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This paper presents findings from a pilot study aiming to strengthen community participation in disaster mitigation and preparedness in a province, Bursa (Turkey), which is located in the first-degree seismic zone. The study was initiated in 1998, right after the Ceyhan-Misis earthquake and a year prior to the devastating 17 August Marmara, Turkey, earthquake. Therefore, the findings will be discussed within the framework of what happened before and after the devastating earthquake in order to analyze possible effects of a major disaster on the momentum and processes of community participation efforts. The initial phase of the pilot study focused on the collection of data through in-depth and focus group interviews aiming to uncover local views on disasters, mitigation, preparedness, and multisectoral collaboration and participation. The results of the initial phase showed an eagerness for local multisectoral participation and favorable attitudes towards community participation. Earthquakes were delineated as the most threatening type of natural disasters in this initial phase. Thus, the study focused solely on earthquakes as a first area to start community involvement and to analyze mechanisms for such involvement. In the second phase of the study, an attempt was made to bring together the local state authorities, municipalities, the private sector, and the nongovernmental organizations, in order to develop an action plan for mitigation and preparedness through the involvement of the local community. This collaboration took place under the initiative of the Local Agenda 21, a local municipal initiative under the U.N. Rio Summit 1992. The most important issue identified by the local multisectoral committee was the need to increase community awareness for earthquakes and to train them on what to do before, during, and after earthquakes. Subsequently, a pamphlet and a training-of-trainers handbook were prepared, and a phase of training of trainees was undertaken. The program had very little momentum due to mainly the hesitancy of the actors from different sectors in forming alliances and due to the purely voluntary nature of the work. There were also problems related to the lack of funding for the project. As the study came to its second year, with a further loss of momentum due to local elections and change of the initial municipality, the August 1999 Marmara earthquake occurred. This very devastating earthquake produced a significant momentum for the community participation initiative in Bursa which was considerably slow to develop. The occurrence of a major disaster while a community participation project was underway provided us with valuable insights on what was hindering the project. It was basically the lack of fear/anxiety, lack of acceptance of risks, lack of local ownership, and the lack of an awareness of possible consequences of such a disaster. The Marmara earthquake of August 1999 demonstrated that there were significant shortcomings in earthquake mitigation and preparedness measures. Due to the extensive damage and the fact that the quake affected a very large area, the response of the government in the immediate postdisaster phase was slow and uncoordinated. However, the Nongovernmental Organizations (NGOs) were rapid in their responses, and numerous NGOs were involved in the recue phase and thereafter. Unfortunately, the NGOs were also not prepared for such a disaster, and thus their efforts were not coordinated. This recent earthquake once again pointed out the necessity of increasing community involvement in disaster management and creating collaborative alliances among local governmental bodies, municipality, the private sector, and the NGOs. Due to very extensive media coverage of the Marmara earthquake, the majority of people in Turkey watched the consequences from the TV and got sensitized to the damage and losses. Furthermore, the popular cultural view broadcasted through the interviews with survivors was that "you cannot trust and rely on external aid. You have to rely on your own resources." The progress in the Bursa study will be discussed within the framework of the impacts of the Marmara earthquake. The strengths and the weaknesses of the present disaster management system in Turkey and the mechanisms uncovered in the Bursa study will be presented together with implications and suggestions for the future.

In 1964, the U.S. Surgeon General formally announced the health risks of tobacco, thereby providing the impetus for one of the most intensive public health interventions in the history of the United States. Spanning several decades, the tobacco control movement has developed an increasingly effective series of social programs and policies designed to encourage nonsmoking and protect nonsmokers from environmental tobacco smoke. In the years following the initiation of the tobacco control movement, the percentage of current cigarette smokers in the American adult population has decreased dramatically from 42.2 percent in 1965 to 22.7 percent in 1999. This decrease translates into about 40 million fewer adult smokers in the United States today than had the rate remained at 42.2 percent. As the Office of Smoking and Health of the CDC notes, "This achievement has few parallels in the history of public health. It was accomplished despite the addictive nature of tobacco and the powerful economic forces promoting its use." In the 35 years following the release of the historic 1964 Surgeon General's Report on Smoking and Health, the antismoking campaign has been a major success. In 1997, the state of Mississippi won an historical settlement against the tobacco industry; several other states followed this precedent. A coalition of 46 state Attorneys General reached a Master Settlement Agreement with the tobacco companies in 1998. These settlements have provided resources for the implementation of a national tobacco control program directed by the American Legacy Foundation, as well as the resources for several state-level comprehensive tobacco control programs. To our knowledge, the present project is the most comprehensive survey of the extent to which tobacco control impacts the daily lives of Americans; it is also the first project to describe the social climate of tobacco control since most of these comprehensive programs were implemented. The 2000 National Social Climate Survey adds new knowledge about the public health movement by determining the degree to which tobacco control practices, beliefs, and norms have become ingrained in the societal fabric of America. The Social Climate Survey monitors tobacco control in the social institutions of everyday life - the American family, the American school, the workplace, government, health care, recreation/leisure, and mass media. There is substantial variability in the penetration of tobacco control across social institutions. Americans are very supportive of tobacco control measures within the family, education, and government institutions that restrict youth access to tobacco but fail to generalize this support for restrictions on youth exposure to environmental tobacco smoke, adult role models, tobacco advertisements, and tobacco logos. Some aspects of tobacco control had considerable impact upon the institutions of the workplace, health and medical care, and government and political order; yet there remains substantial work to be done. Also, tobacco control has met the most resistance in the institutions of recreation, sports, and, notably, leisure and mass communication and culture. Although important gains have been made by the tobacco control movement, the progress has not been universally realized across society. Because 46 million American adults continue to smoke cigarettes, it is clear there is substantial unfinished business for tobacco control. This report investigates one aspect of the unfinished business for tobacco control: the current social climate for tobacco control in American society. In July 2000, the National Social Climate Survey was conducted by the Social Science Research Center at Mississippi State University to determine tobacco use, norms, practices, and beliefs throughout the fabric of American society. Seven social institutions are included in our approach: American family life, education, work, recreation and leisure, government, health, and mass communication. In each of these, tobacco use and tobacco control have evolved. It is these institutional beliefs, norms, and practices that form the essence of the ingrained status of tobacco use in the social fabric of American society. By monitoring the social climate, it becomes possible to identify the arenas in which tobacco control has been successfully ingrained in the fabric of society.

