Living with osteoarthritis: Patient expenditures, health status, and social impact

Objective. To determine out-of-pocket expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

Mecanismos de sincronia social no ritmo circadiano de atividade durante a coabitação em casais de saguis (Callithrix jacchus)

In marmosets, it was observed that the synchrony among circadian activity profiles of animals that cohabite in family groups is stronger than those of the same sex and age of different families. Inside the group, it is stronger between the younger ones than between them and their parents. However, the mechanisms involved in the social synchrony are unknown. With the aim to investigate the synchronization mechanisms involved in the synchrony between the circadian activity profiles during cohabitation in pairs of marmosets, the motor activity was continuously registered by the use of actmeters on three dyads. The pairs were maintained in two different conditions of illumination: light-dark cycle LD 12:12 (LD cohabitation I – 21 days), and thereafter in LL (~350 lux). Under LL, the pairs were submitted to four experimental situations: 1. Cohabitation (LLJ I – 24 days), 2. Removal of one member of the pair to another room with similar conditions (LLS I – 20 days), 3. Reintroduction of the separated member in the cage of the first situation (LLJ II – 30 days) and 4. Removal of a member from each pair to another experimental room (LLS II – 7 days), to evaluate the mechanisms of synchronization. Ultimately, the members of each pair were reintroduced in the cage and were kept in LD cycle 12:12 (LDJ II – 11 days). The rhythms of pairs free-ran in LL, with identical periods between the members of each pair during the two stages of cohabitation. In the stages in which the animals were separated, only the rhythms of two females free-ran in the first stage and of three animals in the second one. In those conditions, the rhythms of animals of each pair showed different endogenous periods. Besides, during cohabitation in LD and LL, the members of each pair showed a stable phase relationship in the beginning of the active phase, while in the stages in which the animals were separated it was noticed a breaking in the stability in the phase relationships between the circadian activity profiles, with an increase in the difference in the phase angles between them. During cohabitation, at the transition between LD and LL, all animals showed free-running rhythms anticipating progressively the beginning and the end of the active phase in a phase similar to the previous condition, showing signs of entrainment to the previous LD. While in the posterior stages this was observed in only three animals between: LLT I and LLS I, and LLT II and LLS II, evidencing signs of entrainment to social cues between the members of each pair. On the other hand, one animal delayed progressively between LLT I and LLS I, three animals delayed between LLS I and LLT II, and three animals between LLT II and LLS II, perhaps by entrainment to the animals maintained outdoors in the colony. Similar process was observed in four animals between LLS II and LDT II, indicating entrainment to LD. In the transition between LLS I and LLT II, signs of masking was observed in the rhythm of a female in response to the male and in another pair in the rhythm of the male in regard to that of the female. The general and maximum correlations in the circadian activity profiles were stronger during cohabitation in LD and LL than in the absence of social contact in LL, evidencing the social effect. The cohabiting pairs had higher values of the maximum correlation in LD and LL than when the profiles were correlated to animals of different cages, with same or different sexes. Similar results were observed in the general correlation. Therefore, it is suggested that cohabitation induces a strong synchrony between circadian activity profiles in marmosets, which involves entrainment and masking. Nevertheless, additional studies are necessary to evaluate the effect of social cues on the synchronization of the circadian rhythm in pairs of marmosets in the absence of external social cues in order to confirm this hypothesis.

La gratuité des soins et ses effets sociaux : entre renforcement des capabilités et du pouvoir d’agir (empowerment) au Burkina Faso

