Evaluation of a novel photography-based home assessment protocol for identification of environmental risk factors for falls in elderly persons

PRINCIPLES To evaluate the validity and feasibility of a novel photography-based home assessment (PhoHA) protocol, as a possible substitute for on-site home assessment (OsHA). METHODS A total of 20 patients aged ≥65 years who were hospitalised in a rehabilitation centre for musculoskeletal disorders affecting mobility participated in this prospective validation study. For PhoHA, occupational therapists rated photographs and measurements of patients' homes provided by patients' confidants. For OsHA, occupational therapists conducted a conventional home visit. RESULTS Information obtained by PhoHA was 79.1% complete (1,120 environmental factors identified by PhoHA vs 1416 by OsHA). Of the 1,120 factors, 749 had dichotomous (potential hazards) and 371 continuous scores (measurements with tape measure). Validity of PhoHA to potential hazards was good (sensitivity 78.9%, specificity 84.9%), except for two subdomains (pathways, slippery surfaces). Pearson's correlation coefficient for the validity of measurements was 0.87 (95% confidence interval [CI 0.80-0.92, p <0.001). Agreement between methods was 0.52 (95%CI 0.34-0.67, p <0.001, Cohen's kappa coefficient) for dichotomous and 0.86 (95%CI 0.79-0.91, p <0.001, intraclass correlation coefficient) for continuous scores. Costs of PhoHA were 53.0% lower than those of OsHA (p <0.001). CONCLUSIONS PhoHA has good concurrent validity for environmental assessment if instructions for confidants are improved. PhoHA is potentially a cost-effective method for environmental assessment.

miR-21 and its target gene CCL20 are both highly overexpressed in the microenvironment of colorectal tumors: significance of their regulation

Recently, we reported a functional interaction between miR-21 and its identified chemokine target CCL20 in colorectal cancer (CRC) cell lines. Here, we investigated whether such functional interactions are permitted at the cellular level which would require an inverse correlation of expression and also co-expression of miR-21 and CCL20 in the same cell. Expression profiling was performed using qPCR, and ELISA, in situ hybridization and immunohistochemistry were applied for the presentation of their cellular localization. We demonstrated that miR-21 as well as CCL20 were both significantly upregulated in CRC tissues; thus, showing no antidromic expression pattern. This provided an initial clue that miR-21 and CCL20 may not be expressed in the same cell. In addition, we located miR-21 expression at the cellular level predominantly in stromal cells such as tumor-associated fibroblasts and to a minor degree in immune cells such as macrophages and lymphocytes. Likewise, CCL20 expression was primarily detected in tumor-infiltrating immune cells. Thus, investigating the cellular localization of miR-21 and its target CCL20 revealed that both molecules are expressed predominantly in the microenvironment of CRC tumors.

The role of nitric oxide in Listeria encephalitis of ruminants and in rats intracisternally infected with Listeria monocytogenes

Listeria monocytogenes is a Gram-positive facultative intracellular bacteria which infects a wide range of hosts. In ruminants, infection with L. monocytogenes frequently causes encephalitis, which is usually fatal in sheep and goat, while cattle often recover with antibiotic therapy. Since the role of NO in the control of Listeria is controversial, we have studied the expression of iNOS in the brains of cattle, sheep and goats which had succumbed to listeria encephalitis. iNOS was demonstrated in decreasing intensity in the M phi of microabscesses from cattle, sheep and goat. iNOS expression was accompanied by NT in the microabscesses of cattle, but was only present to a low degree in sheep and was absent in goats. This is indirect evidence for differences in the ability to produce NO in the three species. Presence of iNOS and NT were inversely correlated with the numbers of bacteria. While microabscesses of goats contained high amounts of L. monocytogenes they occurred only rarely in cattle. To corroborate our hypothesis that NO is involved in the control of listeria encephalitis a new animal model was developed. Eleven day old infant rats were infected intracisternally with a low dose of L. monocytogenes. This resulted in a transient meningoencephalitis with moderate clinical signs and low mortality. Listeria proliferated strongly in the inflammatory lesions during the first days of infection, reached a peak at day 4 and were eliminated until day 7. The presence of bacteria was closely accompanied by high numbers of iNOS-expressing M phi and the formation of NT. Administration of the iNOS inhibitor L-NIL or the radical scavenger PBN resulted in rapid death of the treated animals. However, the increase in bacterial numbers was one order of magnitude higher for animals treated with PBN compared with L-NIL administration. This shows that NO plays an important role in the control of a brain infection with Listeria, but suggests that reactive oxidants other than NO are also involved. In conclusion, our findings point to a possible involvement of the differences in the ability to express iNOS and subsequent NO production in the different clinical outcome of listeria encephalitis in cattle and small ruminants.

