"We are all middle class: On the subjective status in Chile"

Chile is one of the countries with the highest level of income inequality worldwide. Given the association between economic inequality and patterns of social stratification, in such context it would be expected to find a large dispersion of subjective social status' indicators in the population. Nevertheless, analyses from international surveys reveal a strong tendency to the mean of the subjective status i.e. there would be downward and upward biases of the subjective status regarding the objective status. The present research attempts to tackle this phenomenon for the Chilean case, with a focus on the influence of status and class variables on the subjective status. For the analysis we use Chilean data from the social inequality module of the International Social Survey Programme 2009. The results indicate a strong tendency to the mean of the subjective status in the population, particularly from the side of those with higher objective status.

Changes in leg spring behaviour, plantar loading and foot mobility magnitude induced by an exhaustive treadmill run in adolescent middle-distance runners.

OBJECTIVES: This study aimed to determine adjustments in spring-mass model characteristics, plantar loading and foot mobility induced by an exhaustive run. DESIGN: Within-participants repeated measures. METHODS: Eleven highly-trained adolescent middle-distance runners ran to exhaustion on a treadmill at a constant velocity corresponding to 95% of velocity associated with VO₂max (17.8 ± 1.4 kmh(-1), time to exhaustion=8.8 ± 3.4 min). Contact time obtained from plantar pressure sensors was used to estimate spring-mass model characteristics, which were recorded (during 30 s) 1 min after the start and prior to exhaustion using pressure insoles. Foot mobility magnitude (a composite measure of vertical and medial-lateral mobility of the midfoot) was measured before and after the run. RESULTS: Mean contact area (foot to ground), contact time, peak vertical ground reaction force, centre of mass vertical displacement and leg compression increased significantly with fatigue, while flight time, leg stiffness and mean pressure decreased. Leg stiffness decreased because leg compression increased to a larger extent than peak vertical ground reaction forces. Step length, step frequency and foot mobility magnitude did not change at exhaustion. CONCLUSIONS: The stride pattern of adolescents when running on a treadmill at high constant velocity deteriorates near exhaustion, as evidenced by impaired leg-spring behaviour (leg stiffness) and altered plantar loading.

Evolution of a Ladinian (Middle Triassic) intraplatform basin : stratigraphy, microfacies and palaeoecology of the Meride Limestone (Monte San Giorgio, Canton Ticino, Southern Switzerland)

The Monte San Giorgio (Southern Alps, Ticino, Switzerland) is the most important locality in the world for vertebrates dating back to the Middle Triassic. For this reason it was registered in 2003 as a UNESCO World Heritage Site. One of the objectives of this doctoral thesis was to fill some of the cognitive gaps regarding the Ladinian succession, including in particular the San Giorgio Dolomite and the Meride Limestone. In order to achieve this, the entire succession, more than 600 metres thick, was measured and sampled. Biostratigraphic research based on new finds of fossil invertebrates and microfossils and on the palynological analysis of the entire section was integrated with single-zircon U-Pb dating of volcanic ash layers intercalated in the carbonate succession. This enabled a redefinition of the bio-chronostratigraphic and geochronologic framework of the succession, which encompasses a significantly shorter time interval than previously held. The Ladinian section extends from the E. curionii Ammonoid Zone (Early Fassanian) to the P. archelaus Ammonoid Zone (Early Longobardian). The age of the classic fossiliferous levels of the Meride Limestone, rich in organic matter and containing vertebrate fossils which are known all over the world, was defined in both biostratigraphic and geochronologic terms. The presumed stratigraphie significance of the pachypleurosaurid reptiles found in such levels is called into question by new finds. These fossiliferous horizons were found to correspond to the main volcanoclastic intervals of the Buchenstein Formation (Middle and Upper Pietra Verde). Thus, a correlation with the Bagolino Section (Italy) containing the GSSP for the base of the Ladinian was proposed. Bulk sedimentation rates in the studied succession average 200 m/Myr and therefore prove to be 20 times higher than those of the South-Alpine pelagic basins. These values express high carbonate productivity from the surrounding platforms on one hand, and on the other a marked subsidence of the basin. Only in the intervals consisting of laminated limestones did the sedimentation rates drop to average values of around 30 m/Myr. The distribution of organic and inorganic facies appears to be the consequence of relative variations in sea-level. The laminated and organic-matter- rich intervals of the Meride Limestone are linked to a relative sea-level drop which favoured dysoxic to anoxic bottom-water conditions, coupled with an increase in runoff, perhaps due to recurrent explosive volcanic activity. The transient development under dysoxic conditions of monospecific benthic meio-/macrofaunas was documented. Organic matter suggests a predominant origin due to benthic bacterial activity, as can be witnessed in alveolar structures typical of exopolymeric substances secreted by bacteria within microbial mats. A microbial contribution to the carbonate (peloidal) precipitation was documented. The protective effect exerted by these microbial mats is also indicated as the main taphonomic factor contributing to the excellent preservation of vertebrate fossils. A radiolarian assemblage discovered in the lower part of the section (earliest Ladinian, E. curionii Zone) suggests the transient existence of open-marine but not deep-water connections with the tethyan pelagic basins. It shows marked similarities to the faunas typical of the late Anisian, suggesting therefore a low resolution power provided by radiolarian biostratigraphy in recognizing the Anisian/Ladinian boundary. The present thesis describes a new species of conifer (Elatocladus cassinae), a new species of insect (Dasyleptus triassicus) and seven new species of radiolarians (Eptingium danieli, Eptingium neriae, Parentactinosphaera eoladinica, Sepsagon ticinensis, Sepsagon? valporinae, Novamuria wirzi and Pessagnollum? hexaspinosum). In addition, following revision of the type material of already existent taxa, four new genera of radiolarians are introduced: Bernoulliella, Eohexastylus, Ticinosphaera and Lahmosphaera.

