from the Mutt induced the occurrence of faunal elements uncommon of glacial streams in the upper Rhone, where water temperature remains below 4°C. Although the glacial Rhone dominated the system with regard to hydrology and certain environmental conditions, the Mutt tributary has to be seen as the faunal driver of the system. The second part of the study concerned the spatio-temporal differentiation of the habitats and the benthic communities along and across the flood plain. No longitudinal differentiation was found. The spatial transversal differentiation of three habitat types with different environmental characteristics was successfully reflected in the spatial variability of benthic assemblages. This typology separated marginal sites of the flood plain, left bank sites under the influence of the Mutt, and the right bank sites under the influence of the Rh6ne. Faunistic spatial differences were emphasized by the quantitative structure of the fauna, richness, abundances and Simpson index of diversity. Seasonal environmental variability was positively related with Simpson index of diversity and the total richness per site. Low flow conditions were the most favourable season for the fauna and November was characterized by low spatial environmental heterogeneity, high spatial heterogeneity of faunal assemblage, maximum taxonomic richness, a particular taxonomic composition, highest abundances, as well as the highest primary food resources. The third part studied the egg development of three species of Ephemeroptera in the laboratory at 1.5 to 7°C and the ecological implications in the field. Species revealed very contrasting development strategies. Baetis alpinus has a synchronous and efficient egg development, which is faster in warmer habitats, enabling it to exploit short periods of favourable conditions in the floodplain. Ecdyonurus picteti has a very long development time slightly decreasing in warmer conditions. The high degree of individual variation suggests a genetic determination of the degree-days demand. Combined with the glacial local conditions, this strategy leads to an extreme delay of hatching and allows it to develop in very unpredictable habitats. Rhithrogena nivata is the second cold adapted species in Ephemeroptera. The incubation duration is long and success largely depends on the timing of hatching and the discharge conditions. This species is able to exploit extremely unstable and cold habitats where other species are limited by low water temperatures. The fourth part dealt with larval development in different habitats of the floodplain. Addition of data on egg development allowed the description of the life histories of the species from oviposition until emergence. Rhithrogena nivata and loyolaea generally have a two-year development, with the first winter passed as eggs and the second one as larvae. Development of Ecdyonurus picteti is difficult to document but appears to be efficient in a harsh and unpredictable environment. Baetis alpinus was studied separately in four habitats of the floodplain system with contrasting thermal regimes. Differences in success and duration of larval development and in growth rates are emphasised. Subvention mechanisms between habitats by migration of young or grown larvae were demonstrated. Development success and persistence of the populations in the system were thus increased. Emergence was synchronised to the detriment of the optimisation of the adult's size and fecundity. These very different development strategies induce a spatial and temporal distribution in the use of food resources and ecological niches. The last part of this work aimed at the synthesis of the characteristics and the ecological features of three distinct compartments of the system that are the upper Rhone, the Mutt and the floodplain. Their particular role as well as their inter-dependence concerning the structure and the dynamics of the benthic communities was emphasised. Résumé Ce travail de thèse est consacré à l'écologie des invertébrés benthiques dans la zone alluviale proglaciaire du Rhône dans les Alpes suisses. Le Rhône, torrent glaciaire principal, reçoit les eaux de la Mutt, affluent glaciaire secondaire, puis pénètre dans une zone de tressage formée de plusieurs bras. La première partie de l'étude se concentre sur la disruption par la Mutt des processus longitudinaux, tant environnementaux que faunistiques, existants dans le Rhône. Les conditions environnementales régnant dans la Mutt sont moins rudes, la richesse taxonomique plus élevée et le zoobenthos plus abondant que dans le Rhône en amont de la confluence. Bien que les conditions environnementales dans le torrent principal soient peu modifiées par l'affluent, la faune s'avère être plus riche et plus diversifiée en aval de la confluence. La colonisation depuis la Mutt permet l'occurrence de taxons inhabituels dans le Rhône en amont de la confluence, où la température de l'eau se maintient en dessous de 4°C. Bien que le Rhône, torrent glaciaire principal, domine le système du point de vu de l'hydrologie et de certains paramètres environnementaux, l'affluent Mutt doit être considéré comme l'élément structurant la faune dans le système. La deuxième partie concerne la différentiation spatiale et temporelle des habitats et des communautés benthiques à travers la plaine alluviale. Aucune différentiation longitudinale n'a été mise en évidence. La différentiation transversale de trois types d'habitats sur la base des caractéristiques environnementales a été confirmée par la variabilité spatiale de la faune. Cette typologie sépare les sites marginaux de la plaine alluviale, ceux sous l'influence de la Mutt (en rive gauche) et ceux sous l'influence du Rhône amont (en rive droite). Les différences spatiales de la faune sont mises en évidence par la structure quantitative de la faune, la richesse, les abondances et l'indice de diversité de Simpson. La variabilité saisonnière du milieu est positivement liée avec l'indice de diversité de Simpson et la richesse totale par site. L'étiage correspond à la période la plus favorable pour la faune et novembre réunit des conditions de faible hétérogénéité spatiale du milieu, de forte hétérogénéité spatiale de la faune, une richesse taxonomique maximale, une composition faunistique particulière, les abondances ainsi que les ressources primaires les plus élevées. La troisième partie est consacrée à l'étude du développement des oeufs de trois espèces d'Ephémères au laboratoire à des températures de 1.5 à 7°C, ainsi qu'aux implications écologiques sur le terrain. Ces espèces présentent des stratégies de développement très contrastées. Baetis alpinus a un développement synchrone et efficace, plus rapide en milieu plus chaud et lui permettant d'exploiter les courtes périodes de conditions favorables. Ecdyonurus picteti présente une durée de développement très longue, diminuant légèrement dans des conditions plus chaudes. L'importante variation interindividuelle suggère un déterminisme génétique de la durée de développement. Cette stratégie, associée aux conditions locales, conduit à un décalage extrême des éclosions et permet à l'espèce de se développer dans des habitats imprévisibles. Rhithrogena nivata est la seconde espèce d'Ephémères présentant une adaptation au froid. L'incubation des oeufs est longue et son succès dépend de la période des éclosions et des conditions hydrologiques. Cette espèce est capable d'exploiter des habitats extrêmement instables et froids, où la température est facteur limitant pour d'autres espèces. La quatrième partie traite du développement larvaire dans différents habitats de la plaine alluviale. Le développement complet est décrit pour les espèces étudiées de la ponte jusqu'à l'émergence. Rhithrogena nivata et loyolaea atteignent généralement le stade adulte en deux ans, le premier hiver étant passé sous forme d'oeuf et le second sous forme de larve. Le développement de Ecdyonurus picteti est difficile à documenter, mais s'avère cependant efficace dans un environnement rude et imprévisible. Baetis alpinus a été étudié séparément dans quatre habitats de la plaine ayant des régimes thermiques contrastés. La réussite et la durée du développement embryonnaire ainsi que les taux de croissance y sont variables. Des mécanismes de subvention entre habitats sont possibles par la migration de larves juvéniles ou plus développées, augmentant ainsi la réussite du développement et le maintien des populations dans le système. L'émergence devient synchrone, au détriment de l'optimisation de la taille et de la fécondité des adultes. Ces stratégies très différentes induisent une distribution spatiale et temporelle dans l'usage des ressources et des niches écologiques. La dernière partie synthétise les caractéristiques écologiques des trois compartiments du système que sont le Rhône amont, la Mutt et la zone alluviale. Leurs rôles particuliers et leurs interdépendances du point de vue de la structure et de la dynamique des communautés benthiques sont mis en avant.