Combined aerobic/inspiratory muscle training vs. aerobic training in patients with chronic heart failure: The Vent-HeFT trial: a European prospective multicentre randomized trial

AIMS Vent-HeFT is a multicentre randomized trial designed to investigate the potential additive benefits of inspiratory muscle training (IMT) on aerobic training (AT) in patients with chronic heart failure (CHF). METHODS AND RESULTS Forty-three CHF patients with a mean age of 58 ± 12 years, peak oxygen consumption (peak VO2 ) 17.9 ± 5 mL/kg/min, and LVEF 29.5 ± 5% were randomized to an AT/IMT group (n = 21) or to an AT/SHAM group (n = 22) in a 12-week exercise programme. AT involved 45 min of ergometer training at 70-80% of maximum heart rate, three times a week for both groups. In the AT/IMT group, IMT was performed at 60% of sustained maximal inspiratory pressure (SPImax ) while in the AT/SHAM group it was performed at 10% of SPImax , using a computer biofeedback trainer for 30 min, three times a week. At baseline and at 3 months, patients were evaluated for exercise capacity, lung function, inspiratory muscle strength (PImax ) and work capacity (SPImax ), quality of life (QoL), LVEF and LV diameter, dyspnoea, C-reactive protein (CRP), and NT-proBNP. IMT resulted in a significantly higher benefit in SPImax (P = 0.02), QoL (P = 0.002), dyspnoea (P = 0.004), CRP (P = 0.03), and NT-proBNP (P = 0.004). In both AT/IMT and AT/SHAM groups PImax (P < 0.001, P = 0.02), peak VO2 (P = 0.008, P = 0.04), and LVEF (P = 0.005, P = 0.002) improved significantly; however, without an additional benefit for either of the groups. CONCLUSION This randomized multicentre study demonstrates that IMT combined with aerobic training provides additional benefits in functional and serum biomarkers in patients with moderate CHF. These findings advocate for application of IMT in cardiac rehabilitation programmes.

Progression of cardiovascular risk factors in black Africans: 3 year follow up of the SABPA cohort study

Recent work identified a high prevalence of modifiable risk factors for cardiovascular disease (CVD) among urban black South Africans. The aim was to track the progression of CVD risk factors in a multi-ethnic sample of South Africans. Participants were 173 black (aged 47.5 ± 7.8 yrs) and 186 white teachers (aged 49.6 ± 9.9 yrs) that were examined at baseline and 3 years follow-up. Blacks demonstrated a substantially higher prevalence of composite CVD burden (defined as history of physician diagnosed heart disease, use of anti-hypertensives, anti-diabetic, or statin medications at either time point) compared to whites (49.1 vs. 32.0%, p = 0.012) respectively. After controlling for baseline, the black participants demonstrated greater increases in 24 h systolic and diastolic blood pressure, total cholesterol, fasting glucose, fibrinogen, D-dimer, and waist circumference in comparison with whites. In summary, an adverse progression of CVD risk factors was observed in the whole sample, although to a larger degree in black participants. Aggressive treatment strategies for controlling risk factors in black Africans are needed to reduce the increasing burden of CVD in South Africa.

