Individual and Collective Resources and Health in Morocco

The interaction between available individual and collective resources in the determination of health is largely ignored in the literature on the relationship between poverty and health in developing countries. We analyse the role public resources play in the perception that rural women in Morocco have of their health. These resources are taken to contribute directly and indirectly to the improvement of individual health by, on the one hand, providing a health-promoting environment and, on the other, improving the individual?s ability to produce health. The empirical results of multilevel models confirm the expected associations between socioeconomic status, individual vulnerability factors and health. Furthermore, the random part of the model suggests that variation in state of health is also associated with the presence of collective resources. However, the higher the level of women?s individual wealth, the less the characteristics of the community in which they live seem to be associated with their health, and the less the potential vulnerability factors seem to constrain their ability to maintain or improve health. Our results suggest that collective investments derived from various areas of activity will be more favourable to improving health, insofar as they are adapted to the initial capacity of women to benefit from them.health, poverty, rural, women, Morocco

Ressources individuelles et collectives et la santé des femmes au Maroc

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Can aggression provide pleasure?

We investigated the pleasurability of aggressive behavioral decisions. Four questionnaires (on hedonicity, decisión making, justification of aggression, and impulsiveness) were given to 50 participants of both sexes, ranging from 16 to 80 years old. Most participants avoided unpleasant behaviors as part of a trend to maximize pleasure and to minimize displeasure. Mean hedonicity ratings followed a bell curve with increasing levels of aggressiveness (p < .0001). Thus, the participants chose neither passive nor highly aggressive responses to social conflicts, with both extremes receiving the most unpleasant ratings. The results offer empirical support for an interesting point: People may derive pleasure from aggression as long as it is exhibited on a low to medium level. More precisely, people associate pleasure with aggression up to a certain point: Aggressive responses of medium intensity were rated significantly less unpleasant than the most passive and most aggressive ones, which were associated with less pleasure. Conclusion: In social conflicts, behavior tends to maximize experienced pleasure; and impulsive aggression produces pleasure in the aggressor, except at extreme intensities. The point that mild to moderate aggression brings pleasure, whereas extreme or severe aggression does not, provides a perspective that may reconcile conflicting observations in the literature

Chronic aortic regurgitation in rats

Objectives: Aortic regurgitation (AR) induces left ventricular (LV) eccentric hypertrophy in response to chronic volume overload. Patients suffering from this disease often remain asymptomatic for decades before progressive LV dysfunction develops silently. Because of this slow evolution, large clinical trials with long-term follow-up on subjects with chronic AR are hard to perform. To overcome this problem, animal models have been developed in the past but results were very heterogeneous. Methods: Helped by echocardiography, we refined a known technique to induce homogenous degrees of severe AR in Wistar-Kyoto rats. The effects on LV function without treatment and with nifedipine (25 mg/kg daily) (a drug currently recommended in humans with chronic AR) were evaluated by echocardiography. Results: Over 6 months, nontreated animals developed progressive LV dilatation and eccentric hypertrophy, characteristic of chronic LV volume overload. The animals also developed progressive LV systolic dysfunction, mimicking closely the evolution of the disease in humans. Abnormal filling parameters were also detected in the majority of animals. Systolic and diastolic abnormalities were prevented but only partially in the group treated with nifedipine. Conclusion: This model can be used to study chronic AR and LV dysfunction associated with the disease. Nifedipine seems to protect the LV against chronic volume overload but only partially. Treatment strategies currently used in humans deserve further investigation

