Health status, Neighbourhood effects and Public choice: Evidence from France

Observation of socioeconomic statistics between different neighbourhoods highlights significant differences for economic indicators, social indicators and health indicators. The issue faced here is determining the origins of health inequalities: individual effects and neighbourhood effects. Using National Health Survey and French census data from the period 2002-2003, we attempt to measure the individual and collective determinants of Self-Reported Health Status (SRH). By using a principal component analysis of aggregated census data, we obtain three synthetic factors called: "economic and social condition", "mobility" and "generational" and show that these contextual factors are correlated with individual SRHs. Since the 80s, different French governments have formulated public policies in order to take into account the specific problems of disadvantaged and deprived neighbourhoods. In view to concentrating national assistance, the French government has created "zones urbaines sensibles" (ZUS) [Critical Urban Areas, CUA]. Our research shows that in spite of implementing public policy in France to combat health inequalities, by only taking into account the CUA criterion (the fact of being in a CUA or not), many inequalities remain ignored and thus hidden.Health, Neighbourhood Effect, Housing policy

M-lines characterization of selenide and telluride waveguides for mid-infrared interferometry

Nulling interferometry is an astronomical technique that combines equal wavefronts to achieve a deep rejection ratio of an on-axis star, and that could permit to detect Earth-like planets in the mid-infrared band 5 -- 20 microns. Similarly to what is done in the near-infrared, high frequencies spatial filtering of the incoming beams can be achieved using single-mode waveguides operating in the mid-infrared. An appreciable reduction of the instrumental complexity is also possible using integrated optics (IO) devices in this spectral range. The relative lack of single-mode guided optics in the mid-infrared has motivated the present technological study to demonstrate the feasibility of dielectric waveguides functioning at longer wavelengths. We propose to use selenide and telluride components to pursue the development of more complex IO functions.Comment: accepted in OSA Optics Express, 11 pages, 4 figure

Constant training in direct ophthalmoscopy Reply

Laureate Int Univ, Sch Med, Dept Ophthalmol, Rua Doutor Almeida Lima 1-134, BR-03164000 Sao Paulo, BrazilFed Univ Sao Paulo UNIFESP, Dept Ophthalmol, Sao Paulo, BrazilFed Univ Sao Paulo UNIFESP, Dept Ophthalmol, Sao Paulo, BrazilWeb of Scienc

Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four national and international databases PubMed, Scielo, Medline and Cochrane. Initial set of articles was screened based on title and abstracts, followed by full text analysis. It comprises of articles that were published in the past fifteen years (2002-2017). Results: Eighty-three articles concerning simulation models for medical education were found in national and international databases, with only a few describing important aspects of ophthalmoscopy training and current application of simulation in medical education. After secondary analysis, 38 articles were included. Conclusion: Different ophthalmoscopy simulation models have been described, but only very few studies appraise the effectiveness of each individual model. Comparison studies are still required to determine best approaches for medical education and skill enhancement through simulation models, applied to both medical students as well as young ophthalmologists in training.Laureate Int Univ, Sch Med, Dept Ophthalmol, Rua Doutor Almeida Lima 1-134, BR-03164000 Sao Paulo, SP, BrazilFed Univ Sao Paulo UNIFESP, Dept Ophthalmol, Sao Paulo, SP, BrazilFed Univ Sao Paulo UNIFESP, Dept Ophthalmol, Sao Paulo, SP, BrazilWeb of Scienc

Access to HIV prevention and care for HIV-exposed and HIV-infected children : a qualitative study in rural and urban Mozambique

Background: Follow-up of HIV-exposed children for the delivery of prevention of mother-to-child transmission services and for early diagnosis and treatment of HIV infection is critical to their survival. Despite efforts, uptake of postnatal care for these children remains low in many sub-Saharan African countries. Methods: A qualitative study was conducted in three provinces in Mozambique to identify motivators and barriers to improve uptake of and retention in HIV prevention, care and treatment services for HIV-exposed and HIV-infected children. Participant recommendations were also gathered. Individual interviews (n = 79) and focus group discussions (n = 32) were conducted with parents/caregivers, grandmothers, community leaders and health care workers. Using a socioecological framework, the main themes identified were organized into multiple spheres of influence, specifically at the individual, interpersonal, institutional, community and policy levels. Results: Study participants reported factors such as seeking care outside of the conventional health system and disbelief in test results as barriers to use of HIV services. Other key barriers included fear of disclosure at the interpersonal level and poor patient flow and long waiting time at the institutional level. Key facilitators for accessing care included having hope for children's future, symptomatic illness in children, and the belief that health facilities were the appropriate places to get care. Conclusions: The results suggest that individual-level factors are critical drivers that influence the health-seeking behavior of caregivers of HIV-exposed and HIV-infected children in Mozambique. Noted strategies are to provide more information and awareness on the benefits of early pediatric testing and treatment with positive messages that incorporate success stories, to reach more pregnant women and mother-child pairs postpartum, and to provide counseling during tracing visits. Increasing uptake and retention may be achieved by improving patient flow at the institutional level at health facilities, by addressing concerns with family decision makers, and by working with community leaders to support the uptake of services for HIV-exposed children for essential preventive care