Platelets and Anti-Angiogenic Resistance in Ovarian Carcinoma

Background: Resistance to targeted anti-angiogenic therapy is a growing clinical concern given the disappointing clinical impact of anti-angiogenic. Platelets represent a component of the tumor microenvironment that are implicated in metastasis and represent a significant reservoir of angiogenic regulators. Thrombocytosis has been shown to be caused by malignancy and associated with adverse clinical outcomes, however the causal connections between these associations remain to be identified. Materials and Methods: Following IRB approval, patient data were collected on patients from four U.S. centers and platelet levels through and after therapy were considered as indicators of recurrence of disease. In vitro effects of platelets on cancer cell proliferation, apoptosis, and migration were examined. RNA interference was used to query signaling pathways mediating these effects. The necessity of platelet activation for in vitro effect was analyzed. In vivo orthotopic models were used to query the impact of thrombocytosis and thrombocytopenia on the efficacy of cytotoxic chemotherapy, the effect of aspirin on thrombocytosis and cancer, and platelet effect on anti-angiogenic therapy. Results: Platelets were found to increase at the time of diagnosis of ovarian cancer recurrence in a pattern comparable to CA-125. Platelet co-culture increased proliferation, increased migration, and decreased apoptosis in all cell lines tested. RNA interference implicated platelet derived growth factor alpha (PDGFRA) and transforming growth factor beta-receptor 1 (TGFBR1) signaling. Biodistribution studies suggested minimal platelet sequestration of taxanes. Blockade of platelet activation blocked in vitro effects. In vivo, thrombocytosis blocked chemotherapeutic efficacy, thrombocytopenia increased chemotherapeutic efficacy, and aspirin therapy partially blocked the effects of thrombocytosis. In vivo, withdrawal of anti-angiogenic therapy caused loss of therapeutic benefit with evidence of accelerated disease growth. This effect was blocked by use of a small-molecule inhibitor of Focal Adhesion Kinase. Anti-angiogenic therapy was also associated with increased platelet infiltration into tumor that was not seen to the same degree in the control or FAK-inhibitor-treated mice. Conclusions: Platelets are active participants in the growth and metastasis of tumor, both directly and via facilitation of angiogenesis. Blocking platelets, blocking platelet activation, and blocking platelet trafficking into tumor are novel therapeutic avenues supported by this data. Copyright © 2012 Justin Neal Bottsford-Miller, all rights reserved.

Immune response to hepatitis B vaccination in drug using populations: A systematic review and meta-regression analysis

Hepatitis B virus (HBV) is a significant cause of liver diseases and related complications worldwide. Both injecting and non-injecting drug users are at increased risk of contracting HBV infection. Scientific evidence suggests that drug users have subnormal response to HBV vaccination and the seroprotection rates are lower than that in the general population; potentially due to vaccine factors, host factors, or both. The purpose of this systematic review is to examine the rates of seroprotection following HBV vaccination in drug using populations and to conduct a meta-analysis to identify the factors associated with varying seroprotection rates. Seroprotection is defined as developing an anti-HBs antibody level of ≥ 10 mIU/ml after receiving the HBV vaccine. Original research articles were searched using online databases and reference lists of shortlisted articles. HBV vaccine intervention studies reporting seroprotection rates in drug users and published in English language during or after 1989 were eligible. Out of 235 citations reviewed, 11 studies were included in this review. The reported seroprotection rates ranged from 54.5 – 97.1%. Combination vaccine (HAV and HBV) (Risk ratio 12.91, 95% CI 2.98-55.86, p = 0.003), measurement of anti-HBs with microparticle immunoassay (Risk ratio 3.46, 95% CI 1.11-10.81, p = 0.035) and anti-HBs antibody measurement at 2 months after the last HBV vaccine dose (RR 4.11, 95% CI 1.55-10.89, p = 0.009) were significantly associated with higher seroprotection rates. Although statistically nonsignificant, the variables mean age>30 years, higher prevalence of anti-HBc antibody and anti-HIV antibody in the sample population, and current drug use (not in drug rehabilitation treatment) were strongly associated with decreased seroprotection rates. Proportion of injecting drug users, vaccine dose and accelerated vaccine schedule were not predictors of heterogeneity across studies. Studies examined in this review were significantly heterogeneous (Q = 180.850, p = 0.000) and factors identified should be considered when comparing immune response across studies. The combination vaccine showed promising results; however, its effectiveness compared to standard HBV vaccine needs to be examined systematically. Immune response in DUs can possibly be improved by the use of bivalent vaccines, booster doses, and improving vaccine completion rates through integrated public programs and incentives.^

