As a consequence of the rapid economic growth in recent decades, Asia and the Pacific have experienced an impressive reduction in extreme poverty, when measured at the conventional $1.25/day/person poverty line. Whereas in 1981, 1.59 billion Asians were poor (corresponding to a poverty rate of 69.8 percent), in 1990 the number of poor in Asia had fallen to 1.48 billion (a 54.7 percent poverty rate). In fact, by 2005, Asia had succeeded in halving its extreme poverty because its 26.9 percent poverty rate was already less than half the 1990 level and, by 2010, the extreme poverty rate reduced further to 20.7 percent.
The publication highlights successful projects that demonstrate development impact, best practices, and innovation. They were implemented through the hard work of ADB's developing member countries in partnership with ADB project teams and other partners. The results of these projects have changed and will continue to change the lives of people in Asia and the Pacific. Together We Deliver is jointly produced by ADB and its developing member countries as a companion publication to the 2015 Development Effectiveness Review report.
Sri Lanka's performance in poverty reduction over the years has been commendable, with the poverty headcount ratio falling to 6.7% in 2012/13 and successfully achieving the MDG of halving poverty before the deadline. The reduction in poverty should ideally lead to a decrease in expenditure on the poor. However, this has not been the case for Sri Lanka. Government expenditure related to poverty and vulnerability has shown a remarkable increase in recent years. A closer inspection of the existing government poverty and vulnerability initiatives shows that there are many inherent inefficiencies leading to the ineffective implementation of programmes. This policy insight focuses on possible improvement in cost-efficiency of current poverty reduction programmes -- primarily, the Divineguma programme as it is the single largest -- while lessening their fiscal burden and explores the potential of mobilizing private sector participation as a complementary measure of financing poverty reduction.
It is commonly believed that mandating higher legal minimum wages (LMWs) is needed to help the poor earn a level of income that would allow them healthy and dignified lives. It is also seen as a tool to protect the weak against exploitation. This popular belief motivates and justifies the recurrent demands for hefty increases in LMW. But what is the empirical evidence behind this? This article seeks to address this question. It finds that in the Philippines, higher LMWs: (i) are likely to reduce the work hours of average workers; (ii) can be disadvantageous against the very groups that LMWs are intended to protect; (iii) decrease the employment probability of the young, inexperienced, less educated and women laborers; and (iv) tends to ironically reduce average income and raise household poverty rate. These results illustrate how rapid rises in LMWs can be counter-productive and can go against the spirit of equal protection principle of the Constitution. If the goal is to help the poor and protect the weak, then these findings warrant the need to think more deeply and prudently about the use of LMWs and to consider other tools for achieving decent wages.
[Abstract] The alkaline comet assay, or single cell gel electrophoresis, is one of the most popular methods for assessing DNA damage in human population. One of the open issues concerning this assay is the identification of those factors that can explain the large inter-individual and inter-laboratory variation. International collaborative initiatives such as the hCOMET project - a COST Action launched in 2016 - represent a valuable tool to meet this challenge. The aims of hCOMET were to establish reference values for the level of DNA damage in humans, to investigate the effect of host factors, lifestyle and exposure to genotoxic agents, and to compare different sources of assay variability. A database of 19,320 subjects was generated, pooling data from 105 studies run by 44 laboratories in 26 countries between 1999 and 2019. A mixed random effect log-linear model, in parallel with a classic meta-analysis, was applied to take into account the extensive heterogeneity of data, due to descriptor, specimen and protocol variability. As a result of this analysis interquartile intervals of DNA strand breaks (which includes alkali-labile sites) were reported for tail intensity, tail length, and tail moment (comet assay descriptors). A small variation by age was reported in some datasets, suggesting higher DNA damage in oldest age-classes, while no effect could be shown for sex or smoking habit, although the lack of data on heavy smokers has still to be considered. Finally, highly significant differences in DNA damage were found for most exposures investigated in specific studies. In conclusion, these data, which confirm that DNA damage measured by the comet assay is an excellent biomarker of exposure in several conditions, may contribute to improving the quality of study design and to the standardization of results of the comet assay in human populations. ; This article is based upon work from COST Action hCOMET CA15132, supported by COST (European Cooperation in Science and Technology www.cost.eu) - STSM fellowships for Mirta Milić (IMROH, EU 19); IMROH, Zagreb, Croatia, Institute for Medical Research and Occupational Health (IMROH), Zagreb, Croatia, and the Ministry of Science, Education and Sports of the Republic of Croatia (Grant No. 022-0222148-2125) (EU4); Cancer Plan for PestiBG; Grant number: no ENV201401(EU 8, EU9); Italian Ministry of Education, University and Research PRIN 2005, prot. 2005058197 and Cariplo Foundation (Milan, Italy), Rif. Pratica 2007-5810 and Rif. Pratica 2010.2303 (EU 18); Associazione Italiana per la Ricerca sul Cancro (AIRC) (IG 2015/17564). (EU19); European Union Integrated Projects New Generis, 6th Framework Programme, Priority 5: Food Quality and Safety; Newborns and Genotoxic Exposure Risks, FOOD-CT-2005-016320 (EU22); ACT project No. 036APy/09 and No. 005DBB/12 (EU 24); FCT-SFRH/BPD/96196/2013, SFRH/BPD/100948/2014, Portugal (EU 26); MZ 2012/8-UKBA-8; VEGA 1/0703/13, APVV 15-0063 (EU30); Xunta de Galicia (XUGA 10605B98; INCITE08PXIB106155PR; ED481B2016/190-0; Grants ED431B2019/02), Spain (EU 32); Grant 01 173034, Ministry of Education, Science and Technological Development of the Republic of Serbia (EU 42); The Centre for Industrial and Technological Development within National Strategic Consortia for Techical Research (Industrial Research diets and food with specific characteristics for elderly, SENIFOOD); University of Navarra LE/97; Physiopathology of Obesity and Nutrition (CIBER Obn); Carlos III Health Research Institute (CB12/03/30002); Ministerio de Economia y Compatitividad ('Ramón y Cajal' Programme, RYC-2013-14370) of the Spanish Government for personal support (EU 45); the Ministry of Education, Youth and Sports of the Czech Republic project Healthy Aging in Industrial Environment HAIE (CZ.02.1.01/0.0/0.0/16_019/0000798) which is co-financed by the European Union (European Structural and Investment funds; Operation Programme Research, Development and Education); MYES LO 1508 (EU 46); MICRODIAB Study; ClinicalTrials.org (#NCT02231736) (EU 52); The study was funded by the Italian Ministry for Education, University and Scientific Research (MIUR) - Research No. 2005-062547 (EU14, EU53); Projects financed from Serbian Ministry of Education, Science and Technological Development #11146002, #175035, #173034 (EU 54); Mehr foundation organisation, UK (EU 55); MCTI/CNPQ No. 01/2016-Universal; FAPESC No. 09/2015; MEC/MCTI/CAPES/CNPQ/FAPS/ No. 09/2014, Brazil (CSA 6); the National Nuclear Energy Agency of Indonesia (Badan Tenaga Nuklir Nasional) with contract number 080.01.06 3447.001 001.052.A (AS4); Slovak Grant Agency (APVT-21 013202, APVT-21- 017704); Ministry of Health, Slovak Republic (2005/43-SZU-21, 2006/07- SZU-02 MZ SR, 2005/42-SZU-20
Alzheimer's Disease Neuroimaging Initiative. ; [Importance] Plasma phosphorylated tau at threonine 181 (p-tau181) has been proposed as an easily accessible biomarker for the detection of Alzheimer disease (AD) pathology, but its ability to monitor disease progression in AD remains unclear. ; [Objective] To study the potential of longitudinal plasma p-tau181 measures for assessing neurodegeneration progression and cognitive decline in AD in comparison to plasma neurofilament light chain (NfL), a disease-nonspecific marker of neuronal injury. ; [Design, Setting, and Participants] This longitudinal cohort study included data from the Alzheimer's Disease Neuroimaging Initiative from February 1, 2007, to June 6, 2016. Follow-up blood sampling was performed for up to 8 years. Plasma p-tau181 measurements were performed in 2020. This was a multicentric observational study of 1113 participants, including cognitively unimpaired participants as well as patients with cognitive impairment (mild cognitive impairment and AD dementia). Participants were eligible for inclusion if they had available plasma p-tau181 and NfL measurements and at least 1 fluorine-18–labeled fluorodeoxyglucose (FDG) positron emission tomography (PET) or structural magnetic resonance imaging scan performed at the same study visit. Exclusion criteria included any significant neurologic disorder other than suspected AD; presence of infection, infarction, or multiple lacunes as detected by magnetic resonance imaging; and any significant systemic condition that could lead to difficulty complying with the protocol. ; [Exposures] Plasma p-tau181 and NfL measured with single-molecule array technology. ; [Main Outcomes and Measures] Longitudinal imaging markers of neurodegeneration (FDG PET and structural magnetic resonance imaging) and