The challenge of stratifying obesity : attempts in the Quebec family study

Background and aims: Obesity is a major health problem worldwide. Given the heterogeneous obesity phenotype, an optimal obesity stratification would improve clinical management. Since obesity has a strong genetic component, we aimed to develop a polygenic risk score (PRS) to stratify obesity according to the genetic background of the individuals. Methods: A total of 231 single nucleotide polymorphisms (SNP) significantly associated to body mass index (BMI) from 21 genome-wide association studies were genotyped or imputed in 881 subjects from the Quebec Family Study (QFS). The population was randomly split into discovery (80%; n = 704) and validation (20%; n = 177) samples with similar obesity (BMI ≥ 30) prevalence (27.8% and 28.2%, respectively). Familybased associations with obesity were tested for every SNP in the discovery sample and a weighed and continuous PRS231 was constructed. Generalized linear mixed effects models were used to test the association of PRS231 with obesity in the QFS discovery sample and validated in the QFS replication sample. Furthermore, the Fatty Acid Sensor (FAS) Study (n = 141; 27.7% obesity prevalence) was used as an independent sample to replicate the results. Results: The linear trend test demonstrated a significant association of PRS231 with obesity in the QFS discovery sample (ORtrend = 1.19 [95% CI, 1.14-1.24]; P = 2.0x10-16). We also found that the obesity prevalence was significantly greater in the higher PRS231 quintiles compared to the lowest quintile. Significant and consistent results were obtained in the QFS validation sample for both the linear trend test (ORtrend = 1.16 [95% CI, 1.07- 1.26]; P = 6.7x10-4), and obesity prevalence across quintiles. These results were partially replicated in the FAS sample (ORtrend = 1.12 [95% CI, 1.02-1.24]; P = 2.2x10-2). PRS231 explained 7.5%, 3.2%, and 1.2% of BMI variance in QFS discovery, QFS validation, and FAS samples, respectively. Conclusions: These results revealed that genetic background in the form of a 231 BMIassociated PRS has a significant impact on obesity, but a limited potential to accurately stratify it. Further studies are encouraged on larger populations

A saúde periodontal durante a gravidez

Introdução : Durante a gravidez, o corpo da mulher passa por alterações anatómicas e fisiológicas, bem como alterações hormonais. Diversos estudos têm demonstrado que essas variações tornam as mulheres grávidas mais susceptíveis à inflamação da gengiva e à doença periodontal. Objetivo : O objetivo desta dissertação foi efetuar uma revisão integrativa da literatura, de forma a compreender o impacto das alterações hormônais da gravidez, ao nível dos tecidos periodontais, avaliando se a prevenção é eficaz na redução das mesmas. Material e métodos : Foi realizada uma pesquisa bibilográfica na Pubmed, utilizando os MeshTerm: « Pregnancy », « Periodontal Diseases », « Periodontitis », « Gingivitis », « Granuloma, Pyogenic », e « Oral health ». Resultados : Os estudos demonstram que durante a gravidez, as alterações fisiológicas aumentam o risco da mãe de desenvolver infeções na cavidade oral, assim como, uma associação entre a doença periodontal e partos prematuros, bebés de baixo peso e, pré-eclâmpsia. Conclusão : Durante a gravidez, uma pequena quantidade de placa bacteriana é suficiente para despoletar a doença periodontal. Esta, origina problemas para a mãe e para o bebé, durante a gravidez. A avaliação oral sistemática e o aconselhamento na consulta pré natal, são uma solução para limitar os problemas descritos nesta dissertação, dada a falta de conhecimento e as muitas questões que as futuras mães têm sobre saúde oral na gravidez.Introduction : During pregnancy, a woman's body undergoes anatomical and physiological changes, as well as hormonal changes. Several studies have shown that these variations make pregnant women more susceptible to gum inflammation and periodontal disease. Objective : The aim of this dissertation was to carry out an integrative literature review in order to understand the impact of the hormonal changes of pregnancy on periodontal tissues and to assess whether prevention is effective in reducing them. Material and methods : A literature search was conducted on Pubmed using the MeshTerm : « Pregnancy », « Periodontal Diseases », « Periodontitis », « Gingivitis », « Granuloma, Pyogenic », e « Oral health ». Results : Studies show that during pregnancy, physiological changes increase the risk of the mother developing oral cavity infections, as well as an association between periodontal disease and premature births, low birth weight babies and pre-eclampsia. Conclusion : During pregnancy, a small amount of plaque is enough to trigger periodontal disease. This causes problems for both mother and baby during pregnancy. Systematic oral assessment and counselling in the antenatal clinic is a solution to limit the problems described in this dissertation, given the lack of knowledge and the many questions mothers-to-be have about oral health in pregnancy