Lipids in ocean particulate matter and bottom sediments

Lipid contents both in particulate matter and bottom sediments decreases with passage from the shelf toward the open ocean. Lipid concentration in particulate matter collected by a separator (Ls) decreases by a factor of 7 (from 7.05 to 0.95 % of dry matter), while in particulate matter collected on filters (Lf) it decreases by a factor of 13 (from 78 to 6 µg/l) in the vicinity of the Limpopo River and by a factor of 6 (from 74 to 13 µg/l) in the vicinity of the Zambezi River. Concentration of Lf also decreased with depth. In the upper sediment layers lipid concentration was 0.0028-0.039% of dry matter; all mud samples were richer in lipids, than sand samples. During sedimentogenesis there is an increase in proportion of lipids relative to other classes of organic matter, proportion of low-polarity compounds increases among the lipids, and proportion of hydrocarbons rises among these compounds. Sediments inherit composition of particulate matter to the greatest degree in the vicinity of river mouths.

Counselors' education in complex contexts with special reference to Latin America

This paper makes reference to the importance lying, at present, on the professional education of counselors. It goes through the history of the different pre-scientific and scientific stages of counseling, and it points out the main representatives in Latin America . It also shows the current state of the specialization, taking as an antecedent some in-depth, widely encompassing research carried out in the European Union in this area. Coincidences and differences are exposed here in terms of professional profiles, university degrees, institutional dependence, up-dating processes and modes of intervention. The current state of postgraduate studies at university is also touched upon, and the different proposals for further education in Latin America are analyzed as well as their dependence upon an undergraduate degree in Psychology, Educational Sciences or Psycho-pedagogy. Finally, this paper places counseling within the complexity and the need to provide all-encompassing and integrative answers which require a wide and deep enough education so as to answer all these issues and problems.

Counselors' education in complex contexts with special reference to Latin America

This paper makes reference to the importance lying, at present, on the professional education of counselors. It goes through the history of the different pre-scientific and scientific stages of counseling, and it points out the main representatives in Latin America . It also shows the current state of the specialization, taking as an antecedent some in-depth, widely encompassing research carried out in the European Union in this area. Coincidences and differences are exposed here in terms of professional profiles, university degrees, institutional dependence, up-dating processes and modes of intervention. The current state of postgraduate studies at university is also touched upon, and the different proposals for further education in Latin America are analyzed as well as their dependence upon an undergraduate degree in Psychology, Educational Sciences or Psycho-pedagogy. Finally, this paper places counseling within the complexity and the need to provide all-encompassing and integrative answers which require a wide and deep enough education so as to answer all these issues and problems.

Flower and seed biomass, and germination rate of arctic tundra plants in response to long term experimental warming

We provide new information on changes in tundra plant sexual reproduction in response to long-term (12 years) experimental warming in the High Arctic. Open-top chambers (OTCs) were used to increase growing season temperatures by 1-2 °C across a range of vascular plant communities. The warming enhanced reproductive effort and success in most species; shrubs and graminoids appeared to be more responsive than forbs. We found that the measured effects of warming on sexual reproduction were more consistently positive and to a greater degree in polar oasis compared with polar semidesert vascular plant communities. Our findings support predictions that long-term warming in the High Arctic will likely enhance sexual reproduction in tundra plants, which could lead to an increase in plant cover. Greater abundance of vegetation has implications for primary consumers - via increased forage availability, and the global carbon budget - as a function of changes in permafrost and vegetation acting as a carbon sink. Enhanced sexual reproduction in Arctic vascular plants may lead to increased genetic variability of offspring, and consequently improved chances of survival in a changing environment. Our findings also indicate that with future warming, polar oases may play an important role as a seed source to the surrounding polar desert landscape.

Counselors' education in complex contexts with special reference to Latin America

This paper makes reference to the importance lying, at present, on the professional education of counselors. It goes through the history of the different pre-scientific and scientific stages of counseling, and it points out the main representatives in Latin America . It also shows the current state of the specialization, taking as an antecedent some in-depth, widely encompassing research carried out in the European Union in this area. Coincidences and differences are exposed here in terms of professional profiles, university degrees, institutional dependence, up-dating processes and modes of intervention. The current state of postgraduate studies at university is also touched upon, and the different proposals for further education in Latin America are analyzed as well as their dependence upon an undergraduate degree in Psychology, Educational Sciences or Psycho-pedagogy. Finally, this paper places counseling within the complexity and the need to provide all-encompassing and integrative answers which require a wide and deep enough education so as to answer all these issues and problems.

