Das reiche Land der Armen

Nach der internationalen Wirtschaftskrise 1930 wurde in Argentinien das Agrarexportmodell von der importsubstituierenden Industrialisierung (ISI) abgelöst. Diese neue Entwicklungsstrategie ermöglichte Argentinien die Etablierung einer Integrationsgesellschaft, gekennzeichnet durch einen großen Anteil von Mittelklassen in der Bevölkerung, einer hohen Formalisierung der Arbeitsverhältnisse und einer aufsteigenden sozialen Mobilität. Armut und soziale Ungleichheit gehörten zu marginalen sozialen Realitäten des Landes, sodass Argentinien in Lateinamerika lange durch sein gesellschaftliches Integrationsmodell hervorstach. Mitte der 1970er Jahre änderte sich mit der Implementierung des neoliberalen Wirtschaftsmodells diese Realität. Vor allem in den 1990er Jahren wurden neoliberale Reformen nach der Vorlage des Washington Consensus auf radikale Art und Weise durchgeführt und hatten fatale gesellschaftliche Folgen, sodass sich die ehemalige Inklusionsgesellschaft in eine Exklusionsgesellschaft verwandelte. In der Diplomarbeit wird analysiert, wie und warum sich die Sozialstruktur Argentiniens seit 1976 veränderte und wie sich die Veränderungen auf die Beziehungen zwischen den verschiedenen sozialen Schichten auswirkten. Der Ansatz der Chancenstruktur von Carlos Filgueira als Basiskonzept für die Bildung eines integrierten Modells der sozialen Schichtung und Mobilität stellt die theoretische Basis für die Analyse der Veränderungen der Sozialstruktur in Argentinien dar und zeigt, wie sich der Auslöser für auf- und absteigende soziale Mobilität in Argentinien modifizierte. Die neoliberale Wirtschaftspolitik zerstörte die für lange Zeit gültigen Integrationsmechanismen Sozialstaat und Lohnarbeit in Argentinien. Der Staat verlor seine Interventionsrolle zur Verteilung der Ressourcen sowie zur öffentlichen und universellen Garantie der sozialen Sicherheit der Bevölkerung. Weiters führte die Flexibilisierung und Deregulierung des argentinischen Arbeitsmarktes zur Segmentierung der ArbeiterInnen. Eine dualisierende Dynamik am Arbeitsmarkt führt zu einer zunehmenden Kluft zwischen qualifizierten und unqualifizierten ArbeitnehmerInnen, d.h. die Chancen auf aufsteigenden Mobilität haben sich vermindert. Konkret zeigte sich dies im Anstieg der Arbeitslosigkeit, Unterbeschäftigung, Informalität, Prekarität, Einkommensungleichheit sowie im Rückgang der Einkommen. Die Zerstörung der Integrationsmechanismen in der argentinischen Gesellschaft führte zu einem Wachstum und einer Heterogenisierung der Armut, d.h. es nahm nicht nur die Anzahl der Armen zu, sondern weite Teile der Mittelklassen verarmten. Außerdem nahm die soziale Ungleichheit und Polarisierung in Argentinien zu. Der Wandel zu einer ungleichen und polarisierten Gesellschaft in Argentinien führte zum Anstieg der sozialen Konflikte, sodass heute die Kriminalität und die physische Unsicherheit zur Normalität des Landes gehören. Die Folge war die Auflösung der vertikalen Beziehungen in der argentinischen Sozialstruktur. Die sogenannten GewinnerInnen im neoliberalen System segregierten sich in den verschiedensten gesellschaftlichen Bereichen. Die weitere Folge dieser Veränderungen in den Beziehungen zwischen den verschiedenen sozialen Schichten war die Etablierung eines Vergesellschaftungsmodells, das untereinander abgregrenzte und in sich homogene Gruppen produzierte.After the Great Depression of the 1930s Argentina's agricultural export model was displaced by the economic policy of import substitution industrialization (ISI). This new policy allowed Argentina to become an integrated society characterized by a high percentage of middle classes, the formalization of labour relations and upward social mobility. Poverty and social inequality appeared just as extremly marginal phenomenons in the Argentine society, such as that Argentina's model of social integration was unique in Latin America for many years. By the mid of the 1970s however the implementation of the neoliberal model changed Argentina's social reality. Particularly the radical neoliberal reforms of the 1990s, which have been introduced in line with the Washington Consensus, had a fatal impact on the Argentine society. Argentina moved from an inclusive society to an exclusive society. This diploma thesis focuses on the transformation of Argentina's social structure since 1976 and its impact on the relations between the different social classes in the Argentine society. Carlos Filgueira's “structure of opportunities“ model provides the theoretical basis to study the transformation of Argentina's social structure and to analyse how the chances of upward social mobility as well as the risks of downward social mobility have changed. The neoliberal economic policy abolished wage labour and the state, which both provided the basis for social integration in Argentina. By then the state ensured social security and the equitable distribution of resources within the society. The deregulation of the Argentine labour market caused an internal segmentation of the workers. A dualization deepend the gap between skilled and unskilled labour, such as the chances of upward mobility declined. Consequently unemployment, underemployment, informal labour relations, precarious labour relations and income disparity increased; poverty increased as well and became much more heterogeneous. Not only that the number of poor people rose, but large sections of the middle classes sank into poverty. The polarization of the Argentine society and the social inequality were attended by a rise of social conflicts, such as delinquency and physical unsecurity belong to everyday life now. As a result the vertical relations between the different social classes were dissolved; those who profited from the neoliberal reforms segregated themselves from the rest of the society. This transformation of the relations between the different social classes caused a model of sociation which produces isolated and internally homogenous groups

Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk:Systematic Review and Meta-Analysis Involving Data From 8 Studies and 1 192 700 Parous Women

BACKGROUND: Breastfeeding has been robustly linked to reduced maternal risk of breast cancer, ovarian cancer, and type 2 diabetes. We herein systematically reviewed the published evidence on the association of breastfeeding with maternal risk of cardiovascular disease (CVD) outcomes. METHODS AND RESULTS: Our systematic search of PubMed and Web of Science of articles published up to April 16, 2021, identified 8 relevant prospective studies involving 1 192 700 parous women (weighted mean age: 51.3 years at study entry, 24.6 years at first birth; weighted mean number of births: 2.3). A total of 982 566 women (82%) reported having ever breastfed (weighted mean lifetime duration of breastfeeding: 15.6 months). During a weighted median follow‐up of 10.3 years, 54 226 CVD, 26 913 coronary heart disease, 30 843 stroke, and 10 766 fatal CVD events were recorded. In a random‐effects meta‐analysis, the pooled multivariable‐adjusted hazard ratios comparing parous women who ever breastfed to those who never breastfed were 0.89 for CVD (95% CI, 0.83–0.95; I(2)=79.4%), 0.86 for coronary heart disease (95% CI, 0.78–0.95; I(2)=79.7%), 0.88 for stroke (95% CI, 0.79–0.99; I(2)=79.6%), and 0.83 for fatal CVD (95% CI, 0.76–0.92; I(2)=47.7%). The quality of the evidence assessed with the Grading of Recommendations Assessment, Development, and Evaluation tool ranged from very low to moderate, which was mainly driven by high between‐studies heterogeneity. Strengths of associations did not differ by mean age at study entry, median follow‐up duration, mean parity, level of adjustment, study quality, or geographical region. A progressive risk reduction of all CVD outcomes with lifetime durations of breastfeeding from 0 up to 12 months was found, with some uncertainty about shapes of associations for longer durations. CONCLUSIONS: Breastfeeding was associated with reduced maternal risk of CVD outcomes

Anti-Spike IgG antibodies as correlates of protection against SARS-CoV-2 infection in the pre-Omicron and Omicron era

Anti-Spike IgG antibodies against SARS-CoV-2, which are elicited by vaccination and infection, are correlates of protection against infection with pre-Omicron variants. Whether this association can be generalized to infections with Omicron variants is unclear. We conducted a retrospective cohort study with 8457 blood donors in Tyrol, Austria, analyzing 15,340 anti-Spike IgG antibody measurements from March 2021 to December 2022 assessed by Abbott SARS-CoV-2 IgG II chemiluminescent microparticle immunoassay. Using a Bayesian joint model, we estimated antibody trajectories and adjusted hazard ratios for incident SARS-CoV-2 infection ascertained by self-report or seroconversion of anti-Nucleocapsid antibodies. At the time of their earliest available anti-Spike IgG antibody measurement (median November 23, 2021), participants had a median age of 46.0 years (IQR 32.8-55.2), with 45.3% being female, 41.3% having a prior SARS-CoV-2 infection, and 75.5% having received at least one dose of a COVID-19 vaccine. Among 6159 participants with endpoint data, 3700 incident SARS-CoV-2 infections with predominantly Omicron sublineages were recorded over a median of 8.8 months (IQR 5.7-12.4). The age- and sex-adjusted hazard ratio for SARS-CoV-2 associated with having twice the anti-Spike IgG antibody titer was 0.875 (95% credible interval 0.868-0.881) overall, 0.842 (0.827-0.856) during 2021, and 0.884 (0.877-0.891) during 2022 (all p &lt; 0.001). The associations were similar in females and males (P interaction  = 0.673) and across age (P interaction  = 0.590). Higher anti-Spike IgG antibody titers were associated with reduced risk of incident SARS-CoV-2 infection across the entire observation period. While the magnitude of association was slightly weakened in the Omicron era, anti-Spike IgG antibody continues to be a suitable correlate of protection against newer SARS-CoV-2 variants. </p

