Suivi du patient après transplantation cardiaque: monitoring et adaptation de l'immunosuppression [Monitoring and adjustment of immunosuppression after heart transplantation].

Heart transplantation remains the best therapeutic option for the treatment of end-stage heart failure. However, good survival rates can be obtained only if patients are closely monitored, particularly for their immunosuppressive regimens. Currently, a triple-drug regimen usually based on calcineurin-inhibitors (cyclosporin A or tacrolimus), anti-proliferative agents and steroids is used in most recipients. New agents such as the mTOR inhibitors, a more recently developed class of immunosuppressive drugs, can also be used in some patients. The aim of this article is to review currently used immunosuppressive regimens after heart transplantation, and to propose some individualized options depending on specific patient characteristics and recent pharmacological developments in the field.

Viatge al món de les flautes

Viatge al món de les flautes és un material didàctic dirigit a grups de nivell elemental de l’aula de flauta travessera que planteja una introducció a les músiques tradicionals d’arreu del món. Alhora conté una proposta de concert familiar. Els objectius generals del present treball són donar a conèixer la gran família de les flautes juntament amb el seu repertori i fer una recerca pedagògica a l’entorn d’aquest per aplicar-lo a l’aula. La metodologia ha partit d'un treball de camp sobre diverses flautes d’arreu del món, en base al qual s'ha elaborat el concert i diverses propostes didàctiques per treballar a l’aula. Aquest projecte pretén aportar un ventall de noves eines per utilitzar en la docència.

Extensional flow of nematic liquid crystal under electric field gradient

Systematic asymptotic methods are used to formulate a model for the extensional flow of a thin sheet of nematic liquid crystal. With no external body forces applied, the model is found to be equivalent to the so-called Trouton model for Newtonian sheets (and fi bers), albeit with a modi fied "Trouton ratio". However, with a symmetry-breaking electric field gradient applied, behavior deviates from the Newtonian case, and the sheet can undergo fi nite-time breakup if a suitable destabilizing field is applied. Some simple exact solutions are presented to illustrate the results in certain idealized limits, as well as sample numerical results to the full model equations.

Sylvatic population of Triatoma infestans from the Bolivian Chaco: from field collection to characterization

A sylvatic Triatoma infestans DM (dark morph) population detected in the Bolivian Chaco was characterized and compared with various domestic ones. The degree of differentiation of DM was clearly within the T. infestans intra-specific level. Nevertheless marked chromatic and morphometric differences as well as differences in antennal pattern, chromosome banding and randomly amplified polymorphic DNA support the hypothesis of a distinct population. Continuous exchange of insects between wild and domestic habitats seems unlikely in the Chaco.

Estudi amb georadar del jaciment arqueològic de Lady Field (Woolston Manor Farm, Somerset, Gran Bretanya)

Projecte de recerca elaborat a partir d’una estada al University of Bristol, Gran Bretanya, durant agost i setembre del 2007. Els objectius del projecte d’estudi del jaciment de Lady Field (Woolston Manor Farm, Somerset, Gran Bretanya) eren, bàsicament, tres: en primer lloc, posar en pràctica els coneixements teòrics assolits durant la formació en prospecció geofísica; en segon lloc, aportar informació complementària a la aportada per la prospecció tradicional i el sondeig amb gradiòmetre magnètic efectuades prèviament per l’equip investigador del centre, arribant a definir millor les estructures poc definides per l’altre sistema i, finalment, obtenir un cas d’estudi sobre un jaciment medieval a Gran Bretanya, on les condicions geològiques i climàtiques, que afecten els resultats de la prospecció, són diferents a les del nostre país. Aquests objectius s’han assolit, ja que s’ha pogut portar a terme una prospecció de camp amb el sistema de georadar, processar les dades i obtenir-ne dades de qualitat i obtenir informació útil i rellevant de cara a la definició de les restes detectades, una vegada feta la interpretació. Els resultats mostren l’aparició en el subsòl del jaciment de quatre possibles fases d’ocupació, entre les que destaquen un moment amb possibles restes d’una antiga xarxa urbana, treballs agrícoles o un sistema de drenatge del terreny. Finalment l’estudi ha pogut constatar que la prospecció amb GPR en aquestes condicions geològiques és possible, tot i que les climàtiques –essencialment la pluja i la humitat del sòl- suposen complicacions a l’hora d’adquirir dades de forma segura per la maquinària i per la qualitat de les dades.