cognitive test scores (Preclinical Alzheimer Cognitive Composite and Alzheimer Disease Assessment Scale–Cognitive Subscale with 13 tasks). Data were analyzed from June 20 to August 15, 2020. ; [Results] Of the 1113 participants (mean [SD] age, 74.0 [7.6] years; 600 men [53.9%]; 992 non-Hispanic White participants [89.1%]), a total of 378 individuals (34.0%) were cognitively unimpaired (CU) and 735 participants (66.0%) were cognitively impaired (CImp). Of the CImp group, 537 (73.1%) had mild cognitive impairment, and 198 (26.9%) had AD dementia. Longitudinal changes of plasma p-tau181 were associated with cognitive decline (CU: r = –0.24, P < .001; CImp: r = 0.34, P < .001) and a prospective decrease in glucose metabolism (CU: r = –0.05, P = .48; CImp: r = –0.27, P < .001) and gray matter volume (CU: r = –0.19, P < .001; CImp: r = –0.31, P < .001) in highly AD-characteristic brain regions. These associations were restricted to amyloid-β–positive individuals. Both plasma p-tau181 and NfL were independently associated with cognition and neurodegeneration in brain regions typically affected in AD. However, NfL was also associated with neurodegeneration in brain regions exceeding this AD-typical spatial pattern in amyloid-β–negative participants. Mediation analyses found that approximately 25% to 45% of plasma p-tau181 outcomes on cognition measures were mediated by the neuroimaging-derived markers of neurodegeneration, suggesting links between plasma p-tau181 and cognition independent of these measures. ; [Conclusions and Relevance] Study findings suggest that plasma p-tau181 was an accessible and scalable marker for predicting and monitoring neurodegeneration and cognitive decline and was, unlike plasma NfL, AD specific. The study findings suggest implications for the use of plasma biomarkers as measures to monitor AD progression in clinical practice and treatment trials. ; This work was supported by the "Miguel Servet" program grant CP19/00031 of the Spanish Instituto de Salud Carlos III (Dr Grothe); research fellowship A202f0812F from the Brightfocus Foundation, grant AF-930627 from the Swedish Alzheimer Foundation, grant FO2020-0240 from the Swedish Brain Foundation, grant 2020-00124 from the Agneta Prytz-Folkes & Gösta Folkes Foundation, and support from the Swedish Dementia Foundation, the Aina (Ann) Wallströms and Mary-Ann Sjöbloms Foundation, the Anna Lisa and Brother Björnsson's Foundation, Gamla Tjänarinnor, and the Gun and Bertil Stohnes Foundation (Dr Karikari); the Paulo Foundation and the Orion Research Foundation (Dr Snellman); grant 752310 from the European Union's Horizon 2020 Research and Innovation Program under the Marie Skłodowska-Curie action grant agreement, grant PI19/00155 from the Instituto de Salud Carlos III, and grant IJC2018-037478-I from the Spanish Ministry of Science, Innovation and Universities (Juan de la Cierva Programme) (Dr Suárez-Calvet); grant 2018-02532 from the Swedish Research Council, 681712 from the European Research Council, ALFGBG-720931 from the Swedish State Support for Clinical Research, 201809-2016862 from the Alzheimer Drug Discovery Foundation USA, and the UK Dementia Research Institute at University College London (Dr Zetterberg); grant 2017-00915 from the Swedish Research Council, RDAPB-201809-2016615 from the Alzheimer Drug Discovery Foundation USA, AF-742881 from the Swedish Alzheimer Foundation, FO2017-0243 from Hjärnfonden, Sweden, the Swedish state under the agreement between the Swedish government and the County Councils, ALFGBG-715986 from the ALF-agreement, and JPND2019-466-236 from the European Union Joint Program for Neurodegenerative Disorders (Dr Blennow); KAW 2014.0363 from the Knut and Alice Wallenberg Foundation (Wallenberg Centre for Molecular and Translational Medicine, 2017-02869 from the Swedish Research Council, ALFGBG-813971 from the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement, and AF-740191 from the Swedish Alzheimer Foundation (Dr. Schöll). Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (grant AG024904) and Department of Defense ADNI (grant W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc; Cogstate; Eisai Inc; Elan Pharmaceuticals, Inc; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc; Fujirebio; GE Healthcare; IXICO Ltd; Janssen Alzheimer Immunotherapy Research & Development, LLC; Johnson & Johnson Pharmaceutical Research & Development LLC; Lumosity; Lundbeck; Merck & Co, Inc; Meso Scale Diagnostics, LLC; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Therapeutic Research Institute at the University of Southern California. ; Peer reviewed
Article Details: Received: 2019-08-21 | Accepted: 2019-10-10 | Available online: 2019-12-31https://doi.org/10.15414/afz.2019.22.04.124-129The aim of the experiment was to evaluate the technological meat quality of the breed White Mangalitsa through the pH, electric conductivity, drip loss and meat color parameters. Totally, 20 pigs of the breed White Mangalitsa (10 barrows and 10 gilts) were evaluated. Pigs were bred under the intensive breeding conditions. The animals were fed ad libitum using a complete feed compound with the added silage. Pigs were slaughtered upon reaching 110 kg of live weight. The muscles of MLD (Musculus longissimus dorsi) and MSM (Musculus semimembranosus) were evaluated. The meat quality analysis showed that pH1 was similar between the muscles. The evidently lower pH2 value was in MLD (P <0.01). The EC1 value (P <0.01) was significantly higher in the MSM muscle. The EC2 values in MLD and MSM were similar. Between the muscles, an evidentiary difference was observed in water drip loss (P <0.01), higher losses were recorded in MLD. In the SCI a* and SCI b* values, which express the redness and yellowness of the meat, the values in MSM were higher. The lightness of the meat (SCI L*) was the same in both muscles. The differences between the sexes in the observed qualitative parameters were not detected.ReferencesBEDNÁŘOVÁ, M. et al. (2014) Monitoring of color and pH in muscles of pork leg (M. adductor and M. semimembranosus). In Potravinarstvo Slovak Journal of Food Sciences, vol. 8, no. 11, pp. 48–53. doi: https://doi.org/10.5219/337EGERSZEGI, I. et al. (2003) Mangalica – an indigenous swine breed from Hungary: Review. In Archives Animal Breeding, vol. 46, no. 3, pp. 245–256. doi: https://doi.org/10.5194/aab-46-245-2003ENDER, K. et al. (2002) Fleisch und Fett von MangalitzaSchweinen im Labor. In Fleischwirtschaft, vol. 82, no. 6, pp. 125–128.FLEGLER, J. (2015) Das Wollschwein. 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BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. ; Funding: We thank the countless individuals who have contributed to the Global Burden of Disease (GBD) Study 2015 in various capacities. We specifically thank Jeffrey Eaton and John Stover. HW and CJLM received funding for this study from the Bill & Melinda Gates Foundation; the National Institute of Mental Health, National Institutes of Health (NIH; R01MH110163); and the National Institute on Aging, NIH (P30AG047845). LJAR acknowledges the support of Qatar National Research Fund (NPRP 04-924-3-251) who provided the main funding for generating the data provided to the GBD-Institute for Health Metrics and Evaluation effort. BPAQ acknowledges institutional support from PRONABEC (National Program of Scholarship and Educational Loan), provided by the Peruvian government. DB is supported by the Bill & Melinda Gates Foundation (grant number OPP1068048). JDN was supported in his contribution to this work by a Fellowship from Fundacao para a Ciencia e a Tecnologia, Portugal (SFRH/BPD/92934/2013). KD is supported by a Wellcome Trust Fellowship in Public Health and Tropical Medicine (grant number 099876). TF received financial support from the Swiss National Science Foundation (SNSF; project number P300P3-154634). AG acknowledges funding from Sistema Nacional de Investigadores de Panama-SNI. PJ is supported by Wellcome Trust-DBT India Alliance Clinical and Public Health Intermediate Fellowship. MK receives research support from the Academy of Finland, the Swedish Research Council, Alzheimerfonden, Alzheimer's Research & Prevention Foundation, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, AXA Research Fund, Wallenberg Clinical Scholars Award from the Knut och Alice Wallenbergs Foundation, and the Sheika Salama Bint Hamdan Al Nahyan Foundation. AK's work was supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R&D&I and funded by the ISCIII (General Branch Evaluation and Promotion of Health Research), and the European Regional Development Fund (ERDF-FEDER). SML is funded by a National Institute for Health Research (NIHR) Clinician Scientist Fellowship (grant number NIHR/CS/010/014). HJL reports grants from the NIHR, EU Innovative Medicines Initiative, Centre for Strategic & International Studies, and WHO. WM is Program analyst, Population and Development, in the Peru Country Office of the United Nations Population Fund, which does not necessarily endorse this study. For UOM, funding from the German National Cohort Consortium (O1ER1511D) is gratefully acknowledged. KR reports grants from NIHR Oxford Biomedical Research Centre, NIHR Career Development Fellowship, and Oxford Martin School during the conduct of the study. GR acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group supported by the International Society of Nephrology (ISN). ISS reports grants from FAPESP (Brazilian public agency). RSS receives institutional support from Universidad de Ciencias Aplicadas y Ambientales, UDCA, Bogota Colombia. SS receives postdoctoral funding from the Fonds de la recherche en sante du Quebec (FRSQ), including its renewal. RTS was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI14/00894 from ISCIII-FEDER. PY acknowledges support from Strategic Public Policy Research (HKU7003-SPPR-12).
