Spezifische Inhibition des Wnt-Signalwegs und die Analyse der Konsequenzen auf zellbiologischer Ebene

Der kanonische Wnt Signalweg ist durch Regulation einer Vielzahl von Zielgenen in unterschiedliche Prozesse wie Entwicklung, Wachstum und Differenzierung involviert. Fehlregulation des Signalwegs kann zur Tumorentstehung führen. Die exakte Rolle des Wnt Signalwegs und seiner Zielgene in der karzinogenen Kaskade ist noch nicht genau bekannt. In dieser Arbeit sollte die Beteiligung der Wnt Zielgene c-MYC, CCND1 (kodiert Cyclin D1) und VEGF an der Karzinogenese untersucht werden. Um die Funktionen der Wnt Zielgene und ihre zellulären Effekte unabhängig voneinander untersuchen zu können, wurden die Mengen der entsprechenden Transkriptionsprodukte durch siRNA (short interfering RNA) gezielt verringert. Die Konsequenzen der Inaktivierung wurden in Kolon- und Zervixkarzinomzelllinien untersucht, wobei die zellulären Parameter Proliferation, Apoptose, Metabolismus sowie Migration und Adhäsion untersucht wurden. Dabei konnte beobachtet werden, dass der Wnt Signalweg mit seinen Zielgenen Cyclin D1 und c-MYC die Proliferation mit dem Energiemetabolismus von Tumorzellen verknüpft. Darüber hinaus konnte gezeigt werden, dass Cyclin D1 an der Regulation der zelluläre Migration und Adhäsion beteiligt ist, während VEGF die Apoptose abhängig vom zellulären Kontext inhibiert. Diese Ergebnisse liefern erste Hinweise auf die funktionelle Rolle der verschiedenen Zielgene im Prozess der Karzinogenese in Tumoren mit aktiviertem Wnt Signalweg. Damit ist diese Arbeit ein möglicher Ausgangspunkt für Studien mit dem Ziel der gezielten therapeutischen Beeinflussung des Wnt Signalwegs auf Ebene der Zielgene.

Social housing: interventions of densification in urban regeneration (1995-2010). Critical analysis of strategies adopted in Milan, London, São Paulo

The prospect of the continuous multiplication of life styles, the obsolescence of the traditional typological diagrams, the usability of spaces on different territorial scales, imposes on contemporary architecture the search for new models of living. Limited densities in urban development have produced the erosion of territory, the increase of the harmful emissions and energy consumption. High density housing cannot refuse the social emergency to ensure high quality and low cost dwellings, to a new people target: students, temporary workers, key workers, foreign, young couples without children, large families and, in general, people who carry out public services. Social housing strategies have become particularly relevant in regenerating high density urban outskirts. The choice of this research topic derives from the desire to deal with the recent accommodation emergency, according to different perspectives, with a view to give a contribution to the current literature, by proposing some tools for a correct design of the social housing, by ensuring good quality, cost-effective, and eco-sustainable solutions, from the concept phase, through management and maintenance, until the end of the building life cycle. The purpose of the thesis is defining a framework of guidelines that become effective instruments to be used in designing the social housing. They should also integrate the existing regulations and are mainly thought for those who work in this sector. They would aim at supporting students who have to cope with this particular residential theme, and also the users themselves. The scientific evidence of either the recent specialized literature or the solutions adopted in some case studies within the selected metropolitan areas of Milan, London and São Paulo, it is possible to identify the principles of this new design approach, in which the connection between typology, morphology and technology pursues the goal of a high living standard.

