Response of day-to-day home blood pressure variability by antihypertensive drug class after transient ischemic attack or nondisabling stroke.

BACKGROUND AND PURPOSE Visit-to-visit variability in systolic blood pressure (SBP) is associated with an increased risk of stroke and was reduced in randomized trials by calcium channel blockers and diuretics but not by renin-angiotensin system inhibitors. However, time of day effects could not be determined. Day-to-day variability on home BP readings predicts stroke risk and potentially offers a practical method of monitoring response to variability-directed treatment. METHODS SBP mean, maximum, and variability (coefficient of variation=SD/mean) were determined in 500 consecutive transient ischemic attack or minor stroke patients on 1-month home BP monitoring (3 BPs, 3× daily). Hypertension was treated to a standard protocol. Differences in SBP variability from 3 to 10 days before to 8 to 15 days after starting or increasing calcium channel blockers/diuretics versus renin-angiotensin system inhibitors versus both were compared by general linear models, adjusted for risk factors and baseline BP. RESULTS Among 288 eligible interventions, variability in SBP was reduced after increased treatment with calcium channel blockers/diuretics versus both versus renin-angiotensin system inhibitors (-4.0 versus 6.9 versus 7.8%; P=0.015), primarily because of effects on maximum SBP (-4.6 versus -1.0 versus -1.0%; P=0.001), with no differences in effect on mean SBP. Class differences were greatest for early-morning SBP variability (3.6 versus 17.0 versus 38.3; P=0.002) and maximum (-4.8 versus -2.0 versus -0.7; P=0.001), with no effect on midmorning (P=0.29), evening (P=0.65), or diurnal variability (P=0.92). CONCLUSIONS After transient ischemic attack or minor stroke, calcium channel blockers and diuretics reduced variability and maximum home SBP, primarily because of effects on morning readings. Home BP readings enable monitoring of response to SBP variability-directed treatment in patients with recent cerebrovascular events.

Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies

Objectives: To compare countries in western Europe with respect to class differences in mortality from specific causes of death and to assess the contributions these causes make to class differences in total mortality.

Essays on the measurement of school efficiency

Measuring school efficiency is a challenging task. First, a performance measurement technique has to be selected. Within Data Envelopment Analysis (DEA), one such technique, alternative models have been developed in order to deal with environmental variables. The majority of these models lead to diverging results. Second, the choice of input and output variables to be included in the efficiency analysis is often dictated by data availability. The choice of the variables remains an issue even when data is available. As a result, the choice of technique, model and variables is probably, and ultimately, a political judgement. Multi-criteria decision analysis methods can help the decision makers to select the most suitable model. The number of selection criteria should remain parsimonious and not be oriented towards the results of the models in order to avoid opportunistic behaviour. The selection criteria should also be backed by the literature or by an expert group. Once the most suitable model is identified, the principle of permanence of methods should be applied in order to avoid a change of practices over time. Within DEA, the two-stage model developed by Ray (1991) is the most convincing model which allows for an environmental adjustment. In this model, an efficiency analysis is conducted with DEA followed by an econometric analysis to explain the efficiency scores. An environmental variable of particular interest, tested in this thesis, consists of the fact that operations are held, for certain schools, on multiple sites. Results show that the fact of being located on more than one site has a negative influence on efficiency. A likely way to solve this negative influence would consist of improving the use of ICT in school management and teaching. Planning new schools should also consider the advantages of being located on a unique site, which allows reaching a critical size in terms of pupils and teachers. The fact that underprivileged pupils perform worse than privileged pupils has been public knowledge since Coleman et al. (1966). As a result, underprivileged pupils have a negative influence on school efficiency. This is confirmed by this thesis for the first time in Switzerland. Several countries have developed priority education policies in order to compensate for the negative impact of disadvantaged socioeconomic status on school performance. These policies have failed. As a result, other actions need to be taken. In order to define these actions, one has to identify the social-class differences which explain why disadvantaged children underperform. Childrearing and literary practices, health characteristics, housing stability and economic security influence pupil achievement. Rather than allocating more resources to schools, policymakers should therefore focus on related social policies. For instance, they could define pre-school, family, health, housing and benefits policies in order to improve the conditions for disadvantaged children.