The tourism sector has been central to development of the Spanish coastal economies. However, due to the negative impact that this activity has had on coastal ecosystems, aging infrastructure, and overexploitation of natural resources, coastal tourist destination mature (OTCM) have a growing loss of competitiveness. Thus, it is now essential to develop new and innovative methods of analysis and management, in addition to providing a conceptual development can be concretized in technical and operational tools. These tools should be part of urban renewal plans, and must be able to respond to the requirements for the development and management of tourism in the territory, offering new ways of working relationships between tourism, land and environment (KO, 2003). An analysis of some of the processes documented in the Mediterranean coast, it follows that the success of the process of rejuvenation in the destinations usually responds to existence, as an instrument of fundament al political intervention of a shared vision for the destination, which is translated into a specific model of territorial action. That is, the existence of a specific, functional and operative deficit urban model. In response to this finding, the instruments of territorial policy and urban management are key to the rejuvenation of the destination (Trinitat & Clave, 2014). The differential nature of the tourist development is to be incorporated into the instruments of territorial policy and urban management, to address the particular problems of these urban-tourism systems. These tools are essential to reformulate the destination, while not only urbanized space but capable of urban nature (Trinitat & Clave, 2014). The urban nature of the destinations is included conceptually within the postmodern discourse because spaces are eminently consumer and not linked to large production, trade or governmental administration (Mullins, 1991). Therefore, tourism developments have yet to find their own tools s lope urban policy. The analysis of the historical trajectory of target-Costa Canaria Maspalomas has been useful to understand the situation of success, consolidation and decline in the present moment, and has been a key factor in understanding the complexity of the phenomenon and provides guidelines for projection, both at present and in the future, strategies for action and transformation of its tourism model. These phases or periods distinguish a first initial moment, linked to tourism exclusively, which is replaced by the so-called modern era of tourism, which is when the holiday model of sun and beach stands as the paradigm that gives greater identity the destination. Overcoming, in a third time, this time involves the emergence of a new dynamic which, while definitely consolidate the model involving obsolescence and search for new alternatives, both territorial regeneration and positive impact on the sector economic tourism. Tourism policies implemented collide with highly regulated planning system, which implies the following result: reduced restricting creativity and entrepreneurship. This hinders the proper coordination of supply and demand in tourist areas, leading to freeze them and prevented its regeneration and adaptation to new needs, causing a major distortion between supply and demand. For these reasons, a simpler system more flexible urban planning and procedural, with fewer loads, and execution of the same volunteer is needed ; El sector turístico ha sido capital para el desarrollo de las economías litorales españolas. Sin embargo, debido al impacto negativo que el desarrollo de esta actividad ha tenido en los ecosistemas litorales, al envejecimiento de las infraestructuras, y a la sobreexplotación de los recursos naturales, los destinos turísticos costeros maduros (DTCM) presentan una pérdida de competitividad creciente. Es así, que se hace ahora esencial desarrollar nuevas e innovadoras metodologías de análisis y gestión, que además de aportar un desarrollo conceptual puedan ser concretadas en técnicas y herramientas operativas. Estas herramientas deben formar parte de los planes de reforma urbana, y han de ser capaces de dar respuesta a los requerimientos para el desarrollo y la gestión del turismo en el territorio, ofreciendo nuevas vías de trabajo en las relaciones entre turismo, territorio y medio ambiente (KO, 2003). Del análisis de algunos de los procesos documentados en el litoral Mediterráneo, se deduce que, el éxito de los procesos de rejuvenecimiento en los destinos suele responder a la existencia, como instrumento de intervención política fundamental, de una visión compartida para el destino, que se traduzca en un modelo de acción territorial específico. Es decir, a la existencia de un modelo urbano específico, funcional y resolutivo de déficit. Atendiendo a esta constatación, los instrumentos de política territorial y de gestión urbana son claves para el rejuvenecimiento del destino (Trinitat & Clavé, 20 14). El carácter diferencial de la urbanización turística ha de ser incorporado a los instrumentos de política territorial y de gestión urbana, para dar respuesta a las problemáticas particulares de estos sistemas urbanos-turísticos. Estos instrumentos son fundamentales para la reformulación del destino, en tanto que espacio no solamente urbanizado sino capaces de naturaleza urbana (Trinitat & Clavé, 2014). La naturaleza urbana de los destinos se engloba conceptualmente dentro del discurso postmodernista, ya que son espacios eminentemente de consumo y no vinculados a grandes centros de producción, comercio o administración gubernamental (Mullins, 199 1). Por tal motivo, las urbanizaciones turísticas aún tienen pendiente encontrar sus propias herramientas de política urbana. El análisis de la trayectoria histórica del destino Maspalomas-Costa Canaria ha sido útil para entender su situación de éxito, consolidación y declive en el momento presente, y ha sido un factor clave para entender la complejidad del fenómeno, y dar pautas para la proyección, tanto en el presente como en el futuro, de estrategias de actuación y de transformación de su modelo turístico. Estas fases o épocas permiten distinguir un primer momento inicial, ligado a un turismo de carácter exclusivo, que es reemplazado por la denominada época moderna del turismo, que es cuando el modelo vacacional de sol y playa se erige como el paradigma que otorga una mayor identidad al destino. La superación, en un tercer momento, de esta época conlleva el surgimiento de unas nuevas dinámicas las cuales, a la vez que consolidan definitivamente el modelo entrañan su obsolescencia y la búsqueda de nuevas alternativas, tanto de regeneración territorial como de repercusión positiva en el sector económico del turismo. ; Postprint (published version)
The tourism sector has been central to development of the Spanish coastal economies. However, due to the negative impact that this activity has had on coastal ecosystems, aging infrastructure, and overexploitation of natural resources, coastal tourist destination mature (OTCM) have a growing loss of competitiveness. Thus, it is now essential to develop new and innovative methods of analysis and management, in addition to providing a conceptual development can be concretized in technical and operational tools. These tools should be part of urban renewal plans, and must be able to respond to the requirements for the development and management of tourism in the territory, offering new ways of working relationships between tourism, land and environment (KO, 2003). An analysis of some of the processes documented in the Mediterranean coast, it follows that the success of the process of rejuvenation in the destinations usually responds to existence, as an instrument of fundament al political intervention of a shared vision for the destination, which is translated into a specific model of territorial action. That is, the existence of a specific, functional and operative deficit urban model. In response to this finding, the instruments of territorial policy and urban management are key to the rejuvenation of the destination (Trinitat & Clave, 2014). The differential nature of the tourist development is to be incorporated into the instruments of territorial policy and urban management, to address the particular problems of these urban-tourism systems. These tools are essential to reformulate the destination, while not only urbanized space but capable of urban nature (Trinitat & Clave, 2014). The urban nature of the destinations is included conceptually within the postmodern discourse because spaces are eminently consumer and not linked to large production, trade or governmental administration (Mullins, 1991). Therefore, tourism developments have yet to find their own tools s lope urban policy. The analysis of the historical trajectory of target-Costa Canaria Maspalomas has been useful to understand the situation of success, consolidation and decline in the present moment, and has been a key factor in understanding the complexity of the phenomenon and provides guidelines for projection, both at present and in the future, strategies for action and transformation of its tourism model. These phases or periods distinguish a first initial moment, linked to tourism exclusively, which is replaced by the so-called modern era of tourism, which is when the holiday model of sun and beach stands as the paradigm that gives greater identity the destination. Overcoming, in a third time, this time involves the emergence of a new dynamic which, while definitely consolidate the model involving obsolescence and search for new alternatives, both territorial regeneration and positive impact on the sector economic tourism. Tourism policies implemented collide with highly regulated planning system, which implies the following result: reduced restricting creativity and entrepreneurship. This hinders the proper coordination of supply and demand in tourist areas, leading to freeze them and prevented its regeneration and adaptation to new needs, causing a major distortion between supply and demand. For these reasons, a simpler system more flexible urban planning and procedural, with fewer loads, and execution of the same volunteer is needed ; El sector turístico ha sido capital para el desarrollo de las economías litorales españolas. Sin embargo, debido al impacto negativo que el desarrollo de esta actividad ha tenido en los ecosistemas litorales, al envejecimiento de