Deficiency in clonogenic endometrial mesenchymal stem cells in obese women with reproductive failure – a pilot study

The mechanisms of obesity associated reproductive complications remain poorly understood. Endometrial mesenchymal stem-cells are critical for cyclic renewal and uterine function. Recently, W5C5+ cells, with high clonogenicity, capable of producing endometrial stroma in vivo, have been described. We sought to investigate the abundance and cloning efficiency of W5C5+ and W5C5− endometrial cells in relation to Body Mass Index, age and reproductive outcome. Design W5C5+ and W5C5− cells were purified from mid-luteal endometrial biopsies (n = 54) by magnetic bead separation and subjected to in vitro colony-forming assays. Results First trimester pregnancy losses were significantly higher in obese subjects (n = 12) compared to overweight (n = 20) and subjects with normal Body Mass Index (n = 22) (P0.05). Conclusions Our observations suggest that the regenerative capacity and plasticity of the endometrium of obese women is suboptimal, which in turn may account for the increased risk of reproductive complications associated with obesity

Alterações de atributos químicos em solos sob diferentes anos de cultivo de Vitis vinífera L.

Among the problems related to over fertilization in vineyards is the indiscriminate use of N, P and K and Cu- and Zn-based pesticides, which result which may lead to degradation of soil chemical attributes and in nutritional imbalance to plants. This study aimed to evaluate changes in chemical attributes of soils with different years of cultivation of Vitis vinifera L. cv. Pinot Noir. Soils with different cultivation periods (4, 9 and 16 years) and at different depths (0-10, 10-20, 20-30, 30-40, 40-50 and 50-60 cm) were analyzed. The following soil chemical attributes were evaluated: pH H2O, H+Al, OM, available phosphorus and potassium, exchangeable calcium, magnesium and aluminum, manganese, copper, zinc and boron, besides cation exchange capacity  (CEC), base saturation and aluminum saturation. The experimental design was randomized blocks in split plots, considering three times after planting (4, 9 and 16 years) and six depths (0-10, 10-20, 20-30, 30-40, 40-50 and 50-60 cm), with three replicates. Soil chemical attributes were subjected to analysis of variance and means were compared by Tukey test (p<0.05). There was significant variation in the macro and micronutrient contents in relation to both the areas and the depths. Areas with 9 and 16 years had higher macronutrients and micronutrients contents, mainly in the first 10 cm depth, due to the successive uses during the years of vineyard management after the planting of the vines.Entre os problemas relacionados à super fertilização nas vinhas, está o uso indiscriminado de N, P e K e de pesticidas à base Cu e Zn, que podem resultar na degradação dos atributos químicos do solo e no desequilíbrio nutricional das plantas. Este estudo teve como objetivo avaliar alterações nos atributos químicos de solos com diferentes anos de cultivo de Vitis vinifera L. cv. Pinot Noir. Foram analisados solos com diferentes períodos de cultivo (4, 9 e 16 anos) e em diferentes profundidades (0-10, 10-20, 20-30, 30-40, 40-50 e 50-60 cm). Foram avaliados os seguintes atributos químicos do solo: pH H2O, H + Al, MO, fósforo e potássio disponíveis, cálcio, magnésio e alumínio trocáveis, manganês, cobre, zinco e boro, além da Capacidade de troca de cátions (CTC), saturação por bases e saturação por alumínio. O delineamento experimental foi o de blocos casualizados em parcelas subdivididas, considerando três períodos de cultivo (4, 9 e 16 anos) e seis profundidades (0-10, 10-20, 20-30, 30-40, 40-50 e 50-60). cm), com três repetições. Os atributos químicos do solo foram submetidos à análise de variância e as médias foram comparadas pelo teste de Tukey (p <0,05). Houve variação significativa nos teores de macro e micronutrientes em relação às áreas e profundidades. Áreas com 9 e 16 anos apresentaram maiores teores de macronutrientes e micronutrientes, principalmente nos primeiros 10 cm de profundidade, devido aos usos sucessivos durante os anos de manejo da vinha após o plantio das vinhas

Efficient enumeration of maximal split subgraphs and sub-cographs and related classes