Adolescence, immigration et santé mentale : schisme et articulation des discours soignants autour des orientations et des stratégies d'intervention en contexte ethnopsychiatrique

La souffrance psychologique des adolescents fait l'objet d'une attention croissante des pouvoirs publics, des mondes associatifs, et bien sûr des cliniciens et des travailleurs psychosociaux. Pour les adolescents migrants, cette souffrance, aggravée par la fragilité, les malaises et les tensions de l'adolescence, est compliquée par l'appareil de santé publique bureaucratique complexe destiné à traduire dans le langage des soins le malaise des attitudes, des comportements et des tendances qui se dégagent de leur statut de migrant tantôt mal vécu, tantôt réprouvé par leur environnement et leur parcours personnel et familial. Ce mémoire de maîtrise a exploré l'un d'entre eux, celui de la clinique de psychiatrie transculturelle, où l'écoute de ce qui se dit importe tout autant que la traduction et la gestion de ces souffrances. En utilisant une approche anthropologique, j'analyse les discours et les attitudes de dix thérapeutes et les travailleurs sociaux qui interviennent auprès de ces familles. Cette recherche montre que le cadre de gestion sociale et culturelle qui inclut les soignants et les familles, et les ambivalences de jeunes adolescents, ne peut être analysé sans référencer le contexte plus large des différences de classes, d'accès au pouvoir, d'orientations et de bagages culturels affectant à la fois le vécu des adolescents et la manière avec laquelle leurs angoisses seront communiquées et traduites. Dans cette perspective particulière, les paradoxes et les résistances de certains professionnels médicaux et sociaux, dont les positions qu'ils occupent au sein des structures du pouvoir, autrement, pourraient les tenter de s'engager dans des diagnostics faciles liés à la socialisation prétendument difficile de ces adolescences. Au lieu de cela, ils créent des stratégies uniques qui respectent les idiomes officiels encadrant leur autorité médicale et sociale.

Abdellah Taïa et le pays de la tolérance : Une étude sur l’auteur Marocain Abdellah Taïa et ses deux oeuvres L’Armée du salut et Le Jour du Roi.

Ce mémoire a pour but d’étudier comment l’auteur Abdellah Taïa dépeint l’homosexualité et les classes sociales dans la société marocaine, à travers ses oeuvres L’Armée du Salut (2006) et Le Jour du Roi (2010). La méthode utilisée dans le mémoire est l’herméneutique, qui donne la possibilité d’utiliser ses propres interprétations des textes pour les analyser. Les ouvrages étudiés révèlent les difficultés de vivre dans une société religieuse où l’homosexualité est condamnée ainsi qu’interdite par la loi et où l’avenir d’une personne dépend de son statut social.

EU SOU A LUZ DO MUNDO: UM ESTUDO DO SIGNIFICADO DO TERMO LUZ EM JOÃO 9, 1-41

O termo luz se inscreve no encontro das tradições veterotestamentária e grego-romana como uma alternativa a certas necessidades da comunidade joanina: as culturas diferentes dos povos que receberam o evangelho; a diversidade dos problemas que pediam respostas diferentes; a diferença de classes dentro da comunidade; as tomadas de posição discordantes diante da política do império e o conflito entre judeus e cristãos. E é neste ínterim de conflito, tanto interno como externo, um momento doloroso para os dissidentes, porque os prejuízos não eram apenas religiosos, mas provocavam mudanças em todos os âmbitos da vida, que a comunidade joanina procurará alternativa. Por isso, a Narrativa da Cura do Cego de Nascença (Jo 9,1-41) é um espelho para a comunidade. Ela buscará em Jesus a luz de que precisa para continuar. O cego representa a comunidade antes de conhecer a Luz do Mundo. A solidariedade, a fraternidade e o amor mútuos são forças que ajudaram na resistência.(AU)

EU SOU A LUZ DO MUNDO: UM ESTUDO DO SIGNIFICADO DO TERMO LUZ EM JOÃO 9, 1-41

O termo luz se inscreve no encontro das tradições veterotestamentária e grego-romana como uma alternativa a certas necessidades da comunidade joanina: as culturas diferentes dos povos que receberam o evangelho; a diversidade dos problemas que pediam respostas diferentes; a diferença de classes dentro da comunidade; as tomadas de posição discordantes diante da política do império e o conflito entre judeus e cristãos. E é neste ínterim de conflito, tanto interno como externo, um momento doloroso para os dissidentes, porque os prejuízos não eram apenas religiosos, mas provocavam mudanças em todos os âmbitos da vida, que a comunidade joanina procurará alternativa. Por isso, a Narrativa da Cura do Cego de Nascença (Jo 9,1-41) é um espelho para a comunidade. Ela buscará em Jesus a luz de que precisa para continuar. O cego representa a comunidade antes de conhecer a Luz do Mundo. A solidariedade, a fraternidade e o amor mútuos são forças que ajudaram na resistência.(AU)