Altered brain mechanisms of emotion processing in pre-manifest Huntington's disease.

Huntington's disease is an inherited neurodegenerative disease that causes motor, cognitive and psychiatric impairment, including an early decline in ability to recognize emotional states in others. The pathophysiology underlying the earliest manifestations of the disease is not fully understood; the objective of our study was to clarify this. We used functional magnetic resonance imaging to investigate changes in brain mechanisms of emotion recognition in pre-manifest carriers of the abnormal Huntington's disease gene (subjects with pre-manifest Huntington's disease): 16 subjects with pre-manifest Huntington's disease and 14 control subjects underwent 1.5 tesla magnetic resonance scanning while viewing pictures of facial expressions from the Ekman and Friesen series. Disgust, anger and happiness were chosen as emotions of interest. Disgust is the emotion in which recognition deficits have most commonly been detected in Huntington's disease; anger is the emotion in which impaired recognition was detected in the largest behavioural study of emotion recognition in pre-manifest Huntington's disease to date; and happiness is a positive emotion to contrast with disgust and anger. Ekman facial expressions were also used to quantify emotion recognition accuracy outside the scanner and structural magnetic resonance imaging with voxel-based morphometry was used to assess the relationship between emotion recognition accuracy and regional grey matter volume. Emotion processing in pre-manifest Huntington's disease was associated with reduced neural activity for all three emotions in partially separable functional networks. Furthermore, the Huntington's disease-associated modulation of disgust and happiness processing was negatively correlated with genetic markers of pre-manifest disease progression in distributed, largely extrastriatal networks. The modulated disgust network included insulae, cingulate cortices, pre- and postcentral gyri, precunei, cunei, bilateral putamena, right pallidum, right thalamus, cerebellum, middle frontal, middle occipital, right superior and left inferior temporal gyri, and left superior parietal lobule. The modulated happiness network included postcentral gyri, left caudate, right cingulate cortex, right superior and inferior parietal lobules, and right superior frontal, middle temporal, middle occipital and precentral gyri. These effects were not driven merely by striatal dysfunction. We did not find equivalent associations between brain structure and emotion recognition, and the pre-manifest Huntington's disease cohort did not have a behavioural deficit in out-of-scanner emotion recognition relative to controls. In addition, we found increased neural activity in the pre-manifest subjects in response to all three emotions in frontal regions, predominantly in the middle frontal gyri. Overall, these findings suggest that pathophysiological effects of Huntington's disease may precede the development of overt clinical symptoms and detectable cerebral atrophy.

Prospective monitoring of cefepime in intensive care unit adult patients.