Sm-Nd, Rb-Sr, and He isotopic composition and hydrocarbon gases in rocks and minerals from the Markov Deep, Mid-Atlantic Ridge rift valley

The paper presents characteristics of the Nd and Sr isotopic systems of ultrabasic rocks, gabbroids, plagiogranites, and their minerals as well as data on helium and hydrocarbons in fluid inclusions of the same samples. Materials presented in this publication were obtained by studying samples dredged from the MAR crest zone at 5°-6°N (U/Pb zircon dating, geochemical and petrological-mineralogical studies). It was demonstrated that variations in the isotopic composition of He entrapped in rocks and minerals were controlled by variable degrees of mixing of juvenile He, which is typical of basaltic glass for MAR (DM source), and atmospheric He. Increase in the atmospheric He fraction in plutonic rocks and, to a lesser degree, in their minerals reflects involvement of seawater or hydrated material of the oceanic crust in magmatic and postmagmatic processes. This conclusion finds further support in positive correlation between the fraction of mantle He (R ratio) and 87Sr/86Sr ratio. High-temperature hydration of ultrabasic rocks (amphibolization) was associated with increase in the fraction of mantle He, while their low-temperature hydration (serpentinization) was accompanied by drastic decrease in this fraction and significant increase in 87Sr/86Sr ratio. Insignificant variations in 143Nd/144Nd (close to 0.5130) and 87Sr/86Sr (0.7035) in most of gabbroids and plagiogranites as well as the fraction of mantle He in these rocks, amphibolites, and their ore minerals indicate that the melts were derived from the depleted mantle. Similar e-Nd values of gabbroids, plagiogranites, and fresh harzburgites (6.77-8.39) suggest that these rocks were genetically related to a single mantle source. e-Nd value of serpentinized lherzolites (2.62) likely reflects relations of these relatively weakly depleted mantle residues to another source. Aforementioned characteristics of the rocks generally reflect various degrees of mixing of depleted mantle components with crustal components (seawater) during metamorphic and hydrothermal processes that accompanied formation of the oceanic crust.

Considerations on the success rate in aeronautical engineering studies in Spain

The relationship between different learning evaluation methods and the academic success in an aeronautical engineering degree in Spain is analysed. The study is based on data about the evolution of academic achievement obtained along the last ten year, along which the evaluation and learning’s methods have suffered huge changes.

Concienciación para la conservación del patrimonio urbano : los instrumentos de gestión para la recuperación del barrio madrileño de Embajadores