EU SOU A LUZ DO MUNDO: UM ESTUDO DO SIGNIFICADO DO TERMO LUZ EM JOÃO 9, 1-41

O termo luz se inscreve no encontro das tradições veterotestamentária e grego-romana como uma alternativa a certas necessidades da comunidade joanina: as culturas diferentes dos povos que receberam o evangelho; a diversidade dos problemas que pediam respostas diferentes; a diferença de classes dentro da comunidade; as tomadas de posição discordantes diante da política do império e o conflito entre judeus e cristãos. E é neste ínterim de conflito, tanto interno como externo, um momento doloroso para os dissidentes, porque os prejuízos não eram apenas religiosos, mas provocavam mudanças em todos os âmbitos da vida, que a comunidade joanina procurará alternativa. Por isso, a Narrativa da Cura do Cego de Nascença (Jo 9,1-41) é um espelho para a comunidade. Ela buscará em Jesus a luz de que precisa para continuar. O cego representa a comunidade antes de conhecer a Luz do Mundo. A solidariedade, a fraternidade e o amor mútuos são forças que ajudaram na resistência.(AU)

Stability of Ampelometric Characteristics of Vitis vinifera L. cv. 'Syrah' and 'Sauvignon blanc' Leaves: Impact of Within-vineyard Variability and Pruning Method/Bud Load

Historically, grapevine (Vitis vinifera L.) leaf characterisation has been a driving force in the identification of cultivars. In this study, ampelometric (foliometric) analysis was done on leaf samples collected from hand-pruned, mechanically pruned and minimally pruned ‘Sauvignon blanc’ and ‘Syrah’ vines to estimate the impact of within-vineyard variability and a change in bud load on the stability of leaf properties. The results showed that within-vineyard variability of ampelometric characteristics was high within a cultivar, irrespective of bud load. In terms of the O.I.V. coding system, zero to four class differences were observed between minimum and maximum values of each characteristic. The value of variability of each characteristic was different between the three levels of bud load and the two cultivars. With respect to bud load, the number of shoots per vine had a significant effect on the characteristics of the leaf laminae. Single leaf area and lengths of veins changed significantly for both cultivars, irrespective of treatment, while angle between veins proved to be a stable characteristic. A large number of biometric data can be recorded on a single leaf; the data measured on several leaves, however, are not necessarily unique for a specific cultivar. The leaf characteristics analysed in this study can be divided into two groups according to the response to a change in bud load, i.e. stable (angles between the veins, depths of sinuses) and variable (length of the veins, length of the petiole, single leaf area). The variable characteristics are not recommended to be used in cultivar identification, unless the pruning method/bud load is known.

Do the Messages Matter? An Investigation of Classroom Messages and College Students’ Personal Theories about Education

Students hold a number of personal theories about education that influence motivation and achievement in the classroom: theories about their own abilities, knowledge, and the learning process. Therefore, college instructors have a great interest in helping to develop adaptive personal theories in their students. The current studies investigated whether specific messages that instructors send in college classroom might serve as a mechanism of personal theory development. Across 2 studies, 17 college instructors and 401 students completed surveys assessing their personal theories about education at the beginning and end of college courses. Students and instructors reported hearing and sending many messages in the classroom, including instructor help messages, conciliatory messages, uncertainty in the field messages, differential ability messages and generalized positive and negative feedback. Between-class and within-class differences in message reports were associated with students’ personal theories at the end of their courses, controlling for initial personal theories. Students’ initial personal theories were also related to the messages students reported hearing. The findings demonstrate the utility of assessing non-content messages in college classrooms as potential mechanisms for changing students’ personal theories in college. Implications for research and practice are discussed.

Conceptos y prácticas de la actividad física que se reproducen en las clases sociales: aproximación desde el enfoque determinantes/ determinación social de la salud

El concepto de actividad física es concebido de diferentes formas. Mostrando que existen varios factores que afectan de manera directa e indirecta la percepción que los sujetos construyen entorno a él, generando así una aproximación a diferentes definiciones de la actividad física desde varias perspectivas y dimensiones, donde predomina una noción netamente biológica. Este estudio pretende analizar, como desde las clases sociales se concibe la actividad física en sus conceptos y prácticas considerando los modelos de determinantes y determinación social para la salud. Con fin de comprender como los autores de la literatura científica conciben la actividad física y la relación con las clases sociales, desde una perspectiva teórica de los determinantes sociales de la salud y la teoría de la determinación social, se realizó una revisión documental y análisis de contenido de los conceptos y prácticas de la actividad física que se han considerado en los últimos 10 años. Para ello se seleccionaron las bases de datos PubMed y BVS (Biblioteca Virtual de Salud) por sus énfasis en publicaciones de salud mundialmente. Mostrando que la actividad física es concebida dominantemente desde una perspectiva biológica que ejerce una mirada reduccionista. Las relaciones entre actividad física y las clases sociales están claramente establecidas, sin embargo, estas relaciones pueden discrepar teniendo en cuenta el concepto de clase social, el contexto y la orientación de los autores y las poblaciones objetos de estudio. Obteniendo como resultado que los estudios documentados, revisados y analizados muestran una clara tendencia al modelo de determinantes; no obstante, algunos estudios en sus análisis se orientan hacia el modelo de determinación social. En cuanto al concepto de clases sociales los autores consideran una combinación de factores culturales y económicos sin atreverse a adoptar un concepto específico.