La nuovissima Teatrologia. Gli studi teatrali in Italia fra Novecento e Duemila

Scopo del presente progetto di ricerca è indagare i lineamenti degli studi teatrali in Italia negli anni Novanta e Duemila. La tesi, tuttavia, configura piani di indagine più ampi, sia in senso temporale che geografico: prendendo in considerazione il rapporto fra la teatrologia italiana post-novecentesca e la sua tradizione disciplinare, da un lato, e, dall'altro, le esperienze nel medesimo campo di altre culture teatrali occidentali. La tesi si struttura in tre parti: nella prima vengono analizzati i processi di rifondazione (anni Sessanta e Settanta) e di consolidamento (anni Settanta e Ottanta) degli studi teatrali italiani; nella seconda si presentano i caratteri della teatrologia post-novecentesca (anni Novanta e Duemila); nella terza, essi vengono indagati attraverso la lente di uno specifico aspetto che si propone di assumere per descrivere il paradigma disciplinare a quest'altezza: quello del progetto di ricomposizione che sembra manifestarsi negli studi teatrali come messa in dialogo di alcune coppie di polarità oppositive tradizionalmente determinanti (teoria/storia, teoria/pratica, ecc.). Ciascuna delle parti si articola nella ricostruzione storica delle vicende occorse alla disciplina (tenendo conto anche dei loro rapporti con i coevi accadimenti in altri campi artistici, del sapere e socio-culturali) e nell'analisi della produzione scientifica di un determinato periodo. In ogni capitolo, infine, tali elementi vengono messi in relazione sia con le tendenze in atto sui più ampi scenari teatrologici internazionali, che con la tradizione di studio. Il progetto di ricerca si è sviluppato attraverso un'ampia ricognizione bibliografica della produzione scientifica del settore, all'interno di cui è stato dato ampio rilievo al ruolo di quegli ambienti di lavoro teatrologico coagulatisi intorno alle maggiori riviste del campo di studio; si è avvalso inoltre di un intenso programma di ricerca sul campo, che è consistito in una serie di incontri con alcuni dei protagonisti della rifondazione e dello sviluppo della nuova teatrologia italiana.

Factorization and non-local 1/m b corrections in the decay B X s gamma

In this thesis, a systematic analysis of the bar B to X_sgamma photon spectrum in the endpoint region is presented. The endpoint region refers to a kinematic configuration of the final state, in which the photon has a large energy m_b-2E_gamma = O(Lambda_QCD), while the jet has a large energy but small invariant mass. Using methods of soft-collinear effective theory and heavy-quark effective theory, it is shown that the spectrum can be factorized into hard, jet, and soft functions, each encoding the dynamics at a certain scale. The relevant scales in the endpoint region are the heavy-quark mass m_b, the hadronic energy scale Lambda_QCD and an intermediate scale sqrt{Lambda_QCD m_b} associated with the invariant mass of the jet. It is found that the factorization formula contains two different types of contributions, distinguishable by the space-time structure of the underlying diagrams. On the one hand, there are the direct photon contributions which correspond to diagrams with the photon emitted directly from the weak vertex. The resolved photon contributions on the other hand arise at O(1/m_b) whenever the photon couples to light partons. In this work, these contributions will be explicitly defined in terms of convolutions of jet functions with subleading shape functions. While the direct photon contributions can be expressed in terms of a local operator product expansion, when the photon spectrum is integrated over a range larger than the endpoint region, the resolved photon contributions always remain non-local. Thus, they are responsible for a non-perturbative uncertainty on the partonic predictions. In this thesis, the effect of these uncertainties is estimated in two different phenomenological contexts. First, the hadronic uncertainties in the bar B to X_sgamma branching fraction, defined with a cut E_gamma > 1.6 GeV are discussed. It is found, that the resolved photon contributions give rise to an irreducible theory uncertainty of approximately 5 %. As a second application of the formalism, the influence of the long-distance effects on the direct CP asymmetry will be considered. It will be shown that these effects are dominant in the Standard Model and that a range of -0.6 < A_CP^SM < 2.8 % is possible for the asymmetry, if resolved photon contributions are taken into account.