La tesis trata la evolución de la conciencia de la conservación de los centros históricos y de los instrumentos de gestión utilizados en las políticas de rehabilitación del casco antiguo de Madrid, desde las primeras experiencias de los años ‘80 hasta el perfeccionamiento del complejo mecanismo contemporáneo. El proceso de rehabilitación ha demostrado ser extremadamente coherente en cuanto a los objetivos y en cuanto al tema de los instrumentos ha seguido la tendencia de diversificar y flexibilizar. En Madrid se ha utilizado el concepto de rehabilitación en sentido integral, abarca una amplia gama de acciones que implican por una parte, intervenciones directas sobre los edificios y por otra, la valorización del espacio público, de los edificios representativos, la introducción de dotaciones y también un componente social. El tema se analizará desde la perspectiva del barrio de Embajadores, un área muy especial del casco antiguo de la ciudad. Desde 1998 hasta la actualidad allí funciona el Área de Rehabilitación Integral con el nombre de Lavapiés. El barrio de Embajadores representa un caso de extrema complejidad dada su tradición, que mantiene hasta el momento, de barrio popular que ha tenido como consecuencia negativa un grave estado de deterioro de los edificios y de sus estructuras urbanas. Además, presenta una composición socio-cultural muy heterogénea ya que siempre ha alojado oleadas de inmigrantes que llegaban a la capital tanto de las provincias como del extranjero. Los ‘80 marcan en Madrid el inicio de la preocupación por la rehabilitación urbana y de los primeros intentos de definir unos mecanismos. Durante este período el barrio de Embajadores es escenario de los primeros proyectos piloto de rehabilitación. Se sientan las bases del sistema de subvenciones, que empujará hacia un modelo de rehabilitación generalizada. A principios de los años ‘90, la insatisfacción dejada por de los resultados obtenidos, la Administración decide reorganizar la estrategia y se procede a la rehabilitación integral por áreas, concentrando los esfuerzos geográfica y temporalmente. La idea ya se había utilizado diez años antes, pero sin encontrar nunca la voluntad política de aplicarla. En comparación con el casco antiguo, el barrio de Embajadores se dejó para el final del proceso para verificar los métodos en zonas más restringidas en cuanto a superficie y con menos problemas. Desde 1998 hasta hoy, período en que funciona el Área de Rehabilitación Integral de Lavapiés, los distintos tipos de actuaciones, de producción arquitectónica, urbanística y sociocultural, han mostrado su eficacia, de forma que los cambios que aportaron al barrio son evidentes para todos. Mientras que las Áreas de Rehabilitación del centro una vez alcanzados los objetivos, se preparan para su clausura, a nivel administrativo se están definiendo nuevas direcciones y nuevos objetivos para el casco antiguo: subastas para incentivar intervenciones de mejoramiento energético y del nivel de sostenibilidad de los edificios madrileños. La primera parte de la tesis establece las premisas presentando algunos puntos relevantes relativos al desarrollo histórico de los documentos y normativas más importantes que tendrán eco en el proceso de concienciación de la cultura de la conservación del patrimonio urbano de los centros históricos. Después, se habla de la experiencia de rehabilitación urbana en Europa, en España en general y en Madrid en particular, con referencia a los modelos de enfoque, al marco legislativo y a las experiencias relacionadas con el casco antiguo, y en definitiva a la creación de la conciencia de la rehabilitación y conservación de los centros de las ciudades. La segunda parte se centra en el caso de estudio, el barrio de Embajadores. En primer lugar, se presenta en detalle el barrio: ubicación, datos característicos, edificios representativos y flujos que generan, trama urbana, datos sobre la formación histórica, tipologías y características de construcción de los edificios y, para finalizar, algún dato demográfico para introducir la compleja problemática social. Más adelante se exponen las primeras experiencias de rehabilitación: dos proyectos piloto de intervención sobre las viviendas realizados en los años ‘80, uno privado y el otro público. La parte central del trabajo trata sobre la fase intensiva de rehabilitación, proceso puesto en marcha en el año ’98 y que corresponde al período en el que Embajadores es Área de Rehabilitación Integral. Se presentan y analizan los objetivos de la rehabilitación y luego los instrumentos de orden administrativo, normativo y legal que regulan las actuaciones en el barrio. Sucesivamente se afronta la rehabilitación de la parte residencial, en régimen privado y público, que fue el modelo principal que la Administración llevó a cabo. Se presenta todo el proceso, desde la decisión sobre el tipo de rehabilitación, las subvenciones y las soluciones técnicas adoptadas así como la rehabilitación de casos especiales de edificios, que por sus características, el alto nivel de degradación o porque ocupados por inquilinos con dificultades económicas, se realizó con intervención pública. Las enormes dificultades derivadas de la complicada gestión y de las incongruencias de las normativas también se analizan en este trabajo. El autor presenta un dosier de una veintena de trabajos llevados a cobo en el Barrio de Embajadores a lo largo de más de 15 años de experiencia profesional propia. Se intenta, en primer lugar, evaluar la actuación pública en comparación con la privada en cuanto a los modelos propuestos, a las problemáticas que generan y a los resultados obtenidos. Una segunda línea de argumentación se refiere a la relación que se establece entre los instrumentos que se promueven y los que obligan a la conservación y a la rehabilitación de los edificios. Quizás el elemento más interesante, por su conocida innovación, de la experiencia de la obligación de conservación a cargo de los propietarios y la introducción de