Las campañas de control de Triatoma infestans, el principal vector del Trypanosoma cruzi, se han basado solamente en el uso de insecticidas con poder residual y concibieron al sistema como homogéneo. La reinfestación generalmente se inicia en focos residuales peridomiciliarios o en focos pre-existentes que escapan al rociado por diversas causas. Desde estos focos los adultos de T. infestans activamente invaden otros sitios, o son transportados pasivamente en objetos o productos desde comunidades infestadas. En ausencia de rociados adicionales luego de la fase de ataque, la reinfestación domiciliaria se expandió exponencialmente para retornar a sus niveles pre-rociado en 3-4 años en Amamá, Santiago del Estero. Sin embargo, la tasa de recuperación de la abundancia de T. infestans fue mucho menor que la predicha por un simple modelo matemático. La reinfestación no avanzó homogéneamente dentro de la comunidad. Dos estudios longitudinales en Santiago del Estero revelaron que la presencia de un peridomicilio infestado por T. infestans aumentó el riesgo de reinfestación del domicilio respectivo. Los sitios "clave" donde la reinfestación se inició tempranamente fueron los corrales de cabras u ovejas, los corrales de cerdos, los gallineros, y los depósitos. La reinfestación del peridomicilio probablemente sea el resultado de múltiples factores, tales como la degradación del insecticida por los agentes climáticos, y la mayor superficie y disponibilidad de refugios y hospedadores que cuenta el peridomicilio respecto al domicilio. Dicha heterogeneidad ambiental genera heterogeneidad de efectos de los insecticidas y aumenta la probabilidad de persistencia de T. infestans aún bajo control químico. Varios estudios muestran que la vigilancia sostenida luego de la fase de ataque disminuye abruptamente la colonización domiciliaria y el porcentaje de T. infestans infectados por T. cruzi, e interrumpe la aparición de nuevos casos locales de niños infectados. La eliminación sostenida de T. infestans requiere un enfoque que no se centre sólo en los insecticidas sino que incluya al ambiente y los pobladores en su escenario político y social. ; Control campaigns against Triatoma infestans, the principal vector of Trypanosoma cruzi, have relied on the application of residual insecticides and have regarded the system as homogeneous. Reinfestation generally starts in peridomestic residual foci or in preexisting foci that escaped spraying for diverse reasons. From these foci T. infestans adults actively invade other sites, or they are transported passively within objects or goods from infested communities. In the absence of additional spraying of insecticides after the attack phase, domiciliary reinfestation expanded exponentially to return to pre-spraying levels in 3-4 years in Amamá, Santiago del Estero. However, the rate of recovery of T. infestans abundance was much lower than that predicted by a simple mathematical model or in experimental field studies. Reinfestation did not progress homogeneously within the village. Two longitudinal studies in Santiago del Estero revealed that the presence of T. infestans-infested peridomestic sites increased the risk of domiciliary reinfestation. "Key" sites where reinfestation started early were goat or sheep corrals, pig corrals, chicken houses, and storerooms. Peridomestic reinfestation is likely the result of multiple factors, such as insecticide breakdown by climatic agents, and the greater surface and availability of refuges and hosts in peridomestic rather than domiciliary sites. Such environmental heterogeneity generates insecticidal effects heterogeneity and increases the probability of persistence of T. infestans even under control pressures. Several studies showed that sustained surveillance after the attack phase decreased sharply the domiciliary colonization by T. infestans and the percentage of bugs infected with T. cruzi, and the local incidence of infected children. The sustained elimination of T. infestans demands a scientific approach that is not only centered in insecticide use but that also includes the environment and householders in their specific social and political scenario. ; Fil: Gürtler, Ricardo E. ANLIS Dr.C.G.Malbrán; Argentina. ; Problematica de la enfermedad de Chagas. Simposio internacional. Academia Nacional de Medicina. Buenos Aires, 19-20 abril 1999

Since the fall of last year, EMU countries have experienced a slowdown in economic activity triggered by a deceleration of exports. The expansion of internal demand has been more or less intact due to low interest rates and higher terms of trade. Consumer confidence has continued to rise and business confidence seems to have stabilized in early 1999. Economic activity in Euroland will gain momentum again in the course of 1999, mainly driven by domestic demand. The increase in real GDP will amount to 2 percent in 1999 and 2.7 percent in the year 2000. Monetary conditions are currently very favorable and will support the upswing. The three-month money market rate fell to 3.1 % following the concerted reduction of central banks' key interest rates in December 1998. Long-term interest rates are extremely low; corrected for inflation, the rate for Euroland is lower than the long-term average for Germany. In recent months, the growth rate of M3 has been somewhat higher than the reference value announced by the ECB (4.5 percent); narrow money has expanded twice as fast as M3. In addition, the euro has devalued considerably against the US dollar since the beginning of this year. Given the expectation that the slowdown in the economy is only of temporary nature, the ECB will not loosen its policy further but keep its key interest rate at the current low level for the rest of this year. The ECB decided to follow a medium-term strategy. Against this background, the current weakness in Euroland does not imply a need for action. Low inflation is also no reason to cut interest rates because consumer prices have been dampened by special factors, in particular the weakness of raw material prices, and not by a tight monetary policy. If interest rates were lowered in response to this transitory change, they would have to be raised again as soon as this effect fades away. Such a stop-and-go policy should be avoided. Likewise, the recent weakness of the euro against major currencies does not suggest that interest rates should be raised. For very good reasons, the ECB—as well as the American Federal Reserve Board—does not follow a target for exchange rates. According to the Stability and Growth Programs published by the governments, budget deficits in relation to GDP are projected to decline from 2.3 percent in 1998 to 0.9 percent in the year 2002 in Euroland. As the Stability and Growth Pact calls for a balanced budget or even a surplus over the medium term, fiscal policy is, in general, not yet on a course compatible with the intentions of the Maastricht Treaty. Only in smaller countries fiscal policy is making progress, while consolidation in larger member countries is not sufficient. It has often been argued that it is necessary to harmonize VAT rates and particularly capital income taxation in the EU in order to prevent a "race to the bottom", otherwise it would be impossible to supply an adequate level of public goods and to finance the welfare state. However, the development of capital income tax rates in the EU and in other industrialized countries does not provide evidence of a race to the bottom. But even if tax competition should become fiercer, there are still arguments in favor of competition: If tax rates are cut in a process of competition, government expenditures will have to decline with the result that inefficiencies in the public sector will be reduced. Given the high levels of government expenditures in most of the EU countries, there seems to be no risk that governments would be unable to fulfill their specific functions. In addition, tax competition might help to find better tax systems, and every country could learn from the experiences of other countries. In contrast, tax harmonization would probably lead to higher taxes in the EU.