Hypertensive disorders of pregnancy and cardiovascular disease risk: a Mendelian randomisation study

OBJECTIVE: Observational studies show that hypertensive disorders of pregnancy (HDPs) are related to unfavourable maternal cardiovascular disease (CVD) risk profiles later in life. We investigated whether genetic liability to pre-eclampsia/eclampsia and gestational hypertension is associated with CVD risk factors and occurrence of CVD events. METHODS: We obtained genetic associations with HDPs from a genome-wide association study and used individual participant data from the UK Biobank to obtain genetic associations with CVD risk factors and CVD events (defined as myocardial infarction or stroke). In our primary analysis, we applied Mendelian randomisation using inverse-variance weighted regression analysis in ever pregnant women. In sensitivity analyses, we studied men and nulligravidae to investigate genetic liability to HDPs and CVD risk without the ability to experience the underlying phenotype. RESULTS: Our primary analysis included 221 155 ever pregnant women (mean age 56.8 (SD 7.9) years) with available genetic data. ORs for CVD were 1.20 (1.02 to 1.41) and 1.24 (1.12 to 1.38) per unit increase in the log odds of genetic liability to pre-eclampsia/eclampsia and gestational hypertension, respectively. Furthermore, genetic liability to HDPs was associated with higher levels of systolic and diastolic blood pressure and younger age at hypertension diagnosis. Sensitivity analyses revealed no statistically significant differences when comparing the findings with those of nulligravidae and men. CONCLUSIONS: Genetic liability to HDPs is associated with higher CVD risk, lower blood pressure levels and earlier hypertension diagnosis. Our study suggests similar findings in ever pregnant women, nulligravidae and men, implying biological mechanisms relating to HDPs are causally related to CVD risk

Associations between Physical Activity, Sitting Time, and Time Spent Outdoors with Mental Health during the First COVID-19 Lock Down in Austria.

Measures implemented to reduce the spread of SARS-CoV-2 have resulted in a decrease in physical activity (PA) while sedentary behaviour increased. The aim of the present study was to explore associations between PA and mental health in Austria during COVID-19 social restrictions. In this web-based cross-sectional study (April-May 2020) moderate-to-vigorous physical activity (MVPA), sitting time, and time spent outdoors were self-reported before and during self-isolation. Mental well-being was assessed with the Warwick-Edinburgh Mental Well-being Scale, and the Beck depression and anxiety inventories. The majority of the participants (n = 652) were female (72.4%), with a mean age of 36.0 years and a standard deviation (SD) of 14.4. Moreover, 76.5% took part in ≥30 min/day of MVPA, 53.5% sat ≥10 h/day, and 66.1% spent ≥60 min/day outdoors during self-isolation. Thirty-eight point five percent reported high mental well-being, 40.5% reported depressive symptoms, and 33.9% anxiety symptoms. Participating in higher levels of MVPA was associated with higher mental well-being (odds ratio = OR: 3.92; 95% confidence interval = 95%CI: 1.51-10.15), less depressive symptoms (OR: 0.44; 95%CI: 0.29-0.66) and anxiety symptoms (OR = 0.62; 95%CI: 0.41-0.94), and less loneliness (OR: 0.46; 95%CI: 0.31-0.69). Participants sitting <10 h/day had higher odds of mental well-being (OR: 3.58; 95%CI: 1.13-11.35). Comparable results were found for spending ≥60 min/day outdoors. Maintaining one's MVPA levels was associated with higher mental well-being (OR = 8.61, 95%CI: 2.68-27.62). In conclusion, results show a positive association between PA, time spent outdoors and mental well-being during COVID-19 social restrictions. Interventions aiming to increase PA might mitigate negative effects of such restrictions

Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment

Aims: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values. Methods and results: We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: −0.40 to 0.43), and were moderately correlated [r = 0.44; 95% confidence interval (CI): 0.39–0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14–1.22; I² = 30.7%) and 1.20 (1.18–1.23; I² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07–1.12; I² = 8.4%) and 1.14 (1.12–1.16; I²=1.3%) upon multivariable adjustment (all P < 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (P < 0.001), +0.0037 for far wall (P = 0.006)]. Conclusions: The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls

Age at Menopause and the Risk of Stroke: Observational and Mendelian Randomization Analysis in 204 244 Postmenopausal Women

BACKGROUND: Observational studies have shown that women with an early menopause are at higher risk of stroke compared with women with a later menopause. However, associations with stroke subtypes are inconsistent, and the causality is unclear. METHODS AND RESULTS: We analyzed data of the UK Biobank and EPIC-CVD (European Prospective Investigation Into Cancer and Nutrition-Cardiovascular Diseases) study. A total of 204 244 postmenopausal women without a history of stroke at baseline were included (7883 from EPIC-CVD [5292 from the subcohort], 196 361 from the UK Biobank). Pooled mean baseline age was 58.9 years (SD, 5.8), and pooled mean age at menopause was 47.8 years (SD, 6.2). Over a median follow-up of 12.6 years (interquartile range, 11.8–13.3), 6770 women experienced a stroke (5155 ischemic strokes, 1615 hemorrhagic strokes, 976 intracerebral hemorrhages, and 639 subarachnoid hemorrhages). In multivariable adjusted observational Cox regression analyses, the pooled hazard ratios per 5 years younger age at menopause were 1.09 (95% CI, 1.07–1.12) for stroke, 1.09 (95% CI, 1.06–1.13) for ischemic stroke, 1.10 (95% CI, 1.04–1.16) for hemorrhagic stroke, 1.14 (95% CI, 1.08–1.20) for intracerebral hemorrhage, and 1.00 (95% CI, 0.84–1.20) for subarachnoid hemorrhage. When using 2-sample Mendelian randomization analysis, we found no statistically significant association between genetically proxied age at menopause and risk of any type of stroke. CONCLUSIONS: In our study, earlier age at menopause was related to a higher risk of stroke. We found no statistically significant association between genetically proxied age at menopause and risk of stroke, suggesting no causal relationship

Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment

Aims: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values. Methods and results: We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: -0.40 to 0.43), and were moderately correlated [r = 0.44; 95% confidence interval (CI): 0.39-0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14-1.22; I² = 30.7%) and 1.20 (1.18-1.23; I² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07-1.12; I² = 8.4%) and 1.14 (1.12-1.16; I²=1.3%) upon multivariable adjustment (all P < 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (P < 0.001), +0.0037 for far wall (P = 0.006)]. Conclusions: The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls

Correlations of segment-, side-, and wall-specific carotid intima-media thickness

Lisa SeekircherUniversity of Innsbruck, Masterarbeit, 2019(VLID)342004

Assessment of Cardiovascular Risk in Women: Progress so Far and Progress to Come.

Cardiovascular disease is the leading cause of death in women worldwide. Nonetheless, there exist several uncertainties in the prediction, diagnosis, and treatment of cardiovascular disease in women. A cornerstone in the prediction of cardiovascular disease is the implementation of risk scores. A variety of pregnancy- and reproductive-factors have been associated with lower or higher risk of cardiovascular disease. Consequently, the question has been raised, whether these female-specific factors also provide added value to cardiovascular risk prediction. In this review, we provide an overview of the existing literature on sex differences in the association of established cardiovascular risk factors with cardiovascular disease and the relation between female-specific factors and cardiovascular risk. Furthermore, we systematically reviewed the literature for studies that assessed the added value of female-specific factors beyond already established cardiovascular risk factors. Adding female-specific factors to models containing established cardiovascular risk factors has led to little or no significant improvement in the prediction of cardiovascular events. However, analyses primarily relied on data from women aged ≥40 years. Future investigations are needed to quantify whether pregnancy-related factors improve cardiovascular risk prediction in young women in order to support adequate treatment of risk factors and enhance prevention of cardiovascular disease in women