A industrialização como criadora de conjuntos habitacionais para o operariado: o caso do Bairro da Empresa de Cimentos de Leiria: Maceira-Liz

A Revolução Industrial consistiu num amplo conjunto de mudanças que ocorreu nos séculos XVIII e XIX na Europa, em que a grande metamorfose na sociedade sucedeu devido à substituição do trabalho manual pelo uso da máquina. Constituiu-se como fenómeno abrangente que congregou fatores demográficos, sociais, ideológicos, políticos e económicos. A busca de melhores condições de vida e de trabalho, foi fator decisivo para o aumento de população nos grandes núcleos urbanos, circunstância que determinou a procura de uma solução que resolvesse a questão do alojamento da classe trabalhadora. Surgiram assim teorias utópicas e sociais e também modelos urbanísticos dos quais se salientam: o Falanstério de Charles Fourier, Familistério de Jean-Baptiste Godin entre outros. Em Portugal, a industrialização ocorreu mais tarde que na restante Europa, assim como as evoluções e transformações associadas a esta. É neste contexto, que a partir do século XIX, o sector agrícola no país foi sendo gradualmente substituído pela indústria. O aumento da industrialização conduziu a um incremento da concentração de mão-de-obra próxima de grandes cidades industriais, ocorrência que fomentou o aparecimento dos primeiros núcleos habitacionais destinados à classe operária. A cidade sofreu, assim, alterações assinaladas por uma série de acontecimentos resultantes da Revolução Industrial, a par da falta de estratégias ligadas à questão da habitação para as classes desfavorecidas. É neste enquadramento que surge o Bairro do Pessoal da Empresa de Cimento de Leiria, Maceira-Liz. Este procurou responder às necessidades dos trabalhadores oferecendo-lhes boa qualidade de vida. Foi dotado de infraestruturas e equipamentos como a “Casa do Pessoal” ou a Cooperativa Abastecedora, entre outros, necessários ao bom funcionamento e permitindo uma maior sociabilidade entres os seus habitantes Desta forma, para demostrar a sua importância, introduz-se o Bairro do Pessoal da E.C.L no estudo do contexto internacional e nacional. Observam-se e criam-se relações com os modelos das cidades utópicas do século XIX e os conjuntos industriais em Portugal, detentores de alojamento destinado à classe trabalhadora, fazendo uma análise urbanística detalhada do Bairro do Pessoal de Maceira- Liz, uma “Utopia” construída segundo o espirito progressista do seu fundador Henrique Sommer.A partir do estudo dos fundamentos teórico-práticos, da forma de implantação e construção, bem como dos vários planos elaborados para este complexo - que demonstravam uma tentativa de inovar, através da construção de respostas às mudanças da sociedade e arquitetura em Portugal- poderá observar- -se que Maceira-Liz tinha alternativas para resolver a situação sócio- laboral dos operários e tentava resolver questões como a insalubridade da habitação operária da I República. O Bairro do Pessoal de E.C.L. ou Bairro de Maceira-Liz é um dos mais significativos exemplos de urbanismo do tipo fabril em Portugal, que permite fazer uma reflexão crítica e arquitetónica do papel que a arquitetura assume face à questão das diferenças sociais de classes, ao mesmo tempo que se propõe uma solução de revitalização do Bairro a fim de contribuir para a sua preservação e conservação da sua identidade; ABSTRACT: The Industrial Revolution consisted in a wide range of changes that occurred in the eighteenth and nineteenth centuries in Europe, where the great metamorphosis in society succeeded due to the replacement of manual work by the use of machinery. It was established as a wide-ranging phenomenon which gathered demographic, social, ideological, political and economic factors. The search of better conditions of life and work was a decisive factor for the increase of population in major urban centers, a circumstance that led to the search for a solution to solve the question of working-class housing. Thus, utopian and social theories emerged, as also as urban models, of which we stand out: the Charles Fourier Phalanstery, Jean- Baptiste Godin Familistère and others. In Portugal, the industrialization occurred later than in the rest of Europe, as well as developments and changes associated with this. It is in this context that, starting in the nineteenth century, the agricultural sector in the country had been gradually replaced by the industry. The increased industrialization has led to an enlarged concentration of labor work close to major industrial cities, occurrence that fomented the appearance of the first housing units for the working class. So, the city suffered changes shown by a series of events resulting from the Industrial Revolution, together with the lack of strategies linked to the issue of housing for disadvantaged classes. It is in this context that comes the Neighborhood “Bairro do Pessoal da Empresa de Cimento de Leirio, Maceira – Liz”. This tried to respond to workers’ needs by offering them good quality of life. It was gifted with infrastructure and equipment as the “Staff Home” or the Cooperative Supplying, among others, needed for a proper functioning and allowing a greater sociability among its inhabitants. So, to demonstrate its importance, the Quarter of the Cement Company is introduced in the study of national and international context. Relationships with models of utopian cities in the nineteenth and the industrial plants in Portugal, owners of housing for the working class, are observed and created, making a detailed and urban analysis of the Quarter of the Cement Company, a “utopia “ built according to the progressive spirit of its founder Henry Sommer . From the study of the theoretical and practical fundamentals, the way of implementation and construction, as well as the various plans drawn up for this complex - which showed a determination to innovate by building responses to changes in society and architecture in Portugal - it can be founded that Maceira -Liz had alternatives to solve the socio- labor situation of the workers and tried to solve issues such as the unhealthiness of the working room of the First Republic. The Quarter of the Cement Company is one of the most significant examples of the industrial type urbanism in Portugal, which allows a critical and architectural reflection of the role that architecture assumes in what concerns the social class differences issues, while it is proposed a revitalization solution for the Neighborhood in order to contribute to the preservation and conservation of its identity

