The decline and rise of neighbourhoods: the importance of neighbourhood governance

There is a substantial literature on the explanation of neighbourhood change. Most of this literature concentrates on identifying factors and developments behind processes of decline. This paper reviews the literature, focusing on the identification of patterns of neighbourhood change, and argues that the concept of neighbourhood governance is a missing link in attempts to explain these patterns. Including neighbourhood governance in the explanations of neighbourhood change and decline will produce better explanatory models and, finally, a better view about what is actually steering neighbourhood change

Experience of a Preventive Experiment : Spatial Social Mixing in Post-World War II Housing Estates in Helsinki, Finland

The contingent of large housing estates built in the 1960s and 1970s accounts for almost a half of all high-rises in Finland. The primary ideology in their genesis was to combine industrially prefabricated urban housing development with the surrounding forest landscape—together with a policy of spatial social mixing—to prevent social disorder and segregation. These policies seemed to work as intended until the early 1990s, but have since proved to be insufficient. With Western integration and new information and communication-based economic growth, new trends of population differentiation have emerged. As new wealth has moved out to the fringes of cities, the large housing estates have declined socio-economically—and have been enriched ethnically. This differentiation is structurally produced, works through the regional housing market and, as such, is beyond the scope of the preventive policies pursued. Recent attempts at controlling the regional markets and new forms of spatial social mixing have so far proved difficult.The contingent of large housing estates built in the 1960s and 1970s accounts for almost a half of all high-rises in Finland. The primary ideology in their genesis was to combine industrially prefabricated urban housing development with the surrounding forest landscape—together with a policy of spatial social mixing—to prevent social disorder and segregation. These policies seemed to work as intended until the early 1990s, but have since proved to be insufficient. With Western integration and new information and communication-based economic growth, new trends of population differentiation have emerged. As new wealth has moved out to the fringes of cities, the large housing estates have declined socio-economically—and have been enriched ethnically. This differentiation is structurally produced, works through the regional housing market and, as such, is beyond the scope of the preventive policies pursued. Recent attempts at controlling the regional markets and new forms of spatial social mixing have so far proved difficult.Peer reviewe

Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016.

BackgroundThe assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common.AimWe assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data.MethodsUsing CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition.ResultsBetween 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34-59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87-95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21-37) among those 1-5 years prior. Younger age at arrival was a predictor: 15-18 years (81%; IQR: 74-86), 19-25 years (53%; IQR: 45-63), 26-35 years (37%; IQR: 30-46) and 36 years and older (25%; IQR: 21-33).ConclusionsMigrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities

Versterken van de positie van de school in de regio

Samen met studenten werken aan een betere toekomst voor de regio. Dat is regioleren. Ondernemers, overheden en maatschappelijke organisaties bepalen de agenda en werken samen met onderwijs en onderzoek aan oplossingen. Waar liggen de uitdagingen? Voor de instellingen is het een belangrijke uitdaging om aansluiting te vinden bij de regio. Hoe verander je van een onderwijsinstelling in een regionaal kenniscentrum? Hoe wordt je een volwaardige partner in een kenniswerkplaats? Een tweede belangrijke uitdaging ligt in de koppeling van het leren in de regio aan de lerende regio. In het programma Regionale Transitie is deze taak bij de kenniswerkplaatsen gelegd. De kenniswerkplaats is gebaseerd op een gezamenlijke regionale kennisagenda van overheid, ondernemers, maatschappelijke organisaties, onderwijs en onderzoek

The HIV continuum of care in European Union countries in 2013: data and challenges

BACKGROUND: UNAIDS has set a 90-90-90 target to curb the HIV epidemic by 2020, but methods used to assess whether countries have reached this target are not standardised, hindering comparisons. METHODS: Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardised, four-stage continuum of HIV care for 11 European Union (EU) countries for 2013. Stages were defined as: 1) number of people living with HIV (PLHIV) in the country by end of 2013; 2) proportion of stage 1 ever diagnosed; 3) proportion of stage 2 ever initiated ART; and 4) proportion of stage 3 who became virally-suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. RESULTS: In 2013, 674,500 people in the 11 countries were estimated to be living with HIV, ranging from 5,500 to 153,400 in each country. Overall HIV prevalence was 0.22% (range 0.09%-0.36%). Overall proportions, of each previous stage, were 84% diagnosed, 84% on ART, and 85% virally-suppressed (60% of PLHIV). Two countries achieved ≥90% for all stages, and over half had reached ≥90% for at least one stage. CONCLUSIONS: EU countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting further efforts are needed to improve HIV testing rates. Standardising methods to derive comparable continuums of care remains a challenge

Functional Interactions between KCNE1 C-Terminus and the KCNQ1 Channel

The KCNE1 gene product (minK protein) associates with the cardiac KvLQT1 potassium channel (encoded by KCNQ1) to create the cardiac slowly activating delayed rectifier, IKs. Mutations throughout both genes are linked to the hereditary cardiac arrhythmias in the Long QT Syndrome (LQTS). KCNE1 exerts its specific regulation of KCNQ1 activation via interactions between membrane-spanning segments of the two proteins. Less detailed attention has been focused on the role of the KCNE1 C-terminus in regulating channel behavior. We analyzed the effects of an LQT5 point mutation (D76N) and the truncation of the entire C-terminus (Δ70) on channel regulation, assembly and interaction. Both mutations significantly shifted voltage dependence of activation in the depolarizing direction and decreased IKs current density. They also accelerated rates of channel deactivation but notably, did not affect activation kinetics. Truncation of the C-terminus reduced the apparent affinity of KCNE1 for KCNQ1, resulting in impaired channel formation and presentation of KCNQ1/KCNE1 complexes to the surface. Complete saturation of KCNQ1 channels with KCNE1-Δ70 could be achieved by relative over-expression of the KCNE subunit. Rate-dependent facilitation of K+ conductance, a key property of IKs that enables action potential shortening at higher heart rates, was defective for both KCNE1 C-terminal mutations, and may contribute to the clinical phenotype of arrhythmias triggered by heart rate elevations during exercise in LQTS mutations. These results support several roles for KCNE1 C-terminus interaction with KCNQ1: regulation of channel assembly, open-state destabilization, and kinetics of channel deactivation