La documentation sur les interventions de gratuité sélective des soins est encore insuffisante et surtout focalisée sur leurs effets au niveau de l’utilisation des services de santé ou de la réduction des dépenses catastrophiques. Leurs effets sociaux sont occultés par les recherches. L’originalité de cette thèse tient au fait qu’elle constitue la première recherche qui s’est consacrée à cela. Ses résultats sont structurés en quatre articles. Le premier article montre que la gratuité sélective des soins est socialement acceptée, car elle est vue comme contributive au renforcement du lien social. Toutefois, le choix des cibles bénéficiaires est remis en cause. Au nom d’arguments moraux et humanitaires, les communautés préfèrent inclure les personnes âgées dans le ciblage, quitte à les substituer aux plus pauvres, les indigents. Néanmoins, le ciblage des indigents n’a pas entrainé de stigmatisation. Le deuxième article souligne que la fourniture gratuite de soins aux populations par les villageois membres des comités de gestion des centres de santé a contribué au renforcement de leur pouvoir d’agir et celui de leur organisation. Cependant, pour que la participation communautaire soit effective, l’étude montre qu’elle doit s’accompagner d’un renforcement des compétences des communautés Le troisième article soutient que la suppression du paiement des soins a permis aux femmes de ne plus avoir besoin de s’endetter ou de négocier constamment avec leurs maris pour disposer de l’argent des consultations prénatales ou des accouchements. Ce qui a contribué à leur empowerment et rendu possible l’atteinte d’autres réalisations au plan sanitaire (augmentation des accouchements assistés), mais aussi social (renforcement de leur position sociale). Le quatrième article s’est intéressé à étudier la pérennité de ces interventions de gratuité des soins. Les résultats suggèrent que le degré de pérennité de la prise en charge des indigents (district de Ouargaye) est moyen correspondant au degré le plus élevé dans une organisation alors que celui de la gratuité des accouchements et des soins pour les enfants (districts de Dori et de Sebba) est précaire. Cette différence de pérennité est due principalement à la différence d’échelle (taille des populations concernées) et d’ampleur (inégalité des ressources en jeu) entre ces interventions. D’autres facteurs ont aussi influencé cette situation comme les modalités de mise en œuvre de ces interventions (approche projet à Dori et Sebba vs approche communautaire à Ouargaye) Au plan des connaissances, l’étude a mis en exergue plusieurs points dont : 1) l’importance de prendre en compte les valeurs des populations dans l’élaboration des réformes ; 2) la pertinence sociale du ciblage communautaire de sélection des indigents ; 3) la capacité des communautés à prendre en charge leurs problèmes de santé pourvu qu’on leur donne les ressources financières et la formation minimale ; 4) l’importance du processus de pérennisation, notamment la stabilisation des ressources financières nécessaires à la continuité d’une intervention et l’adoption de risques organisationnels dans sa gestion ; 5) l’importance de la suppression de la barrière financière au point de services pour renforcer l’empowerment des femmes et son corolaire leur recours aux services de soins.

A Shine of Truth in the "universal delusional context of reification" (Theodor W. Adorno)

“A Shine of Truth in the ‘universal delusional context of reification’ (Theodor W. Adorno)” comprend sept chapitres, un prologue et un épilogue. Chaque partie se construit à deux niveaux : (1) à partir des liens qui se tissent entre les phrases contiguës ; et (2) à partir des liens qui se tissent entre les phrases non contiguës. Les incipit des paragraphes forment l’argument principal de la thèse. Le sujet de la thèse, Schein (apparence, illusion, clarté) est abordé de manière non formaliste, c’est à dire, de manière que la forme donne d’elle-même une idée de la chose : illusion comme contradiction imposée. Bien que le sujet de la thèse soit l’illusion, son but est la vérité. Le Chapitre I présente une dialectique de perspectives (celles de Marx, de Lukács, de Hegel, de Horkheimer et d'Adorno) pour arriver à un critère de vérité, compte tenu du contexte d’aveuglement universel de la réification ; c’est la détermination de la dissolution de l’apparence. Le Chapitre II présente le concept d’apparence esthétique—une apparence réversible qui s’oppose à l’apparence sociale générée par l’industrie de la culture. Le Chapitre III cherche à savoir si la vérité en philosophie et la vérité en art sont deux genres distincts de vérités. Le Chapitre IV détermine si l’appel à la vérité comme immédiateté de l’expression, fait par le mouvement expressionniste du 20e siècle, est nouveau, jugé à l’aune d’un important antécédent à l’expressionisme musical : « Der Dichter spricht » de Robert Schumann. Le Chapitre V se penche sur la question à savoir si le montage inorganique est plus avancé que l’expressionisme. Le Chapitre VI reprend là où Peter Bürger clôt son essai Theorie de l’avant-garde : ce chapitre cherche à savoir à quel point l’oeuvre d’art après le Dada et le Surréalisme correspond au modèle hégélien de la « prose ». Le Chapitre VII soutient que Dichterliebe, op. 48, (1840), est une oeuvre d’art vraie. Trois conclusions résultent de cette analyse musicale détaillée : (1) en exploitant, dans certains passages, une ambigüité dans les règles de l’harmonie qui fait en sorte tous les douze tons sont admis dans l’harmonie, l’Opus 48 anticipe sur Schoenberg—tout en restant une musique tonale ; (2) l’Opus 48, no 1 cache une tonalité secrète : à l'oeil, sa tonalité est soit la majeur, soit fa-dièse mineur, mais une nouvelle analyse dans la napolitaine de do-dièse majeur est proposée ici ; (3) une modulation passagère à la napolitaine dans l’Opus 48, no 12 contient l’autre « moitié » de la cadence interrompue à la fin de l’Opus 48, no 1. Considérés à la lumière de la société fausse, l’Allemagne des années 1930, ces trois aspects anti-organiques témoignent d’une conscience avancée. La seule praxis de vie qu’apporte l’art, selon Adorno, est la remémoration. Mais l’effet social ultime de garder la souffrance vécue en souvenir est non négligeable : l’émancipation universelle.