Acknowledgements and Dedication -- OVERVIEWS OF REINVENTING FISHERIES MANAGEMENT -- Reinventing Fisheries Management: the Symposium (Tony Pitcher) -- Synopsis of the Symposium (Craig Harris) -- New contexts, New tools (Nigel Haggan) -- Reinventing the Tree (Nigel Haggan) -- THE LARKIN LECTURE -- Fisheries management after 2000: will new paradigms apply? (Abstract) (John Caddy) ABSTRACTS AND DISCUSSION THEME 1: THE PRODUCTION BASE AND ECOSYSTEM MANAGEMENT -- Keynote Address -- The trophic cascade and food web management (James Kitchell) -- Discussion Points of View -Theme 1 -- The control of undesirable introduced species in small freshwater lakes: what we should learn from past experiments (Pierre Magnan) Constraints on the intensity of trophic linkages in lake food webs (Bill Neill) -- Ecosystem management: the next step (Daniel Pauly & Villy Christensen) -- The understanding and prediction of marine production: considerations for the future (James Scandol) A new method to identify individual natal stream sources of salmonids and migration patterns of fish (poster) (Sam Wang & R.Brown) Using mass-balance (ECOPATH) food web models to structure dynamic (ECOSIM) simulation models (demonstration) (Carl Walters, Villy Christensen & Daniel Pauly) -- General Discussion of Theme 1 (Kathy Heise & Alida Bundy) THEME 2: ASSESSMENT, RISK AND ADAPTIVE MANAGEMENT -- Keynote Address -- Rediscovering adaptive management: a framework linking science and decision making in a reinvented fisheries management (Keith Sainsbury) -- Discussion Points of View - Theme 2 -- An overview of tuna assessment and management world wide (Alain Fonteneau) Predictive models of growth, survival and reproduction (Jarl Giske) Benefits of taking uncertainties into account when making decisions in fisheries management: example applications of Bayesian decision analysis (Randall Peterman) Intelligent fisheries assessment in an uncertain world (Laura Richards) -- Fixed exploitation rate strategies for coping with effects of climate change (Carl Walters & Ana Parma) -- General Discussion of Theme 2 (Alida Bundy & Kathy Heise) THEME 3: THE ROLE OF POLICY IN RESPONSIBLE FISHING -- Keynote Address -- People, purses and power - some features of the debate surrounding a developing fisheries policy for South Africa (Kevern Cochrane) -- Discussion Points of View - Theme 3 -- Regime formation and community participation in fisheries management (Craig K.Harris) Measuring the immeasurable: multivariate interdisciplinary method for determining the health of fisheries (Tony Pitcher, David Preikshot, Daniel Pauly & Alida Bundy) Politics and fisheries (Gert van Santen) -- Modifications of Scotian Fundy groundfish management for sustainable use (Michael Sinclair) -- A new paradigm for managing marine fisheries in the next millennium (Michael Sutton) -- First world foreign fishing and third world fisheries: impact on resources, economy and society (poster) (Alida Bundy & Tony Pitcher) -- General Discussion of Theme 3 (Dave Preikshot & Steven Mackinson) THEME 4: THE ROLE OF THE INTERFACE BETWEEN THE SOCIAL AND NATURAL SCIENCES -- Keynote Address -- Fisheries management: science and decision making (David Policansky) Discussion -- Points of View - Theme 4 -- For fishers or fishes?: a comment on the development of an interdisciplinary science of fisheries and fisheries management (Tony Davis) -- A bridge over troubling waters? Strategies for integrating natural and social science for sustainable fisheries (Lawrence Felt) -- Enlarging the shadow of the future - avoiding conflict and conserving fish in a novel management regime off South Devon, UK (Paul Hart) -- Fisheries management: a role for social science? (Svein Jentoft) Observations on the social science of fleet dynamics and local knowledge (Thomas McGuire) General Discussion of Theme 4 (Steven Mackinson & Dave Preikshot) THEME 5: THE ROLE OF ECONOMIC TOOLS IN REINVENTING FISHERIES MANAGEMENT -- Keynote Address -- Fisheries management, politics and markets Rogenvaldur Hannesson Discussion -- Points of View - Theme 5 -- New directions in fishery management: lessons from the collapse of Atlantic Canada's groundfish fishery (Anthony Charles) -- Natural assets and national wealth (Philip Neher) Cooperation and Quotas (Anthony Scott) Linking fish price and fishery practice through eco-certification, labelling and crediting (John Sproul) Uncertainty and the role of economics in reinventing fisheries management (Rashid Sumaila) General Discussion of Theme 5 Dave Preikshot & (Steven Mackinson) THEME 6: THE ROLE OF INSTITUTIONS AND PARTNERSHIPS -- Keynote Address -- Aquatic resources education for developing world needs (Meryl Williams) -- Discussion -- Points of View - Theme 6 A fisheries agreement with the Nisga's people: the first step towards a sustainable fishery and fishery management system (Michael Link) ; Fisheries Centre (FC) ; Unreviewed ; Faculty

Medicinski centar n Slavonskom Brodu bio je za vrijeme rata u Hrvatskoj pošteđen izravnih razaranja i mogao je u relativno mirnim okolnostima obaviti svoje zadatke u primarnoj zdravstvenoj zaštiti i u Bolnici bez većih problema. U tome periodu naša Bolnica bila je najveća pozadinska bolnica u Slavoniji u kojoj su se liječili ranjenici s vinkovačke i novogradiške fronte kao i velik broj prognanika i izbjeglica. Rat u Bosni koji počinje u ožujku 1992. godine širi se na cijelu južnu Slavoniju, Bolnicu u Slavonskom Brodu stavlja u neposrednu blizinu fronte. U dosadaš­ njim napadima na zdravstvene objekte i Bolnicu poginula su 4 čovjeka (od čega dva naša radnika) a troje je ranjeno (od čega su također dva naša radnika). Pričinjena je velika materijalna šteta na bolničkim zgradama kao i ambulantama u selima i u gradu. Žrtve rata i dalje svakodnevno stižu u našu ustanovu. Do sada ih je bilo 5 910 (zaključno s 28. kolovozom 1992.) od čega 665 smrtno stradalih i 5 245 ranjenih. To je naravno samo dio žrtava rata u Posavini, jer znatan broj ranjenih i mrtvih nisu prošli kroz našu ustanovu. Medicinski radnici i ostalo osoblje ove ustanove velikim zalaganjem u teškim okolnostima slijede svjetle primjere drugih ustanova u Hrvatskoj koje su bile u sličnim okolnostima za vrijeme rata u Hrvatskoj, znajući daje to ono najviše što mogu dati u ovoj borbi za slobodu svog naroda. ; Medical tradition in Slavonski Brod is about 300 years old. From the beggining of the 18th century there was in the town Military hospital with pharmacy and mortuary. In the Military hospital civilians were cured as well. After Military Frontier had been abolished Civil hospital was founded. Medical service was organized in so called Medical centre which incorporated all services: primary protection and hospital. The hospital in Slavonski Brod is one of the bigger in Croatia. Before homeland war it contained 800 beds and developed all specialist services. There were modern diagnostics with endoscopic, supersonic vibrations, laboratory, X-rays even computorized tomography services. There were adequate number of experts, too. Out of hospital services are: general medicine, labour medicine, medicine for school children, epidemiology, dentistry and First-aid services. During the homeland war in Croatia, hospital and out-of hospital services didn't bear remarkable destroying and they could work normally behind the front lines in Slavonia. Hard circumstances began with the outburst of the war in Bosnia in March 1992. From this time on the hospital functions only in cellars and works with half a capacity. About 300 beds is always prompt for the needs of war surgery and Intensive care service. All the services of the Primary health prevention of the Medical centre adapted their work to war conditions. The majority of services worked in reserve departments. In majorty of cases they were situated in cellars of children day-care centres in areas out of enemy's reach. Out-of-hospital services were dislocated so that they were nearer to possible patients to lessen the risk of wounding and killing them from enemy gun attacks. Although in difficult conditions, medical staff did all that was needed to give full medical care to patients and other inhabitants of our community. In artillery attacks on the Medical centre four people perished (two of them were our workers) and three were wounded (two were our workers, too). There were big damages on hospital buildings and out ofhospital departments in the town and in the countryside. The victims of the war came every day to Medical centre and up to August 28th, 1992, there were 5910 patients of which 665 perished and 5245 wounded. Of the total number of wounded there were 21,3% civilians, and the percentage of deceased civilians was even bigger. In our town more than 75% dead were civilians and even 20 of them were children younger of 15 years. All that is only a partial number of war victims in Posavina because many wounded and perished were not accepted in our Medical centre.