Carlos Martí Arís e i suoi eteronimi. Vocazione all'anonimo

Questa ricerca indaga la prospettiva investigativa di Carlos Martí Arís. È stato assunto il campo d’azione da lui prediletto, ovvero l’articolato rapporto che in architettura si instaura tra teoria e pratica, comprensivo delle svariate ricadute nel mondo dell’arte e della produzione umana in genere, che fanno del progetto architettonico un campo disciplinare complesso. La sua figura è però assunta in modo strumentale, come grimaldello per addentrarsi in un articolato ambito culturale, che se da un lato coincide con la sua città, Barcellona, dall’altro la trascende grazie a quei “ponti della conoscenza” che CMA interrottamente ha teso al suo intorno. Ci riferiamo alla sua costruzione teorica destinata a consolidare la storica reciprocità tra Italia e Spagna, le cui tematiche urbane e tipologiche ne sono la base, Milano e Barcellona ne sono gli estremi. Ci riferiamo al suo sguardo sull’esperienza del Movimento Moderno e il relativo tema della residenza. Ci riferiamo alla sua naturale vocazione al silenzio, che si oppone al fragoroso rumore della contemporaneità e affianca la discreta parola del mestiere: un modo per porsi all’ascolto. All’ascolto dell’altro e del mondo. Ci riferiamo, insomma, alla sua idea di architettura intesa come «territorio dissodato da tempi remoti»; come trama di corrispondenze sincroniche tra terre, tempi, fatti, uomini, vicini e lontani: condizione ideale per chi voglia disciogliere il proprio lavoro nei labirintici sentieri del mondo, indifferente al rischio di perdersi nell’oblio. Oggi, in cui il progetto architettonico risulta sempre più spesso veicolo di soggettive e arbitrarie sperimentazioni formali, la lezione di CMA indica una via d’uscita: un mo(n)do condiviso che all’arroganza opponga la discrezione, che persuada a celarsi nella tradizione e a porsi umilmente all’ombra dei maestri. Tradizione e Maestri, Eteronimi e Nomi, complementarità a cui CMA affida il suo progetto di anonimato, sovrapersonale e ostinatamente teso a rilevarne le relazioni inedite.

Poetiche della traduzione: le esperienze di Ungaretti-Jaccottet e Char-Sereni

La traduzione poetica viene affrontata sul piano empirico dell'analisi testuale. Una breve introduzione presenta le riflessioni più importanti sulla traduzione del testo poetico, da Benjamin e Steiner fino alle teorie più recenti di Meschonnic, Apel, Berman e Mattioli. Alla luce di queste teorie vengono analizzate le opere di due coppie di poeti e poeti-traduttori. Nel primo esempio troviamo il poeta svizzero (francofono) Philippe Jaccottet alle prese con l'intera opera di Ungaretti; nel secondo il rapporto travagliato di Vittorio Sereni con la poesia di René Char. Oltre a indagare la natura problematica della traduzione poetica come pratica e come esperienza, questa tesi di Letteratura Comparata vuole presentare la traduzione come strumento ermeneutico e come meccanismo rienunciativo: il suo ruolo nella dialettica delle influenze e dell'evoluzione letteraria è da considerarsi infatti essenziale. La vocazione originariamente etica della traduzione è sfondo costante della trattazione.