Vinte e cinco anos depois: efeitos sociais do Projeto ALBRÁS/ALUNORTE em São Lourenço (Barcarena-Pará)

Os moradores de São Lourenço, no município de Barcarena, no Estado do Pará, vêm experimentando transformações nos seus modos de vida a partir da implantação do complexo metalúrgico ALBRAS/ALUNORTE, a partir da década de 90. A pesquisa orientou-se para uma reflexão analítica acerca das percepções dessas pessoas diante das mudanças ocorridas no período e que geram novas configurações em suas estruturas produtivas e nas formas de organização social e que orientam e atualizam suas práticas cotidianas.

Visuell-mediale Landschaftskonstruktionen als Bild-Raum-Diskurse

Durch die massenmediale Zunahme von statischen und bewegten Bilder im Laufe des letzten Jahrhunderts vollzieht sich unsere lebensweltliche Wirklichkeitskonstruktion zu Beginn des 21. Jahrhunderts zunehmend über Visualisierungen, die mit den neuen Formen der Digitalisierung noch an Dynamik zunehmen werden. Mit diesen omnipräsenten visuell-medialen Repräsentationen werden meist räumliche Vorstellungen transportiert, denn Räume werden vor allem über Bilder konstruiert. Diese Bildräume zirkulieren dabei nicht als singuläre Bedeutungszuschreibungen, sondern sind in sprachliche und bildliche Diskurse eingebettet. Visuell-mediale Bild-Raum-Diskurse besitzen zunehmend die Fähigkeit, unser Wissen über und unsere Wahrnehmung von Räumen zu kanalisieren und auf stereotype Raumstrukturen zu reduzieren. Dabei verfestigt sich eine normative Ordnung von bestimmten machtvollen Bildräumen, die nicht genügend kritisch hinterfragt werden. Deshalb ist es für die Geographie von entscheidender Wichtigkeit, mediale Raumkonstruktio- nen, ihre Einbettung in diskursive Bildarchive und ihre essentialistische und handlungspraktische gesellschaftliche Wirkung zu verstehen.rnLandschaften können vor diesem Hintergrund als visuell-medial transportierte Bild-Raum-Diskurse konzeptionalisiert werden, deren gesellschaftliche Wirkmächtigkeit mit Hilfe einer visuell ausgerichteten Diskursanalyse hinterfragt werden sollte. Auf Grundlage einer zeichentheoretischen Ikonologie wurde eine Methodik entwickelt, die visuell ausgerichtete Schrift-Bild-Räume angemessen analysieren kann. Am Beispiel der Inszenierung des Mittelrheintals, wurde, neben einer diachronischen Strukturanalyse der diskursrelevanten Medien (Belletristik, Malerei, Postkarten, Druckgrafiken und Fotografien), eine Feinanalyse der fotografischen „Rheinlandschaften“ von August Sander der 1930er Jahre durchgeführt. Als Ergebnis zeigte sich, dass der Landschaftsdiskurs über das Mittelrheintal immer noch durch die gegenseitige Durchdringung der romantischen Literatur und Malerei in der ersten Hälfte des 19. Jahrhunderts und die historischen Fotografien in den ersten Jahrzehnten des 20. Jahrhunderts bestimmt ist, nicht zuletzt forciert durch die Ernennung zum UNESCO-Welterbe 2002. Der stark visuell ausgerichtete Landschaftsdiskurs trägt somit zum einen positiv konnotierte, romantisch-pittoreske Züge, die die Einheit von Mensch und Natur symbolisieren, zum anderen historisch-konservatorische Züge, die eine Mythifizierung zu einer gewachsenen, authentischen Kulturlandschaft evozieren.

O DEMONÍACO EM MARCOS 3,20-35

O pensamento antigo interpretava todas as manifestações danosas ou enfermidades pessoais e psíquicas como influência satânica. Considerando esse pano de fundo, a proposta deste trabalho é analisar o imaginário da comunidade marcana em relação ao demoníaco e como esse tipo de leitura impactava a vida das pessoas naquela conjuntura. Para tanto, buscaremos identificar na perícope de Mc 3,20-35 os mecanismos demoníacos daquela sociedade e como esse imaginário se refletia no cotidiano da comunidade. Além disso, verificaremos por que as práticas de Jesus envolvendo o exorcismo incomodavam, levando à sua identificação como demônio. Entendemos ser necessário avaliar a atividade taumatúrgica de Jesus e a representatividade que ela tinha em seu contexto, bem como o efeito social que produzia e a sua recepção pela comunidade marcana