Book Reviews in This Article Labour's Economic Policies 1974‐79. Edited by Michael Artis and David Cobham. (Manchester, Manchester University Press, 1991, pp Applied UK Macroeconomics. By Roger Backhouse. (Oxford, Basil Black well, 1991, pp Perspectives on the History of Economic Thought. Volume VI: Themes in Keynesian Criticism and Supplementary Modern Topics. Edited by William J. Barber. (Aldershot, Edward Elgar Publishing Limited, 1991, pp The World Trading System at Risk. By Jagdish Bhagwati. (Hemel Hempstead, Harvester Wheatsheaf, 1991, pp Contemporary Issues in Applied Economics. Edited by Graham Bird and Heather Bird. (Aldershot, Edward Elgar Publishing Limited, 1991, pp A History of Macroeconometric Model‐Building. By Ronald G. Bodkin, Lawrence R. Klein and Kanta Marwah. (Aldershot, Edward Elgar Publishing Limited, 1990, pp Debt, Stabilization and Development. Edited by Guillermo Calvo, Ronald Findlay, Pentti Kouri and Jorge Braga De Macedo. (Oxford, Basil Black well, 1989, pp Unregulated Banking: Chaos or Order? Edited by Forrest Capie and Geoffrey E. Wood. (Basingstoke, Macmillan Academic and Professional Ltd., 1991, pp Between History and Economics: An Introduction to Economic History. By Carlo M. Cipolla. (Oxford, Basil Blackwell, 1991, pp Cheating the Government: The Economics of Evasion. By Frank A. Cowell. (Cambridge, Mass, and London, The MIT Press, 1990, pp Economic Problems of the 1990s: Europe, the Developing Countries and the United States. Edited by Paul Davidson and J. A. Kregel. (Aldershot, Edward Elgar Publishing Limited, 1991, pp Male Bias in the Development Process. Edited by Diane Elson. (Manchester, Manchester University Press, 1991, pp European Financial Integration. Edited by Alberto Giovannini and Colin Mayer. (Cambridge, Cambridge University Press, 1991, pp The Theory of Technological Change and Economic Growth. By Stanislaw Gomulka. (London, Routledge, 1990, pp Surveys in Monetary Economics. Volume 2: Financial Markets and Institutions. Edited by C. J. Green and D. T. Llewellyn. (Oxford, Blackwell Publishers, 1991, pp Power and Economic Institutions: Reinterpretations in Economic History. Edited by Bo Gustafsson. (Aldershot, Edward Elgar Publishing Limited, 1991, pp The Management of Science. Edited by Douglas Hague. Proceedings of Section F (Economics) of the British Association for the Advancement of Science, Sheffield, 1989. (Basingstoke, Macmillan Academic and Professional Ltd., 1991, pp Monetarism and the Keynesians. Lloyds Bank Annual Review, Volume 4. Edited by Christopher Johnson. (London, Pinter Publishers Limited, 1991, pp Firm Search, Sectoral Shifts, and Unemployment: Studies on Labor Market Adjustment in Sweden. By Eugenia Kazamaki. (Stockholm, Almqvist and Wiksell International, 1991, pp Autonomy and Change: The Sources of Economic Growth. By Judith Marquand. (Hemel Hempstead, Harvester Wheatsheaf, 1989, pp Perspectives on the History of Economic Thought. Volume Three: Classicals, Marxians and Neo‐Classicals. Edited by Donald E. Moggridge. (Aldershot, Edward Elgar Publishing Limited, 1990, pp The Nature of the Transnational Firm. Edited by Christos N. Pitelis and Roger Sugden. (London, Routledge, 1991, pp Industrial Districts and Inter‐Firm Co‐Operation in Italy. Edited by F. Pyke, G. Becattini and W. Sengenberger. (Geneva, International Institute for Labour Studies, 1990, pp Industrial Change and Regional Economic Transformation: The Experience of Western Europe. Edited by Lloyd Rodwin and Hidehiko Sazanami. (London, Harper Collins Academic, 1991, pp The Limits of Government: An Essay on the Public Goods Argument. By David Schmidtz. (Oxford, Westview Press, 1991, pp The Political Economy of Public Sector Reform and Privatization. Edited by Ezra N. Suleiman and John Waterbury. (Oxford, Westview Press, 1991, pp Public Finance in Developing Countries. By Vito Tanzi. (Aldershot, Edward Elgar Publishing Limited, 1991, pp Inequality, Poverty, and History. The Kuznets Memorial Lectures of the Economic Growth Center, Yale University. By Jeffrey G. Williamson. (Oxford, Basil Blackwell, 1991, pp European Integration: Trade and Industry. Edited by L. Alan Winters and Anthony Venables. (Cambridge, Cambridge University Press, 1991, pp Unemployment: A Problem of Policy. Analysis of British Experience and Prospects. By G. D. N. Worswick. (Cambridge, Cambridge University Press, 1991, pp

Classification, De-classification, Re-classification.
The strategies of reproduction and in particular the strategies of re-conversion depend on the objective profit-risks offered to investments in a given state of the institutional instruments of reproduction and of the capital they are to reproduce ; it follows that the recent transformations of the relationship between the different classes and the educational System —which have resulted in the massive increase in schooling and all the corresponding changes in the educational System itself, and all the transformations of the social structure which, at least in part, are due to the transformation of the relationships holding between qualifications and job-openings— are the result of an intensification of competition for educational qualifications. Thus, those fractions of the ruling and middle classes which are richest in economc capital have had, in order to ensure their reproduction, to greatly intensify the use they made of the educational System, constraining the fractions whose reproduction was hitherto ensured chiefly by schooling to intensify their investments in schooling. Hence the inflation of qualifications and their devaluation. As a consequence of devaluation, the broadening of the monopoly of the holders of educational qualifications over positions which were until then open to non degree-holders means that the chief victims of this process are those who go onto the job-market without qualifications. Hence a reinforcement of the way in which schooling predetermines professional career opportunities and of the interdependence of qualification and job-opening. The re-conversion of the economic capital into cultural capital permits the middle classes to maintain the position of its heirs and explains the morphological changes within the middle classes and, in particular, the emergeance of a new type of craftsmen and trade with a high cultural investment.