Schizotypy as an organizing framework for social and affective sciences

Schizotypy, defined in terms of commonly occurring personality traits related to the schizophrenia spectrum, has been an important construct for understanding the neurodevelopment and stress-diathesis of schizophrenia. However, as schizotypy nears its sixth decade of application, it is important to acknowledge its impressively rich literature accumulating outside of schizophrenia research. In this article, we make the case that schizotypy has considerable potential as a conceptual framework for understanding individual differences in affective and social functions beyond those directly involved in schizophrenia spectrum pathology. This case is predicated on (a) a burgeoning literature noting anomalies in a wide range of social functioning, affiliative, positive and negative emotional, expressive, and social cognitive systems, (b) practical and methodological features associated with schizotypy research that help facilitate empirical investigation, and (c) close ties to theoretical constructs of central importance to affective and social science (eg, stress diathesis, neural compensation). We highlight recent schizotypy research, ie providing insight into the nature of affective and social systems more generally. This includes current efforts to clarify the neurodevelopmental, neurobiological, and psychological underpinnings of affiliative drives, hedonic capacity, social cognition, and stress responsivity systems. Additionally, we discuss neural compensatory and resilience factors that may mitigate the expression of stress-diathesis and functional outcome, and highlight schizotypy's potential role for understanding cultural determinants of social and affective functions.