Effect of smoke-free policies on the behaviour of social smokers

Objective-To test the hypothesis that proposed amendments to the Occupational Safety and Health Act making all enclosed workplaces in Western Australia smoke free would result in a decrease in cigarette consumption by patrons at nightclubs, pubs, and restaurants without adversely affecting attendance. Design-Cross sectional structured interview survey. Participants and setting-Patrons of several inner city pubs and nightclubs in Perth were interviewed while queuing for admission to these venues. Outcome measures-Current social habits, smoking habits, and how these might be affected by the proposed regulations. Persons who did not smoke daily were classified as social smokers. Results-Half (50%) of the 374 patrons interviewed were male, 51% currently did not smoke at all, 34.3% smoked every day, and the remaining 15.7% smoked, brat not every day. A clear majority (62.5%) of all 374 respondents anticipated no change to the frequency of their patronage of hospitality venues if smoke-free policies became mandatory One in five (19.3%) indicated that they would,ao out more often, and 18.2% said they would go out less often. Half (52%) of daily smokers anticipated no change to their cigarette consumption, while 44.5% of daily smokers anticipated a reduction in consumption. A majority of social smokers (54%) predicted a reduction in their cigarette consumption, with 42% of these anticipating quitting. Conclusions-One in nine (11.5%) of smokers say that adoption of smoke-Pi ee policies would prompt them to quit smoking entirely without a significant decrease in attendance at pubs and nightclubs. There can be few other initiatives as simple, cheap, and popular that would achieve so much for public health.

Unlimited or disrupted communication? How does the development of the mobile phone effect our ability of social action?

The aim of this essay is to discuss the thesis of the German Sociologist Günter Burkhart that in modern societies a phenomenon appeared which he calls “handymania”, an excessive and nearly addictive use of the mobile phones especially from adolescents. After a short overview about the history of the cell phone, I will relate this development to Jürgen Habermas “theory of communicative action”, more precisely to his diagnosis of a pathological society (“lifeworld”) to find out if the “handymania” could be one expression of it. Adjacent I will present social-psychological theories from E.H.Erikson and Tilmann Habermas to ascertain whether juveniles could really be a high-risk group for this kind of addiction. I will focus on the ability to communicate in an Habermasian way that could be seriously harmed by the unregulated usage of cell phones.

Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies

Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.

Corporate social responsibility and its effect on image and reputation: The case of L’Oréal and its acquisition of The Body Shop

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

The effect of social and environmental sustainability on firm resilience

Double degree

The effect of host social system on parasite population genetic structure: comparative population genetics of two ectoparasitic mites and their bat hosts.

BACKGROUND: The population genetic structure of a parasite, and consequently its ability to adapt to a given host, is strongly linked to its own life history as well as the life history of its host. While the effects of parasite life history on their population genetic structure have received some attention, the effect of host social system has remained largely unstudied. In this study, we investigated the population genetic structure of two closely related parasitic mite species (Spinturnix myoti and Spinturnix bechsteini) with very similar life histories. Their respective hosts, the greater mouse-eared bat (Myotis myotis) and the Bechstein's bat (Myotis bechsteinii) have social systems that differ in several substantial features, such as group size, mating system and dispersal patterns. RESULTS: We found that the two mite species have strongly differing population genetic structures. In S. myoti we found high levels of genetic diversity and very little pairwise differentiation, whereas in S. bechsteini we observed much less diversity, strongly differentiated populations and strong temporal turnover. These differences are likely to be the result of the differences in genetic drift and dispersal opportunities afforded to the two parasites by the different social systems of their hosts. CONCLUSIONS: Our results suggest that host social system can strongly influence parasite population structure. As a result, the evolutionary potential of these two parasites with very similar life histories also differs, thereby affecting the risk and evolutionary pressure exerted by each parasite on its host.

Social Determinants of Child Health in Colombia: Can Community Education Moderate the Effect of Family Characteristics?

Contextual effects on child health have been investigated extensively in previous research. However, few studies have considered the interplay between community characteristics and individual-level variables. This study examines the influence of community education and family socioeconomic characteristics on child health (as measured by height and weight-for-age Z-scores), as well as their interactions. We adapted the Commission on Social Determinants of Health (CSDH) framework to the context of child health. Using data from the 2010 Colombian Demographic and Health Survey (DHS), weighted multilevel models are fitted since the data are not self-weighting. The results show a positive impact of the level of education of other women in the community on child health, even after controlling for individual and family socioeconomic characteristics. Different pathways through which community education can substitute for the effect of family characteristics on child nutrition are found. The interaction terms highlight the importance of community education as a moderator of the impact of the mother’s own education and autonomy, on child health. In addition, the results reveal differences between height and weight-for-age indicators in their responsiveness to individual and contextual factors. Our findings suggest that community intervention programmes may have differential effects on child health. Therefore, their identification can contribute to a better targeting of child care policies.