The Disability Adjusted Life Year (DALY) is a widely used summary measure of population health combining years of life lost due to mortality and years of healthy life lost due to disability. A feature of the DALY is that, in the assessment of morbidity, each health condition is associated with a disability weight. The disability weight lies on a scale between 0 (indicating the health condition is equivalent to full health) and 1 (indicating the health condition is equivalent to death). The disability weight associated with each health condition is currently fixed across all social, cultural and environmental contexts. Thus blindness in the United Kingdom has the same disability weight as blindness in Niger in spite of structural interventions in the UK that make the disability less severe than in Niger. Although the fixed disability weight is defended on grounds that it supports a strongly egalitarian flavour in the DALY, we argue that the lack of consideration of realistic contexts results in a measure that will underestimate the burden associated with morbidity in disadvantaged populations and overestimate the burden in advantaged populations. There is, consequently, a loss of information on possible non-clinical points of intervention. Disaggregated estimates of the burden of disease such as those in the World Health Report 2000 should be interpreted with caution.
La dynamique du périmètre littoral portuaire de San-Pédro a été étudiée à partir de 11 profils transversaux implantés en arrière plage au droit de 5 sites, entre la plage Tombolo à l'Ouest et la plage du Club Nautique à l'Est. Il en ressort une évolution variable des segments de côte, en relation surtout avec les installations portuaires et la variation des conditions hydrodynamiques. Les changements morphologiques étant l'expression de l'évolution dynamique obéissent à un rythme saisonnier qui se caractérise par une alternance de périodes d'érosion entre les mois de mai et août et d'engraissement entre novembre et février. Par ailleurs, les analyses granulométriques montrent une variation spatiale du grain moyen, du Club Nautique à la plage Tombolo au cours de la période 1985-1986 corollaire de la dynamique variable des différents secteurs de plage.
Analyses of high energy -low frequency geomorphological events onslopes, fluvial and coastal dynamics in Iceland and methodological contributions Impacts des houles exceptionnelles sur le littoral ivoirien du Golfe de Guinée Exceptional wave impacts on the Ivorian littoral of the Guinea Gulf
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