las infraestructuras, y a la sobreexplotación de los recursos naturales, los destinos turísticos costeros maduros (DTCM) presentan una pérdida de competitividad creciente. Es así, que se hace ahora esencial desarrollar nuevas e innovadoras metodologías de análisis y gestión, que además de aportar un desarrollo conceptual puedan ser concretadas en técnicas y herramientas operativas. Estas herramientas deben formar parte de los planes de reforma urbana, y han de ser capaces de dar respuesta a los requerimientos para el desarrollo y la gestión del turismo en el territorio, ofreciendo nuevas vías de trabajo en las relaciones entre turismo, territorio y medio ambiente (KO, 2003). Del análisis de algunos de los procesos documentados en el litoral Mediterráneo, se deduce que, el éxito de los procesos de rejuvenecimiento en los destinos suele responder a la existencia, como instrumento de intervención política fundamental, de una visión compartida para el destino, que se traduzca en un modelo de acción territorial específico. Es decir, a la existencia de un modelo urbano específico, funcional y resolutivo de déficit. Atendiendo a esta constatación, los instrumentos de política territorial y de gestión urbana son claves para el rejuvenecimiento del destino (Trinitat & Clavé, 20 14). El carácter diferencial de la urbanización turística ha de ser incorporado a los instrumentos de política territorial y de gestión urbana, para dar respuesta a las problemáticas particulares de estos sistemas urbanos-turísticos. Estos instrumentos son fundamentales para la reformulación del destino, en tanto que espacio no solamente urbanizado sino capaces de naturaleza urbana (Trinitat & Clavé, 2014). La naturaleza urbana de los destinos se engloba conceptualmente dentro del discurso postmodernista, ya que son espacios eminentemente de consumo y no vinculados a grandes centros de producción, comercio o administración gubernamental (Mullins, 199 1). Por tal motivo, las urbanizaciones turísticas aún tienen pendiente encontrar sus propias herramientas de política urbana. El análisis de la trayectoria histórica del destino Maspalomas-Costa Canaria ha sido útil para entender su situación de éxito, consolidación y declive en el momento presente, y ha sido un factor clave para entender la complejidad del fenómeno, y dar pautas para la proyección, tanto en el presente como en el futuro, de estrategias de actuación y de transformación de su modelo turístico. Estas fases o épocas permiten distinguir un primer momento inicial, ligado a un turismo de carácter exclusivo, que es reemplazado por la denominada época moderna del turismo, que es cuando el modelo vacacional de sol y playa se erige como el paradigma que otorga una mayor identidad al destino. La superación, en un tercer momento, de esta época conlleva el surgimiento de unas nuevas dinámicas las cuales, a la vez que consolidan definitivamente el modelo entrañan su obsolescencia y la búsqueda de nuevas alternativas, tanto de regeneración territorial como de repercusión positiva en el sector económico del turismo. ; Postprint (published version)
Η ποιότητα στον τομέα της υγείας έχει μελετηθεί σε μεγάλο βαθμό από την κλινική οπτική γωνία, αφήνοντας εκτός την αντίληψη του ασθενούς για την ποιότητα των παρεχόμενων υπηρεσιών. Η ικανοποίηση των ασθενών είναι πολύ σημαντική για τους ιατρικούς παρόχους, τους ίδιους τους ασθενείς (καταναλωτές) και για τρίτους ενδιαφερόμενους στον ιατρικό κλάδο της υγειονομικής περίθαλψης. Οι απόψεις των ασθενών υιοθετούνται ως μέρος της διαδικασίας παραγωγής ενός συστήματος διαχείρισης ποιότητας και η ικανοποίηση των χρηστών για να καθοριστεί η διάσταση της ποιότητας των παρεχόμενων υπηρεσιών. Η παρούσα διατριβή αποσκοπεί στην αξιολόγηση της ποιότητας του Ελληνικού Συστήματος Υγείας μέσω των προτιμήσεων των ίδιων των καταναλωτών του. Ανάμεσα σε άλλους παράγοντες, αρκετοί κοινωνικοοικονομικές παράμετροι λαμβάνονται υπόψη, όπως και αντίστοιχοι δημογραφικές, και χαράσσονται σχετικές πολιτικές. Το Κεφάλαιο 1 εισάγει το θέμα της ικανοποίησης των ασθενών και το συνδέει με την ποιότητα του συστήματος υγείας. Μέσω της βιβλιογραφικής ανασκόπησης αναδεικνύεται η σημασία του, οι παράγοντες που το επηρεάζουν και άλλες προσπάθειες ποσοτικοποίησης και μέτρησής του. Παρουσιάζονται, επίσης, τα κίνητρα για την παρούσα διατριβή, καθώς και τα προβλήματα και τα ερωτήματα μελέτης. Το Κεφάλαιο 2 μελετά το βαθμό ικανοποίησης των Ευρωπαίων πολιτών-ασθενών από την αποδοτικότητα και την ποιότητα του συστήματος υγείας της χώρας τους. Τα αποτελέσματα δείχνουν ότι περισσότεροι από τους μισούς Ευρωπαίους πολίτες είναι ικανοποιημένοι με το σύστημα υγείας της χώρας τους, με το επίπεδο αυτό να σχετίζεται θετικά με τις δημόσιες δαπάνες υγείας, τη γήρανση του πληθυσμού και τον αριθμό των νοσηλευτών-κλινών. Το Κεφάλαιο 3 εξετάζει την απόκλιση που παρατηρείται ανάμεσα στις προτιμήσεις των ασθενών για τη χρηματοδότηση του συστήματος υγείας και στην πραγματική δημόσια χρηματοδότησή του. Η απόκλιση που καταγράφεται ανάμεσα στην πραγματική δαπάνη σε σχέση με τις προτιμήσεις των ασθενών για την κατανομή των πόρων είναι μικρή. Οι προτιμήσεις αυτές φαίνεται να επηρεάζονται σε μεγάλο βαθμό από το επίπεδο εισοδήματος, τον αριθμό των μελών οικογένειας και τον τόπο κατοικίας. Το Κεφάλαιο 4 αναδεικνύει τη σημασία της ηλεκτρονικής παιδείας για τον τομέα της υγείας και μελετά το επίπεδο των Ελλήνων πολιτών. Οι Έλληνες έχουν χαμηλό επίπεδο ηλεκτρονικής παιδείας όσον αφορά στα θέματα υγείας. Το επίπεδο της σχετικής με τα ζητήματα υγείας ηλεκτρονικής παιδείας σχετίζεται θετικά με το επίπεδο εκπαίδευσης και με το βαθμό φυσικής άσκησης, ενώ αρνητικά σχετίζεται με την ηλικία. Το Κεφάλαιο 5 παρουσιάζει τη μελέτη περίπτωσης του Γενικού Νοσοκομείου «Κωνσταντοπούλειο». Τα δεδομένα συγκεντρώθηκαν από τον Ιούνιο του 2011 μέχρι τον Οκτώβριο του 2012 και αφορούν σε 745 νοσηλευόμενους ασθενείς (εσωτερικούς) και 420 ασθενείς που επισκέφτηκαν τα εξωτερικά ιατρεία (εξωτερικούς). Για την εκμαίευση του επιπέδου ικανοποίησης των ασθενών, μελετήθηκε η συσχέτιση της πρόθεσής τους να συστήσουν το νοσοκομείου σε άλλους με δημογραφικούς παράγοντες και παράγοντες που αφορούν στην αποτελεσματικότητα της παροχής υπηρεσιών υγείας. Τα αποτελέσματα δείχνουν ότι οι παράγοντες που σχετίζονται με τη λειτουργία του νοσοκομείου είναι οι πιο σημαντικοί για τη διαμόρφωση του επιπέδου ικανοποίησης των ασθενών. Από τους δημογραφικούς παράγοντες, η ηλικία των ασθενών είναι η μεταβλητή που παραμένει στατιστικά σημαντικά και για τις δύο ομάδες. Συνοπτικά, η ικανοποίηση των ασθενών σχετίζεται με τις εκροές του συστήματος υγείας, αλλά, επίσης, θεωρείται ως ένα εργαλείο για τη διεύρυνση των κοινωνιών ανισοτήτων. Για το λόγο αυτό, η αποτύπωση των παραγόντων που επηρεάζουν το επίπεδο την ικανοποίησης των ασθενών, λαμβάνοντας υπόψη διάφορα χαρακτηριστικά τους, είναι πολύ σημαντική. Η παρούσα διατριβή συμβάλει σε σημαντικά θέματα της διεθνούς βιβλιογραφίας, όπως για παράδειγμα την ενθάρρυνση της συμμετοχής των ασθενών μέσω πολιτικών ενδυνάμωσης της γνώσης τους, διευρύνοντας ακόμα περισσότερο τη δημοκρατική φύση της διαδικασίας λήψης αποφάσεων. ; Quality in healthcare has been studied largely from the clinical perspective, excluding the patient's perception of service quality. Patient satisfaction is a topic that is important both to medical (health) providers, the patients (consumers) and other third-party stakeholders in the medical care industry. Patients' opinions are taken as part of producing a quality management, and the users' satisfaction is taken to determine the service quality dimension. This dissertation aims to evaluate the quality of the Health System through the revealed preferences of its users. Among other factors, we take into account various socioeconomic factors and demographic parameters and derive relevant policy implications. Chapter 1 introduces the topic of patient's satisfaction, relates it with the quality of healthcare service. The literature review reveals its importance, the factors related to it and previous ways to quantify it and measure it. The research motivation factors along with the research problems and questions are also presented. Chapter 2 studies whether the European patients are satisfied with their country's healthcare system quality. The results demonstrate that more than half of the European patients are in general satisfied with their healthcare system. Public health expenditures as a percentage of GDP, population aging, as well as number of doctors and number of nurses increase patient satisfaction. Chapter 3 examines the deviation documented between patients' preferences with respect to healthcare resources allocation and actual public spending on health. There is a small deviation between citizens' preferences with respect to health resources allocation and actual public health spending, while income, number of family members and residence seem to greatly shape these preferences. Chapter 4 explores ehealth literacy as the ability in searching, analyzing, processing and comprehending information from the Internet in order to address or solve health related issues and reveals that the ehealth literacy level of Greek citizens is fair. The degree of ehealth literacy depends positively on education level and physical exercise, and negatively on the age of the participant. Chapter 5 examines the case study of Konstantopouleio General Hospital, providing evidence for the relationship between patient's satisfaction level and received services. The results demonstrate the important role of the attention received by the medical staff, nursing staff, and hospital's environment for both groups of in- and out-patients, while among the demographic factors, the perceived health status and age also play a significant role for the inpatients' satisfaction. The latter remains significant for out-patients, along with education and insurance. Overall, patient satisfaction is related to healthcare outcomes, but it is also considered to be a tool for disseminating social inequalities; therefore, lightening how several factors associate with patients' preferences, and in consequence with patient satisfaction, taking into consideration specific characteristics of users, is extremely important. This research contributes to important discussions in the literature, for instance, the encouragement of patients' participation by introducing policies of empowerment the knowledge dissemination along with the democratization of the decision making process.
