Advancing tools to promote health equity across European Union regions : The EURO-HEALTHY project

Population health measurements are recognised as appropriate tools to support public health monitoring. Yet, there is still a lack of tools that offer a basis for policy appraisal and for foreseeing impacts on health equity. In the context of persistent regional inequalities, it is critical to ascertain which regions are performing best, which factors might shape future health outcomes and where there is room for improvement. Under the EURO-HEALTHY project, tools combining the technical elements of multi-criteria value models and the social elements of participatory processes were developed to measure health in multiple dimensions and to inform policies. The flagship tool is the Population Health Index (PHI), a multidimensional measure that evaluates health from the lens of equity in health determinants and health outcomes, further divided into sub-indices. Foresight tools for policy analysis were also developed, namely: (1) scenarios of future patterns of population health in Europe in 2030, combining group elicitation with the Extreme-World method and (2) a multi-criteria evaluation framework informing policy appraisal (case study of Lisbon). Finally, a WebGIS was built to map and communicate the results to wider audiences. The Population Health Index was applied to all European Union (EU) regions, indicating which regions are lagging behind and where investments are most needed to close the health gap. Three scenarios for 2030 were produced - (1) the 'Failing Europe' scenario (worst case/increasing inequalities), (2) the 'Sustainable Prosperity' scenario (best case/decreasing inequalities) and (3) the 'Being Stuck' scenario (the EU and Member States maintain the status quo). Finally, the policy appraisal exercise conducted in Lisbon illustrates which policies have higher potential to improve health and how their feasibility can change according to different scenarios. The article makes a theoretical and practical contribution to the field of population health. Theoretically, it contributes to the conceptualisation of health in a broader sense by advancing a model able to integrate multiple aspects of health, including health outcomes and multisectoral determinants. Empirically, the model and tools are closely tied to what is measurable when using the EU context but offering opportunities to be upscaled to other settings

Orbital Delivery of Small Payloads Using Hypersonic Airbreathing Propulsion

Scramjet engines promise significantly higher specific impulse than rockets during the hypersonic phase of low-Earth-orbit insertion trajectories. Despite this, scramjets are not used on any current systems due to the difficulty of operating over the large Mach number envelope required by this accelerating trajectory. The key to taking advantage of airbreathing hypersonic engines for low-Earth-orbit insertion is to develop a multistage system that makes use of the scramjet only within its high-performance regime. Amultistage rocket-scramjet-rocket system that accepts this limitation has therefore been examined. This system includes a solid rocket boost to Mach 6, a near-term Mach 6–12 hydrogen-fueled scramjet engine to propel a reusable second stage, and a liquid-fueled final-stage rocket. Trajectory calculations for a system scaled to deliver approximately 100 kg to a 200 km equatorial orbit indicate payload mass fractions of approximately 1.5% with the use of a scramjet stage designed for low drag and efficient packaging. The goal of this work is to guide the future development of scramjets by identifying the areas that will make the most significant improvement to their use for space access.Michael Smart and Matthew Tetlo

Environmental public health risks in European metropolitan areas within the EURO-HEALTHY project

Urban areas in Europe are facing a range of environmental public health challenges, such as air pollution, traffic noise and road injuries. The identification and quantification of the public health risks associated with exposure to environmental conditions is important for prioritising policies and interventions that aim to diminish the risks and improve the health of the population. With this purpose in mind, the EURO-HEALTHY project used a consistent approach to assess the impact of key environmental risk factors and urban environmental determinants on public health in European metropolitan areas. A number of environmental public health indicators, which are closely tied to the physical and built environment, were identified through stakeholder consultation; data were collected from six European metropolitan areas (Athens, Barcelona, Lisbon, London, Stockholm and Turin) covering the period 2000–2014, and a health impact assessment framework enabled the quantification of health effects (attributable deaths) associated with these indicators. The key environmental public health indicators were related to air pollution and certain urban environmental conditions (urban green spaces, road safety). The air pollution was generally the highest environmental public health risk; the associated number of deaths in Athens, Barcelona and London ranged between 800 and 2300 attributable deaths per year. The number of victims of road traffic accidents and the associated deaths were lowest in the most recent year compared with previous years. We also examined the positive impacts on health associated with urban green spaces by calculating reduced mortality impacts for populations residing in areas with greater green space coverage; results in Athens showed reductions of all-cause mortality of 26 per 100,000 inhabitants for populations with benefits of local greenspace. Based on our analysis, we discuss recommendations of potential interventions that could be implemented to reduce the environmental public health risks in the European metropolitan areas covered by this study

Environmental public health risks in European metropolitan areas within the EURO-HEALTHY project

Urban areas in Europe are facing a range of environmental public health challenges, such as air pollution, traffic noise and road injuries. The identification and quantification of the public health risks associated with exposure to environmental conditions is important for prioritising policies and interventions that aim to diminish the risks and improve the health of the population. With this purpose in mind, the EURO-HEALTHY project used a consistent approach to assess the impact of key environmental risk factors and urban environmental determinants on public health in European metropolitan areas. A number of environmental public health indicators, which are closely tied to the physical and built environment, were identified through stakeholder consultation; data were collected from six European metropolitan areas (Athens, Barcelona, Lisbon, London, Stockholm and Turin) covering the period 2000–2014, and a health impact assessment framework enabled the quantification of health effects (attributable deaths) associated with these indicators. The key environmental public health indicators were related to air pollution and certain urban environmental conditions (urban green spaces, road safety). The air pollution was generally the highest environmental public health risk; the associated number of deaths in Athens, Barcelona and London ranged between 800 and 2300 attributable deaths per year. The number of victims of road traffic accidents and the associated deaths were lowest in the most recent year compared with previous years. We also examined the positive impacts on health associated with urban green spaces by calculating reduced mortality impacts for populations residing in areas with greater green space coverage; results in Athens showed reductions of all-cause mortality of 26 per 100,000 inhabitants for populations with benefits of local greenspace. Based on our analysis, we discuss recommendations of potential interventions that could be implemented to reduce the environmental public health risks in the European metropolitan areas covered by this study

Critical-angle transmission grating spectrometer for high-resolution soft x-ray spectroscopy on the International X-ray Observatory

High-resolution spectroscopy at energies below 1 keV covers the lines of C, N, O, Ne and Fe ions, and is central to studies of the Interstellar Medium, the Warm Hot Intergalactic Medium, warm absorption and outflows in Active Galactic Nuclei, coronal emission from stars, etc. The large collecting area, long focal length, and 5 arcsecond half power diameter telescope point-spread function of the International X-ray Observatory will present unprecedented opportunity for a grating spectrometer to address these areas at the forefront of astronomy and astrophysics. We present the current status of a transmission grating spectrometer based on recently developed high-efficiency critical-angle transmission (CAT) gratings that combine the traditional advantages of blazed reflection and transmission gratings. The optical design places light-weight grating arrays close to the telescope mirrors, which maximizes dispersion distance and thus spectral resolution and minimizes demands on mirror performance. It merges features from the Chandra High Energy Transmission Grating Spectrometer and the XMM-Newton Reflection Grating Spectrometer, and provides resolving power R = E/ΔE = 3000 - 5000 (full width half max) and effective area >1000 cm[superscript 2] in the soft x-ray band. We discuss recent results on ray-tracing and optimization of the optical design, instrument configuration studies, and grating fabrication.United States. National Aeronautics and Space Administration (NNX07AG98G)United States. National Aeronautics and Space Administration (NNX08AI62G)United States. National Aeronautics and Space Administration (NNX09AE82A