una revisión periódica del estado de los edificios (ITE), que conduce a su mantenimiento permanente a lo largo del tiempo. El ultimo instrumento aparecido y de por si el más novedoso se refiere a la política de rehabilitación energética iniciada en los últimos años por el Ayuntamiento de Madrid. ABSTRACT Starting from the early experiences of the ‘80s and tackling the complex and improved contemporary techniques of development, the present thesis focuses on raising awareness of the conservation of urban heritage and deals with the evolution of rehabilitation policies adopted in the historical center of Madrid. The rehabilitation process has proven to be extremely coherent in terms of its objectives and, consequently, the subject of the instruments has forged ahead a trend of diversification and flexibility. Madrid has used the concept of rehabilitation in a comprehensive manner, encompassing a wide range of actions, which involved on the one hand, direct interventions on buildings and on the other, the appreciation of the public space with its representative edifices and endowments. Confident that the social components have not been neglected during the rehabilitation proceedings, the topic will be analysed in relation to the neighbourhood of Embajadores, an authentic area of the old town. From 1998 onwards, this quarter serves as a Comprehensive Rehabilitation Area under the name of Lavapies. Considering the tradition and popularity of the district, Embajadores represents a challenging case for rehabilitation projects, aiming to improve the severe state of deterioration of buildings and urban structures. Having a heterogeneous sociocultural dynamic, the neighbourhood has always hosted waves of immigrants who come to the capital both from other provinces and abroad. The 1980s in Madrid marked the beginning of concerns with urban regeneration and the first attempts to define feasible restoration techniques. During this period, the district of Embajadores has benefited from various pilot projects. The financial investments have significant effects on the overall environment, so the model of general rehabilitation has been encouraged throughout the years. In the early 90s, left by the dissatisfaction of the results obtained, the authorities proposed to reorganise the strategy and proceed to the full rehabilitation of areas, concentrating efforts geographically and temporally. The idea had already been used ten years before, but never encountered the political force to be implemented. Compared to the old town, the Embajadores neighbourhood has been left for the end of the process, which focused on verifying the methods in more restricted areas that caused fewer disruptions. For the Comprehensive Rehabilitation Area of Lavapies, the various types of administrative implementations from architectural to urban and socio-cultural productions have proved effective. The improvements experienced by the neighbourhood from 1998 are obvious to all. However, while the areas of rehabilitation of the city centre have achieved their objectives and prepare for closure, the administration is still generating new directions and new targets for the ancient surroundings: auctions to encourage the improvement of energy interventions and the sustainability level for the buildings of Madrid. Therefore, the first part of the thesis establishes the premises and introduces some relevant points concerning the entire city. It describes the historical development of urban projects, indicating the events that will echo in the rehabilitation process. This paper then turns to discuss the experience of urban regeneration in Spain, emphasising the case of Madrid with reference to models of approach, legislative frameworks and appreciation of the old structures. The second part reveals an in depth case study of the district of Embajadores. At first, the thesis provides insights into the neighbourhood: location, general data on representative buildings and propagated trends, urban, historical data on training, building typologies and characteristics. The section introduces some demographic data to complete the portrait of the elaborate social problems encountered in this district, also outlining the first experiences of rehabilitation: two pilot projects on housing intervention made in the 80s, one private and one public. The central part of the thesis deals with the intensive phase of rehabilitation developments launched in the year '98 when Embajadores joined the Comprehensive Rehabilitation Area. It analyses the goals of rehabilitation and the instruments of administrative, regulatory and governing legal proceedings of the neighbourhood. The following chapter addresses the privately and publicly founded plan of residential rehabilitation that constituted the main model conducted by the authorities. It describes the entire process: deciding the type of restoration, subsidies and technical solutions as well as the degree of rehabilitation for special buildings, which either have a high level of degradation or require public intervention when tenants face financial difficulties. The administrative difficulties caused by the enormous bureaucratic machinery and the inconsistencies in regulations are also discussed in this paper. Thus, a just evaluation of the public and private performances regarding the proposed models of rehabilitation, along with the problems they generate and the results obtained is desired throughout the thesis. A second line of argument concerns the relationship established between the instruments that are promoted and requiring conservation and the building restoration. Perhaps the most interesting and innovative element of the new rehabilitation policies is the owners' obligation to preserve their properties and the introduction of a periodic review for the state of the buildings (ITE). These thorough and meticulous regulations lead to an ongoing maintenance of constructions, preventing them from severe or sudden deteriorations.