Public health expenditure and spatial interactions in a decentralized national health system

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a potential solution is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions

What drives invasibility? A multi-model inference test and spatial modelling of alien plant species richness patterns in northern Portugal

Understanding and anticipating biological invasions can focus either on traits that favour species invasiveness or on features of the receiving communities, habitats or landscapes that promote their invasibility. Here, we address invasibility at the regional scale, testing whether some habitats and landscapes are more invasible than others by fitting models that relate alien plant species richness to various environmental predictors. We use a multi-model information-theoretic approach to assess invasibility by modelling spatial and ecological patterns of alien invasion in landscape mosaics and testing competing hypotheses of environmental factors that may control invasibility. Because invasibility may be mediated by particular characteristics of invasiveness, we classified alien species according to their C-S-R plant strategies. We illustrate this approach with a set of 86 alien species in Northern Portugal. We first focus on predictors influencing species richness and expressing invasibility and then evaluate whether distinct plant strategies respond to the same or different groups of environmental predictors. We confirmed climate as a primary determinant of alien invasions and as a primary environmental gradient determining landscape invasibility. The effects of secondary gradients were detected only when the area was sub-sampled according to predictions based on the primary gradient. Then, multiple predictor types influenced patterns of alien species richness, with some types (landscape composition, topography and fire regime) prevailing over others. Alien species richness responded most strongly to extreme land management regimes, suggesting that intermediate disturbance induces biotic resistance by favouring native species richness. Land-use intensification facilitated alien invasion, whereas conservation areas hosted few invaders, highlighting the importance of ecosystem stability in preventing invasions. Plants with different strategies exhibited different responses to environmental gradients, particularly when the variations of the primary gradient were narrowed by sub-sampling. Such differential responses of plant strategies suggest using distinct control and eradication approaches for different areas and alien plant groups.

Structure and spatial variability of Pinus uncinata Ram. growth forms at two contrasting treeline ecotones in the Spanish Pyrenees.

Describimos la distribución espacial de individuos de Pinus uncinata clasificados según su forma de crecimiento y tamaño en dos ecotonos poco perturbados del límite altitudinal del árbol situados en los Pirineos Centrales españoles (Ordesa, O; Tessó, T). En cada sitio situamos una parcela rectangular (30 140 m), que incluía los límites del árbol y del bosque, y cuyo lado mayor seguía el gradiente altitudinal. En ambos sitios, los individuos vivos eran más grandes y tenían un mayor número de cohortes de acículas pendiente abajo. La distribución de las clases de individuos según su forma de crecimiento y tamaño en el sitio O seguía una secuencia de mayor tamaño pendiente abajo, desde abundantes individuos policórmicos arbustivos (krummholz) con pocas cohortes de acículas (1-3) hasta individuos arbóreos mayores unicórmicos con varias cohortes de acículas (4-12). Por el contrario, los cambios estructurales en el ecotono del sitio T fueron graduales y no siguieron de forma tan clara dicha secuencia