INTRODUCTION: Cefepime has been associated with a greater risk of mortality than other beta-lactams in patients treated for severe sepsis. Hypotheses for this failure include possible hidden side-effects (for example, neurological) or inappropriate pharmacokinetic/pharmacodynamic (PK/PD) parameters for bacteria with cefepime minimal inhibitory concentrations (MIC) at the highest limits of susceptibility (8 mg/l) or intermediate-resistance (16 mg/l) for pathogens such as Enterobacteriaceae, Pseudomonas aeruginosa and Staphylococcus aureus. We examined these issues in a prospective non-interventional study of 21 consecutive intensive care unit (ICU) adult patients treated with cefepime for nosocomial pneumonia. METHODS: Patients (median age 55.1 years, range 21.8 to 81.2) received intravenous cefepime at 2 g every 12 hours for creatinine clearance (CLCr) >or= 50 ml/min, and 2 g every 24 hours or 36 hours for CLCr < 50 ml/minute. Cefepime plasma concentrations were determined at several time-points before and after drug administration by high-pressure liquid chromatography. PK/PD parameters were computed by standard non-compartmental analysis. RESULTS: Seventeen first-doses and 11 steady states (that is, four to six days after the first dose) were measured. Plasma levels varied greatly between individuals, from two- to three-fold at peak-concentrations to up to 40-fold at trough-concentrations. Nineteen out of 21 (90%) patients had PK/PD parameters comparable to literature values. Twenty-one of 21 (100%) patients had appropriate duration of cefepime concentrations above the MIC (T>MIC >or= 50%) for the pathogens recovered in this study (MIC <or= 4 mg/l), but only 45 to 65% of them had appropriate coverage for potential pathogens with cefepime MIC >or= 8 mg/l. Moreover, 2/21 (10%) patients with renal impairment (CLCr < 30 ml/minute) demonstrated accumulation of cefepime in the plasma (trough concentrations of 20 to 30 mg/l) in spite of dosage adjustment. Both had symptoms compatible with non-convulsive epilepsy (confusion and muscle jerks) that were not attributed to cefepime-toxicity until plasma levels were disclosed to the caretakers and symptoms resolved promptly after drug arrest. CONCLUSIONS: These empirical results confirm the suspected risks of hidden side-effects and inappropriate PK/PD parameters (for pathogens with upper-limit MICs) in a population of ICU adult patients. Moreover, it identifies a safety and efficacy window for cefepime doses of 2 g every 12 hours in patients with a CLCr >or= 50 ml/minute infected by pathogens with cefepime MICs <or= 4 mg/l. On the other hand, prompt monitoring of cefepime plasma levels should be considered in case of lower CLCr or greater MICs.

Organisational reforms in active welfare states: A comparative analysis of the turn to 'single gateways' in Western Europe

Based on the case of reforms aimed at integrating the provision of income protection and employment services for jobless people in Europe, this thesis seeks to understand the reasons which may prompt governments to engage in large-scale organisational reforms. Over the last 20 years, several European countries have indeed radically redesigned the organisational structure of their welfare state by merging or bundling existing front-line offices in charge of benefit payment and employment services together into 'one-stop' agencies. Whereas in academic and political debates, these reforms are generally presented as a necessary and rational response to the problems and inconsistencies induced by fragmentation in a context of the reorientation of welfare states towards labour market activation, this thesis shows that the agenda setting of these reforms is in fact the result of multidimensional political dynamics. More specifically, the main argument of this thesis is that these reforms are best understood not so such from the problems induced by organisational compartmentalism, whose political recognition is often controversial, but from the various goals that governments may simultaneously achieve by means of their adoption. This argument is tested by comparing agenda-setting processes of large-scale reforms of coordination in the United Kingdom (Jobcentre Plus), Germany (Hartz IV reform) and Denmark (2005 Jobcentre reform), and contrasting them with the Swiss case where the government has so far rejected any coordination initiative involving organisational redesign. This comparison brings to light the importance, for the rise of organisational reforms, of the possibility to couple them with the following three goals: first, goals related to the strengthening of activation policies; second, institutional goals seeking to redefine the balance of responsibilities between the central state and non-state actors, and finally electoral goals for governments eager to maintain political credibility. The decisive role of electoral goals in the three countries suggests that these reforms are less bound by partisan politics than by the particular pressures facing governments arrived in office after long periods in opposition.

Childhood cancer mortality in America, Asia, and Oceania, 1970 through 2007.

BACKGROUND: Over the last 4 decades, childhood cancer mortality declined in most developed areas of the world. However, scant information is available from middle-income and developing countries. The authors analyzed and compared patterns in childhood cancer mortality in 24 developed and middle-income countries in America, Asia, and Oceania between 1970 and 2007. METHODS: Childhood age-standardized annual mortality rates were derived from the World Health Organization (WHO) database for all neoplasms, bone and kidney cancer, non-Hodgkin lymphoma (NHL), and leukemias. RESULTS: Since 1970, rates for all childhood cancers dropped from approximately 8 per 100,000 boys to 3 per 100,000 boys and from 6 per 100,000 girls to 2 per 100,000 girls in North America and Japan. Latin American countries registered rates of approximately 5 per 100,000 boys and 4 per 100,000 girls for 2005 through 2007, similar to the rates registered in more developed areas in the early 1980s. Similar patterns were observed for leukemias, for which the mortality rates were 0.81 per 100,000 boys and 0.55 per 100,000 girls in North America, 0.86 per 100,000 boys and 0.68 per 100,000 girls in Japan, and 1.98 per 100,000 boys and 1.65 per 100,000 girls in Latin America for 2005 through 2007. Bone cancer rates for 2005 through 2007 were approximately 2-fold higher in Argentina than in the United States. During the same period, Mexico registered the highest rate for kidney cancer and Colombia registered the highest rate for NHL, whereas the lowest rates were registered by Japan for kidney and by Japan and the United States for NHL. CONCLUSIONS: Improvements in the adoption of current integrated treatment protocols in Latin American and other lower- and middle-income countries worldwide would avoid a substantial proportion of childhood cancer deaths.