The hysteresis of the habitus tends to conceal the devaluation of qualifications from the classes which are furthest from the educational System. The other classes can, in order to escape loss of position, either produce new professions more adapted to their social claims, or else modify in accordance with these claims, by a redefinition implying a re-evaluation, those professions to which their qualifications give access. This creative redefinition effect can be observed in professions of sparse distribution and low degree of professionalisation, such as the new sectors of cultural and artistic production and all those professions which ensure the best return on the cultural capital transmitted by the family; consultative occupations, and those of presentation and representation. One can only understand the emergeance of that new petty-bourgeoisie which harnesses to its function as intermediary between the classes new instruments of manipulation by reference to the transformations in the methods of ruling which, since they are concerned to ensure the symbolic integration of the ruled classes, grant more importance to the prescribing of needs rather than the instilling of norms.
The increase in school-attendance underlies a whole group of transformations in the educational System itself; the well-defined boundaries of the old system are supplanted by the vague classifications of a system which sanctions vagueness of aspirations. It is as if the new logic of the educational system and the economic system promoted the maximum postponement of the moment when, by a series of imperceptible degrees, the final balance-sheet of the semi-bourgeois abortive careers is settled at last. Hence the type of structural instability we find in the representation of social identity and aspirations.
The outcome of all the opposing effects of re-conversion and re-classification, is a global movement upwards of the structure of the distribution, between classes and segments of classes, of the wealth which is the stake of competitiveness, the maintenance of order, that is to say of relational property, being therefore ensured by the ceaseless changes in substantial properties.

Background: Drugs have become an essential necessity in public health, people and the government has become willingly to spend more money on the country's healthcare system to restore health, save lives, preventing disease and epidemics. Drugs should be properly regulated throughout development, production, importation and subsequent distribution to ensure it is prescribed with safe, effective and of good quality standards. The structure of drug regulations today has evolved over time. During the process, the scope of legislative and regulatory power expanded in result of a series of disastrous events related to pharmaceutical products, the adoption of more restrictive legislative were put in place for stronger safeguard to the public. In comparison to Singapore, Taiwan, US and EU where the drug regulatory system is highly structured, flexible and innovative, Hong Kong (HK) has a relatively simple and stubborn drug regulatory system and drug approval is greatly dependent on the approval status of the advance countries. According to the current registration system in HK, a new drug usually takes about 18-24 months to obtain an approval, and this figure is far behind the standard of Singapore in which medicine could be registered in 60 days. It is vital to have speedy approval process with high standards in safety, efficacy and quality on all approved drugs. If drugs are approved in a rush manner, it will lead to serious adverse drug reactions (ADR), or even deaths in consumption of unsafe, and ineffective drugs. On the other hand, slow approval will make patients suffer and increase the mortality rate to due inaccessibility of appropriate medicines to sustain life and combat diseases. With reference to the initiatives and innovative regulatory frameworks in the abovementioned countries, the modification of the local drug regulatory system is strongly recommended. Aim: 1. To examine the regulatory frameworks between Singapore, Taiwan, US and EU which affect the evaluation timeline required for new drugs approval. 2. As the first study to examine the drug regulations in HK, the regulatory barriers for new drugs submission will be explored and whether the regulatory initiatives from the abovementioned countries may result in an improvement in the overall drug regulation system HK. Method: This dissertation is a literature review and it will employ concentration in the drug regulation systems in Singapore, Taiwan, US and EU with varying levels of pharmaceutical regulation capacities. Search engines including Google, MedLine, PubMed (database up to 2012) with key words search of "Department of Health (DoH), Food and Drug Administration (FDA), European Union (EU), Taiwan FDA, Health Sciences Authority, evaluation routes, drug registration requirement, review timeline, Centre for Drug Evaluation, Pharmaceutical Evaluation Reports, risk management systems, pharmacovigilance, drug legislation". Results: With an in-depth evaluation of the HK's guideline and supporting document required for new drug submission, it is highly recommended that unnecessary documents at new drug submission (NDA) should be elimination to facilitate the new drugs approval process. The regulatory frameworks between all studied countries vary significantly in which implementation of initiatives (e.g. multiple evaluation routes, in-house evaluation system) from individual country affects the standards of new drugs approval and the evaluation timeline required to grant approvals. Conclusion: The regulatory frameworks in HK shall be revised with reference to numerous initiatives developed in the regulatory systems in Singapore, Taiwan, Us and EU. The possible key regulatory barriers which leads to the delays in new drugs approvals in HK includes duplication of certificates, limited number of Pharmacy and Poison Board meetings, the requirement of endorsement of new drugs approvals at the legislative council , absence of in-house evaluation system which allows full assessment of submission dossier, deficiency of clinical trials with the inclusion of local population, absence of electronic submission, multiple evaluation routes and rigorous post-marketing pharmacovigilance monitoring system. If the Department of Health (DoH) in Hong Kong could scrutinize the current regulatory frameworks with referenced to these countries, it will improve the overall drug regulatory system and reduce drug lag due to unnecessary barriers. ; published_or_final_version ; Public Health ; Master ; Master of Public Health