Overseeing the Australian election campaign one could conclude that it truly was a battle to the very end, in which there was an unruly sense of tension and anticipation in the air as 14 million citizens were called to cast their compulsory vote on 21st of August, for the 27th Prime Minister of Australia. The true encounter held between the two traditional front running parties that possessed two flawed leaders.The ALP (Australian Labor Party) the centre left party, who held power from 2007- 2010, faced a recent internal crisis not seen since 1991, a party room coup. The previous Prime Minister Kevin Rudd sworn in, in 2007 was over thrown on the 23rd of June 2010 due to months of dramatic losses in public support and key factions required to sustain his leadership. Key decisions made by the leader such as the controversial resource super profits tax, the global emissions trading scheme, endless broken promises and extravagant spending, all contributed enormously in the decline of voter's approval towards the leader.Consequently this descending dissatisfaction caused severe instability within the party itself and resulted in communication of an internal leadership ballot that would be held by the Labor party caucus, forcing a choice to be made of whether to continue behind Rudd's reign as leader, or choose Deputy Prime Minister Julia Gillard as their representative. Rudd was beaten by a landslide and overnight Gillard replaced him, becoming the first female Prime Minister of Australia. She held this temporary role into the elections for eight weeks and three days while also holding the position of actual contender, representing the Labor Party for the honourable title. After this replacement she commented on various occasions that she could not truly consider herself Prime Minister until she was voted so democratically by the people.The LPA (Liberal Party of Australia) is the self proclaimed centre right party; who demonstrated far more stability as a whole during the campaign although its leader Tony Abbott was highly questioned. Abbott, a previous Minister for Employment Services, Minister for Employment and Workplace Relations & Minister for Health and Aging came to be leader of the Liberals in December of 2009. Voting took place between Malcolm Turnbull (ex Minister for Environment and Water Resource) and himself for the role, as the previous leader (ex Prime Minister John Howard) refused to go into another election. After Howard's departure and refusal to run for another election, Abbott won the previously mentioned internal elections by only one point and thus was chosen to lead the party into the 2010 elections.As the elections were called rather abruptly after the crumbling of the Labor Party, both parties were forced to present strong and structured strategies on their ideas for the growth and prosperity of the nation. The main issues on debate were climate change, economic management, taxation, population policy, asylum seekers, health, and the national broadband network.The Labor Party focused its agenda on "moving Australia forward" as their slogan stated by "talking to the Australian people in this campaign about how our nation can seize the opportunities of the future". Gillard and her team claimed this was possible through: a health reform, advancing the national health and hospital system; "a tax plan for our future" entailing the reinvestment of profits made in the commodities boom of non renewable resources; an enhanced superannuation plan; the creation of a national curriculum based on specific subjects and the building of "better regional cities".On the other hand, the coalition, apart from dictating their ideas on further productivity and positive changes for the country used scare tactics and the fact that Labour was unstable to their advantage. This worked to their benefit to a certain degree as many individuals were disappointed and confused with the decisions of the Labor Party. Leering closer to the election dates figures began to show that Gillard was mounting a strong campaign, and although coming in from behind she won many votes during the campaign. Labors transformation was working in its favour as it held a 42% approval rating as opposed to that of the Liberals a 38%. Gillard's personal approval rating was also many points higher than that of Abbotts, who has the lowest approval ratings since he became liberal leader. These percentages, when Gillard became contender, were entirely opposed as Labors change of leader was illustrated through a massive drop in support.On the 21st of August, voters headed to the polls but this was not even close to the end of this nail biting election. The results slowly began to illustrate that votes were tied as Labor possessed 73 seats and Liberal 72 of the 150 seats in the House of Representatives. No party held a majority (more than 76 seats) of which is required to guarantee a win. Labor needed to gain two votes and Liberal three from the independents in order to assure victory. This began a long and tedious negotiation period between the parties and the independents in order to certify their loyalty to either party that lasted weeks. It was the first hung elections in decades for the nation, as no party had majority over the opposition.Although voting is compulsory statistics post election showed that almost a million Australians decided not to vote and of those who did, around 730,000 chose to vote informally thus their vote was cancelled. Many questioned whether or not Gillard had made an error in deciding to set elections only five weeks after becoming the official candidate. Such prompt campaigns were not usual in Australian politics. Four vital independent votes were needed to reach the House of Representatives seats required. After 17 days of "political deadlock" the votes were locked, 76 for Labor and 74 for Liberal. The result: Julia Gillard was officially sworn in as the first female Prime Minister of Australia on the 14th of September.Gillard proudly stated after her win, "I have big ambitions for this country". During her first 100 days as Prime Minister she has re launched the climate change debate and is currently on her first international trip, attending the Asia-Europe Meeting in Brussels which is the first of four conferences the Prime Minister will be attending in the coming weeks where we will see her abilities on the international scene as leader.*Estudiante de la Licenciatura en Estudios Internacionales.FACS - ORT
Après vingt-cinq ans d'une croissance démographique exubérante, la Catalogne a connu un brusque changement: la nupcialité et la natalité sont tombées à près de la moitié du niveau de 1975 en l'espace de sis ans, alors que le solde migratoire, qui apportait près de 100.000 immigrants dans les bonnes annés de la decénie soixante est tombé à -17.000 en 1982. On est ainsi passé d'un acroissement annuel moyen de 2,5 % entre 1950 et 1975 (ce qui a provoqué un doublement de la population en vint-cinq ans, comme au Tiers Monde) à un acroissement de 0,15 %en 1982, c'est à dire, une sorte d' "accroissement zéro". En 1982, la Catalogne a gagné seulement 10.000 habitants; il sufirait donc d'une legère augmentation de l'émigration de retour, accompagnée d'une gripe comme celle de 1971 ou 1973 pour que le solde devienne négatif. La chute de la natalité a peut-être touché à sa fin et il se peut bien que les naissances se stabilisent à un niveau legèrement supérieur à l'actuel; néanmoins, cela ne sufira pas à faire augmenter sensiblement l'accroissement naturel, car le taux de mortalité risque très fort d'augmenter à cause de l'inévitable et rapide vieillissement de la population. En ce qui concerne la distribution de la population sur le territoire, on observe, d'un côté, le maintien de différences très accentuées, tant en ce qui touche le mouvement naturel comme le mouvement migratoire. De l'autre côté, il paraît que le processus de différentiation démographique se soit arrêté et tende même i s'invertir; en effet, les valeurs les plus élévés tendent à diminuer alors que les plus faibles augmentent. Il en resulte une continuation du phénomène de concentration territoriale observé depuis longue date, mais au relenti. Finalement. on signale que l'absence de croissance et la rareté des mouvements migratoires, ainsi que la présence d'une proportion inhabituellement élévée de ieunes de 15 a 25 ans. sont des conditions qui rendent souhaitable (et peut-être nécessaire) l'élaboration et l'application d'une politique de population territorialment orientée. ; After twenty-five years of exceptionally rapid population growth in Catalonia, a sudden change has occurred: marriage and birth rates have fallen to almost half the 1975 figures in the space of six years, while the net rates of migration fell from almost 100.000 immigrants per annum in the peak years of the sixties, to 17.000 in 1982. As a result, annual population increase dropped from an average of 2,25 % between 1950 and 1975 (which represented the doubling of population in twenty-five years, as in Third World countries) to 0,15 % in 1982 (which is practically stationary growth). In 1982, population increase in Catalonia amounted to a meagre total. of 10.000 inhabitants. Hence, a slight increase in return migratory movements to places of origin, or an influenza epidemic such as those which ocurred in 1971 and 1973 would be suficient to register negative growth rates. Birth rates have possibly reached an all-time minimum, and may well stabilize off at a slightly higher level than at present. Nevertheless, that would not be suficient to register a noteworthy recovery of net population increase, because of a probable increase in death rates due to the rapid and inevitable aging of the population. Also noteworthy is the continuing existence of considerable areal variations in both natural and migratory population growth rates within Catalonia. However, in the five year period between 1975 and 1981, not only do these demographic variations appear to have come to a standstill, but also there are symptoms of a tendency to converge. Certainly, the highest rates tend to diminish, and the lowest to increase. The long-established process of spatial concentration continues, but the pace has slackened. Finally, the coincidence of almost non-existent population growth and migration together with the remarkably large number of young people (between 15 and 25 years of age) make it advisable (and perhaps even necessary) to put a regionally oriented population policy into practice. ; La situació demogràfica a Catalunya ha capgirat bruscament a partir de l'any 1917, després de vint-i-cinc anys d'un creixement poblacional exuberant. La nupcialitat i la natalitat han caigut a prop de la meitat entre 1975 i 1982 i el saldo migratori, que fou de prop de 100.000 immigrants nets en els moments àlgids dels anys seixanta, ha caigut fins a la xifra de -17.000 l'any 1982. S'ha passat així d'un creixement anual mig del 2,25 %, entre 1950 i 1975, a un 0,15 % de creixement total l'any 1982; és a dir, que s'ha passat d'uns índexs de creixement més aviat propis del Tercer Món (duplicant la població cada vinti-cinc anys) a un nivell assimilable al tan polèmic acreixement zero. L'any 1982, l'increment total va ser de 10.000 persones; això és dir que, a qualsevol moment, en virtut d'un lleuger augment del retorn d'immigrants o d'una epidèmia gripal semblant a les de 1971 o 1973, el creixement total pot fer-se negatiu. No cal veure-ho com una catàstrofe però sí cal prendre consciència que ens trobem davant una situació d'estancament demogràfic amb tendència cap a la regressió. La natalitat pot molt bé haver tocat fons i estabilitzar-se a nivells lleugerament superiors als actuals, però això no afectarà gaire al creixement natural degut al probable augment de la taxa de mortalitat en els anys a venir, sota els efectes del progressiu envelliment de la població. Pel que fa a la distribució territorial de la població, s'observa, per una banda, el manteniment d'accentuades difertncies de creixement, tant natural com migratori; per altra banda, en el quinquenni 1975-1981 sembla haver-se trencat la tendència a la diferenciació, i s'observa una evolució de tipus convergent: els valors més elevats tendeixen a disminuir i els més reduïts a créixer. En resulta una continuació del procés de concentració territorial, però a un ritme molt més lent del que hauria resultat de la continuació de les tendències anteriors. Finalment, s'assenyala que la coincidència dels baixos indexs de creixement i mobilitat i del elevat nombre de joves crea les bases (i la necessitat) d'una política de població de caire territorial.
