Cancer survival in the elderly: Effects of socio-economic factors and health care system features (ELDCARE project)

The purpose of the ELDCARE project is to study differences in cancer survival for elderly patients by country, taking into account the socio-economic conditions and the characteristics of health care systems at the ecological level. Fifty-three European cancer registries, from 19 countries, participating in the EUROCARE 3 programme, collected information to compute relative survival on patients aged 65-84 years, diagnosed over the period 1990-1994. National statistics offices provided the macro-economic and labour force indicators (gross domestic product, total health expenditure, and proportion of people employed in the agriculture sector) as well as the features of national health care systems. Survival for several of the cancer sites had high positive Pearson's correlations (r) with the affluence indicators (usually r > 0.7), but survival for the poor prognosis cancers (lung, ovary, stomach) and for cervix uteri was not so well correlated. Among the medical resources considered, the number of computed tomography scanners was the variable most related to survival in the elderly; the number of total health practitioners in the country did not show any relationship. Survival was related to the marital status of elderly women more strongly than for men and younger people. The highest correlations of survival with the percentage of married elderly women in the population were for cancers of the rectum (r = 0.79) and breast (r = 0.66), while survival correlated negatively with the proportion of widows for most cancers. Being married or widowed is for elderly people, in particular elderly women, an important factor influencing psychological status, life habits and social relationships. Social conditions could play a major role in determining health outcomes, particularly in the elderly, by affecting access to health care and delay in diagnosis

Lisbon: From the Nineteenth Century Capital City to the Metropolis

The aim of this article is the study of Lisbon from the time its legal boundaries were enlarged in 1903, until the creation of the Lisbon Metropolitan area in August 1991. The making of urban population is the subject of the second part of this text. In this part we emphasise the regional origins of the majority of the Lisbon population. Only in the 1970-ties the immigration of sub-Sahara Africans became of some significance. The transport networks and the lack of control of the urban expansion in a context of poor public investment are the subject of the third part

The Changing Face of European Ports as a Result of their evolving Use since the Nineteenth Century

The aim of this article is to make a comparative study of the history of European ports during the last two centuries showing their complexity and specific characteristics. Whereas during the process of waterfront development, local governments emphasize the relationship of ports with sailing ships as a marketing instrument, the industrial history of those ports are mostly neglected. This article focuses on the industrial port, showing differences in the chronology of construction and in their urban impact. Hinterland and inland transportation were responsible for a part of those differences, as well as geographical and political circumstances. However, social aspects as well as technological issues showed comparable evolutions. The decline of the industrial port city is a part of the general process of de-industrialization of Europe, but it has its own specific features. At least it is clear that the development of port cities during the last two centuries is far more complex than some stage theories about port development assume