Rainfall is the key factor to understand soil erosion processes, mechanisms, and rates. Most research was conducted to determine rainfall characteristics and their relationship with soil erosion (erosivity) but there is little information about how atmospheric patterns control soil losses, and this is important to enable sustainable environmental planning and risk prevention. We investigated the temporal and spatial variability of the relationships of rainfall, runoff, and sediment yield with atmospheric patterns (weather types, WTs) in the western Mediterranean basin. For this purpose, we analyzed a large database of rainfall events collected between 1985 and 2015 in 46 experimental plots and catchments with the aim to: (i) evaluate seasonal differences in the contribution of rainfall, runoff, and sediment yield produced by the WTs; and (ii) to analyze the seasonal efficiency of the different WTs (relation frequency and magnitude) related to rainfall, runoff, and sediment yield. The results indicate two different temporal patterns: the first weather type exhibits (during the cold period: autumn and winter) westerly flows that produce the highest rainfall, runoff, and sediment yield values throughout the territory; the second weather type exhibits easterly flows that predominate during the warm period (spring and summer) and it is located on the Mediterranean coast of the Iberian Peninsula. However, the cyclonic situations present high frequency throughout the whole year with a large influence extended around the western Mediterranean basin. Contrary, the anticyclonic situations, despite of its high frequency, do not contribute significantly to the total rainfall, runoff, and sediment (showing the lowest efficiency) because of atmospheric stability that currently characterize this atmospheric pattern. Our approach helps to better understand the relationship of WTs on the seasonal and spatial variability of rainfall, runoff and sediment yield with a regional scale based on the large dataset and number of soil erosion experimental stations. ; Spanish Government (Ministry of Economy and Competitiveness, MINECO) and FEDER Projects: CGL2014 52135-C3-3-R, ESP2017-89463-C3-3-R, CGL2014-59946-R, CGL2015-65569-R, CGL2015-64284-C2-2-R, CGL2015-64284-C2-1-R, CGL2016-78075-P, GL2008-02879/BTE, LEDDRA 243857, RECARE-FP7, CGL2017-83866-C3-1-R, and PCIN-2017-061/AEI. Dhais Peña-Angulo received a 'Juan de la Cierva' postdoctoral contract (FJCI-2017-33652 Spanish Ministry of Economy and Competitiveness, MEC). Ana Lucia acknowledge the 'Brigitte-Schlieben-Lange-Programm'. The 'Geoenvironmental Processes and Global Change' (E02_17R) was financed by the Aragón Government and the European Social Fund. José Andrés López-Tarazón acknowledges the Secretariat for Universities and Research of the Department of the Economy and Knowledge of the Autonomous Government of Catalonia for supporting the Consolidated Research Group 2014 SGR 645 (RIUS-Fluvial Dynamics Research Group). Artemi Cerdá thank the funding of the OCDE TAD/CRP JA00088807. José Martínez-Fernández acknowledges the project Unidad de Excelencia CLU-2018-04 co-funded by FEDER and Castilla y León Government. Ane Zabaleta is supported by the Hydro-Environmental Processes consolidated research group (IT1029-16, Basque Government). This paper has the benefit of the Lab and Field Data Pool created within the framework of the COST action CONNECTEUR (ES1306). This research was supported by projects funded by Spanish and FEDER, the 'Brigitte-Schlieben-Lange-Programm'; the Governments of Spanish Autonomous Region of Aragón, Catalonia, Castilla-León and Basque Country. José Andrés López-Tarazón acknowledges the Secretariat for Universities and Research of the Department of the Economy and Knowledge of the Autonomous Government of Catalonia for supporting the Consolidated Research Group 2014 SGR 645 (RIUS-Fluvial Dynamics Research Group). Artemi Cerdá thank the funding of the OCDE TAD/CRP JA00088807. José Martínez-Fernández acknowledges the project Unidad de Excelencia CLU-2018-04 co-funded by FEDER and Castilla y León Government. Ane Zabaleta is supported by the Hydro-Environmental Processes consolidated research group (IT1029-16, Basque Government). This paper has the benefit of the Lab and Field Data Pool created within the framework of the COST action CONNECTEUR (ES1306).

Pathway analysis of genome-wide association studies (GWAS) offer a unique opportunity to collectively evaluate genetic variants with effects that are too small to be detected individually. We applied a pathway analysis to a bladder cancer GWAS containing data from 3,532 cases and 5,120 controls of European background (n = 5 studies). Thirteen hundred and ninety-nine pathways were drawn from five publicly available resources (Biocarta, Kegg, NCI-PID, HumanCyc, and Reactome), and we constructed 22 additional candidate pathways previously hypothesized to be related to bladder cancer. In total, 1421 pathways, 5647 genes and 90,000 SNPs were included in our study. Logistic regression model adjusting for age, sex, study, DNA source, and smoking status was used to assess the marginal trend effect of SNPs on bladder cancer risk. Two complementary pathway-based methods (gene-set enrichment analysis [GSEA], and adapted rank-truncated product [ARTP]) were used to assess the enrichment of association signals within each pathway. Eighteen pathways were detected by either GSEA or ARTP at P≤0.01. To minimize false positives, we used the I2 statistic to identify SNPs displaying heterogeneous effects across the five studies. After removing these SNPs, seven pathways ('Aromatic amine metabolism' [PGSEA = 0.0100, PARTP = 0.0020], 'NAD biosynthesis' [PGSEA = 0.0018, PARTP = 0.0086], 'NAD salvage' [PARTP = 0.0068], 'Clathrin derived vesicle budding' [PARTP = 0.0018], 'Lysosome vesicle biogenesis' [PGSEA = 0.0023, PARTP<0.00012], 'Retrograde neurotrophin signaling' [PGSEA = 0.00840], and 'Mitotic metaphase/anaphase transition' [PGSEA = 0.0040]) remained. These pathways seem to belong to three fundamental cellular processes (metabolic detoxification, mitosis, and clathrin-mediated vesicles). Identification of the aromatic amine metabolism pathway provides support for the ability of this approach to identify pathways with established relevance to bladder ; This project has been funded in part with federal funds from the Natio nal Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Support for individual studies that participated in the effort is as follows: SBCS (Dr. Silverman) - Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics and intramural contract number NCI N02-CP-11015. FIS/Spain 98/1274, FIS/Spain 00/0745, PI061614, and G03/174 Fundació Marató TV3, Red Temática Investigación Cooperativa en Cáncer (RTICC), Consolider ONCOBIO, EU-FP7-201663; and RO1- CA089715 and CA34627. NEBCS (Dr. Silverman) - Intramural research program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics and intramural contract number NCI N02-CP-01037 PLCO (Dr. Purdue) - The National Institutes of Health (NIH) Genes, Environment and Health Initiative(GEI) partly funded DNA extraction and statistical analyses (HG-06-033-NCI-01 and RO1HL091172-01), genotyping at the Johns Hopkins University Center for Inherited Disease Research (U01HG004438 and NIH HHSN268200782096C), and study coordination at the GENEVA (Dr. Caporaso)- The NIH Genes, Environment and Health Initiative [GEI] partly funded DNA extraction and statistical analyses (HG-06-033-NCI-01 and RO1HL091172-01), genotyping at the Johns Hopkins University Center for Inherited Disease Research (U01HG004438 and NIH HHSN268200782096C) and study coordination at the GENEVA Coordination Center (U01HG004446) for EAGLE and part of PLCO studies. Genotyping for the remaining part of PLCO and all ATBC and CPS-II samples were supported by the Intramural Research Program of the National Institutes of Health, NCI, Division of Cancer Epidemiology and Genetics. The PLCO is supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics and supported by contracts from the Division of Cancer Prevention, National Cancer Institute, National Institutes of Health. ATBC (Dr. Albanes) - This research was supported in part by the Intramural Research Program of the NIH and the National Cancer Institute. Additionally, this research was supported by U.S. Public Health Service contracts N01-CN-45165, N01-RC-45035, and N01-RC-37004 from the National Cancer Institute, Department of Health and Human Services

