Facteurs associés à la santé perçue et à la capacité fonctionnelle des personnes âgées dans la préfecture de Bandjoun au Cameroun

Les connaissances sur le vieillissement et sur l’état de santé et la capacité fonctionnelle des personnes âgées en Afrique restent rudimentaires. Une analyse des données sur 613 personnes âgées de 50 ans et plus dans 75 villages et villes de l’ouest du Cameroun permet ici de mettre en contexte les changements démogra-phiques et épidémiologiques qui ponctuent le processus du vieillissement des populations en Afrique et d’illustrer les enjeux liés à la santé et au bien-être des personnes âgées. Ces données sont tirées de l’Enquête sur la famille et la santé au Cameroun (EFSC), réalisée de décembre 1996 à mars 1997. L’étude présente d’abord un portrait démographique et socioéconomique, ainsi que les cadres de vie des personnes âgées dans cet environnement. Ensuite, elle évalue le rôle du statut socioéconomique et des conditions de vie familiale dans la manifestation des différences dans l’état de santé perçu et les limitations d’activité des per-sonnes âgées, et cerne les facteurs associés à l’état de santé perçu et à l’incapa-cité fonctionnelle aux âges avancés. Les hypothèses de recherche sont confir-mées : dans cette population, 1) l’état de santé perçu et les limitations d’activité varient selon le sexe et l’âge; 2) l’état de santé perçu se détériore et les limita-tions d’activité augmentent lorsque le statut socioéconomique diminue; 3) les modes de vie sont en lien avec la santé et la capacité fonctionnelle; 4) il y a une association entre comportement préventif (d’une part) et santé et capacité fonctionnelle (d’autre part); et 5) l’état de santé perçu et la capacité fonctionnelle varient selon le contexte socioéconomique et sanitaire. À la lumière des travaux déjà menés en Afrique et ailleurs, l’auteur dégage les implications de cette recherche en ce qui concerne les conditions de vie et la santé des personnes âgées et les enjeux du vieillissement de la population en Afrique.To date, relatively little is known about the aging, health status and functional capacity of elderly persons in Africa. This study analyzes data on 613 individuals aged 50 or older in 75 villages and towns in western Cameroon to help place into context the demographic and epidemiological changes associated with the aging process in African populations and to illustrate issues related to the health and well-being of older persons. The data are taken from the Enquête sur la famille et la santé au Cameroun (EFSC), carried out from December 1996 to March 1997. The study first presents a demographic and socioeconomic profile of Bandjoun’s elderly and their living environments. It then evaluates the role of socioeconomic status and family living conditions regarding the differences found in the self-rated health and functional limitations of the elderly and identifies factors associated with self-rated health and functional disability in later life. The research hypotheses are confirmed: in this population, 1) self-rated health and functional limitations show gender and age variations; 2) self-rated health deteriorates and functional limitations increase as socioeconomic status declines; 3) people’s lifestyles are linked to health and functional capacity; 4) preventive behaviours are associated with health and functional capacity; and 5) self-rated health and functional capacity vary according to the socioeconomic and health context. In the light of earlier research conducted in Africa and elsewhere, the author describes the implications of this study in regard to older persons’ living conditions and health and in regard to issues related to population aging in Africa

“We’re all on the same boat, but we’re not the same passengers”: an exploration of the hidden and fragmented nature of the homeless subject

The subject of homelessness is one that has been covered extensively in social scientific research. Yet, it continues to remain hidden and fragmented, even to those researchers who have had significant experience working with this population. Using a combination of anthropological methodologies – oral history, archival research, and participant observation –, the current research project examines some of the reasons for this fragmentation of the homeless subject matter, first through an examination of the changes in homelessness literature over time, then via examination of parallels to other homelessness research and the life history of one homeless individual, an exploration of the ways in which shelters impact the lives of those residing within them, and finally through reflection on the ways in which ‘experience’ informs homelessness research

Maximum Electromagnetic Local Density of States via Material Structuring

The electromagnetic local density of states (LDOS) is crucial to many aspects of photonics engineering, from enhancing emission of photon sources to radiative heat transfer and photovoltaics. We present a framework for evaluating upper bounds on LDOS in structured media that can handle arbitrary bandwidths and accounts for critical wave scattering effects with no heuristic approximations. The bounds are solely determined by the bandwidth, material susceptibility, and device footprint, with no assumptions on geometry. We derive an analytical expression for the maximum LDOS consistent with the conservation of energy across the entire design domain, which upon benchmarking with topology-optimized structures is shown to be nearly tight for large devices. Novel scaling laws for maximum LDOS enhancement are found: the bounds saturate to a finite value with increasing susceptibility and scale as the quartic root of the bandwidth for semi-infinite structures made of lossy materials, with direct implications on material selection and design applications.Comment: Corrected minor typos throughout paper; corrected mislabel of inverse designs in Figure 1; added full Supplementary Information; added acknowledgment

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Background: Under-five mortality is a major public health problem and one of the health indicators of health care in sub-Saharan Africa. In order to address inefficient health systems, there is a need to identify the spatial distribution of under-five mortality, especially areas of high mortality clustering. This study aimed to explore spatial and temporal clustering in under-five mortality in the Kassena-Nankana District of the Upper East region. Methods: We used data from the Navrongo Health and Demographic Surveillance System in the Kassena- Nankana District of northern Ghana, which had an average population of 140,000 of which about 18,400 were under five years of age. We analysed under-five mortality in 49 villages during the period 1997–2006. We calculated total under-five mortality rates and investigated their geographical distributions. A spatial scan statistic was used to test for clustering of the mortality in both space and time. Results: Under-five mortality has been declining during the period. However, the data show a persistently higher than average clustering of mortality over the period among villages mainly in the north-eastern parts of the district. Conclusion: There is a higher than average under-five mortality clustering in the villages in the north-east of the district and this may suggest a relatively poor health care system despite the many health interventions that took place over time in the district, including the Community Health and Family Planning Project, whose impact may not have been felt in these parts of the district between 1995 and 2004