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Background: The effect of the renin angiotensin system on blood pressure (BP) values in young adults from the general population is not well studied. We investigated the relationship between the aldosterone-to-renin ratio (ARR) and various BP indices in this population., Methods: We assembled a population-based sample of adults aged 25-41 years. Conventional and 24-hour BP recordings were obtained in all patients. Direct renin concentration and plasma aldosterone concentration were measured. Multivariable regression models were constructed to assess the relationships of ARR with BP and hypertension., Results: We included 1,353 individuals (mean age 37 years, 56% women). The median (interquartile range) ARR, direct renin concentration, and plasma aldosterone concentration were 13.8 (8.7-22.9), 7.2 ng/L (4.4-11.0) and 94 ng/L (68-134). All BP indices were higher across sex-specific ARR quartiles. Per 1-unit increase in log-transformed ARR, the multivariable-adjusted β-coefficients (95% CI) for conventional, 24-hour, daytime, and nighttime systolic BP were 1.68 (0.87-2.48), P < .0001; 2.40 (1.68-3.12), P < .0001; 2.23 (1.48-2.99), P < .0001; and 2.80 (2.03-3.58), P < .0001, respectively. Per 1-unit increase in log-transformed ARR, the multivariable-adjusted odds ratio (95% CI) for conventional, 24-hour, sustained and masked hypertension was 1.70 (1.17-2.28), P = .0004; 1.29 (1.06-1.56), P = .01; 1.82 (1.33-2.49), P = .002; and 1.14 (0.94-1.38), P = .20, respectively., Conclusions: In young adults, ARR was strongly associated with conventional and ambulatory BP. Our data suggest that an aldosterone-driven phenomenon occurs very early in the development of hypertension., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The authors report first clinical experiences with 28 schizophrenic patients who were treated and socially rehabilitated by a specially selected team in a small, stimulus-protected, continuous, open and community-near environment (therapeutic community "Soteria Bern"). The therapeutic concept is based on the vulnerability- and information-processing hypothesis and on further psycho-, socio- and milieutherapeutic experiences with schizophrenics. Neuroleptic drugs were used in comparatively very small doses. With about 2/3 positive outcomes, the first results are encouraging. In a research project over several years they will be systematically compared with more traditional treatment strategies.

This empirical investigation describes the present state of vocational integration of blind persons in Switzerland. The study is based on interviews of 215 blind persons--not multiply handicapped--who left a Swiss special school or rehabilitation center in the period 1960 to 1978. The study investigated the following dimensions: - vocational situation and opportunities in a horizontal comparison; - vocational situation and opportunities in a vertical comparison; - level of wage or salary; - subjective work satisfaction. The results of the investigation show that the degree of vocational integration attained by blind interviewees may be regarded as high. If, on the other hand, the forecast should prove correct that in the 80ies Switzerland, too, can expect a higher rate of unemployment, the efforts aimed at improving the qualification prerequisites for vocational integration of the blind deserve attention. Particular emphasis must be placed - in education, on the teaching of greater social competence; - in counseling and placement, on the provision of suitable measures for qualified training and/or retraining; - in further education, on the dynamic advancement of personal needs in regard to further training, the latter understood as "permanent training".