Theoretical analysis of hidden photon searches in high-precision experiments

Although the Standard Model of particle physics (SM) provides an extremely successful description of the ordinary matter, one knows from astronomical observations that it accounts only for around 5% of the total energy density of the Universe, whereas around 30% are contributed by the dark matter. Motivated by anomalies in cosmic ray observations and by attempts to solve questions of the SM like the (g-2)_mu discrepancy, proposed U(1) extensions of the SM gauge group have raised attention in recent years. In the considered U(1) extensions a new, light messenger particle, the hidden photon, couples to the hidden sector as well as to the electromagnetic current of the SM by kinetic mixing. This allows for a search for this particle in laboratory experiments exploring the electromagnetic interaction. Various experimental programs have been started to search for hidden photons, such as in electron-scattering experiments, which are a versatile tool to explore various physics phenomena. One approach is the dedicated search in fixed-target experiments at modest energies as performed at MAMI or at JLAB. In these experiments the scattering of an electron beam off a hadronic target e+(A,Z)->e+(A,Z)+l^+l^- is investigated and a search for a very narrow resonance in the invariant mass distribution of the lepton pair is performed. This requires an accurate understanding of the theoretical basis of the underlying processes. For this purpose it is demonstrated in the first part of this work, in which way the hidden photon can be motivated from existing puzzles encountered at the precision frontier of the SM. The main part of this thesis deals with the analysis of the theoretical framework for electron scattering fixed-target experiments searching for hidden photons. As a first step, the cross section for the bremsstrahlung emission of hidden photons in such experiments is studied. Based on these results, the applicability of the Weizsäcker-Williams approximation to calculate the signal cross section of the process, which is widely used to design such experimental setups, is investigated. In a next step, the reaction e+(A,Z)->e+(A,Z)+l^+l^- is analyzed as signal and background process in order to describe existing data obtained by the A1 experiment at MAMI with the aim to give accurate predictions of exclusion limits for the hidden photon parameter space. Finally, the derived methods are used to find predictions for future experiments, e.g., at MESA or at JLAB, allowing for a comprehensive study of the discovery potential of the complementary experiments. In the last part, a feasibility study for probing the hidden photon model by rare kaon decays is performed. For this purpose, invisible as well as visible decays of the hidden photon are considered within different classes of models. This allows one to find bounds for the parameter space from existing data and to estimate the reach of future experiments.

Methodenentwicklung zur Charakterisierung von metallischen Nanopartikeln und deren potentieller Einsatz bei der Analyse von Biomolekülen mittels ICP-MS Kopplungstechniken