Analysis and spatial modeling of the indoor radon Swiss data

The present research deals with an important public health threat, which is the pollution created by radon gas accumulation inside dwellings. The spatial modeling of indoor radon in Switzerland is particularly complex and challenging because of many influencing factors that should be taken into account. Indoor radon data analysis must be addressed from both a statistical and a spatial point of view. As a multivariate process, it was important at first to define the influence of each factor. In particular, it was important to define the influence of geology as being closely associated to indoor radon. This association was indeed observed for the Swiss data but not probed to be the sole determinant for the spatial modeling. The statistical analysis of data, both at univariate and multivariate level, was followed by an exploratory spatial analysis. Many tools proposed in the literature were tested and adapted, including fractality, declustering and moving windows methods. The use of Quan-tité Morisita Index (QMI) as a procedure to evaluate data clustering in function of the radon level was proposed. The existing methods of declustering were revised and applied in an attempt to approach the global histogram parameters. The exploratory phase comes along with the definition of multiple scales of interest for indoor radon mapping in Switzerland. The analysis was done with a top-to-down resolution approach, from regional to local lev¬els in order to find the appropriate scales for modeling. In this sense, data partition was optimized in order to cope with stationary conditions of geostatistical models. Common methods of spatial modeling such as Κ Nearest Neighbors (KNN), variography and General Regression Neural Networks (GRNN) were proposed as exploratory tools. In the following section, different spatial interpolation methods were applied for a par-ticular dataset. A bottom to top method complexity approach was adopted and the results were analyzed together in order to find common definitions of continuity and neighborhood parameters. Additionally, a data filter based on cross-validation was tested with the purpose of reducing noise at local scale (the CVMF). At the end of the chapter, a series of test for data consistency and methods robustness were performed. This lead to conclude about the importance of data splitting and the limitation of generalization methods for reproducing statistical distributions. The last section was dedicated to modeling methods with probabilistic interpretations. Data transformation and simulations thus allowed the use of multigaussian models and helped take the indoor radon pollution data uncertainty into consideration. The catego-rization transform was presented as a solution for extreme values modeling through clas-sification. Simulation scenarios were proposed, including an alternative proposal for the reproduction of the global histogram based on the sampling domain. The sequential Gaussian simulation (SGS) was presented as the method giving the most complete information, while classification performed in a more robust way. An error measure was defined in relation to the decision function for data classification hardening. Within the classification methods, probabilistic neural networks (PNN) show to be better adapted for modeling of high threshold categorization and for automation. Support vector machines (SVM) on the contrary performed well under balanced category conditions. In general, it was concluded that a particular prediction or estimation method is not better under all conditions of scale and neighborhood definitions. Simulations should be the basis, while other methods can provide complementary information to accomplish an efficient indoor radon decision making.

Social and individual learning of helping in humans and other species.

Helping behaviors can be innate, learned by copying others (cultural transmission) or individually learned de novo. These three possibilities are often entangled in debates on the evolution of helping in humans. Here we discuss their similarities and differences, and argue that evolutionary biologists underestimate the role of individual learning in the expression of helping behaviors in humans.

Représentations sociales et représentations intimes de la maladie. Quelques réflexions d'un clinicien [Social and private representations of cancer. A clinician's point of view]

This paper discusses social representations in scientific communications and private ones that are linked to the individual imagination. Social representations, in a limited sense, are useful for the development of preventive messages, but of little benefit to clinical work. We highlight some non-explicit aspects of scientific discourse that impact on treatment: projected beliefs and values. We tackle the relationship between the concepts of representation, imagination, identity and temporality in the individual approach of the cancer patient.

Sensitivity of Spring Phenology to Warming Across Temporal and Spatial Climate Gradients in Two Independent Databases

Disparate ecological datasets are often organized into databases post hoc and then analyzed and interpreted in ways that may diverge from the purposes of the original data collections. Few studies, however, have attempted to quantify how biases inherent in these data (for example, species richness, replication, climate) affect their suitability for addressing broad scientific questions, especially in under-represented systems (for example, deserts, tropical forests) and wild communities. Here, we quantitatively compare the sensitivity of species first flowering and leafing dates to spring warmth in two phenological databases from the Northern Hemisphere. One-PEP725-has high replication within and across sites, but has low species diversity and spans a limited climate gradient. The other-NECTAR-includes many more species and a wider range of climates, but has fewer sites and low replication of species across sites. PEP725, despite low species diversity and relatively low seasonality, accurately captures the magnitude and seasonality of warming responses at climatically similar NECTAR sites, with most species showing earlier phenological events in response to warming. In NECTAR, the prevalence of temperature responders significantly declines with increasing mean annual temperature, a pattern that cannot be detected across the limited climate gradient spanned by the PEP725 flowering and leafing data. Our results showcase broad areas of agreement between the two databases, despite significant differences in species richness and geographic coverage, while also noting areas where including data across broader climate gradients may provide added value. Such comparisons help to identify gaps in our observations and knowledge base that can be addressed by ongoing monitoring and research efforts. Resolving these issues will be critical for improving predictions in understudied and under-sampled systems outside of the temperature seasonal mid-latitudes.