PubMed · 15933181
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Kathrin Stanger-Hall. 2005-06-03. Accommodation or prediction?. https://doi.org/10.1126/science.308.5727.1409c
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This study measures the process of convergence in the state of health among the provinces and regions of Spain during 1980-2001 in order to analyse the possible influence of the decentralisation of healthcare management to the regions in this period. Sigma and beta convergence models, traditionally employed in macroeconomics, have been used, taking Life Expectancy at Birth (LEB) and Infant Mortality (IM) as health indicators. The analysis was carried out at two territorial levels: provinces and regions. The results reveal that the process of decentralisation either does not affect convergence or leads to divergence in health. Indeed, in the case of IM the so-called change of role scenario seems to have occurred. Thus, certain provinces with initially poor indicators have improved, overtaking those that were originally in a better position. The final result, however, is of greater dispersion than initially.
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PURPOSE: Two hundreds years after the discovery of the smallpox vaccine, immunization remains one of the most powerful tools of preventive medicine. CURRENT KNOWLEDGE AND KEY POINTS: Immunization was born with Jenner, then Pasteur and expanded during the 19th and 20th century. It started with the empirical observation of cross-immunity between two diseases, cowpox and smallpox. It became a real science, with pathogen isolation, culture and attenuation or inactivation, to prepare a vaccine. Together with clinical and biological efficacy studies and adverse events assessments, it constructed the concept of "vaccinology". Protein conjugation of polyosidic vaccines has made possible early immunisation of infants. Nowadays, recombinant, reassortant, or virus-like particles technologies open the road for new vaccines. FUTURE PROSPECTS: Ongoing research opens the way for the development of new vaccines that will help to control transmittable diseases for which we are lacking antimicrobial agents.