In this paper, we are interested in algorithms that take in input an arbitrary graph $G$, and that enumerate in output all the (inclusion-wise) maximal "subgraphs" of $G$ which fulfil a given property $\Pi$. All over this paper, we study several different properties $\Pi$, and the notion of subgraph under consideration (induced or not) will vary from a result to another. More precisely, we present efficient algorithms to list all maximal split subgraphs, sub-cographs and some subclasses of cographs of a given input graph. All the algorithms presented here run in polynomial delay, and moreover for split graphs it only requires polynomial space. In order to develop an algorithm for maximal split (edge-)subgraphs, we establish a bijection between the maximal split subgraphs and the maximal independent sets of an auxiliary graph. For cographs and some subclasses , the algorithms rely on a framework recently introduced by Conte & Uno called Proximity Search. Finally we consider the extension problem, which consists in deciding if there exists a maximal induced subgraph satisfying a property $\Pi$ that contains a set of prescribed vertices and that avoids another set of vertices. We show that this problem is NP-complete for every "interesting" hereditary property $\Pi$. We extend the hardness result to some specific edge version of the extension problem

Barreiras e facilitadores percebidos por pessoas com transtorno bipolar para a prática de exercício físico : um estudo qualitativo

Introduction: Exercising regularly has benefits for people with bipolar disorder. Nevertheless, as a group, these patients tend to be less physically active than the general population and little is known from the viewpoint of the patients about the barriers and facilitators to such a practice. Objective: To know the barriers and facilitators perceived by people with bipolar disorder for the practice of exercise. Methods: This study had a descriptive, qualitative, exploratory nature. The investigation method used for data collection was a semi-structured in-depth interview, using grounded theory as theoretical framework. Results: The data analysis generated two main areas of interest: adherence to regular physical exercise (barriers and facilitators) and the participants’ exercise history and perception of disease management, as described below. The main findings were: most of our sample did not exercise regularly, nor knew how exercise can positively influence their disorder; with regard to adherence to physical exercise, the presence of symptoms and stigma were the most important barriers to the practice of physical exercise. Social support, especially from family and friends, could be a facilitator to the practice of exercise. Conclusions: Even considering the limitations for generalization of qualitative and exploratory studies, understanding perceived barriers and facilitators for the practice of exercise among people who suffer with bipolar disorder may contribute to the promotion of activities in which people with mental illness can participate.Introdução: A prática regular de exercício físico tem benefícios para pessoas com transtorno bipolar. No entanto, como grupo, esses pacientes tendem a ser mais sedentários do que a população geral, e pouco se sabe do ponto de vista dos pacientes sobre as barreiras e facilitadores para tal prática. Objetivo: Conhecer as barreiras e facilitadores percebidos por pessoas com transtorno bipolar para a prática de exercício. Métodos: Este foi um estudo descritivo, qualitativo e exploratório. O método de investigação utilizado na coleta de dados foi entrevista semiestruturada em profundidade, segundo a grounded theory. Resultados: A análise dos conteúdos que surgiram nas entrevistas gerou duas principais áreas de interesse: adesão ao exercício físico regular (barreiras e facilitadores) e a história de exercícios dos participantes e a percepção do manejo da doença. Os principais achados foram: a maioria da nossa amostra não se exercitava regularmente, nem mesmo sabia como a prática regular podia influenciar positivamente sua doença; em relação à adesão ao exercício físico, a presença dos sintomas e do estigma foram as barreiras mais importantes para praticar o exercício físico. O apoio social, especialmente da família e dos amigos, pode ser um facilitador da adesão ao exercício. Conclusões: Apesar das limitações de um estudo qualitativo e exploratório, conhecer as barreiras e os facilitadores percebidos para a prática de exercício entre pessoas que sofrem de transtorno bipolar pode facilitar a promoção de atividades onde essas pessoas possam participar e se beneficiar efetivamente

El derecho a la sanidad de los inmigrantes en la Comunidad Valenciana: una propuesta de mejora

[ES] El 20 de abril de 2012 se aprobaba una reforma sanitaria que rompería por completo con los principios de universalidad y gratuidad que caracterizaban al Sistema Nacional de Salud: el Real Decreto-Ley 16/2012. Se modificaba de esta manera la legislación sanitaria y de extranjería existente hasta entonces, al limitar la titularidad del derecho a la salud a la condición de asegurado, dejando sin cobertura sanitaria a los inmigrantes en situación administrativa irregular. El fundamento al que se hace referencia para explicar el porqué de esta reforma es la insostenibilidad del SNS debido al denominado “turismo sanitario”. En este trabajo se pretende analizar dicha reforma bajo la normativa internacional ratificada por España, para que de este modo se pueda evidenciar la gran vulneración que el RDL está teniendo sobre el derecho a la salud.Pino Lucas, CA. (2015). EL DERECHO A LA SANIDAD DE LOS INMIGRANTES EN LA COMUNIDAD VALENCIANA: UNA PROPUESTA DE MEJORA. http://hdl.handle.net/10251/55363.TFG