Die qualitative und quantitative Analyse von Biomolekülen hat in den letzten Jahren und Jahrzehnten immer mehr an Bedeutung gewonnen. Durch das Aufkommen und die kontinuierliche Weiterentwicklung neuer Separations- und Detektionsmethoden und deren Verbindung miteinander zu leistungsfähigen Einheiten, erlangte man Schritt für Schritt neue Erkenntnisse bei ihrer Untersuchung. Die Elementmassenspektrometrie als nachweisstarke Detektionsmethode wird von vielen wissenschaftlichen Arbeitsgruppen bei der Trennung und Quantifizierung von Proteinen und Metalloproteinen mittels Detektion der in den Biomolekülen vorkommenden Metalle und Heteroatome angewendet. Heteroatome (z.B. Schwefel, Phosphor) haben im Plasma des ICP-MS (inductively coupled plasma - mass spectrometer) schlechte Ionisationseigenschaften und dementsprechend deutlich höhere Nachweisgrenzen als Metalle. Ein Ansatz, schlecht oder nicht detektierbare Verbindungen (also solche, die keine Metalle oder Heteroatome enthalten) mit dem ICP-MS sichtbar zu machen, ist die Markierung der selbigen mit Metallionen oder -cluster. rnIn dieser Arbeit ist es gelungen, der Analyse ganz unterschiedlicher Substanzklassen, zum einen metallische Nanopartikel und zum anderen Proteine, neue Impulse zu geben und zukünftiges Potential bei der Anwendung gekoppelter Techniken zur Separation und Detektion aufzuzeigen. Durch die Verwendung einer alten, aber neu konzipierten Trenntechnik, der Gelelektrophorese (GE), und deren Kopplung an einen modernen Detektor, dem ICP-MS, kann die für die Proteinanalytik weit verbreitete Gelelektrophorese ihr enormes Potential bei der Trennung verschiedenster Verbindungsklassen mit der exzellenten Nachweisstärke und Elementspezifität des ICP-MS verbinden und dadurch mit deutlich weniger Arbeitsaufwand als bisher qualitative und auch quantitative Ergebnisse produzieren. Bisher war dies nur mit großem präparativem Aufwand unter Verwendung der laser ablation möglich. Bei der Analyse von Nanopartikeln konnte aufgezeigt werden, dass durch die GE-ICP-MS-Kopplung aufgrund der guten Trenneigenschaften der GE vorhandene Spezies bzw. Fraktionen voneinander separiert werden und mit Hilfe des ICP-MS Informationen auf atomarem Niveau gewonnen werden können. Es war möglich, das atomare Verhältnis der Metallatome im Kern und der Schwefelatome in der Ligandenhülle eines Nanopartikels zu bestimmen und damit die Größe des Partikels abzuschätzen. Auch konnte die Anzahl der Goldatome in einem dem Schmid-Cluster ähnlichen Nanopartikel bestimmt werden, was vorher nur mit Hilfe von MALDI-TOF möglich war. Bei der Analyse von Biomolekülen konnte auf einfache Weise der Phosphorylierungsgrad verschiedener Proteine bestimmt werden. Auch bei kleinen Molekülen erzielt die Gelelektrophorese ausgezeichnete Trennergebnisse, wie z. B. bei der Analyse verschiedener Brom- und Iodspezies.rnDie stöchiometrische Kopplung eines Proteins an einen Nanopartikel, ohne eine der beiden Verbindungen in einem größeren Maße zu verändern, stellte jedoch eine Herausforderung dar, die im Rahmen dieser Arbeit nicht vollständig gelöst werden konnte. Verschiedene Ansätze zur Kopplung der beiden Substanzen wurden erprobt, jedoch führte keine zu dem gewünschten Ergebnis einer stöchiometrisch vollständigen und spezifischen Modifikation eines Proteins mit einem Nanopartikel. Durch das Potential der GE-ICP-MS-Kopplung bei der Analyse beider Substanz-klassen und dem Beweis der Praktikabilität und Zuverlässigkeit der Methode ist jedoch der Grundstein für weitere Forschungen auf diesem Gebiet gelegt worden. Ist eine geeignete chemische Kopplung der beiden Substanzklassen gefunden und beherrscht, steht auf analytischer Seite eine leistungsstarke Kombination aus Trennung und Detektion zur Verfügung, um die Quantifizierung von Proteinen entscheidend zu verbessern.rn