HapMap imputed genome-wide association studies (GWAS) have revealed >50 loci at which common variants with minor allele frequency >5% are associated with kidney function. GWAS using more complete reference sets for imputation, such as those from The 1000 Genomes project, promise to identify novel loci that have been missed by previous efforts. To investigate the value of such a more complete variant catalog, we conducted a GWAS meta-analysis of kidney function based on the estimated glomerular filtration rate (eGFR) in 110,517 European ancestry participants using 1000 Genomes imputed data. We identified 10 novel loci with p-value < 5 × 10−8 previously missed by HapMap-based GWAS. Six of these loci (HOXD8, ARL15, PIK3R1, EYA4, ASTN2, and EPB41L3) are tagged by common SNPs unique to the 1000 Genomes reference panel. Using pathway analysis, we identified 39 significant (FDR < 0.05) genes and 127 significantly (FDR < 0.05) enriched gene sets, which were missed by our previous analyses. Among those, the 10 identified novel genes are part of pathways of kidney development, carbohydrate metabolism, cardiac septum development and glucose metabolism. These results highlight the utility of re-imputing from denser reference panels, until whole-genome sequencing becomes feasible in large samples. ; 3C. Three-City Study. The work was made possible by the participation of the control subjects, the patients, and their families. We thank Dr. Anne Boland (CNG) for her technical help in preparing the DNA samples for analyses. This work was supported by the National Foundation for Alzheimer's disease and related disorders, the Institut Pasteur de Lille and the Centre National de Génotypage. The 3C Study was performed as part of a collaboration between the Institut National de la Santé et de la Recherche Médicale (Inserm), the Victor Segalen Bordeaux II University and Sanofi-Synthélabo. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study was also funded by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Agence Française de Sécurité Sanitaire des Produits de Santé, the Aquitaine and Bourgogne Regional Councils, Fondation de France and the joint French Ministry of Research/INSERM "Cohortes et collections de données biologiques" programme. Lille Génopôle received an unconditional grant from Eisai. AGES. Age, Gene/Environment Susceptibility-Reykjavik Study. This study has been funded by NIH contract N01-AG-1-2100, the NIA Intramural Research Program, Hjartavernd (the Icelandic Heart Association), and the Althingi (the Icelandic Parliament). The study is approved by the Icelandic National Bioethics Committee, VSN: 00-063. The researchers are indebted to the participants for their willingness to participate in the study. ARIC. Atherosclerosis Risk in Communities study. The ARIC study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C), R01HL087641, R01HL59367 and R01HL086694; National Human Genome Research Institute contract U01HG004402; and National Institutes of Health contract HHSN268200625226C. The authors thank the staff and participants of the ARIC study for their important contributions. Infrastructure was partly supported by Grant Number UL1RR025005, a component of the National Institutes of Health and NIH Roadmap for Medical Research. This work as well as YL and AK were supported by the German Research Foundation (KO 3598/2-1, KO 3598/3-1 and CRC1140 A05 to AK). ASPS. Austrian Stroke Prevention Study. The research reported in this article was funded by the Austrian Science Fond (FWF) grant number P20545-P05 and P13180. The Medical University of Graz supports the databank of the ASPS. The authors thank the staff and the participants of the ASPS for their valuable contributions. We thank Birgit Reinhart for her long-term administrative commitment and Ing Johann Semmler for the technical assistance at creating the DNA-bank. BMES. Blue Mountains Eye Study. The BMES has been supported by the Australian RADGAC grant (1992- 94) and Australian National Health & Medical Research Council, Canberra Australia (Grant Nos: 974159, 211069, 991407, 457349). The GWAS studies of Blue Mountains Eye Study population are supported by the Australian National Health & Medical Research Council (Grant Nos: 512423, 475604, 529912) and the Wellcome Trust, UK (2008). EGH and JJW are funded by the Australian National Health & Medical Research Council Fellowship Schemes. CILENTO. Italian Network on Genetic Isolates – Cilento. We thank the populations of Cilento for their participation in the study. The study was supported by the Italian Ministry of Universities and CNR 36 (PON03PE_00060_7, Interomics Flagship Project), the Assessorato Ricerca Regione Campania, the Fondazione con il SUD (2011-PDR-13), and the Istituto Banco di Napoli - Fondazione to MC. COLAUS. The CoLaus authors thank Yolande Barreau, Mathieu Firmann, Vladimir Mayor, Anne-Lise Bastian, Binasa Ramic, Martine Moranville, Martine Baumer, Marcy Sagette, Jeanne Ecoffey and Sylvie Mermoud for data collection. The CoLaus study received financial contributions from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation (33CSCO- 122661, 3200BO-111361/2, 3100AO-116323/1, 310000-112552). The computations for CoLaus imputation were performed in part at the Vital-IT center for high performance computing of the Swiss Institute of Bioinformatics. We thank Vincent Mooser for his contribution to the CoLaus study. EGCUT. Estonian Genome Center University of Tartu. EGCUT received financing from FP7 grants (278913, 306031, 313010) and targeted financing from Estonian Government (SF0180142s08). EGCUT studies were covered from Infra-structure grant no. 3.2.0304.11-0312 funded mostly by the European Regional Development Fund, Center of Excellence in Genomics (EXCEGEN) and University of Tartu (SP1GVARENG). We acknowledge EGCUT technical personnel, especially Mr V. Soo and S. Smit. Data analyses were carried out in part in the High Performance Computing Center of the University of Tartu. FamHS. Family Heart Study. The FHS work was supported in part by NIH grants 5R01HL08770003, 5R01HL08821502 (Michael A. Province) from the NHLBI and 5R01DK07568102, 5R01DK06833603 from the NIDDK (I.B.B.). The authors thank the staff and participants of the FamHS for their important contributions. FHS. Framingham Heart Study. This research was conducted in part using data and resources from the Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine. The analyses reflect intellectual input and resource development from the Framingham Heart Study investigators participating in the SNP Health Association Resource (SHARe) project. This work was partially supported by the National Heart, Lung and Blood Institute's Framingham Heart Study (Contract No. N01-HC-25195) and its contract with Affymetrix, Inc. for genotyping services (Contract No. N02-HL-6-4278). A portion of this research utilized the Linux Cluster for Genetic Analysis (LinGA-II) funded by the Robert Dawson Evans Endowment of the Department of Medicine at Boston University School of Medicine and Boston Medical Center. GENDIAN. GENetics of DIAbetic Nephropathy study. The support of the physicians, the patients, and the staff of the Diabetes Zentrum Mergentheim (Head: Prof. Dr. Thomas Haak), the diabetes outpatient clinic Dr Nusser - Dr Kreisel, the dialysis centers KfH Amberg, KfH Bayreuth, KfH Deggendorf, KfH Donauwörth, KfH Freising, KfH Freyung, KfH Fürth, KfH Hof, KfH Ingolstadt, KfH Kelheim, KfH München Elsenheimerstraße, KfH München-Schwabing, KfH Neumarkt, KfH Neusäß, KfH Oberschleißheim, KfH Passau, KfH Plauen, KfH Regensburg Günzstraße, KfH Regensburg Caritas-Krankenhaus, KfH Straubing, KfH Sulzbach-Rosenberg, KfH Weiden, Dialysezentrum Augsburg Dr. Kirschner, Dialysezentrum Bad Alexandersbad, KfH Bamberg, Dialysezentrum Emmering, Dialysezentrum Klinikum Landshut, Dialysezentrum Landshut, Dialysezentrum Pfarrkirchen, Dialysezentrum Schwandorf, Dr. Angela Götz, the medical doctoral student Johanna Christ and the Study Nurse Ingrid Lugauer. The expert technical assistance of Claudia Strohmeier is acknowledged. Phenotyping was funded by the Dr. Robert PflegerStiftung (Dr Carsten A. Böger), the MSD Stipend Diabetes (Dr Carsten A. Böger) and the University Hospital of Regensburg (intramural grant ReForM A to Dr. A. Götz, ReForM C to Dr. Carsten Böger). Genome-wide genotyping was funded by the KfH Stiftung Präventivmedizin e.V. (Dr. Carsten A. Böger, Dr. Jens Brüning), the Else Kröner-Fresenius-Stiftung (2012_A147 to Dr Carsten A. Böger and Dr Iris M. Heid) and the University Hospital Regensburg (Dr Carsten A. Böger). Data analysis was funded by the Else 37 Kröner-Fresenius Stiftung (Dr. Iris M. Heid and Dr. Carsten A. Böger: 2012_A147; Dr. Carsten A. Böger and Dr. Bernhard K. Krämer: P48/08//A11/08). GENDIAN Study Group: Mathias Gorski, Iris M. Heid, Bernhard K. Krämer, Myriam Rheinberger, Michael Broll, Alexander Lammert, Jens Brüning, Matthias Olden, Klaus Stark, Claudia Strohmeier, Simone Neumeier, Sarah