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Early Club Studies emphasised the inclusiveness of club cultures and the PLUR ethos of 'peace, love, unity and respect' alongside a polarised characterisation of nightlife contexts, as either commercial, alcohol-oriented nightclubs offering 'mainstream' pop music, or 'authentic'/'alternative' underground dance clubs associated with widespread illicit drug use. This paper adds to the growing body of research problematising these simplistic characterisations of club cultures and leisure venues across the night-time economy, emphasising elements of fragmentation and segregation alongside the continued importance of social structure and resultant social and spatial exclusion. The authors explore how informal processes - such as club launches, internet promotions and dress codes - together result in the production and reproduction of two contrasting forms of English clubland elites: 'cultural elites' produced through the social, cultural and spatial exclusion of electronic dance music of black origin and its minority ethnic, working class and lower income followers from Manchester city centre dance clubs; and 'consumer elites' produced through the economic and cultural exclusion of working class and lower income club-goers from nightclubs in London's West End. The complex and interweaving practices of cultural distinction and structural discrimination which produce such elites are often closely intertwined with the formal and informal regulation, marginalization and criminalization of specific cultural forms. The paper therefore argues for the construction of more nuanced conceptual understandings of the social divisions and inequalities within nightlife and in studies of young people's leisure opportunities more generally.

In this paper we study the general mortality trends by cancer in Spain (1951-1987), and also by sex and age groups. We focus on lung cancer, establishing comparisons with USA, England and Wales. We appreciate on the general mortality trend that only young age groups show a higher decrease, while in other countries this decrease was also in old age groups. We observed a lower mortality trend in Spain by lung cancer than in the other countries, however increasing the rates in both sexes and more in males. That evolution could be related with the evolution of cancer risk factors and especially lung cancer. On concluded that the general mortality trend in Spain is the same than other developed countries but with some delay in the evolution, when comparing lung cancer. Spain is now in an increasing phase and USA, England and Wales have stabilized their rates and begin to decrease their trends.

In this paper the role of efficiency in health care delivery is discussed. In the first part several definitions of efficiency are presented and the most common efficiency analysis are described. In the second part of the paper some experiences aimed at improving the efficiency of health care delivery in England, Latin America and Mexico are discussed. Finally, the author presents four proposals for the improvement of efficiency of health care delivery in Mexico: monetary reward associated to performance, alternative organization of health services, investment in management training for health manpower, and operational research in the health systems.