Austauschprozesse an Tropopausenfalten extratropischer Zyklonen

Troposphärisches Ozon ist bekannt als wichtiges Oxidationsmittel und als Vorläufergas hoch reaktiver Radikale. Es zählt zu den wichtigsten Treibhausgasen und wirkt bei hohen Konzentrationen an der Erdoberfläche giftig für alle Lebewesen. Zwar wird der Großteil des troposphärischen Ozons photochemisch produziert, ein erheblicher Anteil hat aber stratosphärischen Ursprung und wird entlang von Tropopausenfalten in Zyklonen in die Troposphäre transportiert. Dieser Transport von Luftmassen aus der Stratosphäre in diernTroposphäre (STT) kann zu einem kurzzeitigen, starken Ozonanstieg am Boden führen und langfristig die Chemie der Troposphäre beeinflussen. Die Quantifizierung des Ozoneintrages und die Identifizierung der dafür verantwortlichen Prozesse ist mit großen Unsicherheiten belastet und ein aktuelles Forschungsthema.rnAufgrund ihrer groben Auflösung ist es mit globalen Modellen nicht möglich, die Details dieser STT-Prozesse zu erfassen. Deshalb wird in dieser Arbeit das Modellsystem MECO(n) genutzt, welches das regionale Atmosphärenchemie- und Klimamodell COSMO/MESSy mit dem globalen Chemie-Klimamodell ECHAM5/MESSy (EMAC) koppelt. Eine einheitliche Prozessparametrisierung ermöglicht konsistente, simultane Simulationen in verschiedenen Modellauflösungen. Ein als Teil dieser Arbeit neu entwickeltes Submodell erlaubt die Initialisierung künstlicher, passiver Tracer in Abhängigkeit verschiedener Variablen. Mit einem auf diese Weise freigesetzten, stratosphärischen Tracer lässt sich Ozon mit stratosphärischer Herkunft von solchem, das photochemisch produziert wurde, unterscheiden.rnIm Rahmen einer Fallstudie werden die Austauschprozesse an einer Tropopausenfalte sowohl aus der Eulerischen, als auch aus der Lagrangeschen Perspektive betrachtet. Die Analyse der STT-Prozesse zeigt, dass Luftmassen aus der Stratosphäre durch turbulente und diabatische Prozesse am Rand der Tropopausenfalte in die Troposphäre gelangen und anschließend bis zum Boden transportiert werden. Diese absinkenden, stratosphärischen Luftmassen führen in den Simulationen zu Ozonanstiegen am Boden, die mit Beobachtungsdaten evaluiert werden können. Es wird gezeigt, dass die Ergebnisse der feiner auflösendenrnModellinstanz gut mit den Messungen übereinstimmen.rnIn einer Lagrangeschen Analyse lassen sich Mischungszeitskalen für STT-Prozesse bestimmen. Es wird gezeigt, dass Luftpakete, die sich länger als zehn Stunden in der Troposphäre aufhalten, diese durch den Eintrag ihrer stratosphärischen Tracereigenschaften beeinflussen und daher nicht vernachlässigbar sind. Eine weitere Studie gibt Aufschluss über die Effektivität der Mischung an Tropopausenfalten: Fast die gesamte Luftmasse, die sich zu einem bestimmten Zeitpunkt in der Tropopausenfalte befindet, gelangt innerhalb von zwei Tagen in die Troposphäre.

Analisi di morfologie carsiche o crio-carsiche in relazione alla mobilizzazione di fluidi nella regione di Arabia Terra, Marte.

This thesis tries to interpret the origin and evolution of karst-like forms present in Arabia Terra, a region of Mars that develops in the equatorial zone of the planet. The work has been carried out specifically in the craters Crommelin (4o 91’ N-10o 51’ E), 12000088 (3o 48’ N-1o 30’ E), NE 12000088 (4° 20’ N-2° 50’ E), C "2" (3° 54’ N-1° W), and in their surrounding areas. These craters contain layered deposits characterized by a high albedo and on which erosion is very pronounced. The area containing the craters is a plateau that has the same characteristics of albedo and texture. The preliminary morphological study has made use of instrumentation such as the Mars Reconnaissance Orbiter (MRO), in particular HiRISE images (High Resolution Imaging Science Experiment), CTX (Context Camera) and CRISM (Compact Reconnaissance Imaging Spectrometers for Mars). A regional geomorphological map has been drawn up containing the main morphotypes, and detailed geomorphological maps were prepared for different karst-like morphologies. The analysis of spectral data collected from CRISM instrumentation has allowed to identify the footprint of sulphate minerals in the external area. Data were collected for morphometric negative forms (karst-like) and positive forms (mud volcanoes, dikes and pingos). For the analysis of the relief forms DTMs (Digital Terrain Models) produced by the union of stereographic CTX couples or HiRISE were used. From the analysis of high-resolution images morphological footprints similar to periglacial environments have been identified, including the presence of patterned ground and polygonal cracks found all over the area of investigation, and relief structures similar to pingos present in the crater C "2". These observations allow us to imagine a geological past with a cold climate at the equator able to freeze the few fluids present in the Martian arid terrain. The development of karst-like landforms, on the other hand, can be attributed to a subsequent improval of the weather conditions that led to a normal climate regime for the equatorial areas, resulting in the degradation of the permafrost. The melt waters have thus allowed the partial dissolution of the sulphate layers. The karst-like forms look rather fresh suggesting them to be not that old.

Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer

Objective: Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. Method: Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. Results: Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). Conclusion: A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley ; Sons, Ltd.

Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely.