Hufnagel, Petra Jackermeier, Emilia Ruff, Johanna Christ, Peter Nürnberg, Thomas Haak, Carsten A. Böger. HABC. Health Aging and Body Composition Study. The HABC study was funded by the National Institutes of Aging. This research was supported by NIA contracts N01AG62101, N01AG62103, and N01AG62106. The genome-wide association study was funded by NIA grant 1R01AG032098-01A1 to Wake Forest University Health Sciences and genotyping services were provided by the Center for Inherited Disease Research (CIDR). CIDR is fully funded through a federal contract from the National Institutes of Health to The Johns Hopkins University, contract number HHSN268200782096C. This research was supported in part by the Intramural Research Program of the NIH, National Institute on Aging. HCS. Hunter Community Study. The University of Newcastle provided $300,000 from its Strategic Initiatives Fund, and $600,000 from the Gladys M Brawn Senior Research Fellowship scheme; Vincent Fairfax Family Foundation, a private philanthropic trust, provided $195,000; The Hunter Medical Research Institute provided media support during the initial recruitment of participants; and Dr Anne Crotty, Prof. Rodney Scott and Associate Prof. Levi provided financial support towards freezing costs for the long-term storage of participant blood samples. The authors would like to thank the men and women participating in the HCS as well as all the staff, investigators and collaborators who have supported or been involved in the project to date. A special thank you should go to Alison Koschel and Debbie Quain who were instrumental in setting up the pilot study and initial phase of the project. HPFS. Health Professionals Follow-Up Study. The NHS/HPFS type 2 diabetes GWAS (U01HG004399) is a component of a collaborative project that includes 13 other GWAS (U01HG004738, U01HG004422, U01HG004402, U01HG004729, U01HG004726, U01HG004735, U01HG004415, U01HG004436, U01HG004423, U01HG004728, RFAHG006033; National Institute of Dental & Craniofacial Research: U01DE018993, U01DE018903) funded as part of the Gene Environment-Association Studies (GENEVA) under the NIH Genes, Environment and Health Initiative (GEI). Assistance with phenotype harmonization and genotype cleaning, as well as with general study coordination, was provided by the GENEVA Coordinating Center (U01HG004446). Assistance with data cleaning was provided by the National Center for Biotechnology Information. Genotyping was performed at the Broad Institute of MIT and Harvard, with funding support from the NIH GEI (U01HG04424), and Johns Hopkins University Center for Inherited Disease Research, with support from the NIH GEI (U01HG004438) and the NIH contract "High throughput genotyping for studying the genetic contributions to human disease"(HHSN268200782096C). Additional funding for the current research was provided by the National Cancer Institute (P01CA087969, P01CA055075), and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845). We thank the staff and participants of the NHS and HPFS for their dedication and commitment. INGI-CARLANTINO. Italian Network on Genetic Isolates – Carlantino. We thank Anna Morgan and Angela D'Eustacchio for technical support. We are grateful to the municipal administrators for their collaboration on the project and for logistic support. We thank all participants to this study. INGI-FVG. Italian Network on Genetic Isolates – Friuli Venezia-Giulia. We thank Anna Morgan and Angela D'Eustacchio for technical support. We are grateful to the municipal administrators for their collaboration on the project and for logistic support. We thank all participants to this study. 38 INGI-VAL BORBERA. Italian Network on Genetic Isolates – Val Borbera. We thank the inhabitants of the Val Borbera who made this study possible, the local administrations and the ASL-Novi Ligure (Al) for support. We also thank Clara Camaschella for data collection supervision and organization of the clinical data collection, Fiammetta Vigano` for technical help and Corrado Masciullo for building the analysis platform. The research was supported by funds from Compagnia di San Paolo, Torino, Italy; Fondazione Cariplo, Italy and Ministry of Health, Ricerca Finalizzata 2008 and 2011/2012, CCM 2010, PRIN 2009 and Telethon, Italy to DT. IPM. Mount Sinai BioMe Biobank Program. The Mount Sinai BioMe Biobank Program is supported by The Andrea and Charles Bronfman Philanthropies. KORA-F3 and F4. The genetic epidemiological work was funded by the NIH subcontract from the Children's Hospital, Boston, US, (H.E.W., I.M.H, prime grant 1 R01 DK075787-01A1), the German National Genome Research Net NGFN2 and NGFNplus (H.E.W. 01GS0823; WK project A3, number 01GS0834), the Munich Center of Health Sciences (MC Health) as part of LMUinnovativ, and by the Else KrönerFresenius-Stiftung (P48/08//A11/08; C.A.B., B.K.K; 2012_A147 to CAB and IMH.). The Genetic Epidemiology at the University of Regensburg received financial contributions from the BMBF (01ER1206 and 01ER1507). The kidney parameter measurements in F3 were funded by the Else Kröner-FreseniusStiftung (C.A.B., B.K.K.) and the Regensburg University Medical Center, Germany; in F4 by the University of Ulm, Germany (W.K.). Genome wide genotyping costs in F3 and F4 were in part funded by the Else Kröner-Fresenius-Stiftung (C.A.B., B.K.K.). De novo genotyping in F3 and F4 were funded by the Else Kröner-Fresenius-Stiftung (C.A.B., B.K.K.). The KORA research platform and the MONICA Augsburg studies were initiated and financed by the Helmholtz Zentrum München, German Research Center for Environmental Health, by the German Federal Ministry of Education and Research and by the State of Bavaria. Genotyping was performed in the Genome Analysis Center (GAC) of the Helmholtz Zentrum München. The LINUX platform for computation were funded by the University of Regensburg for the Department of Epidemiology and Preventive Medicine at the Regensburg University Medical Center. LIFELINES. The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants. Lifelines group authors: Behrooz Z Alizadeh1 , H Marike Boezen1 , Lude Franke2 , Pim van der Harst3 , Gerjan Navis4 , Marianne Rots5 , Harold Snieder1 , Morris Swertz2 , Bruce HR Wolffenbuttel6 and Cisca Wijmenga2 1. Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands 2. Department of Genetics, University of Groningen, University Medical Center Groningen, The Netherlands 3. Department of Cardiology, University of Groningen, University Medical Center Groningen, The Netherlands 4. Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, The Netherlands 5. Department of Medical Biology, University of Groningen, University Medical Center Groningen, The Netherlands 6. Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands MESA. Multi-Ethnic Study of Atherosclerosis. University of Washington (N01-HC-95159),Regents of the University of California (N01-HC-95160), Columbia University (N01-HC-95161), Johns Hopkins University 39 (N01-HC-95162, N01-HC-95168), University of Minnesota (N01-HC-95163), Northwestern University (N01-HC-95164), Wake Forest University (N01-HC-95165), University of Vermont (N01-HC-95166), New England Medical Center (N01-HC-95167), Harbor-UCLA Research and Education Institute (N01-HC- 95169), Cedars-Sinai Medical Center (R01-HL-071205), University of Virginia (subcontract to R01-HL- 071205) MICROS. Microisolates in South Tyrol study. We owe a debt of gratitude to all participants. We thank the primary care practitioners R. Stocker, S. Waldner, T. Pizzecco, J. Plangger, U. Marcadent and the personnel of the Hospital of Silandro (Department of Laboratory Medicine) for their participation and collaboration in the research project. In South Tyrol, the study was supported by the Ministry of Health and Department of Educational Assistance, University and Research of the Autonomous Province of Bolzano, the South Tyrolean Sparkasse Foundation, and the European Union framework program 6 EUROSPAN project (contract no. LSHG-CT-2006-018947). NESDA. The Netherlands Study of Depression and Anxiety. The infrastructure for the NESDA study is funded through the Geestkracht programme of the Dutch Scientific Organization (ZON-MW, grant number 10-000-1002) and matching funds from participating universities and mental health care organizations. Genotyping in NESDA was funded by the Genetic Association Information Network (GAIN) of the Foundation for the US National Institutes of Health. NHS. Nurses' Health Study. The NHS/HPFS type 2 diabetes GWAS (U01HG004399) is a component of a collaborative project that includes 13 other GWAS (U01HG004738, U01HG004422, U01HG004402, U01HG004729, U01HG004726, U01HG004735, U01HG004415, U01HG004436, U01HG004423, U01HG004728, RFAHG006033; National Institute of Dental & Craniofacial Research: U01DE018993, U01DE018903) funded as part of the Gene Environment-Association Studies (GENEVA) under the NIH Genes, Environment and Health Initiative (GEI). Assistance with phenotype