The high prevalence of traditional postpartum restricted diets and practices, and inadequate maternal nutritional intake in urban Laos, suggest that antenatal care may be an important opportunity to improve postpartum diets.

The literature reports an association between neighbourhood deprivation and individual depression after adjustment for individual factors. The present paper investigates whether vulnerability to neighbourhood features is influenced by individual "activity space" (i.e., the space within which people move about or travel in the course of their daily activities). It can be assumed that a deprived residential environment can exert a stronger influence on the mental health of people whose activity space is limited to their neighbourhood of residence, since their exposure to their neighbourhood would be greater. Moreover, we studied the relationship between activity space size and depression. A limited activity space could indeed reflect spatial and social confinement and thus be associated with a higher risk of being depressed, or, conversely, it could be linked to a deep attachment to the neighbourhood of residence and thus be associated with a lower risk of being depressed. Multilevel logistic regression analyses of a representative sample consisting of 3011 inhabitants surveyed in 2005 in the Paris, France metropolitan area and nested within 50 census blocks showed, after adjusting for individual-level variables, that people living in deprived neighbourhoods were significantly more depressed that those living in more advantaged neighbourhoods. We also observed a statistically significant cross-level interaction between activity space and neighbourhood deprivation, as they relate to depression. Living in a deprived neighbourhood had a stronger and statistically significant effect on depression in people whose activity space was limited to their neighbourhood than in those whose daily travels extended beyond it. In addition, a limited activity space appeared to be a protective factor with regard to depression for people living in advantaged neighbourhoods and a risk factor for those living in deprived neighbourhoods. It could therefore be useful to take activity space into consideration more often when studying the social and spatial determinants of depression.

To cite this version:Julie Vallée, Emmanuelle Cadot, Francesca Grillo, Isabelle Parizot, Pierre Chauvin. The combined effects of activity space and neighbourhood of residence on participation in preventive health-care activities: The case of cervical screening in the Paris metropolitan area (France).. Health Place, Elsevier, 2010, 16 (5) AbstractEstimates from multilevel regression of 1768 women living in the Paris metropolitan area showed that women who reported concentrating their daily activities in their perceived neighbourhood of residence had a statistically greater likelihood of not having undergone cervical screening during the previous two years. Furthermore, the characteristics of the administrative neighbourhood of residence (such as the practitioner density or the proportion of residents with a recent preventive consultation) had a statistically greater impact in terms of delayed cervical screening on women who concentrated the vast majority of their daily activities within their perceived neighbourhood of residence than among those who did not.The residential environment might promote or damage, to a greater extent, the health behaviour of people whose daily activities are concentrated within their perceived neighbourhood, since we can assume that their exposure to their neighbourhood characteristics is stronger.It could thus be useful to study more often the combined effects of activity space and neighbourhood of residence on participation in preventive health-care activities.Keywords activity space; daily mobility; neighbourhood of residence; cross-level interaction; preventive health care.2

BackgroundThe aetiological diagnostic of fevers in Laos remains difficult due to limited laboratory diagnostic facilities. However, it has recently become apparent that both scrub and murine typhus are common causes of previous undiagnosed fever. Epidemiological data suggests that scrub typhus would be more common in rural areas and murine typhus in urban areas, but there is very little recent information on factors involved in scrub and murine typhus transmission, especially where they are sympatric - as is the case in Vientiane, the capital of the Lao PDR.Methodology and Principal FindingsWe therefore determined the frequency of IgG seropositivity against scrub typhus (Orientia tsutsugamushi) and murine typhus (Rickettsia typhi), as indices of prior exposure to these pathogens, in randomly selected adults in urban and peri-urban Vientiane City (n = 2,002, ≥35 years). Anti-scrub and murine typhus IgG were detected by ELISA assays using filter paper elutes. We validated the accuracy of ELISA of these elutes against ELISA using serum samples. The overall prevalence of scrub and murine typhus IgG antibodies was 20.3% and 20.6%, respectively. Scrub typhus seropositivity was significantly higher among adults living in the periphery (28.4%) than in the central zone (13.1%) of Vientiane. In contrast, seroprevalence of murine typhus IgG antibodies was significantly higher in the central zone (30.8%) as compared to the periphery (14.4%). In multivariate analysis, adults with a longer residence in Vientiane were at significant greater risk of past infection with murine typhus and at lower risk for scrub typhus. Those with no education, living on low incomes, living on plots of land with poor sanitary conditions, living in large households, and farmers were at higher risk of scrub typhus and those living in neighborhoods with high building density and close to markets were at greater risk for murine typhus and at lower risk of scrub typhus past infection.ConclusionsThis study underscores the intense circulation of both scrub and murine typhus in Vientiane city and underlines difference in spatial distribution and risk factors involved in the transmission of these diseases.

Background: Despite a declining prevalence in many countries, smoking rates remain consistently

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International audienceIn literature on neighbourhood effects and on resources accessibility, number of neighbourhood resources to which residents may have access are often estimated from spatial units whose constant size fails to account for unique ways residents experience their neighbourhoods. To investigate this "constant size neighbourhood trap", we compared numbers of health-care resources included in Constant Size Buffers (CSBs) and in Perceived Neighbourhood Polygons (PNPs) from cognitive neighbourhood data collected among 653 residents of the Paris metropolitan area,. We observed that residents of deprived and peripheral areas had smaller PNPs than their counterparts. Studying residents assessments of the quantity of neighbourhood practitioners, we then assessed the validity of using PNPs rather than CSBs to estimate number of neighbourhood resources. Lastly, resource inequalities across the Paris metropolitan area were found to be far wider when considering PNPs rather than CSBs. Using constant neighbourhood delineation can lead to inaccurately measure individual accessibility to neighbourhood resources and to downplay the extent of inequalities in urban resources

Variations of stroke incidence were more marked for the SES indicators of wealth and of income inequality. They were apparent at an earlier age in men and showed a stronger gradient among women.