Can we build on social movement theories to develop and improve community‐based participatory research? a framework synthesis review

A long‐standing challenge in community‐based participatory research (CBPR) has been to anchor practice and evaluation in a relevant and comprehensive theoretical framework of community change. This study describes the development of a multidimensional conceptual framework that builds on social movement theories to identify key components of CBPR processes. Framework synthesis was used as a general literature search and analysis strategy. An initial conceptual framework was developed from the theoretical literature on social movement. A literature search performed to identify illustrative CBPR projects yielded 635 potentially relevant documents, from which eight projects (corresponding to 58 publications) were retained after record and full‐text screening. Framework synthesis was used to code and organize data from these projects, ultimately providing a refined framework. The final conceptual framework maps key concepts of CBPR mobilization processes, such as the pivotal role of the partnership; resources and opportunities as necessary components feeding the partnership's development; the importance of framing processes; and a tight alignment between the cause (partnership's goal), the collective action strategy, and the system changes targeted. The revised framework provides a context‐specific model to generate a new, innovative understanding of CBPR mobilization processes, drawing on existing theoretical foundations

Early LV signaling events in pressure overload

The early events leading to the establishment of left ventricular hypertrophy associated to pressure overload (PO) are not well characterized. To explore these early events, aortic banding (AB) was performed in rats to induce left ventricle (LV) PO. Animals were sacrificed after 24, 48 h or 14 days. An echocardiogram was performed before the procedure and at sacrifice. LVs were preserved for the evaluation of fibrosis, angiotensin II (AT) receptors expression and stress-related MAP kinases (ERK 1/2, JNK and p38) pathways. We observed that concentric LV hypertrophy was established after only 14 days. Collagen I and fibronectin gene expressions were decreased the first 2 days after AB induction whereas AT receptors mRNA levels were sharply increased. ERK 1/2 and JNK activities in LV homogenates were decreased 24 h after AB but came back to normal after 14 days. p38 activity however was stable during the period studied. We also evaluated the presence of two phosphorylated transcription factors related to JNK signaling pathway (ATF-2 and c-Jun) in cardiomyocyte nuclei. The proportion of LV cell nuclei positive for these two activated transcription factors was significantly reduced in AB rats compared to sham. These results suggest that the early response of the LV to acute PO is to attenuate the expression of some pro-fibrotic and pro-hypertrophic signaling pathways and possibly AT signaling by decreasing ERK 1/2 and JNK relative activities

Hypertension and aortic valve regurgitation in rats

Background : Hypertension (HT) and aortic valve regurgitation (AR) often coexist but the specific impacts of AR + HT on the left ventricle (LV) are still unknown. The best treatment strategy for this combination of diseases is also unclear. The objectives of this study were 1) to evaluate LV function, remodeling and 2) to assess the effects of the angiotensin-converting enzyme (ACE) inhibitor captopril (C) in rats with AR ± HT in spontaneously hypertensive rats (SHR). Methods : Animals were grouped as follows: normotensive (NT) Wistar-Kyoto, NT + AR, hypertensive SHR (HT), and HT + AR receiving or not captopril (150 mg/kg/d). Hearts were evaluated in vivo by echocardiography and harvested for tissue analysis after 6 months of evolution. Results : The HT + AR rats had the worst LV hypertrophy (LVH), subendocardial fibrosis, and lowest ejection fraction. Captopril normalized BP in HT and HT + AR, but could not prevent LVH in HT + AR as well as it did in isolated HT. The LV ejection fraction remained below normal in HT + AR + captopril compared to HT alone + captopril. Cardiomyocyte hypertrophy remained in HT + AR + captopril but was normalized in HT + captopril. Subendocardial fibrosis was reduced by captopril in HT + AR. Conclusions : The AR + HT rats had the most severe myocardial abnormalities. High dose captopril was effective to slow LVH and preserve normal LV ejection fraction in isolated HT or AR, but was less effective when both pathologies were combined. Prohypertrophic stimuli clearly remain active in HT + AR despite ACE inhibition. These results suggest that a very aggressive medical treatment strategy may be required to optimize LV protection when AR and HT co-exist