Background: Several single-exposure studies have documented possible effects of environmental factors on lung function, but none has relied on an exposome approach. We aimed to evaluate the association between a broad range of prenatal and postnatal lifestyle and environmental exposures and lung function in children. Methods: In this analysis, we used data from 1033 mother–child pairs from the European Human Early-Life Exposome (HELIX) cohort (consisting of six existing longitudinal birth cohorts in France, Greece, Lithuania, Norway, Spain, and the UK of children born between 2003 and 2009) for whom a valid spirometry test was recorded for the child. 85 prenatal and 125 postnatal exposures relating to outdoor, indoor, chemical, and lifestyle factors were assessed, and lung function was measured by spirometry in children at age 6–12 years. Two agnostic linear regression methods, a deletion-substitution-addition (DSA) algorithm considering all exposures simultaneously, and an exposome-wide association study (ExWAS) considering exposures independently, were applied to test the association with forced expiratory volume in 1 s percent predicted values (FEV1%). We tested for two-way interaction between exposures and corrected for confounding by co-exposures. Findings: In the 1033 children (median age 8·1 years, IQR 6·5–9·0), mean FEV1% was 98·8% (SD 13·2). In the ExWAS, prenatal perfluorononanoate (p=0·034) and perfluorooctanoate (p=0·030) exposures were associated with lower FEV1%, and inverse distance to nearest road during pregnancy (p=0·030) was associated with higher FEV1%. Nine postnatal exposures were associated with lower FEV1%: copper (p=0·041), ethyl-paraben (p=0·029), five phthalate metabolites (mono-2-ethyl 5-carboxypentyl phthalate [p=0·016], mono-2-ethyl-5-hydroxyhexyl phthalate [p=0·023], mono-2-ethyl-5-oxohexyl phthalate [p=0·0085], mono-4-methyl-7-oxooctyl phthalate [p=0·040], and the sum of di-ethylhexyl phthalate metabolites [p=0·014]), house crowding (p=0·015), and facility density around schools (p=0·027). However, no exposure passed the significance threshold when corrected for multiple testing in ExWAS, and none was selected with the DSA algorithm, including when testing for exposure interactions. Interpretation: Our systematic exposome approach identified several environmental exposures, mainly chemicals, that might be associated with lung function. Reducing exposure to these ubiquitous chemicals could help to prevent the development of chronic respiratory disease. Funding: European Community's Seventh Framework Programme (HELIX project). ; The study has received funding from the European Community's Seventh Framework Programme (FP7/2007–2013) under grant agreement number 308333—the HELIX project—for data collection and analyses. The HELIX program built on six existing cohorts that received previous funding, including the major cohorts listed here. MoBa (Norwegian Mother and Child Cohort Study) is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, and the US National Institutes of Health (NIH) National Institute of Environmental Health Sciences (NIEHS; contract number N01-ES-75558), and National Institute of Neurological Disorders and Stroke (grant number 1 UO1 NS 047537–01 and grant number 2 UO1 NS 047537–06A1). The RHEA project was financially supported by European Union projects (EU FP6–2003-Food-3-NewGeneris, EU FP6.STREP Hiwate, EU FP7 ENV.2007·1.2.2.2, Project No 211250 Escape, EU FP7–2008-ENV-1·2.1·4 Envirogenomarkers, EU FP7-HEALTH-2009-single stage CHICOS, EU FP7 ENV.2008.1.2.1.6, proposal number 226285 ENRIECO, EUFP7-HEALTH-2012 proposal number 308333 HELIX, FP7 European Union project, number 264357 MeDALL), and the Greek Ministry of Health (Program of Prevention of Obesity and Neurodevelopmental Disorders in Preschool Children, Heraklion district, Crete, Greece: 2011–14; "RHEA Plus": Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012–15). LC received additional funding from the Southern California Environmental Health Sciences Center (grant number P30ES007048) funded by NIEHS.

Stromal tumor-infiltrating lymphocytes (sTILs) are important prognostic and predictive biomarkers in triple-negative (TNBC) and HER2-positive breast cancer. Incorporating sTILs into clinical practice necessitates reproducible assessment. Previously developed standardized scoring guidelines have been widely embraced by the clinical and research communities. We evaluated sources of variability in sTIL assessment by pathologists in three previous sTIL ring studies. We identify common challenges and evaluate impact of discrepancies on outcome estimates in early TNBC using a newly-developed prognostic tool. Discordant sTIL assessment is driven by heterogeneity in lymphocyte distribution. Additional factors include: technical slide-related issues; scoring outside the tumor boundary; tumors with minimal assessable stroma; including lymphocytes associated with other structures; and including other inflammatory cells. Small variations in sTIL assessment modestly alter risk estimation in early TNBC but have the potential to affect treatment selection if cutpoints are employed. Scoring and averaging multiple areas, as well as use of reference images, improve consistency of sTIL evaluation. Moreover, to assist in avoiding the pitfalls identified in this analysis, we developed an educational resource available at www.tilsinbreastcancer.org/pitfalls. ; R.S. is supported by a grant from the Breast Cancer Research Foundation (BCRF, grant No. 17-194). S.L. is supported by the National Breast Cancer Foundation of Australia Endowed Chair (NBCF-17-001) and the Breast Cancer Research Foundation, New York (BCRF-19-102). S.G. is supported by Susan G Komen Foundation (CCR18547966) and a Young investigator Grant from Breast Cancer Alliance. T.O.N. receives funding support from the Canadian Cancer Society. A.M. acknowledges research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award numbers 1U24CA199374-01, R01CA202752-01A1, R01CA208236-01A1, R01 CA216579-01A1, R01 CA220581-01A1, 1U01 CA239055-01, National Center for Research Resources under award number 1 C06 RR12463-01, VA Merit Review Award IBX004121A from the United States Department of Veterans Affairs Biomedical Laboratory Research and Development Service, the DOD Prostate Cancer Idea Development Award (W81XWH-15-1-0558), the DOD Lung Cancer Investigator-Initiated Translational Research Award (W81XWH-18-1-0440), the DOD Peer Reviewed Cancer Research Program (W81XWH-16-1-0329), the Ohio Third Frontier Technology Validation Fund and the Wallace H. Coulter Foundation Program in the Department of Biomedical Engineering and the Clinical and Translational Science Award Program (CTSA) at Case Western Reserve University. J.S. received funding from NCI grants UG3CA225021 and U24CA215109. C.S. is a Royal Society Napier Research Professor; this work was supported by the Francis Crick Institute that receives its core funding from Cancer Research UK (FC001169, FC001202), the UK Medical Research Council (FC001169, FC001202), and the Wellcome Trust (FC001169, FC001202); C.S. is also funded by Cancer Research UK (TRACERx and CRUK Cancer Immunotherapy Catalyst Network), the CRUK Lung Cancer Centre of Excellence, Stand Up 2 Cancer (SU2C), the Rosetrees Trust, Butterfield and Stoneygate Trusts, NovoNordisk Foundation (ID16584), the Prostate Cancer Foundation, the Breast Cancer Research Foundation (BCRF); the research leading to these results has received funding from the European Research Council (ERC) under the European Union's Seventh Framework Programme (FP7/2007-2013) Consolidator Grant (FP7-THESEUS-617844), European Commission ITN (FP7-PloidyNet 607722), ERC Advanced Grant (PROTEUS) has received funding from the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement No. 835297), Chromavision—this project has received funding from the European's Union Horizon 2020 research and innovation programme (grant agreement No. 665233); support was also provided to C.S. by the National Institute for Health Research, the University College London Hospitals Biomedical Research Centre, and the Cancer Research UK University College London Experimental Cancer Medicine Centre. R.K. and K.P.-G. acknowledge research leading to or reported in this publication was supported by NCI U10CA180868, -180822, UG1-189867, and U24-196067 the Breast Cancer Research Foundation and Genentech.