harmonization and genotype cleaning, as well as with general study coordination, was provided by the GENEVA Coordinating Center (U01HG004446). Assistance with data cleaning was provided by the National Center for Biotechnology Information. Genotyping was performed at the Broad Institute of MIT and Harvard, with funding support from the NIH GEI (U01HG04424), and Johns Hopkins University Center for Inherited Disease Research, with support from the NIH GEI (U01HG004438) and the NIH contract "High throughput genotyping for studying the genetic contributions to human disease"(HHSN268200782096C). The NHS renal function and albuminuria work was supported by DK66574. Additional funding for the current research was provided by the National Cancer Institute (P01CA087969, P01CA055075), and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845). We thank the staff and participants of the NHS and HPFS for their dedication and commitment. NSPHS. The Northern Swedish Population Health Study. The NSPHS was supported by grants from the Swedish Natural Sciences Research Council, the European Union through the EUROSPAN project (contract no. LSHG-CT-2006-018947), the Foundation for Strategic Research (SSF) and the Linneaus Centre for Bioinformatics (LCB). We are also grateful for the contribution of samples from the Medical Biobank in Umeå and for the contribution of the district nurse Svea Hennix in the Karesuando study. RS-I. The Rotterdam Study. The GWA study was funded by the Netherlands Organisation of Scientific Research NWO Investments (nr. 175.010.2005.011, 911-03-012), the Research Institute for Diseases in the Elderly (014-93-015; RIDE2), the Netherlands Genomics Initiative (NGI)/Netherlands Consortium for Healthy Aging (NCHA) project nr. 050-060-810. We thank Pascal Arp, Mila Jhamai, Dr Michael 40 Moorhouse, Marijn Verkerk, and Sander Bervoets for their help in creating the GWAS database. The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University, Rotterdam, Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. The authors are very grateful to the participants and staff from the Rotterdam Study, the participating general practitioners and the pharmacists. We would like to thank Dr. Tobias A. Knoch, Luc V. de Zeeuw, Anis Abuseiris, and Rob de Graaf as well as their institutions the Erasmus Computing Grid, Rotterdam, The Netherlands, and especially the national German MediGRID and Services@MediGRID part of the German D-Grid, both funded by the German Bundesministerium fuer Forschung und Technology under grants #01 AK 803 A-H and # 01 IG 07015 G, for access to their grid resources. Abbas Dehghan is supported by NWO grant (vici, 918-76-619). SAPALDIA. Swiss Study on Air Pollution and Lung Diseases in Adults. The SAPALDIA Team: Study directorate: T Rochat (p), NM Probst Hensch (e/g), N Künzli (e/exp), C Schindler (s), JM Gaspoz (c) Scientific team: JC Barthélémy (c), W Berger (g), R Bettschart (p), A Bircher (a), O Brändli (p), C Brombach (n), M Brutsche (p), L Burdet (p), M Frey (p), U Frey (pd), MW Gerbase (p), D Gold (e/c/p), E de Groot (c), W Karrer (p), R Keller (p), B Martin (pa), D Miedinger (o), U Neu (exp), L Nicod (p), M Pons (p), F Roche (c), T Rothe (p), E Russi (p), P Schmid-Grendelmeyer (a), A Schmidt-Trucksäss (pa), A Turk (p), J Schwartz (e), D. Stolz (p), P Straehl (exp), JM Tschopp (p), A von Eckardstein (cc), E Zemp Stutz (e). Scientific team at coordinating centers: M Adam (e/g), C Autenrieth (pa), PO Bridevaux (p), D Carballo (c), E Corradi (exp), I Curjuric (e), J Dratva (e), A Di Pasquale (s), E Dupuis Lozeron (s), E Fischer (e), M Germond (s), L Grize (s), D Keidel (s), S Kriemler (pa), A Kumar (g), M Imboden (g), N Maire (s), A Mehta (e), H Phuleria (exp), E Schaffner (s), GA Thun (g) A Ineichen (exp), M Ragettli (e), M Ritter (exp), T Schikowski (e), M Tarantino (s), M Tsai (exp) (a) allergology, (c) cardiology, (cc) clinical chemistry, (e) epidemiology, (exp) exposure, (g) genetic and molecular biology, (m) meteorology, (n) nutrition, (o) occupational health, (p) pneumology, (pa) physical activity, (pd) pediatrics, (s) statistics. Funding: The Swiss National Science Foundation (grants no 33CSCO-134276/1, 33CSCO-108796, 3247BO-104283, 3247BO-104288, 3247BO- 104284, 3247-065896, 3100-059302, 3200-052720, 3200-042532, 4026-028099), the Federal Office for Forest, Environment and Landscape, the Federal Office of Public Health, the Federal Office of Roads and Transport, the canton's government of Aargau, Basel-Stadt, Basel-Land, Geneva, Luzern, Ticino, Valais, and Zürich, the Swiss Lung League, the canton's Lung League of Basel Stadt/ Basel Landschaft, Geneva, Ticino, Valais and Zurich, SUVA, Freiwillige Akademische Gesellschaft, UBS Wealth Foundation, Talecris Biotherapeutics GmbH, Abbott Diagnostics, European Commission 018996 (GABRIEL), Wellcome Trust WT 084703MA. The study could not have been done without the help of the study participants, technical and administrative support and the medical teams and field workers at the local study sites. Local fieldworkers : Aarau: S Brun, G Giger, M Sperisen, M Stahel, Basel: C Bürli, C Dahler, N Oertli, I Harreh, F Karrer, G Novicic, N Wyttenbacher, Davos: A Saner, P Senn, R Winzeler, Geneva: F Bonfils, B Blicharz, C Landolt, J Rochat, Lugano: S Boccia, E Gehrig, MT Mandia, G Solari, B Viscardi, Montana: AP Bieri, C Darioly, M Maire, Payerne: F Ding, P Danieli A Vonnez, Wald: D Bodmer, E Hochstrasser, R Kunz, C Meier, J Rakic, U Schafroth, A Walder. Administrative staff: C Gabriel, R Gutknecht. SHIP and SHIP-TREND. The Study of Health in Pomerania. SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grants no. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania, and the network 41 'Greifswald Approach to Individualized Medicine (GANI_MED)' funded by the Federal Ministry of Education and Research (grant 03IS2061A). Genome-wide data have been supported by the Federal Ministry of Education and Research (grant no. 03ZIK012) and a joint grant from Siemens Healthcare, Erlangen, Germany and the Federal State of Mecklenburg- West Pomerania. The University of Greifswald is a member of the 'Center of Knowledge Interchange' program of the Siemens AG and the Caché Campus program of the InterSystems GmbH. The SHIP authors are grateful to Mario Stanke for the opportunity to use his Server Cluster for the SNP imputation as well as to Holger Prokisch and Thomas Meitinger (Helmholtz Zentrum München) for the genotyping of the SHIP-TREND cohort. TRAILS. TRacking Adolescents' Individual Lives. Trails is a collaborative project involving various departments of the University Medical Center and University of Groningen, the Erasmus University Medical Center Rotterdam, the University of Utrecht, the Radboud Medical Center Nijmegen, and the Parnassia Bavo group, all in the Netherlands. TRAILS has been financially supported by grants from the Netherlands Organization for Scientific Research NWO (Medical Research Council program grant GB-MW 940-38-011; ZonMW Brainpower grant 100-001-004; ZonMw Risk Behavior and Dependence grants 60- 60600-98-018 and 60-60600-97-118; ZonMw Culture and Health grant 261-98-710; Social Sciences Council medium-sized investment grants GB-MaGW 480-01-006 and GB-MaGW 480-07-001; Social Sciences Council project grants GB-MaGW 457-03-018, GB-MaGW 452-04-314, and GB-MaGW 452-06- 004; NWO large-sized investment grant 175.010.2003.005; NWO Longitudinal Survey and Panel Funding 481-08-013); the Sophia Foundation for Medical Research (projects 301 and 393), the Dutch Ministry of Justice (WODC), the European Science Foundation (EuroSTRESS project FP-006), and the participating universities. We are grateful to all adolescents, their parents and teachers who participated in this research and to everyone who worked on this project and made it possible. Statistical analyses were carried out on the Genetic Cluster Computer (http://www.geneticcluster.org), which is financially supported by the Netherlands Scientific Organization (NWO 480-05-003) along with a supplement from the Dutch Brain Foundation. WGHS. Women's Genome Health Study. The WGHS is supported by the National Heart, Lung, and Blood Institute (HL043851 and HL080467) and the National Cancer Institute (CA047988 and UM1CA182913), with collaborative scientific support and funding for genotyping provided by Amgen. YFS. Young Finns Study. The YFS has been financially supported by the Academy of Finland: grants 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117787 (Gendi), and 41071 (Skidi), the Social Insurance Institution of Finland, Kuopio, Tampere and Turku University Hospital Medical Funds (grant 9M048 and 9N035 for TeLeht), Juho Vainio Foundation, Paavo Nurmi Foundation, Finnish Foundation of Cardiovascular Research and Finnish Cultural Foundation, Tampere Tuberculosis Foundation and Emil Aaltonen Foundation (T.L). The technical assistance in the statistical analyses by Ville Aalto and Irina Lisinen is acknowledged. ; Peer Reviewed