Educational pathways of minority youth in Norway: intersections of gender, ethnicity and social class

Educational aspirations during lower secondary school and choice of upper secondary education are important for young people’s future trajectories into higher education and labour market positions. In line with ideas about reflexive, autonomous individuals (Giddens, 1991), choice of education is often represented as a young person’ individual decision, and educational guidance as aimed at discovering what ‘fits’ an individual’s personality, interests and abilities. Educational aspirations and choices are also social patterns that are reproduced. Some population categories represent exceptions from expected patterns of social reproduction of educational level and professions. In several countries, one such category is young people from families with migration experiences (Lauglo, 2000; Modood, 2004). In Norway, students have a legal right to non-compulsory upper secondary schooling and 96 percent of the students continue from lower to upper secondary school. In spite of positive developments regarding minority youths’ completion of upper secondary and higher education in later years, studies still persistently show lower educational attainment among minority youth, particularly among boys (Fekjaer, 2006). However, in lower secondary school, minor ity youth tend to have markedly higher educational aspirations and stronger learning motivation than their majority peers, as well as greater effort in school and strong adherence to school values (Lauglo, 2000) despite lower educational attainment or lower socio-economic backgrounds. In addition, gender differences in educational aspirations seem to be smaller among minority youth. The principal objective of the study in progress that will be presented in this paper, is to describe how processes relating to gendered, ethnic and class-based identities influence young people’s educational choices. The study is undertaken as a PhD project in social anthropology. The methodological approach is ethnographic longitudinal fieldwork in two multicultural lower secondary schools in Oslo. The study is part of a larger project that also include quantitative analyses of longitudinal data covering 9th graders in Oslo 2006 through four data collections during lower and upper secondary school.

The ethnography of study abroad: what is study abroad as a cultural event?

Recent research in the field of study abroad shows that study abroad participation among all U.S. students increased 20% since 2001 and nearly 200,000 U.S. students currently go abroad each year. Additionally, about 8% of all undergraduate degree recipients receive part of their education abroad. Although quantitative studies have dominated research on study abroad, my research project calls for a qualitative approach since the goal is to understand what study abroad is as a cultural event, what authentic cultural immersion is, how program stakeholders understand and perceive cultural immersion, and how cultural immersion in programs can be improved. Following the tradition of ethnographic and case study approaches in study abroad research, my study also pivots on ethnography. As an ethnographer I collected data mainly through participant observation, semi-structured interviews, and document analysis. The study abroad participants were a group of undergraduate native speakers of English studying Spanish for seven weeks in Cádiz, a small costal city in southern Spain, as well as program coordinators, host community members, and professors. I also examined the specific program design features, particularly the in-class and out-of-class activities that students participated in. The goal was to understand if these features were conducive to authentic immersion in the language and culture. Eventually, I elaborated an ethnographic evaluation of the study abroad program and its design features suggesting improvements in order to enhance the significance and value of study abroad as a cultural event. Among other things, I discussed the difficulties that students had at the beginning of their sojourn to understand local people, get used to their host families’ small apartments, get adjusted to new schedules and eating habits, and venture out from the main group to individually explore the new social and cultural fabric and interact with the host community. The program evaluation revealed the need for carefully-designed pre-departure preparation sessions, pre-departure credit-bearing courses in intercultural communication, and additional language practice abroad and opportunities to come in contact with the local community through internships, volunteer or field work. My study gives an important contribution in study abroad research and education. It benefits students, teachers, and study abroad directors and coordinators in suggesting ideas on how to improve the program and optimize the students’ cultural experiences abroad. This study is also important because it investigated how US undergraduate learners studying the Spanish language and culture approach and perceive the study abroad experience in Spain.

Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition

A combined clinical and sonographic classification of hepatosplenic schistosomiasis mansoni to be used in field-based studies is proposed herein. Seven hundred forty one individuals out of 892 (83%), living in an area endemic for schistosomiasis in Brazil, have been ubmitted to clinical and ultrasound examinations. Based on two stool examinations the overall prevalence for schistosomiasis in this area was 73%. Abdominal palpation was performed with patients in dorsal decubit, during deep breath, by two experienced physicians and a portable ultrasound was used for the evaluation of liver fibrosis, portal collaterals and spleen size. Four groups of individuals were identified using data obtained by abdominal palpation and ultrasound examination: (1) palpable spleen and intense periportal thickening in 9 individuals (1.2%); (2) spleen not palpable and intense periportal thickening in 15 (2%); (3) palpable spleen with light to moderate periportal thickening in 32 (4.3%), and (4) palpable spleen with a normal liver on ultrasound in 30 (4%). The definition of hepatosplenic schistosomiasis in field-based studies as the finding of Schistosoma mansoni eggs in the stools in an individual with splenomegaly is not acceptable anymore. Abdominal ultrasound should be combined with clinical examination to accurately identify hepatosplenics in endemic areas for schistosomiasis.