Background & aims: The association between drinking water consumption and adiposity has been poorly explored. Therefore, we aimed to analyse the associations between the frequency of drinking water consumption and body weight and waist circumference changes in an elderly Mediterranean cohort. Methods: A total of 1832 elderly participants (aged 55-75 years) with metabolic syndrome from the PREDIMED-Plus study with baseline data on drinking water and other beverages assessed by a validated 32-item Spanish fluid-intake questionnaire and with data on body weight (BW) and waist circumference (WC) at 1-year and 2-year were included in these prospective analyses. Multivariable linear regression models were fitted to assess the β-coefficients and 95% confidence interval (CI) for BW and WC changes in terms of categories of baseline drinking water consumption (tap water and bottled water). The theoretical effect on BW and WC of replacing several beverages with drinking water was assessed using mathematical models. Results: The baseline frequency of drinking water consumption was inversely associated with 1-year and 2-year changes in BW. β-coefficients (95%CI) across categories of water consumption (<2.5, 2.5 to <5, 5 to < 7.5, ≥7.5 servings/d) expressed in % of weight changes at 2 years of follow-up were 0.0, -0.80 (-1.48, -0.12), -1.36 (-2.18, -0.54), and -1.97 (-3.09, -0.86), respectively. Individuals in the two highest categories of drinking water consumption (5 to < 7, and ≥7.5 servings/d) also showed a higher decrease in WC (expressed as % of change) after 2 years of follow-up: -1.11 (-1.96, -0.25) and -1.45 (-2.66, -0.24) compared to the reference intake (<2.5 servings/day), after adjustment for potential confounding factors. The theoretical replacement of soups, beers, spirits, hot beverages, dairy beverages, and other beverages group with drinking water was associated with greater reductions in BW at one- and two-years of follow-up. Conclusions: Drinking water consumption was inversely associated with 2-year adiposity changes in an elderly Mediterranean cohort at high cardiovascular risk. Our results also suggest that the consumption of drinking water instead of energy-containing beverages is associated with lower weight gain. ; The PREDIMED-Plus trial was supported by the Spanish government's official funding agency for biomedical research , ISCIII, through the Fondo de Investigación para la Salud (FIS) and co-funded by European Union ERDF/ESF, "A way to make Europe"/"Investing in your future" (five coordinated FIS projects led by JS-S and JVid, including the following: PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/00728, PI14/01722, PI14/00636, PI14/01206, PI14/01919, PI14/01374, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00366, PI17/00764, PI17/01827, PI17/01441, PI17/01732, PI17/00926, PI19/00309, PI19/01032, PI19/00576, PI19/00017, and PI19/00781), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S, the European Research Council (Advanced Research Grant 2013–2018, 340918) to MÁM-G, the Recercaixa Grant to JS-S (2013ACUP00194), a grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03). Study resulting from the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call "Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut". We thank the CERCA Programme/Generalitat de Catalunya for institutional support. This publication has been possible with the support of the Ministerio de Ciencia , Innovación y Universidades (MICINN) (FPU 17/01925). Jordi Salas-Salvadó, senior author of this study, is partially supported by ICREA under the ICREA Academia programme . IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). Dr. NB-T is supported by a postdoctoral fellowship ( Juan de la Cierva-Formación , FJC2018-036016-I). I.M Gimenez-Alba received an FPU grant from the Ministry of Science, Innovation and Universities (reference FPU 18/01703). C.B. received a Fernando Tarongí Bauzà PhD Grant.

"Nearly all tobacco use begins during youth and young adulthood. These young individuals progress from smoking occasionally to smoking every day. Each day across the United States over 3,800 youth under 18 years of age start smoking. Although much progress has been made to reduce the prevalence of smoking since the first Surgeon General's report in 1964, today nearly one in four high school seniors and one in three young adults under age 26 smoke. Of every three young smokers, only one will quit, and one of those remaining smokers will die from tobacco-related causes. Most of these young people never considered the long-term health consequences associated with tobacco use when they started smoking; and nicotine, a highly addictive drug, causes many to continue smoking well into adulthood, often with deadly consequences. This Surgeon General's report examines in detail the epidemiology, health effects, and causes of tobacco use among youth ages 12 through 17 and young adults ages 18 through 25. For the first time tobacco data on young adults as a discrete population has been explored. This is because nearly all tobacco use begins in youth and young adulthood, and because young adults are a prime target for tobacco advertising and marketing activities. This report also highlights the efficacy of strategies to prevent young people from using tobacco. After years of steady decrease following the Tobacco Master Settlement Agreement of 1998, declines in youth tobacco use have slowed for cigarette smoking and stalled for use of smokeless tobacco. The latest research shows that concurrent use of multiple tobacco products is common among young people, and suggest that smokeless tobacco use is increasing among White males. An important element of this Surgeon General's report is the review of the health conse-quences of tobacco use by young people. Cigarette smoking by youth and young adults is proven to cause serious and potentially deadly health effects immediately and into adulthood. One of the most significant health effects is addiction to nicotine that keeps young people smoking longer, causing increased physical damage. Early abdominal aortic atherosclerosis has been found in young smokers which affects the flow of blood to vital organs such as the lungs. This leads to reduced lung growth that can increase the risk of chronic obstructive pulmonary disease later in life, and reduced lung function. This report examines the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. Tobacco products are among the most heavily marketed consumer goods in the U.S. Much of the nearly $10 billion spent on marketing cigarettes each year goes to programs that reduce prices and make cigarettes more affordable; smokeless tobacco products are similarly promoted. Peer influences; imagery and messages that portray tobacco use as a desirable activity; and environmental cues, including those in both traditional and emerging media platforms, all encourage young people to use tobacco. These influences help attract youth to tobacco use and reinforce the perception that smoking and various forms of tobacco use are a social norm--a particularly strong message during adolescence and young adulthood. Many initiatives have been put into place to help counter the influences that encourage young people to begin tobacco use. The Tobacco Master Settlement Agreement in 1998 curtailed much of the advertising that was particularly appealing to young people. With the passage of the 2009 legislation giving the U.S. Food and Drug Administration the authority to regulate tobacco products and tobacco advertising, we now have another important means of helping decrease the appeal of tobacco use to this population. Coordinated, multi-component interventions that include mass media campaigns, comprehensive community programs, comprehensive statewide tobacco control programs, price increases, and school-based policies have also proven effective in preventing onset and use of tobacco use among youth and young adults." - p. iii ; Also available via the World Wide Web as an Acrobat .pdf file (269.95 KB, 22 p.). ; Includes bibliographical references (p. 8-11).