Skeletal muscle major histocompatibility complex class I and II expression differences in adult and juvenile dermatomyositis

OBJECTIVE: To analyze major histocompatibility complex expression in the muscle fibers of juvenile and adult dermatomyositis. METHOD: In total, 28 untreated adult dermatomyositis patients, 28 juvenile dermatomyositis patients (Bohan and Peter's criteria) and a control group consisting of four dystrophic and five Pompe's disease patients were analyzed. Routine histological and immunohistochemical (major histocompatibility complex I and II, StreptoABComplex/HRP, Dakopatts) analyses were performed on serial frozen muscle sections. Inflammatory cells, fiber damage, perifascicular atrophy and increased connective tissue were analyzed relative to the expression of major histocompatibility complexes I and II, which were assessed as negatively or positively stained fibers in 10 fields (200X). RESULTS: The mean ages at disease onset were 42.0 +/- 15.9 and 7.3 +/- 3.4 years in adult and juvenile dermatomyositis, respectively, and the symptom durations before muscle biopsy were similar in both groups. No significant differences were observed regarding gender, ethnicity and frequency of organ involvement, except for higher creatine kinase and lactate dehydrogenase levels in adult dermatomyositis (p<0.050). Moreover, a significantly higher frequency of major histocompatibility complex I (96.4% vs. 50.0%, p<0.001) compared with major histocompatibility complex II expression (14.3% vs. 53.6%, p = 0.004) was observed in juvenile dermatomyositis. Fiber damage (p = 0.006) and increased connective tissue (p<0.001) were significantly higher in adult dermatomyositis compared with the presence of perifascicular atrophy (p<0.001). The results of the histochemical and histological data did not correlate with the demographic data or with the clinical and laboratory features. CONCLUSION: The overexpression of major histocompatibility complex I was an important finding for the diagnosis of both groups, particularly for juvenile dermatomyositis, whereas there was lower levels of expression of major histocompatibility complex II than major histocompatibility complex I. This finding was particularly apparent in juvenile dermatomyositis.

Class attainment among British men - A multivariate extension of the CASMIN model of intergenerational class mobility

The CASMIN Project is arguably the most influential contemporary study of class mobility in the world. However, CASMIN results with respect to weak vertical status effects on class mobility have been extensively criticized. Drawing on arguments about how to model vertical mobility, Hout and Hauser (1992) show that class mobility is strongly determined by vertical socioeconomic differences. This paper extends these arguments by estimating the CASMIN model while explicitly controlling for individual determinants of socioeconomic attainment. Using the 1972 Oxford Mobility Data and the 1979 and 1983 British Election Studies, the paper employs mixed legit models to show how individual socioeconomic factors and categorical differences between classes shape intergenerational mobility. The findings highlight the multidimensionality of class mobility and its irreducibility to vertical movement up and down a stratification hierarchy.