Accounting for Big City Growth in Low Paid Occupations: Immigration and/or Service Class Consumption

Growth of 'global cities' in the 1980s was supposed to have involved an occupational polarisation, including growth of low paid service jobs. Though held to be untrue for European cities, at the time, some such growth did emerge in London a decade later than first reported for New York. The question is whether there was simply a delay before London conformed to the global city model, or whether another distinct cause was at work in both cases. This paper proposes that the critical factor in both cases was actually an upsurge of immigration from poor countries providing an elastic supply of cheap labour. This hypothesis and its counterpart based on growth in elite jobs are tested econometrically for the British case with regional data spanning 1975-2008, finding some support for both effects, but with immigration from poor countries as the crucial influence in late 1990s London. Keywords: regional labour markets; wages; employment; international migration; consumer demand JEL Codes: J21, J23, F22, R12

Sex-related and non-sex-related comorbidity subtypes of tic disorders: a latent class approach.

BACKGROUND AND PURPOSE: Recent evidence suggests that there may be more than one Gilles de la Tourette syndrome (GTS)/tic disorder phenotype. However, little is known about the common patterns of these GTS/tic disorder-related comorbidities. In addition, sex-specific phenomenological data of GTS/tic disorder-affected adults are rare. Therefore, this community-based study used latent class analyses (LCA) to investigate sex-related and non-sex-related subtypes of GTS/tic disorders and their most common comorbidities. METHODS: The data were drawn from the PsyCoLaus study (n = 3691), a population-based survey conducted in Lausanne, Switzerland. LCA were performed on the data of 80 subjects manifesting motor/vocal tics during their childhood/adolescence. Comorbid attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depressive, phobia and panic symptoms/syndromes comprised the selected indicators. The resultant classes were characterized by psychosocial correlates. RESULTS: In LCA, four latent classes provided the best fit to the data. We identified two male-related classes. The first class exhibited both ADHD and depression. The second class comprised males with only depression. Class three was a female-related class depicting obsessive thoughts/compulsive acts, phobias and panic attacks. This class manifested high psychosocial impairment. Class four had a balanced sex proportion and comorbid symptoms/syndromes such as phobias and panic attacks. The complementary occurrence of comorbid obsessive thoughts/compulsive acts and ADHD impulsivity was remarkable. CONCLUSIONS: To the best of our knowledge, this is the first study applying LCA to community data of GTS symptoms/tic disorder-affected persons. Our findings support the utility of differentiating GTS/tic disorder subphenotypes on the basis of comorbid syndromes.

Navigator-gated free-breathing three-dimensional balanced fast field echo (TrueFISP) coronary magnetic resonance angiography.

RATIONALE AND OBJECTIVES: Recent developments of MR imaging equipment enabled high-quality steady state-free-precession (Balanced FFE, True-FISP) MR-imaging with a substantial 'T2 like' contrast, resulting in a high signal intensity of the blood-pool without the application of exogenous contrast agents. It is hypothesized that Balanced-FFE may be valuable for contrast enhancement in 3D free-breathing coronary MRA. MATERIALS AND METHODS: Navigator-gated free-breathing cardiac triggered coronary MRA was performed in 10 healthy adult subjects and three patients with radiograph defined coronary artery disease using a segmented k-space 3D Balanced FFE imaging sequence. RESULTS: High contrast-to-noise ratio between the blood-pool and the myocardium (29 +/- 8) and long segment visualization of both coronary arteries could be obtained in about 5 minutes during free breathing using the present navigator-gated Balanced-FFE coronary MRA approach. First patient results demonstrated successful display of coronary artery stenoses. CONCLUSION: Balanced FFE offers a potential alternative for endogenous contrast enhancement in navigator-gated free-breathing 3D coronary MRA. The obtained results together with the relatively short scanning time warrant further studies in larger patient collectives.