Future storm surge impacts on insurable losses for the North Sea region

The influence of climate change on storm surges including increased mean sea level change and the associated insurable losses are assessed for the North Sea basin. In doing so, the newly developed approach couples a dynamical storm surge model with a loss model. The key element of the approach is the generation of a probabilistic storm surge event set. Together with parametrizations of the inland propagation and the coastal protection failure probability this enables the estimation of annual expected losses. The sensitivity to the parametrizations is rather weak except when the assumption of high level of increased mean sea level change is made. Applying this approach to future scenarios shows a substantial increase of insurable losses with respect to the present day. Superimposing different mean sea level changes shows a nonlinear behavior at the country level, as the future storm surge changes are higher for Germany and Denmark. Thus, the study exhibits the necessity to assess the socio-economic impacts of coastal floods by combining the expected sea level rise with storm surge projections.

COMPARATIVE STUDY OF INFORMAL HEALTH CARE NETWORKS AND ELDERLY HEALTH STATUS IN ARGENTINA AND CUBA

This study will explore familial and friend support networks and living arrangements among elderly individuals in Latin America and the impact that this type of support has on the health of the elderly individuals in the countries of interest. Using data from the Survey on Health and Well-Being of Elders (SABE) from 1999-2000, I will explore which type of support has a larger impact on overall health. I will also measure differences in unmet needs for certain health services. This topic is particularly interesting because it will help to uncover what policies are best for aiding in the healthcare of the elderly in aging population. Lastly, the investigation of this topic will allow me to draw conclusions about the most effective means of social and public policy for the elderly community and provide me with information about the role of both informal provisions of support from family and friends, and formal provisions of support from the government. My primary focus will be on Argentina, using Buenos Aires as the sample city, and Cuba, using Havana as the sample city. These two countries have increasingly aging populations, poorer resources and vast inequalities, but, extremely different political, economic and cultural situations. Comparing the two countries will further allow me to determine correlations between health and the existence of support networks, as well as provide me with information to make more general claims that may be of use in the United States. Argentina is particularly interesting to me because of my abroad experience and homestay experience with an older Argentine woman who lived alone but depended upon her family for many healthcare needs, doctors’ visits and general well-being. In Argentina, I experienced a different form of living than I am used to in the United States, where many older individuals or couples live in nursing homes or assisted living facilities rather than alone or with family. The changing economic climate of the two countries coupled with labor patterns of women returning to work at rapid rates indicates that policies cannot just rely on either the formal or informal sector but require a combination of the two sectors working together.This paper will first give background on the difference in the economies and the health care systems in Argentina and Cuba and will show why it interesting to study and compare these two countries. I will then discuss the health status of the elderly in each population as well as discuss the informal care networks and the role of family in each country. This section will then be followed by a description of the data and methods used. I will end by drawing conclusions about the study and the outcomes, and then I will attempt to make suggestions about effective health care policies for the elderly.

Polymyalgia rheumatica in a married couple

The case of a married couple developing polymyalgia rheumatica (PMR) consecutively is presented. The 55-year-old wife complained in June 2010 about pain in her neck. Case history, physical examination, and erythrocyte sedimentation rate (ESR) of 80 mm/hour led to the diagnosis of PMR. In May 2011, her 66-year old husband complained about pain in his neck, shoulders, buttocks, and thighs. Considering anamnesis, physical examination, and ESR of 56 mm/hour, the diagnosis of PMR was made. Both wife and husband responded to steroid treatment. When the steroid dose was gradually reduced, both patients relapsed. In order to lower the cumulative dose of glucocorticoid therapy, 10 mg methotrexate per week was added. In the literature, six cases of polymyalgia rheumatica in married couples have been described to date. In four cases, polymyalgia rheumatica occurred first in the wife. The interval of the diagnosis between the spouses ranged from 0 to 89 months. Although in most of the previous case reports a genetic disposition and an infectious agent have been discussed, this hypothesis must be questioned.